(1) No
later than January 1, 2024, the BHA shall promulgate rules pursuant to section 24-4-103 providing minimum standards for the operation of behavioral health entities
within the state, including the following:
(a) Requirements to be met by all behavioral health entities to ensure the
health, safety, and welfare of all behavioral health entity consumers, including, at a
minimum:
(I) Requirements for consumer assessment, treatment, care coordination,
patient rights, and consumer notice;
(II) Administrative and operational standards for governance; consumer
records and record retention; personnel; admission and discharge criteria; policies
and procedures to ensure compliance with regulatory and contract requirements;
and quality management;
(III) Data reporting requirements;
(IV) Physical plant standards, including infection control; and
(V) Occurrence reporting requirements pursuant to section 27-50-510;
(b) Service-specific requirements that apply only to behavioral health
entities electing to provide that service or set of services, including, at a minimum,
standards for the specific types of behavioral health safety net services and other
behavioral health services along the continuum of care created by the BHA
pursuant to part 3 of this article 50, including but not limited to:
(I) Essential behavioral health safety net provider standards; and
(II) Comprehensive community behavioral health provider standards;
(c) Procedures for mandatory BHA inspections of behavioral health entities;
(d) Procedures for written plans for a behavioral health entity to correct
violations found as a result of inspections;
(e) Intermediate enforcement remedies;
(f) Factors for behavioral health entities to consider when determining
whether an applicant's conviction of or plea of guilty or nolo contendere to an
offense disqualifies the applicant from employment with the behavioral health
entity. The state board of human services may determine which offenses require
consideration of these factors.
(g) Timelines for compliance with behavioral health entity standards that
exceed the standards under which a behavioral health entity was previously
licensed or approved.
(2) In approving or rejecting an essential behavioral health safety net
provider for eligibility for enhanced service delivery payment, the commissioner
shall:
(a) Require training on and provision of culturally competent and trauma-informed services;
(b) Consider the adequacy and quality of the services provided, taking into
consideration factors such as geographic location, local community need, and
availability of workforce;
(c) Require written policies and procedures on admitting, discharging,
triaging, and denying services to clients in alignment with the standards
determined by the BHA pursuant to sections 27-50-302 and 27-50-303;
(d) Require that overall responsibility for the administration of an essential
behavioral health safety net provider be vested in a director who is a physician or a
member of one of the licensed mental health professions, unless the provider is
only providing recovery support services. If the director is not a licensed physician
or licensed mental health professional, the provider shall employ or contract with at
least one licensed physician or licensed mental health professional to advise the
director on clinical decisions.
(e) Require that essential behavioral health safety net provider staff include,
wherever feasible and appropriate in the discretion of the commissioner, medical
staff able to provide medical clearance on site, and other professional staff workers
such as psychologists, social workers, educational consultants, peers, community
health workers, and nurses, with such qualifications, responsibilities, and
experience that corresponds with the size and capacity of the provider; and
(f) Require that each essential behavioral health safety net provider from
which services may be purchased:
(I) Be under the control and direction of a county or local board of health, a
board of directors or board of trustees of a corporation, a for-profit or not-for-profit
organization, a regional mental health board, or a political subdivision of the state;
(II) Be free of conflicts of interest; and
(III) Enter into a contract developed pursuant to section 27-50-203 and
accept publicly funded clients.
(3) In approving or rejecting a comprehensive community behavioral health
provider for eligibility for enhanced service delivery payment, the commissioner
shall adhere to the standards for essential behavioral health safety net providers
established in subsection (2) of this section, and the commissioner shall also:
(a) Require that treatment programs of the comprehensive community
behavioral health provider be vested in a director who is a physician or a member of
one of the licensed mental health professions. The director is not required to
provide oversight or direction for recovery services. If the director is not a physician
or licensed mental health professional, the provider shall contract with at least one
licensed physician or licensed mental health professional to advise the director on
clinical decisions.
(b) Consider whether the comprehensive community behavioral health
provider has historically served medically needy or medically indigent patients and
demonstrates a commitment to serve low-income and medically indigent
populations or, in the case of a sole community provider, serves the medically
indigent patients within its medical capability;
(c) Require the comprehensive community behavioral health provider to
waive charges or charge for services on a sliding scale based on income and require
that the provider not restrict access or services because of an individual's financial
limitations;
(d) Require the comprehensive community behavioral health provider to
serve priority populations;
(e) Encourage the comprehensive community behavioral health provider to
emphasize the care and treatment of individuals recently released from
incarceration and hospitals or facilities directed toward assisting individuals with
behavioral or mental health disorders in the individual's adjustment to and
functioning in the community;
(f) Require a process for tracking and reporting denials of care; and
(g) Require that the board in control and direction of the comprehensive
community behavioral health provider include voting members that have lived
experience with mental health disorders and substance use disorders and parents
of children with mental health disorders and substance use disorders.
(4) In approving or rejecting local general or psychiatric hospitals,
nontraditional facilities, innovative care models, and other behavioral health
facilities or programs for the purchase or designation of services not provided by
essential or comprehensive community behavioral health providers, the
commissioner shall consider the following factors:
(a) The general quality of care provided to patients by such agencies;
(b) The organization of the medical staff to provide for the integration and
coordination of the psychiatric treatment program;
(c) The provisions for the availability of nursing, psychological, and social
services and the existence of an organized program of activities under the direction
of an occupational therapist or another qualified person;
(d) The licensure of such entity by the department of public health and
environment or another state agency where applicable;
(e) The methods by which the agency coordinates its services with those
rendered by other agencies to ensure an uninterrupted continuum of care to
individuals with behavioral or mental health disorders; and
(f) The availability of such services to the general public.
(5) In approving or rejecting behavioral health safety net providers pursuant
to subsections (2) and (3) of this section, or other agencies pursuant to subsection
(4) of this section, for the purchase of services, the commissioner shall ensure the
behavioral health safety net providers and agencies comply with federal financial
participation requirements for department-administered programs.
(6) In addition to these duties, the BHA may promulgate rules related to
additional competencies related to serving priority populations. Behavioral health
safety net providers approved by the BHA as demonstrating these additional
competencies may be eligible for enhanced rates. State agencies shall consider
such approved status in determining payment methodologies for services provided.