And that was in the botched awarding of contracts to run a network of walk-in mental health crisis centers, a key initiative from Gov. John Hickenlooper. The centers are designed to to take pressure off of hospital emergency rooms, jails and prisons – which have become the main providers of services for people with mental illness – after decades of funding shortfalls, as reported by I-News at Rocky Mountain PBS.
The state’s first effort at doling out contracts for the centers ended in recrimination and lost time. As a result, Colorado will now spend less than half of what it budgeted for the crisis services in the current fiscal year. Instead of the $19.8 million allocated, the state Department of Human Services expects to spend only $9.7 million, due to delays in the process.
The department issued a new request for proposals to run the crisis centers two weeks ago, after deciding to rescind an award it had made on Oct. 16 to Crisis Access of Colorado, which set up shop in the state for the purpose of applying for the contract.
Crisis Access, affiliated with a Georgia-based crisis intervention company and a mental health treatment organization with operations in Arizona and California, accused the state of making an unlawful political decision when it scrapped the contract. In a protest letter filed on Nov. 11, the company alleged that the state skirted proper procedures and bowed to pressure from a consortium of local community mental health facilities that had lost out on the bid. The state has since rejected the company’s appeal, and Crisis Access said it is considering its next move.
Susan Beckman, who heads the administrative branch of the Department of Human Services, the office responsible for the flawed solicitation process, denied that there was any collusion between the department and local mental health providers in the rescinded bid. She said the original process had been deeply flawed, “an embarrassment to the department.” Before the bid was even awarded, she said she became aware of “blatant” errors including missing scores, incorrect calculations and improper weighting.
A new bidding process means another costly effort by the mental health service providers applying for the job – not to mention those reviewing the proposals. Costs will also be borne by Colorado residents in need of mental health services, as the roll-out for the new crisis centers is postponed.
The story, by Gazette reporter Dave Philipps, reads like an espionage thriller, with hidden cameras and microphones, lies and misinformation to superiors, and all sorts of other surreptitious activity. One of the cadet informants, in fact, described his role as “like a spy movie.”
But this was no Hollywood fiction.
The Gazette confirmed the clandestine program’s existence through phone and text records, through interviews with former OSI agents and multiple OSI informants, court filings and documents obtained through the Freedom of Information Act. And the cadet who thought he was in a spy movie was cashiered from the academy, with promises from the OSI that he would be protected evaporating.
The newspaper found that the program appeared to rely disproportionately on minority cadets, who were then coerced into breaking academy rules, the student honor code and the trust of their fellow cadets to do the OSI’s bidding. The Air Force’s top commander and key members of the academy’s civilian oversight board claimed they had no knowledge of the program.
Prior to publication, academy commanders declined multiple requests for interviews, according to The Gazette. But after publication, the academy issued a statement defending its use of student informants: “The program uses people who confidentially provide vital information about criminal activities that would not otherwise be available. AFOSI uses that information to initiate or resolve criminal investigations. This is an Air Force-wide program and is not something unique at the Air Force’s Academy.”
The informants reported on activities ranging from off-campus parties, to drug use and purchases, to alleged sexual assaults.
Members of Congress, including Sen. John Thune of South Dakota, have tried to intervene on behalf of cadet informants after they were disavowed by OSI and expelled from the academy.
The use of informants is widespread in law enforcement, of course, but their involvement, student on student, in the rigorous world of an elite military academy – in which almost every student is among the top achievers from their high schools and hometowns – raised fundamental questions among the experts interviewed by The Gazette.
One of those persons, Laurie Johnson, a Kansas State University professor who specializes in ethics and honor codes, told The Gazette that trust is at the heart of any honor code, and, “By introducing spying I would think the cadets would believe there’s no trust.” Worse, she said, if the Air Force encourages cadets to break the honor code as informants, it shows leaders have little use for the rules cadets are expected to follow.
