Ending the 'revolving door': Boulder, Boulder County partner to expand substance use services

Jan. 21—As Boulder and Boulder County have continued to pour money into programs supporting people experiencing homelessness to find housing or to remediate the public library after a recent methamphetamine contamination, the municipalities have also teamed up to help anyone with a substance use disorder by offering them a safe place to live and the support needed to recover.

"I think it's another puzzle piece in a slew of other programs that we have that surround our homeless strategy," said Kurt Firnhaber, Boulder director of housing and human services. "I think we all wish that we had this conversation about a year and a half to two years ago. It's taken us a long time to get here, and I think the need for our community has grown even more so during that time."

As part of the work to address substance use disorders, Boulder County began meeting with Tribe Recovery Homes Inc. in 2019. The organization, which began its work about three years ago, provides support to individuals in recovery from substance misuse and mental health-related issues. In addition to outpatient services, it currently has sober recovery homes in the Denver area. After years of work to secure funding, Boulder County was awarded a $900,000 grant from the U.S. Bureau of Justice Assistance in December 2021 to address the community's growing endemic, said Heidi Grove, homeless services systems manager for Boulder County.

According to Boulder County's proposal for the U.S. BJA grant, Boulder County experienced 48 drug-induced deaths in 2019 and 409 deaths over the past 10 years. Emergency department visits in Boulder County related to opioid overdoses increased by 250% from 2017 to 2020. Last year, the Boulder County Jail treated 674 inmates with medical services related to opioid withdrawal, including providing safe medical detoxification during incarceration. An additional 535 inmates had methamphetamine addictions.

In addition to the meth contamination in the Boulder Public Library, the RTD recently closed the restrooms in its Downtown Boulder Station transit facility after confirming the presence of methamphetamine "and/or similar substances" in both restrooms and an adjacent hallway.

Grove said after receiving the grant, the county's work continued. In November, the county partnered with Tribe Recovery Home Inc. to open an outpatient treatment center in one of the county's office buildings. The outpatient center offers general services, meaning clients meet with a therapist to receive substance use, mental health and trauma-related support. The program currently serves 12 clients who are referred to Tribe Recovery Home Inc. by the Boulder County Jail or co-responders units as both have relationships with community members. The services are not completely open to the public but that's next, Grove said.

Boulder made an offer on a home, which if greenlit, will become a recovery center for individuals with substance use disorders such as meth addiction.

"It'll be very unique, and it's very new to Boulder," Grove said. "There are similar kinds of sober living homes (in Boulder), but most of those are really targeted toward higher-income clientele."

Firnhaber declined to share the location of the home that the city has made an offer on and added that the city does not plan to publicly disclose the location of the recovery center.

"These types of services that are being provided really fall under the definition of disabilities, which according to the Fair Housing Act, includes substance use disorder, and for the protection of the clients in the program and to not infringe on the Fair Housing Act, this program has the same rights as any family moving into any home in any neighborhood, and we can't really treat them any differently than any family who wants to buy a home in a neighborhood that they want to," Firnhaber said.

To move the recovery home program forward, the county has dedicated $600,000 — $300,000 for the first home and $300,000 for a future home — to the program. Boulder will cover the remaining costs, which Firnhaber estimates will be about $1.3 million. The city will use money from Boulder's affordable housing fund to purchase the home.

"This is a new type of investment for the city," Firnhaber said. "These resources wouldn't be paid back. These are typically our investments in affordable housing that are in perpetuity, and we don't typically see those resources coming back through."

Jim Adams-Berger, manager of strategic initiatives with Boulder County, said Tribe will also be able to bill Medicaid once it begins serving more clients. Additionally, the Colorado Behavioral Health Administration is in the process of rolling out funds as part of the American Rescue Plan Act, which the county has applied for to support opening a second recovery home, Adams-Berger said.

Osvaldo Cabral, director of clinical services at Tribe, said outpatient services are offered for as long as needed, but the housing program typically lasts six to nine months. During that time, Tribe works to stabilize clients, help them find jobs as well with other aspects of their life. After that, Tribe has an alumni program where it allows former clients to return to hang out and connect with other clients.

"We have a lot of partnerships with different community members (and) different employment offices, and they reach out to us and say 'Hey, do you guys have anybody that needs to be employed?' So, that's always a good sign that employers are calling us because they know that we're building dependable individuals," Cabral said.

Most quality treatment centers are for individuals in a higher socioeconomic status, Cabral said. Tribe's mission is to bring evidence-based, quality support to people who would not usually receive that type of care. People who typically become part of the system's revolving door.

"We're really going to work with them to get them stable, connected and become productive members of the social system," Cabral said. "We want to connect them in a whole different way than they've ever had before and stop that revolving door."