(1) The general assembly acknowledges the rights of individuals to make choices regarding their case management agency and service agency. Therefore, the general assembly believes there exists the need to ensure conflict-free case management services within the medicaid waivers for persons with intellectual and developmental disabilities.

(2) As used in this section, unless the context otherwise requires, "rural community-centered board" means a community-centered board comprised primarily of counties designated by the state office of rural health as a rural or frontier county.

(3) A conflict-free case management system shall be implemented in Colorado as follows:

(a) No later than July 1, 2017, the state department shall determine the options for community-centered boards to become compliant with conflict-free case management;

(b) No later than January 1, 2018, the state department shall publish guidance on the components of a business continuity plan;

(c) No later than July 1, 2018, each community-centered board shall submit a business continuity plan to the state department based on the best option for the community-centered board pursuant to subsection (3)(a) of this section;

(d) Once a community-centered board has submitted its business continuity plan, on or before June 30, 2019, the state department shall complete an analysis of the adequacy of the continuity plan, unreimbursed transition costs, and community impacts of the transition to conflict-free case management;

(e) No later than June 30, 2020, a community-centered board shall complete any necessary changes to its business operation that are required to implement its business continuity plan;

(f) No later than June 30, 2021, at least twenty-five percent of clients receiving home- and community-based services must be served through a system of conflict-free case management; and

(g) No later than June 30, 2022, all clients receiving home- and community-based services must be served through a system of conflict-free case management.

(4) Rural-based services - exemption. (a) The state department is authorized to seek a federal exemption from conflict-free case management requirements for geographic areas within the state where the only willing and qualified entity to provide case management services is also the only willing and qualified entity to provide home- and community-based services in that geographic area.

(b) A rural community-centered board must initially notify the state department in writing, no later than July 1, 2017, to request that the state department seek a federal exemption for its designated service area, as defined in section 25.5-10-202. Upon receipt of the notice, the state department shall evaluate case management service provider capacity, and, if the state department determines that it is supported, the state department shall seek a federal exemption for its designated service area within a reasonable period of time.

(c) Upon notification of federal approval or denial of a federal exemption from conflict-free case management requirements, the rural community-centered board shall submit a business continuity plan and commence any necessary changes to its business operation pursuant to subsection (3)(e) of this section.

(d) The state board shall promulgate rules for the provision of services and supports, including services and supports coordination, when there are multiple agencies operating in a specified geographic area.

(e) If the state department has not received notification by July 1, 2019, regarding approval or denial for a federal exemption from conflict-free case management requirements, the state board shall promulgate rules for the provision of services and supports, including services and supports coordination, for designated service areas where a federal exemption from conflict-free case management is pending.

(f) In order to ensure stability, client choice, and access to services in rural communities, the state board shall promulgate rules, as permitted under federal law, that allow a qualified entity to provide both case management services and home- and community-based services to the same individual if there is insufficient choice or capacity among existing service agencies or case management agencies serving a designated service area of a rural community-centered board.

(5) The state board shall amend its rules consistent with changes in federal law as set forth in 42 CFR (c)(1)(VI), including changes relating to allowable exemptions.