Behavioral Health Entities

C.R.S. tit. 25, art. 27.6
in effect

C.R.S. § 25-27.6-101 Legislative declaration

25-27.6-101. Legislative declaration. (1) The general assembly declares that in order to promote the public health and welfare of the people of Colorado, it is in the public interest to establish and streamline minimum standards and rules for behavioral health entities operating in the state of Colorado and to provide the authority for the administration and enforcement of such minimum standards and rules. These standards and rules must be sufficient to ensure the health, safety, and welfare of behavioral health entity consumers. (2) The intent of creating the behavioral health entity license is to: (a) Provide a single, flexible license category under which community-based behavioral health service providers can provide integrated mental health disorder, alcohol use disorder, and substance use disorder services and meet a consumer's continuum of needs, from crisis stabilization to ongoing treatment; (b) Provide a regulatory framework for innovative behavioral health service delivery models to meet the needs of both individuals and communities; (c) Increase parity in the oversight and protection of consumers' health, safety, and welfare between physical health and behavioral health regardless of the payment source; and (d) Streamline and consolidate the current regulatory structure to enhance community providers' ability to deliver timely and needed services, while ensuring consumer safety. (3) Further, the general assembly determines and declares that, in administering and enforcing standards for behavioral health entities, the department of public health and environment should focus on behavioral health entity consumer safety and outcomes; reducing regulatory gaps, duplication, and conflicts that hinder access to care; and allowing for new, innovative behavioral health service types with minimal barriers. (4) It is the intent of the general assembly that the behavioral health entity license is implemented so that a facility currently licensed or previously eligible for licensure as an acute treatment unit or as a community mental health center, community mental health clinic, or crisis stabilization unit that was licensed as a community clinic will transition to the behavioral health entity license no later than July 1, 2022.

C.R.S. § 25-27.6-102 Definitions

25-27.6-102. Definitions. As used in this article 27.6, unless the context otherwise requires: (1) "Acute treatment unit" means a facility or a distinct part of a facility for short-term psychiatric care, which may include treatment for substance use disorders, that provides a total, twenty-four-hour, therapeutically planned and professionally staffed environment for persons who do not require inpatient hospitalization but need more intense and individual services than are available on an outpatient basis, such as crisis management and stabilization services. (2) "Alcohol use disorder" means a chronic relapsing brain disease characterized by recurrent use of alcohol causing clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, and home. (3) "Alcohol use disorder program" means a program for diagnosis, treatment, and rehabilitation of a person with an alcohol use disorder. (4) "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, serious psychological distress, suicide, and other mental health disorders, and range from unhealthy stress or subclinical conditions to diagnosable and treatable diseases. The term "behavioral health" is also used to describe service systems that encompass prevention and promotion of emotional health and prevention and treatment services for mental health and substance use disorders. (5) "Behavioral health disorder" means one or more of the following: (a) An alcohol use disorder, as defined in subsection (2) of this section; (b) A mental health disorder, as defined in subsection (12) of this section; or (c) A substance use disorder, as defined in subsection (14) of this section. (6) "Behavioral health entity" means a facility or provider organization engaged in providing community-based health services, which may include behavioral health disorder services, alcohol use disorder services, or substance use disorder services, including crisis stabilization, acute or ongoing treatment, or community mental health center services as described in section 27-66-101 (2) and (3), but does not include: (a) Residential child care facilities, as defined in section 26-6-903; or (b) 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. (7) "Community-based" means outside of a hospital, psychiatric hospital, or nursing home. (8) "Community mental health center" has the same meaning as defined in section 27-66-101 (2). (9) "Community mental health clinic" means a health institution planned, organized, operated, and maintained to provide basic community services for the prevention, diagnosis, and treatment of emotional, behavioral, or mental health disorders, such services being rendered primarily on an outpatient and consultative basis. (10) "Crisis stabilization unit" means a facility that provides short-term, bed-based crisis stabilization services in a twenty-four-hour environment for individuals who cannot be served in a less restrictive environment. (11) "Department" means the Colorado department of public health and environment. (12) "Mental health disorder" means one or more substantial disorders of the cognitive, volitional, or emotional processes that grossly impair judgment or capacity to recognize reality or to control behavior. An intellectual or developmental disability alone is insufficient to either justify or exclude a finding of a mental health disorder. (13) "State board" means the state board of health. nt. (12) "Mental health disorder" means one or more substantial disorders of the cognitive, volitional, or emotional processes that grossly impair judgment or capacity to recognize reality or to control behavior. An intellectual or developmental disability alone is insufficient to either justify or exclude a finding of a mental health disorder. (13) "State board" means the state board of health. (14) "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. (15) "Substance use disorder program" means a program for the detoxification, withdrawal, or maintenance treatment of a person with a substance use disorder.

