The bill adds a requirement, as part of mandatory health insurance coverage of preventive health care services, that health plans cover an annual mental health wellness examination of up to 60 minutes that is performed by a qualified mental health care provider. The coverage must:

• Be comparable to the coverage of a physical examination;
• Comply with the requirements of federal mental health parity laws; and
• Not require any deductibles, copayments, or coinsurance for the mental health wellness examination.

The coverage applies to plans issued on or after January 1, 2022.

(Note: This summary applies to this bill as introduced.)

The bill addresses multiple recommendations from the Colorado behavioral health task force (task force), created in 2019, related to the creation of a behavioral health administration (BHA). The BHA would be a single state agency to lead, promote, and administer the state's behavioral health priorities.

The bill requires the department of human services (department) to submit a plan for the creation and establishment of the BHA on or before November 1, 2021, to the joint budget committee and on or before January 30, 2022, to the department's committees of reference. The bill outlines what the plan must, at a minimum, include. The essential duties of the BHA, once established, are set forth.

A timeline is described for the establishment of the BHA in the department and for a future determination of what state department, if different than the department of human services, the BHA will exist.

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

The bill expands the community transition specialist program (program) by redefining "high-risk individual" to allow more individuals to access program services. The bill also expands facilities that can access program services.

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

For the purposes of the "Colorado Medical Practice Act", the bill amends the definition of "telemedicine" to state that the term means the delivery of medical services through HIPAA-compliant telecommunications systems, technologies that are used in a manner that is compliant with the federal "Health Insurance Portability and Accountability Act of 1996", including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, or treatment of a patient while the patient is located at an originating site and the physician, anesthesiologist assistant, or physician assistant person who provides the service is located at a distant site. The bill preserves the existing statutory definition of "telemedicine" for purposes of the "Colorado Medical Assistance Act".

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Current law states that in-person contact between a health-care provider or mental health-care provider and a patient is not required under the state's medicaid program for services delivered through telemedicine that are otherwise eligible for reimbursement under medicaid. The bill requires the department of health care policy and financing to promulgate rules specifically relating to entities that deliver health-care or mental health-care services exclusively or predominately through telemedicine.
(Note: This summary applies to this bill as introduced.)

The bill recreates, with amendments, the "Occupational Therapy Practice Act" (Act), which repealed September 1, 2020. Specifically, the bill:

• Recreates and extends the Act for 9 years, until 2030;
• Modifies the legislative declaration and definitions related to the scope of practice of occupational therapy;
• Designates "occupational therapy consultant", "M.O.T.", "M.O.T./L.", "occupational therapy assistant", "O.T.A.", and "C.O.T.A." as protected titles and clarifies that individuals who legally practice temporarily as occupational therapists in Colorado may use protected titles;
• Reorders and amends certain provisions concerning examinations and applications for licensure by occupational therapists and occupational therapy assistants;
• Adds certain prohibited behaviors as grounds for discipline; and
• Removes obsolete language.
  (Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

The bill enacts the "Audiology and Speech-language Pathology Interstate Compact" allowing audiologists and speech-language pathologists licensed in any compact state to provide:

• Audiology or speech-language pathology services in each member state under a privilege to practice; and
• Telehealth services in each member state under a privilege to practice.

The bill authorizes the director of the division of professions and occupations in the department of regulatory agencies to promulgate rules and to facilitate Colorado's participation in the compact, including notification to the compact commission of any adverse action taken by the director against a Colorado audiologist or speech-language pathologist.

The bill makes the following appropriations:

• $108,432 and 0.3 FTE to the department of regulatory agencies from the division of professions and occupations cash fund;
• $17,014 and 0.1 FTE to the department of law from reappropriated funds;
• $60,000 to the office of the governor for use by the office of information technology from reappropriated funds; and
• $21,503 and 0.1 FTE to the department of public safety for use by the Colorado bureau of investigation from the Colorado bureau of investigation identification unit cash fund.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

The complementary or alternative medicine pilot program (pilot program) currently applies to persons with a spinal cord injury. The bill expands the pilot program to include persons with a primary condition of multiple sclerosis, a brain injury, spina bifida, muscular dystrophy, or cerebral palsy, with the total inability for independent ambulation directly resulting from one of these diagnoses. The bill expands the pilot program to all eligible individuals in Colorado.
(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

The bill requires the division of insurance (division) to retain a contractor on or before November 1, 2021, for the purpose of performing actuarial reviews of proposed legislation that may impose a new health benefit mandate on health benefit plans. The contractor, under the direction of the division, shall conduct an actuarial review of up to 5 legislative proposals for each regular legislative session, each at the request of a member of the general assembly. Each actuarial review performed by the contractor must consider the predicted effects of the legislative proposal during the 5 years immediately following the effective date of the proposed legislation, including specifically described considerations.

In preparing a fiscal note for any legislative proposal that may impose a new health benefit mandate on health benefit plans, the legislative service agency charged with preparing the fiscal note shall either:

• Include in the fiscal note information that is produced by the contractor in review of the legislative proposal; or
• If no information is produced by the contractor in review of the legislative proposal, indicate such fact in the fiscal note.
  (Note: This summary applies to this bill as introduced.)

