C.R.S. Section 25.5-6-704
Implementation of home- and community-based services program for persons with brain injury authorized

  • federal waiver
  • duties of the department
  • rules
  • repeal

(1)

Intentionally left blank —Ed.

(a)

The state department is hereby authorized to seek any necessary waiver from the federal government to develop and implement a home- and community-based services program for persons with brain injury. The state department shall design the program to provide home- and community-based services to eligible persons. Eligibility shall be limited to persons who meet the level of services provided in a hospital, rehabilitation hospital, hospital in lieu of nursing facility care, or who are in need of specialized care provided in a nursing facility in lieu of a hospital.

(b)

The state department shall seek any necessary amendments to the current federal waiver for the home- and community-based services program for persons with brain injury to allow supported living, as defined in section 25.5-6-703 (8), to be provided to eligible persons on a supportive care campus.

(2)

Services for eligible persons may be established in department rules to the extent authorized or required by federal waiver, but must include at least the following:

(a)

Independent living skills training, as indicated in the eligible person’s plan of care, and provided by local agencies determined by the department to be qualified to provide the services;

(b)

Residential care including, but not limited to:

(I)

Transitional living;

(II)

Respite care;

(III)

Supported living;

(c)

Intentionally left blank —Ed.

(I)

Personal care services;

(II)

This subsection (2)(c) is repealed, effective July 1, 2025.

(d)

Assisted transportation;

(e)

Counseling and training including treatment for substance use disorders and family counseling;

(f)

Environmental modification services;

(g)

Day care, which may include physical, occupational, and speech therapies as indicated in the eligible person’s plan of care;

(h)

Structured day treatment, which may include physical, occupational, speech, and cognitive therapies if deemed necessary by the eligible person’s case manager and as indicated in the person’s plan of care. Structured day treatment services are for individuals who may benefit from continued rehabilitation and reintegration into the community.

(i)

Behavioral programming that may be provided in or outside an eligible person’s residence;

(j)

Assistive technology;

(k)

Intentionally left blank —Ed.

(I)

Services provided under the consumer-directed care service model, part 11 of this article.

(II)

This subsection (2)(k) is repealed, effective July 1, 2025.

(3)

The case manager, in coordination with the eligible person and the person’s family or guardian, shall include in each plan of care a process by which the eligible person may receive necessary care, which may include respite care, if the eligible person’s family or service provider is unavailable due to an emergency situation or to unforeseen circumstances. The eligible person and the person’s family or guardian shall be duly informed by the case manager of these alternative care provisions at the time the plan of care is initiated.

(4)

Intentionally left blank —Ed.

(a)

The department shall provide a system of reimbursement for services provided pursuant to this part 7 that encourages the most cost-effective provision of services.

(b)

A member of an eligible person’s family, other than the person’s spouse or a parent of a minor, may be employed to provide personal care services to such person. The maximum reimbursement for the services provided by a member of the person’s family per year for an eligible person shall not exceed the equivalent of four hundred forty-four service units per year for a member of the eligible person’s family. Standards that apply to other providers who provide personal care services apply to a family member who provides these services. In addition, a registered nurse shall supervise a family member in providing services to the extent indicated in the eligible person’s plan of care.

(5)

The state department shall, subject to appropriation, use available federal, state, local, or private funds including, but not limited to, medicaid funds available under Title XIX of the federal “Social Security Act”, as amended, to carry out the purposes of this part 7.

(6)

The state board shall adopt rules concerning the certification of agencies as medicaid providers for the purposes of this part 7, fiscal and administrative procedures, procedures for reviewing plans of care, reimbursement rates, and the scope, duration, and content of programs and the eligibility for specific services provided pursuant to this part 7. The state board shall adopt such rules as are necessary to fulfill the obligations of the state department as the single state agency to administer medical assistance programs in accordance with Title XIX of the federal “Social Security Act”, as amended.

(7)

Intentionally left blank —Ed.

(a)

No later than January 2024, the state department shall submit a report to the senate health and human services committee, the house of representatives public and behavioral health and human services committee, and the house of representatives health and insurance committee, or any successor committees, as part of its “State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act” presentation required by section 2-7-203. At a minimum, the report must identify:

(I)

A reimbursement system with a goal to incentivize and increase transportation provider participation;

(II)

How the state department will ensure compliance with applicable federal laws and waiver requirements;

(III)

A system of common reporting to ensure a recipient does not exceed the medicaid benefit in a multi-provider scenario; and

(IV)

Best practices based on what other states have done to allow transportation network companies to provide nonmedical transportation services for individuals receiving services, including but not limited to, reimbursement rates; driver compensation; and integration with programs that provide nonmedical transportation services.

(b)

In developing the report, the state department shall engage in a stakeholder process that includes individuals with intellectual and developmental disabilities and their families, individuals with disabilities, and transportation network companies. The report may be developed in conjunction with the reporting requirement in sections 25.5-6-307 (6), 25.5-6-409 (6), 25.5-6-606 (9), and 25.5-6-1303 (9).

