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27-60-101. Behavioral health crisis response system - legislative declaration(1) (a) The general assembly finds and declares that:
(I) There are people in Colorado communities who are experiencing behavioral health crises and need professional behavioral health crisis care or urgent psychiatric care from skilled mental health clinicians and medical professionals who excel at providing compassionate behavioral health crisis intervention and stabilization; (II) A behavioral health crisis can happen any hour of the day and any day of the week; (III) Persons in a behavioral health crisis frequently come in contact with community first responders who are often unable to provide necessary behavioral health interventions or who must transport these persons in a behavioral health crisis to emergency rooms for services, or, in cases where a crime is alleged, to jail; (IV) Colorado ranks fiftieth in the nation in the number of inpatient psychiatric beds; (V) Fewer than one-half of the persons who are in a behavioral health crisis and are taken to an emergency room are admitted for inpatient hospitalization, meaning that thousands of people each year return to community streets with little, if any, crisis intervention or treatment for behavioral health disorders; and (VI) Significant time and resources are required of community first responders in addressing persons in a behavioral health crisis and, in many cases, this community response is neither timely nor safe for the person in crisis nor cost-efficient for the state. (b) The general assembly therefore finds that a coordinated behavioral health crisis response system: (I) Serves as a comprehensive and preferred response to behavioral health emergencies throughout Colorado by providing for early intervention and effective treatment of individuals who are experiencing a behavioral health crisis; (I.5) As the appropriate and preferred response to behavioral health crises, eliminates the use of the criminal justice system to hold individuals who are experiencing a mental health crisis and enhances the ability of mental health providers and hospitals to serve individuals who are experiencing a mental health crisis; (II) Provides an appropriate first line of response to individuals in need of an emergency seventy-two-hour mental health hold and utilizes first responders and information technology systems to integrate available behavioral health crisis responses; (III) Should be available in all Colorado communities; (IV) Includes community-based, behavioral health crisis centers where individuals who are experiencing a behavioral health crisis may be stabilized and receive short-term treatment, as clinically appropriate; (V) Decriminalizes mental health disorders by leading the development of a partnership-supported network of crisis services; and [Editor's NOTE: Unfortunately, Crisis Services are not enough to prevent crises -- the State needs an adequately funded continuum of care (which we DON'T HAVE), including intensive mental health services and housing]. (VI) Establishes a statewide framework that creates, strengthens, and enhances community partnerships that will facilitate the preferred response to behavioral health crises, including ensuring that peace officers and other first responders are equipped with a variety of options when they encounter a behavioral health crisis. (c) Therefore, the general assembly declares that it is a matter of statewide concern to incentivize and coordinate existing behavioral health crisis intervention services and to commit resources to expand the crisis response system. (2) Repealed. CRS 27-60-105. Outpatient restoration to competency services - jail-based behavioral health services - legislative declaration - responsible entity - duties - report (1) The general assembly finds and declares that: (a) Colorado's statutory scheme does not designate an entity responsible for competency restoration services, nor does it provide a sufficient framework for the provision of outpatient restoration services to adults or juveniles. As a result, there have been deficits and inconsistencies in the administration of the educational component of outpatient competency restoration services and the coordination and integration of that component with existing services and supports to address the underlying causes of incompetency. (b) The lack of a designated responsible entity for competency restoration services in Colorado has caused inconsistency in competency restoration services throughout the state and delays in proceedings that impact the due process rights of juveniles and adults involved in the juvenile and criminal justice systems, as well as the interests of victims; (c) Competency restoration services must be localized and accessible and take into account the public safety, while still allowing for state-level standards and oversight; (d) Competency restoration services for juveniles must be provided in the least restrictive environment, while taking into account the public safety and the best interests of the juvenile; and (e) Many services essential to the restoration of competency can be provided through existing programs using existing funding. However, the current system lacks funding and responsibility for the educational component of competency restoration services and case management to access and leverage available services and supports which, combined, will help ensure an integrated approach to competency restoration for juveniles and adults. (2) The office of behavioral health shall serve as a central organizing structure and responsible entity for the provision of competency restoration education services, coordination of competency restoration services ordered by the court pursuant to section 19-2-1303 (2) or 16-8.5-111 (2)(a), and jail-based behavioral health services pursuant to section 27-60-106. (3) On or before December 1, 2017, the office shall develop standardized juvenile and adult curricula for the educational