Amendments for SB17-267

Senate Journal, April 12
After consideration on the merits, the Committee recommends that SB17-267 be amended
as follows, and as so amended, be referred to the Committee on Appropriations with
favorable recommendation.

Amend printed bill, page 5, line 12, strike "17-_____," and substitute
"17-267,".

Page 6, strike lines 4 through 27.

Strike page 7.

Page 8, strike lines 1 and 2 and substitute:

"SECTION 3. In Colorado Revised Statutes, 24-75-219, repeal
as amended by Senate Bill 17-262 (2)(c); and repeal as added by
Senate Bill 17-262 (2)(c.3)(I) and (2)(c.7)(I) as follows:
24-75-219. Transfers - transportation - capital construction
- definitions. (2) (c) On June 30, 2018, the state treasurer shall transfer
seventy-nine million dollars from the general fund to the highway users
tax fund.
(c.3) On June 30, 2019, the state treasurer shall transfer:
(I) One hundred sixty million dollars from the general fund to the
highway users tax fund; and
(c.7) On June 30, 2020, the state treasurer shall transfer:
(I) One hundred sixty million dollars from the general fund to the
highway users tax fund; and".

Page 9, strike lines 14 through 27.

Strike pages 10 through 16.

Page 17, strike lines 1 through 17 and substitute:

"SECTION 5. In Colorado Revised Statutes, add part 13 to
article 82 of title 24 as follows:
24-82-1301. Legislative declaration. (1) THE GENERAL
ASSEMBLY HEREBY FINDS AND DECLARES THAT:
(a) DUE TO INSUFFICIENT FUNDING, NECESSARY HIGH-PRIORITY
STATE HIGHWAY PROJECTS AND STATE CAPITAL CONSTRUCTION PROJECTS,
INCLUDING PROJECTS AT STATE INSTITUTIONS OF HIGHER EDUCATION, IN
ALL AREAS OF THE STATE HAVE BEEN DELAYED, AND THE STATE HAS ALSO
DELAYED CRITICAL CONTROLLED MAINTENANCE AND UPKEEP OF STATE
CAPITAL ASSETS;
(b) BY ISSUING LEASE-PURCHASE AGREEMENTS USING STATE
BUILDINGS AS COLLATERAL AS AUTHORIZED BY THIS PART 13, THE STATE
CAN GENERATE SUFFICIENT FUNDS TO ACCELERATE THE COMPLETION OF
MANY OF THE NECESSARY HIGH-PRIORITY STATE HIGHWAY PROJECTS AND
CAPITAL CONSTRUCTION PROJECTS THAT HAVE BEEN DELAYED AND
BETTER MAINTAIN AND PRESERVE EXISTING STATE CAPITAL ASSETS;
(c) IT IS THE INTENT OF THE GENERAL ASSEMBLY THAT:
(I) A MAJORITY OF THE ADDITIONAL FUNDING FOR STATE CAPITAL
CONSTRUCTION PROJECTS REALIZED FROM ISSUING LEASE-PURCHASE
AGREEMENTS BE USED FOR RENOVATION AND RENEWAL PROJECTS; AND
(II) MORE OF THE STATE'S EXISTING CAPITAL CONSTRUCTION
FUNDING BE DEDICATED TO CONTROLLED MAINTENANCE AND UPKEEP OF
STATE CAPITAL ASSETS.
24-82-1302. Definitions. AS USED IN THIS PART 13, UNLESS THE
CONTEXT OTHERWISE REQUIRES:
(1) "ELIGIBLE STATE FACILITY" MEANS ANY FINANCIALLY
UNENCUMBERED BUILDING, STRUCTURE, OR FACILITY THAT IS OWNED BY
THE STATE, INCLUDING A BUILDING, STRUCTURE, OR FACILITY
DETERMINED TO BE ELIGIBLE BY A GOVERNING BOARD OF A STATE
INSTITUTION OF HIGHER EDUCATION.
(2) "CAPITAL CONSTRUCTION" HAS THE SAME MEANING AS SET
FORTH IN SECTION 24-30-1301 (2).
(3) "CONTROLLED MAINTENANCE" HAS THE SAME MEANING AS
SET FORTH IN SECTION 24-30-1301 (4).
(4) "STATE INSTITUTION OF HIGHER EDUCATION" MEANS A STATE
INSTITUTION OF HIGHER EDUCATION, AS DEFINED IN SECTION 23-18-102
(10), AND THE AURARIA HIGHER EDUCATION CENTER CREATED IN ARTICLE
70 OF TITLE 23.
24-82-1303. Lease-purchase agreements for capital
construction and transportation projects. (1) ON OR BEFORE
DECEMBER 31, 2017, THE STATE ARCHITECT, THE DIRECTOR OF THE
OFFICE OF STATE PLANNING AND BUDGETING OR HIS OR HER DESIGNEE,
AND THE STATE INSTITUTIONS OF HIGHER EDUCATION SHALL IDENTIFY
AND PREPARE A COLLABORATIVE LIST OF ELIGIBLE STATE FACILITIES THAT
CAN BE COLLATERALIZED AS PART OF THE LEASE-PURCHASE AGREEMENTS
FOR CAPITAL CONSTRUCTION AND TRANSPORTATION PROJECTS
AUTHORIZED IN THIS PART 13. THE TOTAL CURRENT REPLACEMENT VALUE
OF THE IDENTIFIED BUILDINGS MUST EQUAL AT LEAST ONE BILLION SEVEN
HUNDRED MILLION DOLLARS.
(2) (a) NOTWITHSTANDING THE PROVISIONS OF SECTIONS
24-82-102 (1)(b) AND 24-82-801, AND PURSUANT TO SECTION 24-36-121,
NO SOONER THAN JULY 1, 2018, THE STATE, ACTING BY AND THROUGH
THE STATE TREASURER, SHALL EXECUTE LEASE-PURCHASE AGREEMENTS
EACH FOR NO MORE THAN TWENTY YEARS OF ANNUAL PAYMENTS FOR THE
PROJECTS DESCRIBED IN SUBSECTION (5) OF THIS SECTION. A STATE
INSTITUTION OF HIGHER EDUCATION MAY EITHER CONTRIBUTE THE FULL
AMOUNT OF ITS SHARE OF THE COST OF THE PROJECT, AS DESCRIBED IN
SUBSECTION (3) OF THIS SECTION, AT THE COMMENCEMENT OF THE
PROJECT OR MAY HAVE ITS SHARE OF THE COST OF THE PROJECT INCLUDED
IN THE LEASE-PURCHASE AGREEMENT.
(b) THE ANTICIPATED ANNUAL STATE-FUNDED PAYMENTS FOR THE
PRINCIPAL AND INTEREST COMPONENTS OF THE AMOUNT PAYABLE UNDER
ALL LEASE-PURCHASE AGREEMENTS ENTERED INTO SHALL NOT EXCEED
ONE HUNDRED TWENTY-FIVE MILLION DOLLARS.
(c) THE STATE, ACTING BY AND THROUGH THE STATE TREASURER,
AT THE STATE TREASURER'S SOLE DISCRETION, MAY ENTER INTO ONE OR
MORE LEASE-PURCHASE AGREEMENTS AUTHORIZED BY SUBSECTION (2)(a)
OF THIS SECTION WITH ANY FOR-PROFIT OR NONPROFIT CORPORATION,
TRUST, OR COMMERCIAL BANK AS A TRUSTEE AS THE LESSOR.
(d) ANY LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED
BY SUBSECTION (2)(a) OF THIS SECTION SHALL PROVIDE THAT ALL OF THE
OBLIGATIONS OF THE STATE UNDER THE AGREEMENT ARE SUBJECT TO THE
ACTION OF THE GENERAL ASSEMBLY IN ANNUALLY MAKING MONEY
AVAILABLE FOR ALL PAYMENTS THEREUNDER. PAYMENTS UNDER ANY
LEASE-PURCHASE AGREEMENT MUST BE MADE, SUBJECT TO ANNUAL
ALLOCATION PURSUANT TO SECTION 43-1-113 BY THE TRANSPORTATION
COMMISSION CREATED IN SECTION 43-1-106 (1) OR SUBJECT TO ANNUAL
APPROPRIATION BY THE GENERAL ASSEMBLY, AS APPLICABLE, FROM THE
FOLLOWING SOURCES OF MONEY:
(I) THE CAPITAL CONSTRUCTION LEASE-PURCHASE AGREEMENT
CASH FUND CREATED IN SUBSECTION (3) OF THIS SECTION;
(II) AN ANNUAL AMOUNT EQUAL TO THE PERCENTAGE OF THE
TOTAL ANNUAL PAYMENTS ATTRIBUTABLE TO THE EXECUTED LEASE
PURCHASE AGREEMENTS CREDITED TO THE STATE HIGHWAY FUND AS
SPECIFIED IN SUBSECTION (5)(a) OF THIS SECTION, OR ANY LESSER
AMOUNT THAT IS SUFFICIENT TO MAKE A FULL PAYMENT, FROM ANY
LEGALLY AVAILABLE MONEY UNDER THE CONTROL OF THE
TRANSPORTATION COMMISSION; AND
(III) THE REMAINDER OF THE AMOUNT NEEDED, IN ADDITION TO
THE AMOUNT SPECIFIED IN SUBSECTION (2)(d)(I) OF THIS SECTION, TO
MAKE THE FULL PAYMENT FROM THE GENERAL FUND OR ANY OTHER
LEGALLY AVAILABLE SOURCE OF MONEY.
(e) EACH AGREEMENT MUST ALSO PROVIDE THAT THE
OBLIGATIONS OF THE STATE DO NOT CREATE STATE DEBT WITHIN THE
MEANING OF ANY PROVISION OF THE STATE CONSTITUTION OR STATE LAW
CONCERNING OR LIMITING THE CREATION OF STATE DEBT AND ARE NOT A
MULTIPLE FISCAL-YEAR DIRECT OR INDIRECT DEBT OR OTHER FINANCIAL
OBLIGATION OF THE STATE WITHIN THE MEANING OF SECTION 20 (4) OF
ARTICLE X OF THE STATE CONSTITUTION. IF THE STATE DOES NOT RENEW
A LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED BY SUBSECTION
(2)(a) OF THIS SECTION, THE SOLE SECURITY AVAILABLE TO THE LESSOR
IS THE PROPERTY THAT IS THE SUBJECT OF THE NONRENEWED
LEASE-PURCHASE AGREEMENT.
(f) A LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED BY
SUBSECTION (2)(a) OF THIS SECTION MAY CONTAIN SUCH TERMS,
PROVISIONS, AND CONDITIONS AS THE STATE TREASURER, ACTING ON
BEHALF OF THE STATE, DEEMS APPROPRIATE, INCLUDING ALL OPTIONAL
TERMS; EXCEPT THAT EACH LEASE-PURCHASE AGREEMENT MUST
SPECIFICALLY AUTHORIZE THE STATE OR THE GOVERNING BOARD OF THE
APPLICABLE STATE INSTITUTION OF HIGHER EDUCATION TO RECEIVE FEE
TITLE TO ALL REAL AND PERSONAL PROPERTY THAT IS THE SUBJECT OF
THE LEASE-PURCHASE AGREEMENT ON OR BEFORE THE EXPIRATION OF THE
TERMS OF THE AGREEMENT.
(g) ANY LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED
BY SUBSECTION (2)(a) OF THIS SECTION MAY PROVIDE FOR THE ISSUANCE,
DISTRIBUTION, AND SALE OF INSTRUMENTS EVIDENCING RIGHTS TO
RECEIVE RENTALS AND OTHER PAYMENTS MADE AND TO BE MADE UNDER
THE LEASE-PURCHASE AGREEMENT. THE INSTRUMENTS MAY BE ISSUED,
DISTRIBUTED, OR SOLD ONLY BY THE LESSOR OR ANY PERSON DESIGNATED
BY THE LESSOR AND NOT BY THE STATE. THE INSTRUMENTS DO NOT
CREATE A RELATIONSHIP BETWEEN THE PURCHASERS OF THE
INSTRUMENTS AND THE STATE OR CREATE ANY OBLIGATION ON THE PART
OF THE STATE TO THE PURCHASERS. THE INSTRUMENTS ARE NOT NOTES,
BONDS, OR ANY OTHER EVIDENCE OF STATE DEBT WITHIN THE MEANING
OF ANY PROVISION OF THE STATE CONSTITUTION OR STATE LAW
CONCERNING OR LIMITING THE CREATION OF STATE DEBT AND ARE NOT A
MULTIPLE FISCAL-YEAR DIRECT OR INDIRECT DEBT OR OTHER FINANCIAL
OBLIGATION OF THE STATE WITHIN THE MEANING OF SECTION 20 (4) OF
ARTICLE X OF THE STATE CONSTITUTION.
(h) INTEREST PAID UNDER A LEASE-PURCHASE AGREEMENT
AUTHORIZED PURSUANT TO SUBSECTION (2)(a) OF THIS SECTION,
INCLUDING INTEREST REPRESENTED BY THE INSTRUMENTS, IS EXEMPT
FROM COLORADO INCOME TAX.
(i) THE STATE, ACTING BY AND THROUGH THE STATE TREASURER
AND THE GOVERNING BOARDS OF THE INSTITUTIONS OF HIGHER
EDUCATION, IS AUTHORIZED TO ENTER INTO ANCILLARY AGREEMENTS
AND INSTRUMENTS THAT ARE NECESSARY OR APPROPRIATE IN
CONNECTION WITH A LEASE-PURCHASE AGREEMENT, INCLUDING BUT NOT
LIMITED TO DEEDS, GROUND LEASES, SUB-LEASES, EASEMENTS, OR OTHER
INSTRUMENTS RELATING TO THE REAL PROPERTY ON WHICH THE
FACILITIES ARE LOCATED.
(j) THE PROVISIONS OF SECTION 24-30-202 (5)(b) DO NOT APPLY
