The act requires each covered social media platform (covered platform) to impose a fee on each add-on transaction that occurs on the covered platform. The act creates the youth mental health services access enterprise in the behavioral health administration (BHA) to use the fee revenue to operate and fund programs that provide youth mental health services. The youth mental health services access enterprise constitutes an enterprise for purposes of section 20 of article X of the state constitution. The act defines a 'covered platform' as a sole proprietorship, a partnership, a limited liability company, a corporation, an association, or another legal entity, or an affiliate thereof, that:Conducts business in this state;Generates revenue directly from add-on transactions conducted in an online gaming service, product, or feature;Generates a majority of its annual revenue from online gaming services, products, or features;Publishes one or more online gaming services, products, or features that are reasonably likely to be accessed by a youth;Collects users' personal data or has users' personal data collected on its behalf; andDetermines the purposes and means of the processing of users' personal data. The act defines an 'add-on transaction' as a transaction through which a player or participant in a video game accessed via an online gaming service, product, or feature acquires:An item or ability that provides the player or participant an advantage over other players or participants of the video game; orA feature that alters or enhances the video game as accessed by the online gaming service, product, or feature. The act creates the youth mental health services access enterprise fund, consisting of money credited to the fund as fee revenue, any money received from the issuance of revenue bonds, and any other money that the general assembly may appropriate or transfer to the youth mental health services access enterprise fund. Money in the youth mental health services access enterprise fund is continuously appropriated to the youth mental health services access enterprise. After deducting its administrative expenses, the youth mental health services access enterprise is required to allocate the remaining fee revenue credited to the fund as follows:40% to operate and fund the youth mental health peer navigator grant program, which program is created in the act;35% to operate and fund the crisis resolution team program, which program is created in the act; and25%, beginning January 1, 2028, to operate the existing youth mental health services program. The initial amount of the fee is 5% of the amount of the add-on transaction. On and after October 1, 2027, the youth mental health services access enterprise may adjust the amount of the fee. The act creates the youth mental health peer navigator grant program to award grants to entities that recruit and train young adults to provide prevention services, peer support, and system navigation to youth in schools or community-based settings. The act creates the crisis resolution team program to provide community-based de-escalation and stabilization services to youth who are experiencing high-acuity behavioral health crises and to their caregivers. Under current law, the BHA operates the youth mental health services program to facilitate access to mental health services, including substance use disorder services, for youth in response to mental health needs identified in an initial mental health screening through the program's web-based portal. The youth mental health services program reimburses providers for up to 3 mental health sessions with a youth. The act directs the youth mental health services access enterprise, rather than the BHA, to operate and fund the youth mental health services program beginning January 1, 2028. The act also allows the youth mental health services access enterprise to reimburse a provider for up to 6 mental health sessions with a youth. The act creates the youth programming and protections enterprise to:Award grants through the existing out-of-school time program grant program; andSupport the department of education's enforcement of educational rights on behalf of children. The youth programming and protections enterprise constitutes an enterprise for purposes of section 20 of article X of the state constitution. The act creates the youth programming and protections enterprise fund. In each state fiscal year, after the state treasurer has credited $8 million to the youth mental health services access enterprise fund, the state treasurer must credit any other money received as fees to the youth programming and protections enterprise fund. Under current law, the department of education administers the out-of-school time program grant program and the state board of education awards grants from the program, subject to available appropriations. The act directs the department of education to consult with the youth programming and protections enterprise in administering the out-of-school time program grant program, and the act directs the youth programming and protections enterprise to award grants from the program in consultation with the state board of education. The act also requires the out-of-school time program grant program to provide programming and services that support the mental health and well-being of children and youth. The act requires a covered platform to ensure that the purchase price for an online gaming service, product, or feature that is reasonably likely to be accessed by a minor to be listed in United States dollars at the point of sale. For the 2026-27 state fiscal year, the act appropriates:$294,984 to the department of revenue from the general fund;$26,500 to the department of law from reappropriated funds;$145,750 to the department of law from the youth mental services access enterprise fund created in the act; and$79,500 to the department of law from the youth programming and protections enterprise fund created in the act.(Note: This summary applies to this bill as enacted.)