Coloradans have not recovered yet from the Great Recession in terms of household incomes and the number of those afflicted by poverty.
The U.S. Census Bureau’s 2012 American Community Survey, released earlier this fall, found that the median household income in the state shrank by about 13 percent between 2008 and 2012, from $65,054 to $56,765 in 2012. The numbers are adjusted for inflation.
While income was shrinking, poverty rates, perhaps not surprisingly, went in the opposite direction. The overall poverty in Colorado jumped from 11.4 percent to 13.7 percent between 2008, when the recession deepened, and 2012. The percent of children under 18 living in poverty rose to 18.5 percent, or about one in every six, from 15 percent in 2008.
The federal poverty line for a family of three is currently set at about $19,500.
Among other findings by the survey are fewer married residents in the state, just about 50 percent, compared to 52 percent four years earlier.
The percent of foreign born residents also fell slightly, from 10.1 percent to 9.8 percent. A smaller percent are from Latin American, 53.6 percent in 2012 vs. 57.6 percent in 2008, with a larger percent from Asia, 22.1 percent in 2012 as opposed to 19.6 percent in 2008.
The percent of Coloradans with high school degrees rose from 88.9 percent to 90.6 percent and the percent with college degrees increased from 35.6 percent to 37.7 percent, the survey found.
New Nielsen research shows that Latinas are the primary decision-makers in much of the spending by Latino households. The study said that, taken together, Latinos comprise 52 million people in the U.S. population and are the most influential economic sub-set since the baby boomers.
Colorado school districts are spending more of their budgets on psychologist positions, but the service providers still struggle with large caseloads and a growing number of students with severe behavioral and learning problems.
The state currently has the equivalent 791 full-time school psychologists. That number has inched up 4 percent in the last three academic years, according to data the Colorado Department of Education has collected from 78 districts.
Franci Crepeau-Hobson, former president of the Colorado Society of School Psychologists, said not all schools employ mental health staff.
“There’s actually a national shortage of school psychologists where there are positions open that schools can’t fill and that’s been the case for Colorado for some years, especially for rural and inner-city schools,” Crepeau-Hobson said.
Crepeau-Hobson, who is also an assistant professor at the University of Colorado Denver’s School of Education and Human Development, said that the problems professionals are seeing are getting worse.
“What I’m hearing from the graduates of our program is there are more kids with more severe mental health issues,” she said.
Barb Bieber, the school psychology consultant for the state Department of Education, agreed and pointed out the rising number of students being diagnosed with autism. Since 2010, about 1,100 more students statewide were categorized with autism or autism spectrum disorders bringing the number up to 4,878.
Even more students have some sort of emotional disorder, about 6,680, or roughly eight percent of all those who receive special education services.
Altogether about 88,830 students received special education services as of December 2012. The number has increased each year by more than 2,100 students since 2010, according to the most recent annual special education report from the state.
“The caseloads are too large. That’s been true for some time,” Bieber said.
The National Association of School Psychologists recommends a ratio of no more than 1,000 enrolled students per psychologist. In reality only a dozen or so Colorado districts with more than 1,000 students meet that ratio.
Denver Public Schools surpasses the recommendation and has a school psychologist for every 871 students. Last year the district provided nearly 9,500 students with special education services. That was the largest number in the state followed by Douglas RE-1 with 6,121 and Arapahoe 5 with 6,048 students.
Gilpin County RE-1, Lamar RE-2 and West End RE-2 don’t have a school psychologist on payroll. Hinsdale County RE-1, Park County RE-2, Lake County RE-1 and eight other districts only have part-time positions available. In comparison, DPS has more than 95 psychologists, Cherry Creek 5 has about 80 and Jefferson County has about 68 on staff.
School psychologists help promote safer schools, according to several studies. They are required by law to alert authorities if a student poses imminent danger to others or him or herself, or if child abuse is suspected.
