Behavioral Health Administration

C.R.S. tit. 27, art. 50
in effect

C.R.S. § 27-50-101 Definitions

27-50-101. Definitions. As used in this article 50, unless the context otherwise requires: (1) "Behavioral health" refers to an individual's mental and emotional well-being and actions that affect an individual's overall wellness. Behavioral health issues and disorders include substance use disorders, mental health disorders, serious psychological distress, serious mental disturbance, and suicide and range from unhealthy stress or subclinical conditions to diagnosable and treatable diseases. "Behavioral health" also describes service systems that encompass promotion of emotional health and prevention and treatment services for mental health disorders and substance use disorders. (2) "Behavioral health administration" or "BHA" means the behavioral health administration established in section 27-50-102. (3) "Behavioral health disorder" means an alcohol use disorder, a mental health disorder, or a substance use disorder. (4) "Behavioral health entity" means a facility or provider organization engaged in providing community-based health services, which may include services for a behavioral health disorder but does not include detention and commitment facilities operated by the division of youth services within the department of human services or services provided by a licensed or certified mental health-care provider under the provider's individual professional practice act on the provider's own premises. (5) "Behavioral health program" means the specific services and administration of those services by a behavioral health provider. (6) "Behavioral health provider" means a recovery community organization as defined in section 27-80-126, a recovery support services organization as defined in section 27-60-108, or a licensed organization or professional providing diagnostic, therapeutic, or psychological services for behavioral health conditions. Behavioral health providers include a residential child care facility, as defined in section 26-6-903 (29), and a federally qualified health center. (7) "Behavioral health safety net provider" means comprehensive community behavioral health providers and essential behavioral health safety net providers. A community mental health center pursuant to 42 U.S.C. sec. 300x-2(c) that is licensed as a behavioral health entity may apply to be approved as a comprehensive community behavioral health provider, an essential behavioral health safety net provider, or both. (8) "Behavioral health safety net services" means the specific behavioral health services for children, youth, and adults that must be provided statewide pursuant to part 3 of this article 50. (8.5) "Boarding" means when a child or youth under twenty-one years of age has been waiting longer than twelve hours to be placed in an appropriate treatment setting after being clinically assessed and determined to be in need of inpatient psychiatric treatment and received a determination from a licensed provider of medical stability without the need for urgent medical assessment or hospitalization for a physical condition. (9) "Commissioner" means the commissioner of the behavioral health administration appointed pursuant to section 27-50-103. (10) "Community-based" means outside of a hospital, psychiatric hospital, detention and commitment facility operated by the division of youth services within the department of human services, or nursing home. (11) "Comprehensive community behavioral health provider" means a licensed behavioral health entity or behavioral health provider approved by the behavioral health administration to provide care coordination and the following behavioral health safety net services, either directly or through formal agreements with behavioral health providers in the community or region: (a) Emergency and crisis behavioral health services; (b) Mental health and substance use outpatient services; (c) Behavioral health high-intensity outpatient services; (d) Care management; administration to provide care coordination and the following behavioral health safety net services, either directly or through formal agreements with behavioral health providers in the community or region: (a) Emergency and crisis behavioral health services; (b) Mental health and substance use outpatient services; (c) Behavioral health high-intensity outpatient services; (d) Care management; (e) Outreach, education, and engagement services; (f) Mental health and substance use recovery supports; (g) Repealed. (h) Outpatient competency restoration; and (i) Screening, assessment, and diagnosis, including risk assessment, crisis planning, and monitoring to key health indicators. (11.5) "Covered entity" means an entity subject to HIPAA. (12) "Department" means the department of human services created pursuant to section 26-1-105. (13) "Essential behavioral health safety net provider" means a licensed behavioral health entity or behavioral health provider approved by the behavioral health administration to provide care coordination and at least one of the following behavioral health safety net services: (a) Emergency or crisis behavioral health services; (b) Behavioral health outpatient services; (c) Behavioral health high-intensity outpatient services; (d) Behavioral health residential services; (e) Withdrawal management services; (f) Behavioral health inpatient services; (g) Integrated care services; (h) Hospital alternatives; or (i) Additional services that the behavioral health administration determines are necessary in a region or throughout the state. (13.5) "Extended stay" means when a child or youth under twenty-one years of age has been waiting longer than seventy-two hours to be discharged from an acute level of inpatient psychiatric care to a less intensive or less restrictive clinically appropriate level of psychiatric care, including a discharge home or to a home-like setting with behavioral health supports. (13.7) "Friends and family input form" means a form created pursuant to section 27-50-110 to allow family and friends to provide health or background information about an individual receiving mental health or substance use services. (14) "Health information organization network" has the same meaning as defined in section 25-3.5-103 (8.5). (14.5) "HIPAA" means the federal "Health Insurance Portability and Accountability Act of 1996", 42 U.S.C. secs. 1320d to 1320d-9, as amended. (15) "Mental health disorder" means one or more substantial disorders of the cognitive, volitional, or emotional processes that grossly impairs judgment or capacity to recognize reality or to control behavior. (16) "Primary prevention" means activities and strategies used to intervene before health effects occur through measures that prevent the onset of addiction, delay initial use of alcohol, marijuana, and tobacco, deter the use of illegal drugs, and promote health and wellness. (17) (a) "Priority populations" means people who are: (I) Uninsured, underinsured, medicaid-eligible, publicly insured, or whose income is below thresholds established by the BHA; and (II) Presenting with acute or chronic behavioral health needs, including but not limited to individuals who have been determined incompetent to stand trial, adults with serious mental illness, and children and youth with serious emotional disturbance. people who are: (I) Uninsured, underinsured, medicaid-eligible, publicly insured, or whose income is below thresholds established by the BHA; and (II) Presenting with acute or chronic behavioral health needs, including but not limited to individuals who have been determined incompetent to stand trial, adults with serious mental illness, and children and youth with serious emotional disturbance. (b) The BHA shall further identify underserved populations meeting the criteria of subsection (17)(a) of this section for specific prioritization on a regional or statewide basis based on health equity data, including but not limited to people experiencing or at risk of homelessness; children and youth at risk of out-of-home placement and their parents; people involved with the criminal or juvenile justice system; people of color; American Indians; Alaska natives; veterans; people who are pregnant; people who are lesbian, gay, bisexual, transgender, or queer or questioning; and individuals with disabilities as defined by the federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec. 12101 et seq., as amended. The BHA shall also consider input directly from behavioral health providers that are culturally and linguistically representative of the populations they serve. The BHA shall consider recommendations from the behavioral health administrative services organizations, the advisory council, and regional subcommittees in identifying subpopulations. (18) (a) "State agency" means any state department, state office, or state division in Colorado that administers a behavioral health program. (b) "State agency" does not include the judicial branch of state government. (19) "State board" means the state board of human services created pursuant to section 26-1-107. (20) "Substance use disorder" means a chronic relapsing brain disease, characterized by recurrent use of alcohol, drugs, or both, causing clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. (21) "Substance use disorder program" means a program for the detoxification, withdrawal, maintenance, or treatment of a person with a substance use disorder.

C.R.S. § 27-50-102 Behavioral health administration - creation - coordination - health oversight agency

27-50-102. Behavioral health administration - creation - coordination - health oversight agency. (1) There is established in the department of human services the behavioral health administration. Nothing in this subsection (1) precludes any future legislative action taken pursuant to section 27-60-203 (5) regarding the future location of the BHA. (2) The BHA is charged with creating a coordinated, cohesive, and effective behavioral health system in Colorado. Any state agency that administers a behavioral health program shall collaborate with the BHA to achieve the goals and objectives established by the BHA. In order to ensure regular engagement with other state agencies and to maintain alignment in state programs, resource allocation, priorities, and strategic planning, the commissioner shall chair a regular meeting of the executive directors of state agencies. (3) For the purpose of overseeing the behavioral health-care system in Colorado and discharging the BHA's duties as described in this article 50, the BHA is a health oversight agency, as defined in 45 CFR 164.501.

C.R.S. § 27-50-103 Behavioral health commissioner - appointment - powers, duties, and functions - subdivisions of the BHA

27-50-103. Behavioral health commissioner - appointment - powers, duties, and functions - subdivisions of the BHA. (1) The governor shall appoint the commissioner, who is the head of the BHA. The commissioner has the full authority, with the governor, to lead and develop the state's vision and strategy for behavioral health for children, youth, and adults. (2) The commissioner shall: (a) Be well-versed in behavioral health; (b) Be registered to vote in Colorado during the commissioner's term of service; and (c) Have no pecuniary interest, directly or indirectly, in any behavioral health company or agency other than as a behavioral health services recipient. (3) The commissioner shall ensure that: (a) Behavioral health programs delivered by state agencies and commercial payers are comprehensive, evidence-based, affordable, high quality, equity-focused, and easily accessible for all Coloradans; (b) Behavioral health strategies, program priorities, and funding allocations for behavioral health align with the vision set forth by the BHA and the governor; and (c) There is a streamlined approach to using public money to improve behavioral health across the continuum of care from prevention to recovery. (4) The commissioner shall engage with the legislative and judicial branches of government to achieve the state's vision for behavioral health. (5) The commissioner may establish subdivisions, sections, or units necessary for the proper discharge of the powers, duties, and functions of the BHA. (6) The commissioner shall establish an infrastructure to oversee and be accountable for policy, strategy, and services for children and youth.

C.R.S. § 27-50-104 Powers and duties of the commissioner - rules

27-50-104. Powers and duties of the commissioner - rules. (1) (a) The commissioner may adopt "commissioner rules" for behavioral health programs administered and services provided by the BHA as listed in section 27-50-105 (1). The rules must be promulgated in accordance with section 24-4-103. (b) Any rules adopted by the executive director of the department of human services prior to July 1, 2022, to implement the behavioral health programs to be administered and services to be provided by the BHA listed in section 27-50-105 (1), and whose content meets the definition of "executive director rules" pursuant to section 26-1-108, are effective until revised, amended, or repealed by the commissioner. (2) "Commissioner rules" are solely within the province of the commissioner, except those determinations precluded by authority granted to the state board of human services. "Commissioner rules" must include: (a) Matters of internal administration in the BHA, including organization, staffing, records, reports, systems, and procedures; (b) Fiscal and personnel administration for the BHA; and (c) Accounting and fiscal reporting rules for disbursement of federal funds, contingency funds, and proration of available appropriations. (3) Whenever a statutory grant of rule-making authority in this title 27 refers to the BHA, it means the behavioral health administration acting through either the state board of human services, the commissioner, or both. When exercising rule-making authority pursuant to this title 27, the BHA shall promulgate rules consistent with the powers and the distinction between "board rules" as set forth in section 26-1-107 and "commissioner rules" as set forth in this section. (4) The rules promulgated by the commissioner pertaining to this title 27 are binding upon the behavioral health providers, vendors, and agents of the BHA. At any public hearing relating to a proposed rule, interested persons have the right to present the person's data, views, or arguments orally. Proposed rules of the commissioner are subject to section 24-4-103.

C.R.S. § 27-50-105 Administration of behavioral health programs - state plan - sole mental health authority - gifts, grants, or donations

