SENATE BILL 98079
BY SENATORS Pascoe, Hernandez, Hopper, Johnson, Linkhart, Martinez, Phillips, Reeves, Rupert, Tanner, Thiebaut, and Wham;
also REPRESENTATIVES Lawrence, Alexander, Anderson,
Bacon, Chavez, Clarke, Dyer, Faatz, Gordon, Leyba, Mace, Musgrave,
Reeser, Romero, Snyder, Sullivant, Tucker, Udall, Veiga, S. Williams,
Young, and Zimmerman.
CONCERNING PARITY FOR LONGTERM CARE SERVICES
IN MEDICAID.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. 264506
(1) (a) and (1) (d), Colorado Revised Statutes, are amended to
read:
264506. Spousal protection
protection of income and resources for community spouse
definitions amounts retained responsibility
of state department right to appeal.
(1) As used in this section, unless the context otherwise
requires:
(a) (I) "Community spouse"
means the spouse of a person who is in an institution or nursing
facility OR THE SPOUSE OF A PERSON WHO IS ENROLLED IN THE PACE
PROGRAM AUTHORIZED PURSUANT TO SECTION 264124. THE
PROVISIONS OF THIS SUBPARAGRAPH (I) SHALL BE EFFECTIVE UNTIL JULY
1, 1999.
(II) "COMMUNITY SPOUSE" MEANS
THE SPOUSE OF A PERSON WHO IS IN AN INSTITUTION OR NURSING FACILITY,
THE SPOUSE OF A PERSON WHO IS ENROLLED IN THE PACE PROGRAM AUTHORIZED
PURSUANT TO SECTION 264124, THE SPOUSE OF A PERSON
WHO IS RECEIVING HOME AND COMMUNITYBASED SERVICES
PURSUANT TO PART 6 OF THIS ARTICLE, OR THE SPOUSE OF A PERSON
WHO IS RECEIVING EQUIVALENT SERVICES UNDER THE INTEGRATED CARE
AND FINANCING PROJECT AUTHORIZED PURSUANT TO SECTION 264122.
THE PROVISIONS OF THIS SUBPARAGRAPH (II) SHALL BECOME EFFECTIVE
ON AND AFTER JULY 1, 1999.
(d) (I) "Institutionalized spouse"
means an individual who is in an institution or nursing facility
who is married to a spouse who is not in an institution or nursing
facility.
(II) (A) FOR PURPOSES OF THIS SECTION,
"INSTITUTIONALIZED SPOUSE" INCLUDES AN INDIVIDUAL WHO
IS ENROLLED IN THE PACE PROGRAM AUTHORIZED PURSUANT TO SECTION
264124 AND WHO IS MARRIED TO A SPOUSE WHO IS NOT ENROLLED
IN THE PACE PROGRAM. THE PROVISIONS OF THIS SUBSUBPARAGRAPH
(A) SHALL BE EFFECTIVE UNTIL JULY 1, 1999.
(B) FOR PURPOSES OF THIS SECTION, "INSTITUTIONALIZED
SPOUSE" INCLUDES AN INDIVIDUAL WHO IS ENROLLED IN THE PACE
PROGRAM AUTHORIZED PURSUANT TO SECTION 264124 OR IS
RECEIVING HOME AND COMMUNITYBASED SERVICES PURSUANT
TO PART 6 OF THIS ARTICLE OR IS RECEIVING EQUIVALENT SERVICES
UNDER THE INTEGRATED CARE AND FINANCING PROJECT AUTHORIZED PURSUANT
TO SECTION 264122, AND WHO IS MARRIED TO A SPOUSE
WHO IS NOT ENROLLED IN THE PACE PROGRAM OR RECEIVING HOME
AND COMMUNITYBASED SERVICES OR RECEIVING EQUIVALENT SERVICES
UNDER THE INTEGRATED CARE AND FINANCING PROJECT AUTHORIZED PURSUANT
TO SECTION 264122. THE PROVISIONS OF THIS SUBSUBPARAGRAPH
(B) SHALL BECOME EFFECTIVE ON AND AFTER JULY 1, 1999.
SECTION 2. 264606
(1), Colorado Revised Statutes, is amended to read:
264606. Eligible groups.
(1) Home
HOME and communitybased services under this subpart
1 shall be offered only to persons:
(a) Who are elderly, blind, or physically disabled; and
(b) Who are in need of the level of care
available in a nursing home; and
(c) Who are categorically eligible for
medical assistance, or whose gross income does not exceed three
hundred percent of the current federal supplemental security income
benefit level, and whose resources do not exceed the limit established
for individuals receiving a mandatory minimum state supplementation
of supplemental security income benefits OR, IN THE CASE OF A
PERSON WHO IS MARRIED, DO NOT EXCEED THE AMOUNT AUTHORIZED IN
SECTION 264506; and
(d) For whom the costs of services necessary
to prevent nursing facility placement would not exceed the average
cost of nursing facility care.
SECTION 3. 264623
(2), Colorado Revised Statutes, is amended to read:
264623. Definitions.
As used in this subpart 2, unless the context otherwise requires:
(2) (a) "Eligible person"
means a person with developmental disabilities:
(I) Who meets the definition of categorically
needy as defined in section 264103 (3);
(II) Who is in need of the level of care
available in an intermediate care facility for the mentally retarded;
(III) Whose gross income does not exceed
three hundred percent of the current federal supplemental security
income benefits level or other applicable standard provided in
federal regulations construing the federal "Social Security
Act", as amended, AND WHOSE RESOURCES DO NOT EXCEED THE LIMIT
ESTABLISHED FOR INDIVIDUALS RECEIVING A MANDATORY MINIMUM STATE
SUPPLEMENTATION OF SUPPLEMENTAL SECURITY INCOME BENEFITS OR, IN
THE CASE OF A PERSON WHO IS MARRIED, DO NOT EXCEED THE AMOUNT
AUTHORIZED IN SECTION 264506; and
(IV) For whom it is determined that provision
of such services is necessary to avoid placement in an intermediate
care facility for the mentally retarded.
