As used in this article 67, unless the context otherwise requires:
(1) Behavioral health administration or BHA means the behavioral health administration established in section 27-50-102.
(1.3) Behavioral health safety net provider has the same meaning as defined in section 27-50-101.
(1.5) Care management includes, but is not limited to, consideration of the continuity of care and array of services necessary for appropriately treating a child or youth and the decision-making authority regarding the child's or youth's placement in and discharge from behavioral health services.
(2) Child or youth at risk of out-of-home placement means a child or youth who, although not otherwise categorically eligible for medicaid, meets the following criteria:
(a) The child or youth has been diagnosed as having a mental health disorder, as defined in section 27-65-102;
(b) The child or youth requires a level of care that is provided in a residential child care facility pursuant to section 25.5-6-903, or that is provided through community-based programs, and who, without such care, is at risk of unwarranted child welfare involvement or other system involvement, as described in section 27-67-102, in order to receive funding for treatment;
(c) If the child or youth is determined to be in need of placement in a residential child care facility, he or she shall apply for supplemental security income, but any determination for supplemental security income must not be a criterion for a child or youth to receive services pursuant to this article 67;
(d) The child or youth is a person for whom there is no pending or current action in dependency or neglect pursuant to article 3 of title 19; and
(e) The child or youth is younger than eighteen years of age, but he or she may continue to remain eligible for services until his or her twenty-first birthday.
(2.5) Commissioner means the commissioner of the behavioral health administration.
(3) Community-based care means any intervention that is designed to be an alternative to residential or hospital level of care in which the child or youth resides within a noninstitutional setting.
(4) Repealed.
(5) County department means the county or district department of human or social services.
(6) Family advocate has the same meaning as provided in section 27-69-102 (5).
(7) Family systems navigator has the same meaning as provided in section 27-69-102 (5.5).
(8) First-level appeal means the initial process a medicaid member is required to enact to contest a benefit, service, or eligibility decision made by medicaid or a medicaid managed care entity.
(9) Medicaid child or youth who is at risk of out-of-home placement means a child or youth who is categorically eligible for medicaid but who otherwise meets the definition of a child or youth who is at risk of out-of-home placement as defined in subsection (2) of this section.
(10) Mental health agency means a behavioral health services contractor through the behavioral health administration serving children and youth statewide or in a particular geographic area and with the ability to meet all expectations of this article 67.
(11) Professional person means a person licensed to practice medicine in this state, a psychologist certified to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist certified to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in this state that is operated by the armed forces of the United States, the United States public health service, or the United States department of veterans affairs.
(12) Repealed.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 708, � 2, effective April 29. L. 2017: IP, (2)(a), and IP(3) amended, (SB 17-242), ch. 263, p. 1350, � 247, effective May 25. L. 2018: Entire section R&RE, (HB 18-1094), ch. 343, p. 2038, � 3, effective June 30; (5) amended, (SB 18-092), ch. 38, p. 453, � 139, effective August 8; (2)(b) amended, (HB 18-1328), ch. 184, p. 1244, � 7, effective June 7, 2019. L. 2022: (1) and (10) amended, (1.5) and (2.5) added, and (12) repealed, (HB 22-1278), ch. 222, p. 1545, � 136, effective July 1; (2)(a) amended, (HB 22-1256), ch. 451, p. 3236, � 44, effective August 10; (1.3) added and (10) amended, (HB 22-1278), ch. 222, p. 1594, � 236, effective July 1, 2024; (4)(b) added by revision, (HB 22-1278), ch. 222, pp. 1594, 1605, �� 236, 263.
Editor's note: (1) This section is similar to former � 27-10.3-103 as it existed prior to 2010.
(2) Section 10 of chapter 184 (HB 18-1328), Session Laws of Colorado 2018, provides that section 7 of the act changing subsection (2)(b) takes effect upon notice to the revisor of statutes pursuant to section 25.5-5-306 (6) as enacted in section 2 of the act. For more information, see HB 18-1328. (L. 2018, p. 1247.) On August 14, 2019, the revisor of statutes received the notice referred to in � 25.5-5-306 (6) that the federal department of health and human services approved the waiver on June 7, 2019.
(3) (a) Subsection (5) was numbered as subsection (4) in SB 18-092. That provision was harmonized with and relocated to subsection (5) as it appears in HB 18-1094.
(b) Amendments to subsection (2)(b) by HB 18-1094 and HB 18-1328 were harmonized, effective June 7, 2019.
(4) Amendments to subsection (10) by sections 136 and 236 of HB 22-1278 were harmonized, effective July 1, 2024.
