Human Services Social Services - Digest of Bills

Digest of Bills - 1997

HUMAN SERVICES - SOCIAL SERVICES

S.B. 97-5 Medicaid managed care - appropriations. The bill contains the following provisions:

LEGISLATIVE DECLARATION. Describes the historical impact of federal medicaid requirements on the state and the opportunity that Colorado has to tailor the state's medical assistance program to the state's particular needs. Identifies how the general assembly intends to use the savings that will be realized from the statewide implementation of medicaid managed care.

STATEWIDE MANAGED CARE SYSTEM. The statewide managed care system consists of the following:

Plan. Subject to the receipt of federal waivers, requires the department of health care policy and financing to implement a plan pursuant to which, by July 1, 2000, 75% of Colorado's medical assistance recipients will be in a managed care plan. Subject to the approval of the executive director of the department, allows the following to be implemented statewide by July 1, 2000:
         1) Acute and long-term care pilot program;
         2) Limited enrollment managed care contracts;
         3) Managed mental health services; and
         4) Program of all-inclusive care for the elderly.
Bidding. Authorizes the department of health care policy and financing to institute a program of competitive bidding to provide medical services in a managed care program.
Long-term care. Requires the department of health care policy and financing to assess the results of the long-term care projects in effect during the 3-year phase-in for the implementation of statewide managed care. Restricts the department from contracting for long-term care services as part of the statewide implementation of managed care until further authorization by the joint budget committee and the house and senate health, environment, welfare, and institutions committees.
Cost-savings. Requires the department of health care policy and financing to submit an annual cost savings report to the joint budget committee, the house and senate health, environment, welfare, and institutions committees, and the office of state planning and budgeting. Describes how such cost savings are intended to be used.
Insurance; grants. Creates a program to provide subsidized insurance coverage for uninsured children under age 19 in low-income households. Creates a grant program to assist essential community providers to serve the medically indigent population and to identify and implement additional cost-effective options to expand access to services for such population. Requires the department of health care policy and financing to submit to the joint budget committee and the health, environment, welfare, and institutions committee of the house of representatives by November 1, 1997, a report on a plan to develop a dental services program that assures access to dental services for children in the medicaid program.

ORGANIZATIONS. MCO's. Requires the medical services board to establish criteria pursuant to which medicaid managed care organizations (MCO's) shall be selected. States specific criteria that all MCO's must meet and with which the department of health care policy and financing must verify compliance.

ECP's. Defines an essential community provider (ECP), and requires MCO's to seek proposals from ECP's in the MCO's geographic catchment area for the provision of services that the ECP can provide.

QUALITY MEASUREMENTS. States the criteria that the department of health care policy and financing must use to measure quality, and authorizes the department to promulgate rules to clarify and administer the measurements.

REQUIRED FEATURES OF MANAGED CARE SYSTEM. Establishes the general features that all medicaid managed care programs must contain, including the recipients' right to choose among competing plans, plans to inform recipients of choices available, plans for the monitoring of reasons for disenrollment, complaint and grievance procedures, provisions for billing recipients, required compliance with insurance division regulations concerning marketing of the programs, and requirements concerning an MCO's provision of the prescription drug benefit. Establishes the criteria pursuant to which a recipient's continuity of care shall be considered and maintained.

PRIMARY CARE PHYSICIAN PROGRAM. Authorizes a primary care physician program. Requires the department of health care policy and financing to establish procedures and criteria for the cost-effective operation of the primary care physician program.

CAPITATION RATES - RISK ADJUSTMENT. Requires the department of health care policy and financing to make prepaid capitation payments to managed care organizations based upon a defined scope of services. The capitation rates shall include risk adjustments, reinsurance, or stop-loss funding methods. Payments to plans may vary when it is shown that certain populations are expected to cost more or less than the capitated population as a whole.

PRIVATIZATION. Subject to a finding of cost-effectiveness by the joint budget committee of the general assembly, requires the department of health care policy and financing to hire independent contractors to administer not less than 20% of the statewide managed care program.

DATA COLLECTION. Identifies the types of data that providers must supply to the department of health care policy and financing. Requires the department to compile data on health outcomes and to evaluate the cost-efficiency of the state's managed care programs.

CONSUMER CERTIFICATE CHOICE PROGRAM. Requires the department of health care policy and financing to submit to the general assembly a list of options and recommendations for the implementation of a consumer certificate choice program. Lists issues to be covered and requires recommendations concerning the inclusion of the medically indigent population in the consumer certificate choice program.

DISENROLLMENT FROM MANAGED CARE. Repeals a provision requiring managed care providers to allow recipients to disenroll at any time.

APPROPRIATIONS. Makes adjustments to the annual appropriations act for the appropriation to the department of health care policy and financing.

