C.R.S. Section 25.5-5-305
Pediatric hospice care

  • legislative declaration
  • federal authorization
  • rules
  • fund

(1)

Legislative declaration.

(a)

The general assembly finds and declares that:

(I)

The death of a child has a devastating and enduring impact on the child’s family;

(II)

Too often, children with fatal conditions and their families fail to receive compassionate and consistent care that meets their physical, emotional, and spiritual needs;

(III)

Better care is possible but current methods of organizing and financing palliative, end-of-life, and bereavement care impede the provision of services that are both more appropriate and more cost-efficient;

(IV)

Current federal medicaid regulations contain inherent barriers to providing appropriate palliative and end-of-life care to pediatric patients. These barriers include requirements that preclude the pursuit of curative treatments, mandate a do-not-resuscitate order, and require physician certification that death is expected within six months.

(b)

The general assembly declares that it is in the best interest of the state to investigate and implement hospice guidelines that provide appropriate, compassionate care to dying children and their families while proving to be cost-neutral or cost-saving to the state and federal medicaid programs.

(c)

The general assembly further finds and declares that, while this direction immediately concerns federal approval for hospice care that recognizes the distinct circumstances of children facing life-threatening illnesses and their families, it is the intent of the general assembly that the information and data produced as a result of this act shall be used to improve the delivery of palliative and end-of-life services to persons of all ages when such improvements can be made in a manner that is cost-neutral or cost-saving to the state.

(2)

Definitions.
As used in this section, unless the context otherwise requires:

(a)

“Eligible child” means a child who:

(I)

Is less than nineteen years of age; and

(II)

Is eligible for the state’s medicaid program pursuant to section 25.5-5-101, 25.5-5-201, or 25.5-5-203;

(b)

“Pediatric hospice care” means hospice care for eligible children as authorized in this section.

(3)

Pediatric hospice care.

(a)

Intentionally left blank —Ed.

(I)

The state department shall seek the appropriate federal authorization, conditioned on the receipt of gifts, grants, or donations sufficient to provide for the state’s administrative costs of preparing and submitting the request, for pediatric hospice care that shall include but may not be limited to:

(A)

Respite care;

(B)

Expressive therapies, as defined in rule by the state board;

(C)

Palliative care from the time of diagnosis of a potentially life-threatening illness; and

(D)

A continuum of care through the coordination of services, which may include skilled, intermittent, and around-the-clock nursing care.

(II)

The state department is authorized to seek federal approval for modifications to the provision of hospice care for adults who are eligible for the state’s medicaid program.

(b)

For the provision of pediatric hospice care, the state department shall seek an exemption from the following federal medicaid requirements for the eligibility of and election for hospice care:

(I)

The mandatory do-not-resuscitate order;

(II)

A physician’s certification that a patient is expected to live less than six months; and

(III)

The nonallowance of curative care therapies concurrent with palliative and hospice care.

(c)

In any application for federal authorization pursuant to this section, the state department shall retain bereavement services to the extent available under federal law.

(d)

Pediatric hospice care, as authorized pursuant to this section, shall meet aggregate federal waiver budget neutrality requirements.

(e)

The state department shall implement the provision of pediatric hospice care to the extent authorized by the federal government.

(4)

Review.
The state department shall notify the joint budget committee of the general assembly of the extent to which the state department received federal authorization for pediatric hospice care services pursuant to this section in order for the joint budget committee to review the approved budget neutrality analysis for such services prior to the state department’s implementation.

(5)

Rules.
The state department shall develop the service provisions for pediatric hospice care in consultation with medical professionals who have expertise in providing end-of-life and palliative care to pediatric patients and family members who have experienced the death of a child. The state board shall adopt rules necessary to implement and administer the provisions of this section.

(6)

Fund.
The state department is authorized to seek and accept gifts, grants, or donations from private or public sources for the purpose of providing for the administrative costs of preparing and submitting the request for federal approval for the provision of pediatric hospice care. All private and public funds received through gifts, grants, or donations shall be transmitted to the state treasurer, who shall credit the same to the pediatric hospice care cash fund, which fund is hereby created and referred to in this section as the “fund”. The moneys in the fund shall be subject to annual appropriation by the general assembly for preparing and submitting the request for federal approval pursuant to this section. Any moneys in the fund not expended for the purpose of this section may be invested by the state treasurer as provided by law. All interest and income derived from the investment and deposit of moneys in the fund shall be credited to the fund. Any unexpended and unencumbered moneys remaining in the fund at the end of a fiscal year shall remain in the fund and shall not be credited or transferred or revert to the general fund or another fund.

Source: Section 25.5-5-305 — Pediatric hospice care - legislative declaration - federal authorization - rules - fund, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-25.­5.­pdf (accessed Oct. 20, 2023).

