6 Colo. Code Regs. § 1011-3-2

Current through Register Vol. 47, No. 11, June 10, 2024

Section 6 CCR 1011-3-2 - DEFINITIONS

2.1 Administrator: The term "Administrator" is synonymous with the term "Manager" pursuant to Section 25-3.5-1301(2), C.R.S. For purposes of these rules, the term "Administrator" shall be used and means a person who controls and supervises or offers or attempts to control and supervise the day-to-day operations of a Community Integrated Health Care Service agency.

2.2 Advanced Practice Nurse (APN): An Advanced Practice Registered Nurse who is a professional nurse and is licensed to practice pursuant to Title 12, Article 38, who obtains specialized education or training as provided in Sections 12-38-103 (8.5), and 12-38-111.5, C.R.S. and who applies to and is accepted by the State Board of Nursing for inclusion in the advanced practice registry.

2.3 At-Risk Adult: An individual eighteen years of age or older who is susceptible to mistreatment or self-neglect because the individual is unable to perform or obtain services necessary for his or her health, safety, or welfare, or lacks sufficient understanding or capacity to make or communicate responsible decisions concerning his or her person or affairs.

2.4 Authorized Entity: A licensed ambulance service; a fire department of a town, city, or city and county, a fire protection district, ambulance district, health assurance district, health service district, or metropolitan district, or special district authority; or a health care business entity, including a licensed or certified health care facility that is subject to regulation under Article 3 of Title 25 that performs any of the services that may be provided through a Community Assistance Referral and Education Services Program pursuant to Section 25-3.5-1203(3), C.R.S.

2.5 Care Coordination: The deliberative organization of consumer care activities between two or more participants, including the consumer, involved in a consumer's care to facilitate the delivery of out-of-hospital medical services.

2.6 Care Provider: For the purposes of these rules, a Care Provider is a person who, under state law, has the authority to provide, coordinate, or order out-of-hospital medical services for his or her patients to be provided by CIHCS Providers, and who collaborates with CIHCS agencies on the patient's behalf.

2.7 CIHCS Medical Director (Medical Director): A Colorado licensed physician and/or APN in good standing who is identified as being responsible for supervising, directing, and assuring the competency of those individuals who are employed by or contracted with the CIHCS agency to perform community integrated health care services on behalf of the agency; except that if the agency hires or contracts with a Community Paramedic, only a licensed physician in good standing may supervise, direct, and assure the competency of Community Paramedics.

2.8 Community Assistance Referral and Education Services Program (CARES Program) : A program established by an authorized entity as defined in Section 25-3.5-1202(1), C.R.S. to provide community outreach and health education to residents within the authorized entity's jurisdiction for the purposes of preventing illness and injury, or reducing the incidence of 911 calls and hospital emergency department visits made for nonemergency, non-urgent medical care or services.

2.9 Community Integrated Health Care Services Provider (CIHCS provider): A person who, through employment or under contract, performs certain out-of-hospital medical services, as determined by rule, on behalf of a CIHCS Agency:

2.9.1 A Community Paramedic as defined in Section 2.11 of these rules acting within his or her scope of practice.

2.9.2 An individual who:

A) Is a health care provider who holds a valid Colorado license, registration, or certification by the Colorado Department Of Regulatory Agencies (DORA) and is in good standing; and

B) While acting within the scope of his or her license or certificate is supervised and directed by a CIHCS agency medical director.

2.9.3 An individual who is employed by or contracted with the CIHCS agency who is not licensed, certified, or registered by DORA but who otherwise lawfully engages in practice, including but not limited to, dietetics, nutrition counseling, X-ray technology or phlebotomy while under the supervision and direction of a CIHCS Agency medical director to furnish community integrated health care services as defined in Section 25-3.5-103 (4.3), C.R.S. and as defined in these rules.

2.9.4 Anyone employed by or contracted with the CIHCS Agency who is involved in the fulfillment of a consumer's service plan.

