House Bill 25-1184 Revised

A Bill for an Act

• Page 1, Line 101Concerning community-based continuing care services for

• Page 1, Line 102seniors awaiting admission to a life care institution.

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.)

Under current law, life care institutions provide life and health support services to resident seniors who reside at the life care institution through the help of independent living arrangements, assisted living, or skilled nursing. The bill allows life care institutions to provide community-based continuing care services to seniors in their homes and other services that benefit individuals who are awaiting admission to a life care institution.

• Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:

• Page 2, Line 2SECTION 1.  In Colorado Revised Statutes, amend 11-49-101 as follows:

• Page 2, Line 311-49-101.  Definitions. As used in this article 49, unless the context otherwise requires:

• Page 2, Line 4(1)  "Aged person" means any person sixty-two years of age or older.

• Page 2, Line 5(2)  "Board" means the financial services board created in section 11-44-101.6.

• Page 2, Line 6(3)  "Commissioner" means the state commissioner of financial services, serving in accordance with section 11-44-102.

• Page 2, Line 7(4)  "Community-based continuing care" or "CBCC" means

• Page 2, Line 8a program providing or committing to provide a range of

• Page 2, Line 9services to a participant pursuant to a contract effective for

• Page 2, Line 10the life of the individual and in consideration of the payment of

• Page 2, Line 11a one-time entrance fee or a monthly fee. "Community-based

• Page 2, Line 12continuing care" or "CBCC" also means the provision of services

• Page 2, Line 13to an individual in the individual's private residence, when

• Page 2, Line 14medically feasible, and providing facility-based long-term care

• Page 2, Line 15services, when required, either directly or indirectly through affiliated services or contractual arrangements.

• Page 2, Line 16(5)  "Community-based continuing care entrance fee" or

• Page 2, Line 17"CBCC entrance fee" means an initial or deferred transfer to a

• Page 2, Line 18CBCC provider of a sum of money or other property made or

• Page 2, Line 19promised to be made in advance or at some future time as full or

• Page 3, Line 1partial consideration for acceptance of an individual as a participant.

• Page 3, Line 2(6)  "Community-based continuing care provider" or "CBCC

• Page 3, Line 3provider" means a provider who provides or offers to provide

• Page 3, Line 4community-based continuing care to a participant and has

• Page 3, Line 5operated a life care institution pursuant to this article 49 for at least three years.

• Page 3, Line 6(4)  (7)  "Entrance fee" means the total of any initial or deferred

• Page 3, Line 7transfer to or for the benefit of a provider made pursuant to a life care contract, which transfer:

• Page 3, Line 8(a)  Is made or promised to be made as full or partial consideration

• Page 3, Line 9for the acceptance or maintenance of a specified individual as a resident in a facility; and

• Page 3, Line 10(b)  Is in the form of:

• (I)  Property; or

• Page 3, Line 11(II)  A sum of money in an amount that is greater than four times

• Page 3, Line 12the amount of a regular periodic charge under a life care contract at the facility.

• Page 3, Line 13(5)  (8)  "Facility" means the place with living units in which a provider undertakes to provide life care to a resident.

• Page 3, Line 14(6)  (9)  "Life care" means care provided, made available to a

• Page 3, Line 15resident of a living unit by a provider pursuant to a life care

• Page 3, Line 16contract, for the life of an aged person, including, but not limited to,

• Page 3, Line 17services such as occupancy of a living unit, health care, nutrition

• Page 3, Line 18assistance, medical services, and nursing services within a living unit

• Page 3, Line 19board, lodging, nursing services, or other services required by

• Page 3, Line 20a life care contract.

• Page 4, Line 1(7)  (10)  "Life care contract" means a written contract to provide

• Page 4, Line 2life care to a person for the duration of the person's life conditioned upon

• Page 4, Line 3the transfer of an entrance fee to the provider of the services in addition

• Page 4, Line 4to or in lieu of the payment of regular periodic charges for the life care

• Page 4, Line 5and services involved. A life care contract under which the entrance fee

• Page 4, Line 6is payable to or for the provider in four or more installments is subject to

• Page 4, Line 7the provisions of the "Uniform Consumer Credit Code", articles 1 to 9 of title 5.

• Page 4, Line 8(8)  (11)  "Living unit" means a room, apartment, or other area that

• Page 4, Line 9is within a facility and set aside for the use of one or more identified

• Page 4, Line 10residents and within which life care is provided made available by the

• Page 4, Line 11provider. A resident's living unit may change based on the appropriate care needs of the resident.

