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April 21, 2023 HB 23-1013
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Revised Fiscal Note
(replaces fiscal note dated February 22, 2023)
Drafting Number:
Prime Sponsors:
LLS 23-0162
Rep. Amabile
Sen. Fields; Rodriguez
Date:
Bill Status:
Fiscal Analyst:
April 21, 2023
House Second Reading
Erin Reynolds | 303-866-4146
erin.reynolds@coleg.gov
Bill Topic: USE OF RESTRICTIVE PRACTICES IN PRISONS
Summary of
Fiscal Impact:
☐ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☐ Local Government
☐ Statutory Public Entity
This bill modifies how clinical restraints may be used in correctional facilities by
requiring the Department of Corrections to adhere to National Commission on
Correctional Health Care standards. It also creates involuntary medication
committees. It increases state expenditures beginning in FY 2023-24.
Appropriation
Summary:
For FY 2023-24, the bill requires an appropriation of $18,872 to the Department of
Corrections.
Fiscal Note
Status:
The fiscal note reflects the introduced bill, which was amended by the House Judiciary
Committee and the House Appropriations Committee. It was recommended by the
Legislative Oversight Committee Concerning the Treatment of Persons with
Behavioral Health Disorders in the Criminal and Juvenile Justice Systems.
Table 1
State Fiscal Impacts Under HB 23-1013
Budget Year
FY 2023-24
Out Year
FY 2024-25
Revenue
- -
Expenditures General Fund $18,872 -
Transfers - -
Other Budget Impacts General Fund Reserve $2,831 -
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April 21, 2023 HB 23-1013
Summary of Legislation
This bill modifies how clinical restraints may be used in correctional facilities by requiring the
Department of Corrections (DOC) to adhere to National Commission on Correctional Health Care
(NCCHC) standards, and creates involuntary medication committees, as outlined below.
Clinical restraint use. By July 1, 2027, the bill requires the Department of Corrections (DOC) to
implement policies and practices that conform to the minimum standards prescribed by the most
updated restraint and seclusion standards of the National Commission on Correctional Health Care.
DOC facilities must ensure the use of restraint is documented and maintained in the electronic health
record of the inmate, following specific guidelines that include, among other requirements,
documenting who issued, modified, and terminated the order, and an explanation of the clinical basis
for the use of restraint.
DOC facilities are required to perform an intake evaluation to assess an inmate’s risk of self-harm
behaviors and initiate appropriate safety planning to address any concerns and attempt to avoid the
use of clinical restraints, if possible.
Involuntary medication. The bill prohibits the use of involuntary medication unless certain
conditions are met. Each facility is required to convene an involuntary medication committee, and
may not prescribe involuntary medication to an inmate for a period in excess of 180 days. The use of
involuntary medication must be documented in the inmate’s electronic health record.
Reporting. By January 1, 2024, the DOC must make an annual legislative report on the use of
restraints and involuntary medication in the preceding calendar year, following criteria outlined in
the bill. The DOC must also create an implementation plan to meet NCCHC standards and present
the plan during its SMART Act hearings beginning in 2024 and each year thereafter.
Background
DOC accreditation. The DOC is currently accredited with the American Correctional Association. It
is in contract negotiations to become accredited with the NCCHC, with a contract expected by
July 2023. As such, the department has budgeted for the modified use of clinical restraints, which
includes additional staffing at facilities that specialize in inmate health. For these facilities, additional
staff include correctional officers to facilitate inmate movement, as well as health professionals,
nurses, and psychologists to perform assessments, including behavior assessments upon intake. Also
included in the budget are soft restraint material its 19 facilities, with an estimated 68 units total, with
replacement costs estimated for one-third of materials each year. Each DOC facility will train
21 instructors on the use of soft restraints, who will then train DOC staff on-site.
Restraint event data. In the past three years, the DOC has averaged 73 four-point restraint events per
year in five facilities, as shown in Figure 1. The majority of restraint events occurred at the San Carlos
Correctional Facility and Colorado Territorial Correctional Facility, and often involved multiple
restraint events with the same individuals. There are 11 total four-point restraint beds at these
facilities. Ambulatory restraint events have largely occurred at the same facilities at a lesser rate.
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April 21, 2023 HB 23-1013
Figure 1
Restraint Events at DOC Facilities
Involuntary medication. There are currently 90 DOC inmates who are receiving involuntary
medications, such as mental health medications.
State Expenditures
In FY 2023-24 only, the bill increases state General Fund expenditures by $18,872 in the Department
of Corrections. The DOC requires four laptops and updates to its offender management system to
meet the reporting requirements in the bill.
On an ongoing basis, the bill will increase workload in the DOC. As discussed in the Background
section, because the DOC is currently seeking NCCHC accreditation, which requires soft restraints to
be used and that health staff monitor a restrained inmate every 15 minutes, related staffing and
restraint costs are already accounted for in DOC’s budget.
Effective Date
The bill takes effect upon signature of the Governor, or upon becoming law without his signature.
State and Local Government Contacts
Corrections Information Technology Judicial
Law Public Defender
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.
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