First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
LLS NO. 23-0468.03 Brita Darling x2241
SENATE BILL 23-298
Senate Committees House Committees
Health & Human Services
Appropriations
A BILL FOR AN ACT
C
ONCERNING ALLOWING CERTAIN PUBLIC HOSPITALS TO IMPROVE101
ACCESS TO HEALTH CARE THROUGH COLLABORATION , AND, IN
102
CONNECTION THEREWITH , MAKING AN APPROPRIATION .103
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
The bill permits a hospital that has fewer than 50 beds and is a
county public hospital, a hospital formed by a health service district, or
a hospital affiliated with either such hospital (hospital) to enter into
collaborative agreements to engage in activities that may be characterized
as anticompetitive or result in displacement of competition, such as
SENATE
Amended 2nd Reading
May 1, 2023
SENATE SPONSORSHIP
Gardner and Roberts,
HOUSE SPONSORSHIP
McCormick and Bockenfeld,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. agreements to provide ancillary or specialty services, joint purchasing,
shared services, consulting, and collaboration efforts with payers.
The bill exempts collaborating hospitals from state antitrust laws
and provides immunity from federal antitrust laws under the state action
doctrine for approved collaborative activity.
Prior to entering into a collaborative agreement, the hospitals must
submit the proposed collaborative agreement (proposal) to the department
of health care policy and financing (department) and to the attorney
general. If the department determines that the collaborative agreement
will result in cost savings or other efficiencies that will improve or
expand the delivery of health-care services in rural and frontier
communities, the department must refer the proposal to the attorney
general.
The attorney general must review each proposal that is referred by
the department and determine, within a specified time, that the benefits
are not outweighed by any anticompetitive harm that may result from the
agreement. The department or the attorney general may request additional
information concerning a proposal within 60 days after its original
submission. If additional information is requested, the department and
attorney general have an additional 45 days to review the proposal.
If the department and the attorney general make a favorable
determination, the proposal is approved and the hospitals may enter into
a collaborative agreement. If neither the department nor the attorney
general respond within the time frames set forth in the bill, the
collaborative proposal is deemed approved.
The department or the attorney general may review a collaborative
