A nearly $1 million state grant is helping the Boulder County Jail to continue its work addressing mental health and substance abuse.
Earlier this month, the county was granted a $960,889 Jail Based Behavioral Services Grant to fund substance abuse and mental health treatment for inmates in the Boulder County Jail. Tim Oliveira, Sheriff’s Office Programs and Support Services Commander for the Jail Division, explained that while the county has been receiving this grant for over 10 years, the amount of funding and what it does has grown a lot.
The program was initially designed to identify people with substance abuse and behavioral health issues. It is volunteer only, meaning an inmate cannot be mandated to use the program, and ideal candidates must be staying at the jail for a minimum of 45 days so that they can benefit from the program.
It has grown from there, with other programs folded into this grant, like re-entry coordination and competency enhancement. Oliveira estimated that between 120-150 people are benefitting from the various programs funded by the grant at any given point — roughly a quarter of the average population at the jail.
“It’s really this comprehensive approach to dealing with those already incarcerated who are struggling with both behavioral health and substance abuse issues,” Oliveira said.
Health Services Administrator Melanie Judson spoke about the Jail Medication Assisted Treatment, or JMAT, program that also falls under that funding. The ongoing opioid epidemic, worsened by the explosion of fentanyl, is a big focus of that program.
“When I started here seven years ago, when inmates came into custody, they were just withdrawn from their opiates,” she said. “We monitored withdrawal with a nurse to make sure they were safe; we had medications for comfort. However, we didn’t do any treatment, so when they returned to the community they were high-risk to use again.”
Judson said people recently released from jail are at an 8% higher risk of overdosing because their tolerance has gone down. The jail now offers inmates all medication available to treat substance use disorder to help prevent that.
Along with the necessary staff, the jail pays for medications because Medicaid funds cannot be used for health care in jails and prisons.
One of the most expensive of those medications is Sublocade, a monthly injection used to treat opioid use disorder. At a discounted rate of $1,480 per dose and 18 people currently receiving the medication, the total cost comes to more than $20,000 a month.
“It is the right thing to do for the patient,” Judson said. “It prevents them from having overdoses when they leave. It gives them the treatment and support that they would be entitled to on the outside, which we want to continue here within our jail.”
With the cost of medication making up a significant portion of the Jail Based Behavioral Services grant, Judson added that the jail is looking at other funding sources to support JMAT services. One option could be funding from opioid litigation settlements as those funds are distributed.
Oliveira said there is a clearly established need for these types of services at the jail, which is in a unique position to offer them to people who might otherwise not benefit from these services.
“When somebody comes into custody, at that point they’ve lost so much in their life,” Judson added. “Not just their freedom, but also their job, family members. They’re in need of treatment more than anybody and when they’re here we have this window of opportunity where they want treatment.”
The two said the jail has seen success from this program in many ways, from inmates who change their outlooks to lives saved from overdoses.
“They share with us how much this program has meant to them, how much it’s helped them, how they have plans and a future and some hope — which is not how they came,” Judson said. “Our goal is always that inmates leave here better than when they came.”
Judson also thinks that the need for these types of services is not going away anytime soon.
While the jail utilizes all the funding and programming available, Oliveira said it would be nice to not have to chase the funding and have the state commit to this treatment.
“Mental health in the state of Colorado is not a success of ours. We struggle as a state and the stats are out there,” he said. “Substance abuse falls right into that as well. Why do people use substances? We can speculate, but once they’re addicted it’s a whole other physiological change that happens to their body and they’re brain. It’s not just a choice issue. I think people need to understand that.”
