Colorado § 25.5-4-505.5 - Federal authorization related to persons involved in the criminal justice system - report - rules - legislative declaration.

§ 25.5-4-505.5. Federal authorization related to persons involved in the criminal justice system - report - rules - legislative declaration.

(1) (a) The general assembly finds that:

(I) For decades, federal medicaid policy prohibited the use of federal funding for incarcerated medicaid members;

(II) With the emerging opportunity to allow for coverage of incarcerated medicaid members, Colorado is supportive of ensuring these members have access to needed services and treatment; and

(III) Colorado is committed to ensuring medicaid members have access to a civil, community-based system that meets members' needs and ensures Colorado's county jails, juvenile facilities, and prisons do not become primary access points for health-care services for people experiencing behavioral health conditions.

(b) Therefore, the general assembly declares it is in the best interest of all Coloradans, and especially Coloradans living with behavioral health conditions, to require the department of health care policy and financing to seek a federal waiver of the medicaid inmate exclusion policy that includes annual data reporting requirements that:

(I) Inform Coloradans regarding the unmet health needs of individuals involved in the criminal justice system;

(II) Promote the establishment of continuous civil systems of care within communities demonstrably committed to diversion or deflection efforts, including, but not limited to, mobile outreach, co-responder programs, and prosecutor- or judicial-led initiatives; and

(III) Aim to reduce unnecessary involvement with the criminal justice system and increase access to community-based housing, health care, supports, and services.

(2) (a) No later than April 1, 2024, the state department shall seek a federal authorization to provide, through the state medical assistance program, medication-assisted treatment and case management to a member prior to the member's release and a thirty-day supply of prescription medications to a member upon the member's release from a juvenile institutional facility, as defined in section 25-1.5-301 (2)(b), or a department of corrections facility.

(b) Beginning July 1, 2025, and subject to available appropriations, the services described in subsection (2)(a) of this section are available upon receipt of the necessary federal authorization.

(3) (a) (I) No later than April 1, 2025, the state department shall seek a federal authorization to provide, through the state medical assistance program, medication-assisted treatment and case management to a member prior to the member's release from jail and a thirty-day supply of prescription medications to a member upon the member's release from jail.

(II) The state department shall implement subsection (3)(a)(I) of this section only if the state department determines that providing the services described in subsection (3)(a)(I) of this section is budget neutral.

(b) Beginning July 1, 2026, and subject to available appropriations, the services described in subsection (3)(a) of this section are available upon receipt of the necessary federal authorization.

(4) Upon receipt of the necessary federal authorization, the state department shall:

(a) Conduct a rigorous stakeholder process that includes, but is not limited to, receiving feedback from individuals with lived experience in accessing, or the inability to access, behavioral health services in civil settings, county jails, juvenile institutional facilities, and the department of corrections; and

(b) Require each county with a county jail seeking to provide services pursuant to this section to demonstrate a commitment to diversion or deflection efforts, including, but not limited to, mobile outreach, co-responder programs, and prosecutor- or judicial-led initiatives that aim to reduce unnecessary involvement with the criminal justice system and increase access to community-based housing, health care, supports, and services.

(5) (a) The state department shall reimburse a provider who is licensed and authorized to prescribe, dispense, compound, or administer medication-assisted treatment in a jail setting.

(b) The state department shall ensure as part of the state department's quality oversight that licensed providers who administer medication-assisted treatment in a jail setting maintain emergency policies and procedures that address adverse outcomes.

(6) The state department may expand services available pursuant to this section as authorized pursuant to federal law and regulations. If the state department seeks to expand services, the state department shall demonstrate how the state department will ensure quality of care and client safety, which must include addressing quality and safety in administering medications in a jail setting.

(7) (a) Beginning July 1, 2025, and each July 1 thereafter, the state department shall annually report to the house of representatives health and human services committee and the senate health and human services committee, or their successor committees, the following information:

(I) De-identified information of individuals who have accessed services, including each individual's demographics, the type of services the individual accessed, the duration of the services offered in a carceral setting compared to the duration of the same services offered in a civil setting, and the individual's experiences before and after incarceration, including but not limited to:

(A) Emergency room or crisis system visits;

(B) Inpatient stays for a primary behavioral health condition; and

(C) Services accessed in a qualified residential treatment program, as defined in section 19-1-103, or a psychiatric residential treatment facility, as defined in section 25.5-4-103;

(II) The total number of medicaid members who were unhoused before or after incarceration, if available;

(III) The total number of unique incarceration stays by medicaid members, as demonstrated by the services accessed;

(IV) The total number of individuals who accessed services in a civil setting prior to arrest or detainment and were subsequently evaluated for competency, ordered to competency restoration, restored to competency, or found incompetent to proceed in a forensic setting; and

(V) Persistent gaps in continuity of care in least-restrictive civil settings.

(b) Notwithstanding section 24-1-136 (11)(a)(I) to the contrary, the state department's report continues indefinitely.

(8) The state department may promulgate rules for the implementation of this section.

Source: L. 2024: Entire section added, (HB 24-1045), ch. 470, p. 3284, § 18, effective August 7. L. 2026: (5) amended, (HB 26-1235), ch. 361, p. 2171, § 6, effective August 12; IP(7)(a) amended, (SB 26-169), ch. 311, p. 1810, § 46, effective August 12.