The school security disbursement program (program), which was repealed in 2021, is recreated and reenacted in the department of public safety (department) to provide funding for school districts, district charter schools, institute charter schools, boards of cooperative services, and eligible nonprofit organizations (eligible entities) to implement school security improvements to prevent incidents of school violence. Eligible entities may apply for a disbursement by submitting an application to the department. An eligible entity that receives a disbursement may use the money for one or more of the following purposes: Capital construction that improves the security of a public school facility or public school vehicle; Training in student threat assessment for school staff; In collaboration with local law enforcement agencies, providing the training for peace officers on interactions with students at school; School emergency response training for school staff; Programs to help students become more resilient in meeting the daily challenges they face without resorting to violence against themselves or others; Developing and providing training programs, curricula, and seminars related to school safety incident response; and Developing best practices and protocols related to school safety incident response. The department is required to review the applications received from eligible entities and, subject to available appropriations, to disburse money to applicants that satisfy the application requirements from money credited to the school security disbursement cash fund. The department is required to give priority to applicants that commit to providing matching money for the amount of the disbursement received. Each disbursement recipient is required to report to the department concerning its use of the money, and the department is required to annually provide a summary of the reports to specified committees of the general assembly. The program is repealed, effective July 1, 2032. (Note: This summary applies to this bill as enacted.)
The act creates the school security disbursement program cash fund (cash fund). The department of public safety (department) may disburse money from the cash fund to school districts, charter schools, and boards of cooperative services to improve security within public schools. The act appropriates $6 million from the general fund to the cash fund. The act continues the temporary youth mental health services program and the bi-annual reporting requirements until June 30, 2024, and appropriates $6 million from the behavioral and mental health cash fund to the department of human services for the program. The act appropriates $2 million from the behavioral and mental health cash fund to the department of education for the behavioral health care professional matching grant program. Provisions of the act creating the school security disbursement program cash fund are contingent upon House Bill 22-1120, which recreates the school security disbursement program, becoming law. (Note: This summary applies to this bill as enacted.)
Under existing law, the state department of human services (department) reimburses local governments and nongovernmental agencies that operate domestic abuse programs for providing services to victims of domestic violence. The act renames "domestic abuse programs" as "domestic violence programs", repeals the authority to reimburse local governments, and requires the department to reimburse a nongovernmental agency or a federally recognized Indian tribe that operates a domestic violence, sexual assault, or culturally specific program (program) that provides services to victims of domestic abuse or sexual assault (program services). The act repeals the requirement that programs must request information from each client concerning the relationship of the client to the alleged perpetrator of the abuse. The act permits the department to enter into an agreement with a federally recognized state or tribal domestic violence or sexual assault coalition (coalition) for program services and other related services. A coalition that enters into a contract or agreement with the department shall provide training and technical assistance for programs and may participate in systems advocacy, develop and implement policies to improve the response to and prevention of domestic violence or sexual assault, and conduct statewide community outreach and public education related to domestic violence and sexual assault. A coalition may subcontract with a nongovernmental agency or federally recognized Indian tribe that operates a program. The act creates the state domestic violence and sexual assault services fund, transfers $6 million to the fund from the behavioral and mental health cash fund, and requires the department to publish information on its website about the use of program funds and organizations that receive funds. The act creates the Colorado crime victim services fund (victim services fund) and requires the state treasurer to transfer $32 million to the fund from the economic recovery and relief cash fund and $6 million to the fund from the general fund. The division of criminal justice in the department of public safety makes grants from the victim services fund to government agencies and nonprofit organizations that provide services for crime victims. The division is required to publish information on its website about the use of grant funds and organizations that receive grant awards. The act permits the division of criminal justice to grant money from the victims assistance and law enforcement fund for mass tragedy response. The act limits members of the crime victim services advisory board to serving 3 consecutive 3-year terms on the board. The act requires the state treasurer to transfer $3 million to the victims and witnesses assistance and law enforcement fund from the economic recovery and relief cash fund. The state court administrator is required to distribute the money based on need. The act requires the state treasurer to transfer $1 million to the community crime victims grant program cash fund from the general fund. For state fiscal year 2021-22, the general assembly appropriated $1.5 million to the department of public safety for the state victims assistance and law enforcement program and $4.75 million to the department of human services for the domestic abuse program. The act further appropriates any of that money that is not expended by July 1, 2022, to each department for use in the 2022-23 and 2023-24 state fiscal years. (Note: This summary applies to this bill as enacted.)
