§ 27-50-108 — Systemwide behavioral health grievance system

Colorado § 27-50-108

• Jurisdiction: Colorado
• Title 27: Behavioral
• Art.: Behavioral Health Administration

Text

(1) (a) On or
before July 1, 2024, the BHA shall create and implement a process for collecting,
analyzing, and addressing behavioral health system grievances across payers,
behavioral health administrative services organizations, managed care entities, and
providers at a systemic level that leverages and does not duplicate existing
grievance resolution programs. The BHA shall analyze grievances to identify and
address service delivery gaps and to inform statewide behavioral health system
policy.

(b) The BHA shall, at a minimum, track grievances by behavioral health
provider, topic, region, managed care entity, behavioral health administrative
services organizations, payer source, service, or diagnosis and aggregate
demographic data. In order to promote transparency, accountability, and system
collaboration, the BHA shall publish, at least annually, aggregated and anonymized
data on grievances on a public-facing website.

(c) The BHA shall implement a plan to streamline grievance resolution
programs, promote transparency, improve consumer experience, and promote
clarity and transparency.

(2) On or before July 1, 2024, the BHA shall solicit input from the behavioral
health administration advisory council created pursuant to section 27-50-701, the
sub-committees created pursuant to section 27-50-703, and demographically
diverse stakeholders to develop a process for addressing individual grievances
when traditional grievance programs fail.

(3) The BHA may refer individual grievances to the office of the ombudsman
for behavioral health access to care, created pursuant to section 27-80-303, when
an individual may require further intervention or support to resolve the grievance in
accordance with the charge of the ombudsman.

(4) On or before July 1, 2024, the BHA and state agencies shall execute
formal data-sharing agreements addressing data sharing consistent with state and
federal requirements, cooperation between the BHA and state agencies, and any
other provisions necessary to implement this section. At a minimum, the BHA and
the following entities shall execute such agreements:

(a) The ombudsman for medicaid managed care, established in section 25.5-5-406.1;

(b) The ombudsman for behavioral health access to care, designated
pursuant to section 27-80-303; and

(c) The child protection ombudsman, appointed pursuant to section 19-3.3-102 (3)(a)(I). All data released by the ombudsman shall comply with section 19-3.3-103.5 (1) and (2).

(5) The BHA may promulgate rules as needed to implement this section.

Legislative History

Source: L. 2022: Entire article added, (HB 22-1278), ch. 222, p. 1453, � 1, effective July 1. L. 2025: (4)(c) amended, (HB 25-1200), ch. 270, p. 1398, � 12, effective August 6.