January 2025

CBHC Year in Review: A Look Back at 2024

As we reflect on 2024, the Colorado Behavioral Healthcare Council (CBHC) is proud to highlight key achievements and milestones. This year, we faced new challenges but embraced exciting opportunities to strengthen Colorado’s behavioral health safety net.

Notable moments included our impactful CBHC Day at the Capitol, the annual Behavioral Health Training Conference, and critical legislative and regulatory advocacy. Through these efforts, CBHC demonstrated the power of collaboration in advancing key policy priorities. Highlights include securing a state planning grant for Certified Community Behavioral Health Clinics and championing Medicaid funding for behavioral health providers.

Despite the complexities of the COVID Public Health Emergency (PHE) unwind, Medicaid payment reforms, and new regulatory requirements, CBHC remained dedicated to addressing gaps in care and supporting community mental health centers through financial challenges.

As we continue to advocate for systemic change, we are excited to build on these accomplishments in the coming year, working to improve behavioral health services for all Coloradans.

For a detailed overview of our 2024 achievements, click here to read the full Year in Review.

A Look at the Budget

While the state’s revenue picture has seemingly improved since the September forecasts used for the November 1st budget proposal, a budget shortfall of nearly $1 billion still exists. Uncertainty remains regarding how the Joint Budget Committee (JBC) will address this shortfall and achieve a balanced budget; they have appeared skeptical of many components of the Governor’s budget proposals.

Recently, the Behavioral Health Administration (BHA) and the Department of Health Care Policy & Financing (HCPF) presented their budget requests to the JBC, fielding questions from committee members. Both hearings underscored the importance of interagency collaboration and highlighted key concerns for legislators. CBHC advocates for prioritizing funding for direct services during the budget-setting process, ensuring Colorado maximizes the impact of its funding by minimizing administrative costs.

BHA Hearing:
The JBC closely scrutinized the BHA’s administrative costs, including funding for internal programs and the expenses associated with the Behavioral Health Administrative Service Organizations (BHASOs). Budget writers have questions regarding whether these new administrative entities will divert funding that could be going to direct patient care. They also expressed concern about whether current funding is adequate to ensure provision of safety net services.

A central theme throughout the hearing was the need for effective collaboration. Legislators sought clarification on how BHASOs and Regional Accountable Entities (RAEs) will work together to ensure seamless access to care for individuals within the safety net system. Additionally, the JBC emphasized the importance of strong coordination between the BHA and HCPF, specifically inquiring about how the two agencies will avoid duplication of services, share data effectively, engage with stakeholders jointly, and align their policies to ensure a smooth and efficient system. 

CBHC’s key interests in the BHA budget include funding to compensate providers for expanded services to uninsured individuals with serious mental illness and funding to reduce administrative burdens for comprehensive providers. Additionally, CBHC is actively monitoring program reductions to ensure that there are no negative impacts on patient access to care. 

HCPF Hearing:
Medicaid is the largest driver of state budget expenditures with a multi-faceted budget. Because of its complexity, the HCPF hearing covered multiple days. Legislators examined the factors driving the significant increase in behavioral health expenditures. HCPF explained that key drivers include: a 95% expansion of the provider network since the pandemic, legislative expansions of services (e.g., residential substance use disorder treatment, mobile crisis response), a substantial increase in member utilization, and rising costs driven by increased provider rates and inflation.
 
CBHC appreciates that, in this difficult budget time, Medicaid rates for behavioral health providers are not being reduced. However, inflation and new requirements for providers have increased costs, meaning that a flat rate is an effective cut. We will continue to partner with HCPF and the JBC to safeguard comprehensive providers’ ability to effectively provide the care their communities need.

Because a number of CBHC’s members have seen significant increases in uncompensated care over the last year as Medicaid members lost coverage once the COVID public health emergency ended, a key focus for us ensuring that all who qualify for Medicaid get coverage. Accordingly, we are keenly interested in HCPF’s budget requests for funding county enrollment functions and improving the Consolidated Benefits Management System (CBMS) used for that. We are also eager to explore opportunities for comprehensive providers to become Eligibility Application Partner (EAP) Sites to assist individuals with Medicaid eligibility determinations.

Legislative Overview

The General Assembly convened on January 8th, marking the beginning of the legislative session. The extended bill filing deadline means that new bills are still being introduced. At this writing, CBHC is actively monitoring several related to or with implications for behavioral health: 

SB25-017: Measures to Support Early Childhood Health
SB25-034: Voluntary Do-Not-Sell Firearms Waiver
SB25-041: Competency in Criminal Justice System Services & Bail
SB25-042: Behavioral Health Crisis Response Recommendations
SB25-043: Deflection Supports Justice-Involved Youth
SB25-045: Health-Care Payment System Analysis
HB25-1002: Medical Necessity Determination Insurance Coverage
HB25-1008: Complementary Behavioral Health Systems in Jails
HB25-1033: Medicaid Third-Party Liability Payments