Source: L. 2019: Entire section added, (SB 19-222), ch. 226, p. 2265, � 3, effective May 20.
Editor's note: Subsection (3) provided for the repeal of this section, effective July 1, 2020. (See L. 2019, p. 2265.)
Cross references: For the legislative declaration in SB 19-222, see section 1 of chapter 226, Session Laws of Colorado 2019.
25.5-4-505. Federal authorization related to persons involved in the criminal justice system - assessment - report - repeal. (Repealed)
Source: L. 2022: Entire section added, (SB 22-196), ch. 193, p. 1292, � 7, effective May 19. L. 2023: (1) amended, (HB 23-1301), ch. 303, p. 1830, � 49, effective August 7.
Editor's note: Subsection (3) provided for the repeal of this section, effective June 30, 2024. (See L. 2022, p. 1292.)
25.5-4-505.5. Federal authorization related to persons involved in the criminal justice system - report - rules - legislative declaration. (1) (a) The general assembly finds that:
(I) For decades, federal medicaid policy prohibited the use of federal funding for incarcerated medicaid members;
(II) With the emerging opportunity to allow for coverage of incarcerated medicaid members, Colorado is supportive of ensuring these members have access to needed services and treatment; and
(III) Colorado is committed to ensuring medicaid members have access to a civil, community-based system that meets members' needs and ensures Colorado's county jails, juvenile facilities, and prisons do not become primary access points for health-care services for people experiencing behavioral health conditions.
(b) Therefore, the general assembly declares it is in the best interest of all Coloradans, and especially Coloradans living with behavioral health conditions, to require the department of health care policy and financing to seek a federal waiver of the medicaid inmate exclusion policy that includes annual data reporting requirements that:
(I) Inform Coloradans regarding the unmet health needs of individuals involved in the criminal justice system;
(II) Promote the establishment of continuous civil systems of care within communities demonstrably committed to diversion or deflection efforts, including, but not limited to, mobile outreach, co-responder programs, and prosecutor- or judicial-led initiatives; and
(III) Aim to reduce unnecessary involvement with the criminal justice system and increase access to community-based housing, health care, supports, and services.
(2) (a) No later than April 1, 2024, the state department shall seek a federal authorization to provide, through the state medical assistance program, medication-assisted treatment and case management to a member prior to the member's release and a thirty-day supply of prescription medications to a member upon the member's release from a juvenile institutional facility, as defined in section 25-1.5-301 (2)(b), or a department of corrections facility.
(b) Beginning July 1, 2025, and subject to available appropriations, the services described in subsection (2)(a) of this section are available upon receipt of the necessary federal authorization.
(3) (a) (I) No later than April 1, 2025, the state department shall seek a federal authorization to provide, through the state medical assistance program, medication-assisted treatment and case management to a member prior to the member's release from jail and a thirty-day supply of prescription medications to a member upon the member's release from jail.
(II) The state department shall implement subsection (3)(a)(I) of this section only if the state department determines that providing the services described in subsection (3)(a)(I) of this section is budget neutral.
(b) Beginning July 1, 2026, and subject to available appropriations, the services described in subsection (3)(a) of this section are available upon receipt of the necessary federal authorization.
(4) Upon receipt of the necessary federal authorization, the state department shall:
(a) Conduct a rigorous stakeholder process that includes, but is not limited to, receiving feedback from individuals with lived experience in accessing, or the inability to access, behavioral health services in civil settings, county jails, juvenile institutional facilities, and the department of corrections; and
(b) Require each county with a county jail seeking to provide services pursuant to this section to demonstrate a commitment to diversion or deflection efforts, including, but not limited to, mobile outreach, co-responder programs, and prosecutor- or judicial-led initiatives that aim to reduce unnecessary involvement with the criminal justice system and increase access to community-based housing, health care, supports, and services.
(5) (a) The state department shall only reimburse an opioid treatment program, as defined in section 27-80-203, for administering medication-assisted treatment in a jail setting. At a minimum, an opioid treatment program that administers medication-assisted treatment shall:
(I) Employ a physician medical director;
(II) Ensure the individual receiving medication-assisted treatment undergoes a minimum observation period after receiving medication-assisted treatment as determined by behavioral health administration rule pursuant to section 27-80-204; and
(III) Meet all critical incident reporting requirements as determined by behavioral health administration rule pursuant to section 27-80-204.
