6 CCR 1009-12
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Disease Control and Public Health Response Division COMMUNITY DISASTER BEHAVIORAL HEALTH PROGRAM 6 CCR 1009-12 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Adopted by the Board of Health on June 15, 2022 Section 1: Purpose and Authority A. The Department shall implement the Community Disaster Behavioral Health Program (Program) using existing initiatives and activities to ensure that behavioral health is adequately represented within disaster preparedness and response efforts across the state.
B. Section 25-20.5-1302, C.R.S. directs the State Board of Health to promulgate rules as necessary for the oversight and management of the Program, including allowable uses for funding allocated from the Community Behavioral Health Disaster Preparedness and Response Cash Fund (Cash Fund) created in section 25-20.5-1303, C.R.S..
C. The Program is intended to enhance, support, and formalize behavioral health disaster preparedness and response activities conducted by community behavioral health organizations, including community mental health centers as defined in section 27-66-101(2), C.R.S.
1. Disaster behavioral health response differs from traditional psychotherapeutic interventions. The goal is to promote adaptive functioning and decrease stress in the shadow of a disaster, which helps to restore executive functioning of the brain, such as decision-making, problem-solving, and cognitive processing. A community disaster behavioral health responder is not a practicing therapist but is instead providing a range of basic services through a tiered response effort that is designed to promote individual, family, and community resilience and helps affected individuals return to a pre-event level of functioning as quickly as possible. Disaster response methods include triage, basic support, psychological first aid, and making appropriate professional referrals in the community. These services are provided to survivors as well as professionals and volunteers who respond to emergencies and disasters and others on the scene of such incidents. The actual methods used depend on the type of event, the number of people affected, and the availability of resources.
2. The activities must not replace or supersede any disaster plans prepared or maintained by a local or interjurisdictional emergency management agency, as established in section 24-33.5-707, C.R.S..
Section 2: Definitions A. “Community Behavioral Health Disaster Preparedness and Response Program” or “Program” means the Community Behavioral Health Disaster Preparedness and Response Program created in section 25-20.5-1302, C.R.S..
B. “Community Behavioral Health Disaster Preparedness and Response Cash Fund” or “Cash Fund” means the Community Behavioral Health Preparedness and Response Cash Fund created in section 25-20.5-1303, C.R.S..
C. “Community Behavioral Health Disaster Response Coordinator” or “Response Coordinator” means an individual who is designated by a community mental health center or other behavioral health provider to fulfill the duties and responsibilities of the response coordinator pursuant to section 25-20.5-1302, C.R.S..
D. “Disaster” has the same meaning as set forth in section 24-33.5-703, C.R.S. “Disaster” means the occurrence or imminent threat of widespread or severe damage, injury, or loss of life or property resulting from any natural cause or cause of human origin, including but not limited to fire, flood, earthquake, wind, storm, wave action, hazardous substance incident, oil spill or other water contamination requiring emergency action to avert danger or damage, volcanic activity, epidemic, air pollution, blight, drought, infestation, explosion, civil disturbance, hostile military or paramilitary action, or a condition of riot, insurrection, or invasion existing in the state or in any county, city, town, or district in the state.
E. “Department” means the Colorado Department of Public Health and Environment. Section 3: Allowable Activities A. Allowable activities funded by the Program may include, but are not limited to:
1. Preparedness activities focused on the response to community needs, such as:
a. Risk assessment, hazard vulnerability assessments, and disaster planning with jurisdictional emergency partners;
b. Development of policies and procedures for disaster team preparedness and response planning with jurisdictional emergency partners;
c. Building and maintaining response team capacity, including training requirements;
d. Implementing disaster communication plans;
e. Training on and practicing existing disaster response plans; and f. Engaging with local and state partners for disaster preparedness and medical surge planning.
2. Response activities, such as:
a. Coordination and response with local and state partners;
b. Supporting emergency functions or operations, such as shelters or health and medical resource requests for disaster behavioral health services;
c. Triaging psychological or psycho-social care for disaster-affected individuals;
d. Providing immediate and ongoing support and care for individuals in crisis impacted by emergencies and disasters, both disaster survivors as well as volunteers and professionals who respond to emergencies and disasters and others on the scene of such incidents;
e. Outreach, psychoeducation, and consulting to response personnel and impacted community groups; and f. Providing ongoing follow-up, referrals, and services for affected individuals.
3. Recovery activities, such as:
a. Providing ongoing support opportunities for affected individuals and communities;
b. Maintaining connections for referrals to ongoing care for affected individuals; and c. Demobilization and addressing disaster response team’s recovery needs.
4. Any additional activities as deemed appropriate and necessary by the Department.
B. The Cash Fund will be allocated to annual grants for preparedness activities and as-needed applications for response and recovery activities each fiscal year.
1. Annual grants will be available to organizations who demonstrate eligibility, as established in Section 4, and commit to yearly preparedness activities.
2. As-needed applications may be submitted for allowable response and recovery activities following a disaster event.
C. The Program will prioritize and fund activities that are not supported by other conditional disaster behavioral health programs and funding.
1. Requests for as-needed response and recovery funding from the Cash Fund must demonstrate that other resource requests and sources of funding have been explored, as appropriate to standard emergency management processes, the level of declaration, or the type of disaster hazard. These other resources include but are not limited to:
a. 213 Resource Requests to County Emergency Operation Centers;
b. The Colorado Healing Fund;
c. The SAMHSA/FEMA Crisis Counseling Program;
d. The SAMHSA Emergency Response Grant Program; or e. Disaster specific funding opportunities or other collaborative grants, such as the Antiterrorism and Emergency Assistance Program grant from the federal Department of Justice.
