(1) Using money appropriated for purposes of this section or available from any other governmental or private source, the BHA may purchase services for prevention or for the treatment of alcohol and drug abuse or substance use disorders or both types of services on a contract basis from any tribal nation or any public or private agency, organization, or institution approved by the BHA. The services purchased may be any of those provided through a public program, as set forth in section 27-80-103 (2). In contracting for services, the BHA shall attempt to obtain services that are in addition to, and not a duplication of, existing available services or services that are of a pilot or demonstration nature. An agency operating a public program may also purchase services on a contract basis.
(2) (a) In addition to the services purchased pursuant to subsection (1) of this section, using money appropriated for purposes of this section or available from any other governmental or private source, the BHA may purchase services for the treatment of alcohol and drug abuse or substance use disorders on a contract basis from a behavioral health administrative services organization for a designated service area as set forth in section 27-80-107. A public or private agency, organization, or institution approved by the BHA through the process set forth in section 27-80-107 may be designated as a behavioral health administrative services organization.
(b) Behavioral health administrative services organizations receiving money pursuant to this subsection (2) shall comply with all relevant provisions of and rules promulgated pursuant to this article 80.
(3) Repealed.
(4) As of July 1, 2022, the department of public health and environment is the state department responsible for the administration of prevention services pursuant to this section.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 724, � 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1355, � 257, effective May 25. L. 2019: (3) added, (SB 19-228), ch. 276, p. 2605, � 9, effective May 23. L. 2022: (1) and (2)(a) amended and (4) added, (HB 22-1278), ch. 222, p. 1551, � 147, effective July 1; (2)(a) and (2)(b) amended, (HB 22-1278), ch. 222, p. 1597, � 245, effective August 10.
Editor's note: (1) This section is similar to former � 25-1-206 as it existed prior to 2010.
(2) Subsection (3)(c) provided for the repeal of subsection (3), effective September 1, 2020. (See L. 2019, p. 2605.)
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-107. Designation of managed service organizations - purchase of services - revocation of designation. (1) The behavioral health administration shall establish designated service areas to provide substance use disorder treatment and recovery services in a particular geographical region of the state.
(2) To be selected as a designated managed service organization to provide services in a particular designated service area, a private corporation, for profit or not for profit, or a public agency, organization, or institution shall apply to the behavioral health administration for a designation in the form and manner specified by the commissioner or the commissioner's designee. The designation process is in lieu of a competitive bid process pursuant to the Procurement Code, articles 101 to 112 of title 24. The commissioner or the commissioner's designee shall make the designation based on factors established by the commissioner or the commissioner's designee. The factors for designation established by the executive director or the executive director's designee include the following:
(a) Whether the managed service organization has experience working with public treatment agencies and collaborating with other public agencies;
(b) Whether the managed service organization has experience working with publicly funded clients, including expertise in treating priority populations designated by the behavioral health administration;
(c) Whether the managed service organization has offices in and provides services in the substate planning area or is willing to relocate to the substate planning area;
(d) Whether the managed service organization has experience using the cost-share principles used by the behavioral health administration in its contracts with providers and is willing to cost-share;
(e) Whether the managed service organization has developed an effective, integrated information and fiscal reporting system and has experience working with and is able to comply with state and federal reporting requirements;
(f) Whether the managed service organization has experience engaging in a clinical quality improvement process; and
(g) Whether the managed service organization has experience with public funding requirements and state contracting requirements.
(2.5) (a) On or before January 1, 2023, in order to promote transparency and accountability, the behavioral health administration shall require each managed service organization that has twenty-five percent or more ownership by providers of behavioral health services to comply with the following conflict of interest policies:
(I) Providers who have ownership or board membership in a managed service organization shall not have control, influence, or decision-making authority in how funding is distributed to any provider or the establishment of provider networks.
(II) The behavioral health administration shall quarterly review a managed service organization's funding allocation to ensure that all providers are being equally considered for funding. The behavioral health administration is authorized to review any other pertinent information to ensure the managed service organization is meeting state and federal rules and regulations and is not inappropriately giving preference to providers with ownership or board membership.
(III) An employee of a contracted provider of a managed service organization shall not also be an employee of the managed service organization unless the employee is a medical director for the managed service organization. If the medical director is also an employee of a provider that has board membership or ownership in the managed service organization, the managed service organization shall develop policies, approved by the commissioner of the behavioral health administration, to mitigate any conflict of interest the medical director may have.
(IV) A managed service organization's board shall not have more than fifty percent of contracted providers as board members, and the managed service organization is encouraged to have a community member on the managed service organization's board.
