Children and Youth Mental Health Treatment Act

C.R.S. tit. 27, art. 67
in effect

C.R.S. § 27-67-101 Short title

27-67-101. Short title. The short title of this article 67 is the "Children and Youth Mental Health Treatment Act".

C.R.S. § 27-67-102 Legislative declaration

27-67-102. Legislative declaration. (1) The general assembly finds that many parents in Colorado experience challenging circumstances because their children have significant mental health needs. Many times, the parents are loving, caring parents who have become increasingly frustrated in their attempts to navigate the various governmental systems, including child welfare, mental health, law enforcement, juvenile justice, education, and youth services, in an attempt to find help for their children. Frequently in these situations, an action in dependency or neglect under article 3 of title 19 is neither appropriate nor warranted. (2) The general assembly finds that it is desirable to assist children and youth with mental health needs and their families. The general assembly further finds that it is desirable to make mental health services more available to families who want treatment for their children. The general assembly finds that it is in the best interest of the state to provide a full range of mental health treatment services, including residential care, to children and youth who are not eligible for medicaid. The general assembly further finds that, although the mental health agencies are responsible for providing or coordinating the full range of mental health treatment services, including residential care, for those children and youth who have been found to be categorically eligible for medicaid, there remains a population of children and youth in need of mental health services who are not categorically eligible for medicaid. Accordingly, the general assembly determines that it is appropriate to adopt a program pursuant to which a continuum of services would be provided to these children and youth. (3) The general assembly therefore finds that children and youth who are categorically eligible for medicaid and who may be eligible for mental health treatment services, including residential care, may need support in identifying clear appeals processes.

C.R.S. § 27-67-103 Definitions

27-67-103. Definitions. As used in this article 67, unless the context otherwise requires: (1) "Behavioral health administration" or "BHA" means the behavioral health administration established in section 27-50-102. (1.3) "Behavioral health safety net provider" has the same meaning as defined in section 27-50-101. (1.5) "Care management" includes, but is not limited to, consideration of the continuity of care and array of services necessary for appropriately treating a child or youth and the decision-making authority regarding the child's or youth's placement in and discharge from behavioral health services. (2) "Child or youth at risk of out-of-home placement" means a child or youth who, although not otherwise categorically eligible for medicaid, meets the following criteria: (a) The child or youth has been diagnosed as having a mental health disorder, as defined in section 27-65-102; (b) The child or youth requires a level of care that is provided in a residential child care facility pursuant to section 25.5-6-903, or that is provided through community-based programs, and who, without such care, is at risk of unwarranted child welfare involvement or other system involvement, as described in section 27-67-102, in order to receive funding for treatment; (c) If the child or youth is determined to be in need of placement in a residential child care facility, he or she shall apply for supplemental security income, but any determination for supplemental security income must not be a criterion for a child or youth to receive services pursuant to this article 67; (d) The child or youth is a person for whom there is no pending or current action in dependency or neglect pursuant to article 3 of title 19; and (e) The child or youth is younger than eighteen years of age, but he or she may continue to remain eligible for services until his or her twenty-first birthday. (2.5) "Commissioner" means the commissioner of the behavioral health administration. (3) "Community-based care" means any intervention that is designed to be an alternative to residential or hospital level of care in which the child or youth resides within a noninstitutional setting. (4) Repealed. (5) "County department" means the county or district department of human or social services. (6) "Family advocate" has the same meaning as provided in section 27-69-102 (5). (7) "Family systems navigator" has the same meaning as provided in section 27-69-102 (5.5). (8) "First-level appeal" means the initial process a medicaid member is required to enact to contest a benefit, service, or eligibility decision made by medicaid or a medicaid managed care entity. (9) "Medicaid child or youth who is at risk of out-of-home placement" means a child or youth who is categorically eligible for medicaid but who otherwise meets the definition of a child or youth who is at risk of out-of-home placement as defined in subsection (2) of this section. (10) "Mental health agency" means a behavioral health services contractor through the behavioral health administration serving children and youth statewide or in a particular geographic area and with the ability to meet all expectations of this article 67. (11) "Professional person" means a person licensed to practice medicine in this state, a psychologist certified to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist certified to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in this state that is operated by the armed forces of the United States, the United States public health service, or the United States department of veterans affairs. (12) Repealed.