agreement annually to ensure the outcomes related to the collaborative
agreement are consistent with statute.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add part 9 to article
2
1 of title 25.5 as follows:3
PART 94
HOSPITAL COLLABORATION AGREEMENTS5
25.5-1-901. Hospital collaborative agreements - review of6
proposed collaborative agreements - immunity - legislative7
declaration - definitions - rules. (1) T
HE GENERAL ASSEMBLY FINDS AND8
DECLARES THAT:9
298-2- (a) (I) FRONTIER AND RURAL HOSPITALS CONTINUE TO STRUGGLE1
TO DELIVER HIGH-QUALITY, ACCESSIBLE, LOW-COST CARE DUE TO THE2
RISING COSTS OF MEDICATIONS , SUPPLIES, MEDICAL EQUIPMENT, AND3
CONTRACT LABOR;4
(II) F
RONTIER AND RURAL HOSPITALS ARE LARGELY INDEPENDENT ,5
GOVERNMENTAL FACILITIES THAT ARE GOVERNED BY LOCAL COMMUNITY6
BOARDS;7
(III) F
RONTIER AND RURAL HOSPITALS ARE GENERALLY8
SEPARATED BY LARGE DISTANCES AND ARE CHALLENGED BY THE NEED TO9
PROVIDE ESSENTIAL SERVICES TO LOCAL COMMUNITIES DUE TO THE10
SPARSE POPULATION IN RURAL AREAS ;11
(IV) F
RONTIER AND RURAL HOSPITALS ARE INCREASINGLY12
CHALLENGED BY COMPLEX REQUIREMENTS IMPOSED BY GOVERNMENT AND13
PRIVATE PAYERS THAT DISPROPORTIONATELY NEGATIVELY IMPACT THESE14
PROVIDERS AND UNNECESSARILY DRIVE -UP ADMINISTRATIVE COSTS; AND
15
16
(V) I
N CASES WHERE THE STATE DEPARTMENT , THE DIVISION OF
17
INSURANCE, IF APPLICABLE, AND THE ATTORNEY GENERAL APPROVE18
COLLABORATIVE ARRANGEMENTS , IT IS THE GENERAL ASSEMBLY'S INTENT19
TO PROVIDE PROTECTION TO FRONTIER AND RURAL HOSPITALS FROM20
CERTAIN ANTITRUST SCRUTINY THAT IMPEDES FRONTIER AND RURAL21
HOSPITALS FROM WORKING COLLABORATIVELY TO IMPROVE QUALITY ,22
INCREASE ACCESS, AND REDUCE COSTS OF CARE TO THE COMMUNITIES23
THEY SERVE;24
(b) (I) F
ORTY-SEVEN OF COLORADO'S SIXTY-FOUR COUNTIES25
INCLUDE RURAL AND FRONTIER COMMUNITIES YET CONTAIN ONLY TWELVE26
PERCENT OF COLORADO'S POPULATION;27
298
-3- (II) THIRTY-TWO COUNTIES ARE SERVED BY CRITICAL ACCESS1
HOSPITALS THAT HAVE TWENTY -FIVE OR FEWER BEDS AND ARE2
GENERALLY LOCATED MORE THAN THIRTY -FIVE MILES FROM THE NEXT3
CLOSEST HOSPITAL; ELEVEN COUNTIES LACK ANY HOSPITAL ;4
(III)
THE SCARCITY OF NEARBY HOSPITALS CAUSES MANY5
RESIDENTS TO STRUGGLE TO FIND QUALITY , AFFORDABLE HEALTH CARE6
NEAR THEIR HOMES;7
(IV) F
URTHER, MANY RESIDENTS IN COLORADO'S RURAL AND8
FRONTIER COMMUNITIES FOREGO PREVENTIVE AND BEHAVIORAL HEALTH9
CARE AND LACK COMPREHENSIVE OR SPECIALIZED CARE OR CHOICE IN10
HEALTH-CARE SERVICES, AND TWENTY-FOUR COUNTIES IN COLORADO ARE11
CONSIDERED MATERNAL CARE "DESERTS";12
(V) W
HERE HOSPITALS DO EXIST IN RURAL AND FRONTIER AREAS ,13
THOSE HOSPITALS RECEIVE LOW REIMBURSEMENT RATES DUE TO A14