• Page 4, Line 12(12)  "Participant" means an individual who has entered into a community-based continuing care contract.

• Page 4, Line 13(9)  (13)  "Person" means all corporations, associations,

• Page 4, Line 14partnerships, or individuals, including fraternal or benevolent orders or societies.

• Page 4, Line 15(14)  "Private residence" means the place where a CBCC

• Page 4, Line 16provider provides CBCC to a participant and does not include a living unit or a facility.

• Page 4, Line 17(10)  (15) (a)  "Provider" means a person who undertakes to provide services in a facility pursuant to a life care contract.

• Page 4, Line 18(b)  "Provider" does not include a unit owners' association, as defined in section 38-33.3-103 (3).

• Page 4, Line 19(16)  "Range of services" means services that enable a

• Page 4, Line 20participant to live safely in the participant's private residence.

• Page 5, Line 1(11)  (17)  "Resident" means any person entitled pursuant to a life care contract to receive life care in a facility.

• Page 5, Line 2(12)  (18)  "Third-party service providers" means any person, other

• Page 5, Line 3than a provider, who is the holder of a management contract with a

• Page 5, Line 4provider or who contracts with a provider to provide life care services to residents.

• Page 5, Line 5SECTION 2.  In Colorado Revised Statutes, 11-49-103, amend (2) as follows:

• Page 5, Line 611-49-103.  Withdrawal or dismissal of person - refund. (2)  If

• Page 5, Line 7the provider is an organization described in section 501 (c)(3) of the

• Page 5, Line 8federal "Internal Revenue Code of 1986", as amended, and exempt from

• Page 5, Line 9income taxation under section 501 (a) of the federal "Internal Revenue

• Page 5, Line 10Code of 1986", as amended, it shall be or has a policy not to

• Page 5, Line 11terminate a resident's life care contract due to the inability to

• Page 5, Line 12pay if the resident is otherwise compliant with the life care

• Page 5, Line 13contract, the provider is entitled to make a refund according to a

• Page 5, Line 14schedule provided in its agreement with the resident so long as the

• Page 5, Line 15schedule provides for amortization of the amount paid by the resident

• Page 5, Line 16over a period of not less than sixty months or over the life expectancy of

• Page 5, Line 17the resident if the expectancy is less than sixty months. In such case, the

• Page 5, Line 18refund may be delayed for a reasonable period thereafter until the

• Page 5, Line 19securing by the provider of a substitute fee from another resident or

• Page 5, Line 20prospective resident. The provider may also deduct from any such refund

• Page 5, Line 21amounts due it from the resident for damage done or for any other legitimate offsetting item.

• Page 5, Line 22SECTION 3.  In Colorado Revised Statutes, 11-49-105, add (4)

• Page 5, Line 23as follows:

• Page 6, Line 111-49-105.  Reserve requirements. (4)  A CBCC provider shall

• Page 6, Line 2maintain separate reserves tied to an actuarial assessment, in

• Page 6, Line 3the form and manner required by the commissioner, in order for

• Page 6, Line 4the provider to fully perform its obligations under its community-based continuing care contracts.

• Page 6, Line 5SECTION 4.  In Colorado Revised Statutes, 11-49-106, amend (1), (2), and (3) as follows:

• Page 6, Line 611-49-106.  Annual report by providers - fee. (1)  Each A

• Page 6, Line 7provider and CBCC provider shall file an annual report reports with

• Page 6, Line 8the commissioner within ninety days after the end of its their fiscal year

• Page 6, Line 9that contains contain the certified financial statements for each facility

• Page 6, Line 10or program and such other information as may be required by the

• Page 6, Line 11commissioner. The annual report shall reports must be made in a form prescribed by the commissioner.

• Page 6, Line 12(2)  A provider and CBCC provider shall amend its their annual

• Page 6, Line 13report reports on file with the commissioner if an amendment is

• Page 6, Line 14necessary to prevent the report reports from containing a material misstatement of fact or omission of a material fact.

• Page 6, Line 15(3)  A provider and CBCC provider shall make its their annual report reports available to residents or participants upon request.