(c)

Intentionally left blank —Ed.

(I)

Upon completion of the report described in subsection (7)(a) of this section, the state department shall analyze and review each operational transportation network company, as defined in section 40-10.1-602 (3). The state department shall verify each transportation network company’s viability to ensure the health, safety, welfare, cost effectiveness, and capability in expanding nonmedical transportation services for individuals receiving services pursuant to this section and comply with all rules promulgated pursuant to subsection (7)(e)(I) of this section.

(II)

No later than July 1, 2024, the state department shall authorize verified transportation network companies to provide nonmedical transportation services if the state department finds the transportation network company viable under federal requirements and within budgetary constraints.

(III)

For the purposes of this subsection (7)(c), “verify” means a transportation network company meets all requirements resulting from the report described in subsection (7)(a) of this section.

(d)

The state department may seek any necessary federal authorization for the implementation of this subsection (7).

(e)

Intentionally left blank —Ed.

(I)

The state department shall promulgate any necessary rules to ensure transportation network companies comply with federal and state oversight requirements and shall include all relevant stakeholders, including medicaid recipients, transportation network companies, current providers and drivers for nonmedical transportation services, and other interested parties in the development of such requirements.

(II)

Pursuant to section 40-10.1-105 (1)(l), transportation network companies are not subject to regulation by the public utilities commission when providing nonmedical transportation services pursuant to this section and are instead subject to rules promulgated by the state department pursuant to this subsection (7)(e).

(f)

This subsection (7) does not apply to a provider authorized to provide transportation services pursuant to part 8 of article 1 of title 25.5 prior to August 10, 2022.

Source: Section 25.5-6-704 — Implementation of home- and community-based services program for persons with brain injury authorized - federal waiver - duties of the department - rules - repeal, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-25.­5.­pdf (accessed Oct. 20, 2023).