Interest in the mental health of students has been particularly heightened by mass shooting tragedies, including those at Columbine, the Aurora Theater and Sandy Hook Elementary in Connecticut.
“If there’s a situation where we were worried about a student I’d be the person who would be called,” said Bobbi Ambroso, a school psychologist for Adams 14. “For the mental health piece, I’m the first line of defense a lot of times.”
Adams 14 is one of 19 districts piloting a new evaluation system that the state plans to roll out next year. The system allows principals to determine if a service providers meet five standards including supporting or establishing safe and respectful learning environments for diverse populations of students.
“It does offer consistency for the expectation of the role of a school psychologist, but I do see there being a lot of variability across districts and schools for what pieces of the evaluation you’re responsible for,” Ambroso said.
The evaluation does not address the funding of school psychologists, the distribution of mental health grants, caseloads or severity of problems.
“I don’t think my job is ever going to look the same as another school psychologists and that’s OK because our role is shaped by our community,” Ambroso said. “I’d rather fill the role that’s needed rather than just the one that’s on paper.”
Susan Beckman wants you to know that “a lot of sloppy work”—and not a conspiracy—were behind the state’s botched job of finding someone to run a network of walk-in mental health crisis centers.
Beckman heads the administrative branch of the Department of Human Services, the office responsible for the failed solicitation process. The department has been accused of colluding with local actors to elbow out a newcomer, but Beckman says a slew of mistakes were just human error.
The department on Nov. 22 issued a new request for proposals to run the crisis centers, three weeks after deciding to rescind an award it had made on Oct. 16 to Crisis Access of Colorado, which set up shop in the state for the purpose of applying for the contract.
Crisis Access is affiliated with a private Georgia-based crisis intervention company called Behavioral Health Link and Recovery Innovations, an organization with operations in Arizona, California and Washington.
The contracts will determine who runs the keystone mental health initiative of the Hickenlooper administration. The crisis stabilization centers are meant to take pressure off of hospital emergency rooms, jails and prisons – which have become the main providers of services for people with mental illness—after decades of funding shortfalls.
But so far, the piece of legislation meant to promote unity and cooperation among mental health service providers in Colorado has proven divisive, at best.
Crisis Access has accused the state of making a political decision when it scrapped the contract. In a protest letter filed with the Department of Human Services on Nov. 11, the company called the decision unlawful, and alleged that the state skirted proper procedures and bowed to pressure from a consortium of local community mental health facilities that had lost out on the bid.
“If there were concerns about the process, then the state should have required the regular protest procedures,” says David Covington, who left a job at Magellan Health Services to become CEO of Crisis Access. “That wasn’t done.”
The state rejected Crisis Access’ protest last week.
Beckman says the decision to scrap the award had nothing to do with pressure from the losing bidders. Instead, she blames plain old sloppiness for a bidding process that was “an embarrassment to the department.”
Before the bid was even awarded, says Beckman, she became aware of “blatant” errors including missing scores, incorrect calculations and improper weighting.
“We were wondering how we had gotten this far without checking our work,” says Beckman, adding that in retrospect, the award should never have been publicly announced. “It was just such bad timing. It was awkward. It was not good.”
Her division instead referred the matter to the Colorado Department of Personnel and Administration. That office found that the bid process was not only stocked with errors, says Beckman, but didn’t meet the requirements of the legislation creating the new behavioral health crisis system, including principles of cultural competence, strong community relationships and building on existing foundations.
Harriet Hall was among those who were unhappy with the way the bid went the first time. She heads the Jefferson Center for Mental Health, and is part of a group of local partners who got together to apply to run the crisis centers.
“Our sense of the competing bid was that those strong community relationships were non-existent,” Hall says. “And yet if you looked at the scoring they were scored as high or higher as folks that have the community relationships.”
But Covington says there was no requirement that the bidders have a history of operating in the state. Reviewers were impressed with Crisis Access’ focus on peer support and trauma-informed care, records show.
