A Bill for an Act
Page 1, Line 101Concerning measures to support early childhood health by
Page 1, Line 102integrating early childhood health-care systems into
Page 1, Line 103communities.
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 creates the child care health consultation program (consultation program) in the department of early childhood (department) to expand access to child care health consultants (consultants) and to support whole-child health and well-being in licensed and license-exempt child care and learning settings.
The department shall:
- Contract with an implementation partner (consultant partner) to facilitate the implementation and administration of the consultation program;
- Create a model of child care health consultation (model of care) to provide standards and guidelines to ensure the consultation program is implemented effectively;
- Develop with the consultant partner a statewide professional development plan to support consultants in meeting the expectations outlined in the model of care; and
- Develop a statewide data collection and information system to collect and analyze implementation data and selected consultation program outcomes to identify areas for improvement, promote accountability, and provide insights on how to improve consultation program outcomes to benefit young children and their families.
- Establish an application and selection process with the department for select medical practices to participate in the primary care program;
- Review applications from medical practices and select applicants to participate in the primary care program;
- Work with selected applicants to complete assessments on the applicants' community health-care systems, health and well-being practices, and related concerns; and
- Train and support the medical practices selected to participate in the primary care program to maintain fidelity to the evidence-based model.
The department shall submit a report on the consultation program to the joint budget committee by October 1, 2027, and by each October 1 thereafter.
The bill creates the pediatric primary care practice program (primary care program) in the department. The purpose of the primary care program is to provide funding and support to a pediatric primary care medical practice (medical practice) to integrate into the medical practice a professional who specializes in whole-child and whole-family health and well-being.
The department shall contract with an implementation partner (primary care partner) to create and implement the primary care program. The primary care partner shall create and implement a team-based, research-informed pediatric primary care practice evidence-based model (evidence-based model). The evidence-based model must be a comprehensive approach to guide pediatric care medical practices to deliver services to children from birth to 3 years of age and their families.
The primary care partner shall:
The executive director of the department may adopt rules to carry out the purposes of the consultation program and the primary care program.
This Unofficial Version Includes Committee
Amendments Not Yet Adopted on Second Reading
Page 3, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 3, Line 2SECTION 1. In Colorado Revised Statutes, add part 10 to article 3 of title 26.5 as follows:
Page 3, Line 3PART 10
CHILD CARE HEALTH
Page 3, Line 4CONSULTATION PROGRAM
Page 3, Line 526.5-3-1001. Definitions.As used in this part 10, unless the context otherwise requires:
Page 3, Line 6(1) "Child care health consultant" means a medical
Page 3, Line 7professional who is experienced in maternal and child health
Page 3, Line 8care, credentialed pursuant to the department's professional
Page 3, Line 9development information system, and participates in the child care health consultation program.
Page 3, Line 10(2) "Child care health consultation program" or
Page 3, Line 11"program" means the child care health consultation program,
Page 3, Line 12a voluntary statewide program created in section 26.5-3-1002 (1).
Page 3, Line 13(3) "Implementation partner" means a state public or
Page 3, Line 14private entity that has experience implementing and operating
Page 3, Line 15nationally supported, evidence-based models of child care health consultation.
Page 3, Line 16(4) "Model of child care health consultation" or "model"
Page 3, Line 17means the model of child care health consultation created in section 26.5-3-1003 (2).
Page 3, Line 18(5) "Plan" means the statewide professional development plan created in section 26.5-3-1004 (1).
Page 4, Line 1(6) "Statewide data collection and information system"
Page 4, Line 2or "information system" means the statewide data collection and information system created in section 26.5-3-1005 (1)(a).
