Sections 1 through 8 of the act raise the minimum age of a person to whom cigarettes, tobacco products, and nicotine products (products) may be sold from 18 years of age to 21 years of age. A products retailer must card anyone seeking to purchase products who appears to be under 50 years of age at the time of purchase.

Section 1 repeals criminal penalties against a minor for purchasing or attempting to purchase a product.

Section 7 prohibits a retailer from permitting a person under 18 years of age to sell or participate in the sale of products.

Section 8 also:

• Increases the minimum number of compliance checks required of each retail location at which the products are sold to 2 per year or at least the minimum number annually required by federal regulation, whichever number is greater; and
• Requires the executive director of the department of revenue (executive director) to adopt rules concerning enforcement of the laws governing the regulation of products, including rules:
• Regarding enforcement coordination between the division of liquor enforcement (division) in the department of revenue and local licensing authorities and regarding enforcement against products smuggling;
• Regarding fees, which must not exceed $400 per year, unless the executive director determines that statewide compliance with products regulation has dropped below 90%, at which time the executive director may, by rule, raise the maximum fee to $600; and
• Authorizing a single, large-operator license fee for retailers with more than 10 retail locations, which fee is not subject to the general maximum fee amount.

Section 9 requires every retailer of the products in the state, on and after July 1, 2021, to obtain a license for each retail location owned. The division is charged with licensing retailers and coordinating with local authorities on retail location compliance checks and investigations of complaints about retailers.

Section 10 prohibits:

• New retail locations at which products are sold from being located within 500 feet of a school unless a local licensing authority has approved a license application for the new retail location;
• Retail locations that sell electronic smoking device products from advertising those products in a manner that is visible from outside the retail location; and
• Delivery of products, other than cigars and pipe tobacco, directly to consumers unless the delivery is made by an owner or employee of a licensed retailer who is at least 21 years of age and, at the time of delivery, checks the identification of the individual receiving the delivery to determine that the individual is 21 years of age or older.

Section 11 authorizes the division to seek injunctive relief against a person who violates the act and impose fines on or suspend or revoke the state license of a retailer found to have violated the act.

Section 12 adjusts the fine amounts for violating the prohibition against selling products to minors from a maximum fine of $1,000 to $15,000 for a fifth or subsequent violation within 24 months to a maximum fine of $1,000 to $15,000 for a fourth or subsequent violation within 24 months. Additionally, the division must prohibit a retailer who commits a second or subsequent violation within 24 months from selling products at the retail location where the violation occurred for a specified period of time, starting with at least 7 days for a second violation within 24 months, to at least 30 days for a third violation within 24 months, and finally for up to 3 years for a fourth or subsequent violation within 24 months.

Additionally, section 12 establishes fines ranging from $1,000 for a first violation to $3,000 for a third or subsequent violation within 24 months for the following violations:

• Advertising electronic smoking device products at a retail location where they are sold in a manner that is visible from outside the retail location;
• Delivering products without complying with the delivery requirements; and
• Selling or offering to sell products without a valid state license. If a person sells or offers to sell products without a valid state license at least 3 times within 24 months, the person is not eligible to apply for a state license for 3 years thereafter.

Further, section 12 also applies the same fine structure that applies to selling products from a vending machine or failing to display the requisite warning to a violation of the prohibition against allowing a person under 18 years of age to sell or participate in the sale of products.

For the 2019-20 state fiscal year, the act appropriates $45,414 to the department of revenue from the liquor enforcement division and state licensing authority cash fund (cash fund) for implementation of the act.

For the 2020-21 state fiscal year, the act appropriates:

• $2,391,262 to the department of revenue from the cash fund for implementation of the act;
• $98,605 to the department of law from reappropriated funds received from the department of revenue for legal services for the department of revenue; and
• $69,450 to the department of personnel from reappropriated funds received from the department of revenue for vehicle replacement lease or purchase.
  (Note: This summary applies to this bill as enacted.)

Fiscal Note

Sections 1, 2, 3, and 4 of the act allow the department of corrections, local jails, multijurisdictional jails, municipal jails, and state department of human services facilities (institutions) to make opioid agonists and opioid antagonists available to a person in custody with an opioid use disorder. The institutions are strongly encouraged to maintain the treatment of the person throughout the duration of the person's incarceration or commitment. Qualified medication administration personnel may administer opioid agonists and opioid antagonists. The facilities may contract with community-based health providers for the administration of opioid agonists and opioid antagonists.

Section 5 of the act allows a person to dispose of any controlled substances at a safe station, if safe station personnel are available, and request assistance in gaining access to treatment for a substance use disorder. A "safe station" is defined as any municipal police station; county sheriff's office; or municipal, county, or fire protection district fire station. Safe station personnel shall provide the person with information about the behavioral health crisis response system.

Sections 6 and 7 of the act require the department of corrections and jails to ensure that continuity of care is provided to inmates prior to release, which includes post-release resources and a list of available substance use providers. County jails are required to provide medicaid reenrollment paperwork to a person when the person enters the county jail and file the paperwork with the county department of health and human services upon releasing the person from the county jail's custody.

Section 8 of the act requires the executive director of the department of corrections, in consultation with the offices of behavioral health and economic security in the department of human services, the department of health care policy and financing, the department of local affairs, and local service providers to develop resources for inmates post-release that provide information to help prepare inmates for release and reintegration into their communities.

Section 9 of the act requires a court, when reviewing a petition to seal criminal records, to consider favorably, when applicable, the fact that the petitioner has entered into or successfully completed a licensed substance use disorder treatment program, in determining whether to issue the order.

Sections 10, 11, and 12 of the act allow the office of behavioral health (OBH) in the department of human services (CDHS) to contract with cities and counties for the creation, maintenance, or expansion of criminal justice diversion programs. OBH may require diversion programs to participate as a mobile crisis service. CDHS shall include an update regarding the current status of funding and implementation of the criminal justice diversion programs in its annual SMART Act presentation.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

School Safety Committee. The bill instructs the school safety resource center (center) to convene a working group of necessary and interested stakeholders to assess the needs of school districts with respect to the adequacy and availability of residential mental health treatment for children and youth who have been identified by school personnel as having severe behavioral or mental health disorders and potential ways to resolve such needs. The working group is directed to gather information on the availability, need, and cost associated with residential treatment services for children and youth in Colorado. The center shall use the data to prepare a report and make any legislative recommendations to address the mental health needs of children and youth in Colorado.

The center is required to present the report and any legislative recommendations as part of its presentation to its committee of reference at a hearing held pursuant to the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" in January 2021.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The Legislative Oversight Committee Concerning the Treatment of Persons With Mental Health Disorders in the Criminal and Juvenile Justice Systems. The bill establishes and expands programs within the division of housing in the department of local affairs (division) to build the capacity of communities across the state to provide supportive housing services to individuals with behavioral, mental health, or substance use disorders who are homeless or at risk of becoming homeless and who have contact with the criminal or juvenile justice system, including:

• Expanding statewide training and technical assistance to help communities develop and implement supportive housing programs for individuals who have behavioral, mental health, or substance use disorders who are homeless or at risk of becoming homeless and who have contact with the criminal or juvenile justice system. The program must be targeted to communities that currently face barriers to accessing existing state and federal funding for supportive housing programs.
• Establishing a predevelopment grant program that provides funding to entities working to develop supportive housing interventions for individuals who have behavioral, mental health, or substance use disorders who are homeless or at risk of becoming homeless and who have contact with the criminal or juvenile justice system. The grant money can be used to add new or additional staff capacity to allow the development and implementation of such programs. The division is required to prioritize applicants that will serve rural or frontier communities and to provide hands-on technical assistance to grant recipients.
• Establishing a supportive housing services and homelessness prevention grant program. Grant money can be used to cover the costs of providing supportive housing services that are currently not eligible for reimbursement through the state's medical assistance program. It can also be used to fund homelessness prevention projects for individuals who have behavioral, mental health, or substance use disorders who are homeless or at risk of becoming homeless and who have contact with the criminal or juvenile justice system. The division is required to prioritize applicants that will serve rural or frontier communities and provide hands-on technical assistance to grant recipients.
• Developing a plan to increase participation in regional homeless data systems, support accurate data reporting, and assess housing-related needs. The program must work with regional continuums of care to evaluate how to increase participation in data systems in communities across the state, identify technical needs and associated costs for doing so, and work with communities and stakeholders to integrate or develop an integrated user interface for various data systems related to housing and supportive services. It must also enhance information about best practices and training materials available to communities across the state.
  (Note: This summary applies to this bill as introduced.)

Fiscal Note

With certain exceptions, current law limits the authority of a person who holds a valid permit to carry a concealed handgun by prohibiting a permit holder from carrying a concealed handgun on public elementary, middle, junior high, or high school grounds. The bill removes this limitation.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

With regard to coverage under a health benefit plan for HIV infection prevention medications, the act:

• Prevents a health insurance carrier from requiring a covered person to undergo step therapy or to receive prior authorization before receiving HIV infection prevention drugs prescribed and dispensed by a pharmacist; and
• Requires carriers to reimburse a pharmacist employed at an in-network pharmacy for prescribing HIV infection prevention drugs to a covered person and to provide an adequate consultative fee to those pharmacists.

Additionally, the act:

• Allows a pharmacist to prescribe and dispense HIV infection prevention drugs pursuant to a standing order or a statewide protocol if the pharmacist fulfills specific requirements;
• Directs the department of public health and environment to develop and implement a standing order for pharmacists to prescribe post-exposure HIV infection prevention drugs;
• Directs the state board of pharmacy, the Colorado medical board, and the state board of nursing, in collaboration with the department of public health and environment, to develop statewide drug therapy protocols for pharmacists to prescribe and dispense HIV infection prevention drugs and the state board of pharmacy to promulgate rules to implement the protocols; and
• Expands the definition of "practice of pharmacy" to include the prescribing and dispensing of HIV infection prevention drugs and the ordering of laboratory tests in conjunction with prescribing or dispensing the drugs.

