SENATE BILL 97208
BY SENATORS Wattenberg, Reeves, and Wham;
also REPRESENTATIVES George, Bacon, Chavez, Clarke,
Gotlieb, Hagedorn, Kaufman, Keller, Mace, Miller, Morrison, Nichol,
Reeser, Romero, Saliman, Smith, Takis, Taylor, Tupa, Udall, Veiga,
S. Williams, and Zimmerman.
CONCERNING DENTAL HEALTH PROGRAMS TO ADDRESS DENTAL
PROBLEMS, AND MAKING AN APPROPRIATION THEREFOR.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. Title
25, Colorado Revised Statutes, 1989 Repl. Vol., as amended, is
amended BY THE ADDITION OF A NEW ARTICLE to read:
ARTICLE 21.5
Children's Dental Assistance and Fluoridation
Program
2521.5101. Short title.
THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED AS THE "COLORADO
DENTAL PROGRAM ACT OF 1997".
2521.5102. Legislative
declaration. (1) IT IS THE
PURPOSE OF THIS ARTICLE TO PROMOTE THE PUBLIC HEALTH AND WELFARE
OF THE PEOPLE OF COLORADO BY PROVIDING:
(a) A DENTAL ASSISTANCE PROGRAM OF PREVENTIVE,
EMERGENCY, DIAGNOSTIC, AND LIMITED RESTORATIVE DENTAL CARE FOR
CHILDREN UNDER TWENTYONE YEARS OF AGE WHO ARE NOT INSURED
UNDER A DENTAL PLAN AND ARE NOT ELIGIBLE FOR MEDICAID;
(b) COORDINATION OF DONATED DENTAL SERVICES
FOR DISABLED CHILDREN AND ADULTS; AND
(c) A GRANT PROGRAM TO ASSIST COMMUNITIES
IN ATTAINING APPROPRIATE LEVELS OF FLUORIDE IN DRINKING WATER
PROVIDED BY COMMUNITY WATER SYSTEMS AS A MEANS OF PRIMARY PREVENTION
OF DENTAL DECAY.
(2) THE OBJECTIVES OF THIS ARTICLE SHALL
BE IMPLEMENTED THROUGH VARIOUS EXECUTIVE DEPARTMENTS, AGENCIES,
AND POLITICAL SUBDIVISIONS OF THE STATE IN COOPERATION WITH PRIVATE
INDIVIDUALS AND ORGANIZATIONS.
(3) IT IS THE INTENT OF THE GENERAL ASSEMBLY
THAT NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO CREATE AN EXEMPTION
FROM THE APPLICABLE PROVISIONS OF TITLE 10, C.R.S.
2521.5103. Definitions.
AS USED IN THIS ARTICLE, UNLESS THE CONTEXT OTHERWISE REQUIRES:
(1) "ADVISORY COMMITTEE" MEANS
THE DENTAL ADVISORY COMMITTEE CREATED IN SECTION 2521.5106.
(2) "DEPARTMENT" MEANS THE DEPARTMENT
OF PUBLIC HEALTH AND ENVIRONMENT.
(3) "ELIGIBLE CHILD" MEANS A
CHILD:
(a) WHO IS UNDER THE AGE OF TWENTYONE
YEARS;
(b) WHO IS NOT COVERED UNDER A POLICY
OF DENTAL INSURANCE;
(c) WHO IS NOT ELIGIBLE FOR MEDICAID;
AND
(d) WHOSE FAMILY INCOME IS EQUAL TO OR LESS THAN ONE HUNDRED EIGHTYFIVE PERCENT OF THE FEDERAL POVERTY LEVEL.
