Senate Bill 25-192 Revised

A Bill for an Act

• Page 1, Line 101Concerning the continuation of functions related to the

• Page 1, Line 102regulation of community integrated health-care

• Page 1, Line 103service agencies, and, in connection therewith,

• Page 1, Line 104implementing the recommendations in the 2024 sunset

• Page 1, Line 105report by the department of regulatory agencies.

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/.)

Sunset Process - Senate Health and Human Services Committee. Community integrated health-care services (services) are out-of-hospital medical services that may be provided by an emergency medical service provider who obtains a community paramedic endorsement. A community integrated health-care service agency (agency) is an entity or sole proprietorship that manages and offers services.

The bill implements the recommendations in the 2024 sunset report by the department of regulatory agencies by:

• Continuing the regulation of agencies by 9 years to 2034;
• Adding clarification that a suspension of, a revocation of, or a refusal to renew an agency's license based on the fact that an owner, manager, or administrator of the agency was convicted of a disqualifying felony or misdemeanor includes circumstances in which the owner, manager, or administrator entered into a plea of guilty or nolo contendere for the felony or misdemeanor;
• Updating language to be gender neutral;
• Changing references from "consumers" to "patients or clients";
• Referencing the definition of service in the statutes governing the regulation of agencies; and
• Defining "service" to include mobile integrated health care and, as determined by rule by the state board of health, care and services provided by practitioners other than community paramedics.

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

• Page 2, Line 2SECTION 1.  In Colorado Revised Statutes, 24-34-104, repeal (26)(a)(VII); and add (35)(a)(VI) as follows:

• Page 2, Line 324-34-104.  General assembly review of regulatory agencies

• Page 2, Line 4and functions for repeal, continuation, or reestablishment - legislative

• Page 2, Line 5declaration - repeal. (26) (a)  The following agencies, functions, or both, are scheduled for repeal on September 1, 2025:

• Page 2, Line 6(VII)  The functions of the department of public health and

• Page 2, Line 7environment regarding community integrated health-care service agencies pursuant to part 13 of article 3.5 of title 25, C.R.S.;

• Page 2, Line 8(35) (a)  The following agencies, functions, or both, are scheduled for repeal on September 1, 2034:

• Page 3, Line 1(VI)  The functions of the department of public health and

• Page 3, Line 2environment regarding community integrated health-care service agencies pursuant to part 13 of article 3.5 of title 25.

• Page 3, Line 3SECTION 2.  In Colorado Revised Statutes, amend 25-3.5-1307 as follows:

• Page 3, Line 425-3.5-1307.  Repeal of part - review of functions. This part 13

• Page 3, Line 5is repealed, effective September 1, 2025 September 1, 2034. Before the

• Page 3, Line 6repeal, the department's functions under this part 13 shall be reviewed as

• Page 3, Line 7provided for in is scheduled for review in accordance with section 24-34-104. C.R.S.

• Page 3, Line 8SECTION 3.  In Colorado Revised Statutes, 25-3.5-1301, amend (1); and add (1.5) as follows:

• Page 3, Line 925-3.5-1301.  Definitions - rules. As used in this part 13, unless the context otherwise requires:

• Page 3, Line 10(1) (a)  "Community integrated health-care service agency" or

• Page 3, Line 11"agency" means a sole proprietorship, partnership, corporation, nonprofit

• Page 3, Line 12entity, special district, governmental unit or agency, or licensed or

• Page 3, Line 13certified health-care facility that is subject to regulation under article 1.5

• Page 3, Line 14or 3 of this title that manages and offers, directly or by contract,

• Page 3, Line 15community integrated health-care services Except as provided in

• Page 3, Line 16subsection (1)(b) of this section, "community integrated

• Page 3, Line 17health-care service" has the meaning set forth in section 25-3.5-103 (4.3).

• Page 3, Line 18(b)  "Community integrated health-care service" includes:

• (I)  Mobile integrated health care; and

• Page 3, Line 19(II)  The provision of certain care and services, as

• Page 4, Line 1determined by rule by the board, by practitioners other than community paramedics.

• Page 4, Line 2(1.5)  "Community integrated health-care service agency"

• Page 4, Line 3or "agency" means a sole proprietorship, partnership,

• Page 4, Line 4corporation, nonprofit entity, special district, governmental

• Page 4, Line 5unit or agency, or licensed or certified health-care facility

• Page 4, Line 6that is subject to regulation under article 1.5 or 3 of this title

• Page 4, Line 725 that manages and offers, directly or by contract, community integrated health-care services.

• Page 4, Line 8SECTION 4.  In Colorado Revised Statutes, 25-3.5-1303, amend (1) introductory portion as follows:

• Page 4, Line 925-3.5-1303.  Minimum standards for community integrated

• Page 4, Line 10health-care service agencies - adult protective services data system

• Page 4, Line 11check - rules. (1)  In addition to the services that the board, by rule,

• Page 4, Line 12authorizes a community integrated health-care service agency to perform,

• Page 4, Line 13an agency may perform any of the services that may be provided through

• Page 4, Line 14a CARES program pursuant to section 25-3.5-1203 (3) and the tasks and

• Page 4, Line 15procedures that a community paramedic is authorized to perform within

• Page 4, Line 16his or her the community paramedic's scope of practice in accordance

• Page 4, Line 17with section 25-3.5-206 and rules promulgated adopted pursuant to that

• Page 4, Line 18section. On or before January 1, 2018, The board shall promulgate adopt

• Page 4, Line 19rules providing minimum standards for the operation of an agency within the state. The rules must include the following:

• Page 4, Line 20SECTION 5.  In Colorado Revised Statutes, 25-3.5-1305, amend (2)(a), (3)(a)(I), (3)(b), and (3)(c) as follows:

• Page 4, Line 2125-3.5-1305.  License - application - inspection - record check

• Page 4, Line 22- issuance. (2) (a)  The department shall inspect an agency as it deems

• Page 5, Line 1necessary to ensure the health, safety, and welfare of agency consumers

• Page 5, Line 2patients or clients. An agency shall submit in writing, in a form and

• Page 5, Line 3manner prescribed by the department, a plan detailing the measures that

• Page 5, Line 4the agency will take to correct any violations found by the department as a result of an inspection.

