Page 1
February 16, 2024 HB 24-1045
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 24-0314
Rep. Armagost;
deGruy Kennedy
Sen. Mullica; Will
Date:
Bill Status:
Fiscal Analysts:
February 16, 2024
House Health & Human Services
Kristine McLaughlin | 303-866-4776
kristine.mclaughlin@coleg.gov
Bill Topic: TREATMENT FOR SUBSTANCE USE DISORDERS
Summary of
Fiscal Impact:
☒ State Revenue
☒ State Expenditure
☒ Transfer/Diversion
☒ TABOR Refund
☒ Local Government
☐ Statutory Public Entity
The bill creates and expands programs and services for substance use disorder
treatments. Beginning in FY 2024-25, the bill increases state and local revenue and
expenditures on an ongoing basis, it also diverts and transfers money between funds.
Appropriation
Summary:
For FY 2024-25, the bill requires an appropriation of $6.1 million to multiple state
agencies.
Fiscal Note
Status:
The fiscal note reflects the introduced bill as recommended by the Opioid and Other
Substance Use Disorders Study Committee.
Table 1
State Fiscal Impacts Under HB 24-1045
Budget Year
FY 2024-25
Out Year
FY 2025-26
Out Year
FY 2026-27
Out Year
FY 2027-28
Revenue Cash Funds $220,000 - $220,000 -
Total Revenue $220,000 - $220,000 -
Expenditures General Fund $4,174,792 $501,369 $1,367,305 $29,278,466
Cash Funds $486,207 $789,871 $740,050 ($1,189,337)
Federal Funds $1,447,646 $6,984,734 $7,020,428 $43,855,550
Central Approp. $488,857 $524,667 $569,382 $531,926
Total Expenditures $6,597,502 $8,800,641 $9,697,165 $72,476,605
Total FTE 6.0 FTE 7.8 FTE 10.3 FTE 8.6 FTE
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February 16, 2024 HB 24-1045
Table 1
State Fiscal Impacts Under HB 24-1045 (Cont.)
Budget Year
FY 2024-25
Out Year
FY 2025-26
Out Year
FY 2026-27
Out Year
FY 2027-28
Transfers
1
General Fund ($200,000) ($200,000) ($150,000) ($150,000)
Cash Funds $200,000 $200,000 $150,000 $150,000
Net Transfers $0 $0 $0 $0
Diversions General Fund ($194,051) ($46,726) ($46,726) ($46,726)
Cash Funds $194,051 $46,726 $46,726 $46,726
Net Diversion $0 $0 $0 $0
Other Budget TABOR Refund $220,000 - $220,000 -
GF Reserve $656,219 $105,205 $227,596 $4,414,270
1
This transfer is made via an appropriation from the General Fund to the Child Abuse Prevention Trust Fund.
Summary of Legislation
The bill creates and expands programs and services for substance use disorder (SUD)
treatments. Specifically, the bill:
Creates the Behavioral Health Diversion Pilot Program. This new program will divert select
defendants from the criminal justice system into early recovery services and treatment. If the
defendant completes the treatment program, the court must dismiss offenses with prejudice
and seal all records.
The bill specifies the following for the pilot program:
funding will be allocated by the Diversion Funding Committee, who will develop an
application process for district attorneys and select between two and five applicants;
the program will be operated by the Office of the State Court Administrator;
the participating district attorneys are responsible for selecting program coordinators who
will be responsible for developing all necessary criteria, developing all treatment plans, and
coordinating care;
after the initial assessment, participating district attorneys will assess all other qualifications
and refer qualified applicants to the program;
a candidate’s participation in the program is optional, and if they choose not to participate
or are dismissed for non-compliance prosecution may proceed;
program participants are entitled to vocational assistance from the Division of Employment
and Training in the Department of Labor and Employment (CDLE) in conjunction with the
program coordinator and the Department of Higher Education (DHE);
program coordinators, participating district attorneys, and state court administrators are
subject to various reporting requirements; and
the program is repealed on June 30, 2028. Page 3
February 16, 2024 HB 24-1045
Provides reentry services under Medicaid. The bill requires the Department of Health Care
Policy and Financing (HCPF) to provide the following reentry services to people immediately
before they are released from the Division of Youth Services (DYS) in the Department of Human
Services (CDHS), a Department of Corrections (DOC) facility, or a participating county jail:
screening services;
brief intervention services;
medicated-assisted treatment (MAT) medications, via an opioid treatment program;
additional medications, as needed;
case management services; and
care coordination services.
