A Bill for an Act
Page 1, Line 101Concerning the implementation of the recommendations
Page 1, Line 102made by the direct care workforce stabilization board.
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 implements recommendations made by the direct care workforce stabilization board (board) by:
- Requiring the board to investigate health-care benefits for the direct care workforce;
- Requiring the department of labor and employment (department) to collaborate with the board and other entities to establish a comprehensive "know your rights" training for direct care workers;
- Requiring the department to ensure that the "know your rights" training is available to direct care workers, to allow worker organizations to participate in the training free of charge, and to report direct care worker training completion information to the board; and
- Requiring direct care employers to conduct and document direct care worker training attendance, distribute a notice of rights to direct care workers, and inform all employees about the direct care worker website and communication platform established by the department of health care policy and financing.
- Establish a website and communication platform for direct care workers;
- In coordination with the board, develop a direct care worker-specific notice of rights for direct care employers;
- Collaborate with direct care employers to inform direct care workers about the website and communication platform;
- Allow specified entities access to the contact information of each direct care worker enrolled in the communication platform; and
- Convene and administer an interested party advisory group pursuant to federal requirements.
The bill also requires the director of the division of labor standards and statistics (director) in the department to provide compliance assistance to direct care employers and investigate possible violations by the employers. The director is also required to enforce compliance with the requirements in the bill.
To implement the board's recommendations, the bill also requires the department of health care policy and financing to:
The bill also establishes the direct care worker minimum wage at $17 per hour beginning July 1, 2025, and encourages the state to set the minimum wage for direct care workers at $25 per hour by January 1, 2028.
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 finds and declares that:
Page 2, Line 3(a) Colorado's long-term care system is in crisis;
Page 3, Line 1(b) Colorado's population of adults aged 65 and older is projected
Page 3, Line 2to grow by 36% by 2030, reaching 1.2 million people. Meanwhile, the
Page 3, Line 3state relies on just 59,000 direct care workers to meet this growing
Page 3, Line 4demand, which is far too few to ensure everyone who needs care can access it.
Page 3, Line 5(c) Over 80% of Colorado's direct care workforce are women, and 44% are women of color;
Page 3, Line 6(d) Not all direct care workers are paid a livable wage, many do
Page 3, Line 7not have basic benefits like personal time off and health insurance, and
Page 3, Line 8some experience wage theft and workplace discrimination, leading to a high turnover rate;
Page 3, Line 9(e) In 2023, the general assembly established the direct care
Page 3, Line 10workforce stabilization board, bringing direct care workers, individuals
Page 3, Line 11receiving care, and direct care industry representatives to study the systemic issues driving high turnover and direct care worker shortages;
Page 3, Line 12(f) By 2028, the federal Centers for Medicare and Medicaid
Page 3, Line 13Services will require states to report the percentage of Medicaid payments made for direct care worker compensation; and
Page 3, Line 14(g) The federal Centers for Medicare and Medicaid Services
Page 3, Line 15provides states with 90% of federal funding to implement the direct care worker communication platforms.
Page 3, Line 16(2) Therefore, the intent of the general assembly is to implement
Page 3, Line 17the direct care workforce stabilization board's recommendations to
Page 3, Line 18stabilize the state's direct care workforce and to ensure Coloradans have
Page 3, Line 19access to the high-quality, comprehensive, in-home care they need. The
Page 3, Line 20recommendations include compliance with federal laws and regulations
Page 3, Line 21concerning payment of direct care workers and the acceptance of federal money to support a communication platform.
Page 4, Line 1SECTION 2. In Colorado Revised Statutes, 8-7.5-104, add (3.5) as follows:
Page 4, Line 28-7.5-104. Duties of the board - recommendations for
Page 4, Line 3minimum direct care employment standards - analysis of market
Page 4, Line 4conditions - public outreach - report. (3.5) The board shall
Page 4, Line 5investigate health-care benefits for the direct care workforce,
Page 4, Line 6including the overall costs within the industry in comparison to
Page 4, Line 7other similar industries, the implications of a family caregiver
Page 4, Line 8model for direct care workers on health insurance costs,
Page 4, Line 9innovative solutions for improving quality of care, and
Page 4, Line 10reducing the cost of care and how to fund the health-care benefits.