The act requires the division of homeland security and emergency management in the department of public safety (division) to procure and maintain a stockpile of essential materials that is available for distribution after the governor has a declared a disaster emergency. The division, in consultation with the department of public health and environment, may distribute the essential materials to state agencies, schools, local public health agencies, hospitals, primary care providers, or other health-care providers, or to any other individual or entity that the director of the division determines is in need as a result of the disaster emergency. The division may contract with a third-party entity to administer the stockpile. To ensure that the materials in the stockpile are rotated prior to their expiration date, the act: Requires state agencies to procure essential materials from the division, to the extent possible; and Permits the division to donate or sell essential materials as necessary to avoid having stock that is past its expiration date. Any proceeds from the sale of the essential materials are credited to the newly created emergency stockpile rotation cash fund, which is continuously appropriated to the department of public safety for use by the division for administering the stockpile. Under current law, the state board of health has the authority to adopt rules and to establish standards to assure that hospitals; other acute care facilities; county, district, and municipal public health agencies; and trauma centers are prepared for an emergency epidemic that is declared to be a disaster emergency. The act specifies that under this authority the state board may adopt rules or establish standards for the maintenance of an adequate stockpile of personal protective equipment for infection control and to assure staff proficiency in using the personal protective equipment. (Note: This summary applies to this bill as enacted.)
The act authorizes money from the tobacco master settlement agreement allocated to the state dental loan repayment program to also be used for oral health programs administered by the department of public health and environment (department). The act renames the "state dental loan repayment fund" as the "state dental loan repayment and oral health programs fund" (fund) and modernizes language relating to the fund. The act requires the department to report annually for 6 years to the joint budget committee concerning the amount of money allocated to the state dental loan repayment program and the number of qualified professionals applying for and receiving loan repayment. The report must also include information concerning the proportion and use of money from the fund for oral health programs. (Note: This summary applies to this bill as enacted.)
The act creates the primary care and behavioral health statewide integration grant program in the department of health care policy and financing (state department) to provide grants to primary care clinics for implementation of evidence-based clinical integration care models. The act requires the state department, in collaboration with the behavioral health administration and other agencies, to develop a universal contract for behavioral health services. The act requires the state department to undertake efforts to transform the state department's process for clients attempting to receive long-term care in the community to respond to the United States department of justice's letter of findings concerning the investigation of Colorado's use of nursing facilities to serve adults with physical disabilities. The act appropriates to implement the act: $616,968 to the department from the general fund; $986,948 to the department from federal funds; and $31,750,00 to the department from the behavioral and mental health cash fund.(Note: This summary applies to this bill as enacted.)
The act requires the division of insurance (division) to collaborate with the department of health care policy and financing, the department of personnel, the department of public health and environment, and the primary care payment reform collaborative (collaborative) to develop and promulgate rules for alternative payment model parameters for primary care services offered through health benefit plans. The alternative payment model parameters must: Include transparent risk adjustment parameters that ensure that primary care providers are not penalized for or disincentivized from accepting vulnerable, high-risk patients and are rewarded for caring for patients with more severe or complex health conditions and patients who have inadequate access to affordable housing, healthy food, or other social determinants of health; Utilize patient attribution methodologies that are transparent and reattribute patients on a regular basis, which must ensure that population-based payments are made to a patient's primary care provider rather than other providers who may only offer sporadic primary care services to the patient and include a process for correcting misattribution that minimizes the administrative burden on providers and patients; Include a set of core competencies around whole-person care delivery that primary care providers should incorporate in practice transformation efforts to take full advantage of various types of alternative payment models; and Require an aligned quality measure set that considers the quality measures and the types of quality reporting that carriers and providers are engaging in under current state and federal law and includes quality measures that are patient-centered and patient-informed and address: Pediatric, perinatal, and other critical populations; the prevention, treatment, and management of chronic diseases; and the screening for and treatment of behavioral health conditions. For health-care plans that are issued or renewed on or after January 1, 2025, each carrier must ensure that the carrier's alternative payment models for primary care incorporate the aligned alternative payment model parameters created by the division. By December 1, 2023, the commissioner of insurance must promulgate rules detailing the requirements for alternative payment model parameters alignment. The division shall allow carriers the flexibility to determine which network providers and products are best suited to achieve the goals and incentives set by the division. Once the division has 5 years of data, the division is required to analyze the data, produce a report on the data, and present the findings to the general assembly during the department of regulatory agencies' presentation to legislative committees at hearings held pursuant to the "SMART Act". To assist carriers with implementing primary care alternative payment models, the division is required to retain a third-party contractor to design an evaluation plan for such implementation and retain a third-party contractor to provide technical assistance to carriers. With regard to the collaborative, the act: Requires the collaborative to annually review the alternative payment models developed by the division and provide the division with recommendations on the models; and Adjusts the date on which the collaborative must deliver its annual reports. With regard to the all-payer health claims database, the act: Requires the administrator to include in the annual primary care spending report data related to the aligned quality measure set determined by the division; and Adjusts the date on which the annual reports are due. For the 2022-23 state fiscal year, $56,328 is appropriated to the department of personnel from the general fund for use by the division of human resources to implement the act. (Note: This summary applies to this bill as enacted.)
