(1) Subject to the availability of federal financial participation, services shall be provided to eligible persons pursuant to this part 4.
(2) Any eligible person who accepts and receives services pursuant to this part 4 shall pay to the state department, or to an agent designated by the state department, an amount determined pursuant to federal regulations construing the federal Social Security Act, as amended, concerning the application of patient income to the cost of services.
Source: L. 2006: Entire article added with relocations, p. 1946, � 7, effective July 1.
Editor's note: This section is similar to former � 26-4-628 as it existed prior to 2006.
25.5-6-409. Services for persons with intellectual and developmental disabilities. (1) A program to provide home- and community-based services to persons with intellectual and developmental disabilities who are in need of the level of care available in an intermediate care facility for individuals with intellectual disabilities is hereby established pursuant to the federal Social Security Act, as amended. This program shall provide for the social, habilitative, remedial, residential, health, and other needs of persons with intellectual and developmental disabilities to avoid placement in an intermediate care facility for individuals with intellectual disabilities.
(2) Services for persons with intellectual and developmental disabilities provided through this program must be delivered under the provisions of a statewide services plan, in the form of home- and community-based services waivers or model waivers, developed by the state department and the department of human services and approved by the federal centers for medicare and medicaid services, or any successor agency. This plan must include the specific services to be offered, a plan for the delivery of such services through case management agencies or other service agencies approved pursuant to this article 6 or article 10.5 of title 27 utilizing where appropriate the provision of in-home services, the expected costs of such services, the expected benefits of providing those services, and the administrative provisions which shall govern the implementation of the plan. The plan must provide for all necessary safeguards to ensure the health and welfare of any eligible persons. The average per capita expenditure for services under this plan must not exceed the average per capita expenditure the department of human services or the state department would have made for services otherwise available without this plan.
(3) The plan shall utilize existing community-based services programs to the maximum extent possible and shall coordinate all available forms of assistance for the eligible person.
(4) Repealed.
(5) (a) No later than January 2024, the state department shall submit a report to the senate health and human services committee, the house of representatives public and behavioral health and human services committee, and the house of representatives health and insurance committee, or any successor committees, as part of its State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act presentation required by section 2-7-203. At a minimum, the report must identify:
(I) A reimbursement system with a goal to incentivize and increase transportation provider participation;
(II) How the state department will ensure compliance with applicable federal laws and waiver requirements;
(III) A system of common reporting to ensure a member does not exceed the medicaid benefit in a multi-provider scenario; and
(IV) Best practices based on what other states have done to allow transportation network companies to provide nonmedical transportation services for individuals receiving services, including but not limited to, reimbursement rates; driver compensation; and integration with programs that provide nonmedical transportation services.
(b) In developing the report, the state department shall engage in a stakeholder process that includes individuals with intellectual and developmental disabilities and their families, individuals with disabilities, and transportation network companies. The report may be developed in conjunction with the reporting requirement in sections 25.5-6-307 (6), 25.5-6-606 (9), 25.5-6-704 (8), and 25.5-6-1303 (9).
(c) (I) Upon completion of the report described in subsection (5)(a) of this section, the state department shall analyze and review each operational transportation network company, as defined in section 40-10.1-602 (3). The state department shall verify each transportation network company's viability to ensure the health, safety, welfare, cost effectiveness, and capability in expanding nonmedical transportation services for individuals receiving services pursuant to this section and comply with all rules promulgated pursuant to subsection (5)(e)(I) of this section.
(II) No later than July 1, 2024, the state department shall authorize verified transportation network companies to provide nonmedical transportation services if the state department finds the transportation network company viable under federal requirements and within budgetary constraints.
(III) For the purposes of this subsection (5)(c), verify means a transportation network company meets all requirements resulting from the report described in subsection (5)(a) of this section.
(d) The state department may seek any necessary federal authorization for the implementation of this subsection (5).
(e) (I) The state department shall promulgate any necessary rules to ensure transportation network companies comply with federal and state oversight requirements and shall include all relevant stakeholders, including medicaid members, transportation network companies, current providers and drivers for nonmedical transportation services, and other parties interested in developing the requirements.
(II) Pursuant to section 40-10.1-105 (1)(l), transportation network companies are not subject to regulation by the public utilities commission when providing nonmedical transportation services pursuant to this section and are instead subject to rules promulgated by the state department pursuant to this subsection (5)(e).
(f) This subsection (5) does not apply to a provider authorized to provide transportation services pursuant to part 8 of article 1 of title 25.5 prior to August 10, 2022.
Source: L. 2006: Entire article added with relocations, p. 1946, � 7, effective July 1. L. 2013: (1) amended, (SB 13-167), ch. 394, p. 2294, � 7, effective June 5; (1) and IP(4) amended, (HB 13-1314), ch. 323, p. 1811, � 48, effective March 1, 2014. L. 2021: (2) amended, (HB 21-1187), ch. 83, p. 335, � 33, effective July 1, 2024; (4)(d) added by revision, (HB 21-1187), ch. 83, pp. 335, 354, �� 33, 70. L. 2022: (5) added, (HB 22-1114), ch. 396, p. 2817, � 3, effective August 10. L. 2024: (5)(a)(III) and (5)(e)(I) amended, (SB 24-176), ch. 152, p. 667, � 84, effective August 7.
Editor's note: (1) This section is similar to former � 26-4-629 as it existed prior to 2006.
(2) Amendments to subsection (1) by Senate Bill 13-167 and House Bill 13-1314 were harmonized.
(3) Subsection (4)(d) provided for the repeal of subsection (4), effective July 1, 2024. (See L. 2021, pp. 335, 354.)
Cross references: For the legislative declaration in HB 22-1114, see section 1 of chapter 396, Session Laws of Colorado 2022.