27-50-105. Administration of behavioral health programs - state plan - sole mental health authority - gifts, grants, or donations. (1) The BHA shall administer and provide the following behavioral health programs and services: (a) The regulation of recovery residences pursuant to section 27-80-129; (b) The behavioral health crisis response system created pursuant to section 27-60-103; (c) The behavioral health capacity tracking system created pursuant to section 27-60-104.5; (d) The jail-based behavioral health services program created pursuant to section 27-60-106; (e) Criminal justice diversion programs pursuant to section 27-60-106.5; (f) Peer support professionals and recovery support services organizations pursuant to section 27-60-108; (g) The youth mental health services program created pursuant to section 27-60-109; (h) Behavioral health-care services for rural and agricultural communities pursuant to section 27-60-110; (i) The county-based behavioral health grant program created pursuant to section 27-60-111; (j) The behavioral health-care workforce development program created pursuant to section 27-60-112; (k) The statewide care coordination infrastructure pursuant to section 27-60-204; (l) High-fidelity wraparound services for children and youth pursuant to article 62 of this title 27; (m) The behavioral health safety net system pursuant to article 63 of this title 27; (n) The 988 crisis hotline enterprise created pursuant to section 27-64-103; (o) The care and treatment of persons with mental health disorders pursuant to article 65 of this title 27; (p) The community mental health services purchase program pursuant to section 27-66-104; (q) The standards for approval in the community mental health services purchase program pursuant to section 27-66-105; (r) Trauma-informed care standards of approval pursuant to section 27-66-110; (s) The community transition specialist program created pursuant to article 66.5 of this title 27; (t) The "Children and Youth Mental Health Treatment Act", article 67 of this title 27; (u) Medication consistency for individuals with behavioral or mental health disorders in the criminal and juvenile justice systems pursuant to article 70 of this title 27; (v) Grants for public programs pursuant to section 27-80-103; (w) The purchase of prevention and treatment services pursuant to section 27-80-106; (x) The designation of managed service organizations pursuant to section 27-80-107; (y) The "Increasing Access to Effective Substance Use Disorder Services Act" pursuant to section 27-80-107.5; (z) The coordination of state and federal funds and programs pursuant to section 27-80-109; (aa) Addiction counselor training requirements pursuant to section 27-80-111; (bb) The treatment program for high-risk pregnant women created pursuant to section 27-80-112; (cc) The rural alcohol and substance abuse prevention and treatment program created pursuant to section 27-80-117; (dd) The care navigation program pursuant to section 27-60-204; (ee) The building substance use disorder treatment capacity in underserved communities grant program created pursuant to section 27-80-120; (ff) The recovery residence certifying body pursuant to section 27-80-122; (gg) The high-risk families cash fund created pursuant to section 27-80-123; (hh) Temporary financial housing assistance for individuals with substance use disorders pursuant to section 27-80-125; ing substance use disorder treatment capacity in underserved communities grant program created pursuant to section 27-80-120; (ff) The recovery residence certifying body pursuant to section 27-80-122; (gg) The high-risk families cash fund created pursuant to section 27-80-123; (hh) Temporary financial housing assistance for individuals with substance use disorders pursuant to section 27-80-125; (ii) The recovery support services grant program created pursuant to section 27-80-126; (jj) Controlled substances licensing pursuant to part 2 of article 80 of this title 27; (kk) The comprehensive and coordinated program for the treatment of persons with substance use disorders, persons intoxicated by alcohol, and persons under the influence of drugs pursuant to section 27-81-105; (ll) The standards for public and private treatment facilities that receive public funds pursuant to section 27-81-106; (mm) Acceptance for substance use disorder treatment pursuant to section 27-81-108; (nn) Voluntary treatment of persons with substance use disorders pursuant to section 27-81-109; (oo) Voluntary treatment for persons intoxicated by alcohol, under the influence of drugs, or incapacitated by substances pursuant to section 27-81-110; (pp) The emergency commitment of persons pursuant to section 27-81-111; (qq) The involuntary commitment of a person with a substance use disorder pursuant to section 27-81-112; (rr) Emergency service patrols pursuant to section 27-81-115; (ss) Payment for treatment pursuant to section 27-81-116; (tt) The maternal and child health pilot program pursuant to part 2 of article 82 of this title 27; (uu) Human services referral services pursuant to section 29-11-203; (vv) DUI treatment programs pursuant to article 2 of title 42; (ww) Alcohol and drug driving safety education or treatment pursuant to section 42-4-1301.3; (xx) Gambling addiction account funding pursuant to section 44-30-1301; and (yy) Sports betting funding pursuant to section 44-30-1509. (2) (a) The BHA shall formulate a comprehensive state plan for substance use disorder treatment and mental health services programs for the purpose of administering the federal block grant funds described in subsection (2)(c) of this section. The BHA shall submit the state plan to the governor and, upon the governor's approval, submit the state plan to the appropriate United States agency for review and approval. (b) The BHA is designated as the sole entity for the supervision of the administration of the state plan. (c) The BHA is designated the official mental health authority and is authorized to receive and administer: (I) Grants-in-aid from the federal government pursuant to 42 U.S.C. sec. 246; and (II) Other grants from the federal government for the provision of mental health or integrated behavioral health services. (3) The BHA may provide consultation and conduct training programs at the state, regional, or local level to support the professional development of licensed or approved behavioral health providers. The BHA may reimburse providers for reasonable and necessary expenses incurred in attending the training programs. (4) The BHA may seek, accept, and expend gifts, grants, or donations from private or public sources for the purpose of administering any behavioral health program or service described in subsection (1) of this section. The commissioner, with the approval of the governor, may direct the disposition of any gift, grant, or donation for any purpose consistent with the terms and conditions for which the gift, grant, or donation was given.

C.R.S. § 27-50-106 Transfer of functions

27-50-106. Transfer of functions. (1) The powers, duties, and functions previously administered by the department of public health and environment concerning licensing behavioral health entities pursuant to article 27.6 of title 25 shall transfer to the BHA over a period of two years, with all functions fully transferred to the BHA by January 1, 2025, as follows: (a) The department of public health and environment shall continue issuing and renewing behavioral health entity licenses until September 30, 2023, after which date the department of public health and environment shall not renew or confer any new behavioral health entity licenses. Behavioral health entities that are licensed by the department of public health and environment are subject to the rules and orders of the department of public health and environment until such rules and orders are revised, amended, repealed, or nullified. The department of public health and environment shall continue compliance monitoring and enforcement activities until all licenses the department of public health and environment has conferred are expired, revoked, or surrendered, but not after December 31, 2025. (b) On July 1, 2023, the department of public health and environment shall transfer any applications pending as of that date to the BHA for disposition. (c) On July 1, 2023, the BHA shall begin licensing functions for all new or renewal behavioral health entity licenses. Behavioral health entities that are licensed by the BHA are subject to the rules and orders of the state board of human services, including those transferred and not repealed. (d) Rules concerning behavioral health entities promulgated by the state board of human services pursuant to this section only apply to those behavioral health entities that are licensed by the BHA. (2) No later than July 1, 2024, all behavioral health entities must be licensed by, and in compliance with the rules and orders of, the state board of human services. (3) The department of public health and environment and the BHA shall coordinate to ensure that the oversight and licensing of behavioral health entities transfers smoothly between the department of public health and environment and the BHA without any delays in oversight or related duties.

C.R.S. § 27-50-107 State board of human services - rules

27-50-107. State board of human services - rules. (1) The state board of human services created pursuant to section 26-1-107 is the type 1 board for promulgating, revising, and repealing BHA rules. (2) Any rules promulgated by the state board of human services to implement the provisions of this article 50 or any other behavioral health program administered or service provided by the department of human services prior to July 1, 2022, are effective until revised, amended, or repealed by the state board of human services. (3) The state board of human services may promulgate rules that include, but are not limited to: (a) Any rules necessary to carry out the purposes of a behavioral health program administered by the BHA as listed in section 27-50-105, including record keeping, data collection, and health information organization network connection; (b) Conditions that may be imposed on a behavioral health entity for licensure; (c) Conditions that may be imposed on a behavioral health program for the program to receive public funds as part of the behavioral health safety net system created pursuant to part 3 of this article 50; (d) Requirements for public and private agencies, organizations, and institutions that the BHA may purchase services from pursuant to section 27-80-106 (1), which requirements must include prohibiting the purchase of services from agencies, organizations, and institutions that deny or prohibit access to medical services or substance use disorder treatment and services to a person who is participating in prescribed medication-assisted treatment, as defined in section 23-21-803, for a substance use disorder; and (e) (I) Standards that addiction counselors must meet to participate in behavioral health programs or to provide purchased services, and requirements necessary for addiction counselors to be certified by the state board of addiction counselor examiners, pursuant to part 8 of article 245 of title 12. (II) The rules promulgated pursuant to subsection (3)(e)(I) of this section must include education requirements for certified addiction technicians, certified addiction specialists, and licensed addiction counselors.

C.R.S. § 27-50-108 Systemwide behavioral health grievance system

27-50-108. Systemwide behavioral health grievance system. (1) (a) On or before July 1, 2024, the BHA shall create and implement a process for collecting, analyzing, and addressing behavioral health system grievances across payers, behavioral health administrative services organizations, managed care entities, and providers at a systemic level that leverages and does not duplicate existing grievance resolution programs. The BHA shall analyze grievances to identify and address service delivery gaps and to inform statewide behavioral health system policy. (b) The BHA shall, at a minimum, track grievances by behavioral health provider, topic, region, managed care entity, behavioral health administrative services organizations, payer source, service, or diagnosis and aggregate demographic data. In order to promote transparency, accountability, and system collaboration, the BHA shall publish, at least annually, aggregated and anonymized data on grievances on a public-facing website. (c) The BHA shall implement a plan to streamline grievance resolution programs, promote transparency, improve consumer experience, and promote clarity and transparency. (2) On or before July 1, 2024, the BHA shall solicit input from the behavioral health administration advisory council created pursuant to section 27-50-701, the sub-committees created pursuant to section 27-50-703, and demographically diverse stakeholders to develop a process for addressing individual grievances when traditional grievance programs fail. (3) The BHA may refer individual grievances to the office of the ombudsman for behavioral health access to care, created pursuant to section 27-80-303, when an individual may require further intervention or support to resolve the grievance in accordance with the charge of the ombudsman. (4) On or before July 1, 2024, the BHA and state agencies shall execute formal data-sharing agreements addressing data sharing consistent with state and federal requirements, cooperation between the BHA and state agencies, and any other provisions necessary to implement this section. At a minimum, the BHA and the following entities shall execute such agreements: (a) The ombudsman for medicaid managed care, established in section 25.5-5-406.1; (b) The ombudsman for behavioral health access to care, designated pursuant to section 27-80-303; and (c) The child protection ombudsman, appointed pursuant to section 19-3.3-103. All data released by the ombudsman shall comply with section 19-3.3-103 (1)(a)(I)(B) and (3). (5) The BHA may promulgate rules as needed to implement this section.

C.R.S. § 27-50-109 Centralized digital consent repository working group - duties - report - repeal

27-50-109. Centralized digital consent repository working group - duties - report - repeal. (1) The office of e-health innovation in the governor's office shall convene a working group to evaluate the feasibility of creating a centralized digital consent repository that: (a) Allows patients to provide, extend, deny, and revoke consent for sharing their medical data and information between physical and behavioral health-care providers, family members, community organizations, payers, and state agencies at any time; (b) Enhances care coordination among patients, providers, and family members; and (c) Ensures patient data is accurately recorded and securely stored. (2) The working group shall: (a) Review the state's existing efforts to develop a centralized digital consent repository; (b) Determine the process required to establish a centralized digital consent repository; (c) Evaluate the potential cost of implementing a centralized digital consent repository; (d) Identify the infrastructure needed to establish a centralized digital consent repository; (e) Identify best practices for protecting patient data; (f) Identify solutions for the secure storage of data and for patient and provider access to the data; (g) Discuss the role of the centralized digital consent repository in crisis situations and how to ensure emergent information is communicated in a timely manner between a patient, a provider or facility, and other authorized persons; (h) Engage with the department of regulatory agencies regarding implementation of the release forms; and (i) Make recommendations on any other topics the working group deems relevant. (3) The working group may consult with additional stakeholders and experts as needed to inform the working group's discussions and to answer questions to assist the working group in finalizing its findings and recommendations. (4) The working group must include individuals with legal expertise regarding 42 CFR 2, or successor federal regulations, and HIPAA; a representative from the BHA; a representative of a health information organization network; a representative of a hospital; licensed behavioral health providers, including behavioral health safety net providers; substance use providers; representatives of consumer advocacy organizations; representatives of disability advocacy organizations; and any other individuals that the office of e-health innovation determines are necessary. (5) Beginning September 1, 2024, the working group shall meet at least once in each quarter of the calendar year to develop the report created pursuant to subsection (6) of this section. (6) (a) On or before January 1, 2026, the working group shall submit a report including recommendations regarding the feasibility of creating a centralized digital consent repository to the house of representatives health and human services committee, the senate health and human services committee, and the joint technology committee, or their successor committees. (b) The office of e-health innovation shall make the report available to the public on the office's website. (7) This section is repealed, effective September 1, 2026.

C.R.S. § 27-50-110 Friends and family input form - rules

27-50-110. Friends and family input form - rules. (1) (a) On or before July 1, 2025, the BHA shall create a friends and family input form to allow an individual to provide a treating professional or a licensed or designated facility or organization with information related to a patient receiving mental health or substance use services, including: (I) Information about a patient's: (A) Diagnosis; (B) Past hospitalizations; (C) De-escalation techniques; (D) Current and past providers and their contact information; (E) Potential triggers; (F) Housing status; (G) Family history, relationships, or social context; (H) Current medical conditions; and (I) Current and past medications; and (II) Any other information as determined by the BHA based on feedback received from stakeholders. (b) The friends and family input form must include a clear statement that the friends and family input form may become part of the patient's medical record. (2) On or before October 1, 2024, the BHA shall convene one or more meetings to obtain input and recommendations from stakeholders, including consumer advocates; behavioral health providers, including behavioral health safety net providers; representatives from the department of public health and environment and the department of corrections; individuals with expertise in state and federal privacy law; and individuals who have accessed mental health or substance use services, concerning the best practices for creation and use of the friends and family input form described in subsection (1) of this section. (3) (a) The friends and family input form may be accepted in writing or electronically by any health-care facility or provider licensed or designated by the BHA, any licensee as defined in section 12-245-202 (8), any registrant as defined in section 12-245-202 (16), the department of public health and environment, the department of corrections, a county or district public health agency, the department of health care policy and financing, or any other treatment facility for individuals with behavioral or mental health disorders. (b) Covered entities may accept partially completed submissions of the friends and family input form. (c) A treating professional or a licensed or designated facility or organization shall not distribute the friends and family input form to any other entity if a patient expressly prohibits disclosure, except if a court or other legal authority has ordered the disclosure. (d) Nothing in this section shall be construed to modify or alter any generally accepted ethics, standards, protocols, or laws governing treating professionals. A covered entity, treating professional, or the professional's designee is not subject to any civil, criminal, or regulatory sanction for acting or failing to act in response to the information contained in the friends and family input form or for declining to accept a friends and family input form. (e) If a patient explicitly objects to a covered entity receiving information regarding the patient from a specific individual, the covered entity is not required to accept information from the specific individual. (4) A friend or family member providing information about an individual shall ensure the information is accurate to the best knowledge of the friend or family member providing the information. (5) (a) An individual with a close, personal interest in the well-being of the patient may provide information pursuant to this subsection (5). (b) A treating professional or a licensed or designated facility or organization may accept input in writing or through e-mail from another individual. nformation is accurate to the best knowledge of the friend or family member providing the information. (5) (a) An individual with a close, personal interest in the well-being of the patient may provide information pursuant to this subsection (5). (b) A treating professional or a licensed or designated facility or organization may accept input in writing or through e-mail from another individual. (c) A treating professional or a licensed or designated facility or organization may accept input verbally, including through voicemail. If a treating professional or a licensed or designated facility or organization accepts input verbally, the treating professional or licensed or designated facility or organization shall establish and document the process for accepting verbal input. (d) The provider shall acknowledge receipt of the input provided pursuant to this subsection (5) but is not required to disclose additional information. (6) (a) If the disclosures are permitted by HIPAA, a provider may share a patient's information with family, friends, or any individual with a close, personal interest in the well-being of the patient without the patient's consent if the patient is not present or is incapacitated and the treating professional or the professional's designee determines, based on professional judgment, that it is in the best interest of the patient. (b) If a provider discloses information about a patient without the patient's consent pursuant to subsection (6)(a) of this section, the provider shall discuss only the information that an individual involved needs to know about a patient's care or payment. (c) A provider or facility shall not inform a patient's family, friends, or any individual with a close, personal interest in the well-being of the patient about a past medical problem that is unrelated to the patient's current condition. (d) A provider is not required by HIPAA to share a patient's information when the patient is not present or is incapacitated. The provider may wait until the patient has the opportunity to agree to the disclosure. (7) The BHA shall create a resource page for both providers and families on its website that includes the friends and family input form and information from federal guidance documents and shall notify interested stakeholders of the availability of the friends and family input form and resource page. (8) The BHA shall promulgate rules for behavioral health safety net providers related to maintaining and releasing patient information and implementing the friends and family input form.