PREPONDERANCE OF GOVERNMENT PAYERS AND DECLINING LOCAL TAX15
DOLLARS, WHICH RESULTS IN A REDUCED AMOUNT OF MONEY AVAILABLE16
TO INVEST IN EXPANDING OR UPGRADING FACILITIES OR TO PURCHASE17
NECESSARY, NEW, OR INNOVATIVE MEDICAL SUPPLIES , EQUIPMENT, OR18
TECHNOLOGY;19
(VI) M
ANY
HOSPITALS IN RURAL AND FRONTIER COMMUNITIES20
HAVE DIFFICULTY RECRUITING AND RETAINING QUALIFIED HEALTH -CARE21
PROFESSIONALS AND MAKING AVAILABLE NEEDED SERVICES ; AND22
(VII)
COUNTY PUBLIC HOSPITALS, HEALTH SERVICE DISTRICTS,23
AND HOSPITAL AFFILIATES PERFORM ESSENTIAL PUBLIC FUNCTIONS ON24
BEHALF OF THE STATE;25
(c) A
S PART OF THE GOVERNMENT 'S INTEREST IN PROVIDING26
NEEDED HEALTH-CARE SERVICES IN COLORADO'S RURAL AND FRONTIER27
298
-4- COMMUNITIES, IT IS IMPORTANT FOR THE GOVERNMENT TO SUPPORT 1
EFFORTS TO FIND COLLABORATIVE, INNOVATIVE SOLUTIONS TO THE MANY2
PROBLEMS CONFRONTING RURAL HEALTH CARE , INCLUDING3
COLLABORATIVE OR COORDINATED ACTIVITIES THAT OFFER THE4
OPPORTUNITY TO EXPAND HEALTH -CARE OPTIONS THROUGH JOINT5
PURCHASING AND STAFFING, SHARED SERVICES, AND JOINT ACQUISITION6
OF NEW AND EXPENSIVE DIAGNOSTIC AND TREATMENT SOLUTIONS ;7
(d) I
T IS THE GENERAL ASSEMBLY 'S INTENT TO EXEMPT FROM8
STATE ANTITRUST LAWS, AND TO PROVIDE STATE ACTION IMMUNITY FROM9
FEDERAL ANTITRUST LAWS FOR CERTAIN ACTIVITIES THAT MIGHT BE10
CHARACTERIZED AS ANTICOMPETITIVE OR THAT MIGHT RESULT IN THE11
DISPLACEMENT OF COMPETITION IN THE PROVISION OF HOSPITAL ,12
PHYSICIAN, OR OTHER HEALTH -CARE-RELATED SERVICES OR13
ADMINISTRATIVE OR GENERAL BUSINESS SERVICES ; AND
14
(e) I
N ORDER TO PROMOTE IMPROVED QUALITY OF , INCREASE15
ACCESS TO, AND REDUCE COSTS OF HEALTH-CARE SERVICES IN RURAL AND16
FRONTIER COMMUNITIES THROUGH COLLABORATIVE AGREEMENTS17
AUTHORIZED BY THIS SECTION , THE GENERAL ASSEMBLY FURTHER18
INTENDS TO PROVIDE A SYSTEM OF REVIEW OF RELEVANT COLLABORATIVE19
AGREEMENTS BY THE STATE DEPARTMENT , THE DIVISION OF INSURANCE,
20
IF APPLICABLE, AND THE ATTORNEY GENERAL TO ENSURE THAT ANY21
POTENTIAL BENEFITS OF SUCH COLLABORATIVE AGREEMENTS ARE NOT22
OUTWEIGHED BY THE HARM TO COMPETITION IN RURAL AND FRONTIER23
COMMUNITIES. 24
(2) A
S USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE25
REQUIRES:26
(a) "C
OLLABORATIVE AGREEMENT " MEANS AN AGREEMENT OR27
298
-5- SIMILAR ARRANGEMENT BETWEEN TWO OR MORE HOSPITALS OR HOSPITAL1
AFFILIATES THAT COMPLIES WITH THE REQUIREMENTS SET FORTH IN THIS2
SECTION.3
(b) "C
OUNTY PUBLIC HOSPITAL" MEANS A PUBLIC HOSPITAL4
ESTABLISHED PURSUANT TO SECTION 25-3-301.5
(c) "D
IVISION OF INSURANCE" MEANS THE DIVISION OF INSURANCE
6
IN THE DEPARTMENT OF REGULATORY AGENCIES .7
(d) "HEALTH SERVICE DISTRICT" HAS THE SAME MEANING AS SET8
FORTH IN SECTION 32-1-103 (9).9