2.9.5 Except as provided in Section 5.3.4 , EMS Providers who are not endorsed Community Paramedics are prohibited from providing out-of-hospital medical services to a consumer when employed by or contracting with a CIHCS Agency.

2.10 Community Integrated Health Care Services (CIHCS): The provision of certain out-of-hospital medical services as determined by these rules that a Community Paramedic and other qualified CIHCS Providers may provide and may include:

2.10.1 Services authorized pursuant to Section 25-3.5-1203(3) C.R.S. and as set forth in this rule;

2.10.2 Services authorized under the scope of practice as set forth in 6 CCR 1015-3, Chapter Two for a currently certified Colorado paramedic in good standing who is endorsed as a Community Paramedic; and

2.10.3 Services authorized pursuant to Section 25-3.5-206(4) (a.5)(II), C.R.S.

2.11 Community Integrated Health Care Service Agency (CIHCS Agency or Agency): A sole proprietorship, partnership, corporation, nonprofit entity, special district, governmental unit or agency, or licensed or certified health care facility that is subject to regulation under Article 1.5 or Article 3 of Title 25 that manages and offers, directly or by contract, community integrated health care services.

2.12 Community Paramedic: An emergency medical service provider as defined in Section 25-3.5-103(8), C.R.S. who obtains an endorsement in community paramedicine pursuant to Sections 25-3.5-203.5 and 206, C.R.S. and performs, in addition to a paramedic's scope of practice, authorized tasks and procedures and acts within the scope of practice as established in these rules, and 6 CCR 1015-3, Chapter Two including:

2.12.1 An initial assessment of the patient and any subsequent assessments, as needed;

2.12.2 Medical interventions;

2.12.3 Care coordination;

2.12.4 Resource navigation;

2.12.5 Patient education;

2.12.6 Inventory, compliance, and administration of medications; and

2.12.7 Gathering of laboratory and diagnostic data.

2.13 Consumer (CIHCS Consumer or Consumer): An individual receiving community integrated health care services.

2.14 Department: The Colorado Department of Public Health and Environment.

2.15 DORA: The Colorado Department of Regulatory Agencies.

2.16 Initial Assessment: As used in these rules, means the Agency's evaluation of the consumer's immediate needs.

2.17 Licensed in Good Standing: As used in these rules, means any individual providing services pursuant to these rules who holds a current and valid Colorado license, registration, or certification to provide services under the applicable licensing, registration, or certification authority and who is not subject to any restrictions.

2.18 Medical Direction: For purposes of these rules means the supervision and direction of individuals who perform acts on behalf of an Agency by a physician and/or advanced practice registered nurse (APN) who is licensed in Colorado and is in good standing, and who is identified as being responsible for assuring the competency of those individuals in the performance of acts on behalf of the Agency. If the Agency hires or contracts with a Community Paramedic, only a Colorado-licensed physician in good standing may provide medical direction for a Community Paramedic provider.

2.19 Out-of-Hospital Medical Services: For purposes of these rules means performing the initial assessment of the consumer and any subsequent assessments, as needed, furnishing of medical treatment and interventions, care coordination, resource navigation, patient education, medication inventory, compliance, and administration, and gathering of laboratory and diagnostic data. Such services also include nursing services, rehabilitative services, complementary health services, and behavioral health services that may be provided out-of-hospital, as well as the furnishing of other necessary out-of-hospital services and goods for the purpose of preventing, alleviating, curing or healing human illness, physical disability, physical injury, or alcohol, drug, or controlled substance abuse. All out-of-hospital medical services must be performed within each CIHCS Provider's scope of practice.

2.20 Owner: An officer, director, general partner, limited partner, or other person having a financial or equity interest of twenty-five percent or greater.

2.21 Service Plan: The approved written plan specific to each consumer receiving CIHCS in a series of visits that identifies the consumer's physical, medical, social, mental health, and/or environmental needs, as necessary; sets forth the out-of-hospital medical services the CIHCS Agency agrees to provide to the consumer; and, is overseen by the CIHCS Agency medical director.

6 CCR 1011-3-2

40 CR 21, November 10, 2017, effective 1/1/2018