BEHAVIORAL HEALTH

Colorado’s behavioral health system is broken, which has made it increasingly difficult for people to access vital care. This year, we had a once-in-a-lifetime opportunity to infuse $450 million in federal pandemic relief funds to help transform our behavioral health system so it better meets the needs of folks with mental health conditions and substance use disorders. Colorado Democrats remain committed to increasing access to stigma-free care that will help us continue addressing the behavioral health crisis and save lives.

$450 Million Behavioral Health Transformation Package

School and Pediatric Behavioral Health Care Integrations | SB22-147

Kolker & Sonnenberg / Young & Pelton

Over the last decade, youth suicide has increased an astonishing 51 percent, as youth behavioral health has reached a crisis level. The bill expands behavioral health investments for Colorado youth by $11 million, investing in three programs: (1) $4.6 million to the Colorado Pediatric Psychiatry Consultation and Access Program (CoPPCAP), which supports providers in identifying and treating mild to moderate behavioral health conditions in children; (2) $5 million to the existing behavioral health care professional matching grant program to help schools hire needed behavioral health providers; and (3) $1.5 million to support new and existing school-based health centers. 

Colorado Land-based Tribe Behavioral Health Services Grant Program | SB22-148

Donovan & Simpson / McLachLan & Catlin

Every Coloradan deserves mental health support in their communities and this bill will support the Colorado Native Tribes’ efforts to expand critical behavioral health access in their communities. To further Colorado Tribes’ ability to provide culturally responsive behavioral health care in specialized facilities, this bill provides a one-time $5 million grant to Colorado land-based tribes to support building or renovating a tribal behavioral health facility for inpatient services and transitional housing.

Investments in Statewide Care Coordination Infrastructure | SB22-177

Pettersen & Rankin / Titone & Bradfield

We need to make sure Coloradans can fully utilize already existing behavioral health services so we can more quickly and efficiently connect Coloradans with the care they need. This bill appropriates $12.2 million to improve Colorado’s statewide care coordination infrastructure to better serve Coloradans seeking behavioral health care. The legislation requires the Behavioral Health Administration to better train new and existing behavioral health care navigators on available behavioral health safety net system services and delivery, and on ways to better connect individuals seeking care with the support they need. The bill also seeks to cut red tape associated with provider enrollment and credentialing for navigators and care coordination providers, so they can spend less time on paperwork and more time helping Coloradans in need.

Behavioral Health Care Workforce Development | SB22-181

Bridges & Simpson / Cutter & Van Beber

If we want to achieve our goal of transforming Colorado’s behavioral health system and better meet the needs of patients, then we need a robust workforce to help us do it. This bill directs the Behavioral Health Administration (BHA) to invest $72 million to bolster and stabilize the state’s behavioral health care workforce, which will help more Coloradans access the critical care they need to thrive. The BHA’s workforce plan must include efforts to diversify the behavioral health workforce, expand the peer support professional workforce, reduce the administrative burden on providers, and support the existing workforce. The bill also provides funding to the community college system to build a robust career pathway for the behavioral health field. 

Health Needs Of Persons In Criminal Justice System | SB22-196

Gonzales & Lee / Bacon & Benavidez

Criminalizing people with behavioral health needs is the most expensive and least effective way to provide mental health care services to the folks who need it most. This bill invests $50.7 million in the Early Intervention, Deflection, and Redirection from the Criminal Justice System Grant Program to help communities prevent people with mental health conditions and substance use disorders from becoming involved with the criminal justice system. It can also be used to redirect individuals with behavioral health needs away from the criminal justice system and into appropriate treatment. The bill includes $6.5 million in investments to support the continuity of care and treatment for individuals in the criminal justice system with opioid use disorders and mental health disorders, as well as $4 million to the Judicial Department to support pretrial diversion programs designed to keep individuals with behavioral health conditions out of jail. 