$13,347 is appropriated from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance to implement the act.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The act:

• Requires a carrier that provides coverage for opiate antagonists to reimburse a hospital if the hospital provides a covered person with an opiate antagonist upon discharge;
• Requires a pharmacist who dispenses a prescription for an opioid to notify the individual to whom the opioid is being dispensed about the availability of an opiate antagonist;
• Allows a pharmacist or pharmacy technician to sell a nonprescription syringe or needle to any person and exempts pharmacists and pharmacy technicians who sell nonprescription syringes or needles from the drug paraphernalia criminal statutes;
• Extends civil and criminal immunity for a person who acts in good faith to furnish or administer an opiate antagonist to an individual the person believes to be suffering an opiate-related drug overdose when the opiate antagonist was expired; and
• Allows a nonprofit organization to operate a clean syringe exchange program without local board of health approval and requires the nonprofit organization to annually report specified information to the department of public health and environment.
  (Note: This summary applies to this bill as enacted.)

Fiscal Note

The act requires a health benefit plan, beginning January 1, 2022, to provide coverage for nonpharmacological treatment as an alternative to opioids. The required coverage must include, at a cost-sharing amount not to exceed the cost-sharing amount for a primary care visit for nonpreventive services and without a prior authorization requirement, at least 6 physical therapy visits, 6 occupational therapy visits,6 chiropractic visits, and 6 acupuncture visits per year.

The act requires an insurance carrier (carrier) that provides prescription drug benefits to provide coverage, beginning January 1, 2022, for at least one atypical opioid that is approved by the federal food and drug administration (FDA) for the treatment of acute or chronic pain at the lowest cost-sharing tier of the carrier's formulary with no requirement for step therapy or prior authorization and to not require step therapy for any additional FDA-approved atypical opioids.

The act precludes a carrier that has a contract with a physical therapist, occupational therapist, or acupuncturist from:

• Prohibiting the physical therapist, occupational therapist, or acupuncturist from, or penalizing the physical therapist, occupational therapist, or acupuncturist for, providing a covered person information on the amount of the covered person's financial responsibility for the covered person's physical therapy, occupational therapy, or acupuncture services; or
• Requiring the physical therapist, occupational therapist, or acupuncturist to charge or collect a copayment from a covered person that exceeds the total charges submitted by the physical therapist, occupational therapist, or acupuncturist.

The commissioner of insurance is required to take action against a carrier that the commissioner determines is not complying with these prohibitions.

The act requires the executive director of the department of regulatory agencies to promulgate rules that limit the supply of a benzodiazepine that a prescriber may prescribe to patient who has not had a prescription for benzodiazepine in the last 12 months.

Current law limits an opioid prescriber from prescribing more than a 7-day supply of an opioid to a patient who has not had an opioid prescription within the previous 12 months unless certain conditions apply, and this prescribing limitation is set to repeal on September 1, 2021. The act continues the prescribing limitation indefinitely.

The act requires the Colorado medical board (board) to consult with the center for research into substance use disorder prevention, treatment, and recovery support strategies to promulgate rules establishing competency-based continuing education requirements for physicians and physician assistants concerning prescribing practices for opioids.

With regard to the prescription drug monitoring program (program), the act:

• Modifies requirements for adding prescription information to the program; (program)
• Prohibits the state board of pharmacy from charging practitioners or pharmacists a fee for registering or maintaining an account with the program;
• Continues indefinitely the requirement that a health care provider query the program before prescribing a second fill for an opioid;
• Requires each health care provider to query the program before prescribing a second fill for a benzodiazepine, unless certain exceptions apply;
• Requires the board to promulgate rules designating additional controlled substances and other prescription drugs to be tracked by the program; and
• In addition to current law allowing medical examiners and coroners to query the program when conducting an autopsy, allows medical examiners and coroners to query the program when conducting a death investigation.

The act appropriates $18,540 from the division of professions and occupations cash fund to the department of regulatory agencies to implement the act, with $2,550 allocated to the Colorado medical board and $15,990 reappropriated to the department of law to provide legal services to the department of regulatory agencies.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The bill adds a requirement, as part of mandatory health insurance coverage of preventive health care services, that health plans cover an annual mental health wellness examination of up to 60 minutes that is performed by a qualified mental health care provider. The coverage must:

• Be comparable to the coverage of a physical examination;
• Comply with the requirements of federal mental health parity laws; and
• Not require any deductibles, copayments, or coinsurance for the mental health wellness examination.

The bill appropriates $13,347 from the division of insurance cash fund to the division of insurance in the department of regulatory agencies for personal services to implement the bill.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Fiscal Note

The bill repeals statutory provisions:

• Prohibiting the possession of certain ammunition magazines; and
• Requiring each of certain ammunition magazines that are manufactured in Colorado on or after July 1, 2013, to include a permanent stamp or marking indicating that the magazine was manufactured or assembled after July 1, 2013.
  (Note: This summary applies to this bill as introduced.)

Fiscal Note

Current law requires health insurance carriers (carriers) to provide preventive health insurance coverage for colorectal cancer screenings in accordance with U.S. preventive services task force guidelines. The bill requires carriers to instead provide coverage for colorectal cancer screenings in accordance with American Cancer Society guidelines. The coverage must include coverage for a colonoscopy or other medical test or procedure for colorectal cancer screening and a follow-up colonoscopy, if necessary, and coverage for high-risk individuals additionally provide coverage for persons 45 years of age and older.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Fiscal Note

Under current law, the safe2tell program is required to provide awareness and educational materials to preschools. The act removes this requirement.

The act clarifies that safe2tell does not have to provide information about a call to law enforcement and school personnel if the call was forwarded to the statewide behavioral crisis response system. The act requires the safe2tell program to develop training materials outlining appropriate responses to safe2tell tips to ensure standardized messaging. The act directs the department of law to devise a process and develop standardized protocols so that any communication related to mental health or substance use received by safe2tell may be transferred to the statewide behavioral crisis response system.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The act addresses the authority of the state government to regulate perfluoroalkyl and polyfluoroalkyl substances (PFAS).

Section 1 of the act addresses when PFAS may be used for firefighting foam system testing both in general and in certain aircraft hangars.

Section 2 requires the solid and hazardous waste commission to promulgate rules for both a certificate of registration for any facility, fire department, or lessee subject to federal rules and regulations that uses or stores PFAS in its operations and for standards for the capture and disposal of PFAS.

Section 3 prohibits the use of class B firefighting foam that contains intentionally added PFAS in certain aircraft hangars beginning January 1, 2023.

The act appropriates $43,836 from the hazardous waste service fund to the department of public health and environment for use by the hazardous materials and waste management division.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The bill adds definitions for "peer support professional" and "recovery support services organization" for the purposes of permissible claims submitted for reimbursement under the medical services program. A recovery support services organization (recovery organization) may bill and submit for reimbursement certain eligible peer support services (support services) provided by peer support professionals. The department of human services (department) is responsible for approving a recovery support services organization for reimbursement for support services. The bill sets forth detailed criteria for approval by the department, and the department is given rule-making authority to establish other criteria and standards as necessary.

The bill creates a refundable income tax credit available for income tax years commencing on or after January 1, 2021, but before January 1, 2031, for eligible peer support professionals (eligible individuals) who have worked in Colorado at least part-time for at least 3 years in the behavioral health sector and who either return to school or who graduate and return to work in the public or private health care sector. The tax credit is available for 4 consecutive years for eligible individuals who return to school and for 3 consecutive years for eligible individuals who return to work after attending school. The office of behavioral health in the department of human services (office) shall, in conjunction with the department of human services, review documentation supplied by eligible individuals seeking the tax credit and provide certification to the department of revenue if eligibility criteria for the tax credit is met. The office may not issue tax credit certificates that total more than $100,000 per income tax year.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill prohibits a landlord of a mobile home park or a residential premises (landlord) from:

• Charging a tenant or mobile home owner a late fee for late payment of rent unless the rent payment is late by at least 14 calendar days;
• Charging a tenant or mobile home owner a late fee in an amount that exceeds the greater of:
• $20; or
• The lesser of 3% of the tenant's or home owner's monthly rent obligation or 3% of the amount of the rent obligation that remains due;
• Removing, excluding, or initiating eviction procedures against a tenant or mobile home owner solely as a result of the tenant's or mobile home owner's failure to pay late fees;
• Imposing a late fee on a tenant for the late payment or nonpayment of any portion of the rent for which a rent subsidy provider, rather than the tenant, is responsible for paying;
• Imposing a late fee more than once for each late payment;
• Requiring a tenant or mobile home owner to pay interest on late fees; or
• Recouping any amount of a late fee from a rent payment made by a tenant or mobile home owner.

A landlord may recoup one or more late fees from a tenant or mobile home owner's security deposit if the payment of each late fee is no more than 180 days overdue and the landlord provides written notice to the tenant or mobile home owner that the landlord has recouped each late fee from the tenant or mobile home owner's security deposit.

A landlord shall not require a tenant or mobile home owner to pay any fee or other charge other than the rent; except that a landlord may require a tenant or mobile home owner to pay a use-based fee that is described in the rental agreement.

If a landlord provides to a tenant or mobile home owner a utility service that is not individually metered, the landlord shall include the cost of the utility service in the tenant's or mobile home owner's rent and charge the actual cost of the utility service on a uniform basis to all tenants or mobile home owners who receive the service.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill establishes a parent's bill of rights that sets forth specific parental rights related to directing the upbringing, education, and health care of a minor child.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill requires a court to sentence an adult or a juvenile who is convicted as an adult who commits the felony offenses of possession of a weapon by a previous offender or unlawfully carrying a weapon on school grounds to the department of corrections for a term of incarceration. The bill clarifies that a sentence for a second or subsequent offense for possession of a weapon by a previous offender, when the weapon involved is a dangerous weapon or when the prior conviction or adjudication was for burglary, arson, or any felony involving the use of force or the use of a deadly weapon, runs consecutively with any prior sentences being served by the offender.
(Note: This summary applies to this bill as introduced.)

Fiscal Note

The act enacts the "Colorado Building Families Act", which requires health benefit plans issued or renewed in Colorado on or after January 1, 2022, to cover diagnosis of infertility, treatment for infertility, and fertility preservation services. The coverage for fertility medications must not impose any limits that are not applicable to coverage under the plan for other prescription medications, and the plan cannot impose deductibles, copayments, coinsurance, benefit maximums, waiting periods, or other limitations that are not applicable to other medical services covered under the plan. A religious employer may request an exclusion from the infertility coverage in a health benefit plan offered by the religious employer if the coverage conflicts with the religious organization's bona fide religious beliefs and practices.