2521.5104. Dental assistance
program for children. (1) SUBJECT
TO AVAILABLE APPROPRIATIONS, THE DEPARTMENT SHALL ADMINISTER A
PROGRAM OF DENTAL ASSISTANCE TO ANY CHILD WHO IS AN ELIGIBLE CHILD,
REFERRED TO IN THIS ARTICLE AS "THE PROGRAM". DENTAL
ASSISTANCE UNDER THE PROGRAM SHALL CONSIST OF PREVENTIVE, EMERGENCY,
DIAGNOSTIC, AND LIMITED RESTORATIVE SERVICES PROVIDED BY APPROPRIATE
LICENSED DENTAL PROVIDERS, INCLUDING DENTISTS AND DENTAL HYGIENISTS
WORKING IN PRIVATE AND PUBLIC SETTINGS.
(2) THE DEPARTMENT SHALL PROMULGATE RULES
NECESSARY FOR THE IMPLEMENTATION OF THE PROGRAM, AFTER CONSULTATION
WITH THE ADVISORY COMMITTEE CREATED IN SECTION 2521.5106.
(3) THE DEPARTMENT SHALL ADMINISTER THE
PROGRAM THROUGH RECRUITMENT OF QUALIFIED PROVIDERS, INCLUDING
DENTAL HYGIENISTS. THE DEPARTMENT SHALL CONTRACT WITH APPROPRIATE
PROVIDERS, PROVIDER NETWORKS, OR DENTAL PLANS TO PROVIDE SERVICES
AND SHALL DETERMINE APPROPRIATE PAYMENT MECHANISMS. THE DEPARTMENT
SHALL COLLABORATE WITH OTHER STATE OR PRIVATE ENTITIES THAT DETERMINE
INCOME ELIGIBILITY, WHICH MAY INCLUDE THE ADMINISTRATOR FOR THE
CHILDREN'S HEALTH PLAN, ARTICLE 17 OF TITLE 26, C.R.S., TO DETERMINE
THE INCOME ELIGIBILITY OF CHILDREN APPLYING FOR THE DENTAL ASSISTANCE
PROGRAM.
2521.5105. Copayment eligibility children's dental plan cash fund payment schedule. (1) A CHILD WHO MEETS THE ELIGIBILITY CRITERIA SET FORTH IN SECTION 2521.5103 (3) SHALL BE ELIGIBLE FOR SERVICES PURSUANT TO THIS SECTION; EXCEPT THAT THE NUMBER OF CHILDREN SERVED SHALL DEPEND ON THE AMOUNTS APPROPRIATED FOR THE PROGRAM. THE DEPARTMENT SHALL DETERMINE COSTS FOR EACH ELIGIBLE CHILD AND FOR INDIVIDUAL SERVICES OR COMBINATIONS OF SERVICES AND SHALL ESTABLISH COPAYMENTS OR FEES FOR EACH PARTICIPATING ELIGIBLE CHILD, NOT TO EXCEED A CAP PER ELIGIBLE FAMILY. ANY SUCH PAYMENTS UNDER THIS PROGRAM SHALL BE CREDITED TO THE CHILDREN'S DENTAL PLAN CASH FUND, WHICH FUND IS HEREBY CREATED IN THE STATE TREASURY. THE FUND SHALL ALSO CONSIST OF MONEYS FROM GIFTS, DONATIONS, OR GRANTS OF ANY KIND FROM ANY PUBLIC OR PRIVATE ENTITY. MONEYS IN THE FUND SHALL BE SUBJECT TO ANNUAL APPROPRIATION BY THE GENERAL ASSEMBLY TO HELP DEFRAY THE EXPENSES OF THE DENTAL ASSISTANCE PROGRAM. THE DEPARTMENT IS AUTHORIZED TO SPEND MONEYS IN THE FUND FOR PURPOSES OF THE DENTAL ASSISTANCE PROGRAM. AT THE END OF EACH FISCAL YEAR, ANY UNEXPENDED OR UNALLOCATED FUNDS SHALL REMAIN IN THE CASH FUND AND SHALL NOT BE TRANSFERRED TO THE GENERAL FUND.
