HOUSE 2nd Reading Unamended April 6, 2011 SENATE 3rd Reading Unamended March 1, 2011 SENATE Amended 2nd Reading February 25, 2011First Regular Session Sixty-eighth General Assembly STATE OF COLORADO REVISED This Version Includes All Amendments Adopted on Second Reading in the Second House LLS NO. 11-0397.01 Bob Lackner SENATE BILL 11-063 SENATE SPONSORSHIP Giron and Newell, HOUSE SPONSORSHIP Kefalas, Senate Committees House Committees Local Government and Energy State, Veterans, & Military Affairs A BILL FOR AN ACT Concerning the promotion of health care accessibility by encouraging local governments to consider the health care needs of their communities in the composition of their master land use plans. Bill Summary (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://www.leg.state.co.us/billsummaries.) The bill authorizes counties, regions, and municipalities (local governments) to include in their comprehensive or master land use plans a community health element reflecting current and projected population estimates pursuant to which the applicable local government will indicate how its planning decisions will promote public health and safety and the general welfare of the residents of the local government. Matters to be addressed in connection with this element of the master plan may include, without limitation, accessibility, availability, affordability, and delivery of health care services and health care facilities; public safety; civic participation within the territorial boundaries of the local government; and any other factors or policies that will promote public health and safety and the general welfare within the territorial boundaries of the local government. In assessing the accessibility, availability, affordability, and delivery of current and anticipated health care services and facilities, the bill authorizes the applicable planning commission to consider: Surrounding local governments in order to develop an inventory of existing facilities and services and an assessment of transit accessibility; and Population estimates and projections provided by the Colorado department of local affairs to establish current and projected needs of facilities and services. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. Legislative declaration. (1) The general assembly hereby finds, determines, and declares that: (a) New and emerging pandemics increase the burdens faced by county, municipal, and other local health care delivery systems; (b) Acts of domestic and international terrorism increase the need for counties, municipalities, and special districts to ensure that their health care infrastructure is equipped to respond to biological and other attacks that threaten the health and welfare of their populations; (c) The state demography office of the Colorado department of local affairs estimates that the state's population will increase by fifty percent by the year 2035 to almost seven million seven hundred thousand people; (d) Colorado faces urgent and interconnected problems regarding health care that will only continue as the state's population increases; (e) Future demographic projections provide the basis for planning for a community's future health care needs; (f) A community's comprehensive or master plan is a public document that reflects decisions and regulations made by city and county officials and citizens to guide the future physical, economic, and social development of that community; (g) A community's current and anticipated health care needs are integral components to the physical, economic, and social development of that community and its health care workforce; (h) Access to health care is directly connected to transit accessibility; and (i) As critical delivery points for the provision of health care and emergency services to a community, and major contributors to a community's workforce, hospitals bring a unique capacity to increase positive heath outcomes for Colorado residents and to educate stakeholders about the safety and quality of health care in their community. (2) The general assembly further finds, determines, and declares that: (a) In 2008, the blue ribbon commission for health care reform identified objectives for state-level health reform including: Reducing the number of uninsured Coloradans; making it easier for Coloradans to obtain and maintain their health care coverage; improving the delivery of services to vulnerable populations; encouraging and rewarding prevention and personal responsibility; preserving and enhancing consumer choice; strengthening the safety net of health care providers; and identifying administrative streamlining measures to reduce public expenditures related to health care; (b) Under Senate Bill 08-194, the department of public health and environment was required to develop a comprehensive, statewide public health improvement plan, refereed to herein as the "state plan", on or before December 31, 2009, and every five years thereafter, and, as soon as practicable after the approval of each state plan, each county or district public health agency was required to prepare a county or district public health plan, referred to herein as the "local plan", which was required to be consistent with the state plan; (c) With the enactment of House Bill 09-1111 in 2009, the general assembly recognized that a shortage of qualified health care professionals exists in most areas of the state, particularly in rural and low-income communities, and that lack of access to health care increases health inequities in Colorado and increases the overall cost of health care services; (d) A growing number of local governments nationwide are recognizing the value of including health care in the comprehensive master planning process; (e) By recognizing the importance of accessibility and affordability of health care in a community's development, cities and counties can provide a foundation for an increased quality of life for the residents of their communities; (f) Assessing communities' current and anticipated health care needs and available services in the city and county comprehensive planning process may increase the quality of life for all Colorado citizens; and (g) The statewide task force focused on healthy eating and active living, convened by the Colorado department of public health and environment, is currently convening to provide policy makers with model policies and plans to promote healthy eating and active living. (3) The general assembly further finds, determines, and declares that the purpose of Senate Bill 11-063, enacted in 2011, is to encourage municipalities, counties, and regions subject to master planning requirements to consider including a community health element in their master plans as a foundation for increased quality of life for their residents and the sustained well-being of the population. The general assembly further declares that the ultimate purpose of Senate Bill 11-063 is to reduce disparities in the accessibility, availability, affordability, and delivery of health care services faced by Coloradans living in different regions of the state. Nothing in Senate Bill 11-063 shall prohibit planning commissions or other bodies responsible for developing a community's master plan from collaborating with adjoining municipalities, counties, or regions as appropriate to better assess their communities' health care needs and to design master plans that promote and evidence such cooperation. SECTION 2. 