The act directs the division of insurance to make a determination as to whether the coverage required by the act is in addition to essential health benefits required by the federal "Patient Protection and Affordable Care Act" (Affordable Care Act) and would be subject to defrayal by the state pursuant to the Affordable Care Act. The division is to seek confirmation of its determination from the federal department of health and human services, and the coverage applies and is to be implemented by the division in health benefit plans issued or renewed on or after January 1, 2022, if the division receives confirmation that the coverage is not an additional benefit or if the federal department fails to respond in a timely manner.

The act appropriates $3,337 from the division of insurance cash fund to the division of insurance in the department of regulatory agencies for personal services to implement the act.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

Section 1 of the bill enacts the "Colorado Prescription Drug Price TransparencyAct of 2020", which requires:

• Health insurers, starting in 2021, to submit to the commissioner of insurance (commissioner) information regarding prescription drugs covered under their health insurance plans that the health insurers paid for in the preceding calendar year, including information about rebates received from prescription drug manufacturers, a certification regarding how rebates were accounted for in insurance premiums, and a list of all pharmacy benefit management firms (PBMs) with whom they contract;
• Prescription drug manufacturers to notify the commissioner, state purchasers, health insurers, PBMs, pharmacies, and hospitals when the manufacturer, on or after January 1, 2021, increases the price of certain prescription drugs by more than specified amounts or introduces a new specialty drug in the commercial market;
• Prescription drug manufacturers, within 15 days after the end of each calendar quarter that starts on or after January 1, 2021, to provide specified information to the commissioner regarding the drugs about which the manufacturer notified purchasers;
• Health insurers or, if applicable, PBMs to annually report specified information to the commissioner regarding rebates and administrative fees received from manufacturers for prescription drugs they paid for in the prior calendar year and the average wholesale price paid for prescription drugs by individuals, small employers, and large employers enrolled in health plans issued by the health insurer or that contain prescription drug benefits managed or administered by the PBM; and
• Certain nonprofit organizations to compile and submit to the commissioner an annual report indicating the amount of each payment, donation, subsidy, or thing of value received by the nonprofit organization or its officers, employees, or board members from a prescription drug manufacturer, PBM, health insurer, or trade association and the percentage of the nonprofit organization's total gross income that is attributable to those payments, donations, subsidies, or things of value.

The commissioner is required to post the information received from health insurers, prescription drug manufacturers, PBMs, and nonprofit organizations on the division of insurance's website, excluding any information that the commissioner determines is proprietary. Additionally, the commissioner, or a disinterested third-party contractor, is to analyze the data reported by health insurers, prescription drug manufacturers, PBMs, and nonprofit organizations and other relevant information to determine the effect of prescription drug costs on health insurance premiums. The commissioner is to publish a report each year, submit the report to the governor and specified legislative committees, and present the report during annual "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearings. The commissioner is authorized to adopt rules as necessary to implement the requirements of the bill.

Health insurers that fail to report the required data are subject to a fine of up to $10,000 per day per report. Nonprofit organizations are subject to a fine of up to $10,000 for failure to comply with reporting requirements.

Section 2 specifies that failing to ensure that a PBM that a health insurer uses to manage or administer its prescription drug benefits is complying with reporting requirements constitutes an unfair method of competition and an unfair or deceptive act or practice in the business of insurance.

Section 3 specifies that a PBM is an entity that manages or administers prescription drug benefits for a health insurer, either pursuant to a contract or as an entity associated with the health insurer.

Under sections 4 and 5 , a prescription drug manufacturer that fails to notify purchasers or fails to report required data to the commissioner is subject to discipline by the state board of pharmacy, including a penalty of up to $10,000 per day for each day the manufacturer fails to comply with the notice or reporting requirements. The commissioner is to report manufacturer violations to the state board of pharmacy.

Section 6 requires a health insurer to reduce premiums for the health plans it issues or renews on or after January 1, 2022, to adjust for the rebates the health insurer received from prescription drug manufacturers in the previous plan year.
(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill creates tax incentives to encourage employers to voluntarily support paid parental and medical leave programs for their eligible employees and to encourage eligible employees to save for time away from work during parental and medical leave.

Specifically, section 2 of the bill establishes leave savings accounts. A leave savings account is an account with a financial institution for which the individual uses money to pay for any expense while he or she is on eligible leave, which includes:

• The birth of a child of the individual and caring for the child;
• The placement of a child with the individual for adoption or foster care;
• Caring for a spouse, child, or parent of the individual if the spouse, child, or parent has a serious health condition;
• A serious health condition that makes the individual unable to perform the functions of the position of the individual;
• Time for an individual to care for himself or herself or to care for a parent or child after being a victim of domestic abuse; or
• Any qualifying exigency, as determined by the United States secretary of labor, arising out of the fact that a spouse, child, or parent of the individual is on covered active duty, or has been notified of an impending call or order to covered active duty, in the United States armed forces.

An individual may annually contribute up to $5,000 of wages to a leave savings account. An employer may make a contribution to the employee's leave savings account in any amount. The department of health care policy and financing is required to establish a form for an individual to report information regarding leave savings accounts, and the individual must annually file this form with the department of revenue to be eligible for the tax benefit.

Section 3 allows an employee to claim a state income tax deduction for amounts they or their employer contribute to a leave savings account. A taxpayer is also allowed to deduct any interest or other income earned during the taxable year on the investment of money in their leave savings account.

Section 4 creates an income tax credit for an employer that pays an employee for leave that is between 8 and 12 weeks long. The leave must be for one of the same reasons for which an employee may use money in a leave savings account as specified above. The amount of the credit is equal to 15% of the amount paid, so long as the amount paid is at least 50% of the employee's regular salary for a specified time period.

Section 4 also creates an income tax credit for an employer that contributes to an employee's leave savings account. The amount of the credit is equal to 15% of the amount contributed to the account; except that a credit is not allowed for contributions to a leave savings account that exceed $3,000 in a single year.

Both credits are not refundable, but they may be carried forward up to 5 years.

The bill also specifies that for employers, an amount equal to the amount the taxpayer contributed to an employee's leave savings account and an amount equal to the amount the taxpayer paid in wages for an employee while on family leave, to the extent an income tax credit is claimed, will be added to the taxpayer's federal taxable income.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The act makes various changes and additions to the existing "Mobile Home Park Act" and "Mobile Home Park Act Dispute Resolution and Enforcement Program" (program).

The act clarifies provisions relating to notices that the management of a mobile home park (management) is required to provide to a home owner in the mobile home park (home owner) when management intends to terminate the home owner's tenancy in the mobile home park (park). The time a home owner has to cure certain instances of noncompliance is increased from 30 days to 90 days, and this 90-day period to cure runs concurrently with the period to sell the mobile home or remove it from the premises, which is increased from 60 to 90 days.

The act restates, with amendments, the permissible reasons for which management may terminate a home owner's tenancy and the notice requirements associated with a termination. Currently, management may terminate a home owner's tenancy if the homeowner's conduct constitutes an annoyance to other homeowners or interference with management. The act eliminates this as a permissible reason for termination of tenancy. When a landlord intends to change the use of the land on which a park sits, and the change will result in eviction of the home owners, the amount of prior notice that the landlord is required to provide to the home owners is increased from 6 months to 12 months. A notice to quit tenancy and a notice of nonpayment of rent must include language notifying a home owner of the home owner's right to file a complaint through the program.

Currently, management may charge an amount up to 2 month's rent as a security deposit for a multiwide unit. The act reduces the amount to no more than one month's rent.

The act clarifies management's duties concerning maintenance and repair of a park and creates new duties relating to the maintenance and repair of water, sewer, and other utility service lines or related connections. Management must annually provide certain information concerning water usage and billing to home owners and post the information in a clearly visible location in at least one common area of the park. If management charges home owners for water usage in the park, management must provide each home owner a monthly water bill showing the amount owed by the home owner, the total amount owed by all home owners in the park, the methodologies used to determine the amount billed to each home owner, and, if management purchases the water from a provider, the total amount paid by management to the provider.

The act prohibits management from taking retaliatory action against a home owner who exercises any right conferred upon the home owner by law. An action by management is presumed to be retaliatory if the action was taken within 120 days after the home owner made an effort to secure or enforce the home owner's rights, and management may rebut a presumption of retaliation with sufficient evidence that an action was taken against the home owner for a nonretaliatory purpose.

The act allows management to add or amend rules and regulations only after acquiring the consent of each home owner or after providing written notice of the amendment to each home owner at least 60 days before the amendment becomes effective. A home owner may file a complaint challenging a rule, regulation, or amendment pursuant to the program within 60 days after receiving the notice. If a home owner files a complaint, and the new or amended rule or regulation will increase a cost to the home owner in an amount equal to or exceeding 10% of the home owner's monthly rent obligation under the rental agreement, management may not enforce the rule, regulation, or amendment unless and until the parties reach an agreement concerning the rule, regulation, or amendment or the dispute resolution process concludes with a written determination that the rule, regulation, or amendment may be enforced.

The act requires management to respect the privacy of home owners. Management has a right of entry to the land upon which a mobile home is situated for the maintenance of utilities and to ensure compliance with applicable codes, statutes, ordinances, administrative rules, rental agreements, and the rules of the community. A landlord shall not make entry in a manner that interferes with a home owner's peaceful enjoyment of the land except in the case of an emergency. Except when posting notices that are required by law or by a rental agreement, management shall make a reasonable effort to notify a home owner of management's intention to make entry at least 48 hours before making entry.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The act gives home owners in a mobile home park the opportunity to make an offer to buy the park if the landlord anticipates selling it or changing the use of the land. A landlord must give notice of a pending sale to the home owners, the applicable municipality or county, the division of housing in department of local affairs, and each home owners' association, residents' association, or similar body that represents the residents of the park. A landlord must give notice of a pending change of use of the land to all home owners of the park at least 12 months before the change of use occurs. After receiving notice of a pending sale or change of use, home owners have 90 days to make an offer to purchase and arrange financing if necessary. A purchase may be made by an association representing at least 51% of the home owners. The landlord may request that information relating to any pending offer be kept confidential and, if the landlord so requests, the association is required to do so.

If a sale of a mobile home park occurs and the home owners are not the buyers, the landlord must send the municipality or county and the division of housing an affidavit of compliance with the requirements of the act.

The notice and purchase-option provisions do not apply if the proposed sale is to a family member of the landlord, another closely affiliated person or entity, or someone who is already a cotenant of the property or if a transfer occurs due to inheritance or eminent domain.
(Note: This summary applies to this bill as enacted.)