The bill specifies that:
pending federal authorization, HCPF will implement the new benefit on July 1, 2025, for
people in a DYS or a DOC facility and July 1, 2026, for people in county jail, with the
exception of MAT, which will be provided without federal authorization;
the Behavioral Health Administration (BHA) will approve county jails for participation based
on their commitment to diversion efforts and issue licenses to provide these services to the
incarcerated members; and
HCPF will produce an annual report which will require tracking participants following release
and assessing the system.
Provides partial hospitalization services for SUD under Medicaid. The bill requires HCPF to
seek federal authorization to provide partial hospitalization services for SUD.
Expands the Colorado Child Abuse Prevention Trust Fund. The bill appropriates $150,000
annually and an additional $50,000 for two years to the Colorado Child Abuse Prevention Trust
Fund under the Department of Early Childhood (CDEC).
Provides safety net provider application support services. The bill requires the BHA to
contract with an independent third-party to support providers seeking to become approved
BHA safety net providers.
Creates the Contingency Management Grant Program. The bill creates a grant program in
the BHA to support selected substance use disorder treatment programs.
Other changes. The bill makes several other changes as outlined below.
Places new reporting requirements on HCPF, the BHA, and the Department of Regulatory
Agencies (DORA).
Prohibits state-regulated insurance plans from applying a prior authorization requirement
for SUD treatment drugs based on dosage, and prohibits insurance from applying a different
reimbursement rate for SUD treatment drugs to pharmacists and take-home drugs. Page 4
February 16, 2024 HB 24-1045
Requires the BHA to promulgate rules around gaining a certificate as an addiction specialist
or technician.
Requires the various boards under the DORA and potentially the Department of Public
Health and Environment (CDPHE) to develop a statewide drug therapy protocol for
pharmacists to prescribe, dispense, and administer MAT drugs.
Makes changes to the MAT expansion pilot program including making pharmacies eligible
for grants, removing the restriction on the number of counties that may be selected for
participation, expanding membership requirements for the board, and changing the
reporting requirements.
Requires the BHA to collect data on and review the admission criteria for withdrawal
management facilities.
State Revenue
The bill increases cash fund revenue to the Prescription Drug Monitoring Cash Fund by $220,000
every other year starting in FY 2024-25 from increased licensing fees paid by pharmacists. The
bill may also reduce state revenue from criminal fees and fines. These impacts are discussed
below.
State regulated insurance plan requirements—fee impact on pharmacists. The bill amends
the practice of pharmacy to include exercising prescriptive authority for any FDA-approved
product or medication for opioid use disorder in accordance with federal law, if authorized
through a collaborative agreement. This will require participating pharmacists to register to
provide these services with the Prescription Drug Monitoring Program (PDMP). The registration
fee is $22 for a two-year license and there are approximately 10,000 licensed pharmacists in the
state. Table 2 identifies the fee impact of this bill. Fee revenue is subject to TABOR.
Table 2
Fee Impact on Pharmacists
Fiscal Year Type of Fee
Proposed
Fee
Number
Affected
Total Fee
Impact
FY 2024-25 Biennial Registration Fee $22 10,000 $220,000
FY 2026-27 Biennial Registration Fee $22 10,000 $220,000
Behavioral Health Diversion Pilot program. The bill will minimally reduce state revenue from
criminal fees and fines credited to the Judicial Department if more individuals are diverted into
community-based treatment rather than being convicted of criminal offenses. Fine penalties for
most misdemeanors and petty offenses range from $50 to $5,000 depending on the offense.
