Rep. Rebekah Stewart

With regard to the family and medical leave insurance program (program), the act extends the duration of paid family and medical leave, up to an additional 12 weeks, for a parent who has a child receiving inpatient care in a neonatal intensive care unit. The act also changes the premiums financing the program benefits by extending the current premium amount, 0.9% of wages per employee, through 2025 and setting the premium amount for the 2026 calendar year at 0.88% of wages per employee. For each subsequent calendar year, the director of the division of family and medical leave insurance (director) is required set the premium on or before September 1 of the preceding year, in a manner such that: At the end of the year, the balance of the family and medical leave insurance fund (fund) is not less than 6 months' worth of projected expenditures from the fund required for performance of the functions and duties of the director; The volatility of the premium rate is minimized; and The premium amount does not exceed 1.2% of wages per employee.(Note: This summary applies to this bill as enacted.)

The act adds statutory protections for in vitro fertilization and other assisted reproductive health-care procedures. Current law requires gamete banks and fertility clinics (donor banks) to maintain donor identifying information and update it every 3 years. The act requires donor banks to encourage donors to inform the donor banks of significant updates to the donor's medical history after the donor made a donation. The donor bank is then required to document that significant medical history update. Current law prohibits donor banks from interfering with an adult donor-conceived person communicating about the gamete donor with the donor-conceived person's friends, family, or other third parties. The act encourages donor banks to provide information to donor-conceived persons regarding the physical and emotional risks associated with releasing a donor's private information to outside parties. The act repeals certain provisions relating to gamete donor record stewardship in the event of donor bank dissolution, bankruptcy, or insolvency and eliminates the requirement that donor banks inform a recipient parent about future implications about a gamete donor's medical history or other persons conceived using the same gamete donor. Current law requires the department of public health and environment (department) to draft written materials that must be provided to individuals prior to donating or receiving gametes. The act maintains that requirement, but does not require donor banks to use the department's written material. Donor banks are permitted to develop their own written materials to meet the statutory requirement of providing certain information to an individual prior to donating or receiving gametes. The act eliminates the department's ability to perform on-site inspections or perform in-person investigations on donor banks located outside the state. (Note: This summary applies to this bill as enacted.)

The act removes the term "homosexuality" from the definition of sexual conduct in the sexually explicit materials harmful to children part of the "Colorado Criminal Code". (Note: This summary applies to this bill as enacted.)

Under current law, there are 2 programs available to low-income individuals to buy in to the state medical assistance program: One for adults with disabilities and one for children with disabilities (medicaid buy-in programs). Individuals who participate in either program pay a premium based on their family income. The premiums are credited to the medicaid buy-in cash fund. The premiums credited to the medicaid buy-in cash fund are used to offset the costs of providing the medicaid buy-in programs. The costs of providing the medicaid buy-in programs are also offset by the money in the healthcare affordability and sustainability fee cash fund in the Colorado healthcare affordability and sustainability enterprise (CHASE) within the department of health care policy and financing (HCPF). The act repeals the existing medicaid buy-in cash fund and creates the healthcare affordability and sustainability medicaid buy-in cash fund (buy-in cash fund) within CHASE and directs that individuals who participate in the existing medicaid buy-in programs pay their premiums into the buy-in cash fund. The act creates a medicaid buy-in enterprise support board within CHASE to support the existing enterprise with the implementation of the medicaid buy-in program, including consulting with HCPF and the state medical services board on the amount of the premiums for and other components of the medicaid buy-in programs. Because CHASE is an enterprise for purposes of the Taxpayer's Act of Rights, its revenue does not count against the state fiscal year spending limit. For the 2025-26 state fiscal year, $6,660,761 is appropriated from the buy-in cash fund to HCPF for medical and long-term care services for medicaid-eligible individuals. The act also decreases in a corresponding amount an appropriation to HCPF from the existing Medicaid buy-in cash fund and adjusts similar appropriations to HCPF for the 2024-25 state fiscal year. (Note: This summary applies to this bill as enacted.)

The act changes the term "epinephrine auto-injector" to "emergency-use epinephrine" in order to encompass alternatives to injecting epinephrine as a means to treat anaphylaxis in school settings. (Note: This summary applies to this bill as enacted.)

Current law requires the department of corrections (department) to assess a copayment for inmate-initiated visits to providers of medical, dental, mental health, and optometric care services. Current law permits a waiver or reduction of the copayment under a range of circumstances. The department's current administrative regulations assess fees when an inmate fails to attend or refuses a scheduled health-care appointment. The act eliminates the copayment and prohibits the department from assessing a fee when an inmate fails to attend or refuses a health-care appointment. The department is required to report during its 2026 "SMART Act" hearing on the number of times in the previous year that an inmate failed to attend a scheduled health-care appointment or requested an appointment when the request was not relevant to an actual medical condition. The act reduces appropriations to the department by a net of $165,682, which includes an increase of $157,179 appropriated from the general fund and a decrease of $322,861 from cash funds. VETOED by Governor 5/29/2025(Note: This summary applies to this bill as enacted.)