APPROVED by Governor June 3, 1997
EFFECTIVE June 3, 1997

S.B. 97-6 Restructuring of human services delivery system - local advisory boards - phase-out of county merit system. Repeals and reenacts the statutes creating the process for restructuring the health and human services system, thereby repealing the local planning committees, the legislative restructuring oversight committee, and the restructuring steering committee. In their place, authorizes the creation of local health and human services advisory boards to meet the intent of the original restructuring legislation that there be an ongoing process or forum for continued coordination and collaboration at the local level concerning the delivery of human services. Allows counties, judicial districts, or other service areas to jointly create such boards.

Authorizes the consolidation of two or more local advisory groups that are currently authorized or mandated in statute and that have similar members and functions. Allows local entities to consolidate local advisory groups in addition to, in combination with, or in lieu of creating local health and human services advisory boards. If consolidating boards have different appointing authorities, requires each appointing authority to agree to the consolidation and appointments. States that the consolidation of advisory bodies does not change the requirements of each of the separate functions, and provides that the responsibilities of each group as specified in statute must continue to be met. Specifies the advisory groups that may be consolidated.

Consolidates the authority to adopt rules governing program scope or substantive provisions in the state board of human services and eliminates the authority of the executive director of the state department of human services to adopt rules regarding program scope or substantive provisions.

Effective January 1, 2001, abolishes the state-operated county merit system for employees of county departments of social services and the merit system council. Requires county departments to cover their employees under a personnel system that is in compliance with federal requirements for personnel administration for social services employees. Prior to transferring county employees to a successor merit system, requires each county to submit a transition plan to the department of human services for approval. Requires the department to submit a progress report on or before January 1, 2000, to the health, environment, welfare, and institutions committees of the house of representatives and the senate and to the state board of human services on the implementation of the transition of counties from the merit system to successor county merit systems. Directs that the state personnel board may contract to provide personnel services for civil defense employees of the political subdivisions of the state whose personnel services are currently being provided by the merit system council of the department of human services.

APPROVED by Governor May 28, 1997
EFFECTIVE July 1, 1997

S.B. 97-11 Women in the military national memorial - fund - repeal - appropriation. Establishes a women in the military memorial fund in the state treasury to consist of moneys

received through gifts, grants, contributions, and donations. Authorizes the division of veterans affairs in the department of human services to accept such gifts, grants, contributions, and donations. Authorizes the executive director of the department of human services to expend moneys from the fund to contribute toward the construction of a national memorial in Washington, D.C., recognizing women who have served or who are currently serving in the military, the reserves, or the national guard. Directs the general assembly to make annual appropriations from the fund to the division for the implementation of the act.

Repeals the law, effective July 1, 2002.

Appropriates $26,000 out of any moneys in the women in the military memorial cash fund to the department of human services for allocation to the division of veterans affairs for the implementation of the act.

APPROVED by Governor June 4, 1997
EFFECTIVE June 4, 1997

S.B. 97-42 Medicaid - rate setting methodology for reimbursement of nursing facilities - appropriation. Places a 6% cap on annual increases in administrative costs and an 8% cap on annual increases in health care services costs for rates for the reimbursement of Class I and Class V nursing facilities providing services through the medicaid program. In addition, effective July 1, 1997, provides that only such costs as are reasonable, necessary, and patient-related for medicaid clients may be reported for reimbursement for Class I and Class V nursing home facilities. Permits a nursing facility to include the level of medicare part A ancillary costs that were included and allowed in the medicaid cost report filed prior to July 1, 1997, but limits any subsequent increase in this amount to either the increase in the facility's allowable medicare part A ancillary costs or the percentage increase in the cost of medical care reported in the consumer price index for the same time period, whichever is lower. Excludes part B costs for medicare from allowable reimbursement for nursing facilities. Authorizes the department of health care policy and financing to promulgate rules for calculating the limitations and cost reporting requirements for nursing facilities' rates.

Authorizes the department of health care policy and financing to use a case-mix reimbursement system for reimbursing some or all Class I and Class V medicaid nursing facilities. Directs that such case-mix reimbursement system shall be instituted if the department and the joint budget committee of the general assembly determine prior to implementation that such a reimbursement system will not increase state expenditures for nursing facility care. States that the administrative costs for implementing a case-mix reimbursement system shall be paid from the savings that result from the caps and cost reporting requirements. Authorizes the department and the medical services board to adopt rules as necessary to implement a case-mix reimbursement system. Requires the department to report to the joint budget committee and to the health, environment, welfare, and institutions committees of the general assembly by November 1, 1997, on its efforts to develop a case-mix reimbursement system, the feasibility of implementing the system by July 1, 1998, and the impact upon medicaid nursing facility rates caused by the inclusion of medicare costs in medicaid cost reports.

Adjusts the appropriation in the long bill for fiscal year 1997-98 to the department of health care policy and financing by increasing the appropriation to medical programs, administration, by $752,479 and 1.0 FTE and by decreasing the appropriation to medical programs, medical services, by $15,737,425.

