Healthcare

HB 1305 allows remote psychiatric inpatient facilities in Colorado to operate under a main hospital's general license instead of needing separate psychiatric hospital licensing, provided they meet specific criteria. These facilities must be located within 35 miles of a main hospital in a rural area, offer 17+ inpatient beds, meet all psychiatric hospital standards, and maintain federal provider-based status. The main hospital remains responsible for all licensing enforcement actions related to the remote location, and the facility must pay a separate licensing fee. This change aims to streamline operations while maintaining regulatory oversight through the main hospital's license.

The act prohibits sterilization of a person with an intellectual and developmental disability without the person's informed consent if the person has decision-making capacity. The act prohibits sterilization of a person with an intellectual and developmental disability without the person's informed consent if the person does not have decision-making capacity, except in accordance with processes in existing law that allow another person with legal authority to make medical decisions for the person to consent on the person's behalf.     The act repeals provisions that:Explain what happens when there is a disagreement about whether an adult with an intellectual and developmental disability is capable of consenting to sterilization;Set forth a process for a person to petition a court for, and a court to order, sterilization of a person with an intellectual and developmental disability who either cannot consent or is a minor; andRequire all records, hearings, and proceedings related to a decision to sterilize a person with an intellectual and developmental disability to remain confidential.(Note: This summary applies to this bill as enacted.)

The act prohibits individuals lawfully permitted to provide psychotherapy services in the state (regulated professionals) from allowing an artificial intelligence system (AI system) to interact with clients in any form of therapeutic communication without synchronous, real-time interaction between the regulated professional, the AI system, and the client, or generate therapeutic recommendations or treatment plans without review and approval by the regulated professional.     Except for educational, administrative, simulation, or training purposes or as part of a research program, a regulated professional shall not use an AI system to provide, direct, or guide psychotherapy, clinical intervention, counseling, diagnosis, treatment planning, or other activity that constitutes the practice of psychotherapy with an individual or group unless the use satisfies the conditions specified in the act. At initial client contact, a regulated professional shall inform clients of the prohibitions regarding use of AI systems in the practice of psychotherapy. Regulated professionals may be disciplined by the appropriate licensing board in the department of regulatory agencies for violations of this act.     The act allows regulated professionals to use an AI system to assist in providing administrative support or supplementary support, as these terms are defined in the act, for psychotherapy services if the regulated professional maintains responsibility for reviewing any outputs of the AI system used to provide administrative support or supplementary support. If a client's therapeutic session will be recorded or transcribed through the use of an AI system, the regulated professional must disclose in advance the use of an AI system and the purposes for its use, and obtain written, informed consent from the client.     The act does not prohibit a regulated professional from using an AI system within accredited or approved educational, instructional, or professional training programs, so long as the AI system is used solely for educational, administrative, simulation, or training purposes and is not deployed, marketed, or represented as a tool for use with clients, patients, or the public. Further, a regulated professional may be involved in the development, testing, or evaluation of an AI system solely for research purposes under the oversight of a federally registered institutional review board, so long as the AI system is not offered to consumers or used outside of the research setting.     The act does not apply to regulated professionals who use or recommend the use of technology in the state that does not diagnose or treat mental health disorders, clearly discloses that the technology is not a substitute for clinical care, and:Provides self-help, therapeutic homework, coaching, patient navigation, guided meditation, journaling, or other tools specified in the act; orIs regulated by the federal food and drug administration.     Except as provided in the act, the act also makes it an unfair or deceptive trade practice under the 'Colorado Consumer Protection Act' for an individual, corporation, or entity (person) to use any term, letter, or phrase in the use of an AI system in a manner that:Indicates or implies that the AI system's outputs are provided by, endorsed by, or equivalent to services provided by a regulated professional;Represents that the AI system provides psychotherapy services; orRepresents that a user's data is confidential in a manner that would lead a reasonable user to believe that the privacy of their data is protected in a manner similar to therapist-client confidentiality.      The act does not impose liability on a regulated professional for defects in or failures of an AI system that are attributable to the developer or deployer of the AI system.     Further, under conditions specified in the act, nothing in the act prohibits a person from developing, testing, or evaluating an AI system solely for research purposes or using an AI system in educational, instructional, or training programs. In addition, it is not an unfair or deceptive trade practice for a person to use a technology that does not diagnose or treat mental health disorders, clearly discloses that the technology is not a substitute for clinical care, and:Provides self-help, therapeutic homework, coaching, patient navigation, guided meditation, journaling, or other tools specified in the act; orIs regulated by the federal food and drug administration.(Note: This summary applies to this bill as enacted.)