C.R.S. § 27-50-201 Behavioral health system monitoring - capacity - safety net performance

27-50-201. Behavioral health system monitoring - capacity - safety net performance. (1) On or before July 1, 2024, the BHA shall establish a performance monitoring system to track capacity and performance of all behavioral health providers, including those that contract with managed care entities or behavioral health administrative services organizations, and inform needed changes to the public and private behavioral health system in the state. (2) The BHA shall set minimum performance standards for treatment of children, youth, and adults that address key metrics for behavioral health providers and behavioral health administrative services organizations licensed by the BHA pursuant to part 5 of this article 50, including but not limited to: (a) Accessibility of care, including: (I) Availability of services; (II) Timeliness of service delivery; and (III) Capacity tracking consistent with section 27-60-104.5; and (b) Quality of care, including appropriate triage and access based on client need and for priority populations. (3) In setting minimum performance standards, the BHA shall collaborate with state agencies to consider: (a) Evidence-based and promising practices; (b) Themes identified through grievances pursuant to section 27-50-108; (c) Input from the behavioral health administration advisory council created pursuant to section 27-50-701; (d) Alignment with existing state and federal requirements; (e) Alignment with the BHA's comprehensive state plan developed pursuant to section 27-50-105 (2); and (f) Reducing the administrative burden of data collection and reporting for behavioral health providers. (3.5) (a) In setting minimum performance standards for children and youth under twenty-one years of age, the BHA shall consult with a working group, including members from the department of health care policy and financing, the department of human services, county departments of human or social services, managed care entities, hospitals, and other relevant stakeholders, including stakeholders who represent individuals with intellectual and developmental disabilities, to help develop the performance monitoring system framework that addresses the minimum performance standards for treatment of children and youth pursuant to subsection (2) of this section. The framework must consider measures of accountability for children and youth who are boarding or in extended stay. (b) The working group may, through gifts, grants, or donations, enter into an agreement with a third-party contractor that has expertise in child welfare and youth mental health research, including outcome measurement and impact analysis, to assist in developing the framework. (c) No later than April 1, 2024, the working group shall submit the framework to the BHA to inform the performance monitoring system. The BHA shall make the framework publicly available on the BHA's website. (3.7) (a) (I) Beginning September 1, 2023, and each quarter thereafter until October 1, 2024, each hospital shall report information to the BHA that is consistent with federal privacy laws in a form and manner specified by the BHA on the total number of children and youth patients who were boarding or had extended stays in the previous quarter; if known, how many children and youth who were boarding or had extended stays and were in county custody at the time they were boarding or had extended stays; and, to the extent possible, for patients who were ultimately discharged during the quarter, where the patients were discharged to. total number of children and youth patients who were boarding or had extended stays in the previous quarter; if known, how many children and youth who were boarding or had extended stays and were in county custody at the time they were boarding or had extended stays; and, to the extent possible, for patients who were ultimately discharged during the quarter, where the patients were discharged to. (II) Beginning September 1, 2023, and each quarter thereafter until October 1, 2024, the department of human services, in consultation with county departments of human or social services, shall report information to the BHA in a form and manner specified by the BHA that is consistent with federal privacy laws on the total number of children and youth in the custody of, or who had involvement with, a county department of human or social services who spent time at least overnight in a hotel or a county department of human or social services office as a stopgap setting. (b) (I) No later than September 1, 2023, and each quarter thereafter until October 1, 2024, the BHA shall report aggregated and de-identified information submitted to the BHA pursuant to subsection (3.7)(a) of this section to the working group. The BHA shall make the de-identified and aggregated data publicly available on the BHA's website. (II) If the information reported pursuant to this subsection (3.7)(b) is not able to be aggregated and de-identified in compliance with the federal "Health Insurance Portability and Accountability Act of 1996", as amended, 42 U.S.C. secs. 1320d to 1320d-9, the BHA shall not report the information until the population is large enough to be reported in compliance with the federal law. (4) The BHA and the department of health care policy and financing shall collaborate to align performance metrics and standards for providers, managed care entities, and behavioral health administrative services organizations to the greatest extent possible. (5) (a) The BHA shall collaborate with the department of health care policy and financing to establish data collection and reporting requirements that align with the performance standards established in this section and that are of a high value in promoting systemic improvements. In establishing data collection and reporting requirements, the BHA must consider the impact on behavioral health providers and clients and state information technology systems. (b) Where applicable, the BHA shall coordinate with the health information organization networks to prioritize leveraging the health information organization network infrastructure to meet the requirements of this section and to promote the interoperable exchange of data to improve the quality of patient care. The BHA shall coordinate with the health information organization networks on relevant provisions of the universal contract pursuant to section 27-50-203 (1)(a). (6) Compliance with the requirements described in this section shall be enforced through: (a) The universal contracting provisions developed pursuant to section 27-50-203; (b) Designation of behavioral health administrative services organizations pursuant to section 27-50-402; and (c) Applicable licensing standards, including licensing behavioral health entities pursuant to part 5 of this article 50. (7) The BHA shall analyze the data collected pursuant to this section and create public-facing system accountability platforms to report on performance standards for behavioral health providers, behavioral health administrative services organizations, and managed care entities. (8) The BHA shall document how the BHA's activities conducted pursuant to this section comply with state and federal privacy laws and standards.

C.R.S. § 27-50-202 Formal agreements - state agencies and tribal governments

27-50-202. Formal agreements - state agencies and tribal governments. (1) On or before July 1, 2023, the commissioner shall collaborate with state agencies and tribal governments, while respecting tribal sovereignty, to implement formal agreements between the BHA and state agencies, and the BHA and tribal governments that have initiatives, funding, programs, or services related to behavioral health. The formal agreements must provide the structure for implementing behavioral health standards by formalizing expectations specific to: (a) Collaborative problem solving for challenges that arise in the behavioral health system; (b) Consideration of BHA funding and resource allocation priorities across the behavioral health continuum of care, including primary prevention and harm reduction, as well as recommendations for other state agencies' and tribal governments' funding priorities, to ensure a coordinated statewide effort to align behavioral health funding with the BHA's vision, demonstrated gaps in funding or resource allocation, and governor priorities; (c) Data sharing and health information sharing, including a process for data sharing and analysis that: (I) Prioritizes protection of patient privacy and, to the extent possible, eliminates any sharing of personally identifiable information and personal health information; and (II) Must be transparently disclosed to all relevant parties; (d) Requiring, when applicable, the use of the universal contracting provisions generated in collaboration with state agencies pursuant to section 25-50-203 and the use of behavioral health administrative services organizations pursuant to part 4 of this article 50; (e) Reporting and data sharing to the BHA, including behavioral-health-related metrics, to ensure state agencies and tribal governments share data; (f) Managed care entity standards, such as use of nationally recognized practice guidelines for utilization management approved by the BHA and shared parameters for network adequacy; (g) Parity monitoring and compliance to support the department of health care policy and financing's and the division of insurance's enforcement of parity provisions; and (h) A method for the state agencies and tribal governments to inform the BHA of problems that need resolution and to collaborate with the BHA to address those problems. (2) The commissioner, in collaboration with state agencies and tribal governments, shall annually review the formal agreements and update the formal agreements as necessary. Formal agreements may be expanded to other state agencies and branches of government as needed and appropriate.

C.R.S. § 27-50-203 Universal contracting provisions - requirements

27-50-203. Universal contracting provisions - requirements. (1) On or before July 1, 2023, the BHA shall work with the department of health care policy and financing, in collaboration with relevant stakeholders and other state agencies, to develop universal contracting provisions to be used by state agencies when contracting for behavioral health services in the state. The universal contracting provisions shall provide clear, standardized requirements addressing at least the following: (a) Minimum data collection and reporting, including electronic data and participation in health information organization networks; (b) Grievance and occurrence reporting, including to the BHA; (c) Collaboration with other state agencies; (d) Use of evidence-based practices; (e) Access to care and quality of care standards, including accountability to the performance standards developed pursuant to section 27-50-201; (f) Programmatic and financial reporting; (g) Consequences for not meeting contract requirements; (h) Standard payment methodologies, based on provider type or other factors, as determined by the BHA; (i) Claims submissions and billing procedures and guidelines; (j) Limitations of liability; (k) Compliance with behavioral health safety net standards, including provision of services for priority populations; (l) Utilization management; (m) Utilization of required tools or programs that improve quality outcomes, accessibility of social determinants of health supports, affordability, referral efficiency, or other state priorities; (n) Policies on accepting, discharging, triaging, and denying services to clients consistent with sections 27-50-302 and 27-50-303; (o) Standards for serving priority populations and high-acuity clients based on state need and provider type; and (p) Compliance with all applicable federal statutes and regulations, including anti-discrimination laws. (2) The universal contracting provisions may include alternate standardized provisions, depending on its application, such as whether the provider is a comprehensive community behavioral health provider or an essential behavioral health safety net provider, the service type, or other factors. (3) Additional terms not included in the universal contract may be negotiated and added by the contracting parties.

C.R.S. § 27-50-204 Reporting

27-50-204. Reporting. (1) Beginning October 1, 2022, and each October 1 thereafter, the BHA shall prepare and submit a report, known as the behavioral health system plan, to the joint budget committee and the public and behavioral health and human services committee of the house of representatives and the health and human services committee of the senate, or any successor committees. At a minimum, the report must include a description of the BHA's vision and strategy for the behavioral health system, updates on performance standards developed pursuant to section 27-50-201 (2), analysis of the grievances collected pursuant to section 27-50-108, updates on formal agreements and collaborations with state agencies pursuant to this article 50, opportunities to improve reimbursement for integrated physical and mental health services, updates on care coordination pursuant to section 27-50-301 (3), and the report of the advisory council created pursuant to section 27-50-701. (2) Beginning January 1, 2023, and each January 1 thereafter, the BHA shall present the report prepared pursuant to subsection (1) of this section as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing required by section 2-7-203.

C.R.S. § 27-50-301 Behavioral health safety net system implementation

27-50-301. Behavioral health safety net system implementation. (1) No later than July 1, 2024, the BHA, in collaboration with the department of health care policy and financing and the department of public health and environment, shall establish a comprehensive and standardized behavioral health safety net system throughout the state that must include behavioral health safety net services for children, youth, and adults, including adults who have a serious mental illness and children and youth who have a serious emotional disturbance, along a continuum of care. (2) The BHA shall ensure that all Coloradans have access to the behavioral health safety net system, which must: (a) Proactively engage priority populations with adequate case management and care coordination throughout the care continuum; (b) Promote competency in de-escalation techniques; (c) Develop, maintain, and utilize adequate networks for timely access to treatment, including high-intensity behavioral health treatment and community-based treatment for children, youth, and adults; (d) Require collaboration with all state and local law enforcement jurisdictions and counties in the service area, including judicial districts and county departments of human or social services; (e) Triage individuals who need services outside the scope of the behavioral health safety net system; (f) Incorporate and demonstrate trauma-informed care practices; (g) Promote patient-centered care and cultural awareness; (h) Update information as requested by the BHA about available treatment options and outcomes in each region of the state; (i) Prioritize relevant programs or services eligible for federal grants or reimbursement, including relevant programs or services identified in the federal Title IV-E prevention services clearinghouse; (j) Utilize evidence-based or evidence-informed programming to promote quality services; and (k) Meet any other criteria established by the BHA. (3) In establishing the standardized and comprehensive behavioral health safety net system, the BHA shall: (a) In collaboration with state agencies and the advisory council created pursuant to section 27-50-701, establish and routinely assess what types of behavioral health services are provided on a community, regional, and statewide basis for children, youth, and adults. The BHA shall ensure that, at a minimum, the following behavioral health safety net services are available for children, youth, and adults statewide: (I) Emergency or crisis behavioral health services; (II) Mental health and substance use outpatient services; (III) Behavioral health high-intensity outpatient services; (IV) Behavioral health residential services; (V) Withdrawal management services; (VI) Behavioral health inpatient services; (VII) Mental health and substance use recovery supports; (VIII) Integrated care services; (IX) Care management; (X) Outreach, education, and engagement services; (XI) Outpatient competency restoration; (XII) Care coordination; (XIII) Hospital alternatives; (XIV) Screening, assessment, and diagnosis, including risk assessment, crisis planning, and monitoring to key health indicators; and (XV) Additional services that the BHA determines are necessary in a region or throughout the state. (b) When routinely assessing the services available regionally and statewide, as required in subsection (3)(a) of this section, assess adequacy of funding and resources necessary to implement the behavioral health system plan pursuant to section 27-50-204; (c) Set clinical and practice standards and health, safety, and welfare standards, including standards specific to children and youth, when appropriate, through the licensing of behavioral health entities and the approval of behavioral health safety net providers; (d) Establish statewide, regional, and local behavioral health network adequacy standards, including standards specific to children and youth, when appropriate; and standards and health, safety, and welfare standards, including standards specific to children and youth, when appropriate, through the licensing of behavioral health entities and the approval of behavioral health safety net providers; (d) Establish statewide, regional, and local behavioral health network adequacy standards, including standards specific to children and youth, when appropriate; and (e) Implement a behavioral health administrative services organization structure pursuant to part 4 of this article 50. (4) Except as provided in section 27-50-303, behavioral health safety net providers shall not refuse to treat an individual based on the individual's: (a) Insurance coverage, lack of insurance coverage, or ability to pay; (b) Clinical acuity level related to the individual's behavioral health condition or conditions, including whether the individual has been certified for short-term treatment or long-term care and treatment pursuant to article 65 of this title 27; (c) Readiness to transition out of the Colorado mental health institute at Pueblo, the Colorado mental health institute at Fort Logan, or any other mental health institute or licensed facility providing inpatient psychiatric services or acute care hospital providing stabilization because the individual no longer requires inpatient care and treatment; (d) Involvement in the criminal or juvenile justice system; (e) Current involvement in the child welfare system; (f) Co-occurring mental health and substance use disorders, physical disability, or intellectual or developmental disability, irrespective of primary diagnosis, co-occurring conditions, or if an individual requires assistance with activities of daily living or instrumental activities of daily living, as defined in section 12-270-104 (6); (g) Displays of aggressive behavior, or history of aggressive behavior, as a symptom of a diagnosed mental health disorder or substance use disorder; (h) Clinical presentation or behavioral presentation in any previous interaction with a provider; (i) Place of residence; or (j) Disability, age, race, creed, color, sex, sexual orientation, gender identity, gender expression, marital status, national origin, ancestry, or tribal affiliation. (5) The BHA may promulgate rules or determine other appropriate processes to approve behavioral health providers as behavioral health safety net providers. Behavioral health providers that do not hold a license from the BHA but are otherwise licensed or authorized to provide behavioral health services in the state of Colorado are eligible to be approved as behavioral health safety net providers.

