Colorado 2024 2024 Regular Session

Colorado Senate Bill SB175 Engrossed / Bill

Filed 04/22/2024

                    Second Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
REENGROSSED
This Version Includes All Amendments
Adopted in the House of Introduction
LLS NO. 24-0137.01 Brita Darling x2241
SENATE BILL 24-175
Senate Committees House Committees
Health & Human Services
Appropriations
A BILL FOR AN ACT
C
ONCERNING MEASURES TO IMPROVE PERINATAL HEALTH OUTCOMES ,
101
AND, IN CONNECTION THEREWITH , MAKING AN APPROPRIATION .102
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 requires health benefit plans to provide coverage for doula
services in the same scope and duration of coverage for doula services
that will be included in the department of health care policy and
financing's request for federal authorization of doula services under the
"Colorado Medical Assistance Act" (medical assistance program). Doulas
providing services must meet the same qualifications for and submit to
SENATE
3rd Reading Unamended
April 22, 2024
SENATE
Amended 2nd Reading
April 19, 2024
SENATE SPONSORSHIP
Fields and Buckner, Hansen, Bridges, Coleman, Cutter, Exum, Fenberg, Ginal, Gonzales,
Hinrichsen, Jaquez Lewis, Kolker, Marchman, Michaelson Jenet, Mullica, Priola, Roberts,
Sullivan, Winter F., Zenzinger
HOUSE SPONSORSHIP
McLachlan and Jodeh,
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. the same regulation as individuals providing doula services as
recommended in the report of the department of public health and
environment resulting from the stakeholder process for doula services
under the medical assistance program.
Coverage for doula services will be implemented for large
employer health benefit plans issued or renewed in this state on and after
July 1, 2025. For small group and individual plans, doula services will be
implemented if the division of insurance and the federal department of
health and human services determine that the benefit does not require
state defrayal of the cost of the benefit or the division of insurance
determines defrayal is not required and the federal department fails to
respond to the divison's request for confirmation of the determination
within 365 days after the request is made.
The bill authorizes the department of public health and
environment (department) to partner with the designated state perinatal
care quality collaborative (perinatal quality collaborative) to track the
statewide implementation of the recommendations of the Colorado
maternal mortality review committee, implement perinatal health quality
improvement programs with hospitals that provide labor and delivery or
neonatal care services (hospital) to improve infant and maternal health
outcomes, and address disparate care outcomes among certain populations
and of those living in frontier areas of the state.
The bill requires hospitals to submit specified data to the perinatal
quality collaborative concerning disparities in perinatal health care and
health-care outcomes; to annually participate in at least one maternal or
infant health quality improvement initiative (initiative), as determined by
the hospitals; and to report to the perinatal quality collaborative regarding
the implementation and outcomes of the initiative. The bill authorizes
financial support for hospitals in rural and frontier areas of the state,
hospitals that serve a higher number of medical assistance patients or
uninsured patients, and hospitals with lower-acuity maternal or neonatal
levels of care.
In collaboration with the department, the bill requires the perinatal
quality collaborative to issue an annual report on clinical quality
improvements in maternal and infant health outcomes and related data
that can be shared with hospitals and health facilities, policymakers, and
others and posted on the internet.
