Colorado § 27-50-302 - Requirement to serve priority populations - screening and triage for individuals in need of behavioral health services - referrals.

§ 27-50-302. Requirement to serve priority populations - screening and triage for individuals in need of behavioral health services - referrals.

(1) Except as provided in this section, comprehensive community behavioral health providers must provide the safety net services listed in section 27-50-101 (11) to priority populations.

(2) Except as provided in section 27-50-303, essential behavioral health safety net providers shall provide the safety net service or services that they contract with the behavioral health administrative services organization or managed care entity to provide to priority populations.

(3) Notwithstanding any other provision of this section to the contrary, emergency and crisis services must be available to any individual who is experiencing a behavioral health crisis, regardless of whether the individual is a priority population.

(4) (a) When a priority population client initiates treatment with a behavioral health safety net provider, prior to the intake the provider shall complete an initial screening and triage process to determine urgency and appropriateness of care with the provider.

(b) The behavioral health safety net provider shall use standard criteria, as determined by the BHA, for determining whether a client's needs exceed the clinical expertise of the provider.

(c) If a priority population client's needs exceed the treatment capacity or clinical expertise of an essential behavioral health safety net provider, the provider shall refer the client to another appropriate provider.

(d) If a priority population client's needs exceed the treatment capacity or clinical expertise of a comprehensive community behavioral health provider, the provider must ensure that the client has access to interim behavioral health services in a timely manner until the client is connected to the most appropriate provider for ongoing care. This may include use of providers within the network of the behavioral health administrative services organization or the regional managed care entity.

(e) The comprehensive community behavioral health provider shall obtain approval from the behavioral health administrative services organization under which the provider is operating, or the regional managed care entity for medicaid clients, prior to referring a priority population client to alternative services; except that an individual experiencing a behavioral health crisis may be referred to emergency or crisis services without prior approval.

(f) A behavioral health safety net provider shall include services that address the language, ability, and cultural barriers, as necessary, to serve communities of color and other underserved populations.

(5) When referring a client to alternative services, a behavioral health safety net provider shall assist the client in identifying and initiating services with an appropriate provider for ongoing care. As appropriate, the behavioral health safety net provider shall use the behavioral health administrative services organization or, for medicaid clients, the regional managed care entity for care coordination.

(6) (a) Behavioral health safety net providers shall track the following information for all individuals who were referred to alternative services pursuant to this section:

(I) Client demographics;

(II) Standardized descriptions of the needs of the client that could not be met and require the client to be referred to another provider;

(III) The outcome and timeliness of the referral; and

(IV) Any other information required by the BHA.

(b) The provider shall provide the report at regular intervals to the BHA and to either the behavioral health administrative services organization under which the provider is operating or, for medicaid clients, to the managed care entity.

Source: L. 2022: Entire article added, (HB 22-1278), ch. 222, p. 1462, § 1, effective July 1. L. 2023: (4)(f) added, (HB 23-1236), ch. 206, p. 1059, § 23, effective May 16.