C.R.S. Section 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.

(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;

(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.

Source: Section 27-50-403 — Behavioral health administrative services organizations - contract requirements - individual access - care coordination, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-27.­pdf (accessed Oct. 20, 2023).

27‑50‑101
Definitions 27‑50‑102
Behavioral health administration - creation - coordination - health oversight agency 27‑50‑103
Behavioral health commissioner - appointment - powers, duties, and functions - subdivisions of the BHA 27‑50‑104
Powers and duties of the commissioner - rules 27‑50‑105
Administration of behavioral health programs - state plan - sole mental health authority - gifts, grants, or donations 27‑50‑106
Transfer of functions 27‑50‑107
State board of human services - rules 27‑50‑108
Systemwide behavioral health grievance system 27‑50‑201
Behavioral health system monitoring - capacity - safety net performance 27‑50‑202
Formal agreements - state agencies and tribal governments 27‑50‑203
Universal contracting provisions - requirements 27‑50‑204
Reporting 27‑50‑301
Behavioral health safety net system implementation 27‑50‑302
Requirement to serve priority populations - screening and triage for individuals in need of behavioral health services - referrals 27‑50‑303
Essential behavioral health safety net providers - approval to serve limited priority populations 27‑50‑304
Behavioral health safety net provider network - incentives - preferred status - rules 27‑50‑401
Regional behavioral health administrative services organizations - establishment 27‑50‑402
Behavioral health administrative services organizations - application - designation - denial - revocation 27‑50‑403
Behavioral health administrative services organizations - contract requirements - individual access - care coordination 27‑50‑404
Care coordination - responsibilities of behavioral health administrative services organizations - coordination with managed care entities 27‑50‑405
Behavioral health administrative services organizations - stakeholder input - report - rules 27‑50‑501
Behavioral health entities - license required - criminal and civil penalties 27‑50‑502
Behavioral health entities - minimum standard - rules 27‑50‑503
Licenses - application - inspection - issuance 27‑50‑504
License fees - rules 27‑50‑505
License - denial - suspension - revocation 27‑50‑506
Behavioral health licensing cash fund - creation 27‑50‑507
Employee and contracted service provider - criminal history record check 27‑50‑508
Enforcement 27‑50‑509
Purchase of services by courts, counties, municipalities, school districts, and other political subdivisions 27‑50‑510
Behavioral health entities - consumer information - reporting - release - rules 27‑50‑601
Department of health care policy and financing - behavioral health network standards 27‑50‑602
Division of insurance behavioral health network standards 27‑50‑603
State agency behavioral health network and program standards 27‑50‑701
Behavioral health administration advisory council - creation 27‑50‑702
Advisory council - membership 27‑50‑703
Advisory council - regional subcommittees - subcommittees - working groups 27‑50‑801
Veteran suicide prevention pilot program - rules - report - definitions - repeal 27‑50‑802
Study of health effects of felonizing fentanyl possession - repeal 27‑50‑803
Technical assistance to jails - appropriation - repeal 27‑50‑901
Short title 27‑50‑902
Definitions 27‑50‑903
Sixth through twelfth grade mental health screening program - created - rules
Green check means up to date. Up to date

Current through Fall 2024

§ 27-50-403’s source at colorado​.gov