Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
LLS NO. 22-0805.01 Jane Ritter x4342
HOUSE BILL 22-1283
House Committees Senate Committees
Public & Behavioral Health & Human Services
Appropriations
A BILL FOR AN ACT
C
ONCERNING ENHANCED RESIDENTIA L SERVICES FOR PERSONS WITH101
BEHAVIORAL HEALTH
NEEDS, AND, IN CONNECTION THEREWITH,102
MAKING AN APPROPRIATION .103
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;
HOUSE
Amended 2nd Reading
April 19, 2022
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. ! Provides operational support for psychiatric residential
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
1283-2- (g) The federal government enacted the "American Rescue Plan1
Act of 2021" to provide support to state, local, and tribal governments in2
responding to the impact of the COVID-19 pandemic.3
(2) The general assembly further declares that:4
(a) Children, youth, and families have been disproportionately5
impacted by the COVID-19 pandemic and its negative public health6
impacts, especially the behavioral health of children, youth, and families.7
The programs and services funded by the federal money in this act are8
appropriate uses of the money transferred to Colorado under the9
"American Rescue Plan Act". This money will expand access to10
evidence-based treatment for behavioral health services, including11
additional in-home and residential respite care; operational support that12
is critical for psychiatric residential treatment facilities and qualified13
residential treatment programs for youth across the state; and building and14
staffing a neuro-psych facility with a capacity of up to sixteen beds for15
youth less than twenty-one years of age at the Colorado mental health16
institute at Fort Logan; and17
(b) The services described in this act are critical government18
services.19
SECTION 2. In Colorado Revised Statutes, add with amended20
and relocated provisions 26-5-116 as follows:21
26-5-116. [Formerly 27-60-113] Out-of-home placement for22
children and youth with mental or behavioral needs - funding -23
report - rules - legislative declaration - repeal. (1) (a) The general24
assembly finds and declares that:25
(I) The COVID-19 pandemic has lead to an emergency need for26
increased placements for children and youth with behavioral or mental27
1283
-3- health needs, including those involved with the child welfare system; and1
(II) As the state works to transition to the critical requirements of2
the federal "Family First Prevention Services Act", it must ensure a3
smooth transition by helping existing residential child care facilities4
transition to qualified residential treatment programs or psychiatric5
residential treatment facilities.6
(b) Therefore, the general assembly declares that the state should7
provide resources to qualified residential treatment programs, psychiatric8
residential treatment facilities, or therapeutic foster care providers to9
address this emergency situation and ensure there are high-quality10
providers available to meet these needs.11
(2) (a) On or before August 1, 2021, the state department shall12
develop a program to provide emergency resources to licensed providers13
to help remove barriers such providers face in serving children and youth14
whose behavioral or mental health needs require services and treatment15
in a residential child care facility. Any such licensed provider shall meet16
the requirements of a qualified residential treatment program, as defined17
in section 26-5.4-102; a psychiatric residential treatment facility, as18
defined in section 26-5.4-103 (19.5) SECTION 25.5-4-103 (19.5);19
TREATMENT FOSTER CARE; or therapeutic foster care. as defined in section20
26-6-102 (39).21
(b) (I) BEGINNING JULY 1, 2022, THE STATE DEPARTMENT SHALL22
PROVIDE ONGOING OPERATIONAL SUPPORT FOR PSYCHIATRIC RESIDENTIAL23
TREATMENT FACILITIES, THERAPEUTIC FOSTER CARE, TREATMENT FOSTER24
CARE, AND QUALIFIED RESIDENTIAL TREATMENT PROGRAMS AS DESCRIBED25
IN SUBSECTION (2)(a) OF THIS SECTION.26
(II) FOR THE 2022-23 BUDGET YEAR, THE GENERAL ASSEMBLY27