The bill requires coverage of over-the-counter, prescribed choline
supplements for pregnant people to fulfill the federal food and drug
administration's daily adequate intake for pregnant people.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 10-16-104, add2
175-2- (3)(e) as follows:1
10-16-104.  Mandatory coverage provisions - definitions - rules2
- applicability. (3)  Maternity coverage. (e)  Doula services. (I)  A
S3
USED IN THIS SUBSECTION (3)(e), UNLESS THE CONTEXT OTHERWISE4
REQUIRES:5
(A)  "D
OULA" MEANS A TRAINED BIRTH COMPANION WHO PROVIDES6
PERSONAL, NONMEDICAL SUPPORT TO PREGNANT AND POSTPARTUM7
PEOPLE AND THEIR FAMILIES PRIOR TO CHILDBIRTH , DURING LABOR AND8
DELIVERY, AND DURING THE POSTPARTUM PERIOD AND WHO HAS THE9
QUALIFICATIONS AND TRAINING REQUIRED BY THE STATE .10
(B)  "D
OULA SERVICES" MEANS SERVICES PROVIDED BY A DOULA .11
(C)  "M
EDICAL ASSISTANCE PROGRAM " MEANS THE "COLORADO12
M
EDICAL ASSISTANCE ACT", ARTICLES 4, 5, AND 6 OF TITLE 25.5.13
(D)  "R
EPORT" MEANS THE REPORT OF THE DEPARTMENT OF14
HEALTH CARE POLICY AND FI NANCING	, INCLUDING THE FINDINGS AND15
RECOMMENDATIONS FOR DOULA SERVICES , RESULTING FROM THE16
STAKEHOLDER PROCESS REQUIRED PURSUANT TO SECTION 25.5-4-506.17
(II)  E
XCEPT AS PROVIDED IN SUBSECTION (3)(e)(VI) OF THIS18
SECTION, MATERNITY COVERAGE PURSUANT TO THIS SUBSECTION (3) MUST19
INCLUDE COVERAGE FOR DOULA SERVICES .20
(III)  T
HE COVERAGE FOR DOULA SERVICES PURSUANT TO THIS21
SUBSECTION (3)(e) MUST:22
(A)  I
NCLUDE THE SAME SCOPE AND DURATION OF COVERAGE FOR23
DOULA SERVICES THAT IS INCLUDED IN THE DEPARTMENT OF HEALTH CARE24
POLICY AND FINANCING'S REQUEST SUBMITTED PURSUANT TO SECTION25
25.5-4-506
 FOR FEDERAL AUTHORIZATION FOR DOULA SERVICES UNDER26
THE MEDICAL ASSISTANCE PROGRAM ; EXCEPT THAT THE COMMISSIONER27
175
-3- MAY ADOPT RULES AS NECESSARY TO IMPLEMENT THE BENEFIT IN THE1
PRIVATE INSURANCE MARKET ; AND2
(B)  R
EQUIRE THE SAME QUALIFICATIONS FOR AND REGULATION OF3
INDIVIDUALS PROVIDING DOULA SERVICES AS RECOMMENDED IN THE4
REPORT FOR INDIVIDUALS PROVIDING DOULA SERVICES UNDER THE5
MEDICAL ASSISTANCE PROGRAM .6
(IV)  T
HIS SUBSECTION (3)(e) APPLIES TO, AND THE DIVISION SHALL7
IMPLEMENT THE REQUIREMENTS OF THIS SUBSECTION (3)(e) FOR, LARGE8
EMPLOYER HEALTH BENEFIT PLANS ISSUED OR RENEWED IN THIS STATE ON9
OR AFTER JULY 1, 2025, OR TWELVE MONTHS AFTER THE DATE ON WHICH10
THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING SUBMITS ITS11