Page 4, Line 11SECTION 3. In Colorado Revised Statutes, add 8-7.5-108 and 8-7.5-109 as follows:
Page 4, Line 128-7.5-108. Direct care employers - direct care worker rights
Page 4, Line 13training - direct care worker communication platform - direct care
Page 4, Line 14worker website. (1) By January 1, 2026, the department shall
Page 4, Line 15collaborate with the board and any other entities deemed
Page 4, Line 16relevant by the department to establish a comprehensive "know
Page 4, Line 17your rights" training for direct care workers that includes information concerning:
Page 4, Line 18(a) The direct care worker base wage;
(b) Wages and hours for overtime work;
Page 4, Line 19(c) The "Healthy Families and Workplaces Act", part 4 of article 13.3 of this title 8;
Page 4, Line 20(d) The "Family Care Act", part 2 of title 13.3 of this title 8;
Page 5, Line 1(e) The federal "Patient Protection and Affordable Care Act", Pub.L. 111-148, as it relates to worker rights;
Page 5, Line 2(f) Travel time rules, as the rules relate to the employment of direct care workers;
Page 5, Line 3(g) Civil rights protected by Colorado law that are relevant to the employment of direct care workers;
Page 5, Line 4(h) Where a direct care worker can learn more about the topics covered in the training;
Page 5, Line 5(i) Where and how to file a complaint, including rights
Page 5, Line 6secured under the "Protecting Opportunities and Workers' Rights Act", Senate Bill 23-172, enacted in 2023; and
Page 5, Line 7(j) The contents of the website established in section
Page 5, Line 825.5-1-208, how to use the communication platform established
Page 5, Line 9in section 25.5-1-208, the benefits to the direct care worker of
Page 5, Line 10participation in the communication platform, how direct care
Page 5, Line 11worker contact information will be used, and how to opt in to and opt out of the communication platform.
Page 5, Line 12(2) The department shall:
Page 5, Line 13(a) Ensure that the comprehensive "know your rights"
Page 5, Line 14training required to be established by subsection (1) of this
Page 5, Line 15section is available to direct care workers and direct care employers;
Page 5, Line 16(b) Allow worker organizations to participate in the "know your rights" training;
Page 5, Line 17(c) Not charge a fee to direct care employers or direct
Page 5, Line 18care workers for the "know your rights" training; and
Page 6, Line 1(d) Report periodically to the board concerning direct care worker completion of the "know your rights" training.
Page 6, Line 2(3) A direct care employer shall:
Page 6, Line 3(a) Require each direct care worker to provide
Page 6, Line 4documentation of a completed "know your rights" training or to
Page 6, Line 5attend the "know your rights" training administered by the
Page 6, Line 6department that is in place prior to January 1, 2026, and the
Page 6, Line 7"know your rights" training established pursuant to subsection
Page 6, Line 8(1) of this section during the direct care worker's regular paid
Page 6, Line 9work hours and at no charge to the direct care worker or to a direct care consumer;
Page 6, Line 10(b) Distribute a direct care worker-specific notice of
Page 6, Line 11rights developed by the department in coordination with the
Page 6, Line 12department of health care policy and financing pursuant to
Page 6, Line 13section 25.5-1-208 (3)(a) to each direct care worker at the time of
Page 6, Line 14hire that includes information on the "know your rights" training;
Page 6, Line 15(c) Inform all employees about the direct care worker
Page 6, Line 16website and communication platform established by the
Page 6, Line 17department of health care policy and financing pursuant to section 25.5-1-208; and
Page 6, Line 18(d) Inform each direct care worker of the contents of the
Page 6, Line 19website and communication platform, how to use the platform,
Page 6, Line 20how to opt in to the platform, how contact information may be
Page 6, Line 21shared, and how to opt out of the enrollment in and communications from the platform.
Page 6, Line 228-7.5-109. Compliance assistance - violations - enforcement.
Page 7, Line 1(1) The director of the division of labor standards and
Page 7, Line 2statistics shall provide compliance assistance to direct care
Page 7, Line 3employers as warranted and shall investigate leads concerning
Page 7, Line 4possible violations of the training and notice requirements set
Page 7, Line 5forth in this article 7.5 and other alleged labor violations
Page 7, Line 6against direct care workers that, in the director's good faith discretion and judgment, warrant investigation.
Page 7, Line 7(2) The director of the division of labor standards and
Page 7, Line 8statistics shall enforce compliance and shall impose a fine on a
Page 7, Line 9direct care employer that violates this article 7.5 of one
Page 7, Line 10hundred dollars for each direct care worker affected by each
Page 7, Line 11violation; except that a direct care employer that
Page 7, Line 12demonstrates a good faith effort to comply with this article 7.5
Page 7, Line 13is not subject to a fine for the employer's first violation. The
Page 7, Line 14director shall double the amount of the fine for each violation after a section violation by an employer.
