Supervised-Use Sites & the Opioid Crisis
Nationally, people are now more-likely to die from an opioid overdose than from a car crash. In Colorado, opioid-related deaths have tripled in the past fifteen years, and Denver’s rates of opioid- related deaths are markedly higher than that of the rest of the state. Last year, Denver City Council authorized a pilot supervised-use site, which would provide a safe space with trained professionals and medical supplies for people who use drugs but aren’t yet in recovery. Such sites are proven to drastically reduce harm and prevent death by overdose. They provide a pathway to recovery and there has been a positive association between using a supervised use site and starting in addiction treatment.
Do you support the continuance of the city’s plan to open a supervised use site in Denver (pending state legislation)?
In addition to your support or opposition of supervised use sites, what are your plans to address the opioid crisis in Denver?
Personally, I know the impacts of addiction on loved ones and the damaging ripple effect it can have on a family. As Mayor, I am aggressively addressing this crisis. I am broken-hearted to report that 200 people per year are dying of a drug overdose in Denver – more than homicides and traffic fatalities combined.
Presently, Denver is trying a variety of approaches to reduce that number:
- Joining other cities and counties across the state to sue opioid manufacturers
- Launching a 24/7 treatment-on-demand pilot program with Denver Health
- Hiring substance abuse navigators to steer people into treatment and recovery
- Hiring peer navigators in our libraries and homeless shelters
- Deploying two dozen social workers with police officers
I supported Denver’s supervised use site ordinance. While the idea of supervised injection sites is not new globally, it is a relatively new concept for the U.S., even for cities like Denver that already use other harm-reduction strategies such as clean needle exchanges and sharps disposal boxes. Though the state legislature has decided not to introduce a bill for this purpose this session, it is still one tool we can consider if that becomes a viable option in Colorado. Even then, there are a host of other hurdles – including federal law and community concerns about where such a facility would be located that must be overcome before a supervised injection sites could ever be opened in Denver.
As mentioned above, we have a multitude of strategies we are leveraging to stem this crisis. Last year, we released a substance misuse strategic action plan and immediately began to implement it by piloting a 24/7 treatment-on- demand program in partnership with Denver Health. We also have hired two – with plans to hire more – Substance Use Navigators to help steer people struggling with drug addiction into treatment and recovery. In addition, to help people get access to treatment, housing and support, we’re hiring up to 10 homeless peer navigators, who will be stationed at homeless shelters, the courts and other places throughout Denver. This expands the successful peer navigator program at the Denver Central Library.
Finally, we must also be clear that this opioid crisis could have been avoided, yet for greed and indifference. I directed the City Attorney’s Office to use every legal tool available in holding opioid manufacturers liable for the social and economic devastation their actions have caused our city and our people. Alongside 16 neighboring jurisdictions, we filed a federal lawsuit against manufacturers just this past January.
When people are accused of a crime, they often spend extraordinary amounts of time in jail because they are not able to afford and quickly pay even low amounts of bail. The longer a person sits behind bars, the higher their chance of experiencing physical and mental health issues due to inadequate care is. Additional consequences can include loss of employment and/or housing. The bond industry further exacerbates the health effects of the cash bail system by exploiting low-income people and people of color, adding stress and fear to an already difficult situation, and worsening the inequitable negative mental and physical health outcomes of the accused.
Do you support ending cash bail in Denver? Why or why not?
What other policies would you pursue to reduce the detrimental health effects of the existing criminal justice system?
Yes. Denver must address systemic economic disadvantages and an antiquated criminal justice system that force people of lower income into jail. The inability to pay small fines, lack of transportation options or other socio- economic challenges often results in people being detained or incarcerated for procedural wrongdoings, such as a failure to appear in court.
My administration has been committed to criminal justice reform since we took office, focusing on improving policing practices, restructuring drug laws, increasing social programs and enhancing community re-entry opportunities. In many ways, we have moved the needle on these goals, making major changes to the Department of Safety during my administration. We have more work to do.
We must work to prevent crime by connecting individuals to resources and assistance to address their basic needs. My administration has taken President Obama’s My Brother’s Keeper Community Challenge to connect young men of color to community mentors and career opportunities. I supported the creation of the Gang Reduction Initiative of Denver (GRID), which hires ex-felons to help with targeted outreach and intervention to active gang members. And I launched the co-responder program to pair police officers with mental health professionals to assist and divert those experiencing behavioral challenges to services, housing, and programs instead of jail and to deploy de- escalation tactics in the field.
My administration is also working to support the formerly incarcerated with programs to reduce recidivism, provide job trainings and apprenticeships, and civically engage these individuals. Through local-hire ordinances, we are working to decrease prison recidivism rates by offering better job training for people who have been previously incarcerated and we are working to ensure that there are jobs available to them in their own communities. In 2016, I directed city agencies to “ban the box” and no longer ask applicants for many jobs about their criminal backgrounds in order to give prior offenders a second chance. We must do the same at the state and federal levels. My administration was the first county in Colorado to work with the Colorado Criminal Justice Reform Coalition (CCJRC) to allow voter registration in our Downtown Denver Detention Center and Denver County Jail.