25.5‑6‑101
Spousal protection - protection of income and resources for community spouse - definitions - amounts retained - responsibility of state department - right to appeal
25.5‑6‑102
Court-approved trusts - transfer of property for persons seeking medical assistance for nursing home care - undue hardship - legislative declaration
25.5‑6‑103
Court-approved trusts - transfer of property for persons seeking medical assistance - rule-making authority for trusts created on or after July 1, 1994 - undue hardship
25.5‑6‑104
Long-term care placements - comprehensive and uniform client assessment instrument - report - legislative declaration - definitions - repeal
25.5‑6‑105
Legislative declaration relating to implementation of single entry point system - repeal
25.5‑6‑106
Single entry point system - authorization - phases for implementation - services provided - repeal
25.5‑6‑107
Financing of single entry point system - repeal
25.5‑6‑108.5
Community long-term care studies - authority to implement - alternative care facility report
25.5‑6‑110
Private-public partnership education and information program concerning long-term care insurance authorized
25.5‑6‑113
Health home - integrated services - legislative declaration - contracting - definitions
25.5‑6‑115
Notification of federal immigration consequences
25.5‑6‑116
Community placement transformation - creation - report - repeal
25.5‑6‑201
Special definitions relating to nursing facility reimbursement
25.5‑6‑202
Providers - nursing facility provider reimbursement - exemption - rules - repeal
25.5‑6‑203
Nursing facilities - provider fees - federal waiver - fund created - rules - repeal
25.5‑6‑204
Providers - reimbursement - intermediate care facility for individuals with intellectual disabilities - reimbursement - maximum allowable
25.5‑6‑205
Collection of penalties assessed against nursing facilities - creation of cash fund
25.5‑6‑206
Personal needs benefits - amount - patient personal needs trust fund required - funeral and final disposition expenses - penalty for illegal retention and use
25.5‑6‑208
Nursing facility provider reimbursement - rules - definition - repeal
25.5‑6‑209
Establishment of nursing facility provider demonstration of need - criteria - rules
25.5‑6‑210
Additional supplemental payments - nursing facilities - funding methodology - reporting requirement - rules - repeal
25.5‑6‑301
Short title
25.5‑6‑302
Legislative declaration
25.5‑6‑303
Definitions - repeal
25.5‑6‑304
Administration
25.5‑6‑305
Provision of services for elderly and blind individuals and individuals with disabilities
25.5‑6‑306
Eligible groups
25.5‑6‑307
Services for the elderly, blind, and disabled
25.5‑6‑308
Cost of services
25.5‑6‑309
Special provisions - post-eligibility treatment of income
25.5‑6‑310
Special provisions - personal care services provided by a family - repeal
25.5‑6‑311
Duties of state department
25.5‑6‑312
Gifts - grants
25.5‑6‑313
Rules - federal authorization
25.5‑6‑314
Training for staff providing direct-care services to clients with dementia - rules - definitions
25.5‑6‑401
Short title
25.5‑6‑402
Legislative declaration - Prader-Willi syndrome
25.5‑6‑403
Definitions
25.5‑6‑404
Duties of the department of health care policy and financing and the department of human services
25.5‑6‑405
Relationship to other programs
25.5‑6‑406
Appropriations - reimbursement for services - direct support professionals - legislative declaration - definitions - repeal
25.5‑6‑407
Gifts - grants
25.5‑6‑408
Eligibility - fees
25.5‑6‑409
Services for persons with intellectual and developmental disabilities
25.5‑6‑409.3
Consolidated waiver - intellectual and developmental disabilities - conflict-free case management - legislative declaration - repeal
25.5‑6‑409.5
Transition plan for youth with intellectual and developmental disabilities to adult services - legislative declaration - report - rules - cash fund
25.5‑6‑410
Qualification for federal funding
25.5‑6‑411
Personal needs trust fund required
25.5‑6‑413
Elimination of subminimum wage - transition plan for individuals with disabilities - waiver - legislative declaration - definition
25.5‑6‑601
Short title
25.5‑6‑602
Legislative declaration - no entitlement created
25.5‑6‑603
Definitions
25.5‑6‑604
Cost of services
25.5‑6‑605
Relationship to single entry point for long-term care - repeal
25.5‑6‑606
Implementation of program for persons with mental health disorders authorized - federal waiver - duties of the department of health care policy and financing and the department of human services - rules
25.5‑6‑607
Implementation of part contingent upon receipt of federal waiver - repeal of part
25.5‑6‑701
Short title
25.5‑6‑702
Legislative declaration - no entitlement created
25.5‑6‑703
Definitions - repeal
25.5‑6‑704
Implementation of home- and community-based services program for persons with brain injury authorized - federal waiver - duties of the department - rules - repeal
25.5‑6‑705
Implementation of part contingent upon receipt of federal waiver - repeal of part
25.5‑6‑706
Rate structure - rules - quality assurance
25.5‑6‑901
Disabled children care program - eligibility criteria - documentation requirements - report to the general assembly
25.5‑6‑902
Children’s personal assistance services and family support program - repeal
25.5‑6‑903
Residential child health-care program - waiver - home- and community-based services - rules
25.5‑6‑1101
Definitions
25.5‑6‑1102
Service model - consumer-directed care - repeal
25.5‑6‑1103
Reporting
25.5‑6‑1201
Legislative declaration - repeal
25.5‑6‑1202
Definitions
25.5‑6‑1203
In-home support services - eligibility - licensure exclusion - in-home support service agency responsibilities - rules - repeal
25.5‑6‑1204
Provision of services - duties of state department - gifts - grants
25.5‑6‑1205
Accountability - rate structure - rules
25.5‑6‑1206
Report - repeal
25.5‑6‑1207
Repeal of part
25.5‑6‑1301
Legislative declaration
25.5‑6‑1302
Definitions
25.5‑6‑1303
Pilot program - complementary or alternative medicine - rules
25.5‑6‑1304
Repeal of part
25.5‑6‑1401
Legislative declaration
25.5‑6‑1402
Definitions
25.5‑6‑1403
Waivers and amendments
25.5‑6‑1404
Medicaid buy-in program - eligibility - premiums - medicaid buy-in fund - report - rules - repeal
25.5‑6‑1405
Rule-making authority
25.5‑6‑1406
Availability of federal financial assistance under medical assistance
25.5‑6‑1501
Community transition services and supports - legislative declaration - rules
25.5‑6‑1601
Definitions
25.5‑6‑1602
State department to request increase in reimbursement rate for certain services
25.5‑6‑1603
Minimum wage - wage pass-through requirement for certain home care agencies - applicability - reports - recovery
25.5‑6‑1604
Training for home care agency employees - process for reviewing and enforcing training requirements
25.5‑6‑1605
Exemptions
25.5‑6‑1701
Legislative declaration
25.5‑6‑1702
Definitions
25.5‑6‑1703
Case management system - defined service areas - case management services - only willing and qualified provider exemption - rules
25.5‑6‑1704
Intellectual and developmental disability determination - functional eligibility determination - rules
25.5‑6‑1705
Person-centered support plan
25.5‑6‑1706
Termination of long-term services and supports for member receiving services
25.5‑6‑1707
Records and confidentiality of information
25.5‑6‑1708
Performance audits - Colorado local government audit law - public disclosure of board administration and operations
25.5‑6‑1709
Community-centered board designation - rules
25.5‑6‑1801
Legislative declaration
25.5‑6‑1802
Definitions
25.5‑6‑1803
Development of spending plan
25.5‑6‑1804
Spending plan - approval by joint budget committee - reporting
25.5‑6‑1805
Home- and community-based services improvement fund - creation - transfer - expenditures
25.5‑6‑1806
Repeal of part
25.5‑6‑1901
Definitions
25.5‑6‑1902
Community first choice option - covered services - state plan amendment
25.5‑6‑1903
Permissible services and supports
25.5‑6‑1904
Maintenance of effort
25.5‑6‑1905
Eligibility
Green check means up to date. Up to date

Current through Fall 2024

§ 25.5-6-704’s source at colorado​.gov