Colo. Rev. Stat. § 26.5-3-402, Definitions

As used in this part 4, unless the context otherwise requires:

(1) Administrative unit means a school district, a board of cooperative services, a charter school network, a charter school collaborative, or the state charter school institute that is providing educational services to exceptional children and that is responsible for the local administration of the education of exceptional children pursuant to article 20 of title 22.

(2) Carrier has the same meaning as set forth in section 10-16-102 (8).

(3) Certified early intervention service broker or broker means:

(a) Repealed.

(b) On and after July 1, 2024, a case management agency or an entity, as those terms are defined in section 25.5-6-1702, that has entered into a contract with the department to perform the duties and functions specified in section 26.5-3-408 in a particular defined service area. Notwithstanding section 27-10.5-104 (4), if there is not a case management agency or an entity and the department is unable to designate an organization to serve as the broker for a particular defined service area, the department shall serve as the broker for the defined service area and may contract directly with early intervention service providers to provide early intervention services to eligible children in the defined service area.

(4) Child find means the program component of IDEA that requires states to find, identify, locate, evaluate, and serve all children with disabilities, from birth to twenty-one years of age. Child find includes:

(a) Part C child find, which is the program component of IDEA that requires states to find, identify, locate, evaluate, and serve children from birth through two years of age; and

(b) Part B child find, which is the program component of IDEA that requires states to find, identify, locate, evaluate, and serve children from three to twenty-one years of age.

(5) Coordinated system of payment means the policies and procedures developed by the department, in cooperation with the departments of education, health care policy and financing, and public health and environment, and with the division of insurance in the department of regulatory agencies, private health insurance carriers, and certified early intervention service brokers, to ensure that available public and private sources of funds to pay for early intervention services for eligible children are accessed and utilized in an efficient manner.

(6) Defined service area, on and after July 1, 2024, means the geographical area that a community-centered board serves as specified in the contract between the community-centered board and the department.

(7) Repealed.

(8) Early intervention evaluations means evaluations conducted pursuant to the early intervention program for infants and toddlers under part C of IDEA.

(9) Early intervention services means services as defined by the department in accordance with part C that are authorized through an eligible child's IFSP and are provided to families at no cost or through the application of a sliding fee schedule. Early intervention services, as specified in an eligible child's IFSP, qualify as meeting the standard for medically necessary services as used by private health insurance and as used by public medical assistance, to the extent allowed pursuant to section 25.5-1-124.

(10) Early intervention state plan means the state plan for a comprehensive and coordinated system of early intervention services required pursuant to part C.

(11) Eligible child means an infant or toddler, from birth through two years of age, who, as defined by the department in accordance with part C, has significant delays in development or has a diagnosed physical or mental condition that has a high probability of resulting in significant delays in development or who is eligible for services pursuant to section 27-10.5-102 (11)(c).

(12) Evaluation means:

(a) For the purposes of part C child find, the procedures used to determine a child's initial and continuing eligibility for part C child find, including but not limited to:

(I) Determining the status of the child in each of the developmental areas;

(II) Identifying the child's unique strengths and needs;

(III) Identifying any early intervention services that might serve the child's needs; and

(IV) Identifying priorities and concerns of the family and any resources to which the family has access.

(b) For the purposes of part B child find, the procedures used under IDEA for children with disabilities to determine whether a child has a disability and the nature and extent of special education and related services that the child will need.

(13) IDEA means the federal Individuals with Disabilities Education Act, 20 U.S.C. sec. 1400 et seq., as amended, and its implementing regulations, 34 CFR part 300 and also 34 CFR part 303 as it pertains to child find.

(14) Individualized family service plan or IFSP means a written plan developed pursuant to 20 U.S.C. sec. 1436, as amended, and 34 CFR 303.340, or any successor regulation, that authorizes the provision of early intervention services to an eligible child and the child's family. An IFSP serves as the individualized plan, pursuant to section 27-10.5-102 (20)(c), for a child from birth through two years of age.

(15) Infants and toddlers means children from birth through two years of age.

(16) Multidisciplinary team means the involvement of two or more disciplines or professions in the provision of integrated and coordinated services, including evaluation and assessment activities defined in 34 CFR 303.321, or any successor regulation, and development of the child's IFSP.

(17) Part B means the program component of IDEA that requires states to find, identify, locate, evaluate, and serve children with disabilities from three to twenty-one years of age.

(18) Part C means the early intervention program for infants and toddlers who are eligible for services under part C of IDEA.