TO A LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED BY OR TO
ANY ANCILLARY AGREEMENT OR INSTRUMENT ENTERED INTO PURSUANT
TO THIS SUBSECTION (2). THE STATE CONTROLLER OR HIS OR HER
DESIGNEE SHALL WAIVE ANY PROVISION OF THE FISCAL RULES
PROMULGATED PURSUANT TO SECTION 24-30-202 (1) AND (13), THAT THE
STATE CONTROLLER FINDS INCOMPATIBLE OR INAPPLICABLE WITH
RESPECT TO A LEASE-PURCHASE AGREEMENT OR AN ANCILLARY
AGREEMENT OR INSTRUMENT.
(3) A STATE INSTITUTION OF HIGHER EDUCATION, BUT NOT THE
STATE BOARD FOR COMMUNITY COLLEGES AND OCCUPATIONAL
EDUCATION, SHALL TRANSFER TO THE STATE TREASURER TWENTY
PERCENT OF THE TOTAL PROJECT COST OF ANY NEW CAPITAL
CONSTRUCTION PROJECT THAT RECEIVES FUNDING THROUGH THIS PART 13
WITHOUT AN APPROPRIATION FROM THE GENERAL ASSEMBLY. THE STATE
TREASURER SHALL CREDIT ANY MONEY RECEIVED PURSUANT TO THIS
SUBSECTION (3) TO THE CAPITAL CONSTRUCTION LEASE-PURCHASE
AGREEMENT CASH FUND, REFERRED TO IN THIS SUBSECTION (3) AS THE
"FUND", WHICH IS HEREBY CREATED IN THE STATE TREASURY. MONEY IN
THE FUND IS CONTINUOUSLY APPROPRIATED TO THE STATE TREASURER TO
MAKE PAYMENTS ON LEASE-PURCHASE AGREEMENTS EXECUTED AS
REQUIRED BY SUBSECTION (2)(a) OF THIS SECTION. ALL INTEREST AND
INCOME DERIVED FROM THE INVESTMENT AND DEPOSIT OF MONEY IN THE
FUND IS CREDITED TO THE FUND.
(4) (a) BEFORE EXECUTING A LEASE-PURCHASE AGREEMENT
REQUIRED BY SUBSECTION (2)(a) OF THIS SECTION, IN ORDER TO PROTECT
AGAINST FUTURE INTEREST RATE INCREASES, THE STATE, ACTING BY AND
THROUGH THE STATE TREASURER AND AT THE DISCRETION OF THE STATE
TREASURER, MAY ENTER INTO AN INTEREST RATE EXCHANGE AGREEMENT
PURSUANT TO ARTICLE 59.3 OF TITLE 11. A LEASE-PURCHASE AGREEMENT
EXECUTED AS REQUIRED BY SUBSECTION (2)(a) OF THIS SECTION IS A
PROPOSED PUBLIC SECURITY FOR THE PURPOSES OF ARTICLE 59.3 OF TITLE
11. ANY PAYMENTS MADE BY THE STATE UNDER AN AGREEMENT ENTERED
INTO PURSUANT TO THIS SUBSECTION (4) MUST BE MADE SOLELY FROM
MONEY MADE AVAILABLE TO THE STATE TREASURER FROM THE
EXECUTION OF A LEASE-PURCHASE AGREEMENT, FROM MONEY DESCRIBED
IN SUBSECTIONS (2)(d)(I), (2)(d)(II), AND (2)(d)(III) OF THIS SECTION, OR
FROM MONEY IN THE CAPITAL CONSTRUCTION LEASE-PURCHASE
AGREEMENT CASH FUND CREATED IN SUBSECTION (3) OF THIS SECTION.
(b) ANY AGREEMENT ENTERED INTO PURSUANT TO THIS
SUBSECTION (4) MUST ALSO PROVIDE THAT THE OBLIGATIONS OF THE
STATE DO NOT CREATE STATE DEBT WITHIN THE MEANING OF ANY
PROVISION OF THE STATE CONSTITUTION OR STATE LAW CONCERNING OR
LIMITING THE CREATION OF STATE DEBT AND ARE NOT A MULTIPLE
FISCAL-YEAR DIRECT OR INDIRECT DEBT OR OTHER FINANCIAL
OBLIGATION OF THE STATE WITHIN THE MEANING OF SECTION 20 (4) OF
ARTICLE X OF THE STATE CONSTITUTION.
(c) ANY MONEY RECEIVED BY THE STATE UNDER AN AGREEMENT
ENTERED INTO PURSUANT TO THIS SUBSECTION (4) SHALL BE USED TO
MAKE PAYMENTS ON LEASE-PURCHASE AGREEMENTS ENTERED INTO
PURSUANT TO SUBSECTION (2) OF THIS SECTION OR TO PAY THE COSTS OF
THE PROJECT FOR WHICH A LEASE-PURCHASE AGREEMENT WAS EXECUTED.
(5) PROCEEDS OF LEASE-PURCHASE AGREEMENTS EXECUTED AS
REQUIRED BY SUBSECTION (2)(a) OF THIS SECTION SHALL BE USED AS
FOLLOWS:
(a) SEVENTY-SIX AND FIVE-TENTHS PERCENT OF THE PROCEEDS
SHALL BE CREDITED TO THE STATE HIGHWAY FUND CREATED IN SECTION
43-1-219 AND USED BY THE DEPARTMENT OF TRANSPORTATION IN
ACCORDANCE WITH SECTION 43-4-206 (1)(b)(V); AND
(b) TWENTY-THREE AND FIVE-TENTHS PERCENT OF THE PROCEEDS
SHALL BE USED FOR CONTROLLED MAINTENANCE AND CAPITAL
CONSTRUCTION PROJECTS IN THE STATE AS FOLLOWS:
(I) THIRTEEN MILLION SIX THOUSAND EIGHTY-ONE DOLLARS FOR
LEVEL I CONTROLLED MAINTENANCE;
(II) SIXTY MILLION SIX HUNDRED THIRTY-SEVEN THOUSAND
THREE HUNDRED FIVE DOLLARS FOR LEVEL II CONTROLLED
MAINTENANCE;
(III) FORTY MILLION TWO HUNDRED NINE THOUSAND FIVE
HUNDRED THIRTY-FIVE DOLLARS FOR LEVEL III CONTROLLED
MAINTENANCE; AND
(IV) THE REMAINDER FOR CAPITAL CONSTRUCTION PROJECTS AS
PRIORITIZED BY THE CAPITAL DEVELOPMENT COMMITTEE. THE CAPITAL
DEVELOPMENT COMMITTEE SHALL POST THE FINAL PRIORITIZED LIST ON
THE COMMITTEE'S WEBSITE AND FORWARD THE LIST TO THE OFFICE OF
STATE PLANNING AND BUDGETING, THE STATE INSTITUTIONS OF HIGHER
EDUCATION, AND THE STATE TREASURER NO LATER THAN NOVEMBER 1,
2017.
SECTION 6. In Colorado Revised Statutes, 23-1-106, amend
(10.2)(a)(I) and (10.2)(a)(II); and add (10.2)(a)(III) as follows:
23-1-106. Duties and powers of the commission with respect
to capital construction and long-range planning - legislative
declaration - definitions. (10.2) (a) (I) Notwithstanding any law to the
contrary AND EXCEPT AS PROVIDED IN SUBSECTION (10.2)(a)(III) OF THIS
SECTION, all academic facilities acquired or constructed, or an auxiliary
facility repurposed for use as an academic facility, solely from cash funds
held by the state institution of higher education and operated and
maintained from such cash funds or from state moneys appropriated for
such purpose, or both, including, but not limited to, those facilities
described in paragraph (b) of subsection (9) SUBSECTION (9)(b) of this
section, that did not previously qualify for state controlled maintenance
funding will qualify for state controlled maintenance funding, subject to
funding approval by the capital development committee and the
eligibility guidelines described in section 24-30-1303.9. C.R.S.
(II) For purposes of this paragraph (a) SUBSECTION (10.2)(a), the
eligibility for state controlled maintenance funding commences on the
date of the acceptance of the construction or repurposing of the facility
or the closing date of any acquisition. The date of the acceptance of
construction or repurposing shall be determined by the office of the state
architect.
(III) IF AN ACADEMIC FACILITY IS ACQUIRED OR CONSTRUCTED, OR
IF AN AUXILIARY FACILITY IS REPURPOSED FOR USE AS AN ACADEMIC
FACILITY, SOLELY FROM CASH FUNDS HELD BY THE STATE INSTITUTION OF
HIGHER EDUCATION AND OPERATED AND MAINTAINED FROM SUCH CASH
FUNDS, THEN AS OF THE DATE OF THE ACCEPTANCE OF CONSTRUCTION OR
REPURPOSING THAT OCCURS ON OR AFTER JULY 1, 2018, SUCH FACILITY
IS NOT ELIGIBLE FOR CONTROLLED MAINTENANCE FUNDING.
SECTION 7. In Colorado Revised Statutes, 24-30-1303.9,
amend (7)(a)(II), (7)(a)(III), and (7)(a)(IV); and add (7)(a)(V) as
follows:
24-30-1303.9. Eligibility for state controlled maintenance
funding - legislative declaration. (7) (a) Controlled maintenance funds
may not be used for:
(II) Auxiliary facilities as defined in section 23-1-106 (10.3);
C.R.S.;
(III) Leasehold interests in real property; or
(IV) Any work properly categorized as capital construction; OR
(V) FACILITIES DESCRIBED IN SECTION 23-1-106 (10.2)(a)(III).
SECTION 8. In Colorado Revised Statutes, 25.5-4-301, amend
(1)(a)(I) and (1)(a)(II); and add (1)(a)(II.3) as follows:
25.5-4-301. Recoveries - overpayments - penalties - interest -
adjustments - liens - review or audit procedures. (1) (a) (I) Except as
provided in section 25.5-4-302 and subparagraph (III) of this paragraph
(a), no SUBSECTION (1)(a)(III) OF THIS SECTION, A recipient or estate of
the recipient shall be IS NOT liable for the cost or the cost remaining after
payment by medicaid, medicare, or a private insurer of medical benefits
authorized by Title XIX of the social security act, by this title TITLE 25.5,
or by rules promulgated by the state board, which FOR benefits are
rendered to the recipient by a provider of medical services WHO IS
ENROLLED IN THE MEDICAL ASSISTANCE PROGRAM AND authorized to
render such THE service in the state of Colorado, except FOR those
contributions required pursuant to section 25.5-4-209 (1). However, a
recipient may enter into a documented agreement with a provider WHO
IS ENROLLED IN THE MEDICAL ASSISTANCE PROGRAM under which the
recipient agrees to pay for items or services that are nonreimbursable
under the medical assistance program. Under these circumstances, a
recipient is liable for the cost of such THOSE services and items.
(II) The provisions of subparagraph (I) of this paragraph (a) shall
SUBSECTION (1)(a)(I) OF THIS SECTION apply regardless of whether
medicaid has actually reimbursed the provider. and regardless of whether
the provider is enrolled in the Colorado medical assistance program.
(II.3) IF A PROVIDER WHO IS NOT ENROLLED IN THE MEDICAL
ASSISTANCE PROGRAM PROVIDES MEDICAL SERVICES TO A RECIPIENT
THAT WOULD BE REIMBURSABLE UNDER THE MEDICAL ASSISTANCE
PROGRAM IF THE PROVIDER WERE AN ENROLLED PROVIDER, PRIOR TO
PROVIDING MEDICAL SERVICES, THE NONENROLLED PROVIDER SHALL
ENTER INTO A WRITTEN AGREEMENT WITH THE RECIPIENT. THE
AGREEMENT MUST SET FORTH THE SPECIFIC MEDICAL SERVICES PROVIDED,
THE USUAL AND CUSTOMARY COST FOR THE SERVICES, THE COST TO THE
RECIPIENT FOR THE SERVICES PROVIDED, AND THE TERMS OF PAYMENT BY
THE CLIENT. THE AGREEMENT MUST ALSO INCLUDE THE STATEMENT THAT
THE RECIPIENT UNDERSTANDS THAT HE OR SHE WOULD NOT BE LIABLE FOR
THE COST OF REIMBURSABLE MEDICAL SERVICES IF THE RECIPIENT
OBTAINED THE SERVICES FROM AN ENROLLED PROVIDER. THE AGREEMENT
MUST BE SIGNED AND DATED BY BOTH THE RECIPIENT AND THE
NONENROLLED PROVIDER. UNDER THESE CIRCUMSTANCES, THE RECIPIENT
IS LIABLE FOR THE COST OF THE MEDICAL SERVICES.".

