Behavioral Health Laws & Rules

The CDHS Office of Behavioral Health (OBH) is responsible for regulating the provision of behavioral health services by developing and monitoring reasonable and proper standards, rules and regulations.

 

Laws & Rules Updates

OPEN for Comment: Proposed Rule Updates to the Children and Youth Mental Health Treatment Act

The Office of Behavioral Health has created a rule draft updating how the Children and Youth Mental Health Treatment Act will be implemented to align with the changes to the Act with the passage of House Bill 18-1094. Significant changes to the Act from House Bill 18-1094 include:

  • Renaming the “Child Mental Health Treatment Act” to the “Children and Youth Mental Health Treatment Act”; 
  • Expanding eligibility for services from age 18 to age 21 and expanding service availability statewide; 
  • Requiring the Department of Human Services (DHS) to develop a standardized risk stratification tool for use by mental health agencies in determining eligibility;
  • Requiring DHS to provide family advocacy to any family seeking funding, or receiving funding, through this Act;
  • Requiring DHS to maintain a list of providers approved to receive funding under this Act, and requiring Mental Health Agencies to provide a list of providers to eligible families;
  • Continuing the ability of a parent or guardian of a non-Medicaid eligible child or youth to receive mental health services for the child or youth without unwarranted child welfare involvement; 
  • When evaluating a child or youth for eligibility for mental health treatment services, the evaluating mental health agency shall use a standardized risk stratification tool; and,
  • Establishing a new definition of mental health agency to capture a larger set of behavioral health services providers.

The Office of Behavioral Health is required to provide public notice on proposed rules. The proposed rule draft can be found here. Interested stakeholders have an opportunity to present feedback prior to the submission of the rules to the State Board of Human Services for review and adoption. Feedback will be accepted until 5 p.m. on Aug. 30, 2018. Feedback on the proposed rules can be submitted to the Office of Behavioral Health here.

NOW AVAILABLE: Involuntary Transportation Hold Frequently Asked Questions Document

The Office of Behavioral Health has created a frequently asked questions (FAQ) document answering questions related to the Involuntary Transportation for Immediate Screening Hold (M-0.5). The Involuntary Transportation Hold FAQ document can be found here. This FAQ document is designed to provide additional information on the Involuntary Transportation Hold and can be utilized in addition to the Involuntary Transportation Hold resources provided here.
 

UPDATE: Proposed Rules for Facilities Reporting Mental Health Procedure Data

In response to feedback the Office of Behavioral Health received on Proposed Rules for Emergency Departments Reporting 72-Hour Hold Data, the 27-65 designated facility data reporting rules (Rule Volume 2 CCR 502-1, Section 21.280.23) has been updated to align data reporting requirements across facility types.
 
The updated proposed rule draft that streamlines the 27-65 designated facility data reporting requirements with the emergency department 27-65 data reporting requirements can be found here . These proposed rules are projected to be presented for first reading at the State Board of Human Services on Oct. 5.
 
If you have questions about these proposed rules, please contact OBH Regulations Administrator, Ryan Templeton at ryan.templeton@state.co.us by COB Aug. 1.
 

OPEN for Comment: Proposed Rules for the Community Transition Specialist Program

Senate Bill 18-270 (27-66.5, C.R.S.) created a statewide Community Transition Specialist Program in the Colorado Department of Human Services, Office of Behavioral Health. This voluntary program promotes community living for individuals discharging from inpatient services in hospitals and withdrawal management facilities, by assisting the individual in obtaining housing, accessing treatment, advocacy, and other community based services. The proposed rules will further establish program eligibility requirements, by clarifying the definition of a “high-risk individual”.
 
The Office of Behavioral Health is required to provide public notice on proposed rules. The proposed rule draft can be found here. Interested stakeholders have an opportunity to present feedback prior to the submission of the rules to the State Board of Human Services for review and adoption. Feedback will be accepted until 5 p.m. on Aug. 1. Feedback on the proposed rules can be submitted to the Office of Behavioral Health here. 
 

