For purposes of entering into a cooperative purchasing agreement pursuant to section 24-110-201, a nonprofit case management agency or a nonprofit service agency may be certified as a local public procurement unit as provided in section 24-110-207.5.
Source: L. 2013: Entire article added with relocations, (HB 13-1314), ch. 323, p. 1754, � 1, effective March 1, 2014. L. 2021: Entire section amended, (HB 21-1187), ch. 83, p. 339, � 40, effective July 1, 2024.
Editor's note: This section is similar to former � 27-10.5-103.5 as it existed prior to 2013.
25.5-10-206. Authorized long-term services and supports - conditions of funding - purchase of services and supports - adult protective services data system check - boards of county commissioners - appropriation. (1) Subject to annual appropriations by the general assembly, the state department shall provide or purchase, pursuant to subsection (4) of this section, authorized long-term services and supports from case management agencies or service agencies for persons who have been determined to be eligible for such long-term services and supports pursuant to section 25.5-6-1704 and as specified in the eligible person's individualized plan. Those long-term services and supports may include, but need not be limited to, the following:
(a) Family support services, including an array of supportive services provided to the person receiving services and the person's family, that enable the family to maintain the person in the family home, thereby preventing or delaying the need for out-of-home placement that is unwanted by the person or the family, pursuant to section 25.5-10-301;
(b) Case management services;
(c) Respite care services, including temporary care of a person with an intellectual and developmental disability to offer relief to the person's family or caregiver or to allow the family or caregiver to deal with emergency situations or to engage in personal, social, or routine activities and tasks that otherwise may be neglected, postponed, or curtailed due to the demands of supporting a person who has an intellectual and developmental disability;
(d) Day services and supports that offer opportunities for persons with intellectual and developmental disabilities to experience and actively participate in valued adult roles in the community. These services and supports will enable persons receiving services to access and participate in community activities, such as work, recreation, higher education, and senior citizen activities. Day services may also include the administration of nutrition or fluids through gastrostomy tubes, if administered by a person authorized pursuant to section 25.5-10-204 (2)(j) and supervised by a licensed nurse or physician.
(e) Residential services and supports, including an array of training, learning, experiential, and support activities provided in living alternatives designed to meet the individual needs and preferences of persons receiving services and may include the administration of nutrition or fluids through gastrostomy tubes, if administered by a person authorized pursuant to section 25.5-10-204 (2)(j) and supervised by a licensed nurse or physician; and
(f) Ancillary services, including activities that are secondary but integral to the provision of the services and supports specified in this subsection (1).
(2) Service agencies and case management agencies receiving funds pursuant to subsection (1) of this section shall comply with all of the provisions of this article 10 and the rules promulgated thereunder.
(3) Case management services must be purchased from the case management agency, except as otherwise provided in subsection (4) of this section.
(4) (a) The state department may purchase long-term services and supports directly from service agencies and case management services from case management agencies if:
(I) Required by the federal requirements for the state to qualify for federal funds under Title XIX of the federal Social Security Act, as amended, including programs authorized pursuant to part 4 of article 6 of this title; or
(II) The executive director has determined that a long-term service or support provided or purchased by a case management agency does not meet established standards and the continuation of purchase of the long-term service or support through the case management agency is not in the best interests of the persons receiving services.
(b) (I) The state department shall only purchase long-term services and supports directly from those case management agencies or service agencies that meet established standards.
(II) The standards referenced in subsection (4)(b)(I) of this section must include a requirement that, on and after January 1, 2019, prior to employment, the name of a person who will be providing direct care, as defined in section 26-3.1-101 (3.5), to an at-risk adult, as defined in section 26-3.1-101 (1.5), as well as any other required identifying information, is submitted to the department of human services for a check of the Colorado adult protective services data system pursuant to section 26-3.1-111, to determine if the person is substantiated in a case of mistreatment of an at-risk adult.