Page 4, Line 326.5-3-1002. Child care health consultation program - created
Page 4, Line 4- purpose - rules. (1) (a) On or before July 1, 2026, the department
Page 4, Line 5shall create the child care health consultation program to
Page 4, Line 6expand access to child care health consultants and to support
Page 4, Line 7whole-child health and well-being in licensed and
Page 4, Line 8license-exempt child care and learning settings to ensure
Page 4, Line 9children have access to learning and supports. Through the
Page 4, Line 10program, child care health consultants combine their
Page 4, Line 11knowledge of early childhood health care and education to
Page 4, Line 12help licensed and license-exempt child care and learning
Page 4, Line 13settings implement best practices to create healthy and safe learning environments for children.
Page 4, Line 14(b) The purpose of the program is to:
Page 4, Line 15(I) Increase the number and diversity of qualified and
Page 4, Line 16appropriately trained child care health consultants in the
Page 4, Line 17state who can consult with providers who work with young
Page 4, Line 18children and families in licensed and license-exempt child care and learning settings;
Page 4, Line 19(II) Provide support and guidance to providers to address
Page 4, Line 20the health and well-being needs of children and families served in licensed and license-exempt child care and learning settings;
Page 4, Line 21(III) Develop a model of child care health consultation
Page 4, Line 22that is rooted in diversity, equity, and inclusion, and provides
Page 5, Line 1guidance to child care health consultants on the qualifications
Page 5, Line 2and professional competencies needed to participate in the
Page 5, Line 3program and the expectations of the program. The model must
Page 5, Line 4include the program's expected outcomes and long-term goal of
Page 5, Line 5limiting administrative and financial burdens so providers have access to child care health consultants.
Page 5, Line 6(IV) Develop and maintain a statewide professional
Page 5, Line 7development plan that assists child care health consultants in meeting the requirements set forth in the model.
Page 5, Line 8(2) (a) The department shall contract with an
Page 5, Line 9implementation partner to facilitate the implementation and
Page 5, Line 10administration of the program. The department shall select an
Page 5, Line 11implementation partner that has, at a minimum, experience and
Page 5, Line 12expertise with evidence-based child care health consultation
Page 5, Line 13programs. The implementation partner must, at a minimum,
Page 5, Line 14provide training and support to child care health consultants in the program to achieve the goals of the program.
Page 5, Line 15(b) In developing the program, the department shall work in consultation with:
Page 5, Line 16(I) The office of head start within the United States
Page 5, Line 17department of health and human services' administration for children and families as set forth in 42 U.S.C. sec. 9831 et seq.;
Page 5, Line 18(II) Nationally recognized entities that support the
Page 5, Line 19implementation of sustainable systems or programs that focus
Page 5, Line 20on promoting health and well-being outcomes for young children; and
Page 5, Line 21(III) Key stakeholders in the state, including:
(A) Child care health consultants;
Page 6, Line 1(B) Nonprofit organizations with expertise in early childhood whole-child health;
Page 6, Line 2(C) Organizations representing parents of children who would benefit from child care health consultations;
Page 6, Line 3(D) Hospitals and other health-care provider
Page 6, Line 4organizations with expertise in working with children facing
Page 6, Line 5special health-care needs or challenges that impede optimal growth and development;
Page 6, Line 6(E) Early child care and education providers; and
(F) Clinicians with expertise in pediatric health.
Page 6, Line 7(3) The executive director may adopt rules to carry out the purposes of this part 10.
Page 6, Line 826.5-3-1003. Model of child care health consultation -
Page 6, Line 9standards - guidelines - statewide qualifications and competencies.
Page 6, Line 10(1) (a) To be a child care health consultant in the program, an individual must meet the following qualifications:
Page 6, Line 11(I) Be in good standing as a:
Page 6, Line 12(A) Nurse who is licensed pursuant to article 255 of title
Page 6, Line 1312 and has knowledge and experience in pediatrics or maternal and child health; or
Page 6, Line 14(B) Physician who is licensed pursuant to article 240 of
Page 6, Line 15title 12 and has knowledge and experience in pediatrics or maternal and child health; and
Page 6, Line 16(II) Successfully complete a mandatory training program as required by the department.