C.R.S. § 27-50-302 Requirement to serve priority populations - screening and triage for individuals in need of behavioral health services - referrals

27-50-302. Requirement to serve priority populations - screening and triage for individuals in need of behavioral health services - referrals. (1) Except as provided in this section, comprehensive community behavioral health providers must provide the safety net services listed in section 27-50-101 (11) to priority populations. (2) Except as provided in section 27-50-303, essential behavioral health safety net providers shall provide the safety net service or services that they contract with the behavioral health administrative services organization or managed care entity to provide to priority populations. (3) Notwithstanding any other provision of this section to the contrary, emergency and crisis services must be available to any individual who is experiencing a behavioral health crisis, regardless of whether the individual is a priority population. (4) (a) When a priority population client initiates treatment with a behavioral health safety net provider, prior to the intake the provider shall complete an initial screening and triage process to determine urgency and appropriateness of care with the provider. (b) The behavioral health safety net provider shall use standard criteria, as determined by the BHA, for determining whether a client's needs exceed the clinical expertise of the provider. (c) If a priority population client's needs exceed the treatment capacity or clinical expertise of an essential behavioral health safety net provider, the provider shall refer the client to another appropriate provider. (d) If a priority population client's needs exceed the treatment capacity or clinical expertise of a comprehensive community behavioral health provider, the provider must ensure that the client has access to interim behavioral health services in a timely manner until the client is connected to the most appropriate provider for ongoing care. This may include use of providers within the network of the behavioral health administrative services organization or the regional managed care entity. (e) The comprehensive community behavioral health provider shall obtain approval from the behavioral health administrative services organization under which the provider is operating, or the regional managed care entity for medicaid clients, prior to referring a priority population client to alternative services; except that an individual experiencing a behavioral health crisis may be referred to emergency or crisis services without prior approval. (f) A behavioral health safety net provider shall include services that address the language, ability, and cultural barriers, as necessary, to serve communities of color and other underserved populations. (5) When referring a client to alternative services, a behavioral health safety net provider shall assist the client in identifying and initiating services with an appropriate provider for ongoing care. As appropriate, the behavioral health safety net provider shall use the behavioral health administrative services organization or, for medicaid clients, the regional managed care entity for care coordination. (6) (a) Behavioral health safety net providers shall track the following information for all individuals who were referred to alternative services pursuant to this section: (I) Client demographics; (II) Standardized descriptions of the needs of the client that could not be met and require the client to be referred to another provider; (III) The outcome and timeliness of the referral; and (IV) Any other information required by the BHA. (b) The provider shall provide the report at regular intervals to the BHA and to either the behavioral health administrative services organization under which the provider is operating or, for medicaid clients, to the managed care entity.

C.R.S. § 27-50-303 Essential behavioral health safety net providers - approval to serve limited priority populations

27-50-303. Essential behavioral health safety net providers - approval to serve limited priority populations. (1) Essential behavioral health safety net providers must serve all priority populations unless the universal contracting provisions with the behavioral health administrative services organization limit the provider's scope and responsibility to a specific underserved population pursuant to subsection (2) of this section. (2) Behavioral health administrative services organizations may contract with an essential behavioral health safety net provider to provide a safety net service or services, including those determined necessary pursuant to section 27-50-301 (3)(a)(XV), to only one or more specific underserved populations within the priority populations.

C.R.S. § 27-50-304 Behavioral health safety net provider network - incentives - preferred status - rules

27-50-304. Behavioral health safety net provider network - incentives - preferred status - rules. (1) The BHA shall ensure that each region in the state includes a network of behavioral health safety net providers that collectively offer a full continuum of behavioral health services. (2) The BHA shall provide statewide technical assistance specific to strengthening and expanding the behavioral health safety net system and increasing provider participation within the publicly funded behavioral health safety net provider network. (3) The BHA and state agencies, through the behavioral health administrative services organizations established pursuant to part 4 of this article 50 and managed care entities as defined in section 25.5-5-403, shall: (a) Subject to performance and available funds, provide behavioral health safety net providers with opportunities for quality incentives, value-based payment, or other enhanced payments or preferred contract statuses; (b) Prioritize comprehensive community behavioral health providers in awarding contracts for behavioral health services; and (c) Consider, upon application, behavioral health safety net providers for state-administered and county-administered grant funds related to the prevention, treatment, recovery, and harm reduction for behavioral health services. (4) To be eligible for enhanced service payments, behavioral health safety net providers must meet specific BHA licensing or approval standards, pursuant to part 5 of this article 50. (5) To meet the requirement in subsection (1) of this section, the behavioral health administrative services organizations and managed care entities may contract with potential and existing approved safety net providers to expand service capacity in a specific region of the state. (6) Nothing in this section limits the ability of state agencies to award contracts or grants for the procurement of behavioral health services directly to any county, city and county, municipality, school district, health service district, or other political subdivision of the state or any county, city and county, district, or juvenile court, or to any nonprofit or for-profit organization in accordance with applicable law. (7) The BHA may promulgate rules as necessary to implement this section.

C.R.S. § 27-50-305 Resources to support behavioral health safety net providers - independent third-party contract

27-50-305. Resources to support behavioral health safety net providers - independent third-party contract. (1) No later than July 1, 2025, the BHA shall contract with an independent third-party entity to provide services and supports to behavioral health providers seeking to become a behavioral health safety net provider with the goal of the provider becoming self-sustaining. (2) The independent third-party entity shall assist behavioral health providers in accessing alternative payment models and enhanced reimbursement rates through the BHA and medicaid by providing: (a) Support to providers in completing the annual cost reporting to inform medicaid rate-setting; (b) Analysis of current accounting practices and recommendations on implementing new or modified practices to support the soundness of cost reporting; (c) Administrative support for enrolling in different payer types, including, but not limited to, medicaid, medicare, and commercial insurance; (d) Billing and coding support; (e) Claims processing; (f) Data analysis; (g) Compliance and training on policies and procedures; (h) Shared purchasing for technology; (i) Assistance in building provider capacity to become a behavioral health safety net provider; and (j) Any other service and support approved by the BHA. (3) The independent third-party entity shall prioritize providing services and supports to a behavioral health provider that has not previously used the state cost report process to set medicaid rates. (4) The independent third-party entity shall be nonpartisan and shall not lobby, personally or in any other manner, directly or indirectly, for or against any pending legislation before the general assembly.

C.R.S. § 27-50-401 Regional behavioral health administrative services organizations - establishment

27-50-401. Regional behavioral health administrative services organizations - establishment. (1) No later than July 1, 2025, the BHA shall select and contract with regionally informed behavioral health organizations to establish, administer, and maintain adequate networks of behavioral health safety net services and care coordination, as described in part 3 of this article 50. (2) The BHA shall establish a community-informed structure for a behavioral health administrative services organization to operate. In establishing the behavioral health administrative services organization structure, the BHA shall consult with the department of health care policy and financing to ensure consideration of the regional structure that serves the medicaid population.

C.R.S. § 27-50-402 Behavioral health administrative services organizations - application - designation - denial - revocation

27-50-402. Behavioral health administrative services organizations - application - designation - denial - revocation. (1) At least once every five years, the commissioner shall solicit applications through a competitive bid process pursuant to the "Procurement Code", articles 101 to 112 of title 24, for entities to apply to be a behavioral health administrative services organization. Any qualified public or private corporation; for-profit or not-for-profit organization; or public or private agency, organization, or institution may apply in the form and manner determined by the BHA's rules. The BHA is authorized to award contracts to more than one applicant. The BHA shall use competitive bidding procedures to encourage competition and improve the quality of services. (2) The commissioner shall select a behavioral health administrative services organization based on factors established by BHA rules and the "Procurement Code", articles 101 to 112 of title 24. The BHA shall require an applicant to furnish letters of support from stakeholders in the region the applicant is applying to contract for, including, but not limited to, county commissioners and advocacy or community-based organizations. The letters of support must demonstrate the applicant's ability to serve the community. The factors for selection must include, but are not limited to, the following: (a) The applicant's experience working with publicly funded clients, including expertise in treating priority populations determined by the BHA; (b) The applicant's experience working with and engaging relevant stakeholders in the service area, including behavioral health providers; state and local agencies; and the local community, including advocacy organizations and clients of behavioral health services; (c) The extent to which real or perceived conflicts of interest between the applicant and behavioral health facilities or behavioral health providers are mitigated; and (d) The extent to which the applicant's board complies with conflict of interest policies, including to the following: (I) The board shall not have more than fifty percent of contracted providers as board members; (II) Providers who have ownership or board membership in a behavioral health administrative services organization shall not have control or decision-making authority in the establishment of provider networks; and (III) An employee of a contracted provider of a behavioral health administrative services organization shall not also be an employee of the behavioral health administrative services organization unless the employee is the clinical officer or utilization management director of the behavioral health administrative services organization. If the individual is also an employee of a provider that has board membership or ownership in the behavioral health administrative services organization, the behavioral health services organization shall develop policies approved by the commissioner to mitigate any conflict of interest the employee may have. (e) The extent to which the applicant's board membership reflects the diversity and interests of relevant stakeholders, including, but not limited to, representation by individuals with lived behavioral health experience and family of individuals with lived behavioral health experience.

C.R.S. § 27-50-403 Behavioral health administrative services organizations - contract requirements - individual access - care coordination

27-50-403. Behavioral health administrative services organizations - contract requirements - individual access - care coordination. (1) The BHA shall develop a contract for designated behavioral health administrative services organizations, which must include, but is not limited to, the following: (a) Requirements to establish and maintain a continuum of care and network adequacy in the service area consistent with part 3 of this article 50, including but not limited to providing all behavioral health safety net services described in section 27-50-301; (b) Expectations for subcontracting with behavioral health safety net providers and other providers, consistent with part 3 of this article 50, including prioritization of comprehensive community behavioral health providers; (c) Expectations for adherence to the universal contracting provisions developed pursuant to section 27-50-203 and use of the universal contracting provisions with all relevant subcontractors; (d) Reporting requirements related to claiming federal funding for eligible services and programs; (e) Prohibitions on denying or prohibiting access to any medically necessary behavioral health service, including medication-assisted treatment, as defined in section 23-21-803, for a substance use disorder; (f) Requirements to serve all individuals in need of services and a specific prohibition on denial of services for any of the reasons provided in section 27-50-301 (4); (g) Agreements on data collection and reporting, including any provisions necessary to implement section 27-50-201; (h) Procedures related to corrective actions pursuant to section 27-50-402; (i) Any provisions necessary to ensure the behavioral health administrative services organization fulfills the functions provided in subsection (2) of this section; (j) Requirements for calculating and reporting the annual administrative costs. The BHA shall establish and enforce the maximum allowable administrative cost ratios for the behavioral health administrative services organizations and report the actual performance of each behavioral health administrative services organization annually. (k) A requirement that the behavioral health administrative services organization perform appropriate fiscal management and quality oversight of providers in its network within the scope of the provider's contract, including, but not limited to, the behavioral health administrative services organization directly engaging in audits and corrective action plans with providers in its network to ensure compliance with the contract. (l) Requirements for the behavioral health administrative services organizations to collaborate with diversion programs, statewide criminal justice programs, and the bridges wraparound care program created pursuant to article 8.6 of title 16, when the programs are available in the behavioral health administrative services organization's region. (2) A behavioral health administrative services organization shall: (a) Proactively engage hard-to-serve individuals with adequate case management and care coordination throughout the care continuum; (b) Implement trauma-informed care practices; (c) Accept and provide behavioral health safety net services to individuals outside of the behavioral health administrative services organization's region; (d) Promote competency in de-escalation techniques; (e) Through network adequacy and other methods, ensure timely access to treatment, including high-intensity behavioral health treatment and community-based treatment for all individuals including children, youth, and adults; (f) Require collaboration with all local law enforcement and county agencies in the service area, including county departments of human or social services and local collaborative management programs within the service area; (g) Triage individuals who need alternative services outside the scope of the behavioral health safety net system; for all individuals including children, youth, and adults; (f) Require collaboration with all local law enforcement and county agencies in the service area, including county departments of human or social services and local collaborative management programs within the service area; (g) Triage individuals who need alternative services outside the scope of the behavioral health safety net system; (h) Promote patient-centered care, cultural awareness, and coordination of care to appropriate behavioral health safety net providers; (i) Collaborate with schools and school districts in the service area to identify gaps in services and to promote student access to behavioral health services at school and in the contracting with providers to build the network of behavioral health safety net services, inclusion of relevant programs or services eligible for federal grants or reimbursement, including relevant programs or services identified in the federal Title IV-E prevention services clearinghouse; (j) Update information as requested by the BHA about available treatment options and outcomes in each region of the state; (k) Utilize evidence-based or evidence-informed programming to promote quality services; (l) Consider, when contracting with providers to build the network of behavioral health safety net services, inclusion of relevant programs or services eligible for federal grants or reimbursement, including relevant programs or services identified in the federal Title IV-E prevention services clearinghouse; and (m) Meet any other criteria established by the BHA.

