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April 14, 2022 HB 22-1302
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Revised Fiscal Note
(replaces fiscal note dated March 23, 2022)
Drafting Number:
Prime Sponsors:
LLS 22-0815
Rep. Kennedy; Will
Sen. Jaquez Lewis; Priola
Date:
Bill Status:
Fiscal Analyst:
April 14, 2022
Senate Health
Erin Reynolds | 303-866-4146
Erin.Reynolds@state.co.us
Bill Topic: HEALTH-CARE PRACTICE TRANSFORMATION
Summary of
Fiscal Impact:
☐ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☐ Local Government
☐ Statutory Public Entity
The bill creates the Primary Care and Behavioral Health Statewide Integration Grant
Program to be administered by the Department of Health Care Policy and Financing
to provide grants to physical and behavioral health care providers for implementation
of evidence-based clinical integration care models. The bill increases state
expenditures from FY 2022-23 through FY 2025-26.
Appropriation
Summary:
For FY 2022-23, the bill includes an appropriation of $34.75 million to the Department
of Health Care Policy and Financing and an appropriation of $250,000 to the University
of Colorado School of Medicine.
Fiscal Note
Status:
The revised fiscal note reflects the reengrossed bill. It has also been updated to adjust
the timing of expenditures to ensure compliance with federal ARPA deadlines.
Table 1
State Fiscal Impacts Under HB 22-1302
Budget Year
FY 2022-23
Out Year
FY 2023-24
Revenue
- -
Expenditures
1
Cash Funds
$35,000,000 -
Centrally Appropriated $55,460 $124,115
Total Expenditures $35,055,460 $124,115
Total FTE 2.3 FTE 5.0 FTE
Transfers - -
Other Budget Impacts - -
1
FY 2022-23 funding in HCPF will be spent over two fiscal years, as detailed in Table 2 in the State Expenditures
section. Money in the Behavioral and Mental Health Cash Fund comes from federal ARPA funds.
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April 14, 2022 HB 22-1302
Summary of Legislation
The bill creates the Primary Care and Behavioral Health Statewide Integration Grant Program to be
administered by the Department of Health Care Policy and Financing (HCPF) to provide grants to
physical and behavioral health care providers for implementation of evidence-based clinical
integration care models. In FY 2022-23, the bill appropriates $31.75 million to HCPF from the
Behavioral and Mental Health Cash Fund for this purpose.
Grants may be used to develop outpatient health care infrastructure; increase access to health care;
invest in early behavioral health-related interventions; address the behavioral health workforce; and
develop and implement alternative payment models. The bill outlines match requirements for
hospital-owned or –affiliated practices. The bill outlines certain grantee criteria that HCPF is required
to prioritize when awarding grants. HCPF is require to establish a set of statewide resources to
support grant recipients and may enter into an interagency agreement or contract to establish these
resources. Grant recipients are required to spend or obligate funding no later than December 31, 2024,
and expend funding by December 31, 2026.
HCPF is required to form a steering committee to provide input into grant application requirements,
feedback and direction on data collection standards and review, and engage with community
partners. Any steering committee member who is not a state employee may be reimbursed for
reasonable travel expenses.
HCPF, in collaboration with the Behavioral Health Administration (BHA) in the Department of
Human Services and the Division of Insurance in the Department of Regulatory Agencies, must
prepare a report that includes recommendations on best practices for integrated care models using
data collected from grant recipients related to clinical quality improvement and access to care.
In addition, HCPF is required to develop a universal contract for behavioral health services in
collaboration with the BHA by July 1, 2023. For FY 2022-23, the General Assembly is required to
appropriate $3.0 million from the Behavioral and Mental Health Cash Fund for this purpose.
The bill also includes an appropriation of $250,000 from the Behavioral and Mental Health Cash Fund
to the Department of Higher Education for use by the University of Colorado.
