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Under current law, the
department of public health and environment (CDPHE) licenses and
establishes, and enforces standards for the operation of, health facilities
in the state, including rehabilitation centers, community mental health
centers, acute treatment units, facilities for persons with developmental
disabilities, nursing care facilities, hospice care, assisted living
residences, and home care agencies. CDPHE conducts periodic, announced and
unannounced inspections of licensed facilities to ensure compliance with
the standards it develops. The state board of health (board) is required to
establish by rule a schedule of fees to be assessed against health
facilities that is sufficient to meet CDPHE's direct and indirect costs in
regulating health facilities.
Additionally, under
current law, both CDPHE and the department of human services (DHS) jointly
regulate community residential homes for persons with developmental
disabilities.
Section 1 of the bill
declares that the legislative intent of the bill is to eliminate
duplication and unnecessary government oversight in the regulation of
health facilities in Colorado.
Sections 2, 3, 4, and
12 eliminate CDPHE's authority to license and develop standards for the
operation of community residential homes, shifting oversight of these homes
solely to DHS. Additionally, if home care agency personal care services,
which are otherwise regulated by CDPHE, are provided by a service agency
that delivers services and supports to persons with developmental
disabilities, DHS is tasked with inspecting those services in conjunction
and simultaneously with its inspection of the community residential home.
DHS is directed to institute an abbreviated, periodic inspection system for
community residential homes and a performance incentive system to reduce
license renewal fees for community residential homes for which no
significant deficiencies that negatively affect the life, health, and
safety of their consumers have been found by DHS.
Sections 2, 3, and 4
also:
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Require CDPHE to develop an abbreviated, periodicinspection
system, which it must use for health facilities that have been licensed for
at least 3 years and have not been subject to any enforcement activity or
substantiated complaints resulting in the discovery of significant
deficiencies that negatively affect the life, health, or safety of
consumers of the facilities within the prior 3 years;
á
Restrict the ability of CDPHE, when considering
a licenseapplication or a request to approve new construction or remodel of
a health facility, to impose standards for construction that are more
stringent than, or do not comply with, applicable national, state, and
local building and fire codes;
á
With regard to the dual responsibilities of CDPHE
andDHS over community mental health centers and acute treatment units,
require the departments to consider changes in health care policy and
practice that incorporate integrated health care services;
á
Limit CDPHE's licensure authority over
community clinics to those community clinics that: Provide health care
services on an ambulatory basis; are not licensed as an on-campus
department or service of a hospital or listed as an off-campus location
under a hospital's license; and either operate inpatient beds or provide
emergency services at the facility. CDPHE retains authority to license prison
clinics regulated by the department of corrections.
á
Require CDPHE to determine an applicant's
fitness to conduct and maintain a health facility based solely on specific
fitness information or documentation submitted by the applicant or obtained
by CDPHE through its own review or investigation of the applicant; and
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Eliminate the ability of CDPHE to conduct a
fitness review of a new owner of a facility unless the transfer of
ownership results in a transfer of at least 50% of direct or indirect
ownership interest in the facility or business to one or more new owners.
Under sections 5 and
12, a licensed health facility, program of all-inclusive care for the
elderly (PACE) provider, or community residential home that applies to
renew its license may submit evidence of its accreditation by a nationally
recognized accrediting body or regulation pursuant to a 3-way agreement
between the PACE provider, the centers for medicare and medicaid services
(CMS), and the department of health care policy and financing (HCPF), as
applicable, in which case CDPHE or, for purposes of community residential
homes, DHS is to deem that accreditation, regulation, or certification as
satisfaction of the state licensing requirements. CDPHE or DHS, as
applicable, is permitted to request additional information from a facility
if the state's standards for licensure of that type of facility are more
stringent than the applicable standards for accreditation, regulation, or
certification.
Sections 6 and 7
prohibit the board from increasing provisional or full license fees above
the levels set in rules as of the effective date of the sections. The board
retains the ability to lower the fee amounts. Section 7 further requires
CDPHE to develop a performance incentive system to provide a reduction in
license renewal fees for health facilities that have no significant
deficiencies that negatively affect the life, health, or safety of
consumers of the facility.
Section 8 establishes
the health care industry facility advisory council (advisory council) in
CDPHE to advise the department and the board on matters related to state
licensure of health care facilities. The purpose of the advisory council is
to:
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Advise CDPHE and the board on proposed
standards for the operation of licensed health care facilities;
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Review and make recommendations to CDPHE and
the board on proposed new or amended rules regarding health care facility
licensure;
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Review and make recommendations to CDPHE and
the board regarding modifications to licensing fees;
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Review and make recommendations concerning
CDPHE guidelines, policies, and procedures for licensure; and
á
Seek advice and counsel from outside experts
when it deems necessary.
CDPHE and the board are
required to accept and take the advisory council's recommendations into
consideration before taking action on any of the matters on which the
advisory council submits recommendations. Under section 9, the advisory
council is subject to sunset review by the department of regulatory
agencies and repeal on September 1, 2022, unless continued by the general
assembly.
Section 10 clarifies
that home care placement agencies are not licensed or certified by CDPHE
and prohibits home care placement agencies from making such a claim.
Noncompliance with this prohibition subjects a home care placement agency
to a civil penalty imposed by CDPHE.
For purposes of board
rules pertaining to the regulation of home care agencies, section 11
requires the board to establish different requirements that are appropriate
based on the type of facility or provider delivering the services to the
home care consumer and prohibits the board from requiring PACE providers to
submit information that is redundant or inconsistent with the federal
requirements the PACE provider is subject to pursuant to its 3-way agreement
with CMS and HCPF.
Section 13 prohibits an
appropriation of state funds to implement the bill.
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