HB 1305 — Licensing of Behavioral Health Facilities

SecondNOTE: Regular Session Seventy-fifth General Assembly STATE OF COLORADO REREVISED This Version Includes All Amendments Adopted in the Second House LLS NO.

26-0847.01This Veronicabill Parishhas x2606been HOUSEprepared BILLfor 26-1305the HOUSEsignatures SPONSORSHIPof Lukens,the Brown,appropriate Duran,legislative Espenoza,officers Gonzalezand R.,the Jackson,Governor. Lieder, Lindsay, Marshall, McCluskie, McCormick, Nguyen, Ricks, Rutinel, Smith, Stewart K., Stewart R.

SENATETo SPONSORSHIPdetermine Roberts,whether Amabile,Benavidez,Bridges,Catlin,Coleman,Cutter,Daugherty,Exum,Gonzalesthe J.,Governor Jodeh,has Kipp,signed Kolker,the Lindstedt,bill Liston,or Marchman,taken Mullica,other Peltonaction B.,on Snyder,it, Wallace,please Weissmanconsult dthe dlegislative estatus 6sheet, athe 0legislative Thistory, nor 2the NSession gLaws. 4 E i i House Committees Senate Committees S a p Health & Human Services Health & Human Services e A d i A BILL FOR AN ACT a e 2 C ONCERNINGENHANCINGACCESSTOINPATIENTBEHAVIORALHEALTH T d 2 A n 3 BY ALIGNING STATE AND FEDERAL STATUTES .

EHOUSE dBILL i26-1305 SBY dREPRESENTATIVE(S) pLukens, eBrown, ADuran, BillEspenoza, SummaryGonzalez mR., AJackson, (Note:Lieder, Lindsay, Marshall, McCormick, Nguyen, Ricks, Rutinel, Smith, Stewart K., Stewart R., McCluskie, Boesenecker, English, Weinberg;

Thisalso summarySENATOR(S) appliesRoberts, toAmabile, thisBenavidez, billBridges, asCatlin, introducedCutter, andDaugherty, doesExum, notreflectanyamendmentsthatmaybesubsequentlyadopted.IfthisbillGonzales dJ., passesJodeh, thirdKipp, readingKolker, inLindstedt, theListon, houseMarchman, ofMullica, introduction,Pelton aB., billSnyder, summaryWallace, thatWeissman, eColeman. 6 m 0 applies to the reengrossed version of this bill will be available at S n , http://leg.colorado.gov.) U g 2 O i c H e a The bill allows remote psychiatric inpatient health-care facilities R M r to operate under a main hospital's license if certain conditions are met.

3CONCERNING TheENHANCING billACCESS outlinesTO theINPATIENT processBEHAVIORAL byHEALTH whichBY aALIGNING remoteSTATE psychiatricAND inpatientFEDERAL health-careSTATUTES facility. can apply to operate under a main hospital.

eBe nit eenacted 2by Ethe aGeneral 2Assembly Uof Uthe 0State Oof nColorado: h Shading denotes HOUSE amendment.

DoubleSECTION1. underlining denotes SENATE amendment.

HInColoradoRevisedStatutes,25-1.5-103,add(1)(e) aas afollows: Capital letters or bold & italic numbers indicate new material to be added to existing law.e M Dashes through the words or numbers indicate deletions from existing law.

d 1 Be it enacted by the General Assembly of the State of Colorado:

SECTION 1.

In Colorado Revised Statutes, 25-1.5-103, add (1)(e) as follows:

Healthfacilities-powersanddutiesofdepartmentHealth facilities - powers and duties of department - rules - limitations on rules - definitions - repeal.

(1) ThedepartmentThe department has, in addition to all other powers and duties imposeduponitbylaw,imposed upon it by law, the powers and duties provided in this section as follows:

(e)Capital TOletters ESTABLISHor ANDENFORCEbold STANDARDSFORTHE& OPERATIONitalic ANDnumbers MAINTENANCEindicate OFnew REMOTEmaterial PSYCHIATRICadded INPATIENTto LOCATIONSexisting OFlaw; GENERAL HOSPITALS ,AS DEFINED IN SECTION25-3-101 (2)(d).

SECTION2.dashes through words or numbers indicate deletions from existing law and such material is not part of the act.

InColoradoRevisedStatutes,25-3-101,add(2)(c),(e) (2)(d),TO (5),ESTABLISH (6),AND (7),ENFORCE (8),STANDARDS asFOR follows:THE OPERATION AND MAINTENANCE OF REMOTE PSYCHIATRIC INPATIENT LOCATIONS OF GENERAL HOSPITALS ,AS DEFINED IN SECTION 25-3-101 (2)(d).