(c) The state department may purchase services and supports, including service and support coordination, from a family caregiver if the executive director has determined that the provision of a service or support by a family caregiver in the family home would provide the person receiving the service or support with the least restrictive environment.
(d) Nothing in this section shall be construed to prohibit the provision of services and supports, including case management services, directly by the department of human services through regional centers, for persons receiving services in regional centers.
(e) Nothing in this section shall be construed to require the provision of services and supports, including case management services, directly by the state department.
(5) Governmental units, including but not limited to counties, municipalities, school districts, health service districts, and state institutions of higher education, are authorized at their own expense to furnish money, materials, or long-term services and supports to persons with intellectual and developmental disabilities, or to purchase long-term services and supports for such persons through designated case management agencies or service agencies, so long as no conditions or requirements imposed as a result of the provision or purchase conflict with the provisions of this article 10 or the rules promulgated thereunder.
(6) Boards of county commissioners may levy up to one mill for the purpose of purchasing services and supports for persons with intellectual and developmental disabilities. To the extent authorized by federal law, and subject to annual appropriation by the general assembly, and pursuant to rules established by the state board, a county may transfer the revenue raised pursuant to the mill levy to the state department to receive matching federal funds to provide medicaid-approved waiver services to persons with intellectual and developmental disabilities.
(7) (a) Each year the general assembly shall appropriate moneys to the state department to provide or purchase services and supports for persons with intellectual and developmental disabilities pursuant to this section. Unless specifically provided otherwise, services and supports shall be purchased on the basis of state funding less any federal or cash funds received for general operating expenses from any other state or federal source, less funds available to a person receiving residential services or supports after such person receives an allowance for personal needs or for meeting other obligations imposed by federal or state law, and less the required local school district funds specified in paragraph (b) of this subsection (7). The yearly appropriation, when combined with all other sources of funds, shall in no case exceed one hundred percent of the approved program costs as determined by the general assembly.
(b) Each school district shall pay to the case management agency purchasing programs attended by a student with an intellectual and developmental disability, who is domiciled in the school district and may be counted in the district's pupil enrollment, an amount at least equal to the district's per pupil revenues as determined pursuant to the Public School Finance Act of 2025, article 54 of title 22. This subsection (7) applies to students who are less than twenty-two years of age.
Source: L. 2013: Entire article added with relocations, (HB 13-1314), ch. 323, p. 1754, � 1, effective March 1, 2014. L. 2017: (4)(b) amended, (HB 17-1284), ch. 272, p. 1505, � 12, effective May 31; IP(1), (2), (3), IP(4)(a), (4)(b), and (5) amended, (HB 17-1343), ch. 320, p. 1723, � 3, effective June 5. L. 2021: IP(1), (2), (3), IP(4)(a), (4)(a)(II), (4)(b)(I), (5), and (7)(b) amended, (HB 21-1187), ch. 83, p. 339, � 41, effective July 1, 2024. L. 2024: (7)(b) amended, (HB 24-1448), ch. 236, p. 1537, � 60, effective May 23.
Editor's note: (1) This section is similar to former � 27-10.5-104 as it existed prior to 2013.
(2) Amendments to subsection (4)(b) by HB 17-1284 and HB 17-1343 were harmonized.
25.5-10-207. Long-term services and supports - waiting list reduction - cash fund - repeal. (Repealed)
Source: L. 2013: Entire article added with relocations, (HB 13-1314), ch. 323, p. 1757, � 1, effective March 1, 2014. L. 2014: (1.5), (2), and (3) amended and (3.5) added, (HB 14-1252), ch. 18, p. 135, � 1, effective March 1; (2) repealed, (HB 14-1051), ch. 33, p. 184, � 1, effective August 6. L. 2015: (6) added, (SB 15-168), ch. 16, p. 40, � 1, effective March 13. L. 2016: (7) added, (SB 16-196), ch. 226, p. 866, � 4, effective June 6; (3)(b) and (3)(c) amended and (3)(d) added, (SB 16-192), ch. 256, p. 1052, � 2, effective June 8. L. 2017: IP(3), (3)(c), and (3)(d) amended and (3)(e), (8), and (9) added, (HB 17-1343), ch. 320, p. 1724, � 4, effective June 5. L. 2021: (3)(c) and (3)(e) amended, (HB 21-1187), ch. 83, p. 340, � 42, effective July 1, 2024; (3)(d)(II) added by revision, (HB21-1187), ch. 83, pp. 340, 354, �� 42, 70.
