10 Colo. Code Regs. § 2505-10-8.212
Current through Register Vol. 47, No. 16, August 25, 2024
Section 10 CCR 2505-10-8.212 - COMMUNITY BEHAVIORAL HEALTH SERVICES8.212.1ENROLLMENT8.212.1.A. The following individuals are not eligible for enrollment in the Community Behavioral Health Services program: 1. Qualified Medicare Beneficiary only (QMB-only).2. Qualified Disabled and Working Individuals (QDWI)3. Qualified Individuals 1 (QI 1).4. Special Low Income Medicare Beneficiaries (SLMB).5. Undocumented aliens, including non-qualified, undocumented and qualified aliens who have not met the five-year bar who are eligible for Federal Medicaid for care and services related to the treatment of an approved medical condition.6. Individuals enrolled in the Program of All-Inclusive Care for the Elderly (PACE).7. Individuals who are inpatient at the Colorado Mental Health Institute at Pueblo or the Colorado Mental Health Institute at Fort Logan who are:a. Found by a criminal court to be Not Guilty by Reason of Insanity (NGRI);b. Found by a criminal court to be Incompetent to Proceed (ITP); or c. Ordered by a criminal court to a State Institute for Mental Disease (IMD) for evaluation (e.g. Competency to proceed, sanity, conditional release revocation, pre-sentencing).8. Individuals between ages 21 and 64 who receive inpatient treatment who are inpatient at the Colorado Mental Health Institute at Pueblo or the Colorado Mental Health Institute at Fort Logan.9. Individuals who are NGRI and who are in the community on Temporary Physical Removal (TPR) from the Colorado Mental Health Institute at Pueblo and who are eligible for Medicaid are exempted from the Community Behavioral Health Services program while they are on TPR. TPR individuals remain under the control and care of the Institute.10. Classes of individuals determined by the Department to require exclusion from the Community Behavioral Health Services program, defined as individuals residing in State Regional Centers for people with developmental disabilities and associated satellite residences for more than 90 days.11. Individuals who receive an individual exemption as set forth at Section 8.212.2.12. Individuals while determined presumptively eligible for Medicaid.13. Children or youth in the custody of the Colorado Department of Human Services-Division of Child Welfare or Division of Youth Corrections who are placed by those agencies in a Psychiatric Residential Treatment Facility (PRTF) as defined in C.R.S. 25.5-4-103, Residential Child Care Facilities (RCCF) or Qualified Residential Treatment Programs (QRTP), as defined in C.R.S. 26-6-102.8.212.1.B. All other Medicaid clients shall be enrolled in the Community Behavioral Health Services program, and into a behavioral health organization in the client's geographic area. 1. The Department automatically re-enrolls a client into the same behavioral health organization if there is a loss of Medicaid eligibility of two months or less.