Fiscal Note

The act implements the recommendations of the department of regulatory agencies in its sunset review and report on the regulation of naturopathic doctors as follows:

• Continues the regulation of naturopathic doctors by the department of regulatory agencies for 9 years, until September 1, 2029; and
• Provides immunity from liability for the director of the division of professions and occupations (director), division staff, consultants, and complainants in any civil action brought against the individual for acts occurring while the individual is acting in the individual's capacity as director, board member, staff, consultant, or witness, respectively.

The act also:

• Requires that of the 3 doctors of medicine or osteopathy who serve on the naturopathic medicine advisory committee (committee), one must be a pediatrician and one must be a member of a statewide multispecialty medical society;
• Requires the committee to meet at least once each year and tasks the committee with reviewing the naturopathic doctor formulary, making recommendations to the director on additions to the formulary, and discussing issues of importance to naturopathic doctors and their patients;
• Allows the director to make additions to the naturopathic formulary; and
• Prohibits a person who is not registered as a naturopathic doctor from using any title that implies the person is registered or licensed as a naturopathic doctor.
  (Note: This summary applies to this bill as enacted.)

Fiscal Note

The act creates the Colorado affordable health care coverage easy enrollment program (program) for the purpose of leveraging the tax filing process to connect uninsured Coloradans to free or subsidized health care coverage through a health care coverage affordability program, which includes medicaid, the children's basic health plan, or a subsidized health benefit plan, or other creditable coverage. The program will allow Coloradans to request on their state income tax returns that the Colorado health benefit exchange (exchange) assess whether uninsured household members are potentially eligible for free or subsidized health care coverage. If the tax filer requests that the eligibility of uninsured household members be assessed under the program, the tax filer will receive information about coverage options and assistance with enrollment.

The act creates the affordable health care coverage easy enrollment advisory committee (advisory committee) to guide implementation of the program. The advisory committee is co-chaired by the executive director of the exchange and the executive director of the department of revenue (department), or their designees, and consists of the following 9 members, appointed by the board of directors of the exchange:

• A representative of the department of health care policy and financing;
• A representative of the division of insurance in the department of regulatory agencies;
• A representative of consumer advocacy groups;
• A representative of small employers;
• A representative of insurers;
• A health care consumer;
• A health coverage guide or other person with expertise in the process of applying for federal insurance or assistance;
• An insurance producer; and
• A tax preparer.

If the exchange verifies that the uninsured individual is a United States citizen, the exchange, through procedures determined by the advisory committee, will assess whether uninsured individuals identified through the program are potentially eligible for a health care coverage affordability program or other creditable coverage, notify uninsured individuals about their potential eligibility, and enroll or assist with enrolling uninsured individuals in creditable coverage.

The department is required to implement the tax forms and schedules created by the advisory committee and to share the tax information gathered, as authorized by individual tax filers, with the exchange.

The executive director of the department is required to promulgate rules to implement the new tax forms and schedules and to implement the authorized sharing of the tax information provided on the state individual income tax return forms for the purpose of enrolling uninsured individuals in a health care coverage affordability program.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The bill requires the department of education (department) to give preference to grant applicants that articulate a strong, comprehensive approach to significantly reduce the use of school policing, school resource officers, and invasive security technologies and practices, and implement evidence-based or promising practices designed to promote school safety and healthy learning environments. The department shall also give preference to grant applicants that demonstrate the applicant's current use of evidence-based or promising practices designed to promote school safety and healthy learning environments.

The preference criteria only applies to the student re-engagement grant program, the expelled and at-risk student services grant program, the school bullying prevention and education grant program, and the behavioral health care professional matching grant program.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill creates the "Vaccine Consumer Protection Act" (Act), which Act:

• Requires health care providers and health care facilities to provide vaccine information to patients;
• Requires health care providers and health care facilities that recommend or administer a vaccine to a patient to ensure that the patient or the patient's parent or guardian completes a vaccination contraindication checklist created by the state board of health;
• Requires health care providers and health care facilities to report vaccine adverse events to the federal vaccine adverse event reporting system;
• Prohibits health care providers and health care facilities from recommending or administering a vaccine to a patient who is under 18 years of age without the consent of the patient's parent or guardian;
• Prohibits health care providers, health care facilities, health insurers, and schools from treating people who delay or decline vaccinations differently than people who have received vaccinations;
• Authorizes the assessment of fines for violations of the Act; and
• Requires the department of public health and environment to post specific vaccine information on its website.
  (Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill phases out sub-minimum wage employment for employers that hold a special certificate from the United States department of labor that authorizes employers to pay employees whose earning capacity is impaired by age, physical or mental deficiency, or injury less than the minimum wage. The bill requires each employer that holds a special certificate to submit a transition plan to the Colorado department of labor and employment detailing how the employer plans to phase out sub-minimum wage employment.

The bill requires the employment first advisory partnership in the department of labor and employment to develop actionable recommendations to address structural and fiscal barriers to phase out sub-minimum wage employment and successfully implement competitive integrated employment and report the recommendations to the general assembly.

The bill requires the department of health care policy and financing to grant money to private employers, not to exceed $25,000 per employer, to provide assistance in developing and implementing a transition plan to phase out sub-minimum wage employment. The bill requires the department of health care policy and financing to add employment-related services for individuals with intellectual and developmental disabilities.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

Upon the issuance of a protection order, the court shall:

• Require the person to state in court or complete an affidavit in court stating the number of firearms in the person's immediate possession or control and the location of all firearms in the person's immediate possession or control;
• Require the person to complete a firearm information form that states the number of firearms in the person's immediate possession or control or subject to the person's immediate possession or control, the type of each firearm, and the location of each firearm; and
• Transmit a copy of the protection order and the firearm information form to the sheriff of the county of the person's residence.

The bill prohibits any full and truthful statements made to the court regarding the number of firearms in the person's immediate possession or control or subject to the person's immediate possession or control and the location of the firearms from being used against the person in any other civil or criminal proceedings.

The bill excludes legal holidays and weekends from the current time frame a person has to relinquish a firearm. The bill allows a court to grant a person an additional 24 hours to relinquish a firearm if the person is unable to comply with the required time frame of relinquishment.

Current law requires a person to either sell or transfer possession of the firearm, arrange for the storage of the firearm by a law enforcement agency, or sell or transfer the firearm to a private party who may legally possess the firearm. The bill requires a private party to complete a firearms acknowledgment form that informs the private party of the relevant state and federal laws, lists the consequences of noncompliance, and asks if the private party is able to legally possess a firearm. The bill prohibits the person from transferring the firearm to a private party living in the same residence as the person at the time of transfer.

The bill requires the court to conduct a hearing to ensure the person has complied with the relinquishment requirements. Failure to appear at the hearing constitutes a violation of the protection order, and the court may issue a warrant for the person's arrest or a search warrant of the person's residence.

The bill requires a person who does not possess a firearm at the time the order is issued to complete a declaration of nonpossession form in court. If the person possessed a firearm at the time of the qualifying incident giving rise to the duty to relinquish the firearm but sold or transferred the firearm to a private party prior to the issuance of the protection order, the person shall disclose the sale or transfer in court.

The bill requires a federally licensed firearms dealer, law enforcement agency, or private party to issue a signed affidavit memorializing the sale or transfer of the firearm.

The bill allows a law enforcement agency to enter into an agreement with any other law enforcement agency to assume the duties of the sheriff. If a law enforcement agency elects to store a firearm, the bill allows the law enforcement agency to seek a matching incentive fee from the department of public safety on an annual basis in an amount equal to the total amount charged by the agency for providing storage of a firearm. The matching fee must be used to maintain or increase firearm storage capacity. The bill requires a sheriff who elects to store a firearm to obtain a search warrant prior to testing or examining the firearm to facilitate any criminal investigation or prosecution.

The bill prohibits a private party from returning a firearm to the person until the private party receives a written statement of the results of the background check conducted by the bureau authorizing the return of the firearm to the person.

Current law requires a copy of the written receipt and the written statement of the background check to be filed with the court as proof of relinquishment. The bill requires the signed affidavit to be filed with the court instead of the receipt. Both the signed affidavit and written statement are only available for inspection by the court and the parties to the proceeding.

A federally licensed firearms dealer, law enforcement agency, or private party that elects to store a firearm is not civilly liable for any resulting damages to the firearm, as long as such damage did not result from the willful and wrongful act or gross negligence of the person or agency storing the firearm.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill amends existing law relating to the administration of epinephrine auto-injectors to include permitting public schools to obtain a stock supply of inhalers containing albuterol (inhaler) that the school nurse or trained school personnel may administer to a student who the school nurse or trained personnel believe is experiencing respiratory distress. Persons administering an inhaler must complete training on administering an inhaler and on recognizing symptoms of respiratory distress.

The state board of education, with assistance from the department of public health and environment, shall promulgate rules for the administration of inhalers to students, including education and training necessary for personnel administering inhalers.

The inhalers may be obtained and used through standing orders and protocols issued by a licensed physician and other medical personnel with prescriptive authority. Schools may seek monetary donations to purchase inhalers and may enter into arrangements with manufacturers and suppliers to obtain inhalers at reduced prices or for free.

If a school district acts consistent with the law and does not engage in willful or wanton conduct that causes damages, the school, school district, and school employees are immune from civil liability for any damages related to administering the inhaler to a student who was believed to be in respiratory distress.

In addition, the bill amends existing law relating to the administration of epinephrine auto-injectors outside of school settings to include permitting authorized entities, such as recreation camps, amusement parks, and sports arenas, to obtain a stock supply of inhalers containing albuterol to administer to persons believed to be in respiratory distress. Persons administering the inhalers for authorized entities must complete training on administering an inhaler and on recognizing symptoms of respiratory distress.

The inhalers may be obtained and used through standing orders and protocols issued by a licensed physician and other medical personnel with prescriptive authority. Authorized entities may seek monetary donations to purchase inhalers.

If an authorized entity acts consistent with the law and does not engage in willful or wanton conduct that causes damages, the authorized entity and its employees are immune from criminal liability or civil suit for any damages related to administering the inhaler to a person who was believed to be in respiratory distress.

A physician, school nurse, pharmacist, and other medical personnel acting in accordance with the law are not subject to discipline by a licensing board for either administering an inhaler in a school or for prescribing inhalers for a school or a designated entity.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill creates a regulatory and service system to provide secure transportation services, with different requirements than traditional ambulance services, for individuals experiencing a behavioral health crisis. Mobile crisis services, units linked to the walk-in crisis services, and crisis respite services may arrange for secure transportation in response to a behavioral health crisis. The department of human services shall allow for the development of secure transportation alternatives.