Beginning on January 1, 2028, a health insurance carrier (carrier) of an individual or group health benefit plan in Colorado (plan) shall, when calculating a covered person's contribution to an out-of-pocket maximum or cost-sharing requirement under the plan, account for and credit to the covered person's contribution an out-of-pocket expense that the covered person incurs by purchasing a prescription drug directly from a pharmacy or direct-to-consumer platform (contribution credit). The carrier shall apply the contribution credit to the out-of-pocket maximum or cost-sharing requirement that is applicable in the plan year in which the out-of-pocket expense was incurred. To receive a contribution credit, a covered person must provide to the carrier proof of payment for a direct purchase of a prescription drug, such as an itemized receipt or pharmacy record, within 90 days after making the purchase (proof of payment). The carrier may request additional information or documentation if the proof of payment is insufficient or incomplete. The carrier shall not apply a contribution credit in the following circumstances:For an amount of a covered person's out-of-pocket expense incurred by the direct purchase of a prescription drug that is greater than the amount the covered person would have incurred if they had obtained the same prescription drug in the same plan year from an in-network pharmacy and pursuant to the terms of their plan;If the covered person does not provide proof of payment;If the covered person incurred the out-of-pocket expense by purchasing a prescription drug that is not covered under the formulary of the covered person's plan, unless the carrier grants an exception; orIf the covered person does not comply with the carrier's utilization management processes, including prior authorization and step therapy protocols required under the covered person's plan.(Note: This summary applies to this bill as enacted.)
Current law requires the general assembly to annually appropriate $50,000 to provide vouchers to individuals living in rural and frontier communities in need of behavioral health-care services. The bill repeals the requirement to appropriate money for that purpose. The act:Repeals the requirement that the BHA contract with an independent third party to provide services and supports to behavioral health providers seeking to become behavioral health safety net providers;Repeals the building substance use disorder treatment capacity in underserved communities grant program;Repeals the recovery support services grant program;Transfers the balance of the high-risk families cash fund (fund) to the general fund and repeals the fund on July 1, 2026; andReduces appropriations to the behavioral health administration for the affected programs and services.(Note: This summary applies to this bill as enacted.)
The act creates the Colorado behavior analyst licensing board (board) under the direction and supervision of the division of professions and occupations in the department of regulatory agencies. On and after July 1, 2028, an individual is prohibited from engaging in or offering the practice of applied behavior analysis unless the individual is licensed by the board. The board is authorized to license behavior analysts and assistant behavior analysts if they meet the requirements specified by the act and the rules adopted by the board pursuant to the act. An individual who seeks to practice as a behavior analyst or assistant behavior analyst must meet the following requirements:File an application for a license;Have a valid certification in good standing with a certifying entity;Complete a fingerprint-based criminal history record check;Carry professional liability insurance in an amount determined by the board by rule unless working as a public employee covered under governmental immunity; andIf the individual seeks to practice as an assistant behavior analyst, be supervised by a licensed behavior analyst and practice within the scope of practice established by rules of the board. The board may deny or refuse to renew a license, suspend or revoke a license, impose probationary conditions on a license, or issue a cease-and-desist letter or seek injunctive relief against a licensee or an applicant for licensure who has engaged in specified grounds for discipline or unprofessional conduct. The board may also send a licensee a letter of admonition or a confidential letter of concern under certain circumstances. The act exempts specified individuals from the licensing requirements established by the act. An individual who practices or offers or attempts to practice as a behavior analyst or assistant behavior analyst without being licensed pursuant to the act and who is not exempted from licensure commits a class 2 misdemeanor. The board may adopt rules as necessary to implement the act. The regulation of behavior analysts and assistant behavior analysts is scheduled for repeal on September 1, 2031. Before the repeal, the functions of the board in regulating applied behavior analysis are scheduled for review in accordance with the sunset law. The act requires the department of health care policy and