Rep. Gretchen Rydin

The act repeals the health-care delivery system reform incentive payments program in the Colorado healthcare affordability and sustainability enterprise (enterprise) and creates the hospital quality incentive program (incentive program) to use enterprise hospital provider fee revenue to make additional payments to hospitals that meet performance metrics in delivering safer and more effective care that improves patient outcomes and reduces preventable utilization to reduce health-care costs. Prior to implementing the program, the enterprise board shall approve the percentage of hospitals' reimbursement in the incentive program and the incentive program structure, performance measures, and scoring methodology. Once the incentive program is implemented, the total amount of payments made under the incentive program must not exceed 9% of the total reimbursements made to hospitals in the previous state fiscal year.(Note: This summary applies to this bill as enacted.)

The act repeals the teacher recruitment education and preparation program (TREP) after the 2026-27 budget year. The act repeals the teacher recruitment and preparation program and pathways in early technology early college high schools working group on July 1, 2027.     On July 1, 2026, the act requires the state treasurer to transfer $799,200 from the electrifying school buses grant program cash fund to the state education fund. The general assembly declares that TREP may receive funding from the state education fund.     For the 2026-27 state fiscal year, the act caps the amount that a district receives for a student participating in TREP under the school finance formulas at $7,104.     The act increases the cash fund appropriation to the department of education for state share of districts' total program funding and decreases the cash fund appropriation for extended high school in the 2026-27 long bill in order to fund TREP for the 2026-27 state fiscal year. The amount of the changes is contingent on whether House Bill 26-1364, concerning the calculation of the consumer price index for the 2025 calendar year, becomes law.(Note: This summary applies to this bill as enacted.)

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.)

The act creates the strengthen Colorado homes enterprise (enterprise), which is a government-owned business created in the division of insurance (division) in the department of regulatory agencies. The enterprise is governed by a 7-member board (board), including the commissioner of insurance (commissioner), or their designee; members with expertise in home hardening, risk mitigation, resilient roof systems, and insurance underwriting or actuarial analysis; and members representing the interests of insurance companies, consumers, and counties.     The primary purpose of the enterprise is to impose and collect an annual fee (fee) from an admitted insurance company that offers multiperil homeowner's insurance policies in the state and is subject to certain filing requirements with the division, not including the fair access to insurance requirements association (insurer).     The enterprise shall use fee revenue to provide business services to insurers that pay the fee, including:Reducing insurer losses and administrative expenses due to hail damage claims by defraying the cost of retrofitting residential property by providing grants for the installation of resilient roof systems (grants). At least 85% of the fee revenue must be used for grants to Colorado homeowners to retrofit residential property to reduce insurer losses due to hail and windstorms.Analyzing data on hail losses to identify areas of the state to target for installation of resilient roof systems;Setting standards for resilient roof systems and awarding workforce training grants for installing and certifying resilient roof systems;Creating codes of conduct for roofing contractors to ensure roofs are properly and appropriately installed;Evaluating roofing protocols to ascertain if the protocols meet science-based, certifiable standards; Conducting or contracting with a third party to conduct a study to analyze insurance risk in high-risk wildfire areas of the state; andImproving market stability throughout the state.     Beginning in the 2027 calendar year, the amount of the fee imposed and collected by the enterprise is an amount equal to 0.5% of the total premium collected by an insurer on multiperil homeowner's insurance policies in the state in the immediately preceding calender year. The insurer shall not surcharge the fee amount to policyholders. The enterprise may lower or cease collecting the fee from an insurer in any calendar year to ensure that total fee revenue does not exceed $100 million in the first 5 years of the enterprise's existence.          In awarding grants, the board shall prioritize homes that are the homeowner applicant's (applicant) primary residence and shall consider other criteria, including applicant income, the age of the roof, the size of the home, the number of grant applicants, whether the home is in a locality with hail-resistant building codes, and whether the applicant lives in a location that has historically had a higher susceptibility to extreme weather events. In order to ensure the necessary workforce, fee revenue may also be used to award grants to defray the costs of training and certification related to installing and certifying resilient roof systems. A contractor that is awarded bids and receives money from a grant is prohibited from waiving homeowner's insurance deductibles.     In addition, the board shall use fee revenue to conduct or contract with a third party to conduct a study to analyze insurance risk in high-risk wildfire areas of the state, including an analysis of market competition in those areas and the impact of a high risk program on the potential losses in the high-risk wildfire areas of the state and the availability of homeowner's insurance in those areas. The board or third party conducting the study shall engage with relevant stakeholders that include, at a minimum, representatives of reinsurers and reinsurance brokers, insurers writing homeowner's insurance contracts or policies in Colorado, individuals with expertise in complex financial instruments and debt instruments, and consumers or other individuals with expertise in wildfire mitigation. The board shall send the study to certain committees of the general assembly.          The board shall adopt rules and policies for the regulation of the enterprise's affairs and the conduct of enterprise business, including standards for resilient roof systems and standards for contractor-specialized training in the installation of impact-resistant roof systems.     No sooner than January 1, 2027, and upon the commissioner adopting rules, an insurer offering multiperil homeowner's insurance for property or risks located in the state is required to submit an annual filing to the commissioner that includes the number of policies in force, the number of homes that have installed a resilient roof system, the discount applied to homes due to the presence of a resilient roof system, and the wind and hail claims frequency and severity for homes with and without a resilient roof system.     $66,250 is appropriated from the legal services cash fund to the department of law to provide legal services to the department of regulatory agencies to implement the act. The appropriation is from revenue received from the department of regulatory agencies that is continuously appropriated to the department of regulatory agencies from the strengthen Colorado homes enterprise fund. The appropriation to the department of law is based on an assumption that the department of law will require an additional 0.3 FTE to implement the act.(Note: This summary applies to this bill as enacted.)