CAC Trainer Fees Executive Director Rules Adopted June 18

On June 18, 2018, CDHS Executive Director Reggie Bicha adopted rules to formalize the fees currently established in the Certified Addiction Counselor (CAC) Clinical Training Program – OBH Approved Trainer Program. Pursuant to Section 27-80-111, C.R.S., rules needed to be established by the executive director for the fees to be charged for addiction counselor training. The adopted rules that will go into effect Aug. 1 can be found here. Additional information on the Certified Addiction Counselor Training Program can be found here.

Medication Consistency in Designated Facilities Rule Adopted June 1, 2018, effective August 1, 2018.

To ensure individuals, with behavioral or mental health disorders, transitioning between settings and service providers have access to a broad spectrum of effective medications. Senate Bill 17-019 requires: The use of a medication formulary that lists required medications that are to be used across systems; and, Rules that require providers under the authority of the Department of Human Services to use the medication formulary. The required formulary psychotropic medications can be found here.

Rules for Medication Consistency in Designated Facilities were adopted by the State Board of Human Services on June 1, 2018. These rule will go into effect Aug. 1, 2018. The adopted rule can be found here.

Involuntary Transportation for Immediate Screening Rules Adopted April 6, 2018, effective June 1, 2018

The Involuntary Transportation for Immediate Screening Rules were adopted at the State Board of Human Services meeting on April 6. The proposed rules are designed to provide a procedure for how designated facilities are to implement this new hold, created by Senate Bill 17-207.

The Involuntary Transportation for Immediate Screening Rules will go into effect June 1, 2018. The adopted rules can be found here.

OPEN for Comment: Proposed Rule Update for Incorporation by Reference and DUI Provisions

This rule change proposal updates how references within OBH Rule Volume 2 CCR 502-1 are cited, this update will align OBH Rule Volume 2 CCR 502-1 with federal incorporation by reference requirements established in 1 CFR Part 51.  The rule change proposal also removes outdated regulatory requirements for DUI providers, as some approved DUI curriculum do not require a pre-test or a post-test.

The Office of Behavioral Health is required to provide public notice on proposed rules. The proposed rule draft can be found here. Interested stakeholders have an opportunity to present feedback prior to the submission of the rules to the Executive Director of the Department of Human Services for review and adoption. Feedback will be accepted until 5 p.m. on May 9. Feedback on the proposed rules can be submitted to the Office of Behavioral Health here.

OPEN for Comment: Proposed Rules for Emergency Departments Reporting 72-Hour Hold Data

Senate Bill 17-207 (27-65-105(7), C.R.S.) made a requirement for emergency medical services facilities (emergency departments) to report their 72-hour hold data to the Office of Behavioral Health annually. The proposed rules establish what data shall be submitted and the procedure for how these emergency medical services facilities report their data to the Office of Behavioral Health.

The Office of Behavioral Health is required to provide public notice on proposed rules. The proposed rule draft can be found here. Interested stakeholders have an opportunity to present feedback prior to the submission of the rules to the Executive Director of the Department of Human Services for review and adoption. Feedback will be accepted until 5 p.m. on May 9. Feedback on the proposed rules can be submitted to the Office of Behavioral Health here.

OPEN for Comment: Proposed Rule Update for License/Designation Renewal Timing

Facilities licensed or designated by the Office of Behavioral Health must submit a renewal application every two years. Current rule allows facilities to have their license or designation stay in effect after the expiration date as long as OBH receives the renewal application on or before the date of the expiration. Other OBH rules require licensing renewal applications be submitted to OBH 60 days prior to the expiration of the license, creating inconsistency in the licensing renewal process and allowing facilities to operate after their license has expired.

The proposed rule removes the regulatory provision that a license or designation remains in effect during the approval process when a renewal application is submitted to OBH on or before the current expiration date. This requires facilities to submit their renewal application 60 days prior to the expiration of their current license or designation, which is a current OBH rule.

