A schizophrenic man had opened fire on a packed movie theater in Aurora, killing 12 and injuring dozens more.
Something had to be done.
The Aurora theater shooter had tried to get mental health treatment before the killings. That provided a possible opening for then-Colorado Gov. John Hickenlooper to search for preventive solutions. He turned to his cabinet and asked for a plan to expand crisis mental health services. He got a comprehensive blueprint to spend millions more, but it came with strings attached: To get the money, the system might have to change.
“If you keep putting more money into that system, you’re likely to get more of the same result,” said Reggie Bicha, former head of the Colorado Department of Human Services. “And we felt as a leadership team at CDHS, and the governor’s team supported this, that we needed some new ideas and new perspectives, and we wanted these new dollars to go out in a competitive array.”
Ultimately, that didn’t happen.
As Colorado embarks on a new attempt to reform the delivery network for mental health care in the state, the events of 2014 offer a look at how difficult it can be to impose change on the politically connected, deeply-entrenched group of community-based providers that have managed the system for decades.
That year, everyone from the governor to the head of the state Department of Human Services and legislative leaders announced their intention to change the system and increase access to psychiatric care for poor Coloradans in crisis.
But after a bid was awarded to a new provider with an innovative plan, the state reversed course, sweeping aside their declared desire for reform and challenging their own bid procedures. Then, when the winning bidder also won in court, the current providers stepped in, settling the case, tightening their hold on mental health treatment in the state and seemingly permanently eliminating the biggest threat to their dominance they had ever faced.
Experts at the state who had long worked for change were crushed.
“That was the most difficult, probably, time in my career I’ve ever had,” said Chris Habgood, a former staffer at the state Department of Human Services who wrote the plan for change in the 2014 effort. “Because when you know you’re doing something that is the right thing to do, to help people, you’re so excited about creating this new system that will help Coloradans.
“And then all of a sudden it comes to a crashing halt because the service delivery system didn’t like what the outcome was … there’s winners and losers, and the losers didn’t like losing and they were gonna make sure that they were not the losers.”
In partnership with COLab and news organizations across the state, CPR News has spent months examining how Colorado’s system for treating people who are both poor and mentally ill came to be, and how it has survived challenges to its structure.
Previous stories from the consortium have shown how some of the state’s 17 community-based mental health providers have failed to provide treatment to the toughest and most expensive cases while avoiding competition.
And while the companies point out that thousands of people are helped through the system each year, studies have shown that Colorado has the highest rate of adult mental illness in the nation and one of the lowest rates of access to care.
George DelGrosso, who in 2014 oversaw the Colorado Behavioral Health Council, the lobbying group that represents the existing providers, did not return multiple messages seeking comment. Doyle Forrestal, who took over from DelGrosso as head of the CBHC in 2015, said she believes the terms of the 2014 settlement preclude her from commenting on it. She declined an interview, and claimed it was unlawful to discuss details of the centers’ secret agreement to stifle the competitor.
The current head of the Jefferson Center for Mental Health, which was among the centers that drove the settlement, noted that it happened under previous leadership, and questioned why CPR News and COLab were continuing to examine the performance and history of the current providers.
“It seems there exists an intent to harm the integrity and reputation of community mental health centers, at a time when it is critical that we remain available to thousands of people in our community who need and trust the care we provide,” wrote Kiara Kuenzler, president and CEO of the Jefferson Center for Mental Health, in an email to CPR News. “Jefferson Center serves more than 25,000 people each year, and CMHCs serve more than 200,000 people across Colorado each year.”
Read the rest of the story here.