HCPF and the Behavioral Health Administration (BHA) are partnering to strengthen the Colorado crisis continuum of services through the American Rescue Plan Act section 9813. This collaboration involves expanding and improving the community-based mobile crisis intervention service under Health First Colorado (Colorado’s Medicaid program) for individuals experiencing a behavioral health crisis, which can include both mental health and substance use related issues. In addition to federal requirements, this policy has been informed by robust stakeholder engagement, national best practices, and state policy. ARPA 9817 funds are being used to support providers in meeting the new standards and are administered via the BHA through Administrative Service Organization (ASO) provider contracts.
This benefit will standardize mobile crisis response (MCR) services. The benefit is designed to de-escalate, stabilize and keep members in the community while reducing arrests and hospitalizations. Providers may begin enrolling as a crisis provider MCR specialty type with Health First Colorado June 1, 2023. The benefit will launch July 1, 2023. This service is available to all Coloradans regardless of insurance status.
MCR Program Goals
- Improve the quality and consistency of mobile crisis services for Coloradans experiencing a mental health or substance use disorder crisis.
- Reduce unnecessary emergency department visits, inpatient hospitalizations and arrests of individuals experiencing a behavioral health crisis.
- Enhance efforts to connect individuals who have experienced a crisis to ongoing community-based mental health services.
- Strengthen provider capacity and expertise to ensure mobile crisis response services work effectively, including for members of priority populations.
- Increase awareness of the MCR services and how to access them.
- Integrate the MCR benefit into other state crisis investments and initiatives, including rollout of 988.
- Align reimbursement with the Colorado Crisis System managed by the BHA.
What MCR is Not:
- MCR is not a replacement for ongoing mental health and substance use disorder treatment services.
- MCR does not replace nor stop other crisis response services; it is another option for communities and an opportunity for greater collaboration across crisis providers.
Benefit Overview
The MCR service will offer de-escalation and stabilization to people in a self-defined behavioral health crisis. MCR should be used to address an emergent and unforeseen crisis — it is not intended to replace ongoing mental health conditions and/or substance use disorder treatment services. This service is provided by a two-person multidisciplinary MCR team with federally required training and expertise. MCR teams must be able to respond 24 hours a day, 365 days a year to individuals in crisis, at their community-based location.
In the hours and days after a crisis is addressed, MCR providers will coordinate follow-up care and referrals to behavioral health treatment services and/or other community-based support. This level of support is based on member preference and may include home-based follow-up visits if clinically indicated. When members require transportation to a facility for additional physical or behavioral health services, the MCR team will arrange for appropriate transportation.
MCR Service Definition
This service definition outlines the components that comprise the MCR benefit. It is intended for use by MCR teams eligible for BHA endorsement and enrollment as a Health First Colorado provider delivering services to all people in Colorado in crisis regardless of insurance, age, location, prior use, or residency status. This service definition reflects national best practices and Colorado’s unique needs for service delivery and provider performance. The definition details the following elements of the new MCR benefit:
- Engagement with Community
- Service activities
- Provider/agency Requirements, Enrollment, and Billing
- Staffing Requirements
- 24/7/365 Availability, Timeliness, and Location of Service Standards, and
- Use of Telehealth and other Technology
The service definition applies to both BHA and HCPF MCR services. It will be used as a companion to the Medicaid State Behavioral Health Services Billing Manual July 2023, and any BHA crisis contracts.
Ways to Engage
Current stakeholder engagement includes regular bi-weekly technical assistance (TA) meetings open to all stakeholders, including but not limited to ASOs, Regional Accountable Entities (RAEs), community members, advocates, Health First Colorado members and providers. TA meetings include general technical assistance, as well as periodic training sessions about specific topics such as accessibility and harm reduction. Register for the meeting series here.
Resources
- Policy Memo PM 23-002, "Joint Policy Memo on Facility-Based Mobile Crisis Response in Colorado," informing all stakeholders of facility-based response MCR policy.
- Policy Memo PM 23-004 "Joint Agency policy Memo on Law Enforcement in Mobile Crisis Response," informing all stakeholders of law enforcement MCR policy.
- Enrollment How-To: MCR providers can visit the provider enrollment page for info and resources.
- Benefit Design Stakeholder Engagement Information: Visit this BHA webpage to review prior stakeholder information including presentation slides and recordings.
Stay Informed
Please email Emily Holcomb, Mobile Crisis Policy Advisor, with questions, suggestions, or to be added to our email list.