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,
Page 1, Line 103and, in connection therewith, making 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.)
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 state is encouraged to institute an hourly minimum wage
Page 3, Line 15rate of twenty-five dollars per hour by January 1, 2028, for individuals who provide direct care services.
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 and
Page 4, Line 9medicaid rates, innovative solutions for improving quality of
Page 4, Line 10care, and reducing the cost of care and how to fund the
Page 4, Line 11health-care benefits and whether medicaid reimbursement can contribute to the cost of these health-care benefits.
Page 4, Line 12SECTION 3. In Colorado Revised Statutes, add 8-7.5-108 and 8-7.5-109 as follows:
Page 4, Line 138-7.5-108. Direct care employers - direct care worker rights
Page 4, Line 14training - direct care worker communication platform - direct care
Page 4, Line 15worker website. (1) By January 1, 2026, the department shall
Page 4, Line 16collaborate with the board and any other entities deemed
Page 4, Line 17relevant by the department to establish a comprehensive "know
Page 4, Line 18your rights" training for direct care workers that includes information concerning:
Page 4, Line 19(a) The direct care worker base wage;
(b) Wages and hours for overtime work;
Page 4, Line 20(c) The "Healthy Families and Workplaces Act", part 4 of
Page 4, Line 21article 13.3 of this title 8;
Page 5, Line 1(d) The "Family Care Act", part 2 of title 13.3 of this title 8;
Page 5, Line 2(e) The federal "Patient Protection and Affordable Care Act", Pub.L. 111-148, as it relates to worker rights;
Page 5, Line 3(f) Travel time rules, as the rules relate to the employment of direct care workers;
Page 5, Line 4(g) Civil rights protected by Colorado law that are relevant to the employment of direct care workers;
Page 5, Line 5(h) Where a direct care worker can learn more about the topics covered in the training;
Page 5, Line 6(i) Where and how to file a complaint, including rights
Page 5, Line 7secured under the "Protecting Opportunities and Workers' Rights Act", Senate Bill 23-172, enacted in 2023; and
Page 5, Line 8(j) The contents of the website established in section
Page 5, Line 925.5-1-208, how to use the communication platform established
Page 5, Line 10in section 25.5-1-208, the benefits to the direct care worker of
Page 5, Line 11participation in the communication platform, how direct care
Page 5, Line 12worker contact information will be used, and how to opt in to and opt out of the communication platform.
Page 5, Line 13(2) The department shall:
Page 5, Line 14(a) Ensure that the comprehensive "know your rights"
Page 5, Line 15training required to be established by subsection (1) of this
Page 5, Line 16section is available to direct care workers and direct care employers;
Page 5, Line 17(b) Allow worker organizations to participate in the "know your rights" training;
Page 5, Line 18(c) Allow representatives of the board to participate in the "know your rights" trainings;
Page 6, Line 1(d) Not charge a fee to direct care employers or direct care workers for the "know your rights" training;
Page 6, Line 2(e) Report periodically to the board concerning direct care worker completion of the "know your rights" training; and
Page 6, Line 3(f) Provide a certification of completion of the "know your rights" training to the direct care worker.
Page 6, Line 4(3) A direct care employer shall:
Page 6, Line 5(a) On or before October 1, 2026, or within ninety days
Page 6, Line 6after the direct care worker website and the communication
Page 6, Line 7platform are established pursuant to section 25.5-1-208 (2),
Page 6, Line 8whichever is earlier, require each direct care worker to provide
Page 6, Line 9documentation of a completed "know your rights" training administered by the department.
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 12board and the department of health care policy and financing
Page 6, Line 13pursuant to section 25.5-1-208 (3)(a) to each direct care worker
Page 6, Line 14employed by the employer and to each new direct care worker at the time of hire that includes:
Page 6, Line 15(I) "Know your rights" training information;
Page 6, Line 16(II) The contents of the direct care worker website and communication platform;
Page 6, Line 17(III) How to opt in to the communication platform and the potential benefits of opting into the communication platform;
Page 6, Line 18(IV) How to use the communication platform;
Page 6, Line 19(V) How and what direct care worker contact information may be shared; and
Page 7, Line 1(VI) How to opt out of the communication platform and communications from the communication platform; and
Page 7, Line 2(c) Inform all employees about the direct care worker
Page 7, Line 3website and communication platform established by the
Page 7, Line 4department of health care policy and financing pursuant to section 25.5-1-208.
Page 7, Line 58-7.5-109. Compliance assistance - violations - enforcement.
Page 7, Line 6(1) The director of the division of labor standards and
Page 7, Line 7statistics shall provide compliance assistance to direct care
Page 7, Line 8employers as warranted and shall investigate leads concerning
Page 7, Line 9possible violations of the training and notice requirements set
Page 7, Line 10forth in this article 7.5 and other alleged labor violations
Page 7, Line 11against direct care workers that, in the director's good faith discretion and judgment, warrant investigation.
