HOUSE BILL 22-1303
BY REPRESENTATIVE(S) Amabile and Sandridge, Gonzales-Gutierrez,
Michaelson Jenet, Benavidez, Bernett, Bird, Boesenecker, Caraveo, Cutter,
Duran, Exum, Gray, Hooton, Jodeh, Kennedy, Kipp, Lindsay, Lontine,
McCluskie, McCormick, McLachlan, Mullica, Roberts, Sirota, Snyder,
Tipper, Weissman, Woodrow, Young, Garnett, Esgar, Froelich, Bacon,
Carver, Catlin, Daugherty, Herod, Pico, Ricks, Titone, Valdez D.;
also SENATOR(S) Winter and Smallwood, Buckner, Cooke, Donovan,
Gardner, Hisey, Jaquez Lewis, Kirkmeyer, Kolker, Lee, Moreno, Pettersen,
Simpson, Story, Fenberg.
C
ONCERNING AN INCREASE IN THE NUMBER OF RESIDENTIAL BEHAVIORAL
HEALTH BEDS
, AND, IN CONNECTION THEREWITH , MAKING AN
APPROPRIATION
.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. Legislative declaration. (1) The general assembly
finds and declares that:
(a) During the COVID-19 pandemic, adults with behavioral health
needs have faced unprecedented challenges;
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. (b) During this time, adults and their families have needed increased
availability of behavioral and mental health care, including residential beds;
(c) At least one hundred twenty-five additional residential beds for
adults with severe mental illness or urgent behavioral health needs that
require long-term services and supports or immediate intervention must be
created statewide and made available as long as necessary for stabilization;
(d) The Colorado mental health institute at Fort Logan needs sixteen
additional beds to serve adults in need of competency services and adults
with serious mental illness or chronic behavioral health needs in need of
civil commitment;
(e) The federal government enacted the "American Rescue Plan Act
of 2021" to enable state, local, and tribal governments to provide critical
government services in response to the adverse impacts of the COVID-19
pandemic;
(f) People with serious mental illness are in need of longer-term
treatment and stabilization services in their communities;
(g) The residential beds funded by this act are appropriate uses of
the federal money transferred to Colorado under the "American Rescue Plan
Act". This funding will expand access to residential beds; and
(h) The services described in this act are critical government
services.
SECTION 2. In Colorado Revised Statutes, add 27-94-107 as
follows:
27-94-107. Renovation for additional beds. (1) T
HE DEPARTMENT
OF HUMAN SERVICES SHALL RENOVATE A BUILDING AT THE CENTER TO ADD
AT LEAST SIXTEEN INPATIENT BEDS
. THE DEPARTMENT SHALL SPEND OR
OBLIGATE ALL MONEY APPROPRIATED FOR THE RENOVATION BY
DECEMBER
30, 2024. ANY MONEY OBLIGATED BY DECEMBER 30, 2024, MUST BE
EXPENDED BY
DECEMBER 30, 2026.
(2) I
NITIALLY, THE BEDS MAY BE USED FOR PERSONS NEEDING
COMPETENCY SERVICES
. WHEN THE WAIT LIST FOR COMPETENCY SERVICES
PAGE 2-HOUSE BILL 22-1303 PROVIDED PURSUANT TO SECTION 16-8.5-111 IS ELIMINATED OR TRENDING
SO THAT IT CAN BE REASONABLY EXPECTED TO BE ELIMINATED WITHIN ONE
YEAR
, THE DEPARTMENT OF HUMAN SERVICES SHALL IMPLEMENT A PLAN TO
TRANSITION THE BEDS CREATED IN SUBSECTION
(1) OF THIS SECTION TO
SERVE CIVIL PATIENTS AND IMMEDIATELY NOTIFY THE JOINT BUDGET
COMMITTEE OF THE GENERAL ASSEMBLY
. WITHIN ONE YEAR AFTER THE
NOTIFICATION TO THE JOINT BUDGET COMMITTEE
, ALL BEDS CREATED
PURSUANT TO SUBSECTION
(1) OF THIS SECTION MUST SERVE CIVIL PATIENTS.
