2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › COLORADO MEDICAL ASSISTANCE ACT (§§ 25.5-4-101 — 25.5-6-2001) › Article 5 - COLORADO MEDICAL ASSISTANCE ACT - SERVICES AND PROGRAMS (§§ 25.5-5-101 — 25.5-5-804) › Part 3 - SERVICES WITH SPECIAL STATE PROVISIONS (§§ 25.5-5-301 — 25.5-5-338) › Section 25.5-5-333 - [Effective 8/7/2024] Primary care and behavioral health statewide integration grant program - creation - report - definition - repeal

(1)
As used in this section, unless the context otherwise requires, "grant program" means the primary care and behavioral health statewide integration grant program created in subsection (2) of this section.
(2)
There is created in the state department the primary care and behavioral health statewide integration grant program to provide grants to physical and behavioral health-care providers for implementation of evidence-based clinical integration care models, as defined by the state department, in collaboration with the behavioral health administration in the department of human services.
(3)
(a)
Grant recipients may use the money received through the grant program for the following purposes:
(I)
Developing infrastructure for primary care, pediatric, and behavioral health-care providers to better serve individuals with behavioral health needs in outpatient health-care settings;
(II)
Increasing access to quality health care for individuals with behavioral health needs;
(III)
Investing in early interventions for children, youth, and adults that reduce escalation and exacerbation of behavioral health conditions;
(IV)
Addressing the need to expand the behavioral health-care workforce;
(V)
Developing and implementing alternative payment models, including the development of protocols, processes, work flow, and partnerships; and
(VI)
Training primary care providers in trauma-informed care, adverse childhood experiences, and trauma recovery.
(b)
Any money received through the grant program must supplement and not supplant existing health-care services. Grant recipients shall not use money received through the grant program for:
(I)
Ongoing or existing executive and senior staff salaries;
(II)
Services already covered by medicaid or a member's other insurance; or
(III)
Ongoing or existing electronic health records costs.
(c)
(I)
(A)
If a grant recipient is a hospital-owned or hospital-affiliated practice that is not part of a hospital system and has less than ten percent total profit as measured by state department transparency reporting, the grant recipient shall provide a twenty-five percent match for the awarded amount. The grant recipient may use community benefit funds, in-kind personnel time, or federal relief funding for the twenty-five percent match required pursuant to this subsection (3)(c)(I)(A).
(B)
If a grant recipient is a hospital-owned or hospital-affiliated practice that is part of a hospital system or has ten percent or more total profit as measured by state department transparency reporting, the grant recipient shall provide a fifty percent match for the awarded amount. The grant recipient may use community benefit funds, in-kind personnel time, or federal relief funding for the fifty percent match required pursuant to this subsection (3)(c)(I)(B).
(C)
If a grant recipient is a critical access hospital, as defined in section
10-16-1303 (2)
, the grant recipient shall provide a ten percent match for the awarded amount. The grant recipient may use community benefit funds, in-kind personnel time, or federal relief funding for the ten percent match required pursuant to this subsection (3)(c)(I)(C).
(II)
For the purposes of this subsection (3)(c), "hospital-affiliated" means there is a contractual relationship between a hospital or an entity that is owned by or under common ownership and control with the hospital in which the contractual relationship enables the hospital or entity that is owned by or under common ownership and control with the hospital to exercise control over one of the following entities:
(A)
Another hospital;
(B)
An entity owned by or under common ownership and control with another hospital; or
(C)
A physician group practice.
(d)
The state department may provide funding to physical and behavioral health-care providers through infrastructure building and population-based payment mechanisms.
(e)
Grant recipients shall participate in technical assistance education and training and related workgroups as determined by the state department.
(4)
(a)
The state department shall administer the grant program and, subject to available appropriations, shall award grants as provided in this section. Subject to available appropriations, grants shall be paid out of the behavioral and mental health cash fund created in section
24-75-230
.
(b)
In order to support real-time transformation and access to care, the state department shall ensure timely payment to grant recipients for services related to the grant program.