(b) The state department shall ensure as part of the state department's quality oversight that opioid treatment programs that administer medication-assisted treatment in a jail setting maintain emergency policies and procedures that address adverse outcomes.
(6) The state department may expand services available pursuant to this section as authorized pursuant to federal law and regulations. If the state department seeks to expand services, the state department shall demonstrate how the state department will ensure quality of care and client safety, which must include addressing quality and safety in administering medications in a jail setting.
(7) (a) Beginning July 1, 2025, and each July 1 thereafter, the state department shall annually report to the house of representatives public and behavioral health and human services committee and the senate health and human services committee, or their successor committees, the following information:
(I) De-identified information of individuals who have accessed services, including each individual's demographics, the type of services the individual accessed, the duration of the services offered in a carceral setting compared to the duration of the same services offered in a civil setting, and the individual's experiences before and after incarceration, including but not limited to:
(A) Emergency room or crisis system visits;
(B) Inpatient stays for a primary behavioral health condition; and
(C) Services accessed in a qualified residential treatment program, as defined in section 19-1-103, or a psychiatric residential treatment facility, as defined in section 25.5-4-103;
(II) The total number of medicaid members who were unhoused before or after incarceration, if available;
(III) The total number of unique incarceration stays by medicaid members, as demonstrated by the services accessed;
(IV) The total number of individuals who accessed services in a civil setting prior to arrest or detainment and were subsequently evaluated for competency, ordered to competency restoration, restored to competency, or found incompetent to proceed in a forensic setting; and
(V) Persistent gaps in continuity of care in least-restrictive civil settings.
(b) Notwithstanding section 24-1-136 (11)(a)(I) to the contrary, the state department's report continues indefinitely.
(8) The state department may promulgate rules for the implementation of this section.
Source: L. 2024: Entire section added, (HB 24-1045), ch. 470, p. 3284, � 18, effective August 7.
25.5-4-505.7. Reentry services for justice-involved individuals reinvestment cash fund - creation - definitions. (1) As used in this section, unless the context otherwise requires:
(a) Federal authorization means the authorization the state department received from the federal centers for medicare and medicaid services to provide reentry services to justice-involved individuals through the state medical assistance program.
(b) Fund means the reentry services for justice-involved individuals reinvestment cash fund created in this section.
(2) The reentry services for justice-involved individuals reinvestment cash fund is created in the state treasury. The fund consists of money appropriated pursuant to subsection (3) of this section and any other money that the general assembly may appropriate or transfer to the fund. In accordance with section 24-36-114 (1), the state treasurer shall credit all interest and income derived from the deposit and investment of money in the fund to the general fund.
(3) Beginning June 30, 2026, and on June 30 of each year thereafter, the state treasurer shall transfer from the general fund to the fund an amount of money equal to the amount of unspent money that reverted to the general fund in that year from the appropriation from the general fund to the state department for reentry services for justice-involved individuals.
(4) Subject to annual appropriation by the general assembly, the state department may expend money from the fund for medicaid services for individuals who are incarcerated in, are at risk of being incarcerated in, or are being released from a carceral facility, and for related administrative services, as authorized through the federal authorization.
(5) On or after November 1, 2025, and on or after November 1 each year thereafter, the state department shall present to the joint budget committee a recommendation for spending money in the fund to expand and enhance services authorized by the federal authorization. When developing the recommendation, the state department shall consult with state agencies participating in services provided through, and stakeholders who represent the members receiving services included in, the federal authorization.
Source: L. 2025: Entire section added, (SB 25-308), ch. 299, p. 1524, � 3, effective May 30.
25.5-4-506. Coverage for doula services - stakeholder process - federal authorization - scholarship program - training - report - definitions - repeal. (1) As used in this section, unless the context otherwise requires:
(a) Doula means a trained birth companion who provides personal, nonmedical support to pregnant and postpartum people and their families prior to childbirth, during labor and delivery, and during the postpartum period.
(b) Maternity advisory committee means the committee facilitated by the state department composed predominantly of Black, Indigenous, and other people of color with maternity care experience as members.