SECTION 3. In Colorado Revised Statutes, add article 71 of title
27 as follows:
ARTICLE 71
Mental Health Residential Facility
27-71-101. Legislative declaration. T
HE GENERAL ASSEMBLY FINDS
AND DECLARES THAT THERE IS AN URGENT NEED FOR COMMUNITY
-BASED
MENTAL HEALTH RESIDENTIAL BEDS THROUGHOUT THE STATE TO SERVE
INDIVIDUALS WHO NEED THE SUPPORT OF A RESIDENTIAL SETTING
.
27-71-102. Definitions. A
S USED IN THIS ARTICLE 71, UNLESS THE
CONTEXT OTHERWISE REQUIRES
:
(1) "A
SSISTED LIVING RESIDENCE" HAS THE SAME MEANING AS
DEFINED IN SECTION
25-27-102 (1.3).
(2) "B
EHAVIORAL HEALTH ADMINISTRATION " OR "BHA" MEANS THE
BEHAVIORAL HEALTH ADMINISTRATION ESTABLISHED PURSUANT TO SECTION
27-60-203.
(3) "B
EHAVIORAL HEALTH DISORDER " HAS THE SAME MEANING AS
DEFINED IN SECTION
25-27.6-102 (5).
(4) "B
EHAVIORAL HEALTH ENTITY " HAS THE SAME MEANING AS
DEFINED IN SECTION
25-27.6-102 (6).
(5) "D
EPARTMENT" MEANS THE DEPARTMENT OF HUMAN SERVICES .
(6) "L
EVEL OF CARE" MEANS THE INTENSITY OF EFFORT REQUIRED TO
DIAGNOSE
, PRESERVE, OR MAINTAIN AN INDIVIDUAL 'S PHYSICAL OR
PAGE 3-HOUSE BILL 22-1303 EMOTIONAL STATUS , WITH CONSIDERATION TOWARDS CREATING A
MINIMALLY RESTRICTIVE AND HOMELIKE ENVIRONMENT
, WHEN FEASIBLE
AND SAFE
.
(7) "L
ONG TERM FACILITY" MEANS A RESIDENTIAL FACILITY
OPERATED BY A BEHAVIORAL HEALTH ENTITY OR ASSISTED LIVING
RESIDENCE WITH THE INTENT TO SUPPORT
, STABILIZE, AND PROMOTE
LONG
-LASTING RECOVERY BY PROVIDING THE APPROPRIATE LEVEL OF CARE
TO PATIENTS WITH MENTAL HEALTH DISORDERS
.
(8) "M
ENTAL HEALTH RESIDENTIAL FACILITY" OR "MENTAL HEALTH
FACILITY
" MEANS A RESIDENTIAL MENTAL HEALTH FACILITY OPERATED BY
A BEHAVIORAL HEALTH ENTITY OR AN ASSISTED LIVING RESIDENCE TO SERVE
INDIVIDUALS WITH A MENTAL HEALTH DISORDER WHO NEED THE SUPPORT OF
A LONG
-TERM RESIDENTIAL SETTING INCLUDING PERSONS COMING FROM A :
(a) C
OLORADO MENTAL HEALTH INSTITUTE ;
(b) H
OSPITAL DESIGNATED AS A PLACEMENT FACILITY FOR
SEVENTY
-TWO HOUR EVALUATION AND TREATMENT , AND SHORT-TERM AND
LONG
-TERM SUPPORT;
(c) C
OMMUNITY BEHAVIORAL HEALTH SAFETY NET PROVIDER ;
(d) W
ALK-IN CRISIS CENTER, CRISIS STABILIZATION UNIT, OR ACUTE
TREATMENT UNIT OPERATING AS PART OF THE BEHAVIORAL HEALTH CRISIS
RESPONSE SYSTEM
; OR
(e) HOSPITAL EMERGENCY ROOM .