The act requires the department of human services (department) to renovate a building at the mental health institute at Fort Logan to create at least 16 additional inpatient beds for persons in need of residential behavioral health treatment. The act authorizes the new beds to be used for persons needing competency services until the backlog of such persons is eliminated, and at that point the beds may begin to serve civil patients. The act also directs the department and the department of health care policy and financing to create, develop, or contract to add at least 125 additional beds at mental health residential facilities (mental health facilities) throughout the state for adults in need of ongoing supportive services. For the new beds, the act requires the department, in collaboration with the behavioral health administration, the department of health care policy and financing, and relevant stakeholders, to establish criteria for admissions and discharge planning, quality assurance monitoring, appropriate length of stay, and compliance with applicable federal law. The act requires mental health facilities to be licensed by the department of public health and environment as an assisted living facility or by the department as a behavioral health entity during the 2022-23 state fiscal year. Starting in the 2023-24 state fiscal year, the mental health facilities must be licensed by the behavioral health administration. The act appropriates to the department from the behavioral and mental health cash fund: $728,296 for use by administration and finance; $39,854,179 for use by the office of behavioral health for contract beds and renovations in mental health residential facilities, costs associated with additional beds in department facilities, and oversight of the additional beds; $6,578,266 for costs associated with the operation of additional beds at the Colorado mental health institute at Fort Logan; $6,991,567 for capital construction at the mental health institute at Fort Logan; and $3,692,111 for capital construction at three existing department facilities to create mental health residential facilities. The act also appropriates $91,938 to the department of health care policy and financing. (Note: This summary applies to this bill as enacted.)
The act directs the state treasurer to transfer $11,720,278 from the general fund to the division of professions and occupations cash fund for use beginning in the 2022-23 state fiscal year and until fully expended to fund the expenses of the state board of nursing in order to facilitate fee relief for nurses, nurse aides, and psychiatric technicians. (Note: This summary applies to this bill as enacted.)
The act implements the recommendations of the behavioral health transformational task force concerning youth and family residential care. Specifically, the act: Provides operational support for psychiatric residential treatment facilities and qualified residential treatment programs for youth; Creates in-home and residential respite care in up to 7 regions of the state for children and families; and Provides funds to build and staff a neuro-psych facility at the Colorado mental health institute at Fort Logan. The act makes the following appropriations to the department of human services from the behavioral and mental health cash fund: $11,628,023 is appropriated for respite and residential programs; $7,500,000 is appropriated for use by the behavioral health administration to expand substance use residential treatment beds for adolescents and for crisis response service systems; and $539,926 is appropriated for use by the behavioral health administration and is for building maintenance costs associated with the youth neuro-psych facility at the Colorado mental health institute at Fort Logan. An additional $35,000,000 is appropriated for capital construction costs related to the construction of a youth neuro-psych facility at the Colorado mental health institute at Fort Logan.(Note: This summary applies to this bill as enacted.)