Fees are also imposed for a variety of court-related costs, which vary based on the offense but
may include probation supervision. Revenue from criminal fees and fines is subject to TABOR.
Actual state revenue impact will depend on myriad factors and cannot be estimated.
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February 16, 2024 HB 24-1045
State Transfers and Diversions
The bill transfers and diverts money between funds as outlined below.
State transfers. The bill requires the following appropriations to transfer money from the
General Fund to the Child Abuse Prevention Trust Fund in CDEC: $200,000 per year in
FY 2024-25 and FY 2025-26, and $150,000 per year starting in FY 2026-27 and future years. Use
of these funds are described in the CDEC section of the State Expenditures section below.
State diversions. This bill diverts about $194,000 in FY 2024-25 and $47,000 in FY 2025-26 and
ongoing from the General Fund. This revenue diversion occurs because the bill increases costs in
the Department of Regulatory Agencies, Division of Insurance, which is funded with premium tax
revenue that would otherwise be credited to the General Fund.
State Expenditures
The bill impacts state expenditures in eight state agencies on an ongoing basis, including the
Judicial Department, CDLE, DHE, HCPF, DOC, BHA, CDEC, and DORA. It will increase expenditures
in all but one of the agencies, DOC, until at least FY 2027-28. In FY 2024-25, the majority of
these costs are from the General Fund with a significant portion from federal funds and the
remainder from the following cash funds: the Healthcare Affordability and Sustainability Cash
Fund, the Colorado Child Abuse Prevention Trust Fund, and the Division of Insurance Cash Fund.
In FY 2025-26 and FY 2026-27 the cost share will partially shift to federal funds as a result of
DOC General Fund savings. In FY 2027-28, expenditures will significantly increase as a result of
increased expenditures in HCPF, which will be primarily funded from federal funds with a
significant portion from the General Fund; however, these costs will be partially offset by savings
in the Judicial Department and the BHA in the General Fund and the Correction Treatment Cash
Fund. Costs are shown in Table 3 and discussed below.
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February 16, 2024 HB 24-1045
Table 3
Expenditures Under HB 24-1045
FY 2024-25 FY 2025-26 FY 2026-27 FY 2027-28
Judicial Department
Grant Program (Assumes 5 JDs) $500,000 $500,000 $500,000 $500,000
County Jail Reentry Services Savings - - - ($4,903,555)
Judicial Subtotal $500,000 $500,000 $500,000 ($4,403,555)
General Fund $500,000 $500,000 $500,000 $500,000
Cash Funds - - - ($4,903,555)
Department of Labor and Employment
Personal Services $53,877 $61,573 $61,573 $61,573
Operating Expenses $896 $1,024 $1,024 $1,024
Capital Outlay Costs $6,670 - - -
Vocational Services—Service Costs $1,200,000 $1,200,000 $1,200,000 $1,200,000
Vocational Services—Travel Costs $6,000 $6,000 $6,000 $6,000
Centrally Appropriated Costs
1
$387,962 $390,852 $390,852 $390,852
FTE – Personal Services 0.7 FTE 0.8 FTE 0.8 FTE 0.8 FTE
CDLE Subtotal $1,655,405 $1,659,449 $1,659,450 $1,659,450
General Fund $1,267,443 $1,268,597 $1,268,597 $1,268,597
Centrally Appropriated Costs $387,962 $390,852 $390,852 $390,852
Department of Higher Education
Personal Services $69,270 $76,967 $76,967 $76,967
Operating Expenses $1,152 $1,280 $1,280 $1,280
Capital Outlay Costs $6,670 - - -
Travel $6,000 $6,000 $6,000 $6,000
Centrally Appropriated Costs
1
$14,521 $16,134 $16,134 $16,134
FTE – Personal Services 0.9 FTE 1.0 FTE 1.0 FTE 1.0 FTE
DHE Subtotal $97,613 $100,381 $100,381 $100,381
General Fund $83,092 $84,247 $84,247 $84,247
Centrally Appropriated Costs $14,521 $16,134 $16,134 $16,134 Page 7
February 16, 2024 HB 24-1045
Table 3
Expenditures Under HB 24-1045 (Cont.)