The board of county commissioners of the county in which the secure transportation service is based (commissioners) shall issue a license to an entity (licensee), valid for one year, that provides secure transportation services if the minimum requirements set by rule by the state board of health are met or exceeded. The commissioners shall also issue operating permits, valid for 12 months following issuance, to each vehicle operated by the licensee. A fee may be charged for each license to reflect the direct and indirect costs to the applicable county in implementing secure transportation services licensure. The state board of health is given authority to promulgate rules concerning secure transportation licensure.

The department of health care policy and financing is directed to create and implement a secure transportation benefit on or before January 1, 2022.

Language is added to exempt secure transportation services from regulation under the public utilities commission.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill replaces the term "illegal alien" with "undocumented immigrant" "unauthorized worker" as it relates to public contracts for services.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Fiscal Note

The act adds language to Colorado's children's code to clarify that refusing an immunization on the grounds of medical, religious, or personal belief considerations or opting to exclude immunization notification information from the immunization tracking system does not alone constitute child abuse or neglect.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

For the local school food purchasing program, the act:

• Makes technical changes to when a local education provider may apply to the program and when the department of education (department) selects providers;
• Requires the department to ensure geographic and district pupil size diversity among providers;
• Changes the limit for the number of lunches that all local education providers provided in the prior year to 10 million;
• Changes the reimbursement formula to $0.05 for every meal that the local education provider provided in the previous year; and
• Specifies that if the department does not spend the full appropriation for the program, up to 5% of the appropriation is available to the department in the following year to pay for the required evaluation and report.
  (Note: This summary applies to this bill as enacted.)

Fiscal Note

The act creates a requirement that of the 90 hours of professional development training currently required for renewal of a teacher's license during the term of the teacher's license, at least 10 of those hours must include some form of behavioral health training that is culturally responsive and trauma- and evidence-informed and increases awareness of laws and practices relating to educating students with disabilities in the classroom, including child find and inclusive learning environments. The 10 clock hours may be obtained by any combination of related courses, so long as at least 1 of the 10 clock hours is related to behavioral health training and at least 1 of the 10 clock hours is related to educating students with disabilities in the classroom.

The act requires teacher preparation programs to include in program graduation requirements that each teacher candidate in an initial educator licensure program complete at least 1 semester- or quarter-length course in behavioral health training that is culturally responsive and trauma- and evidence-informed.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The bill directs the state department of health care policy and financing (department) to issue a request for proposals to contract with a vendor to provide a comprehensive care coordination and treatment training model (model) for persons with intellectual and developmental disabilities and co-occurring behavioral health needs. The selected vendor must be able to provide the model using teleconferencing formats to better reach rural areas of the state. Community-centered boards, mental health centers, and program-approved service agencies shall nominate up to 20 providers to receive the training. The department may select an additional 10 providers from underserved areas of the state to receive the training.
(Note: This summary applies to this bill as introduced.)

Fiscal Note

On and after September 1, 2020, the bill prohibits the sale of flavored cigarettes, tobacco products, and nicotine products, including flavored electronic cigarettes, and products intended to be added to cigarettes, tobacco products, or nicotine products to produce a flavor other than tobacco.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The act creates the occupational credential portability program (program) in the division of professions and occupations within the department of regulatory agencies, which permits a member of a regulated profession or occupation from another jurisdiction to obtain licensure, certification, registration, or enrollment in the profession or occupation in this state by endorsement, reciprocity, or transfer. The program is available to members of business and health care professions and occupations regulated by the division and the regulatory boards in the division for which licensure, certification, registration, or enrollment by endorsement is permitted under current law; except that the following professions and occupations are specifically excluded from the program:

• Combative sports;
• Electricians;
• Fantasy contests;
• Mortuaries and crematories;
• Nontransplant tissue banks;
• Outfitters and guides;
• Passenger tramway operators;
• Plumbers;
• Private investigators;
• Direct-entry midwives; and
• Surgical assistants and surgical technologists.

Under the program, the director of the division and most regulatory boards and commissions within the division (regulators) are required to strive to reduce certification, registration, licensure, and enrollment barriers for applicants and to adopt rules to establish the program in the least burdensome way necessary to protect the public.

The act also relocates the existing occupational credential exemption for military spouses to the new occupational credential portability program and modifies the exemption by specifying that the exemption is valid for 3 years and applying the exemption to all members of business and health care professions and occupations regulated by the division and the regulatory boards in the division.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The act adds discrimination based on source of income as a type of unfair housing practice. "Source of income" is defined to include any source of money paid directly, indirectly, or on behalf of a person, including income from any lawful profession or from any government or private assistance, grant, or loan program.

A person is prohibited from refusing to rent, lease, show for rent or lease, or transmit an offer to rent or lease housing based on a person's source of income. In addition, a person cannot discriminate in the terms or conditions of a rental agreement against another person based on source of income, or based upon the person's participation in a 3rd-party contract required as a condition of receiving public housing assistance. A person cannot include in any advertisement for the rent or lease of housing any limitation or preference based on source of income, or to use representations related to a person's source of income to induce another person to rent or lease property. The restrictions do not apply to a landlord with 3 or fewer rental units. A landlord who owns 5 or fewer single family rental homes, and no more than 5 total rental units including any single family rental homes, is not required to accept federal housing choice vouchers for the single family homes.

A landlord is not prohibited from checking the credit of prospective tenant. Checking the credit of a prospective tenant is not an unfair housing practice if the landlord checks the credit of every prospective tenant.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The bill requires tanning facility owners, operators, or employees of owners and operators to obtain from first-time users and retain on file a signed acknowledgment of the risks associated with using artificial tanning devices. Additionally, the bill prohibits owners, operators, or employees from allowing a minor who is under 18 years of age to use an artificial tanning device. A person who violates either of these requirements is subject to a penalty of $250 for the first violation and $500 for each subsequent violation.
(Note: This summary applies to this bill as introduced.)

Fiscal Note

Beginning January 1, 2022, the bill requires a health insurance carrier (carrier) that offers an individual health benefit plan in this state to offer a Colorado option plan in the Colorado counties where the carrier offers the individual health benefit plan. The commissioner of insurance (commissioner) is required to develop and implement a Colorado option plan that must:

• Be offered to Colorado residents who purchase health insurance in the individual market;
• Implement a standardized plan that:
• Allows consumers to easily compare health benefit plans; and
• Provides first-dollar, predeductible coverage for certain services;
• Include the essential health benefits package;
• Provide different, specific levels of coverage;
• Include a hospital reimbursement rate formula;
• Require hospital participation;
• Require a minimum medical loss ratio of 85%; and
• Require carriers and pharmacy benefit management firms to pass rebate savings through to consumers and document the savings and pass-through in a form and manner determined by the commissioner.

The Colorado option advisory board (board) is created to advise and make recommendations to the commissioner on all aspects of the Colorado option plan.

The bill authorizes the commissioner to promulgate rules to develop, implement, and operate the Colorado option plan, including:

• Expanding the Colorado option plan to the small group market;
• Establishing a hospital reimbursement rate formula; and
• Requiring carriers to offer the Colorado option plan in specific counties.

If a hospital refuses to participate in the Colorado option plan, the department of public health and environment may issue a warning, impose fines, or suspend, revoke, or impose conditions on the hospital's license.

The commissioner, in consultation with the board, is required to evaluate the Colorado option plan beginning July 1, 2024, and each year thereafter.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill clarifies that the existing authority of cities and counties (local governments) to plan for and regulate the use of land includes the authority to regulate development or redevelopment in order to promote the construction of new affordable housing units. The provisions of the state's rent control statute do not apply to any land use regulation that restricts rents on newly constructed or redeveloped housing units as long as the regulation provides a choice of options to the property owner or land developer and creates one or more alternatives to the construction of new affordable housing units on the building site.
(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill creates the offense of unlawful storage of a firearm if a person stores a firearm in a manner that the person knows, or should know:

• That a juvenile can gain access to the firearm without the permission of the juvenile's parent or guardian; or
• A resident of the premises is ineligible to possess a firearm under state or federal law.

Unlawful storage of a firearm is a class 2 misdemeanor.

The bill requires licensed firearms dealers to provide with each firearm, at the time of a firearm sale or transfer, a locking device capable of securing the firearm. Transferring a firearm without a locking device is an unclassified misdemeanor punishable by a maximum $500 fine.

The bill requires the state court administrator to annually report to the general assembly about the number of charges related to safe firearms storage, and the disposition of those charges.

The bill requires the department of public health and environment to develop and implement a firearms storage education campaign to educate the public about the safe storage of firearms and state requirements related to firearms safety and storage. The bill creates the firearms safe storage education campaign fund (fund) in the state treasury. A voluntary contribution designation line for the fund will appear on the state individual income tax return form (form) for the 5 income tax years following the year that the executive director of the department of revenue certifies to the revisor of statutes that there is a space available on the form and the fund is next in the queue.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill requires an individual who owns a firearm to report the loss or theft of that firearm to a law enforcement agency within 48 hours after discovering that the firearm was lost or stolen. A first offense for failure to make such a report is a petty offense punishable by a twenty-five dollar fine and a second or subsequent offense is a class 3 misdemeanor. The 48-hour reporting requirement does not apply to a licensed gun dealer.

The bill requires a law enforcement agency that receives a report of a lost or stolen firearm to enter information about the lost or stolen firearm into the national crime information center database.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

Beginning when the higher federal match afforded through the federal "Families First Coronavirus Response Act" expires, the act reduces the adult dental benefit so that it does not exceed $1,000 per year for a participant.

From the savings from the reduction of the adult dental benefit in the medical assistance program, the act transfers $1,139,402 from the unclaimed property trust fund to the general fund in the 2020-21 fiscal year and $2,278,804 in the 2021-22 fiscal year. Furthermore, the act requires $331,462 to be appropriated from the healthcare affordability and sustainability fee cash fund to offset general fund expenditures for the state medical assistance program.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

Joint Budget Committee. Pursuant to the declaration of a state fiscal emergency (emergency declaration), for the 2020-21 fiscal year only, the bill expands the purposes for which tobacco tax revenues in the tobacco education programs fund and the prevention, early detection, and treatment fund may be used to include any health-related purpose and to serve populations enrolled in the children's basic health plan and the Colorado medical assistance program at the programs' respective levels of enrollment as of January 1, 2005.

