Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Behavioral Health Care topic
No spam. Unsubscribe anytime.
Boulder presents behavioral health framework; CARE crisis response logs 299 contacts in 2024
Summary
City staff outlined a new behavioral health framework aligned with the county roadmap and gave the first year update on CARE, the city’s civilian clinical response. Council pressed for disaggregated data, sustainability plans for ARPA‑funded pilots, and options to expand treatment capacity.
Boulder City Council received the city’s first behavioral health framework and a year‑one overview of the Community Assistance Response and Engagement (CARE) program, which sends clinicians and paramedics to certain non‑violent mental health and substance use calls.
The framework: roles and priorities
Kurt Furkofer, director of Housing and Human Services, and Wendy Schwartz, who leads behavioral health work in HHS, told council the framework defines the city’s role as one of augmentation, advocacy and strategic investment rather than wholesale service delivery. "Behavioral health is an umbrella term encompassing mental health, including substance use disorder," Schwartz said as she introduced the framework.
Staff described four primary city roles: augment existing services within the city’s scope (for example, CARE and CERT); advocate with regional and state partners; sustain and strategically invest in local providers (particularly where insurance does not cover costs); and incubate and evaluate ideas aimed at filling gaps in service.
Staff emphasized priorities that are difficult for the city to solve alone but where local action can have impact: preserving safety‑net behavioral services, improving service navigation, addressing people with dual diagnosis/high acuity needs, and focusing on suicide prevention and substance use treatment.
Context and constraints
Staff reviewed state and national context that affects local options: national and state mental health indicators cited in the presentation included a statement that nearly one in five Boulder County residents reported eight or more days of poor mental health in the prior 30 days, and staff cited Colorado as having a high suicide rate relative to other states. Staff also noted a large decline in Medicaid enrollment across Colorado after federal continuous enrollment protections ended in 2023; they reported a staff estimate that Colorado experienced the largest decrease in net Medicaid enrollment among states between 2023 and 2024 and that Clinica (the local safety‑net provider) had many clients become uninsured after redetermination.
Council questions focused on prevention, funding sources, evaluation and workforce. Council asked how the city’s priorities align with Boulder County’s 2023 Behavioral Health Roadmap; staff said the roadmap provides a countywide vision and that the city framework is intentionally aligned and complementary. Council members pressed for disaggregated outcome data by race, ethnicity and income, and requested clarity about sustainability for ARPA‑funded pilots (staff said some ARPA grants were designed as one‑time start‑ups with planned sustainability paths, but noted not all programs have committed ongoing funding yet).
CARE program update (clinical response to non‑violent behavioral health calls)
Staff presented CARE program metrics for 2024. CARE launched part‑time in December 2023 and expanded to 9 a.m.–7 p.m., seven days a week by mid‑March 2024. Staff reported 299 CARE responses, follow‑ups and case management contacts in 2024. CARE accounted for approximately 2% of Fire Department responses and slightly less than 1% of Police Department responses over the year. The most frequent issues encountered were situational reactions, suicidal ideation and substance use.
Staff provided additional operational details: CARE calls required police assistance 22 times and ambulance transport 37 times; there were three arrests and zero uses of force on CARE calls in 2024. Staff said more than half of CARE contacts remained in the community after clinician intervention (safety planning or connection to services) rather than being transported. The city contracted an external evaluator to analyze CARE after the first full year; staff said that evaluation work will begin in the second quarter of 2025.
Council feedback and next steps
Council asked for: disaggregated outcome data and clearer equity measures; explicit sustainability plans and funding scenarios for pilot programs funded with one‑time dollars (including the item identified as Elevate Boulder); more clarity on how regional opioid settlement funds and other sources could be used for larger capital or programmatic investments (for example, residential treatment beds); and attention to workforce shortages that limit providers’ ability to expand services.
Staff said the city will continue collaborating with Boulder County and regional partners, develop dashboards and performance indicators, refine sustainability plans for ARPA‑funded pilots, and pursue coordinated strategies for workforce and funding. Clinica and county representatives said they are pursuing new residential capacity and workforce efforts but noted cost and staffing constraints.
Ending: Council accepted the framework as a basis for future policy discussions and directed staff to return with deeper data disaggregation, fiscal scenarios for sustaining pilots, and the CARE evaluation when available.
