| Summary |
Colorado's Child Welfare System Interim Study Committee.
The bill requires the behavioral health administration (BHA), in
partnership with the office of children, youth, and families in the
department of human services; the department of health care policy and
financing; the division of insurance in the department of regulatory
agencies; and the department of public health and environment, to
develop, establish, and maintain a comprehensive children's behavioral
health statewide system of care (system of care). The system of care will
serve as the single point of access to address the behavioral health needs
of children and youth in Colorado, regardless of payer, insurance, and
income.
The system of care shall serve children and youth up to twenty-one
years of age who have mental health disorders, substance use disorders,
co-occurring behavioral health disorders, or intellectual and
developmental disabilities.
The system of care must include, at a minimum, a statewide
behavioral health standardized screening and assessment,
trauma-informed mobile crisis response and stabilization services for
children and youth, tiered care coordination for moderate and intensive
levels of need, parent and youth peer support, intensive in-home and
community-based services, and respite services.
The bill establishes the office of the children's behavioral health
statewide system of care (office) in the BHA. The office is the primary
governance entity and is responsible for convening all relevant state
agencies involved in the system of care, including, but not limited to, the
department of human services office of children, youth, and families, the
division of child welfare, and the division of youth services; the
department of health care policy and financing; the division of insurance
in the department of regulatory agencies; and the department of public
health and environment. The office will be directed by the deputy
commissioner of the office.
The bill requires the office to create and convene, on or before
November 1, 2024, a leadership team responsible for decision-making
and oversight. The leadership team is required to provide a report to the
house of representatives public and behavioral health and human services
committee and the senate health and human services committee, or their
successor committees, on or before July 1, 2027.
The office is required to create and convene, on or before January
15, 2025, an implementation team that shall create an implementation
plan for the system of care. The implementation plan must receive an
annual minimum appropriation of $10 million and include the creation of
a capacity-building center, which shall develop, implement, and fund,
within available appropriations, the following:
•
A student loan forgiveness program for students in
behavioral health disciplines who make a 3- to 5-year
commitment to work in shortage areas in the system of
care;
•
Paid internships and clinical rotations in the system of care
and a description of multiple options for payment;
•
Revisions to graduate medical education programs at
Colorado institutions of higher education to support
internships, residencies, fellowships, and student programs
in child and youth behavioral health;
•
A financial aid program for youth transitioning out of
foster care who wish to pursue a career in children and
youth behavioral health, developed in partnership with
Colorado institutions of higher education and community
colleges; and
•
An expansion of current BHA efforts related to behavioral
health apprenticeships, internships, stipends, and
pre-licensure workforce support specific to service
children, youth, and families.
On or before January 15, 2025, the office is required to create an
advisory council, composed of, at a minimum, family and youth
providers, local partners, county departments of human and social
services, county commissioners, juvenile justice agencies, families or
individuals with lived experience using children's or youths' behavioral
health services, consumer advocacy organizations, and university
partners.
The BHA shall develop a state-level process to monitor, report on,
and promptly resolve complaints, grievances, and appeals, including
recipient rights issues. The process must be available to providers, clients,
case management entities, and anyone else working with the children and
youth in the system of care.
The bill requires the leadership team to begin, or contract for, on
or before January 1, 2025, a cost and utilization analysis of the
populations of children and youth who are included in the system of care.
On or before July 1, 2025, the department of health care policy and
financing, in consultation with the office, is required to establish standard
and uniform medical necessity criteria for all system of care services. The
department of health care policy and financing is required to set standard
rate and utilization floors for all system of care services across all
managed care entities.
On or before July 1, 2025, the bill requires the department of
health care policy and financing to establish a standard statewide
medicaid fee schedule or rate frame for behavioral health services for
children and youth and incorporate the fee schedule and rate frame into
the contracts with managed care entities and behavioral health
administrative services organizations. The fee schedule or rate frame must
increase rates and incorporate enhanced rates or quality bonuses for
evidence-based practices and extended weekday and weekend clinic
hours and allow maximum flexibility for use of telehealth to expand
access.
The bill requires that each managed care entity or behavioral
health administrative services organization contract with or have
single-use agreements with every qualified residential treatment facility
or psychiatric residential treatment facility that is licensed in Colorado.
The office, advised by state and county partners, providers, and
racially, ethnically, culturally, and geographically diverse family and
youth representatives, is required to develop and establish a data and
quality team. The data team shall track and report annually on key child
welfare factors.
The bill requires the BHA, advised by the office, to establish or
procure a capacity-building center. The capacity-building center shall, at
a minimum:
•
Train, coach, and certify providers of the array of services
offered through the system of care;
•
Provide training, coaching, and certification related to the
use of behavioral health screening and assessment tools to
support a uniform assessment process and training in
trauma-informed care to staff at relevant state agencies;
•
Work with rural health clinics and federally qualified
health centers to expand their capacity to provide
behavioral health services to children and youth;
•
Offer training and other strategies to expand the number of
behavioral health providers in rural and other underserved
communities; and
•
Utilize data and reports to target its investment to build
capacity in regions identified as lacking capacity.
The bill requires the BHA to develop a website to provide
regularly updated information to families, youth, providers, staff, system
partners, and others regarding the goals, principles, activities, progress,
and timelines for the system of care. The website must include key
performance dashboard indicators; changes in access by the child welfare
population; changes in access disparities between racial, ethnic, and
regional groups; and changes in access to intensive- and moderate-care
coordination with high-fidelity wraparound.
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