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-4- SHALL APPROPRIATE MONEY FROM THE BEHAVIORAL AND MENTAL HEALTH1
CASH FUND CREATED IN SECTION 24-75-230 TO THE STATE DEPARTMENT2
TO FUND OPERATIONAL SUPPORT FOR PSYCHIATRIC RESIDENTIAL3
TREATMENT FACILITIES FOR YOUTH, QUALIFIED RESIDENTIAL TREATMENT4
PROGRAMS, THERAPEUTIC FOSTER CARE, AND TREATMENT FOSTER CARE5
FOR YOUTH ACROSS THE STATE AS DESCRIBED IN THIS SUBSECTION (2).6
(III) MONEY SPENT PURSUANT TO THIS SUBSECTION (2) MUST7
CONFORM WITH THE ALLOWABLE PURPOSES SET FORTH IN THE FEDERAL8
"AMERICAN RESCUE PLAN ACT OF 2021", PUB.L. 117-2, AS AMENDED.9
THE STATE DEPARTMENT SHALL EITHER SPEND OR OBLIGATE SUCH10
APPROPRIATION PRIOR TO DECEMBER 30, 2024, AND EXPEND THE11
APPROPRIATION ON OR BEFORE DECEMBER 31, 2026.12
(IV) THIS SUBSECTION (2)(b) IS REPEALED, EFFECTIVE SEPTEMBER13
1, 2027.14
(c) THE STATE DEPARTMENT AND ANY PERSON WHO RECEIVES15
MONEY FROM THE STATE DEPARTMENT SHALL COMPLY WITH THE16
COMPLIANCE, REPORTING, RECORD-KEEPING, AND PROGRAM EVALUATION17
REQUIREMENTS ESTABLISHED BY THE OFFICE OF STATE PLANNING AND18
BUDGETING AND THE STATE CONTROLLER IN ACCORDANCE WITH SECTION19
24-75-226 (5).20
(3) The state department may promulgate rules concerning the21
placement of a child or youth in the program. The rules may address22
quality assurance monitoring, admissions, discharge planning, appropriate23
length of stay, an appeals process for children and youth who are24
determined ineligible for the program, and compliance with applicable25
federal law, including the federal "Family First Prevention Services Act";26
except that rules concerning the placement of a child or youth who is not27
1283
-5- in the custody of a state or county department of human or social services1
shall MUST not inappropriately apply compliance with such act.2
(4) (a) On or before December 31, 2021, the state department shall3
contract with licensed providers for the delivery of services to children4
and youth who are determined eligible for and placed in the program. A5
provider that contracts with the state department shall not:6
(I) Deny admittance of a child or youth if the child or youth7
otherwise meets the eligibility criteria for the program; or8
(II) Discharge a child or youth based on the severity or complexity9
of the child CHILD'S or youth's physical, behavioral, or mental health10
needs; except that the state department may arrange for the placement of11
a child or youth with an alternate contracted provider if the placement12
with the alternate provider is better suited to deliver services that meet the13
needs of the child or youth.14
(b) The state department shall reimburse a provider directly for the15
costs associated with the placement of a child or youth in the program for16
the duration of the treatment, including the costs the provider17
demonstrates are necessary in order for the provider to operate18
continuously during this period.19
(c) The state department shall coordinate with the department of20
health care policy and financing to support continuity of care and21
payment for services for any children or youth placed in the program.22
(d) The state department shall reimburse the provider one hundred23
percent of the cost of unutilized beds in the program to ensure available24
space for emergency residential out-of-home placements.25
(5) (a) A hospital, health-care provider, provider of case26
management services, school district, managed care entity, or state or27
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-6- county department of human or social services may refer a family for the1
placement of a child or youth in the program. The entity referring a child2
or youth for placement in the program shall submit or assist the family3
with submitting an application to the state department for review. The4
state department shall consider each application as space becomes5
available. The state department shall approve admissions into the program6
and determine admission and discharge criteria for placement.7
(b) The state department shall develop a discharge plan for each8
