The act renames the existing "health disparities grant program" as the "health disparities and community grant program" (program) and expands the program to authorize the office of health equity (office) to:Award grants from money currently transferred from the prevention, early detection, and treatment fund to the health disparities grant program fund (fund) for the purpose of positively affecting social determinants of health to reduce the risk of future disease and exacerbating health disparities in underrepresented populations; and Award grants from any additional money appropriated by the general assembly to the fund to community organizations to reduce health disparities in underrepresented communities through policy and systems changes regarding the social determinants of health. On or before July 1, 2022, and continuing every 2 years thereafter, the department of public health and environment (department), in collaboration with the health equity commission and other stakeholders, is required to conduct an assessment and publish a report concerning health disparities and inequities that includes an assessment of the impact of social determinants of health on health disparities and inequities and recommended strategies to begin to address such inequities.Within 6 months after the publication of the department's first report, the governor is required to convene the health equity commission to develop an equity strategic plan and to ensure that there is coordination in equity-related work across state agencies to address the social determinants of health. Additional state agencies are added to and required to participate on the commission and are required to develop an equity strategic plan in the agency's respective area.$4,872,818 is appropriated to the department for use by the office of health equity to implement the act. Of the total amount appropriated, $4,821,035 is from the general fund and $51,783 is from the health disparities grant program fund.(Note: This summary applies to this bill as enacted.)
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The act directs the department of health care policy and financing (department) to develop a spending plan (spending plan) for using enhanced, one-time federal matching money received pursuant to the "American Rescue Plan Act of 2021" (federal act) to enhance, expand, and strengthen medicaid-eligible home- and community-based services for older adults and people with disabilities.The department shall develop a proposed spending plan considering feedback from providers, medical assistance recipients, and advocates consistent with federal guidance on allowable uses of the federal act funding. Money from the federal act may be used for home- and community-based services, as defined in the federal act, including home health-care services, personal care services, PACE services, waiver services, case management services, and rehabilitative services. The act specifies possible components of the spending plan. The department shall submit the proposed spending plan to the joint budget committee of the general assembly for approval. The joint budget committee may reject or approve the spending plan and may make recommendations for modifications to the spending plan. If the spending plan is rejected, the department shall submit a new spending plan as soon as possible. The department shall not implement the spending plan unless the spending plan is approved by the joint budget committee.The act authorizes the department to make expenditures identified in the spending plan approved by the joint budget committee; except that the spending authority expires if a supplemental appropriation bill is enacted. During the next legislative session, the joint budget committee shall introduce a supplemental appropriation bill for the amount of the expenditures authorized. For fiscal years commencing on and after July 1, 2021, the general assembly may also appropriate money for purposes authorized under the federal act. The act repeals the statutory provisions effective July 1, 2025. Commencing November 1, 2021, and quarterly thereafter, the act requires the department to submit expenditure reports with additional information specified in the act concerning the use of the money received pursuant to the federal act.The act transfers $260,730,099 from the general fund to the home- and community-based services improvement fund, created in the act, and $19,830,918 from the ARPA home- and community-based services account, created in the act, in the healthcare affordability and sustainability fee cash fund to implement the spending plan.(Note: This summary applies to this bill as enacted.)
The act creates the legislative interim committee on school finance (interim committee). The interim committee will meet during the 2021 and 2022 legislative interims and during the 2022 and 2023 legislative sessions to approve legislation. The committee consists of 4 senators and 4 representatives with equal representation from each party. The act specifies the issues the interim committee must consider. The interim committee may introduce up to a total of 5 bills, joint resolutions, and concurrent resolutions in each of the 2022 and 2023 legislative sessions. The interim committee will contract with a qualified third-party vendor to study approaches to better measure student economic disadvantage in Colorado in addition to or in lieu of using eligibility for the federal school lunch program as a proxy for at-risk students.The act appropriates $100,153 from the general fund to the legislative department to implement the act.(Note: This summary applies to this bill as enacted.)
During the 2020 regular legislative session, the general assembly enacted Senate Bill 20-123 concerning the rights of college athletes, and, in connection therewith, establishing their right to receive compensation for the use of their names, images, and likenesses and their right to obtain professional and legal representation. The governor subsequently signed Senate Bill 20-123 into law.Senate Bill 20-123 was enacted with an effective date of January 1, 2023. The act changes this effective date to July 1, 2021.(Note: This summary applies to this bill as enacted.)