Editor's note: Subsection (9)(a) provided for the repeal of this section, effective July 1, 2022. (See L. 2017, p. 1724.)
25.5-10-207.5. Strategic plan for long-term services and supports - joint hearing - appropriation - reporting - legislative declaration - rules. (1) (a) The general assembly finds that:
(I) Colorado has a long commitment to supporting persons with intellectual and developmental disabilities in communities of their choosing;
(II) Coloradans with intellectual and developmental disabilities who are eligible for state services and supports should be able to access services and supports in a timely manner to allow them to benefit from those services and supports and lead lives that build on their independence;
(III) Providing early and timely access to services and supports for persons with intellectual and developmental disabilities is an excellent and cost-effective investment that results in substantial future savings;
(IV) The presence of a waiting list as long as fifteen years for essential services and supports contradicts Colorado's commitment to supporting persons in the least restrictive environment of their choosing;
(V) Colorado must have accurate data concerning the need for services and supports for persons with intellectual and developmental disabilities and their families and must regularly forecast this data to ensure that effective policy and programs are directed to meet these needs;
(VI) The waiting list includes persons with intellectual and developmental disabilities who are at risk of experiencing a crisis due to the advanced age, reduced capacity, and illness of their caregivers;
(VII) After a lifetime of providing continuous support, these caregivers deserve the comfort of knowing that their loved one will have needed services and supports; and
(VIII) Persons with intellectual and developmental disabilities and their caregivers should not have to experience a crisis before getting needed assistance, as each crisis puts undue hardship and strain on the person and caregiver, and the services system.
(b) Therefore, the general assembly declares that Colorado is committed to developing a strategic plan to ensure that Coloradans with intellectual and developmental disabilities and their families will be able to access the services and supports they need and want at the time that they need and want those services and supports.
(2) During each regular session of the general assembly, the joint budget committee and the health and human services committees of the senate and the house of representatives, or any successor committees, shall hold a joint hearing and take public testimony on the status of the waiting lists for persons with intellectual and developmental disabilities who are waiting for enrollment into a home- and community-based services program or a program provided pursuant to this article 10 and the availability of general fund money to reduce the number of persons on the waiting lists and the amount of time eligible persons wait for such services. Notwithstanding the provisions of section 24-1-136 (11)(a)(I), the state department shall present testimony, including the information provided in the report pursuant to subsection (3) of this section, as well as information concerning the ongoing implementation of the strategic plan required pursuant to subsection (4) of this section, including any revisions to the strategic plan. Additionally, the state department, case management agencies, and providers shall report on the use and effectiveness of any money appropriated in the preceding state fiscal year for increasing system capacity. The goal of the hearing is to propose an appropriation from the general fund to the intellectual and developmental disabilities services cash fund.
(3) (a) Notwithstanding the provisions of section 24-1-136 (11)(a)(I), on or before November 1, 2014, and November 1 of each year thereafter, in accordance with section 24-1-136 (9), the state department shall report to the general assembly the total number of persons with intellectual and developmental disabilities who are waiting at the time of the report for enrollment into a home- and community-based services program or a program provided pursuant to this article 10. The report must also include information concerning the ongoing implementation of the strategic plan required pursuant to subsection (4) of this section, including any revisions to the strategic plan.
(b) The information reported pursuant to paragraph (a) of this subsection (3) relating to persons with intellectual and developmental disabilities who are waiting for enrollment into a home- and community-based services program or a program provided pursuant to this article shall be disaggregated by:
(I) The specific medicaid waiver program or other intellectual and developmental disabilities program, service, or support;
(II) The persons who need services immediately but who are not currently receiving services;
(III) The persons who need services immediately who are currently receiving some services; and
(IV) The persons who are eligible for services but who do not need services at this time.