C.R.S. § 27-50-404 Care coordination - responsibilities of behavioral health administrative services organizations - coordination with managed care entities

27-50-404. Care coordination - responsibilities of behavioral health administrative services organizations - coordination with managed care entities. (1) (a) Behavioral health administrative services organizations and managed care entities have the shared responsibility of providing care coordination services in a manner consistent with article 60 of this title 27 for individuals utilizing the behavioral health safety net system. (b) Managed care entities are responsible for providing care coordination services, as required by section 25.5-5-419, to individuals enrolled in the state medical assistance program. (c) Behavioral health administrative services organizations are responsible for providing care coordination services, whether directly or through contract with behavioral health safety net providers, to individuals who are not currently enrolled in the state medical assistance program, with access for priority populations as required by part 3 of this article 50. (2) The BHA shall establish objective and standardized processes for care coordination, including: (a) Coordination between behavioral health administrative services organizations and other care coordination entities, including managed care entities, case management agencies, counties, and other behavioral health administrative services organizations, to ensure continuity of care across shared populations consistent with subsection (1) of this section; (b) Referral processes between entities, including a behavioral health administrative services organization's responsibility to provide care coordination to an individual pending commencement of care coordination services by another entity; and (c) Processes to ensure efficient and person-centered care coordination services for individuals who have acute and complex needs, including individuals involved in the civil involuntary treatment system pursuant to articles 65 and 81 of this title 27; individuals transitioning out of treatment settings or acute care settings; and individuals involved in the child welfare, juvenile justice, or criminal justice systems. (3) A behavioral health administrative services organization shall ensure care coordination services through its network and include local partners, when appropriate, such as counties, school districts, the office of bridges of Colorado established in article 95 of title 13, and local collaborative management programs.

C.R.S. § 27-50-405 Behavioral health administrative services organizations - stakeholder input - report - rules

27-50-405. Behavioral health administrative services organizations - stakeholder input - report - rules. (1) Each behavioral health administrative services organization shall develop a process to solicit and respond to input from stakeholders about behavioral health services and gaps in the service area. A behavioral health administrative services organization shall publicly post an annual report that includes: (a) A report on the stakeholder input received in the prior year, anonymized and aggregated to protect individual privacy; (b) Descriptions of how the behavioral health administrative services organization has responded to, or plans to respond to, stakeholder input from the prior year, including descriptions of policy or practice changes or explanations of why no changes were made; and (c) The plan for stakeholder engagement for the upcoming year. (2) In soliciting and responding to input from stakeholders pursuant to subsection (1) of this section, the behavioral health administrative services organization shall, at a minimum, engage the following stakeholders within the service area: (a) Clients of behavioral health services and their families; (b) Behavioral health safety net providers; (c) Counties; (d) Law enforcement; (e) Hospitals and physical health providers; and (f) Judicial districts. (3) The behavioral health administrative services organization may also engage stakeholders in neighboring service areas, as appropriate. (4) The BHA may promulgate rules as necessary to implement this section.

C.R.S. § 27-50-501 Behavioral health entities - license required - criminal and civil penalties

27-50-501. Behavioral health entities - license required - criminal and civil penalties. (1) (a) On and after January 1, 2024, it is unlawful for any person, partnership, association, or corporation to conduct or maintain a behavioral health entity, including a substance use disorder program or alcohol use disorder program, without having obtained a license from the BHA. (b) On and after January 1, 2024, an entity seeking initial licensure as a behavioral health entity shall apply for a behavioral health entity license from the BHA if the entity would previously have been licensed or subject to any of the following: (I) Behavioral health entity licensure by the department of public health and environment; (II) Approval or designation by the office of behavioral health, as it existed before July 1, 2022, or the BHA pursuant to this article 50 or article 66 of this title 27; or (III) Approval by the office of behavioral health, as it existed before July 1, 2022, or the BHA pursuant to section 27-81-106 as an approved treatment program for substance use disorders. (c) A facility with a license or approval on or before December 31, 2023, as a behavioral health entity or a substance use disorder program shall apply for a behavioral health entity license prior to the expiration of the facility's current license or approval. Such a facility is subject to the standards under which it is licensed or approved as of January 1, 2024, until such time as the BHA's behavioral health entity license is issued or denied. (2) Any person who violates the provisions of this section is guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine of not less than fifty dollars but not more than five hundred dollars and may be subject to a civil penalty assessed by the BHA of not less than fifty dollars but not more than one hundred dollars for each day the person is in violation of this section. The assessed penalty accrues from the date the BHA finds that the person is in violation of this section. The BHA shall assess, enforce, and collect the penalty in accordance with article 4 of title 24 and credit the money to the general fund. Enforcement and collection of the penalty occurs following the decision reached in accordance with procedures set forth in section 24-4-105. (3) (a) Notwithstanding any provision of law to the contrary, the BHA shall not issue or renew any license described in this part 5 unless the BHA receives a certificate of compliance for the applicant's building or structure from the division of fire prevention and control in the department of public safety in accordance with part 12 of article 33.5 of title 24. (b) The BHA shall take action on an application for licensure within thirty days after the date that the BHA receives from the applicant all of the necessary information and documentation required for licensure, including a certificate of compliance from the division of fire prevention and control.

C.R.S. § 27-50-502 Behavioral health entities - minimum standard - rules

27-50-502. Behavioral health entities - minimum standard - rules. (1) No later than January 1, 2024, the BHA shall promulgate rules pursuant to section 24-4-103 providing minimum standards for the operation of behavioral health entities within the state, including the following: (a) Requirements to be met by all behavioral health entities to ensure the health, safety, and welfare of all behavioral health entity consumers, including, at a minimum: (I) Requirements for consumer assessment, treatment, care coordination, patient rights, and consumer notice; (II) Administrative and operational standards for governance; consumer records and record retention; personnel; admission and discharge criteria; policies and procedures to ensure compliance with regulatory and contract requirements; and quality management; (III) Data reporting requirements; (IV) Physical plant standards, including infection control; and (V) Occurrence reporting requirements pursuant to section 27-50-510; (b) Service-specific requirements that apply only to behavioral health entities electing to provide that service or set of services, including, at a minimum, standards for the specific types of behavioral health safety net services and other behavioral health services along the continuum of care created by the BHA pursuant to part 3 of this article 50, including but not limited to: (I) Essential behavioral health safety net provider standards; and (II) Comprehensive community behavioral health provider standards; (c) Procedures for mandatory BHA inspections of behavioral health entities; (d) Procedures for written plans for a behavioral health entity to correct violations found as a result of inspections; (e) Intermediate enforcement remedies; (f) Factors for behavioral health entities to consider when determining whether an applicant's conviction of or plea of guilty or nolo contendere to an offense disqualifies the applicant from employment with the behavioral health entity. The state board of human services may determine which offenses require consideration of these factors. (g) Timelines for compliance with behavioral health entity standards that exceed the standards under which a behavioral health entity was previously licensed or approved. (2) In approving or rejecting an essential behavioral health safety net provider for eligibility for enhanced service delivery payment, the commissioner shall: (a) Require training on and provision of culturally competent and trauma-informed services; (b) Consider the adequacy and quality of the services provided, taking into consideration factors such as geographic location, local community need, and availability of workforce; (c) Require written policies and procedures on admitting, discharging, triaging, and denying services to clients in alignment with the standards determined by the BHA pursuant to sections 27-50-302 and 27-50-303; (d) Require that overall responsibility for the administration of an essential behavioral health safety net provider be vested in a director who is a physician or a member of one of the licensed mental health professions, unless the provider is only providing recovery support services. If the director is not a licensed physician or licensed mental health professional, the provider shall employ or contract with at least one licensed physician or licensed mental health professional to advise the director on clinical decisions. (e) Require that essential behavioral health safety net provider staff include, wherever feasible and appropriate in the discretion of the commissioner, medical staff able to provide medical clearance on site, and other professional staff workers such as psychologists, social workers, educational consultants, peers, community health workers, and nurses, with such qualifications, responsibilities, and experience that corresponds with the size and capacity of the provider; and wherever feasible and appropriate in the discretion of the commissioner, medical staff able to provide medical clearance on site, and other professional staff workers such as psychologists, social workers, educational consultants, peers, community health workers, and nurses, with such qualifications, responsibilities, and experience that corresponds with the size and capacity of the provider; and (f) Require that each essential behavioral health safety net provider from which services may be purchased: (I) Be under the control and direction of a county or local board of health, a board of directors or board of trustees of a corporation, a for-profit or not-for-profit organization, a regional mental health board, or a political subdivision of the state; (II) Be free of conflicts of interest; and (III) Enter into a contract developed pursuant to section 27-50-203 and accept publicly funded clients. (3) In approving or rejecting a comprehensive community behavioral health provider for eligibility for enhanced service delivery payment, the commissioner shall adhere to the standards for essential behavioral health safety net providers established in subsection (2) of this section, and the commissioner shall also: (a) Require that treatment programs of the comprehensive community behavioral health provider be vested in a director who is a physician or a member of one of the licensed mental health professions. The director is not required to provide oversight or direction for recovery services. If the director is not a physician or licensed mental health professional, the provider shall contract with at least one licensed physician or licensed mental health professional to advise the director on clinical decisions. (b) Consider whether the comprehensive community behavioral health provider has historically served medically needy or medically indigent patients and demonstrates a commitment to serve low-income and medically indigent populations or, in the case of a sole community provider, serves the medically indigent patients within its medical capability; (c) Require the comprehensive community behavioral health provider to waive charges or charge for services on a sliding scale based on income and require that the provider not restrict access or services because of an individual's financial limitations; (d) Require the comprehensive community behavioral health provider to serve priority populations; (e) Encourage the comprehensive community behavioral health provider to emphasize the care and treatment of individuals recently released from incarceration and hospitals or facilities directed toward assisting individuals with behavioral or mental health disorders in the individual's adjustment to and functioning in the community; (f) Require a process for tracking and reporting denials of care; and (g) Require that the board in control and direction of the comprehensive community behavioral health provider include voting members that have lived experience with mental health disorders and substance use disorders and parents of children with mental health disorders and substance use disorders. (4) In approving or rejecting local general or psychiatric hospitals, nontraditional facilities, innovative care models, and other behavioral health facilities or programs for the purchase or designation of services not provided by essential or comprehensive community behavioral health providers, the commissioner shall consider the following factors: (a) The general quality of care provided to patients by such agencies; (b) The organization of the medical staff to provide for the integration and coordination of the psychiatric treatment program; (c) The provisions for the availability of nursing, psychological, and social services and the existence of an organized program of activities under the direction of an occupational therapist or another qualified person; ty of care provided to patients by such agencies; (b) The organization of the medical staff to provide for the integration and coordination of the psychiatric treatment program; (c) The provisions for the availability of nursing, psychological, and social services and the existence of an organized program of activities under the direction of an occupational therapist or another qualified person; (d) The licensure of such entity by the department of public health and environment or another state agency where applicable; (e) The methods by which the agency coordinates its services with those rendered by other agencies to ensure an uninterrupted continuum of care to individuals with behavioral or mental health disorders; and (f) The availability of such services to the general public. (5) In approving or rejecting behavioral health safety net providers pursuant to subsections (2) and (3) of this section, or other agencies pursuant to subsection (4) of this section, for the purchase of services, the commissioner shall ensure the behavioral health safety net providers and agencies comply with federal financial participation requirements for department-administered programs. (6) In addition to these duties, the BHA may promulgate rules related to additional competencies related to serving priority populations. Behavioral health safety net providers approved by the BHA as demonstrating these additional competencies may be eligible for enhanced rates. State agencies shall consider such approved status in determining payment methodologies for services provided.