25.5‑5‑101
Mandatory provisions - eligible groups - rules - repeal
25.5‑5‑102
Basic services for the categorically needy - mandated services
25.5‑5‑103
Mandated programs with special state provisions - rules
25.5‑5‑104
Qualified medicare beneficiaries
25.5‑5‑105
Qualified disabled and working individuals
25.5‑5‑201
Optional provisions - optional groups - rules - repeal
25.5‑5‑202
Basic services for the categorically needy - optional services
25.5‑5‑203
Optional programs with special state provisions - repeal
25.5‑5‑204
Presumptive eligibility - pregnant person - children - long-term care - state plan
25.5‑5‑204.5
Continuous eligibility - children
25.5‑5‑206
Medicaid buy-in program - disabled children - disabled adults - federal authorization - rules
25.5‑5‑207
Adult dental benefit - adult dental fund - creation - legislative declaration
25.5‑5‑208
Additional services - training - grants - screening, brief intervention, and referral
25.5‑5‑301
Clinic services
25.5‑5‑302
Clinic services - children and pregnant women - utilization of certain providers
25.5‑5‑303
Private-duty nursing
25.5‑5‑304
Hospice care
25.5‑5‑305
Pediatric hospice care - legislative declaration - federal authorization - rules - fund
25.5‑5‑307
Child mental health treatment and family support program
25.5‑5‑308
Breast and cervical cancer prevention and treatment program - creation - legislative declaration - definitions - funds - repeal
25.5‑5‑309
Pregnant women - needs assessment - referral to treatment program - definition
25.5‑5‑310
Treatment program for high-risk pregnant and parenting women - cooperation with private entities - definition
25.5‑5‑311
Treatment program for high-risk pregnant and parenting women - data collection
25.5‑5‑312
Treatment program for high-risk pregnant and parenting women - extended coverage - federal approval
25.5‑5‑314
Substance use disorder treatment for Native Americans - federal approval
25.5‑5‑315
Acceptance of gifts, grants, and donations - Native American substance abuse treatment cash fund
25.5‑5‑316
Legislative declaration - state department - disease management programs authorization - report
25.5‑5‑318
Health services - provision by school districts - repeal
25.5‑5‑319
Family planning pilot program - rules - federal waiver - repeal
25.5‑5‑320
Telemedicine - reimbursement - disclosure statement - rules - definition
25.5‑5‑321
Telemedicine - home health care - home health telemedicine cash fund - rules - repeal
25.5‑5‑321.5
Telehealth - interim therapeutic restorations - reimbursement - definitions
25.5‑5‑322
Over-the-counter medications - rules
25.5‑5‑323
Complex rehabilitation technology - no prior authorization - metrics - report - rules - legislative declaration - definitions
25.5‑5‑324
Nonemergency medical transportation - urgent and secure transportation need - report - repeal
25.5‑5‑325
Residential and inpatient substance use disorder treatment - medical detoxification services - federal approval - performance review report
25.5‑5‑326
Access to clinical trials - definitions
25.5‑5‑327
Eligible peer support services - reimbursement - definitions
25.5‑5‑328
Secure transportation for behavioral health crises - benefit - funding
25.5‑5‑329
Family planning services - federal authorization - rules - definitions
25.5‑5‑330
Screening for perinatal mood and anxiety disorder
25.5‑5‑331
Federally qualified health center - clinical pharmacy services - reimbursement - rules
25.5‑5‑332
Therapy using equine movement - federal authorization - definition
25.5‑5‑333
Primary care and behavioral health statewide integration grant program - creation - report - definition - repeal
25.5‑5‑334
Community health worker services - federal authorization - reporting - rules - definition
25.5‑5‑335
Continuous medical coverage for children and adults feasibility study - federal authorization - rules - report - definition
25.5‑5‑336
Prohibition on using the body mass index or ideal body weight - medical necessity criteria
25.5‑5‑401
Short title
25.5‑5‑402
Statewide managed care system - rules - definitions - repeal
25.5‑5‑403
Definitions
25.5‑5‑406.1
Required features of statewide managed care system
25.5‑5‑408
Capitation payments - availability of base data - adjustments - rate calculation - capitation payment proposal - preference - assignment of medicaid recipients - definition
25.5‑5‑410
Data collection for managed care programs
25.5‑5‑412
Program of all-inclusive care for the elderly - services - eligibility - legislative declaration - rules - definitions
25.5‑5‑414
Telemedicine - legislative intent
25.5‑5‑415
Medicaid payment reform and innovation pilot program - legislative declaration - creation - selection of payment projects - report - rules
25.5‑5‑418
Primary care provider sustainability fund - creation - use of fund
25.5‑5‑419
Accountable care collaborative - reporting - rules
25.5‑5‑420
Advancing care for exceptional kids
25.5‑5‑421
Parity reporting - state department - public input
25.5‑5‑422
Medication-assisted treatment - limitations on MCEs - definition
25.5‑5‑423
Independent review organization - review denial of residential and inpatient substance use disorder treatment claims - contract
25.5‑5‑424
Residential and inpatient substance use disorder treatment - MCE standardized utilization management process - medical necessity - report
25.5‑5‑425
Audit of MCE denials for residential and inpatient substance use disorder treatment authorization - report
25.5‑5‑500.3
Authorization to bill third party
25.5‑5‑501
Providers - drug reimbursement
25.5‑5‑502
Unused medications - reuse - rules - definition
25.5‑5‑503
Prescription drug benefits - authorization - dual-eligible participation
25.5‑5‑504
Providers of pharmaceutical services
25.5‑5‑505
Prescribed drugs - mail order - rules
25.5‑5‑506
Prescribed drugs - utilization review
25.5‑5‑507
Prescription drug information and technical assistance program - rules
25.5‑5‑509
Substance use disorder - prescription drugs - opiate antagonist
25.5‑5‑510
Pharmacy reimbursement - substance use disorder - injections
25.5‑5‑511
Reimbursement for pharmacists’ services - legislative declaration
25.5‑5‑512
Pharmacy benefit - mental health and substance use disorders - legislative declaration
25.5‑5‑513
Pharmacy benefits - prescription drugs - rebates - analysis
25.5‑5‑514
Prescription drugs used for treatment or prevention of HIV - prohibition on utilization management - definition
25.5‑5‑515
Pharmacy reimbursement - vaccine administration to children - legislative declaration
25.5‑5‑516
Serious mental illness - prescribed drugs
25.5‑5‑801
Legislative declaration
25.5‑5‑802
Definitions
25.5‑5‑803
High-fidelity wraparound services for children and youth - federal approval - reporting
25.5‑5‑804
Integrated funding pilot
Green check means up to date. Up to date

Current through Fall 2024

§ 25.5-5-305’s source at colorado​.gov