(19) Private health insurance means a health coverage plan, as defined in section 10-16-102 (34), that is purchased by individuals or groups to provide, deliver, arrange for, pay for, or reimburse any of the costs of health-care services, as defined in section 10-16-102 (33), provided to a person entitled to receive benefits or services under the health coverage plan.

(20) Public medical assistance means medical services that are provided by the state through the Colorado Medical Assistance Act, articles 4 to 6 of title 25.5, or the Children's Basic Health Plan Act, article 8 of title 25.5, or other public medical assistance funding sources to qualifying individuals.

(21) Qualified early intervention service provider or qualified provider means a person or agency, as defined by the department by rule in accordance with part C, who provides early intervention services or early intervention evaluations and is listed on the registry of early intervention service providers pursuant to section 26.5-3-408 (1). In the event of a shortage of qualified early intervention evaluators, the department may contract with an administrative unit to conduct early intervention evaluations if a contract is entered between the department and the administrative unit, including written consent of the director of special education, with conditions for conducting and completing the evaluations, including identification of staff, costs for services, timelines for contract completion, and any other contract elements.

(22) Service coordination means the activities carried out by a service coordinator to coordinate evaluation and intake activities, assist, and enable an eligible child and the eligible child's family to receive the rights, procedural safeguards, and services that are authorized to be provided under part C.

(23) State interagency coordinating council means the council that is established pursuant to part C and appointed by the governor to advise and assist the lead agency designated or established under part C.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 614, � 3, effective July 1; (1) amended, (HB 22-1294), ch. 242, p. 1796, � 15, effective August 10.

Editor's note: (1) This section is similar to former � 27-10.5-702 as it existed prior to 2022.

(2) Amendments to � 27-10.5-702 (1) by HB 22-1294 were harmonized and relocated to subsection (1) as it was amended by HB 22-1295.

(3) Subsections (3)(a)(II) and (7)(b) provided for the repeal of subsections (3)(a) and (7), respectively, effective July 1, 2024. (See L. 2022, p. 614.)

26.5-3-403. Early intervention services - administration - duties of department - rules. (1) Subject to annual appropriation from the general assembly, the department shall administer early intervention services and shall coordinate early intervention services with existing services provided to eligible children and their families.

(2) The executive director shall promulgate rules as necessary for the implementation of this part 4 and to ensure that all IDEA timelines and requirements are met, including but not limited to administrative remedies if the timelines and requirements are not met.

(3) In administering early intervention services, the department shall perform the following duties:

(a) Design early intervention services in a manner consistent with part C;

(b) Develop rules, for promulgation by the executive director, after consultation with the state interagency coordinating council;

(c) Ensure eligibility determination for a child with disabilities from birth through two years of age, based in part on information received concerning the screening and evaluation;

(d) Ensure that an individualized family service plan is developed for infants and toddlers from birth through two years of age who are eligible for early intervention services. The IFSP must be developed in compliance with part C requirements, including the mandatory IFSP meeting at which the family receives information concerning the results of the initial early intervention evaluation. The initial IFSP must be developed in collaboration with a representative from an evaluation provider that participated in the child's evaluation. The representative shall participate in the initial meeting for the development of the child's IFSP.

(e) Allocate money;

(f) (I) Repealed.

(II) On and after July 1, 2024, coordinate training and provide technical assistance to certified early intervention service brokers, service providers, and other constituents who are involved in the delivery of early intervention services to eligible children;

(g) Monitor and evaluate early intervention services provided through this part 4;

(h) Coordinate contracts, expenditures, and billing for early intervention services provided through this part 4; and

(i) On and after July 1, 2024, certify early intervention service brokers within a defined service area.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 618, � 3, effective July 1.

Editor's note: (1) This section is similar to former � 27-10.5-703 as it existed prior to 2022.

(2) Subsection (3)(f)(I)(B) provided for the repeal of subsection (3)(f)(I), effective July 1, 2024. (See L. 2022, p. 618.)

26.5-3-404. Child find - responsibilities - interagency operating agreements. (1) The department shall perform the following responsibilities and duties for infants and toddlers who are referred for early intervention services:

(a) Develop and implement, in coordination with certified early intervention service brokers, service agencies, governmental units, and the departments of education, public health and environment, and health care policy and financing, a statewide plan for public education, outreach, and awareness efforts related to child find and the availability of early intervention services;

(b) Ensure that referrals from the community are accepted and families are assisted in connecting with the appropriate agency for intake and case management services, as defined in section 25.5-10-202;

(c) Facilitate the implementation of early intervention evaluations that are the responsibility of the department pursuant to this part 4 and implement an effective and collaborative system of early intervention services. The department shall enter into any necessary interagency operating agreements at the state and local levels for such facilitation and implementation.