C.R.S. § 27-67-104 Provision of mental health treatment services for children and youth

27-67-104. Provision of mental health treatment services for children and youth. (1) (a) A parent or guardian may apply to a mental health agency on behalf of a child or youth for mental health treatment services for the child or youth pursuant to this section, if the parent or guardian believes the child or youth is at risk of out-of-home placement. The parent's or guardian's request for services described in this section may be done with assistance from a family advocate, family systems navigator, nonprofit advocacy organization, or county department; however, the BHA is not obligated to pay for any services provided by entities with which they do not contract. In such circumstances, the mental health agency is responsible for evaluating the child or youth and clinically assessing the child's or youth's need for mental health services and, when warranted, to provide treatment services as necessary and in the best interests of the child or youth and the child's or youth's family. When evaluating a child or youth for eligibility, the mental health agency shall use a standardized risk stratification tool, in a manner determined by rule of the state board of human services. Following the evaluation of the child or youth, the mental health agency shall provide a written notification to the child's or youth's parent or guardian that includes a comprehensive list of potential treatment providers, with a disclosure that the child's or youth's family may choose to seek services from the provider of their choice, including but not limited to the mental health agency. The written notification must also inform the child's or youth's family that they may request assistance from a family advocate, family systems navigator, nonprofit advocacy organization, or county department; however, the BHA is not obligated to pay for any services provided by entities with which they do not contract. The BHA shall maintain a list of available providers on a public website and shall update the website quarterly. The mental health agency is responsible for the provision of the treatment services and care management, including any residential treatment, community-based care, or any post-residential follow-up services that may be appropriate for the child's or youth's needs or the child's or youth's family's needs. A dependency or neglect action pursuant to article 3 of title 19 is not required in order to allow a family access to residential mental health treatment services for a child or youth. (b) At the time of the assessment by the mental health agency, if requested services are denied, or at the time when the mental health agency has recommended that the child or youth be discharged from services, the mental health agency shall advise the family, both orally and in writing, of the appeal process available to them. The mental health agency shall have two working days within which to complete any internal appeal process. Within five working days after the mental health agency's final denial or recommendation for discharge, a parent or guardian may request an objective third party at the BHA who is a professional person to review the action of the mental health agency. A family advocate, family systems navigator, nonprofit advocacy organization, or county department may assist a family in filing an appeal; however, the BHA is not obligated to pay for any services provided by entities with which they do not contract. The review must occur within three working days of the parent's or guardian's request. The professional person shall determine if the requested services are appropriate. mily systems navigator, nonprofit advocacy organization, or county department may assist a family in filing an appeal; however, the BHA is not obligated to pay for any services provided by entities with which they do not contract. The review must occur within three working days of the parent's or guardian's request. The professional person shall determine if the requested services are appropriate. (1.5) (a) The parent or guardian of a medicaid child or youth who is at risk of out-of-home placement may request, within five days after all first-level medicaid appeals processes are exhausted, an objective third party at the BHA who is a professional person to review the service request made to medicaid. A family advocate, family system navigator, or county department may assist a family in filing an appeal. The review must occur within three working days of the parent's or guardian's request. (b) The administrative law judge considering the medicaid appeal for the medicaid child or youth who is at risk of out-of-home placement shall take into consideration the objective third-party review by the BHA as part of the administrative law judge's reconsideration and decision of the medicaid service request. (2) If at any time the mental health agency determines pursuant to section 19-3-304 that there is reasonable cause to know or suspect that a child or youth has been subjected to abuse or neglect, then the mental health agency shall immediately make a referral to the statewide child abuse hotline established in section 26-5-111 or the appropriate county department. Within ten working days after the referral, if assigned for an assessment by the county department, a representative of the mental health agency shall meet with the county department and the family. Upon referral to the county department, if assigned for an assessment, the county department shall proceed with the assessment to determine whether there is a sufficient basis to believe that physical or sexual abuse or neglect or some other form of abuse or neglect of a child's or youth's physical well-being has occurred.