REQUEST PURSUANT TO SECTION 25.5-4-506 FOR FEDERAL AUTHORIZATION12
FOR DOULA SERVICES UNDER THE MEDICAL ASSISTANCE PROGRAM ,13
WHICHEVER IS LATER.14
(V)  W
ITH RESPECT TO INDIVIDUAL AND SMALL GROUP HEALTH15
BENEFIT PLANS, THE DIVISION SHALL:16
(A)  R
EVIEW THE ACTUARIAL REVIEW CONDUCTED PURSUANT TO17
SECTION 10-16-155.5 AND SUBMIT TO THE FEDERAL DEPARTMENT OF18
HEALTH AND HUMAN SERVICES THE DIVISION 'S DETERMINATION AS TO19
WHETHER THE BENEFIT SPECIFIED IN THIS SUBSECTION (3)(e) IS IN20
ADDITION TO ESSENTIAL HEALTH BENEFITS AND WOULD BE SUBJECT TO21
DEFRAYAL BY THE STATE PURSUANT TO 42 U.S.C. SEC. 18031 (d)(3)(B);22
AND23
(B)  R
EQUEST THAT THE FEDERAL DEPARTMENT OF HEALTH AND24
HUMAN SERVICES CONFIRM THE DIVISION'S DETERMINATION WITHIN SIXTY25
DAYS AFTER RECEIPT OF THE DIVISION'S REQUEST AND SUBMISSION OF ITS26
DETERMINATION.27
175
-4- (VI)  THIS SUBSECTION (3)(e) APPLIES TO, AND THE DIVISION SHALL1
IMPLEMENT THE REQUIREMENTS OF THIS SUBSECTION (3)(e) FOR,2
INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLANS ISSUED OR3
RENEWED IN THIS STATE UPON THE EARLIER OF :4
(A)  T
WELVE MONTHS AFTER THE FEDERAL DEPARTMENT OF5
HEALTH AND HUMAN SERVICES CONFIRMS THE DIVISION 'S DETERMINATION6
OR OTHERWISE INFORMS THE DIVISION THAT THE COVERAGE SPECIFIED IN7
THIS SUBSECTION (3)(e) DOES NOT CONSTITUTE AN ADDITIONAL BENEFIT8
THAT REQUIRES DEFRAYAL BY THE STATE PURS UANT TO 	42 U.S.C. SEC.9
18031 (d)(3)(B); 
OR10
(B)  T
HE PASSAGE OF MORE THAN THREE HUNDRED SIXTY -FIVE11
DAYS SINCE THE DIVISION SUBMITTED ITS DETERMINATION AND REQUEST12
FOR CONFIRMATION PURSUANT TO SUBSECTION (3)(e)(V) OF THIS SECTION,13
AND THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES HAS14
FAILED TO RESPOND TO THE REQUEST WITHIN THAT PERIOD , IN WHICH CASE15
THE DIVISION SHALL CONSIDER THE FEDERAL DEPARTMENT	'S16
UNREASONABLE DELAY A PRECLUSION FROM REQUIRING DEFRAYAL BY THE17
STATE.18
SECTION 2. In Colorado Revised Statutes, 25-1.5-103, add19
(1)(d) as follows:20
25-1.5-103.  Health facilities - powers and duties of department21
- rules - limitations on rules - definitions - repeal. (1)  The department22
has, in addition to all other powers and duties imposed upon it by law, the23
powers and duties provided in this section as follows:24
(d) (I)  T
O ENSURE THAT EACH HOSPITAL THAT PROVIDES LABOR25
AND DELIVERY OR NEONATAL CARE SERVICES IS COMPLYING WITH THE26
REQUIREMENTS SPECIFIED IN SECTION 25-52-106.5, INCLUDING27