Funding for Community Behavioral Health Continuum of Care Gap Grants | HB22-1281

Winter & Rankin / Gonzales-Gutierrez & Ricks

In an effort to ensure Coloradans across the state—including children, youth and families—have access to the behavioral health care they need, this bill invests $75 million in grants for local governments and nonprofit organizations to implement innovative, community-based programs with the goal of meeting regional gaps and transforming behavioral health outcomes across the state. $40 million will go to children, youth, and family services grants, while $35 million will go to community investment grants. The bill also directs $15 million to the Substance Use Workforce Stability Grant program to support direct care staff. 

Youth and Family Residential Behavioral Health Care | HB22-1283

Buckner & Priola / Michaelsen Jenet & Bradfield

Colorado does not have adequate capacity to serve children and youth with complex behavioral health needs. As a result, too many children are sent out-of-state to access treatment, far away from their families and support network. This bill invests $54 million to support intensive youth and family residential and outpatient care, ensuring that children, youth, and families can access behavioral health treatment and services they need right here in Colorado.

Health-care Practice Transformation | HB22-1302

Jaquez Lewis & Priola / Kennedy & Will 

Navigating Colorado’s behavioral health system can be complex and difficult, leaving far too many folks with limited or no options for help. This bill invests $35 million to improve behavioral health outcomes by better integrating physical and behavioral health care. The bill will provide grants to primary care practices to integrate behavioral health care into their clinical models, helping Coloradans access whole person care and early behavioral health interventions before a crisis. The funding could be used to better streamline and co-locate behavioral and physical health care services in outpatient, pediatric and primary care settings. The bill also requires the Colorado Department of Healthcare Policy & Financing and the Behavioral Health Administration to develop universal contracting provision for behavioral health services to streamline and bring consistency to the state’s behavioral health system. 

Increase Residential Behavioral Health Beds | HB22-1303

Winter & Smallwood / Amabile & Sandridge

Currently, Colorado does not have enough residential treatment beds to treat individuals with serious mental health needs or substance use disorders, including individuals with co-occuring conditions or in need of civil commitment. The bill invests $65 million to expand inpatient and residential treatment options, including the addition of 16 beds at the Colorado Mental Health Institute at Fort Logan and 125 residential treatment beds across the state. These beds will be available for adults with urgent behavioral health needs that require long-term services and supports, and will flexibly serve all populations, including individuals involved in the criminal justice system and those awaiting competency restoration services.

Improving the Behavioral Health System

Interstate Licensed Professional Counselor Compact | SB22-077

Ginal & Woodward / Larson & Young

This bill enacts the Interstate Licensed Professional Counselors Compact which will allow licensed professional counselors in any state that has joined the compact to provide services in each member state under a privilege of practice, including telehealth services in each member state. 

Conflict Of Interest In Public Behavioral Health | SB22-106

Kolker & Sonnenberg / Michaelson Jenet & Rich

In Colorado, access to care has never been more challenging, suicide rates are at an all-time high, and a record number of people with serious mental health conditions are incarcerated due to unmet health needs. This bill is an important part of helping to fix some of these issues by increasing transparency and removing conflicts of interest, thus creating more trust in our payer systems. This bill seeks to address recent concerns around conflicts of interest between intermediaries in the state’s behavioral health system (ASOs, MSOs, RAEs) and the providers who contract with them. By Oct 2022, Colorado’s Department of Healthcare Policy & Financing (HCPF) must require that any intermediary that has 25% or more provider ownership comply with specific requirements. By July 2025, HCPF must address perceived or actual provider ownership or control of these intermediaries.

SB22-156 Medicaid Prior Authorization & Recovery Of Payment | SB22-156

Kolker & Fenberg / Amabile & Young

In order to increase access to vital care, we need to reduce the administrative burden on our providers and help recruit and retain Colorado’s mental health provider workforce, while ensuring clients in need of help receive care without undue interruption. The bill prohibits a prepaid inpatient health plan from requiring prior authorization for outpatient psychotherapy services; and from retroactively recovering provider payments if a recipient was initially determined to be eligible for medical benefits or the prepaid inpatient health plan makes an error processing the claim but the claim is otherwise accurately submitted by the provider. 