• Page 6, Line 16SECTION 5.  In Colorado Revised Statutes, amend 11-49-107 as follows:

• Page 6, Line 1711-49-107.  Examination - fees. The commissioner may conduct

• Page 6, Line 18an examination of the affairs of any a provider or CBCC provider as

• Page 6, Line 19often as the commissioner deems it necessary for the protection of the

• Page 6, Line 20interests of the people of this state. Providers and CBCC providers shall

• Page 6, Line 21maintain copies of their books and records in Colorado to provide access

• Page 7, Line 1for the purposes of this article 49. The commissioner shall assess each

• Page 7, Line 2provider at least semiannually, to cover the annual direct and indirect

• Page 7, Line 3costs of examinations, supervision, and administration conducted

• Page 7, Line 4pursuant to the provisions of this section. The assessments shall must be

• Page 7, Line 5calculated in terms of cents per thousand dollars of total escrowed

• Page 7, Line 6entrance fees and reserves maintained. The assessment calculation, or

• Page 7, Line 7ratio of the assessment charged to total escrowed entrance fees and

• Page 7, Line 8reserves maintained, shall must be alike in all cases. On or before the

• Page 7, Line 9dates specified by the commissioner, each association provider and

• Page 7, Line 10CBCC provider shall pay its assessment. If deemed necessary, the

• Page 7, Line 11commissioner may estimate a per diem rate to be charged for

• Page 7, Line 12examinations and charge a provider or CBCC provider for the actual cost of any examination documented by the commissioner.

• Page 7, Line 13SECTION 6.  In Colorado Revised Statutes, amend 11-49-109 as follows:

• Page 7, Line 1411-49-109.  Violation.Any A person acting in the capacity of a

• Page 7, Line 15provider or CBCC provider who enters into a life care contract or

• Page 7, Line 16CBCC contract, or extends the term of an existing life care contract or

• Page 7, Line 17CBCC contract, without acting in compliance with the provisions of this article 49 commits a class 2 misdemeanor.

• Page 7, Line 18SECTION 7.  In Colorado Revised Statutes, amend 11-49-110 as follows:

• Page 7, Line 1911-49-110.  Article does not apply to facilities licensed by

• Page 7, Line 20department of public health and environment. The provisions of this

• Page 7, Line 21article 49 shall not apply to any hospital or other facility that the

• Page 7, Line 22department of public health and environment is authorized to license

• Page 7, Line 23pursuant to part 1 of article 1.5 and part 1 of article 3 of title 25; except

• Page 8, Line 1that nursing care facilities, and assisted living residences, and home

• Page 8, Line 2health agencies that are part of the facility of a provider as defined in section 11-49-101 shall be are subject to the provisions of this article 49.

• Page 8, Line 3SECTION 8.  In Colorado Revised Statutes, 11-49-111, add (2), (3), and (4) as follows:

• Page 8, Line 411-49-111.  Life care contract and CBCC contract - content.

• Page 8, Line 5(2)  A community-based continued care contract must be written

• Page 8, Line 6in a clear and coherent manner using words with common and everyday meanings and must:

• Page 8, Line 7(a)  Show the value of all property transferred, including

• Page 8, Line 8donations, subscriptions, fees, and any other amounts paid or payable by, or on behalf of, the participant;

• Page 8, Line 9(b)  Show all services that are provided by the CBCC

• Page 8, Line 10provider to the prospective participant, including, in detail, all

• Page 8, Line 11items that the participant will receive, whether the items will be

• Page 8, Line 12provided for a designated time period or for the life of the participant, and the monthly charge for the service;

• Page 8, Line 13(c)  Be accompanied by a financial statement showing in

• Page 8, Line 14reasonable detail the financial condition of the CBCC provider,

• Page 8, Line 15including a statement of earnings for the previous thirty-six months, that must be furnished to the prospective participant;

• Page 8, Line 16(d)  Describe the physical health, mental health, and

• Page 8, Line 17financial conditions of the participant under which the CBCC

• Page 8, Line 18provider may require the participant to end their participation in the program;

• Page 8, Line 19(e)  Describe the circumstances under which a participant

• Page 8, Line 20may remain in the program in the event that a participant is unable to produce a required payment;

• Page 9, Line 1(f) (I)  Provide that the CBCC provider shall not cancel a

• Page 9, Line 2community-based continuing care contract with the participant

• Page 9, Line 3without showing good cause. Good cause is limited to the following:

• Page 9, Line 4(A)  Proof that the participant is a danger to themself or others;

