2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › COLORADO MEDICAL ASSISTANCE ACT (§§ 25.5-4-101 — 25.5-6-2001) › Article 6 - COLORADO MEDICAL ASSISTANCE ACT - LONG-TERM CARE (§§ 25.5-6-101 — 25.5-6-2001) › Part 1 - LONG-TERM CARE ADMINISTRATION (§§ 25.5-6-101 — 25.5-6-116) › Section 25.5-6-106 - [Effective 8/7/2024] Single entry point system - authorization - phases for implementation - services provided - repeal

(1)
Authorization.
The state board is hereby authorized to adopt rules providing for the establishment of a single entry point system that consists of single entry point agencies throughout the state for the purpose of enabling persons eighteen years of age or older in need of long-term care to access appropriate long-term care services.
(2)
Single entry point agencies - service programs - functions.
(a)
A single entry point agency must be an agency in a local community through which any person eighteen years of age or older who is in need of long-term care can access needed long-term care services. A single entry point agency may be a private, nonprofit organization; a county agency, including a county department of human or social services; a county nursing service; an area agency on aging; or a multicounty agency. Persons in need of specialized assistance such as services for persons with intellectual and developmental disabilities or behavioral or mental health disorders may be referred by a single entry point agency to programs under the department of human services.
(b)
The agency may serve private paying members on a fee-for-service basis and shall serve members of publicly funded long-term care programs, including, but not limited to, the following:
(I)
Nursing facility care;
(II)
Home- and community-based services for the elderly, blind, and disabled;
(III)
Repealed.
(IV)
Long-term home health care, including services provided by a PACE organization providing a program of all-inclusive care for the elderly pursuant to section
25.5-5-412
;
(V)
Home care allowance;
(VI)
Alternative care facilities;
(VII)
Adult foster care;
(VIII)
Certain in-home services available pursuant to the federal "Older Americans Act of 1965", as amended; and
(IX)
Home- and community-based services for persons with brain injury.
(c)
The major functions of a single entry point must include, but need not be limited to, the following:
(I)
Providing information;
(II)
Screening and referral services;
(III)
Assessing members' needs in accordance with section
25.5-6-104
;
(IV)
Developing plans of care for members;
(V)
Determining payment sources available to members for long-term care services;
(VI)
Authorizing the provision of certain long-term care services, as designated by the state department;
(VII)
Determining eligibility for certain long-term care programs, as designated by the state department;
(VIII)
Delivering case management services as an administrative function;
(IX)
Targeting outreach efforts to those most at risk of institutionalization;
(IX.5)
Informing eligible persons about the benefits of participating in the program of all-inclusive care for the elderly provided by a PACE organization pursuant to section
25.5-5-412
as an alternative to enrollment in a managed care organization, an organization contracted with the state department pursuant to part 4 of article
5
of this title, or other risk-bearing entity;
(X)
Identifying resource gaps and coordinating resource development;
(XI)
Recovering overpayment of benefits in accordance with rules adopted by the state board;
(XII)
Maintaining fiscal accountability; and
(XIII)
Rendering state certified services, as provided by state board rules, as a qualified and state certified agency.
(3)
State certification of a single entry point agency - quality assurance standards.
(a)
Upon selection of a single entry point agency, the state department shall contract with an agency for five years but shall recertify the agency annually based on an evaluation procedure provided for in paragraph (b) of this subsection (3).
(b)
The state board shall adopt rules for the establishment of a quality assurance program for the purpose of monitoring the quality of services provided to members and for recertifying single entry point agencies. The rules shall provide for: Procedures to evaluate the quality of services provided by the agency; an assessment of the agency's compliance with program requirements, including compliance with case management standards, which standards shall be adopted by the state department; an assessment of an agency's performance of administrative functions, including reasonable costs per Member, timely responses, managing programs in one consolidated unit, on-site visits to members, community coordination and outreach, and Member monitoring; a determination as to whether targeted populations are being identified and served; and an evaluation concerning financial accountability.
(c)
The state department shall monitor each single entry point agency in the state for compliance with quality assurance standards adopted by the state and may provide for the implementation of sanctions at any time for noncompliance. In addition, each county department may enter into cooperative agreements or contracts with the single entry point agencies to assure quality performance by the single entry point agency serving such county.
(d)
Ongoing reimbursement to single entry points shall be contingent upon compliance with quality assurance standards.
(e)
State board rules adopted pursuant to this section must include the requirement that, on and after January 1, 2019, prior to employment, a single entry point agency shall submit the name of a person who will be providing direct care, as defined in section
26-3.1-101
(3.5), to an at-risk adult, as defined in section
26-3.1-101
(1.5), as well as any other required identifying information, to the department of human services for a check of the Colorado adult protective services data system pursuant to section
26-3.1-111
, to determine if the person is substantiated in a case of mistreatment of an at-risk adult.
(4)
This section is repealed, effective July 1, 2024.
Amended by 2024 Ch. 152,§ 72, eff. 8/7/2024.
Repealed by 2021 Ch. 83, § 69, eff. 7/1/2024.
Amended by 2018 Ch. 62, § 6, eff. 8/8/2018.
Amended by 2017 Ch. 272, § 11, eff. 5/30/2017.
Amended by 2017 Ch. 263, § 206, eff. 5/25/2017.
L. 2006: Entire article added with relocations, p. 1915, § 7, effective July 1. L. 2012: (2)(b)(IV) amended and (2)(c)(IX.5) added, (SB 12-023), ch. 309, p. 309, § 2, effective April 12. L. 2017: (2)(a) amended, (SB 17-242), ch. 1329, p. 1329, § 206, effective May 25; (3)(e) added, (HB 17-1284), ch. 1505, p. 1505, § 11, effective May 31. L. 2018: (2)(b)(III) repealed, (SB 18-093), ch. 610, p. 610, § 6, effective August 8. L. 2021: (4) added by revision, (HB 21-1187), ch. 83, pp. 353, 354, §§ 69, 70.
This section is similar to former § 26-4-522 as it existed prior to 2006.
2024 Ch. 152, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
This section is set out more than once due to postponed, multiple, or conflicting amendments.
(1) For the "Older Americans Act of 1965", see Pub.L. 89-73, codified at 42 U.S.C. sec. 3001 et seq. (2) For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 18-093, see section 1 of chapter 62, Session Laws of Colorado 2018.