The bill prohibits the department of health care policy and financing (department) from denying a medicaid member (member) the ability to purchase primary care services or enter into a direct primary care agreement. A member who purchases direct primary care services from a direct primary health-care provider or enters into a direct primary care agreement must sign a document acknowledging that the direct primary health-care provider is enrolled in the Colorado medical assistance program only as an ordering, prescribing, and referring provider; that the direct primary health-care provider does not accept medicaid payments for the services rendered; that the member cannot submit a claim for medicaid reimbursement for the services rendered by the direct primary health-care provider; and that the member retains the right to receive primary care services from a primary care provider who is enrolled in the Colorado medical assistance program.(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

The bill prohibits a public health facility from denying, restricting, or conditioning the granting, use, or exercise of full medical staff privileges to a certified nurse midwife or a certified midwife (licensee) engaged in independent practice within their scope of practice solely on the basis of their licensure. If granted, privileges extended to a licensee must include admitting and discharge privileges, be consistent with those of other medical staff, and permit a licensee to exercise the same voting rights as other members of the medical staff.(Note: This summary applies to this bill as introduced.)

The act declares emergency medical services as an essential service in the state and an integral part of the state's health-care infrastructure.      The act also declares that emergency medical service providers, whether responding on duty or as a volunteer and regardless of location, provide essential services when providing emergency ambulance services and nonemergency ambulance services.      The act also updates certain definitions related to emergency medical services, including the addition of a definition of 'out-of-hospital services', which term is defined to mean the furnishing of necessary health-care goods and services outside of a hospital setting but does not include prehospital setting transports.     The act clarifies that an off-duty emergency medical service provider is not obligated to respond to the scene of a medical emergency or provide emergency medical services.(Note: This summary applies to this bill as enacted.)

Current law requires a recovery residence operated in Colorado to be certified by a third-party certifying body, unless the recovery residence has been operating in Colorado for 30 or more years as of May 23, 2019.     Beginning July 1, 2027, the act requires a recovery residence to obtain a license from the behavioral health administration (BHA). The act sets forth application procedures and rules for minimum standards of operating a recovery residence. A recovery residence must report specified occurrences to the BHA, including occurrences that result in the death of or specified injury to a resident, involve abuse and neglect of a resident, involve misappropriation of a resident's property, or in which a resident's drugs are diverted for use by another person. Recovery residence licensing is subject to sunset review prior to its repeal in 2033.(Note: This summary applies to this bill as enacted.)

The bill prohibits a person, health-care provider, or mental health professional from knowingly performing surgery on, or prescribing, administering, or providing hormones or puberty blockers to, a minor for the purpose of altering the minor's biological sex characteristics, or providing mental health therapy, counseling, or referrals that promote or affirm a minor's belief that the minor was born in the wrong body or that the minor needs medical intervention to address distress related to the minor's biological sex (prohibited interventions).     The bill prohibits the state from investigating or penalizing a minor's parent, or terminating the parent's rights, for refusing to consent to a prohibited intervention for the minor. A public school, health-care provider, or a governmental entity is prohibited from withholding information from a minor's parent regarding the minor's express desire to transition the minor's biological sex.     The bill prohibits state or federal funding, medicaid reimbursement, and health insurance coverage from being used to pay for a prohibited intervention. A person who, as a minor, was subjected to a prohibited intervention may bring a civil action within 20 years after attaining the age of 18 years against the person, health-care provider, or mental health professional who performed or provided the prohibited intervention.     The bill requires a regulator to revoke a health-care provider's or mental health professional's license for performing or providing a prohibited intervention. A person who knowingly performs or provides a prohibited intervention commits a class 5 felony, and the court is required to sentence the person to the maximum term of imprisonment and impose the maximum fine.(Note: This summary applies to this bill as introduced.)

The bill requires all health benefit plans in the state and the medicaid program to provide coverage for hormone replacement therapy, as prescribed by licensed physicians, for women who are experiencing menopause or perimenopause.     Coverage for hormone replacement therapy will be implemented for all large employer health benefit plans issued or renewed in this state on or after January 1, 2027. Coverage for hormone replacement therapy will be implemented for all individual and small group health benefit plans issued or renewed in this state on or after January 1, 2028, as long as the state is not required to defray the cost of the coverage of the hormone replacement therapy.     The state medicaid program is required to provide hormone replacement therapy beginning on July 1, 2027.(Note: This summary applies to this bill as introduced.)

The act allows an applicant for licensure as a marriage and family therapist (LMFT) whose master's or doctoral degree program did not include an internship or practicum to also be registered as an LMFT candidate but requires these candidates to complete an additional 700 supervised clinical hours to become an LMFT.(Note: This summary applies to this bill as enacted.)