With the National Governor’s Association meeting underway in the nation’s capital last week, the Washington Post ran a speculative piece on whom Democrats might nominate in 2024 if not Joe Biden. After recounting the deficits and expressed reticence of several of the more frequently “mentioned,” the Post concluded, “It would seem there’s an opening for someone new on the national stage. Colorado Gov. Jared Polis is perhaps the most intriguing possibility, fresh off a big re-election win and with a record that has departed from Democratic orthodoxy in some high-profile ways.” The governor’s frequently libertarian impulses indeed separate him from much of the remaining field, traits he took time to showcase on several of the Sunday talk shows while in D. C.
Polis has yet to receive the “best Governor in America” accolades once heaped on Republican Bill Owens and Democrat John Hickenlooper. Neither of them, however, came close to winning a presidential nomination. American politics has become sufficiently unpredictable that we all know nearly any outcome is at least possible. Colorado’s governor suffers from several vulnerabilities he has no more than a year to address if he’s to be taken seriously on the national stage.
Colorado’s four-star economy is a major plus, but a growing crime wave engulfing the state has to be brought under control. Kwame Spearman, Denver mayoral candidate and purchaser of the Tattered Cover, reported during last week’s candidate debate that his delivery truck has had five catalytic converters stolen over the past year. A friend of mine, in town for a family funeral this week, had the converter stolen from his rental vehicle. The rental company is asking $1,200 for a replacement.
Polis’ successful rollout of statewide pre-K schooling offers another bragging point for the governor. Alarming by contrast is Colorado’s last place for providing adult mental health services. We may have improved to number forty-seven in 2022, not much to write home about. As Vincent Atchity, CEO of Mental Health Colorado, observed in the Denver Gazette, rankings on the bottom rungs tend to “jigger” around. Colorado actually has shown little improvement. Just 13% of substance abuse victims receive treatment. Meanwhile, the state still ranks first or second annually for suicides and an epidemic of teen anxiety and depression includes 60% of girls reporting persistent sadness, twice the rate for boys with similar despair.
To the governor’s credit, he persuaded the Legislature to pour $450 million dollars of pandemic funds into improving mental health services and has hired the well-regarded Dr. Morgan Medlock to captain a newly created cabinet Department for Behavioral Health, reporting directly to him. If he is going to achieve genuine progress, Polis will have to get his hands dirty assisting her. Only on the job for six months, Medlock issued her 2023 Strategic Plan at the end of January that spells out the enormity of her task.
123 fragmented programs are identified, spread across 13 existing agencies and the Judicial Branch (Corrections) as well as local school systems that all require coordination. The plan is currently more aspirational than a blueprint for change. Nothing is said, for example, about restructuring the community mental health center model which has failed so many. Translating this strategic plan into coherent reforms will demand leadership from the top.
In my experience bureaucracies tend to be feudal systems masquerading as hierarchies. Only the governor has sufficient muscle to push and prod his Cabinet into a cooperative mindset. There are also systemic problems that lie well outside the purview of state government. State Rep. Daphna Michaelson-Jenet, who has led on mental health reform legislation, has introduced a bill (HB23-1130) to curb the use of step-therapy protocols required by health insurers. These prevent seriously mentally ill patients from receiving drugs prescribed by their doctors until older, cheaper alternatives prove unsuccessful. Michaelson-Jenet seeks to return treatment decisions to those providing direct care to patients. Expect a fight and trumped-up claims that newer, more effective remedies will drive up premiums.
A similar problem exists in staffing. Mental health and addiction counseling practitioners are among the most poorly paid of all health care workers. The threadbare system currently offering services across Colorado struggles to fill available positions. In researching this article, I learned it is believed the state hospital in Pueblo is in danger of closing its doors. More than half the current staff are either temp workers or contract employees who lack professional qualifications for their jobs. Implementing quality mental health services statewide will demand a workforce that may not exist. While community providers offer poverty wages to clinicians, their executives knock down generous salaries
If the governor manages to push through these obstacles and produce a success in reforming mental health services — integrating first responders, law enforcement, court staff, corrections, health care and community providers — Democrats nationwide will take notice.
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