For individuals who have been incarcerated, I have instructed the Department of Public Safety to eliminate Pretrial Electronic Monitoring Fees for clients because of the extra cost and negative impact to low income and poor families. And just this year, I announced that the city would expunge low-level marijuana convictions through clinics and procedural requests. I am committed to making this as accessible and transparent of a process as possible.
Through this collection of strategies and a multitude of other policies, we are working to reform the criminal justice system and ensure everyone is able to pursue a life that is safe, healthy and productive.
Tobacco & E-Cigarettes
Colorado’s kids use e-cigarettes at twice the national rate and 91,000 of our youth will die prematurely from the health effects of tobacco. Annual health care costs in our state from the effects of smoking are $1.89 billion. Tobacco use remains the leading cause of preventable death and disability in Denver. There are a number of proven ways to stem the tobacco and e-cigarette crisis: licensure of tobacco and e-cigarette sales, increasing taxes on those products, and raising the age of purchase to 21 are some the most effective.
Do you support enacting licensure requirements and increasing the taxes on tobacco and nicotine products for the city of Denver?
I support raising the age of purchase to 21. Nationally, more than 425 communities in 25 states have adopted a Tobacco 21 policy, and Denver is in the early stages of pursuing this with City Council as well. Tobacco use remains the leading cause of preventable death and disability in Denver. In addition to the prevalence of cigarettes and chewing tobacco, the rise of vaping has created a new, concerning access point to nicotine addiction, especially for our youth. Additionally, vaping is not as closely regulated as cigarettes and other tobacco products, therefore, it can be difficult to determine what chemicals the products contain. These companies don’t have to follow safety guidelines for devices or disclose the ingredients they put in e-liquid. Major medical organizations and health journals, including the American Medical Association and the American Academy of Pediatrics, support regulations on the sale of vaping devices and tobacco products. Denver has a strong tobacco enforcement program and, under my direction, has added resourecs to step up those efforts in recent years. We believe we have been effective in montioring and enforcing tobacco laws using our existing tools, but will continue to evaluate and determine whether additional tools like licensing are necessary. Under current state law, there are some financial consequences for a city imposing its own tobacco tax, but we are closely watching legislation that may change that this session and will engage in a policy discussion about the benefits of such a tax should the law change.
Mental Health Care
The need for improved mental and behavioral health care in our city is vast: 20 percent of Denverites deal with a daily mental health or addiction issue. In Colorado, suicide is the leading cause of death for those between the ages of 10 and 24 and 1-in-8 Denver Public School students have seriously thought about suicide. Currently, only 40 percent of people with daily mental health or addiction issues receive adequate care. Recognizing the severity of the issue, Denver voters in 2018 overwhelmingly passed Initiated Ordinance 301, also known as Caring 4 Denver. The 0.25 percent sales tax will fund mental health services, facilities, suicide prevention, opioid and substance use prevention, first-responder training, and more.
A to-be-determined nonprofit organization will be administering the Caring 4 Denver funds. How would you prioritize utilizing the funds to address mental and behavioral health and addiction needs in the city of Denver? What can the city do beyond Caring 4 Denver to address these issues?
I am pleased that the Denver voters overwhelmingly passed this legislation indicating their support for their neighbors in our community who are grappling with behavioral health challenges. The city continues to work with the proponents of the Caring 4 Denver as they seat the two boards necessary for implementation and establish the organizational structure and processes to begin administering resources by 2020.
I am greatly optimistic about the benefits Caring 4 Denver will bring to our city and the public. It will not only significantly increase financial resources available today, but it will spur new and innovative solutions to this societal challenge.
I supported the Caring 4 Denver initiative knowing that it would take our city’s collective work to the next level. In 2014, Denver was one of the first major metropolitan cities in the country to establish an Office of Behavioral Health Strategies, which works to ensure coordination among the city’s current activities in behavioral health, increase training of key city personnel around mental health and substance use issues, raise mental health and substance use awareness within city government and in the community, and work with key partners.
We also recently established a communitywide mental health task force, which is being co-led by the Denver Department of Public Health and Environment and Denver Health and Hospital Authority. This task force is charged with developing a strategic plan and guiding implementation of various tactics intended to address the mental health challenges facing Denver today.
Clearly, the city is just one partner in this critical work. There are many phenomenal partners throughout Colorado and Denver who are providing expert assistance to support those facing behavioral and mental health challenges. The city has focused on helping to bolster areas that have needed additional resources focusing on Denver’s families and youth, those in our criminal justice system and those experiencing chronic homelessness.
The city will continue to expand successful programs such as our Social Impact Bond housing program that provides housing and wrap around services including behavioral health support to 325 individuals experiencing homelessness. We also continue to expand the co-responder program in partnership with the Mental Health Center of Denver and our specialized Outreach Courts.
Individuals Experiencing Homelessness
In Denver, the number of individuals experiencing unsheltered homelessness between 2015 and 2018 has increased 58 percent – from 827 to 1,308 people. Unsheltered means persons not in places meant for habitation, i.e. streets, bridges, abandoned buildings, and outdoor camps. Moreover, 30 percent of the Metro Denver homeless population reported experiencing chronic homelessness. The City of Denver is seeking solutions to assist individuals experiencing homelessness in our community that strike the right balance between housing options, shelters, and resources for these individuals to transition into a stable environment long-term.