financing (state department) to reimburse an applied behavior analysis provider for applied behavior analysis services provided by a behavior technician certified by a certifying entity to a medicaid member with autism spectrum disorder or other conditions for which coverage may be available under state department policies. Subject to federal approval, the state department shall reimburse the applicable applied behavior analysis provider for applied behavior analysis services provided by a behavior technician who is required by the state department to be certified by a certifying entity, but is not certified at the time of services, for services provided during one temporary period of not less than 45 days while the behavior technician is pursuing the certification if specified conditions are met. The department of human services (department) is required to prescribe and publish standards for the licensing and regulation of applied behavior analysis clinics (clinics). The department is authorized to adopt rules concerning specific subjects related to standards for clinics. Clinics are required to comply with specified requirements regarding local government zoning regulations, licensing fees, and qualifications for employees of the clinics. The act changes the definition of 'day treatment center' to 'day treatment facility' and requires that facilities that were not subject to the definition before the effective date of the act but that meet the amended definition submit an application for licensure by the department on or before August 1, 2026 , and become licensed before August 1, 2027.(Note: This summary applies to this bill as enacted.)
Joint Budget Committee. Current law authorizes medicaid reimbursement for therapy using equine movement provided by a licensed physical therapist, a licensed occupational therapist, or a certified speech-language pathologist. The bill repeals this provision and reduces the 2026-27 appropriation to the department of health care policy and financing by $181,514.(Note: This summary applies to this bill as introduced.)
The act recreates a provision that authorizes the state to retain the percentage of reimbursement that is in excess of the 50% federal match received for certain medicaid services provided (enhanced federal financial participation) during the COVID-19 pandemic. The provision is repealed once the reconciliation of all reimbursements and payments for services delivered during the period of enhanced federal financial participation has been completed.(Note: This summary applies to this bill as enacted.)
This Senate Resolution officially designates April 2026 as National Donate Life Month in Colorado. The measure serves to raise public awareness about organ, eye, and tissue donation and honors the individuals who contribute to transplant programs. Additionally, the Senate will send a copy of this resolution to the Donor Alliance to support their outreach efforts.
The act limits the benefits pregnant women and children with a certain family household income and citizen or immigration status are eligible for under the state medical assistance program and the medical assistance program. Eligible pregnant women and children are subject to the following limitations on benefits:Beginning July 1, 2026, there is an annual cap on dental services in the amount of $1,100;Beginning January 1, 2027, behavioral health services offered must be provided on a fee-for-service basis only;Beginning January 1, 2027, services offered through the accountable care collaborative are no longer covered; andBeginning January 1, 2027, managed care services through the medical assistance program are no longer covered. Beginning January 1, 2027, children under 19 years old whose family household income does not exceed 260% of the federal poverty line, adjusted for family size, and who are not eligible for the medical assistance program due to their immigration status, are not eligible for home- and community-based services, community first choice, long-term home health, private duty nursing, hospice care, and nursing home care unless those children already receive those services on or before December 31, 2026. Beginning January 1, 2027, the act caps enrollment of children in the state medical assistance program at 25,000 children if either enrollment exceeds 25,000 or the expenditures for a fiscal quarter exceeds one-quarter of the appropriation for state medical assistance plus 5% to account for seasonality fluctuations. If one of the conditions is met, the enrollment cap begins on the first day of the month following 60 days after the department of health care policy and financing (state department) determines that the condition was met. The act repeals provisions requiring the state department to develop an outreach and enrollment strategy for enrolling eligible groups into new coverage options and repeals the state children's basic health plan. The act appropriates $3,378,166 from the general fund to the state department to implement the act and reduces appropriations to the state department by $14,202,723 if certain conditions are met.(Note: This summary applies to this bill as enacted.)