• Page 5, Line 5(3) (a) (I)  With the submission of an application for a license

• Page 5, Line 6pursuant to this section, each owner, manager, and administrator of an

• Page 5, Line 7agency applying for an initial or renewal license shall submit a complete

• Page 5, Line 8set of his or her the owner's, manager's, or administrator's

• Page 5, Line 9fingerprints to the Colorado bureau of investigation for the purpose of

• Page 5, Line 10conducting a state and national fingerprint-based criminal history record

• Page 5, Line 11check utilizing the records of the Colorado bureau of investigation and

• Page 5, Line 12the federal bureau of investigation. The Colorado bureau of investigation

• Page 5, Line 13shall forward the results of a criminal history record check to the department.

• Page 5, Line 14(b) (I)  The department may deny a license or renewal of a license

• Page 5, Line 15if the results of a record check of an owner, manager, or administrator

• Page 5, Line 16demonstrates that the owner, manager, or administrator has been

• Page 5, Line 17convicted of a felony or a misdemeanor involving conduct that the

• Page 5, Line 18department determines could pose a risk to the health, safety, or welfare

• Page 5, Line 19of community integrated health-care service consumers patients or clients.

• Page 5, Line 20(II)   As used in this subsection (3)(b), "convicted" includes an entry of a plea of guilty or nolo contendere.

• Page 5, Line 21(c)  If an agency applying for an initial license is temporarily

• Page 5, Line 22unable to satisfy all of the requirements for licensure, the department may

• Page 5, Line 23issue a provisional license to the agency; except that the department shall

• Page 6, Line 1not issue a provisional license to an agency if operation of the agency will

• Page 6, Line 2adversely affect the health, safety, or welfare of the agency's consumers

• Page 6, Line 3patients or clients. The department may require an agency applying

• Page 6, Line 4for a provisional license to demonstrate to the department's satisfaction

• Page 6, Line 5that the agency is taking sufficient steps to satisfy all of the requirements

• Page 6, Line 6for full licensure. A provisional license is valid for ninety days and may be renewed one time at the department's discretion.

• Page 6, Line 7SECTION 6.  In Colorado Revised Statutes, 25-3.5-1306, amend (3) as follows:

• Page 6, Line 825-3.5-1306.  License denial - suspension - revocation.

• Page 6, Line 9(3) (a)  After conducting a hearing on the matter in accordance with

• Page 6, Line 10article 4 of title 24, C.R.S., the department may revoke or refuse to renew

• Page 6, Line 11an agency license where if the owner, manager, or administrator of the

• Page 6, Line 12agency has been convicted of a felony or misdemeanor involving conduct

• Page 6, Line 13that the department determines could pose a risk to the health, safety, or welfare of the agency's consumers patients or clients.

• Page 6, Line 14(b)  As used in this subsection (3), "convicted" includes an entry of a plea of guilty or nolo contendere.

• Page 6, Line 15SECTION 7.  In Colorado Revised Statutes, 25-3.5-108, amend (1)(b)(II)(D) as follows:

• Page 6, Line 1625-3.5-108.  EMS system sustainability task force - created -

• Page 6, Line 17powers and duties - membership - reports - repeal. (1) (b)  The task force consists of the following twenty voting members:

• Page 6, Line 18(II)  The following eight members appointed by the director of the department:

• Page 6, Line 19(D)  One individual representing a community integrated

• Page 6, Line 20health-care service agency, as defined in section 25-3.5-1301 (1) section 25-3.5-1301 (1.5), that is licensed pursuant to part 13 of this article 3.5;

• Page 7, Line 1SECTION 8.  In Colorado Revised Statutes, 26-3.1-111, amend (7)(c) as follows:

• Page 7, Line 226-3.1-111.  Access to CAPS - employment checks -

• Page 7, Line 3conservatorship and guardianship checks - confidentiality - fees -

• Page 7, Line 4rules - legislative declaration - definitions. (7)  The following employers shall request a CAPS check pursuant to this section:

• Page 7, Line 5(c)  A community integrated health-care service agency, as defined in section 25-3.5-1301 (1) section 25-3.5-1301 (1.5);

• Page 7, Line 6SECTION 9.  Act subject to petition - effective date. This act

• Page 7, Line 7takes effect at 12:01 a.m. on the day following the expiration of the

• Page 7, Line 8ninety-day period after final adjournment of the general assembly; except

• Page 7, Line 9that, if a referendum petition is filed pursuant to section 1 (3) of article V

• Page 7, Line 10of the state constitution against this act or an item, section, or part of this

• Page 7, Line 11act within such period, then the act, item, section, or part will not take

• Page 7, Line 12effect unless approved by the people at the general election to be held in

• Page 7, Line 13November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.