• Page 9, Line 5(B)  Persistent nonpayment by the participant of a monthly or periodic fee;

• Page 9, Line 6(C)  Repeated conduct by the participant that interferes with other participants' quiet enjoyment of a facility or service;

• Page 9, Line 7(D)  Persistent refusal to comply with written rules and regulations of the program;

• Page 9, Line 8(E)  A material misrepresentation made intentionally or

• Page 9, Line 9recklessly by the participant in their application for

• Page 9, Line 10participation in the program, or related materials, regarding

• Page 9, Line 11information that, if accurately provided, would result in either

• Page 9, Line 12the participant not qualifying for participation or a material

• Page 9, Line 13increase in the cost of providing the care and services provided under the CBCC contract to the participant; or

• Page 9, Line 14(F)  A material breach by the participant of the terms and conditions of the community-based continuing care contract.

• Page 9, Line 15(II)  If a CBCC provider intends to cancel a CBCC contract

• Page 9, Line 16and terminate a participant's participation, the provider must

• Page 9, Line 17give the participant written notice of, and a reasonable

• Page 9, Line 18opportunity to cure within a reasonable period, the conduct

• Page 9, Line 19that warrants the cancellation of the CBCC contract. The

• Page 10, Line 1notice must specify which of the circumstances described in

• Page 10, Line 2subsection (2)(f)(I) of this section occurred that warrants termination of the CBCC contract.

• Page 10, Line 3(g)  Provide in clear and understandable language, in

• Page 10, Line 4print no larger than the largest type used in the body of the

• Page 10, Line 5CBCC contract, the terms governing a refund of a portion of the

• Page 10, Line 6CBCC entrance fee and the manner in which the CBCC provider may use the funds from the CBCC entrance fee if not refunded;

• Page 10, Line 7(h)  State the terms that a CBCC contract is cancelled by

• Page 10, Line 8the death of the participant. The CBCC contract may contain a

• Page 10, Line 9provision to the effect that, upon the death of the participant,

• Page 10, Line 10the money paid for the community-based continuing care of the

• Page 10, Line 11participant is considered earned and is property of the CBCC provider.

• Page 10, Line 12(i)  Provide a participant with at least a thirty-day notice

• Page 10, Line 13prior to a change in fees, charges, or the scope of care or services, except for changes required by state or federal law.

• Page 10, Line 14(3)  A participant has the right to rescind a CBCC

• Page 10, Line 15contract and receive a full refund of the CBCC entrance fee

• Page 10, Line 16within seven days after making an initial deposit or executing

• Page 10, Line 17the CBCC contract. A participant is not required to begin the

• Page 10, Line 18provision of care or services outlined in the participant's CBCC contract before the expiration of the seven-day period.

• Page 10, Line 19(4)  If a participant dies before the program begins, or is

• Page 10, Line 20precluded from participating in the program due to illness,

• Page 10, Line 21injury, or incapacity, the contract automatically rescinds and

• Page 10, Line 22the participant or the participant's legal representative must

• Page 11, Line 1receive a full refund of all money paid to the CBCC provider,

• Page 11, Line 2except costs specifically incurred by the CBCC provider at the

• Page 11, Line 3request of the participant and set forth in writing in a separate addendum signed by both parties to the contract.

• Page 11, Line 4SECTION 9.  In Colorado Revised Statutes, 11-49-112, amend (1) introductory portion and (1)(f); and repeal (1)(e) as follows:

• Page 11, Line 511-49-112.  Register. (1)  Every provider and CBCC provider

• Page 11, Line 6shall maintain a register setting forth the following facts concerning each

• Page 11, Line 7person or participant residing in the a life care institution or receiving CBCC:

• Page 11, Line 8(e)  Mother's maiden name;

• Page 11, Line 9(f)  The person responsible for each resident's care and maintenance; and

• Page 11, Line 10SECTION 10.  In Colorado Revised Statutes, amend 11-49-113 as follows:

• Page 11, Line 1111-49-113.  Advertisements and solicitations of life care

• Page 11, Line 12contracts and CBCC contracts - requirements. Any report, circular,

• Page 11, Line 13public announcement, certificate, or financial statement, or any other

• Page 11, Line 14printed matter or advertising material that is designed for or used to solicit

• Page 11, Line 15or induce persons to enter into any life care contract or CBCC

• Page 11, Line 16contract, and that lists or refers to the name of any individual or

• Page 11, Line 17organization as being interested in or connected with the person,

• Page 11, Line 18association, or corporation to perform the contract, shall must clearly

• Page 11, Line 19state the extent of financial responsibility assumed by that individual or

• Page 11, Line 20organization for the person, association, or corporation and the fulfillment of its contracts.