Under current law, if a defendant is found incompetent to proceed and the defendant will not be restored to competency in the foreseeable future, the court is required to dismiss charges against the defendant and the defendant, in limited circumstances, may be referred for certification for short-term treatment through a civil court process. The act maintains the requirement for the court to dismiss the charges against a defendant if the defendant's highest charged offense is among certain misdemeanor offenses, and the act maintains certification for short-term treatment as an option for the defendant. However, if the defendant is unrestorable or the defendant has reached the statutory maximum time permitted to be restored, the act authorizes the district attorney or county attorney (prosecution) to notify the court that the prosecution seeks civil commitment or an enhanced protective placement of a defendant if the prosecution can prove by clear and convincing evidence that the defendant:Has a mental disability or developmental disability;Committed an act that, in the absence of any mental disability or developmental disability, would constitute homicide, a crime of violence, or a felony that constitutes unlawful sexual behavior, and the act is or was charged in a criminal case in Colorado in which competency was raised; and Poses a substantial risk of serious harm to others. If the prosecution seeks civil commitment or an enhanced protective placement, the court is required to stay the order dismissing the defendant's case, set a trial within 91 days after the date the written notice was filed, and order the department of human services (CDHS) to identify an appropriate provider and placement for the defendant in the event a civil commitment or enhanced protective placement is granted. The defendant may stipulate that the court order a civil commitment or enhanced protective placement. If the court finds the prosecution has not met its burden, the court is required to deny the prosecution's request to civilly commit the defendant or order an enhanced protective placement of the defendant; except that the court may consider whether to order other civil proceedings. If the court finds the prosecution has met its burden, the court is required to order the civil commitment or enhanced protective placement of the defendant, place the defendant and issue any related orders, transfer jurisdiction of the civil commitment or enhanced protective placement to an appropriate civil court with jurisdiction, and dismiss the defendant's criminal case. When the court orders the civil commitment or enhanced protective placement, the court shall make a finding of the defendant's primary diagnosis that constitutes the mental disability or developmental disability. The court shall order the defendant civilly committed to the legal custody of CDHS unless the defendant's primary diagnosis is an intellectual and developmental disability (IDD) or a neurocognitive disorder, in which case, the court shall order an enhanced protective placement and legal custody of the defendant to the department of health care policy and financing (HCPF). If CDHS proposes placing the defendant into inpatient care, the court shall order, without further court review, that the defendant be placed into inpatient care at the discretion of CDHS if the court ordered a civil commitment or that the defendant be placed into inpatient care at the discretion of HCPF if the court ordered an enhanced protective placement. If CDHS has not identified an appropriate provider that is willing to accept placement of the defendant, the court shall set a review hearing within 35 days after the order for civil commitment or enhanced protective placement and order CDHS, in consultation with the behavioral health administration (BHA), to identify at least one appropriate provider. Upon receiving jurisdiction of a civil commitment or enhanced protective placement, the act requires the civil court to supervise the civil commitment or enhanced protective placement by notifying the county attorney, appointing an attorney to represent the respondent, and setting a review hearing. At the hearing, the respondent has the right to request modification of the terms of the civil commitment or enhanced protective placement and the right to periodic review, including whether the respondent qualifies for termination of the civil commitment or enhanced protective placement. The court is required to ensure the respondent is placed in the least-restrictive setting adequate to protect the victims and community. If the respondent is not placed into inpatient care at the discretion of CDHS, or if CDHS proposes to move the respondent into or out of inpatient care, the court shall, prior to modifying the civil commitment or enhanced protective placement to change the respondent's provider or placement, review the appropriateness of the proposed provider or placement. The provider charged with the physical care and custody of the respondent is required to submit a report to the court and the parties annually by the date the respondent was civilly committed or ordered into enhanced protective placement unless a substantially similar examination was ordered by the court within the previous 12 months. The act requires the court to terminate the respondent's civil commitment or enhanced protective placement if the respondent no longer poses a substantial risk of serious harm to others or the respondent does not have the applicable disorder or disability that is likely to cause the respondent to be a danger to the respondent's self or a danger to others and the respondent has demonstrated sufficient capacity and willingness to conform their conduct to the requirements