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. 22-0815.01 Shelby Ross x4510
HOUSE BILL 22-1302
House Committees Senate Committees
Public & Behavioral Health & Human Services
Appropriations
A BILL FOR AN ACT
C
ONCERNING HEALTH-CARE PRACTICE TRANSFORMATION TO SUPPORT101
WHOLE-PERSON HEALTH THROUGH INTEGRATED CARE MODELS ,102
AND, IN CONNECTION THEREWITH , 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 creates the primary care and behavioral health statewide
integration grant program in the department of health care policy and
financing to provide grants to primary care clinics for implementation of
evidence-based clinical integration care models.
The bill requires the department of health care policy and
HOUSE
Amended 2nd Reading
April 8, 2022
HOUSE SPONSORSHIP
Kennedy and Will, Amabile, Gonzales-Gutierrez, Michaelson Jenet
SENATE SPONSORSHIP
Jaquez Lewis 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. financing, in collaboration with the behavioral health administration and
other agencies, to develop a universal contract for behavioral health
services.
The bill makes an appropriation.
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) Since the COVID-19 pandemic began, rates of psychological4
distress, including anxiety, depression, and other behavioral and mental5
health disorders, among them substance use disorders, have increased;6
(b) From 2015 to 2019, Colorado's state innovation model used7
federal grant funding to support 344 primary care practices and four8
community mental health centers to integrate behavioral and physical9
health care, build a network of regional health connectors that links10
practices with community resources, and advance the development of11
value-based payment structures;12
(c) A federal evaluation showed that Colorado's practice13
transformation program was associated with greater access to behavioral14
health care and fewer behavioral-health-related emergency visits;15
(d) Efforts to continue the progress of the state innovation model16
have continued, but too few Coloradans have access to behavioral health17
services, and even fewer have access to these services in their primary18
care provider's office;19
(e) The federal government enacted the "American Rescue Plan20
Act of 2021" (ARPA), Pub.L. 117-2, to provide support to state, local,21
and tribal governments in responding to the impact of the COVID-1922
pandemic; and23
1302-2- (f) Regulations construing ARPA promulgated by the federal1
department of treasury identify a nonexclusive list of uses for the2
COVID-19 pandemic and its negative public health impacts.3
(2) Therefore, the general assembly declares that:4
(a) Investments in practice transformation, including behavioral5
