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.)
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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.)
Effective July 1, 2025, the act repeals the natural disaster grant fund from which awards were granted to local governments for improvements to domestic wastewater treatment works or public drinking water systems that were impacted by a natural disaster. (Note: This summary applies to this bill as enacted.)
The act defines an "equestrian zone" as an area that a municipality or county determines is suburban or urban and contains: Public equestrian venues; Residential neighborhoods that are equestrian centric and were zoned in such a manner as to allow housing privately owned equines but are now being developed for primarily residential use or that are zoned in such a manner as to allow housing privately owned equines; Keystone properties that have equestrian facilities that have boarding facilities for equines, training for equestrians, equine service and education programs, equine stables that facilitate animal welfare rescue programs or equine therapy programs, breeding facilities for equines, or nonpublic equestrian venues that provide services to the equestrian community; or Roads or trails that equestrians regularly use and that are related to the areas described above. The act authorizes municipalities and counties to: Construct and maintain equestrian road crossings or horse-trailer parking necessary to access equestrian trails and install signs that notify the public of the infrastructure; Identify locations where equestrian road crossings are needed to safely use horse trails, construct and maintain the equestrian road crossings in those places, and install signs notifying the public of the crossings; Publish a map showing the location and character of existing or proposed equestrian infrastructure; Erect road signs bearing the universal equestrian sign symbol and the words "wide and slow" in equestrian zones; and Identify and show the location and character of existing or proposed equestrian infrastructure, venues, and riding zones on master plans. A municipality or county may organize public events to educate the public about equestrian use of recreational trails and roads and the duties of users of trails and roads with regard to equestrian users. The chief of the Colorado state patrol is authorized to educate sheriffs and local law enforcement about equestrian safety. The department of revenue is given the duty of adopting rules to add equestrian safety to driver's education curricula. (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 exempts an assisted living residence that has not undergone new construction or major renovations from complying with the facility guideline institute guidelines. The department of health care policy and financing (state department) must establish a process for reviewing and updating the general billing manual on an annual basis and ensure that the general billing manual includes all necessary CPT codes or links to the state department's list of CPT codes. The act allows the Colorado healthcare affordability and sustainability enterprise to receive public funds. Beginning January 1, 2026, for claims that must be reprocessed as a result of updating the provider rates, the act requires a managed care organization to issue payment to a contracted provider within one year after the provider rate is updated. The state department must notify the managed care organizations of changes to the provider rates within 60 days of changing the provider rates. The act requires the state department to include in each new contract with, or renewal of a contract with, a managed care entity (MCE) a provision requiring the MCE to submit to the state department, on an annual basis, the amount the MCE is paid and the MCE's medical loss ratio. The state department is required to publish this information, as well as historical medical loss ratio data for each MCE, and publish on an annual basis audit findings regarding an MCE's most recently completed medical loss ratio audit on the state department's website. The act prohibits the state department from imposing signature requirements on a physician or practitioner certifying a medicaid member's (member) plan of care that involves physical therapy, occupational therapy, or speech therapy. The act requires that for members receiving home- and community-based services, if a service the member receives is discontinued or no longer a covered service, the state department must confirm the timeline for the continuity of treatment with the federal centers for medicare and medicaid during the transition period of the benefit or service being discontinued and must communicate that timeline to the member impacted by the benefit or service being discontinued. (Note: This summary applies to this bill as enacted.)
The act prevents a pharmacy benefit manager (PBM) from prohibiting a rural independent pharmacy from using a private courier or a delivery service to deliver a prescription drug to a patient. A PBM is required to reimburse a rural independent pharmacy for a prescription drug in an amount not less than the national average drug acquisition cost for the dispensed prescription drug ingredients, plus pay a dispensing fee. When a PBM conducts an audit of a rural independent pharmacy and the audit results in a recoupment of more than $1,000 or a penalty of more than $1,000, the PBM must: Electronically notify the rural independent pharmacy of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds; If the rural independent pharmacy does not respond to the electronic notification within 30 days after the electronic notification, again electronically notify the rural independent pharmacy of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds; and If the rural independent pharmacy does not respond to the second electronic notification within 30 days after the second electronic notification, serve process on the rural independent pharmacy notifying of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds. The act allows a rural independent pharmacy to operate without being under the direct charge of a pharmacist if the initial interpretation and final evaluation of the prescription is done by a state-licensed pharmacist in person or remotely. (Note: This summary applies to this bill as enacted.)
The act authorizes the department of health care policy and financing (HCPF) to seek and accept gifts from private or public sources for the primary care fund. The act authorizes a federally qualified health center (FQHC) to establish a separate subsidiary company for the purpose of providing fee-for-service services outside of the FQHC's standard cost report if the subsidiary is providing fee-for-service services that have historically been provided and reimbursed on a fee-for-service basis and if HCPF determines that the subsidiary's reimbursements would be budget neutral. Upon receiving any necessary federal authorization, HCPF is required to reimburse a subsidiary of an FQHC on a fee-for-service basis for services that are eligible for fee-for-service reimbursement. A subsidiary that receives reimbursement is authorized to pass through money received from the reimbursement directly to the FQHC operating as the subsidiary's parent corporation. Services reimbursed to an FQHC's subsidiary are excluded from the FQHC's cost report. The act requires HCPF to exclude all costs associated with a subsidiary company from the calculation of a FQHC's reimbursement rates and requires a FQHC that establishes a separate subsidiary company to include the costs associated with the subsidiary in its cost report that is necessary to calculate reimbursement rates. (Note: This summary applies to this bill as enacted.)
The Tony Grampsas youth services grant program (grant program) provides grants to community-based programs to reduce incidents of youth crime and violence. The youth mentoring program, the student dropout prevention and intervention program, and the student before-and-after school project (collectively, the "programs") were created within the grant program. The act repeals the individual programs and instead lists the programs as allowable uses for grant money under the grant program. The act transfers certain responsibilities from the Tony Grampsas youth services board (board) to the department of human services (department). The act repeals local public-to-private funding match requirements. The act requires each entity that receives a grant to annually report certain information to the department; except that an entity that has an operating budget of less than $1.5 million, or that receives a grant in the amount of not more than $25,000, is not required to report on the outcomes achieved by the services provided and the methods used to track the outcomes. The act decreases the appropriation from the marijuana tax cash fund to the youth mentoring services cash fund by $500,000 and reappropriates the money to the grant program by $500,000. The act decreases the appropriation from the youth mentoring services cash fund to the grant program by $504,120. (Note: This summary applies to this bill as enacted.)
The act extends the achieving a better life experience state income tax deduction (ABLE deduction) until December 31, 2030. The act specifies that the purposes of the ABLE deduction are to provide support to individuals with disabilities and their families and to provide an incentive for individuals with disabilities and their families to set aside money in an account to cover future disability-related expenses. (Note: This summary applies to this bill as enacted.)