(d) Facilitate the implementation of part C child find and early intervention evaluations and the use of medicaid funds. The department and entities that conduct early intervention evaluations may, when appropriate, share information with the department of education, the department of health care policy and financing, or other entities that conduct early intervention evaluations, so long as each department or local agency acts in compliance with the federal Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. sec. 1320d, as amended, and the federal Family Educational Rights and Privacy Act of 1974, 20 U.S.C. sec. 1232g, as amended, and all federal regulations and applicable guidelines adopted thereto.

(2) As of July 1, 2022, the department shall administer part C child find pursuant to this part 4.

(3) On or before July 1, 2022, the department shall establish a state-level interagency operating agreement, referred to in this section as the agreement, with the department of education concerning the coordination of transitions of children from part C child find to part B child find. In developing the agreement, the department and the department of education shall involve stakeholder participation, including representatives from administrative units and part C entities. The agreement must also include:

(a) The definition of a child who is potentially eligible for part B;

(b) The processes for a parent of a child to opt out of required notifications;

(d) A process for resolving disputes between an administrative unit and a part C entity concerning the satisfaction of agreement requirements, including remedies and sanctions;

(e) A process for resolving disputes between the department and the department of education concerning systemic and statewide issues related to agreement requirements;

(f) The development and delivery of standardized communication materials for a parent of a child who is potentially eligible for part B, including information concerning eligibility, referral, evaluation, and service delivery;

(g) The development and delivery of standardized training for part C and part B providers, including information concerning eligibility, referral, evaluation, and service delivery for the programs;

(h) The process for transferring a child's assessment, IFSP, and other necessary information to an administrative unit for consideration of a part B evaluation and eligibility determination, if a parent has provided written consent;

(i) (I) Processes to ensure timely notification to the administrative unit if a child is potentially eligible for part B. At a minimum, timely notification must occur not later than when a child is two years and six months of age; except that timely notification must occur not later than when a child is two years and three months of age if a child has a low incidence diagnosis including, but not limited to, visual impairment, including blindness; hearing impairment, including deafness; or deaf-blind.

(II) If a child is determined to be eligible for part C when the child is older than the ages described in subsection (3)(i)(I) of this section, timely notification must occur not later than ten business days after the eligibility determination.

(j) A process for including an administrative unit representative in a transition conference for a child who transitions from part C to part B;

(k) A process for including an early intervention services provider in the development of an IEP, as defined in section 22-20-103 (15), if requested by the parent of the child; and

(l) A process for timely transferring data that is required by law between the department and the department of education.

(4) The department and the department of education shall review and revise the agreement to account for any changes to state or federal law, as necessary. At a minimum, the agreement must be reviewed once every five years. In the review and revision of the agreement, the department and the department of education shall involve stakeholder participation, including representatives from administrative units and part C entities.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 619, � 3, effective July 1.

Editor's note: This section is similar to former � 27-10.5-704 as it existed prior to 2022.

26.5-3-405. Authorized services - conditions of funding - purchases of services - rules. (1) (a) Repealed.

(b) The executive director shall promulgate rules as necessary, in accordance with this part 4, to implement, on and after July 1, 2024, the purchase of early intervention services directly or through certified early intervention service brokers.

(2) (a) Repealed.

(b) On and after July 1, 2024, certified early intervention service brokers and service agencies receiving money pursuant to section 26.5-3-408 shall comply with all of the provisions of this part 4 and the rules promulgated pursuant to this part 4.

(3) (a) and (b) Repealed.

(c) On and after July 1, 2024, certified early intervention service brokers shall obtain or provide early intervention services, subject to available appropriations, including but not limited to:

(I) Service coordination with families of eligible children. The purpose of service and support coordination is to enable a family to utilize service systems to meet its needs in an effective manner and increase the family's confidence and competence. Service coordination is to be rendered in an interagency context that emphasizes interagency collaboration. A family must have, to the extent possible, a choice as to who performs certain facets of service coordination as established in the family's individualized family service plan.

(II) Coordination of early intervention services with local agencies and other community resources at the local level to avoid duplication and fragmentation of early intervention services. A certified early intervention service broker shall:

(A) Coordinate with the local interagency effort regarding outreach, identification, screening, multidisciplinary assessment, and eligibility determination for families served by the certified early intervention service broker who requested the services;

(B) Coordinate with the local family support services program; and

(4) The department is authorized to use up to three percent of the amount of the appropriation for early intervention services for training and technical assistance to ensure that the latest developments for early intervention services are rapidly integrated into service provision throughout the state.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 621, � 3, effective July 1.