30-28-106 (3), Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW PARAGRAPH to read: 30-28-106. Adoption of master plan - contents - definitions. (3) (h) (I) The master plan of a county or region adopted in accordance with this section may include a community health element reflecting current and projected population estimates pursuant to which the county or region shall indicate how its planning decisions will promote public health and safety and the general welfare of the residents of the county or region, as applicable. Matters to be addressed in connection with this element of the master plan may include, without limitation, accessibility, availability, affordability, and delivery of health care services and health care facilities; public safety; civic participation within the territorial boundaries of the county or region; and any other factors or policies that will promote public health and safety and the general welfare within the territorial boundaries of the county or region. In assessing the accessibility, availability, affordability, and delivery of current and anticipated health care services and facilities, the planning commission may consider: (A) Surrounding counties, regions, or municipalities in order to develop an inventory of existing facilities and services and an assessment of transit accessibility; and (B) Population estimates and projections provided by the Colorado department of local affairs to establish current and projected needs of facilities and services. (II) Nothing in subparagraph (I) of this paragraph (h) shall be construed to preclude the development of a health care facility or hospital that is not included in the master plan of a county or region, nor shall anything in said subparagraph (I) be construed as requiring any hospital or facility to offer any service that is included in the plan. (III) To the extent practicable, a county or region that elects to include a community health element in its master plan is strongly encouraged to collaborate with a public health agency of the county or district, as applicable, in the inclusion of such element and to further use information contained in a public health plan governing the county or region pursuant to the provisions of subpart 3 of part 5 of article 1 of title 25, C.R.S., in the inclusion of such element. (IV) As used in this paragraph (h), unless the context otherwise requires: (A) "Health care facility" or "facility" includes, without limitation, public and private health care clinics or practices, including school-based health centers; locations that provide access to alternative medicines; long-term care facilities; rehabilitative centers; hospices; and pharmacies. For purposes of this paragraph (h), "health care facility" shall not include a hospital, or any facility owned or operated by a hospital, that is licensed or certified pursuant to section 25-3-101, C.R.S. (B) "Health care service" or "service" means, without limitation, adolescent health care, behavioral care, chiropractic services, dental services, the provision of durable medical equipment, emergency care, well woman care, geriatric care, health and medical instruction at local educational institutions, hearing services and the provision of hearing aids, inpatient care, long-term care, mental health services, obstetric and gynecological care, outpatient care, pediatric services, the provision of prescription drugs and medication therapy management, primary and preventive care, substance abuse treatment, trauma care, vision care and correction, and care for individuals with disabilities. SECTION 3. 31-23-206, Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW SUBSECTION to read: 31-23-206. Master plan - definitions. (5.5) (a) The master plan of a municipality adopted in accordance with this section may include a community health element reflecting current and projected population estimates pursuant to which the municipality shall indicate how its planning decisions will promote public health and safety and the general welfare of the residents of the municipality. Matters to be addressed in connection with this element of the master plan may include, without limitation, accessibility, availability, affordability, and delivery of health care services and health care facilities; public safety; civic participation within the territorial boundaries of the municipality; and any other factors or policies that will promote public health and safety and the general welfare within the territorial boundaries of the municipality. In assessing the accessibility, availability, affordability, and delivery of current and anticipated health care services and facilities, the planning commission may consider: (I) Surrounding counties, regions, or municipalities in order to develop an inventory of existing facilities and services and an assessment of transit accessibility; and (II) Population estimates and projections provided by the Colorado department of local affairs to establish current and projected needs of facilities and services. (b) To the extent practicable, a municipality that elects to include a community health element in its master plan is strongly encouraged to collaborate with a public health agency of the municipality or of the county or district within which the municipality is located, as applicable, in the inclusion of such element and to further use information contained in a public health plan governing the municipality pursuant to the provisions of subpart 3 of part 5 of article 1 of title 25, C.R.S., in the inclusion of such element. (c) Nothing in paragraph (a) of this subsection (5.5) shall be construed to preclude the development of a health care facility or hospital that is not included in the master plan of a municipality, nor shall anything in said paragraph (a) be construed as requiring any hospital or facility to offer any service that is included in the plan. (d) As used in this subsection (5.5), unless the context otherwise requires: (I) "Health care facility" or "facility" includes, without limitation, public and private health care clinics or practices, including school-based health centers; locations that provide access to alternative medicines; long-term care facilities; rehabilitative centers; hospices; and pharmacies. For purposes of this subsection (5.5), "health care facility" shall not include a hospital, or any facility owned or operated by a hospital, that is licensed or certified pursuant to section 25-3-101, C.R.S. (II) "Health care service" or "service" means, without limitation, adolescent health care, behavioral care, chiropractic services, dental services, the provision of durable medical equipment, emergency care, well woman care, geriatric care, health and medical instruction at local educational institutions, hearing services and the provision of hearing aids, inpatient care, long-term care, mental health services, obstetric and gynecological care, outpatient care, pediatric services, the provision of prescription drugs and medication therapy management, primary and preventive care, substance abuse treatment, trauma care, vision care and correction, and care for individuals with disabilities. SECTION 4. Act subject to petition - effective date. This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly (August 10, 2011, if adjournment sine die is on May 11, 2011); except that, if a referendum petition is filed pursuant to section 1 (3) of article V of the state constitution against this act or an item, section, or part of this act within such period, then the act, item, section, or part shall not take effect unless approved by the people at the general election to be held in November 2012 and shall take effect on the date of the official declaration of the vote thereon by the governor.