Renumber succeeding sections accordingly.

Page 21, line 15, strike "17-_____," and substitute "17-267,".

Page 22, line 9, strike "17-_____," and substitute "17-267,".

Page 26, line 16, strike "17-_____," and substitute "17-267,".

Page 45, line 24, strike "17-_____," and substitute "17-267,".

Page 46, line 4, strike "17-_____," and substitute "17-267,".

Page 51, line 18, strike "of" and substitute "for".

Page 51, line 20, strike "OF" and substitute "FOR".

Page 51, line 27, strike "OF" and substitute "FOR".

Page 54, strike lines 6 through 8 and substitute "for the same. ANY
PROCEEDS OF LEASE-PURCHASE AGREEMENTS EXECUTED AS REQUIRED BY
SECTION 24-82-1303 (2)(a) THAT ARE CREDITED TO THE STATE HIGHWAY
FUND PURSUANT TO SECTION 24-82-1303 (5)(a) SHALL BE USED".

Page 55, strike lines 3 through 5 and substitute: "AND, BEGINNING IN
2018, ANY PROCEEDS OF LEASE-PURCHASE AGREEMENTS EXECUTED AS
REQUIRED BY SECTION 24-82-1303 (2)(a) THAT ARE CREDITED TO THE
STATE HIGHWAY FUND PURSUANT TO SECTION 24-82-1303 (5)(a) AND".

Page 56, line 18, strike "6 through 15, 17, and 18" and substitute "9
through 18, 20, and 21".

Page 56, line 20, strike "6 through 15, 17, and 18" and substitute "9
through 18, 20, and 21".


Finance


Senate Journal, May 5
After consideration on the merits, the Committee recommends that SB17-267 be amended
as follows, and as so amended, be referred to the Committee of the Whole with favorable
recommendation.

Strike the Finance Committee Report, dated April 11, 2017.

