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June 13, 2022 HB 22-1283
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Final Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 22-0805
Rep. Michaelson Jenet;
Bradfield
Sen. Buckner; Priola
Date:
Bill Status:
Fiscal Analyst:
June 13, 2022
Signed into Law
Aaron Carpenter | 303-866-4918
Aaron.Carpenter@state.co.us
Bill Topic: YOUTH & FAMILY BEHAVIORAL HEALTH CARE
Summary of
Fiscal Impact:
☐ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☐ Local Government
☐ Statutory Public Entity
The bill requires the Colorado Department of Human Services to create an in-home
and residential respite care program, provide operational support for psychiatric
residential treatment facilities, create additional substance use treatment beds,
continue the crisis service program, and build a neuro-psych facility. The bill will
increase state expenditures on an ongoing basis starting in FY 2022-23.
Appropriation
Summary:
For FY 2022-23, the bill requires and includes an appropriation of $54.7 million to the
Department of Human Services.
Fiscal Note
Status:
The fiscal note reflects the enacted bill.
Table 1
State Fiscal Impacts Under HB 22-1283
Budget Year
FY 2022-23
Out Year
FY 2023-24
Out Year
FY 2024-25
Out Year
FY 2025-26
Revenue
- - - -
Expenditures General Fund
- - $12,662,442 $22,800,839
Cash Funds
1
$44,001,961 $5,773,287 $4,892,700 -
Centrally Approp. $69,797 $69,797 $69,797 $69,797
Total Expenditures $44,071,758 $5,843,084 $17,624,939 $22,870,636
Total FTE 4.0 FTE 4.0 FTE 4.0 FTE 4.0 FTE
Transfers - - - -
Other Budget Impacts - - $1,899,366 $3,420,126
1
FY 2022-23 funding may be spent over up to four fiscal years, as detailed in Table 2 in the State Expenditures
section.
Money in the Behavioral and Mental Health Cash Fund consists of federal ARPA funds.
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June 13, 2022 HB 22-1283
Summary of Legislation
The bill requires the Colorado Department of Human Services (CDHS) to create an in-home and
residential respite care program, provide operational support for psychiatric residential treatment
facilities, continue the Statewide Access to Crisis System Services, create new substance use treatment
beds, and build a neuro-psych facility, as described below. For each of the four programs, the bill
requires the General Assembly to appropriate funding from the Behavioral and Mental Health
Cash Fund in FY 2022-23 for implementation costs, and requires the CDHS to obligate funds by
December 30, 2024, and expend funds by December 31, 2026.
In-home and residential respite care services and facilities. Starting January 1, 2023, the bill requires
the CDHS to create in-home and residential respite care services and facilities for children and families
in up to seven regions of the state as determined by the CDHS and a committee of stakeholders. Under
the bill, respite care would be provided to foster care home to allow the foster parent or the foster
child a temporary break. The bill outlines requirements for these services, including: time and
capacity limitations, sibling placement, and reporting requirements, among others.
Starting in FY 2023-24, the bill requires that money appropriated to the CDHS for in-home and
residential respite care services must continue to support the Statewide Access to Crisis System
Services until June 30, 2026.
Residential mental health and substance use treatment. The bill requires the Behavioral Health
Administration to create, develop, or contract to add additional residential substance use treatment
beds for youth.
Support for psychiatric residential treatment facilities. Senate Bill 21-137 created a pilot program to
provide emergency resources to licensed providers to serve children and youth whose behavioral or
mental health needs require services and treatment in a residential child care facility. Starting
July 1, 2022, the bill requires the CDHS to provide operational support for psychiatric residential
treatment facilities for youth and qualified residential treatment programs for youth across the state
for this program. The bill also extends the program to provide emergency resources to licensed
providers serving youth who need services and treatment in a residential child care facility from
July 1, 2025, to July 1, 2028.
Neuro-psych facility. Starting July 1, 2022, the CDHS must begin the process of building and staffing
a neuro-psych facility. The facility must have a capacity of up to 16 residential beds for youth who
are under 21 years old. The CDHS must develop and implement admission criteria that ensures
Colorado children have been evaluated for the least restrictive level of care before being admitted to
the facility.
Background
The Behavioral Health Transformational Task Force recommended that the General Assembly invest
in increased adult inpatient and residential care using federal American Rescue Plan Act (ARPA)
funds (Recommendation B.1). The task force report is available online at:
https://leg.colorado.gov/sites/default/files/images/committees/2017/bhttf_final_report.pdf Page 3
June 13, 2022 HB 22-1283
State Expenditures
The bill increases state expenditures in the CDHS by $90.4 million over four fiscal years starting in
FY 2022-23 from the Behavioral and Mental Health Cash Fund and, beginning in FY 2024-25, the
General Fund. Starting in FY 2025-26, ongoing costs estimated at $22.9 million per year will be paid
from the General Fund. Expenditures are shown in Table 2 and detailed below.