27-71-103. Mental health residential facilities - additional beds.
(1) (a) O
N OR BEFORE JULY 1, 2024, THE DEPARTMENT AND THE
DEPARTMENT OF HEALTH CARE POLICY AND FINANCING SHALL JOINTLY
CREATE
, DEVELOP, OR CONTRACT, WHICH MAY INCLUDE THE COST OF
RENOVATION AT PRIVATE FACILITIES
, FOR AT LEAST AN ADDITIONAL ONE
HUNDRED AND TWENTY
-FIVE BEDS AT MENTAL HEALTH RESIDENTIAL
FACILITIES THROUGHOUT THE STATE BASED ON THE GREATEST AREAS OF
NEED
. THE BEDS IN THE MENTAL HEALTH FACILITIES ARE AVAILABLE FOR
ADULT INDIVIDUALS IN NEED OF ONGOING SUPPORTIVE SERVICES
, BUT
INDIVIDUALS WITH A SEVERE MENTAL ILLNESS OR A DUAL DIAGNOSIS OF
PAGE 4-HOUSE BILL 22-1303 MENTAL ILLNESS AND ALCOHOL OR SUBSTANCE USE DISORDER MUST BE
PRIORITIZED
. WHEN AVAILABLE, THE DEPARTMENT SHALL USE EXISTING
DEPARTMENT PROPERTIES FOR THE MENTAL HEALTH FACILITIES
.
(b) A
T A MINIMUM, THE DEPARTMENT SHALL ENSURE THAT THE
MENTAL HEALTH RESIDENTIAL FACILITIES OFFER THE FOLLOWING SERVICES
:
(I) A
SSISTANCE WITH MEDICATION;
(II) D
IRECT SUPPORT PERSONNEL INCLUDING ASSISTANCE WITH
ACTIVITIES OF DAILY LIVING
;
(III) I
NTENSIVE CASE MANAGEMENT SERVICES ;
(IV) L
IFE SKILLS TRAINING; AND
(V) NON-MEDICAL TRANSPORTATION .
(c) T
HE DEPARTMENT AND THE DEPARTMENT OF HEALTH CARE
POLICY AND FINANCING SHALL WORK COLLABORATIVELY TO ENSURE THE
BEDS IN THE MENTAL HEALTH FACILITIES ARE ELIGIBLE FOR FEDERAL
FUNDING THROUGH THE MEDICAL ASSISTANCE PROGRAM
.
(2) (a) T
HE BEDS AT THE MENTAL HEALTH FACILITIES CREATED
PURSUANT TO THIS SECTION ARE INTENDED PRIMARILY FOR ADULT
INDIVIDUALS WITH SERIOUS MENTAL ILLNESS OR A CO
-OCCURRING MENTAL
HEALTH AND SUBSTANCE USE DISORDER IN NEED OF SERVICES
. A MENTAL
HEALTH FACILITY MAY ALSO PROVIDE SERVICES TO AN INDIVIDUAL IN NEED
OF COMPETENCY RESTORATION PURSUANT TO ARTICLE
8.5 OF TITLE 16 WHO
DOES NOT REQUIRE IMPRISONMENT IN A JAIL
.
(b) T
HE DEPARTMENT, IN COLLABORATION WITH THE BEHAVIORAL
HEALTH ADMINISTRATION AND THE DEPARTMENT OF HEALTH CARE POLICY
AND FINANCING
, SHALL PRIORITIZE PLACEMENT FOR INDIVIDUALS IN THE
CIVIL SYSTEM WHO ARE LEAVING THE MENTAL HEALTH INSTITUTES AT
PUEBLO AND FORT LOGAN, CIVIL INDIVIDUALS BEING DISCHARGED FROM
INPATIENT SETTINGS
, INDIVIDUALS RECEIVING INVOLUNTARY MENTAL
HEALTH TREATMENT PURSUANT TO ARTICLE
65 OF THIS TITLE 27, AND CIVIL
INDIVIDUALS IN NEED OF RESIDENTIAL SERVICES WHO ARE IN A MENTAL
HEALTH CRISIS FACILITY
, ACUTE CARE HOSPITAL, OR IN THE COMMUNITY.