of the law. If the respondent does not meet the criteria for termination, the respondent is not entitled to another termination trial within one year after the conclusion of the previous trial. The court shall convert a civil commitment to an enhanced protective placement if the respondent does not meet the criteria for termination but the respondent has a mental health disorder that is an IDD or a neurocognitive disorder, without having any other mental health disorder that is not an IDD or a neurocognitive disorder and that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If the defendant does not meet the criteria for termination and has co-occurring mental health disorders that include an IDD or a neurocognitive disorder, the court may, upon the recommendation of CDHS, convert the civil commitment to an enhanced protective placement. The court shall convert an enhanced protective placement to a civil commitment if the respondent does not meet the criteria for termination and the respondent no longer has an IDD or a neurocognitive disorder that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If the defendant does not meet the criteria for termination and has co-occurring mental health disorders that do not include an IDD or a neurocognitive disorder, the court may, upon the recommendation of CDHS, convert the enhanced protective placement to a civil commitment. Under current law, an emergency mental health hold (M1 hold) may be initiated against a person for not more than 72 hours if the person appears to have a mental health disorder and, as a result of the mental health disorder, appears to be a danger to the person's self or others, or appears to be gravely disabled. A person detained for an M1 hold and transported to an emergency medical services facility or facility designated by the commissioner (facility) of the BHA is required to receive an evaluation as soon as possible after the person presents to the facility. The act authorizes a person who has an M1 hold initiated against them while in confinement to receive an evaluation at the person's place of confinement rather than being transported to a facility. If the person is released from confinement while under an M1 hold, the person responsible for the confinement is required to coordinate with the BHA to transfer the person to a facility. Under current law, if a person under an M1 hold meets the criteria for certification for short-term treatment, the person may be certified for not more than 3 months. Rather than requiring an M1 hold as a prerequisite to short-term certification or certification for long-term care and treatment, the act authorizes a person to be certified if the person:Has been advised of the availability of, but has not accepted, voluntary treatment or with consideration of all reasonably available information, is believed will not remain in voluntary treatment; and By clear and convincing evidence, has a mental health disorder and, as a result of the mental health disorder, the person is a danger to the person's self, a danger to others, or gravely disabled. A person may not be certified for short-term treatment or long-term care and treatment if the person has an IDD or neurocognitive disorder without any other mental health disorder that is not an IDD or neurocognitive disorder and that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If a respondent is certified, the court shall order CDHS to provide care coordination and make diligent efforts to find a provider for the respondent that is willing to hold the certification. The respondent may be certified for long-term care and treatment if the respondent continues to meet the criteria and standards for certification for short-term treatment. The certification terminates when the professional person in charge of the respondent's treatment and the BHA determine the respondent no longer meets the criteria for certification. To terminate a short-term treatment certification less than 30 days after the initial certification, two professional persons are required to individually consult and review the respondent's case and agree that the respondent no longer meets the criteria for certification. A court may order the short-term or long-term protective placement of a person:Who, by clear and convincing evidence, has a neurocognitive disorder;When reasonable grounds exist to believe that the person will not remain in a voluntary treatment program; andWho, by clear and convincing evidence, is a danger to the person's self, a danger to others. The act aligns the provisions for short-term and long-term protective placement with certifications for short-term treatment and long-term care and treatment. No later than October 1, 2027, the act requires CDHS to construct and operate an outpatient treatment facility for adults with behavioral health needs, including adults who are found incompetent to proceed and unlikely to be restored to competency. To implement the act, for the 2025-26 state fiscal year, the act appropriates to CDHS $535,934 from the general fund and $4,777,898 from the capital construction fund. To implement the act, the act makes the following appropriations for state fiscal year 2026-27:$17,802,360 to CDHS from the general fund, of which $242,323 is reappropriated to the department of law and $52,644 to the office of information technology;To the judicial department, $26,296 from the judicial department information technology cash fund and $5,401,437 from the general fund, of which $1,719,409 is for use by the office of state public defender and specified independent agencies;$842,808 to HCPF from the general fund; and$150,000 to the department of law from the general fund.(Note: This summary applies to this bill as enacted.)