Amend printed bill, strike everything below the enacting clause and
substitute:
"SECTION 1. Legislative declaration. (1) The general
assembly hereby finds and declares that:
(a) In comparison to the urban and suburban areas of the state,
rural Colorado, on average and with some exceptions, faces complex
demographic, economic, and geographical challenges including:
(I) An older population that requires more medical care;
(II) Less robust and diverse economic activity and associated
lower average wages and household incomes; and
(III) Greater challenges, due to distance and less adequate
transportation infrastructure, in accessing critical services such as health
care; and
(b) The purpose of this legislation is to ensure and perpetuate the
sustainability of rural Colorado by addressing some of these
demographic, economic, and geographical challenges and by such other
means as the general assembly, in its considered judgment, finds
necessary and appropriate.
(2) The general assembly further finds and declares that the
sustainability of rural Colorado is directly connected to the economic
vitality of the state as a whole, and that all of the provisions of this act,
including provisions that on their face apply to and affect all areas of the
state but that especially benefit rural Colorado, relate to and serve and are
necessarily and properly connected to the general assembly's purpose of
ensuring and perpetuating the sustainability of rural Colorado.
SECTION 2. In Colorado Revised Statutes, amend 2-3-119 as
follows:
2-3-119. Audit of healthcare affordability and sustainability
fee - cost shift. Starting with the second full state fiscal year following
the receipt of the notice from the executive director of the department of
health care policy and financing pursuant to section 25.5-4-402.3 (7),
C.R.S., and thereafter At the discretion of the legislative audit committee,
the state auditor shall conduct or cause to be conducted a performance
and fiscal audit of the hospital provider HEALTHCARE AFFORDABILITY
AND SUSTAINABILITY fee established pursuant to section 25.5-4-402.3,
C.R.S. SECTION 25.5-4-402.4.
SECTION 3. In Colorado Revised Statutes, 2-3-1203, repeal
(8)(a)(V) as follows:
2-3-1203. Sunset review of advisory committees - legislative
declaration - definition - repeal. (8) (a) The following statutory
authorizations for the designated advisory committees will repeal on July
1, 2019:
(V) The hospital provider fee oversight and advisory board
created in section 25.5-4-402.3, C.R.S.;
SECTION 4. In Colorado Revised Statutes, add 22-54-139 as
follows:
22-54-139. Additional funding for schools - use of retail
marijuana sales tax revenue transferred to state public school fund
- definitions. (1) AS USED IN THIS SECTION, UNLESS THE CONTEXT
OTHERWISE REQUIRES:
(a) "LARGE RURAL DISTRICT" MEANS A DISTRICT IN COLORADO
THAT THE DEPARTMENT OF EDUCATION DETERMINES IS RURAL, BASED ON
THE GEOGRAPHIC SIZE OF THE DISTRICT AND THE DISTANCE OF THE
DISTRICT FROM THE NEAREST LARGE, URBANIZED AREA, AND THAT HAD
A FUNDED PUPIL COUNT FOR THE PRIOR BUDGET YEAR OF ONE THOUSAND
PUPILS OR MORE BUT FEWER THAN SIX THOUSAND FIVE HUNDRED PUPILS.
(b) "PER PUPIL DISTRIBUTION AMOUNT" MEANS:
(I) FOR A LARGE RURAL DISTRICT, AN AMOUNT EQUAL TO THIRTY
MILLION DOLLARS MULTIPLIED BY THE PERCENTAGE SPECIFIED IN
SUBSECTION (2)(a) OF THIS SECTION AND THEN DIVIDED BY THE SUM OF
THE TOTAL FUNDED PUPIL COUNT FOR THE PRIOR BUDGET YEAR OF ALL
LARGE RURAL DISTRICTS; AND
(II) FOR A SMALL RURAL DISTRICT, AN AMOUNT EQUAL TO THIRTY
MILLION DOLLARS MULTIPLIED BY THE PERCENTAGE SPECIFIED IN
SUBSECTION (2)(b) OF THIS SECTION AND THEN DIVIDED BY THE SUM OF
THE TOTAL FUNDED PUPIL COUNT FOR THE PRIOR BUDGET YEAR OF ALL
SMALL RURAL DISTRICTS;
(c) "SMALL RURAL DISTRICT" MEANS A DISTRICT IN COLORADO
THAT THE DEPARTMENT OF EDUCATION DETERMINES IS RURAL, BASED ON
THE GEOGRAPHIC SIZE OF THE DISTRICT AND THE DISTANCE OF THE
DISTRICT FROM THE NEAREST LARGE, URBANIZED AREA, AND THAT HAD
A FUNDED PUPIL COUNT FOR THE PRIOR BUDGET YEAR OF FEWER THAN
ONE THOUSAND PUPILS.
(2) FOR THE 2017-18 BUDGET YEAR, ALL OF THE GROSS RETAIL
MARIJUANA SALES TAX PROCEEDS TRANSFERRED FROM THE GENERAL
FUND TO THE STATE PUBLIC SCHOOL FUND CREATED IN SECTION
22-54-114 (1) AS REQUIRED BY SECTION 39-28.8-203 (1)(b)(I.3)(B) IS
APPROPRIATED FROM THE STATE PUBLIC SCHOOL FUND TO THE
DEPARTMENT FOR MONTHLY DISTRIBUTION TO EACH LARGE RURAL
DISTRICT AND EACH SMALL RURAL DISTRICT FOR THE PURPOSE OF
IMPROVING STUDENT LEARNING AND THE EDUCATIONAL ENVIRONMENT,
INCLUDING BUT NOT LIMITED TO LOAN FORGIVENESS FOR EDUCATORS AND
STAFF, TECHNOLOGY, AND TRANSPORTATION, AS FOLLOWS:
(a) FIFTY-FIVE PERCENT OF THE MONEY IS ALLOCATED TO LARGE
RURAL DISTRICTS AND DISTRIBUTED TO EACH LARGE RURAL DISTRICT IN
AN AMOUNT EQUAL TO THE PER PUPIL DISTRIBUTION AMOUNT MULTIPLIED
BY THE LARGE RURAL DISTRICT'S FUNDED PUPIL COUNT FOR THE PRIOR
BUDGET YEAR FOR PROPORTIONAL APPORTIONMENT TO EVERY SCHOOL IN
THE DISTRICT BASED ON THE NUMBER OF STUDENTS ENROLLED IN EACH
SCHOOL FOR THE PRIOR BUDGET YEAR; AND
(b) FORTY-FIVE PERCENT OF THE MONEY IS ALLOCATED TO SMALL
RURAL SCHOOL DISTRICTS AND DISTRIBUTED TO EACH SMALL RURAL
DISTRICT IN AN AMOUNT EQUAL TO THE PER PUPIL DISTRIBUTION AMOUNT
MULTIPLIED BY THE SMALL RURAL DISTRICT'S FUNDED PUPIL COUNT FOR
THE PRIOR BUDGET YEAR FOR PROPORTIONAL APPORTIONMENT TO EVERY
SCHOOL IN THE DISTRICT BASED ON THE NUMBER OF STUDENTS ENROLLED
IN EACH SCHOOL FOR THE PRIOR BUDGET YEAR.
(3) FOR THE 2018-19 BUDGET YEAR AND FOR EACH BUDGET YEAR
THEREAFTER, ALL OF THE GROSS RETAIL MARIJUANA SALES TAX
PROCEEDS TRANSFERRED FROM THE GENERAL FUND TO THE STATE PUBLIC
SCHOOL FUND CREATED IN SECTION 22-54-114 (1) AS REQUIRED BY
SECTION 39-28.8-203 (1)(b)(I.5)(B) IS APPROPRIATED FROM THE STATE
PUBLIC SCHOOL FUND TO THE DEPARTMENT TO MEET THE STATE'S SHARE
OF THE TOTAL PROGRAM OF ALL DISTRICTS AND FUNDING FOR INSTITUTE
CHARTER SCHOOLS.
SECTION 5. In Colorado Revised Statutes, 23-1-106, amend
(10.2)(a) as follows:
23-1-106. Duties and powers of the commission with respect
to capital construction and long-range planning - legislative
declaration - definitions. (10.2) (a) (I) Notwithstanding any law to the
contrary AND EXCEPT AS PROVIDED IN SUBSECTION (10.2)(a)(III) OF THIS
SECTION, all academic facilities acquired or constructed, or an auxiliary
facility repurposed for use as an academic facility, solely from cash funds
held by the state institution of higher education and operated and
maintained from such cash funds or from state moneys MONEY
appropriated for such purpose, or both, including, but not limited to,
those facilities described in paragraph (b) of subsection (9) SUBSECTION
(9)(b) of this section, that did not previously qualify for state controlled
maintenance funding will qualify for state controlled maintenance
funding, subject to funding approval by the capital development
committee and the eligibility guidelines described in section
24-30-1303.9. C.R.S.
(II) For purposes of this paragraph (a) SUBSECTION (10.2)(a), the
eligibility for state controlled maintenance funding commences on the
date of the acceptance of the construction or repurposing of the facility
or the closing date of any acquisition. The date of the acceptance of
construction or repurposing shall be determined by the office of the state
architect.
(III) IF AN ACADEMIC FACILITY IS ACQUIRED OR CONSTRUCTED, OR
IF AN AUXILIARY FACILITY IS REPURPOSED FOR USE AS AN ACADEMIC
FACILITY, SOLELY FROM CASH FUNDS HELD BY THE STATE INSTITUTION OF
HIGHER EDUCATION AND OPERATED AND MAINTAINED FROM SUCH CASH
FUNDS, THEN AS OF THE DATE OF THE ACCEPTANCE OF CONSTRUCTION OR
REPURPOSING THAT OCCURS ON OR AFTER JULY 1, 2018, THE FACILITY IS
NOT ELIGIBLE FOR CONTROLLED MAINTENANCE FUNDING.
SECTION 6. In Colorado Revised Statutes, 24-1-119.5, add (9)
as follows:
24-1-119.5. Department of health care policy and financing
- creation. (9) THE COLORADO HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY ENTERPRISE CREATED IN SECTION 25.5-4-402.4 (3) SHALL
EXERCISE ITS POWERS AND PERFORM ITS DUTIES AND FUNCTIONS AS IF THE
SAME WERE TRANSFERRED BY A TYPE 2 TRANSFER, AS DEFINED IN
SECTION 24-1-105, TO THE DEPARTMENT OF HEALTH CARE POLICY AND
FINANCING. SECTION 7. In Colorado Revised Statutes, 24-4-103,
amend (8)(c)(I) as follows:
24-4-103. Rule-making - procedure - definitions - repeal.
(8) (c) (I) Notwithstanding any other provision of law to the contrary and
the provisions of section 24-4-107, all rules adopted or amended on or
after January 1, 1993, and before November 1, 1993, shall expire at
11:59 p.m. on May 15 of the year following their adoption unless the
general assembly by bill acts to postpone the expiration of a specific rule,
and commencing with rules adopted or amended on or after November
1, 1993, all rules adopted or amended during any one-year period that
begins each November 1 and continues through the following October
31 shall expire at 11:59 p.m. on the May 15 that follows such one-year
period unless the general assembly by bill acts to postpone the expiration
of a specific rule; except that a rule adopted pursuant to section
25.5-4-402.3 (5) (b) (III), C.R.S., shall expire SECTION 25.5-4-402.4
(6)(b)(III) EXPIRES at 11:59 p.m. on the May 15 following the adoption
of the rule unless the general assembly acts by bill to postpone the
expiration of a specific rule. The general assembly, in its discretion, may
postpone such expiration, in which case, the provisions of section
24-4-108 or 24-34-104 shall apply, and the rules shall expire or be ARE
subject to review as provided in said THOSE sections. The postponement
of the expiration of a rule shall DOES not constitute legislative approval
of the rule nor be AND IS NOT admissible in any court as evidence of
legislative intent. The postponement of the expiration date of a specific
rule shall DOES not prohibit any action by the general assembly pursuant
to the provisions of paragraph (d) of this subsection (8) SUBSECTION
(8)(d) OF THIS SECTION with respect to such THE rule.
SECTION 8. In Colorado Revised Statutes, 24-30-1303.9,
amend (7)(a)(II), (7)(a)(III), and (7)(a)(IV); and add (7)(a)(V) as
follows:
24-30-1303.9. Eligibility for state controlled maintenance
funding - legislative declaration. (7) (a) Controlled maintenance funds
may not be used for:
(II) Auxiliary facilities as defined in section 23-1-106 (10.3);
C.R.S.;
(III) Leasehold interests in real property; or
(IV) Any work properly categorized as capital construction; OR
(V) FACILITIES DESCRIBED IN SECTION 23-1-106 (10.2)(a)(III).
SECTION 9. In Colorado Revised Statutes, add 24-37-305 as
follows:
24-37-305. 2018-19 fiscal year - required reductions in
departmental and executive branch budget requests. (1) (a) EXCEPT
AS OTHERWISE PROVIDED IN SUBSECTION (1)(b) OF THIS SECTION, FOR THE
2018-19 BUDGET YEAR, EACH PRINCIPAL DEPARTMENT OF STATE
GOVERNMENT THAT SUBMITS A BUDGET REQUEST TO THE OFFICE OF STATE
PLANNING AND BUDGETING SHALL REQUEST, WHEN SUBMITTING THE
BUDGET REQUEST, A TOTAL BUDGET FOR THE DEPARTMENT THAT IS AT
LEAST TWO PERCENT LOWER THAN ITS ACTUAL BUDGET FOR THE 2017-18
FISCAL YEAR.
(b) THE REQUIREMENT SPECIFIED IN SUBSECTION (1)(a) OF THIS
SECTION DOES NOT APPLY TO THE DEPARTMENT OF EDUCATION CREATED
IN SECTION 24-1-115 (1) OR THE DEPARTMENT OF TRANSPORTATION
CREATED IN SECTION 24-1-128.7 (1).
(2) THE OFFICE OF STATE PLANNING AND BUDGETING SHALL
STRONGLY CONSIDER THE BUDGET REDUCTION PROPOSALS MADE BY EACH
PRINCIPAL DEPARTMENT PURSUANT TO SUBSECTION (1) OF THIS SECTION
WHEN PREPARING THE ANNUAL EXECUTIVE BUDGET PROPOSALS TO THE
GENERAL ASSEMBLY FOR THE GOVERNOR AS REQUIRED BY SECTION
24-37-302 (1)(g) AND SHALL SEEK TO ENSURE, SUBJECT TO SECTION
24-37-303, THAT THE EXECUTIVE BUDGET PROPOSAL FOR EACH
DEPARTMENT IS AT LEAST TWO PERCENT LOWER THAN THE DEPARTMENT'S
ACTUAL BUDGET FOR THE 2017-18 FISCAL YEAR.
SECTION 10. In Colorado Revised Statutes, 24-75-219, repeal
as added by Senate Bill 17-262 (2)(c.3)(I) and (2)(c.7)(I) as follows:
24-75-219. Transfers - transportation - capital construction
- definitions. (2)(c.3) On June 30, 2019, the state treasurer shall transfer:
(I) One hundred sixty million dollars from the general fund to the
highway users tax fund; and
(c.7) On June 30, 2020, the state treasurer shall transfer:
(I) One hundred sixty million dollars from the general fund to the
highway users tax fund; and
SECTION 11. In Colorado Revised Statutes, 24-77-103.6,
amend (6)(b)(I) as follows:
24-77-103.6. Retention of excess state revenues - general fund
exempt account - required uses - excess state revenues legislative
report. (6) As used in this section:
(b) (I) "Excess state revenues cap" for a given fiscal year means:
either of the following:
(A) If the voters of the state approve a ballot issue to authorize
the state to incur multiple-fiscal year obligations at the November 2005
statewide election, an amount that is equal to the highest total state
revenues for a fiscal year from the period of the 2005-06 fiscal year
through the 2009-10 fiscal year, adjusted each subsequent fiscal year for
inflation and the percentage change in state population, plus one hundred
million dollars, and adjusting such sum for the qualification or
disqualification of enterprises and debt service changes; or
(B) If the voters of the state do not approve a ballot issue to
authorize the state to incur multiple-fiscal year obligations at the
November 2005 statewide election, FOR EACH FISCAL YEAR UP TO AND
INCLUDING THE 2016-17 FISCAL YEAR, an amount that is equal to the
highest total state revenues for a fiscal year from the period of the
2005-06 fiscal year through the 2009-10 fiscal year, adjusted each
subsequent fiscal year for inflation, the percentage change in state
population, the qualification or disqualification of enterprises, and debt
service changes;
(C) FOR THE 2017-18 FISCAL YEAR, AN AMOUNT THAT IS EQUAL
TO THE EXCESS STATE REVENUES CAP FOR THE 2016-17 FISCAL YEAR
CALCULATED PURSUANT TO SUBSECTION (6)(b)(I)(B) OF THIS SECTION,
ADJUSTED FOR INFLATION, THE PERCENTAGE CHANGE IN STATE
POPULATION, THE QUALIFICATION OR DISQUALIFICATION OF ENTERPRISES,
AND DEBT SERVICE CHANGES, LESS TWO HUNDRED MILLION DOLLARS;
AND
(D) FOR THE 2018-19 FISCAL YEAR AND EACH SUCCEEDING FISCAL
YEAR, THE AMOUNT OF THE EXCESS STATE REVENUES CAP FOR THE
2017-18 FISCAL YEAR CALCULATED PURSUANT TO SUBSECTION
(6)(b)(I)(C) OF THIS SECTION, ADJUSTED EACH SUBSEQUENT FISCAL YEAR
FOR INFLATION, THE PERCENTAGE CHANGE IN STATE POPULATION, THE
QUALIFICATION OR DISQUALIFICATION OF ENTERPRISES, AND DEBT
SERVICE CHANGES.
SECTION 12. In Colorado Revised Statutes, add part 13 to
article 82 of title 24 as follows:

LEASE-PURCHASE AGREEMENTS FOR STATE PROPERTY
24-82-1301. Legislative declaration. (1) THE GENERAL
ASSEMBLY HEREBY FINDS AND DECLARES THAT:
(a) DUE TO INSUFFICIENT FUNDING, NECESSARY HIGH-PRIORITY
STATE HIGHWAY PROJECTS AND STATE CAPITAL CONSTRUCTION PROJECTS,
INCLUDING PROJECTS AT STATE INSTITUTIONS OF HIGHER EDUCATION, IN
ALL AREAS OF THE STATE HAVE BEEN DELAYED, AND THE STATE HAS ALSO
DELAYED CRITICAL CONTROLLED MAINTENANCE AND UPKEEP OF STATE
CAPITAL ASSETS;
(b) BY ISSUING LEASE-PURCHASE AGREEMENTS USING STATE
BUILDINGS AS COLLATERAL AS AUTHORIZED BY THIS PART 13, THE STATE
CAN GENERATE SUFFICIENT FUNDS TO ACCELERATE THE COMPLETION OF
MANY OF THE NECESSARY HIGH-PRIORITY STATE HIGHWAY PROJECTS AND
CAPITAL CONSTRUCTION PROJECTS THAT HAVE BEEN DELAYED AND
BETTER MAINTAIN AND PRESERVE EXISTING STATE CAPITAL ASSETS;
(c) IT IS THE INTENT OF THE GENERAL ASSEMBLY THAT A
MAJORITY OF THE ADDITIONAL FUNDING FOR STATE CAPITAL
CONSTRUCTION PROJECTS REALIZED FROM ISSUING LEASE-PURCHASE
AGREEMENTS BE USED FOR CONTROLLED MAINTENANCE AND UPKEEP OF
STATE CAPITAL ASSETS.
24-82-1302. Definitions. AS USED IN THIS PART 13, UNLESS THE
CONTEXT OTHERWISE REQUIRES:
(1) "CAPITAL CONSTRUCTION" HAS THE SAME MEANING AS SET
FORTH IN SECTION 24-30-1301 (2).
(2) "CONTROLLED MAINTENANCE" HAS THE SAME MEANING AS
SET FORTH IN SECTION 24-30-1301 (4).
(3) "ELIGIBLE STATE FACILITY" MEANS ANY FINANCIALLY
UNENCUMBERED BUILDING, STRUCTURE, OR FACILITY THAT IS OWNED BY
THE STATE, INCLUDING A BUILDING, STRUCTURE, OR FACILITY
DETERMINED TO BE ELIGIBLE BY A GOVERNING BOARD OF A STATE
INSTITUTION OF HIGHER EDUCATION, AND DOES NOT INCLUDE ANY
BUILDING, STRUCTURE, OR FACILITY THAT IS PART OF THE STATE
EMERGENCY RESERVE FOR ANY STATE FISCAL YEAR AS DESIGNATED IN
THE ANNUAL GENERAL APPROPRIATION ACT.
(4) "STATE INSTITUTION OF HIGHER EDUCATION" MEANS A STATE
INSTITUTION OF HIGHER EDUCATION, AS DEFINED IN SECTION 23-18-102
(10), AND THE AURARIA HIGHER EDUCATION CENTER CREATED IN ARTICLE
70 OF TITLE 23.
24-82-1303. Lease-purchase agreements for capital
construction and transportation projects. (1) ON OR BEFORE
DECEMBER 31, 2017, THE STATE ARCHITECT, THE DIRECTOR OF THE
OFFICE OF STATE PLANNING AND BUDGETING OR HIS OR HER DESIGNEE,
AND THE STATE INSTITUTIONS OF HIGHER EDUCATION SHALL IDENTIFY
AND PREPARE A COLLABORATIVE LIST OF ELIGIBLE STATE FACILITIES THAT
CAN BE COLLATERALIZED AS PART OF THE LEASE-PURCHASE AGREEMENTS
FOR CAPITAL CONSTRUCTION AND TRANSPORTATION PROJECTS
AUTHORIZED IN THIS PART 13. THE TOTAL CURRENT REPLACEMENT VALUE
OF THE IDENTIFIED BUILDINGS MUST EQUAL AT LEAST TWO BILLION
DOLLARS.
(2) (a) NOTWITHSTANDING THE PROVISIONS OF SECTIONS
24-82-102 (1)(b) AND 24-82-801, AND PURSUANT TO SECTION 24-36-121,
NO SOONER THAN JULY 1, 2018, THE STATE, ACTING BY AND THROUGH
THE STATE TREASURER, SHALL EXECUTE LEASE-PURCHASE AGREEMENTS,
EACH FOR NO MORE THAN TWENTY YEARS OF ANNUAL PAYMENTS, FOR
THE PROJECTS DESCRIBED IN SUBSECTION (4) OF THIS SECTION. THE STATE
SHALL EXECUTE THE LEASE-PURCHASE AGREEMENTS ONLY IN
ACCORDANCE WITH THE FOLLOWING SCHEDULE:
(I) DURING THE 2018-19 STATE FISCAL YEAR, THE STATE SHALL
EXECUTE LEASE-PURCHASE AGREEMENTS IN AN AMOUNT UP TO FIVE
HUNDRED MILLION DOLLARS;
(II) DURING THE 2019-20 STATE FISCAL YEAR, THE STATE SHALL
EXECUTE LEASE-PURCHASE AGREEMENTS IN AN AMOUNT UP TO FIVE
HUNDRED MILLION DOLLARS;
(III) DURING THE 2020-21 STATE FISCAL YEAR, THE STATE SHALL
EXECUTE LEASE-PURCHASE AGREEMENTS IN AN AMOUNT UP TO FIVE
HUNDRED MILLION DOLLARS; AND
(IV) DURING THE 2021-22 FISCAL YEAR, THE STATE SHALL
EXECUTE LEASE-PURCHASE AGREEMENTS IN AN AMOUNT UP TO FIVE
HUNDRED MILLION DOLLARS.
(b) THE ANTICIPATED ANNUAL STATE-FUNDED PAYMENTS FOR THE
PRINCIPAL AND INTEREST COMPONENTS OF THE AMOUNT PAYABLE UNDER
ALL LEASE-PURCHASE AGREEMENTS ENTERED INTO PURSUANT TO
SUBSECTION (2)(a) OF THIS SECTION SHALL NOT EXCEED ONE HUNDRED
FIFTY MILLION DOLLARS.
(c) THE STATE, ACTING BY AND THROUGH THE STATE TREASURER,
AT THE STATE TREASURER'S SOLE DISCRETION, MAY ENTER INTO ONE OR
MORE LEASE-PURCHASE AGREEMENTS AUTHORIZED BY SUBSECTION (2)(a)
OF THIS SECTION WITH ANY FOR-PROFIT OR NONPROFIT CORPORATION,
TRUST, OR COMMERCIAL BANK AS A TRUSTEE AS THE LESSOR.
(d) ANY LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED
BY SUBSECTION (2)(a) OF THIS SECTION SHALL PROVIDE THAT ALL OF THE
OBLIGATIONS OF THE STATE UNDER THE AGREEMENT ARE SUBJECT TO THE
ACTION OF THE GENERAL ASSEMBLY IN ANNUALLY MAKING MONEY
AVAILABLE FOR ALL PAYMENTS THEREUNDER. PAYMENTS UNDER ANY
LEASE-PURCHASE AGREEMENT MUST BE MADE, SUBJECT TO ANNUAL
ALLOCATION PURSUANT TO SECTION 43-1-113 BY THE TRANSPORTATION
COMMISSION CREATED IN SECTION 43-1-106 (1) OR SUBJECT TO ANNUAL
APPROPRIATION BY THE GENERAL ASSEMBLY, AS APPLICABLE, FROM THE
FOLLOWING SOURCES OF MONEY:
(I) FIRST, NINE MILLION DOLLARS ANNUALLY, OR ANY LESSER
AMOUNT THAT IS SUFFICIENT TO MAKE EACH FULL PAYMENT DUE, SHALL
BE PAID FROM THE GENERAL FUND OR ANY OTHER LEGALLY AVAILABLE
SOURCE OF MONEY FOR THE PURPOSE OF FULLY FUNDING THE
CONTROLLED MAINTENANCE AND CAPITAL CONSTRUCTION PROJECTS IN
THE STATE TO BE FUNDED WITH THE PROCEEDS OF LEASE-PURCHASE
AGREEMENTS AS SPECIFIED IN SUBSECTION (4)(a) OF THIS SECTION;
(II) NEXT, FIFTY MILLION DOLLARS ANNUALLY, OR ANY LESSER
AMOUNT THAT IS SUFFICIENT TO MAKE EACH FULL PAYMENT DUE, SHALL
BE PAID FROM ANY LEGALLY AVAILABLE MONEY UNDER THE CONTROL OF
THE TRANSPORTATION COMMISSION SOLELY FOR THE PURPOSE OF
ALLOWING THE CONSTRUCTION, SUPERVISION, AND MAINTENANCE OF
STATE HIGHWAYS TO BE FUNDED WITH THE PROCEEDS OF
LEASE-PURCHASE AGREEMENTS AS SPECIFIED IN SUBSECTION (4)(b) OF
THIS SECTION AND SECTION 43-4-206 (1)(b)(V); AND
(III) THE REMAINDER OF THE AMOUNT NEEDED, IN ADDITION TO
THE AMOUNTS SPECIFIED IN SUBSECTIONs (2)(d)(I) AND (2)(d)(II) OF THIS
SECTION, TO MAKE EACH FULL PAYMENT DUE SHALL BE PAID FROM THE
GENERAL FUND OR ANY OTHER LEGALLY AVAILABLE SOURCE OF MONEY.
(e) EACH AGREEMENT MUST ALSO PROVIDE THAT THE
OBLIGATIONS OF THE STATE DO NOT CREATE STATE DEBT WITHIN THE
MEANING OF ANY PROVISION OF THE STATE CONSTITUTION OR STATE LAW
CONCERNING OR LIMITING THE CREATION OF STATE DEBT AND ARE NOT A
MULTIPLE FISCAL-YEAR DIRECT OR INDIRECT DEBT OR OTHER FINANCIAL
OBLIGATION OF THE STATE WITHIN THE MEANING OF SECTION 20 (4) OF
ARTICLE X OF THE STATE CONSTITUTION. IF THE STATE DOES NOT RENEW
A LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED BY SUBSECTION
(2)(a) OF THIS SECTION, THE SOLE SECURITY AVAILABLE TO THE LESSOR
IS THE PROPERTY THAT IS THE SUBJECT OF THE NONRENEWED
LEASE-PURCHASE AGREEMENT.
(f) A LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED BY
SUBSECTION (2)(a) OF THIS SECTION MAY CONTAIN SUCH TERMS,
PROVISIONS, AND CONDITIONS AS THE STATE TREASURER, ACTING ON
BEHALF OF THE STATE, DEEMS APPROPRIATE, INCLUDING ALL OPTIONAL
TERMS; EXCEPT THAT EACH LEASE-PURCHASE AGREEMENT MUST
SPECIFICALLY AUTHORIZE THE STATE OR THE GOVERNING BOARD OF THE
APPLICABLE STATE INSTITUTION OF HIGHER EDUCATION TO RECEIVE FEE
TITLE TO ALL REAL AND PERSONAL PROPERTY THAT IS THE SUBJECT OF
THE LEASE-PURCHASE AGREEMENT ON OR BEFORE THE EXPIRATION OF THE
TERMS OF THE AGREEMENT.
(g) ANY LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED
BY SUBSECTION (2)(a) OF THIS SECTION MAY PROVIDE FOR THE ISSUANCE,
DISTRIBUTION, AND SALE OF INSTRUMENTS EVIDENCING RIGHTS TO
RECEIVE RENTALS AND OTHER PAYMENTS MADE AND TO BE MADE UNDER
THE LEASE-PURCHASE AGREEMENT. THE INSTRUMENTS MAY BE ISSUED,
DISTRIBUTED, OR SOLD ONLY BY THE LESSOR OR ANY PERSON DESIGNATED
BY THE LESSOR AND NOT BY THE STATE. THE INSTRUMENTS DO NOT
CREATE A RELATIONSHIP BETWEEN THE PURCHASERS OF THE
INSTRUMENTS AND THE STATE OR CREATE ANY OBLIGATION ON THE PART
OF THE STATE TO THE PURCHASERS. THE INSTRUMENTS ARE NOT NOTES,
BONDS, OR ANY OTHER EVIDENCE OF STATE DEBT WITHIN THE MEANING
OF ANY PROVISION OF THE STATE CONSTITUTION OR STATE LAW
CONCERNING OR LIMITING THE CREATION OF STATE DEBT AND ARE NOT A
MULTIPLE FISCAL-YEAR DIRECT OR INDIRECT DEBT OR OTHER FINANCIAL
OBLIGATION OF THE STATE WITHIN THE MEANING OF SECTION 20 (4) OF
ARTICLE X OF THE STATE CONSTITUTION.
(h) INTEREST PAID UNDER A LEASE-PURCHASE AGREEMENT
AUTHORIZED PURSUANT TO SUBSECTION (2)(a) OF THIS SECTION,
INCLUDING INTEREST REPRESENTED BY THE INSTRUMENTS, IS EXEMPT
FROM COLORADO INCOME TAX.
(i) THE STATE, ACTING BY AND THROUGH THE STATE TREASURER
AND THE GOVERNING BOARDS OF THE INSTITUTIONS OF HIGHER
EDUCATION, IS AUTHORIZED TO ENTER INTO ANCILLARY AGREEMENTS
AND INSTRUMENTS THAT ARE NECESSARY OR APPROPRIATE IN
CONNECTION WITH A LEASE-PURCHASE AGREEMENT, INCLUDING BUT NOT
LIMITED TO DEEDS, GROUND LEASES, SUB-LEASES, EASEMENTS, OR OTHER
INSTRUMENTS RELATING TO THE REAL PROPERTY ON WHICH THE
FACILITIES ARE LOCATED.
(j) THE PROVISIONS OF SECTION 24-30-202 (5)(b) DO NOT APPLY
TO A LEASE-PURCHASE AGREEMENT EXECUTED AS REQUIRED BY OR TO
ANY ANCILLARY AGREEMENT OR INSTRUMENT ENTERED INTO PURSUANT
TO THIS SUBSECTION (2). THE STATE CONTROLLER OR HIS OR HER
DESIGNEE SHALL WAIVE ANY PROVISION OF THE FISCAL RULES
PROMULGATED PURSUANT TO SECTION 24-30-202 (1) AND (13), THAT THE
STATE CONTROLLER FINDS INCOMPATIBLE OR INAPPLICABLE WITH
RESPECT TO A LEASE-PURCHASE AGREEMENT OR AN ANCILLARY
AGREEMENT OR INSTRUMENT.
(3) (a) BEFORE EXECUTING A LEASE-PURCHASE AGREEMENT
REQUIRED BY SUBSECTION (2)(a) OF THIS SECTION, IN ORDER TO PROTECT
AGAINST FUTURE INTEREST RATE INCREASES, THE STATE, ACTING BY AND
THROUGH THE STATE TREASURER AND AT THE DISCRETION OF THE STATE
TREASURER, MAY ENTER INTO AN INTEREST RATE EXCHANGE AGREEMENT
PURSUANT TO ARTICLE 59.3 OF TITLE 11. A LEASE-PURCHASE AGREEMENT
EXECUTED AS REQUIRED BY SUBSECTION (2)(a) OF THIS SECTION IS A
PROPOSED PUBLIC SECURITY FOR THE PURPOSES OF ARTICLE 59.3 OF TITLE
11. ANY PAYMENTS MADE BY THE STATE UNDER AN AGREEMENT ENTERED
INTO PURSUANT TO THIS SUBSECTION (3) MUST BE MADE SOLELY FROM
MONEY MADE AVAILABLE TO THE STATE TREASURER FROM THE
EXECUTION OF A LEASE-PURCHASE AGREEMENT OR FROM MONEY
DESCRIBED IN SUBSECTIONS (2)(d)(I) AND (2)(d)(II) OF THIS SECTION.
(b) ANY AGREEMENT ENTERED INTO PURSUANT TO THIS
SUBSECTION (3) MUST ALSO PROVIDE THAT THE OBLIGATIONS OF THE
STATE DO NOT CREATE STATE DEBT WITHIN THE MEANING OF ANY
PROVISION OF THE STATE CONSTITUTION OR STATE LAW CONCERNING OR
LIMITING THE CREATION OF STATE DEBT AND ARE NOT A MULTIPLE
FISCAL-YEAR DIRECT OR INDIRECT DEBT OR OTHER FINANCIAL
OBLIGATION OF THE STATE WITHIN THE MEANING OF SECTION 20 (4) OF
ARTICLE X OF THE STATE CONSTITUTION.
(c) ANY MONEY RECEIVED BY THE STATE UNDER AN AGREEMENT
ENTERED INTO PURSUANT TO THIS SUBSECTION (3) SHALL BE USED TO
MAKE PAYMENTS ON LEASE-PURCHASE AGREEMENTS ENTERED INTO
PURSUANT TO SUBSECTION (2) OF THIS SECTION OR TO PAY THE COSTS OF
THE PROJECT FOR WHICH A LEASE-PURCHASE AGREEMENT WAS EXECUTED.
(4) PROCEEDS OF LEASE-PURCHASE AGREEMENTS EXECUTED AS
REQUIRED BY SUBSECTION (2)(a) OF THIS SECTION SHALL BE USED AS
FOLLOWS:
(a) (I) THE FIRST ONE HUNDRED TWENTY MILLION DOLLARS OF
THE PROCEEDS OF LEASE-PURCHASE AGREEMENTS ISSUED DURING THE
2018-19 STATE FISCAL YEAR SHALL BE USED FOR CONTROLLED
MAINTENANCE AND CAPITAL CONSTRUCTION PROJECTS IN THE STATE AS
FOLLOWS:
(A) THIRTEEN MILLION SIX THOUSAND EIGHTY-ONE DOLLARS FOR
LEVEL I CONTROLLED MAINTENANCE;
(B) SIXTY MILLION SIX HUNDRED THIRTY-SEVEN THOUSAND
THREE HUNDRED FIVE DOLLARS FOR LEVEL II CONTROLLED
MAINTENANCE;
(C) FORTY MILLION TWO HUNDRED NINE THOUSAND FIVE
HUNDRED THIRTY-FIVE DOLLARS FOR LEVEL III CONTROLLED
MAINTENANCE; AND
(D) THE REMAINDER FOR CAPITAL CONSTRUCTION PROJECTS AS
PRIORITIZED BY THE CAPITAL DEVELOPMENT COMMITTEE.
(II) THE CAPITAL DEVELOPMENT COMMITTEE SHALL POST THE LIST
OF SPECIFIC CONTROLLED MAINTENANCE PROJECTS AND THE COST OF
EACH PROJECT FUNDED PURSUANT TO SUBSECTION (4)(a)(I)(A),
(4)(a)(I)(B), OR (4)(a)(I)(C) OF THIS SECTION ON ITS OFFICIAL WEBSITE NO
LATER THAN MAY 11, 2017.