APPROVED by Governor June 3, 1997
EFFECTIVE June 3, 1997

S.B. 97-101 Medical assistance - federal matching funds for school districts - report. Authorizes school districts, boards of cooperative services, and state K-12 educational institutions to enter into contracts with the department of health care policy and financing to receive federal matching funds for amounts spent in providing health services to students who are medicaid recipients. Clarifies that such contracts are voluntary and subject to availability of state and federal funds. Specifies the procedure for entering into contracts.

Requires contracting entities to develop a services plan that identifies the health services needed by their students and the services they anticipate providing. Limits the medical services that may be provided without parental consent and the use of family health questionnaires and personally identifiable data. Requires contracting entities to perform an assessment of the needs of uninsured and underinsured students, and authorizes the contracting entities to spend up to 30% of the federal funds received on health care for low-income students.

Specifies that a contracting entity will receive an amount of federal funds up to the amount specified in the contract, less administrative costs. Places a cap on administrative costs. Requires the medical services board to specify the health services that contracting entities may provide. Authorizes contracting entities to provide services directly or by contract with other entities.

Directs the department of health care policy and financing to apply for a waiver of federal requirements, as may be necessary to implement the contracting provisions. Requires the department to work with the office of state planning and budgeting and the joint budget committee in implementing contracts. Authorizes the department and the department of education to enter into an interagency agreement to implement the contracting provisions, and authorizes the medical services board and the state board of education to adopt rules as necessary under the agreement.

Requires the department of health care policy and financing to hold annual public hearings to receive comments on the contracting process. Requires the department to submit a formal evaluation of the program to the senate and house committees on education and health, environment, welfare, and institutions after the program has been in effect 5 years.

Appropriates $17,854,326 and 2.0 FTE to the department of health care policy and financing, of which $8,564,720 shall be from amounts provided by school districts and $9,289,606 from federal matching funds. Appropriates $90,288 to the department of health care policy and financing and $99,399 to the department of education for administrative costs. Transfers $9,099,919 of the federal funds to the department of education for distribution to contracting entities.

APPROVED by Governor May 28, 1997
EFFECTIVE May 28, 1997

S.B. 97-112 Central fund for state and veterans nursing homes - continuation - general fund loan forgiveness. Continues the authority of the department of human services to expend moneys from the central fund for state and veterans nursing homes. Specifies that all interest earned on the investment of moneys in such fund remain therein rather than be transferred to the general fund.

Reaffirms the statutory duty of the executive director of the department of human services to sell, with the approval of the state board of human services, surplus real property at the Colorado state veterans center at Homelake (Homelake facility) to the highest bidder for not less than the appraised value of such land. Provides that moneys from such sales shall be deposited in the central fund for state and veterans nursing homes and applied toward the retirement of outstanding anticipation warrants issued to cover the costs of completing the construction of the domiciliary care unit and the addition to the nursing home unit at the Homelake facility.

Recites facts surrounding an $831,397.35 loan from the general fund to the Colorado state veterans nursing home at Rifle. Forgives $407,348.54 of the remaining balance of $540,407.35 of such general fund loan as of July 1, 1996.

APPROVED by Governor May 27, 1997
EFFECTIVE July 1, 1997

S.B. 97-120 Welfare reform - child care - medicaid - tax credits - appropriation. The bill contains the following provisions:

"COLORADO WORKS" PROGRAM. Enacts a new program to replace aid to families with dependent children (AFDC) and related programs.

Intent. Declares that the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (the "federal welfare reform act") gives states unprecedented authority to implement welfare strategies to suit local conditions and to emphasize work in such a way as to ensure the long-term self-sufficiency of participants.
No entitlement. Provides that there is no legal entitlement to public assistance under the "Colorado Works" program.
General provisions. Repeals the AFDC, job opportunity and basic skills training (JOBS), and Colorado personal responsibility and employment demonstration (C-PREP) programs, effective July 1, 1997. Establishes an implementation date of July 1, 1997, for the "Colorado Works" program, the purposes of which are to:
         1) Assist participants to terminate their dependence on welfare;
         2) Develop policies that ensure that participants are in work activities; and
         3) Allow counties increased control over the implementation of the program.
County block grants and maintenance of effort. Using state and federal funds, provides a block grant to each county which, for 1997-98, will be 100% of state and federal funds received by such county in 1994-95 for:
        1)        The AFDC program;
        2)        The JOBS program;
        3)        The C-PREP pilot program (if operated in the county);
        4)        The administrative costs related to those programs.

Requires a county to spend 100% of the amount of its own funds that it spent in 1995-96 for the AFDC, JOBS, and C-PREP programs and their related administrative costs as a maintenance of effort. Authorizes adjustments to future block grants based on population, performance, and other factors that affect the number of needy families in such county. Requires the state to make an annual appropriation of funds to be applied to the state's maintenance of historic effort as specified in the federal welfare reform act.

