Senate Bill 25-226 Reengrossed

A Bill for an Act

• Page 1, Line 101Concerning an extension of the renamed complementary and

• Page 1, Line 102integrative medicine program for a person with a

• Page 1, Line 103primary condition resulting in a total inability for

• Page 1, Line 104independent ambulation, and, in connection therewith,

• Page 1, Line 105making an appropriation.

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/.)

Joint Budget Committee. There is a pilot program for complementary and alternative medicine for disabled people. The bill changes the name of the program to the "complementary and integrative medicine program". The bill extends the program and clarifies that the program covers persons with a primary condition of multiple sclerosis, a brain injury, spina bifida, muscular dystrophy, or cerebral palsy, when one of these diagnoses directly results in a total inability for independent ambulation.

The bill makes an appropriation.

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

• Page 2, Line 2SECTION 1.  In Colorado Revised Statutes, 25.5-6-1201, amend (1) as follows:

• Page 2, Line 325.5-6-1201.  Legislative declaration - repeal. (1)  The general

• Page 2, Line 4assembly finds that there may be a more effective way to deliver home-

• Page 2, Line 5and community-based services to the elderly, blind, and disabled; to

• Page 2, Line 6disabled children; and to persons with spinal cord injuries that allows for

• Page 2, Line 7more self-direction in their care and a cost savings to the state. The

• Page 2, Line 8general assembly also finds that every person who is currently receiving

• Page 2, Line 9home- and community-based services does not need the same level of

• Page 2, Line 10supervision and care from a licensed health-care professional in order to

• Page 2, Line 11meet the person's care needs and remain living in the community. The

• Page 2, Line 12general assembly, therefore, declares that it is beneficial to the elderly,

• Page 2, Line 13blind, and disabled members of home- and community-based services, to

• Page 2, Line 14members of the disabled children care program, and to members enrolled

• Page 2, Line 15in the spinal cord injury waiver pilot complementary and integrative

• Page 2, Line 16medicine program for the state department to develop a service that would allow the members to receive in-home support.

• Page 2, Line 17SECTION 2.  In Colorado Revised Statutes, amend 25.5-6-1301 as follows:

• Page 2, Line 1825.5-6-1301.  Legislative declaration. (1)  The general assembly

• Page 2, Line 19finds that:

• Page 3, Line 1(a)  A person living with a spinal cord injury, multiple

• Page 3, Line 2sclerosis, a brain injury, spina bifida, muscular dystrophy, or

• Page 3, Line 3cerebral palsy could benefit from complementary and alternative

• Page 3, Line 4integrative medicine such as chiropractic care, massage therapy, or acupuncture; and

• Page 3, Line 5(b)  Complementary and alternative integrative medicine could

• Page 3, Line 6improve the quality of life and help reduce the need for continuous or

• Page 3, Line 7more expensive procedures, medications, and hospitalizations for a an

• Page 3, Line 8eligible person with a spinal cord injury and could allow a an eligible person with a spinal cord injury to be employed.

• Page 3, Line 9SECTION 3.  In Colorado Revised Statutes, 25.5-6-1302, amend (1) and (3) as follows:

• Page 3, Line 1025.5-6-1302.  Definitions. As used in this part 13, unless the context otherwise requires:

• Page 3, Line 11(1)  "Complementary or alternative integrative medicine" means

• Page 3, Line 12a form of diverse health-care services not provided for under this article

• Page 3, Line 13article 6 or article 4 or 5 of this title title 25.5 prior to August 5, 2009,

• Page 3, Line 14but authorized by the rules of the state board adopted pursuant to section

• Page 3, Line 1525.5-6-1303 (4). The medicine is limited to chiropractic care, massage therapy, and acupuncture performed by licensed or certified providers.

• Page 3, Line 16(3)  "Pilot program" "Program" means the pilot program

• Page 3, Line 17authorized pursuant to section 25.5-6-1303 to allow an eligible person

• Page 3, Line 18with a disability to receive complementary and alternative integrative medicine.

• Page 3, Line 19SECTION 4.  In Colorado Revised Statutes, 25.5-6-1303, amend

• Page 3, Line 20(1)(a), (2)(a), (2)(b) introductory portion, (2)(b)(II), (2)(b)(III), (2)(d), (3),

• Page 3, Line 21(4), and (7); and repeal (2)(c) and (5) as follows:

• Page 4, Line 125.5-6-1303.  Complementary or integrative medicine - rules.

• Page 4, Line 2(1) (a)  The general assembly authorizes the state department to

• Page 4, Line 3implement a pilot program that would allow an eligible person with a

• Page 4, Line 4disability to receive complementary or alternative integrative medicine

• Page 4, Line 5to the extent authorized by federal waiver. The pilot program may begin

• Page 4, Line 6no later than January 1, 2012. The state department shall design and

• Page 4, Line 7implement the pilot program with input from an advisory committee that

• Page 4, Line 8must include, but need not be limited to, persons with spinal cord injuries

• Page 4, Line 9who are receiving complementary or alternative medicine. The state

• Page 4, Line 10department may seek any federal waivers that may be necessary to implement this part 13.

• Page 4, Line 11(2) (a)  The purpose of the pilot program is to expand the choice

• Page 4, Line 12of therapies available to eligible persons with disabilities to study the

• Page 4, Line 13success of complementary and alternative medicine, and to produce an

• Page 4, Line 14overall cost savings for the state compared to the estimated expenditures

• Page 4, Line 15that would have otherwise been spent for the same persons with spinal cord injuries absent the pilot program.

• Page 4, Line 16(b)  In order to qualify and to remain eligible for the pilot program authorized by this section, a person shall must:

• Page 4, Line 17(II)  Be willing to participate in the pilot program;

• Page 4, Line 18(III)  Demonstrate a current need, as further defined in rule by the state board, for complementary or alternative integrative medicine; and

• Page 4, Line 19(c)  The state department shall implement subsection (2)(b) of this section no later than July 1, 2022.