Editor's note: (1) This section is similar to former � 27-10.5-705 as it existed prior to 2022.

(2) Subsections (1)(a)(II), (2)(a)(II), and (3)(b) provided for the repeal of subsections (1)(a), (2)(a), and (3)(a) and (3)(b), respectively, effective July 1, 2024. (See L. 2022, p. 621.)

26.5-3-406. Coordinated system of payment for early intervention services - duties of departments. (1) In order to implement the provisions of this part 4, the department, as lead agency for part C, is responsible for the following, subject to available appropriations:

(a) Establishing an early intervention state plan for a statewide, comprehensive system of early intervention evaluations and early intervention services in accordance with part C child find;

(b) Establishing an interagency operating agreement between the department and the departments of education, health care policy and financing, and public health and environment regarding the responsibilities of each department to assist in the development and implementation of a statewide, comprehensive system of early intervention services and a coordinated system of payments for early intervention services;

(c) Developing, in cooperation with the department of education, the department of health care policy and financing, the department of public health and environment, the division of insurance in the department of regulatory agencies, private health insurance carriers, and certified early intervention service brokers, a coordinated system of payment of early intervention services using public and private money;

(d) (I) Repealed.

(II) On and after July 1, 2024, certifying early intervention service brokers for early intervention services provided pursuant to this part 4; and

(e) Ensuring an appropriate allocation of payment responsibilities for early intervention services among federal, state, local, and private sources, including public medical assistance and private insurance coverage.

(2) Any additional source of money that may become available for the payment of early intervention services on or after July 1, 2008, as a result of the development and implementation of a statewide, comprehensive system of early intervention services and a coordinated system of payments for early intervention services must not replace or reduce any other federal or state money available for the payment of early intervention services on or before July 1, 2008.

(3) (a) Repealed.

(b) On and after July 1, 2024, nothing in this part 4 inhibits, encumbers, or controls the use of local money, including county grants, revenues from local mill levies, and private grants and contributions, that a certified early intervention service broker or county government may elect to allocate for the benefit of eligible children.

(4) In developing a coordinated system of payment, the department shall not directly or indirectly create a new entitlement for early intervention services funded from the state general fund. However, this subsection (4) does not prohibit any adjustments to public medical assistance required by section 25.5-1-124.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 623, � 3, effective July 1.

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26.5-3-407. Cooperation among state agencies - implementing coordinated payment system - revisions to rules. (1) The departments of education, health care policy and financing, and public health and environment shall cooperate with the department to implement the provisions of this part 4 and each department shall:

(a) Participate in the ongoing review of funding practices for early intervention services and develop or revise procedures for a coordinated system of payment for early intervention services;

(b) Use uniform forms and procedures for billing the costs of early intervention services to public medical assistance, as specified in the Colorado Medical Assistance Act, articles 4 to 6 of title 25.5, or the Children's Basic Health Plan Act, article 8 of title 25.5, as appropriate, and private health insurance, as specified in part 1 of article 16 of title 10;

(d) Perform other tasks and functions necessary for the implementation of this part 4.

(2) The division of insurance in the department of regulatory agencies shall provide assistance to the department related to the requirements and implementation of section 10-16-104 (1.3) and insurance laws and rules related to billing and claims handling.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 624, � 3, effective July 1.

Editor's note: This section is similar to former � 27-10.5-707 as it existed prior to 2022.

26.5-3-408. Certified early intervention service brokers - duties - payment for early intervention services - fees. (1) (a) Repealed.

(b) On and after July 1, 2024, for each defined service area in the state, the certified early intervention service broker for the area shall:

(I) Establish a registry of qualified early intervention service providers to provide early intervention services to eligible children in the defined service area. The certified early intervention service broker for a defined service area may provide early intervention services directly or may subcontract the provision of services to other qualified providers on the registry.

(II) Accept and process claims for reimbursement for early intervention services provided pursuant to this part 4 by qualified providers;

(III) Negotiate for the payment of early intervention services provided to eligible children in the defined service area by qualified providers, to the extent permissible under federal law; and

(IV) Ensure payment to a qualified provider for early intervention services rendered by the qualified provider.