child or youth placed in the program. The plan must include the eligible9
period of placement of the child or youth and shall identify the entity that10
will be responsible for the placement costs if the child or youth remains11
with the provider beyond the date of eligibility identified in the plan.12
(c) The entity or family that places the child or youth in the13
program retains the right to remove the child or youth from the program14
any time prior to the discharge date specified by the state department.15
(6) Within seven days after submitting an application to the state16
department for placing a child or youth in the program, the state17
department shall work with the referring entity and the child's or youth's18
parents or legal guardians to ensure the child or youth is assessed for19
eligibility for enrollment into the state medical assistance program. A20
child or youth who is eligible for enrollment into the state medical21
assistance program shall be enrolled. Enrollment of a child or youth into22
the state medical assistance program does not constitute automatic23
placement into the program.24
(7) No later than November 1, 2022, 2023, and 2024 ON OR25
BEFORE NOVEMBER 1, 2023, AND EVERY NOVEMBER 1 THEREAFTER, the26
state department shall submit a written report to the house of27
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-7- representatives public and behavioral health and human services1
committee, the senate health and human services committee, or their2
successor committees, and the joint budget committee. At a minimum, the3
report must include:4
(a) The number of applications received for placement of children5
and youth in the program;6
(b) The number of children and youth accepted for placement in7
the program;8
(c) The duration of each placement; and9
(d) The daily rate paid to each provider for placement of children10
and youth.11
(8) This section is intended to provide enhanced emergency12
services resulting from the increased need for services due to the13
COVID-19 pandemic. No later than September 30, 2024, the state14
department shall submit recommendations to the house of representatives15
public and behavioral health and human services committee, the senate16
health and human services committee, or their successor committees, and17
the joint budget committee about how to provide necessary services for18
children and youth in need of residential care, including hospital19
step-down services on an ongoing basis.20
(9) This section is repealed, effective July 1, 2025 JULY 1, 2028.21
SECTION 3. In Colorado Revised Statutes, 27-60-103, add (1.5)22
as follows:23
27-60-103. Behavioral health crisis response system - services24
- request for proposals - criteria - reporting - rules - definition -25
repeal. (1.5) (a) B
EGINNING JANUARY 1, 2023, THE STATE DEPARTMENT26
SHALL CREATE IN-HOME AND RESIDENTIAL RESPITE CARE SERVICES AND27
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-8- FACILITIES FOR CHILDREN AND FAMILIES IN UP TO SEVEN REGIONS OF THE1
STATE, AS DETERMINED BY THE STATE DEPARTMENT AND A COMMITTEE OF2
INTERESTED STAKEHOLDERS .3
(b) (I) F
OR THE 2022-23 BUDGET YEAR, THE GENERAL ASSEMBLY4
SHALL APPROPRIATE MONEY FROM THE BEHAVIORAL AND MENTAL HEALTH5
CASH FUND PURSUANT TO SECTION 24-75-230 TO THE STATE DEPARTMENT6
TO FUND IN-HOME AND RESIDENTIAL RESPITE CARE ACROSS THE STATE AS7
DESCRIBED IN THIS SUBSECTION (1.5).8
(II) M
ONEY SPENT PURSUANT TO THIS SUBSECTION (1.5) 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 STATE DEPARTMENT SHALL EITHER12
SPEND OR OBLIGATE SUCH APPROPRIATION PRIOR TO DECEMBER 30, 2024,13
AND EXPEND THE APPROPRIATION ON OR BEFORE DECEMBER 31, 2026.14
(III) T
HIS SUBSECTION (1.5)(b) IS REPEALED, EFFECTIVE15
S
EPTEMBER 1, 2027.16
17
(c) (I) BEGINNING IN STATE FISCAL YEAR 2023-24, MONEY18
APPROPRIATED TO THE STATE DEPARTMENT FOR THE PURPOSE OF THIS19
SUBSECTION (1.5) MUST CONTINUE THE STATEWIDE ACCESS TO CRISIS20
SYSTEM SERVICES FOR CHILDREN AND YOUTH UNTIL JUNE 30, 2026;21
(II) BEGINNING IN THE STATE FISCAL YEAR 2022-23, MONEY22