Background
The Behavioral Health Transformational Task Force recommended that the General Assembly
integrate primary care and behavioral health using federal American Rescue Plan Act (ARPA) funds
(Recommendation D). The task force report is available online at:
https://leg.colorado.gov/sites/default/files/images/committees/2017/bhttf_final_report.pdf
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April 14, 2022 HB 22-1302
State Expenditures
The bill increases state expenditures in HCPF by $34.75 million over FY 2022-23 and FY 2023-24, paid
from the Behavioral and Mental Health Cash Fund. HCPF will also have additional administrative
expenses, paid using General Fund and federal funds, in FY 2024-25 and FY 2025-26. Finally, the bill
appropriates $250,000 for a workforce program at the University of Colorado School of Medicine in
FY 2022-23. Expenditures are shown in Table 2, and detailed below.
Table 2
Expenditures Under HB 22-1302
FY 2022-23 FY 2023-24 FY 2024-25 FY 2025-26
Department of Health Care Policy and Financing
Personal Services $191,907 $456,634 $456,634 $228,316
Operating Expenses $3,105 $6,750 $6,750 $3,375
Capital Outlay Costs $24,800 $6,200 - -
Contractor Costs $1,072,720 $3,487,720 $3,115,000 $378,750
Grants $14,750,082 $14,750,082 - -
Regional Health Connector
Workforce Program (Higher Ed.) $250,000 - - -
Centrally Appropriated Costs
1
$55,460 $124,115 $124,115 $62,058
Total $16,348,074 $18,831,501 $3,702,499 $672,499
Total FTE 2.3 FTE 5.0 FTE 5.0 FTE 2.5 FTE
1
Centrally appropriated costs are not included in the bill's appropriation
Department of Health Care Policy and Financing. HCPF will create the Primary Care and Behavioral
Health Statewide Integration Grant Program, with resources dedicated to evaluating clinical
integration care models.
Staffing. Over four fiscal years, HCPF requires 5.0 FTE to implement the grant program. This
includes 1.0 FTE policy advisor hired October 1, 2022, to oversee grant program design at a
midpoint salary assuming the person hired will have clinical experience; an administrative
assistant, rate and financial analyst, and grant specialist hired January 1, 2023, to facilitate the
program, assist in training grant sites in alternative payment models and new data sharing
practices, and budget tracking and report; and finally a policy advisor hired July 1, 2023, to
perform detailed analysis, also hired at the midpoint assuming clinical expertise.
Contractors. HCPF will engage the following contractors to support the grant program, all of
which assume an hourly rate of $202:
• grant application and review contractor, which will review 60 applications per year in
FY 2022-23 and FY 2023-24 with six hours of review per application;
• clinical consultation contractors, which will require 7,500 hours in FY 2023-24 and
FY 2024-25, and 3,750 in FY 2025-26 to conduct site visits and other clinical engagement
with grantees; Page 4
April 14, 2022 HB 22-1302
• a contractor to create the universal contracting provisions and monitor compliance, which
will require 4,950 hours per year from FY 2022-23 through FY 2024-25; and
• billing and data sharing contractors, which will require 4,455 hours in FY 2023-24 and
2,970 per year in two subsequent fiscal years.
Grants. Grant amounts assume the remainder of funding after administrative expenses, preliminarily
estimated at about $29.8 million, will be awarded in equal amounts over two fiscal years. The actual
timing of issuing grants may differ depending on applications received and HCPF funding decisions.
Regional Health Connector Workforce Program. The bill appropriates $250,000 for the Regional
Health Connector Workforce Program, which is operated by the University of Colorado School of
Medicine. This appropriation is from the Behavioral and Mental Health Cash Fund.
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.
Effective Date
The bill takes effect upon signature of the Governor, or upon becoming law without his signature,
except that section 3, concerning the creation of a universal contract, takes effect only if
House Bill 22-1278 becomes law, in which case section 3 takes effect either upon the effective date of
this act or House Bill 22-1278, whichever is later.
State Appropriations
The bill includes the following appropriations to the Department of Health Care Policy and Financing
from the Behavioral and Mental Health Cash Fund which are further appropriated to HCPF through
December 30, 2024:
$31,750,000 for the Primary Care and Behavioral Health Statewide Integration Grant Program, and
2.3 FTE;
$3,000,000 for universal contracting provisions.
The bill also includes an appropriation of $250,000 from the Behavioral and Mental Health Cash Fund
to the Department of Higher Education for use by the University of Colorado School of Medicine.
State and Local Government Contacts
Health Care Policy and Financing Information Technology Law
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.