How do we bet serve the needs of people who are experiencing homelessness in Denver? What specific policies would you pursue and/or ordinances would you modify?
I grew up in Denver as one of ten kids, raised by a single mom in public housing. I know firsthand the pain of poverty and homelessness. There were many times when we didn’t know where we were going to sleep or if we would have enough to eat. I am committed to fighting for Denver’s most vulnerable people so that everyone has access to a home, a job and a future.
Today, the city invests more than $50 million in homeless services every year, an amount that increases annually. My administration has helped place more than 7,500 homeless families and individuals into stable housing, nearly tripled our annual investment in services, and helped open three new shelters. While the city plays a critical role in stemming homelessness, we cannot solve this challenge alone. This is a complex issue that can only be addressed with a multi-faceted approach by numerous organizations and resources. This includes creating more shelters, expanding access to mental health care and drug addiction treatment, addressing wage stagnation, identifying creative housing solutions and better connecting people to available resources.
There are myriad reasons for homelessness, foremost among them: escalating housing costs and a shortage of attainable housing, substance misuse, mental health concerns, and disconnection from family. I will continue to implement creative policy solutions that help people transition to a healthy, safe and thriving life. We have launched innovative programs to better assist people experiencing homelessness, including peer navigator programs at the Denver Central Library, which connects people with resources to get off the street, and the Denver Day Works program, which employs people experiencing homelessness to work in city facilities and parks. We’ve also added tiny homes as an innovative approach to providing more shelter with fewer resources.
Our Social Impact Bond housing program has allowed Denver to leverage $8.7 million from lenders to provide housing and supportive case management services to 325 individuals experiencing homelessness who frequently use the city’s emergency services, including police, jail, the courts and emergency rooms. By shifting the focus to preventative services, we can better serve those experiencing homelessness.
While we continue to monitor the impacts of our current programs, we also are working on new programs to reduce barriers and support the most vulnerable in our community, including adding more emergency shelter and dedicated housing options for families experiencing homelessness. We are bolstering transitional and other housing opportunities for youth. Denver Day Works is expanding to serve people at-risk of homelessness due to job loss. We are opening specialized shelters for the elderly, people living with disabilities and those recovering from hospitalization. Additionally, we are working to identify a fair and equitable process for putting people into upcoming units produced by the Affordable Housing Fund.
Colorado is facing disproportionate effects of climate change. Here in Denver, we are seeing substantial increases in the number of days each year topping 90 degrees Fahrenheit. Those temperatures exacerbate illnesses like asthma and cardiovascular disease, cause earlier snow melt, increase ozone pollution, and worsen long-standing water supply problems. The city has created the 80×50 Climate Action Plan, which highlights key strategies in the three sectors most responsible for greenhouse gas emissions in the city: buildings, transportation, and electricity generation. Denver’s long-term greenhouse gas reduction goal is to reduce emissions 80 percent below 2005 baselines levels by 2050. Today, many clean energy technologies, such as wind, solar, and battery storage, are available.
Do you support the city’s 80×50 Climate Action Plan?
What additional policies or practices should be implemented to protect our air, water, and the public’s health?
The health of our climate is of the utmost importance to ensure there is a safe, sustainable and healthy future for generations to come. Over the past 8 years under my administration, we have made impressive progress. Despite a population increase of 100,000 new residents, we have reduced carbon emissions by 7 percent and reduced air pollution from vehicles by more than 20 percent.
We have a bold strategy outlined to get us beyond the goal of 80 percent reduced carbon by 2050. The 80×50 Climate Action Plan lays out long-term goals in the categories of Buildings, Transportation and Electricity to ensure every key sector is on track to help us meet our 2050 goal. Working in tandem with the Mobility Action Plan, we can make the necessary strides to set Denver as a national model for carbon reduction.
I am committed to getting the city on 100 percent clean electricity by 2030. I am committed to make Denver a leader in clean and local energy that comes from the sun, wind or other innovative renewable technologies. I am committed to transform Denver buildings into high-performing places to live, work, learn and play. And I am committed to inspire community action and ensure environmental justice, equity and affordability as Denver transitions to a carbon-free energy system. I am also thrilled that Xcel Energy has committed to an industry-leading carbon reduction goal, so we can work together toward making this a reality in our city. Reducing carbon emissions is a must, and together we can achieve an affordable, reliable and sustainable energy future.
In 2019, our Buildings group under the Climate Action Team is expanding to ensure we can maximize the impact from our benchmarking and transparency policy, the Green Building Ordinance, and new initiatives like Energy Smart Leasing. In addition, this team will work closely with Community Planning and Development and the Bloomberg American Cities Climate Challenge team to update our building code and create a stretch code and roadmap to net zero energy buildings by 2035. With buildings accounting for the largest source of Denver’s emissions, we will continue to creatively expand our programs, policies and incentives to ensure the building sector stays on track to meet the goals in the 80×50 Climate Action Plan.