health integration, will increase access to behavioral health-care services6
for Coloradans struggling due to the public health emergency; and7
(b) The programs and services funded by the federal money in this8
act are important government services and appropriate uses of the money9
transferred to Colorado under ARPA.10
SECTION 2. In Colorado Revised Statutes, add 25.5-5-332 as11
follows:12
25.5-5-332. Primary care and behavioral health statewide13
integration grant program - creation - report - definition - repeal.14
(1) A
S USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE15
REQUIRES, "GRANT PROGRAM " MEANS THE PRIMARY CARE AND16
BEHAVIORAL HEALTH STATEWIDE INTEGRATION GRANT PROGRAM17
CREATED IN SUBSECTION (2) OF THIS SECTION.18
(2) T
HERE IS CREATED IN THE STATE DEPARTMENT THE PRIMARY19
CARE AND BEHAVIORAL HEALTH STATEWIDE INTEGRATION GRANT20
PROGRAM TO PROVIDE GRANTS TO PHYSICAL AND BEHAVIORAL HEALTH21
CARE PROVIDERS FOR IMPLEMENTATION OF EVIDENCE -BASED CLINICAL22
INTEGRATION CARE MODELS, AS DEFINED BY THE STATE DEPARTMENT , IN23
COLLABORATION WITH THE BEHAVIORAL HEALTH ADMINISTRATION IN THE24
DEPARTMENT OF HUMAN SERVICES .25
(3) (a) G
RANT RECIPIENTS MAY USE THE MONEY RECEIVED26
THROUGH THE GRANT PROGRAM FOR THE FOLLOWING PURPOSES :27
1302
-3- (I) DEVELOPING INFRASTRUCTURE FOR PRIMARY CARE , PEDIATRIC,1
AND BEHAVIORAL HEALTH -CARE PROVIDERS TO BETTER SERVE2
INDIVIDUALS WITH BEHAVIORAL HEALTH NEEDS IN OUTPATIENT HEALTH3
CARE SETTINGS;4
(II) I
NCREASING ACCESS TO QUALITY HEALTH CARE FOR5
INDIVIDUALS WITH BEHAVIORAL HEALTH NEEDS ;6
(III) I
NVESTING IN EARLY INTERVENTIONS FOR CHILDREN , YOUTH,7
AND ADULTS THAT REDUCE ESCALATION AND EXACERBATION OF8
BEHAVIORAL HEALTH CONDITIONS ;9
(IV) A
DDRESSING THE NEED TO EXPAND THE BEHAVIORAL10
HEALTH-CARE WORKFORCE; AND11
(V) D
EVELOPING AND IMPLEMENTING ALTERNATIVE PAYMENT12
MODELS, INCLUDING THE DEVELOPMENT OF PROTOCOLS , PROCESSES, WORK13
FLOW, AND PARTNERSHIPS.14
(b) A
NY MONEY RECEIVED THROUGH THE GRANT PROGRAM MUST15
SUPPLEMENT AND NOT SUPPLANT EXISTING HEALTH -CARE SERVICES.16
G
RANT RECIPIENTS SHALL NOT USE MONEY RECEIVED THROUGH THE17
GRANT PROGRAM FOR:18
(I) O
NGOING OR EXISTING EXECUTIVE AND SENIOR STAFF19
SALARIES;20
(II) S
ERVICES ALREADY COVERED BY MEDICAID OR A CLIENT 'S21
INSURANCE; OR22
(III) O
NGOING OR EXISTING ELECTRONIC HEALTH RECORDS COSTS .23
(c) (I)
(A) IF A GRANT RECIPIENT IS A HOSPITAL -OWNED OR24
HOSPITAL-AFFILIATED PRACTICE THAT IS NOT PART OF A HOSPITAL SYSTEM25
AND HAS LESS THAN TEN PERCENT TOTAL PROFIT AS MEASURED BY STATE26
DEPARTMENT TRANSPARENCY REPORTING , THE GRANT RECIPIENT SHALL27
1302
-4- PROVIDE A TWENTY-FIVE PERCENT MATCH FOR THE AWARDED AMOUNT .1
T
HE GRANT RECIPIENT MAY USE COMMUNITY BENEFIT FUNDS , IN-KIND2
PERSONNEL TIME, OR FEDERAL RELIEF FUNDING FOR THE TWENTY -FIVE3