Page 7, Line 15SECTION 4. In Colorado Revised Statutes, add 25.5-1-208 and 25.5-1-209 as follows:
Page 7, Line 1625.5-1-208. Direct care worker website and communication
Page 7, Line 17platform - enrollment of direct care workers - training, worker
Page 7, Line 18rights, employment matching - department of labor and employment
Page 7, Line 19access - gifts, grants, or donations - definitions. (1) As used in this
Page 7, Line 20section and section 25.5-1-209, unless the context otherwise requires:
Page 7, Line 21(a) "Board" means the direct care workforce stabilization board created in section 8-7.5-103.
Page 7, Line 22(b) "Direct care consumer" has the meaning set forth in section 8-7.5-102.
Page 8, Line 1(c) "Direct care employer" has the meaning set forth in section 8-7.5-102.
Page 8, Line 2(d) "Direct care services" has the meaning set forth in section 8-7.5-102.
Page 8, Line 3(e) "Direct care worker" has the meaning set forth in section 8-7.5-102.
Page 8, Line 4(f) "Medical assistance program" means the "Colorado Medical Assistance Act", articles 4 to 6 of this title 25.5.
Page 8, Line 5(g) "Platform" or "communication platform" means the
Page 8, Line 6direct care worker communication platform created in this section.
Page 8, Line 7(h) "Website" means the direct care worker website created in this section.
Page 8, Line 8(i) "Worker organization" has the meaning set forth in section 8-7.5-102.
Page 8, Line 9(2) The state department shall collaborate with the
Page 8, Line 10board to establish a direct care worker website and
Page 8, Line 11communication platform for direct care workers. The state department shall ensure that the platform:
Page 8, Line 12(a) Supports direct care consumers in identifying and employing qualified direct care workers;
Page 8, Line 13(b) Facilitates recruitment and retention of direct care
Page 8, Line 14workers paid through reimbursement by the medical assistance program;
Page 8, Line 15(c) Ensures access to care for all members;
Page 8, Line 16(d) Supports the state department in monitoring access to
Page 9, Line 1and quality of care for direct care consumers who receive direct care services;
Page 9, Line 2(e) Provides a regular cadence of communication by the
Page 9, Line 3state department, to be determined in consultation with the
Page 9, Line 4board, to workers who have opted in to the communication
Page 9, Line 5platform, including updates from the board, relevant state
Page 9, Line 6department initiatives, and potential changes to worker rights and benefits;
Page 9, Line 7(f) Maintains an electronic employment matching system
Page 9, Line 8to help direct care consumers identify direct care workers with
Page 9, Line 9the right availability and skill set, experience with dementia, language proficiency, and specific certifications; and
Page 9, Line 10(g) Provides each direct care worker with the opportunity to opt in to and opt out of the communication platform.
Page 9, Line 11(3) The state department shall:
Page 9, Line 12(a) In coordination with the board, develop a direct care
Page 9, Line 13worker-specific notice of rights for direct care employers to
Page 9, Line 14distribute to their employees pursuant to section 8-7.5-108 (3)(b); and
Page 9, Line 15(b) Collaborate with direct care employers to inform direct care workers of the benefits of the platform.
Page 9, Line 16(4) (a) The website must include:
Page 9, Line 17(I) Training on direct care worker basic job duties, health
Page 9, Line 18and safety in the workplace, and how to provide culturally competent care;
Page 9, Line 19(II) Information regarding direct care worker rights,
Page 9, Line 20including increases to the direct care worker base wage; the
Page 10, Line 1"Healthy Families and Workplaces Act", part 4 of article 13.3 of
Page 10, Line 2title 8; new labor laws, rules, regulations, and practices; or
Page 10, Line 3other laws, rules, regulations, and processes designed to stabilize the direct care workforce;
Page 10, Line 4(III) A calendar of the training events that are provided
Page 10, Line 5by the state department and are free of charge to direct care
Page 10, Line 6workers concerning the rights of direct care workers and the information that can be learned in each training;
Page 10, Line 7(IV) The ability for communication platform users to opt in to and opt out of platform communications;
Page 10, Line 8(V) Communication on how direct care workers can access medical assistance program benefits, including:
Page 10, Line 9(A) Medical assistance program buy-in for working adults with disabilities; and
Page 10, Line 10(B) Medical assistance for a family member in the direct
Page 10, Line 11care worker's household with a disability or who is sixty-five years of age or older;
Page 10, Line 12(VI) Access to the state department's core curriculum training; and
Page 10, Line 13(VII) A link to the state department's direct care worker survey.
