Second Regular Session Seventy-third General Assembly STATE OF COLORADO INTRODUCED LLS NO. 22-0805.01 Jane Ritter x4342 HOUSE BILL 22-1283 House Committees Senate Committees Public & Behavioral Health & Human Services A BILL FOR AN ACT C ONCERNING ENHANCED RESIDENTIA L SERVICES FOR PERSONS WITH101 BEHAVIORAL HEALTH NEEDS .102 Bill Summary (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov .) The bill implements the recommendations of the behavioral health transformational task force concerning youth and family residential care. Specifically, the bill: ! Creates in-home and residential respite care in 10-12 regions of the state for children and families; ! Provides operational support for psychiatric residential HOUSE SPONSORSHIP Michaelson Jenet and Bradfield, Amabile, Gonzales-Gutierrez SENATE SPONSORSHIP Buckner and Priola, Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment. Capital letters or bold & italic numbers indicate new material to be added to existing statute. Dashes through the words indicate deletions from existing statute. treatment facilities and qualified residential treatment programs for youth; and ! Provides funds to build and staff a neuro-psych facility at the Colorado mental health institute at Fort Logan. The bill requires the general assembly to appropriate money from the behavioral and mental health cash fund to the department of human services to implement the provisions of the bill. Be it enacted by the General Assembly of the State of Colorado:1 SECTION 1. Legislative declaration. (1) The general assembly2 finds and declares that:3 (a) During the COVID-19 pandemic, children and youth faced4 unprecedented behavioral health challenges;5 (b) During this unprecedented time, children, youth, and their6 families may have lost access to, or needed increased availability of,7 behavioral and mental health care;8 (c) Since the COVID-19 pandemic began, rates of psychological9 distress among youth have increased, including symptoms of anxiety,10 depression, and other behavioral and mental health disorders;11 (d) Additional in-home and residential respite care services and12 facilities for children and families must be created in ten to twelve13 regions of the state to meet the increased need;14 (e) Funding for additional operational support is critical for15 psychiatric residential treatment facilities and qualified residential16 treatment programs for youth across the state;17 (f) It is crucial to begin the process of building and staffing a18 neuro-psych facility with a capacity of up to sixteen beds for youth less19 than twenty-one years of age at the Colorado mental health institute at20 Fort Logan; and21 (g) The federal government enacted the "American Rescue Plan22 HB22-1283-2- Act of 2021" to provide support to state, local, and tribal governments in1 responding to the impact of the COVID-19 pandemic.2 (2) The general assembly further declares that:3 (a) Children, youth, and families have been disproportionately4 impacted by the COVID-19 pandemic and its negative public health5 impacts, especially the behavioral health of children, youth, and families.6 The programs and services funded by the federal money in this act are7 appropriate uses of the money transferred to Colorado under the8 "American Rescue Plan Act". This money will expand access to9 evidence-based treatment for behavioral health services, including10 additional in-home and residential respite care; operational support that11 is critical for psychiatric residential treatment facilities and qualified12 residential treatment programs for youth across the state; and building and13 staffing a neuro-psych facility with a capacity of up to sixteen beds for14 youth less than twenty-one years of age at the Colorado mental health15 institute at Fort Logan; and16 (b) The services described in this act are critical government17 services.18 SECTION 2. In Colorado Revised Statutes, 27-60-103, add (1.5)19 as follows:20 27-60-103. Behavioral health crisis response system - services21 - request for proposals - criteria - reporting - rules - definition -22 repeal. (1.5) (a) B EGINNING JANUARY 1, 2023, THE STATE DEPARTMENT23 SHALL CREATE IN-HOME AND RESIDENTIAL RESPITE CARE SERVICES AND24 FACILITIES FOR CHILDREN AND FAMILIES IN TEN TO TWELVE REGIONS OF25 THE STATE, AS DETERMINED BY THE STATE DEPARTMENT AND A26 COMMITTEE OF INTERESTED STAKEHOLDERS .27 HB22-1283 -3- (b) (I) FOR THE 2022-23 BUDGET YEAR, THE GENERAL ASSEMBLY1 SHALL APPROPRIATE MONEY FROM THE BEHAVIORAL AND MENTAL HEALTH2 CASH FUND PURSUANT TO SECTION 24-75-230 TO THE STATE DEPARTMENT3 TO FUND IN-HOME AND RESIDENTIAL RESPITE CARE ACROSS THE STATE AS4 DESCRIBED IN THIS SUBSECTION (1.5).5 (II) M ONEY SPENT PURSUANT TO THIS SUBSECTION (1.5) MUST6 CONFORM WITH THE ALLOWABLE PURPOSES SET FORTH IN THE FEDERAL7 "A MERICAN RESCUE PLAN ACT OF 2021", PUB.L. 117-2, AS THE ACT MAY8 BE SUBSEQUENTLY AMENDED . THE STATE DEPARTMENT SHALL EITHER9 SPEND OR OBLIGATE SUCH APPROPRIATION PRIOR TO DECEMBER 30, 2024,10 AND EXPEND THE APPROPRIATION ON OR BEFORE DECEMBER 31, 2026.11 (III) T HIS SUBSECTION (1.5)(b) IS REPEALED, EFFECTIVE12 S EPTEMBER 1, 2027.13 (c) (I) F OR THE PURPOSES OF THIS SUBSECTION (1.5), RESPITE CARE14 IS PROVIDED IN A FOSTER CARE HOME, OTHER THAN THE CURRENT FOSTER15 CARE HOME WHERE THE CHILD OR YOUTH IN FOSTER CARE RESIDES .16 R ESPITE CARE IS USED TO ALLOW THE FOSTER PARENT A TEMPORARY17 BREAK FROM PROVIDING CARE. RESPITE CARE IS ALSO USED WHEN A CHILD18 OR YOUTH IN FOSTER CARE NEEDS A TEMPORARY BREAK FROM THE CHILD 'S19 OR YOUTH'S CURRENT FOSTER CARE HOME .20 (II) A NON-EMERGENCY RESPITE CARE OCCASION MAY NOT21 EXCEED THIRTY CALENDAR DAYS , WITH A MAXIMUM OF SIXTY DAYS PER22 CALENDAR YEAR; EXCEPT THAT THE CERTIFYING AGENCY , CASEWORKER,23 AND GUARDIAN AD LITEM MAY APPROVE EXCEPTIONS IN EXCESS OF SIXTY24 DAYS PER YEAR.25 (III) N ON-EMERGENCY RESPITE CARE MAY NOT EXCEED THE26 IDENTIFIED CAPACITY OF THE RESPITE FOSTER CARE HOME .27 HB22-1283 -4- (IV) A SIBLING GROUP MAY BE CONSIDERED A SINGLE PLACEMENT1 FOR RESPITE CARE.2 (V) S PACE REQUIREMENTS FOR RESPITE CARE SPECIFIED BY RULE3 APPLY.4 (VI) E MERGENCY RESPITE CARE THAT CAUSES THE FOSTER CARE5 HOME TO EXCEED THE IDENTIFIED CAPACITY MUST NOT OCCUR FOR MORE6 THAN SEVEN CONSECUTIVE DAYS PER MONTH AND MUST NOT EXCEED7 TWENTY-EIGHT DAYS IN A CALENDAR YEAR . THE RESPITE FOSTER CARE8 HOME MAY NOT EXCEED MORE THAN TWO CHILDREN OR YOUTH IN FOSTER9 CARE ABOVE THE HOME'S IDENTIFIED CAPACITY AND AGE RANGE .10 (VII) T HE RESPITE FOSTER CARE HOME MUST BE IN COMPLIANCE11 WITH ALL OTHER APPLICABLE RULES REGULATING FOSTER CARE HOMES .12 (d) T HE STATE DEPARTMENT AND ANY PERSON THAT RECEIVES13 MONEY FROM THE STATE DEPARTMENT SHALL COMPLY WITH THE14 COMPLIANCE, REPORTING, RECORD-KEEPING, AND PROGRAM EVALUATION15 REQUIREMENTS ESTABLISHED BY THE OFFICE OF STATE PLANNING AND16 BUDGETING AND THE STATE CONTROLLER IN ACCORDANCE WITH SECTION17 24-75-226 (5).18 SECTION 3. In Colorado Revised Statutes, 27-60-113, amend19 (2), (3), (7) introductory portion, and (9) as follows:20 27-60-113. Out-of-home placement for children and youth21 with mental or behavioral needs - report - rules - funding - legislative22 declaration - repeal. (2) (a) On or before August 1, 2021, the state23 department shall develop a program to provide emergency resources to24 licensed providers to help remove barriers such providers face in serving25 children and youth whose behavioral or mental health needs require26 services and treatment in a residential child care facility. Any such27 HB22-1283 -5- licensed provider shall meet the requirements of a qualified residential1 treatment program, as defined in section 26-5.4-102, a psychiatric2 residential treatment facility, as defined in section 26-5.4-103 (19.5), or3 therapeutic foster care, as defined in section 26-6-102 (39).4 (b) (I) B EGINNING JULY 1, 2022, THE STATE DEPARTMENT SHALL5 PROVIDE OPERATIONAL SUPPORT FOR PSYCHIATRIC RESIDENTIAL6 TREATMENT FACILITIES FOR YOUTH AND QUALIFIED RESIDENTIAL7 TREATMENT PROGRAMS FOR YOUTH ACROSS THE STATE .8 (II) F OR THE 2022-23 BUDGET YEAR, THE GENERAL ASSEMBLY9 SHALL APPROPRIATE MONEY FROM THE BEHAVIORAL AND MENTAL HEALTH10 CASH FUND