PERCENT MATCH REQUIRED PURSUANT TO THIS SUBSECTION
(3)(c)(I)(A).4
(B) IF A GRANT RECIPIENT IS A HOSPITAL -OWNED OR5
HOSPITAL-AFFILIATED PRACTICE THAT IS PART OF A HOSPITAL SYSTEM6
OR HAS TEN PERCENT OR MORE TOTAL PROFIT AS MEASURED BY STATE7
DEPARTMENT TRANSPARENCY REPORTING , THE GRANT RECIPIENT SHALL8
PROVIDE A FIFTY PERCENT MATCH FOR THE AWARDED AMOUNT . THE9
GRANT RECIPIENT MAY USE COMMUNITY BENEFIT FUNDS , IN-KIND10
PERSONNEL TIME, OR FEDERAL RELIEF FUNDING FOR THE FIFTY PERCENT11
MATCH REQUIRED PURSUANT TO THIS SUBSECTION (3)(c)(I)(B).12
(C) IF A GRANT RECIPIENT IS A CRITICAL ACCESS HOSPITAL , AS13
DEFINED IN SECTION 10-16-1303 (2), THE GRANT RECIPIENT SHALL14
PROVIDE A TEN PERCENT MATCH FOR THE AWARDED AMOUNT. THE GRANT15
RECIPIENT MAY USE COMMUNITY BENEFIT FUNDS, IN-KIND PERSONNEL16
TIME, OR FEDERAL RELIEF FUNDING FOR THE TEN PERCENT MATCH17
REQUIRED PURSUANT TO THIS SUBSECTION (3)(c)(I)(C).18
(II) FOR THE PURPOSES OF THIS SUBSECTION (3)(c),19
"HOSPITAL-AFFILIATED" MEANS THERE IS A CONTRACTUAL RELATIONSHIP20
BETWEEN A HOSPITAL OR AN ENTITY THAT IS OWNED BY OR UNDER21
COMMON OWNERSHIP AND CONTROL WITH THE HOSPITAL IN WHICH THE22
CONTRACTUAL RELATIONSHIP ENABLES THE HOSPITAL OR ENTITY THAT IS23
OWNED BY OR UNDER COMMON OWNERSHIP AND CONTROL WITH THE24
HOSPITAL TO EXERCISE CONTROL OVER ONE OF THE FOLLOWING ENTITIES:25
(A) ANOTHER HOSPITAL;26
(B) AN ENTITY OWNED BY OR UNDER COMMON OWNERSHIP AND27
1302
-5- CONTROL WITH ANOTHER HOSPITAL ; OR1
(C) A PHYSICIAN GROUP PRACTICE.2
(d) T
HE STATE DEPARTMENT MAY PROVIDE FUNDING TO PHYSICAL3
AND BEHAVIORAL HEALTH-CARE PROVIDERS THROUGH INFRASTRUCTURE4
BUILDING AND POPULATION-BASED PAYMENT MECHANISMS .5
(e) G
RANT RECIPIENTS SHALL PARTICIPATE IN TECHNICAL6
ASSISTANCE EDUCATION AND TRAINING AND RELATED WORKGROUPS AS7
DETERMINED BY THE STATE DEPARTMENT .8
(4) (a) T
HE STATE DEPARTMENT SHALL ADMINISTER THE GRANT9
PROGRAM AND, SUBJECT TO AVAILABLE APPROPRIATIONS , SHALL AWARD10
GRANTS AS PROVIDED IN THIS SECTION . SUBJECT TO AVAILABLE11
APPROPRIATIONS, GRANTS SHALL BE PAID OUT OF THE BEHAVIORAL AND12
MENTAL HEALTH CASH FUND CREATED IN SECTION 24-75-230.13
(b) I
N ORDER TO SUPPORT REAL -TIME TRANSFORMATION AND14
ACCESS TO CARE, THE STATE DEPARTMENT SHALL ENSURE TIMELY15
PAYMENT TO GRANT RECIPIENTS FOR SERVICES RELATED TO THE GRANT16
PROGRAM.17
(5) G
RANT APPLICANTS SHALL DEMONSTRATE A COMMITMENT TO18
MAINTAINING MODELS AND PROGRAMS THAT , AT A MINIMUM:19
(a) M
EASURABLY INCREASE ACCESS TO BEHAVIORAL HEALTH20
SCREENING, REFERRAL, TREATMENT, AND RECOVERY CARE;21
(b) I
MPLEMENT OR EXPAND EVIDENCE -BASED MODELS FOR22
INTEGRATION;23
(c) L
EVERAGE MULTIDISCIPLINARY TREATMENT TEAMS ;24
(d) S
ERVE PUBLICLY FUNDED CLIENTS;25
(e) M
AINTAIN A PLAN FOR HOW TO ADDRESS A CLIENT WITH26