Also pursuant to the emergency declaration, for the 2020-21 fiscal year only, the bill authorizes grantees under certain programs funded through tobacco tax revenue to use the grant money to investigate and control the spread of COVID-19.

The bill repeals an obsolete provision of law.

The bill makes and reduces certain appropriations.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The act refers a ballot issue to the voters at the November 2020 general election for the following tax changes:

• To increase the statutory per cigarette tax from 1 cent to 6.5 cents until July 1, 2024, then to 8 cents until July 1, 2027, and thereafter to 10 cents;
• To increase the statutory tobacco products tax from 20% of the manufacturer's list price (MLP) to 30% of MLP until July 1, 2024, then to 36% of MLP until July 1, 2027, and to 42% thereafter of MLP for tobacco products;
• To create a tax on nicotine products that is equal to 50% of MLP until July 1, 2024, then 56% of MLP until July 1, 2027, and thereafter 62% of MLP, which is the same tax as the total tax levied on most tobacco products, including the tax from Amendment 35, with the increase;
• To establish a tax rate for cigarettes, tobacco products, and nicotine products that are modified risk tobacco products approved by the United States department of health and human services that is 50% of the statutory tax rate;
• To establish a minimum tax for tobacco products that are moist snuff;
• To expand the cigarette and tobacco products taxes to include delivery sales made by a seller outside of the state directly to a consumer; and
• To create an inventory tax on cigarettes that is imposed on all stamped cigarettes and unaffixed stamps in a wholesaler or wholesale subcontractor's possession or control at the time of a tax increase that takes place after January 1, 2022.

If voters approve the ballot measure, then the state will have the authority to impose these taxes and the rest of the act will be effective.

The act also establishes a minimum price for cigarettes that is equal to $7 for a pack and $70 for a carton until July 1, 2024, and $7.50 for a pack and $75 for a carton on and after July 1, 2024, and civil penalties imposed for any person who sells cigarettes for less than the minimum amount. A portion of the sales tax revenue that is estimated to be attributable to the minimum price requirement is transferred from the general fund to the newly created preschool programs cash fund, from which the general assembly may appropriate money to a designated department to be used for an array of preschool education purposes.

The new nicotine products tax is modeled after the tobacco products tax. Nicotine products are products that contain nicotine and that are ingested into the body, which at this time is typically through vaping with an electronic cigarette. The excise tax is levied on the sale, use, consumption, handling, or distribution of all nicotine products in the state, and it is imposed on a distributor at the time the product is brought into the state, made here, or shipped or transported to retailers in the state, or the wholesaler or distributor makes a delivery sale. If a distributor fails to pay the tax, then any person or entity in possession of the nicotine products is liable for the tax.

To be a distributor of nicotine products, a person must have a license. The license costs $10 per year and requires that the distributor must have a tax license and comply with all of the laws relating to the collection of the tax. Distributors are required to file electronic quarterly returns. Licensees are required to maintain certain records, and retailers are likewise required to maintain records about nicotine products they purchase from a licensed distributor. The department of revenue may share the names and addresses of persons who purchased nicotine products for resale with the department of public health and environment and county and district public health agencies.

To account for the fully phased-in increased taxes per cigarette, the discount percentage on cigarette stamps that a cigarette wholesaler may retain for its collection costs is reduced from 4% to .4% and the similar discount for a tobacco products distributor is reduced from 3.33% to 1.6%. A nicotine products distributor will be permitted to retain 1.1% of the taxes collected.

The revenue from the new nicotine products tax, the inventory tax, and the additional cigarette and tobacco products taxes is deposited in the old age pension fund and then credited to the general fund in accordance with the state constitution. The state treasurer is required to transfer an amount equal to the total new tax revenue from the general fund to the 2020 tax holding fund (holding fund). For fiscal years beginning prior to July 1, 2023, the bulk of the money in the holding fund will be transferred to the state education fund, and thereafter, to the preschool programs cash fund. In addition, the state treasurer is required to transfer varying amounts of money in different fiscal years from the holding fund to the following funds:

• The tobacco tax cash fund;
• The general fund;
• The housing development grant fund;
• The eviction legal defense fund;
• The newly created rural schools cash fund, which will in turn be distributed to small and large rural school districts based on funded pupil counts; and
• The tobacco education programs fund.

The state auditor is required to annually conduct a financial audit of the use of the new tax revenue.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

School Safety Committee. The bill requires the department of education (department) to offer a train the trainer program (program) designed to improve school culture, promote youth behavioral and mental health, and prepare attendees to teach a youth behavioral and mental health training course. The department must make the program available to employees of a school district, charter school, or board of cooperative services (local education provider). A local education provider and its employees are not required to participate in the program. The department may enter into an agreement with an organization to provide the program. The department is required to annually evaluate the effectiveness of the program. The general assembly is required to annually appropriate up to $1 million for the program. The program is repealed June 30, 2024.

The program must include evidence-based instruction on, and prepare an attendee to teach a youth behavioral and mental health training course that includes, any of the following subjects:

• Using trauma-informed approaches to improve overall school climate and culture;
• Identifying behavioral and mental health challenges and substance use disorders;
• Restorative practices for addressing youth behavioral and mental health challenges;
• Improving youth social and emotional health;
• Bullying prevention and intervention strategies;
• Encouraging positive bystander behavior;
• Best practices for providing assistance in noncrisis situations;
• De-escalation of crisis situations; or
• Identifying and accessing available behavioral and mental health resources and substance use disorder support services and treatment.
  (Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill creates the "Get on Your Feet Student Loan Repayment Assistance Program" to provide no more than 24 monthly payments on a qualified loan on behalf of a qualified recipient.

A qualified recipient is required to satisfy eligibility and program participation requirements.

The department of higher education is required to administer the program pursuant to guidelines promulgated by the commission on higher education.

A person who received a program award but did not satisfy all eligibility and program participation requirements may be required to fully or partially reimburse the state.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The act requires insurance carriers to provide coverage for the treatment of substance use disorders in accordance with the American society of addiction medicine (ASAM) criteria for placement, medical necessity, and utilization management determinations in accordance with the most recent edition of the ASAM criteria. The act also authorizes the commissioner of insurance, in consultation with the department of human services (DHS) and the department of health care policy and financing, to identify by rule alternate nationally recognized substance-use-disorder-specific treatment criteria if the ASAM criteria are no longer available, relevant, or reflect best practices. These provisions apply to health benefits plans issued or renewed on or after January 1, 2022.

The act prohibits managed service organization contracted providers; withdrawal management services; and recovery residences from denying access to medical or substance use disorder treatment services, including recovery services, to persons who are participating in prescribed medication-assisted treatment for substance use disorders. In addition, the act prohibits courts and parole, probation, and community corrections from prohibiting the use of prescribed medication-assisted treatment as a condition of participation or placement.

The act requires managed care entities to provide coordination of care for the full continuum of substance use disorder and mental health treatment and recovery services, including support for individuals transitioning between levels of care.

The act authorizes the commissioner of insurance, in consultation with the department of public health and environment (CDPHE), to promulgate rules, or to seek a revision of the essential health benefits package, for prescription medications for medication-assisted treatment to be included on insurance carriers' formularies.

The act requires insurance carriers to report to the commissioner of insurance on the number of in-network providers who are licensed to prescribe medication-assisted treatment for substance use disorders, including buprenorphine, and the number of prescriptions for medication-assisted treatment filled by enrollees. Further, insurance carriers shall report on the carrier's efforts to ensure sufficient capacity for and access to medication-assisted treatment. The act requires the commissioner of insurance to promulgate rules concerning the reporting.

The act requires insurance carriers to provide coverage for at least one opiate antagonist.

The act consolidates part 1 of article 82 of title 27, Colorado Revised Statutes, relating to emergency treatment and voluntary and involuntary commitment of persons for treatment of drugs into the existing part 1 of article 81 of title 27 relating to emergency treatment and voluntary and involuntary commitment of persons for treatment of alcohol use disorders, in order to create a single process that includes all substances. The new scope of part 1 of article 81 of title 27 includes both alcohol use disorder and substance use disorder under the defined term "substance use disorder".The amendments and additions to part 1 of article 81 of title 27 include:

• Defining "administrator" to include an administrator's designee;
• Adding a definition of "incapacitated by substances" to include a person who is incapacitated by alcohol or incapacitated by substances;
• Changing terminology throughout that refer to "substances" to include both alcohol and drugs;
• Adjusting the duration of the initial involuntary commitment from 30 days to up to 90 days;
• Allowing a person to enter into a stipulated order for committed treatment, expediting placement into treatment;
• Removing the mandatory hearing for the initial involuntary commitment but allowing a person to request a hearing if the person does not want to enter into a stipulated order for committed treatment;
• Incorporating in statute "patient's rights" relating to civil commitment;
• Using person-centered language throughout the statutory process; and
• Relocating the existing opioid crisis recovery funds advisory committee from article 82 in title 27 to article 81 in title 27.

In addition, the act amends statutory references, including several in the professional licensing statutes in title 12, Colorado Revised Statutes, to remove references to both alcohol use disorder and substance use disorder as grounds for professional discipline, and replaces those terms with the single term "substance use disorder", which the act now defines in article 81 of title 27 to include both drugs and alcohol. The act also amends statutory references to provisions in part 2 of article 82 of title 27, which the act repeals and replaces those references with a new reference to the relevant provisions in article 81 of title 27.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

School Safety Committee. Current law requires school districts to adopt a written policy setting forth the school district's attendance requirements. The bill requires the policy to include excused absences for behavioral health concerns.
(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Fiscal Note

The act:

• Continues the opioid and other substance use disorders study committee (committee) for an additional 4 years, meeting every other year beginning in 2021;
• In addition to the existing areas of study, for the 2021 interim, requires the committee to study the relationship between mental health conditions and substance use disorders and the effect of COVID-19 on substance use disorders;
• Requires the state substance abuse trend and response task force to convene stakeholders for the purpose of generating policy recommendations related to opioid and other substance use disorders and reviewing progress on bills introduced by the committee and passed by the general assembly;
• Modifies how child abuse, neglect, or dependency is determined in situations involving alcohol or substance exposure; and
• Authorizes the statewide perinatal substance use data linkage project to conduct ongoing research related to the incidence of perinatal substance exposure or related infant and family health and human service outcomes based on the new standards for determining child abuse, neglect, or dependency when alcohol or substance exposure is involved.