Page 6, Line 17(b) The department shall ensure each child care health
Page 7, Line 1consultant who participates in the program meets the
Page 7, Line 2qualifications and professional competencies described in
Page 7, Line 3subsection (1)(a) of this section. Child care health consultants
Page 7, Line 4who participate in the program must use the department's
Page 7, Line 5professional development information system to enter their qualification and professional competency information.
Page 7, Line 6(2) On or before January 1, 2027, the department may
Page 7, Line 7create, in consultation with the stakeholders described in
Page 7, Line 8section 26.5-3-1002 (2)(b), a model of child care health
Page 7, Line 9consultation. The purpose of the model is to provide standards
Page 7, Line 10and guidelines to ensure the program is implemented effectively,
Page 7, Line 11with primary consideration given to evidence-based services. The
Page 7, Line 12standards and guidelines must include, at a minimum, the following:
Page 7, Line 13(a) Job qualifications for child care health consultants, as described in subsection (1)(a) of this section;
Page 7, Line 14(b) Job expectations for child care health consultants;
(c) Expected program outcomes;
Page 7, Line 15(d) Guidance on the ratios of child care health
Page 7, Line 16consultants to children in licensed and license-exempt child care and learning settings;
Page 7, Line 17(e) Required competencies for child care health
Page 7, Line 18consultants in the program and the appropriate
Page 7, Line 19competency-based training to achieve the required competencies;
Page 7, Line 20(f) Expectations for a program structure that meets the
Page 7, Line 21needs of local communities;
Page 8, Line 1(g) A process for the competitive selection, placement, and public funding of child care health consultants;
Page 8, Line 2(h) Guidance on the scope and frequency of services child
Page 8, Line 3care health consultants may provide to providers who work with young children and families, including:
Page 8, Line 4(I) Training, including, but not limited to, training on health and safety;
Page 8, Line 5(II) Delegation and ongoing supervision of medication administration and health procedures;
Page 8, Line 6(III) Referrals to other services;
(IV) Coaching;
Page 8, Line 7(V) Preventions to support the health and well-being of children; and
Page 8, Line 8(VI) Other appropriate consultative services that support and enhance whole-child health and well-being;
Page 8, Line 9(i) Methods to increase the number of bilingual or
Page 8, Line 10multilingual child care health consultants and to ensure cultural competency of child care health consultants;
Page 8, Line 11(j) Methods to ensure the child care health consultants
Page 8, Line 12participating in the program represent the diversity of the state,
Page 8, Line 13including linguistic, cultural, and geographic diversity, so child
Page 8, Line 14care health consultants are able to connect with providers and the young children and families served by the program;
Page 8, Line 15(k) Guidance on how to work in and with a variety of child
Page 8, Line 16care environments and providers in order to meet the diverse needs of young children and families;
Page 8, Line 17(l) A process for child care health consultants to
Page 9, Line 1educate and work with diverse early childhood professionals,
Page 9, Line 2including, but not limited to, early childhood education
Page 9, Line 3teachers and providers, elementary school teachers and
Page 9, Line 4administrators, child welfare caseworkers, public health
Page 9, Line 5professionals, and health-care professionals on best practices to create healthy and safe learning environments;
Page 9, Line 6(m) Guidance for child care health consultants to
Page 9, Line 7educate early childhood professionals, as described in subsection (2)(l) of this section, about the program; and
Page 9, Line 8(n) An outline of the achievement outcome goals for the program and for child care health consultants, including:
Page 9, Line 9(I) Increase staff knowledge, confidence, and
Page 9, Line 10effectiveness of improving health and well-being outcomes for
Page 9, Line 11children in licensed and license-exempt child care and learning settings;
Page 9, Line 12(II) Increase caregiver access to training and resources
Page 9, Line 13to support children with special needs, disabilities, and developmental delays;
Page 9, Line 14(III) Increase the compliance of a licensed or
Page 9, Line 15license-exempt child care and learning setting with best
Page 9, Line 16practices standards and health and safety requirements
Page 9, Line 17established by the department pursuant to part 3 of article 5 of this title 26.5;
Page 9, Line 18(IV) Strengthen environmental health practices;
Page 9, Line 19(V) Support and improve the quality of health and safety
Page 9, Line 20policies and practices within licensed and license-exempt child
Page 9, Line 21care and learning settings;
Page 10, Line 1(VI) Increase the number of children who receive oral, developmental, vision, and hearing screenings and referrals;
Page 10, Line 2(VII) Improve access for children to medical homes, as
Page 10, Line 3defined in section 25.5-1-103; enrollment in health insurance; and up-to-date immunizations;
Page 10, Line 4(VIII) Improve families' access to resources that support the healthy development of children; and
Page 10, Line 5(IX) Increase inclusion of children with special
Page 10, Line 6health-care needs in licensed and license-exempt child care and learning settings.
