Amendments for SB23-002
Senate Journal, March 3
After consideration on the merits, the Committee recommends that SB23-002 be amended
as follows, and as so amended, be referred to the Committee on Appropriations with
favorable recommendation.
Amend printed bill, page 2, after line 3 insert:
"(a) The American Public Health Association defines "community
health worker" as a frontline public health worker who is a trusted member of,
and has a close understanding of, the community that worker serves. This
trusting relationship enables the worker to serve as a liaison between health and
social services and improve the quality and cultural competence of service
delivery. "Community health worker" is meant to be an umbrella term for
individuals who may go by many names, such as health promoters, community
outreach workers, promotores de salud, health navigators, and patient
navigators.".
Reletter succeeding paragraphs accordingly.
Page 3, line 21, after the period add "Community health worker interventions
improve patient self-efficacy, quality of life, adherence to medical care, and
satisfaction with care for individuals with kidney failure.".
Page 3, after line 24 insert:
"(j) Community health workers include violence prevention
professionals who may be employed by hospital-based violence intervention
programs. These workers identify and target risk factors of violence, then link
program participants with hospital and community-based resources. The rate of
hospital readmission for participants who engaged in these programs was
reduced by 50 percent, with an accrued savings of $32,000, a tenfold
reduction.".
Reletter succeeding paragraphs accordingly.
Page 5, line 3, strike "MENTAL," and substitute "BEHAVIORAL,".
Page 5, line 4, strike "COMBAT" and substitute "ADDRESS".
Page 5, line 5, strike "COMPETENCE" and substitute "RESPONSIVENESS".
Page 5, line 6, strike "THIS TERM MAY INCLUDE HEALTH".
Page 5, strike lines 7 and 8.
Page 5, line 14, after "HEALTH NAVIGATION," insert "TRANSITIONS OF CARE
SUPPORTS,".
Page 5, line 15, strike "ASSESSMENT," and substitute "ASSESSMENT FOR
NONCLINICAL AND SOCIAL NEEDS,".
Page 5, line 21, after "WORKERS," insert "REPRESENTATIVES FROM A STATEWIDE
GROUP REPRESENTING COMMUNITY HEALTH WORKERS,".
Page 5, line 23, strike "A REPRESENTATIVE OF A" and substitute
"REPRESENTATIVES FROM".
Page 5, line 25, strike "PROGRAM FOR HEALTH NAVIGATORS," and substitute
"PROGRAMS FOR HEALTH NAVIGATORS AND COMMUNITY HEALTH WORKERS,".
Page 6, strike line 10 through 12 and substitute:
"(d) A PATIENT SAFETY MONITORING RESPONSIBILITIES AND GRIEVANCE
PROCESS;".
Page 6, line 19 and 20, strike "PAYMENT MODEL" and substitute "MANAGED
CARE OR VALUES-BASED PAYMENT MODELS".
Page 6, line 21, strike "FUTURE THAT" and substitute "FUTURE;".
Page 6, strike lines 22 and 23.
Page 6, before line 24 insert:
"(h) NEW PROVIDER TYPES THAT COULD FACILITATE COMMUNITY
HEALTH WORKER SERVICES OUTSIDE OF TRADITIONAL HEALTH-CARE SETTINGS,
SUCH AS COMMUNITY-BASED ORGANIZATIONS; AND".
Reletter succeeding paragraph accordingly.
Page 7, after line 3 insert:
"(4) IN CONSIDERATION OF OPPORTUNITIES FOR FUTURE EXPANSION OF
THE COMMUNITY HEALTH WORKER WORKFORCE, THE COLORADO DEPARTMENT
OF PUBLIC HEALTH AND ENVIRONMENT IS ENCOURAGED TO PARTNER WITH THE
STATE DEPARTMENT AND STAKEHOLDERS TO MAKE RECOMMENDATIONS FOR
TRAINING AND COMPETENCY STANDARDS RELATED TO SPECIALIZATION THAT
WOULD ENABLE COMMUNITY HEALTH WORKERS TO SPECIALIZE THEIR WORK
WITH DIFFERENT POPULATIONS AND HEALTH CONDITIONS.".
Renumber succeeding subsections accordingly.
Page 7, line 8, strike "REPORT AND MUST BE" and substitute "REPORT. THE
STATE DEPARTMENT SHALL WORK WITH STAKEHOLDERS TO DETERMINE HOW
SERVICES PROVIDED BY COMMUNITY HEALTH WORKERS WILL BE CAPTURED IN
FEDERALLY QUALIFIED HEALTH CENTERS' COST REPORTS.".
Page 7 strike lines 9 and 10.
Page 7, strike lines 15 through 27 and substitute "CLINIC'S COST REPORT. THE
STATE DEPARTMENT SHALL WORK WITH STAKEHOLDERS TO DETERMINE HOW
SERVICES PROVIDED BY COMMUNITY HEALTH WORKERS WILL BE CAPTURED IN
RURAL HEALTH CENTERS' COST REPORTS.".
Page 8, strike lines 1 through 13 and substitute:
"(7) THE STATE DEPARTMENT SHALL CONSULT WITH THE COLORADO
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT IN PROMULGATING RULES
CONCERNING THE VOLUNTARY COMPETENCY-BASED COMMUNITY HEALTH
WORKER REGISTRY MANAGED BY THE COLORADO DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT AND ANY ADDITIONAL CRITERIA OR STANDARDS
THAT MAY BE NECESSARY.
