The act repeals the health-care delivery system reform incentive payments program in the Colorado healthcare affordability and sustainability enterprise (enterprise) and creates the hospital quality incentive program (incentive program) to use enterprise hospital provider fee revenue to make additional payments to hospitals that meet performance metrics in delivering safer and more effective care that improves patient outcomes and reduces preventable utilization to reduce health-care costs. Prior to implementing the program, the enterprise board shall approve the percentage of hospitals' reimbursement in the incentive program and the incentive program structure, performance measures, and scoring methodology. Once the incentive program is implemented, the total amount of payments made under the incentive program must not exceed 9% of the total reimbursements made to hospitals in the previous state fiscal year.(Note: This summary applies to this bill as enacted.)
The act establishes the ibogaine research pilot program (pilot program) in the behavioral health administration (BHA) to research the safety and effectiveness of using ibogaine to treat mental health conditions and substance use disorders. The act requires the BHA to establish a committee to review pilot program site applications and make recommendations to the BHA on which applicants to accept. The BHA may select up to 5 ibogaine pilot sites. The act allows the BHA to seek, accept, and expend gifts, grants, and donations and establishes the ibogaine research pilot program cash fund. The pilot program is contingent on the BHA receiving sufficient gifts, grants, and donations to administer the pilot program and award grants to the selected ibogaine pilot sites to help with financing needs. Under current law, the division of natural medicine advisory board consists of 15 voting members, 8 of whom must have general expertise and experience related to natural medicine and 7 of whom must have specialized expertise and experience in various areas of natural medicine. The act amends the expertise and experience requirements to apply equally to all 15 voting members. The act adds that a facilitator of natural medicine services is not liable for a physical or psychological injury that a participant may experience as a result of the facilitator's performance or supervision of the natural medicine services that a participant receives, unless the injury is the result of the facilitator's intentional misconduct, gross negligence, or a deviation from the recognized standard of care. The act authorizes the state licensing authority for natural medicine or natural medicine product (state licensing authority) to adopt rules related to the administration, manufacturing, and use of ibogaine. The act sets requirements for how the state licensing authority must prioritize reviewing applications for licensure to facilitate natural medicine services and allows the state licensing authority to set different licensing fees depending on the type of natural medicine the applicant is seeking licensure for. The act allows the state licensing authority to accept gifts, grants, and donations from public or private sources and requires gifts, grants, or donations received to be deposited in the regulated natural medicine division cash fund. The act requires the BHA to work to secure federal research and development funding available through the advanced research projects agency for health within the federal department of health and human services, or other available funding, in order to advance research on the use of ibogaine for the treatment of serious mental illness. The act updates the powers and duties of the director of the division of professions and occupations to include adopting rules that guide the use and administration of ibogaine. A licensee seeking to cultivate, manufacture, dispense, or administer ibogaine shall, in consultation with Indigenous communities, establish a benefit-sharing plan that directly benefits those Indigenous communities. The act:Updates definition of 'administration session' to include the use of regulated natural medicine and regulated natural medicine product that the participant purchases to consume during the administration session;Prohibits a person from advertising bona fide harm reduction services or bona fide support services offered for remuneration, advertising natural medicine or natural medicine products, or using harm reduction services or support services to conduct sales of natural medicine;Clarifies that the state licensing authority is not required to conduct routine, periodic, or pre-operational inspections as a condition of licensure unless expressly required;Requires state licensing authority to adopt rules regarding licensing privileges and restrictions of a limited regulated natural medicine sales license and eligibility requirements for an applicant to obtain a limited regulated natural medicine sales license;Allows the state licensing authority to adopt rules regarding the application procedures and license requirement for a healing center to operate a temporary premises; and requirements for cultivation, manufacture, testing, or dispensing of ibogaine;Allows the department of public health and environment to issue a temporary premises permit to a licensed natural medicine healing center if certain conditions are met and allows a healing center to apply for a temporary premises permit;Prohibits a healing center licensee from selling regulated natural medicine or regulated natural medicine product unless a co-located limited regulated natural medicine sales licensee conducts the transaction in accordance with certain requirements; andAllows the director of the natural medicine division to issue an order to cease and desist if the director determines that a person is acting or has acted without a license to operate a natural medicine business or to own, grow, harvest, transfer, manufacture, supervise, provide, or administer natural medicine.(Note: This summary applies to this bill as enacted.)