Page 10, Line 726.5-3-1004. Statewide professional development plan - child
Page 10, Line 8care health consultants. (1) On or before January 1, 2027, the
Page 10, Line 9department and the implementation partner may develop a
Page 10, Line 10statewide professional development plan to support child care
Page 10, Line 11health consultants in meeting the expectations outlined in the
Page 10, Line 12model of child care health consultation. In developing the plan,
Page 10, Line 13the department and implementation partner shall work
Page 10, Line 14collaboratively, to the extent practicable, with the stakeholders described in section 26.5-3-1002 (2)(b).
Page 10, Line 15(2) The plan must include:
Page 10, Line 16(a) Training to meet the competencies outlined in the model; and
Page 10, Line 17(b) Guidance on how to provide ongoing support to child
Page 10, Line 18care health consultants, supervisors of child care health consultants, and other experts.
Page 10, Line 1926.5-3-1005. Data collection - evaluation - reporting.
Page 10, Line 20(1) (a) On or before January 1, 2027, subject to available
Page 11, Line 1appropriations, the department shall develop a statewide data
Page 11, Line 2collection and information system to collect and analyze
Page 11, Line 3implementation data and selected program outcomes to identify
Page 11, Line 4areas for improvement, promote accountability, and provide
Page 11, Line 5insights on how to improve program outcomes to benefit young children and families.
Page 11, Line 6(b) The information system and any related processes
Page 11, Line 7must place the least burden possible on the child care health
Page 11, Line 8consultants in the program. In selecting the implementation
Page 11, Line 9data and outcomes, the department must incorporate variability across diverse settings and populations.
Page 11, Line 10(2) (a) Notwithstanding section 24-1-136 (11)(a)(I), by
Page 11, Line 11October 1, 2027, and by each October 1 thereafter, the
Page 11, Line 12department may submit a compiled report to the joint budget committee. The report must include the following information:
Page 11, Line 13(I) A gap analysis of:
Page 11, Line 14(A) The number of child care health consultants participating in the program;
Page 11, Line 15(B) The types of licensed and license-exempt child care
Page 11, Line 16and learning settings in which child care health consultants
Page 11, Line 17practice and the needs of the licensed and license-exempt child
Page 11, Line 18care and learning settings that have not been addressed by the existing child care consultants' practice; and
Page 11, Line 19(C) Instances when a licensed or license-exempt child care
Page 11, Line 20or learning setting is unable to serve a child due to the
Page 11, Line 21financial burden on the licensed or license-exempt child care or
Page 11, Line 22learning setting and when there is not a child care health consultant available in the geographic region; and
Page 12, Line 1(II) Program adjustments needed to ensure all eligible
Page 12, Line 2licensed and license-exempt child care and learning settings have equitable access to the program.
Page 12, Line 3(b) Notwithstanding section 24-1-136 (11)(a)(I), beginning
Page 12, Line 4in January 2028, and every two years thereafter, the
Page 12, Line 5department may include as part of its "SMART Act" hearing,
Page 12, Line 6required by section 2-7-203, the compiled report described in subsection (2)(a) of this section.