Emergency fund. Allows a county to apply to the state department of human services for additional funds from a short-term emergency fund in certain specified circumstances.
Reserve fund. Requires the state to maintain a long-term reserve fund that is subject to appropriation.
Performance contract; performance measurements. Requires the state department to enter into an annual performance contract with each county that specifies the county's duties and responsibilities in connection with the implementation of the "Colorado Works" program. Directs the state board of human services to develop statewide performance goals and a formula for measuring each county's progress toward those goals.
Target populations. Allows persons who were eligible for AFDC on July 16, 1996, who meet income and resource requirements, and who cooperate in obtaining any applicable child support to receive assistance under the "Colorado Works" program. States that two-parent families shall be treated the same as single-parent families. Persons who will not receive assistance include:
        1) Those who have received assistance for more than 60 months;
        2) A minor parent not living with an adult, unless there is a risk of abuse;
        3) A minor parent not engaged in an educational program;
        4) Fugitive felons and parole or probation violators;
        5) Persons convicted of drug felonies on or after July 1, 1997, unless such persons have taken action toward rehabilitation.
Forms of assistance. Requires a county to assess participants in the "Colorado Works" program. Requires the state department of human services to promulgate rules for screening for victims of domestic violence. Requires a county to enter into individual responsibility contracts with participants in which the participant agrees upon goals for securing employment and self-sufficiency and any sanctions for failing to adhere to the terms of such a contract.

Requires delivery of the basic assistance grant statewide and allows a county to provide any other assistance the county deems appropriate. Allows a county to provide a "diversion grant" under specified conditions.

Sanctions. Requires the state board of human services to promulgate rules that address the imposition of sanctions affecting the basic assistance grant. Authorizes a county to terminate the basic assistance grant if a participant refuses to engage in work. Allows a county to impose any other sanctions on assistance other than the basic assistance grant that the county deems appropriate.
Waivers. Allows the governor and the state department of human services to issue waivers of certain statutes and rules to a county in connection with its implementation of the "Colorado Works" program. Prohibits waivers of statewide eligibility criteria or the amount of the basic assistance grant.
Reporting; regionalization; contracting. Requires the state department of human services to report to the federal government as required by the federal welfare reform act. Allows a county to work with another county or counties to administer the "Colorado Works" program. Authorizes contracting with private entities, including nonprofit organizations, for the administration or operation of the "Colorado Works" program. Requires the state department of human services to work with counties to develop and collect data on interstate and intrastate migration of participants.
Legislative oversight committee. Establishes a legislative oversight committee to oversee the implementation of the "Colorado Works" program. Provides that the legislative oversight committee shall be comprised of the members of the health, environment, welfare, and institutions committees of the house and the senate. Repeals the provisions creating and directing the legislative oversight committee, effective July 1, 2001.

CHILD CARE ASSISTANCE PROGRAM. Establishes the allocation formula and priorities for the Colorado child care assistance program.

TITLE IV-E FOSTER CARE PROGRAM. Provides that eligibility for Title IV-E foster care shall be based upon AFDC rules that were in effect on June 1, 1995.

MEDICAL ASSISTANCE PROGRAM. Makes the following changes to the state's medical assistance program:

Eligibility. Exercises the state's option under the federal welfare reform act to provide medical assistance to persons who met the eligibility criteria for AFDC that were in effect on July 16, 1996.
Buy-in program. Directs the state department of health care policy and financing to seek waivers to allow for the creation of a medicaid buy-in program for persons who are in transition between receiving public assistance and being self-sufficient.

TAX CREDITS. Establishes a tax credit against state taxes for an employer of any person receiving public assistance under the Colorado Works program in the amount of 20% of the employer's annual investment in certain employment-related services provided on behalf of such an employee.

APPROPRIATIONS. Makes adjustments to appropriations made in the annual appropriations act in connection with the implementation of this act by the state department of human services. Appropriates $4,090,712 to the state department of health care policy and financing for the implementation of this act. Appropriates $40,175 and 0.8 FTE to the department of law for the implementation of this act. Appropriates $4,271 to the department of law for the provision of legal services to the department of labor and employment related to the implementation of this act.

EFFECTIVE DATE. Provides that portions of the act take effect upon passage; except that the provision for a statewide grievance process for workers allegedly displaced by participants takes effect upon passage, but only if SB 97-42, enacted at the First Regular Session of the Sixty-first General Assembly, becomes law.

APPROVED by Governor June 3, 1997
PORTIONS EFFECTIVE July 1, 1997

S.B. 97-141 Independent living services - requirements. Repeals and reenacts the statutes on independent living centers to reflect changes in the federal law governing independent living services for individuals with significant disabilities, including the types of services offered and evaluation standards for compliance by centers. Mandates that each independent living center maintain an individual consumer service record indicating the consumer's choice of services, including an individualized independent living plan regarding the consumer's choice of services or a written waiver of such plan. Authorizes the department of human services to contract with independent living centers for independent living core services.

Includes a statement of the intent of the general assembly that the general fund appropriation in the 1997-98 long bill to the department of human services, division of vocational rehabilitation, for independent living grants be appropriated only to the independent living centers that are certified by the department as of June 1, 1997, and that such appropriation be distributed in equal amounts to each of those centers.