Behavioral Health Crisis Response System | HB22-1214

Kolker & Priola / Pelton & Young

We must break down barriers that prevent people experiencing a crisis from getting support, and help make sure every Coloradan can get the lifesaving care they need before it’s too late. This initiative will make it easier for mobile crisis programs and walk-in centers to provide critical services and behavioral health support to all individuals in crisis.The bill requires crisis system facilities and programs to meet minimum standards to provide mental health and substance use disorder services. It clarifies that crisis system facilities and programs must provide behavioral health services to individuals experiencing a substance use disorder crisis and mobile crisis programs and walk-in centers must provide crisis services to any individual (including youth and individuals with a disability). 

Medicaid Mental Health Reimbursement Rates Report | HB22-1268

Ginal & Simpson / Holtorf & Amabile

Community mental health providers serve as a critical backstop in our behavioral health care system. Unfortunately, recent reports in the media have shed light on significant pay discrepancies for providers in CMHCs compared to the private sector. This bill requires Colorado’s Department of Healthcare Policy & Finance (HCPF) to prepare a report about medicaid reimbursement rates for community mental health providers and independent mental health and substance abuse treatment providers. An independent auditor must be hired to prepare the report and present recommendations to the legislature. HCPF must also develop recommendations on creating equitable payment models for these two provider types. 

Behavioral Health Administration | HB22-1278

Lee & Simpson / Pelton & Young

Coloradans deserve easy access to the behavioral health care they need to maintain their health and well-being, but far too many folks are left with limited or no options for help. This bill creates the Behavioral Health Administration (BHA) in the Department of Human Services to streamline the state’s behavioral health system and services. The BHA will take over most of the behavioral health programs handled by the Office of Behavioral Health. The BHA will also establish a statewide behavioral health grievance system, a performance monitoring system, a comprehensive behavioral health safety net system, and regionally-based behavioral health administrative service organizations (BHASOs). The BHA will take over behavioral health licensing and penalties, and will establish minimum standards for behavioral health entities.

License Registration Fee Relief For Mental Health Professionals | HB22-1299

Fields & Kolker / Young

The pandemic has not only exacerbated stress for Coloradans, it has significantly increased the workload for our mental health workers. This legislation will make it easier and cheaper for mental health workers to apply or renew their licenses. The bill transfers $3.7 million to Colorado’s Department of Regulatory Agencies (DORA) to pay for expenses of the state board of psychologist examiners, state board of social work examiners, state board of marriage and family therapist examiners, state board of licensed professional counselor examiners, state board of unlicensed psychotherapists, and the state board of addiction counselor examiners to provide fee relief for mental health professionals regulated by the boards.

Child Residential Treatment & Runaway Youth | HB22-1375

Buckner / Michaelson Jenet

The bill creates a 22-member task force to prevent youth from running away from out-of-home placements. The task force will analyze the root causes of why children run away from out-of-home placement; develop a consistent, prompt, and effective response to recover missing children; and, address the safety and wellbeing of a child upon the child’s return to out-of-home placement.

Increasing Coloradans Access to Behavioral Health Services

Law Enforcement Agency Peace Officer Services | SB22-005

Bridges & Cooke / Roberts & Woog

The mental health crisis in Colorado reaches every community in unique ways. “For members of law enforcement, serving on the frontline of traumatic situations can have devastating effects on their mental health. This bill expands and appropriates $5 million to the Peace Officers Behavioral Health Support and Community Partnerships Grant Program. Law enforcement agencies can use the funds to provide counseling services, training, peer support programs, or a remote network to provide behavioral health services to officers.  

Pretrial Diversion for Persons with Behavioral Health Disorders | SB22-010 

Simpson & Lee / Benavidez & Amabile

A jail cell is no place for someone with a mental health condition or substance use disorder. Diverting folks away from the criminal justice system and into community programs through this bill will help ensure individuals in crisis are met with treatment, not punishment. The legislation expands the existing pretrial diversion program to include diversion programs that are intended to identify eligible individuals with behavioral health disorders and divert such individuals out of the criminal justice system and into community treatment programs.