(e) "HOSPITAL" MEANS A FACILITY WITH FEWER THAN FIFTY BEDS10
THAT IS:11
(I) A
COUNTY PUBLIC HOSPITAL;12
(II) A
HOSPITAL ESTABLISHED, MAINTAINED, OR OPERATED13
DIRECTLY OR INDIRECTLY BY A HEALTH SERVICE DISTRICT ; OR14
(III) A
HOSPITAL AFFILIATE.15
(f)
"HOSPITAL AFFILIATE" MEANS AN AFFILIATE OF A COUNTY16
PUBLIC HOSPITAL OR HEALTH SERVICE DISTRICT THAT IS UNDER THE SOLE17
CONTROL OF THE COUNTY PUBLIC HOSPITAL OR HEALTH SERVICE DISTRICT .18
(3) E
XCEPT AS PROVIDED IN SUBSECTION (4) OF THIS SECTION, AND19
SUBJECT TO THE REQUIREMENTS IN SUBSECTIONS (5), (6), AND (7)
OF THIS20
SECTION, A HOSPITAL IS AUTHORIZED TO ENTER INTO COLLABORATIVE21
AGREEMENTS WITH ONE OR MORE HOSPITALS OR HOSPITAL AFFILIATES TO22
ENGAGE IN THE FOLLOWING ACTIVITIES:23
(a) A
NCILLARY CLINICAL SERVICES, ACQUISITION OF EQUIPMENT,24
CLINIC MANAGEMENT, OR HEALTH-CARE PROVIDER RECRUITMENT ;25
(b) J
OINT PURCHASING OR LEASING ARRANGEMENTS , INCLUDING26
THE JOINT PURCHASING OR LEASING OF:27
298
-6- (I) MEDICAL AND GENERAL SUPPLIES;1
(II) M
EDICAL AND GENERAL EQUIPMENT ;2
(III) P
HARMACEUTICALS; OR3
(IV) T
EMPORARY STAFFING THROUGH A STAFFING AGENCY ;4
(c) C
ONSULTING SERVICES WITH A FOCUS ON PUBLIC HEALTH IN5
RURAL OR FRONTIER COMMUNITIES AND NON -HOSPITAL-SPECIFIC6
INNOVATIONS IN HEALTH-CARE DELIVERY IN THOSE COMMUNITIES ;7
(d) P
URCHASING JOINT PROFESSIONAL , GENERAL LIABILITY, OR8
PROPERTY INSURANCE;9
(e) S
HARING BACK-OFFICE SERVICES, SUCH AS SHARING A BUSINESS10
OFFICE, ACCOUNTING AND FINANCE SERVICES , HUMAN RESOURCES, AND11
RISK MANAGEMENT AND COMPLIANCE SERVICES , BUT NOT INCLUDING12
SHARING SERVICE CHARGING EXPENSES OR RATES AMONG HOSPITALS ;13
(f) S
HARING DATA SERVICES, INCLUDING SHARED SERVICES FOR14
ELECTRONIC HEALTH RECORDS AND DATA EXTRACTION AND ANALYSIS15
SERVICES, CHARGE MANAGEMENT , AND POPULATION HEALTH ANALYSIS ;16
AND17
(g) N
EGOTIATING WITH HEALTH INSURANCE OR GOVERNMENT18
PAYERS, WHICH NEGOTIATIONS ARE LIMITED TO:19
(I) S
HARED CARE PROTOCOLS INTENDED TO IMPROVE PATIENT20
MANAGEMENT AND OUTCOMES , INCLUDING IMPLEMENTATION OF21
EVIDENCE-BASED PROTOCOLS, CLINICAL PATHWAYS, AND RECOGNIZED22
BEST PRACTICES IN THE CARE AND TREATMENT OF PATIENTS , INCLUDING23
CLINICAL THERAPIES, NUTRITION, EXERCISE, DIAGNOSTIC TESTING, AND24
MEDICATION MANAGEMENT ;25
(II)
COLLABORATIVE EFFORTS WITH PAYERS TO PROMOTE26
APPROPRIATE AND ESSENTIAL SERVICES TO BE PROVIDED IN THE LOCAL27
298
-7- COMMUNITY;1
(III)
MANAGEMENT OF PRIOR AUTHORIZATION REQUESTS ; AND2
(IV)
ANALYSIS OF AGGREGATE DATA TO COMPARE COSTS OF3
PROCEDURES AND TO ANALYZE PATIENT OUTCOMES .4
(4) N
OTWITHSTANDING ANY COLLABORATIVE AGREEMENTS5
DESCRIBED IN
SUBSECTION (3) OF THIS SECTION, THE IMMUNITY AND6
