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February 2, 2023 HB 23-1067
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 23-0450
Rep. Young; Bradfield
Sen. Cutter
Date:
Bill Status:
Fiscal Analyst:
February 2, 2023
House Public & Behavioral Health
Shukria Maktabi | 303-866-4720
shukria.maktabi@coleg.gov
Bill Topic: FAMILY INTERVENER PROGRAM DEAFBLIND CHILDREN
Summary of
Fiscal Impact:
☒ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☐ Local Government
☐ Statutory Public Entity
The bill creates the Family and Community Intervener Program in the Department of
Human Services to support deafblind children and their families. The bill increases
state expenditures on an ongoing basis and may increase state revenue.
Appropriation
Summary:
The bill requires an appropriation of $166,353 to the Department of Human Services.
Fiscal Note
Status:
The fiscal note reflects the introduced bill.
Table 1
State Fiscal Impacts Under HB 23-1067
Budget Year
FY 2023-24
Out Year
FY 2024-25
Revenue - -
Expenditures Cash Funds $166,353 $282,707
Transfers - -
Other Budget Impacts - -
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February 2, 2023 HB 23-1067
Summary of Legislation
The bill creates the Family and Community Intervener Program to support deafblind children and
their families by providing the services of an intervener trained in deafblindness, building language
and communication skills, and intervention strategies.
By October 1, 2023, the Colorado Commission for the Deaf, Hard of Hearing, and Deafblind (the
commission) within the Colorado Department of Human Services (DHS) must contract with a
program manager to oversee the program and interveners. The program will be funded through the
Colorado Telephone Users with Disabilities Fund. Starting in 2025, upon approval of the Department
of Health Care Policy and Financing, the program must provide intervener services to eligible children
through the Community First Option under Medicaid.
Background
The commission is responsible for ensuring equal access to government services for the deaf, hard of
hearing, and deafblind in Colorado. The Commission is funded through a surcharge on landlines,
mobile wireless, and voice-over-internet-protocol customers that is allocated through the Telephone
Users with Disability Fund (TUDF) in the Department of Regulatory Agencies. The Colorado Public
Utilities Commission (PUC) can make adjustments to the surcharge.
The Community First Option program under Medicaid provides attendant care services to assist in
daily living and health-related activities that allow a person to remain in their home or a community
based setting, rather than in an institution such as a nursing home. Available services include
dressing, bathing, shopping, and medication monitoring, among others. To receive services, a person
must be eligible for Medicaid and have needs that meet an institutional level of care.
State Revenue
To the extent that the PUC adjusts the surcharge in future fiscal years to cover the costs of providing
services under the program, state cash fund revenue to the TUDF will increase, depending on the
overall surcharge adjustments.
State Expenditures
Expenditures in the DHS will increase by $166,353 in FY 2023-24 and by $282,707 in FY 2024-25, as
shown in Table 2 and described below. Expenditures are paid from the TUDF.
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February 2, 2023 HB 23-1067
Table 2
Expenditures Under HB23-1067
FY 2023-24 FY 2024-25
Department of Human Services
Contract for Program Manager $75,000 $100,000
Intervener Service Costs $91,353 $182,707
Total Cost $166,353 $282,707
Program manager. DHS requires $100,000 annually to hire a contractor to manage the project. This
contract cost will cover salary, office space, equipment, health insurance, and other benefits for the
program manager. FY 2023-24 costs are prorated for an October 1 start date.
Intervener service costs. DHS will have costs of $91,353 in FY 2023-24 and $182,707 in FY 2024-25 to
provide intervener services to eligible children. The fiscal note assumes that the program will provide
12 hours of services per month to 24 deafblind children in FY 2023-24, with an increase to 32 children
in following years. These costs include intervener assignments, travel time for rural assignments, and
mileage reimbursement for travel. These program costs are estimated based on similar programs for
deafblind children in Colorado, and are prorated for eight months in FY 2023-24.
Medicaid reimbursement and costs. The bill potentially increases workload and costs for the
Department of Health Care Policy and Financing to add intervener services for deafblind children to
the Community First Choice Option program under Medicaid. If such services were approved, the
department would have costs to make IT system changes, develop rates, and implement the new
benefit. Also, covering intervener services under Medicaid would likely reduce costs paid by the
DHS, as Medicaid would be providing reimbursement for eligible children. This would also allow
federal matching funds to cover a portion of these costs. However, as described in the Technical Note
section below, it is assumed that the Department of Health Care Policy and Financing cannot currently
approve these services, and the potential costs and reimbursements for services have not been
estimated.
Technical Note
Per federal regulations, home- and community-based services under the Community First Choice
Option cannot be directed to a specific diagnosis, such as deafblind. Because of this, the Department
of Health Care Policy and Financing would be unable to approve these services and would not
implement Section 26-21-106(8.5)(d), C.R.S., as included in the bill.
Effective Date
The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming no
referendum petition is filed. Page 4
February 2, 2023 HB 23-1067
State Appropriations
For FY 2023-24, the bill requires an appropriation of $166,353 from the Telephone Users with
Disabilities Fund to the Department of Human Services.
State and Local Government Contacts
Counties Health Care Policy and Financing Human Services
Information Technology 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.