SECTION 2.

In Colorado Revised Statutes, 25-3-101, add (2)(c), (2)(d), (5), (6), (7), (8), and (9) as follows:

(c) "M AIN HOSPITAL"MEANSHOSPITAL " MEANS A HEALTH -CARE FACILITY THAT IS LICENSEDASAGENERALHOSPITALANDOPERATESAREMOTEPSYCHIATRICLICENSED AS A GENERAL HOSPITAL AND OPERATES A REMOTE PSYCHIATRIC INPATIENT LOCATION UNDER A GENERAL HOSPITAL 'SS LICENS.LICENSE.

(d) "R EMOTE PSYCHIATRIC INPATIENT LOCATION OF A GENERAL HOSPITAL "OR" REMOTEOR "REMOTE PSYCHIATRIC INPATIENT LOCATION " MEANS A HEALTH -CARE FACILITY THAT IS FEDERALLY DETERMINED OR SEEKING FEDERAL DETERMINATION AS A REMOTE LOCATION OF A MAIN HOSPITAL WITH PROVIDER -BASED STATUS PURSUANT TO 42CFR42 CFR 413.65, DELIVERS HEALTH -CARE-CARESERVICESUNDERTHENAME SERVICES UNDER THE NAME ,OWNERSHIP ,AND,ANDFINANCIALAND FINANCIAL AND ADMINISTRATIVE CONTROL OF A MAIN HOSPITAL , AND MEETS THE FOLLOWING CRITERIA :

(I) (A) W AS INITIALLY LICENSED BY THE DEPARTMENT AS A -2- 1305 PSYCHIATRIC HOSPITAL;ORHOSPITAL ;OR (B) W OULDOULDOTHERWISEBESUBJECTTOLICENSINGASAPSYCHIATRIC OTHERWISEHOSPITAL BE; SUBJECT TO LICENSING AS A PSYCHIATRIC HOSPITAL;

(II) MEETSMEETSALLTHE ALL THE STATE BOARDBOARDOFHEALTHLICENSINGRULESFOR OFA HEALTHPSYCHIATRIC LICENSINGHOSPITAL RULES,INCLUDING FORAPSYCHIATRICHOSPITALBUILDING ,INCLUDINGBUILDINGSTANDARDSADOPTEDSTANDARDS ADOPTED PURSUANT TO SECTION 25-1-108 (1)(c)(II);

(IV) IS LOCATED WITHIN THIRTYTHIRTY-FIVE -FIVE MILES OFOFTHE THE MAIN HOSPITAL IN A RURAL AREA AS DEFINED IN SECTION25-1.5-103 (3)(b);(3)(b)AND PAGE 2-HOUSE BILL 26-1305 (V) O FFERS PRIMARILY INPATIENT PSYCHIATRIC SERVICES WITH SEVENTEEN OR MORE INPATIENT BEDS .

AND(5) (V)A OHEALTH FFERS-CARE PRIMARILYFACILITY INPATIENTTHAT IS A REMOTE PSYCHIATRIC SERVICESINPATIENT WITHLOCATION SEVENTEENOF ORA MOREGENERAL INPATIENTHOSPITAL BEDSIS NOT REQUIRED TO BE SEPARATELY LICENSED AS A PSYCHIATRIC HOSPITAL .

(5)THE ADEPARTMENT HEALTH-CARESHALL FACILITYRECOGNIZE THATTHE ISHEALTH A-CARE REMOTEFACILITY PSYCHIATRICAS INPATIENTLAWFULLY LOCATIONLICENSED OFUNDER ATHE GENERALMAIN HOSPITAL ISS NOTGENERAL REQUIREDLICENSE TO,UPON BEPROOF SEPARATELYTHAT LICENSEDTHE ASREMOTE A PSYCHIATRIC HOSPITAL.INPATIENT LOCATION SATISFIES THE CRITERIA IN SUBSECTION (2)(d)OF THIS SECTIO.

