(1) (a) The general assembly finds that:
Many individuals who need treatment for substance use disorders must wait weeks ormonths to access residential or outpatient services;
When dealing with a substance use disorder, any delay in starting treatment couldmean life or death for the affected individual; and
Individuals who are engaged in seeking treatment for a substance use disorder would benefit from care navigation services to connect those individuals with available treatment facilities or programs.
(b) Therefore, the general assembly declares that care navigation services that help individuals who are ready to begin treatment to gain timely access to that treatment are vital to the well-being of many Coloradans in crisis.
As used in this section, "engaged client" means an individual who is interested in andwilling to engage in substance use disorder treatment services or other treatment services either for the individual or an affected family member or friend.
Subject to available appropriations, the department shall implement a care navigation program to assist engaged clients in obtaining access to treatment for substance use disorders. At a minimum, services available statewide must include independent screening of the treatment needs of the engaged client using nationally recognized screening criteria to determine the correct level of care; the identification of licensed or accredited substance use disorder treatment options, including social and medical detoxification services, medication-assisted treatment, and inpatient and outpatient treatment programs; and the availability of various treatment options for the engaged client.
To implement the care navigation program, the office shall include care navigationservices in the twenty-four-hour telephone crisis service created pursuant to section 27-60-103. The contractor selected by the office must provide care navigation services to engaged clients statewide. Care navigation services must be available twenty-four hours a day and must be accessible through various formats. The contractor shall coordinate services in conjunction with other state care navigation and coordination services and behavioral health response systems to ensure coordinated and integrated service delivery. The use of peer support specialists is encouraged in the coordination of services. The contractor shall assist the engaged client with accessing treatment facilities, treatment programs, or treatment providers and shall provide services to engaged clients regardless of the client's payer source or whether the client is uninsured. Once the engaged client has initiated treatment, the contractor is no longer responsible for care navigation for that engaged client for that episode. Engaged clients who are enrolled in the medical assistance program pursuant to articles 4, 5, and 6 of title 25.5 shall be provided with contact information for their managed care entity. The contractor shall conduct ongoing outreach to inform behavioral health providers, counties, county departments of human or social services, jails, law enforcement personnel, health care professionals, and other interested persons about care navigation services.
The contractor shall enter into a memorandum of understanding with the office of theombudsman for behavioral health access to care created pursuant to section 27-80-303. If the contractor believes that a health benefit plan is in violation of state and federal parity laws, rules, or regulations pursuant to section 10-16-104 (5.5) and the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008", Pub.L. 110-343, as amended, with the engaged client's written permission, the contractor shall assist the engaged client with reporting the alleged violation to the office of the ombudsman for behavioral health access to care.
The contractor shall collect and transmit to the department, in the time and mannerdetermined by rule of the department, the following data and information relating to engaged clients served by the contractor:
Demographic characteristics of the engaged client, including age, sex, ethnicity, andcounty of residence;
The type of substance for which the engaged client is seeking treatment;
Any self-reported or identified mental health conditions;
Whether the engaged client was able to secure treatment and where, and, if not, thereasons why;
The length of time the contractor provided care navigation services to the engagedclient;
Whether the engaged client had private or public insurance or was eligible for services through the office due to income;
Services or treatment options that were not available in the engaged client's community, including recovery services, housing, transportation, and other supports; and
The number of family members or friends calling on behalf of an engaged client oran individual with a substance use disorder.
The state board may promulgate any rules necessary to implement the care navigation program.
No later than September 1 during the first year in which the care navigation programis implemented pursuant to this section, and no later than September 1 of each year thereafter in which the care navigation program is implemented, the department shall submit an annual report to the joint budget committee, the public health care and human services committee and the health and insurance committee of the house of representatives, and the health and human services committee of the senate, or any successor committees, concerning the utilization of care navigation services pursuant to this section, including a summary of the data and information collected by the contractor pursuant to subsection (6) of this section, in accordance with state and federal health care privacy laws. Notwithstanding the provisions of section 24-1-136 (11)(a)(I), the reporting requirements of this subsection (8) continue indefinitely.
Source: L. 2019: Entire section added, (HB 19-1287), ch. 175, p. 2015, § 3, effective May 14. L. 2020: (3) and (8) amended, (HB 20-1391), ch. 211, p. 1026, § 2, effective June 30.