The act makes changes to requirements for preventive care coverage by health insurers for breast cancer screening, including: Relocating in statute the high-risk breast cancer screening requirements; Defining and specifying criteria for the use of diagnostic breast examinations and supplemental breast examinations; and Clarifying that, in addition to regular breast cancer screening, diagnostic and supplemental breast examinations that are medically necessary and conducted within nationally recognized screening guidelines do not require cost sharing by the patient.(Note: This summary applies to this bill as enacted.)

Beginning July 1, 2026, absent an emergency placement change, the act requires a county or district department of human or social services (county department) child welfare caseworker (caseworker) to create an individualized placement transition plan (plan) for a child any time the child is moved from one placement in a foster care home, kinship foster care home, or non-certified kinship care home (placement) to another or back to the child's home. The plan must prioritize the mental, emotional, and physical needs of the child while considering the needs of the parents, current providers, and future providers as the needs of the parents, current providers, and future providers relate to the care of the child. If a sibling group is moved from a placement together, the caseworker may develop a single plan for the sibling group, as long as the plan takes into account the individualized needs of each child. The plan, at a minimum, must include: A determination of pre-transition logistics to adequately prepare for the child's new placement; A plan for pre- and post-transition communications between individuals who have relevant information for the transition; A timeline to transition the child to a new placement; A plan to physically move the child to the new placement; and A framework for a caseworker's post-transition communications. The department of human services (state department), within existing resources, shall create a training on the importance of plans that is recorded and made available on a training system that can be accessed statewide. The training must focus on plans and individuals who have lived experience with placement transitions, including an emphasis on individuals who experienced placement transitions. Newly employed caseworkers must complete the training within the first year of employment as a caseworker. All caseworkers may complete this training every 3 years. A foster care, kinship foster care, or non-certified kinship care provider (provider) may complete the training and may receive support from the state department or the county department to improve the provider's skills in transitioning a child in the provider's care from one placement to another. The state department may adopt rules for purposes of the plans. (Note: This summary applies to this bill as enacted.)

No later than October 1, 2025, the act requires the department of human services (state department), in consultation with the works allocation committee, to: Develop a standardized process for each county to collect and report to the state department on a monthly basis certain information about the Colorado works program; Develop recommendations that include a menu of standardized outcome measures and required levels of evidence for third-party contracted services funded with Colorado's temporary assistance for needy families (TANF) allocation; and Submit a report to the joint budget committee (JBC) that includes a description of the standardized process and recommendations. Beginning January 1, 2026, and each January thereafter, the act requires the state department to submit a report to the JBC that includes the information collected and reported through the standardized process and the total dollar amount of Colorado's TANF allocation that is redistributed through the state budget or other programs and services and publish the information on a monthly basis on the state department's website in a publicly accessible format. No later than July 1, 2026, the act requires the state department to submit a report to the JBC that includes certain information related to the standard of need for eligibility for basic cash assistance. For the 2025-26 state fiscal year, the act appropriates $154,000 to the department of human services for use by the office of economic security to conduct the works program evaluation. (Note: This summary applies to this bill as enacted.)

Beginning on or before July 1, 2027, the act requires a county department of human or social services (county department) to determine whether a child or youth who is in foster care and who has a deceased parent (child or youth) may be eligible to receive survivor benefits administered by the United States railroad retirement board, social security administration, or veterans benefits administration (federal survivor benefits). The county department must make an initial eligibility determination within 90 days after assuming legal custody of or authority over the child or youth. Under current law, certain federal agencies appoint a representative payee or fiduciary (representative payee) to receive and manage federal benefits on behalf of a child or youth in foster care. If a child or youth may be eligible for federal survivor benefits and the county department is the most appropriate representative payee, the act requires the county department to apply for federal survivor benefits on behalf of the child or youth. If the county department determines that the child or youth may be eligible for federal survivor benefits but that the county department is not the most appropriate representative payee, the county department shall provide information to the prospective representative payee that the county department has identified about how to apply for federal survivor benefits on behalf of the child or youth and how to become the child's or youth's representative payee. Under current law, a county department serving as a representative payee may use federal benefits to offset the cost of providing basic care and services to a child or youth in foster care. The act prohibits this offset practice with respect to federal survivor benefits. Instead, the act directs a county department serving as a representative payee to establish an account for the federal survivor benefits (account). A county department serving as a representative payee must save money in the account for the needs of the individual child or youth. Once the child or youth leaves foster care, the county department is required to release funds in the account to the child or youth. The act sets forth various accounting and notice requirements related to federal survivor benefits and requires the department of human services (department), in consultation with interested stakeholders, to adopt rules providing guidance for county departments. The guidance extends to procedures for identifying a representative payee, county department responsibilities when federal survivor benefits are denied or when a child or youth leaves foster care, and policies governing the establishment and maintenance of an account for federal survivor benefit funds. The department must provide technical assistance to a county department about how to conserve federal survivor benefit funds in the best interests of an individual child or youth. (Note: This summary applies to this bill as enacted.)