Page 7, Line 12(2) The director of the division of labor standards and
Page 7, Line 13statistics shall enforce compliance and shall impose a fine on a
Page 7, Line 14direct care employer that violates this article 7.5 of one
Page 7, Line 15hundred dollars for each direct care worker affected by each
Page 7, Line 16violation. A direct care employer that demonstrates a good
Page 7, Line 17faith effort to comply with this article 7.5 is not subject to a
Page 7, Line 18fine for the employer's first violation for a worker covered by
Page 7, Line 19the violation. The director shall double the amount of the fine
Page 7, Line 20for each violation after a prior violation of the same or similar
Page 7, Line 21type within five years. The division shall transmit the money
Page 7, Line 22collected from fines imposed pursuant to this subsection (2) to
Page 7, Line 23the state treasurer, who shall credit the money to the wage theft enforcement fund created in section 8-4-113 (3).
Page 8, Line 1SECTION 4. In Colorado Revised Statutes, add 25.5-1-208 and 25.5-1-209 as follows:
Page 8, Line 225.5-1-208. Direct care worker website and communication
Page 8, Line 3platform - enrollment of direct care workers - training, worker
Page 8, Line 4rights, employment matching - department of labor and employment
Page 8, Line 5access - gifts, grants, or donations - definitions. (1) As used in this
Page 8, Line 6section and section 25.5-1-209, unless the context otherwise requires:
Page 8, Line 7(a) "Board" means the direct care workforce stabilization board created in section 8-7.5-103.
Page 8, Line 8(b) "Direct care consumer" has the meaning set forth in section 8-7.5-102.
Page 8, Line 9(c) "Direct care employer" has the meaning set forth in section 8-7.5-102.
Page 8, Line 10(d) "Direct care services" has the meaning set forth in section 8-7.5-102.
Page 8, Line 11(e) "Direct care worker" has the meaning set forth in section 8-7.5-102.
Page 8, Line 12(f) "Medical assistance program" means the "Colorado Medical Assistance Act", articles 4 to 6 of this title 25.5.
Page 8, Line 13(g) "Platform" or "communication platform" means the
Page 8, Line 14direct care worker communication platform created in this section.
Page 8, Line 15(h) "Website" means the direct care worker website created in this section.
Page 8, Line 16(i) "Worker organization" has the meaning set forth in section 8-7.5-102.
Page 9, Line 1(2) On or before July 1, 2026, the state department shall
Page 9, Line 2collaborate with the board and establish a direct care worker
Page 9, Line 3website and communication platform for direct care workers. The state department shall ensure that the platform:
Page 9, Line 4(a) Supports direct care consumers in identifying and employing qualified direct care workers;
Page 9, Line 5(b) Facilitates recruitment and retention of direct care
Page 9, Line 6workers paid through reimbursement by the medical assistance program;
Page 9, Line 7(c) Ensures access to care for all members;
Page 9, Line 8(d) Supports the state department in monitoring access to
Page 9, Line 9and quality of care for direct care consumers who receive direct care services;
Page 9, Line 10(e) Provides a regular cadence of communication by the
Page 9, Line 11state department, to be determined in consultation with the
Page 9, Line 12board, to workers who have opted in to the communication
Page 9, Line 13platform, including updates from the board, relevant state
Page 9, Line 14department initiatives, and potential changes to worker rights and benefits;
Page 9, Line 15(f) Maintains an electronic employment matching system
Page 9, Line 16to help direct care consumers identify direct care workers with
Page 9, Line 17the right availability and skill set, experience with dementia, language proficiency, and specific certifications; and
Page 9, Line 18(g) Provides each direct care worker with the opportunity to opt in to and opt out of the communication platform.
Page 9, Line 19(3) The state department shall:
Page 10, Line 1(a) In coordination with the board, develop a direct care
Page 10, Line 2worker-specific notice of rights for direct care employers to
Page 10, Line 3distribute to their employees pursuant to section 8-7.5-108 (3)(b); and
Page 10, Line 4(b) Collaborate with direct care employers to inform direct care workers of the benefits of the platform.
Page 10, Line 5(4) (a) The website must include:
Page 10, Line 6(I) Training on direct care worker basic job duties, health
Page 10, Line 7and safety in the workplace, and how to provide culturally competent care;
Page 10, Line 8(II) Information regarding direct care worker rights,
Page 10, Line 9including increases to the direct care worker base wage; the
Page 10, Line 10"Healthy Families and Workplaces Act", part 4 of article 13.3 of
Page 10, Line 11title 8; new labor laws, rules, regulations, and practices; or
Page 10, Line 12other laws, rules, regulations, and processes designed to stabilize the direct care workforce;
Page 10, Line 13(III) A calendar of the training events that are provided
Page 10, Line 14by the state department and are free of charge to direct care
Page 10, Line 15workers concerning the rights of direct care workers and the information that can be learned in each training;
Page 10, Line 16(IV) The ability for communication platform users to opt in to and opt out of platform communications;
Page 10, Line 17(V) Communication on how direct care workers can access medical assistance program benefits, including:
Page 10, Line 18(A) Medical assistance program buy-in for working adults with disabilities;
Page 10, Line 19(B) Medical assistance for a family member in the direct
Page 11, Line 1care worker's household with a disability or who is sixty-five years of age or older;and
Page 11, Line 2(C) Other benefits the department deems applicable.
