A Bill for an Act
Page 1, Line 101Concerning a community integration plan for individuals
Page 1, Line 102with disabilities.
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://leg.colorado.gov.)
The bill establishes that public and governmental entities (entities) shall administer services, programs, and activities in the most integrated setting that is appropriate to the needs of individuals with disabilities. The bill establishes when entities are required to provide home- and community-based services (services) to individuals with disabilities.
If an entity cuts services, the entity shall assess whether the service cut increases the risk of institutionalization for individuals receiving services. If so, the entity must develop a plan to reduce that risk.
The bill directs the department of health care policy and financing to develop a comprehensive community integration plan (plan) for implementing its obligation to provide individuals with disabilities with opportunities to live, work, and be served in integrated settings. The plan must be reviewed and updated every 3 years.
An entity is not required to comply with the provisions of the bill if it can establish that doing so would require a fundamental alteration of its program, services, or activities.
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. Legislative declaration. (1) The general assembly
Page 2, Line 3finds and declares that:
Page 2, Line 4(a) The United States supreme court decision in Olmstead v. L.C.,
Page 2, Line 5527 U.S. 581 (1999), enshrined in law the duty upon states to actively
Page 2, Line 6work toward helping individuals with disabilities transition out of
Page 2, Line 7institutions and into the community and to have community-based
Page 2, Line 8services available to decrease the risk of institutionalization;
Page 2, Line 9(b) Olmstead placed on states the obligation to administer
Page 2, Line 10services, programs, and activities in the most integrated setting
Page 2, Line 11appropriate to the needs of qualified individuals with disabilities;
Page 2, Line 12(c) Segregating individuals with disabilities in institutions denies
Page 2, Line 13those individuals the freedom to make decisions, keeps them apart from
Page 2, Line 14family and friends, and denies them opportunities that exist in their
Page 2, Line 15communities. Segregation also denies communities the contributions that
Page 2, Line 16individuals with disabilities make to their communities.
Page 2, Line 17(d) Community-based services are cheaper in the long run than
Page 2, Line 18institutionalization services.
Page 2, Line 19(2) The general assembly further declares that codifying in state
Page 2, Line 20law the rights that were legally recognized as federal law through
Page 3, Line 1Olmstead is crucial because:
Page 3, Line 2(a) The fundamental rights for individuals with disabilities to live
Page 3, Line 3in the least restrictive setting and to have access to services in the
Page 3, Line 4community is consistent with Colorado's recognition of the humanity and
Page 3, Line 5dignity of all individuals;
Page 3, Line 6(b) It will make Olmstead violations reviewable by the Colorado
Page 3, Line 7civil rights division, which is a more transparent and user-friendly process
Page 3, Line 8for non-attorneys than the department of justice complaint process;
Page 3, Line 9(c) It will allow Olmstead violations to be subject to litigation
Page 3, Line 10through the state courts, which can resolve cases more quickly and with
Page 3, Line 11less expense; and
Page 3, Line 12(d) The Olmstead decision required states to develop an Olmstead
Page 3, Line 13plan. Colorado's plan, called the "Colorado community living plan", was
Page 3, Line 14developed more than 10 years ago as a collaboration between the state
Page 3, Line 15departments of health care policy and financing, human services, and
Page 3, Line 16local affairs. The plan's effectiveness has never been evaluated or
Page 3, Line 17updated, and many people feel the plan is insufficient.
Page 3, Line 18SECTION 2. In Colorado Revised Statutes, add part 11 to article
Page 3, Line 191 of title 25.5 as follows:
Page 3, Line 20PART 11
Page 3, Line 21COMMUNITY INTEGRATION
Page 3, Line 2225.5-1-1101. Definitions.As used in this part 11, unless the
Page 3, Line 23context otherwise requires:
Page 3, Line 24(1) "Disability" has the same meaning as set forth in the
Page 3, Line 25federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec.
Page 3, Line 2612101 et seq.
Page 3, Line 27(2) "Fundamental alteration" means a change that is so
Page 4, Line 1significant that it alters the essential nature of the goods,
Page 4, Line 2services, facilities, privileges, advantages, or accommodations
Page 4, Line 3offered by a state or public entity.
Page 4, Line 4(3) "Home- and community-based services" means any of
Page 4, Line 5the following:
Page 4, Line 6(a) Home health-care services authorized pursuant to
Page 4, Line 7paragraph (7) of section 1905(a) of the "Social Security Act", 42
Page 4, Line 8U.S.C. sec. 1396d(a);
Page 4, Line 9(b) Personal care services authorized pursuant to
Page 4, Line 10paragraph (24) of section 1905(a) of the "Social Security Act", 42
Page 4, Line 11U.S.C. sec. 1396d(a);
Page 4, Line 12(c) PACE services authorized pursuant to paragraph (26)
Page 4, Line 13of section 1905(a) of the "Social Security Act", 42 U.S.C. sec.