(b) THE REMAINDER OF THE PROCEEDS SHALL BE CREDITED TO
THE STATE HIGHWAY FUND CREATED IN SECTION 43-1-219 AND USED BY
THE DEPARTMENT OF TRANSPORTATION IN ACCORDANCE WITH SECTION
43-4-206 (1)(b)(V).
SECTION 13. In Colorado Revised Statutes, 25.5-3-108, amend
(17) as follows:
25.5-3-108. Responsibility of the department of health care
policy and financing - provider reimbursement. (17) Subject to
adequate funding BEING made available under section 25.5-4-402.3
SECTION 25.5-4-402.4, the state department COLORADO HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY ENTERPRISE CREATED IN SECTION
25.5-4-402.4 (3) shall increase hospital reimbursements up to one
hundred percent of hospital costs for providing medical care under the
program.
SECTION 14. In Colorado Revised Statutes, 25.5-4-209, amend
(1)(b); and add (1)(c) and (1)(d) as follows:
25.5-4-209. Payments by third parties - copayments by
recipients - review - appeal - children's waiting list reduction fund.
(1) (b) Subject to any limitations imposed by Title XIX AND THE
REQUIREMENTS SET FORTH IN SUBSECTION (1)(c) OF THIS SECTION, a
recipient shall be required to MUST pay at the time of service a portion of
the cost of any medical benefit rendered to the recipient or to the
recipient's dependents pursuant to this article ARTICLE 4 or article 5 or 6
of this title TITLE 25.5, as determined by rule RULES of the state
department.
(c) (I) EXCEPT AS OTHERWISE PROVIDED IN SUBSECTION (1)(c)(II)
OF THIS SECTION, ON AND AFTER JANUARY 1, 2018, FOR PHARMACY AND
FOR HOSPITAL OUTPATIENT SERVICES, INCLUDING URGENT CARE CENTERS
AND FACILITIES AND EMERGENCY SERVICES, THE RULES OF THE STATE
DEPARTMENT REQUIRED BY SUBSECTION (1)(b) OF THIS SECTION MUST
REQUIRE THE RECIPIENT TO PAY:
(A) FOR PHARMACY, AT LEAST DOUBLE THE AVERAGE AMOUNT
PAID BY RECIPIENTS IN STATE FISCAL YEAR 2015-16; OR
(B) FOR HOSPITAL OUTPATIENT SERVICES, AT LEAST DOUBLE THE
AMOUNT REQUIRED TO BE PAID AS SPECIFIED IN THE RULES AS OF
JANUARY 1, 2017.
(II) FOR BOTH PHARMACY AND HOSPITAL OUTPATIENT SERVICES,
THE AMOUNT REQUIRED TO BE PAID BY THE RECIPIENT SHALL NOT EXCEED
ANY SPECIFIED MAXIMUM DOLLAR AMOUNT ALLOWED BY FEDERAL LAW
OR REGULATIONS AS OF JANUARY 1, 2017.
(d) THE STATE DEPARTMENT SHALL EVALUATE OPTIONS TO
EXEMPT INDIVIDUALS WHO ARE QUALIFIED FOR INSTITUTIONAL CARE BUT
ARE INSTEAD ENROLLED IN HOME- AND COMMUNITY-BASED SERVICE
WAIVERS FROM THE INCREASED PAYMENT REQUIREMENTS SPECIFIED IN
SUBSECTION (1)(c) OF THIS SECTION.
SECTION 15. In Colorado Revised Statutes, 25.5-4-402, amend
(3)(a) as follows:
25.5-4-402. Providers - hospital reimbursement - rules.
(3) (a) In addition to the reimbursement rate process described in
subsection (1) of this section and subject to adequate funding BEING
made available pursuant to section 25.5-4-402.3 SECTION 25.5-4-402.4,
the state department COLORADO HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY ENTERPRISE CREATED IN SECTION 25.5-4-402.4 (3) shall
pay an additional amount based upon performance to those hospitals that
provide services that improve health care outcomes for their patients.
This amount shall be determined by The state department SHALL
DETERMINE THIS AMOUNT based upon nationally recognized performance
measures established in rules adopted by the state board. The state quality
standards shall MUST be consistent with federal quality standards
published by an organization with expertise in health care quality,
including but not limited to, the centers for medicare and medicaid
services, the agency for healthcare research and quality, or the national
quality forum.
SECTION 16. In Colorado Revised Statutes, repeal as amended
by Senate Bill 17-256 25.5-4-402.3.
SECTION 17. In Colorado Revised Statutes, add 25.5-4-402.4
as follows:
25.5-4-402.4. Hospitals - healthcare affordability and
sustainability fee - legislative declaration - Colorado healthcare
affordability and sustainability enterprise - federal waiver - fund
created - rules. (1) Short title. THE SHORT TITLE OF THIS SECTION IS THE
"COLORADO HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
ENTERPRISE ACT OF 2017".
(2) Legislative declaration. THE GENERAL ASSEMBLY HEREBY
FINDS AND DECLARES THAT:
(a) THE STATE AND THE PROVIDERS OF PUBLICLY FUNDED
MEDICAL SERVICES, AND HOSPITALS IN PARTICULAR, SHARE A COMMON
COMMITMENT TO COMPREHENSIVE HEALTH CARE REFORM;
(b) HOSPITALS WITHIN THE STATE INCUR SIGNIFICANT COSTS BY
PROVIDING UNCOMPENSATED EMERGENCY DEPARTMENT CARE AND
OTHER UNCOMPENSATED MEDICAL SERVICES TO LOW-INCOME AND
UNINSURED POPULATIONS;
(c) THIS SECTION IS ENACTED AS PART OF A COMPREHENSIVE
HEALTH CARE REFORM AND IS INTENDED TO PROVIDE THE FOLLOWING
SERVICES AND BENEFITS TO HOSPITALS AND INDIVIDUALS:
(I) PROVIDING A PAYER SOURCE FOR SOME LOW-INCOME AND
UNINSURED POPULATIONS WHO MAY OTHERWISE BE CARED FOR IN
EMERGENCY DEPARTMENTS AND OTHER SETTINGS IN WHICH
UNCOMPENSATED CARE IS PROVIDED;
(II) REDUCING THE UNDERPAYMENT TO COLORADO HOSPITALS
PARTICIPATING IN PUBLICLY FUNDED HEALTH INSURANCE PROGRAMS;
(III) REDUCING THE NUMBER OF PERSONS IN COLORADO WHO ARE
WITHOUT HEALTH CARE BENEFITS;
(IV) REDUCING THE NEED OF HOSPITALS AND OTHER HEALTH
CARE PROVIDERS TO SHIFT THE COST OF PROVIDING UNCOMPENSATED
CARE TO OTHER PAYERS;
(V) EXPANDING ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH
CARE FOR LOW-INCOME AND UNINSURED POPULATIONS; AND
(VI) PROVIDING THE ADDITIONAL BUSINESS SERVICES SPECIFIED
IN SUBSECTION (4)(a)(IV) OF THIS SECTION TO HOSPITALS THAT PAY THE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE CHARGED AND
COLLECTED AS AUTHORIZED BY SUBSECTION (4) OF THIS SECTION BY THE
COLORADO HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
ENTERPRISE CREATED IN SUBSECTION (3)(a) OF THIS SECTION;
(d) THE COLORADO HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY ENTERPRISE PROVIDES BUSINESS SERVICES TO HOSPITALS
WHEN, IN EXCHANGE FOR PAYMENT OF HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEES BY HOSPITALS, IT:
(I) OBTAINS FEDERAL MATCHING MONEY AND RETURNS BOTH THE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE AND THE
FEDERAL MATCHING MONEY TO HOSPITALS TO INCREASE REIMBURSEMENT
RATES TO HOSPITALS FOR PROVIDING MEDICAL CARE UNDER THE STATE
MEDICAL ASSISTANCE PROGRAM AND THE COLORADO INDIGENT CARE
PROGRAM AND TO INCREASE THE NUMBER OF INDIVIDUALS COVERED BY
PUBLIC MEDICAL ASSISTANCE; AND
(II) PROVIDES ADDITIONAL BUSINESS SERVICES TO HOSPITALS AS
SPECIFIED IN SUBSECTION (4)(a)(IV) OF THIS SECTION;
(e) IT IS NECESSARY, APPROPRIATE, AND IN THE BEST INTEREST OF
THE STATE TO ACKNOWLEDGE THAT BY PROVIDING THE BUSINESS
SERVICES SPECIFIED IN SUBSECTIONS (2)(d)(I) AND (2)(d)(II) OF THIS
SECTION, THE COLORADO HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY ENTERPRISE ENGAGES IN AN ACTIVITY CONDUCTED IN
THE PURSUIT OF A BENEFIT, GAIN, OR LIVELIHOOD AND THEREFORE
OPERATES AS A BUSINESS;
(f) CONSISTENT WITH THE DETERMINATION OF THE COLORADO
SUPREME COURT IN NICHOLL V. E-470 PUBLIC HIGHWAY AUTHORITY, 896
P.2d 859 (COLO. 1995), THAT THE POWER TO IMPOSE TAXES IS
INCONSISTENT WITH ENTERPRISE STATUS UNDER SECTION 20 OF ARTICLE
X OF THE STATE CONSTITUTION, IT IS THE CONCLUSION OF THE GENERAL
ASSEMBLY THAT THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
FEE CHARGED AND COLLECTED BY THE COLORADO HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY ENTERPRISE IS A FEE, NOT A TAX,
BECAUSE THE FEE IS IMPOSED FOR THE SPECIFIC PURPOSES OF ALLOWING
THE ENTERPRISE TO DEFRAY THE COSTS OF PROVIDING THE BUSINESS
SERVICES SPECIFIED IN SUBSECTIONS (2)(d)(I) AND (2)(d)(II) OF THIS
SECTION TO HOSPITALS THAT PAY THE FEE AND IS COLLECTED AT RATES
THAT ARE REASONABLY CALCULATED BASED ON THE BENEFITS RECEIVED
BY THOSE HOSPITALS; AND
(g) SO LONG AS THE COLORADO HEALTHCARE AFFORDABILITY
AND SUSTAINABILITY ENTERPRISE QUALIFIES AS AN ENTERPRISE FOR
PURPOSES OF SECTION 20 OF ARTICLE X OF THE STATE CONSTITUTION, THE
REVENUES FROM THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
FEE CHARGED AND COLLECTED BY THE ENTERPRISE ARE NOT STATE
FISCAL YEAR SPENDING, AS DEFINED IN SECTION 24-77-102 (17), OR STATE
REVENUES, AS DEFINED IN SECTION 24-77-103.6 (6)(c), AND DO NOT
COUNT AGAINST EITHER THE STATE FISCAL YEAR SPENDING LIMIT IMPOSED
BY SECTION 20 OF ARTICLE X OF THE STATE CONSTITUTION OR THE
EXCESS STATE REVENUES CAP, AS DEFINED IN SECTION 24-77-103.6
(6)(b)(I).
(3) (a) THE COLORADO HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY ENTERPRISE, REFERRED TO IN THIS SECTION AS THE
"ENTERPRISE", IS CREATED. THE ENTERPRISE IS AND OPERATES AS A
GOVERNMENT-OWNED BUSINESS WITHIN THE STATE DEPARTMENT FOR THE
PURPOSE OF CHARGING AND COLLECTING THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE, LEVERAGING HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE REVENUE TO OBTAIN FEDERAL
MATCHING MONEY, AND UTILIZING AND DEPLOYING THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE REVENUE AND FEDERAL
MATCHING MONEY TO PROVIDE THE BUSINESS SERVICES SPECIFIED IN
SUBSECTIONS (2)(d)(I) AND (2)(d)(II) OF THIS SECTION TO HOSPITALS
THAT PAY THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE.
(b) THE ENTERPRISE CONSTITUTES AN ENTERPRISE FOR PURPOSES
OF SECTION 20 OF ARTICLE X OF THE STATE CONSTITUTION SO LONG AS IT
RETAINS THE AUTHORITY TO ISSUE REVENUE BONDS AND RECEIVES LESS
THAN TEN PERCENT OF ITS TOTAL REVENUES IN GRANTS FROM ALL
COLORADO STATE AND LOCAL GOVERNMENTS COMBINED. SO LONG AS IT
CONSTITUTES AN ENTERPRISE PURSUANT TO THIS SUBSECTION (3)(b), THE
ENTERPRISE IS NOT SUBJECT TO ANY PROVISIONS OF SECTION 20 OF
ARTICLE X OF THE STATE CONSTITUTION.
(c) (I) THE REPEAL OF THE HOSPITAL PROVIDER FEE PROGRAM, AS
IT EXISTED PURSUANT TO SECTION 25.5-4-402.3 BEFORE ITS REPEAL,
EFFECTIVE JULY 1, 2017, BY SENATE BILL 17-267, ENACTED IN 2017, AND
THE CREATION OF THE COLORADO HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY ENTERPRISE AS A NEW ENTERPRISE TO CHARGE AND
COLLECT A NEW HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE
AS AUTHORIZED BY SUBSECTION (4) OF THIS SECTION AND PROVIDE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE-FUNDED
BUSINESS SERVICES TO HOSPITALS THAT REPLACE AND SUPPLEMENT
SERVICES PREVIOUSLY FUNDED BY HOSPITAL PROVIDER FEES IS THE
CREATION OF A NEW GOVERNMENT-OWNED BUSINESS THAT PROVIDES
BUSINESS SERVICES TO HOSPITALS AS A NEW ENTERPRISE FOR PURPOSES
OF SECTION 20 OF ARTICLE X OF THE STATE CONSTITUTION, DOES NOT
CONSTITUTE THE QUALIFICATION OF AN EXISTING GOVERNMENT-OWNED
BUSINESS AS AN ENTERPRISE FOR PURPOSES OF SECTION 20 OF ARTICLE X
OF THE STATE CONSTITUTION OR SECTION 24-77-103.6 (6)(b)(II), AND,
THEREFORE, DOES NOT REQUIRE OR AUTHORIZE ADJUSTMENT OF THE
STATE FISCAL YEAR SPENDING LIMIT CALCULATED PURSUANT TO SECTION
20 OF ARTICLE X OF THE STATE CONSTITUTION OR THE EXCESS STATE
REVENUES CAP, AS DEFINED IN SECTION 24-77-103.6 (6)(b)(I).
(II) NOTWITHSTANDING SUBSECTION (3)(c)(I) OF THIS SECTION,
BECAUSE THE REPEAL OF THE HOSPITAL PROVIDER FEE PROGRAM, AS IT
EXISTED PURSUANT TO SECTION 25.5-4-402.3 BEFORE ITS REPEAL BY
SENATE BILL 17-267, ENACTED IN 2017, WILL ALLOW THE STATE TO
SPEND MORE GENERAL FUND MONEY FOR GENERAL GOVERNMENTAL
PURPOSES THAN IT WOULD OTHERWISE BE ABLE TO SPEND BELOW THE
EXCESS STATE REVENUES CAP, AS DEFINED IN SECTION 24-77-103.6
(6)(b)(I), IT IS APPROPRIATE TO RESTRAIN THE GROWTH OF GOVERNMENT
BY LOWERING THE BASE AMOUNT USED TO CALCULATE THE EXCESS STATE
REVENUES CAP FOR THE 2017-18 STATE FISCAL YEAR BY TWO HUNDRED
MILLION DOLLARS.
(d) THE ENTERPRISE'S PRIMARY POWERS AND DUTIES ARE:
(I) TO CHARGE AND COLLECT THE HEALTHCARE AFFORDABILITY
AND SUSTAINABILITY FEE AS SPECIFIED IN SUBSECTION (4) OF THIS
SECTION;
(II) TO LEVERAGE HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEE REVENUE COLLECTED TO OBTAIN FEDERAL
MATCHING MONEY, WORKING WITH OR THROUGH THE STATE DEPARTMENT
AND THE STATE BOARD TO THE EXTENT REQUIRED BY FEDERAL LAW OR
OTHERWISE NECESSARY;
(III) TO EXPEND HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEE REVENUE, MATCHING FEDERAL MONEY, AND ANY
OTHER MONEY FROM THE HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEE CASH FUND AS SPECIFIED IN SUBSECTIONS (4) AND (5)