The act requires a health benefit plan issued or renewed on or after January 1, 2023, to provide a cost-sharing benefit for nonpharmacological treatment where an opioid might be prescribed. The required cost-sharing benefit must include a cost-sharing amount not to exceed the cost-sharing amount for a primary care visit for nonpreventive services, at least 6 physical therapy visits, 6 occupational therapy visits, 6 chiropractic visits, and 6 acupuncture visits per year. The division of insurance (division) is required to submit to the federal department of human services a determination as to whether the cost-sharing benefit is in addition to an essential benefit and subject to defrayal by the state pursuant to federal law and a request for confirmation of the determination. The division is required to implement the benefit only if the benefit does not constitute an additional benefit that requires a defrayal.The act requires an insurance carrier (carrier) that provides prescription drug benefits to provide coverage, beginning January 1, 2023, for at least one atypical opioid that is approved by the federal food and drug administration (FDA) for the treatment of acute or chronic pain, which coverage must be at the lowest cost-sharing tier of the carrier's formulary with no requirement for step therapy or prior authorization. Additionally, a carrier cannot require step therapy for any additional FDA-approved atypical opioids.The act precludes a carrier that has a contract with a physical therapist, occupational therapist, chiropractor, or acupuncturist from:Prohibiting the physical therapist, occupational therapist, chiropractor, or acupuncturist from, or penalizing the physical therapist, occupational therapist, chiropractor, or acupuncturist for, providing a covered person information on the amount of the covered person's financial responsibility for the covered person's physical therapy, occupational therapy, chiropractic services, or acupuncture services; or Requiring the physical therapist, occupational therapist, chiropractor, or acupuncturist to charge a covered person an amount or collect a copayment from a covered person that exceeds the total charges submitted to the carrier by the physical therapist, occupational therapist, chiropractor, or acupuncturist. The commissioner of insurance is required to take action against a carrier that the commissioner determines is not complying with these prohibitions.Current law limits specified prescribers from prescribing more than a 7-day supply of an opioid to a patient who has not obtained an opioid prescription from that prescriber within the previous 12 months unless certain conditions apply. This prescribing limitation is set to repeal on September 1, 2021.The act continues the prescribing limitation indefinitely.The also requires the applicable board for each prescriber to promulgate rules that limit the supply of a benzodiazepine, which is a sedative commonly prescribed for anxiety and as a sleep aid, that a prescriber may prescribe to a patient who has not had a prescription for a benzodiazepine in the last 12 months, except for benzodiazepines prescribed to treat specific disorders or conditions.The act continues indefinitely the requirement that a health-care provider query the prescription drug monitoring program (program) before prescribing an opioid, including a benzodiazepine, and changes current law to require the query on every prescription fill, not just the second fill. This section also requires a practitioner to query the program before prescribing a benzodiazepine unless it is to treat a specific disorder or condition.In addition to current law allowing medical examiners and coroners to query the program when conducting an autopsy, section 16 allows medical examiners and coroners to query the program when conducting a death investigation.The act also authorizes the state board of pharmacy to provide a means of sharing prescription information from the program with the health information organization network in order to work collaboratively with statewide health information exchanges designated by the department of health care policy and financing.The act requires the center for research into substance use disorder prevention, treatment, and recovery support strategies to include in its continuing education activities the best practices for prescribing benzodiazepines and the potential harm of inappropriately limiting prescriptions to chronic pain patients and makes an appropriation for this purpose.The act directs the office of behavioral health in the department of human services to convene a collaborative with institutions of higher education, nonprofit agencies, and state agencies for the purpose of gathering feedback from local public health agencies, institutions of higher education, nonprofit agencies, and state agencies concerning evidence-based prevention practices.$382,908 is appropriated to the department of human services for use by the office of behavioral health. $13,000 is appropriated to the department of regulatory agencies for use by the division of insurance. $215,207 is appropriated to the department of regulatory agencies.(Note: This summary applies to this bill as enacted.)
The act creates a work group that is tasked with developing a sustainable model that is not embedded in the child welfare system to better serve students. The act outlines membership in the work group, duties of the work group, and reporting requirements for the work group and commissioner of education.The act requires, in state fiscal year 2021-22 only, and within available appropriations, that the department of education distribute supplemental payments to facility schools approved by the department as of October 1, 2021. The supplemental payments must be above and beyond the current daily per pupil revenue rate as established for the 2021-22 state fiscal year.For the 2021-22 state fiscal year, the act appropriates $6,200,000 to the department of education from the general fund for the facility school work group and supplemental payments to facility schools.(Note: This summary applies to this bill as enacted.)