C.R.S. § 27-50-503 Licenses - application - inspection - issuance

27-50-503. Licenses - application - inspection - issuance. (1) An application for a license to operate a behavioral health entity must be submitted to the BHA annually in the form and manner prescribed by the BHA. (2) (a) The BHA shall investigate and review each original application and each renewal application for a license to operate a behavioral health entity. The BHA shall determine an applicant's compliance with this article 50 and the rules adopted pursuant to section 27-50-504 before the BHA issues a license. (b) The BHA shall inspect the applicant's facilities as it deems necessary to ensure that the health, safety, and welfare of the behavioral health entity's consumers are protected. The behavioral health entity shall submit in writing, in a form prescribed by the BHA, a plan detailing the measures that the behavioral health entity will take to correct any violations found by the BHA as a result of inspections undertaken pursuant to this subsection (2). (3) The BHA shall keep all health-care information or documents obtained during an inspection or investigation of a behavioral health entity pursuant to subsection (2) of this section confidential. Any such records, information, or documents obtained are exempt from disclosure pursuant to sections 24-72-204 and 27-50-510. (4) (a) With the submission of an application for a license to operate a behavioral health entity, or within ten days after a change in ownership or management of a behavioral health entity, each owner and manager shall submit a complete set of the owner's or manager's fingerprints to the Colorado bureau of investigation for the purpose of conducting a fingerprint-based criminal history record check. The Colorado bureau of investigation shall forward the fingerprints to the federal bureau of investigation for the purpose of conducting fingerprint-based criminal history record checks. Each owner and each manager shall pay the Colorado bureau of investigation the costs associated with the fingerprint-based criminal history record check. Upon completion of the criminal history record check, the Colorado bureau of investigation shall forward the results to the BHA. The BHA may acquire a name-based criminal history record check for an applicant who has twice submitted to a fingerprint-based criminal history record check and whose fingerprints are unclassifiable. (b) The BHA shall use the information from the criminal history record checks performed pursuant to subsection (4)(a) of this section to determine whether the person applying for licensure has been convicted of a crime that involves conduct that the BHA determines could pose a risk to the health, safety, or welfare of a behavioral health entity's consumers. The BHA shall consider that persons in recovery may have a history of criminal justice involvement and that criminal history does not require a dismissal of an application for a license. The BHA shall keep information obtained in accordance with this subsection (4) confidential. (5) The BHA shall not issue a license to operate a behavioral health entity if the owner or manager of the behavioral health entity has been convicted of a felony or misdemeanor that involves conduct that the BHA determines could pose a risk to the health, safety, or welfare of the behavioral health entity's consumers. (6) Except as otherwise provided in subsection (7) of this section, the BHA shall issue or renew a license to operate a behavioral health entity when it is satisfied that the applicant or licensee is in compliance with the requirements set forth in this article 50 and the rules promulgated pursuant to this article 50. Except for provisional licenses issued in accordance with subsection (7) of this section, a license issued or renewed pursuant to this section expires one year after the date of issuance or renewal. a behavioral health entity when it is satisfied that the applicant or licensee is in compliance with the requirements set forth in this article 50 and the rules promulgated pursuant to this article 50. Except for provisional licenses issued in accordance with subsection (7) of this section, a license issued or renewed pursuant to this section expires one year after the date of issuance or renewal. (7) (a) The BHA may issue a provisional license to operate a behavioral health entity to an applicant for the purpose of operating a behavioral health entity for a period of ninety days if the applicant is temporarily unable to conform to all of the minimum standards required pursuant to this article 50; except that the BHA shall not issue a provisional license to an applicant if the operation of the behavioral health entity will adversely affect the health, safety, or welfare of the behavioral health entity's consumers. (b) As a condition of obtaining a provisional license, the applicant shall show proof to the BHA that attempts are being made to conform and comply with the applicable standards required pursuant to this article 50. (c) The BHA shall not grant a provisional license prior to the completion of a criminal history background check in accordance with subsection (4) of this section and a determination in accordance with subsection (5) of this section. (d) A second provisional license may be issued, for a like term and fee, to effect compliance. No further provisional licenses may be issued for the current year after the second issuance pursuant to this subsection (7)(d).

C.R.S. § 27-50-504 License fees - rules

27-50-504. License fees - rules. (1) (a) By January 1, 2024, the commissioner shall promulgate rules establishing a schedule of fees sufficient to meet the direct and indirect costs of administration and enforcement of this part 5. (b) The BHA shall assess and collect, from behavioral health entities subject to licensure pursuant to section 27-50-503, fees in accordance with the fee schedule established pursuant to subsection (1)(a) of this section. (2) The BHA shall transmit fees collected pursuant to subsection (1) of this section to the state treasurer, who shall credit the money to the behavioral health licensing cash fund created pursuant to section 27-50-506. (3) Fees collected pursuant to subsection (1) of this section may be used by the BHA to provide technical assistance and education to behavioral health entities related to compliance with Colorado law, in addition to regulatory and administrative functions. The BHA may contract with private entities to assist the BHA in providing technical assistance and education.

C.R.S. § 27-50-505 License - denial - suspension - revocation

27-50-505. License - denial - suspension - revocation. (1) When an application for an initial license to operate a behavioral health entity pursuant to section 27-50-503 has been denied by the BHA, the BHA shall notify the applicant in writing of the denial by mailing a notice to the applicant at the address shown on the application. Any applicant aggrieved by a denial may pursue a review as provided in article 4 of title 24, and the BHA shall follow the provisions and procedures specified in article 4 of title 24. (2) (a) The BHA may suspend, revoke, or refuse to renew the license of any behavioral health entity that is out of compliance with the requirements of this part 5 or the rules promulgated pursuant to this part 5. Suspension, revocation, or refusal must not occur until after a hearing and in compliance with the provisions and procedures specified in article 4 of title 24; except that the BHA may summarily suspend a behavioral health entity's license before a hearing in accordance with section 24-4-104 (4)(a). (b) After conducting a hearing in accordance with article 4 of title 24, the BHA may revoke or refuse to renew a behavioral health entity's license if the owner, manager, or administrator of the behavioral health entity has been convicted of a felony or misdemeanor involving conduct that the BHA determines could pose a risk to the health, safety, or welfare of the behavioral health entity's consumers. (3) The BHA may impose intermediate restrictions or conditions on a behavioral health entity that may include at least one of the following: (a) Retaining a consultant to address corrective measures; (b) Monitoring by the BHA for a specific period; (c) Providing additional training to employees, owners, or operators of the behavioral health entity; (d) Complying with a directed written plan to correct the violation; or (e) (I) Paying a civil fine not to exceed two thousand dollars in a calendar year. (II) The assessment of civil fines shall follow the procedures set forth in section 26.5-5-323. (4) If the BHA assesses a civil fine pursuant to subsection (3)(e) of this section, the BHA shall transmit the money to the state treasurer, who shall credit the money to the general fund.

C.R.S. § 27-50-506 Behavioral health licensing cash fund - creation

27-50-506. Behavioral health licensing cash fund - creation. The behavioral health licensing cash fund, referred to in this section as the "fund", is created in the state treasury. The fund consists of money credited to the fund pursuant to section 27-50-504 (2). The money in the fund is subject to annual appropriation by the general assembly for the direct and indirect costs of the BHA in performing its duties pursuant to this part 5. At the end of any state fiscal year, all unexpended and unencumbered money in the fund remains in the fund and must not be credited or transferred to the general fund or any other fund.

C.R.S. § 27-50-507 Employee and contracted service provider - criminal history record check

27-50-507. Employee and contracted service provider - criminal history record check. A behavioral health entity shall require an applicant seeking employment with, or seeking to contract to provide services for, the behavioral health entity to submit to a criminal history record check before employment or execution of a contract. The behavioral health entity shall pay the costs of the criminal history record check. The criminal history record check must be conducted not more than ninety days before the employment of or contract with the applicant.

C.R.S. § 27-50-508 Enforcement

27-50-508. Enforcement. The BHA is responsible for the enforcement of this article 50 and the rules adopted pursuant to this article 50.

C.R.S. § 27-50-509 Purchase of services by courts, counties, municipalities, school districts, and other political subdivisions

27-50-509. Purchase of services by courts, counties, municipalities, school districts, and other political subdivisions. Any county, city and county, municipality, school district, health service district, or other political subdivision of the state or any county, city and county, district, or juvenile court may enter into intergovernmental agreements with any county, municipality, school district, health service district, or other political subdivision of the state or may enter into contractual agreements with any provider licensed by the BHA for the purchase of behavioral health services. For the purchase of behavioral health services by counties or cities and counties as authorized by this section, the board of county commissioners of any county or the city council of any city and county may levy a tax not to exceed two mills upon real property within the county or city and county if the board first submits the question of the levy to a vote of the qualified electors at a general election and receives the electors' approval of the levy.

C.R.S. § 27-50-510 Behavioral health entities - consumer information - reporting - release - rules

27-50-510. Behavioral health entities - consumer information - reporting - release - rules. (1) Each behavioral health entity licensed, approved, or designated pursuant to this part 5 shall report to the BHA all of the following occurrences: (a) Any occurrence that results in the death of a patient or resident of the facility and is required to be reported to the coroner pursuant to section 30-10-606, as arising from an unexplained cause or under suspicious circumstances; (b) Any occurrence that results in any of the following serious injuries to a patient or resident: (I) Brain or spinal cord injuries; (II) Life-threatening complications of anesthesia or life-threatening transfusion errors or reactions; or (III) Second- or third-degree burns involving twenty percent or more of the body surface area of an adult patient or resident or fifteen percent or more of the body surface area of a child patient or resident; (c) Any occurrence when a patient or resident of the facility cannot be located following a search of the facility, the facility grounds, and the area surrounding the facility, and: (I) There are circumstances that place the patient's or resident's health, safety, or welfare at risk; or (II) The patient or resident has been missing for eight hours; (d) Any occurrence involving physical, sexual, or verbal abuse of a patient or resident, as described in section 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3-402, 18-3-404, or 18-3-405, by another patient or resident, an employee of the facility, or a visitor to the facility; (e) Any occurrence involving caretaker neglect of a patient or resident, as defined in section 26-3.1-101 (2.3); (f) Any occurrence involving misappropriation of a patient's or resident's property. As used in this subsection (1)(f), "misappropriation of a patient's or resident's property" means a pattern of or deliberately misplacing, exploiting, or wrongfully using, either temporarily or permanently, a patient's or resident's belongings or money without the patient's or resident's consent. (g) Any occurrence in which drugs intended for use by patients or residents are diverted to use by other persons. If the diverted drugs are injectable, the behavioral health entity shall also report the full name and date of birth of any individual who diverted the injectable drugs, if known. (h) Any occurrence involving the malfunction or intentional or accidental misuse of patient or resident care equipment that occurs during treatment or diagnosis of a patient or resident and that significantly adversely affects or, if not averted, would have significantly adversely affected a patient or resident of the facility. (2) The state board of human services shall promulgate rules specifying the manner, time period, and form in which the reports required pursuant to subsection (1) of this section must be made. (3) Any report submitted pursuant to subsection (1) of this section is strictly confidential; except that information in any such report may be transmitted to an appropriate regulatory agency having jurisdiction for disciplinary or license sanctions. The information in such reports shall not be made public upon subpoena, search warrant, discovery proceedings, or otherwise, except as provided in subsection (5) of this section. uant to subsection (1) of this section is strictly confidential; except that information in any such report may be transmitted to an appropriate regulatory agency having jurisdiction for disciplinary or license sanctions. The information in such reports shall not be made public upon subpoena, search warrant, discovery proceedings, or otherwise, except as provided in subsection (5) of this section. (4) The BHA shall investigate each report submitted pursuant to subsection (1) of this section that the BHA determines was appropriately submitted. For each report investigated, the BHA shall prepare a summary of its findings, including the BHA's conclusions and whether there was a violation of licensing or approval standards or a deficiency and whether the facility acted appropriately in response to the occurrence. If the investigation is not conducted on site, the BHA shall specify in the summary how the investigation was conducted. Any investigation conducted pursuant to this subsection (4) is in addition to and not in lieu of any inspection required to be conducted pursuant to section 27-50-503 (2) with regard to licensing. (5) (a) The BHA shall make the following information available to the public: (I) Any investigation summaries prepared pursuant to subsection (4) of this section; (II) Any complaints against a behavioral health entity that have been filed with the BHA and that the BHA has investigated, including the conclusions reached by the BHA and whether there was a violation of licensing or approval standards or a deficiency and whether the facility acted appropriately in response to the subject of the complaint; and (III) A listing of any deficiency citations issued against each behavioral health entity. (b) The information released pursuant to this subsection (5) shall not identify the patient or resident or the health-care professional involved in the report. (6) Prior to the completion of an investigation pursuant to this section, the BHA may respond to any inquiry regarding a report received pursuant to subsection (1) of this section by confirming that it has received such report and that an investigation is pending. (7) In addition to the report to the BHA for an occurrence described in subsection (1)(d) of this section, the occurrence must be reported to a law enforcement agency.

C.R.S. § 27-50-601 Department of health care policy and financing - behavioral health network standards

27-50-601. Department of health care policy and financing - behavioral health network standards. (1) The statewide managed care system, created pursuant to part 4 of article 5 of title 25.5 and implemented by the department of health care policy and financing, shall use health facilities licensed by the department of public health and environment pursuant to article 1.5 of title 25 or licensed by the BHA pursuant to part 5 of this article 50 and individual behavioral health practitioners licensed by the department of regulatory agencies and federally qualified health centers, as defined in the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(4), when creating statewide or regional behavioral health networks. (2) The department of health care policy and financing shall align all community-based behavioral health programs and networks with the behavioral health continuum of care, behavioral health safety net services, and care coordination provider standards created by the BHA pursuant to part 3 of this article 50. (3) The department of health care policy and financing shall require that all behavioral health providers enter into a contract developed pursuant to section 27-50-203 when contracting for community-based behavioral health services in the state. (4) The BHA shall collaborate with the department of health care policy and financing to support the early and periodic screening, diagnostic, and treatment benefit access and provider network.

