Larimer mental health tax work underway

Larimer County voters taxed themselves to bring in the new Mental Health Matters Program; now it’s time for the program to show them it can not only saves lives but also save money in the long run, according to the director of the county’s Behavioral Health Services.

“We should not just assume that taxpayers will continue to fund this after 20 years,” said Director Laurie Stolen. “I think it’s our responsibility” to attempt to make the program self-funding when the tax sunsets, she said.

If it sounds as if Stolen has a big project in front of her, she does.

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The county’s 0.25 percent sales and use tax is expected to generate some $15.4 million in this, the first year. A large majority of the proceeds will necessarily go toward capital costs for a 64-bed behavioral health facility slated to open in mid-2021.

However, the program is designed to begin delivering results even before it has a building. Stolen said the county has already earmarked $1 million for distributed funding to communities. Stolen said the funds are not available yet, as her department is creating a funding application and a scoring matrix for evaluation.

Essentially, the program is looking to create partners in the communities to address concerns in those individual communities. A policy advisory council with elected representatives from Larimer County’s eight municipalities will decide which services to fund based on the gaps in each community.

Berthoud’s representative, Mayor Will Karspeck, said the advisory committee has already met four times, and he thought all of the committee members were focused on filling in the gaps for the entire county, rather than just focusing on their own needs.

“We’re still working out how those funds might look like, whether it might be a block funding or if we could allow pilot projects,” Karspeck said. “Right now it’s all very preliminary, but I think everyone is not looking at just our town perspective, but as a region. The rural (population) and smaller communities also need attention.

Karspeck also said that he’s paying a lot of attention to mental health specialists and where they might see the most significant gaps. “Once we get more of an idea what non-profits might be eligible, I’m hoping they will be reaching out to me, and I’ll certainly be reaching out to people.”

The county released a request for proposals for designing and building the treatment center in mid-May, the cost of which has been estimated at $28 million, Stolen said. The bulk of the tax proceeds will go toward building the center, so at least two years of the tax funding will go to that purpose.

“We’re hoping for ’21 or early ’22 (for completion of the center),” she said.  The building site between Loveland and Fort Collins on South Taft Hill and Trilby Road is owned by the county, which will own the building and lease it to a service provider.

The facility itself will have six different levels of care, Stolen said, including medical triage, mental health assessment, walk-in crises for all ages and crisis stabilization. The hospital is designed as a short-term residential hospital, which usually denotes stays of about 12 days, but patients could stay up to 30 days. There will be three levels of detox at the facility, which includes social and medical monitoring.

“The annual budget for operations of the facility will be around $15 million, but about $5 million of that will be recapturable (for instance, from insurance),” Stolen said. “So there will be actual operational costs of around $11 million.”

“Our goal is to braid funding as best as we can, by bringing partners on board, with a goal of trying to find sustainable funding,” she said. But the larger savings, she said, could be in decreasing return visits and reducing crisis management.

“We want to make sure we are utilizing our system smarter than we are now,” Stolen said. “The real task of the treatment center is bringing new partners into mental health treatment.”

Once the treatment center is operational the county hopes that between $4 million and $6 million will be available for bridge funding. Essentially, these funds will be used for people who can’t afford treatment, need treatment in their own community, or even need transportation to treatment.

“That’s what makes this project unique, and I think it is what will make it successful,” Stolen said. “We want to decrease the cost of long-term care, by getting access to intervention to the underinsured or not insured. We want to eliminate all the things that keep people from recovery and stability.”

Program supporters point out that the center and its programs can translate into savings for taxpayers by reducing the number of people with mental or behavioral health issue who are housed in county jail; or on a more societal level, reducing uninsured emergency room use.

Stolen previously worked on a similar county program, Alternatives to Incarceration for Individuals with Mental Health Needs, which showed success in reducing jail bed days. However, she said getting to people before they encounter legal problems could be even more effective.

Mental health experts say that every $1 spent on substance use treatment yields $4 to $7 in economic benefits such as reduced criminal justice costs. However, Stolen is well aware that the economic benefits don’t translate into recoverable costs to the program.

“We have got to be accountable to the taxpayers,” she said about the 20-year funding sunset. “At least we have got to be able to explain why we didn’t get there when that rolls around.”