$74,620 is appropriated from the general fund to the department of human services and reappropriated to the department of law to purchase legal services. The appropriation to the office of the governor, for use by the office of information technology for applications administration, is reduced by $74,620.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

An assistance unit that receives a basic cash assistance (BCA) payment from the Colorado works program at any time within one month after the effective date of the act shall receive a one-time $500 supplemental payment in addition to the amount of BCA an assistance unit currently receives. The one-time supplemental payment is not income for the purpose of any publicly funded program. The act prohibits the general assembly from appropriating more than $10 million for the one-time supplemental payments. If the one-time supplemental payment to each assistance unit exceeds $10 million, the one-time supplemental payment must be distributed evenly to each assistance unit.

Beginning July 1, 2021, and each fiscal year thereafter, the joint budget committee must review the sustainability of the Colorado long-term works reserve.

The act appropriates $8,424,500 to the department of human services from the federal temporary assistance for needy families block grant.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The bill directs the department of health care policy and financing (state department), or a third party with whom the department contracts, to collect, analyze, and report prescription drug production cost data regarding the 20 highest-cost prescription drugs per course of therapy and the 20 highest-cost prescription drugs by volume that were purchased or paid for by the departments of corrections, human services, personnel, and health care policy and financing (departments) during the 2019-20 and future state fiscal years. Upon receipt of a list of the highest-cost prescription drugs purchased or paid for by the departments, the state department or its designated contractor, as applicable, is directed to request from the manufacturers of the drugs on the list information showing the basis for and components of the wholesale acquisition cost (WAC) of each drug on the list.

The state department or its designated contractor, as applicable, is to analyze the data received from drug manufacturers and report its findings regarding the basis for the WAC for each prescription drug on the list, specifying the percentage of the WAC that is attributable to each component driving the WAC. The state department is required to provide an annual prescription drug price transparency report by December 1, 2021, and each December 1 thereafter to specified legislative committees. The state department and its designated contractor, as applicable, are required to maintain the confidentiality of any proprietary information received from a drug manufacturer, and that information is exempt from the "Colorado Open Records Act".

The executive director of the state department is authorized to adopt rules as necessary to implement and administer the bill. A manufacturer that fails to report the required information is subject to a civil penalty of up to $10,000 per day.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill creates the "Immigrant Tenant Protection Act" (Act), which prohibits a landlord from:

• Demanding, requesting, or collecting information regarding or relating to the immigration or citizenship status of a tenant;
• Disclosing or threatening to disclose information regarding or relating to the immigration or citizenship status of a tenant to any person, entity, or immigration or law enforcement agency;
• Harassing, intimidating, or retaliating against a tenant for exercising the tenant's rights or opposing prohibited conduct;
• Interfering with a tenant's rights, including influencing or attempting to influence a tenant to surrender possession of a dwelling unit or to not seek to occupy a dwelling unit based solely or in part on the immigration or citizenship status of the tenant;
• Refusing to enter into a lease agreement or approve a subtenancy, or to otherwise preclude a tenant from occupying a dwelling unit, based solely or in part on the immigration or citizenship status of the tenant; and
• Bringing an action to recover possession of a dwelling unit based solely or in part on the immigration or citizenship status of a tenant.

The Act is enforceable through a private right of action.

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Fiscal Note

In 2019, the Colorado general assembly enacted, and the governor subsequently signed into law, the Canadian prescription drug importation program (program) in the department of health care policy and financing (department). The department is directed to request approval of the program on or before September 1, 2020, from the United States secretary of health and human services and to implement the program upon receipt of approval.

The bill states that the department may expand the program to allow a manufacturer, wholesale distributor, or pharmacy from a nation other than Canada to export prescription drugs into the state under the program if certain conditions are met.

If, upon the satisfaction of these conditions, the department decides to expand the program, the executive director of the department shall notify the president of the senate and the speaker of the house of representatives, as well as the health and human services committee of the senate and the health and insurance committee of the house of representatives, or any successor committees, of the department's intent to do so. The executive director shall provide the notice at least 30 days before the program is expanded, and the notice may include any recommendations of the department for legislation to amend the program to reflect its expansion.

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Fiscal Note

The bill requires the staff of the legislative council to prepare business fiscal impact notes (notes) on legislative bills in each regular session of the general assembly. The speaker of the house of representatives, the minority leader of the house of representatives, the president of the senate, and the minority leader of the senate are authorized to request 2 notes each, or more at the discretion of the director of research of the legislative council.

The bill requires the staff of the legislative council to meet with the member of leadership requesting the note and with the sponsor of the legislative bill to discuss whether a note can practically be completed for that legislative bill. If not, the member of leadership may request a note on a different legislative bill.

A business fiscal impact note is defined as a note that uses available data to analyze the potential direct economic effects of a legislative bill on Colorado businesses, including costs related to compliance, impacts on hiring or job losses, savings or cost reductions, and other fiscal impacts.

The bill requires the director of research of the legislative council to develop the procedures for requesting, completing, and updating the notes and to memorialize the procedures in a letter to the executive committee of the legislative council.

The staff of the legislative council must designate a 5-day period during which Colorado businesses can submit comments on the impacts of a legislative bill selected for the preparation of the note, or a shorter time if the bill is selected during the last 30 days of session. The staff must summarize and compile the comments as part of the note.

Finally, the legislative bill requires each state department, agency, or institution to cooperate with and provide information for a note of a legislative bill in the manner requested by the staff of the legislative council.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill creates the home visiting expansion grant program (grant program) in the department of human services (department). The purpose of the grant program is to expand the number of children and families served by nationally recognized, evidence-based home visiting models (models) throughout the state and thus improve school readiness of Colorado children. The grant program has 2 cycles of 3 years each and shall award up to a total of $2 million in grants for each cycle, payable in equal annual amounts.

The state board of human services is authorized to promulgate rules that specify the criteria for the grant program, including eligibility of applicants and models, timeline, and review and selection criteria.

The department is required to prepare an evaluation report at the conclusion of each grant cycle and present that report as part of its next "SMART Act" report to its committee of reference.

The grant program is repealed, effective September 1, 2028.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill repeals the Colorado reinsurance program in 2022 and limits the operation of the program to one benefit year.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The bill codifies a number of preventive health care services currently required to be covered by health insurance carriers pursuant to the federal "Patient Protection and Affordable Care Act" and adds them to the current list of services required to be covered by Colorado health insurance carriers, which services are not subject to policy deductibles, copayments, or coinsurance. The bill expands certain preventive health care services to include osteoporosis screening, urinary incontinence screening, and screening and treatment of a sexually transmitted infection (STI).

Current law requires a health care provider or facility to perform a diagnostic exam for an STI and subsequently prescribe treatment for an STI at the request of a minor patient. The bill allows a health care provider to administer, dispense, or prescribe preventive measures or medications where applicable. The consent of a parent is not a prerequisite for a minor to receive preventive care, but a health care provider shall counsel the minor on the importance of bringing the minor's parent or legal guardian into the minor's confidence regarding the services.

Current law requires the executive director of the department of health care policy and financing to authorize reimbursement for medical or diagnostic services provided by a certified family planning clinic. The bill defines family planning services and authorizes reimbursement for family planning services. The bill allows staffing by medical professionals to be accomplished through telemedicine.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

The act codifies a definition of "nonmedical exemption" to mean an immunization exemption based upon a religious belief whose teachings are opposed to immunizations or a personal belief that is opposed to immunizations.

The act requires the department of public health and environment (department) to develop standardized forms and a submission process for persons who want to claim a nonmedical exemption for an immunization for a religious or personal belief. A person who wants to claim a nonmedical exemption for an immunization can do so by submitting to the school either:

• A certificate of completion of the online education module; or
• A certificate of nonmedical exemption.

The act requires the department to annually evaluate the state's immunization practices, including an examination of best practices and guidelines recommended by the advisory committee on immunization practices. The state board of health may update the state's immunization practices pursuant to the annual evaluation.

The act creates a vaccinated children standard, whereby the immunization rate goal for every school is 95% of the student population to be vaccinated. The act requires the department to amend an immunization document it currently publishes annually to include information about the vaccinated children standard. Every school shall publish its immunization rate and exemption rate for the measles, mumps, and rubella vaccine on the document and annually distribute it to the parents, legal guardians, and students of the school.

The act requires, as applicable, a practitioner who is a licensed physician, physician assistant, advanced practice nurse, or person authorized to administer immunizations within their scope of practice to students to submit immunization, medical, or nonmedical exemption data to the immunization tracking system. The practitioner is not subject to a regulatory sanction for noncompliance.

The act appropriates $41,906 from the general fund to the department of public health and environment for the following uses:

• $31,884 for use by the environmental epidemiology division for program costs and an additional 0.1 FTE; and
• $10,022 for the purchase of information technology services, which is reappropriated to the office of the governor for use by the office of information technology.
  (Note: This summary applies to this bill as enacted.)

Fiscal Note

The act aligns the requirements for a minor to obtain a new birth certificate from the state registrar and a new driver's license or identification card from the department of revenue with the requirements for an adult. A minor must also obtain a statement from a medical or mental health professional confirming that the minor's sex designation does not align with the minor's gender identity.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The bill requires a health care facility to provide an itemized statement or bill to a patient within 30 days after discharge from the facility or within 7 days after the patient's written request. The statement or bill must list all medical services provided in understandable language, without using procedure codes or drug codes exclusively and with a breakdown of the charges for which payment is expected from the patient.

(Note: This summary applies to this bill as introduced.)

Fiscal Note

Current state law prohibits local governments from substantively regulating the use and application of pesticides. The bill authorizes local governments to regulate pesticide use and application. In connection with this authorization, the bill:

• Declares pesticide regulation a matter of both statewide and local concern;
• Repeals provisions that prohibit local regulation of pesticide use and application and explicitly authorizes a county to enact this type of regulation;
• Permits local governments to regulate pesticide use and application except in connection with the cultivation of marijuana and the production of agricultural products;
• Clarifies that a local government must meet the requirements of state and federal law; and
• Gives state courts exclusive jurisdiction to review local pesticide laws.
  (Note: This summary applies to this bill as introduced.)

Fiscal Note

The act creates the air quality enterprise and specifies that its revenues are exempt from the state constitution's TABOR provisions. The enterprise will conduct air quality modeling, monitoring, data assessment, and research; implement emission mitigation projects; and provide its data to the division of administration (division) and the air quality control commission (commission) in the department of public health and environment (department) to facilitate the administration of the state's air quality laws, including by facilitating the timely issuance and effective enforcement of appropriate emission permits.

