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.
This Unofficial Version Includes Committee
Amendments Not Yet Adopted on Second Reading
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; and
Page 3, Line 7(b) The Olmstead decision required states to develop an Olmstead
Page 3, Line 8plan. Colorado's plan, called the "Colorado community living plan", was
Page 3, Line 9developed more than 10 years ago as a collaboration between the state
Page 3, Line 10departments of health care policy and financing, human services, and
Page 3, Line 11local affairs. The plan's effectiveness has never been evaluated or
Page 3, Line 12updated, and the plan is insufficient.
Page 3, Line 13SECTION 2. In Colorado Revised Statutes, add 8-88-102.5 as
Page 3, Line 14follows:
Page 3, Line 158-88-102.5. Comprehensive community integration plan for
Page 3, Line 16individuals with disabilities - review and assessment. (1) On or
Page 3, Line 17before September 1, 2028, CDOO shall serve as the lead agency
Page 3, Line 18responsible for developing a comprehensive community
Page 3, Line 19integration plan, referred to in this section as the "plan", for
Page 3, Line 20implementing the state's commitment to providing individuals
Page 3, Line 21with disabilities opportunities to live, work, and be served in the
Page 3, Line 22least restrictive settings possible. In developing the plan, CDOO
Page 3, Line 23shall collaborate with the department of health care policy
Page 3, Line 24and financing, the department of human services, the
Page 3, Line 25department of local affairs, other state agencies impacted by
Page 3, Line 26the plan, and stakeholders. The plan must include:
Page 3, Line 27(a) An analysis of the extent to which the state is
Page 4, Line 1providing services in the most integrated setting;
Page 4, Line 2(b) Concrete commitments to expand integrated
Page 4, Line 3opportunities for individuals with disabilities;
Page 4, Line 4(c) Specific and reasonable time frames, measurable goals,
Page 4, Line 5and benchmarks for which the state is held accountable;
Page 4, Line 6(d) Funding sources to support the plan, which may come
Page 4, Line 7from reallocating existing service money; and
Page 4, Line 8(e) Commitments concerning how the state will meet its
Page 4, Line 9goals for each group of individuals with disabilities who are
Page 4, Line 10unnecessarily segregated.
Page 4, Line 11(2) The CDOO shall review and update the plan every
Page 4, Line 12three years, beginning on September 1, 2031. Part of the review
Page 4, Line 13must be an assessment of whether the time frames, goals, and
Page 4, Line 14benchmarks set pursuant to subsection (1)(c) of this section have
Page 4, Line 15been met. If the benchmarks were not met, the updated plan must
Page 4, Line 16include a description of the barriers to implementation and how
Page 4, Line 17those barriers will be addressed.
Page 4, Line 18SECTION 3. In Colorado Revised Statutes, add part 11 to article
Page 4, Line 191 of title 25.5 as follows:
Page 4, Line 20PART 11
Page 4, Line 21COMMUNITY INTEGRATION
Page 4, Line 2225.5-1-1101. Definitions.As used in this part 11, unless the
Page 4, Line 23context otherwise requires:
Page 4, Line 24(1) "Community-based services" means any of the
Page 4, Line 25following:
Page 4, Line 26(a) Home health-care services authorized pursuant to
Page 4, Line 27paragraph (7) of section 1905(a) of the "Social Security Act", 42
Page 5, Line 1U.S.C. sec. 1396d(a);
Page 5, Line 2(b) Personal care services authorized pursuant to
Page 5, Line 3paragraph (24) of section 1905(a) of the "Social Security Act", 42
Page 5, Line 4U.S.C. sec. 1396d(a);
Page 5, Line 5(c) PACE services authorized pursuant to paragraph (26)
Page 5, Line 6of section 1905(a) of the "Social Security Act", 42 U.S.C. sec.
Page 5, Line 71396d(a);
Page 5, Line 8(d) Home- and community-based services authorized
Page 5, Line 9pursuant to subsections (b), (c), (i), (j), and (k) of section 1915 of
Page 5, Line 10the "Social Security Act", 42 U.S.C. sec. 1396n; services
Page 5, Line 11authorized pursuant to a waiver under section 1115 of the
Page 5, Line 12"Social Security Act", 42 U.S.C. sec. 1315; and services through
Page 5, Line 13coverage authorized under section 1937 of the "Social Security
Page 5, Line 14Act", 42 U.S.C. sec. 1396u-7;
Page 5, Line 15(e) Case management services authorized under section
Page 5, Line 161905(a)(19) of the "Social Security Act", 42 U.S.C. sec.