If there’s any consensus, it’s that the state’s mistakes will be expensive to fix. A new bidding process means another costly effort by the mental health service providers applying for the job – not to mention those reviewing the proposals.
Beckman says the disruption is worth it in order to re-do the bid process with a fresh crew and a clean slate.
“When we’re done, everyone’s going to say, this is a really good process,” says Beckman.
The state hopes to finalize the new contracts by Feb. 24 – four months later than planned.
Colorado’s bookend tragedies of Columbine and Aurora ended in the loss of 25 innocent lives and continue to drive the debate about gun violence and public policy. But those devastating mass shootings represent only a tiny fraction of gun deaths in the state. In the 12 full years between those horrific events, 6,258 people died of gunshot wounds in Colorado.
I-News at Rocky Mountain PBS – using data from the state health department and the U.S. Census Bureau, thousands of pages of police, coroner and court records, and numerous on-the-ground interviews – has developed a sobering portrait of this unremitting gun carnage. The analysis plotted all of those deaths by the census tract where each victim lived. Of the 1,249 census tracts in Colorado, only 80 escaped a gun death during the period of study.
Suicides accounted for 76 percent of the 6,258 deaths from guns during the 12 years, while homicides comprised 20 percent. The rest were either accidental, legal shootings by law enforcement or unexplained. Nationally, about 60 percent of gun deaths are suicides.
Gun suicides were disproportionately committed by white residents, according to the I-News inquiry, while homicide victims were predominately minority. White residents, who make up 70 percent of the state’s population, accounted for 88 percent of the gun suicides. On the other hand, 58 percent of homicide victims were minorities, who comprise 30 percent of the state’s residents. Blacks were victims in 21 percent of the homicides, but only make up 4 percent of Colorado’s population. Latinos were victims in 34 percent of homicides, while comprising 21 percent of the state’s population.
Mesa County had three of the four deadliest census tract neighborhoods in the state for gun suicides. El Paso County had the highest overall death toll from gun suicides, 596 over the 12 years.
Interestingly, a new Quinnipiac Poll reported by The Denver Post recently showed that 55 percent of Coloradans oppose “stricter new gun control laws,” but an overwhelming 85 percent reported supporting background checks for all gun buyers. They narrowly approved, 49 percent to 48 percent, limiting ammunition magazines to 15 rounds.
Yet it was those two gun control measures that led to such an outcry earlier this year, leading to the recall of state senators in Colorado Springs and Pueblo and providing much of the fuel for the 51st state movement. According to Quinnipiac, they’re both supported by the Colorado public at large.
Feel like a nice cool glass of ice water? Before you take a sip, you might want to take a quick tour of your home. How’s the fill valve in your toilet? Do you have a vacuum breaker on your outside spigots? What about your boiler?
Without the right plumbing bits and pieces in place, you could be at risk of drinking toilet water, sipping lawn fertilizers or slurping hazardous chemicals. If they aren’t protected, cross connections between the drinking water in your home and non-potable water sources can mean that dirty water gets mixed with the clean. It might take as little as a change in water pressure.
And it’s not just in your home. Backflow can happen almost anywhere—from schools to restaurants to water treatment plants.
A review of state records by I-News at Rocky Mountain PBS shows that throughout Colorado, hazardous cross connections rate among the most persistent public health risks in water distribution systems.
I-News found that 30 percent of water providers inspected by the state since 2009 were found to be in violation for something related to cross connections or backflow—most often issues related to documenting or managing risks. And 9 percent of the water systems were found to have potentially hazardous cross connections.
Among schools operating their own small water systems, inspectors found cross connection issues to be even more prevalent. Roughly 47 percent were found to be in some kind of violation of cross connection or backflow rules, while risky cross-connections were found in 19 percent of the schools, according to a recent analysis by the Colorado Department of Public Health and Environment.
If left unchecked, these routine plumbing problems can make people sick.