• Page 11, Line 21SECTION 11.  In Colorado Revised Statutes, 30-28-115, amend (2)(b)(II) as follows:

• Page 12, Line 130-28-115.  Public welfare to be promoted - legislative

• Page 12, Line 2declaration - construction. (2) (b) (II)  The general assembly declares

• Page 12, Line 3that the establishment of group homes for the aged for the exclusive use

• Page 12, Line 4of not more than eight persons sixty years of age or older per home is a

• Page 12, Line 5matter of statewide concern. The general assembly further finds and

• Page 12, Line 6declares that it is the policy of this state to enable and assist persons sixty

• Page 12, Line 7years of age or older who do not need nursing facilities and who so elect

• Page 12, Line 8to live in normal residential surroundings, including single-family

• Page 12, Line 9residential units. Group homes for the aged shall must be distinguished

• Page 12, Line 10from nursing facilities, as defined in section 25.5-4-103 (14) section

• Page 12, Line 1125.5-4-103, and institutions providing life care, as defined in section

• Page 12, Line 1211-49-101 (6) section 11-49-101. Every county having adopted or that

• Page 12, Line 13shall adopt that adopts a zoning ordinance shall provide for the location

• Page 12, Line 14of group homes for the aged. A group home for the aged established

• Page 12, Line 15under this subsection (2)(b)(II) shall must not be located within seven

• Page 12, Line 16hundred fifty feet of another such group home, unless otherwise provided for by the county.

• Page 12, Line 17SECTION 12.  In Colorado Revised Statutes, 31-23-303, amend (2)(b)(II) as follows:

• Page 12, Line 1831-23-303.  Legislative declaration. (2) (b) (II)  The general

• Page 12, Line 19assembly declares that the establishment of group homes for the aged for

• Page 12, Line 20the exclusive use of not more than eight persons sixty years of age or

• Page 12, Line 21older per home is a matter of statewide concern. The general assembly

• Page 12, Line 22further finds and declares that it is the policy of this state to enable and

• Page 12, Line 23assist persons sixty years of age or older who do not need nursing

• Page 12, Line 24facilities, and who so elect, to live in normal residential surroundings,

• Page 13, Line 1including single-family residential units. Group homes for the aged shall

• Page 13, Line 2must be distinguished from nursing facilities, as defined in section

• Page 13, Line 325.5-4-103 (14) section 25.5-4-103, and institutions providing life care,

• Page 13, Line 4as defined in section 11-49-101 (6) section 11-49-101. Every

• Page 13, Line 5municipality having adopted or that shall adopt that adopts a zoning

• Page 13, Line 6ordinance shall provide for the location of group homes for the aged. A

• Page 13, Line 7group home for the aged established under this subsection (2)(b) shall

• Page 13, Line 8must not be located within seven hundred fifty feet of another such group

• Page 13, Line 9home, unless otherwise provided for by the municipality. Nothing in this

• Page 13, Line 10subsection (2)(b) shall be construed to exempt the group homes from

• Page 13, Line 11compliance with any state, county, or municipal health, safety, and fire

• Page 13, Line 12codes. On April 29, 1976, every person sixty years of age or older who

• Page 13, Line 13resides in a skilled or intermediate health-care facility and who may be

• Page 13, Line 14transferred or discharged therefrom to a group home for the aged shall not

• Page 13, Line 15be so discharged or transferred unless he or she has received ninety days'

• Page 13, Line 16advance written notice thereof or has agreed in writing to the proposed transfer or discharge.

• Page 13, Line 17SECTION 13.  Act subject to petition - effective date. This act

• Page 13, Line 18takes effect at 12:01 a.m. on the day following the expiration of the

• Page 13, Line 19ninety-day period after final adjournment of the general assembly; except

• Page 13, Line 20that, if a referendum petition is filed pursuant to section 1 (3) of article V

• Page 13, Line 21of the state constitution against this act or an item, section, or part of this

• Page 13, Line 22act within such period, then the act, item, section, or part will not take

• Page 13, Line 23effect unless approved by the people at the general election to be held in

• Page 13, Line 24November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.