OF THIS SECTION;
(IV) TO ISSUE REVENUE BONDS PAYABLE FROM THE REVENUES OF
THE ENTERPRISE;
(V) TO ENTER INTO AGREEMENTS WITH THE STATE DEPARTMENT
TO THE EXTENT NECESSARY TO COLLECT AND EXPEND HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE REVENUE;
(VI) TO ENGAGE THE SERVICES OF PRIVATE PERSONS OR ENTITIES
SERVING AS CONTRACTORS, CONSULTANTS, AND LEGAL COUNSEL FOR
PROFESSIONAL AND TECHNICAL ASSISTANCE AND ADVICE AND TO SUPPLY
OTHER SERVICES RELATED TO THE CONDUCT OF THE AFFAIRS OF THE
ENTERPRISE, INCLUDING THE PROVISION OF ADDITIONAL BUSINESS
SERVICES TO HOSPITALS AS SPECIFIED IN SUBSECTION (4)(a)(IV) OF THIS
SECTION; AND
(VII) TO ADOPT AND AMEND OR REPEAL POLICIES FOR THE
REGULATION OF ITS AFFAIRS AND THE CONDUCT OF ITS BUSINESS
CONSISTENT WITH THE PROVISIONS OF THIS SECTION.
(e) THE ENTERPRISE SHALL EXERCISE ITS POWERS AND PERFORM
ITS DUTIES AS IF THE SAME WERE TRANSFERRED TO THE STATE
DEPARTMENT BY A TYPE 2 TRANSFER, AS DEFINED IN SECTION 24-1-105.
(4) Healthcare affordability and sustainability fee. (a) FOR
THE FISCAL YEAR COMMENCING JULY 1, 2017, AND FOR EACH FISCAL
YEAR THEREAFTER, THE ENTERPRISE IS AUTHORIZED TO CHARGE AND
COLLECT A HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE, AS
DESCRIBED IN 42 CFR 433.68 (b), ON OUTPATIENT AND INPATIENT
SERVICES PROVIDED BY ALL LICENSED OR CERTIFIED HOSPITALS,
REFERRED TO IN THIS SECTION AS "HOSPITALS", FOR THE PURPOSE OF
OBTAINING FEDERAL FINANCIAL PARTICIPATION UNDER THE STATE
MEDICAL ASSISTANCE PROGRAM AS DESCRIBED IN THIS ARTICLE 4 AND
ARTICLES 5 AND 6 OF THIS TITLE 25.5, REFERRED TO IN THIS SECTION AS
THE "STATE MEDICAL ASSISTANCE PROGRAM", AND THE COLORADO
INDIGENT CARE PROGRAM DESCRIBED IN PART 1 OF ARTICLE 3 OF THIS
TITLE 25.5, REFERRED TO IN THIS SECTION AS THE "COLORADO INDIGENT
CARE PROGRAM". THE ENTERPRISE SHALL USE THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE REVENUE TO:
(I) PROVIDE A BUSINESS SERVICE TO HOSPITALS BY INCREASING
REIMBURSEMENT TO HOSPITALS FOR PROVIDING MEDICAL CARE UNDER:
(A) THE STATE MEDICAL ASSISTANCE PROGRAM; AND
(B) THE COLORADO INDIGENT CARE PROGRAM;
(II) PROVIDE A BUSINESS SERVICE TO HOSPITALS BY INCREASING
THE NUMBER OF INDIVIDUALS COVERED BY PUBLIC MEDICAL ASSISTANCE
AND THEREBY REDUCING THE AMOUNT OF UNCOMPENSATED CARE THAT
THE HOSPITALS MUST PROVIDE;
(III) PAY THE ADMINISTRATIVE COSTS TO THE ENTERPRISE IN
IMPLEMENTING AND ADMINISTERING THIS SECTION SUBJECT TO THE
LIMITATION THAT ADMINISTRATIVE COSTS OF THE ENTERPRISE ARE
LIMITED TO THREE PERCENT OF THE ENTERPRISE'S EXPENDITURES BASED
ON A METHODOLOGY APPROVED BY THE OFFICE OF STATE PLANNING AND
BUDGETING AND THE STAFF OF THE JOINT BUDGET COMMITTEE OF THE
GENERAL ASSEMBLY; AND
(IV) PROVIDE OR CONTRACT FOR OR ARRANGE THE PROVISION OF
ADDITIONAL BUSINESS SERVICES TO HOSPITALS BY:
(A) CONSULTING WITH HOSPITALS TO HELP THEM IMPROVE BOTH
COST EFFICIENCY AND PATIENT SAFETY IN PROVIDING MEDICAL SERVICES
AND THE CLINICAL EFFECTIVENESS OF THOSE SERVICES;
(B) ADVISING HOSPITALS REGARDING POTENTIAL CHANGES TO
FEDERAL AND STATE LAWS AND REGULATIONS THAT GOVERN THE
PROVISION OF AND REIMBURSEMENT PAID FOR MEDICAL SERVICES UNDER
THE PROGRAMS ADMINISTERED PURSUANT TO THIS ARTICLE 4 AND
ARTICLES 5 AND 6 OF THIS TITLE 25.5;
(C) PROVIDING COORDINATED SERVICES TO HOSPITALS TO HELP
THEM ADAPT AND TRANSITION TO ANY NEW OR MODIFIED PERFORMANCE
TRACKING AND PAYMENT SYSTEMS FOR THE PROGRAMS ADMINISTERED
PURSUANT TO THIS ARTICLE 4 AND ARTICLES 5 AND 6 OF THIS TITLE 25.5,
WHICH MAY INCLUDE DATA SHARING, TELEHEALTH COORDINATION AND
SUPPORT, ESTABLISHMENT OF PERFORMANCE METRICS, BENCHMARKING
TO SUCH METRICS, AND CLINICAL AND ADMINISTRATIVE PROCESS
CONSULTING AND OTHER APPROPRIATE SERVICES;
(D) PROVIDING ANY OTHER SERVICES TO HOSPITALS THAT AID
THEM IN EFFICIENTLY AND EFFECTIVELY PARTICIPATING IN THE PROGRAMS
ADMINISTERED PURSUANT TO THIS ARTICLE 4 AND ARTICLES 5 AND 6 OF
THIS TITLE 25.5; AND
(E) PROVIDING FUNDING FOR, AND IN COOPERATION WITH THE
STATE DEPARTMENT AND HOSPITALS SUPPORTING THE IMPLEMENTATION
OF, A HEALTH CARE DELIVERY SYSTEM REFORM INCENTIVE PAYMENTS
PROGRAM AS DESCRIBED IN SUBSECTION (8) OF THIS SECTION.
(b) THE ENTERPRISE SHALL RECOMMEND FOR APPROVAL AND
ESTABLISHMENT BY THE STATE BOARD THE AMOUNT OF THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE THAT IT INTENDS TO CHARGE
AND COLLECT. THE STATE BOARD MUST ESTABLISH THE FINAL AMOUNT
OF THE FEE BY RULES PROMULGATED IN ACCORDANCE WITH ARTICLE 4 OF
TITLE 24. THE STATE BOARD SHALL NOT ESTABLISH ANY AMOUNT THAT
EXCEEDS THE FEDERAL LIMIT FOR SUCH FEES. THE STATE BOARD MAY
DEVIATE FROM THE RECOMMENDATIONS OF THE ENTERPRISE, BUT SHALL
EXPRESS IN WRITING THE REASONS FOR ANY DEVIATIONS. IN
ESTABLISHING THE AMOUNT OF THE FEE AND IN PROMULGATING THE
RULES GOVERNING THE FEE, THE STATE BOARD SHALL:
(I) CONSIDER RECOMMENDATIONS OF THE ENTERPRISE;
(II) ESTABLISH THE AMOUNT OF THE HEALTHCARE AFFORDABILITY
AND SUSTAINABILITY FEE SO THAT THE AMOUNT COLLECTED FROM THE
FEE AND FEDERAL MATCHING FUNDS ASSOCIATED WITH THE FEE ARE
SUFFICIENT TO PAY FOR THE ITEMS DESCRIBED IN SUBSECTION (4)(a) OF
THIS SECTION, BUT NOTHING IN THIS SUBSECTION (4)(b)(II) REQUIRES THE
STATE BOARD TO INCREASE THE FEE ABOVE THE AMOUNT RECOMMENDED
BY THE ENTERPRISE; AND
(III) FOR THE 2017-18 FISCAL YEAR, ESTABLISH THE AMOUNT OF
THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE SO THAT THE
AMOUNT COLLECTED FROM THE FEE IS APPROXIMATELY EQUAL TO THE
SUM OF THE AMOUNTS OF THE APPROPRIATIONS SPECIFIED FOR THE FEE IN
THE GENERAL APPROPRIATION ACT, SENATE BILL 17-254, ENACTED IN
2017, AND ANY OTHER SUPPLEMENTAL APPROPRIATION ACT.
(c) (I) IN ACCORDANCE WITH THE REDISTRIBUTIVE METHOD SET
FORTH IN 42 CFR 433.68 (e)(1) AND (e)(2), THE ENTERPRISE, ACTING IN
CONCERT WITH OR THROUGH AN AGREEMENT WITH THE STATE
DEPARTMENT IF REQUIRED BY FEDERAL LAW, MAY SEEK A WAIVER FROM
THE BROAD-BASED HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
FEE REQUIREMENT OR THE UNIFORM HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEE REQUIREMENT, OR BOTH. IN ADDITION, THE
ENTERPRISE, ACTING IN CONCERT WITH OR THROUGH AN AGREEMENT
WITH THE STATE DEPARTMENT IF REQUIRED BY FEDERAL LAW, SHALL SEEK
ANY FEDERAL WAIVER NECESSARY TO FUND AND, IN COOPERATION WITH
THE STATE DEPARTMENT AND HOSPITALS, SUPPORT THE IMPLEMENTATION
OF A HEALTH CARE DELIVERY SYSTEM REFORM INCENTIVE PAYMENTS
PROGRAM AS DESCRIBED IN SUBSECTION (8) OF THIS SECTION. SUBJECT TO
FEDERAL APPROVAL AND TO MINIMIZE THE FINANCIAL IMPACT ON
CERTAIN HOSPITALS, THE ENTERPRISE MAY EXEMPT FROM PAYMENT OF
THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE CERTAIN
TYPES OF HOSPITALS, INCLUDING BUT NOT LIMITED TO:
(A) PSYCHIATRIC HOSPITALS, AS LICENSED BY THE DEPARTMENT
OF PUBLIC HEALTH AND ENVIRONMENT;
(B) HOSPITALS THAT ARE LICENSED AS GENERAL HOSPITALS AND
CERTIFIED AS LONG-TERM CARE HOSPITALS BY THE DEPARTMENT OF
PUBLIC HEALTH AND ENVIRONMENT;
(C) CRITICAL ACCESS HOSPITALS THAT ARE LICENSED AS GENERAL
HOSPITALS AND ARE CERTIFIED BY THE DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT UNDER 42 CFR PART 485, SUBPART F;
(D) INPATIENT REHABILITATION FACILITIES; OR
(E) HOSPITALS SPECIFIED FOR EXEMPTION UNDER 42 CFR 433.68
(e).
(II) IN DETERMINING WHETHER A HOSPITAL MAY BE EXCLUDED,
THE ENTERPRISE SHALL USE ONE OR MORE OF THE FOLLOWING CRITERIA:
(A) A HOSPITAL THAT IS LOCATED IN A RURAL AREA;
(B) A HOSPITAL WITH WHICH THE STATE DEPARTMENT DOES NOT
CONTRACT TO PROVIDE SERVICES UNDER THE STATE MEDICAL ASSISTANCE
PROGRAM;
(C) A HOSPITAL WHOSE INCLUSION OR EXCLUSION WOULD NOT
SIGNIFICANTLY AFFECT THE NET BENEFIT TO HOSPITALS PAYING THE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE; OR
(D) A HOSPITAL THAT MUST BE INCLUDED TO RECEIVE FEDERAL
APPROVAL.
(III) THE ENTERPRISE MAY REDUCE THE AMOUNT OF THE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE FOR CERTAIN
HOSPITALS TO OBTAIN FEDERAL APPROVAL AND TO MINIMIZE THE
FINANCIAL IMPACT ON CERTAIN HOSPITALS. IN DETERMINING FOR WHICH
HOSPITALS THE ENTERPRISE MAY REDUCE THE AMOUNT OF THE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE, THE ENTERPRISE
SHALL USE ONE OR MORE OF THE FOLLOWING CRITERIA:
(A) THE HOSPITAL IS A TYPE OF HOSPITAL DESCRIBED IN
SUBSECTION (4)(c)(I) OF THIS SECTION;
(B) THE HOSPITAL IS LOCATED IN A RURAL AREA;
(C) THE HOSPITAL SERVES A HIGHER PERCENTAGE THAN THE
AVERAGE HOSPITAL OF PERSONS COVERED BY THE STATE MEDICAL
ASSISTANCE PROGRAM, MEDICARE, OR COMMERCIAL INSURANCE OR
PERSONS ENROLLED IN A MANAGED CARE ORGANIZATION;
(D) THE HOSPITAL DOES NOT CONTRACT WITH THE STATE
DEPARTMENT TO PROVIDE SERVICES UNDER THE STATE MEDICAL
ASSISTANCE PROGRAM;
(E) IF THE HOSPITAL PAID A REDUCED HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE, THE REDUCED FEE WOULD NOT
SIGNIFICANTLY AFFECT THE NET BENEFIT TO HOSPITALS PAYING THE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE; OR
(F) THE HOSPITAL IS REQUIRED NOT TO PAY A REDUCED
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE AS A CONDITION
OF FEDERAL APPROVAL.
(IV) THE ENTERPRISE MAY CHANGE HOW IT PAYS HOSPITAL
REIMBURSEMENT OR QUALITY INCENTIVE PAYMENTS, OR BOTH, IN WHOLE
OR IN PART, UNDER THE AUTHORITY OF A FEDERAL WAIVER IF THE TOTAL
REIMBURSEMENT TO HOSPITALS IS EQUAL TO OR ABOVE THE FEDERAL
UPPER PAYMENT LIMIT CALCULATION UNDER THE WAIVER.
(d) THE ENTERPRISE MAY ALTER THE PROCESS PRESCRIBED IN THIS
SUBSECTION (4) TO THE EXTENT NECESSARY TO MEET THE FEDERAL
REQUIREMENTS AND TO OBTAIN FEDERAL APPROVAL.
(e) (I) THE ENTERPRISE SHALL ESTABLISH POLICIES ON THE
CALCULATION, ASSESSMENT, AND TIMING OF THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE. THE ENTERPRISE SHALL ASSESS
THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE ON A
SCHEDULE TO BE SET BY THE ENTERPRISE BOARD AS PROVIDED IN
SUBSECTION (7)(d) OF THIS SECTION. THE PERIODIC HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE PAYMENTS FROM A HOSPITAL
AND THE ENTERPRISE'S REIMBURSEMENT TO THE HOSPITAL UNDER
SUBSECTIONS (5)(b)(I) AND (5)(b)(II) OF THIS SECTION ARE DUE AS
NEARLY SIMULTANEOUSLY AS FEASIBLE; EXCEPT THAT THE ENTERPRISE'S
REIMBURSEMENT TO THE HOSPITAL IS DUE NO MORE THAN TWO DAYS
AFTER THE PERIODIC HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
FEE PAYMENT IS RECEIVED FROM THE HOSPITAL. THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE MUST BE IMPOSED ON EACH
HOSPITAL EVEN IF MORE THAN ONE HOSPITAL IS OWNED BY THE SAME
ENTITY. THE FEE MUST BE PRORATED AND ADJUSTED FOR THE EXPECTED
VOLUME OF SERVICE FOR ANY YEAR IN WHICH A HOSPITAL OPENS OR
CLOSES.
(II) THE ENTERPRISE IS AUTHORIZED TO REFUND ANY UNUSED
PORTION OF THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE.
FOR ANY PORTION OF THE HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEE THAT HAS BEEN COLLECTED BY THE ENTERPRISE BUT
FOR WHICH THE ENTERPRISE HAS NOT RECEIVED FEDERAL MATCHING
FUNDS, THE ENTERPRISE SHALL REFUND BACK TO THE HOSPITAL THAT
PAID THE FEE THE AMOUNT OF THAT PORTION OF THE FEE WITHIN FIVE
BUSINESS DAYS AFTER THE FEE IS COLLECTED.
(III) THE ENTERPRISE SHALL ESTABLISH REQUIREMENTS FOR THE
REPORTS THAT HOSPITALS MUST SUBMIT TO THE ENTERPRISE TO ALLOW
THE ENTERPRISE TO CALCULATE THE AMOUNT OF THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE. NOTWITHSTANDING THE
PROVISIONS OF PART 2 OF ARTICLE 72 OF TITLE 24 OR SUBSECTION (7)(f)
OF THIS SECTION, INFORMATION PROVIDED TO THE ENTERPRISE PURSUANT
TO THIS SECTION IS CONFIDENTIAL AND IS NOT A PUBLIC RECORD.
NONETHELESS, THE ENTERPRISE MAY PREPARE AND RELEASE SUMMARIES
OF THE REPORTS TO THE PUBLIC.
(f) A HOSPITAL SHALL NOT INCLUDE ANY AMOUNT OF THE
HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE AS A SEPARATE
LINE ITEM IN ITS BILLING STATEMENTS.
(g) THE STATE BOARD SHALL PROMULGATE ANY RULES PURSUANT
TO THE "STATE ADMINISTRATIVE PROCEDURE ACT", ARTICLE 4 OF TITLE
24, NECESSARY FOR THE ADMINISTRATION AND IMPLEMENTATION OF THIS
SECTION. PRIOR TO SUBMITTING ANY PROPOSED RULES CONCERNING THE
ADMINISTRATION OR IMPLEMENTATION OF THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE TO THE STATE BOARD, THE
ENTERPRISE SHALL CONSULT WITH THE STATE BOARD ON THE PROPOSED
RULES AS SPECIFIED IN SUBSECTION (7)(d) OF THIS SECTION.
