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May 6, 2022 HB 22-1302
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Revised Fiscal Note
(replaces fiscal note dated April 14, 2022)
Drafting Number:
Prime Sponsors:
LLS 22-0815
Rep. Kennedy; Will
Sen. Jaquez Lewis; Priola
Date:
Bill Status:
Fiscal Analyst:
May 6, 2022
Senate Second Reading
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. It also requires the department to
undertake efforts to transform its process for clients attempting to receive long-term
care in the community. The bill increases state expenditures through FY 2025-26.
Appropriation
Summary:
For FY 2022-23, the bill includes an appropriation of $36.6 million to multiple state
agencies.
Fiscal Note
Status:
The revised fiscal note reflects the reengrossed bill, as amended by the Senate Health
and Human Services and Senate Appropriations Committees.
Table 1
State Fiscal Impacts Under HB 22-1302
Budget Year
FY 2022-23
Out Year
FY 2023-24
Revenue
- -
Expenditures General Fund $616,968 $566,968
Cash Funds
1
$35,000,000 -
Federal Funds $986,948 $536,948
Centrally Appropriated $301,659 $370,314
Total Expenditures $36,905,575 $1,474,230
Total FTE 14.3 FTE 17.0 FTE
Transfers - -
Other Budget Impacts General Fund Reserve $92,545 $85,045
1
Cash funds appropriated in FY 2022-23 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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May 6, 2022 HB 22-1302
Summary of Legislation
Primary Care and Behavioral Health Statewide Integration Grant Program. 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.
Universal contracting provisions. HCPF is required to develop universal contracting provisions 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.
Regional Health Connector Workforce Program. 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 for the Regional Health Connector Workforce Program.
Community placement transformation. The bill requires HCPF to undertake efforts to transform its
process for clients attempting to receive long-term care in the community. HCPF must report on its
efforts to the Joint Budget Committee and relevant legislative committees by January of 2023 and 2024.
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 Page 3
May 6, 2022 HB 22-1302
State Expenditures
The bill increases costs for the primary care and behavioral health programs, primarily in HCPF, by
about $39.4 million over a four-year period, with $35.0 million in costs in the first two years paid from
the Behavioral and Mental Health Cash Fund and $4.4 million over the next two years paid from the
General Fund and federal funds. HCPF will also have costs of $1.9 million in FY 2022-23 and
$1.4 million in FY 2023-24, paid from the General Fund and federal funds, to facilitate placement of
individuals with disabilities in community settings. 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
Primary Care and Behavioral Health Statewide Integration Grant Program
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 - -
CU (Higher Ed.) $250,000 - - -
Centrally Appropriated Costs
1
$55,460 $124,115 $124,115 $62,058
FTE—Personal Services 2.3 FTE 5.0 FTE 5.0 FTE 2.5 FTE
Grant Program Subtotal $16,348,074 $18,831,501 $3,702,499 $672,499
Transforming Long-Term Care in the Community
Personal Services $853,316 $853,316 - -
Operating Expenses $11,400 $11,400 - -
Leased Space $79,200 $79,200 - -
Strategic Advisory Team Contract $160,000 $160,000 - -
Systems Updates $500,000 - - -
Centrally Appropriated Costs $246,199 $246,199 - -
FTE—Personal Services 12.0 FTE 12.0 FTE - -
Long-Term Care Subtotal $1,850,115 $1,350,115 - -
HCPF Total $18,198,189 $20,181,616 $3,702,499 $672,499
General Funds $616,968 $566,968 $1,789,192 $305,221
BMH Cash Fund $16,292,614 $18,707,386 - -
Federal Funds $986,948 $536,948 $1,789,192 $305,220
Centrally Appropriated Costs $301,659 $370,314 $124,115 $62,058
HCPF FTE 14.3 FTE 17.0 FTE 5.0 FTE 2.5 FTE
1
Centrally appropriated costs are not included in the bill's appropriation
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May 6, 2022 HB 22-1302
Grant Program—HCPF. 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;
• 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.
Transforming Long-Term Care in the Community—HCPF. In FY 2022-23 and FY 2023-24, HCPF
requires 12.0 FTE to transform the process for clients attempting to receive long-term care in the
community and to submit reports to the General Assembly on its efforts related to the Olmstead
decision by January 2023 and January 2024. Any future resources will be addressed 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.
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May 6, 2022 HB 22-1302
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 universal contracting provisions, 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 to the Department of Health Care Policy and Financing for
FY 2022-23 of $1,603,916, including $616,968 General Fund and $986,948 federal funds, and 12.0 FTE
for transforming long-term care in the community.
Finally, the bill includes an FY 2022-23 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 for the Regional Health Connector Workforce Program.
State and Local Government Contacts
Health Care Policy and Financing Higher Education
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.