CO Code § 25.5-10-202 (2021)
2021 Colorado Code|Title 25.5 - Health Care Policy and Financing|Article 10 - Community Living|Part 2 - Intellectual and Developmental Disabilities|§ 25.5-10-202. Definitions - Repeal

 As used in this article 10, unless the context otherwise requires:    “Abuse” means any of the following acts or omissions committed against a person with an intellectual and developmental disability:   The nonaccidental infliction of physical pain or injury, as demonstrated by, but not limited to, substantial or multiple skin bruising, bleeding, malnutrition, dehydration, burns, bone fractures, poisoning, subdural hematoma, soft tissue swelling, or suffocation;    Confinement or restraint that is unreasonable under generally accepted caretaking standards; or    Unlawful sexual behavior as defined in section 16-22-102 (9).  (1.3) “Authorized representative” means a person designated by the person receiving services, or by the parent or guardian of the person receiving services, if appropriate, to assist the person receiving services in acquiring or utilizing services or supports pursuant to this article. The extent of the authorized representative's involvement shall be determined upon designation.  (1.6) “Caretaker” means a person who:   Is responsible for the care of a person with an intellectual and developmental disability as a result of a family or legal relationship;    Has assumed responsibility for the care of a person with an intellectual and developmental disability; or    Is paid to provide care, services, or oversight of services to a person with an intellectual and developmental disability. (1.8)   “Caretaker neglect” means neglect that occurs when adequate food, clothing, shelter, psychological care, physical care, medical care, habilitation, supervision, or other treatment necessary for the health and safety of a person with an intellectual and developmental disability is not secured for a person with an intellectual and developmental disability or is not provided by a caretaker in a timely manner and with the degree of care that a reasonable person in the same situation would exercise, or a caretaker knowingly uses harassment, undue influence, or intimidation to create a hostile or fearful environment for an at-risk adult with an intellectual and developmental disability.    Notwithstanding the provisions of paragraph (a) of this subsection (1.8), the withholding, withdrawing, or refusing of any medication, any medical procedure or device, or any treatment, including but not limited to resuscitation, cardiac pacing, mechanical ventilation, dialysis, artificial nutrition and hydration, any medication or medical procedure or device, in accordance with any valid medical directive or order, or as described in a palliative plan of care, shall not be deemed caretaker neglect.    As used in this subsection (1.8), “medical directive or order” includes a medical durable power of attorney, a declaration as to medical treatment executed pursuant to section 15-18-104, C.R.S., a medical order for scope of treatment form executed pursuant to article 18.7 of title 15, C.R.S., and a CPR directive executed pursuant to article 18.6 of title 15, C.R.S. (1.9) [ ] “Case management agency” means a public or private not-for-profit or for-profit agency that meets all applicable state and federal requirements and is certified by the state department to provide case management services pursuant to section 25.5-10-209.5 . The case management agency shall provide case management services pursuant to a contract with the state department. (1.9) [ ] “Case management agency” has the same meaning as set forth in section 25.5-6-1702 (2) .             [ ] “Case management services” means the following:   Repealed.    Service and support coordination; and    The monitoring of all services and supports delivered pursuant to the individualized plan and the evaluation of results identified in the individualized plan.       [ ] “Case manager” means a person who assists with case management services and supports provided pursuant to this article for persons with intellectual and developmental disabilities.      “Community-centered board” means a private corporation, for-profit or not-for-profit, that is designated pursuant to section 25.5-10-209.    This subsection (4) is repealed, effective July 1, 2024.       “Community residential home” means a group living situation accommodating at least four but no more than eight persons, which is licensed by the state and in which services and supports are provided to persons with intellectual and developmental disabilities. (5.5) “Competitive integrated employment” has the same meaning as set forth in section 8-84-301 , C.R.S. (5.7) [ ] “Conflict-free case management” means, pursuant to 42 CFR 441.301 (c)(1)(VI), case management services provided to a person with an intellectual and developmental disability enrolled in a home- and community-based services waiver that are provided by a case management agency that is not the same agency that provides services and supports to that person. Service agencies and case management agencies are responsible for ensuring persons who are employed by the agency meet the requirements of this article 10. (5.7) [ ] “Conflict-free case management” has the same meaning as set forth in section 25.5-6-1702 (6) .    “Consent” means an informed assent that is expressed in writing and freely given. Consent shall always be preceded by the following:   A fair explanation of the procedures to be followed, including an identification of procedures that are experimental;    A description of the attendant discomforts and risks;    A description of the expected benefits;    A disclosure of appropriate alternative procedures together with an explanation of the respective benefits, discomforts, and risks;    An offer to answer any inquiries concerning procedures;    An instruction that the person giving consent is free to withdraw consent and to discontinue participation in the project or activity at any time; and    A statement that withholding or withdrawal of consent shall not prejudice future provision of appropriate services and supports to persons.       “Contribution” means the benefits gained by the household or community in which a person lives as the result of the person engaging in meaningful activities, including but not limited to income-producing work, volunteer work, continuing education, and participation in community activities.    “Court” means a district court of the state of Colorado or the probate court in the appropriate jurisdiction.    [ ] “Designated service area” means the geographical area specified by the executive director to be served by a designated community-centered board.    “Developmental disabilities professional” has the same meaning as “intellectual and developmental disabilities professional” as set forth in subsection (25) of this section.      of subsection (26) of this section.    “Person with a developmental disability” or “individual with a developmental disability” has the same meaning as “person with an intellectual and developmental disability” as set forth in paragraph (b) of subsection (26) of this section.    “Child with a developmental delay” has the same meaning as set forth in paragraph (c) of subsection (26) of this section.       “Division” means the division of intellectual and developmental disabilities, created in this part 2.    “Early intervention services and supports” has the same meaning as set forth in section 27-10.5-102, C.R.S. (13.5) “Eligible for home- and community-based services” means a “person with an intellectual and developmental disability”, as defined in section 25.5-6-403 , who meets the definition of an “eligible person”, as defined in section 25.5-6-403 .    [ ] “Eligible for supports and services” refers to any person with an intellectual and developmental disability as determined by a community-centered board pursuant to section 25.5-10-211.    “Enrolled” means that a person with an intellectual and developmental disability who is eligible for supports and services has been authorized, as defined by rules promulgated by the state board, to participate in the program funded pursuant to this section. (15.3) [ ] “Entity” has the same meaning as set forth in section 25.5-6-1702 (8) . (15.5) “Exploitation” means an act or omission that:   Uses deception, harassment, intimidation, or undue influence to permanently or temporarily deprive a person with an intellectual and developmental disability of the use, benefit, or possession of any thing of value;    Employs the services of a third party for the profit or advantage of the person or another person to the detriment of the person with an intellectual and developmental disability;    Forces, compels, coerces, or entices a person with an intellectual and developmental disability to perform services for the profit or advantage of the person or another person against the will of the person with an intellectual and developmental disability; or    Misuses the property of a person with an intellectual and developmental disability in a manner that adversely affects the person with an intellectual and developmental disability's ability to receive health care or health-care benefits or to pay bills for basic needs or obligations.         “Family” means the interdependent group of persons that consists of:   A parent, child, sibling, grandparent, aunt, uncle, spouse, or any combination thereof and a family member with an intellectual and developmental disability;    An adoptive parent of and a family member with an intellectual and developmental disability;    One or more persons to whom legal custody of a person with an intellectual and developmental disability has been given by a court and in whose home such person resides; or    Any other family unit as may be defined in rules developed pursuant to section 25.5-10-306.       State board rules must define the families that are eligible to receive services and supports pursuant to this article, and rules of the state board of human services must define the families that are eligible to receive services and supports pursuant to article 10.5 of title 27, C.R.S.       “Family caregiver” means a family member of the person with an intellectual and developmental disability who provides care to the person with an intellectual and developmental disability in the family home, who meets the requirements for a qualified family caregiver, as established by rule of the state board, and who is working through a program-approved service agency, as established by rule of the state board.    “Gastrostomy tube” means a tube that has been surgically inserted into the stomach through the abdominal wall, or a tube that has been inserted through the nasal passage into the stomach, or both. (18.5) “Harmful act” means an act committed against a person with an intellectual and developmental disability by a person with a relationship to the person with an intellectual and developmental disability when such act is not defined as abuse, caretaker neglect, or exploitation but causes harm to the health, safety, or welfare of a person with an intellectual and developmental disability.    “Human rights committee” means a third-party mechanism to adequately safeguard the legal rights of persons receiving services by participating in the granting of informed consent, monitoring the suspension of rights of persons receiving services, monitoring behavioral development programs in which persons with intellectual and developmental disabilities are involved, monitoring the use of psychotropic medication by persons with intellectual and developmental disabilities, and reviewing investigations of allegations of mistreatment of persons with intellectual and developmental disabilities who are receiving services or supports under this article.    “IDEA” has the same meaning as set forth in section 27-10.5-102, C.R.S.    “Inclusion” means:   The use by persons with intellectual and developmental disabilities of the same community resources that are used by and available to other persons;    The participation by persons with intellectual and developmental disabilities in the same community activities in which persons without intellectual and developmental disabilities participate. Participation includes regular contact with persons without intellectual and developmental disabilities.    Vocational experiences for persons with intellectual and developmental disabilities in community settings that offer opportunities to associate with other persons who do not have intellectual and developmental disabilities; and    Living in homes that are in residential neighborhoods and in proximity to community resources.       “Independent residential support services” means a community living situation, defined by rule of the state board, in which services and supports are provided to no more than three persons with intellectual and developmental disabilities and for which a state license is not required.    “Individualized family service plan” or “IFSP” has the same meaning as set forth in section 27-10.5-102, C.R.S.      “Individualized plan” means a written plan designed by an interdisciplinary team for the purpose of identifying:   The needs and preferences of the person or family receiving services;    The specific services and supports appropriate to meet those needs and preferences;    The projected date for initiation of services and supports; and    The anticipated results to be achieved by receiving the services and supports.       [ ] Every individualized plan must include a statement of agreement with the plan, signed by the person receiving services or other such person legally authorized to sign on behalf of the person and by a representative of the community-centered board or case management agency.    Any other service or support plan designated by the state department that meets all of the requirements of an individualized plan is considered to be an individualized plan pursuant to this article.      Every individualized plan that includes the provision of respite care for medical purposes, pursuant to section 25.5-10-205, shall include a process by which the person receiving services and supports may receive necessary care if the person's family or caregiver is unavailable due to an emergency situation or unforeseen circumstances. The family or caregiver must be duly informed by the interdisciplinary team of these alternative care provisions at the time the individualized plan is initiated. (d) (I) Every individualized plan that includes the provision of respite care for medical purposes, pursuant to section 25.5-10-205, shall include a process by which the person receiving services and supports may receive necessary care if the person's family or caregiver is unavailable due to an emergency situation or unforeseen circumstances. The family or caregiver must be duly informed by the interdisciplinary team of these alternative care provisions at the time the individualized plan is initiated.    Nothing in this paragraph (d) requires the provision of respite care. However, any individual plan that includes the provision of respite care for medical purposes must contain a contingency plan.          “Intellectual and developmental disabilities professional” means a person who has professional training and experience in the intellectual and developmental disabilities field, as defined by rule of the state board.      “Intellectual and developmental disability” means a disability that manifests before the person reaches twenty-two years of age, that constitutes a substantial disability to the affected person, and that is attributable to an intellectual and developmental disability or related conditions, including Prader-Willi syndrome, cerebral palsy, epilepsy, autism, or other neurological conditions when the condition or conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with an intellectual and developmental disability. Unless otherwise specifically stated, the federal definition of “developmental disability” found in 42 U.S.C. sec. 15002 (8) does not apply.    [ ] “Person with an intellectual and developmental disability” means a person determined by a community-centered board to have an intellectual and developmental disability and includes a child with a developmental delay.    “Child with a developmental delay” means:   A person less than five years of age with delayed development as defined by rule of the state board; or    A person less than five years of age who is at risk of having an intellectual and developmental disability as defined by rule of the state board.          “Interdependence” means those multiple interactive relationships that are necessary to create a sense of belonging and support between and among people that are mutually sought, sustained over time, and beneficial to those involved.    [ ] “Interdisciplinary team” means a group of people convened by a designated community-centered board or by a case management agency that includes the person receiving services; the parents or guardian of a minor; a guardian or an authorized representative, as appropriate; the person who coordinates the provisions of services and supports; and others chosen by the person receiving services, who are assembled to work in a cooperative manner to develop or review the individualized plan.    [ ] “Least restrictive environment” means an environment that represents the least departure from the typical patterns of living and that effectively meets the needs and preferences of the person receiving services. “Least restrictive environment” may include, but need not be limited to, receiving services from a community-centered board, service agency, case management agency, or a family caregiver in the family home. (29.5) “Mistreated” or “mistreatment” means:   Abuse;    Caretaker neglect;    Exploitation; or    A harmful act.    Repealed.       “Office” means the office of community living created in part 1 of this article.    “Person receiving services” means a person with an intellectual and developmental disability who is enrolled in a program funded pursuant to this article.    “Program” means a specific group of services or supports as defined by rules promulgated by the state board and for which funding is available pursuant to this article to a person with an intellectual and developmental disability who is eligible for supports and services.    “Regional center” has the same meaning as set forth in section 27-10.5-102, C.R.S.    “Service agency” means a person or any publicly or privately operated program, organization, or business providing services or supports for persons with intellectual and developmental disabilities.    “Service and support coordination” means planning, locating, facilitating access to, coordinating, and reviewing all aspects of needed services, supports, and resources that are provided in cooperation with the person receiving services, the person's family, as appropriate, the family of a child with a developmental delay, and the involved public or private agencies. Planning includes the development or review of an existing individualized plan. “Service and support coordination” also includes the reassessment of the needs and preferences of the person receiving services or the needs of the family of the person, with maximum participation of the person receiving services and the person's parents, guardian, or authorized representative, as appropriate.    “Services and supports” or “supports and services” means one or more of the following: Education, training, independent or supported living assistance, therapies, identification of natural supports, and other activities provided:   To enable persons with intellectual and developmental disabilities to make responsible choices, exert greater control over their lives, experience presence and inclusion in their communities, develop their competencies and talents, maintain relationships, foster a sense of belonging, and experience personal security and self-respect;    To enhance child development and healthy parent-child and family interaction for eligible persons and their families; and    To enable families, who choose or desire to maintain a family member with an intellectual and developmental disability at home, to obtain support and to enjoy a typical lifestyle.       “Sterilization” means any surgical or other medical procedure that has as its primary purpose to render a person permanently incapable of reproduction. (37.5) “Undue influence” means the use of influence to take advantage of a person with an intellectual and developmental disability's vulnerable state of mind, neediness, pain, or emotional distress.    “Waiting list” means the list of persons with intellectual and developmental disabilities who are waiting for enrollment into a program provided pursuant to this article.     Editor's note: This version of subsection (1.9) is effective until July 1, 2024. Editor's note: This version of subsection (1.9) is effective July 1, 2024. Editor's note: This version of subsection (2) is effective until July 1, 2024.  (2) [ ] “Case management services” has the same meaning as set forth in section 25.5-6-1702 3.  Editor's note: This version of subsection (2) is effective July 1, 2024. Editor's note: This version of subsection (3) is effective until July 1, 2024.  (3) [ ] “Case manager” has the same meaning as set forth in section 25.5-6-1702 (4) .  Editor's note: This version of subsection (3) is effective July 1, 2024.  Editor's note: This version of subsection (5.7) is effective until July 1, 2024. Editor's note: This version of subsection (5.7) is effective July 1, 2024. Editor's note: This version of subsection (9) is effective until July 1, 2024.  (9) [ ] “Defined service area” has the same meaning as set forth in section 25.5-6-1702 (7) .  Editor's note: This version of subsection (9) is effective July 1, 2024.  Editor's note: This version of subsection (14) is effective until July 1, 2024.  (14) [ ] “Eligible for supports and services” refers to any person with an intellectual and developmental disability as determined by a case management agency pursuant to section 25.5-6-1704 .  Editor's note: This version of subsection (14) is effective July 1, 2024. Editor's note: This subsection (15.3) is effective July 1, 2024. Editor's note: This version of subsection (24)(b) is effective until July 1, 2024.  (b) [ ] Every individualized plan must include a statement of agreement with the plan, signed by the person receiving services or other such person legally authorized to sign on behalf of the person and by a representative of the case management agency.  Editor's note: This version of subsection (24)(b) is effective July 1, 2024. Editor's note: This version of subsection (26)(b) is effective until July 1, 2024.  (b) [ ] “Person with an intellectual and developmental disability” means a person determined by a case management agency to have an intellectual and developmental disability and includes a child with a developmental delay.  Editor's note: This version of subsection (26)(b) is effective July 1, 2024. Editor's note: This version of subsection (28) is effective until July 1, 2024.  (28) [ ] “Interdisciplinary team” means a group of people convened by a designated case management agency that includes the person receiving services; the parents or guardian of a minor; a guardian or an authorized representative, as appropriate; the person who coordinates the provisions of long-term services and supports; and others chosen by the person receiving services, who are assembled to work in a cooperative manner to develop or review the individualized plan.  Editor's note: This version of subsection (28) is effective July 1, 2024. Editor's note: This version of subsection (29) is effective until July 1, 2024.  (29) [ ] “Least restrictive environment” means an environment that represents the least departure from the typical patterns of living and that effectively meets the needs and preferences of the person receiving services. “Least restrictive environment” may include, but need not be limited to, receiving services from a service agency, a case management agency, or a family caregiver in the family home.  Editor's note: This version of subsection (29) is effective July 1, 2024.  History. Source: L. 2013: Entire article added with relocations,(HB 13-1314), ch. 323, p. 1745, § 1, effective March 1, 2014. L. 2016: (1) and (19) amended and (1.3), (1.6), (1.8), (15.5), (29.5), and (37.5) added,(HB 16-1394), ch. 172, p. 562, § 14, effective July 1; (5.5) added,(SB 16-077), ch. 360, p. 1505, § 4, effective July 1. L. 2017: IP, (4), (14), (24)(b), (28), (29), and IP(36) amended, (1.9), (5.7), and (13.5) added, and (2)(a) repealed,(HB 17-1343), ch. 320, p. 1721, § 1, effective June 5. L. 2018: (26) amended,(SB 18-074), ch. 98, p. 770, § 3, effective August 8; (26)(a) amended,(SB 18-096), ch. 44, p. 474, § 16, effective August 8. L. 2019: (26)(a) amended,(SB 19-241), ch. 390, p. 3474, § 41, effective August 2. L. 2020: (1)(c), IP(15.5), (29.5)(c), and (29.5)(d) amended, (18.5) added, and (29.5)(e) repealed,(HB 20-1302), ch. 265, p. 1275, § 10, effective September 14. L. 2021: (1.9), (2), (3), (5.7), (9), (14), (24)(b), (26)(b), (28), and (29) amended and (15.3) added,(HB 21-1187), ch. 83, p. 337, § 38, effective July 1, 2024; (4)(b) added by revision,(HB 21-1187), ch. 83, pp. 335, 354, §§ 38, 70.    Editor's note:    This section is similar to former § 27-10.5-102 as it existed prior to 2013.    Amendments to subsection (26)(a) by SB 18-074 and SB 18-096 were harmonized.     Cross references:   For the legislative declaration in SB 16-077, see section 1 of chapter 360, Session Laws of Colorado 2016. For the legislative declaration in SB 18-096, see section 1 of chapter 44, Session Laws of Colorado 2018.