Nov. 20, 2020: On Nov. 2, Governor Jared Polis released his budget proposal for Fiscal Year 2021-22, including proposed investments in tele-behavioral health and children’s crisis services, protection of most of the Office of Behavioral Health's (OBH) funding for mental health and crisis services, and some reductions to OBH programs that have been underspent or will see reduced demand due to the Medicaid substance use disorder residential benefit. More details on these budget items are provided below.
The Joint Budget Committee is conducting meetings with their staff and Department staff in November and December to review the Governor’s FY 2021-22 budget request. You can find the JBC’s schedule here. The JBC held a briefing on OBH at 9 a.m. on Nov. 20. As a follow up, on Dec. 9 between 1:30 p.m. and 5 p.m., OBH will present to the JBC and answer questions raised at our staff briefing. The JBC will use these meetings to further clarify programs, services, or budget requests prior to drafting legislation allocating funds during the upcoming legislative session.
The following list provides details on OBH funding changes in the Fiscal Year 2021-22 budget proposal from the Governor. In addition, we expect that the cuts made to OBH’s budget in the current fiscal year were one-time cuts and will not continue in FY 2021-22.
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Behavioral Health Infrastructure Investments: The request includes an increase of $20 million across the Department of Human Services and the Department of Health Care Policy and Financing to support tele-behavioral health services statewide and decrease administrative burden so that providers can focus on patients.
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This one-time investment directly aligns with the technology and telehealth recommendations put forth by the Behavioral Health Task Force created by Governor Polis.
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These funds are available after restoring major cuts, and the Governor’s budget directs these one-time funds to stimulate the economy and help Colorado recover faster and better. These funds were the difference between the revenue forecast and actual revenue received for FY 19-20.
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Specifically, the request includes the following investments through OBH:
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$2.3 million for on-demand virtual crisis services to be delivered via tele-behavioral health through a downloadable app.
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$2.4 million to consolidate billing information, data collection and reporting for Medicaid and non-Medicaid behavioral health funds.
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$2.4 million to invest in Health Information Exchange for behavioral health providers to enable care coordination for clients, improve transitions of care for patients as they transfer from different treatment providers and provide clinicians real-time information to make informed treatment decisions.
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$300,000 to build a bed capacity tracker that would provide real-time notifications about availability of beds across the state.
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$1 million for a virtual training system for providers that will expand workforce capacity across the state.
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$1 million for capacity-building grants for telehealth to support small providers with technology infrastructure for HIPAA-compliant telehealth services and electronic health records and building.
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Behavioral Health Services for Children in Crisis: The request includes an increase of $910,000 General Fund for improved crisis services for children and youth in Colorado who need access to immediate, effective, and comprehensive behavioral health interventions. The request will provide child, youth and family-specific training of crisis system staff; provide training in specific interventions for mobile, and walk-in providers in interventions for children and youth with disabilities; and increase follow-up capacity for children, youth and families.
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Family First Prevention and Services Act: The request seeks an increase of $1.8 million total funds, including $1.7 million General Fund, and 3.6 FTE to continue implementation of the federal Family First Prevention Services Act (Family First). This request through the Office of Children, Youth and Families includes funding for OBH to develop a network of providers who will ensure statewide coverage of qualified individuals who can complete the independent assessments for Qualified Residential Treatment Program referrals.
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Increase Medicaid Match for Substance Use Treatment: The request seeks a one-time reduction of $11.4 million General Fund for substance use disorder treatment services as a result of the expansion of the Medicaid benefit to include inpatient and residential substance use disorder treatment on January 1, 2021. This expansion reduces the demand for inpatient and residential substance use disorder treatment funded by the Department of Human Services because many of the individuals previously funded by the Department will be eligible for the Medicaid benefit.
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Reduction to Community Behavioral Health Services: The request seeks a one-time decrease of $2.8 million total funds to lower contracts for Jail Based Behavioral Health Services ($1.5 million) and community-based behavioral health services for justice-involved individuals ($1.3 million).
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These areas were chosen for modest reductions to support the state’s budget balancing effort based on an analysis of prior fiscal years’ underspending.
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The cumulative impact of this decision item and the reinstatement of the one-time reductions to community behavioral health services taken in FY 2020-21 nets the total reduction for community behavioral health services to $554,188 total funds for FY 2021-22.
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True-up of CDHS and CDOC Meal Interagency Agreement: This technical request seeks an increase of $140,827 reappropriated funds transferred to the Department of Human Services (CDHS) from the Department of Corrections (DOC) to cover the costs of food served to DOC offenders by the Colorado Mental Health Institute at Pueblo. The proposed increase is needed to cover the rising costs of staffing, food, and operations to provide nutritional meals for DOC’s San Carlos Correctional Facility, La Vista Correctional Facility, and Youth Offender System.
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Campus Utility Infrastructure Upgrade, Colorado Mental Health Institute at Fort Logan: The request seeks an increase of $15.9 million General Fund for the second phase of a three-phase project to replace infrastructure on the Colorado Mental Health Institute at Fort Logan campus. The proposed projects for the second phase include replacing pavement, sidewalks, fire and domestic water lines, sanitary sewers; improving storm drainage; and installing below-grade conduits in concrete trenches for communication and security needs.
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Campus Utility Infrastructure Upgrade, Colorado Mental Health Institute at Pueblo: The request seeks an increase of $10.5 million General Fund for the first phase of a three-phase project to replace infrastructure on the Colorado Mental Health Institute at Pueblo campus. The proposed projects for the first phase include work on the south side of the campus beginning with design work and initial construction of the water and sewer line replacement, and new roads and walkways.
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CMHIP HVAC Replacements in Four MHI Buildings: The request includes an increase of $4.2 million General Fund for the first phase of a three-phase project to update and replace old HVAC systems in patient care facilities at the Colorado Mental Health Institute at Pueblo. The proposed plan for phase one is to perform the professional services, including design, for all four facilities within the scope of work.