The act requires the state department of human services (state department), beginning in state fiscal year 2024-25, to use the child welfare allocations funding model (funding model) to determine the capped and targeted allocations for child welfare services and the funding required for adoption and relative guardianship subsidies, the independent living program, additional county child welfare staff, and family and children's programs.The funding model determines the appropriate level of funding required to fully meet all state and federal requirements concerning the comprehensive delivery of child welfare services. The act clarifies what must be included in the funding model and requires the state department and the child welfare allocations committee to annually submit a report on the funding model to the joint budget committee.The state department is required to enter into a 3-year agreement with an outside entity to annually modify the funding model based on recommendations from the child welfare allocations committee and evaluations and deliver the results of the model each year. The act requires a child welfare workload study to inform the funding model. To maintain the integrity of the data used in the funding model, the child welfare allocations committee annually examines county practices regarding data collection and financial management, an evaluation group annually evaluates the funding model, and, every 3 years, an outside evaluating entity conducts a comprehensive evaluation of the implementation of the funding model.The act includes a $250,000 appropriation to the state department.(Note: This summary applies to this bill as enacted.)
The act makes several changes to the current child welfare system, including:Ensuring that out-of-home placements in the division of youth services align with the requirements of the federal "Family First Prevention Services Act of 2018" to qualify for Title IV-E reimbursement for such placements; Ensuring appropriate capacity for out-of-home placements in Colorado; Authorizing a county to negotiate rates above the base anchor rates established by the department of human services (department) with licensed out-of-home placement providers serving children in higher acuity cases; Requiring the department to contract with a vendor to update the existing actuarial analysis to include division of youth services out-of-home placement providers and new out-of-home placement provider options under federal law, and to update and fully implement the existing rate methodology with the updated provider rates by September 30, 2021; Commencing with the 2022-23 fiscal year, requiring the department to contract with an independent vendor every 3 years to conduct a new actuarial analysis of all provider rates for licensed out-of-home placement providers, including the division of youth services providers, to update the rate-setting methodology to reflect the new actuarial analysis and to implement any adjusted provider rates by July 1, 2024, and by July 1 of each fiscal year immediately following the fiscal year in which a new actuarial analysis results in adjusted rates; and Requiring the use of a portion of the federal "Family First Transition and Support Act of 2019" funding to be used to support the transition of current providers to a placement option that meets the needs of the child or youth and maximizes federal Title IV-E and medicaid reimbursements. The act requires the department to convene a working group of geographically and demographically diverse partners and stakeholders to provide feedback and recommendations regarding the collection of fees for the residential care of children or youth in out-of-home placement who are not adjudicated dependent or neglected, ensuring compliance with federal law, including but not limited to Title IV of the federal "Social Security Act". On or before March 31, 2022, the department shall submit a report of the recommendations of the working group to select committees of the general assembly.The act appropriates $250,000 to the department from the general fund for use by the child welfare division for provider rate actuarial services.(Note: This summary applies to this bill as enacted.)
The act requires county departments of human or social services to apply for the children's habilitation residential program (CHRP) waiver for children with intellectual and developmental disabilities who are referred for placement in the program and show proof of enrollment or denial of eligibility to the department of human services when they apply for placement in CHRP. The act does not guarantee a placement if the child is enrolled in CHRP.For the 2021-22 state fiscal year, the act appropriates $1,162,912 to the department of human services for use by the division of child welfare. This appropriation is from the general fund and is based on an assumption that the division will require an additional 0.5 FTE. To implement this act, the division may use this appropriation for residential placements for children with intellectual and developmental disabilities. Any money appropriated in this section not expended prior to July 1, 2022, is further appropriated to the division for the 2022-23 state fiscal year for the same purpose.(Note: This summary applies to this bill as enacted.)
The act creates the revenue loss restoration cash fund (fund). The state treasurer is required to transfer $1 billion from the "American Rescue Plan Act of 2021" cash fund to the fund. This amount is a portion of the money that the state receives from the federal coronavirus state fiscal recovery fund that represents the state's revenue loss as calculated under United States department of treasury guidelines.The general assembly may appropriate or transfer money from the fund to a department for the provision of government services, including kindergarten through twelfth grade public education, housing, state employees, asset maintenance, seniors, criminal justice, state parks, agriculture, and transportation infrastructure. On and after January 1, 2022, the general assembly may only appropriate money from the fund through the annual general appropriation act or a supplemental appropriation act. The money in the fund is allocated to be used over the next 3 fiscal years.(Note: This summary applies to this bill as enacted.)