(5) Healthcare affordability and sustainability fee cash fund.
(a) ANY HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE
COLLECTED PURSUANT TO THIS SECTION BY THE ENTERPRISE MUST BE
TRANSMITTED TO THE STATE TREASURER, WHO SHALL CREDIT THE FEE TO
THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE CASH FUND,
WHICH FUND IS HEREBY CREATED AND REFERRED TO IN THIS SECTION AS
THE "FUND". THE STATE TREASURER SHALL CREDIT ALL INTEREST AND
INCOME DERIVED FROM THE DEPOSIT AND INVESTMENT OF MONEY IN THE
FUND TO THE FUND. THE STATE TREASURER SHALL INVEST ANY MONEY IN
THE FUND NOT EXPENDED FOR THE PURPOSES SPECIFIED IN SUBSECTION
(5)(b) OF THIS SECTION AS PROVIDED BY LAW. MONEY IN THE FUND SHALL
NOT BE TRANSFERRED TO ANY OTHER FUND AND SHALL NOT BE USED FOR
ANY PURPOSE OTHER THAN THE PURPOSES SPECIFIED IN THIS SUBSECTION
(5) AND IN SUBSECTION (4) OF THIS SECTION.
(b) ALL MONEY IN THE FUND IS SUBJECT TO FEDERAL MATCHING
AS AUTHORIZED UNDER FEDERAL LAW AND IS CONTINUOUSLY
APPROPRIATED TO THE ENTERPRISE FOR THE FOLLOWING PURPOSES:
(I) TO MAXIMIZE THE INPATIENT AND OUTPATIENT HOSPITAL
REIMBURSEMENTS TO UP TO THE UPPER PAYMENT LIMITS AS DEFINED IN
42 CFR 447.272 AND 42 CFR 447.321;
(II) TO INCREASE HOSPITAL REIMBURSEMENTS UNDER THE
COLORADO INDIGENT CARE PROGRAM TO UP TO ONE HUNDRED PERCENT
OF THE HOSPITAL'S COSTS OF PROVIDING MEDICAL CARE UNDER THE
PROGRAM;
(III) TO PAY THE QUALITY INCENTIVE PAYMENTS PROVIDED IN
SECTION 25.5-4-402 (3);
(IV) SUBJECT TO AVAILABLE REVENUE FROM THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE AND FEDERAL MATCHING
FUNDS, TO EXPAND ELIGIBILITY FOR PUBLIC MEDICAL ASSISTANCE BY:
(A) INCREASING THE ELIGIBILITY LEVEL FOR PARENTS AND
CARETAKER RELATIVES OF CHILDREN WHO ARE ELIGIBLE FOR MEDICAL
ASSISTANCE, PURSUANT TO SECTION 25.5-5-201 (1)(m), FROM SIXTY-ONE
PERCENT TO ONE HUNDRED THIRTY-THREE PERCENT OF THE FEDERAL
POVERTY LINE;
(B) INCREASING THE ELIGIBILITY LEVEL FOR CHILDREN AND
PREGNANT WOMEN UNDER THE CHILDREN'S BASIC HEALTH PLAN TO UP TO
TWO HUNDRED FIFTY PERCENT OF THE FEDERAL POVERTY LINE;
(C) PROVIDING ELIGIBILITY UNDER THE STATE MEDICAL
ASSISTANCE PROGRAM FOR A CHILDLESS ADULT OR AN ADULT WITHOUT
A DEPENDENT CHILD IN THE HOME, PURSUANT TO SECTION 25.5-5-201
(1)(p), WHO EARNS UP TO ONE HUNDRED THIRTY-THREE PERCENT OF THE
FEDERAL POVERTY LINE; AND
(D) PROVIDING A BUY-IN PROGRAM IN THE STATE MEDICAL
ASSISTANCE PROGRAM FOR DISABLED ADULTS AND CHILDREN WHOSE
FAMILIES HAVE INCOME OF UP TO FOUR HUNDRED FIFTY PERCENT OF THE
FEDERAL POVERTY LINE;
(V) TO PROVIDE CONTINUOUS ELIGIBILITY FOR TWELVE MONTHS
FOR CHILDREN ENROLLED IN THE STATE MEDICAL ASSISTANCE PROGRAM;
(VI) TO PAY THE ENTERPRISE'S ACTUAL ADMINISTRATIVE COSTS
OF IMPLEMENTING AND ADMINISTERING THIS SECTION, INCLUDING BUT
NOT LIMITED TO THE FOLLOWING COSTS:
(A) ADMINISTRATIVE EXPENSES OF THE ENTERPRISE;
(B) THE ENTERPRISE'S ACTUAL COSTS RELATED TO IMPLEMENTING
AND MAINTAINING THE HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEE, INCLUDING PERSONAL SERVICES, OPERATING, AND
CONSULTING EXPENSES;
(C) THE ENTERPRISE'S ACTUAL COSTS FOR THE CHANGES AND
UPDATES TO THE MEDICAID MANAGEMENT INFORMATION SYSTEM FOR THE
IMPLEMENTATION OF SUBSECTIONS (5)(b)(I) TO (5)(b)(III) OF THIS
SECTION;
(D) THE ENTERPRISE'S PERSONAL SERVICES AND OPERATING COSTS
RELATED TO PERSONNEL, CONSULTING SERVICES, AND FOR REVIEW OF
HOSPITAL COSTS NECESSARY TO IMPLEMENT AND ADMINISTER THE
INCREASES IN INPATIENT AND OUTPATIENT HOSPITAL PAYMENTS MADE
PURSUANT TO SUBSECTION (5)(b)(I) OF THIS SECTION, INCREASES IN THE
COLORADO INDIGENT CARE PROGRAM PAYMENTS MADE PURSUANT TO
SUBSECTION (5)(b)(II) OF THIS SECTION, AND QUALITY INCENTIVE
PAYMENTS MADE PURSUANT TO SUBSECTION (5)(b)(III) OF THIS SECTION;
(E) THE ENTERPRISE'S ACTUAL COSTS FOR THE CHANGES AND
UPDATES TO THE COLORADO BENEFITS MANAGEMENT SYSTEM AND
MEDICAID MANAGEMENT INFORMATION SYSTEM TO IMPLEMENT AND
MAINTAIN THE EXPANDED ELIGIBILITY PROVIDED FOR IN SUBSECTIONS
(5)(b)(IV) AND (5)(b)(V) OF THIS SECTION;
(F) THE ENTERPRISE'S PERSONAL SERVICES AND OPERATING COSTS
RELATED TO PERSONNEL NECESSARY TO IMPLEMENT AND ADMINISTER THE
EXPANDED ELIGIBILITY FOR PUBLIC MEDICAL ASSISTANCE PROVIDED FOR
IN SUBSECTIONS (5)(b)(IV) AND (5)(b)(V) OF THIS SECTION, INCLUDING
BUT NOT LIMITED TO ADMINISTRATIVE COSTS ASSOCIATED WITH THE
DETERMINATION OF ELIGIBILITY FOR PUBLIC MEDICAL ASSISTANCE BY
COUNTY DEPARTMENTS; AND
(G) THE ENTERPRISE'S PERSONAL SERVICES, OPERATING, AND
SYSTEMS COSTS RELATED TO EXPANDING THE OPPORTUNITY FOR
INDIVIDUALS TO APPLY FOR PUBLIC MEDICAL ASSISTANCE DIRECTLY AT
HOSPITALS OR THROUGH ANOTHER ENTITY OUTSIDE THE COUNTY
DEPARTMENTS, IN CONNECTION WITH SECTION 25.5-4-205, THAT WOULD
INCREASE ACCESS TO PUBLIC MEDICAL ASSISTANCE AND REDUCE THE
NUMBER OF UNINSURED SERVED BY HOSPITALS;
(VII) TO OFFSET THE LOSS OF ANY FEDERAL MATCHING MONEY
DUE TO A DECREASE IN THE CERTIFICATION OF THE PUBLIC EXPENDITURE
PROCESS FOR OUTPATIENT HOSPITAL SERVICES FOR MEDICAL SERVICES
PREMIUMS THAT WERE IN EFFECT AS OF JULY 1, 2008;
(VIII) SUBJECT TO ANY NECESSARY FEDERAL WAIVERS BEING
OBTAINED, TO PROVIDE FUNDING FOR A HEALTH CARE DELIVERY SYSTEM
REFORM INCENTIVE PAYMENTS PROGRAM AS DESCRIBED IN SUBSECTION
(8) OF THIS SECTION; AND
(IX) TO PROVIDE ADDITIONAL BUSINESS SERVICES TO HOSPITALS
AS SPECIFIED IN SUBSECTION (4)(a)(IV) OF THIS SECTION.
(6) Appropriations. (a) (I) THE HEALTHCARE AFFORDABILITY
AND SUSTAINABILITY FEE IS TO SUPPLEMENT, NOT SUPPLANT, GENERAL
FUND APPROPRIATIONS TO SUPPORT HOSPITAL REIMBURSEMENTS.
GENERAL FUND APPROPRIATIONS FOR HOSPITAL REIMBURSEMENTS SHALL
BE MAINTAINED AT THE LEVEL OF APPROPRIATIONS IN THE MEDICAL
SERVICES PREMIUM LINE ITEM MADE FOR THE FISCAL YEAR COMMENCING
JULY 1, 2008; EXCEPT THAT GENERAL FUND APPROPRIATIONS FOR
HOSPITAL REIMBURSEMENTS MAY BE REDUCED IF AN INDEX OF
APPROPRIATIONS TO OTHER PROVIDERS SHOWS THAT GENERAL FUND
APPROPRIATIONS ARE REDUCED FOR OTHER PROVIDERS. IF THE INDEX
SHOWS THAT GENERAL FUND APPROPRIATIONS ARE REDUCED FOR OTHER
PROVIDERS, THE GENERAL FUND APPROPRIATIONS FOR HOSPITAL
REIMBURSEMENTS SHALL NOT BE REDUCED BY A GREATER PERCENTAGE
THAN THE REDUCTIONS OF APPROPRIATIONS FOR THE OTHER PROVIDERS
AS SHOWN BY THE INDEX.
(II) IF GENERAL FUND APPROPRIATIONS FOR HOSPITAL
REIMBURSEMENTS ARE REDUCED BELOW THE LEVEL OF APPROPRIATIONS
IN THE MEDICAL SERVICES PREMIUM LINE ITEM MADE FOR THE FISCAL
YEAR COMMENCING JULY 1, 2008, THE GENERAL FUND APPROPRIATIONS
WILL BE INCREASED BACK TO THE LEVEL OF APPROPRIATIONS IN THE
MEDICAL SERVICES PREMIUM LINE ITEM MADE FOR THE FISCAL YEAR
COMMENCING JULY 1, 2008, AT THE SAME PERCENTAGE AS THE
APPROPRIATIONS FOR OTHER PROVIDERS AS SHOWN BY THE INDEX. THE
GENERAL ASSEMBLY IS NOT OBLIGATED TO INCREASE THE GENERAL FUND
APPROPRIATIONS BACK TO THE LEVEL OF APPROPRIATIONS IN THE
MEDICAL SERVICES PREMIUM LINE ITEM IN A SINGLE FISCAL YEAR AND
SUCH INCREASES MAY OCCUR OVER NONCONSECUTIVE FISCAL YEARS.
(III) FOR PURPOSES OF THIS SUBSECTION (6)(a), THE "INDEX OF
APPROPRIATIONS TO OTHER PROVIDERS" OR "INDEX" MEANS THE AVERAGE
PERCENT CHANGE IN REIMBURSEMENT RATES THROUGH APPROPRIATIONS
OR LEGISLATION ENACTED BY THE GENERAL ASSEMBLY TO HOME HEALTH
PROVIDERS, PHYSICIAN SERVICES, AND OUTPATIENT PHARMACIES,
EXCLUDING DISPENSING FEES. THE STATE BOARD, AFTER CONSULTATION
WITH THE ENTERPRISE BOARD, IS AUTHORIZED TO CLARIFY THIS
DEFINITION AS NECESSARY BY RULE.
(b) IF THE REVENUE FROM THE HEALTHCARE AFFORDABILITY AND
SUSTAINABILITY FEE IS INSUFFICIENT TO FULLY FUND ALL OF THE
PURPOSES DESCRIBED IN SUBSECTION (5)(b) OF THIS SECTION:
(I) THE GENERAL ASSEMBLY IS NOT OBLIGATED TO APPROPRIATE
GENERAL FUND REVENUES TO FUND SUCH PURPOSES;
(II) THE HOSPITAL PROVIDER REIMBURSEMENT AND QUALITY
INCENTIVE PAYMENT INCREASES DESCRIBED IN SUBSECTIONS (5)(b)(I) TO
(5)(b)(III) OF THIS SECTION AND THE COSTS DESCRIBED IN SUBSECTION
(5)(b)(VI) OF THIS SECTION SHALL BE FULLY FUNDED USING REVENUE
FROM THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE AND
FEDERAL MATCHING FUNDS BEFORE ANY ELIGIBILITY EXPANSION IS
FUNDED; AND
(III) (A) IF THE STATE BOARD PROMULGATES RULES THAT EXPAND
ELIGIBILITY FOR MEDICAL ASSISTANCE TO BE PAID FOR PURSUANT TO
SUBSECTION (5)(b)(IV) OF THIS SECTION, AND THE STATE DEPARTMENT
THEREAFTER NOTIFIES THE ENTERPRISE BOARD THAT THE REVENUE
AVAILABLE FROM THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
FEE AND THE FEDERAL MATCHING FUNDS WILL NOT BE SUFFICIENT TO PAY
FOR ALL OR PART OF THE EXPANDED ELIGIBILITY, THE ENTERPRISE BOARD
SHALL RECOMMEND TO THE STATE BOARD REDUCTIONS IN MEDICAL
BENEFITS OR ELIGIBILITY SO THAT THE REVENUE WILL BE SUFFICIENT TO
PAY FOR ALL OF THE REDUCED BENEFITS OR ELIGIBILITY. AFTER
RECEIVING THE RECOMMENDATIONS OF THE ENTERPRISE BOARD, THE
STATE BOARD SHALL ADOPT RULES PROVIDING FOR REDUCED BENEFITS OR
REDUCED ELIGIBILITY FOR WHICH THE REVENUE WILL BE SUFFICIENT AND
SHALL FORWARD ANY ADOPTED RULES TO THE JOINT BUDGET COMMITTEE.
NOTWITHSTANDING THE PROVISIONS OF SECTION 24-4-103 (8) AND (12),
FOLLOWING THE ADOPTION OF RULES PURSUANT TO THIS SUBSECTION
(6)(b)(III)(A), THE STATE BOARD SHALL NOT SUBMIT THE RULES TO THE
ATTORNEY GENERAL AND SHALL NOT FILE THE RULES WITH THE
SECRETARY OF STATE UNTIL THE JOINT BUDGET COMMITTEE APPROVES
THE RULES PURSUANT TO SUBSECTION (6)(b)(III)(B) OF THIS SECTION.
(B) THE JOINT BUDGET COMMITTEE SHALL PROMPTLY CONSIDER
ANY RULES ADOPTED BY THE STATE BOARD PURSUANT TO SUBSECTION
(6)(b)(III)(A) OF THIS SECTION. THE JOINT BUDGET COMMITTEE SHALL
PROMPTLY NOTIFY THE STATE DEPARTMENT, THE STATE BOARD, AND THE
ENTERPRISE BOARD OF ANY ACTION ON THE RULES. IF THE JOINT BUDGET
COMMITTEE DOES NOT APPROVE THE RULES, THE JOINT BUDGET
COMMITTEE SHALL RECOMMEND A REDUCTION IN BENEFITS OR
ELIGIBILITY SO THAT THE REVENUE FROM THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE AND THE MATCHING FEDERAL
FUNDS WILL BE SUFFICIENT TO PAY FOR THE REDUCED BENEFITS OR
ELIGIBILITY. AFTER APPROVING THE RULES PURSUANT TO THIS
SUBSECTION (6)(b)(III)(B), THE JOINT BUDGET COMMITTEE SHALL
REQUEST THAT THE COMMITTEE ON LEGAL SERVICES, CREATED PURSUANT
TO SECTION 2-3-501, EXTEND THE RULES AS PROVIDED FOR IN SECTION
24-4-103 (8) UNLESS THE COMMITTEE ON LEGAL SERVICES FINDS AFTER
REVIEW THAT THE RULES DO NOT CONFORM WITH SECTION 24-4-103
(8)(a).
(C) AFTER THE STATE BOARD HAS RECEIVED NOTIFICATION OF THE
APPROVAL OF RULES ADOPTED PURSUANT TO SUBSECTION (6)(b)(III)(A)
OF THIS SECTION, THE STATE BOARD SHALL SUBMIT THE RULES TO THE
ATTORNEY GENERAL PURSUANT TO SECTION 24-4-103 (8)(b) AND SHALL
FILE THE RULES AND THE OPINION OF THE ATTORNEY GENERAL WITH THE
SECRETARY OF STATE PURSUANT TO SECTION 24-4-103 (12) AND WITH
THE OFFICE OF LEGISLATIVE LEGAL SERVICES. PURSUANT TO SECTION
24-4-103 (5), THE RULES ARE EFFECTIVE TWENTY DAYS AFTER
PUBLICATION OF THE RULES AND ARE ONLY EFFECTIVE UNTIL THE
FOLLOWING MAY 15 UNLESS THE RULES ARE EXTENDED PURSUANT TO A
BILL ENACTED PURSUANT TO SECTION 24-4-103 (8).
(c) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SECTION,
IF, AFTER RECEIPT OF AUTHORIZATION TO RECEIVE FEDERAL MATCHING
FUNDS FOR MONEY IN THE FUND, THE AUTHORIZATION IS WITHDRAWN OR
CHANGED SO THAT FEDERAL MATCHING FUNDS ARE NO LONGER
AVAILABLE, THE ENTERPRISE SHALL CEASE COLLECTING THE HEALTHCARE
AFFORDABILITY AND SUSTAINABILITY FEE AND SHALL REPAY TO THE
HOSPITALS ANY MONEY RECEIVED BY THE FUND THAT IS NOT SUBJECT TO
FEDERAL MATCHING FUNDS.
(7) Colorado healthcare affordability and sustainability
enterprise board. (a) (I) EXCEPT AS OTHERWISE PROVIDED IN
SUBSECTION (7)(a)(II) OF THIS SECTION, THE ENTERPRISE BOARD CONSISTS
OF THIRTEEN MEMBERS APPOINTED BY THE GOVERNOR, WITH THE ADVICE
AND CONSENT OF THE SENATE, AS FOLLOWS:
(A) FIVE MEMBERS WHO ARE EMPLOYED BY HOSPITALS IN
COLORADO, INCLUDING AT LEAST ONE PERSON WHO IS EMPLOYED BY A
HOSPITAL IN A RURAL AREA, ONE PERSON WHO IS EMPLOYED BY A
SAFETY-NET HOSPITAL FOR WHICH THE PERCENT OF MEDICAID-ELIGIBLE
INPATIENT DAYS RELATIVE TO ITS TOTAL INPATIENT DAYS IS EQUAL TO OR
GREATER THAN ONE STANDARD DEVIATION ABOVE THE MEAN, AND ONE
PERSON WHO IS EMPLOYED BY A HOSPITAL IN AN URBAN AREA;
(B) ONE MEMBER WHO IS A REPRESENTATIVE OF A STATEWIDE
ORGANIZATION OF