5 Big Themes You Should Know from the 2023 Legislative Session

Drama. Intrigue. Dealmaking. Walkouts. Yes, we’re talking about the 2023 Colorado legislative session. As the dust continues to slowly settle after the end of the session, we’re seeing some big themes emerge on a range of topics – a few even related to mental health.

Here are 5 big mental health themes you should know about from this year’s legislative session.

1: Youth mental health. Suicide rates among young people are continuing to rise, all while parents’ rights remain top of mind in many communities. It was against this backdrop that HB23-1003 “School Mental Health Assessment” was introduced. This bill proposed the creation of a mental health screening in schools, similar to other health screenings that are already standard (hearing, vision, etc.). Students whose screenings indicate a need for mental health support would be referred to I Matter, a free state program that pairs youth with therapists. You might be able to guess what the parents’ rights groups thought about this concept, and you would be correct – much of the primary opposition to this bill came from that camp, which resulted in a few amendments that added language around parental notification and opt-out options. Despite these compromises, the bill passed on a party-line vote and is awaiting signature from the governor.

2: Gun Safety. This was the most productive year on gun bills in Colorado’s history, with more policies being enacted than during any other single legislative session. An increase in the minimum age to purchase a firearm from 18? to 21 years old, along with a new three-day waiting period, a ban on “ghost guns,” an expansion of who can petition for an “Extreme Risk Petition Order” (often referred to as the “red flag” law) and the ability to sue a firearm manufacturer for liability were a few of the notable bills that passed. One notable bill that didn’t make it to the governor’s desk would have banned assault weapons in Colorado. While Governor Polis has signed some into law, several are being challenged in court – this will be an area to watch over the coming months.

Wondering what gun control policies have to do with mental health? Check out this piece in last month’s Report to the Community.

3: Psychologists prescribing medications. You might remember this as the sneak peek at the end of our January edition. As promised, HB23-10721 “Licensed Psychologist Prescriptive Authority” bill outlined a path for psychologists to gain the ability to prescribe certain mental health medications. Licensed psychologists could become eligible for prescribing authority after completing a combination of classroom education, advanced training, supervised practice hours, peer reviews and additional licensure by the state. Some stakeholders were concerned that even this extensive pathway would not provide the depth of clinical training psychiatrists go through before becoming independent practitioners. There were also questions around how much this would actually help increase access to prescribing providers in rural areas. After much debate, the bill passed and was signed by the governor.

4. Overdose prevention. As the opioid epidemic continues to rage, with fentanyl ripping through communities and new adulterants now gaining a foothold across the country, urgent action is needed to save lives. We’ll mention two bills on this topic here – one that passed, another that did not (see if you can guess which is which).

HB23-1167 “Reporting of Emergency Overdose Events” proposed expanding the state’s Good Samaritan law to cover people who help someone experiencing an overdose. Current state law shields from prosecution those who report an overdose event and satisfy other requirements; this bill would add individuals who didn’t actually do the reporting but who provided aid.

HB23-1202 “Overdose Prevention Centers Authorization” proposed allowing cities in Colorado to authorize overdose prevention centers within their jurisdiction. This would not have mandated that a single center be opened – at all, ever – just that municipalities that wanted to explore the concept further would no longer be prevented from doing so by state law – essentially, the state would “get out of the way” of cities considering this approach in their public health and overdose prevention efforts.

The results: HB 1167 (expanding the good Samaritan law) passed. HB 1202 (allowing cities to authorize overdose prevention centers) did not – to get technical, it was “postponed indefinitely” by the Senate Health & Human Services Committee. WellPower continues to advocate for this well-established harm reduction, public health approach to an epidemic that is claiming lives every single day.

5. Justice system. This was another significant area this year, with several bills passing both chambers with room to spare. HB23-1013 “Use of Restrictive Practices in Prisons” introduced more regulations on the use of restraints – both physical and chemical (i.e., medications) – in correctional facilities, including requirements that orders for the use of restraints be signed by a mental health provider, that less restrictive interventions be attempted first and documented, and that a clinical basis for the restraint be included in the order.

HB23-1153 “Pathways to Behavioral Healthcare” initiated a feasibility study to explore ways of preventing people with serious and persistent mental illness from entering the criminal justice system, and instead to more easily access care. Insider info: the bill sponsors want to prepare for a ballot measure in the future that would provide funding for wellness courts, which have seen positive outcomes in other states.

Finally, HB23-1012 “Juvenile Competency to Proceed” updates criteria for assessing whether young people in the juvenile justice system are “competent to proceed” with the legal process. (Check out this post for more information about what “competency” means in the justice system.)

And because you’ve made it this far, a bonus theme: the Behavioral Health Administration (BHA). This was another topic in our 2023 preview, as several aspects of the original legislation needed some “cleaning up.” Following the recent controversy surrounding the unexpected departure of the now-former head of the BHA, HB23-1236 “Implementation Updates to Behavioral Health Administration” pushed back the implementation timeline of the BHA, clarified some important licensing requirements, changed language around administrative regions and fixed a typo that could have resulted in duplicative and contradictory oversight of providers by two different state agencies.

Notably, this cleanup bill also mandates that “essential providers” will now need to provide more than just one of the types of services designated as “safety net” in order to be eligible for enhanced Medicaid reimbursement. This is a bit technical, but may help alleviate some of the concerns we’ve discussed previously – check out this post for more info.