Page 12, Line 7(3) (a) On or before July 1, 2032, the department may
Page 12, Line 8contract with an independent third party to conduct an
Page 12, Line 9evaluation of the program to determine whether the program
Page 12, Line 10outcomes were met and whether the program had a measurable
Page 12, Line 11effect on the health and well-being of young children and their families across the state.
Page 12, Line 12(b) In January 2033, during the"SMART Act" hearing
Page 12, Line 13required pursuant to section 2-7-203, the department shall
Page 12, Line 14present the results of the evaluation described in subsection(3)(a) of this section.
Page 12, Line 1526.5-3-1006. Funding. (1) The department, in partnership
Page 12, Line 16with the department of health care policy and financing and the
Page 12, Line 17division of insurance in the department of regulatory agencies,
Page 12, Line 18shall explore funding sources toimplement the program and the
Page 12, Line 19requirements of this part 10, including potential funding options
Page 12, Line 20through the children's basic health plan, set forth in article 8
Page 12, Line 21of title 25.5, and the state medical assistance program, set forth
Page 12, Line 22in articles 4 to 6 of title 25.5.
Page 13, Line 1(2) On or before January 1, 2027, the department shall
Page 13, Line 2report to the joint budget committee any identified funding sources.
Page 13, Line 3(3) The department may seek, accept, and expend gifts,
Page 13, Line 4grants, or donations from private or public sources for the purposes of this part 10.
Page 13, Line 5(4) The department is not obligated to implement this part
Page 13, Line 610 until the department has sufficient appropriations to cover the costs of the program.
Page 13, Line 7SECTION 2. In Colorado Revised Statutes, add part 11 to article 3 of title 26.5 as follows:
Page 13, Line 8PART 11
PEDIATRIC PRIMARY
Page 13, Line 9CARE PRACTICE PROGRAM
Page 13, Line 1026.5-3-1101. Definitions.As used in this part 11, unless the context otherwise requires:
Page 13, Line 11(1) "Implementation partner" means a state public or
Page 13, Line 12private entity that has experience implementing and operating
Page 13, Line 13nationally supported evidence-based, research-informed pediatric primary care programs.
Page 13, Line 14(2) "Pediatric primary care practice evidence-based
Page 13, Line 15model" or "evidence-based model" means the team-based,
Page 13, Line 16research-informed pediatric primary care practice evidence-based model described in section 26.5-3-1102 (2).
Page 13, Line 17(3) "Pediatric primary care practice program" or
Page 13, Line 18"program" means the pediatric primary care practice program
Page 13, Line 19described in section 26.5-3-1102 (1).
Page 14, Line 126.5-3-1102. Pediatric primary care practice program -
Page 14, Line 2created - model - rules. (1) (a) The department shall implement
Page 14, Line 3and operate the pediatric primary care practice program. The
Page 14, Line 4purpose of the program is to provide funding and support to a
Page 14, Line 5pediatric primary care medical practice to integrate into the
Page 14, Line 6medical practice a professional who specializes in whole-child and whole-family health and well-being.
Page 14, Line 7(b) The department shall contract with an
Page 14, Line 8implementation partner to implement, operate, and administer
Page 14, Line 9the program. The implementation partner shall demonstrate experience and expertise in:
Page 14, Line 10(I) Placing professionals who specialize in whole-child
Page 14, Line 11and whole-family health and well-being with pediatric primary care medical practices;
Page 14, Line 12(II) Identifying the concerns of families and health-care professionals about child development and family needs; and
Page 14, Line 13(III) Offering support strategies, guidance, and community resources to families.
Page 14, Line 14(2) (a) The implementation partner shall create and
Page 14, Line 15implement a team-based, research-informed pediatric primary
Page 14, Line 16care practice evidence-based model. The evidence-based model
Page 14, Line 17must be a comprehensive approach to guide pediatric primary
Page 14, Line 18care medical practices to deliver services to children from
Page 14, Line 19birth to three years of age and their families. The
Page 14, Line 20evidence-based model must demonstrate improvements in
Page 14, Line 21physical health, behavioral health, developmental outcomes,
Page 14, Line 22and social outcomes for children from birth to three years of age and their families.