(2) THE DEPARTMENT IS AUTHORIZED TO RECEIVE
GIFTS, DONATIONS, OR GRANTS OF ANY KIND FROM ANY PUBLIC OR PRIVATE
ENTITY TO CARRY OUT THE PURPOSES OF THIS ARTICLE SUBJECT TO THE
TERMS AND CONDITIONS UNDER WHICH GIVEN; EXCEPT THAT NO GIFT, DONATION,
OR GRANT SHALL BE ACCEPTED IF THE CONDITIONS ATTACHED THERETO
REQUIRE THE USE OR EXPENDITURE THEREOF IN A MANNER CONTRARY TO
LAW. ALL SUCH GIFTS, DONATIONS, AND GRANTS SHALL BE TRANSMITTED
TO THE STATE TREASURER, WHO SHALL CREDIT THE SAME TO THE CHILDREN'S
DENTAL PLAN CASH FUND, CREATED PURSUANT TO SUBSECTION (1) OF THIS
SECTION.
(3) THE DEPARTMENT SHALL DEFINE THE TYPES
OF DENTAL SERVICES TO BE PROVIDED UNDER THIS ARTICLE WITH THE
ADVICE OF THE DENTAL ADVISORY COMMITTEE.
(4) THE DEPARTMENT SHALL ANNUALLY SET
THE PAYMENT RATE FOR SERVICES, WHICH SHALL BE ADEQUATE TO ATTRACT
SUFFICIENT PROVIDERS IN THE PROGRAM BUT SHALL BE LESS THAN THE
USUAL AND CUSTOMARY CHARGES FOR THE TYPES OF DENTAL SERVICES PROVIDED
IN ACCORDANCE WITH SUBSECTION (3) OF THIS SECTION.
2521.5106. Dental advisory
committee creation repeal.
(1) THERE IS HEREBY CREATED IN THE DEPARTMENT A DENTAL
ADVISORY COMMITTEE, WHICH SHALL BE APPOINTED BY THE EXECUTIVE
DIRECTOR OF THE DEPARTMENT. THE DENTAL ADVISORY COMMITTEE SHALL
BE COMPRISED OF TEN MEMBERS, INCLUDING ONE MEMBER REPRESENTING
THE DEPARTMENT WHO SHALL BE A NONVOTING MEMBER, ONE MEMBER
REPRESENTING THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING,
TWO DENTISTS PROVIDING DENTAL CARE TO THE INDIGENT, ONE DENTAL
HYGIENIST, ONE REPRESENTATIVE OF A CHARITABLE PROGRAM THAT FULLY
SUBSIDIZES DENTAL CARE FOR CHILDREN, ONE DENTIST IN PRIVATE PRACTICE
WHO REPRESENTS THE PROFESSIONAL DENTAL ASSOCIATION, ONE REPRESENTATIVE
FROM A DENTAL SCHOOL, AND TWO PARENTS OF ELIGIBLE CHILDREN. TERMS
OF THE MEMBERS SHALL BE THREE YEARS; EXCEPT THAT THE TERMS OF
THE FIRST APPOINTEES SHALL BE STAGGERED FROM ONE TO THREE YEARS
TO ALLOW FOR CONTINUITY OF THE COMMITTEE. MEMBERS OF THE ADVISORY
COMMITTEE SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICE OTHER
THAN REIMBURSEMENT FOR REASONABLE TRAVEL EXPENSES.
(2) THE ADVISORY COMMITTEE SHALL HAVE
THE FOLLOWING FUNCTIONS:
(a) TO ADVISE THE DEPARTMENT ON THE TYPES
OF DENTAL SERVICES THAT SHOULD BE PROVIDED UNDER THE DENTAL ASSISTANCE
PROGRAM;
(b) TO ADVISE THE DEPARTMENT ON THE FEE
STRUCTURE FOR THE DENTAL SERVICES PROVIDED UNDER THE DENTAL ASSISTANCE
PROGRAM;
(c) TO ADVISE THE DEPARTMENT ON REASONABLE
RULES NECESSARY TO IMPLEMENT THE DENTAL ASSISTANCE PROGRAM, THE
COORDINATION OF DONATED DENTAL SERVICES, AND THE GRANT PROGRAM
DESCRIBED IN SECTION 2521.5108, INCLUDING BUT NOT
LIMITED TO HOW PRIORITIES FOR PROGRAM IMPLEMENTATION AND RESOURCE
ALLOCATION WILL BE DETERMINED.