Currently, the 'Workers' Compensation Act of Colorado' provides that certain cancers contracted by firefighters are considered occupational diseases presumed to have been a result of the firefighters' employment. A firefighter's employer or an insurer may rebut this presumption by showing by a preponderance of the medical evidence that the cancer did not occur on the job. The act expands the types of cancer that are considered occupational diseases and strengthens the rebuttable presumption to require an employer to show clear and convincing evidence that the cancer did not occur on the job. The act exempts firefighters who are employed by the state.(Note: This summary applies to this bill as enacted.)
The act creates the Colorado behavior analyst licensing board (board) under the direction and supervision of the division of professions and occupations in the department of regulatory agencies. On and after July 1, 2028, an individual is prohibited from engaging in or offering the practice of applied behavior analysis unless the individual is licensed by the board. The board is authorized to license behavior analysts and assistant behavior analysts if they meet the requirements specified by the act and the rules adopted by the board pursuant to the act. An individual who seeks to practice as a behavior analyst or assistant behavior analyst must meet the following requirements:File an application for a license;Have a valid certification in good standing with a certifying entity;Complete a fingerprint-based criminal history record check;Carry professional liability insurance in an amount determined by the board by rule unless working as a public employee covered under governmental immunity; andIf the individual seeks to practice as an assistant behavior analyst, be supervised by a licensed behavior analyst and practice within the scope of practice established by rules of the board. The board may deny or refuse to renew a license, suspend or revoke a license, impose probationary conditions on a license, or issue a cease-and-desist letter or seek injunctive relief against a licensee or an applicant for licensure who has engaged in specified grounds for discipline or unprofessional conduct. The board may also send a licensee a letter of admonition or a confidential letter of concern under certain circumstances. The act exempts specified individuals from the licensing requirements established by the act. An individual who practices or offers or attempts to practice as a behavior analyst or assistant behavior analyst without being licensed pursuant to the act and who is not exempted from licensure commits a class 2 misdemeanor. The board may adopt rules as necessary to implement the act. The regulation of behavior analysts and assistant behavior analysts is scheduled for repeal on September 1, 2031. Before the repeal, the functions of the board in regulating applied behavior analysis are scheduled for review in accordance with the sunset law. The act requires the department of health care policy and financing (state department) to reimburse an applied behavior analysis provider for applied behavior analysis services provided by a behavior technician certified by a certifying entity to a medicaid member with autism spectrum disorder or other conditions for which coverage may be available under state department policies. Subject to federal approval, the state department shall reimburse the applicable applied behavior analysis provider for applied behavior analysis services provided by a behavior technician who is required by the state department to be certified by a certifying entity, but is not certified at the time of services, for services provided during one temporary period of not less than 45 days while the behavior technician is pursuing the certification if specified conditions are met. The department of human services (department) is required to prescribe and publish standards for the licensing and regulation of applied behavior analysis clinics (clinics). The department is authorized to adopt rules concerning specific subjects related to standards for clinics. Clinics are required to comply with specified requirements regarding local government zoning regulations, licensing fees, and qualifications for employees of the clinics. The act changes the definition of 'day treatment center' to 'day treatment facility' and requires that facilities that were not subject to the definition before the effective date of the act but that meet the amended definition submit an application for licensure by the department on or before August 1, 2026 , and become licensed before August 1, 2027.(Note: This summary applies to this bill as enacted.)