175
-5- PARTICIPATING IN AT LEAST ONE MATERNAL OR INFANT HEALTH QUALITY1
IMPROVEMENT INITIATIVE AND SUBMITTING OUTCOME DATA TO THE2
PERINATAL QUALITY COLLABORATIVE DEFINED IN SECTION 25-52-103 (3).3
(II)  T
HIS SUBSECTION (1)(d) IS REPEALED, EFFECTIVE SEPTEMBER4
1,
 2029.5
SECTION 3. In Colorado Revised Statutes, 25-52-103, amend6
(3); and add (6.5) as follows:7
25-52-103.  Definitions. As used in this article 52, unless the8
context otherwise requires:9
(3)  "Designated state perinatal care quality collaborative" 
OR10
"
PERINATAL QUALITY COLLABORATIVE " means a statewide nonprofit11
network of health facilities, clinicians, and public health professionals12
working to improve the quality of care for mothers and babies through13
continuous quality improvement.14
(6.5)  "M
EDICAL ASSISTANCE PROGRAM " MEANS THE MEDICAL15
ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO ARTICLES 4 TO 6 OF16
TITLE 25.5.17
SECTION 4. In Colorado Revised Statutes, add 25-52-106.5 as18
follows:19
25-52-106.5.  Perinatal health quality improvement program20
- perinatal health quality improvement
 engagement program -21
perinatal quality collaborative duties - data collection - reporting -22
legislative declaration - definitions. (1)  T
HE GENERAL ASSEMBLY FINDS23
AND DECLARES THAT:24
(a)  D
ISPARITIES IN MATERNAL AND INFANT HEALTH-CARE ACCESS,25
DELIVERY, AND OUTCOMES IN COLORADO PERSIST, SUCH THAT BIRTHING26
PEOPLE WHO ARE AMERICAN INDIAN/ALASKA NATIVE ARE NEARLY THREE
27
175
-6- TIMES MORE LIKELY TO DIE DURING PREGNANCY OR WITHIN ONE YEAR1
POSTPARTUM THAN THE OVERALL POPULATION OF THOSE GIVING BIRTH IN2
C
OLORADO;
3
(b)  B
IRTHING PEOPLE WHO ARE BLACK ARE NEARLY TWO TIMES
4
MORE LIKELY TO DIE DURING PREGNANCY OR WITHIN ONE YEAR5
POSTPARTUM THAN THE OVERALL POPULATION OF THOSE GIVING BIRTH IN6
C
OLORADO;
7
(c) BIRTHING PEOPLE LIVING IN FRONTIER COUNTIES ARE MORE8
LIKELY TO DIE FROM PREGNANCY -RELATED CAUSES THAN THOSE LIVING9
IN URBAN COUNTIES, AND PEOPLE INSURED THROUGH THE MEDICAL10
ASSISTANCE PROGRAM ARE MORE LI KELY TO DIE DURING PREGNANCY OR11
WITHIN ONE YEAR POSTPARTUM THAN THOSE WITH PRIVATE INSURANCE ;12
(d) DISCRIMINATION CONTRIBUTED TO HALF OF ALL13
PREGNANCY-ASSOCIATED DEATHS IN COLORADO, AND NINETY PERCENT OF14
ALL DEATHS WERE DEEMED PREVENTABLE BY THE COLORADO MATERNAL15
MORTALITY REVIEW COMMITTEE ;16
(e) IN 2022, THE UNITED STATES' INFANT MORTALITY RATE17
INCREASED FOR THE FIRST TIME IN TWO DECADES . INFANTS BORN TO18