Dental Hygienists Peer Health Assistance Program | SB22-058 

Simpson / McCormick

This bill establishes a peer health assistance program for dental hygienists through which dental hygienists can access treatment and/or counseling for physical, emotional or psychological problems. A dental hygienist may be referred to the program in lieu of disciplinary action, and must then attend and complete the program. Starting July 1, 2022, each dental hygienist renewing their license must pay a fee of no more than $15.

Behavioral Health Support For Criminal Justice Advocates | SB22-188 

Fields & Coram / Roberts & Titone

This bill creates a public defender and prosecutor behavioral health support program in Colorado’s Department of Local Affairs (DOLA). The bill appropriates $500K for the program, which can be used for counseling, training, and peer support programs. The bill also specifies that a peer support professional in the program cannot be examined as a witness in court about client communications without consent of their client.

Repurpose The Ridge View Campus | SB22-211

Fields & Hinrichsen / A. Valdez

Addressing homelessness is so much more than creating more housing options. It’s about connecting people without stable housing to services, care and housing they need to move forward. This bill repurposes an unused, state-owned facility as the Ridge View Supportive Residential Community which will serve to provide housing, a continuum of behavioral health service treatment, medical care, vocational training, and skill development for Ridge View residents and the general public. Specifically, Ridge View will provide a transitional housing program for individuals experiencing homelessness and voluntarily choosing to focus on recovery; substance use recovery treatment and services informed by the American Society of Addiction Medicine; and a Federally Qualified Health Center to provide residents and the public with access to medical treatments that help facilitate recovery, including medical and dental care and a continuum of behavioral health services. This repurposing is funded by a $45 million transfer from the Economic Recovery & Relief Cash Fund.

County Coroner And Mortuary Mental Health Program | HB22-1221

Fields / Michaelson Jenet

This bill creates the Mortuary Mental Health and Wellness Program. The program provides mental health and wellness services to individuals working in county coroner offices, funeral directors, and mortuary science practitioners where existing health insurance plans do not include such coverage.

Children's Mental Health Programs | HB22-1369

Story & Sonnenberg / Sirota & Pelton

Stress and trauma can have negative effects on young Coloradans, but far too often families have nowhere to turn to care for their kids’ mental health. This bill requires the Department of Early Childhood to contract with a Colorado-based nonprofit entity to provide children's mental health programs, and appropriates $2 million in federal funds. This investment will support early intervention and home-based prevention programs to help families provide the critical behavioral health services their children need to care for their mental health. 

Denver-metro Regional Navigation Campus Grant | HB22-1378

Coleman & Hansen / Jodeh & Sullivan

The homelessness crisis has hit our communities hard, and addressing it requires all hands on deck, which is exactly the approach this legislation takes. This bill will connect folks without stable housing to the services, care and housing they need, and give more Coloradans support they need. This bill tasks the Division of Housing to issue a request for application (RFA) for eligible recipients to build or acquire, and then facilitate, a regional navigation campus to respond to and prevent homelessness. Eligible recipients include local governments in the Denver-Metro area, or a nonprofit organization applying in conjunction with a Denver-Metro local government (includes: Adams, Arapahoe, Douglas, and Jefferson counties; city and counties of Denver & Broomfield; Denver Regional Council of Governments). Applicants must demonstrate how they plan to offer services for behavioral health and substance use disorder treatment, medical care, transitional and permanent supportive housing, emergency shelter, vocational rehabilitation, case management, transportation, life skills training, and other potential capabilities. This RFA is to be funded by a $50 million transfer from the Economic Recovery & Relief Cash Fund.

Miscellaneous

Treatment Behavioral Health Disorders Justice System | SB22-021

Rodriguez & Lee / Benavidez & Amabile

In order to properly address the behavioral health crisis, we need to ensure that we’re not only looking for ways to address mental health needs across Colorado, but also substance use disorder needs. This bill extends and makes changes to the Legislative Oversight Committee Concerning the Treatment of Persons with Mental Health Disorders in the Criminal and Juvenile Justice Systems. Changing the scope of the committee from “persons with mental health disorders” to “people with behavioral health disorders” will help us better address the treatment of Coloradans with behavioral health disorders within the criminal and juvenile justice systems. 