EMERGENCY NEEDS;27
1302
-6- (f) MAINTAIN A PLAN FOR HOW TECHNOLOGY WILL BE LEVERAGED1
FOR WHOLE-PERSON CARE, WHICH MAY INCLUDE PLANS FOR DATA2
SECURITY, ELECTRONIC HEALTH RECORDS REFORMS , AND TELEHEALTH3
IMPLEMENTATION OR EXPANSION ; AND4
(g) I
MPLEMENT OR ENGAGE IN STATE -DEPARTMENT-SPECIFIED5
TOOLS AND SHARED LEARNING AND RESOURCES , INCLUDING BUT NOT6
LIMITED TO:7
(I) P
EER LEARNING COLLABORATIVES TO DEVELOP SUSTAINABLE8
POPULATION-BASED PAYMENT MODELS LED BY THE STATE DEPARTMENT ;9
(II) U
SE OF ELECTRONIC TOOLS FOR SCREENING AND REFERRALS ;10
AND11
(III) D
ATA-SHARING BEST PRACTICES.12
(6) I
N SELECTING GRANT RECIPIENTS, THE STATE DEPARTMENT13
SHALL
FIRST PRIORITIZE APPLICANTS THAT SERVE PRIORITY POPULATIONS14
THAT EXPERIENCE DISPARITIES IN HEALTH-CARE ACCESS AND OUTCOMES,15
INCLUDING BUT NOT LIMITED TO HISTORICALLY MARGINALIZED AND16
UNDERSERVED COMMUNITIES, DETERMINED BY THE COMMUNITIES WITH17
THE HIGHEST PROPORTION OF PATIENTS RECEIVING ASSISTANCE THROUGH18
THE "COLORADO MEDICAL ASSISTANCE ACT", ARTICLES 4, 5, AND 6 OF19
TITLE 25.5. THE STATE DEPARTMENT SHALL THEN PRIORITIZE APPLICANTS20
THAT MEET AS MANY OF THE FOLLOWING CRITERIA AS POSSIBLE :21
(a) S
ERVE INDIVIDUALS WITH CO-OCCURRING AND COMPLEX CARE22 NEEDS, SERIOUS MENTAL ILLNESSES, OR DISABILITIES;23
(b) S
ERVE CHILDREN AND
YOUTH;24
(c) I
NCLUDE OPPORTUNITIES TO BUILD OUT COMMUNITY HEALTH25
WORKER, BEHAVIORAL HEALTH AIDE, OR SIMILAR PROGRAMS, SUPPORTED26
BY POPULATION-BASED PAYMENTS;27
1302
-7- (d) SERVE PREGNANT AND POSTPARTUM PEOPLE ;1
(e) THE PRACTICE IS CONSIDERED A SMALL AND INDEPENDENT2
PRACTICE;3
(f) DEMONSTRATE THE ABILITY AND INTENT TO SERVE4
CULTURALLY DIVERSE POPULATIONS AND POPULATIONS WITH LIMITED5
ENGLISH PROFICIENCY;6
(g) INCLUDE WORKFORCE CAPACITY -BUILDING COMPONENTS;7
(h) INCLUDE HIGH-INTENSITY OUTPATIENT SERVICES;8
(i) IMPROVE DATA EXCHANGE AND DATA INTEGRATION THAT9
SUPPORTS WHOLE-PERSON CARE;10
(j) UTILIZE TELEHEALTH;11
(k) ALIGN WITH OR PARTICIPATE IN COMMERCIAL ALTERNATIVE12
PAYMENT MODELS;13
(l) DEMONSTRATE COMMUNITY PARTNERSHIPS ; OR14
(m) PARTICIPATE IN THE REGIONAL HEALTH CONNECTOR15
WORKFORCE PROGRAM CREATED IN SECTION 23-21-901.16
(7) (a) T
HE STATE DEPARTMENT SHALL ESTABLISH A SET OF17
STATEWIDE RESOURCES TO SUPPORT GRANT RECIPIENTS . AT A MINIMUM,18
THE RESOURCES MUST INCLUDE :19 (I) A CLINICAL CONSULTATION AND PRACTICE TRANSFORMATION20
SUPPORT TEAM PROVIDED BY THE COLORADO HEALTH EXTENSION SYSTEM21
IN THE PRACTICE INNOVATION PROGRAM ; AND22
(II) A
SUSTAINABLE BILLING AND DATA PARTNERSHIP TEAM THAT23
WILL TRAIN AND SUPPORT GRANT RECIPIENTS IN MEETING ST ANDARDS FOR24
ALTERNATIVE PAYMENT MODELS AND CREATING AND IMPLEMENTING25
DATA-SHARING PRACTICES AND POLICIES THAT SUPPORT MENTAL HEALTH26
