Critical Incident Report

In accordance with 2 CCR 502-1, all agencies that hold a BHA license or designation, including - but not limited to - a Behavioral Health Entity (BHE) license, Safety Net License, 27-65 designation, or RSSO through BHA are subject to submit Critical Incident Reports to the Behavioral Health Administration per BHA rules 2.16; 6.5.2; 11.3.2.; 12.3.2.B.9.; 21.140; 21.300.3.J., and 21.600.7.A.

Last updated: July 7, 2025

How to fill out a critical incident report

Step 1:
Access the Critical Incident Report form.   

Step 2:

Determine which license type your agency holds and be versed on the most recent rule for that licensure type: 2 CCR 502-1 (Ctrl + F: Critical Incident).

• Behavioral Health Entity (BHE)
• 27-65 designation
• Legacy rule
• Controlled Substance Licensure (CSL)
• Safety Net licensure
  • Essential
  • Comprehensive
• RSSO
• A combination of licensures

Step 3:

Enter a valid email address on page one (1) of the form. The email address helps BHA follow up with the submitter if we need additional information.

Step 4:

Fill out the critical incident report form with as much detail as possible. If at any time you have questions or you need your agency added to the dropdown menu in the form, contact:
Chelsae Ziemer
303-551-4190 / cdhs_bha_ci@state.co.us

Step 5:

After you submit the critical incident report through the portal, it will be automatically populated into the BHA tracker, and we will review it. If we need further information, we will reach out. Otherwise, we will save it and close it out as “appropriately reported.” We will send a copy of the entry to the email address you entered at the beginning of the form.

If you are interested in what BHA does with critical incident data, you can read our Fiscal Year Annual BHA Grievance Reports.

Contact us

Chelsea Ziemer
cdhs_bha_ci@state.co.us