• Page 4, Line 20(d)  The pilot program is available to all eligible individuals in Colorado.

• Page 4, Line 21(3)  The state department shall develop the accountability

• Page 5, Line 1requirements for the pilot program necessary to safeguard the use of

• Page 5, Line 2public moneys money and to promote effective and efficient service delivery.

• Page 5, Line 3(4)  The state board shall adopt rules as necessary for the implementation and administration of the pilot program.

• Page 5, Line 4(5)  The state department shall cause to be conducted an

• Page 5, Line 5independent evaluation of the pilot program to be completed no later than

• Page 5, Line 6January 1, 2025. The state department shall provide a report of the

• Page 5, Line 7evaluation to the health and human services committee of the senate and

• Page 5, Line 8the public health care and human services committee of the house of

• Page 5, Line 9representatives, or any successor committees. The report on the evaluation must include the following:

• Page 5, Line 10(a)  The number of eligible persons with disabilities participating in the pilot program;

• Page 5, Line 11(b)  The cost-effectiveness of the pilot program;

• Page 5, Line 12(c)  Feedback from members and the state department concerning the progress and success of the pilot program;

• Page 5, Line 13(d)  Any changes to the health status or health outcomes of the persons participating in the pilot program;

• Page 5, Line 14(e)  Other information relevant to the success and problems of the pilot program; and

• Page 5, Line 15(f)  Recommendations concerning the feasibility of continuing the pilot program beyond the pilot stage and changes, if any, that are needed.

• Page 5, Line 16(7)  Unless the state department receives sufficient appropriations,

• Page 5, Line 17the state department is not required to seek federal approval or implement for the pilot program.

• Page 5, Line 18SECTION 5.  In Colorado Revised Statutes, amend 25.5-6-1304 as follows:

• Page 6, Line 1 25.5-6-1304.  Repeal of part. This part 13 is repealed, effective September 1, 2025 September 1, 2030.

• Page 6, Line 2SECTION 6.  In Colorado Revised Statutes, 25.5-6-1403, amend (4) as follows:

• Page 6, Line 325.5-6-1403.  Waivers and amendments. (4)  The state

• Page 6, Line 4department shall seek federal authorization to implement a medicaid

• Page 6, Line 5buy-in program for adults who are eligible to receive home- and

• Page 6, Line 6community-based services pursuant to the supported living services

• Page 6, Line 7waiver; the developmental disabilities waiver or its successor, part 4 of

• Page 6, Line 8this article 6; the persons with brain injury waiver, part 7 of this article 6;

• Page 6, Line 9and the spinal cord injury waiver pilot complementary and

• Page 6, Line 10integrative medicine program, part 13 of this article 6. The state

• Page 6, Line 11department shall prepare and submit any requests necessary for federal

• Page 6, Line 12approval not later than January 1, 2023, and shall implement the medicaid

• Page 6, Line 13buy-in program pursuant to this subsection (4) not later than three months after receiving federal approval.

• Page 6, Line 14SECTION 7.  Appropriation. (1)  For the 2025-26 state fiscal

• Page 6, Line 15year, $66,637 is appropriated to the department of health care policy and

• Page 6, Line 16financing for use by the executive director's office. This appropriation is

• Page 6, Line 17from the general fund. To implement this act, the office may use this appropriation as follows:

• Page 6, Line 18(a)  $65,487 for personal services, which amount is based on an assumption that the office will require an additional 2.0 FTE; and

• Page 6, Line 19(b)  $1,150 for operating expenses.

• Page 6, Line 20(2)  For the 2025-26 state fiscal year, the general assembly

• Page 6, Line 21anticipates that the department of health care policy and financing will

• Page 7, Line 1receive $66,637 in federal funds to implement this act, which amount is

• Page 7, Line 2subject to the "(I)" notation as defined in the annual general appropriation

• Page 7, Line 3act for the same fiscal year. The appropriation in subsection (1) of this

• Page 7, Line 4section is based on the assumption that the department will receive this amount of federal funds to be used as follows:

• Page 7, Line 5(a)  $65,487 for personal services; and

• (b)  $1,150 for operating.

• Page 7, Line 6(3)  For the 2025-26 state fiscal year, $1,214,019 is appropriated

• Page 7, Line 7to the department of health care policy and financing. This appropriation

• Page 7, Line 8is from the general fund, which is subject to the "(M)" notation as defined

• Page 7, Line 9in the annual general appropriation act for the same fiscal year. To

• Page 7, Line 10implement this act, the department may use this appropriation for medical and long-term care services for medicaid eligible individuals.

• Page 7, Line 11(4)  For the 2025-26 state fiscal year, the general assembly

• Page 7, Line 12anticipates that the department of health care policy and financing will

• Page 7, Line 13receive $1,214,019 in federal funds for medical and long-term care

• Page 7, Line 14services for medicaid eligible individuals to implement this act. The

• Page 7, Line 15appropriation in subsection (3) of this section is based on the assumption that the department will receive this amount of federal funds.

• Page 7, Line 16SECTION 8.  Act subject to petition - effective date. This act

• Page 7, Line 17takes effect at 12:01 a.m. on the day following the expiration of the

• Page 7, Line 18ninety-day period after final adjournment of the general assembly; except

• Page 7, Line 19that, if a referendum petition is filed pursuant to section 1 (3) of article V

• Page 7, Line 20of the state constitution against this act or an item, section, or part of this

• Page 7, Line 21act within such period, then the act, item, section, or part will not take

• Page 7, Line 22effect unless approved by the people at the general election to be held in

• Page 8, Line 1November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.