(5)
Grant applicants shall demonstrate a commitment to maintaining models and programs that, at a minimum:
(a)
Measurably increase access to behavioral health screening, referral, treatment, and recovery care;
(b)
Implement or expand evidence-based models for integration that improve patient health as evidenced by relevant and meaningful outcomes measures, including patient-reported outcomes;
(c)
Leverage multidisciplinary treatment teams;
(d)
Serve publicly funded consumers;
(e)
Maintain a plan for how to address a Member with emergency needs;
(f)
Maintain a plan for how technology will be leveraged for whole-person care, which may include plans for data security, electronic health records reforms, care management platforms, and telehealth implementation or expansion; and
(g)
Implement or engage in state-department-specified tools and shared learning and resources, including but not limited to:
(I)
Peer learning collaboratives to develop sustainable population-based payment models led by the state department;
(II)
Use of electronic tools for screening, measurement-based care management, and referrals; and
(III)
Data-sharing best practices.
(6)
In selecting grant recipients, the state department shall first prioritize applicants that serve priority populations that experience disparities in health-care access and outcomes, including but not limited to historically marginalized and underserved communities, determined by the communities with the highest proportion of patients receiving assistance through the "Colorado Medical Assistance Act", this article 5 and articles
4
and 6 of this title 25.5. The state department shall then prioritize applicants that meet as many of the following criteria as possible:
(a)
Serve individuals with co-occurring and complex care needs, serious mental illnesses, or disabilities;
(b)
Serve children and youth;
(c)
Include opportunities to build out community health worker, behavioral health aide, or similar programs, supported by population-based payments;
(d)
Serve pregnant and postpartum people;
(e)
The practice is considered a small and independent practice;
(f)
Demonstrate the ability and intent to serve culturally diverse populations and populations with limited English proficiency;
(g)
Include workforce capacity-building components;
(h)
Include high-intensity outpatient services;
(i)
Improve data exchange and data integration that supports whole-person care;
(j)
Utilize telehealth;
(k)
Align with or participate in commercial alternative payment models;
(l)
Demonstrate community partnerships; or
(m)
Participate in the regional health connector program created in section
25-20.5-2001
.
(7)
(a)
The state department shall establish a set of statewide resources to support grant recipients. At a minimum, the resources must include:
(I)
A clinical consultation and practice transformation support team provided by the Colorado health extension system in the practice innovation program; and
(II)
A sustainable billing and data partnership team that will train and support grant recipients in meeting standards and core competencies for alternative payment models, transforming the primary care providers' payment systems to focus on integrative, whole-person care, and creating and implementing data-sharing practices and policies that support mental health disorders, substance use disorders, and co-occurring disorders.
(b)
The state department may enter into interagency agreements or procure contracts to establish the resources pursuant to this subsection (7).
(8)
The state department may procure a grant application and support team to assist the state department with drafting the grant application, reviewing applications, and administering and processing grant awards.
(9)
A grant recipient must spend or obligate any money received pursuant to this section in accordance with section
24-75-226 (4)(d)
.
(10)
(a)
The state department shall establish a steering committee to:
(I)
Provide continuous input into grant application requirements;
(II)
Provide feedback and direction on data collection standards and review; and
(III)
Engage with community partners who will help support the integrated care practices through referrals and trusted communications.
(b)
The state department shall select a state department employee to chair the steering committee, staff the steering committee, and reimburse any participant who is not a state employee for reasonable travel expenses.
(11)
The state department shall, in collaboration with the behavioral health administration and the division of insurance, prepare a report that includes recommendations on best practices for sustaining integrated care models. In preparing the report, the state department shall collect data from each grant recipient related to clinical quality improvement and access to care. Grant recipients shall provide data to the state department in a timely manner, as determined by the state department. The state department is authorized to recoup or discontinue grant funding for grant recipients that do not comply with the data reporting requirements or grant standards set by the state department.
(12)
The state department and any person who receives money from the state department pursuant to this section 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)
.
(13)
This section is repealed, effective July 1, 2027.
Amended by 2024 Ch. 152,§ 54, eff. 8/7/2024.
Amended by 2023 Ch. 436,§ 5, eff. 8/7/2023.
Added by 2022 Ch. 180, § 2, eff. 5/18/2022.
2024 Ch. 152, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2023 Ch. 436, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
This section is set out more than once due to postponed, multiple, or conflicting amendments.