(5) Subsection (4)(b) provided for the repeal of subsection (4), effective July 1, 2024. (See L. 2022, pp. 1594, 1605.)
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 18-092, see section 1 of chapter 38, Session Laws of Colorado 2018. For the legislative declaration in HB 18-1328, see section 1 of chapter 184, Session Laws of Colorado 2018.
27-67-104. Provision of mental health treatment services for children and youth. (1) (a) A parent or guardian may apply to a mental health agency on behalf of a child or youth for mental health treatment services for the child or youth pursuant to this section, if the parent or guardian believes the child or youth is at risk of out-of-home placement. The parent's or guardian's request for services described in this section may be done with assistance from a family advocate, family systems navigator, nonprofit advocacy organization, or county department; however, the BHA is not obligated to pay for any services provided by entities with which they do not contract. In such circumstances, the mental health agency is responsible for evaluating the child or youth and clinically assessing the child's or youth's need for mental health services and, when warranted, to provide treatment services as necessary and in the best interests of the child or youth and the child's or youth's family. When evaluating a child or youth for eligibility, the mental health agency shall use a standardized risk stratification tool, in a manner determined by rule of the state board of human services. Following the evaluation of the child or youth, the mental health agency shall provide a written notification to the child's or youth's parent or guardian that includes a comprehensive list of potential treatment providers, with a disclosure that the child's or youth's family may choose to seek services from the provider of their choice, including but not limited to the mental health agency. The written notification must also inform the child's or youth's family that they may request assistance from a family advocate, family systems navigator, nonprofit advocacy organization, or county department; however, the BHA is not obligated to pay for any services provided by entities with which they do not contract. The BHA shall maintain a list of available providers on a public website and shall update the website quarterly. The mental health agency is responsible for the provision of the treatment services and care management, including any residential treatment, community-based care, or any post-residential follow-up services that may be appropriate for the child's or youth's needs or the child's or youth's family's needs. A dependency or neglect action pursuant to article 3 of title 19 is not required in order to allow a family access to residential mental health treatment services for a child or youth.
(b) At the time of the assessment by the mental health agency, if requested services are denied, or at the time when the mental health agency has recommended that the child or youth be discharged from services, the mental health agency shall advise the family, both orally and in writing, of the appeal process available to them. The mental health agency shall have two working days within which to complete any internal appeal process. Within five working days after the mental health agency's final denial or recommendation for discharge, a parent or guardian may request an objective third party at the BHA who is a professional person to review the action of the mental health agency. A family advocate, family systems navigator, nonprofit advocacy organization, or county department may assist a family in filing an appeal; however, the BHA is not obligated to pay for any services provided by entities with which they do not contract. The review must occur within three working days of the parent's or guardian's request. The professional person shall determine if the requested services are appropriate.
(1.5) (a) The parent or guardian of a medicaid child or youth who is at risk of out-of-home placement may request, within five days after all first-level medicaid appeals processes are exhausted, an objective third party at the BHA who is a professional person to review the service request made to medicaid. A family advocate, family system navigator, or county department may assist a family in filing an appeal. The review must occur within three working days of the parent's or guardian's request.
(b) The administrative law judge considering the medicaid appeal for the medicaid child or youth who is at risk of out-of-home placement shall take into consideration the objective third-party review by the BHA as part of the administrative law judge's reconsideration and decision of the medicaid service request.
(2) If at any time the mental health agency determines pursuant to section 19-3-304 that there is reasonable cause to know or suspect that a child or youth has been subjected to abuse or neglect, then the mental health agency shall immediately make a referral to the statewide child abuse hotline established in section 26-5-111 or the appropriate county department. Within ten working days after the referral, if assigned for an assessment by the county department, a representative of the mental health agency shall meet with the county department and the family. Upon referral to the county department, if assigned for an assessment, the county department shall proceed with the assessment to determine whether there is a sufficient basis to believe that physical or sexual abuse or neglect or some other form of abuse or neglect of a child's or youth's physical well-being has occurred.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 709, � 2, effective April 29. L. 2018: Entire section amended, (HB 18-1094), ch. 343, p. 2039, � 4, effective June 30; (1)(a) amended, (HB 18-1431), ch. 313, p. 1892, � 11, effective August 8. L. 2022: (1) and (1.5) amended, (HB 22-1278), ch. 222 , p. 1546, � 137, effective July 1.
Editor's note: (1) This section is similar to former � 27-10.3-104 as it existed prior to 2010.
(2) Amendments to subsection (1)(a) by HB 18-1094 and HB 18-1431 were harmonized.