C.R.S. § 25-27.6-103 Behavioral health entity implementation and advisory committee - creation - membership - duties - repeal

25-27.6-103. Behavioral health entity implementation and advisory committee - creation - membership - duties - repeal. (1) There is established in the department the behavioral health entity implementation and advisory committee, referred to in this section as the "committee". The committee shall: (a) Offer advice to the department and the state board concerning the phased-in implementation of the behavioral health entity license, rules promulgated by the state board pursuant to this article 27.6, and implementation of the behavioral health entity licensing transition; (b) Provide ongoing advice to the department regarding behavioral health entities and behavioral health entity licensing; and (c) Identify a coordinated and aligned process of sharing information across state departments to ensure behavioral health services are available to all residents of Colorado. (2) (a) The committee consists of: (I) The executive directors of the departments of public health and environment, human services, health care policy and financing, and public safety or their designees; and (II) The following members to be appointed by the executive director of the department of public health and environment: (A) One member that represents crisis stabilization units or acute treatment units; (B) One member that represents community mental health centers; (C) One member that represents a mental health provider that is not a community mental health center; (D) One member that represents a provider of substance use disorder treatment and recovery services that is not a community health center; (E) One member that represents a provider of substance use disorder withdrawal management services that is not a community health center; (F) One member that represents a provider of substance use disorder services that meets the definition of behavioral health entity in section 25-27.6-102 (6) but has not been subject to licensure by the department; (G) One member that represents a substance use treatment provider from a rural or frontier county; (H) One member who is a consumer who has experience living with a substance use disorder; (I) One member that represents behavioral health consumers; (J) One member that represents family members of persons with a behavioral health disorder; and (K) One member from an advocacy organization that represents behavioral health consumers. (b) In making the appointments pursuant to subsection (2)(a)(II) of this section, the executive director shall consider the geographic diversity of the state. (3) The executive directors shall agree to serve or make their designations no later than September 1, 2019. The executive director of the department of public health and environment shall make his or her initial appointments by October 1, 2019. In case of a vacancy, an executive director shall agree to serve or make a designation, and the executive director of the department of public health and environment shall make the replacement appointment as soon as practicable. (4) Members of the committee serve on a voluntary basis and serve without compensation; except that members are reimbursed for the actual and reasonable expenses incurred while performing their duties. (5) This section is repealed, effective September 1, 2025. Before the repeal, the committee is scheduled for review in accordance with section 2-3-1203.

C.R.S. § 25-27.6-105 Minimum standards for behavioral health entities - rules

25-27.6-105. Minimum standards for behavioral health entities - rules. (1) On or before April 30, 2021, the state board shall promulgate rules pursuant to section 24-4-103 providing minimum standards for the operation of behavioral health entities within the state. In promulgating the rules, the state board shall establish requirements appropriate to the various types of services provided by behavioral health entities. (2) On or before April 30, 2023, the state board shall promulgate rules that must include the following: (a) Basic 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) Consumer assessment, care coordination, patient rights, and consumer notice requirements; (II) Administrative and operational standards for governance; consumer records and record retention; personnel, admission, and discharge criteria; policies and procedures; and quality management; (III) Physical plant standards, including infection control; and (IV) Occurrence reporting requirements promulgated pursuant to section 25-1-124; (b) Service-specific requirements that apply only to behavioral health entities electing to provide that service, including, at a minimum, standards for the services included in the definitions in section 25-27.6-102 of acute treatment unit, community mental health center, community mental health clinic, crisis stabilization unit, walk-in centers, and alcohol use disorder and substance use disorder services that meet the regulatory requirements for licensing, operations, and partnerships with the state; (c) Mandatory department inspections of behavioral health entities; (d) Behavioral health entity written plans, detailing the measures that will be taken to correct violations found as a result of inspections, submitted to the department for approval; (e) Intermediate enforcement remedies imposed by the department as authorized in section 25-27.6-110 (2)(b); (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 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.