B
LACK AND NATIVE AMERICAN BIRTHING PEOPLE ARE TWO TIMES MORE19
LIKELY TO DIE COMPARED WITH THEIR WHITE AND 	HISPANIC20
COUNTERPARTS.21
(f)
  THE COMMITTEE AND THE MATERNAL HEALTH TASK FORCE22
ESTABLISHED BY THE DEPARTMENT RECOMMEND STATEWIDE , UNIVERSAL23
PARTICIPATION IN QUALITY IMPROVEMENT INITIATIVES LED BY THE24
PERINATAL QUALITY COLLABORATIVE AND THE ADOPTION OF ALLIANCE25
FOR INNOVATION ON MATERNAL HEALTH PATIENT SAFETY BUNDLES ;26
(g) THE NATIONAL GOVERNORS ASSOCIATION, THROUGH ITS27
175
-7- MATERNAL AND INFANT HEALTH INITIATIVE , SIMILARLY RECOMMENDS THE1
ADOPTION OF PATIENT SAFETY BUNDLES AND INCREASED FUNDING FOR2
STATE MATERNAL MORTALITY REVIEW COMMITTEES AND PERINATAL3
QUALITY COLLABORATIVES ;4
(h) NINETY-SIX PERCENT OF BIRTHS IN COLORADO OCCUR IN5
HOSPITALS, AND THERE IS A NEED TO PROVIDE PRACTICAL SUPPORT TO6
HOSPITALS, ESPECIALLY FRONTIER AND RURAL HOSPITALS , FOR THE7
IMPLEMENTATION OF CLINICAL QUALITY IMPROVEMENT INITIATIVES ; AND8
(i) PARTICIPATION IN STATE PERINATAL QUALITY COLLABORATIVES9
HAS BEEN SHOWN TO IMPROVE MATERNAL AND INFANT HEALTH OUTCOMES10
THROUGH IMPROVED ACCESS TO , AND THE TIMELINESS OF, TREATMENT11
AND THROUGH REDUCED SERIOUS PREGNANCY COMPLICATIONS .12
(2)  A
S USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE13
REQUIRES:14
(a)  "E
NGAGEMENT PROGRAM " MEANS THE PERINATAL HEALTH15
QUALITY IMPROVEMENT ENGAGEMENT PROGRAM CREATED IN SUBSECTION16
(5)
 OF THIS SECTION.17
(b)  "H
OSPITAL" MEANS A HOSPITAL LICENSED OR CERTIFIED18
PURSUANT TO SECTION 25-1.5-103 THAT PROVIDES NONEMERGENT
19
PERINATAL CARE SERVICES.20
(c)  "Q
UALITY IMPROVEMENT PROGRAM " MEANS THE HOSPITAL21
PERINATAL HEALTH QUALITY IMPROVEMENT PROGRAM CREATED IN22
SUBSECTION (4) OF THIS SECTION.23
(3) (a)  T
HE DEPARTMENT SHALL CONTRACT WITH THE PERINATAL24
QUALITY COLLABORATIVE TO :25
(I)  T
RACK STATEWIDE IMPLEMENTATION OF THE COMMITTEE 'S26
RECOMMENDATIONS TO PREVENT MATERNAL MORTALITY ;27
175
-8- (II)  IMPLEMENT HOSPITAL QUALITY IMPROVEMENT PROGRAMS1
THROUGH PERINATAL CARE SETTINGS TO REDUCE PREVENTABLE CAUSES2
OF MATERNAL MORTALITY AND MORBIDITY ; AND3
(III)  A
DDRESS DISPARATE CARE OF AND OUTCOMES AMONG4
A
MERICAN INDIAN/ALASKA NATIVE AND BLACK BIRTHING POPULATIONS,5
BIRTHING PEOPLE INSURED THROUGH THE MEDICAL ASSISTANCE PROGRAM ,6
AND BIRTHING PEOPLE LIVING IN RURAL AND
 FRONTIER COUNTIES.7
(b)  I
N IMPLEMENTING HOSPITAL QUALITY IMPROVEMENT
8