The act requires the nonemergency medical transportation broker (broker) to establish the transportation community advisory board (TCAB) and requires the state department of health care policy and financing (state department) to collaborate with the TCAB prior to establishing rules and processes for the safety and oversight of nonmedical transportation services and nonemergency medical transportation (NEMT) services.     The act requires, in collaboration with the TCAB, certain rules for NEMT the state department must adopt. The state department may impose trip caps or market-share restrictions on a transportation provider (provider) as part of corrective action plan. The act requires providers to use vehicles equipped with 2-way video cameras and a video recording system when transporting members.     The act establishes how the broker must roll out their implementation and requires the broker to provide all providers with software, a communication toolkit, training, and technical assistance to facilitate NEMT services. The broker may encourage medicaid members (members) to book transportation services at least 2 days before their requested transportation date, and the broker shall accept and make reasonable efforts to fulfill same-day and next-day transportation requests. The act requires providers, only after all service regions have been implemented, to accommodate member requests for preferred or alternate drivers when operationally feasible.     The act requires the broker, and, if there is no broker, the providers to verify that individuals using the transportation services are eligible members during the scheduling of transportation services. The act prohibits the broker from operating, owning, or controlling a provider in Colorado. The act requires the broker to provide their trip assignment rules and procedures to the state department for approval and for publication on the state department's website. The act allows a transportation network company to provide NEMT services when a provider is unavailable.     The state department shall ensure all transportation providers, drivers, and vehicles are credentialed, and services provided by noncredentialed drivers or in noncredentialed vehicles are not eligible for reimbursement. The act prohibits the state department from denying payment of services to providers if the provider provides scheduled transportation services in good faith based on the information provided by the broker or if the provider had no knowledge of an inaccuracy and the provider followed all applicable rules and procedures. Subject to available appropriations, the act requires the state department to audit providers and audit the broker annually.     The act requires the state department to categorize all NEMT expenditures as medical services and make changes to the NEMT program as necessary to obtain medical services federal match rates for NEMT services. The act also eliminates the requirement that the state department provide transportation services as an administrative cost.     The act reduces appropriations to the state department from the general fund by $76,639 and from the healthcare affordability and sustainability hospital provider fee cash fund by $20,941,853.(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.)

Maddy summaryThis bill updates how Colorado state colleges and universities receive performance-based funding starting in the 2027-28 fiscal year. It renames "performance funding" to "results-informed funding" and modifies the metrics used to calculate these funds, including graduation rates, student retention, and Pell-eligible student enrollment. The legislation also introduces a new definition for "co-located degree partnerships" and excludes students in these programs from certain graduation rate calculations. Additionally, the bill changes how funding components are ordered and removes requirements for sequential calculation of funding amounts.

After an individual has been discharged from a facility where an individual was held for an emergency mental health hold, current law requires the facility to attempt to follow up with the individual at least 48 hours after discharge. The act extends the time to attempt to follow up with the individual to 72 hours following discharge, excluding weekends and holidays.     The act restricts the behavioral health administration (BHA) from issuing or renewing a license for a behavioral health entity unless the BHA receives a certificate of compliance for the applicant's building or structure from the division of fire prevention and control. The act adds the following exceptions to this requirement:An applicant that provides only telehealth services is not required to receive a certificate of compliance; andAn applicant that provides only outpatient services may receive a certificate of compliance from the division of fire prevention and control based on inspections conducted by a fire department that employs a certified inspector rather than from the division of fire prevention and control.(Note: This summary applies to this bill as enacted.)

The act exempts Colorado courts' e-filing system from the requirement that users certify that they will not disclose personal identifying information obtained from the system for federal immigration enforcement.     The act authorizes a public health agency to inspect or examine a facility that houses or detains individuals who are noncitizens for purposes of civil immigration proceedings.     Under current law, the department of public health and environment is authorized to inspect facilities that house or detain individuals who are noncitizens for purposes of civil immigration proceedings. The act expands the inspection authority, including the frequency of inspections and things that are subject to inspection. A facility that refuses to allow the inspection is subject to a civil penalty. The department of public health and environment is authorized to set fees for inspections and deposit the money from the fees in the immigration facility inspection and detention cash fund, which is created in the state treasury.     The act authorizes the department of public health and environment to require facilities that house or detain individuals who are noncitizens for purposes of civil immigration proceedings to comply with requirements, including health and safety standards and reporting requirements. A facility that fails to comply is subject to a civil penalty. The act requires the department of public health and environment to submit an annual report to the attorney general concerning facilities' compliance with these new requirements and make the report publicly available on its website.     The act requires the P.O.S.T. board to establish training standards related to peace officer compliance with current laws concerning civil immigration detainers. P.O.S.T.-certified peace officers must complete the training before December 31, 2027.     The act requires the attorney general to develop and make publicly available a policy regarding current laws concerning the protection of personal identifying information.     The act appropriates $107,283 to the department of public health and environment from the immigration facility inspection and detention cash fund.(Note: This summary applies to this bill as enacted.)

The act gives county departments of human or social services and the Colorado department of human services (department) the statutory authority needed to conduct the required fingerprint-based criminal history record checks for individuals who provide out-of-home care for child-welfare-involved youth in accordance with the federal bureau of investigation's standards.     For the 2026-27 state fiscal year, the general assembly anticipates that the department will receive $350,000 in federal funds to implement the act, and $350,000 is appropriated to the office of the governor for use by the office of information technology to implement the act. The $350,000 appropriation is from reappropriated funds received from the department.(Note: This summary applies to this bill as enacted.)