C.R.S. § 25-27.6-106 License - application - inspection - issuance

25-27.6-106. License - application - inspection - issuance. (1) An application for a license to operate a behavioral health entity must be submitted to the department annually upon the form and in the manner as prescribed by the department. (2) (a) (I) The department shall investigate and review each original application and each renewal application for a license to operate a behavioral health entity. The department shall determine an applicant's compliance with this article 27.6 and the rules adopted pursuant to section 25-27.6-105 before the department issues a license. (II) The department shall make inspections of the applicant's facilities as it deems necessary to ensure that the health, safety, and welfare of the behavioral health entity's consumers are being protected. The behavioral health entity shall submit in writing, in a form prescribed by the department, a plan detailing the measures that will be taken to correct any violations found by the department as a result of inspections undertaken pursuant to this subsection (2). (b) The department shall keep all health-care information or documents obtained during an inspection or investigation of a behavioral health entity pursuant to subsection (2)(a) of this section confidential. All records, information, or documents so obtained are exempt from disclosure pursuant to sections 24-72-204 and 25-1-124. (3) (a) With the submission of an application for a license to operate a behavioral health entity, or within ten days after a change in owner or manager of a behavioral health entity, each owner and manager shall submit a complete set of the person'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 bureau the costs associated with the fingerprint-based criminal history record check. Upon completion of the fingerprint-based criminal history record check, the bureau shall forward the results to the department. When the results of a fingerprint-based criminal history record check of a person performed pursuant to this subsection (3) reveal a record of arrest without a disposition, the department shall require that person to submit to a name-based judicial record check, as defined in section 22-2-119.3 (6)(d). (b) The department shall use the information from the record checks performed pursuant to subsection (3)(a) of this section to determine whether the person applying for licensure has been convicted of a felony or misdemeanor that involves conduct that the department determines could pose a risk to the health, safety, or welfare of behavioral health entity consumers. The department shall keep information obtained in accordance with this section confidential. (4) The department 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 department determines could pose a risk to the health, safety, or welfare of the behavioral health entity's consumers. (5) Except as otherwise provided in subsection (6) of this section, the department 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 27.6 and the rules promulgated pursuant to this article 27.6. Except for provisional licenses issued in accordance with subsection (6) of this section, a license issued or renewed pursuant to this section expires one year after the date of issuance or renewal. havioral health entity when it is satisfied that the applicant or licensee is in compliance with the requirements set forth in this article 27.6 and the rules promulgated pursuant to this article 27.6. Except for provisional licenses issued in accordance with subsection (6) of this section, a license issued or renewed pursuant to this section expires one year after the date of issuance or renewal. (6) The department 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 27.6; except that the department 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 consumers of the behavioral health entity. As a condition of obtaining a provisional license, the applicant shall show proof to the department that attempts are being made to conform and comply with the applicable standards required pursuant to this article 27.6. The department shall not grant a provisional license prior to the completion of a background check in accordance with subsection (3) of this section and a determination in accordance with subsection (4) of this section. 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.

C.R.S. § 25-27.6-107 License fees - rules

25-27.6-107. License fees - rules. (1) (a) By April 30, 2021, the state board shall promulgate rules establishing a schedule of fees sufficient to meet the direct and indirect costs of administration and enforcement of this article 27.6. (b) The department shall assess and collect, from behavioral health entities subject to licensure pursuant to section 25-27.6-106, fees in accordance with the fee schedule established by the state board. (2) The department shall transmit fees collected pursuant to this section to the state treasurer, who shall credit the money to the behavioral health entity cash fund created in section 25-27.6-108. (3) Fees collected pursuant to subsection (1) of this section may be used by the department to provide technical assistance and education to behavioral health entities related to compliance with Colorado law, in addition to regulatory and administrative functions. The department may contract with private entities to assist the department in providing technical assistance and education.

C.R.S. § 25-27.6-108 Behavioral health entity cash fund - created

25-27.6-108. Behavioral health entity cash fund - created. (1) The behavioral health entity 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 25-27.6-107. The money in the fund is subject to annual appropriation by the general assembly for the direct and indirect costs of the department in performing its duties pursuant to this article 27.6. At the end of any 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. (2) On December 31, 2024, the state treasurer shall transfer all unexpended and unencumbered money in the fund to the behavioral health licensing cash fund created pursuant to section 27-50-506.

C.R.S. § 25-27.6-109 Employee or contracted service provider criminal history record check - rules

25-27.6-109. Employee or contracted service provider criminal history record check - rules. A behavioral health entity shall require an applicant seeking employment with or seeking to contract to provide services to 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. § 25-27.6-110 License denial, suspension, or revocation

25-27.6-110. License denial, suspension, or revocation. (1) When an application for an initial license pursuant to section 25-27.6-106 has been denied by the department, the department 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 department shall follow the provisions and procedures specified in article 4 of title 24. (2) (a) The department may suspend, revoke, or refuse to renew the license of any behavioral health entity that is out of compliance with the requirements of this article 27.6 or the rules promulgated thereunder. Suspension, revocation, or refusal must be done after a hearing thereon and in compliance with the provisions and procedures specified in article 4 of title 24. (b) (I) The department may impose intermediate restrictions or conditions on a licensee that operates a behavioral health entity that may include one or more of the restrictions or conditions specified in section 25-27-106 (2)(b). (II) If the department assesses a civil fine pursuant to this subsection (2)(b), the department shall transmit the money to the state treasurer, who shall credit the money to the general fund.

C.R.S. § 25-27.6-111 Enforcement

25-27.6-111. Enforcement. The department is responsible for the enforcement of this article 27.6 and the rules adopted pursuant to this article 27.6.

C.R.S. § 25-27.6-112 Repeal of article

25-27.6-112. Repeal of article. This article 27.6 is repealed, effective January 1, 2025.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-25.docxFetched: 10/6/2026