PAGE 5-HOUSE BILL 22-1303 (c) THE STATE DEPARTMENT , IN COLLABORATION WITH THE
BEHAVIORAL HEALTH ADMINISTRATION AND THE DEPARTMENT OF HEALTH
CARE POLICY AND FINANCING
, SHALL ESTABLISH CRITERIA FOR ADMISSIONS
AND DISCHARGE PL ANNING
, QUALITY ASSURANCE MONITORING ,
APPROPRIATE LENGTH OF STAY , AND COMPLIANCE WITH APPLICABLE
FEDERAL LAW
. FOR THE MENTAL HEALTH RESIDENTIAL FACILITIES CREATED
PURSUANT TO THIS SECTION
, ADMISSION CRITERIA FOR FACILITIES MUST
INCLUDE
:
(I) P
RIORITIZATION OF PEOPLE WITH SERIOUS MENTAL ILLNESS WHO
HAVE COMPLEX OR CO
-OCCURRING CONDITIONS AS DEFINED BY THE STATE
DEPARTMENT
; AND
(II) FOR TREATMENT BEDS THAT DO NOT SERVE INDIVIDUALS
COVERED UNDER A HOME
- AND COMMUNITY-BASED WAIVER, OFFERING
PRIORITY PLACEMENT TO INDIVIDUALS UNDER A CERTIFICATION FOR
SHORT
-TERM OR EXTENDED SHORT-TERM TREATMENT PURSUANT TO SECTION
27-65-107 OR 27-65-108 AND LONG-TERM CARE AND TREATMENT PURSUANT
TO SECTION
27-65-109 ON AN OUTPATIENT BASIS.
(d) T
HE STATE DEPARTMENT SHALL COLLABORATE WITH RELEVANT
STAKEHOLDERS WHEN ESTABLISHING THE CRITERIA DESCRIBED IN
SUBSECTION
(2)(c) OF THIS SECTION.
(3) T
HE DEPARTMENT SHALL DISTRIBUTE THE MONEY FOR THE
CREATION OF ADDITIONAL BEDS PURSUANT TO THIS SECTION NO LATER THAN
DECEMBER 30, 2024. ANY PERSON RECEIVING MONEY PURSUANT TO THIS
SECTION SHALL SPEND OR OBLIGATE ALL MONEY RECEIVED BY
DECEMBER
30, 2024. ANY MONEY OBLIGATED BY DECEMBER 30, 2024, MUST BE
EXPENDED BY
DECEMBER 30, 2026.
27-71-104. Mental health residential facilities - initial license
requirements - repeal. (1) O
N OR AFTER JULY 1, 2022, ANY PERSON,
PARTNERSHIP, ASSOCIATION, OR CORPORATION OPERATING A MENTAL
HEALTH RESIDENTIAL FACILITY SHALL OBTAIN A LICENSE FROM THE
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT OR THE DEPARTMENT
OF HUMAN SERVICES AS EITHER
:
(a) A
N ASSISTED LIVING RESIDENCE LICENSED PURSUANT TO ARTICLE
27 OF TITLE 25; OR
PAGE 6-HOUSE BILL 22-1303 (b) A BEHAVIORAL HEALTH ENTITY LICENSED PURSUANT TO ARTICLE
27.6 OF TITLE 25.
(2) N
OTWITHSTANDING THE REQUIREMENT OF SUBSECTION (1) OF
THIS SECTION
, A MENTAL HEALTH FACILITY NEED NOT BE LICENSED AS A
MENTAL HEALTH FACILITY IF THE FACILITY IS
:
(a) L
ICENSED PURSUANT TO ARTICLE 27 OF TITLE 25; AND
(b) PROVIDING SERVICES TO INDIVIDUALS UNDER A HOME - AND
COMMUNITY
- BASED SERVICES FOR PERSONS WITH MAJOR MENTAL HEALTH
DISORDERS WAIVER PURSUANT TO PART
6 OF ARTICLE 6 OF TITLE 25.5.
(3) O
N AND AFTER JULY 1, 2023, THE BEHAVIORAL HEALTH
ADMINISTRATION IS RESPONSIBLE FOR LICENSING MENTAL HEALTH HOME
-
AND COMMUNITY-BASED WAIVER RESIDENTIAL FACILITIES.
