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COVID-19 Guidance
for Behavioral Health Providers

March 12, 2020

Behavioral Health Providers: 

The Colorado Department of Human Services, Office of Behavioral Health (OBH) has been monitoring the spread of COVID-19 (novel coronavirus). Following Governor Polis’s state of emergency declaration, we want to provide you with approved state and federal resources and guidance that can help keep clients, employees and visitors safe.


In this email:  Guidance for CDHS facilities is being issued in communications to staff.
 
State and Federal COVID-19 Resources 
The Colorado Department of Public Health and Environment (CDPHE) is leading the state response to COVID-19. The CDPHE website (colorado.gov/cdphe/2019-novel-coronavirus) has the most up-to-date information on state efforts to contain and treat the virus. You can also find national updates about the novel coronavirus from the U.S. Centers for Disease Control and Prevention (CDC) at cdc.gov/coronavirus/2019-ncov

CDPHE Hotline 
CDPHE has set up a hotline for general COVID-19 questions that is available in many languages: 
CDPHE and the CDC are the best resources for COVID-19 information. Please consult these organizations for all medical questions.
 
OBH Guidance for Behavioral Health Facilities
OBH aims to limit disruption of services while protecting patients and staff from infection risk. To that end, we are issuing the following guidance: 
  • Review your emergency preparedness plan: By OBH rule, all licensed and designated facilities must have an emergency preparedness plan on file. Please review and update this plan as soon as possible so your facility can appropriately manage any cases of COVID-19 and ensure clients have access to necessary services in the event of a disruption.
  • Explore telehealth and telemedicine options: For most services (please see noted exceptions in the "Submit Waivers" bullet), OBH rule does not limit the use of telemedicine and telehealth options at licensed and designated facilities. Telemedicine and telehealth should be used with clients when appropriate. For best practices in telehealth and telemedicine, please see this HealthIT.gov guide.  
  •  
    • Billing: During this period, our providers may document these encounters and submit for billing to OBH contracts as they would otherwise for an in-office, in-person service. Even though the Uniform Service Coding Manual may not otherwise allow for telehealth, OBH will not enforce that criteria, starting now through the end of March, at which time we will reassess. If providers have issues with submitting data to OBH, which is used for billing support, please have them contact OBH Senior Data Compliance Manager Sharon Pawlak.
  • Submit waivers for Criminal Justice, DUI and Children and Youth Mental Health Treatment Act (CYMHTA) programs if needed: By OBH rule, Criminal Justice, DUI and CYMHTA programs must deliver services face-to-face in the same room. While we strive to continue these services in person, you may submit a waiver to OBH if you believe this requirement will put patients and staff at considerable risk. To submit a waiver, please fill out this form
  • Follow state and federal guidance on managing patients: To keep patients safe, the CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) recommend distancing patients at least six feet, extending hours to reduce crowds and encouraging hand washing and regular facility cleaning. Read more prevention measures for providers on the CDC website. 
  • Notify OBH of any closures: By OBH rule, all licensed and designated facilities must notify OBH of any closures immediately. Certified Opioid Treatment programs (OTPs) must also inform the Drug Enforcement Agency of closures.
Please fill out this form if you have any questions or concerns.
 
Additional Guidance for Opioid Treatment Programs (OTPs)
On a phone call last week, SAMHSA issued the following guidance specifically for OTPs: 
  • OTPs must have policies for emergency preparations that include continuing to dose during an outbreak. Hospitals should be used as a last resort.
  • OTPs should be prepared to have extra supplies of medication on site to allow for home dosing when appropriate.
  • OTP should consider extending hours of operation to reduce overcrowding and allow for more distance between clients in waiting areas.
Please fill out this form if you have any questions or concerns.
 
Additional Guidance for Colorado Crisis Services in Dispatching Mobile Response
We recommend that crisis providers adopt this protocol before dispatching mobile response.

Screening Questions
  1. Does the client show any respiratory issues, sneezing, coughing and fever?
  2. Did the client travel internationally?
  3. Did the client have known exposure to someone who has tested positive for COVID-19?
Screening Response
  • If the client answers no to all questions above, proceed as normal.
  • If the client answers yes to any of the above questions, ask the client to call 911 to report their behavioral health crisis. Encourage the client to call their doctor about potential COVID-19 symptoms or exposure.  
Please fill out this form if you have any questions or concerns.
 
Watch for additional updates
We commit to updating you with new information and additional procedures. We appreciate your efforts in keeping Coloradans safe and healthy.

Sincerely,

Robert Werthwein, Director
Office of Behavioral Health 
Colorado Department of Human Services
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