APPROPRIATED TO THE STATE DEPARTMENT FOR THE PURPOSE OF23
IMPLEMENTING THIS SUBSECTION (1.5) MUST SUPPORT RESIDENTIAL24
RESPITE CARE PROVIDED TO YOUTH INVOLVED IN THE FOSTER CARE25
SYSTEM; AND26
(III) RESPITE FOSTER CARE HOMES MUST BE IN COMPLIANCE WITH27
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-9- ALL OTHER APPLICABLE RULES REGULATING FOSTER CARE HOMES .1
(d) T
HE STATE DEPARTMENT AND ANY PERSON THAT RECEIVES2
MONEY FROM THE STATE DEPARTMENT SHALL COMPLY WITH THE3
COMPLIANCE, REPORTING, RECORD-KEEPING, AND PROGRAM EVALUATION4
REQUIREMENTS ESTABLISHED BY THE OFFICE OF STATE PLANNING AND5
BUDGETING AND THE STATE CONTROLLER IN ACCORDANCE WITH SECTION6
24-75-226
(5).7
SECTION 4. In Colorado Revised Statutes, repeal 27-60-113.8
9
SECTION 5. In Colorado Revised Statutes, add 27-80-127 as10
follows:11
27-80-127. Children and youth in need of residential mental12
health and substance use treatment -repeal. (1) ON OR BEFORE JULY13
1, 2023, THE BEHAVIORAL HEALTH ADMINISTRATION, CREATED PURSUANT14
TO PART 2 OF ARTICLE 60 OF TITLE 27, SHALL CREATE, DEVELOP, OR15
CONTRACT TO ADD ADDITIONAL RESIDENTIAL SUBSTANCE USE TREATMENT16
BEDS FOR YOUTH. TO THE GREATEST EXTENT POSSIBLE, THE DEPARTMENT17
SHALL ENSURE THAT BOTH MENTAL HEALTH AND SUBSTANCE USE18
TREATMENT SERVICES ARE AVAILABLE IN ONE RESIDENTIAL LOCATION .19
THE DEPARTMENT SHALL WORK COLLABORATIVELY WITH THE20
BEHAVIORAL HEALTH ADMINISTRATION FOR LICENSING AND DETERMINING21
THE GREATEST AREAS OF NEED.22
(2) (a) (I) FOR THE 2022-23 BUDGET YEAR, THE GENERAL23
ASSEMBLY SHALL APPROPRIATE FIVE MILLION DOLLARS FROM THE24
BEHAVIORAL AND MENTAL HEALTH CASH FUND, CREATED PURSUANT TO25
SECTION 24-75-230, TO THE DEPARTMENT TO EXPAND SUBSTANCE USE26
RESIDENTIAL TREATMENT BEDS FOR ADOLESCENTS , AS DESCRIBED IN27
1283
-10- SUBSECTION (1) OF THIS SECTION.1
(II) MONEY SPENT PURSUANT TO THIS SUBSECTION (2) MUST2
CONFORM WITH THE ALLOWABLE PURPOSES SET FORTH IN THE FEDERAL3
"AMERICAN RESCUE PLAN ACT OF 2021", PUB.L. 117-2, AS AMENDED.4
THE DEPARTMENT SHALL EITHER SPEND OR OBLIGATE SUCH5
APPROPRIATION PRIOR TO DECEMBER 30, 2024, AND EXPEND THE6
APPROPRIATION ON OR BEFORE DECEMBER 31, 2026.7
(b) THIS SUBSECTION (2) IS REPEALED, EFFECTIVE SEPTEMBER 1,8
2027.9
(3) THE DEPARTMENT OF HUMAN SERVICES AND ANY PERSON THAT10
RECEIVES MONEY FROM THE DEPARTMENT OF HUMAN SERVICES SHALL11
COMPLY WITH THE COMPLIANCE, REPORTING, RECORD-KEEPING, AND12
PROGRAM EVALUATION REQUIREMENTS ESTABLISHED BY THE OFFICE OF13
STATE PLANNING AND BUDGETING AND THE STATE CONTROLLER IN14
ACCORDANCE WITH SECTION 24-75-226 (5).15
SECTION 6. In Colorado Revised Statutes, add 27-90-112 as16
follows:17
27-90-112. Youth neuro-psych facility - funding - repeal.18
(1) B
EGINNING JULY 1, 2022, THE DEPARTMENT OF HUMAN SERVICES19
SHALL BEGIN THE PROCESS
TO CREATE, DEVELOP, OR CONTRACT FOR A20
NEURO-PSYCH FACILITY. THE NEURO-PSYCH FACILITY MUST HAVE A21
CAPACITY OF AT LEAST SIXTEEN RESIDENTIAL BEDS FOR COLORADO22
YOUTH WHO ARE LESS THAN TWENTY -ONE YEARS OF AGE . THE23
DEPARTMENT SHALL DEVELOP AND IMPLEMENT ADMISSION CRITERIA THAT24
ENSURES THAT COLORADO CHILDREN AND YOUTH, PRIOR TO BEING25
ADMITTED, HAVE BEEN EVALUATED FOR THE LEAST RESTRICTIVE LEVEL OF26
CARE AND THAT GEOGRAPHIC LOCATION , CURRENT HEALTH-CARE27
1283
-11- PROVIDER, AND PAYER TYPE ARE NOT THE PRIMARY DETERMINING1
FACTORS IN WHETHER A YOUTH HAS ACCESS TO A BED AT THE2
NEURO-PSYCH FACILITY.3
(2) (a) (I) F
OR THE 2022-23 BUDGET YEAR, THE GENERAL4
ASSEMBLY SHALL APPROPRIATE MONEY FROM THE BEHAVIORAL AND5
MENTAL HEALTH CASH FUND PURSUANT TO SECTION 24-75-230 TO THE6
DEPARTMENT OF HUMAN SERVICES TO FUND OPERATIONAL SUPPORT FOR7
PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES FOR YOUTH AND8
QUALIFIED RESIDENTIAL TREATMENT PROGRAMS FOR YOUTH ACROSS THE9
STATE AS DESCRIBED IN THIS SUBSECTION (2).10
(II) M
ONEY SPENT PURSUANT TO THIS SUBSECTION (2) MUST11
CONFORM WITH THE ALLOWABLE PURPOSES SET FORTH IN THE FEDERAL12
"A
MERICAN RESCUE PLAN ACT OF 2021", PUB.L. 117-2, AS
AMENDED.13
T
HE DEPARTMENT OF HUMAN SERVICES SHALL EITHER SPEND OR OBLIGATE14