THE(6) DEPARTMENTA SHALLREMOTE RECOGNIZEPSYCHIATRIC THEINPATIENT HEALTHLOCATION -CAREOF FACILITYA ASGENERAL LAWFULLYHOSPITAL LICENSEDIS UNDERSUBJECT THETO MAINSTATE HOSPITALBOARD SOF GENERALHEALTH LICENSE,UPONLICENSING PROOFRULES THATFOR THEPSYCHIATRIC REMOTEHOSPITALS PSYCHIATRICAND INPATIENTIS LOCATIONNOT SATISFIESSUBJECT THETO CRITERIASTATE INBOARD SUBSECTIONOF (2)(dOFHEALTH THISLICENSING SECTIO.RULES FOR GENERAL HOSPITALS.

(6)(7) A REMOTENY PSYCHIATRICENFORCEMENT INPATIENTACTION LOCATIONBY OFTHE ADEPARTMENT GENERALMUST BE TAKEN AGAINST THE MAIN HOSPITAL IS'S SUBJECTGENERAL TOHOSPITAL STATELICENSE BOARD, OFREGARDLESSOFWHETHERTHEACTIONARISESFROMCONDUCTTHATOCCURS HEALTHAT LICENSINGTHE RULESMAIN FORHOSPITALLOCATION PSYCHIATRICHOSPITALSANDISNOTSUBJECTTOSTATEBOARDOFHEALTHOR LICENSINGTHE RULESREMOTE FORPSYCHIATRIC GENERALINPATIENT HOSPITALS.LOCATION .

(7)(8) AI NYN ENFORCEMENTTHE ACTIONEVENT BYTHAT THE DEPARTMENTREMOTE MUSTPSYCHIATRIC BEINPATIENT TAKENLOCATION AGAINSTIS THENO MAINLONGER HOSPITALFEDERALLY SDETERMINED GENERALAS HOSPITALA LICENSEREMOTE ,LOCATION REGARDLESS OF WHETHERA THEGENERAL ACTIONHOSPITAL ARISESWITH FROMPROVIDER CONDUCT-BASED THATSTATUS -3-PURSUANT 1305TO OCCURS42 ATCFR THE413.65,THE MAINREMOTE HOSPITALPSYCHIATRIC INPATIENT LOCATION ORMUST THESEEK REMOTEA PSYCHIATRIC INPATIENTHOSPITAL LOCATION.LICENSE IN ORDER TO CONTINUE OPERATING.

(8)(9) IN(a) THEA EVENTHEALTH -CARE FACILITY THAT THEDELIVERS REMOTEHEALTH PSYCHIATRIC-CARE INPATIENTSERVICES LOCATIONISNOLONGERFEDERALLYDETERMINEDASAREMOTELOCATIONUNDER OFAGENERALHOSPITALWITHPROVIDERTHE -BASEDSTATUSPURSUANTTONAME 42, CFROWNERSHIP 413.65,THE, REMOTEAND PSYCHIATRICFINANCIAL INPATIENTAND LOCATIONMUSTADMINISTRATIVE SEEKCONTROL OF A PSYCHIATRICMAIN HOSPITAL LICENSE IN ORDER TO CONTINUE OPERAT.NG (9) (a) AHEALTH-CARE FACILITY THAT DELIVERSDOES HEALT-CARENOT SERVICESMEET UNDER THE NAMEREQUIREMENTS ,OF OWNERSHIPSUBSECTION ,(2)(d)(IVOF ANDTHIS FINANCIALSECTION ANDMAY ADMINISTRATIVECONTROLOFAMAINHOSPITALTHATDOESNOTMEETTHEELECT REQUIREMENTSOFSUBSECTIONTO (2)(d)(IVOFTHISSECTIONMAYELECTTO BECOME A REMOTE PSYCHIATRIC INPATIENT LOCATION OF A GENERAL HOSPITAL FOR PURPOSES OF THIS SECTION IF THE FAC:LITYFACILITY (I) WASW AS LICENSED BY THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENTASAPSYCHIATRICHOSPITALPRIORTOTHEEFFECTIVEDATEENVIRONMENT AS A PSYCHIATRIC HOSPITAL PRIOR TO THE EFFECTIVE DATE OF THIS SUBSECTION(9);

(II) WASW AS FEDERALLY DETERMINED AS A REMOTE LOCATION OF A GENERALHOSPITALWITHPROVIDERBASEDSTATUSPURSUANTTOPAGE 42CFR3-HOUSE 413.65PRIORBILL 26-1305 GENERAL HOSPITAL WITH PROVIDER BASED STATUS PURSUANT TO 42 CFR 413.65 PRIOR TO THE EFFECTIVE DATE OF THIS SUBSECTI(9);SUBSECTION (9);

(III) METSMEETSTHECRITERIADESCRIBEDINSUBSECTIONS THE(2)(d)(IAND CRITERIA DESCRIBED IN SUBSECTIO(2)(d)(II) AND (2)(d)(V)OF THIS SECTI;ANDSECTION;AND (IV) ISI S CERTIFIED TO ACCEPT MEDICAID AND SERVES MEDICAID MEMBERS .