(2) No later than September 1, 2023, the state department shall initiate a stakeholder process to promote the expansion and utilization of doula services for pregnant and postpartum members in the state. In conducting the stakeholder process, the state department shall:
(a) Design an outreach strategy that includes best practices in community engagement, including, but not limited to:
(I) Engaging trusted community partners to support the work;
(II) Reimbursement of participation costs for individuals who are not otherwise paid to participate;
(III) Reimbursement of child care costs for individuals who participate; and
(IV) Translation services and meeting times that allow diverse and inclusive participation;
(b) Solicit feedback related to:
(I) An approved doula certification process that incorporates national and local training programs;
(II) A billing process for doula services;
(III) Ways to recruit doulas and integrate them into hospital deliveries;
(IV) Support needed to build and retain a doula workforce;
(V) Community outreach to determine how to best promote doula services; and
(VI) The doula scholarship program created in subsection (7) of this section.
(3) Stakeholders must be diverse with regard to race, ethnicity, immigration status, sexual orientation, and gender, and must represent other populations that experience greater health disparities and inequities. The state department may include the following in the stakeholder process:
(a) Doulas and potential doulas who may serve members who include, but are not limited to, Black, Indigenous, and other people of color, refugees, non-English speakers, people living in rural areas, and people who were recently incarcerated;
(b) Individuals indirectly involved in the delivery of doula services, including, but not limited to, clinical providers, hospitals, managed care entities, and state partners, including, but not limited to, the department of public health and environment, department of human services, department of early childhood, and department of regulatory agencies;
(c) Representatives from the division of insurance with subject matter expertise;
(d) Representatives from the maternity advisory committee;
(e) Consumer advocates; and
(f) Experts on perinatal care and quality.
(4) For state fiscal year 2024-25, the state department shall submit a report to the general assembly as part of the state department's SMART Act presentation required by section 2-7-203. The report must include findings and recommendations from the stakeholder process as described in subsection (2) of this section. The state department shall work with the maternity advisory committee to create the report.
(5) In carrying out the stakeholder process described in subsection (2) of this section, the state department is exempt from the Procurement Code, articles 101 to 112 of title 24.
(6) Not later than July 1, 2024, the state department shall seek federal authorization to provide doula services for pregnant and postpartum people to improve health outcomes of pregnant and postpartum people who face a disproportionately greater risk of poor birth outcomes.
(7) (a) Not later than July 1, 2024, the state department shall create a doula scholarship program that grants funds to individuals without sufficient financial resources to complete doula training and certification programs necessary to provide doula services.
(b) In designing the doula scholarship program, the state department shall solicit input from groups identified in subsection (3) of this section.
(c) The state department shall define eligibility criteria for the doula scholarship program that includes, but is not limited to, the following:
(I) Proof of financial hardship;
(II) Proof of state residency; and
(III) A statement of intent to serve as a doula provider in Colorado for pregnant and postpartum members.
(d) The state department shall define criteria for organizations to conduct training and certification programs for doulas that include, but are not limited to:
(I) An approved certification process for doulas;
(II) An equitable approach to doula recruitment and training; and
(III) An approved budget to provide free training to attendees.
(e) The state department may require individuals who receive scholarship money pursuant to the doula scholarship program described in this subsection (7) to submit to the state department, not later than six months after the individual's completion of doula training or certification, documentation that the individual is serving as a doula for members or is working toward enrollment as a doula for members. If an individual does not complete the documentation, the state department may seek repayment of the funds awarded to the individual through the doula scholarship program.
(f) (I) Any money appropriated to the doula scholarship program and not expended prior to July 1, 2024, is further appropriated to the state department through June 30, 2025, to be used for the same purpose.
(II) This subsection (7)(f) is repealed, effective July 1, 2026.
(g) Notwithstanding section 24-1-136 (11)(a)(I), the state department shall report annually beginning in 2025 to the general assembly as part of the state department's SMART Act presentation, as required by section 2-7-203, on the utilization and outcomes of the doula scholarship program.
Source: L. 2023: Entire section added, (SB 23-288), ch. 279, p. 1652, � 2, effective May 30. L. 2024: (1)(b), IP(2), (3)(a), (7)(c)(III), and (7)(e) amended, (SB 24-176), ch. 152, p. 644, � 41, effective August 7.
Cross references: For the legislative declaration in SB 23-288, see section 1 of chapter 279, Session Laws of Colorado 2023.