2020 Colorado Revised Statutes
Title 25.5 - Health Care Policy And Financing
Article 6. Colorado Medical Assistance Act Long-term Care
Section 25.5-6-403. Definitions.

As used in this part 4, unless the context otherwise requires:

1. "Developmentally disabled person" means a person with an intellectual and developmental disability as defined in subsection (3.3)(a) of this section.

2. (a) "Eligible person" means a person with developmental disabilities:

1. Who meets the definition of categorically needy as defined in section 25.5-4-103 (4);

2. Who is in need of the level of care available in an intermediate care facility forindividuals with intellectual disabilities;

3. Whose gross income does not exceed three hundred percent of the current federalsupplemental security income benefits level or other applicable standard provided in federal regulations construing the federal "Social Security Act", as amended, and whose resources do not exceed the limit established for individuals receiving a mandatory minimum state supplementation of supplemental security income benefits or, in the case of a person who is married, do not exceed the amount authorized in section 25.5-6-101; and

4. For whom it is determined that provision of such services is necessary to avoidplacement in an intermediate care facility for individuals with intellectual disabilities.

(b) The amount of parental income and resources that shall be attributable to a child's gross income for purposes of eligibility under paragraph (a) of this subsection (2) shall be set forth in rules promulgated by the state board of human services created in section 26-1-107, C.R.S.

3. "In-home services" means those services described in section 25.5-10-205 providedto support persons living with their family.

(3.3) (a) "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 those 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.

2. "Person with an intellectual and developmental disability" or "youth with an intellectual and developmental disability" means a person or youth determined by a communitycentered board to have an intellectual and developmental disability and shall include a child with a developmental delay.

3. "Child with a developmental delay" means:

1. A person less than five years of age with delayed development as defined by rule ofthe state board; or

2. A person less than five years of age who is at risk of having an intellectual anddevelopmental disability as defined by rule of the state board.

4. "Plan of care" means a coordinated plan of care for provision of services in otherthan a nursing facility or institutional setting, developed and managed, subject to review and approval pursuant to section 25.5-6-404, by a community centered board for persons with developmental disabilities. This plan of care shall fully identify the services to be provided to eligible persons. Prior to the provision of those services, a physician may be required to review an assessment document to insure that it adequately describes the medical needs of the eligible person.

5. (a) "Services for persons with intellectual and developmental disabilities" means those services:

1. Approved for reimbursement by the federal government; and

2. Necessary to prevent a person, eligible for services under subsection (2) of this section, from being subjected to placement in an intermediate care facility for individuals with intellectual disabilities.

(b) "Services for persons with intellectual and developmental disabilities" includes, but is not limited to, social, habilitative, remedial, residential, health services, and services provided under the consumer-directed care service model, part 11 of this article, which shall include the selection, from a list of qualified entities, of an organization of the eligible person's choice to provide financial management services for the eligible person.

Source: L. 2006: Entire article added with relocations, p. 1943, § 7, effective July 1. L. 2013: (2)(a)(II), (2)(a)(IV), and (5)(a)(II) amended, (SB 13-167), ch. 394, p. 2294, § 5, effective June 5; (1), (3), IP(5)(a), (5)(a)(II), and (5)(b) amended, (HB 13-1314), ch. 323, p. 1810, § 47, effective March 1, 2014. L. 2014: (3.3) added, (HB 14-1368), ch. 304, p. 1288, § 1, effective May 31. L. 2018: (1), (3.3)(a), and (3.3)(c)(II) amended, (SB 18-074), ch. 98, p. 770, § 2, effective August 8; (3.3)(a) amended, (SB 18-096), ch. 44, p. 474, § 15, effective August 8. L. 2019: (3.3)(a) amended, (SB 19-241), ch. 390, p. 3473, § 40, effective August 2.

Editor's note: (1) This section is similar to former § 26-4-623 as it existed prior to 2006.

(2) Amendments to subsection (3.3)(a) by SB 18-074 and SB 18-096 were harmonized.

Cross references: (1) For additional definitions applicable to this part 4, see § 25.5-4103.

(2) For the legislative declaration in SB 18-096, see section 1 of chapter 44, Session Laws of Colorado 2018.