SENATE 3rd Reading Unamended May 10, 2011 SENATE Amended 2nd Reading May 9, 2011 HOUSE 3rd Reading Unamended April 11, 2011 HOUSE Amended 2nd Reading April 8, 2011 First Regular Session Sixty-eighth General Assembly STATE OF COLORADO REREVISED This Version Includes All Amendments Adopted in the Second House LLS NO. 11-0087.01 Christy Chase HOUSE BILL 11-1217 HOUSE SPONSORSHIP Acree, Joshi, Kerr A., Stephens, Summers SENATE SPONSORSHIP Boyd, Roberts House Committees Senate Committees Health and Environment Health and Human Services Appropriations A BILL FOR AN ACT Concerning measures to expand access to health care throughout the state. 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 enacts measures to expand access to health care in Colorado, including the following: Section 1 of the bill expands the school-based health center grant program administered by the prevention services division in the department of public health and environment to allow the division to award grants to center operators to offer rehabilitative services at existing centers. Sections 2 and 3 of the bill expand eligibility for participation in the state loan repayment program to health care providers who do not provide primary care services, practice in a for-profit setting, or are otherwise not currently eligible. These providers' eligibility is contingent upon their agreement to provide services in underserved areas of the state and upon a corresponding expansion of the federal government's national loan repayment program. Section 4 charges the center for improving value in health care (CIVHC), which was established in 2008 by an executive order of the governor, with studying and recommending improvements to the system for reimbursing health care providers who deliver care to recipients of the state's public medical assistance programs as well as to insured individuals. Section 5 requires the department of health care policy and financing to reimburse providers for medical care, services, or goods provided to medicaid recipients, regardless of the location of the service delivery, and to seek a waiver from the United States department of health and human services if necessary to implement this requirement. Sections 6 and 7 authorize the state and local governments to enter into agreements with health care providers to allow the providers to use available space in a building owned by the state or local government and located in a federally designated health professional shortage area for purposes of providing access to health care to persons residing in close proximity to the public building. As a condition of the agreement to use space in the public building, the health care provider must agree to accept medicaid patients at those sites. Section 8 extends governmental immunity to health care practitioners who provide care to patients, including medicaid patients, in available space in a public building located in a federally designated health professional shortage area pursuant to an agreement authorized by section 6 or 7 of the bill. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. Part 1 of article 1 of title 25.5, Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW SECTION to read: 25.5-1-128. Provider payments - exemption from certain state fiscal requirements. (1) (a) Notwithstanding any provision of law to the contrary, when the state department has regulatory authority over a provider and has established a state department-approved provider application to provide a service or bill the state department or its authorized contractor for the service, the provider and the state department are exempt from the requirements of section 24-30-202 (1), C.R.S. (b) The executive director may adopt rules to implement this section for any program the state department is authorized to administer, including: (I) The "Colorado Medical Assistance Act", articles 4 to 6 of this title; (II) The "Children's Basic Health Plan Act", article 8 of this title; (III) The "Colorado Indigent Care Program", part 1 of article 3 of this title; (IV) The school health services program authorized by section 25.5-5-318; (V) The primary care fund, pursuant to part 3 of article 3 of this title; and (VI) State-funded health and medical care pursuant to article 2 of this title. (2) As used in this section, "provider" means a health care provider, mental health care provider, pharmacist, home health agency, general provider, as defined in section 25.5-3-103 (3), qualified provider, as defined in section 25.5-3-203 (5), school district, as defined in section 25.5-5-318 (1) (a), or any other entity that provides health care, health care coordination, outreach, enrollment, or administrative support services through fee-for-service, the primary care physician program, a managed care entity, a behavioral health organization, a medical home, or any system of care that coordinates health care or services, as defined and authorized through state board or executive director rule. 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 a 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 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 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 a 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. 25.5-6-108.5 (2) (b), Colorado Revised Statutes, is amended to read: 25.5-6-108.5. Community long-term care studies - authority to implement - alternative care facility report. (2) (b) The study conducted pursuant to this subsection (2) shall be completed by January 1, 2011 2012, and, if federal approval is obtained prior to final figure-setting for the fiscal year commencing July 1, 2011 2012, the state department shall submit a request through the budget process for implementation of the approved changes for that fiscal year. SECTION 5. 25.5-4-402.3, Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW SUBSECTION to read: 25.5-4-402.3. Providers - hospital - provider fees - legislative declaration - federal waiver - fund created - rules - advisory board - repeal. (8) The state department shall evaluate legislation enacted by the general assembly after July 1, 2009, to determine whether the legislation impacts a public medical assistance program in a manner that limits the expansion of eligibility for public medical assistance pursuant to sub-subparagraph (B) of subparagraph (IV) of paragraph (b) of subsection (4) of this section or creates a barrier to access to health care for the persons eligible for public medical assistance pursuant to sub-subparagraph (B) of subparagraph (IV) of paragraph (b) of subsection (4) of this section. If the state department determines that the expansion of eligibility is limited by the legislation or that the legislation creates a barrier to access to health care for those eligible populations, the state department shall not implement the legislation. SECTION 6. Appropriation. In addition to any other appropriation, there is hereby appropriated, to the department of health care policy and financing, for allocation to the executive director's office, general professional services and special projects, for the fiscal year beginning July 1, 2011, the sum of seventy-five thousand dollars ($75,000), or so much thereof as may be necessary, for the implementation of this act. Of said sum, thirty-seven thousand five hundred dollars ($37,500) shall be from the department of health care policy and financing cash fund, and thirty-seven thousand five hundred dollars ($37,500) shall be from federal funds. SECTION 7. Effective date. This act shall take effect July 1, 2011. SECTION 8. Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.