Why the founding director was fired
Mesa County Behavioral Health's closure will take place only two years after the department's founding and three months after its former director, Lisa Mills, was terminated for a slew of county policy violations. Some of the six violations attributed to her termination, which the Sentinel obtained through an open records request in March, include sharing confidential information, engaging in financial quid-pro-quos and hindering service delivery by disparaging colleagues and agencies. Those transgressions were identified by the Law Firm of Betchel & Santo, which Mesa County contracted to investigate Mills for nearly $17,000. The Sentinel's request for a copy of the investigation report was denied, so the extent to which Mills benefited financially is unclear. The Sentinel reported in 2023 how Mills, who initially worked for public health, was embroiled in a tension between former Mesa County Public Health Executive Director Jeff Kuhr and former Mesa County Commissioner Janet Rowland. Given that neither Kuhr nor Rowland is still working with Mesa County, much of that controversy is now irrelevant, except for how it led to the creation of Mesa County Behavioral Health. Specifically, Kuhr and Rowland had to agree on a space that "better fit" Mills and an exclusive focus on behavioral health after Mills allegedly disregarded public health's instructions in favor of the former commissioner's priorities. Mills was contacted on multiple occasions for comment, but she has yet to respond.
With its founding director's termination and a future of uncertain funding, Mesa County determined that its Behavioral Health Department could no longer operate independently.
According to Mesa County Deputy Administrator Matt Lewis, the department will be officially eliminated June 30, but its two programs will tentatively continue.
One of its services, the Crisis Co-Response Unit, has moved to the Mesa County Sheriff's Office. Its second service, the Multi-Agency Collaboration (MAC), will cease operations June 30, but it could be revamped by Mesa County Public Health.
"Really, it's a paper move," Lewis said. "The function that (co-response) provides, the work that they do and the offices they operate out of, nothing is changing tomorrow."
"We are system builders, building the system from A to Z, and the Behavioral Health Department built a lot of good bones into some of the things we need to do (with MAC)," Mesa County Public Health Executive Director Xavier Crockett said. "The unfortunate piece is that the state and federal funding are up and down every other week right now."
Lewis added that since the department facilitated behavioral health programs, rather than providing direct services, the change in county administration will not impact any mental health services being received, nor will it affect the number of local mental health care providers.
Similarly, he said the county is "working very hard to find a home for all of the employees who might be impacted by this" in different county departments.
CO-RESPONSE TO CONTINUE
The Crisis Co-Response Unit has already been relocated, with an official transfer into the Mesa County Sheriff's Office taking place on May 21.
The co-response program pairs licensed mental health clinicians with law enforcement officers on calls related to mental health and substance abuse.
The behavioral health support empowers officers to de-escalate situations that might not warrant institutionalization, allowing those in crisis to remain in the community and access long-term care, rather than exacerbating their struggles.
MCSO Captain Todd Sorenson added that co-response often handles crises more quickly than patrol officers, freeing up time for them to respond to calls that pose a higher risk to community safety.
"We desperately wanted to salvage that program. We did not want it to go by the wayside because it lends a lot of value to patrol," Sorenson said. "We want to (efficiently handle) crisis calls so (first responders) don't have to deal with them because they're time-consuming and complex a lot of times."
Both teams will remain based in (what was) the Mesa County Behavioral Health Building at 551 Chipeta Ave. The department's former headquarters opened in October of last year, after a $1.5 million renovation subsidized by a Colorado Behavioral Health Administration grant.
The space features offices and a locker room dedicated to co-response, but Lewis added that it also ensures continuity for current clients and prior clients seeking further assistance.
Sorenson added that the sheriff's office acquiring the program will not impact the overall budget since co-response is grant-funded through 2026. However, he said the unit could eventually be covered through the office's general fund to ensure long-term sustainability.
"A lot of that is evidence-based budgeting or budgeting for outcomes, so we've got to produce fruit, and that's exactly what we're doing," Sorenson said.
Beyond preserving the service, MCSO Sgt. Linda Bowman said they have made notable improvements and additions to serve larger parts of the community, with hopes of greater efficacy.
One of those additions, following up with clients, seems simple, but has had substantial success so far. According to Bowman, follow-ups provide the opportunity to check on a client's well-being, clarify any client questions and assist with any barriers in resource connection.
Another addition is "postvention," where co-responders visit traumatic incidents and assist those exposed with reconciling any impacts.
"We can be there in that capacity to help counsel people and make sure that they're stable and safe and address their needs in that moment," Bowman said.
"It doesn't have to be a crisis like you might typically think of it, such as a suicidal person; it can be a really traumatic car crash (where) my child is injured. People will feel guilt and responsibility for that, and we can help through that kind of crisis, too," she added. "It's not just the big stuff, it's the little stuff that matters, too."
MAKING A CASE FOR MAC
The MAC initiative is a partnership between law enforcement, the county's detention facility and local hospitals, aiming to address the basic needs among "frequent fliers" of the jail and emergency departments.
By fulfilling some of those needs -- such as food, shelter and health care access -- Bowman said those individuals stand a substantially higher chance of rehabilitating and becoming independent.
MAC was also created to serve as a "single point of entry" that makes it easy for clients to transition between different levels of care as they recover, lessening barriers and improving the odds of compliance in the long run.
Bowman and Sorenson added that MAC was an invaluable supplement to their co-response and overall law enforcement work, as the program allowed responding officers to access notes on prior encounters and ensure crises do not continue after a co-response call.
"We're doing as best we can with the resources we have to keep people out of critical infrastructure, but we need throughput at the same time," Sorenson said. "We can't just sit with these people on the street (forever), we need some place to hand them off. MAC was a great resource for us to hand them off and keep them out of jail."
However, the grant funding that has subsidized the program since its creation will expire June 30, without renewal.
According to Lewis, the four behavioral health providers contracted to provide MAC services were notified in advance and remain viable to provide mental healthcare independently.
Crockett added that those four providers delivered largely successful outcomes, but over 30 behavioral health providers exist in the community. So, he said there is an exciting opportunity for public health to revive MAC on a larger scale that utilizes more of those agencies.
MAC 2.0 would exist within public health's new Behavioral Health Division, which Crockett said they have already acquired funding for the hiring of two staffers.
"Our Community Health Improvement Plan has huge pieces of behavioral health in it," Crockett said. "So, as we're building out those pieces, we're going to take the pieces that the behavioral health department has been able to do with the funding they've been able to get."
"The unfortunate piece is that the funding's gone, (but) we're going to put it all together, and we're going to make it sustainable," he added. "Here, it becomes a part of the system overall ... and I think that's the big piece that has been missing."
He added that the division is charged with a larger purpose of expanding behavioral health care capacity, facilitating education and promoting community-wide awareness of the available resources.
Funding for a MAC revamp, however, is uncertain. Crockett said he has high hopes they will receive funding after several conversations with the Behavioral Health Administration and other state partners, but they will not receive a decision until sometime in June.
At the same time, receiving the grant won't guarantee MAC's permanent continuation, as Crockett said a large chunk of funds are up in the air as Congress looks to make major cuts in this year's federal budget.
"The system's going to take a little bit of time to build out, but we have the bones to really scale it to what it needs to be," Crockett said. "The biggest piece in terms of funding is that we need to know what the state and the feds are going to be doing with their legislation for us to know what lane on the highway we can actually get into to actually access the funding."