Last fall, 26 people at a medical facility in Colorado Springs fell ill after drinking water that tasted and smelled odd.
The building, which includes Memorial Hospital’s surgery and wound care centers, shut down until an investigation by state public health authorities identified the probable culprit: a faulty connection between the drinking water and the ventilation, or HVAC, system.
Propylene glycol – an ingredient in antifreeze – had been leaking into the pipes for three days, officials found. Investigators said other anti-corrosive chemicals may have gotten into the water, as well.
NexCore Properties, which manages the building, had no comment on the state’s findings. Paula Freund, a spokeswoman for Memorial Hospital, said she’s confident the water problem has been fixed.
Fred Spengler is one of a few technicians in the state trained to find and fix cross connections in homes and businesses. In Colorado, he says, it’s often older homes that have problems, or those with special features like solar panels or heated driveways.
But issues turn up in mundane places, too.
“Lots of the cross connections have to do with toilets,” says Spengler.
A 2004 study conducted in Iowa by the University of Southern California’s Foundation for Cross Connection Control and Hydraulic Research found that nearly one in ten homes had a direct connection to a health hazard – most often in the toilet, but also in heating and cooling systems, water softeners and outside spigots.
Patrick Sylvester, the study’s project manager, said in an interview that he was surprised how many homes had faulty sewer connections – 14 of the 188 homes included in the study.
Only four percent of the homes were fully protected from a direct or indirect cross connection, according to the USC report.
“Most of the cross connections could be abated with a few dollars and a few minutes,” the study found, “but residents were unaware of the hazards existing in their own plumbing system.”
As in larger water systems, faulty cross connections at home can cause health problems if a change in water pressure or a disruption to the water line coincides with an unprotected connection. In most instances, an illness caused by backflow would be tough to trace to its cause; it might be dismissed as a 24-hour bug.
In some cases, the consequences can be serious. In Commerce City last year, Nick and Roxanne Cattaneo were awarded more than $900,000 from Aquakleen Products Inc. after their family’s sewer line was mistakenly connected to their drinking water during the installation of a water softener.
Commerce City officials warned at the time that Aquakleen had installed water softeners at more than 100 households without a permit. Backflow from a household has the potential to pollute public water, too.
A lawyer representing Aquakleen said the company had no comment.
From 1970 to 2001, according to the National Research Council, there were 12,000 reported illnesses from 459 instances of backflow. The number doesn’t catch unreported cases.
“Because of the enormous range of contaminant sources involved, as well as the number of unprotected cross connections, backflow events collectively constitute the greatest potential health risk from distribution system contamination,” the National Research Council reported in 2006.
In Colorado, state water quality inspectors periodically inspect larger water systems—which include anything from a school or a campground with its own well and filtration system, to a town or a city.
Larger water systems like the city of Denver are required to keep records of the highest-hazard spots in their jurisdiction – places like the Denver Zoo, where the water district found in 2006 that water meant for washing down the lion’s den was mixed with employees’ drinking water.
Nearly one in three water systems in the last five years has been dinged for failing to keep adequate testing records or for other backflow-related problems.
Most schools aren’t routinely tested by the state – it’s left to their water providers to mitigate the risks. But schools with their own wells have a poor record of compliance.
The water system that supplies Caliche School in the northeastern Colorado town of Iliff, for example, failed to install backflow preventers in the mop sink, the auto shop and the training room, state inspectors found during the most recent inspection in 2010. School officials say the backflow preventers are now in place, and the water system is being upgraded.
Officials from the state public health department downplay the risks associated with backflow, emphasizing that water pollution from a bad connection depends on a lot of things going wrong at the same time – for instance, a pressure change, an absence of protection, and the presence of a harmful contaminant.
“It is a potential risk, and it is something that we evaluate,” says Ron Falco, who manages the state’s safe drinking water program. “A cross connection by itself isn’t a contamination.”