C.R.S. § 27-50-602 Division of insurance behavioral health network standards

27-50-602. Division of insurance behavioral health network standards. The commissioner of the division of insurance in the department of regulatory agencies, while assessing and standardizing provider networks in this state pursuant to section 10-1-108, shall ensure community-based behavioral health networks align with the behavioral health continuum of care, behavioral health safety net services, and care coordination provider standards created by the BHA pursuant to part 3 of this article 50.

C.R.S. § 27-50-603 State agency behavioral health network and program standards

27-50-603. State agency behavioral health network and program standards. (1) All state agencies administering community-based behavioral health programs shall ensure the community-based behavioral health programs align with the behavioral health continuum of care, behavioral health safety net services, and care coordination provider standards created by the BHA pursuant to part 3 of this article 50. (2) All state agencies shall use the universal contracting provisions developed pursuant to section 27-50-203 when contracting for community-based behavioral health services in the state.

C.R.S. § 27-50-701 Behavioral health administration advisory council - creation

27-50-701. Behavioral health administration advisory council - creation. (1) There is created in the behavioral health administration the behavioral health administration advisory council, referred to in this part 7 as the "advisory council", for the purpose of making recommendations to the commissioner and the state board of human services to improve the behavioral health system for children, youth, and adults throughout Colorado. (2) The advisory council shall receive routine briefings from the commissioner on the progress of the BHA and behavioral health reform efforts, including updates related to performance data collected pursuant to section 27-50-201 and related to formal agreements and collaborations with state agencies pursuant to this article 50, and may provide feedback as a method to ensure accountability and transparency. Other advisory council duties include: (a) Providing diverse community input on challenges, gaps, and potential solutions to inform the BHA's vision and strategic plan; (b) Establishing working groups to support the BHA in problem solving and developing solutions; (c) Ensuring there is public accountability and transparency through reviewing the BHA's public-facing transparency activities, including the performance data collected pursuant to section 27-50-201; and (d) Preparing an annual report of recommendations and submitting it to the BHA by September 1 of each year. The report shall be included in the BHA's annual behavioral health system plan pursuant to section 27-50-204 (1).

C.R.S. § 27-50-702 Advisory council - membership

27-50-702. Advisory council - membership. (1) The advisory council membership must be reflective of the demographic and geographic populations of this state to ensure ongoing stakeholder input and involvement. (2) (a) The advisory council consists of not less than fifteen members and not more than twenty members appointed by the commissioner for three-year terms; except that some of the initial terms may be for two years. In addition to maintaining a majority of members who represent individuals with lived behavioral health experience or families of individuals with lived behavioral health experience, the commissioner shall appoint at least one member that represents: (I) Rural communities; (II) Each tribal government within Colorado; (III) County governments; (IV) Persons with disabilities, as defined in section 24-34-301, a family member of a person with a disability, or an advocacy organization for persons with disabilities; (V) The Colorado state judicial branch, in consultation with the state court administrator's office; (VI) Behavioral health safety net providers; (VII) Persons with expertise in the behavioral health needs of children and youth; and (VIII) Persons with expertise in crime victimization, trauma, or adverse childhood experiences as they impact the victim's lifetime. (b) In making appointments to the advisory council, the commissioner shall consider including members that represent the racial and ethnic diversity of the state; that represent the lesbian, gay, bisexual, transgender, or queer or questioning community; that are involved in the criminal or juvenile justice system; and that represent other populations with health disparities.

C.R.S. § 27-50-703 Advisory council - regional subcommittees - subcommittees - working groups

27-50-703. Advisory council - regional subcommittees - subcommittees - working groups. (1) The BHA shall create a regional subcommittee structure as part of the behavioral health administrative service organizations to promote local community input pertaining to behavioral health service needs. In establishing a regional subcommittee structure, the BHA shall, to the best of the BHA's ability, align geographically with judicial districts whenever feasible, taking into consideration community feedback on where and how individuals receive services in their communities. Regional subcommittee members are appointed for three-year terms; except that initial terms may be for two years. The subcommittee consists of nine members. Membership of the regional subcommittees must include: (a) One individual with expertise in the behavioral health needs of children and youth appointed by a local or regional public health or human service agency within the subcommittee's region; (b) One individual who represents a behavioral health safety net provider that operates within the region appointed by a local or regional public health or human service agency within the subcommittee's region; (c) A county commissioner of a county situated within the region appointed by the BHA; (d) One individual with a connection to a kindergarten through twelfth grade school district within the subcommittee's region appointed by a local or regional public health or human service agency within the subcommittee's region; (e) One individual with the criminal justice system within the subcommittee's region appointed by a local or regional public health or human service agency within the subcommittee's region; (f) One individual with lived experience or a community member who is not also a behavioral health provider appointed by a local or regional public health or human service agency within the subcommittee's region; (g) One individual with lived experience appointed by the BHA; and (h) Two individuals with lived experience not associated with a behavioral health treatment provider appointed by the behavioral health administrative service organization created pursuant to part 4 of this article 50 who represent the subcommittee's region. (1.3) The regional subcommittee is created to directly inform the behavioral health administrative service organization in the region in order to improve services, accountability, and transparency in the region. The behavioral health administrative service organization shall staff all subcommittee meetings, which shall meet a minimum of six times a year and allow for public comment during each meeting. The behavioral health administrative service organization shall engage with the regional subcommittee, at a minimum, on the following areas: (a) When determining what services are needed to establish a full continuum of care in the region; (b) When addressing barriers to individuals accessing quality and timely care in the region; and (c) Needed specialty services for priority populations. (1.5) The behavioral health administration advisory council, created pursuant to section 27-50-701, shall establish a process to receive direct feedback from the regional subcommittee throughout the year to consider including in the behavioral health administration advisory council's annual report required pursuant to section 27-50-701 (2)(d). (2) The BHA may create committees within the advisory council to meet other state and federal board or advisory council requirements, which may include: (a) The behavioral health planning and advisory council, authorized pursuant to 42 U.S.C. sec. 300x-3; (b) The mental health advisory board for service standards and rules created pursuant to section 27-65-130; and to section 27-50-701 (2)(d). (2) The BHA may create committees within the advisory council to meet other state and federal board or advisory council requirements, which may include: (a) The behavioral health planning and advisory council, authorized pursuant to 42 U.S.C. sec. 300x-3; (b) The mental health advisory board for service standards and rules created pursuant to section 27-65-130; and (c) The child and youth mental health services standards advisory board created pursuant to section 27-67-109. (3) Unless committee membership is established pursuant to state or federal law, the regional subcommittee and committee membership shall maintain a majority of members who represent individuals with lived behavioral health experience or families of individuals with lived behavioral health experience. (4) The advisory council has the authority to create advisory council workgroups focused on topics of need as determined by the advisory council in collaboration with the BHA.

C.R.S. § 27-50-801 Veteran suicide prevention pilot program - rules - report - definitions - repeal

27-50-801. Veteran suicide prevention pilot program - rules - report - definitions - repeal. (1) As used in this section, unless the context otherwise requires: (a) "Pilot program" means the veteran suicide prevention pilot program described in subsection (2) of this section. (b) "Veteran" has the same meaning set forth in section 28-5-100.3. (2) (a) The behavioral health administration shall establish a veteran suicide prevention pilot program to reduce the suicide rate and suicidal ideation among veterans by providing no-cost, stigma-free, confidential, and effective behavioral health treatment for veterans and their families. (b) The BHA shall establish the pilot program to provide services for seven hundred veterans in El Paso county. Subject to available appropriations, the BHA may, at any time, expand the pilot program to serve more than seven hundred veterans or to other areas of the state. (3) (a) The pilot program must: (I) Provide a single phone number or offer electronic means of contacting the pilot program, including e-mail or an electronic form on the pilot program's website, that a veteran may use to contact the pilot program to make inquiries about available services and schedule consultations and treatment appointments; (II) Provide treatment for conditions experienced by veterans that may contribute to suicidal ideation, including, but not limited to, post-traumatic stress disorder, depression, military sexual trauma, substance use disorder, and symptoms of traumatic brain injury; and (III) Develop an individualized treatment plan for each veteran who is receiving treatment. (b) The pilot program may enter into agreements with treatment providers in the pilot program area to provide the services described in subsections (3)(a)(II) and (3)(a)(III) of this section. (4) The BHA shall adopt rules necessary for the administration of this section. (5) The BHA may enter into an agreement with a nonprofit or educational organization to administer the pilot program. The nonprofit or educational organization must have at least five years' experience providing services described in this section to veterans and satisfy any additional qualifications established by the BHA. The BHA shall adopt rules to establish additional qualifications for a nonprofit or educational organization to ensure efficient and effective administration of the pilot program and a process for selecting a nonprofit or educational organization to administer the pilot program. (6) In its annual report to the committees of reference pursuant to section 2-7-203, the BHA shall include information concerning the pilot program and whether any changes should be made to the pilot program that would increase its effectiveness. In its final report prior to the repeal of this section, the BHA shall include a recommendation of whether the pilot program should be continued. (7) This section is repealed, effective June 30, 2025.

C.R.S. § 27-50-802 Study of health effects of felonizing fentanyl possession - repeal

27-50-802. Study of health effects of felonizing fentanyl possession - repeal. (1) No later than November 1, 2022, the BHA shall contract with an independent nonprofit or educational entity that has expertise in clinical epidemiology, biostatistics, substance use and addiction, data collection and analysis, and, if possible, the intersection between the criminal justice system and substance use, to conduct an independent study of the health effects of criminal penalties pursuant to changes to section 18-18-403.5 (2.5) in House Bill 22-1326, enacted in 2022. At a minimum, the study must address the following: (a) Whether the penalties pursuant to section 18-18-403.5 (2.5): (I) Decreased or increased fentanyl-related overdoses, both fatal and nonfatal, among individuals charged with a felony compared to individuals charged with a misdemeanor pursuant to section 18-18-403.5 (2.5), and compared to individuals with opiate misuse or use disorder not charged with criminal possession of opiates; and (II) Increased or decreased initiation and retention of evidence-based, effective treatment for individuals charged with an opiate use disorder among individuals charged with a felony compared to individuals charged with a misdemeanor pursuant to section 18-18-403.5 (2.5), and compared to individuals with opiate misuse or use disorder who were not charged with criminal possession of opiates; (b) Differential health outcomes for individuals based on the individual's race, gender, ethnicity, age, economic status, pregnancy or postpartum status, or housing status, for individuals charged with a felony pursuant to section 18-18-403.5 (2.5), compared to individuals charged with a misdemeanor pursuant to section 18-18-403.5 (2.5), and compared to individuals with opiate misuse or use disorders who were not charged pursuant to section 18-18-403.5 (2.5). Differential health outcomes to consider include, but are not limited to, fatal and nonfatal overdoses and initiation and retention on medications for opiate use disorder. (c) Whether effective, evidence-based treatment for opiate use disorder in the general population diminished in quality or quantity as a result of individuals ordered by the court into treatment based on charges brought pursuant to section 18-18-403.5 (2.5); and (d) Whether penalties pursuant to section 18-18-403.5 (2.5) impact the likelihood of individuals addicted to fentanyl to seek or receive treatment, provide help to another person in the case of an overdose, or utilize naloxone, non-laboratory synthetic opiate detection tests, and other harm reduction resources. (2) (a) The BHA shall make reasonable efforts to provide necessary data requested by the independent entity to complete the study required pursuant to subsection (1) of this section. The BHA shall establish a data-sharing agreement with, at a minimum, the department of public health and environment, the department of health care policy and financing, the judicial department, the department of corrections, the department of regulatory agencies, and, if feasible, county sheriffs and county coroners, to provide data to the independent entity including, but not limited to: (I) All reasonably available criminal justice data requested by the independent entity; (II) Opiate overdose death records, including toxicology reports, if available; (III) Prescription data for medication for opiate use disorder, including for individuals in jail or prison charged pursuant to section 18-18-403.5 (2.5); (IV) Encounters with emergency medical services providers, law enforcement agencies, or health-care facilities for fatal and nonfatal fentanyl or other opiate-related overdose; and (V) Available information regarding the history of overdose, incarceration, and substance use treatment for individuals charged pursuant to section 18-18-403.5 (2.5), including whether the individual has sought and been denied on-demand treatment. y medical services providers, law enforcement agencies, or health-care facilities for fatal and nonfatal fentanyl or other opiate-related overdose; and (V) Available information regarding the history of overdose, incarceration, and substance use treatment for individuals charged pursuant to section 18-18-403.5 (2.5), including whether the individual has sought and been denied on-demand treatment. (b) The independent entity may perform a qualitative assessment by, at a minimum, conducting focus groups or interviews with a representative sample of individuals who use drugs and substance use disorder care providers and harm reduction providers across the state and continuum. (c) No later than December 31, 2024, the independent entity shall submit a comprehensive report of the entity's findings to the BHA. (d) No later than January 31, 2025, the BHA shall publish the report on the BHA's website and submit the report to the house of representatives judiciary committee, the house of representatives public and behavioral health and human services committee, the senate health and human services committee, and the senate judiciary committee, or their successor committees, as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" presentation required pursuant to section 2-7-203. (3) The costs associated with performing the study pursuant to this section must be paid from the correctional treatment cash fund created in section 18-19-103 (4). (4) This section is repealed, effective July 1, 2025.

