What can we reason but from what we know? -Alexander Pope
By Marianne Goodland
Legislative reporter
The State Senate this week took on the issue of behavioral health in rural Colorado, with two measures designed to help farmers and ranchers with mental health programs and providers.
Senator Perry Will, R-New Castle, called the need for behavioral health a pervasive issue in the agricultural industry and in rural communities.
That need is compounded by a lack of adequate behavioral health providers and programs, Will said.
Farmers and ranchers have a suicide rate three and a half times that seen in the general population, Will said, citing the National Rural Health Association.
United States adults living in rural areas get less mental health treatment and face working with mental health providers who may lack specialized training, Will added. There’s also the stigma of needing care.
Sen. Janice Marchman, D-Berthoud, told the Senate Health & Human Services Committee last week Senate Bill 55 will require a liaison between the ag department and the Behavioral Health Administration.
Tackling behavioral health issues in rural Colorado is nothing new. Under the administration of then-Governor John Hickenlooper, then-Commissioner of Ag Don Brown of Yuma County started up a program to train Colorado Crisis Services hotline operators on talking to farmers about mental health.
That led the Department of Agriculture to set up a training video for crisis counselors on how to speak the language of agriculture.
Since then, the ag department has continued to expand its rural mental health programming. In 2021, the department received a $500,000 grant from the United States Department of Agriculture’s National Institute of Food and Agriculture to increase awareness and access to mental health care for farmers, ranchers and ag workers. That allowed for partnerships with five organizations, including Colorado Farm Bureau’s Colorado Agricultural Addiction and Mental Health Program.
In 2022, the General Assembly appropriated another $200,000 to the ag department for rural mental health services in 34 counties, primarily on the Western Slope.
But the need far outstripped the funding; 55 applications from organizations in 63 out of 64 counties applied for the four 2022 grants, with a total ask of $3.3 million.
The two grant programs will be consolidated into one under Senate Bill 55, to be known as the agricultural behavioral health grant program.
The bill also requires a group of leaders and experts in agriculture and behavioral health care to convene to improve access to behavioral health care for those involved in agriculture. The group will identify gaps and best practices, Marchman said.
“We hope this bill will encourage an unprecedented amount of collaboration,” Marchman said.
The bill comes with a maximum cost to the state in the 2024-25 budget of $736,000, with more than $518,000 devoted to grants.
That could be problematic in an upcoming budget year that has little discretionary money available. Senate President Steve Fenberg of Boulder told reporters last week the total available for new programs is about $15 million.
The bill could also compete with another on agricultural mental health that was heard immediately after the Will/Marchman bill.
That drew concerns from committee members, and the sponsors admitted they had not talked to the sponsors of the second measure.
SB 55 won an 8-1 vote and was sent to the Senate Appropriations Committee.
The second measure is Senate Bill 57, and it would create the Agricultural Workforce Mental Health and Suicide Prevention Program, also within the Department of Agriculture and tied to the current 988 suicide prevention hotline.
Sponsor Sen. Tom Sullivan, D-Centennial, told the committee stories of suicide among farmers. Suicide is one of the leading causes of death in the United States and since 2000 suicide rates are rising in rural America, Sullivan said. Colorado is among the top 10 states with the highest rates of suicides, with suicide in the ag industry at twice the national average.
SB 57 carries with it a cost of about $300,000 per year. Those funds would help create a public awareness program to promote suicide prevention among agricultural workers, contract with an organization to offer free and confidential crisis support hotline specific to agricultural workers, coordinate suicide prevention and crisis management services with the state Department of Human Services and the Behavioral Health Administration, and collaborate with the BHA to ensure those calling the 988 crisis hotline and the crisis support hotline created in the bill are served.
Tyler Garrett of Rocky Mountain Farmers Union said they appreciated the awareness campaign but said it might funnel money to just one organization and that could create confusion and duplication of services at a time when someone is facing their greatest crisis. That single-organization concept was also concern shared by the Colorado Behavioral Health Care Council.
Garrett suggested the two bills work together and work with existing programs instead of setting up new ones.
The bill passed on a 5-3 party-line vote, including a “no” vote from Will, and headed to Senate Appropriations.
In the House, veterinary medicine was the focus for hearings in the past week with the House Agriculture, Water and Natural Resources Committee.
Both bills approved by the committee were sponsored by Representative Karen McCormick, D-Longmont, a veterinarian.
House Bill 1047 would allow veterinary technicians to expand their roles, allowing those working in rural areas to do more under the supervision of their veterinarians, according to co-sponsor Rep. Marc Catlin, R-Montrose.
It does not infringe on the work of those who provide assistance and care but are not vet techs, Catlin said. It intends to help address the workforce shortage, particularly in rural Colorado, he explained.
HB 1047 redefines immediate direct and indirect supervision of vet techs and a new profession, vet tech specialists, as well as expand the scope of practice, McCormick said. “That will free up veterinarians to see more patients,” she said.
The bill’s primary purpose is to direct the Department of Regulatory Agencies to set up rules allowing veterinarians to delegate certain tasks to veterinary technicians and veterinary technician specialists, as well as allow veterinary technicians to receive a specialist designation.
The bill is backed by Colorado Farm Bureau and Rocky Mountain Farmers Union and does not carry any costs to the State.
The second bill is House Bill 1048, which deals with veterinary telehealth, another proposal to help with the workforce shortage.
HB 1048 would allow a licensed veterinarian with an established veterinarian-patient relationship to use telehealth to provide veterinary services to patients, with the client or owner’s consent. That also requires the vet to first do an in-person physical exam of the patient before using telehealth for future appointments.
Both bills won unanimous votes from the ag committee and preliminary approval from the full House on Feb. 9. Both measures came from the Water Resources and Agricultural Review Committee, which reviewed the proposals during the fall.
A proposal that didn’t make it past the fall ag committee could now be headed to the ballot.
Colorado State University is considering a new master’s degree program in veterinary clinical care, to be known as a veterinary professional associate. The proposal is contained in initiative #145, currently awaiting a review of its petition before heading out for signatures.
The measure is statutory, which means it would require only a 50 percent plus one approval and signatures can be collected in large urban areas instead of the entire state.
It also bypasses the normal process for approval of degree-granting programs, which has been handled for decades by the Colorado Commission on Higher Education and the state Department of Higher Education.
The Vet Care Coalition, largely drawn from animal rights groups, is backing the measure.
That includes Colorado Voters for Animals, which won support from Democrats in the General Assembly for banning wild animals in circuses and was a backer of the ballot measure that allowed wolves to be brought back to Colorado.
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