PROGRAMS, THE PERINATAL QUALITY COLLABORATIVE SHALL PROVIDE9
QUALITY IMPROVEMENT PROGRAM SUPPORT THAT MAY INCLUDE:10
(I)  C
LINICAL QUALITY IMPROVEMENT SCIENCE EDUCATION11
CONCERNING BEST PRACTICES AND INNOVATIONS TO SUPPORT OPTIMAL12
OUTCOMES;13
(II)  T
AILORED INTERVENTIONS DESIGNED TO ADDRESS THE NEEDS14
OF PRIORITY POPULATIONS;15
(III)  I
NDIVIDUALIZED PROGRAM IMPLEMENTATION GUIDANCE AND16
SUPPORT;17
(IV)  D
ATA REPORTING, ANALYSIS, AND RAPID RESPONSE18
FEEDBACK FOR ASSISTANCE IN MONITORING THE SUSTAINABILITY OF19
IMPLEMENTED CHANGES ;20
(V)  P
ROVIDER TRAINING IN STIGMA, BIAS, AND TRAUMA-INFORMED21
AND RESPECTFUL CARE; AND22
(VI)  P
UBLIC RECOGNITION AS A MATERNAL AND INFANT CARE23
QUALITY CHAMPION.24
(c)  T
HE DEPARTMENT SHALL PROVIDE VITAL STATISTICS DATA TO25
THE PERINATAL QUALITY COLLABORATIVE FOR PURPOSES OF DATA26
ANALYSIS AND REPORTING . THE PERINATAL QUALITY COLLABORATIVE
27
175
-9- SHALL DEVELOP A DATA-SHARING AGREEMENT WITH THE DEPARTMENT TO1
IDENTIFY SPECIFIC VITAL STATISTICS DATA THAT MUST BE SHARED . THE2
DATA-SHARING AGREEMENT MUST ADDRESS THE CONFIDENTIALITY OF3
DATA TO ENSURE THAT DATA SHARING IS PROTECTED .4
(4)  Hospital perinatal health quality improvement program.5
A
 HOSPITAL SHALL:6
(a)  N
O LATER THAN JULY 1, 2025, AND NO LATER THAN JULY 1
7
EACH YEAR THEREAFTER , SUBMIT TO THE PERINATAL QUALITY8
COLLABORATIVE, EITHER DIRECTLY OR THROUGH A STATEWIDE9
ASSOCIATION OF HOSPITALS, A MINIMUM DATA SET OF KEY DRIVERS OF10
DISPARITIES IN PERINATAL HEALTH CARE AND HEALTH -CARE OUTCOMES,11
MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY , AND INFANT12
HEALTH CARE AND HEALTH -CARE OUTCOMES, INCLUDING:13
(I)  C
ESAREAN DELIVERIES;14
(II)  P
ERINATAL HYPERTENSION, SEPSIS, AND CARDIAC CONDITIONS;15
(III)  M
ATERNAL AND NEONATAL READMISSIONS AND LENGTH OF16
STAY;17
(IV)  U
NEXPECTED NEWBORN COMPLICATIONS ;18
(V)  P
ERINATAL MENTAL HEALTH AND SUBSTANCE USE19
CONDITIONS;20
(VI)  O
BSTETRIC HEMORRHAGE ; AND21
(VII)  P
RETERM BIRTH; AND
22
(b)  B
EGINNING DECEMBER 15, 2025, PARTICIPATE
 ANNUALLY IN23
AT LEAST ONE MATERNAL OR INFANT HEALTH QUALITY IMPROVEMENT24
INITIATIVE, AS DETERMINED BY THE HOSPITAL, IN COLLABORATION WITH25
THE PERINATAL QUALITY COLLABORATIVE PURSUANT TO SUBSECTION (3)26
OF THIS SECTION, WITH THE GOAL OF:27
175
-10- (I)  PROMOTING EVIDENCE-BASED, CULTURALLY RELEVANT, SAFE,1
EQUITABLE, HIGH-QUALITY CARE; AND2
(II)  P
REVENTING MATERNAL AND INFANT MORTALITY AND SEVERE3
MORBIDITY.