The state rarely punishes water providers solely for problems related to cross connections—even in cases of repeated problems.
However, they acknowledge that the state regulations need updating – in part to offer more guidance to small, cash-strapped systems.
After a salmonella outbreak in the southern Colorado city of Alamosa in 2008 that was unrelated to backflow, a team of investigators called for a series of reforms to prevent future incidents of waterborne illness, including updating state regulations related to cross connections.
Four years after that report came out, however, the old rules are still in place. The outdated regulations don’t mention specific hazards to look out for—things like chemical laboratories, aircraft manufacturing facilities or mortuaries. They also don’t spell out specific backflow prevention methods or set testing standards.
Falco, who was lead author of the 2009 report on Alamosa, says that the current rules don’t pose any risk to the public. He said that inspectors have stepped up surveillance of backflow-related risks since 2009, and expects to see improvements in water providers’ records.
The new rules are expected to launch by January 2015.
Learn how to look for backflow dangers in your toilet or faucets. Watch this video from our partners at 9News.
How to Control Cross Connections in Your Home
A few simple steps can help protect your drinking water from contamination via backflow in your home. Hiring a backflow prevention technician or a licensed plumber is the best way to make sure your plumbing is safe.
- Make sure the lower end of each faucet is at least an inch above the top edge of the sink or tub.
- Lift the top of your toilet tank and look inside. Make sure the fill valve is at least an inch above the water.
- The bowl refill tube should also be above the water line.
- Install a backflow preventer on your boiler. Otherwise, pressure from the boiler water –which is often treated with hazardous anti-corrosion chemicals–may be pushed into the potable water line.
- Install a vacuum breaker on each outside spigot.
- Never leave a hose submerged in a bucket, hot tub or swimming pool. Contaminants from the yard can be sucked back into your drinking water.
- If you’re using a Miracle-Gro nozzle or other add-on to your hose, unscrew it when you’re done using it. Without a backflow preventer in place, fertilizer or other chemicals can contaminate your water.
- Install a vacuum breaker well above the ground and above the level of all sprinkler heads in your yard, to ensure that chemicals, fertilizer or pet waste aren’t pulled into your drinking water.
Marijuana businesses and regulators are gearing up for the biggest change in the industry's brief history. Colorado dispensaries will be able to begin selling recreational pot on January 1 to anyone 21 or older.
"We're going to be looking at three to four times the demand," said Andy Williams, president of the Medicine Man medical marijuana dispensary in Denver. He predicts long lines outside his east Denver store when it opens at 8:30 a.m. on New Years Day. Medicine Man is one of an estimated 100 medical marijuana stores in Colorado that are expected to begin selling recreational pot in January.
Marijuana businesses and regulators are gearing up for the biggest change in the industry’s brief history. Colorado dispensaries will be able to begin selling recreational pot on January 1 to anyone 21 or older.
“We’re going to be looking at three to four times the demand,” said Andy Williams, president of the Medicine Man medical marijuana dispensary in Denver. He predicts long lines outside his east Denver store when it opens at 8:30 a.m. on New Years Day. Medicine Man is one of an estimated 100 medical marijuana stores in Colorado that are expected to begin selling recreational pot in January.
Williams expects to find it difficult to keep up with an anticipated surge in demand. “Production is going to be literally capped at less than twice the capacity that we have right now,” he said. “So prices are going to go up.”
In addition to production limits, there are other obstacles for potential pot entrepreneurs come the first of the year. Many jurisdictions in Colorado have imposed moratoriums or bans on retail pot shops. And, initially at least, only current medical dispensaries will be able to start selling recreational marijuana. Even so, annual sales of marijuana in Colorado are forecast to rise by more than $350 million in 2014, a 60 percent increase on 2012 sales.
“That will produce tens of millions of dollars in new tax revenue for the state,” said Brian Vicente, an attorney and pro-marijuana activist.