Page 11, Line 3(VI) Access to the state department's core curriculum training; and
Page 11, Line 4(VII) A link to the state department's direct care worker survey.
Page 11, Line 5(b) The state department shall review and approve all
Page 11, Line 6website and communication platform content for accuracy before it is posted publicly.
Page 11, Line 7(5) (a) Within three months after the establishment of the
Page 11, Line 8communication platform and every three months thereafter,
Page 11, Line 9the state department shall allow the department of labor and
Page 11, Line 10employment, worker organizations, organizations representing
Page 11, Line 11direct care employers, and organizations representing direct
Page 11, Line 12care consumers to have access to the full name, telephone
Page 11, Line 13number, and email address for each direct care worker who has
Page 11, Line 14opted into the communication platform to inform the worker of
Page 11, Line 15their rights, to support the worker in engaging with the board,
Page 11, Line 16and to accomplish the communication platform's direct care consumer-matching functions.
Page 11, Line 17(b) In fulfilling the obligations of this section, the state
Page 11, Line 18department, worker organizations, organizations representing
Page 11, Line 19direct care employers, and organizations representing direct
Page 11, Line 20care consumers must comply with applicable laws and rules
Page 11, Line 21protecting personal identifying information, including part 1 of
Page 11, Line 22article 74 of title 24 and part 13 of article 1 of title 6. Worker
Page 12, Line 1organizations and organizations representing direct care
Page 12, Line 2consumers shall not have access to the name or private data of
Page 12, Line 3any direct care consumer or direct care consumer's
Page 12, Line 4representative or indicate that an individual direct care
Page 12, Line 5worker is a direct care consumer's relative or has the same
Page 12, Line 6address as a direct care consumer.An organization or
Page 12, Line 7individual who receives direct care worker contact information
Page 12, Line 8shall not share, sell, or otherwise distribute the information except for the purposes in subsection (5)(a) of this section.
Page 12, Line 10SECTION 5. In Colorado Revised Statutes, 25.5-6-1603, amend (2) as follows:
Page 12, Line 1125.5-6-1603. Minimum wage - wage pass-through requirement
Page 12, Line 12for certain home care agencies - applicability - reports - recovery.
Page 12, Line 13(2) (a) On and after
July 1, 2020Page 12, Line 14rate for
personsPage 12, Line 15including personal care services, homemaker services, or in-home
Page 12, Line 16support services for which a home care agency may receive
Page 12, Line 17reimbursement pursuant to the "Colorado Medical Assistance Act", is
twelve dollars and forty-one centsPage 12, Line 19(b) The state department shall enforce the minimum
Page 12, Line 20direct care worker base wage that is required by this subsection (2).
Page 12, Line 21SECTION 6. Appropriation. (1) For the 2025-26 state fiscal
Page 12, Line 22year, $120,105 is appropriated to the department of health care policy and
Page 12, Line 23financing for use by the executive director's office. This appropriation is
Page 13, Line 1from the general fund. To implement this act, the office may use this appropriation as follows:
Page 13, Line 2(a) $95,960 for personal services, which amount is based on an assumption that the office will require an additional 2.5 FTE;
Page 13, Line 3(b) $11,605 for operating expenses; and
(c) $12,540 for general professional services and special projects.
Page 13, Line 4(2) For the 2025-26 state fiscal year, the general assembly
Page 13, Line 5anticipates that the department of health care policy and financing will
Page 13, Line 6receive $220,424 in federal funds to implement this act, which amount is
Page 13, Line 7subject to the "(I)" notation as defined in the annual general appropriation
Page 13, Line 8act for the same fiscal year. The appropriation in subsection (1) of this
Page 13, Line 9section is based on the assumption that the department will receive this amount of federal funds to be used as follows:
Page 13, Line 10(a) $95,959 for personal services;
(b) $11,605 for operating expenses; and
Page 13, Line 11(c) $112,860 for general professional services and special projects.
Page 13, Line 12(2) For the 2025-26 state fiscal year, $168,459 is appropriated to
Page 13, Line 13the department of labor and employment for use by the division of labor
Page 13, Line 14standards and statistics. This appropriation is from the general fund, and
Page 13, Line 15is based on an assumption that the division will require an additional 1.6
Page 13, Line 16FTE. To implement this act, the division may use this appropriation for program costs related to labor standards.
Page 13, Line 17SECTION 7. 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 14, Line 1of the state constitution against this act or an item, section, or part of this
Page 14, Line 2act within such period, then the act, item, section, or part will not take
Page 14, Line 3effect unless approved by the people at the general election to be held in
Page 14, Line 4November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.