Table 2
CDHS Expenditures Under HB 22-1283
Cost Components FY 2022-23 FY 2023-24 FY 2024-25 FY 2025-26
Division of Child Welfare
Personal Services $331,260 $331,260 $331,260 $331,260
Operating Expenses $5,400 $5,400 $5,400 $5,400
Capital Outlay Costs $18,600 - - -
Respite Contract Beds
1
$1,562,200 $1,562,200 $1,562,200 $1,562,200
Operational Support
1
$2,080,500 $2,080,500 $2,080,500 $2,080,500
Travel Reimbursement $4,001 $4,001 $4,001 $4,001
Centrally Appropriated Costs
2
$69,797 $69,797 $69,797 $69,797
FTE – Personal Services 4.0 FTE 4.0 FTE 4.0 FTE 4.0 FTE
DCW Subtotal $4,071,758 $4,053,158 $4,053,158 $4,053,158
Behavioral Health Administration
SUD Beds $5,000,000 - - -
Crisis System Services
1
- $1,250,000 $1,250,000 $1,250,000
BHA Subtotal $5,000,000 $1,250,000 $1,250,000 $1,250,000
Neuro-Psych Facility
Capital Construction
1
$35,000,000 - - -
Building Maintenance - $539,926 $399,421 $415,398
Operating Beds - - $11,922,360 $17,152,080
Neuro-Psych Facility Subtotal $35,000,000 $539,926 $12,321,781 $17,567,478
Total $44,071,758 $5,843,084 $17,624,939 $22,870,636
Total FTE 4.0 FTE 4.0 FTE 4.0 FTE 4.0 FTE
1
Behavioral and Mental Health Cash Fund spending from FY 2022-23 to FY 2024-25 is assumed to be obligated by
December 30, 2024. Funds appropriated for bed construction in FY 2022-23 will be spent through FY 2024-25.
2
Centrally appropriated costs are not included in the bill's appropriation.
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June 13, 2022 HB 22-1283
Division of Child Welfare. Starting in FY 2022-23, expenditures in the Division of Child Welfare in
the CDHS will increase to create a respite program and to provide operating support for residential
treatment beds, as described below. Contract bed costs are assumed to be covered by the Behavioral
and Mental Health Cash Fund through FY 2024-25, and then will be covered by General Fund starting
in FY 2025-26. Staffing costs are assumed to be covered by the Behavioral and Mental Health Cash
Fund through FY 2023-24, and then will be covered by General Fund starting in FY 2024-25.
Respite program. Starting in FY 2022-23, expenditures in the CDHS will increase to create a
respite program. The fiscal note assumes that the department will contract and provide staffing
for three different bed types:
• two psychiatric residential treatment facility bed at $1,000 per day;
• four qualified residential treatment program beds at $500 per day, and
• one treatment foster care beds at $290 per day.
In addition to beds, the CDHS will require 3.0 FTE to oversee the different bed placements. Staff
will contract with providers and oversee the contracts, coordinate bed placements, and determine
admissions and discharges for bed types, and will support and mange any referrals to the
neuro-psych facility for children in the child welfare system.
Operating support. Starting in FY 2022-23, expenditures in the CDHS will increase to provide
operating support for the SB 21-137 pilot program. To provide support, the CDHS will continue
the operation of six psychiatric residential treatment facility beds at the current rate of $950 per
day and continue the existing staff to support that placement.
Behavioral Health Administration. Starting in FY 2022-23, expenditures in the Behavioral Health
Administration will increase to provide additional residential mental health and substance use
treatment beds and to continue the Statewide Access to Crisis System Services program, as described
below.
SUD beds. The bill appropriates $5.0 million to create and develop additional residential
substance use treatment beds for youth. It is estimated that this amount will increase beds by 8 to
15 beds and represents one-time funding. Any continuation costs will be addressed through the
annual budget process.
Crisis System Services. The bill requires the General Assembly to appropriate money in
FY 2022-23 to continue the Crisis System Services program until June 30, 2026. The program
currently costs $1.25 million per year and is appropriated through FY 2022-23. Therefore, the
program will require an appropriation of $3.75 million, or $1.25 million per year to continue
through June 30, 2026. The fiscal note assumes funds will come from the Behavioral and Mental
Health Cash Fund and will be obligated by December 30, 2024. Costs in FY 2025-26 are assumed
to come from the General Fund.
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June 13, 2022 HB 22-1283
Neuro-Psych Facility—CDHS. Starting in FY 2022-23, expenditures in the CDHS will increase to
build a new neuro-psych facility, as well as to maintain and staff the facility, as described below.
Capital construction. The fiscal note estimates that construction of a new neuro-psych facility will
cost $35.0 million over approximately three years.
Building maintenance. Starting in FY 2023-24, expenditures will increase in the CDHS to provide
equipment and staff to maintain the new facility. Costs in FY 2023-24 include one-time startup
costs, while out-year costs include maintenance costs such as housekeeping and other support
operations. The fiscal note assumes that these costs will come from the Behavioral and Mental
Health Cash Fund in FY 2023-24 and from the General Fund starting in FY 2024-25.
Bed staffing. Assuming the facility is up and running in FY 2024-25, expenditures in the CDHS
will also increase to staff the 16 beds. The fiscal note assumes that staff will begin
September 1, 2024, and that it will cost $2,722 per day to staff a bed based on the current cost to
staff beds at the other mental health institutes. Costs in FY 2025-26 are adjusted for inflation. It
is assumed that ongoing staffing resources for the facility will continue beyond FY 2025-26, likely
paid from the General Fund, and that these costs will be requested through the annual budget
process.
Centrally appropriated costs. Pursuant to a Joint Budget Committee policy, certain costs associated
with this bill are addressed through the annual budget process and centrally appropriated in the Long
Bill or supplemental appropriations bills, rather than in this bill. These costs, which include employee
insurance and supplemental employee retirement payments, are shown in Table 2.
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 2023-24. Based
on this fiscal note, the bill is expected to increase the amount of General Fund held in reserve as shown
in Table 1, which will decrease the amount of General Fund available for other purposes.
Effective Date
This bill was signed into law by the Governor and took effect on May 18, 2022.
State Appropriations
For FY 2022-23, the bill requires and includes an appropriation of $54,667,948 from the Behavioral and
Mental Health Cash Fund to the Department of Human Services and 4.0 FTE. It includes spending
authority through December 30, 2024.
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June 13, 2022 HB 22-1283
State and Local Government Contacts
Child Protection Ombudsman Counties
Human Services Information Technology
Office of Respondent Parents' Counsel Office of the Child's Representative
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.