APPROVED by Governor May 28, 1997
EFFECTIVE May 28, 1997

S.B. 97-147 Medical assistance - disabled work incentive program - repeal. If moneys are appropriated for the fiscal year starting July 1, 1998, establishes a pilot program to continue medicaid eligibility for up to 150 disabled persons who exceed limitations on income or assets because they go to work. Provides that medicaid coverage under the program may wrap around private medical insurance. Specifies that participants shall remain eligible for medicaid even after the program terminates, so long as the state continues a medicaid program and the participants continue to meet the eligibility requirements as they existed before the program was terminated.

Allows the department of health care policy and financing to collect premiums from the disabled persons or their employers on a sliding scale based upon the disabled person's income and resources. Requires the department of health care policy and financing to apply for federal waivers. Authorizes the medical services board to adopt rules to implement the program. Establishes a fund to receive donations to implement the program and to study the cost-effectiveness of the program.

Directs the department to study the program with the vocational rehabilitation program in the department of human services and to report to the joint budget committee by October 1, 2000. Repeals the program effective July 1, 2001.

Provides that the act shall not take effect unless moneys are appropriated for the program for the fiscal year 1998-99.

APPROVED by Governor May 28, 1997
EFFECTIVE July 1, 1998

S.B. 97-171 Public assistance - immigrants - appropriations. The bill contains the following provisions:

TANF and medicaid for qualified aliens.

Provides that qualified aliens, as defined in the federal "Personal Responsibility and Work Opportunity Reconciliation Act of 1996", Public Law 104-193 (the "federal welfare legislation"), who entered the United States before August 22, 1996, are eligible to receive assistance under the state temporary assistance to needy families (TANF) program and medicaid.
Bars qualified aliens arriving on or after August 22, 1996, from receipt of TANF assistance and medicaid for 5 years.
Allows qualified aliens who were or would have been eligible for supplemental security income (SSI) as a result of a disability but who are not eligible for such SSI as a result of the passage of the federal welfare legislation to be eligible for medicaid, if such qualified aliens meet the resource, income, and disability requirements for SSI.

State programs for qualified aliens.

Provides that legal immigrants may receive benefits under the old age pension, the aid to the blind, the aid to the needy disabled, and the medically indigent programs if they meet the eligibility criteria for such programs other than citizen status. As a condition of eligibility for receipt of public assistance, a legal immigrant shall agree to refrain from executing an affidavit of support for the purpose of sponsoring an alien on or after July 1, 1997, during the pendency of such legal immigrant's receipt of public assistance.

Other programs for legal immigrants.

Establishes an emergency assistance program for legal immigrants who are residents of Colorado.
Requires the state department to promulgate rules to enforce sponsor commitments under affidavits of support.

Appropriations. Makes adjustments to the annual appropriations act in connection with appropriations therein for the state department of human services and the state department of health care policy and financing for the implementation of this act.

APPROVED by Governor June 3, 1997
EFFECTIVE July 1, 1997

S.B. 97-174 Child care services - consolidation. Establishes a pilot program for community consolidated child care services that shall be implemented and monitored by the state department of human services, with input and cooperation from the state department of education. Requires the state department of human services to develop a request for proposals on or before July 1, 1997, to be distributed to the governing bodies of municipalities, counties, and school districts to design consolidated programs of comprehensive early childhood care and education services intended to serve children in low-income families, with a special emphasis on families participating in work activities related to welfare reform.

Specifies criteria for selecting the pilot site agencies. Identifies the program goals of the pilot site agencies, including minimum program components and consolidation of state and federal funding sources.

Requires the state department of human services to designate not more than 12 pilot site agencies on or before October 1, 1997. Requires the state department of human services to evaluate the pilot program no later than March 1, 1999.

APPROVED by Governor May 28, 1997
EFFECTIVE May 28, 1997

S.B. 97-218 Child welfare services - capped allocations - dependency and neglect appeals - dependency and neglect criteria - conflict resolution process - placement criteria - placement reporting - investigations of reports of dependency and neglect. The bill contains the following provisions:

Amendments concerning child welfare services:

Requires the state department of human services to develop formulas for capped and targeted allocations for child welfare services by June 15, 1997, with input from the child welfare allocations committee. Provides that the child welfare allocations committee consists of 4 county commissioners and 4 persons appointed by the state department.
Requires counties to receive capped allocations for child welfare services for state fiscal year 1997-98 and each fiscal year thereafter. Allows for adjustments to such capped allocations based upon caseload growth or changes in federal law or funding.
Requires the state department of human services to develop a management training package to be delivered to counties by October 1, 1997, to assist the counties in the delivery of child welfare services.
Requires the state department of human services to pursue federal waivers to implement the act.
Allows a county to negotiate rates, services, and outcomes with providers on and after July 1, 1997, if the county has a request-for-proposal process in effect for soliciting bids from providers or another mechanism for evaluating the rates, services, and outcomes from such providers.
Allows the state department of human services to enter into performance contracts with not more than three counties or groups of counties for the delivery of child welfare services. Requires an interested county to apply to the state department no later than August 1, 1997. Requires the selected counties to commence operations under the performance contracts no later than September 1, 1997. Allows a county that has entered into a performance contract with the state department of human services to be exempt from the rules of the state board of human services governing the delivery of child welfare services. Repeals the provisions relating to the delivery of child welfare services under such performance contracts, effective July 1, 1998.
Requires the state department of human services, with input from the judicial department, the child welfare allocations committee, and a legislative oversight committee, to study and make recommendations by January 1, 1998, on the advisability of implementing managed care for the delivery of child welfare services on a statewide basis. Repeals the provisions relating to this study, effective July 1, 1998.

Amendments to Children's Code - dependency and neglect:

Defines emotional abuse as an identifiable and substantial impairment of the child's intellectual or psychological functioning or development or a substantial risk of impairment of the child's intellectual or psychological functioning or development.
Clarifies what shall be a final and appealable order in dependency and neglect cases.
Codifies "prospective harm" as a basis for a petition in dependency and neglect.
Creates a conflict resolution process for grievances concerning the conduct of county department personnel in performing their duties in connection with child abuse and neglect reports, investigations, petitions, and dispositions.
Establishes placement criteria and placement reporting requirements concerning children who are placed out of the home.
Allows parents, grandparents, relatives, or foster parents who have had a child in their care for more than three months who have information or knowledge concerning the care of the child to intervene following adjudication with or without counsel.
Provides that these amendments take effect July 1, 1997.

Appropriations: Appropriates $17,653 to the judicial department from the family issues cash fund for the implementation of the act.

APPROVED by Governor June 3, 1997
PORTIONS EFFECTIVE July 1, 1997

H.B. 97-1029 Family development centers - continuation - appropriation. Extends the family development center program by 3 years, from July 1, 1997, to July 1, 2000. Deletes references to the program being a pilot program. Appropriates moneys for the program from the family issues cash fund.

APPROVED by Governor May 28, 1997
EFFECTIVE May 28, 1997

H.B. 97-1065 Public and medical assistance - personal identification systems - study. Creates a committee to evaluate and recommend appropriate methods of personal identification to be used in verifying eligibility for public assistance and medical assistance. Requires the committee to report its recommendations to the general assembly, the department of human services, and the department of health care policy and financing. Directs those departments to report to the House and Senate health, environment, welfare, and institutions committees on their recommendations for implementing the committee's report. Requires, to the extent possible, the use of an applicant's social security number as a method of personal identification for every person applying for public assistance or medical assistance.

APPROVED by Governor April 19, 1997
EFFECTIVE April 19, 1997

H.B. 97-1079 Homeless youth - family reconciliation services - taking youth into custody - licensed homeless youth shelters - voluntary alternative residences - harboring a minor. Homeless Youth Act. Adopts the "Homeless Youth Act", which act allows any homeless youth or family member in conflict or experiencing problems with a homeless youth, to receive family reconciliation services from the county department of social services if the county elects to establish such a program. Defines "homeless youth" as a youth who is at least 15 years of age but less than 18 years of age and who has certain residential needs. Provides that such services may be provided to alleviate personal or family situations that present a serious and imminent threat to the health, safety, or welfare of the youth or family and to maintain intact families when possible. Describes family reconciliation services as services that are designed to develop skills and support within a family. Requires county departments that elect to provide educational reconciliation services to work cooperatively with school district boards of education in fashioning educational programs for homeless youth.

Family intervention reconciliation services. Allows the department of human services to elect to contract directly with private nonprofit organizations or entities for the provision of family intervention reconciliation services or to pass the moneys to the county departments of those counties electing to provide such services. Authorizes the county department to privatize the provision of such services and voluntary alternative residences.

Youth in custody. Establishes certain circumstances under which a law enforcement officer may take a youth into custody without a court order for the purpose of transporting the youth to the home of the youth's parent or, in certain situations, to a licensed homeless youth shelter or a licensed child care facility. Requires the officer to inform the youth of the reason for such custody.

Provision of crisis intervention and alternative residential services. Authorizes licensed child care facilities and licensed homeless youth facilities to provide both crisis intervention services and alternative residential services to homeless youth. Directs that a youth who is not returned to the home of the youth's parent and who is not placed in a voluntary alternative residential placement shall reside in a licensed child care facility or a licensed homeless youth shelter for a period not to exceed 2 weeks and requires the facility or shelter to make a concerted effort to reconcile the family. Requires each law enforcement officer taking a youth into custody under this provision and each facility or shelter admitting a youth, to provide the youth and the youth's parent with a statement furnished by the department of human services concerning the availability of counseling services, the availability of longer term residential arrangements, and the possibility of referral to the county department of social services.