PROTECTIONS GRANTED TO HOSPITALS AND HOSPITAL AFFILIATES7
ENTERING INTO COLLABORATIVE AGREEMENTS PURSUANT TO THIS8
SECTION DOES NOT EXTEND TO COLLABORATIVE AGREEMENTS WITH9
ANOTHER HOSPITAL OR HOSPITAL AFFILIATE THAT HAVE THE EFFECT OF :10
(a) S
ETTING REIMBURSEMENT RATES OR OTHER COMPENSATION11
FROM ANY COMMERCIAL SELF -INSURED OR COMMERCIAL HEALTH12
INSURANCE OR GOVERNMENT PAYER ;13
(b) D
IVIDING OR ALLOCATING AMONG HOSPITALS OR HOSPITAL14
AFFILIATES SPECIFIC MARKETS FOR THE DELIVERY OF ANY GENERAL ACUTE15
CARE OR SPECIALTY LINES OF HEALTH-CARE SERVICES; OR16
(c) N
EGOTIATING OR AGREEING TO COMPENSATION UNDER17
HEALTH-CARE STAFFING ARRANGEMENTS FOR HOSPITAL EMPLOYEES THAT18
RESULTS IN A REDUCTION OF WAGES OF HOSPITAL STAFF , WHETHER
19
EMPLOYED BY THE HOSPITAL, A STAFFING AGENCY, OR OTHER EMPLOYER.20
(5) P
RIOR TO ENGAGING IN ANY JOINT ACTIVITY DESCRIBED BY A21
PROPOSED COLLABORATIVE AGREEMENT EXECUTED PURSUANT TO22
SUBSECTION (3) OF THIS SECTION, THE HOSPITALS OR HOSPITAL AFFILIATES23
SHALL JOINTLY SUBMIT THE PROPOSED COLLABORATIVE AGREEMENT TO24
THE STATE DEPARTMENT AND TO THE DIVISION OF INSURANCE , IF THE
25
PROPOSED COLLABORATIVE AGREEMENT INCLUDES NEGOTIATING WITH26
HEALTH INSURANCE PAYERS, AS DESCRIBED IN SUBSECTION (3)(g) OF THIS27
298
-8- SECTION, PURSUANT TO RULES THAT MAY BE PROMULGATED FOR THE1
SUBMISSION AND REVIEW OF PROPOSALS BY THE STATE DEPARTMENT AND2
BY THE DIVISION OF INSURANCE, IF APPLICABLE. THE STATE DEPARTMENT3
AND THE DIVISION OF INSURANCE , IF APPLICABLE, MAY REQUEST4
ADDITIONAL INFORMATION NECESSARY TO REVIEW THE PROPOSAL .5
(6) W
ITHIN FIFTEEN DAYS AFTER RECEIPT OF A PROPOSED
6
COLLABORATIVE AGREEMENT AND THE RECEIPT OF ADDITIONAL7
INFORMATION REQUESTED BY THE STATE DEPARTMENT AND BY THE8
DIVISION OF INSURANCE, IF APPLICABLE, IF THE DEPARTMENT OF HEALTH9
CARE POLICY AND FINANCING CONCLUDES THAT A PROPOSED10
COLLABORATIVE ACTIVITY WILL RESULT IN COST SAVINGS OR OTHER11
EFFICIENCIES THAT WILL IMPROVE OR EXPAND THE DELIVERY OF12
HEALTH-CARE SERVICES IN RURAL AND FRONTIER COMMUNITIES IN13
C
OLORADO, THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING14
SHALL REFER THE PROPOSAL TO THE ATTORNEY GENERAL TO DETERMINE ,15
PURSUANT TO RULES WHICH MAY BE PROMULGATED FOR SUCH PURPOSE ,16
THAT THE BENEFITS OF THE COLLABORATIVE ACTIVITY ARE NOT17
OUTWEIGHED BY ANY ANTICOMPETITIVE HARM THAT MAY ARISE FROM THE18
COLLABORATIVE ACTIVITY.19
(7) W
ITHIN FORTY-FIVE
DAYS AFTER RECEIVING A REFERRAL20
AND REVIEW FROM THE STATE DEPARTMENT AND THE DIVISION OF21
INSURANCE, IF APPLICABLE, THE ATTORNEY GENERAL SHALL REVIEW THE22
PROPOSED COLLABORATIVE AGREEMENT AND EITHER APPROVE OR DENY23
