For years, Aurora Mental Health Center has been fighting a battle of supply and demand. While services offered through the center’s detox facility on Potomac Street for people battling drug and alcohol addiction are in demand, CEO Kelly Phillips-Henry said the center has struggled to find space for needed growth.
The need for substance abuse treatment services has been exacerbated by the COVID-19 pandemic in particular, with the CEO referring to a “national crisis of substance use and abuse.”
In October, the U.S. Substance Abuse and Mental Health Services Administration reported that the pandemic was driving rates of drug and alcohol use across the country. The administration referenced a survey given in late 2020 which indicated that an estimated 25.9 million Americans who drank alcohol in the past year and 10.9 million people who had taken other drugs during that time were using those substances more than they did before the pandemic.
Around 5% of all adults were said to have seriously considered suicide in the same timeframe, and 0.5% attempted suicide. Adults with mental illnesses and kids ages 12 to 17 who had a past-year major depressive episode were more likely than others to report that the pandemic negatively affected their mental health “quite a bit or a lot.”
But Phillips-Henry said the demand for services has not guaranteed them space for another detox facility. On the contrary, she said zoning challenges and opposition from neighbors have regularly blocked them from finding other sites.
“Those became huge obstacles,” she said. “Lo and behold, we weren’t able to secure a second location.”
Then, a few years ago, the center got word that Jefferson Hills, another mental health care provider and the owner of the Potomac property as of 2020, was looking to sell. Given the difficulties of locking down more space for their detox program, Phillips-Henry said Aurora Mental Health Center jumped at the chance to buy the land.
In July 2020, they finalized a deal with Jefferson Hills to purchase the 7.3-acre property for $7.3 million.
“We believe they could have gotten significantly more for that piece of land given its location and its size,” chief strategy and operations officer Kathie Snell said. “We felt really fortunate that they were willing to work with us and make it available for the community.”
The deal also laid the groundwork for what is being planned as the AuMHC Acute Care Center, which Phillips-Henry said is being designed along the lines of national “best practices” such as locating acute care and crisis stabilization services together along with providers of housing and physical health care.
The Acute Care Center at 1290 Potomac St. would bring AuMHC’s walk-in crisis services, crisis stabilization unit, Connect to Care same-day services (currently at 791 Chambers Road) and detox program together under one roof on a campus that would also include housing and a health care building.
And supporters say the location itself is well-suited for a facility like the Acute Care Center. As a state-licensed community mental health center, AuMHC’s mission specifically includes serving low-income clients and the uninsured.
Besides being situated near the central intersection of Mississippi Avenue and I-225, the Potomac property is in the 80012 ZIP Code, bordering ZIP Codes 80010 and 80011, all of which are poorer than the city and state as a whole, according to U.S. Census Bureau data. Marketing Director Lori MacKenzie noted that the center uses poverty rates as a proxy to gauge Medicaid eligibility among the general population.
Another specific group served by the center is the homeless, who Phillips-Henry said are “high utilizers of our crisis services.” AuMHC estimates that 45% of homeless individuals have a mental illness and at least 60% have a substance use disorder. Snell also estimated that, for two-thirds of all homeless people, mental illness preceded their loss of housing.
One of the buildings included in the ultimate vision for the campus would be an affordable housing development, and the CEO said Aurora Housing Authority has been tentatively selected as a partner following a request-for-proposal process.
“By having housing and addressing some of the social determinants of health, we believe we’re going to be able to have an impact there,” she said.
Aurora ZIP Codes 80010 through 80014 are also the zones that the center’s clients most commonly call home, MacKenzie said.
Right now, detox and crisis care services are spread out between Potomac and the AuMHC location on the Anschutz Medical Campus, roughly 5 miles to the north.
That also means police and paramedics are forced to decide what services are best for the individuals they’re transporting to receive emergency mental health care. Consolidating AuMHC’s services under one roof would lift the burden of that decision from the shoulders of first responders. The Potomac property is also up the street from the Medical Center of Aurora.
Snell said the vast majority of people who pass through the doors of AuMHC’s detox facility are brought there by first responders.
“We get very, very few people who self-refer to our detox,” she said.
But Phillips-Henry said the center wouldn’t just care for people in crisis. It would also be open beyond traditional hours so that members of the public could walk in and at least begin the process of connecting with an outpatient therapist. She said AuMHC’s goal is to be able to connect people with care regardless of where they visit.
“Our philosophy is there’s no wrong door.”
The need is now. The plan is for 2023.
As of now, the project’s sponsors say they want to see ground broken on the Acute Care Center this fall and doors open by fall 2023.
Perhaps the biggest thing standing between them and the realization of their vision for the campus is money. On March15, the center reported a funding gulf of $18.8 million, including what it would take to recoup the cost of the property.
That’s not including the affordable housing or the separate health clinic that could also be built on the campus, though Phillips-Henry said the AuMHC building wouldn’t necessarily be contingent on those moving forward.