On and after January 1, 2027, when determining coverage for health-care services, the act requires entities that use an artificial intelligence system (AI system) for the purpose of conducting utilization review of health-care services, including health insurance companies (carriers), pharmacy benefit managers, private utilization review organizations, behavioral health administrative services organizations, and managed care entities (entities), ensure that the AI system complies with certain requirements specified in the act. Specifically, an entity shall ensure that the AI system:Makes determinations based on medical or clinical history, the patient's individual clinical circumstances, and other relevant clinical factors specified in the act, with denial of coverage reviewed by a licensed clinician or physician or other competent regulated professional who is competent to evaluate the specific clinical issues and review the health benefit plan's terms of coverage (competent regulated professional);Does not base its determination solely on group data without reference to the individual's data;Is not used in any way that discriminates against individuals in violation of other state or federal laws and is fairly and equitably applied, including in accordance with regulations and guidance issued by the federal department of health and human services; andIs periodically reviewed to ensure the AI systems outcomes are accurate and reliable and that an individual's health data is not used beyond its intended or stated purpose. Entities that use AI systems shall disclose to the division of insurance, the department of human services, or the department of health care policy and financing, as applicable, the utilization review functions for which the AI system will be used and the points in the utilization review process when it will be used, the process for human oversight of adverse coverage determinations, and the process for maintaining audit information to ensure that the use of the AI system complies with the requirements in the act. The AI system may be used to assist in utilization review, including expedited approvals. A carrier's denial of coverage for a service based in whole or in part on medical necessity shall not be issued solely on the output of an AI system without human review by a licensed clinician or physician or other competent regulated professional. Further, the act prohibits a carrier and a payer of services under the 'Colorado Medical Assistance Act' and the 'Children's Basic Health Plan Act' from paying for psychotherapy services that are provided directly to a client and that are conducted by an AI system.(Note: This summary applies to this bill as enacted.)
The act requires the department of health care policy and financing and the behavioral health administration to publish on each department's website an easily accessible list of secure transportation providers that have contracts with managed care entities and behavioral health administrative services organizations, as applicable.(Note: This summary applies to this bill as enacted.)
The act allows an injured person to bring a cause of action for claims of injury caused by sexual orientation or gender identity change efforts (efforts) against a licensed mental health professional and allows the cause of action to be commenced at any time without limitation. Specifically, the act applies to a civil cause of action brought against a licensed mental health professional who seeks to direct a patient toward a predetermined sexual orientation or gender identity outcome or eliminate or reduce sexual or romantic attractions or feelings toward individuals of a particular sex or gender. The act permits the injured individual, or the individual's personal representative or estate if the individual is deceased, to recover economic, noneconomic, and exemplary damages, and any other damages deemed appropriate by the court. A cause of action may be brought as a survival action within 5 years after the death of the person who underwent efforts.(Note: This summary applies to this bill as enacted.)
On and after July 1, 2027, a manufacturer of a hair relaxer product or a hairpiece product (covered hair product) is prohibited from selling or distributing a covered hair product in the state that contains an intentionally added carcinogen or reproductive toxicant unless the covered hair product has a warning label that notifies the consumer that the covered hair product contains an intentionally added carcinogen or reproductive toxicant, which warning label must comply with certain requirements depending on whether the covered hair product contains an intentionally added carcinogen, an intentionally added reproductive toxicant, or both (warning label requirement). The warning label requirement does not apply to a covered hair product that is sold or distributed to a commercial entity for professional use. On and after July 1, 2028, the attorney general may adopt rules updating the warning label requirement. A violation of the warning label requirement constitutes a deceptive trade practice.(Note: This summary applies to this bill as enacted.)
The act allows an applicant for licensure as a marriage and family therapist (LMFT) whose master's or doctoral degree program did not include an internship or practicum to also be registered as an LMFT candidate but requires these candidates to complete an additional 700 supervised clinical hours to become an LMFT.(Note: This summary applies to this bill as enacted.)