DISORDERS, SUBSTANCE USE DISORDERS, AND CO-OCCURRING DISORDERS.27
1302
-8- (b) THE STATE DEPARTMENT MAY ENTER INTO INTERAGENCY1
AGREEMENTS OR PROCURE CONTRACTS TO ESTABLISH THE RESOURCES2
PURSUANT TO THIS SUBSECTION (7).3
(8) T
HE STATE DEPARTMENT MAY PROCURE A GRANT APPLICATION4
AND SUPPORT TEAM TO ASSIST THE STATE DEPARTMENT WITH DRAFTING5
THE GRANT APPLICATION, REVIEWING APPLICATIONS, AND ADMINISTERING6
AND PROCESSING GRANT AWARDS .7
(9) A
GRANT RECIPIENT SHALL SPEND OR OBLIGATE ANY MONEY8
RECEIVED PURSUANT TO THIS SECTION NO LATER THAN
DECEMBER 30,9
2024.
ANY MONEY A GRANT RECIPIENT OBLIGATES MUST BE EXPENDED NO10
LATER THAN
DECEMBER 30, 2026.11
(10) (a) T
HE STATE DEPARTMENT SHALL ESTABLISH A STEERING12
COMMITTEE TO:13
(I) P
ROVIDE CONTINUOUS INPUT INTO GRANT APPLICATION14
REQUIREMENTS;15
(II) P
ROVIDE FEEDBACK AND DIRECTION ON DATA COLLECTION16
STANDARDS AND REVIEW ; AND17
(III) E
NGAGE WITH COMMUNITY PARTNERS WHO WILL HELP18
SUPPORT THE INTEGRATED CARE PRACTICES THROUGH REFERRALS AND19
TRUSTED COMMUNICATIONS .20
(b) T
HE STATE DEPARTMENT SHALL SELECT A STATE DEPARTMENT21
EMPLOYEE TO CHAIR THE STEERING COMMITTEE , STAFF THE STEERING22
COMMITTEE, AND REIMBURSE ANY PARTICIPANT WHO IS NOT A STATE23
EMPLOYEE FOR REASONABLE TRAVEL EXPENSES .24
(11) T
HE STATE DEPARTMENT SHALL , IN COLLABORATION WITH25
THE BEHAVIORAL HEALTH ADMINISTRATION AND THE DIVISION OF26
INSURANCE, PREPARE A REPORT THAT INCLUDES RECOMMENDATIONS ON27
1302
-9- BEST PRACTICES FOR SUSTAINING INTEGRATED CARE MODELS . IN1
PREPARING THE REPORT, THE STATE DEPARTMENT SHALL COLLECT DATA2
FROM EACH GRANT RECIPIENT RELATED TO CLINICAL QUALITY3
IMPROVEMENT AND ACCESS TO CARE . GRANT RECIPIENTS SHALL PROVIDE4
DATA TO THE STATE DEPARTMENT IN A TIMELY MANNER , AS DETERMINED5
BY THE STATE DEPARTMENT. THE STATE DEPARTMENT IS AUTHORIZED TO6
RECOUP OR DISCONTINUE GRANT FUNDING FOR GRANT RECIPIENTS THAT7
DO NOT COMPLY WITH THE DATA REPORTING REQUIREMENTS OR GRANT8
STANDARDS SET BY THE STATE DEPARTMENT .9
(12) T
HE STATE DEPARTMENT AND ANY PERSON WHO RECEIVES10
MONEY FROM THE STATE DEPARTMENT PURSUANT TO THIS SECTION 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
(13) T
HIS SECTION IS REPEALED, EFFECTIVE JULY 1, 2027.16
SECTION 3. In Colorado Revised Statutes, 25.5-5-402, add (3.5)17
as follows:18
25.5-5-402. Statewide managed care system - rules - definition19
- repeal. (3.5) (a) N
O LATER THAN JULY 1, 2023, THE STATE20
DEPARTMENT, IN COLLABORATION WITH THE BEHAVIORAL HEALTH21
ADMINISTRATION IN THE DEPARTMENT OF HUMAN SERVICES AND OTHER22
STATE AGENCIES, SHALL DEVELOP THE UNIVERSAL CONTRACT AS23
DESCRIBED IN SECTION 27-50-203.24
(b) (I) F
OR THE 2022-23 STATE FISCAL YEAR, THE GENERAL25
ASSEMBLY SHALL APPROPRIATE THREE MILLION DOLLARS FROM THE26
BEHAVIORAL AND MENTAL HEALTH CASH FUND , CREATED IN SECTION27