(4) (a) On or before November 1, 2014, the state department shall develop, in consultation with intellectual and developmental disability system stakeholders, a comprehensive strategic plan including administrative procedures and adequate funding to enroll eligible persons with intellectual and developmental disabilities into home- and community-based services programs and programs provided pursuant to this article 10 at the time those persons choose to enroll in the programs or need the services or supports. As part of developing the strategic plan, the state department shall review the statutory definition of waiting list set forth in section 25.5-10-202 and make recommendations concerning amendments to the definition. In engaging stakeholders, the state department shall include both persons and families receiving services, as well as persons and families waiting for enrollment into programs, services, or supports. These persons and families must include, at a minimum, persons and families who reside in each defined service area within the state. In developing the strategic plan, the state department shall review relevant recommendations from the community living advisory group created in the office pursuant to the governor's executive order D 2012-027, as well as other relevant information. The strategic plan must include specific recommendations and annual benchmarks for achieving this enrollment goal by July 1, 2020, including recommendations relating to increasing system capacity. The state department shall review the strategic plan annually and revise the plan as needed to meet the enrollment goal. Nothing in this section precludes the state department from considering changes in the structure of the state's intellectual and developmental disabilities programs, including medicaid waiver modification.
(b) The state department shall submit the strategic plan to the general assembly in accordance with section 24-1-136 (9), C.R.S., and shall present the strategic plan to the joint budget committee on or before December 1, 2014.
(5) In its annual submission of the state department's budget request to the joint budget committee, the governor's office of state planning and budgeting shall reference the number of persons who are waiting at the time of the November 1 report for enrollment into a home- and community-based services program or a program provided pursuant to this article and shall indicate to the joint budget committee those budget requests related specifically to achieving the enrollment goal set forth in the strategic plan required pursuant to this section.
(6) (a) Subject to the availability of reserve capacity enrollment, a person with an intellectual and developmental disability who is on the waiting list for services and who is at risk of experiencing an emergency due to any of the criteria included in subsection (6)(b) of this section and who meets other applicable criteria for enrollment established by the state board shall be offered enrollment into the home- and community-based services developmental disabilities waiver using a person-centered transition process.
(b) No later than June 1, 2019, the state board shall promulgate rules regarding the criteria for reserve capacity enrollments for those persons described in subsection (6)(a) of this section, which criteria must include but is not limited to:
(I) The age of the custodial parent or caregiver;
(II) The loss of the custodial parent or caregiver;
(III) Incapacitation of the custodial parent or caregiver;
(IV) Any life-threatening or serious persistent illness of the custodial parent or caregiver; and
(V) A threat to health or safety that the custodial parent or caregiver places on the person with intellectual and developmental disabilities.
(c) As part of the rule-making process for reserve capacity enrollment pursuant to subsection (6)(b) of this section, the state board shall solicit feedback from persons with intellectual and developmental disabilities and family members of persons with intellectual and developmental disabilities.
(7) During the state fiscal year beginning July 1, 2018, the state department shall initiate three hundred nonemergency enrollments from the waiting list for the home- and community-based services developmental disabilities waiver.
(8) Beginning July 2018, and continuing monthly thereafter, the state department shall include in its monthly premiums, expenditures, and caseload report the number of persons who were moved off the developmental disabilities waiting list, specifying the enrollments initiated under the order of selection and the enrollments initiated under the reserve capacity criteria.
Source: L. 2014: Entire section added, (HB 14-1051), ch. 33, p. 184, � 2, effective August 6. L. 2017: (2) and (3)(a) amended, (HB 17-1060), ch. 6, p. 17, � 10, effective November 2. L. 2018: (1)(a)(IV) amended and (1)(a)(VI), (1)(a)(VII), (1)(a)(VIII), (6), (7), and (8) added, (HB 18-1407), ch. 248, p. 1531, � 3, effective May 24. L. 2021: (2) and (4)(a) amended, (HB 21-1187), ch. 83, p. 341, � 43, effective July 1, 2024.