4
          5
(5)  Perinatal health quality improvement engagement6
program. (a)  N
O LATER THAN JULY 1, 2025, THE DEPARTMENT SHALL7
CREATE A PERINATAL HEALTH QUALITY IMPROVEMENT ENGAGEMENT8
PROGRAM THAT PROVIDES FINANCIAL SUPPORT TO HOSPITALS AND
9
FACILITIES THAT PROVIDE EMERGENT LABOR AND DELIVERY OR PERINATAL10
CARE SERVICES THAT DO NOT HAVE SUFFICIENT RESOURCES TO11
PARTICIPATE IN ONE OR MORE MATERNAL OR INFANT HEALTH QUALITY12
IMPROVEMENT INITIATIVES PURSUANT TO SUBSECTION (4) OF THIS13
SECTION.14
(b)  T
HE DEPARTMENT SHALL SELECT HOSPITALS AND FACILITIES
15
THAT PROVIDE EMERGENT LABOR AND DELIVERY OR PERINATAL CARE16
SERVICES TO PARTICIPATE IN THE ENGAGEMENT PROGRAM AND MAY17
CONTRACT WITH THE PERINATAL QUALITY COLLABORATIVE TO18
ADMINISTER THE ENGAGEMENT PROGRAM . IN ORDER TO PARTICIPATE IN19
THE ENGAGEMENT PROGRAM , A HOSPITAL OR FACILITY MUST COMMIT TO20
WORK WITH THE PERINATAL QUALITY COLLABORATIVE ON THE MATERNAL21
OR INFANT HEALTH QUALITY IMPROVEMENT INITIATIVES SELECTED BY THE22
HOSPITAL OR FACILITY.23
(c)  T
HE DEPARTMENT SHALL PRIORITIZE FINANCIAL SUPPORT FOR24
HOSPITALS AND FACILITIES
 THAT:25
(I)  A
RE IN RURAL AND FRONTIER AREAS OF THE STATE ;26
(II)  Q
UALIFY FOR DISPROPORTIONATE SHARE PAYMENTS UNDER27
175
-11- THE MEDICAL ASSISTANCE PROGRAM ; OR1
(III)  H
AVE LOWER-ACUITY MATERNAL OR NEONATAL LEVELS OF2
CARE DESIGNATIONS.3
(d)  H
OSPITALS AND FACILITIES
 RECEIVING FINANCIAL SUPPORT4
PURSUANT TO THE ENGAGEMENT PROGRAM MAY USE THE FINANCIAL5
SUPPORT FOR QUALITY IMPROVEMENT , INCLUDING DEDICATED STAFF TIME,6
TRAINING COSTS, TRAVEL, CONTINUING EDUCATION, AND DATA ENTRY7
AND TECHNICAL ASSISTANCE.8
(6)  Collaboration with the perinatal quality collaborative.9
(a)  T
HE DEPARTMENT SHALL CONTRACT WITH THE PERINATAL QUALITY
10
COLLABORATIVE TO:11
(I)  T
RACK STATEWIDE IMPLEMENTATION OF THE COMMITTEE 'S12
RECOMMENDATIONS , DEVELOPED PURSUANT TO SECTION 25-52-104, TO13
PREVENT MATERNAL MORTALITY ; AND14
(II)  N
O LATER THAN JULY 1, 2026, AND NO LATER THAN JULY 1
15
EACH YEAR THEREAFTER , ISSUE A REPORT TO THE DEPARTMENT16
CONCERNING:17
(A)  C
LINICAL
 QUALITY IMPROVEMENT EFFORTS TO REDUCE18
DISPARITIES IN PERINATAL HEALTH OUTCOMES AND TO PREVENT19
MATERNAL AND INFANT MORTALITY AND MORBIDITY THAT INCLUDES20
RELEVANT, AGGREGATE HOSPITAL MATERNAL AND INFANT HEALTH21
QUALITY METRICS AND THAT MAY BE DISTRIBUTED TO POLICYMAKERS ,22
HEALTH-CARE PROVIDERS, HOSPITALS AND OTHER HEALTH FACILITIES ,23
PUBLIC HEALTH PROFESSIONALS , AND OTHER INTERESTED PERSONS TO24
ASSIST THE DEPARTMENT IN PROMOTING DATA ACCESS AND FACILITATING25
ADDITIONAL EFFORTS TO REDUCE MATERNAL AND INFANT MORTALITY AND26
MORBIDITY;	27
175
-12- (B)  HOSPITAL PARTICIPATION IN MATERNAL AND INFANT1
PERINATAL QUALITY IMPROVEMENT INITIATIVES PURS	UANT TO2
SUBSECTION (4)(b) OF THIS SECTION;3
(C)  I
MPLEMENTATION OF THE FEDERAL HEALTH RESOURCES AND
4
SERVICES ADMINISTRATION MATERNAL AND CHILD HEALTH BUREAU 'S AND5
A
MERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS' ALLIANCE
6
FOR INNOVATION ON MATERNAL HEALTH PATIENT SAFETY BUNDLES AND7
RELATED PERFORMANCE METRICS , INCLUDING THE STATUS OF ADDRESSING8
DRIVERS OF PERINATAL HEALTH DISPARITIES AND MATERNAL AND INFANT9
MORTALITY AND MORBIDITY AS DESCRIBED IN SUBSECTION (4)(a) OF THIS10
SECTION; AND11
(D)  A
REAS OF OPPORTUNITY FOR ONGOING IMPROVEMENT .