(b) If the office is unable to contract with a managed service organization that meets the requirements of this subsection (2.5), the office may designate another existing managed service organization to temporarily provide the services for that region, for up to one year, pending designation of a new managed service organization. If the office is unable to designate a new managed service organization, the temporary managed service organization may continue to provide the regional substance use disorder services on a year by year basis.
(c) As used in this subsection (2.5), unless the context otherwise requires:
(I) Medical director means a physician who oversees the medical care and other designated care and services in a managed service organization. The medical director may be responsible for helping to develop clinical quality management and utilization management.
(II) Ownership means an individual who is a legal proprietor of an organization, including a provider or individual who owns assets of an organization, or has a financial stake, interest, or governance role in the managed service organization.
(3) The designation of a managed service organization by the commissioner, as described in subsection (2) of this section, is an initial decision of the department that may be reviewed by the executive director in accordance with the provisions of section 24-4-105. Review by the executive director in accordance with section 24-4-105 constitutes final agency action for purposes of judicial review.
(4) (a) The terms and conditions for providing substance use disorder treatment and recovery services must be specified in the contract entered into between the behavioral health administration and the designated managed service organization. Contracts entered into between the behavioral health administration and the designated managed service organization must include terms and conditions prohibiting a designated managed service organization contracted treatment provider from denying or prohibiting access to medication-assisted treatment, as defined in section 23-21-803, for a substance use disorder.
(b) Contracts entered into between the behavioral health administration and the designated managed service organization must include terms and conditions that outline the expectations for the designated managed service organization to invest in the state's recovery services infrastructure, which include peer-run recovery support services and specialized services for underserved populations. Investments are based on available appropriations.
(5) The contract may include a provisional designation for ninety days. At the conclusion of the ninety-day provisional period, the commissioner may choose to revoke the contract or, subject to meeting the terms and conditions specified in the contract, may choose to extend the contract for a stated time period.
(6) A managed service organization that is designated to serve a designated service area may subcontract with a network of service providers to provide treatment and recovery services for alcohol and drug abuse and substance use disorders within the particular designated service area.
(7) (a) The commissioner may revoke the designation of a designated managed service organization upon finding that the managed service organization is in violation of the performance of the provisions of or rules promulgated pursuant to this article 80. The revocation must conform to the provisions and procedures specified in article 4 of title 24, and occur only after notice and an opportunity for a hearing is provided as specified in article 4 of title 24. A hearing to revoke a designation as a designated managed service organization constitutes final agency action for purposes of judicial review.
(b) Once a designation has been revoked pursuant to subsection (7)(a) of this section, the commissioner may designate one or more service providers to provide the treatment services pending designation of a new designated managed service organization or may enter into contracts with subcontractors to provide the treatment services.
(c) From time to time, the commissioner may solicit applications from applicants for managed service organization designation to provide substance use disorder treatment and recovery services for a specified planning area or areas.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 724, � 2, effective April 29. L. 2017: (1), IP(2), (2)(b), (2)(d), (3), (4), (5), (6), and (7) amended, (SB 17-242), ch. 263, p. 1355, � 258, effective May 25. L. 2020: (4) amended, (SB 20-007), ch. 286, p. 1390, � 2, effective July 13. L. 2021: (1), (4), (6), and (7)(c) amended, (HB 21-1021), ch. 256, p. 1510, � 3, effective September 7. L. 2022: (2.5) added, (SB 22-106), ch. 196, p. 1312, � 3, effective May 20. L. 2023: (1), IP(2), (2)(b), (2)(d), IP(2.5)(a), (2.5)(a)(II), (3), (4), (5), and (7) amended, (HB 23-1236), ch. 206, p. 1067, � 42, effective May 16.
Editor's note: This section is similar to former � 25-1-206.5 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-107.5. Increasing access to effective substance use disorder services act - managed service organizations - substance use disorder services - assessment - community action plan - allocations - reporting requirements - evaluation. (1) The short title of this section is the Increasing Access to Effective Substance Use Disorder Services Act.
(2) On or before February 1, 2017, each behavioral health administrative services organization designated pursuant to section 27-80-107 shall assess the sufficiency of substance use disorder services within its geographic region for adolescents ages seventeen and younger, young adults ages eighteen through twenty-five, pregnant women, women who are postpartum and parenting, and other adults who are in need of such services. During the community assessment process, each behavioral health administrative services organization shall seek input and information from appropriate behavioral health entities, county departments of human or social services, local public health agencies, substance use disorder treatment providers, law enforcement agencies, probation departments, organizations that serve veterans or homeless individuals, and other relevant stakeholders. The community assessment must include an analysis of existing funding and resources within the community to provide a continuum of substance use disorder services, including prevention, intervention, treatment, and recovery support services, for adolescents ages seventeen and younger, young adults ages eighteen through twenty-five, pregnant women, women who are postpartum and parenting, and other adults who are in need of such services.