Notice requirements. Requires any person who provides shelter to a youth without consent of the youth's parent and after knowledge that the youth is away from the home of the youth's parent without permission to notify the parent or a law enforcement officer within 24 hours after the youth is sheltered. Requires a licensed homeless youth shelter or licensed child care facility that has admitted a youth to immediately notify the youth's parent of the youth's whereabouts, physical and emotional condition, and the circumstances surrounding the youth's placement and that familial reconciliation is of paramount concern to the shelter or facility. Requires the licensed homeless youth shelter or licensed child care facility to arrange transportation for the youth, if there is agreement between the youth and parent, to the parent's residence or to an alternative residential placement facility. Directs the parent, to the extent of the parent's ability, to reimburse the party who paid for the transportation costs.

Voluntary alternative residence - parental agreement. Requires that any available family reconciliation services be provided to a youth and the youth's family when the youth voluntarily resides elsewhere than with the youth's parent. Allows a youth and his or her parent to enter into a written agreement for voluntary out-of-home alternative residence with a relative or other responsible adult, in a licensed child care facility, or in a licensed homeless youth shelter. Allows such agreements to provide for payment arrangements. Specifies that the person assuming responsibility for the provision of a residence under an agreement shall have the authority to enroll the youth in the school district in which the voluntary alternative residence is located and to obtain preventive medical and dental care and treatment for the youth.

Voluntary alternative residence - lack of parental agreement. Allows for a referral to the county department of social services if the youth and the youth's parent cannot agree on an initial voluntary alternative residence within 2 weeks after admission to the licensed child care facility or licensed homeless youth shelter. Authorizes such facility or shelter to arrange for the establishment of a supervised independent living arrangement or voluntary residential agreement between the youth and a relative or other responsible adult or with a licensed child care facility or licensed homeless youth shelter under certain circumstances. Limits the situations under which a supervised independent living arrangement may be established. Clarifies that a voluntary residential agreement shall not require the county department of social services to assume custody of the youth or to exercise any parental power or control over the youth or require medicaid assistance. Authorizes the person assuming responsibility for the provision of a residence for the youth to enroll the youth in the school district in which the youth resides and to obtain preventive medical and dental care and treatment for the youth.

Homeless youth shelters. Requires the department of human services to license facilities serving as homeless youth shelters, if such facilities meet certain requirements.

Harboring a minor. Replaces the crime of aiding or harboring a runaway child with the crime of harboring a minor. Specifies that, in addition to providing shelter to a minor without the consent of a parent, the crime of harboring a minor includes the following acts: Intentional failure to release the minor to a law enforcement officer when requested; intentional failure to disclose the location of a minor to a law enforcement officer when requested; intentional obstruction of an officer from taking a minor into custody; intentional assistance of a minor in avoiding custody by an officer; and intentional failure to notify a parent, guardian, custodian, or law enforcement officer that a minor is being sheltered within 24 hours after shelter has been provided. Provides that it is not a crime for the minor to be sheltered in a licensed child care facility or a licensed homeless youth shelter for 2 weeks, if done in accordance with statutory procedures. Creates a defense to prosecution under the crime of harboring a minor if the defendant had custody of the minor pursuant to a court order.

APPROVED by Governor May 22, 1997
EFFECTIVE May 22, 1997

H.B. 97-1263 Public assistance - benefit cap. Provides that, after July 1, 1997, if an additional child is born into a household that is receiving aid to families with dependent children or assistance under a successor program funded by federal block grant moneys under the federal "Personal Responsibility and Work Opportunity Reconciliation Act of 1996", Public Law 104-193, the household or the participant shall not be considered eligible for any incremental increase in the cash assistance that would otherwise be granted to the household or the participant.

Allows a single custodial parent who does not receive additional assistance for the birth of such a child to receive the total value of all child support payments due and collected for such child. Allows the value of such payments to be excluded from income for the purposes of determining eligibility for aid to families with dependent children or for assistance under a successor program funded by federal block grant moneys under the federal "Personal Responsibility and Work Opportunity Reconciliation Act of 1996", Public Law 104-193.

Authorizes a county department of social services to issue vouchers for the purpose of providing assistance for the benefit of any additional children to whom the benefit cap applies.

VETOED by Governor June 3, 1997

H.B. 97-1270 Public assistance - condition of eligibility - immunization of children. As a condition of eligibility for any successor program to AFDC funded by federal block grant moneys under the federal "Personal Responsibility and Work Opportunity Reconciliation Act of 1996", requires a participant to provide verification or written confirmation by a physician or nurse that each child in the household is being brought up-to-date with immunizations and that, no later than the first scheduled redetermination of eligibility, each child in the household has received any immunization for which the child is eligible according to the age of the child. Allows exemptions based on religious or medical reasons.

APPROVED by Governor April 19, 1997
EFFECTIVE July 1, 1997

H.B. 97-1304 Children's basic health plan - managed care coverage for eligible children - implementation by the department of health care policy and financing - appropriations. Children's basic health plan creation. Creates the children's basic health plan to be implemented by the department of health care policy and financing (department).