SUCH APPROPRIATION PRIOR TO DECEMBER 30, 2024, AND EXPEND THE15
APPROPRIATION ON OR BEFORE DECEMBER 31, 2026.16
(b) T
HIS SUBSECTION (2) IS REPEALED, EFFECTIVE SEPTEMBER 1,17
2027.18
(3) T
HE DEPARTMENT OF HUMAN SERVICES AND ANY PERSON THAT19
RECEIVES MONEY FROM THE DEPARTMENT OF HUMAN SERVICES SHALL20
COMPLY WITH THE COMPLIANCE , REPORTING, RECORD-KEEPING, AND21
PROGRAM EVALUATION REQUIREMENTS ESTABLISHED BY THE OFFICE OF22
STATE PLANNING AND BUDGETING AND THE STATE CONTROLLER IN23
ACCORDANCE WITH SECTION 24-75-226 (5).24
SECTION 7. Appropriation. For the 2022-23 state fiscal year,25
$9,809,673 is appropriated to the department of human services for use26
by the division of child welfare. This appropriation is from the behavioral27
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-12- and mental health cash fund created in section 24-75-230 (2)(a), C.R.S.,1
and is of money the state received from the federal coronavirus state2
fiscal recovery fund. The division may use this appropriation for respite3
and residential programs. Any money appropriated in this section not4
expended prior to July 1, 2023, is further appropriated to the division5
from July 1, 2023, through December 30, 2024, for the same purpose.6
These appropriations are based on the assumption that the office will7
require 4.0 FTE in the 2022-23 state fiscal year and 4.0 FTE in the8
2023-24 state fiscal year to implement the act.9
SECTION 8. Appropriation. (1) For the 2022-23 state fiscal10
year, $7,500,000 is appropriated to the department of human services for11
use by the behavioral health administration. This appropriation is from the12
behavioral and mental health cash fund created in section 24-75-23013
(2)(a), C.R.S., and is of money the state received from the federal14
coronavirus state fiscal recovery fund. Any money appropriated in this15
section not expended prior to July 1, 2023, is further appropriated to the16
administration from July 1, 2023, through December 30, 2024, for the17
same purpose. To implement this act, the department may use this18
appropriation as follows:19
(a) $5,000,000 to expand substance use residential treatment beds20
for adolescents pursuant to section 27-80-127, C.R.S.; and21
(b) $2,500,000 for crisis response system services.22
SECTION 9. Appropriation. For the 2022-23 state fiscal year,23
$539,926 is appropriated to the department of human services for use by24
the office of behavioral health. This appropriation is from the behavioral25
and mental health cash fund created in section 24-75-230 (2)(a), C.R.S.,26
and is of money the state received from the federal coronavirus state27
1283
-13- fiscal recovery fund. The office may use this appropriation for building1
maintenance costs associated with the youth neuro-psych facility at the2
Colorado mental health institute at Fort Logan established pursuant to3
section 27-94-107, C.R.S. Any money appropriated in this section not4
expended prior to July 1, 2023, is further appropriated to the5
administration from July 1, 2023, through December 30, 2024, for the6
same purpose.7
SECTION 10. Capital construction appropriation. For the8
2022-23 state fiscal year, $35,000,000 is appropriated to the department9
of human services. This appropriation is from the behavioral and mental10
health cash fund created in section 24-75-230 (2)(a), C.R.S., and is of11
money the state received from the federal coronavirus state fiscal12
recovery fund. To implement this act, the department may use this13
appropriation for capital construction related to the construction of a14
neuro-psych facility at the Colorado mental health institute at Fort Logan.15
Any money appropriated in this section not expended prior to July 1,16
2023, is further appropriated to the administration from July 1, 2023,17
through December 30, 2024, for the same purpose.18
SECTION 11. Safety clause. The general assembly hereby finds,19
determines, and declares that this act is necessary for the immediate20
preservation of the public peace, health, or safety.21
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