Page 5, Line 171396d(a)(19), and section 1915(g) of the "Social Security Act", 42
Page 5, Line 18U.S.C. sec. 1396n(g);
Page 5, Line 19(f) Rehabilitative services, including those related to
Page 5, Line 20behavioral health, described in section 1905(a)(13) of the "Social
Page 5, Line 21Security Act", 42 U.S.C. sec. 1396d(a)(13); and
Page 5, Line 22(g) Any other services specified by the United States
Page 5, Line 23secretary of health and human services.
Page 5, Line 24(2) "Disability" has the same meaning as set forth in the
Page 5, Line 25federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec.
Page 5, Line 2612101 et seq.
Page 5, Line 27(3) "Fundamental alteration" means a change that is so
Page 6, Line 1significant that it alters the essential nature of the goods,
Page 6, Line 2services, facilities, privileges, advantages, or accommodations
Page 6, Line 3offered by a state or public entity.
Page 6, Line 5(4) "Individual with a disability" means an individual with
Page 6, Line 6a disability or disabilities.
Page 6, Line 7(5) "Most integrated setting" means the setting that
Page 6, Line 8enables an individual with a disability to interact to the fullest
Page 6, Line 9extent possible with persons who do not have a disability.
Page 6, Line 10(6) "Plan" means the state's comprehensive community
Page 6, Line 11integration plan, developed pursuant to section 25.5-1-1104.
Page 6, Line 12(7) "Public or governmental entity" means:
Page 6, Line 13(a) The state or any department, board, agency,
Page 6, Line 14instrumentality, authority, or commission of the state; and
Page 6, Line 15(b) Any political subdivision of the state, including:
Page 6, Line 16(I) A county, city, or city and county;
Page 6, Line 17(II) A school district as defined in section 22-36-107;
Page 6, Line 18(III) A local improvement district as defined in section
Page 6, Line 1932-7-103;
Page 6, Line 20(IV) A law enforcement authority;
Page 6, Line 21(V) A water, sanitation, fire protection, metropolitan,
Page 6, Line 22irrigation, drainage, or other special district created pursuant
Page 6, Line 23to title 32;
Page 6, Line 24(VI) Any other municipal, quasi-municipal, or public
Page 6, Line 25corporation organized pursuant to the state constitution or
Page 6, Line 26other law; and
Page 6, Line 27(VII) Any department, board, agency, instrumentality,
Page 7, Line 1authority, or commission of a political subdivision of the state.
Page 7, Line 2(8) "Sufficient risk" means an action or lack of action by
Page 7, Line 3a public or governmental entity that will likely cause a decline
Page 7, Line 4in the health, safety, or welfare of an individual with a
Page 7, Line 5disability that would lead to the placement of the individual in
Page 7, Line 6an institution.
Page 7, Line 725.5-1-1102. Case management-based services and activities.
Page 7, Line 8Each public and governmental entity shall administer services,
Page 7, Line 9programs, and activities in the most integrated setting
Page 7, Line 10appropriate to the needs of an individual with a disability.
Page 7, Line 1125.5-1-1103. Community-based services - cutting services by
Page 7, Line 12state or public entity - plan to ameliorate risk of institutionalization
Page 7, Line 13for individuals with disabilities. (1) Each public and governmental
Page 7, Line 14entity shall provide community-based services to an
Page 7, Line 15individual with a disability when:
Page 7, Line 16(a) The services are appropriate;
Page 7, Line 17(b) The affected individual does not oppose receiving
Page 7, Line 18community-based treatment or services;
Page 7, Line 19(c) Community-based services can be reasonably
Page 7, Line 20accommodated, taking into account the resources available to
Page 7, Line 21the public or governmental entity and the needs of others in the
Page 7, Line 22community who are receiving community-based services from
Page 7, Line 23the public or governmental entity; and
Page 7, Line 24(d) There is sufficient risk of institutionalization to
Page 7, Line 25individuals with disabilities who are residing in the community
Page 7, Line 26if the services are not provided.
