(1) The state board shall promulgate rules pursuant to section 24-4-103, C.R.S., providing minimum standards for the operation of home care agencies and home care placement agencies within the state of Colorado that apply regardless of the source of payment for the home care services or the diagnosis of the home care consumer. In promulgating these rules, the state board shall establish different requirements appropriate to the various types of skilled home health and personal care services, including differentiating requirements for providers that are substantially funded through medicare and medicaid reimbursement, providers for the program of all-inclusive care for the elderly established in section 25.5-5-412, C.R.S., providers that are already licensed under this title, and providers that are solely or substantially privately funded. This differentiation must include consideration of the requirements already imposed by other federal and state regulatory agencies and must require the department of health care policy and financing and the department to work jointly to resolve differing requirements. The rules must include the following:
Inspection of home care agencies by the department or its designated representative;
Minimum educational, training, and experience standards for the administrator andstaff of an agency, including a requirement that such persons be of good, moral, and responsible character;
Requirements for disclosure notices to be provided by home care agencies and homecare placement agencies to home care consumers concerning the duties and employment status of the individual providing services. With regard to home care placement agencies, the rules must require a home care placement agency to disclose in writing, at a minimum, the following to each home care consumer client in the form and manner prescribed by the department before referring a provider to the client:
That the home care placement agency is not the employer of any provider it refers toa home care consumer; and
That the home care placement agency does not direct, control, schedule, or train anyprovider it refers;
Intermediate enforcement remedies as authorized by section 25-27.5-108;
A requirement and form for written plans, to be submitted by agencies to the department for approval, detailing the measures that will be taken to correct violations found as a result of inspections;
Establishing occurrence reporting requirements pursuant to section 25-1-124;
(I) Fees for home care agency licensure. Home care agency fees are payable to thehome care agency cash fund. The annual fee must include a component that reflects whether a survey is planned for the year based on the agency's compliance history. The state board shall develop a methodology for establishing differentiating fees for licensure of home care agencies, including community-centered boards and service agencies, to reflect the differences in type, scope, and volume of services provided by the various types of home care agencies, including their volume of medicaid and medicare services, and that allows for reduced fees for home care agencies that are certified prior to initial license application. The department shall not charge a duplicate fee for survey work conducted pursuant to its role as state survey agency for the federal centers for medicare and medicaid services or the Colorado department of health care policy and financing.
(II) Notwithstanding section 25-3-105 (1)(a)(I)(B), the state board may set and adjust licensure fees for home care agencies as appropriate based on the differentiating fee methodology developed by the state board pursuant to this paragraph (g).
Requirements for home care agencies to provide evidence of and maintain eitherliability insurance coverage or a surety bond in lieu of liability insurance coverage and for home care placement agencies to provide evidence of and maintain liability insurance coverage as required in section 25-27.5-103 (2)(a)(II) in amounts set through rules of the state board;
Factors for home care agencies and home care placement agencies to consider whendetermining whether an applicant's conviction of or plea of guilty or nolo contendere to an offense disqualifies the applicant from employment or a referral. The state board may determine which offenses require consideration of the factors.
Requirements for home care placement agencies to retain their records for a length oftime determined by the state board to be available for inspection by the department pursuant to section 25-27.5-106 (2)(a)(III); and
Fees for the registration of home care placement agencies to cover the direct andindirect costs associated with implementing the department's oversight of home care placement agencies.
(1.5) To the extent the state board rules adopted pursuant to subsection (1) of this section address supervision requirements for home care agencies, the rules must allow for supervision in person or by telemedicine or telehealth. Any rules adopted by the state board pursuant to this subsection (1.5) shall be in conformity with applicable federal law and must take into consideration the appropriateness, suitability, and necessity of the method of supervision permitted.
Rules promulgated by the state board are subject to judicial review in accordancewith the requirements of section 24-4-106, C.R.S.
There is hereby established a home care advisory committee, which shall make recommendations to the department and the state board concerning the rules promulgated pursuant to this article 27.5 and implementation of the licensing of home care agencies. The executive director of the department shall appoint the members of the advisory committee. The advisory committee must, at a minimum, include representatives from skilled home health services agencies, personal care services agencies, members of the disabled community who are home care consumers, seniors or representatives of seniors who are home care consumers, providers of medicaid services, providers of in-home support services, representatives of home care placement agencies, and representatives of the departments of health care policy and financing and human services. Members of the advisory committee serve at the pleasure of the appointing authority on a voluntary basis without compensation.
The department shall regulate a provider of PACE home care services for minimumstandards for the operation of home care agencies as follows:
For a PACE provider that serves only medicaid or medicare clients, if a full federalrecertification survey required by the department of health care policy and financing is conducted at least every three years, the department shall accept the federal recertification survey in lieu of a separate survey for relicensure;
The department shall not impose any requirement on a PACE provider that is morestringent than the federal and state medicaid PACE regulations, the three-way agreement entered into by the provider, CMS, and the department of health care policy and financing, and the
PACE provider's policies and procedures;
In reviewing a PACE provider's compliance with home care licensure, the department shall coordinate with the department of health care policy and financing regarding both license and certification requirements to ensure that the departments' similar regulations are congruently met;
At the time that a PACE provider enrolls a PACE participant in a PACE program, thePACE provider shall give the client the department's contact information in writing to allow the client to report any complaints that may arise out of the client's PACE home care services. The department shall undertake any investigation arising from a complaint, other than a complaint alleging matters that are outside of the department's licensing authority.
Under the department's licensing authority, the department has complete authority toenforce all home care requirements applicable to a PACE provider. If the department is unable to take corrective action congruently with the department of health care policy and financing, the department shall forward the proposed corrective action to and consult with the department of health care policy and financing before taking final action against a PACE provider.
Source: L. 2008: Entire article added, p. 2236, § 3, effective August 5. L. 2012: IP(1) amended, (HB 12-1294), ch. 252, p. 1259, § 11, effective June 4. L. 2014: IP(1), (1)(c), (1)(g), and (1)(h) amended and (1)(i), (1)(j), (1)(k), and (4) added, (HB 14-1360), ch. 373, p. 1774, § 3, effective July 1. L. 2019: (3) amended, (SB 19-146), ch. 314, p. 2821, § 5, effective August 2. L.
2020: (1.5) added, (SB 20-212), ch. 235, p. 1140, § 3, effective July 6.
Cross references: For the legislative declaration in the 2012 act amending the introductory portion to subsection (1), see section 1 of chapter 252, Session Laws of Colorado 2012. For the legislative declaration in SB 20-212, see section 1 of chapter 235, Session Laws of Colorado 2020.