The act creates the health-care workforce resilience and retention program (program) using existing initiatives to ensure that Colorado's health-care workforce is supported in order to meet the health-care demands of Coloradans and to support the resilience, well-being, and retention of health-care workers. The program is authorized to seek and expend gifts, grants, and donations to support the program. The program is exempt from the procurement code. The act appropriates $2 million from the economic recovery and relief cash fund for the program. The act creates the practice-based health education grant program (grant program) to increase practice-based training opportunities necessary for health profession students enrolled in accredited Colorado schools to complete degree requirements and become licensed to practice or program participants enrolled in other training or residency programs offered by a public or nonprofit Colorado medical school or accredited residency program to gain hands-on experience in pursuit of a license in the health-care field. The primary care office in the department of public health and environment administers the grant program and shall conduct a stakeholder engagement process to determine key operational components of the grant program policies and procedures. The act appropriates $20 million from the economic recovery and relief cash fund for the grant program. The act directs the state board for community colleges and occupational education (board) to administer the in-demand short-term health-care credentials program in order to support the expansion of available health-care professionals. The bill appropriates $26 million from the economic recovery and relief cash fund for these programs. The board shall allocate funds to community colleges, area technical colleges, local district colleges, and community not-for-profit organizations that deliver hybrid programming that leverages place-based supports in partnership with local district colleges, community colleges, and area technical colleges through reimbursement based on students enrolled in eligible programs for fiscal years 2022-23 to 2025-26 to: Provide assistance for tuition, fees, and course materials for eligible programs; Support alignment with existing efforts, such as apprenticeship and work-based learning, for students to earn eligible program credentials that lead into health-care careers such as nursing; and If unexpended resources exist or if the program use is less than anticipated, to expand eligible programs in allied health based on in-demand credential needs or include high school equivalency support and attainment for students without a high school degree who participate in the program. The act requires the primary care office and the governor's office of information technology to work through the government data advisory board to determine data-sharing agreements that integrate data collected by the state under existing authorities that may inform the analysis of need, allocation of resources, and evaluation of performance of state-administered or state-financed health workforce planning or development initiatives. Under current law, a nurse who holds a volunteer nurse license cannot get paid for nursing tasks. The act removes this limitation. The act directs the nurse-physician advisory task force for Colorado health care to make recommendations on: Alignment of health-care licensing with federal statutory minimums; Identification of unnecessary regulatory burdens or barriers; Regulatory reforms that support health-care licensees to work at their full scope of practice; and Feasibility of temporary candidate licenses for students nearing the completion of an accredited health-care program. The act makes the following changes and additions to the school nurse grant program: Repeals the requirement of a 5-year grant cycle; Requires that the grant supplement, not supplant, funding for school nurse positions existing in the local education provider's most recent fiscal year prior to applying for a grant; Directs the department of public health and environment to annually award grants; and Appropriates $3 million to the department of public health and environment for the grant program from the economic recovery and relief cash fund. The act appropriates $10 million from the economic recovery and relief cash fund to the department of public health and environment. The department shall use this appropriation for recruitment, re-engagement efforts of workers in the health-care profession with current or expired licenses, and staffing. (Note: This summary applies to this bill as enacted.)
Beginning in 2023, the act requires each health insurance carrier (carrier) that offers an individual or small group health benefit plan in this state to offer at least 25% of its health benefit plans on the Colorado health benefit exchange (exchange) and at least 25% of its plans not on the exchange in each bronze, silver, gold, and platinum benefit level in each service area as copayment-only payment structures for all prescription drug cost tiers. Starting in 2024, a carrier or, if a carrier uses a pharmacy benefit manager (PBM) for claims processing services or other prescription drug or device services under a health benefit plan offered by the carrier in the individual market, the PBM, or a representative of the carrier or the PBM, is prohibited from modifying or applying a modification to the current prescription drug formulary during the current plan year. The act repeals and reenacts the current requirements for step therapy and requires a carrier to use clinical review criteria to establish the step-therapy protocol. For each health benefit plan issued or renewed on or after January 1, 2024, the bill requires each carrier or PBM to demonstrate to the division of insurance that: 100% of the estimated rebates received or to be received in connection with dispensing or administering prescription drugs included in the carrier's prescription drug formulary are used to reduce costs; For small group and large employer health benefit plans, all rebates are used to reduce employer or individual employee costs; and For individual health benefit plans, all rebates are used to reduce consumers' premiums and out-of-pocket costs for prescription drugs and that health insurers will maximize the use of rebates to reduce consumer costs. The act requires the division of insurance to conduct and complete a study to evaluate how rebates my be applied in the individual market to reduce consumers' costs. The act requires health insurers to annually report: Data demonstrating that discounts and rebates received are used to reduce costs for policyholders; and An actuarial certification attesting that the health insurer and PBM are compliant with the law and that the data submitted to the division is accurate. The act requires the commissioner of insurance (commissioner) to promulgate rules to implement the rebate requirements in the act. Beginning in 2023, the act requires the department of health care policy and financing, in collaboration with the administrator of the all-payer claims database, to conduct an annual analysis of the prescription drug rebates received in the previous calendar year, by carrier and prescription drug tier, and make the analysis available to the public. For the 2022-23 state fiscal year, $252,667 is appropriated from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance to implement the act. (Note: This summary applies to this bill as enacted.)