Page 7, Line 27(2) If the public or governmental entity cuts services, it
Page 8, Line 1shall assess whether the service cuts increase the risk of
Page 8, Line 2institutionalization for those individuals who are receiving
Page 8, Line 3services. If so, the entity shall make a plan to ameliorate the
Page 8, Line 4risk. In making such budget cuts, public and governmental
Page 8, Line 5entities have a duty to take all reasonable steps to avoid
Page 8, Line 6placing individuals with disabilities at risk of
Page 8, Line 7institutionalization.
Page 8, Line 925.5-1-1104. Exception for fundamental alteration of an
Page 8, Line 10entity's program. (1) A public or governmental entity is not
Page 8, Line 11required to comply with this part 11 if doing so would require a
Page 8, Line 12fundamental alteration of the entity's program.
Page 8, Line 13(2) (a) The following factors must be considered for
Page 8, Line 14purposes of evaluating a fundamental alteration defense to not
Page 8, Line 15complying with this part 11:
Page 8, Line 16(I) The amount of money the public or governmental
Page 8, Line 17entity allots, spends, receives, or could receive if the entity
Page 8, Line 18applied for available federal funding to provide services to
Page 8, Line 19individuals with disabilities;
Page 8, Line 20(II) All relevant costs, not just those funded by the
Page 8, Line 21single agency that operates or funds the segregated or
Page 8, Line 22integrated setting for individuals with disabilities;
Page 8, Line 23(III) Changes in the costs of the segregated setting
Page 8, Line 24compared with changes in costs of community-based services;
Page 8, Line 25and
Page 8, Line 26(IV) Any possible transitional costs of converting from
Page 8, Line 27segregated to integrated settings for individuals with
Page 9, Line 1disabilities. Transitional costs may be considered, but are not
Page 9, Line 2determinative.
Page 9, Line 3(b) If a public or governmental entity decides to serve
Page 9, Line 4new individuals with disabilities in segregated settings after
Page 9, Line 5individuals with disabilities in a plaintiff class are moved to
Page 9, Line 6integrated settings, rather than to close or downsize the
Page 9, Line 7segregated settings, the costs associated with such a decision
Page 9, Line 8must not be included in the fundamental alteration analysis.
Page 9, Line 9SECTION 4. In Colorado Revised Statutes, amend 8-88-205 as
Page 9, Line 10follows:
Page 9, Line 118-88-205. Disability support fund. (1) There is created in the
Page 9, Line 12state treasury the disability support fund, which consists of money that
Page 9, Line 13may be appropriated or transferred to the fund by the general assembly;
Page 9, Line 14and any gifts, grants, or donations received by the department for the
Page 9, Line 15purpose of implementing this
part 2Page 9, Line 16(2) The money in the fund is subject to annual appropriation by
Page 9, Line 17the general assembly for the direct and indirect costs associated with the
Page 9, Line 18implementation of this
part 2Page 9, Line 19expended for the purpose of this section may be invested by the state
Page 9, Line 20treasurer as provided by law. All interest and income derived from the
Page 9, Line 21investment and deposit of money in the fund must be credited to the fund.
Page 9, Line 22Any unexpended and unencumbered money remaining in the fund at the
Page 9, Line 23end of a fiscal year must remain in the fund for use as provided in this
Page 9, Line 24
part 2Page 9, Line 25fund or another fund. If this section is repealed, prior to its repeal, all
Page 9, Line 26unexpended and unencumbered money remaining in the fund must be
Page 9, Line 27transferred to the general fund.
Page 10, Line 1SECTION 5. Act subject to petition - effective date. This act
Page 10, Line 2takes effect at 12:01 a.m. on the day following the expiration of the
Page 10, Line 3ninety-day period after final adjournment of the general assembly; except
Page 10, Line 4that, if a referendum petition is filed pursuant to section 1 (3) of article V
Page 10, Line 5of the state constitution against this act or an item, section, or part of this
Page 10, Line 6act within such period, then the act, item, section, or part will not take
Page 10, Line 7effect unless approved by the people at the general election to be held in
Page 10, Line 8November 2026 and, in such case, will take effect on the date of the
Page 10, Line 9official declaration of the vote thereon by the governor.