§ 25.5-6-1102 — Service model - consumer-directed care

Colorado § 25.5-6-1102

• Jurisdiction: Colorado
• Title 25.5: Health
• Art.: Colorado Medical Assistance Act -

Text

(1) The state
department shall implement a consumer-directed care service model that allows
eligible persons to receive a direct payment through a voucher to purchase
qualified services. The state department is authorized to seek any federal waivers
or waiver amendments that may be necessary to implement this part 11. The state
department shall design and implement the consumer-directed care service model
with input from consumers of home- and community-based services or their
authorized representatives. An eligible person shall not be required to disenroll
from the person's waiver program in order to receive qualified services through the
consumer-directed care service model.

(2) In order to qualify and to remain eligible for the consumer-directed care
service model authorized by this section, a person shall:

(a) Be eligible for community first choice services pursuant to part 19 of this
article 6;

(b) Be willing to participate;

(c) Obtain a statement from his or her primary care physician or advanced
practice registered nurse indicating that the person has sound judgment and the
ability to direct his or her care or has an authorized representative;

(d) Demonstrate the ability to handle the financial aspects of self-directed
care or has an authorized representative who is able to handle the financial aspects
of the eligible person's care; and

(e) Meet any other qualifications established by the state board by rule.

(3) The allocation issued to the eligible person pursuant to this part 11 must
be based on the eligible person's historical utilization of home- and community-based services pursuant to parts 3 to 12 of this article 6, the case management
agency's care plan, or any approved resource allocation process as determined by
the state department and the department of human services for the eligible person.

(4) While an eligible person is participating in the consumer-directed care
service model established in this part 11, that person shall be ineligible to receive a
home care allowance as provided in section 26-2-122.3 (1)(b), C.R.S.

(5) The state department shall develop the accountability requirements
necessary to safeguard the use of public dollars, to promote effective and efficient
delivery of services, and to monitor the safety and welfare of eligible persons under
this part 11.

(6) The state board shall adopt rules as necessary for the implementation
and administration of the consumer-directed care service model authorized by this
part 11. Such rules shall include a provision allowing an eligible person to designate
a family member or authorized representative to be responsible for managing the
financial matters associated with the consumer-directed care or to direct the
eligible person's care. The designee shall not receive reimbursement for managing
the financial matters associated with the eligible person's care or for directing the
eligible person's care.

(7) Sections 12-255-104 (7), (8.5), and (11), 12-255-125 (1), and 12-255-214
(1)(b) shall not apply to a person who is directly employed by an individual
participating in the consumer-directed care service model pursuant to this section
and who is acting within the scope and course of such employment. However, such
person may not represent himself or herself to the public as a licensed nurse, a
certified nurse aide, a licensed practical or professional nurse, a registered nurse,
or a registered professional nurse. This exclusion shall not apply to any person who
has had his or her license as a nurse or certification as a nurse aide suspended or
revoked or his or her application for such license or certification denied.

(8) Repealed.

(9) A person who has been designated as an authorized representative under
this part 11 shall submit an affidavit, which shall become part of the eligible
person's file, stating that:

(a) He or she is at least eighteen years of age;

(b) He or she has known the eligible person for at least two years;

(c) He or she has not been convicted of any crime involving exploitation,
abuse, or assault on another person; and

(d) He or she does not have a mental, emotional, or physical condition that
could result in harm to the eligible person.

Legislative History

Source: L. 2006: Entire article added with relocations, p. 1968, � 7, effective July 1. L. 2008: (2)(c) amended, p. 134, � 24, effective January 1, 2009. L. 2019: (7) amended, (HB 19-1172), ch. 136, p. 1710, � 189, effective October 1. L. 2020: (7) amended, (HB 20-1183), ch. 157, p. 703, � 61, effective July 1. L. 2021: (3) amended, (HB 21-1187), ch. 83, p. 336, � 36, effective July 1, 2024. L. 2023: (2)(a) and (3) amended, (SB 23-289), ch. 270, p. 1609, � 11, effective July 1, 2025; (8)(b) added by revision, (SB 23-289), ch. 270, pp. 1609, 1611, �� 11, 19.