(3) (a) THIS SECTION IS REPEALED,
EFFECTIVE JULY 1, 2006.
(b) PRIOR TO SAID REPEAL, THE DENTAL ADVISORY
COMMITTEE SHALL BE REVIEWED, AS PROVIDED IN SECTION 231203
(3), C.R.S.
2521.5107. Donated dental
services contract. THE DEPARTMENT
SHALL CONTRACT WITH A NONPROFIT ORGANIZATION TO ADMINISTER A DONATED
DENTAL SERVICES PROGRAM TO PROVIDE DENTAL TREATMENT TO PEOPLE
WHO ARE DISABLED OR ELDERLY, HAVE SERIOUS DENTAL PROBLEMS BUT
CANNOT AFFORD SUCH CARE, AND ARE NOT ELIGIBLE FOR MEDICAID. PURSUANT
TO THE TERMS OF THE CONTRACT, THE NONPROFIT ORGANIZATION SHALL
DETERMINE APPLICANT ELIGIBILITY AND, THROUGH THE USE OF REFERRAL
COORDINATORS, SHALL MATCH ELIGIBLE PERSONS WITH DENTISTS AND LABORATORIES
THAT VOLUNTEER TO PROVIDE DONATED DENTAL SERVICES. SUBJECT TO
AVAILABLE APPROPRIATIONS, THE CONTRACT SHALL COVER THE COSTS INCURRED
BY THE NONPROFIT ORGANIZATION IN IMPLEMENTING THE DONATED DENTAL
SERVICES PROGRAM.
2521.5108. Fluoridation
of community water supplies grants rules.
(1) THE DEPARTMENT SHALL ADMINISTER A GRANT PROGRAM
TO ASSIST COMMUNITY WATER SYSTEMS IN ADJUSTING THE LEVEL OF FLUORIDE
IN DRINKING WATER AS A MEANS OF PREVENTING DENTAL DECAY FOR BOTH
CHILDREN AND ADULTS, SUBJECT TO AVAILABLE APPROPRIATIONS.
(2) SUBJECT TO CRITERIA ESTABLISHED BY
THE DEPARTMENT PURSUANT TO SUBSECTION (3) OF THIS SECTION, THE
DEPARTMENT SHALL AWARD GRANTS TO COMMUNITIES THAT PROVIDE FOR
SOME OR ALL OF THE FOLLOWING:
(a) ASSISTANCE IN THE DESIGN, PURCHASE,
INSTALLATION, AND MAINTENANCE OF EQUIPMENT TO ADD PROPER AMOUNTS
OF FLUORIDE TO DRINKING WATER;
(b) TRAINING OF WATER PLANT PERSONNEL
IN THE PROPER OPERATION OF FLUORIDATION EQUIPMENT;
(c) MONITORING OF THE FLUORIDE CONTENT
BY OBTAINING PERIODIC SAMPLES OF FINISHED DRINKING WATER TO ASSURE
THE PROPER LEVEL OF FLUORIDE TO PREVENT DENTAL DECAY AND TO PREVENT
RISK TO THE PUBLIC HEALTH.
(3) THE DEPARTMENT SHALL ESTABLISH CRITERIA
FOR AWARDING GRANTS FOR ASSISTANCE UNDER THE FLUORIDATION PROGRAM
OUTLINED IN THIS SECTION. THE CRITERIA SHALL INCLUDE BUT NOT BE
LIMITED TO GIVING PRIORITY TO THOSE COUNTIES OR COMMUNITY WATER
SYSTEMS WITH THE GREATEST NEED FOR DENTAL SERVICES AND THE FEWEST
DENTAL RESOURCES AND TO THOSE COMMUNITIES THAT AGREE TO SHARE
PART OF THE COST OF THE DESIGN, PURCHASE, INSTALLATION, AND MAINTENANCE
OF FLUORIDATION EQUIPMENT.