The enterprise is governed by a board of directors comprised of the executive director of the department or the executive director's designee and 9 members appointed by the governor and representing the commission, fee payers, business management, and scientific researchers. The board shall establish by rule the following enterprise fees in an amount that, in aggregate, reflects the value of the services the enterprise provides:

• A fee per ton of air pollutant;
• A fee for services performed for third parties for air quality modeling, monitoring, assessment, or research;
• A fee for emission mitigation project services.

The fees are credited to the newly created air quality enterprise cash fund. Revenue collected from the fees must not exceed the following amounts:

• For state fiscal year 2021-22, $1 million;
• For state fiscal year 2022-23, $3 million;
• For state fiscal year 2023-24, $4 million; and
• For state fiscal years commencing on or after July 1, 2024, $5 million.

The enterprise is required to submit an annual report to the general assembly each December 1 detailing its activities, revenues, and the value of its business services. The enterprise is repealed on September 1, 2034, and is subject to sunset review.

For purposes of the fees for air pollutant emission notices, annual per-ton emissions, and application processing, the act:

• Removes the statutory maximum for the fees;
• Establishes the amount of the fees for state fiscal years 2020-21 and 2021-22; and
• Allows the commission to thereafter adjust the fees by rule.

Additionally, for annual per-ton emission fees and processing fees, the act specifies the purposes for which the increased revenues from those fees may be spent and requires annual reporting by the division regarding the fees.

The act appropriates $10,660 from the general fund to the department and reappropriates the money to the department of law for legal services necessary to implement the act.

(Note: This summary applies to this bill as enacted.)

Fiscal Note

The act establishes the health insurance affordability enterprise, for purposes of section 20 of article X of the state constitution, that is authorized to assess a health insurance affordability fee (insurer fee) on certain health insurers and a special assessment (hospital assessment) on hospitals in order to:

• Provide business services to carriers that pay the insurer fee, including services to increase enrollment in health benefit plans offered by carriers across the state; increase the number of individuals who are able to purchase health benefit plans in the individual market by providing financial support for certain qualifying individuals; fund the reinsurance program that offsets the costs carriers would otherwise pay for covering consumers with high medical costs; improve the stability of the market throughout the state by providing consistent private health care coverage and reducing the movement of individuals from insured to uninsured status; reduce provider cost shifting from the individual market and the uninsured to the group market; and create a healthier risk pool for all carriers by establishing a path for consistent coverage for individuals; and
• Provide business services to hospitals, including by reducing the amount of uncompensated care provided by hospitals; reducing the need of providers to shift costs of providing uncompensated care to other payers; and expanding access to high-quality, affordable health care for low-income and uninsured residents.

The enterprise is to start assessing and collecting the insurer fee in 2021, which fee is based on a percentage of premiums collected by health insurers in the previous calendar year on health benefit plans issued in the state. The hospital assessment is a specified amount assessed and collected in the 2022 and 2023 calendar years. Money collected from the insurer fee and hospital assessment is to be deposited in the health insurance affordability cash fund (fund), which the act creates. The act also transfers an amount of premium taxes collected by the state in 2020 or later years that exceeds the amount collected in 2019, but not more than 10% of the enterprise's revenues, to the fund.

The enterprise is required to use the insurer fee, the hospital assessment, and any premium tax revenues or other money available in the fund, in accordance with the allocation specified in the act, for the following purposes:

• To provide funding for the Colorado reinsurance program;
• To provide payments to carriers to increase the affordability of health insurance on the individual market for Coloradans who receive the premium tax credit available under federal law;
• To provide subsidies for state-subsidized individual health coverage plans purchased by qualified low-income individuals who are not eligible for the premium tax credit or public assistance health care programs;
• To pay the actual administrative costs of the enterprise and the division of insurance for implementing and administering the act, limited to 3% of the enterprise's revenues; and
• To pay the costs for consumer enrollment, outreach, and education activities regarding health care coverage.

The enterprise is governed by an 11-member board composed of the executive director of the Colorado health benefit exchange and the commissioner of insurance or their designees and 9 members appointed by the governor and representing various aspect of the health care industry and health care consumers.

With regard to the Colorado reinsurance program and enterprise, the act:

• Incorporates the reinsurance program enterprise within the health insurance affordability enterprise;
• Eliminates funding for the reinsurance program from special assessments on hospitals and health insurers, excess premium tax revenues, and specified transfers from the state general fund and instead allocates a portion of the health insurance affordability enterprise revenues to the reinsurance program annually; and
• Extends the reinsurance program, subject to federal approval of a new or extended state innovation waiver to enable the state to operate the reinsurance program and access federal funding for the program.
  (Note: This summary applies to this bill as enacted.)

Fiscal Note

Beginning July 1, 2023, the act requires all local law enforcement agencies and the Colorado state patrol to issue body-worn cameras to their officers, except for those working in jails, working as administrative or civilian staff, the executive detail of the state patrol, and those working in court rooms. A peace officer shall wear and activate a body-worn camera when responding to a call for service or during any interaction with the public initiated by the peace officer when enforcing the law or investigating possible violations of the law. A peace officer may turn off a body-worn camera to avoid recording personal information that is not case related; when working on an unrelated assignment; when there is a long break in the incident or contact that is not related to the initial incident; and during administrative, tactical, and management discussions. A peace officer does not need to wear or activate a body-worn camera if the peace officer is working undercover. The act creates inferences, presumptions, and sanctions for failing to activate or tampering with a body-worn camera. The act requires all recordings of an incident be released to the public within 21 days after the local law enforcement agency or Colorado state patrol receives a complaint of misconduct. The act allows for redaction or nonrelease of the recording to the public if there is a specified privacy interest at stake.

Beginning July 1, 2023, the act requires the division of criminal justice in the department of public safety (division) to create an annual report of the information that is reported to the division, aggregated and broken down by state or local agency that employs peace officers, along with the underlying data. Each local agency and the Colorado state patrol that employs peace officers shall report to the division:

• All use of force by its peace officers that results in death or serious bodily injury;
• All instances when a peace officer resigned while under investigation for violating department policy;
• All data relating to contacts conducted by its peace officers; and
• All data related to the use of an unannounced entry by a peace officer.

The division of criminal justice shall maintain a statewide database with data collected in a searchable format and publish the database on its website. Any state or local law enforcement agency that fails to meet its reporting requirements is subject to suspension of its funding by its appropriating authority.

If any peace officer is convicted of or pleads guilty or nolo contendere to a crime involving the unlawful use or threatened use of physical force or the failure to intervene in another officer's use of unlawful force or is found civilly liable in either case, the P.O.S.T. board shall permanently revoke the peace officer's certification. The P.O.S.T. board shall not, under any circumstances, reinstate the peace officer's certification or grant new certification to the peace officer unless exonerated by a court.

The act states that in response to a protest or demonstration, a law enforcement agency and any person acting on behalf of the law enforcement agency shall not:

• Discharge kinetic impact projectiles and all other non- or less-lethal projectiles in a manner that targets the head, pelvis, or back;
• Discharge kinetic impact projectiles indiscriminately into a crowd; or
• Use chemical agents or irritants, including pepper spray and tear gas, prior to issuing an order to disperse in a sufficient manner to ensure the order is heard and repeated if necessary, followed by sufficient time and space to allow compliance with the order.

The act allows a person who has a constitutional right secured by the bill of rights of the Colorado constitution that is infringed upon by a peace officer to bring a civil action for the violation. A plaintiff who prevails in the lawsuit is entitled to reasonable attorney fees, and a defendant in an individual suit is entitled to reasonable attorney fees for defending any frivolous claims. Qualified immunity is not a defense to the civil action. The act requires a political subdivision of the state to indemnify its employees for such a claim; except that if the peace officer's employer determines the officer did not act upon a good faith and reasonable belief that the action was lawful, then the peace officer is personally liable for 5 percent of the judgment or $25,000, whichever is less, unless the judgment is uncollectible from the officer, then the officer's employer satisfies the whole judgment. A public entity does not have to indemnify a peace officer if the peace officer was convicted of a criminal violation for the conduct from which the claim arises.

The act creates a new use of force standard by limiting the use of physical force and limiting the use of deadly force when force is authorized. The act prohibits a peace officer from using a chokehold.

The act requires a peace officer to intervene when another officer is using unlawful physical force and requires the intervening officer to file a report regarding the incident. If a peace officer fails to intervene when required, the P.O.S.T. shall decertify the officer.

Under current law, if a grand jury does not bring charges against a person, the grand jury may issue a report. The act requires the grand jury to issue a report when it does not charge a person.

Beginning, January 1, 2022, the act requires the P.O.S.T. board to create and maintain a database containing information related to a peace officer's:

• Untruthfulness;
• Repeated failure to follow P.O.S.T. board training requirements;
• Decertification; and
• Termination for cause.

The act makes it unlawful for any governmental authority to engage in a pattern or practice of conduct by peace officers that deprives persons of rights, privileges, or immunities secured or protected by the constitution or laws of the United States or the state of Colorado. Whenever the attorney general has reasonable cause to believe that a violation of this provision has occurred, the attorney general may in a civil action obtain any and all appropriate relief to eliminate the pattern or practice.

The act allows the P.O.S.T. board to revoke peace officer certification for a peace officer who has failed to complete required peace officer training after giving the officer 30 days to satisfactorily complete the training.

The act gives the P.O.S.T. board the authority to promulgate rules for enforcement of the provisions related to peace officer certification. The attorney general may bring criminal charges for violations of the provisions related to peace officer certification if violation is willful or wanton, or impose fines upon any individual officer or agency for failure to comply with the provisions related to peace officer certification.

The act requires a peace officer to have a legal basis for making a contact. After making a contact, a peace officer shall report to the peace officer's employing agency information that the agency is required to report to the division of criminal justice.

The act appropriates $617,478 from the highway users tax fund to the department of public safety for use by the Colorado state patrol. To implement this act, the patrol may use this appropriation as follows:

• $50,288 for civilians, including an additional 1.0 FTE;
• $7,550 for operating expenses;
• $463,700 for information technology asset maintenance; and
• $95,940 for the purchase of legal services, which is reappropriated to the attorney general's office.
  (Note: This summary applies to this bill as enacted.)

Fiscal Note