Section 4: Participating Providers Eligibility Criteria, Preparedness Capabilities Measures, and Award Determination A. All providers who submit requests for participation in the Program must demonstrate capabilities and capacity, or emerging capabilities and capacity, in the following programmatic elements:
1. Service capacity a. Be able to provide subject matter expertise for supporting people with mental health conditions in disaster incidents.
b. Have existing relationships with Colorado’s behavioral health system and behavioral health services to refer individuals in need of higher-acuity or specific behavioral health services.
c. Designate a Disaster Behavioral Health Response Coordinator (Response Coordinator) and back-up Response Coordinator to maintain the responsibilities and duties of the role.
d. Serve the general public of the service area through disaster preparedness and response programming and coordinate response with other community disaster behavioral health program organizations that serve the same communities.
2. Planning a. Must be in compliance with Centers for Medicare and Medicaid (CMS) preparedness standards within their organization.
b. Will maintain relationships (e.g. regular meeting attendance, documented agreements, and plans) with their service area’s local and regional emergency preparedness and response (EPR) partners and coalitions, to at least include:
i. Local Public Health Agencies (LPHA);
ii. Healthcare Coalitions (HCCs); and iii. Colorado Crisis Education and Response Network (CoCERN).
3. Response Team Availability a. Can maintain organization continuity while fielding a team of 8 or more fully trained Disaster Behavioral Health Responders available for public response in the service area.
4. Training a. Ensure Disaster Behavioral Health Responders are trained to CoCERN protocol credentialing standards.
b. Have representation from the organization at 30 hours of training meetings per year.
c. Connect strongly with LPHAs in the service area for Emergency Support Function (ESF) #8 planning, training, exercises, and response coordination.
5. Culturally and linguistically appropriate services a. Provide culturally and linguistically appropriate services as guided by Culturally and Linguistically Appropriate Services (CLAS standards).
b. Maintain community-based relationships that inform, evaluate, and improve culturally and linguistically appropriate practices and capacity.
B. The Department will utilize the following measures in assessing preparedness and capabilities of providers:
1. Number of responders with completed CoCERN Disaster Behavioral Health Responder training requirements.
2. Designation of organization’s Disaster Behavioral Health Response Coordinator and back up coordinator.
3. Ongoing participation in:
a. Behavioral Health Disaster Coordinators’ meetings;
b. CoCERN meetings; and c. Regional and local planning, training, exercise events with HCCs and LPHAs.
C. Eligible providers may seek funding from the Department for annual preparedness activities and as-needed response and recovery activities outlined in Section 3 (Activities).
D. The Department will award funding based on need, alignment with the intent of the Program, and a determination of priority.
1. The Cash Fund will not be used in non-disaster programs and will not support other statute or program-mandated duties, such as:
a. Victim Advocate Activities;
b. Mental health or substance abuse treatment;
c. Required school-based services;
d. CMS preparedness requirements or continuity of operations planning;
e. Treatment for mental illness/substance abuse crisis interventions; or f. Mental health first aid training.
2. The Program will prioritize and fund program activities that are not supported by other conditional disaster behavioral health programs and funding (e.g. Crisis Counseling Assistance and Training Program available under federal disaster declarations, activities funded by the Colorado Healing Fund).
E. The Department may prioritize awards in a way that promotes the geographic and socio- economic diversity of providers.
F. All requests for funding, and award decisions made by the Department, are publicly accessible and may be utilized in reporting the outcomes of the Program and allocated funds.
G. The Department may request specific data elements be collected by an awarded provider in accordance with the intent of the Program as necessary for reporting on the outcomes of utilized funding.
Section 5: Other Program Management and Oversight A. Annual Program cycle 1. The Program will be administered through annual grants for preparedness activities each state fiscal year and through as-needed applications for response and recovery activities.
a. Providers interested in participating in the Program will submit and update annually an organizational profile demonstrating that they satisfy organizational eligibility criteria (see Section 4) and confirm their intent to participate in yearly preparedness activities.
b. The Program will seek diverse geographic and socio-economic coverage by providers.
c. Providers must participate in preparedness grants in order to apply for as-needed response and recovery funds.
2. The Department will make disaster behavioral health capabilities available for review before organizations submit their intent to participate.
B. Response funding allocation 1. A proportion of the annual allocation to the Cash Fund will be reserved for as-needed response and recovery applications.
a. The proportion reserved for as-needed response and recovery activities will be annually determined following the period in which providers submit their intent to participate.
b. Allowable as-needed response and recovery activities will be supported on a first-come, first-served basis.
2. If more than one provider serves an impacted area and each wishes to submit an application for as-needed response and recovery activity funding, the providers must collaborate to identify working relationships or activity distinctions.
3. If a provider serves an impacted area and recognizes the need to involve other provider(s) to cover needs, the primary provider may involve the secondary provider(s) as a sub-recipient of the funds they receive.
C. Program Reporting 1. On an annual basis, the Department will report on the following aspects of the Program:
a. Provider participation, including number, geographic coverage, and socio- economic reach;
b. Funding dispersed, to preparedness and response activities respectively;
c. Preparedness, response, and recovery activities conducted with Cash Fund support;
d. Any programmatic and funding limits identified, including changes to allowable uses of the Cash Fund;
e. Other measures and capability assessments of disaster behavioral health integration in disaster preparedness and response efforts including:
f. When available, narratives and feedback about disaster behavioral health efforts from key emergency partners, impacted communities, disaster behavioral health providers themselves.
2. The Department will gather information for the annual report through organizational profiles, annual preparedness statements of work, as-needed response and recovery applications on a fiscal year basis.
_________________________________________________________________________ Editor’s Notes History New rule eff. 08/14/2022.