Editor's note: Subsection (2) is similar to former � 25.5-10-207 (2) as it existed prior to 2014.
Cross references: For the legislative declaration in HB 18-1407, see section 1 of chapter 248, Session Laws of Colorado 2018.
25.5-10-208. Service agencies and case management agencies - money - rules. (1) A service agency and a case management agency shall comply with the requirements set forth in this article 10 and the rules promulgated thereunder.
(2) The state board shall promulgate rules to implement the purchase of long-term services and supports from a service agency, case management agency, or family caregiver. The rules must include, but need not be limited to:
(a) Terms and conditions necessary to promote the effective delivery of services and supports, including those services and supports delivered by a family caregiver;
(b) Procedures for obtaining an annual audit of case management agencies and service agencies to provide financial information deemed necessary by the state department to establish costs of long-term services and supports and to ensure proper management of money received pursuant to section 25.5-10-206;
(c) Repealed.
(d) Specification of which long-term services and supports are to be reimbursed by the state department and secondarily by the case management agency, the source of reimbursement, actual long-term service or support costs, incentives, and program service objectives that affect reimbursement;
(e) The methods of coordinating the purchase of services and supports, including but not limited to service and support coordination, with other federal, state, and local programs that provide funding for authorized services and supports; and
(f) Criteria for and limitations on any rates that case management agencies charge to service agencies based upon a percentage of the rates that service agencies charge for long-term services and supports.
(3) Any incorporated service agency that is registered in Colorado as a foreign corporation shall organize a local advisory board consisting of persons who reside within the defined service area. The advisory board shall be representative of the community at large and persons receiving services and their families.
(4) Upon a determination by the executive director that services or supports have not been provided in accordance with the program or financial administration standards specified in this article 10 and the rules promulgated thereunder, the executive director may reduce, suspend, or withhold payment to a case management agency or service agency under contract with a case management agency, or service agency from which the state department purchased long-term services or supports directly. When the executive director decides to reduce, suspend, or withhold payment, the executive director shall specify the reasons therefor and the actions that are necessary to bring the case management agency or service agency into compliance.
(5) Nothing in this article or in any rules promulgated pursuant thereto and no actions taken by the executive director pursuant to this article shall be construed to affect the obtaining of funds from local authorities, including those funds obtained from a mill levy assessed by a county or municipality for the purpose of purchasing services or supports for persons with intellectual and developmental disabilities, or to require that such funds from local authorities be used to supplant state or federal funds available for purchasing services and supports for persons with developmental disabilities.
Source: L. 2013: Entire article added with relocations, (HB 13-1314), ch. 323, p. 1758, � 1, effective March 1, 2014. L. 2017: (1), IP(2), (2)(b), (2)(c), and (4) amended, (HB 17-1343), ch. 320, p. 1724, � 5, effective June 5. L. 2021: IP(2), (2)(b), (2)(d), (2)(f), (3), and (4) amended, (HB 21-1187), ch. 83, p. 342, � 44, effective July 1, 2024; (2)(c)(II) added by revision, (HB 21-1187), ch. 83, pp. 342, 354, �� 44, 70.
Editor's note: (1) This section is similar to former � 27-10.5-104.5 as it existed prior to 2013.
(2) Subsection (2)(c)(II) provided for the repeal of subsection (2)(c), effective July 1, 2024. (See L. 2021, pp. 342, 354.)