12
(b)  I
N COMPLIANCE WITH ALL APPLICABLE STATE AND FEDERAL13
LAWS RELATING TO THE PUBLICATION OF HEALTH INFORMATION AND14
LEGALLY BINDING DATA USE AGREEMENTS , THE PERINATAL QUALITY15
COLLABORATIVE AND THE DEPARTMENT SHALL MAKE AN AGGREGATED
16
AND DE-IDENTIFIED REPORT PREPARED PURSUANT TO SUBSECTION17
(6)(a)(II) 
OF THIS SECTION PUBLICLY AVAILABLE ON THE DEPARTMENT 'S18
WEBSITE AND ON THE WEBSITE OF THE PERINATAL 	QUALITY19
COLLABORATIVE.20
(c)  T
HE PERINATAL QUALITY COLLABORATIVE SHALL CONSULT
21
WITH A STATEWIDE ASSOCIATION OF HOSPITALS AND WITH DIVERSE22
HOSPITAL LEADERSHIP TO SUPPORT ONGOING HOSPITAL ENGAGEMENT IN23
QUALITY IMPROVEMENT AND TO ADVISE PRACTITIONERS IN CLINICAL24
SETTINGS ACROSS THE STATE ON THE ADVANCEMENT OF BEST PRACTICES25
TO REDUCE MATERNAL AND INFANT MORTALITY AND MORBIDITY .26
(d)  D
ATA SUBMITTED PURSUANT TO SUBSECTION (4)(a) OF THIS
27
175
-13- SECTION IS CONSIDERED CONFIDENTIAL AND PROPRIETARY , CONTAINS1
TRADE SECRETS, OR IS NOT A PUBLIC RECORD PURSUANT TO PART 2 OF2
ARTICLE 72 OF TITLE 24 AND IS ONLY REPORTABLE IN AN AGGREGATED3
AND DE-IDENTIFIED MANNER.4
SECTION 5. In Colorado Revised Statutes, add 25.5-5-517 as5
follows:6
25.5-5-517.  Coverage for choline dietary supplements. (1)  N
O
7
LATER THAN JULY 1, 2025, THE STATE BOARD SHALL PROMULGATE RULES8
TO INCLUDE COVERAGE UNDER THE MEDICAL ASSISTANCE PROGRAM FOR9
OVER-THE-COUNTER CHOLINE DIETARY SUPPLEMENTS FOR PREGNANT10
PERSONS.11
(2)  T
HE STATE DEPARTMENT SHALL SEEK FEDERAL APPROVAL , AS
12
NECESSARY, FOR THE COVERAGE DESCRIBED IN SUBSECTION (1) OF THIS13
SECTION.14
SECTION 6. Appropriation. (1)  For the 2024-25 state fiscal15
year, $1,328,652 is appropriated to the department of public health and16
environment for use by the prevention services division. This17
appropriation is from the general fund and is based on an assumption that18
the division will require an additional 0.9 FTE. To implement this act, the19
division may use this appropriation for maternal and child health related20
to community health.21
SECTION 7. Safety clause. The general assembly finds,22
determines, and declares that this act is necessary for the immediate23
preservation of the public peace, health, or safety or for appropriations for24
the support and maintenance of the departments of the state and state25
institutions.26
175
-14-