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February 10, 2022 HB 22-1114
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 22-0413
Rep. Larson; Valdez A.
Date:
Bill Status:
Fiscal Analyst:
February 10, 2022
House HHS
Erin Reynolds | 303-866-4146
Erin.Reynolds@state.co.us
Bill Topic: TRANSPORTATION SERVICES FOR MEDICAID WAIVER RECIPIENTS
Summary of
Fiscal Impact:
☐ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☐ Local Government
☐ Statutory Public Entity
The bill authorizes a transportation network company to provide non-medical
transportation services to persons enrolled in certain Medicaid waiver programs
beginning July 1, 2024. It will increase state expenditures on an ongoing basis
beginning in FY 2022-23.
Appropriation
Summary:
For FY 2022-23, the bill requires an appropriation of $547,674 to the Department of
Health Care Policy and Financing.
Fiscal Note
Status:
The fiscal note reflects the introduced bill.
Table 1
State Fiscal Impacts Under HB 22-1114
Budget Year
FY 2022-23
Out Year
FY 2023-24
Out Year
FY 2024-25
Out Year
FY 2025-26
Revenue
- - - -
Expenditures General Fund $88,411 $36,282 $270,000 $540,000
Cash Funds $22,400 $19,833 - -
Federal Funds $436,863 $344,801 $270,000 $540,000
Total Expenditures $547,674 $400,916 $540,000 $1,080,000
Transfers - - - -
Other Budget Impacts General Fund Reserve $13,262 $5,442 $40,500 $81,000
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February 10, 2022 HB 22-1114
Summary of Legislation
Beginning July 1, 2024, the bill authorizes a transportation network company to provide non-medical
transportation services to persons enrolled in the following Medicaid waiver programs:
the Brain Injury Waiver (BI);
the Developmental Disabilities Waiver (DD);
the Elderly, Blind and Disabled Waiver (EBD);
the Community Mental Health Supports Waiver (CMHS); and
the Spinal Cord Injury Waiver (SCI).
The Department of Health Care Policy and Financing (HCPF) may seek any necessary federal
authorization and must promulgate any necessary rules to ensure transportation network companies
comply with any required background checks, CAPS (check Adult Protective Services) checks, drug
tests, training, and vehicle inspections. HCPF must submit a report to the legislature by January 2024
identifying a reimbursement system with a goal to incentivize and increase transportation provider
participation.
Background
Non-medical transportation (NMT) and non-emergency medical transportation (NEMT) are required
Medicaid benefits available on all six adult waiver programs, including BI, DD, EBD, CMHS, SCI, and
the Supported Living Services Waiver (SLS). Currently, the service provides transportation by
credentialed drivers, as well as taxi service, mobility vans, and public transportation, where available.
Reimbursement for this service utilizes Fee-for-Service, negotiated market price, and public pricing
rate methodologies and is calculated by multiplying the rate by the number of units utilized. HCPF
also oversees the safety and oversight of Medicaid non-medical and non-emergency medical
transportation services.
Transportation network companies are services that use a digital network to connect riders to drivers
for the purpose of providing transportation, such as Lyft and Uber.
State Expenditures
The bill increases state expenditures in HCPF by the amounts shown in Table 2 from the General Fund,
cash funds, and federal funds.
Health Care Policy and Financing. Costs in HCPF include contract staff, computer programming,
and increased service costs, as discussed below.
Staff. HCPF requires contract support from a business analyst and policy advisor over two years
to implement the program. The business analyst will coordinate the systems updates between
multiple systems vendors and departmental programs. Business analyst costs assume 1,120 hours
at $180 per hour in FY 2022-23 and 800 hours at $185 per hour in FY 2023-24. The policy advisor
will coordinate recommendations related to stakeholder feedback, health and safety issues, and
rate setting methodologies, among other tasks. Policy analyst costs assume 615 hours at $202 per Page 3
February 10, 2022 HB 22-1114
hour in FY 2022-23 and 125 hours at $208 per hour in FY 2023-24. Existing department staff will
promulgate rules, submit waiver amendments, and work with contract staff within existing
resources.
MMIS programming. Programming costs for the Medicaid Management Information System
assume 1,596 hours in each of FY 2022-23 and FY 2023-24 at an hourly cost of $139 in FY 2022-23
and $142 in FY 2023-24.
Service costs. HCPF data show that there are approximately 2,250 applicable waiver participants
currently utilizing NMT taxi services at a monthly cost of $200. The fiscal note assumes a
20 percent increase in utilization due to the ease and availability of transportation network
company services. FY 2024-25 costs reflect half-year utilization to account for a ramp-up period.
Table 2
Expenditures Under HB 22-1114
FY 2022-23 FY 2023-24 FY 2024-25 FY 2024-25
Department of Health Care Policy and Financing
Contract Business Analyst $201,600 $148,000 - -
Contract Policy Advisor $124,230 $26,000 - -
MMIS Programming $221,844 $226,916 - -
Service Costs - - $540,000 $1,080,000
Total Cost $547,674 $400,916 $540,000 $1,080,000
General Fund $88,411 $36,282 $270,000 $540,000
Cash Funds $22,400 $19,833 - -
Federal Funds $436,863 $344,801 $270,000 $540,000
Other Budget Impacts
General Fund reserve. Under current law, an amount equal to 15 percent of General Fund
appropriations must be set aside in the General Fund statutory reserve beginning in FY 2022-23. Based
on this fiscal note, the bill is expected to increase the amount of General Fund held in reserve by the
amounts shown in Table 1, which will decrease the amount of General Fund available for other
purposes.
Effective Date
The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming no
referendum petition is filed.
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February 10, 2022 HB 22-1114
State Appropriations
For FY 2022-23, the bill requires the following appropriations to the Department of Health Care Policy
and Financing:
$88,411 from the General Fund;
$22,400 from cash funds; and
$436,863 from federal funds.
State and Local Government Contacts
Health Care Policy and Financing Information Technology
Law Regulatory Agencies
The revenue and expenditure impacts in this fiscal note represent changes from current law under the bill for each
fiscal year. For additional information about fiscal notes, please visit: leg.colorado.gov/fiscalnotes.