EDITORIAL: Support a plan to expand behavioral health care
Apr. 14—Don't throw paper at a deadly dilemma that requires genuine services and results. Stop promising and producing health care coverage when the need is health care. A new supply side bill in the Legislature moves us in the right direction.
Politicians typically exacerbate the health care crisis by showing how much they purportedly care while doing nothing serious to create more service. Their repetitive formulaic failure involves some variation of manufacturing "health insurance" policies or "coverage" and promising these gifts to the uninsured.
It is a futile philosophy. Imagine giving hotel vouchers, call them "shelter policies," to the homeless. Imagine doing so when the rooms are full or hoteliers refuse to accept the government's payment as adequate reimbursement. Gee, thanks for nothing.
Printing health care policies = easy. Expanding health care = hard. As such, we routinely hear Colorado Democratic Sen. Michael Bennet and a few cohorts promise Medicare for All. Simply add "X" to "Medicare" and tell everyone they might soon have it as an option. Oh, if it were only that simple.
Offering Medicare benefits to everyone means taking care from people who earned it and giving it to those who did not. If and when the government expands Medicare to everyone who wants it, we will see endless stories about new Medicare members waiting for appointments and enduring dangerous delays in treatments. We'll see demand outpace supply each time someone takes an unearned Medicare policy.
To better serve more people by giving them more health care, politicians must find creative ways to incentivize more service providers. It means more medical schools, nursing degree programs, and practitioners ranging from transplant surgeons to candy stripers. Because society's demand for health care exceeds what the system can supply, any meaningful solution involves creating more providers.
Toward that outcome in one sliver of health care, Republicans and Democrats want the state to increase the number of "peer support professionals" to help patients recovering from mental illness and/or substance abuse. House Bill 1021 would require the Colorado Department of Human Services to establish procedures to approve "recovery support services organizations" for reimbursement of peer-support professional services with various health care funds managed by the state.
In most cases, peer support providers are not doctors, nurses, physician's assistants, registered nurses, nurse practitioners, or any of the other health care professionals licensed to provide compensated services. More frequently, they are people with experience one cannot get by merely paying tuition and studying. These are often recovering substance abusers or those who have overcome mental illnesses.
Hiring and retaining peer professionals can be difficult because they are expenses to treatment providers. The proposed law would make them financial assets by allowing organizations to bill for their services, which in turn enables them to better compensate these professional peers. Better compensation will attract more qualified individuals to seek work as peer providers.
Our state's mental health and substance abuse problems are rising. It manifests in more crime, fatal and injurious traffic events, loneliness, depression, despair and suicide. The pandemic has aggravated a dilemma we faced before most had heard of COVID-19. That is why a local Catholic priest shared with his assembly last week the personal devastation of officiating four funerals in four days for teenagers who took their lives in unrelated events.
Too many people suffering from mental distress do not get the help or intervention they need because the public and private health care markets provide too few professionals and services. A "policy" that ostensibly covers patients won't help if it doesn't deliver care. Nearly anyone who has sought affordable services to treat a loved one in need of behavioral health care knows about the shortages of providers and the weeks or months of waiting for care needed within days or hours.
"The Federal Centers for Medicare and Medicaid Services recognize that peer support professionals can be an important component in a state's delivery of effective mental health and substance abuse use disorder treatment," the bill's draft language explains.
"Peer support services can cut hospitalizations, increase a person's engagement in self-care and wellness, and help to decrease a person's psychotic symptoms."
As with all legislation, the details matter and legislators have lots of work ahead in their quest to perfect HB-1021. Whatever gets passed, this bill will improve life in Colorado if it leads to more service by an expanding base of peer professionals who understand behavioral health. Grandstanding politicians can toss around all the health care policies they want, which probably makes them feel good. Real solutions, which probably include HB-1021, will enhance the supply of care.
The Gazette Editorial Board