(3) (a) On or before March 1, 2017, each behavioral health administrative services organization that has completed a community assessment pursuant to subsection (2) of this section shall prepare and submit in electronic format to the BHA and the department of health care policy and financing a community action plan to increase access to effective substance use disorder services, referred to in this section as the community action plan. The community action plan must summarize the results of the community assessment and include a description of how the behavioral health administrative services organization will utilize its allocation of funding from the marijuana tax cash fund created in section 39-28.8-501 to address the most critical service gaps in its geographic region and a timeline for implementation of the community action plan.
(b) A behavioral health administrative services organization may periodically update its community action plan to reflect changes in community needs and priorities. Any such updated plan must be submitted in electronic format to the BHA and the department of health care policy and financing.
(c) On or before May 1, 2017, the BHA shall post the community action plans from the behavioral health administrative services organizations developed pursuant to subsection (3)(a) of this section on its website. On or before May 1, 2017, the BHA shall submit a report summarizing all of the community action plans received from the behavioral health administrative services organizations to the joint budget committee, the health and human services committee of the senate, and the public and behavioral health and human services committee of the house of representatives, or any successor committees. The BHA shall post on its website any updated community action plans received pursuant to subsection (3)(b) of this section.
(4) (a) Repealed.
(b) On July 1, 2017, and on every July 1 thereafter, the BHA shall disburse to each behavioral health administrative services organization that has submitted a community action plan one hundred percent of the behavioral health administrative services organization's allocation from the money appropriated from the marijuana tax cash fund.
(c) It is the intent of the general assembly that each behavioral health administrative services organization use money allocated to it from the marijuana tax cash fund to cover expenditures for substance use disorder services that are not otherwise covered by public or private insurance. Each behavioral health administrative services organization may use its allocation from the marijuana tax cash fund to implement its community action plan, including expenditures for substance use disorder services and for any start-up costs or other expenses necessary to increase capacity to provide such services. A behavioral health administrative services organization must spend its allocation in the state fiscal year in which it is received or in the next state fiscal year thereafter. If there is any money from the allocation remaining after the second state fiscal year, then the behavioral health administrative services organization shall return the money to the BHA. If an enhanced residential and inpatient substance use disorder treatment and medical detoxification services benefit becomes available under the Colorado medical assistance program, behavioral health administrative services organizations shall determine to what extent money allocated from the marijuana tax cash fund may be used to assist in providing substance use disorder treatment, including residential and inpatient substance use disorder treatment and medical detoxification services, if those services are not otherwise covered by public or private insurance.
(d) Repealed.
(5) (a) On or before September 1, 2017, and on or before each September 1 thereafter, each behavioral health administrative services organization shall submit an annual report to the BHA, the joint budget committee, the health and human services committee of the senate, and the public and behavioral health and human services committee of the house of representatives, or their successor committees, concerning the amount and purpose of actual expenditures made using money from the marijuana tax cash fund in the previous state fiscal year. The report must contain a description of the impact of the expenditures on addressing the needs that were identified in the initial and any subsequent community assessments and action plans developed pursuant to subsection (3) of this section, as well as any other requirements established for the contents of the report by the BHA.
(b) A behavioral health administrative services organization shall provide the BHA with information about actual expenditures as required by the BHA.
(c) Repealed.
(6) Repealed.
(7) Notwithstanding section 24-1-136 (11)(a)(I), the BHA shall report on outcomes related to the implementation of this section as part of its annual State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act hearing required by section 2-7-203, beginning with the hearing that precedes the 2019 legislative session.
Source: L. 2016: Entire section added, (SB 16-202), ch. 209, p. 748, � 1, effective June 1. L. 2017: IP(5)(c) amended, (SB 17-234), ch. 154, p. 524, � 17, effective August 9. L. 2018: (4)(c), (4)(d)(I), (5)(a), (5)(b), IP(5)(c), and (5)(c)(II) amended and (7) added, (HB 18-1172), ch. 110, p. 801, � 1, effective April 9; (4)(c) amended, (HB 18-1136), ch. 373, p. 2271, � 3, effective June 5. L. 2022: (3), (4)(b), (4)(c), (5)(a), (5)(b), and (7) amended, and (4)(a), (4)(d), (5)(c), and (6) repealed, (HB 22-1278), ch. 222, p. 1553, � 149, effective July 1; (2), (3), (4)(b), (4)(c), (5)(a), and (5)(b) amended, (HB 22-1278), ch. 222, p. 1598, � 246, effective August 10.
Editor's note: Amendments to subsection (4)(c) by HB 18-1172 and HB 18-1136 were harmonized.