(4) THE DEPARTMENT SHALL PROMULGATE NECESSARY
RULES FOR THE IMPLEMENTATION OF THE FLUORIDATION PROGRAM.
2521.5109. No general fund
moneys. IT IS THE INTENT OF THE GENERAL
ASSEMBLY THAT NO GENERAL FUND MONEYS BE APPROPRIATED FOR THE PURPOSES
OF IMPLEMENTING THIS ARTICLE.
SECTION 2. 231203
(3), Colorado Revised Statutes, 1980 Repl. Vol., as amended, is
amended BY THE ADDITION OF A NEW PARAGRAPH to read:
231203. Sunset review of
advisory committees. (3) The
following dates are the dates for which the statutory authorization
for the designated advisory committees is scheduled for repeal:
(s) JULY 1, 2006: THE DENTAL ADVISORY
COMMITTEE, APPOINTED PURSUANT TO SECTION 2521.5106,
C.R.S.
SECTION 3. 1016104
(7) (a) (I) (A), Colorado Revised Statutes, 1994 Repl. Vol., is
amended to read:
1016104. Mandatory coverage
provisions. (7) Reimbursement of providers.
(a) Sickness and accident insurance. (I) (A) Notwithstanding
any provisions of any policy of sickness and accident insurance
issued by an entity subject to the provisions of part 2 of this
article OR A PREPAID DENTAL CARE PLAN SUBJECT TO THE PROVISIONS
OF PART 5 OF THIS ARTICLE, whenever any such policy OR PLAN provides
for reimbursement for any service which
THAT may be lawfully performed by a person licensed in this state
for the practice of osteopathy, medicine, dentistry, DENTAL HYGIENE,
optometry, psychology, chiropractic, or podiatry, reimbursement
under such policy OR PLAN shall not be denied when such service
is rendered by a person so licensed. Nothing in this part 1 or
part
PARTS 2 OR 5 of this article shall preclude an insurance company
from setting different fee schedules in an insurance policy for
different services performed by different professions, but the
same fee schedule shall be used for those portions of health services
which
THAT are substantially identical although performed by different
professions.
SECTION 4. Appropriation.
(1) (a) In addition to any other appropriation,
there is hereby appropriated, out of the children's dental plan
cash fund created in section 2521.5105, Colorado Revised
Statutes, to the department of public health and environment,
for the fiscal year beginning July 1, 1997, the sum of one hundred
twentythree thousand dollars ($123,000), or so much thereof
as may be necessary, to be allocated as follows:
(I) Eightyeight thousand dollars
($88,000) for the dental assistance program for children;
(II) Ten thousand dollars ($10,000) for
donated dental services pursuant to section 2521.5107,
Colorado Revised Statutes; and
(III) Twentyfive thousand dollars
($25,000) for the grant program for fluoridation of community
water supplies pursuant to section 2521.5108, Colorado
Revised Statutes.
(b) Of the amount appropriated pursuant
to this subsection (1), twentythree thousand dollars ($23,000)
shall be from cash funds collected pursuant to section 2521.5105,
Colorado Revised Statutes, and one hundred thousand dollars ($100,000)
shall be from gifts and donations received from private or public
sources.
SECTION 5. 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.
____________________________ ____________________________
Tom Norton Charles E. Berry
PRESIDENT OF SPEAKER OF THE HOUSE
THE SENATE OF REPRESENTATIVES
____________________________ ____________________________
Joan M. Albi Judith M. Rodrigue
SECRETARY OF CHIEF CLERK OF THE HOUSE
THE SENATE OF REPRESENTATIVES
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE OF COLORADO