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Residential and Inpatient Services

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The Department of Health Care Policy and Financing (HCPF) is expanding the spectrum of behavioral health services for Health First Colorado (Colorado’s Medicaid program) members. This includes residential and inpatient receiving facilities that provide behavioral health treatment for over 24 hours.

“Residential Services” means the on-site service for individuals whose mental health and/or substance use issues and symptoms are severe enough to require a twenty-four (24)-hour per day structured program and oversight, but that do not require hospitalization.

“Inpatient” refers to inpatient hospitalization as well as twenty-four (24) hour residential levels of care.

  • Residential respite services offer short-term case management and supportive housing after a behavioral health crisis to support member engagement in ongoing behavioral health outpatient care.
  • A Crisis Stabilization Unit (CSU) provides short-term, bed-based crisis stabilization services for children or adults in a 24-hour environment that can include individual therapy, group therapy and/or psychiatric evaluation, in a locked or unlocked unit. Members in a CSU must be assessed at least every 3 days for continued appropriateness.
  • An Acute Treatment Unit (ATU) provides short-term psychiatric care for adults, which may include treatment for substance use disorders, that provides a 24-hour, therapeutically planned and professionally staffed environment for individual therapy, group therapy and/or psychiatric evaluation in a locked unit that is less restrictive than an inpatient hospital. Members in an ATU must be assessed at least every 10 days for continued appropriateness.
  • Withdrawal Management facilities, also known as substance use disorder clinics, offer assessment and support for behavioral health crises involving substance use disorders.
  • Eating Disorder Facilities provide comprehensive treatment for individuals with eating disorders. This treatment addresses the physical, mental, and behavioral aspects of the disorder and may include psychotherapy, medical care, nutritional counseling, medications, or a combination of these approaches to support an individual struggling with an eating disorder.
  • Mental Health Transitional Living (MHTL) Homes:
    • MHTL Level 1 Homes provide support with social and life skills development, as well as assistance with other daily life activities based on an individual's needs. This setting is available to Health First Colorado waiver participants only.
    • MHTL Level 2 Homes provide clinical services (individual and group therapy), intensive case management, and medication management.
    • MHTL HCPF Memo
  • Emergency departments are facilities that provide emergency care. For more information on providing Behavioral Health services in an emergency department setting, please see the HCPF Crisis Services Hospital Billing Guidance.
  • An Inpatient hospital provides the highest level of behavioral health treatment in a locked facility.
  • Substance Use residential facilities follow ASAM Levels
    • 3.1 Clinically Managed Low-Intensity Services
    • 3.5 Clinically Managed High-Intensity Residential Services
    • 3.7 Medically Monitored Intensive Inpatient Services
    • 4 Medically Managed Intensive Inpatient Services
  • Institute of Mental Diseases (IMD) are defined as “a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services.” Residential and inpatient facilities must comply with IMD rules.

Youth Residential Services

  • A Psychiatric Residential Treatment Facility (PRTF) is an inpatient psychiatric facility for children and youth who need intensive psychiatric care but do not require the level of care of an inpatient hospital setting. For more information, please visit the Residential Programs for Youth section of the Colorado Department of Human Services website.
  • A Qualified Residential Treatment Program (QRTP) is a facility that provides residential trauma-informed treatment that is designed to address the needs, including clinical needs, of children with serious emotional or behavioral disorders or disturbances. As appropriate, QRTP treatment facilitates the participation of family members in the child’s treatment program, including siblings, and documents outreach to family members, including siblings.

HCPF is creating a Transition Plan with specific policies, expectations, and workflows for RAEs, Providers, and County Child Welfare staff to utilize between April 1, 2025 - October 1, 2025 to ensure youth needing residential treatment, in a residential facility, or discharging from a residential facility will not be impacted by the transition to ACC Phase 3 on July 1, 2025.  

Please review the CW Residential Services Transition Slidedeck for more information about this transition and provide General Questions and Comments.

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