(b) The amount of parental income and
resources which
THAT shall be attributable to a child's gross income for purposes
of eligibility under paragraph (a) of this subsection (2) shall
be set forth in rules and regulations
promulgated by the department of human services.
SECTION 4. 264644,
Colorado Revised Statutes, is amended to read:
264644. Program established
financial eligibility. (1) In
recognition of the social and economic benefits accruing from
the maintenance of persons with HIV/AIDS in their own homes, the
general assembly hereby finds and declares that a program shall
be implemented by the state department to provide the services
set forth in section 264645 to those persons with
HIV/AIDS whose gross income does not exceed three hundred percent
of the current federal supplemental security income benefit level,
whose resources do not exceed the limit established by the state
department for individuals receiving a mandatory minimum state
supplementation of SSI benefits pursuant to section 262204,
OR, IN THE CASE OF A PERSON WHO IS MARRIED, DO NOT EXCEED THE
AMOUNT AUTHORIZED IN SECTION 264506, and for whom
a licensed physician certifies that such program provides an appropriate
alternative to institutionalized care.
(2) Any person who accepts and receives
services authorized under this subpart 3 shall pay to the state
department, or to an agent or provider designated by the state
department, an amount that shall be the lesser of the person's
gross income, minus federally allowed maintenance and medical
deductions, or the projected cost of services to be rendered to
the person under the case plan. Such amount shall be reviewed
and revised as necessary each time the case plan is reviewed.
SECTION 5. 264673,
Colorado Revised Statutes, is amended to read:
264673. Definition.
As used in this subpart 5, unless the context otherwise requires:
(1) "Eligible person" means
a person:
(a) Who has a primary diagnosis of major
mental illness, as such term is defined in the diagnostic and
statistical manual of mental disorders used by the mental health
profession, and includes schizophrenic, paranoid, major affective,
and schizoaffective disorders, and atypical psychosis, but does
not include dementia, including alzheimer's disease or related
disorders;
(b) Who is in need of the level of care
available in a nursing facility;
(c) Who is categorically eligible for
medical assistance, or whose gross income does not exceed three
hundred percent of the current federal supplemental security income
benefit level, and whose resources do not exceed the limit established
for individuals receiving a mandatory minimum state supplementation
of supplemental security income benefits OR, IN THE CASE OF A
PERSON WHO IS MARRIED, DO NOT EXCEED THE AMOUNT AUTHORIZED IN
SECTION 264506; and
(d) For whom the cost of services necessary
to prevent nursing facility placement would not exceed the average
cost of nursing home care.
SECTION 6. 264683
(4), Colorado Revised Statutes, is amended to read:
264683. Definitions.
As used in this subpart 6, unless the context otherwise requires:
(4) "Eligible person" means
a person:
(a) Who has a diagnosis of brain injury,
as such term is defined in subsection (3) of this section;
(b) Who is in need of the level of care
available in a hospital, rehabilitation hospital, or hospital
in lieu of a nursing facility;
(c) Who is categorically eligible for
medical assistance, or has a gross income that does not exceed
three hundred percent of the current federal supplemental security
income benefit level and resources that do not exceed the limit
established for individuals receiving a mandatory minimum state
supplementation of supplemental security income benefits OR, IN
THE CASE OF A PERSON WHO IS MARRIED, DO NOT EXCEED THE AMOUNT
AUTHORIZED IN SECTION 264506; and
(d) For whom the cost of services would
not exceed the average cost of hospital care.
SECTION 7. 264124 (6), Colorado Revised Statutes, is amended to read:
264124. Program of allinclusive
care for the elderly services eligibility.
(6) For purposes of this section, "eligible
person" means a frail elderly individual who voluntarily
enrolls in the PACE program and whose gross income does not exceed
three hundred percent of the current federal supplemental security
income benefit level, whose resources do not exceed the limit
established by the state department of human services for individuals
receiving a mandatory minimum state supplementation of SSI benefits
pursuant to section 262204, OR IN THE CASE OF A PERSON
WHO IS MARRIED, DO NOT EXCEED THE AMOUNT AUTHORIZED IN SECTION
264506, and for whom a physician licensed pursuant
to article 36 of title 12, C.R.S., certifies that such a program
provides an appropriate alternative to institutionalized care.
The term "frail elderly" means an individual who meets
functional eligibility requirements, as established by the state
department, for nursing home care and who is sixtyfive years
of age or older.
SECTION 8. Effective
date. This act shall take effect upon passage.
SECTION 9. No
appropriations report to the joint budget committee.
(1) For state fiscal year 199899, the general
assembly has determined that this act can be implemented within
existing appropriations, and therefore no separate appropriation
of state moneys is necessary to carry out the purposes of this
act.
(2) For state fiscal year 19992000
and state fiscal years thereafter, it is the intent of the general
assembly that any savings associated with the deinstitutionalization
project implemented by the state department of health care policy
and financing shall be applied to cover additional costs, if any,
associated with the implementation of this act.
(3) The state department of health care
policy and financing shall present to the joint budget committee
of the general assembly those savings from deinstitutionalization
used to fund this act for state fiscal year 19992000.
SECTION 10. 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
____________________________ ____________________________
Patricia K. Dicks Judith M. Rodrigue
ASSISTANT SECRETARY OF CHIEF CLERK OF THE HOUSE
THE SENATE OF REPRESENTATIVES
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE
OF COLORADO