The Office of Behavioral Health is required to provide public notice on proposed rules. The proposed rule draft can be found here. Interested stakeholders have an opportunity to present feedback prior to the submission of the rules to the Executive Director of the Department of Human Services for review and adoption. Feedback will be accepted until 5 p.m. on May 9. Feedback on the proposed rules can be submitted to the Office of Behavioral Health here.

April Rule Adoption Hearing at State Board of Human Services for the Involuntary Transportation for Immediate Screening Rules

On March 2, the Office of Behavioral Health presented the Involuntary Transportation for Immediate Screening proposed rules for second reading at the State Board of Human Services. The proposed rules are designed to provide a procedure for how designated facilities are to implement this new hold, created by Senate Bill 17-207.

The State Board of Human Services postponed the adoption hearing for these rules until April 6 to allow for clarifying and procedural updates to the proposed rules.

The rule-making packet that will be presented at the State Board of Human Service Meeting on April 6 can be found here.

Medication Consistency Rules Scheduled for First Reading at State Board of Human Services in May

To ensure individuals, with behavioral or mental health disorders, transitioning between settings and service providers have access to a broad spectrum of effective medications. Senate Bill 17-019 requires:

  • The use of a medication formulary that lists required medications that are to be used across systems;
  • Education and marketing of the medication formulary and cooperative medication purchasing opportunities for facilities and providers;
  • Electronic sharing of patient-specific information; and,
  • Rules that require providers under the authority of the Department of Human Services or Department of Corrections to use the medication formulary.

In compliance with Senate Bill 17-019, the Office of Behavioral Health has created a rule draft requiring the use of the medication formulary in facilities designated by the Office of Behavioral to provide mental health services. The updated rule-making packet incorporating stakeholder feedback can be found here. Also, the Medication Formulary can be found here. The rule will be presented at the State Board meeting on May 4. 

Second Reading at State Board of Human Services of the Involuntary Transportation for Immediate Screening Proposed Rules

The Office of Behavioral Health will be presenting the Involuntary Transportation for Immediate Screening proposed rules for second reading (adoption) at the State Board of Human Services meeting on March 2, 2018, at 10 a.m. at 1575 Sherman St. in Denver. The rule-making packet being presented can be found here.

Signed into law by Governor Hickenlooper on May 18, 2017, SB17-207 introduced new language intended to divert individuals with behavioral health disorders from entering the criminal justice system.  This legislation included changes to Section 27-65-105, C.R.S., one of those changes created a new involuntary transportation of immediate screening hold.  This new Involuntary Transportation Hold:

  • Creates a new option for intervening professionals to transport an individual who appears in need of immediate evaluation for treatment to an outpatient facility;
  • Ensures that civil liberties protections that currently exist in statute remain the same;
  • Encourages first responders to transfer the decision to place a more restrictive M-1 hold to healthcare providers.
    • The intent is to ensure individuals aren’t held unnecessarily and restore to liberty individuals who do not meet criteria for a hold, while also not mandating facilities to act outside their capabilities.
    • The evaluation for a hold would not require individuals to stay in the outpatient facility, or be detained elsewhere, unless the evaluation determined a need to initiate an M-1 hold.
  • Introduces a focus on community collaboration between systems to formalize how law enforcement, behavioral health providers, and other clinical settings collaborate in responding to crises.

The Office of Behavioral Health, in collaboration with the Mental Health Advisory Board for Service Standards and Regulations, created a rules draft for how a 27-65 Designated Facility provides services when an individual arrives at their facility on the new involuntary transportation for immediate screening hold.  

The new rules will only affect designated facilities, but the rules will provide the outline for best-practice guidelines.  The Office of Behavioral Health will create and distribute these best-practice guidelines, to inform individuals with lived experience, other facilities, and intervening professionals on how the new hold procedure should be implemented.