House Committee of Reference Report
Committee on Health & Human Services
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February 17, 2026
After consideration on the merits, the Committee recommends the following:
HB26-1018 be amended as follows, and as so amended, be referred to the Committee on Appropriations with favorable recommendation:
Page 1, Line 1Amend printed bill, strike everything below the enacting clause and
Page 1, Line 2substitute:
Page 1, Line 3"SECTION 1. In Colorado Revised Statutes, add 25.5-6-120 as
Page 1, Line 4follows:
Page 1, Line 525.5-6-120. Transition coordination stakeholder process - data
Page 1, Line 6collection - report - legislative recommendations - definitions - repeal.
Page 1, Line 7(1) As used in this section, unless the context otherwise
Page 1, Line 8requires:
Page 1, Line 9(a) "Escalation" means a documented procedure used by a
Page 1, Line 10transition coordination agency, case management agency,
Page 1, Line 11managed care entity, county department, or the state
Page 1, Line 12department to elevate and resolve delays, barriers, or
Page 1, Line 13coordination failures that prevent or risk preventing timely
Page 1, Line 14completion of a transition, for the purpose of facilitating and
Page 1, Line 15expediting the processing and completion of the transition.
Page 1, Line 16(b) "Transition coordination agency" means an entity
Page 1, Line 17contracted with or designated by the state department to
Page 1, Line 18provide transition coordination services to members
Page 1, Line 19transitioning from an institutional or facility-based setting to
Page 1, Line 20a home- and community-based setting, including assisting with
Page 1, Line 21discharge planning, service coordination, provider
Page 1, Line 22identification, and facilitation of home- and community-based
Page 1, Line 23services necessary to support a safe and timely transition.
Page 1, Line 24(c) "Transition process" means the series of coordinated
Page 1, Line 25activities conducted by the state department, transition
Page 1, Line 26coordination agencies, case management agencies, managed care
Page 1, Line 27entities, counties, providers, and other involved entities to plan,
Page 2, Line 1authorize, and implement a member's movement from an
Page 2, Line 2institutional or facility-based setting to a home- and
Page 2, Line 3community-based setting, including assessment, service
Page 2, Line 4planning, service authorization, provider arrangement, and
Page 2, Line 5discharge coordination.
Page 2, Line 6(2) On or before August 12, 2026, the state department
Page 2, Line 7shall engage a stakeholder process to evaluate data regarding
Page 2, Line 8individuals transitioning out of a nursing facility and into a
Page 2, Line 9home- and community-based setting and develop legislative
Page 2, Line 10recommendations to ensure continuity of care, through-care
Page 2, Line 11coordination, and service planning for individuals transitioning
Page 2, Line 12out of a nursing facility and into a home- and community-based
Page 2, Line 13setting.
Page 2, Line 14(3) At a minimum, the stakeholder process must include
Page 2, Line 15representatives from the following agencies and organizations:
Page 2, Line 16(a) Transition coordination agencies;
Page 2, Line 17(b) County departments of human or social services;
Page 2, Line 18(c) Case management agencies, as defined in section
Page 2, Line 1925.5-6-1702;
Page 2, Line 20(d) Managed care entities;
Page 2, Line 21(e) Individuals who have transitioned out of a nursing
Page 2, Line 22facility and into the community and the individuals' caregivers
Page 2, Line 23or legal representatives;
Page 2, Line 24(f) Providers who provide services in rural areas;
Page 2, Line 25(g) Representatives of the intellectual and
Page 2, Line 26developmental disability community; and
Page 2, Line 27(h) Any other agency or organization the state
Page 2, Line 28department deems necessary to participate in the stakeholder
Page 2, Line 29process.
Page 2, Line 30(4) At a minimum, the stakeholder process must:
Page 2, Line 31(a) Develop a detailed, step-by-step description of the
Page 2, Line 32current transition coordination process, including
Page 2, Line 33identification of each entity responsible for each stage of the
Page 2, Line 34transition process;
Page 2, Line 35(b) Identify statutory, regulatory, and contractual
Page 2, Line 36timelines applicable to each entity involved in the transition
Page 2, Line 37process and the amount of time each entity has to complete
Page 2, Line 38required actions;
Page 2, Line 39(c) To the extent possible, collect and analyze data
Page 2, Line 40regarding:
Page 2, Line 41(I) The average time required to complete each stage of
Page 2, Line 42the transition process;
Page 2, Line 43(II) The average delay that occurs at each stage of the
Page 3, Line 1transition process, if any;
Page 3, Line 2(III) The number and frequency of escalations used within
Page 3, Line 3the transition process and the circumstances under which
Page 3, Line 4escalation occurs;
Page 3, Line 5(IV) The number and percentage of individuals who
Page 3, Line 6transition out of a nursing facility without home- and
Page 3, Line 7community-based services in place at the time of discharge; and
Page 3, Line 8(V) Any additional data necessary to evaluate transition
Page 3, Line 9process system performance, accountability, and outcomes;
Page 3, Line 10(d) Identify system gaps, duplications, barriers, or
Page 3, Line 11misaligned incentives contributing to delays or failed
Page 3, Line 12transitions;
Page 3, Line 13(e) Evaluate, as they relate to the transition process,
Page 3, Line 14payment structures, accountability mechanisms,
Page 3, Line 15information-sharing practices, and role clarity among entities;
Page 3, Line 16and
Page 3, Line 17(f) Develop legislative recommendations to improve
Page 3, Line 18timelines, accountability, and outcomes of transition
Page 3, Line 19coordination.
Page 3, Line 20(5) The state department shall use the existing transition
Page 3, Line 21stakeholder advisory council established by the state
Page 3, Line 22department to support the requirements of section 25.5-6-1501,
Page 3, Line 23or a successor advisory body, to facilitate the work required by
Page 3, Line 24this section.
Page 3, Line 25(6) The state department shall include as part of the
Page 3, Line 26state department's "SMART Act" presentation required by
Page 3, Line 27section 2-7-203, a summary of the information detailed in
Page 3, Line 28subsection (4) of this section and legislative recommendations
Page 3, Line 29to establish long-term services and supports for an individual
Page 3, Line 30transitioning out of a nursing facility for consideration during
Page 3, Line 31the 2027 legislative session.
Page 3, Line 32(7) This section is repealed, effective July 1, 2027.
Page 3, Line 33SECTION 2. Act subject to petition - effective date. This act
Page 3, Line 34takes effect at 12:01 a.m. on the day following the expiration of the
Page 3, Line 35ninety-day period after final adjournment of the general assembly (August
Page 3, Line 3612, 2026, if adjournment sine die is on May 13, 2026); except that, if a
Page 3, Line 37referendum petition is filed pursuant to section 1 (3) of article V of the
Page 3, Line 38state constitution against this act or an item, section, or part of this act
Page 3, Line 39within such period, then the act, item, section, or part will not take effect
Page 3, Line 40unless approved by the people at the general election to be held in
Page 3, Line 41November 2026 and, in such case, will take effect on the date of the
Page 3, Line 42official declaration of the vote thereon by the governor.".
Page 3, Line 43