Under current law, if a defendant is found incompetent to proceed and the defendant will not be restored to competency in the foreseeable future, the court is required to dismiss charges against the defendant and the defendant, in limited circumstances, may be referred for certification for short-term treatment through a civil court process. The act maintains the requirement for the court to dismiss the charges against a defendant if the defendant's highest charged offense is among certain misdemeanor offenses, and the act maintains certification for short-term treatment as an option for the defendant. However, if the defendant is unrestorable or the defendant has reached the statutory maximum time permitted to be restored, the act authorizes the district attorney or county attorney (prosecution) to notify the court that the prosecution seeks civil commitment or an enhanced protective placement of a defendant if the prosecution can prove by clear and convincing evidence that the defendant:Has a mental disability or developmental disability;Committed an act that, in the absence of any mental disability or developmental disability, would constitute homicide, a crime of violence, or a felony that constitutes unlawful sexual behavior, and the act is or was charged in a criminal case in Colorado in which competency was raised; and Poses a substantial risk of serious harm to others. If the prosecution seeks civil commitment or an enhanced protective placement, the court is required to stay the order dismissing the defendant's case, set a trial within 91 days after the date the written notice was filed, and order the department of human services (CDHS) to identify an appropriate provider and placement for the defendant in the event a civil commitment or enhanced protective placement is granted. The defendant may stipulate that the court order a civil commitment or enhanced protective placement. If the court finds the prosecution has not met its burden, the court is required to deny the prosecution's request to civilly commit the defendant or order an enhanced protective placement of the defendant; except that the court may consider whether to order other civil proceedings. If the court finds the prosecution has met its burden, the court is required to order the civil commitment or enhanced protective placement of the defendant, place the defendant and issue any related orders, transfer jurisdiction of the civil commitment or enhanced protective placement to an appropriate civil court with jurisdiction, and dismiss the defendant's criminal case. When the court orders the civil commitment or enhanced protective placement, the court shall make a finding of the defendant's primary diagnosis that constitutes the mental disability or developmental disability. The court shall order the defendant civilly committed to the legal custody of CDHS unless the defendant's primary diagnosis is an intellectual and developmental disability (IDD) or a neurocognitive disorder, in which case, the court shall order an enhanced protective placement and legal custody of the defendant to the department of health care policy and financing (HCPF). If CDHS proposes placing the defendant into inpatient care, the court shall order, without further court review, that the defendant be placed into inpatient care at the discretion of CDHS if the court ordered a civil commitment or that the defendant be placed into inpatient care at the discretion of HCPF if the court ordered an enhanced protective placement. If CDHS has not identified an appropriate provider that is willing to accept placement of the defendant, the court shall set a review hearing within 35 days after the order for civil commitment or enhanced protective placement and order CDHS, in consultation with the behavioral health administration (BHA), to identify at least one appropriate provider. Upon receiving jurisdiction of a civil commitment or enhanced protective placement, the act requires the civil court to supervise the civil commitment or enhanced protective placement by notifying the county attorney, appointing an attorney to represent the respondent, and setting a review hearing. At the hearing, the respondent has the right to request modification of the terms of the civil commitment or enhanced protective placement and the right to periodic review, including whether the respondent qualifies for termination of the civil commitment or enhanced protective placement. The court is required to ensure the respondent is placed in the least-restrictive setting adequate to protect the victims and community. If the respondent is not placed into inpatient care at the discretion of CDHS, or if CDHS proposes to move the respondent into or out of inpatient care, the court shall, prior to modifying the civil commitment or enhanced protective placement to change the respondent's provider or placement, review the appropriateness of the proposed provider or placement. The provider charged with the physical care and custody of the respondent is required to submit a report to the court and the parties annually by the date the respondent was civilly committed or ordered into enhanced protective placement unless a substantially similar examination was ordered by the court within the previous 12 months. The act requires the court to terminate the respondent's civil commitment or enhanced protective placement if the respondent no longer poses a substantial risk of serious harm to others or the respondent does not have the applicable disorder or disability that is likely to cause the respondent to be a danger to the respondent's self or a danger to others and the respondent has demonstrated sufficient capacity and willingness to conform their conduct to the requirements