PURSUANT TO SECTION 24-75-230 TO THE STATE DEPARTMENT11 TO FUND OPERATIONAL SUPPORT FOR PSYCHIATRIC RESIDENTIAL12 TREATMENT FACILITIES FOR YOUTH AND QUALIFIED RESIDENTIAL13 TREATMENT PROGRAMS FOR YOUTH ACROSS THE STATE AS DESCRIBED IN14 THIS SUBSECTION (2).15 (III) M ONEY SPENT PURSUANT TO THIS SUBSECTION (2) MUST16 CONFORM WITH THE ALLOWABLE PURPOSES SET FORTH IN THE FEDERAL17 "A MERICAN RESCUE PLAN ACT OF 2021", PUB.L. 117-2, AS THE ACT MAY18 BE SUBSEQUENTLY AMENDED . THE STATE DEPARTMENT SHALL EITHER19 SPEND OR OBLIGATE SUCH APPROPRIATION PRIOR TO DECEMBER 30, 2024,20 AND EXPEND THE APPROPRIATION ON OR BEFORE DECEMBER 31, 2026.21 (IV) T HIS SUBSECTION (2)(b) IS REPEALED, EFFECTIVE SEPTEMBER22 1, 2027.23 (c) T HE STATE DEPARTMENT AND ANY PERSON THAT RECEIVES24 MONEY FROM THE STATE DEPARTMENT SHALL COMPLY WITH THE25 COMPLIANCE, REPORTING, RECORD-KEEPING, AND PROGRAM EVALUATION26 REQUIREMENTS ESTABLISHED BY THE OFFICE OF STATE PLANNING AND27 HB22-1283 -6- BUDGETING AND THE STATE CONTROLLER IN ACCORDANCE WITH SECTION1 24-75-226 (5).2 (3) The state department may promulgate rules concerning the3 placement of a child or youth in the program. The rules may address4 quality assurance monitoring, admissions, discharge planning, appropriate5 length of stay, an appeals process for children and youth who are6 determined ineligible for the program, and compliance with applicable7 federal law, including the federal "Family First Prevention Services Act"8 AND WAIVERS FOR CERTAIN REQUIREMENTS OF SUCH ACT ; except that rules9 concerning the placement of a child or youth who is not in the custody of10 a state or county department of human or social services shall MUST not11 inappropriately apply compliance with such act.12 (7) No later than November 1, 2022, 2023, and 2024 ON OR13 BEFORE NOVEMBER 1, 2023, AND EVERY NOVEMBER 1 THEREAFTER, the14 state department shall submit a written report to the house of15 representatives public and behavioral health and human services16 committee, the senate health and human services committee, or their17 successor committees, and the joint budget committee. At a minimum, the18 report must include:19 (9) This section is repealed, effective July 1, 2025 JULY 1, 2028.20 SECTION 4. In Colorado Revised Statutes, add 27-94-107 as21 follows:22 27-94-107. Youth neuro-psych facility at the center - funding23 - repeal. (1) B EGINNING JULY 1, 2022, THE DEPARTMENT OF HUMAN24 SERVICES SHALL BEGIN THE PROCESS OF BUILDING AND STAFFING A25 NEURO-PSYCH FACILITY AT THE CENTER . THE NEURO-PSYCH FACILITY26 MUST HAVE A CAPACITY OF UP TO SIXTEEN RESIDENTIAL BEDS FOR YOUTH27 HB22-1283 -7- WHO ARE LESS THAN TWENTY -ONE YEARS OF AGE.1 (2) (a) (I) F OR THE 2022-23 BUDGET YEAR, THE GENERAL2 ASSEMBLY SHALL APPROPRIATE MONEY FROM THE BEHAVIORAL AND3 MENTAL HEALTH CASH FUND PURSUANT TO SECTION 24-75-230 TO THE4 DEPARTMENT OF HUMAN SERVICES TO FUND OPERATIONAL SUPPORT FOR5 PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES FOR YOUTH AND6 QUALIFIED RESIDENTIAL TREATMENT PROGRAMS FOR YOUTH ACROSS THE7 STATE AS DESCRIBED IN THIS SUBSECTION (2).8 (II) M ONEY SPENT PURSUANT TO THIS SUBSECTION (2) MUST9 CONFORM WITH THE ALLOWABLE PURPOSES SET FORTH IN THE FEDERAL10 "A MERICAN RESCUE PLAN ACT OF 2021", PUB.L. 117-2, AS THE ACT MAY11 BE SUBSEQUENTLY AMENDED . THE DEPARTMENT OF HUMAN SERVICES12 SHALL EITHER SPEND OR OBLIGATE SUCH APPROPRIATION PRIOR TO13 D ECEMBER 30, 2024, AND EXPEND THE APPROPRIATION ON OR BEFORE14 D ECEMBER 31, 2026.15 (b) T HIS SUBSECTION (2) IS REPEALED, EFFECTIVE SEPTEMBER 1,16 2027.17 (3) T HE DEPARTMENT OF HUMAN SERVICES AND ANY PERSON THAT18 RECEIVES MONEY FROM THE DEPARTMENT OF HUMAN SERVICES SHALL19 COMPLY WITH THE COMPLIANCE , REPORTING, RECORD-KEEPING, AND20 PROGRAM EVALUATION REQUIREMENTS ESTABLISHED BY THE OFFICE OF21 STATE PLANNING AND BUDGETING AND THE STATE CONTROLLER IN22 ACCORDANCE WITH SECTION 24-75-226 (5).23 SECTION 5. Safety clause. The general assembly hereby finds,24 determines, and declares that this act is necessary for the immediate25 preservation of the public peace, health, or safety.26 HB22-1283 -8-