Sunset Process - Senate Health and Human Services Committee. The bill implements the recommendation of the department of regulatory agencies' sunset review and report concerning the "Michael Skolnik Medical Transparency Act of 2010" to continue the act for 7 years, until 2028.
(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

The bill authorizes the director of the division of professions and occupations or the applicable regulatory board in the department of regulatory agencies (regulator) to suspend or waive statutes or rules governing a health care profession or occupation over which a regulator has authority during a disaster emergency declared by the governor. The suspension or waiver of a statute or rule is limited to those in which strict compliance would prevent, hinder, or delay necessary action in coping with or responding to the disaster emergency and may not suspend, waive, or modify any supervisory requirements.

The bill allows a regulator to promulgate emergency rules commensurate with the nature of the disaster emergency and within the limits of the declaration and the applicable practice act for a health care profession or occupation. The emergency rules automatically expire 60 days after the termination of the declared disaster emergency.

(Note: This summary applies to this bill as introduced.)

Section 1 of the bill titles the bill the "Behavioral Health Recovery Act of 2021". Section 2 of the bill continues the requirement that a podiatrist must adhere to the limitations on prescribing opioids.Sections 3 and 4 of the bill continue the funding for the medication-assisted treatment expansion pilot program (pilot program) for the 2020-21 through 2022-23 state fiscal years and repeal the pilot program on June 30, 2023.Section 5 of the bill expands the Colorado state university AgrAbility project (project) by providing funding for the project's rural rehabilitation specialists to provide information, services, and research-based, stress-assistance information, education, suicide prevention training, and referrals to behavioral health-care services to farmers, ranchers, agricultural workers, and their families to mitigate incidences of harmful responses to stress experienced by these individuals.Section 6 of the bill appropriates money to the department of public health and environment to address behavioral health disorders through public health prevention and intervention and to work with community partners to address behavioral health, mental health, and substance use priorities throughout the state.Section 7 of the bill continuously appropriates money to the harm reduction grant program.Section 8 of the bill requires a managed care organization (MCO) to notify a person's provider of approval of authorization of services no later than 24 hours after the submission of the request for services. The initial authorization for intensive residential treatment must be no less than 7 days, and the initial authorization for transitional residential treatment must be no less than 14 days. The initial authorization period may be longer if the MCO does not have sufficient information from the person's provider. MCOs shall continually authorize services in accordance with the person's provider if the MCO's determination conflicts with the provider's recommendation. MCOs shall provide specific justification for each denial of continued authorization for all 6 dimensions in the most recent edition of "The ASAM Criteria for Addictive, Substance-related, and Co-occuring Conditions".Section 9 of the bill requires the state medical assistance program (medicaid) to include screening for perinatal mood and anxiety disorders for each child enrolled in medicaid in accordance with the health resources and services administration guidelines. The screening must be made available to any person, regardless of whether the person is enrolled in medicaid, so long as the person's child is enrolled in medicaid. Section 10 of the bill requires the department of human services to develop a statewide data collection and information system to analyze implementation data and selected outcomes to identify areas for improvement, promote accountability, and provide insights to continually improve child and program outcomes.Section 11 of the bill requires the department of human services, in collaboration with the department of agriculture, to contract with a nonprofit organization primarily focused on serving agricultural and rural communities in Colorado to provide vouchers to individuals living in rural and frontier communities in need of behavioral health-care services.Section 12 of the bill requires the center for research into substance use disorder prevention, treatment, and recovery support strategies to engage in community engagement activities to address substance use prevention, harm reduction, criminal justice response, treatment, and recovery.Section 13 of the bill continues the building substance use disorder treatment capacity in underserved communities grant program.Section 14 of the bill requires the perinatal substance use data linkage project to utilize data from multiple state-administered data sources when examining certain issues related to pregnant and postpartum women with substance use disorders and their infants.Section 15 of the bill requires the office of behavioral health to use a competitive selection process to select a recovery residence certifying body to certify recovery residences and educate and train recovery residence owners and staff on industry best practices. Section 16 of the bill requires the office of behavioral health to establish a program to provide temporary financial housing assistance to individuals with a substance use disorder who have no supportive housing options when the individual is transitioning out of a residential treatment setting and into recovery or receiving treatment for the individual's substance use disorder.Section 16 of the bill also creates the recovery support services grant program for the purpose of providing recovery-oriented services to individuals with a substance use and co-occurring mental health disorder.Section 17 of the bill continues the appropriation to the maternal and child health pilot program.Section 18 of the bill continues the program to increase public awareness concerning the safe use, storage, and disposal of opioids and the availability of nalaxone and other drugs used to block the effects of an opioid overdose.Section 19 of the bill continues the harm reduction grant program and the maternal and child health pilot program.Section 20 of the bill appropriates money to various state departments for certain programs.
(Note: This summary applies to this bill as introduced.)