of the law. If the respondent does not meet the criteria for termination, the respondent is not entitled to another termination trial within one year after the conclusion of the previous trial. The court shall convert a civil commitment to an enhanced protective placement if the respondent does not meet the criteria for termination but the respondent has a mental health disorder that is an IDD or a neurocognitive disorder, without having any other mental health disorder that is not an IDD or a neurocognitive disorder and that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If the defendant does not meet the criteria for termination and has co-occurring mental health disorders that include an IDD or a neurocognitive disorder, the court may, upon the recommendation of CDHS, convert the civil commitment to an enhanced protective placement. The court shall convert an enhanced protective placement to a civil commitment if the respondent does not meet the criteria for termination and the respondent no longer has an IDD or a neurocognitive disorder that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If the defendant does not meet the criteria for termination and has co-occurring mental health disorders that do not include an IDD or a neurocognitive disorder, the court may, upon the recommendation of CDHS, convert the enhanced protective placement to a civil commitment. Under current law, an emergency mental health hold (M1 hold) may be initiated against a person for not more than 72 hours if the person appears to have a mental health disorder and, as a result of the mental health disorder, appears to be a danger to the person's self or others, or appears to be gravely disabled. A person detained for an M1 hold and transported to an emergency medical services facility or facility designated by the commissioner (facility) of the BHA is required to receive an evaluation as soon as possible after the person presents to the facility. The act authorizes a person who has an M1 hold initiated against them while in confinement to receive an evaluation at the person's place of confinement rather than being transported to a facility. If the person is released from confinement while under an M1 hold, the person responsible for the confinement is required to coordinate with the BHA to transfer the person to a facility. Under current law, if a person under an M1 hold meets the criteria for certification for short-term treatment, the person may be certified for not more than 3 months. Rather than requiring an M1 hold as a prerequisite to short-term certification or certification for long-term care and treatment, the act authorizes a person to be certified if the person:Has been advised of the availability of, but has not accepted, voluntary treatment or with consideration of all reasonably available information, is believed will not remain in voluntary treatment; and By clear and convincing evidence, has a mental health disorder and, as a result of the mental health disorder, the person is a danger to the person's self, a danger to others, or gravely disabled. A person may not be certified for short-term treatment or long-term care and treatment if the person has an IDD or neurocognitive disorder without any other mental health disorder that is not an IDD or neurocognitive disorder and that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If a respondent is certified, the court shall order CDHS to provide care coordination and make diligent efforts to find a provider for the respondent that is willing to hold the certification. The respondent may be certified for long-term care and treatment if the respondent continues to meet the criteria and standards for certification for short-term treatment. The certification terminates when the professional person in charge of the respondent's treatment and the BHA determine the respondent no longer meets the criteria for certification. To terminate a short-term treatment certification less than 30 days after the initial certification, two professional persons are required to individually consult and review the respondent's case and agree that the respondent no longer meets the criteria for certification. A court may order the short-term or long-term protective placement of a person:Who, by clear and convincing evidence, has a neurocognitive disorder;When reasonable grounds exist to believe that the person will not remain in a voluntary treatment program; andWho, by clear and convincing evidence, is a danger to the person's self, a danger to others. The act aligns the provisions for short-term and long-term protective placement with certifications for short-term treatment and long-term care and treatment. No later than October 1, 2027, the act requires CDHS to construct and operate an outpatient treatment facility for adults with behavioral health needs, including adults who are found incompetent to proceed and unlikely to be restored to competency. To implement the act, for the 2025-26 state fiscal year, the act appropriates to CDHS $535,934 from the general fund and $4,777,898 from the capital construction fund. To implement the act, the act makes the following appropriations for state fiscal year 2026-27:$17,802,360 to CDHS from the general fund, of which $242,323 is reappropriated to the department of law and $52,644 to the office of information technology;To the judicial department, $26,296 from the judicial department information technology cash fund and $5,401,437 from the general fund, of which $1,719,409 is for use by the office of state public defender and specified independent agencies;$842,808 to HCPF from the general fund; and$150,000 to the department of law from the general fund.(Note: This summary applies to this bill as enacted.)