Colorado voters this month approved a 25 percent tax on retail pot sales. The first $40 million of tax revenues will be spent on school construction. “We have been contacted by elected officials and government officials in numerous other states that want to learn about what’s going on in Colorado,” said Vicente.
The only other state to that will allow recreational marijuana sales is Washington. With 20 other states and the District of Columbia already permitting medical marijuana sales, pro-pot activists say they expect more places to follow Colorado and Washington’s lead.
The state legislature’s flood disaster study committee traveled to Lyons, Longmont and Estes Park last week and got a compelling earful from officials about the status of flood recovery work. The three cities were among the many that sustained major damage during the mid-September floods, and the race is on to at least temporarily repair municipal infrastructure before the onset of winter.
In some cases – well, probably in almost every case – that becomes a matter of money.
Lyons Mayor Julie Van Domelen and town administrator Victoria Simonsen told the visiting legislators that their town had sustained $50 million in flood damages, according to Scott Rochat of The Longmont Times-Call, but that after federal and state funds come through, Lyons will only be on the hook for about $6.25 million in matching funds. The bad news, Rochat wrote, is that Lyons, with a population of just over 2,000, doesn’t have that kind of money, either.
Longmont, the much larger city with a population above 88,600, is currently estimating its infrastructure damage at $132 million and it has been paying for repairs by tapping its reserve fund, putting off other capital projects and raising its stormwater and park maintenance fees. But city officials worry that if federal and state reimbursements don’t come through quickly enough that they, too, will have money problems.
One major question of the day was vocalized by State Rep. Jerry Sonnenberg, R-Sterling. “Has there been a decision made, whether to make sure the (St. Vrain) river goes back to its original channel or if it should stay in its new channel?”
Officials from both Longmont and Lyons said no decision had been made, but that one needs to be made and acted upon before spring runoff next year, said The Times-Call, which has done exemplary reporting on flood recovery.
“Between December and March, the stream needs to have banks again, and we need to know who’s going to do that,” said Lyons administrator Simonsen.
Even as much of the unaffected state has moved on from the epic flooding, the communities most impacted are still grappling with basic questions about the future, even as they race to make workable repairs before winter.
An initiative put forward by Gov. John Hickenlooper in the aftermath of the Aurora theater shooting is intended to improve mental health services in the state by putting nearly $20 million into walk-in crisis centers and a state-wide hotline.
Additional funding will also be put into modernizing treatment at the state’s two public mental health institutes, Fort Logan in Denver and Pueblo, boosting inpatient capacity and other services, resulting in an overall 13.5 percent increase for behavioral health care in fiscal year 2013-2014.
The money is badly needed, say state officials, healthcare providers and advocates for the mentally ill, to ease pressure on emergency rooms and jails.
But many of the doctors and professionals working on the front lines of the crisis say the money isn’t enough to fill a yawning gap in services to prevent and treat mental illness.
Per-capita spending on mental health services in the state, when adjusted by the medical rate of inflation, dropped 28 percent from 1981 to 1990, according to data collected by the National State Mental Health Program Directors Research Institute Inc., or NRI. Federal budget cuts and an economic crisis in Colorado contributed to that steep decline. And the cuts made in that decade were never recovered, according to analysis of the data by I-News at Rocky Mountain PBS. In 2010, the state spent the equivalent of 20 percent less per person on mental health services than it did in 1981.
The persistent funding shortfall long ago made jails and prisons the primary residential treatment centers for the mentally ill, clogged emergency rooms, boosted medical expenses across the board, and expanded the ranks of the homeless on the streets of Denver and other cities.
On an average Friday or Saturday night, the mentally ill can make up about half of the sick, injured and wounded crowding the rooms and hallways of the emergency department at Denver Health, according to Dr. Chris Colwell, department director. These are people who might not be there at all if they had received essential mental health care elsewhere, he says.
As inpatient psychiatric beds have disappeared across the state, he’s watched the problem get worse.