25.5-6-409.3. Consolidated waiver - intellectual and developmental disabilities - conflict-free case management - legislative declaration - repeal. (Repealed)
Source: L. 2015: Entire section added, (HB 15-1318), ch. 304, p. 1248, � 1, effective August 5. L. 2021: (6) added by revision, (HB 21-1187), ch. 83, pp. 353, 354, �� 69, 70. L. 2023: (2) and (4) amended, (HB 23-1301), ch. 303, p. 1832, � 52, effective August 7. L. 2024: IP(3.3)(a), (3.3)(a)(I), and (3.3)(a)(III) amended, (SB 24-176), ch. 152, p. 667, � 85, effective August 7.
Editor's note: (1) SB 24-176 amended subsections IP(3.3)(a), (3.3)(a)(I), and (3.3)(a)(III), effective August 7, 2024, but those amendments did not take effect due to the repeal of this section, effective July 1, 2024.
(2) Subsection (6) provided for the repeal of this section, effective July 1, 2024. (See L. 2021, pp. 353, 354.)
25.5-6-409.5. Transition plan for youth with intellectual and developmental disabilities to adult services - legislative declaration - report - rules - cash fund. (1) The general assembly finds and declares that:
(a) Youth with intellectual and developmental disabilities who are eighteen to twenty years of age are currently served through the county child welfare system; and
(b) The home- and community-based services program for persons with intellectual and developmental disabilities is better designed to meet the complex needs of these youth.
(2) Therefore, the general assembly declares that, in order to have a person-centered system, youth with intellectual and developmental disabilities who are eighteen years of age and older who are currently being served through child welfare services must be transitioned to the home- and community-based services program for persons with intellectual and developmental disabilities and a plan developed for the ongoing transition of such youth when they turn eighteen years of age, except in extenuating circumstances when the court or interdisciplinary team determines that it is not in the best interest of the youth to transition.
(3) (a) On or before June 30, 2014, each county department of human or social services shall identify youth with intellectual and developmental disabilities who are receiving services through the child welfare system in that county and who:
(I) Are twenty years of age or older as of June 30, 2014;
(II) Are nineteen years of age or older but younger than twenty-one years of age as of June 30, 2014;
(III) Are eighteen years of age or older but younger than twenty years of age as of June 30, 2014; and
(IV) Will become eighteen years of age on or after June 30, 2014, and before January 1, 2015.
(b) On or before October 1, 2014, and as necessary thereafter, each county department of human or social services shall identify youth with intellectual and developmental disabilities who are receiving services through the child welfare system in that county and who will become eighteen years of age within the following six months.
(c) Each county department of human or social services shall develop a plan to transition youth identified pursuant to paragraphs (a) and (b) of this subsection (3) to adult services for persons with intellectual and developmental disabilities. The transition plan must meet the criteria set forth in subsection (4) of this section and any rules promulgated by the state board to implement this section. Each county's plan must provide for:
(I) Youth described in paragraph (a) of this subsection (3) to be transitioned as soon as possible but in no case later than January 1, 2016; and
(II) Youth described in subparagraph (IV) of paragraph (a) of this subsection (3) or paragraph (b) of this subsection (3) to be transitioned as soon as possible based on individual needs but in no case earlier than their eighteenth birthday.
(d) The requirement to transition youth as set forth in subsection (3)(c) of this section does not apply to youth currently serving a sentence in the division of youth services or to youth under a court order in a juvenile delinquency case, unless the court approves the transition by written court order.
(4) For each youth with intellectual and developmental disabilities who is going to be transitioned to adult services for persons with intellectual and developmental disabilities pursuant to subsection (3) of this section, the county department of human or social services that is currently providing services to the youth through its child welfare system shall develop a transition plan for that youth. The transition plan must, at a minimum:
(a) Include the department-prescribed assessment provided by the case management agency, as defined in section 25.5-6-1702 that is performed as soon as possible for those youth who are being transitioned pursuant to subsection (3) of this section and at seventeen and a half years of age for those youth who are being transitioned pursuant to subsection (3)(a)(IV) or (3)(b) of this section. In all instances, the assessment must be completed within six months of a youth's transition to adult services.
(b) Provide for the social, habilitative, remedial, residential, educational, health, and other needs of the youth who is being transitioned; and
(c) Address any legal needs concerning guardianship of the youth who is being transitioned.
(5) In all instances, the involved parties and the county department of human or social services shall consider and place precedence on the best interest of the youth prior to the transition process, as set forth in sections 19-3-205 and 19-3-213, C.R.S.
(6) It is the intent of the general assembly that county child welfare systems and case management agencies, as defined in section 25.5-6-1702, collaborate to ensure minimal disruption for youth during the transition process.
(7) The medical services board and the state board of human services may promulgate rules as necessary and appropriate for the implementation of this section.
(8) The department shall submit a report to the joint budget committee on or before January 1, 2015, and on or before January 1, 2016, on the status of the youth being transitioned. The report must include, at a minimum:
(a) The number of youth transitioned to date by county;
(b) The needs assessment of the youth who have been transitioned; and
(c) The type of adult residential locations of the youth who have been transitioned.
(9) Repealed.
Source: L. 2014: Entire section added, (HB 14-1368), ch. 304, p. 1289, � 2, effective May 31. L. 2017: (3)(d) amended, (HB 17-1329), ch. 381, p. 1983, � 60, effective June 6. L. 2021: (4)(a) and (6) amended, (HB 21-1187), ch. 83, p. 336, � 34, effective July 1, 2024.
Editor's note: Subsection (9)(b) provided for the repeal of subsection (9), effective July 1, 2016. (See L. 2014, p. 1289.)