Page 4, Line 141396d(a);
Page 4, Line 15(d) Home- and community-based services authorized
Page 4, Line 16pursuant to subsections (b), (c), (i), (j), and (k) of section 1915 of
Page 4, Line 17the "Social Security Act", 42 U.S.C. sec. 1396n; services
Page 4, Line 18authorized pursuant to a waiver under section 1115 of the
Page 4, Line 19"Social Security Act", 42 U.S.C. sec. 1315; and services through
Page 4, Line 20coverage authorized under section 1937 of the "Social Security
Page 4, Line 21Act", 42 U.S.C. sec. 1396u-7;
Page 4, Line 22(e) Case management services authorized under section
Page 4, Line 231905(a)(19) of the "Social Security Act", 42 U.S.C. sec.
Page 4, Line 241396d(a)(19), and section 1915(g) of the "Social Security Act", 42
Page 4, Line 25U.S.C. sec. 1396n(g);
Page 4, Line 26(f) Rehabilitative services, including those related to
Page 4, Line 27behavioral health, described in section 1905(a)(13) of the "Social
Page 5, Line 1Security Act", 42 U.S.C. sec. 1396d(a)(13); and
Page 5, Line 2(g) Any other services specified by the United States
Page 5, Line 3secretary of health and human services.
Page 5, Line 4(4) "Individual with a disability" means an individual with
Page 5, Line 5a disability or disabilities.
Page 5, Line 6(5) "Most integrated setting" means the setting that
Page 5, Line 7enables an individual with a disability to interact to the fullest
Page 5, Line 8extent possible with persons who do not have a disability.
Page 5, Line 9(6) "Plan" means the state's comprehensive community
Page 5, Line 10integration plan, developed pursuant to section 25.5-1-1104.
Page 5, Line 11(7) "Public or governmental entity" means:
Page 5, Line 12(a) The state or any department, board, agency,
Page 5, Line 13instrumentality, authority, or commission of the state; and
Page 5, Line 14(b) Any political subdivision of the state, including:
Page 5, Line 15(I) A county, city, or city and county;
Page 5, Line 16(II) A school district as defined in section 22-36-107;
Page 5, Line 17(III) A local improvement district as defined in section
Page 5, Line 1832-7-103;
Page 5, Line 19(IV) A law enforcement authority;
Page 5, Line 20(V) A water, sanitation, fire protection, metropolitan,
Page 5, Line 21irrigation, drainage, or other special district created pursuant
Page 5, Line 22to title 32;
Page 5, Line 23(VI) Any other municipal, quasi-municipal, or public
Page 5, Line 24corporation organized pursuant to the state constitution or
Page 5, Line 25other law; and
Page 5, Line 26(VII) Any department, board, agency, instrumentality,
Page 5, Line 27authority, or commission of a political subdivision of the state.
Page 6, Line 1(8) "Sufficient risk" means an action or lack of action by
Page 6, Line 2a public or governmental entity that will likely cause a decline
Page 6, Line 3in the health, safety, or welfare of an individual with a
Page 6, Line 4disability that would lead to the placement of the individual in
Page 6, Line 5an institution.
Page 6, Line 625.5-1-1102. Services, programs, and activities.Each public
Page 6, Line 7and governmental entity shall administer services, programs,
Page 6, Line 8and activities in the most integrated setting appropriate to the
Page 6, Line 9needs of an individual with a disability.
Page 6, Line 1025.5-1-1103. Community-based services - cutting services by
Page 6, Line 11state or public entity - plan to ameliorate risk of institutionalization
Page 6, Line 12for individuals with disabilities. (1) Each public and governmental
Page 6, Line 13entity shall provide home- and community-based services to an
Page 6, Line 14individual with a disability when:
Page 6, Line 15(a) The services are appropriate;
Page 6, Line 16(b) The affected individual does not oppose receiving
Page 6, Line 17home- or community-based treatment or services;
Page 6, Line 18(c) Home- and community-based services can be
Page 6, Line 19reasonably accommodated, taking into account the resources
Page 6, Line 20available to the public or governmental entity and the needs of
Page 6, Line 21others in the community who are receiving home- or
Page 6, Line 22community-based services from the public or governmental
Page 6, Line 23entity; and
Page 6, Line 24(d) There is sufficient risk of institutionalization to
Page 6, Line 25individuals with disabilities who are residing in the community
Page 6, Line 26if the services are not provided.
