CO Code § 25.5-6-804 (2021)
2021 Colorado Code|Title 25.5 - Health Care Policy and Financing|Article 6 - Colorado Medical Assistance Act - Long-Term Care|Part 8 - Home- and Community-Based Services for Children With Autism|§ 25.5-6-804. Services - Duties of the State Department - Rules

  Subject to the provisions of this part 8, home- and community-based services for children with autism shall include only the following services, as specified in the eligible child's care plan:   Occupational therapy;    Speech therapy;    Psychological and psychiatric services;    Physical therapy;    Behavioral therapy; and    Services provided under the consumer-directed care service model, part 11 of this article.       Within the limits of the general assembly's annual appropriations, the medical services board shall set an annual dollar limit on the amount of services that an eligible child may receive pursuant to this part 8.    The state department shall utilize the services of existing service provider agencies to provide services pursuant to this part 8. A service provider agency shall retain no more than fifteen percent of the established service reimbursement rate for administrative costs.    A care planning agency may be certified to provide the services described in subsection (1) of this section if otherwise qualified as a provider under the state medical assistance program.    [ ] The state department shall contract with a community centered board for persons with developmental disabilities to serve as the single entry point agency for services and as the care planning agency for eligible children. If a community centered board is unwilling or unable to enter into the contract with the state department, the state department may contract with a single entry point agency identified pursuant to section 25.5-6-106 or a state-department-approved case management agency to serve as the entry point agency and as the care planning agency. The care planning process shall include the eligible child's family or guardian, the eligible child's lead provider, and the eligible child's case manager. For the purpose of implementing this part 8 the care planning process shall be coordinated with any other care plan or case manager the eligible child may have.    A member of an eligible child's family may be employed to provide services to the child. The reimbursement limitation in section 25.5-6-310 shall not apply to services provided pursuant to this part 8 by a family member.    The state department shall develop the service provisions, which shall include provisions for the supervision of direct care providers, and the care planning process under this part 8 in consultation with parents of children with autism and medical professionals who have expertise in treating children with autism.      The state board shall adopt rules necessary to implement and administer the provisions of this part 8, including but not limited to requiring an ongoing evaluation process for each eligible child and the use of an external evaluation contractor for this purpose.    An eligible child participating in services pursuant to this part 8 shall be evaluated at entry into the program, at least every six months during the course of services, and at the termination of services pursuant to this part 8. The evaluations shall include, but need not be limited to:   An assessment of the eligible child's expressive and receptive communication through the use of a standardized and norm-referenced assessment as determined by the state department through rule;    An assessment of the eligible child's adaptive skills including self-help skills through the use of a norm-referenced and standardized assessment as determined by the state department through rule; and    An assessment of the severity of the eligible child's maladaptive behavior, including self-injurious or aggressive behaviors or tantrums, through the use of a norm-referenced and standardized assessment as determined by the state department through rule.       The evaluations shall be conducted pursuant to the provisions of paragraph (b) of this subsection (8) by the child's lead therapist or other trained professionals as designated by the department.    The evaluator shall provide a copy of the evaluation, including any supporting data, to the eligible child's parent or legal guardian and to the agency responsible for the eligible child's care planning. The agency responsible for the eligible child's care planning shall retain a copy of the eligible child's evaluation and supporting data.    Any costs associated with the evaluations required pursuant to this subsection (8) shall be included within the annual cost limitation on services set forth in subsection (2) of this section. Evaluations of an eligible child may be conducted through the eligible child's school or with other resources that are not part of the services provided pursuant to this part 8, so long as the evaluations are consistent with the provisions of paragraph (b) of this subsection (8).    The ongoing evaluation of children receiving services under the program pursuant to this subsection (8) shall not be used to alter a child's eligibility to participate in the program.       Repealed.    Subject to available appropriations, it is the intent of the general assembly to provide services to every eligible child who applies for the waiver program and that no eligible child is placed on a waiting list for services.    Editor's note: This version of subsection (5) is effective until July 1, 2024.  (5) [ ] The state department shall contract with a case management agency, as defined in section 25.5-6-1702 , for persons with intellectual and developmental disabilities to serve as the agency for services and as the care planning agency for eligible children. The care planning process shall include the eligible child's family or guardian, the eligible child's lead provider, and the eligible child's case manager. For the purpose of implementing this part 8, the care planning process shall be coordinated with any other care plan or case manager the eligible child may have.  Editor's note: This version of subsection (5) is effective July 1, 2024.   History. Source: L. 2006: Entire article added with relocations, p. 1959, § 7, effective July 1. L. 2010: (5) amended,(SB 10-129), ch. 105, p. 354, § 1, effective April 15. L. 2012: (8) amended and (9) and (10) added,(SB 12-159), ch. 203, p. 808, § 2, effective July 1. L. 2015: (2) and (10) amended and (9) repealed,(HB 15-1186), ch. 234, p. 867, § 3, effective July 1. L. 2021: (5) amended,(HB 21-1187), ch. 83, p. 336, § 35, effective July 1, 2024.    Editor's note:   This section is similar to former § 26-4-694 as it existed prior to 2006.   Cross references:   For the legislative declaration in the 2012 act amending subsection (8) and adding subsections (9) and (10), see section 1 of chapter 203, Session Laws of Colorado 2012.