Funding. Creates the children's basic health plan trust in the state treasury. Provides that annual appropriations to the trust from the state shall be made by the general assembly based on the amount of savings achieved through reforms, consolidations, and streamlining of health care programs realized through actual reductions in administrative and programmatic costs and not decreases in the number of caseloads of such programs. Requires the department to submit an annual savings report to the joint budget committee of the general assembly and the office of state planning and budgeting that states the cost savings anticipated from health care program reforms, consolidation, and streamlining. Allows the department to accept gifts, grants, and donations for the trust.

Duties of the department. Authorizes the department to: Design a schedule of health care services to be included in the plan; design and implement a structure of periodic premiums due to the department from enrollees in the plan based on a sliding fee scale; design detailed rules of eligibility and enrollment; allow a procedure where a financial sponsor may pay the premium; create a procedure for the department to pay subsidies for eligible children to enroll in the plan or a comparable health insurance plan; and establish criteria to allow a managed care plan, the department, or some other entity to verify eligibility. Allows the department to contract with the Colorado children's health plan for the provision of services.

Financial management. Requires the department to promulgate rules to ensure that sufficient funds are present in the trust to implement the provisions of the plan. The board is required to assess the expenditures for the plan and compare it to the funds in the trust and make the adjustments necessary to ensure that expenditures remain within the limits of available revenue. Allows the department to institute a program for competitive bidding to select managed care contractors for the provision of medical services to children enrolled in the plan. Declares that the children's basic health plan is not an entitlement and enrollment is limited based upon annual appropriations from the trust by the general assembly. When funding is limited, requires the department to give priority to children who would qualify for medicaid as if there were no asset testing and to children with gross family incomes under 133% of the federal poverty level.

Eligibility. States that only children under 18 years of age, whose gross family income does not exceed 185% of the federal poverty level, and who have not been covered by a health insurance plan with benefits comparable to the plan are eligible for subsidized enrollment in the plan. Allows uninsured children whose gross family income exceeds 185% of the federal poverty level to enroll in the plan but not be eligible for a subsidy from the department. Requires that a child be uninsured for the 3 months prior to application to the plan. Mandates that, if one child is enrolled in the plan, all uninsured children in the family must be enrolled.

Managed care plans. Authorizes the department to establish a method to select the managed care plans to contract with the department for the provision of health care services to children under the plan.

Federal waivers. Requires the department to apply for any federal waiver necessary to implement the plan.

Privatization. Allows the department to enter into personal services contracts for the administration of the children's basic health plan contingent upon the approval of the state personnel director.

Appropriation. Appropriates $2,000,000 to the children's basic health plan trust fund from the general fund. Appropriates $2,000,000 from the children's basic health plan trust to the department of health care policy and financing. Modifies a lettered note designation associated with the department of higher education, regents of the university of Colorado health sciences center, Colorado child health plan in the annual general appropriation act to show that $2,374,570 shall be from program reserves and from moneys received from the department of health care policy and financing.

APPROVED by Governor May 28, 1997
EFFECTIVE May 28, 1997

H.B. 97-1344 Public assistance - medical assistance - appeal process. Requires every county department of social services or service delivery agency to adopt a procedure for the resolution of disputes between the county department or service delivery agency and an applicant for or recipient of public assistance or medical assistance prior to appeal to the state. Directs that the dispute resolution process include an opportunity for all clients to have a county conference, upon the client's request, and such requirement may be met through a telephonic conference upon the agreement of the client and the county department. Provides that the dispute resolution process must meet rules adopted by the state board on expeditious time frames, notice, and an opportunity to be heard and to present evidence. Provides that if the dispute is not resolved by the local dispute resolution process, the applicant or recipient may appeal to the department of human services or the department of health care policy and financing, as applicable. Allows two or more counties to establish jointly the dispute resolution process. Requires the state board of human services and the medical services board, respectively, to adopt rules on the dispute resolution process and on what issues are appealable to the state. Requires county notices to applicants or recipients to inform them of the basis of the county's decision or action, their rights to a county conference under the dispute resolution process, and their rights to a state level appeal and the process for making such an appeal.

States that any disputes at the county or state level related to the successor program to aid to families with dependent children shall be decided in accordance with rules promulgated by the state board of human services and with the county's official written policies governing delivery of assistance under such program.

Requires the department of human services or the department of health care policy and financing to make an investigation if the department initiates the review of a county decision and give the county an opportunity to rebut its findings or conclusions.

Directs the department of human services, the department of health care policy and financing, and the division of administrative hearings in the department of personnel to work together to streamline the appeal process at the state level.

Authorizes the department of human services to apply to the United States department of agriculture and the health care financing administration for waivers to develop a process for appeals that ensures that issues may be consolidated at the local and state levels. Eliminates statutes concerning evidentiary conferences at the county level.

APPROVED by Governor June 3, 1997
EFFECTIVE July 1, 1997