Page 6, Line 27(2) If the public or governmental entity cuts services, it
Page 7, Line 1shall assess whether the service cuts increase the risk of
Page 7, Line 2institutionalization for those individuals who are receiving
Page 7, Line 3services. If so, the entity shall make a plan to ameliorate the
Page 7, Line 4risk. In making such budget cuts, public and governmental
Page 7, Line 5entities have a duty to take all reasonable steps to avoid
Page 7, Line 6placing individuals with disabilities at risk of
Page 7, Line 7institutionalization.
Page 7, Line 825.5-1-1104. State plan for comprehensive community
Page 7, Line 9integration for individuals with disabilities - regular review and
Page 7, Line 10assessment. (1) On or before September 1, 2026, the state
Page 7, Line 11department shall develop a comprehensive community
Page 7, Line 12integration plan for implementing its obligation to provide
Page 7, Line 13individuals with disabilities with opportunities to live, work, and
Page 7, Line 14be served in the most integrated settings possible. The plan must
Page 7, Line 15include:
Page 7, Line 16(a) An analysis of the extent to which the state is
Page 7, Line 17providing services in the most integrated setting;
Page 7, Line 18(b) Concrete commitments to expand integrated
Page 7, Line 19opportunities for individuals with disabilities;
Page 7, Line 20(c) Specific and reasonable time frames, measurable goals,
Page 7, Line 21and benchmarks for which the state may be held accountable;
Page 7, Line 22(d) Funding sources to support the plan, which may come
Page 7, Line 23from reallocating existing service money; and
Page 7, Line 24(e) Commitments concerning how the state must meet its
Page 7, Line 25goals for each group of individuals with disabilities who are
Page 7, Line 26unnecessarily segregated.
Page 7, Line 27(2) The state department shall review and update the plan
Page 8, Line 1every three years, beginning on September 1, 2029. Part of the
Page 8, Line 2review must be a neutral assessment of whether the time frames,
Page 8, Line 3goals, and benchmarks have been met. If the benchmarks are not
Page 8, Line 4met, the updated plan must include a description of the barriers
Page 8, Line 5that led to the plan not being implemented fully and a plan for
Page 8, Line 6how those barriers will be addressed.
Page 8, Line 725.5-1-1105. Exception for fundamental alteration of an
Page 8, Line 8entity's program. (1) A public or governmental entity is not
Page 8, Line 9required to comply with this part 11 if doing so would require a
Page 8, Line 10fundamental alteration of the entity's program.
Page 8, Line 11(2) (a) The following factors must be considered for
Page 8, Line 12purposes of evaluating a fundamental alteration defense to not
Page 8, Line 13complying with this part 11:
Page 8, Line 14(I) The amount of money the public or governmental
Page 8, Line 15entity allots, spends, receives, or could receive if the entity
Page 8, Line 16applied for available federal funding to provide services to
Page 8, Line 17individuals with disabilities;
Page 8, Line 18(II) All relevant costs, not just those funded by the
Page 8, Line 19single agency that operates or funds the segregated or
Page 8, Line 20integrated setting for individuals with disabilities;
Page 8, Line 21(III) Changes in the costs of the segregated setting
Page 8, Line 22compared with changes in costs of home- or community-based
Page 8, Line 23services; and
Page 8, Line 24(IV) Any possible transitional costs of converting from
Page 8, Line 25segregated to integrated settings for individuals with
Page 8, Line 26disabilities. Transitional costs may be considered, but are not
Page 8, Line 27determinative.
Page 9, Line 1(b) If a public or governmental entity decides to serve
Page 9, Line 2new individuals with disabilities in segregated settings after
Page 9, Line 3individuals with disabilities in a plaintiff class are moved to
Page 9, Line 4integrated settings, rather than to close or downsize the
Page 9, Line 5segregated settings, the costs associated with such a decision
Page 9, Line 6must not be included in the fundamental alteration analysis.
Page 9, Line 7SECTION 3. Act subject to petition - effective date. This act
Page 9, Line 8takes effect at 12:01 a.m. on the day following the expiration of the
Page 9, Line 9ninety-day period after final adjournment of the general assembly; except
Page 9, Line 10that, if a referendum petition is filed pursuant to section 1 (3) of article V
Page 9, Line 11of the state constitution against this act or an item, section, or part of this
Page 9, Line 12act within such period, then the act, item, section, or part will not take
Page 9, Line 13effect unless approved by the people at the general election to be held in
Page 9, Line 14November 2026 and, in such case, will take effect on the date of the
Page 9, Line 15official declaration of the vote thereon by the governor.