Page 1 March 31, 2022 SB 22-173 Legislative Council Staff Nonpartisan Services for Colorado’s Legislature Fiscal Note Drafting Number: Prime Sponsors: LLS 22-0947 Sen. Rodriguez; Smallwood Date: Bill Status: Fiscal Analyst: March 31, 2022 Senate Business Annie Scott | 303-866-5851 Annie.Scott@state.co.us Bill Topic: TELEPHARMACY CRITERIA REMOVE LOCATION RESTRICTION Summary of Fiscal Impact: ☒ State Revenue ☒ State Expenditure ☐ State Diversion ☒ TABOR Refund ☐ Local Government ☐ Statutory Public Entity This bill removes geographic restrictions on telepharmacy outlets, and allows the State Board of Pharmacy to adopt rules. This bill increases state revenue and expenditures beginning in FY 2022-23. Appropriation Summary: For FY 2022-23, the bill requires an appropriation of $140,110 to the Department of Regulatory Agencies. Fiscal Note Status: The fiscal note reflects the introduced bill. Table 1 State Fiscal Impacts Under SB 22-173 Budget Year FY 2022-23 Out Year FY 2023-24 Revenue Cash Funds $368,800 - Expenditures Cash Funds $140,110 $148,997 Centrally Appropriated $32,131 $37,740 Total Expenditures $172,241 $186,737 Total FTE 1.2 FTE 1.5 FTE Other Budget Impacts Tabor Refund $368,800 - Page 2 March 31, 2022 SB 22-173 Summary of Legislation Under current law, a telepharmacy outlet must be located more than 20 miles from any pharmacy or telepharmacy outlet. The bill removes this geographic restriction, and allows the State Board of Pharmacy to adopt rules for telepharmacy outlets, including requirements concerning: applications; structures and equipment; staffing, training, and consultant pharmacist visitations; inventory record-keeping and storage requirements; operational policies and procedures; the number of telepharmacy outlets that may be operated by a central pharmacy; prescription volume; and criteria for requesting exemptions from the requirements. Assumptions The fiscal note assumes that the removal of geographic restrictions will result in 800 currently registered pharmacies moving from a Prescription Drug Outlet (PDO) license to an Other Outlet license, and that: each facility will require an annual protocol review and 200 facilities will require protocol revisions; 156 complaints will be received; 52 cases will require investigation; 13 cases will result in disciplinary action; and 2 cases will be referred to the Attorney General. State Revenue This bill will increase state revenue by $368,800 to the Division of Professions and Occupations Cash Fund in FY 2022-23 from fees to cover the costs of the bill for two fiscal years. Fee impact on telepharmacy outlets. Colorado law requires legislative service agency review of measures which create or increase any fee collected by a state agency. These fee amounts are estimates only; actual fees will be set administratively by the Department of Regulatory Agencies (DORA) based on cash fund balance, estimated program costs, and the estimated number of licenses subject to the fee. As shown in Table 2, the fiscal note assumes that 800 pharmacies currently registered as a Prescription Drug Outlet (PDO) will instead register as an Other Outlet under the bill, and will pay the increased initial licensing fee in FY 2022-23. Page 3 March 31, 2022 SB 22-173 Table 2 Fee Impact on Specialized Prescription Drug Outlets Type of Fee Current Fee Estimated Fee Fee Increase Number Affected Total Fee Impact Other Outlet License $160 $920 $760 800 $736,000 PDO Renewal License $459 $459 - (800) ($367,200) FY 2022-23 Total $368,800 State Expenditures The bill increases state expenditures in the Division of Professions and Occupations (DPO) in the DORA by $172,241 in FY 2022-23 and $186,767 in FY 2023-24 from the Division of Professions and Occupations Cash Fund. Expenditures are shown in Table 3 and detailed below. Table 3 Expenditures Under SB22-173 FY 2022-23 FY 2023-24 Department of Regulatory Agencies Personal Services $98,060 $117,671 Operating Expenses $1,350 $1,755 Capital Outlay Costs $6,200 - Legal Services $34,500 $29,571 Centrally Appropriated Costs 1 $32,131 $37,740 FTE – Personal Services 1.0 FTE 1.3 FTE FTE – Legal Services 0.2 FTE 0.2 FTE Total Cost $172,241 $186,737 Total FTE 1.2 FTE 1.5 FTE 1 Centrally appropriated costs are not included in the bill's appropriation. Oversight. Beginning in FY 2022-23, the DPO requires 0.5 FTE of a pharmacist to conduct pharmaceutical compliance, performance and drug accountability audits, investigate complaints and possible fraud, and participate in enforcement activities as necessary. Costs are adjusted for a September 1 start date in the first year and standard operating and capital outlay costs are included. Page 4 March 31, 2022 SB 22-173 Enforcement. Beginning in FY 2022-23, the DPO will require 0.8 FTE of a criminal investigator to identify individuals involved in an investigation, interview witnesses, obtain relevant documents and verify the authenticity of those documents, examine books or records, collect evidence, prepare subpoenas, and write investigation reports. Costs are adjusted for a September 1 start date in the first year and standard operating and capital outlay costs are included. Legal services. In FY 2022-23, the DPO will require 350 hours of legal services from the Department of Law for rule making and adjudication at a blended rate of $98.57 per hour and 0.2 FTE. This fiscal note assumes that 50 hours will be required to assist with promulgation of rules in the first year, and that each case referred to the Attorney General will require 150 hours of staff time for enforcement and complaint resolution. 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 3. Other Budget Impacts TABOR refunds. The bill is expected to increase the amount of state revenue required to be refunded to taxpayers by the amounts shown in the State Revenue section above. This estimate assumes the March 2022 LCS revenue forecast. A forecast of state revenue subject to TABOR is not available beyond FY 2023-24. Because TABOR refunds are paid from the General Fund, increased cash fund revenue will reduce the amount of General Fund available to spend or save. Effective Date The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming no referendum petition is filed. State Appropriations In FY 2022-23, the bill requires an appropriation of $140,110 from the Division of Professions and Occupations Cash Fund the Department of Regulatory Agencies, and 1.0 FTE. Of this amount, $34,500 is reappropriated to the Department of Law with 0.2 FTE. State and Local Government Contacts 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.