(4) T
HIS SECTION IS REPEALED, EFFECTIVE SEPTEMBER 1, 2024.
27-71-105. Mental health residential facilities - licensing
requirements - rules. (1) O
N AND AFTER JULY 1, 2023, UNLESS LICENSED
AS AN ASSISTED LIVING FACILITY
, ANY PERSON, PARTNERSHIP, ASSOCIATION,
OR CORPORATION OPERATING A MENTAL HEALTH RESIDENTIAL FACILITY
SHALL OBTAIN A LICENSE FROM THE BEHAVIORAL HEALTH ADMINISTRATION
.
B
Y JULY 1, 2023, THE BHA SHALL PROMULGATE RULES ESTABLISHING
MINIMUM STANDARDS FOR THE OPERATION AND LICENSING OF MENTAL
HEALTH FACILITIES
. THE RULES MUST ADDRESS, AT A MINIMUM, HEALTH,
SAFETY, WELFARE, AND PROGRAMMATIC AND TREATMENT CONSIDERATION .
(2) N
OTWITHSTANDING THE REQUIREMENT OF SUBSECTION (1) OF
THIS SECTION
, A MENTAL HEALTH FACILITY NEED NOT BE LICENSED AS A
MENTAL HEALTH FACILITY IF THE FACILITY IS
:
(a) L
ICENSED PURSUANT TO ARTICLE 27 OF TITLE 25; AND
(b) PROVIDING SERVICES TO INDIVIDUALS UNDER A HOME - AND
COMMUNITY
- BASED SERVICES FOR PERSONS WITH MAJOR MENTAL HEALTH
DISORDERS WAIVER PURSUANT TO PART
6 OF ARTICLE 6 OF TITLE 25.5.
SECTION 4. Appropriation. (1) For the 2022-23 state fiscal year,
PAGE 7-HOUSE BILL 22-1303 $728,296 is appropriated to the department of human services for use by
administration and finance. This appropriation is from the behavioral and
mental health cash fund created in section 24-75-230 (2)(a), C.R.S., and is
of money the state received from the federal coronavirus state fiscal
recovery fund. Any money appropriated in this section not expended prior
to July 1, 2023, is further appropriated to the department from July 1, 2023,
through December 30, 2024, for the same purpose. To implement this act,
the department may use this appropriation as follows:
(a) $372,264 for personal services related to administration, which
amount is based on an assumption that the department will require 3.3 FTE
in the 2022-23 state fiscal year and 3.3 FTE in the 2023-24 state fiscal year;
(b) $346,040 for operating expenses related to administration; and
(c) $9,992 for vehicle lease payments.
(2) For the 2022-23 state fiscal year, $9,992 is appropriated to the
department of personnel for use by the division of capital assets. This
appropriation is from reappropriated funds received from the department of
human services under subsection (1)(c) of this section. To implement this
act, the department of personnel may use this appropriation to provide
vehicles to the department of human services. Any money appropriated in
this section not expended prior to July 1, 2023, is further appropriated to the
department from July 1, 2023, through December 30, 2024, for the same
purpose.