The auxiliary buildings could cost around $20-25 million and $13-15 million respectively, while the AuMHC center would cost $31.8 million in total, also including the cost of the property.
Arapahoe County has allocated $5 million of its American Rescue Plan Act funds for the project. Snell said they hope to hear back from Adams County on AuMHC’s request for $3.1 million in federal pandemic dollars “in a matter of weeks.”
The center has also reportedly received $1 million as a community program allocation through the office of Rep. Jason Crow as well as an additional $587,000 from Signal, an organization designated by the state to manage and monitor substance abuse treatment services for the uninsured.
Snell said the center is also looking into its eligibility for more ARPA funding controlled by the state and has expressed its interest to the governor’s office.
“We may have to hit pause on our own process until we learn what additional dollars we may be able to secure from the state,” Phillips-Henry said. “We really want to be able to see us keep the movement going.”
The funding will go toward replacing the circa-1980s building at 1290 Potomac St., which Phillips-Henry called “tired,” and setting up the interior of the new building.
Snell said AuMHC could squeeze out some savings if they’re able to find a temporary home for their detox program while the construction is underway, which would allow them to scrape the old building all at once. The center plans to keep its detox open during the work.
Much of the benefit of the new center will come from the gathering of services together under a single roof. For that reason, while the center has previously reported difficulties finding licensed clinicians and other workers to staff their facilities, Snell said the establishment of the acute care center wouldn’t exacerbate the problem necessarily by requiring them to ramp up staffing.
“We’re not starting from scratch. We have the staff,” Snell said.
The capacity of the detox program will increase however, from 30 beds to around 45 beds. Snell said they’ve been operating around 20 beds during the pandemic due to related restrictions.
The size of their crisis stabilization unit is capped at 16 beds. Other programs don’t necessarily have limits on their capacity. Snell also said there is still open space in the proposed building whose use will be decided on through a community meeting process, but she said it could include residential treatment for adult substance abuse or bed-based stabilization services for youth.
She said the center is still lobbying the state to relax requirements for certification and licensing of staff, noting that the certification process for addiction counselors is particularly long.
A brochure for the Acute Care Center says AuMHC hopes to serve 10,000 people through the facility in its first year of operation.
Questions about bidding and competition
In January, Aurora City Council voted to contribute another $7 million in ARPA funds to the construction of the new AuMHC Acute Care Center on Potomac, carving the money out of a pool of $10 million that had been proposed to be made available on a competitive basis for infrastructure projects related to mental illness and substance abuse treatment.
The decision was controversial — five of the City Council’s 11 members voted against the allocation, questioning why AuMHC wasn’t required to go through a bidding process before being handed the money.
“To me, it was irresponsible to not follow that process,” councilmember Curtis Gardner said, adding that he was supportive of the project itself but not the way it was ultimately funded by the city.
“We have an immediate crisis. By burying our head in the sand and saying we’re going to build this campus years in the future, it’s just not soon enough,” he said.
Gardner has brought multiple proposals to the council for funding mental health care in the community, including establishing a “mental health board” appointed by the council that would have been tasked with spending $10 million of the city’s ARPA allocation.
Council members originally indicated that the city would commit between $8 million and $10 million to the Acute Care Campus. While Phillips-Henry acknowledged that the difference in the final funding amount meant a greater gap in getting the center built, she said AuMHC is grateful for the city’s contribution.
The council’s decision left $3 million in competitive funding up for grabs. On March 14, Mile High Behavioral Healthcare CEO Bob Dorshimer said his organization would be seeking $2 million of that to build what he called a “family preservation center” on Montview Boulevard which would combine services through the Colfax Community Network with adolescent behavioral health care.
“We think it’s a grand vision that Aurora Mental Health has,” Dorshimer said. “We celebrate them. And we hope to get the same treatment from the city, obviously, so we can also do something important with those ARPA dollars.”
The project is also taking shape at the same time as a new state agency designed to oversee behavioral health care in Colorado, which would impact the uninsured and other vulnerable populations in particular.
When asked about the rise in telehealth services and the ongoing need for brick-and-mortar facilities such as the Acute Care Campus, Snell said the center plans to move forward with a “hybrid” model of care and that around half of all AuMHC staff are working in-person.
“What we’ve come to understand … is that we have a number of clients who are very happy with telehealth services, and it’s their preference, and we have a group of clients who really want services face to face,” she said.
The center’s crisis services will continue to be handled in person, though, with Snell mentioning that “when someone is in crisis, it can really be a life or death situation.”
Phillips-Henry said the combination of services at the center is unique in the state and that their staff, who speak more than 40 languages, are well-equipped to serve a diverse group of clients in central Aurora.
“There’s no other campus to my knowledge that’s doing this yet in Colorado. We would be the first, and I think it’s happening in the right community.”