(b) A HEALTH-CAREHEALTH CARE FACILITY THAT QUALIFIES AS A REMOTE PSYCHIATRICINPATIENTLOCATIONOFAGENERALHOSPITALPURSUANTTOPSYCHIATRIC THISSUBJECTIONINPATIENT (9ISSUBJECTLOCATION TOTHESAMEREQUIREMENTSAPPLIEDTOOF AREMOTEPSYCHIATRICINPATIENTLOCATIONPURSUANTTOTHISSECTIONA GENERAL HOSPITAL PURSUANT TO THIS SUBJECTION (9)ISSUBJECT TOTHE SAME REQUIREMENTS APPLIED TO A REMOTE PSYCHIATRIC INPATIENT LOCATION PURSUANT TO THIS SECTION .

-4-SECTION3. 1305 SECTION 3.

InInColoradoRevisedStatutes,25-3-102,add(1)(d.5) Colorado Revised Statutes, 25-3-102, add (1)(d.5) and (4) as follows:

(1)(d.5)(1) TEMAINHOSPITALMUSTDEMONSTRATETHATITMEETS(d.5) THE FOLLOWINGMAIN CONDITIONSHOSPITAL INMUST ITSDEMONSTRATE APPLICATIONTHAT FORIT RENEWALMEETS OFTHEFOLLOWINGCONDITIONSINITSAPPLICATIONFORRENEWALOFALICENSE A LICENSE DESCRIBED IN SECTION 25-3-101 IN ORDER FOR A REMOTE PSYCHIATRICINPATIENTLOCATIONTOCONTINUETOOPERATEUNDERTHEPSYCHIATRIC INPATIENT LOCATION TO CONTINUE TO OPERATE UNDER THE MAIN HOSPITALSHOSPITAL S GENERAL HOSPITAL LICENS:LICENSE :

(I) TEREMOTEPSYCHIATRICINPATIENTLOCATIONISDESIGNATEDTHE BYTHECOMMISSIONEROFTHEBEHAVIORALHEALTHADMINISTRATIONTOREMOTE PSYCHIATRIC INPATIENT LOCATION IS DESIGNATED BY THE COMMISSIONER OF THE BEHAVIORAL HEALTH ADMINISTRATION TO PROVIDE SERVICES PURSUANT TO ARTICL65ARTICLE 65 OF TITLE27;TITLE 27;

(II) TEREMOTEPSYCHIATRICINPATIENTLOCATIONISFEDERALLYTHE REMOTE PSYCHIATRIC INPATIENT LOCATION IS FEDERALLY DETERMINED AS A REMOTE LOCATION OF A GENERAL HOSPITAL WITH PROVIDER BASED-BASED STATUS PURSUANT TO 42 CFR 413.65;

(III) TETHE REMOTE PSYCHIATRIC INPATIENT LOCATION MEETS ALL STATE BOARD OF HEALTH PSYCHIATRIC HOSPITAL RULE;ANDRULES ;AND (IV) THEREMOTEPSYCHIATRICINPATIENTLOCATIONISCERTIFIEDT HE REMOTE PSYCHIATRIC INPATIENT LOCATION IS CERTIFIED TO ACCEPT MEDICAID AND SERVES MEDICAID MEMBERS.MEMBERS .

(4)PAGE I4-HOUSE ATBILL ANY26-1305 TIME(4) FATANYTIMEAREMOTEPSYCHIATRICINPATIENTLOCATIONOF A REMOTEGENERAL PSYCHIATRICHOSPITAL INPATIENTIS LOCATIONNO OFAGENERALHOSPITALISNOLONGERFEDERALLYDETERMINEDTOHAVELONGER FEDERALLY DETERMINED TO HAVE PROVIDER BASED-BASED STATUS PURSUANT TO 42 CFR 413.65,THE413.65, THE REMOTE PSYCHIATRICINPATIENTLOCATIONMUSTSECUREAPSYCHIATRICHOSPITALPSYCHIATRIC INPATIENT LOCATIONMUST SECURE A PSYCHIATRIC HOSPITAL LICENSE FROM THE DEPARTMENT TO CONTINUE OPERATIONS.OPERATIONS .