Sen. Tony Exum

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.)

The act creates the provider stabilization fund for use by Colorado department of health care policy and financing (department) to distribute provider stabilization payments to safety net providers who provide services to low-income, uninsured individuals on a sliding-fee schedule or at no cost. Provider stabilization payments will be distributed to eligible safety net providers based on the proportion of low-income, uninsured individuals that an individual provider serves in comparison to the total number of low-income, uninsured individuals served by all eligible safety net providers. The state treasurer is directed to make an interest-free loan of interest earnings on the principal in the unclaimed property trust fund (UPTF) and, if the interest earnings are insufficient, from the principal of the UPTF as well, to the provider stabilization fund as follows: $25 million for the 2025-26 state fiscal year; $20 million for the 2026-27 state fiscal year; and $15 million for each of the 2027-28, 2028-29, and 2029-30 state fiscal years. The act specifies that the loan from the UPTF to the provider stabilization fund is an interfund loan that is not classified as revenue, is booked as an interfund receivable or payable, is not state fiscal year spending or state revenues, and does not count against the state fiscal year spending limit or the excess state revenues cap. The department is directed to repay the loan by January 1, 2045, but in any year in which state revenues do not exceed the limit on state fiscal year spending, the department must present to the joint budget committee a proposal to repay all or a portion of the loan at an earlier time, and to the extent possible, the general assembly must prioritize repaying the loan starting in the 2030-31 state fiscal year or sooner if funds are available. The provider stabilization fund also consists of any money the general assembly appropriates, transfers, or credits to the fund and any gifts, grants, or donations the department may receive for the fund. The act directs the department to leverage money in the provider stabilization fund to obtain federal matching money. The act establishes a provider stabilization fund advisory board (advisory board) to assist the department in implementing and administering the provider stabilization fund. The department, with assistance from the advisory board, is required to submit an annual report on the provider stabilization fund to specified committees, the governor, and the medical services board in the department. The advisory board is scheduled for repeal on September 1, 2031, and is subject to a sunset review by the department of regulatory agencies before the repeal. The act appropriates $25,000,000 from the provider stabilization fund to the department to implement the act, allocated as follows: $138,505 for personal services to administer the act, including 2.0 FTE; $15,900 for operating expenses; and $24,845,595 for provider stabilization payments to eligible safety net providers.(Note: This summary applies to this bill as enacted.)

The act creates the American Indian affairs interim committee (committee). The purpose of the committee is to examine issues and challenges that impact American Indian Tribal Nations. The committee consists of 6 voting members of the general assembly who serve for the duration of the committee unless they resign, are removed, or are no longer in office and 2 nonvoting members, one from the Southern Ute Indian Tribe and one from the Ute Mountain Ute Tribe. The act allows the committee to meet up to 6 times and recommend up to 5 bills during each interim, but the committee does not meet or recommend legislation during the 2025 interim. On or before January 15, 2031, the act requires the committee to submit a report to the executive committee of the legislative council summarizing the work of the committee during the preceding 5 years. The committee is repealed, effective June 30, 2031. (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.)

The act implements recommendations made by the direct care workforce stabilization board (board) by: Requiring the board to investigate health-care benefits for the direct care workforce; Requiring the department of labor and employment (department) to collaborate with the board and other entities to establish a comprehensive "know your rights" training for direct care workers; Requiring the department to ensure that the "know your rights" training is available to direct care workers, to allow worker organizations to participate in the training free of charge, and to report direct care worker training completion information to the board; and Requiring direct care employers to document each direct care worker's completion of the "know your rights" training. The act also requires the director of the division of labor standards and statistics (director) in the department to provide compliance assistance to direct care employers and investigate possible violations by the direct care employers. The director is also required to enforce compliance with the requirements in the act. To implement the board's recommendations, the act also requires the department of health care policy and financing to: In collaboration with the board, establish a website and communication platform for direct care workers and develop a direct care worker-specific notice of rights for direct care employers; Collaborate with direct care employers to inform direct care workers about the website and communication platform; and Allow specified entities access to the contact information of each direct care worker enrolled in the communication platform. For the 2025-26 state fiscal year, the act appropriates $120,105 to the department of health care policy and financing based on an assumption that the department of health care policy and financing will receive certain federal funding. Also for the 2025-26 state fiscal year, the act appropriates $168,459 to the department of labor and employment for use by the division of labor standards and statistics. (Note: This summary applies to this bill as enacted.)

Infusion pharmacies supply medicaid members with parenteral nutrition, which provides patients with essential nutrients through an intravenous infusion. The act requires the state department of health care policy and financing (state department) to create specific professional dispensing fees for the preparation and dispensing of parenteral nutrition (fees) to encourage an adequate level of market participation among infusion pharmacies that serve medicaid members. During the year beginning January 1, 2026, the fees must not exceed 30% of infusion pharmacy administrative costs for the preparation and dispensing of parenteral nutrition. The state department shall seek federal authorization, as necessary, to implement the fees. The act requires the state department to annually report on the adequacy of the infusion pharmacy network that supplies parenteral nutrition to medicaid members. For the 2025-26 state fiscal year, the act appropriates $54,832 to the state department from the general fund. The state department may use the appropriation for medical and long-term care services for medicaid-eligible individuals. The general assembly anticipates that the state department will receive an equal amount in federal funds to implement the act. (Note: This summary applies to this bill as enacted.)

Embodied carbon is the carbon associated with greenhouse gas emissions arising from the production, construction, use, and end-of-life of products or systems used in the construction of buildings, roads, and other infrastructure. Section 1 of the act adds embodied carbon improvements to the list of new energy improvements that are eligible for property-assessed clean energy financing provided by the Colorado new energy improvement district. An embodied carbon improvement is one or more installations or modifications to real property using eligible materials that result in the reduction of the installation's or modification's embodied carbon emissions. Section 2 modifies the industrial clean energy tax credit so that embodied carbon investments are greenhouse gas emissions reduction improvements that, if certified, are eligible for the credit for a portion of the capital costs incurred in placing them in service. An embodied carbon investment is one that results in a 15% or greater reduction in cradle-to-gate embodied emissions of eligible materials when compared to the eligible materials' cradle-to-gate baseline. (Note: This summary applies to this bill as enacted.)

The act reorganizes and updates statutes pertaining to the duties of the office of the child protection ombudsman (office) and the child protection ombudsman (ombudsman). The act: Clarifies when the ombudsman may receive and conduct an independent and impartial investigation of complaints concerning child protection services; Clarifies the types of information, documents, or records that the ombudsman does and does not have access to; Reorganizes statutes that pertain to when an ombudsman investigates a complaint; Reorganizes statutes that pertain to the ombudsman's duties; Reorganizes and creates a new provision that pertains to the office's access to information necessary to conduct an independent review of a complaint; Reorganizes and creates a new provision focused on the office's and ombudsman's duty to confidentiality; and Provides the office access to residential child care facilities and facilities established and operated by the department of human services (facilities). The office may only access facilities in coordination with the facility directors in response to a request from a child or youth residing in the facility; in response to a request from a child's or youth's family member, caregiver, or other concerned individual; or to distribute materials created by the office informing children or youth on how to access the office, the office's services, and how to file a complaint with the office.(Note: This summary applies to this bill as enacted.)