C.R.S. § 27-67-105 Monitoring - reports

27-67-105. Monitoring - reports. (1) On or before September 1, 2018, and by September 1 of each year thereafter, each mental health agency shall report to the BHA the following information: (a) The number of children and youth who are at risk of out-of-home placement and whose parent or legal guardian requested residential or community-based care pursuant to section 27-67-104 to whom the following services were provided: (I) An assessment pursuant to section 27-67-104 (1)(a); (II) Community-based care; (III) Residential treatment; or (IV) Post-residential follow-up services; (b) The number of children and youth who are at risk of out-of-home placement and for whom a child abuse and neglect referral was made to the county department; (c) The number of children and youth for whom either: (I) An assessment was requested but not performed, and the reasons that the assessment was not performed; or (II) An assessment was performed but the mental health agency did not provide services pursuant to this article 67, and the reasons that services were not provided, including whether the family refused the services offered; (d) The costs associated with the provision of the mental health treatment services described in subsection (1)(a) of this section; (e) The demographic information of the children, youth, and families served, as outlined by the BHA; (f) The outcomes of treatment for the children and youth served, as determined by the BHA in consultation with mental health agencies, service providers, and families; (g) The length of stay and funding totals for residential services and community-based care; and (h) The aggregate number of third-party reviews completed by the BHA for children served pursuant to this article 67, delineated by children who are and are not categorically eligible for medicaid. (2) On or after January 1, 2019, the BHA shall make the information obtained pursuant to subsection (1) of this section available to the public by posting it to the BHA's website. Any information so posted must not include any personal health information.

C.R.S. § 27-67-106 Funding - rules

27-67-106. Funding - rules. (1) In order to make mental health treatment available, it is the intent of the general assembly that mental health treatment provided pursuant to this article to each child described in section 27-67-103 (2) be provided by mental health agencies. (2) (a) If neither the family's private insurance nor federal medicaid funding cover all of the costs associated with the services provided to a child at risk of out-of-home placement pursuant to this article, then the family is responsible for paying that portion that is not covered by private insurance or federal medicaid funding on a sliding scale basis as set forth in subsection (3) of this section. Any remaining portion of the services not covered by private insurance, federal medicaid funding, or the family's share, shall be paid for from any moneys appropriated by the general assembly for that purpose. (b) Repealed. (3) The state board of human services shall promulgate rules implementing a sliding scale for the payment of services, including mental health treatment and room and board, that are not covered by private insurance or federal medicaid funding. It is the intent of the general assembly that subsidies provided by the state through general fund money must be used to assist the lowest income families to ensure the maximum use of appropriate least restrictive treatment services and to provide access to the greatest number of children and youth.

C.R.S. § 27-67-107 Dispute resolution - rules

27-67-107. Dispute resolution - rules. (1) The BHA shall utilize, when appropriate, established grievance and dispute resolution processes in order to assure that parents have access to mental health services on behalf of their children. (2) The state board of human services shall promulgate rules to assure that a grievance process is available to parents concerning the provision of mental health services and to assure that a dispute resolution process is available for disputes between the county departments and mental health agencies.

C.R.S. § 27-67-109 Child and youth mental health services standards - advisory board

27-67-109. Child and youth mental health services standards - advisory board. (1) The advisory board established in subsection (2) of this section is responsible for recommending standards and rules relevant to the provision of mental health services to children and youth covered by this article 67. (2) An advisory board to the BHA is established for the purpose of assisting and advising the commissioner in accordance with this section in the development of service standards and rules. The advisory board consists of not less than eleven nor more than fifteen members appointed by the BHA as follows: (a) One representative each from the BHA; the office of children, youth, and families; the department of health care policy and financing; and a leading professional association of psychiatrists in this state; (b) One member representing nonprofit health-care facilities; (c) One member representing children or youth consumers of services for persons with mental health disorders; (d) One member representing families of persons with mental health disorders; (e) One member representing children's health-care facilities; (f) One member representing a behavioral health safety net provider that performs evaluations pursuant to this article 67; (g) One member representing a county human or social services agency; (h) One member representing individuals with intellectual and developmental disabilities; and (i) Other persons from both the private and the public sectors who are recognized or known to be interested and informed in the area of the advisory board's purpose and function. (3) In making appointments to the advisory board, the BHA must include representation by at least one member who is a person with a disability, a family member of a person with a disability, or a member of an advocacy group for persons with disabilities, provided that the other requirements of subsection (2) of this section are met.
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