Illustration for Dante's Inferno by Gustave Dore.  Virgil pushes a sinner back into the River Styx.  Well What's Our Point?  You could take this a lot of ways.  The point is that when we don't provide people the level of services people need --- WE PUSH THEM BACK INTO HELL --- namely homelessness & incarceration.


CO's Mental Health Continuum of Care HELL

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We criticize CO State Gov't a lot.  They are doing a lot of innovative things:  Integration of Physical & Behavioral Healthcare, Crisis Services, & basic mental health services.

​Where things can really go to HELL IN A HANDBASKET are:
  • Longer Term Bed Space:  CO has a chronic disastrous shortage.  [Generally, not Medicaid].
  • Residential Services:  CO Medicaid funds this as an "alternative service" meaning in layman's terms there is NOT ENOUGH TO GO AROUND.
  • Enhanced Services: 
    • ​For most intents and purposes, Assertive Community Treatment [ACT] provides Wraparound Services with 24/7 availability.  ACT is an "alternative service" and there is NOT ENOUGH TO GO AROUND.  ACT is considered the "Gold Standard" of intensive community mental health treatment & is often included in US Dept. of Justice ADA/Olmstead settlement agreements.
    • Intensive Case Management (ICM) sometimes referred to as ACT-Lite it is also an alternative service and there is NOT ENOUGH TO GO AROUND.
International Journal of Circumpolar Health (2015)

Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study

"Clinical primary care approaches for CMDs [Common Mental Disorders] in Nunavik are currently more reactive than preventive. This suggests that recovery services for those affected are suboptimal."

WHAT's THE POINT:  CO has a lot people with mental illness who have a lot of crises and/or are incarcerated or homeless -- and that suggests that the recovery services/Continuum of Care are suboptimal, and in fact they are suboptimal.

https://www.ncbi.nlm.nih.gov/pubmed/25979200
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North Carolina Adult Mental Health Continuum of Care: (b)(3) Support Services are referring to Peer Support Services [We see Peer Services throughout the Continuum of Care. CO is doing some of that -- they could do a lot more such as Peer Run Respite Services.


​​THOUSANDS OF COLORADANS WHO ARE HOMELESS OR ARE BEING RELEASED FROM JAILS OR PRISONS MAY NEED:


*Residential Services
*Assertive Community Treatment
*Intensive case management

What is the state's plan to bring those services to scale?

We think this not only goes to Olmstead, but to Parity and Medicaid Network Adequacy.

How can a State have Medicaid Network Adequacy if it doesn't have an adequate Continuum of Care?