25.5-10-209. Community-centered boards - designation - purchase of services and supports - performance audits - Colorado local government audit law - public disclosure of board administration and operations - repeal. (Repealed)
Source: L. 2013: Entire article added with relocations, (HB 13-1314), ch. 323, p. 1760, � 1, effective March 1, 2014. L. 2016: (4), (5), (6), (7), and (8) added, (SB 16-038), ch. 199, p. 702, � 2, effective August 10. L. 2017: (2)(e) amended, (HB 17-1343), ch. 320, p. 1725, � 6, effective June 5. L. 2021: (9) added by revision, (HB 21-1187), ch. 83, pp. 353, 354, �� 69, 70. L. 2022: (2)(d) and (2)(f) amended, (HB 22-1295), ch. 123, p. 848, � 77, effective July 1.
Editor's note: (1) Prior to its repeal, this section was similar to former � 27-10.5-105 as it existed prior to 2013.
(2) Subsection (9) provided for the repeal of this section, effective July 1, 2024. (See L. 2021, pp. 353, 354.)
25.5-10-209.3. Cross-system behavioral health crisis response - comprehensive care coordination and treatment model - training - legislative declaration. (1) (a) The general assembly declares that persons with intellectual and developmental disabilities and co-occurring behavioral health diagnoses and needs:
(I) Experience limited access to appropriate treatment, including crisis intervention, stabilization, and prevention, and such individuals who live in rural areas of Colorado are particularly impacted by this limited access to appropriate treatment;
(II) Deserve to live, work, play, and thrive in their communities;
(III) Require a heightened level of care;
(IV) Require evidence-based treatment to help lead full lives within their communities; and
(V) Experience significant gaps in care, including a lack of access to appropriate treatment.
(b) Therefore, as a preliminary measure to close these gaps in care, the general assembly finds that the state must invest in extensive, expanded training using a comprehensive model of care that is available via teleconference. The training must be available for up to thirty individuals across the state in order to adequately address the limited access to treatment in rural areas.
(2) (a) As soon as possible, the state department shall obtain a vendor to provide extensive statewide training to professional persons who work with persons with intellectual and developmental disabilities and co-occurring behavioral health needs.
(b) A qualified vendor must:
(I) Utilize a comprehensive care coordination and treatment model that is evidence-based;
(II) Be able to show demonstrated success in multiple states;
(III) Have experience with rural issues;
(IV) Have at least ten years of experience working with professionals who work with individuals with intellectual and developmental disabilities;
(V) Maintain a national database that involves the standardized collection, analysis, and reporting of outcomes associated with the impact of the training on the individuals being served; and
(VI) Be able to provide the training statewide using teleconference technology.
(3) (a) No later than sixty calendar days after a vendor is obtained pursuant to subsection (2)(a) of this section, case management agencies, mental health centers, and other program-approved service agencies in the state shall nominate one provider in their geographic service area to be trained in the comprehensive care coordination and treatment model designed and provided by the vendor selected pursuant to subsection (2) of this section. Up to twenty providers may be selected for training pursuant to this subsection (3)(a). Selected providers must have a clinical background and prior experience working with the intellectual and developmental disabilities population. If more than twenty providers are nominated through this process, the state department shall make final selections, giving preference to providers in underserved areas.
(b) The state department shall coordinate with case management agencies in underserved areas of the state to select an additional ten providers to be trained in the comprehensive care coordination and treatment model.
(4) Participating providers shall complete the training provided no later than one calendar year after a provider is nominated pursuant to subsection (3)(a) of this section.
(5) The state department shall reimburse participating providers at the provider's current pay rate for time spent in training.
Source: L. 2021: Entire section added, (HB 21-1166), ch. 234, p. 1233, � 1, effective June 15. L. 2022: (2)(a), (3)(a), and (4) amended, (HB 22-1189), ch. 15, p. 126, � 1, effective August 10.
25.5-10-209.5. Case management agencies - certification - purchase of services and supports - rules - repeal. (Repealed)
Source: L. 2017: Entire section added, (HB 17-1343), ch. 320, p. 1725, � 7, effective June 5. L. 2021: (6) added by revision, (HB 21-1187), ch. 83, pp. 353, 354, �� 69, 70.
Editor's note: Subsection (6) provided for the repeal of this section, effective July 1, 2024. (See L. 2021, pp. 353, 354.)