Promoting Crisis Services To Students | HB22-1052

Moreno & Priola / McKean & McLachlan

We need to ensure that our students are aware of the resources available to them if they are experiencing a crisis in case they need immediate help. This bill requires each student identification card to contain the phone number, website address, and text talk number for the 24-hour telephone crisis service center. Schools without student IDs must display outreach materials. This bill will help us expand access to crisis care for youth while reducing the stigma surrounding behavioral health needs in Colorado. 

Behavioral Health Crisis Response Training Deadlines | HB22-1189

Moreno & Rankin / Herod & McCluskie

This Joint Budget Committee (JBC) bill extends training deadlines for behavioral health professionals.  

Mental Health Professionals Technical Changes | HB22-1307

Moreno / D.Valdez & Pico

This Statutory Revision Committee bill makes technical changes to the statutes regulating mental health professionals. 

Protecting Injured Workers' Mental Health Records | HB22-1354 

Winter / Lindsay & Michaelson Jenet

The bill amends the Workers’ Compensation Act of Colorado to limit the disclosure of records related to a claimant’s mental health.

School Security and School Behavioral Health Services Funding | HB22-1243

Kolker & Hinrichsen / Exum & Van Winkle

Too many kids don’t know where to turn when they are in a mental health crisis. This bill puts an additional $2 million in federal funds toward the behavioral health care professional matching grant program and $6 million in federal funds to extend the popular I-Matter program beyond its scheduled repeal in June 2022, paving the way to serve youth with free counseling sessions for another two years. 

Fentanyl Accountability and Prevention | HB22-1326

Pettersen & Cooke / Garnett

We are in the third wave of the opioid epidemic and in the worst overdose crisis in the history of this country. This bill is about saving lives with a comprehensive public health and public safety approach, and complements the work we’re doing to fix Colorado’s broken behavioral health system. The bill increases criminal penalties for individuals distributing, manufacturing, dispensing or selling a substance that contains fentanyl. It also increases criminal penalties for possession of fentanyl, importation of fentanyl, and distribution of fentanyl leading to death. It creates an educational campaign on the dangers of fentanyl, directs funding to an investigative fund for fentanyl-related crimes, and mandates several studies on the impact of the bill. Critically, the bill increases access to treatment by mandating that jails provide medication-assisted treatment (MAT) for individuals with a substance use disorder (and provides $3 million in funding), and directs $10 million for treatment and withdrawal management programs. Lastly, the bill increases harm reduction efforts by allocating close to $20 million in federal funds for the naloxone bulk purchase fund, $600,000 for fentanyl testing strips, and $6 million in federal funds for the Colorado Department of Public Health & Environment harm reduction grant program. 

Competency To Proceed And Restoration To Competency | HB22-1386

Hansen & Gardner / Soper & Amabile

The bill makes modifications to evaluations and proceedings for individuals found incompetent to proceed, including requiring courts to order outpatient (rather than inpatient) restoration services for a defendant whose highest charge is a misdemeanor. It also appropriates $28.6 million in federal funds to contract for additional inpatient beds as well as $800,000 from the Behavioral Health cash fund for a feasibility study related to a potential inpatient bed facility.

Crime Victims Services | SB22-183

Winter & Gardner / Duran & Weissman

During the pandemic Colorado saw an alarming rise in cases of domestic violence. This bill creates a grant program in the Colorado Department of Public Safety to award grants to government agencies and nonprofit organizations that provide services to crime victims, including improving access to services for marginalized communities and victims of color. The bill transfers $35 million of federal funds to the Colorado Crime Victim Services Fund. The bill also creates the Domestic Violence and Sexual Assault Services Fund, and transfers $6 million of federal funds to this program. Funds can be used for advocacy and counseling for domestic violence victims, prevention and education campaigns, among other uses.