“I don’t think people understand the crisis that we’re in,” Colwell says.
Black Coloradans see the doctor less frequently, get less preventive care and report being in worse health than other residents of the state, according to a recent health survey.
The biennial Colorado Health Access Survey, which polled 10,224 households between April 15 and July 27, provides one of the most comprehensive snapshots of how Colorado residents experience the health care system.
Around 14 percent of the Coloradans surveyed said they were uninsured, down from around 16 percent in 2011. That equates to about 740,000 of the state’s approximately 5.2 million residents. But these numbers varied widely across regions, income levels, age groups and ethnic groups, highlighting disparities in the way Coloradans receive medical care.
Hispanics were the most likely to be uninsured. Around 22 percent of Latinos polled in the latest survey said they didn’t have any insurance. Still, more Hispanics had insurance than just two years ago, when 26 percent said they were uninsured.
By contrast, a growing number of African Americans reported being uninsured than in the past. Roughly 20 percent of those surveyed said they were uninsured, up sharply from 14 percent in 2011. The trend marked continued erosion in the ranks of the insured in Colorado’s small African-American community. In 2009, only 12 percent of African Americans surveyed said they didn’t have insurance.
At the same time, black Coloradans were increasingly less likely to report having seen a general doctor in the previous year or to have received preventive care. And around 19 percent of African Americans in the state said they used the emergency room as their primary source of care, compared with 5.7 percent of the population as a whole.
Grant Jones, executive director of the Denver-based Center for African American Health, said the information was surprising.
“At a time when we’re moving toward greater access and coverage and quality of care,” Jones said, “it’s alarming to see fewer people accessing care and seeing a doctor on a regular basis in the African American community.”
But African Americans weren’t skipping the doctor because they were healthier, the findings suggests. Instead, fewer black people in Colorado reported being in excellent health than other communities, while more reported being in poor health.
Black Coloradans were more likely than others to cite cost as a barrier to care, or to say they didn’t seek an appointment because they were uninsured, according to the Colorado Health Institute’s analysis of the survey. They were also more likely to say that they couldn’t get a doctor’s appointment in time, had trouble getting transportation or couldn’t get time off work.
The complete I-News at Rocky Mountain PBS report on the new survey can be found here.
One distinction that Colorado is happy to no longer have is the largest gap in the nation in college graduation rates between the state’s white and black residents. The percentage of black adults in the state with college degrees rose to 24 percent in 2012, up from 20 percent in 2010, according to new information from the U.S. Census Bureau. That progress moved Colorado down two notches in that particular measurement, behind Connecticut and Massachusetts.
Both Latino and black adults experienced improving high school graduation rates, narrowing those gaps with white adults to their lowest levels in decades, an I-News at Rocky Mountain PBS analysis of new data from the American Community Survey found. Eighty-nine percent of black adults had high school degrees in 2012, compared to 96 percent among whites. Latinos still trailed at 68 percent, but that’s an improvement of three percentage points since 2010.
“That’s good news all the way around,” said Lt. Gov. Joe Garcia, who also is executive director of the Colorado Higher Education Department. “It’s the result of more focus and more collaboration between K-12 and higher education.”
An I-News investigation published earlier this year of six decades of Census data found that minority gains made in key economic and education areas had eroded over time. In many cases, the disparities between Latinos, blacks and whites were wider in 2010 than they were in the 1960s and 1970s. The Losing Ground project has been widely disseminated and discussed since publication. The new data shows some improvement, at least in the education measures.
Losing Ground also analyzed family income, home ownership and poverty rates during the six decades. Those measurements fluctuated between 2010 and 2012, the analysis found. Black family median income, for example, was 58 percent of white family median income, a drop of four percentage points, while Latino family median income was 53 percent, a rise of two percentage points.
Home ownership was flat or slightly declining for all three groups, while poverty among blacks rose four points to 29 percent.