27-50-108. Systemwide behavioral health grievance system

27-50-108. Systemwide behavioral health grievance system. (1) (a) On or before July 1, 2024, the BHA shall create and implement a process for collecting, analyzing, and addressing behavioral health system grievances across payers, behavioral health administrative services organizations, managed care entities, and providers at a systemic level that leverages and does not duplicate existing grievance resolution programs. The BHA shall analyze grievances to identify and address service delivery gaps and to inform statewide behavioral health system policy.

(b) The BHA shall, at a minimum, track grievances by behavioral health provider, topic, region, managed care entity, behavioral health administrative services organizations, payer source, service, or diagnosis and aggregate demographic data. In order to promote transparency, accountability, and system collaboration, the BHA shall publish, at least annually, aggregated and anonymized data on grievances on a public-facing website.

(c) The BHA shall implement a plan to streamline grievance resolution programs, promote transparency, improve consumer experience, and promote clarity and transparency.

(2) On or before July 1, 2024, the BHA shall solicit input from the behavioral health administration advisory council created pursuant to section 27-50-701, the sub-committees created pursuant to section 27-50-703, and demographically diverse stakeholders to develop a process for addressing individual grievances when traditional grievance programs fail.

(3) The BHA may refer individual grievances to the office of the ombudsman for behavioral health access to care, created pursuant to section 27-80-303, when an individual may require further intervention or support to resolve the grievance in accordance with the charge of the ombudsman.

(4) On or before July 1, 2024, the BHA and state agencies shall execute formal data-sharing agreements addressing data sharing consistent with state and federal requirements, cooperation between the BHA and state agencies, and any other provisions necessary to implement this section. At a minimum, the BHA and the following entities shall execute such agreements:

(a) The ombudsman for medicaid managed care, established in section 25.5-5-406.1;

(b) The ombudsman for behavioral health access to care, designated pursuant to section 27-80-303; and

(c) The child protection ombudsman, appointed pursuant to section 19-3.3-103. All data released by the ombudsman shall comply with section 19-3.3-103 (1)(a)(I)(B) and (3).

(5) The BHA may promulgate rules as needed to implement this section.