(8) FOR PURPOSES OF MEDICAID REIMBURSEMENT, A COMMUNITY
HEALTH WORKER SHALL:
(a) WORK UNDER THE SUPERVISION OF A CLINICIAN OR WITHIN A
LICENSED OR OTHERWISE APPROVED AND MEDICAID-ENROLLED HEALTH
PROVIDER AGENCY; AND
(b) MEET THE MINIMUM QUALIFICATIONS AND CREDENTIALING
REQUIREMENTS OF THE VOLUNTARY COMPETENCY-BASED COMMUNITY HEALTH
WORKER REGISTRY AS DEFINED IN SECTION 25-20.5-112.
(9) THE STATE DEPARTMENT SHALL ENSURE THAT REIMBURSEMENT
POLICIES AND FEDERAL AUTHORITIES FOR EXISTING UNLICENSED HEALTH
WORKERS, SUCH AS PEER SUPPORT PROFESSIONALS, RECOVERY PROFESSIONALS,
MANAGED CARE NAVIGATION STAFF, AND OTHERS, ARE ALIGNED AND
INCORPORATED WITH THE COMMUNITY HEALTH WORKER PAYMENT MODELS.".
Renumber succeeding subsection accordingly.
Page 8, line 17, strike "AND" and substitute "OR".
Page 8, line 17, strike "COST" and substitute "COSTS OR".
Page 8, line 18, after "SERVICES" insert "AND CONSIDERATIONS FOR THE
GENERAL ASSEMBLY TO EXPAND COMMUNITY HEALTH WORKER SERVICES IN
COMMUNITY-BASED ORGANIZATIONS THAT ARE OUTSIDE OF THE TRADITIONAL
HEALTH-CARE SETTING".
Page 8, after line 25, add:
"SECTION 3. In Colorado Revised Statutes, add 25-20.5-112 as
follows:
25-20.5-112. Voluntary competency-based community health
worker registry - requirements - rules - definition. (1) AS USED IN THIS
SECTION, UNLESS THE CONTEXT OTHERWISE REQUIRES, "VOLUNTARY
COMPETENCY-BASED COMMUNITY HEALTH WORKER REGISTRY" MEANS THE
REGISTRY IN THE DEPARTMENT THAT LISTS INDIVIDUALS WHO HAVE COMPLETED
STATE-APPROVED TRAINING AND CREDENTIALING REQUIREMENTS BASED ON
COMPETENCY STATEMENTS THAT REPRESENT GENERALIST ENTRY-LEVEL CORE
COMPETENCIES FOR UNLICENSED COMMUNITY HEALTH WORKERS.
(2) A COMMUNITY HEALTH WORKER MUST COMPLETE A
STATE-APPROVED TRAINING PROGRAM THAT MEETS CREDENTIALING
REQUIREMENTS BASED ON COMPETENCY STATEMENTS THAT REPRESENT
GENERALIST ENTRY-LEVEL CORE COMPETENCIES FOR UNLICENSED COMMUNITY
HEALTH WORKERS, AND MUST BE LISTED ON THE DEPARTMENT'S VOLUNTARY
COMPETENCY-BASED COMMUNITY HEALTH WORKER REGISTRY IN ORDER TO BE
REIMBURSED THROUGH THE STATE MEDICAL ASSISTANCE PROGRAM FOR
PROVIDING COMMUNITY HEALTH WORKER COVERED SERVICES TO A MEDICAID
MEMBER.
(3) PARTICIPATION IN THE VOLUNTARY COMPETENCY-BASED
COMMUNITY HEALTH WORKER REGISTRY IS NOT REQUIRED FOR COMMUNITY
HEALTH WORKERS WHO DO NOT SEEK REIMBURSEMENT THROUGH MEDICAID.
(4) THE DEPARTMENT SHALL PROMULGATE RULES PURSUANT TO THIS
ARTICLE 20.5 AS NECESSARY TO IMPLEMENT AND ADMINISTER THE VOLUNTARY
COMPETENCY-BASED COMMUNITY HEALTH WORKER REGISTRY.".
Renumber succeeding section accordingly.
Senate Journal, April 6
After consideration on the merits, the Committee recommends that SB23-002 be amended
as follows, and as so amended, be referred to the Committee of the Whole with favorable
recommendation and with a recommendation that it be placed on the Consent Calendar.
Amend printed bill, page 8, before line 26 insert:
"SECTION 3. Appropriation. (1) For the 2023-24 state fiscal year,
$40,717 is appropriated to the department of health care policy and financing
for use by the executive director's office. This appropriation is from the general
fund and is based on an assumption that the office will require an additional 0.8
FTE. To implement this act, the office may use this appropriation as follows:
(a) $36,842 for personal services, which amount is based on an
assumption that the office will require an additional 0.8 FTE; and
(b) $3,875 for operating expenses.
(2) For the 2023-24 state fiscal year, the general assembly anticipates
that the department of health care policy and financing will receive $40,717 in
federal funds to implement this act, which amount is subject to the "(I)"
notation as defined in the annual general appropriation act for the same fiscal
year. The appropriation in subsection (1) of this section is based on the
assumption that the department will receive this amount of federal funds to be
used as follows:
(a) $36,842 for personal services; and
(b) $3,875 for operating expenses.
(3) For the 2023-24 state fiscal year, $169,973 is appropriated to the
department of public health and environment for use by chronic disease
prevention programs in the prevention services division. This appropriation is
from the general fund and is based on an assumption that the programs will
require an additional 2.0 FTE. To implement this act, the programs may use this
appropriation for the community health workers initiative.".
Renumber succeeding section accordingly.
Page 1, line 103, strike "WORKER." and substitute "WORKER, AND, IN
CONNECTION THEREWITH, MAKING AN APPROPRIATION.".
Appro-
priations