THE PROPOSED COLLABORATIVE AGREEMENT OR REQUEST ADDITIONAL24
INFORMATION RELATED TO THE PROPOSAL . IF A REQUEST FOR ADDITIONAL25
INFORMATION IS MADE, THE ATTORNEY GENERAL HAS AN ADDITIONAL26
FORTY-FIVE DAYS TO COMPLETE THE REVIEW FOLLOWING RECEIPT OF THE27
298
-9- REQUESTED INFORMATION .1
(8) (a) A
COLLABORATIVE AGREEMENT IS APPROVED IF :
2
(I) T
HE STATE DEPARTMENT AND THE DIVISION OF INSURANCE , IF
3
APPLICABLE CONCLUDE THAT THE PROPOSED COLLABORATIVE AGREEMENT4
WILL RESULT IN IMPROVED QUALITY , INCREASED ACCESS OR COST5
SAVINGS, OR OTHER EFFICIENCIES THAT WILL IMPROVE OR EXPAND THE6
DELIVERY OF HEALTH -CARE SERVICES IN RURAL AND FRONTIER7
COMMUNITIES IN COLORADO; AND8
(II) T
HE ATTORNEY GENERAL CONCLUDES THAT THE BENEFITS
9
IDENTIFIED BY THE STATE DEPARTMENT AND BY THE DIVISION OF10
INSURANCE, IF APPLICABLE, ARE OUTWEIGHED BY ANY COMPETITIVE11
CONCERNS IDENTIFIED BY THE ATTORNEY GENERAL , OR THE ATTORNEY12
GENERAL DOES NOT RESPOND WITHIN THE TIME FRAMES SPECIFIED IN13
SUBSECTION (7) OF THIS SECTION. 14
(b) (I) E
XCEPT AS PROVIDED IN SUBSECTION (8)(b)(III) OF THIS
15
SECTION, IF A PROPOSED COLLABORATIVE AGREEMENT IS DENIED , THE16
HOSPITALS OR HOSPITAL AFFILIATES MAY REQUEST RECONSIDERATION BY17
RESUBMITTING THE PROPOSED AGREEMENT TO THE ATTORNEY GENERAL18
WITHIN THIRTY DAYS AFTER THE DENIAL ALONG WITH ADDITIONAL19
MATERIALS, INFORMATION, OR OTHER EVIDENCE THAT WAS NOT20
PREVIOUSLY SUBMITTED RELATING TO THE DETERMINATION OF THE21
BENEFITS OR ANTICOMPETITIVE HARM ASSOCIATED WITH THE PROPOSED22
COLLABORATIVE AGREEMENT .23
(II) T
HE ATTORNEY GENERAL HAS FORTY -FIVE DAYS FROM THE
24
DATE OF THE REQUEST TO RECONSIDER THE DENIAL AND MAY CONSULT25
WITH THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING OR THE26
DIVISION OF INSURANCE AS PART OF THE RECONSIDERATION . THE27
298
-10- PROPOSED COLLABORATIVE AGREEMENT IS NOT DEEMED APPROVED IF THE1
ATTORNEY GENERAL FAILS TO RESPOND WITHIN THE FORTY -FIVE-DAY2
RECONSIDERATION PERIOD.3
(III) A
REQUEST FOR RECONSIDERATION OF A PROPOSED
4
COLLABORATIVE AGREEMENT MAY BE MADE ONLY ONCE WITHIN THE5
THIRTY-DAY PERIOD FOLLOWING THE DENIAL OF THE PROPOSED6
COLLABORATIVE AGREEMENT . THE ATTORNEY GENERAL'S DECISION ON A7
PROPOSED COLLABORATIVE AGREEMENT THAT IS NOT SUBMITTED FOR8
RECONSIDERATION WITHIN THIRTY DAYS OR THAT IS DENIED UPON9
RECONSIDERATION IS FINAL AND NON-APPEALABLE.10
(c) THE STATE DEPARTMENT , THE DIVISION OF INSURANCE, IF11
APPLICABLE, OR THE ATTORNEY GENERAL MAY REVIEW A COLLABORATIVE12
AGREEMENT ANNUALLY TO ENSURE THE OUTCOMES RELATED TO THE13
COLLABORATIVE AGREEMENT ARE CONSISTENT WITH THIS SECTION .14
SECTION 2. In Colorado Revised Statutes, add 25-3-304.5 as15
follows:16