SECTION 5. Appropriation. (1) For the 2022-23 state fiscal year,
$39,854,179 is appropriated to the department of human services for use by
the office of behavioral health. This appropriation is from the behavioral
and mental health cash fund created in section 24-75-230 (2)(a), C.R.S., and
is of money the state received from the federal coronavirus state fiscal
recovery fund. Any money appropriated in this section not expended prior
to July 1, 2023, is further appropriated to the office from July 1, 2023,
through December 30, 2024, for the same purpose. To implement this act,
the department may use this appropriation as follows:
(a) $2,559,676 for oversight costs related to mental health
residential facilities, which amount is based on an assumption that the office
will require 7.0 FTE in the 2022-23 state fiscal year and 7.0 FTE in the
PAGE 8-HOUSE BILL 22-1303 2023-24 state fiscal year;
(b) $3,809,582 for costs associated with mental health residential
facilities located in department-owned properties, which amount is based
on an assumption that the office will require 14.8 FTE in the 2023-24 state
fiscal year; and
(c) $33,484,921 for contract beds in and the renovation of mental
health residential facilities.
SECTION 6. Appropriation. For the 2022-23 state fiscal year,
$6,578,266 is appropriated to the department of human services for use by
the office of behavioral health. This appropriation is from the behavioral
and mental health cash fund created in section 24-75-230 (2)(a), C.R.S., and
is of money the state received from the federal coronavirus state fiscal
recovery fund. The office may use this appropriation for costs associated
with the operation of additional beds at the Colorado mental health institute
at Fort Logan established pursuant to section 27-94-107, C.R.S. Any money
appropriated in this section not expended prior to July 1, 2023, is further
appropriated to the office from July 1, 2023, through December 30, 2024,
for the same purpose. These appropriations are based on the assumption that
the office will require an additional 59.2 FTE in the 2023-24 state fiscal
year to implement this act.
SECTION 7. Capital construction appropriation. For the
2022-23 state fiscal year, $6,991,567 is appropriated to the department of
human services. This appropriation is from the behavioral and mental health
cash fund created in section 24-75-230 (2)(a), C.R.S. To implement this act,
the department may use this appropriation for capital construction related
to the renovation for additional inpatient beds at the Colorado mental health
institute at Fort Logan. Any money appropriated in this section not
expended prior to July 1, 2023, is further appropriated to the department
from July 1, 2023, through December 30, 2024, for the same purpose.
SECTION 8. Capital construction appropriation. For the
2022-23 state fiscal year, $3,692,111 is appropriated to the department of
human services. This appropriation is from the behavioral and mental health
cash fund created in section 24-75-230 (2)(a), C.R.S. To implement this act,
the department may use this appropriation for capital construction related
to the renovation of three existing department properties to create mental
PAGE 9-HOUSE BILL 22-1303 health residential facilities pursuant to section 27-71-103 (1)(a), C.R.S. Any
money appropriated in this section not expended prior to July 1, 2023, is
further appropriated to the department from July 1, 2023, through December
30, 2024, for the same purpose.
SECTION 9. Appropriation. (1) For the 2022-23 state fiscal year,
$91,938 is appropriated to the department of health care policy and
financing for use by the executive director's office. This appropriation is
from the general fund. To implement this act, the office may use this
appropriation as follows:
(a) $84,388 for personal services, which amount is based on an
assumption that the office will require an additional 1.8 FTE; and
(b) $7,550 for operating expenses.
(2) For the 2022-23 state fiscal year, the general assembly
anticipates that the department of health care policy and financing will
receive $91,937 in federal funds to implement this act, which amount is
subject to the "(I)" notation as defined in the annual general appropriation
act for the same fiscal year. The appropriation in subsection (1) of this
section is based on the assumption that the department will receive this
amount of federal funds to be used as follows:
(a) $84,387 for personal services; and
(b) $7,550 for operating expenses.
SECTION 10. Safety clause. The general assembly hereby finds,
PAGE 10-HOUSE BILL 22-1303 determines, and declares that this act is necessary for the immediate
preservation of the public peace, health, or safety.
____________________________ ____________________________
Alec Garnett Steve Fenberg
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Robin Jones Cindi L. Markwell
CHIEF CLERK OF THE HOUSE SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 11-HOUSE BILL 22-1303