Page 15, Line 1(b) In addition to creating and implementing the
Page 15, Line 2evidence-based model described in subsection (2)(a) of this section, the implementation partner shall:
Page 15, Line 3(I) With the department, establish an application and
Page 15, Line 4selection process for pediatric primary care medical practices to participate in the program;
Page 15, Line 5(II) Review applications from pediatric primary care
Page 15, Line 6medical practices and select eligible medical practices to participate in the program;
Page 15, Line 7(III) Work with pediatric primary care medical practices
Page 15, Line 8selected for the program to complete assessments on the
Page 15, Line 9medical practices' community health-care systems, health and
Page 15, Line 10well-being practices, and related concerns, when necessary or as required by the evidence-based model; and
Page 15, Line 11(IV) Train and support the pediatric primary care medical
Page 15, Line 12practices selected for the program to maintain fidelity to the evidence-based model.
Page 15, Line 13(3) (a) To be eligible for the program, a pediatric primary
Page 15, Line 14care medical practice must incorporate the evidence-based
Page 15, Line 15model into the medical practice. The department and the
Page 15, Line 16implementation partner shall prioritize the selection of
Page 15, Line 17pediatric primary care medical practices that offer children
Page 15, Line 18from birth to three years of age and their families the following services:
Page 15, Line 19(I) An evaluation of the relationship between the child
Page 15, Line 20and the caregiver through assessments, interventions, and referrals;
Page 16, Line 1(II) Child development, social-emotional, and behavioral health screenings;
Page 16, Line 2(III) Screenings that identify family risk factors and
Page 16, Line 3needs, including perinatal and postpartum mood disorders, social determinants of health, and other risk factors;
Page 16, Line 4(IV) Access to short-term behavioral health consultations; and
Page 16, Line 5(V) Ongoing, preventative team-based well-child visits.
Page 16, Line 6(b) A pediatric primary care medical practice selected for
Page 16, Line 7the program shall partner with professionals who specialize in
Page 16, Line 8whole-child and whole-family health and well-being and who
Page 16, Line 9use data and outcomes to demonstrate adherence to the evidence-based model.
Page 16, Line 10(4) The department may adopt rules to carry out the purposes of this part 11.
Page 16, Line 1126.5-3-1103. Funding. (1) The department, in partnership
Page 16, Line 12with the department of health care policy and financing and the
Page 16, Line 13behavioral health administration in the department of human
Page 16, Line 14services, shall explore funding sources to implement the
Page 16, Line 15program and the requirements of this part 11, including
Page 16, Line 16potential funding options through the children's basic health
Page 16, Line 17plan, set forth in article 8 of title 25.5, and the state medical assistance program, set forth in articles 4 to 6 of title 25.5.
Page 16, Line 18(2) On or before January 1, 2026, the department shall
Page 16, Line 19report to the joint budget committee any identified funding
Page 16, Line 20sources for this part 11.
Page 17, Line 1(3) The department may seek, accept, and expend gifts,
Page 17, Line 2grants, or donations from private or public sources for the purposes of this part 11.
Page 17, Line 3(4) The department is not obligated to implement this part
Page 17, Line 411 until the department has sufficient appropriations to cover the costs of the program.
Page 17, Line 5SECTION 3. Act subject to petition - effective date. This act
Page 17, Line 6takes effect at 12:01 a.m. on the day following the expiration of the
Page 17, Line 7ninety-day period after final adjournment of the general assembly; except
Page 17, Line 8that, if a referendum petition is filed pursuant to section 1 (3) of article V
Page 17, Line 9of the state constitution against this act or an item, section, or part of this
Page 17, Line 10act within such period, then the act, item, section, or part will not take
Page 17, Line 11effect unless approved by the people at the general election to be held in
Page 17, Line 12November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.