25-3-304.5. Hospital collaborative agreements - additional17
powers. I
N ADDITION TO THE POWERS SPECIFIED IN SECTION 25-3-304, THE
18
BOARD OF TRUSTEES OF A COUNTY PUBLIC HOSPITAL MAY ENTER INTO A19
COLLABORATIVE AGREEMENT WITH ANOTHER COUNTY PUBLIC HOSPITAL ,20
HEALTH SERVICE DISTRICT, OR HOSPITAL AFFILIATE IN ACCORDANCE WITH21
SECTION 25.5-1-901.22
SECTION 3. In Colorado Revised Statutes, 32-1-1003, add23
(1)(c.5) as follows:24
32-1-1003. Health service districts - additional powers. (1) In25
addition to the powers specified in section 32-1-1001, the board of any26
health service district has any or all of the following powers for and on27
298
-11- behalf of such district:1
(c.5) T
O ENTER INTO A COLLABORATIVE AGREEMENT WITH2
ANOTHER HEALTH SERVICE DISTRICT , COUNTY PUBLIC HOSPITAL , OR3
HOSPITAL AFFILIATE IN ACCORDANCE WITH SECTION 25.5-1-901.
4
SECTION 4. Appropriation. (1) For the 2023-24 state fiscal5
year, $30,260 is appropriated to the department of health care policy and6
financing for use by the executive director's office. This appropriation is7
from the healthcare affordability and sustainability fee cash fund created8
in section 25.5-4-402.4 (5)(a), C.R.S. To implement this act, the office9
may use this appropriation as follows:10
(a) $26,385 for personal services, which amount is based on an11
assumption that the office will require an additional 0.8 FTE; and12
(b) $3,875 for operating expenses.13
(2) For the 2023-24 state fiscal year, the general assembly14
anticipates that the department of health care policy and financing will15
receive $30,259 in federal funds to implement this act, which amount is16
subject to the "(I)" notation as defined in the annual general appropriation17
act for the same fiscal year. The appropriation in subsection (1) of this18
section is based on the assumption that the department will receive this19
amount of federal funds to be used as follows:20
(a) $26,384 for personal services; and21
(b) $3,875 for operating expenses.22
SECTION 5. Act subject to petition - effective date. This act23
takes effect at 12:01 a.m. on the day following the expiration of the24
ninety-day period after final adjournment of the general assembly; except25
that, if a referendum petition is filed pursuant to section 1 (3) of article V26
of the state constitution against this act or an item, section, or part of this27
298
-12- act within such period, then the act, item, section, or part will not take1
effect unless approved by the people at the general election to be held in2
November 2024 and, in such case, will take effect on the date of the3
official declaration of the vote thereon by the governor.4
298
-13-