(1) (a) The BHA may issue a statewide request for proposals to entities with the capacity to create a coordinated and seamless behavioral health crisis response system to provide crisis intervention services for communities throughout the state. Separate proposals may be solicited and accepted for each of the five components listed in subsection (1)(b) of this section. The crisis response system created through this request for proposals process must be based on the following principles: (I) Cultural competence; (II) Strong community relationships; (III) The use of peer support; (IV) The use of evidence-based practices; (V) Building on existing foundations with an eye toward innovation; (VI) Utilization of an integrated system of care; and (VII) Outreach to students through school-based clinics. (b) The components of the crisis response system must reflect a continuum of care from crisis response through stabilization and safe return to the community, with adequate support for transitions to each stage. Specific components include: (I) A twenty-four-hour telephone crisis service that is staffed by skilled professionals who are capable of assessing child, adolescent, and adult crisis situations and making the appropriate referrals; (II) Walk-in crisis services and crisis stabilization units with the capacity for immediate clinical intervention, triage, and stabilization. The walk-in crisis services and crisis stabilization units must employ an integrated health model based on evidence-based practices that consider an individual's physical and emotional health, are a part of a continuum of care, and are linked to mobile crisis services and crisis respite services. (III) Mobile crisis services and units that are linked to the walk-in crisis services and crisis respite services and that have the ability to initiate a response in a timely fashion to a behavioral health crisis; (IV) Residential and respite crisis services that are linked to the walk-in crisis services and crisis respite services and that include a range of short-term crisis residential services, including but not limited to community living arrangements; and (V) A public information campaign. (1.5) (a) Beginning January 1, 2023, the state department shall create in-home and residential respite care services and facilities for children and families in up to seven regions of the state, as determined by the state department and a committee of interested stakeholders. (b) (I) For the 2022-23 budget year, the general assembly shall appropriate money from the behavioral and mental health cash fund pursuant to section 24-75-230 to the state department to fund in-home and residential respite care across the state as described in this subsection (1.5). (II) The use of money appropriated pursuant to this subsection (1.5) and money that originates from the ARPA refinance state money cash fund, created in section 24-75-226.5, appropriated for the same purpose, must conform with the allowable purposes set forth in the federal "American Rescue Plan Act of 2021", Pub.L. 117-2, as the act may be subsequently amended. The state department shall spend or obligate such appropriation in accordance with section 24-75-226 (4)(d). (III) This subsection (1.5)(b) is repealed, effective September 1, 2027. (c) (I) Beginning in state fiscal year 2023-24, money appropriated to the state department for the purpose of this subsection (1.5) must continue the statewide access to crisis system services for children and youth until June 30, 2026. (II) Beginning in the state fiscal year 2022-23, money appropriated to the state department for the purpose of implementing this subsection (1.5) must support residential respite care provided to youth involved in the foster care system. (III) Respite foster care homes must be in compliance with all other applicable rules regulating foster care homes. (d) The state department and any person that receives money from the state department shall comply with the compliance, reporting, record-keeping, and program evaluation requirements established by the office of state planning and budgeting and the state controller in accordance with section 24-75-226 (5). (1.7) Beginning January 1, 2025, the BHA shall use the money transferred to the behavioral and mental health cash fund pursuant to sections 24-75-230 (2)(a) and 39-37-301 (2)(a)(II), to continue and expand access to behavioral health crisis response system services for children and youth in accordance with this article 60. (2) The BHA shall collaborate with the committee of interested stakeholders established in subsection (3) of this section to develop the request for proposals, including eligibility and award criteria. Priority may be given to entities that have demonstrated partnerships with Colorado-based resources. Proposals will be evaluated on, at a minimum, an applicant's ability, relative to the specific component involved, to: (a) Demonstrate innovation based on evidence-based practices that show evidence of collaboration with existing systems of care to build on current strengths and maximize resources; (b) Coordinate closely with community mental health organizations that provide services regardless of the source of payment, such as behavioral health organizations, community mental health centers, regional care collaborative organizations, substance use treatment providers, and managed service organizations; (c) Serve individuals regardless of their ability to pay; (d) Be part of a continuum of care; (e) Utilize peer supports; (f) Include key community participants; (g) Demonstrate a capacity to meet the demand for services; (h) Understand and provide services that are specialized for the unique needs of child and adolescent patients; and (i) Reflect an understanding of the different response mechanisms utilized between mental health and substance use disorder crises. (3) The BHA shall establish a committee of interested stakeholders that will be responsible for reviewing the proposals and awarding contracts pursuant to this section. Representatives from the state department of health care policy and financing must be included in the committee of interested stakeholders. A stakeholder participating in the committee must not have a financial or other conflict of interest that would prevent him or her from impartially reviewing proposals. (4) (a) If additional money is appropriated, the BHA may issue additional requests for proposals consistent with this section and the state procurement code, articles 101 and 102 of title 24. (b) If the full appropriation by the general assembly for the implementation of this section is not dispersed as specified in paragraph (a) of this subsection (4), the committee shall accept and review proposals and award contracts as the proposals are received and not require an application be held until a subsequent request for proposals. (5) If necessary, the state board may promulgate rules to implement the provisions of this article 60 or the services to be supplied pursuant to this article 60. (6) (a) Beginning in January 2014, and every January thereafter, the BHA shall report progress on the implementation of the crisis response system, as well as information about and updates to the system, as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing required by section 2-7-203. (b) and (c) Repealed. (7) Repealed. (8) (a) On or before January 1, 2023, in order to promote transparency and accountability, the office shall require each administrative 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 an administrative 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 office shall quarterly review an administrative service organization's funding allocation to ensure that all providers are being equally considered for funding. The office is authorized to review any other pertinent information to ensure the administrative 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 an administrative service organization shall not also be an employee of the administrative service organization unless the employee is a medical director for the administrative service organization. If the medical director is also an employee of a provider that has board membership or ownership in the administrative service organization, the administrative 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) An administrative service organization's board shall not have more than fifty percent of contracted providers as board members, and the administrative service organization is encouraged to have a community member on the administrative service organization's board. (b) If the office is unable to contract with an administrative service organization that meets the requirements of this subsection (8), the office may designate another existing administrative service organization to temporarily provide the services for that region, for up to one year, pending designation of a new administrative service organization. If the office is unable to designate a new administrative service organization, the temporary administrative service organization may continue to provide the regional behavioral health crisis response system services on a year by year basis. (c) As used in this subsection (8), unless the context otherwise requires: (I) "Medical director" means a physician who oversees the medical care and other designated care and services in an administrative services 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 administrative services organization.
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