C.R.S. § 27-50-803 Technical assistance to jails - appropriation

27-50-803. Technical assistance to jails - appropriation. (1) The behavioral health administration shall provide technical assistance to facilities in meeting their requirements pursuant to section 17-26-104.9 (1.5). Technical assistance includes development and implementation of medication-assisted treatment, development of guidelines for nonmedical evaluations, including timelines for performing a subsequent medical evaluation and administering medical withdrawal management, approval of prescribers by the United States drug enforcement agency, and other appropriate withdrawal management care, and assistance with identifying bulk purchasing opportunities for necessary services. (2) Repealed.

C.R.S. § 27-50-804 School-based mental health support program - creation - appropriation - definitions - repeal

27-50-804. School-based mental health support program - creation - appropriation - definitions - repeal. (1) As used in this section, unless the context otherwise requires: (a) "Cognitive behavioral skill-building" means a theoretical framework underlying a set of skills that may be taught to help an individual improve emotional difficulties ranging from mild worry or disappointment to severe depression, anxiety, or other mental illnesses. (b) "Evidence-based" means practices, interventions, or programs that are supported by extensive empirical data, including randomized controlled trials, supporting their efficacy for their intended purpose. (c) "High-quality training" means in-person or virtual training that includes content on theory, rationale, and concrete skills; leverages demonstrations and skills practice with feedback; is grounded in the field of implementation science; and takes into account the clinical and environmental barriers to implementation. (d) "Implementation and sustainment support" means providing in-person or virtual coaching to assist public schools in planning, executing, reflecting, and building systems to embed program practices in school operations, preferably in partnership with community-based or hospital-based licensed mental health providers. (e) "Mindfulness" means a framework and set of practices for helping an individual improve awareness of the individual's own thoughts, emotions, physical feelings, and behaviors to increase the individual's resiliency in response to common life events. (f) "Multi-tiered systems of support" means a framework for enhancing the implementation of evidence-based practices to achieve positive outcomes for every student by organizing the efforts of educators within systems to be more effective. (g) "Program" means the school-based mental health support program created in subsection (2) of this section. (2) There is created in the behavioral health administration the school-based mental health support program to provide high-quality training, resources, and implementation and sustainment support for the existing public school educator workforce to provide evidence-based mental health services for students through a contract with an external provider. The program shall emphasize supporting schools in rural areas and schools with students who do not have equitable access to mental health care. (3) (a) No later than January 1, 2025, the BHA shall contract with an external provider to begin implementing the program no later than the start of the 2025-26 school year. (b) In contracting with an external provider, the BHA shall: (I) Establish a timeline that the external provider shall follow in implementing the program; (II) Establish a plan to evaluate the efficacy of the program across school types and student populations; (III) Determine, in consultation with the external provider, periodic dates on which to provide funding to the external provider in order for the external provider to make necessary purchases and investments to implement the program; and (IV) Collaborate with the external provider to determine the cost of implementing the program in at least four hundred public schools by the start of the 2027-28 school year. (4) (a) An interested external provider must apply for the contract in the manner prescribed by the BHA. (b) The BHA shall select an external provider that: (I) Does not have licensing agreements that prohibit the use of curricula or resources that a school district already uses or intends to use in the future; and (II) Has been subject to external, third-party evaluations that indicate its efficacy among several different school types and with several different student subpopulations. by the BHA. (b) The BHA shall select an external provider that: (I) Does not have licensing agreements that prohibit the use of curricula or resources that a school district already uses or intends to use in the future; and (II) Has been subject to external, third-party evaluations that indicate its efficacy among several different school types and with several different student subpopulations. (c) When selecting an external provider, the BHA shall consider whether an applicant is able to: (I) Provide high-quality training, resources, and implementation and sustainment support across all three tiers of the multi-tiered systems of support, which include: (A) Classroom-based mental wellness and resiliency skills for students; (B) Cognitive behavioral skill-building and mindfulness skill-building for anxiety or depression for youth who demonstrate an additional need for mental health support; and (C) Resources and training to manage suicide risk and coordinate care among families, schools, and external providers for youth who are at risk of suicide; and (II) In consideration of local control, flexibly partner with school districts to enable school districts to decide which tiers from among the mental health multi-tiered systems of support to implement; and (III) Use evidence-based mental health practices that have been subject to external evaluation, randomized controlled trials, and peer review. (5) In selecting the external provider, the BHA shall prioritize applicants that: (a) Are not-for-profit entities; (b) Incur one-time costs and do not require recurring or additional expenses paid for by the BHA beyond the first year of implementation; (c) Have a demonstrated history of partnerships, and a clear strategy for building future partnerships, with community or hospital-based providers to assist public schools in implementing mental health supports for students; and (d) Have a demonstrated history of funding internal and external evaluations of the efficacy of the external provider's program in partnership with institutions of higher education or organizations that have similar skills in conducting randomized controlled trials and other quantitative and qualitative evaluation techniques. (6) (a) For the 2024-25 state fiscal year, the general assembly shall appropriate two million five hundred thousand dollars from the general fund to the department of human services for use by the BHA to administer the program. (b) The BHA may use up to one hundred thousand dollars of the total appropriation to administer the application and selection process described in subsections (4) and (5) of this section. (7) This section is repealed, effective July 1, 2028.

C.R.S. § 27-50-805 Contingency management grant program - creation - definitions - repeal

27-50-805. Contingency management grant program - creation - definitions - repeal. (1) As used in this section, unless the context otherwise requires: (a) "Contingency management program" means an evidence-based treatment program that provides motivational incentives to treat individuals with a stimulant use disorder. (b) "Grant program" means the contingency management grant program created in subsection (2) of this section. (c) "Stimulant use disorder" means a substance use disorder, as defined in section 27-80-203 (23.3), involving a class of drugs that includes cocaine, methamphetamine, or prescription stimulants. (d) "Substance use disorder treatment program" has the same meaning as set forth in section 27-80-203 (23.5). (2) There is created in the behavioral health administration the contingency management grant program to provide grants to substance use disorder treatment programs that implement a contingency management program for individuals with a stimulant use disorder. (3) (a) Grant recipients may use the money received through the grant program for staffing, training, supplies, administrative costs, the costs of vouchers and prizes up to five hundred ninety-nine dollars per client during the treatment period, and other related expenses as approved by the BHA. (b) Any money received through the grant program must supplement and not supplant existing substance use disorder treatment and other health-care services. Grant recipients shall not use money received through the grant program for ongoing or existing executive and senior staff salaries or services already covered by medicaid or a client's insurance. (4) The BHA shall administer the grant program and, subject to available appropriations, shall award grants as provided in this section. (5) In selecting grant recipients, the BHA shall prioritize applicants that reside in a jurisdiction with demonstrated need to help mitigate overdose incidents and overdose deaths. (6) The BHA may contract with a grant application and support team to assist the BHA with drafting the grant application, reviewing applications, and administering and processing grant awards. (7) This section is repealed, effective July 1, 2027.

C.R.S. § 27-50-901 Short title

27-50-901. Short title. The short title of this part 9 is the "Sixth Through Twelfth Grade Mental Health Screening Act".

C.R.S. § 27-50-902 Definitions

27-50-902. Definitions. As used in this part 9, unless the context otherwise requires: (1) "Mental health screening" means a brief, structured questionnaire completed by a participating student that is used for early identification of a mental health concern, which concern may be either validated or refuted upon review by a subject matter expert. (2) "Parent" means a child's biological parent, adoptive parent, legal guardian, or custodian. (3) "Participating school" means a public school that meets the requirements stated in section 27-50-903 (2) and participates in the sixth through twelfth grade mental health screening program created in this part 9. (4) "Program" means the sixth through twelfth grade mental health screening program created in this part 9. (5) "Public school" means a public school of a school district in this state or an institute charter school. (6) "Screener" means the entity selected by the BHA pursuant to this part 9 to conduct the mental health screening.

C.R.S. § 27-50-903 Sixth through twelfth grade mental health screening program - created - rules

27-50-903. Sixth through twelfth grade mental health screening program - created - rules. (1) There is created in the BHA the sixth through twelfth grade mental health screening program to identify potential risks related to unmet mental or emotional health needs of students in grades six through twelve and to provide a student who has a mental or emotional health concern with resources and referrals to address the student's mental or emotional health concerns. (2) The BHA shall consult with the Colorado department of public health and environment, the Colorado department of human services, and the Colorado department of education to make recommendations for the purposes of identifying priority counties and districts for the implementation of the program. A public school recommended for the program must be a public school that serves any of grades six through twelve. (3) To participate in the program, a public school must notify the BHA, in the manner prescribed by the BHA, before May 1 in the year before the school year that the public school wants to begin participation. (4) A participating school shall provide written notice to a student's parent within the first two weeks of the school year that a mental health screening will be conducted at the school. The written notice must include: (a) The purpose for the screening; (b) The screener selected to conduct the mental health screening; (c) The date and time the mental health screening is scheduled; (d) A statement that the parent will be notified following any mental health screening if additional resources or service referrals are necessary to address the student's mental health concern; (e) A statement notifying the parent that the parent has the right to opt the parent's child out of participation in the mental health screening and that provides information on how to opt out and the time frame for opting out, which must be a time frame of at least fourteen days; and (f) Any other information determined necessary by the BHA or participating school. (5) A parent or guardian has the authority to opt out of their child's participation in the mental health screening in the manner prescribed by the participating school. (6) A mental health screening must: (a) Be conducted at the participating school in the manner prescribed by the BHA; (b) Be conducted by a screener that meets the requirements of subsection (8) of this section; (c) Utilize an evidence-based screening tool to conduct the mental health screening; (d) Be made available in a student's native language; and (e) Be reproducible in a digital format and in any other format necessary to be accessible to all students. (6.5) Each participating public school shall publish on its website the mental health screening questionnaire form or other document provided to students, the parental consent form, policies and procedures related to performing the mental health screening, and any other materials related to the mental health screening performed pursuant to this part 9. This subsection (6.5) does not require the publication of completed mental health screenings. (7) Prior to conducting a mental health screening, the screener must inform the student of the circumstances in which confidentiality will not be maintained. (8) The BHA shall select a screener to conduct the mental health screenings through a request for proposals process established by the BHA. At a minimum, the screener shall: (a) Not provide direct mental health services; (b) Have the infrastructure and ability to operate statewide; (c) Have the ability to collect and report data from the mental health screening; (d) Have experience delivering and managing a statewide mental health screening program with reliable and consistent performance; (e) Be trauma-informed; and by the BHA. At a minimum, the screener shall: (a) Not provide direct mental health services; (b) Have the infrastructure and ability to operate statewide; (c) Have the ability to collect and report data from the mental health screening; (d) Have experience delivering and managing a statewide mental health screening program with reliable and consistent performance; (e) Be trauma-informed; and (f) Comply with any other requirements the BHA determines necessary. (9) After a mental health screening is conducted, the screener shall review all results and determine which students need additional mental health services within twenty-four hours after a student completes the mental health screening. (10) (a) If, after reviewing the mental health screening results, the screener believes a student is at risk of attempting suicide, physical self-harm, harming others, or is in need of immediate attention from a mental health professional, the screener shall immediately notify the student's parents and school. After receiving such notification, the school shall follow the school's crisis response policy and must immediately notify the school district's section 504 coordinator and special education director. This information must not be used to prevent a student from continuing to attend school; except that a school shall adhere to section 504 and disciplinary protections pursuant to the federal "Individuals with Disabilities Education Act", 20 U.S.C. sec. 1400, as amended. (b) If, after reviewing the mental health screening results, the screener believes a student has a mental health concern, including, but not limited to, those stated in subsection (10)(a) of this section, and is in need of additional mental health services, the screener shall notify the student's parent within forty-eight hours after the student completes the mental health screening and provide the student and the student's parent with information on behavioral health resources and services and information about the rights of students with disabilities pursuant to section 504 of the federal "Rehabilitation Act of 1973", 29 U.S.C. sec. 794, as amended; and the federal "Individuals with Disabilities Education Act", 20 U.S.C. sec. 1400, as amended. (11) If at any time during the mental health screening the screener believes that a student is a victim of child abuse or neglect or that the child's home situation presents an immediate serious threat of harm to the child, the screener shall report the known or suspected child abuse or neglect to the county department of human or social services or a local law enforcement agency. (12) Individually identifiable information collected for or by the screener is subject to the federal "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended. The screener is the custodian of all records associated with mental health screenings. The screener may not disclose records or information without written consent from the student, if the student is over eighteen years of age, or the student's parent. All parties subject to the requirements of this section shall comply with all applicable requirements of the federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec. 12101, et seq., as amended; section 504 of the federal "Rehabilitation Act of 1973", 29 U.S.C. sec. 794, as amended; and Title VI of the federal "Civil Rights Act of 1964", as amended. (13) The commissioner shall promulgate rules pursuant to article 4 of title 24 as necessary to implement and administer the mental health screening created by this section. (14) Within six months after conducting a mental health screening at a school, the screener shall make de-identified data concerning the results of the mental health screening available to the school in accordance with the federal "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended. implement and administer the mental health screening created by this section. (14) Within six months after conducting a mental health screening at a school, the screener shall make de-identified data concerning the results of the mental health screening available to the school in accordance with the federal "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended. (15) A student who is home-schooled but who participates in extracurricular activities or athletic programs at a participating school is exempt from the mental health screening pursuant to this part 9. Nothing in this subsection (15) exempts a student who is home-schooled from any other rights provided by law. (16) The BHA shall work with the department of health care policy and financing to identify a process for reimbursement for screenings or related services provided to any student covered by the state medical assistance program, to the greatest extent allowable pursuant to state and federal requirements.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-27.docxFetched: 10/6/2026

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