component of competency restoration services. The curricula must have a content and delivery mechanism that allows it to be tailored to meet individual needs, including those of persons with intellectual and developmental disabilities. (4) Beginning July 1, 2018, the office has the following duties and responsibilities, subject to available appropriations: (a) To oversee providers of the education component of competency restoration services, including: (I) Establishing and enforcing qualifications of competency restoration educators, including minimum and ongoing training requirements; (II) Evaluating models for the delivery of competency restoration education in a manner that maximizes and expands on available resources while minimizing costs to the state; and (III) Maintaining an adequate pool of competency restoration providers, as defined by: (A) Qualifications and training; (B) Geographical accessibility, in light of the goal of ensuring community-based restoration in the least restrictive environment throughout the state; and (C) Ability to provide culturally competent and developmentally appropriate competency restoration education tailored to an individual's unique needs; (b) To develop models for providing competency restoration services that integrate competency restoration education with other case management and treatment, ensure continuation of ongoing treatment and services as appropriate, avoid duplication of services, and achieve efficiencies by coordinating with existing community resources and programs; (c) To preserve the integrity of the competency evaluation process by ensuring that competency restoration educators operate independently from competency evaluators at the case level; (d) To engage with key stakeholders in the juvenile and adult justice systems to develop best practices in the delivery of competency restoration services; (e) To make recommendations for legislation; and (f) To oversee the functions of the jail-based behavioral health services program created in section 27-60-106. (5) Notwithstanding section 24-1-136 (11)(a)(I), on or before January 1, 2019, and every January 1 thereafter, the office shall submit an annual written report to the general assembly summarizing the office's provision of competency restoration education, its efforts toward the coordination of competency restoration education with other existing services, and the results of the jail-based behavioral health services program created in section 27-60-106. The report must include: (a) Data on the number of individuals ordered to competency restoration services, the average time frame for beginning and ending such services, the types of settings in which competency restoration services are provided, and the outcomes of such services; (b) A description of the office's engagement with community partners to coordinate competency restoration services in an effective and efficient manner; (c) Identification of best and promising practices for education and coordination of competency restoration services; (d) A description of opportunities to maximize and increase available resources and funding; (e) A description of gaps in and conflicts with existing funding, services, and programming essential to the effective restoration of competency for juveniles and adults; and (f) A description of the services funded through the jail-based behavioral health services program created in section 27-60-106. |
The new jail-based behavioral health services program passed in 2018 is NOT an entitlement and is "subject to available appropriations."
CRS 27-60-106. Jail-based behavioral health services program - purpose - created - funding (1) There is created in the office the jail-based behavioral health services program, referred to in this section as the "program". The program may receive money from the correctional treatment cash fund pursuant to section 18-19-103 (5)(c)(V). (2) The purpose of the program is to: (a) Provide adequate staff to complete behavioral health screenings; prescribe psychiatric medications as necessary; and provide mental health counseling, substance use disorder treatment pursuant to section 18-19-103 (5)(c)(V), and transitional care coordination; (b) Train jail staff on behavioral health disorders and best practices in working with individuals with mental health, substance use, and co-occurring disorders; and (c) Fund administrative costs to jails that implement the requirements outlined in subsection (3) of this section. (3) The office shall prioritize jails with minimal behavioral health services, including but not limited to rural and frontier jails. (4) Subject to available appropriations, the office may require a county jail that receives funding through the program to: (a) Screen all individuals booked into the jail facility with standardized evidence-based screening tools, as determined by the office, for mental health disorders, substance use disorders, and suicide risk; (b) Assess all individuals booked into the jail facility for substance use withdrawal symptoms and develop protocols for medical detoxification monitoring procedures; (c) Assess all individuals booked into the jail facility for psychiatric medication needs by requesting and reviewing medical and prescription history; (d) Have access to all psychiatric medications, as defined by the medication formulary established pursuant to section 27-70-103; (e) Assist in the provision of coordinated services for individuals in jail custody who may require competency restoration services; (f) Coordinate services with community behavioral health providers prior to the release of an inmate to ensure continuity of care following his or her release from the jail facility; (g) Track performance outcomes for measures developed by the office, including behavioral health disorder prevalence and service data through information-sharing processes, as defined by the office; and (h) Partner with the office to develop feasible health information exchange strategies for medical and behavioral health records. |