(2) Certified early intervention service brokers shall use procedures and forms determined by the department to document the provision or purchase of early intervention services on behalf of eligible children. Invoices or insurance claims for early intervention services must be submitted based on the available funding source for each eligible child and the reimbursement rate for the appropriate federal, state, local, or private funding sources, including public medical assistance and private health insurance.

(3) The department shall establish a schedule of fees to be charged by certified early intervention service brokers for providing broker services pursuant to this part 4. In developing the fee schedule, the department shall obtain input from certified early intervention service brokers and shall consider the duties of brokers pursuant to this part 4, the expenses incurred by brokers, and the relevant market conditions.

(4) Use of a certified early intervention broker is voluntary; except that private health insurance carriers that are included pursuant to section 10-16-104 (1.3) are required to make payment in trust pursuant to section 26.5-3-409. Nothing in this part 4 prohibits a qualified provider of early intervention services from directly billing the appropriate program of public medical assistance or a participating provider, as defined in section 10-16-102 (46), or from directly billing a private health insurance carrier for services rendered pursuant to this part 4 for insurance plans that are not included pursuant to section 10-16-104 (1.3).

(5) To the extent requested by the department, certified early intervention service brokers shall participate in ongoing reviews of funding practices for early intervention services and the development or revision of procedures for a coordinated system of payment for early intervention services.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 625, � 3, effective July 1.

Editor's note: (1) This section is similar to former � 27-10.5-708 as it existed prior to 2022.

(2) Subsection (1)(a)(II) provided for the repeal of subsection (1)(a), effective July 1, 2024. (See L. 2022, p. 625.)

26.5-3-409. Payment from private health insurance for early intervention services - trust fund. (1) Private health insurance carriers that are required to make payment of benefits for early intervention services for which coverage is required pursuant to section 10-16-104 (1.3) shall pay benefits to the department in trust for payment to a broker or provider for early intervention services provided to an eligible child. Upon notification from the department that a child is eligible, the child's private health insurance carrier has thirty days to make payment to the department.

(2) (a) When a private health insurance carrier makes payments of benefits for an eligible child to the department in trust, the money must be deposited in the early intervention services trust fund, which trust fund is created in the state treasury. Except as provided in subsection (2)(b) of this section, the principal of the trust fund must only be used to pay certified early intervention service brokers or qualified early intervention service providers for early intervention services provided to the eligible child for whom the money was paid to the department in trust by the private health insurance carrier. Except as provided in subsection (2)(b) of this section, the principal of the trust fund does not constitute state fiscal year spending for purposes of section 20 of article X of the state constitution, and the money is deemed custodial funds that are not subject to appropriation by the general assembly.

(b) (I) For the 2008-09 fiscal year and each fiscal year thereafter, the general assembly shall make appropriations to the department from the principal of the early intervention services trust fund for the direct and indirect costs of administering this section. Any money appropriated to the department pursuant to this subsection (2)(b)(I) constitutes state fiscal year spending for purposes of section 20 of article X of the state constitution.

(II) All interest derived from the deposit and investment of money in the early intervention services trust fund must be credited to the trust fund, may be appropriated to the department in accordance with this subsection (2)(b)(II), and constitutes state fiscal year spending for purposes of section 20 of article X of the state constitution.

(c) Within ninety days after the department determines that a child is no longer an eligible child for purposes of section 10-16-104 (1.3), the department shall notify the carrier that the child is no longer eligible and that the carrier is no longer required to provide the coverage required by said section for that child. Any money deposited in the trust fund on behalf of an eligible child that is not expended on behalf of the child before the child becomes ineligible must be returned to the carrier that made the payments in trust for the child.

(3) No later than March 1, 2009, and no later than April 1 each year thereafter, the department shall provide a report to each private health insurance carrier that has made payments of benefits for an eligible child to the department in trust. The report must specify the total amount of benefits paid to brokers or qualified providers for services provided to the eligible child during the prior calendar year, including the amount paid to each broker or qualified provider and the services provided to the eligible child. The department shall provide the report required by this subsection (3) at least annually and more often, as determined by the department and the carrier.

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 626, � 3, effective July 1.

Editor's note: This section is similar to former � 27-10.5-709 as it existed prior to 2022.

26.5-3-410. Annual report - cooperation from certified early intervention service brokers and qualified providers. (Repealed)

Source: L. 2022: Entire article added with relocations, (HB 22-1295), ch. 123, p. 627, � 3, effective July 1. L. 2024: Entire section repealed, (SB 24-135), ch. 34, p. 117, � 30, effective March 22.

Editor's note: Prior to its repeal, this section was similar to former � 27-10.5-710 as it existed prior to 2022.