The act establishes the ibogaine research pilot program (pilot program) in the behavioral health administration (BHA) to research the safety and effectiveness of using ibogaine to treat mental health conditions and substance use disorders. The act requires the BHA to establish a committee to review pilot program site applications and make recommendations to the BHA on which applicants to accept. The BHA may select up to 5 ibogaine pilot sites. The act allows the BHA to seek, accept, and expend gifts, grants, and donations and establishes the ibogaine research pilot program cash fund. The pilot program is contingent on the BHA receiving sufficient gifts, grants, and donations to administer the pilot program and award grants to the selected ibogaine pilot sites to help with financing needs. Under current law, the division of natural medicine advisory board consists of 15 voting members, 8 of whom must have general expertise and experience related to natural medicine and 7 of whom must have specialized expertise and experience in various areas of natural medicine. The act amends the expertise and experience requirements to apply equally to all 15 voting members. The act adds that a facilitator of natural medicine services is not liable for a physical or psychological injury that a participant may experience as a result of the facilitator's performance or supervision of the natural medicine services that a participant receives, unless the injury is the result of the facilitator's intentional misconduct, gross negligence, or a deviation from the recognized standard of care. The act authorizes the state licensing authority for natural medicine or natural medicine product (state licensing authority) to adopt rules related to the administration, manufacturing, and use of ibogaine. The act sets requirements for how the state licensing authority must prioritize reviewing applications for licensure to facilitate natural medicine services and allows the state licensing authority to set different licensing fees depending on the type of natural medicine the applicant is seeking licensure for. The act allows the state licensing authority to accept gifts, grants, and donations from public or private sources and requires gifts, grants, or donations received to be deposited in the regulated natural medicine division cash fund. The act requires the BHA to work to secure federal research and development funding available through the advanced research projects agency for health within the federal department of health and human services, or other available funding, in order to advance research on the use of ibogaine for the treatment of serious mental illness. The act updates the powers and duties of the director of the division of professions and occupations to include adopting rules that guide the use and administration of ibogaine. A licensee seeking to cultivate, manufacture, dispense, or administer ibogaine shall, in consultation with Indigenous communities, establish a benefit-sharing plan that directly benefits those Indigenous communities. The act:Updates definition of 'administration session' to include the use of regulated natural medicine and regulated natural medicine product that the participant purchases to consume during the administration session;Prohibits a person from advertising bona fide harm reduction services or bona fide support services offered for remuneration, advertising natural medicine or natural medicine products, or using harm reduction services or support services to conduct sales of natural medicine;Clarifies that the state licensing authority is not required to conduct routine, periodic, or pre-operational inspections as a condition of licensure unless expressly required;Requires state licensing authority to adopt rules regarding licensing privileges and restrictions of a limited regulated natural medicine sales license and eligibility requirements for an applicant to obtain a limited regulated natural medicine sales license;Allows the state licensing authority to adopt rules regarding the application procedures and license requirement for a healing center to operate a temporary premises; and requirements for cultivation, manufacture, testing, or dispensing of ibogaine;Allows the department of public health and environment to issue a temporary premises permit to a licensed natural medicine healing center if certain conditions are met and allows a healing center to apply for a temporary premises permit;Prohibits a healing center licensee from selling regulated natural medicine or regulated natural medicine product unless a co-located limited regulated natural medicine sales licensee conducts the transaction in accordance with certain requirements; andAllows the director of the natural medicine division to issue an order to cease and desist if the director determines that a person is acting or has acted without a license to operate a natural medicine business or to own, grow, harvest, transfer, manufacture, supervise, provide, or administer natural medicine.(Note: This summary applies to this bill as enacted.)