Page 10, Line 14(b) The state department shall review and approve all
Page 10, Line 15website and communication platform content for accuracy before it is posted publicly.
Page 10, Line 16(5) (a) Within three months after the establishment of the
Page 10, Line 17communication platform and every three months thereafter,
Page 10, Line 18the state department shall allow the department of labor and
Page 11, Line 1employment, worker organizations, industry organizations, and
Page 11, Line 2organizations representing direct care consumers to have
Page 11, Line 3access to the contact information for each direct care worker
Page 11, Line 4enrolled in the communication platform to inform the worker
Page 11, Line 5of their rights, to support the worker in engaging with the
Page 11, Line 6board, and to accomplish the communication platform's direct care consumer-matching functions.
Page 11, Line 7(b) In fulfilling the obligations of this section, the state
Page 11, Line 8department, worker organizations, industry organizations, and
Page 11, Line 9organizations representing direct care consumers must comply
Page 11, Line 10with applicable laws and rules protecting personally
Page 11, Line 11identifying information. Worker organizations and
Page 11, Line 12organizations representing direct care consumers shall not
Page 11, Line 13have access to the name or private data of any direct care
Page 11, Line 14consumer or direct care consumer's representative or indicate
Page 11, Line 15that an individual direct care worker is a direct care
Page 11, Line 16consumer's relative or has the same address as a direct care consumer.
Page 11, Line 1725.5-1-209. Duties of the state department - recommendations
Page 11, Line 18for minimum direct care employment standards - analysis of market
Page 11, Line 19conditions - public outreach - advisory group - report. (1) The definitions in section 25.5-1-208 apply to this section.
Page 11, Line 20(2) (a) Pursuant to the federal centers for medicare and
Page 11, Line 21medicaid requirements, the state department shall convene an
Page 11, Line 22interested parties advisory group at least every two years and
Page 11, Line 23as often as the state department deems necessary. The advisory
Page 11, Line 24group must include health-care providers, representatives of
Page 12, Line 1the state department and the department of labor and
Page 12, Line 2employment, representatives of worker organizations, and
Page 12, Line 3representatives of industry organizations. The advisory group
Page 12, Line 4shall make recommendations to the board concerning adequate wages and other workforce support for direct care workers.
Page 12, Line 5(b) The department shall administer the advisory group in accordance with 42 CFR 447.203 (b)(6).
Page 12, Line 6(c) Notwithstanding section 24-1-136 (11)(a)(I), on or
Page 12, Line 7before January 1, 2027, and annually thereafter, the state
Page 12, Line 8department shall report to the board and the joint budget committee of the general assembly:
Page 12, Line 9(I) The percentage of home- and community-based services
Page 12, Line 10payments that direct care workers received in compensation,
Page 12, Line 11including salaries, wages, benefits, and payroll taxes, in the previous state fiscal year; and
Page 12, Line 12(II) The percentage of home- and community-based
Page 12, Line 13services payments that direct care employers received in the previous state fiscal year.
Page 12, Line 14SECTION 5. In Colorado Revised Statutes, 25.5-6-1603, amend (2) as follows:
Page 12, Line 1525.5-6-1603. Minimum wage - wage pass-through requirement
Page 12, Line 16for certain home care agencies - applicability - reports - recovery.
Page 12, Line 17(2) (a) On and after
July 1, 2020Page 12, Line 18rate for
personsPage 12, Line 19including personal care services, homemaker services, or in-home
Page 12, Line 20support services for which a home care agency may receive
Page 12, Line 21reimbursement pursuant to the "Colorado Medical Assistance Act", is
twelve dollars and forty-one centsPage 13, Line 1(b) The state is encouraged to institute an hourly
Page 13, Line 2minimum wage rate of twenty-five dollars per hour by January 1, 2028, for individuals who provide direct care services.
Page 13, Line 3(c) The state department shall enforce the minimum direct care worker base wage that is required by this subsection (2).
Page 13, Line 4SECTION 6. Act subject to petition - effective date. This act
Page 13, Line 5takes effect at 12:01 a.m. on the day following the expiration of the
Page 13, Line 6ninety-day period after final adjournment of the general assembly; except
Page 13, Line 7that, if a referendum petition is filed pursuant to section 1 (3) of article V
Page 13, Line 8of the state constitution against this act or an item, section, or part of this
Page 13, Line 9act within such period, then the act, item, section, or part will not take
Page 13, Line 10effect unless approved by the people at the general election to be held in
Page 13, Line 11November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.