1302
-10- 24-75-230, TO THE STATE DEPARTMENT FOR THE DEVELOPMENT ,1
IMPLEMENTATION, AND ADMINISTRATION OF THE UNIVERSAL CONTRACT .2
(II) T
HIS SUBSECTION (3.5)(b) IS REPEALED, EFFECTIVE JULY 1,3
2024.4 SECTION 4. Appropriation. (1) For the 2022-23 state fiscal5
year, $31,750,000 is appropriated to the department of health care policy6
and financing for use by other medical services. This appropriation is7
from the behavioral and mental health cash fund created in section8
24-75-230 (2)(a), C.R.S., is of money the state received from the federal9
coronavirus state fiscal recovery fund, and is based on an assumption that10
the division will require an additional 2.3 FTE. To implement this act, the11
division may use this appropriation for the primary care and behavioral12
health statewide integration grant program. Any money appropriated in13
this section not expended prior to July 1, 2023, is further appropriated to14
the division from July 1, 2023, through December 30, 2024, for the same15
purpose.16
(2) For the 2022-23 state fiscal year, $3,000,000 is appropriated to17
the department of health care policy and financing for use by the18
executive director's office, general administration. This appropriation is19
from the behavioral and mental health cash fund created in section20
24-75-230 (2)(a), C.R.S., and is of money the state received from the21
federal coronavirus state fiscal recovery fund. To implement this act, the22
division may use this appropriation for the universal contract for23
behavioral health services. Any money appropriated in this section not24
expended prior to July 1, 2023, is further appropriated to the division25
from July 1, 2023, through December 30, 2024, for the same purpose.26
(3) For the 2022-23 fiscal year, $250,000 is appropriated to the27
1302
-11- department of higher education for use by the regents of the university of1
Colorado. This appropriation is from the behavioral and mental health2
cash fund created in section 24-75-230 (2)(a), C.R.S., and is of money the3
state received from the federal coronavirus state fiscal recovery fund. To4
implement this act, the regents may use this appropriation for allocation5
to the school of medicine for the regional health connector workforce6
program.7
SECTION 5. Effective date. This act takes effect upon passage;8
except that section 3 of this act takes effect only if House Bill 22-12789
becomes law, in which case section 3 takes effect either upon the10
effective date of this act or House Bill 22-1278, whichever is later.11
SECTION 6. Safety clause. The general assembly hereby finds,12
determines, and declares that this act is necessary for the immediate13
preservation of the public peace, health, or safety.14
1302
-12-