FY 2024-25 FY 2025-26 FY 2026-27 FY 2027-28
Department of Health Care Policy and Financing
Personal Services $235,042 $338,124 $401,447 $324,480
Operating Expenses $3,456 $5,120 $6,400 $5,120
Capital Outlay Costs $20,010 $6,670 $6,670 -
Reentry Services—State Facilities - $7,978,516 $7,978,516 $7,978,516
Reentry Services—County Jail (non-MAT) - - - $50,297,505
Reentry Services—County Jail (MAT) - - - $26,048,273
Reentry Services Systems Costs $677,194 $237,510 $241,310 -
Partial Hospitalization Costs $6,400,000 $6,400,000 $6,400,000 $6,400,000
Partial Hospitalization Savings ($5,374,500) ($5,374,500) ($5,374,500) ($5,374,500)
Centrally Appropriated Costs
1
$55,370 $81,082 $99,362 $79,801
FTE – Personal Services 2.7 FTE 4.0 FTE 5.0 FTE 4.0 FTE
HCPF Subtotal $2,016,571 $9,672,522 $9,759,205 $85,759,196
General Fund $413,853 $2,054,127 $2,86,658 $38,296,919
Cash Funds $99,703 $552,579 $552,758 $3,526,925
Federal Funds $1,447,646 $6,984,734 $7,020,428 $43,855,550
Centrally Appropriated Costs $55,370 $81,082 $99,362 $79,801
Department of Corrections
State Facility Reentry Services Savings - ($5,280,000) ($5,280,000) ($5,280,000)
DOC Subtotal $0 ($5,280,000) ($5,280,000) ($5,280,000)
General Fund - ($5,280,000) ($5,280,000) ($5,280,000)
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February 16, 2024 HB 24-1045
Table 3
Expenditures Under HB 24-1045 (Cont.)
FY 2024-25 FY 2025-26 FY 2026-27 FY 2027-28
Behavioral Health Administration
Personal Services $93,235 $108,628 $233,592 $163,447
Operating Expenses $1,664 $1,920 $3,584 $2,304
Capital Outlay Costs $20,010 - $6,670 -
Legal Services - - $38,406 $115,218
County Jail Reentry Services Savings - - - ($6,544,903)
County Jail Reentry Services Licensing
Systems Costs
- - $670,551 $167,637
Application Support Services $500,000 $500,000 $500,000 $500,000
Contingency Management Grant Costs $1,250,000 $1,250,000 $1,250,000 -
Opioid Treatment Workgroup $26,550 $8,850 - -
Withdrawal Facility Data Management $18,945 $5,000 $5,000 $5,000
Centrally Appropriated Costs
1
$23,457 $27,164 $53,600 $35,704
FTE – Personal Services 1.3 FTE 1.5 FTE 2.8 FTE 1.8 FTE
FTE – Legal Services 0.0 FTE 0.0 FTE 0.2 FTE 0.5 FTE
BHA Subtotal $1,933,861 $1,901,562 $2,761,403 ($5,555,593)
General Fund $1,910,404 $1,874,398 $2,707,803 ($5,591,297)
Centrally Appropriated Costs $23,457 $27,164 $53,600 $35,704
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February 16, 2024 HB 24-1045
Table 3
Expenditures Under HB 24-1045 (Cont.)
FY 2024-25 FY 2025-26 FY 2026-27 FY 2027-28
Department of Early Childhood
Child Care Task Force for SUD Treatment $50,000 $50,000 - -
Prenatal Substance Exposure Initiatives $150,000 $150,000 $150,000 $150,000
CDEC Subtotal $200,000 $200,000 $150,000 $150,000
Cash Funds $200,000 $200,000 $150,000 $150,000
Department of Regulatory Agencies
Personal Services $29,322 $36,652 $36,652 $36,652
Operating Expenses $512 $640 $640 $640
Capital Outlay Costs $6,670 - - -
Network Adequacy Report $150,000 - - -
Centrally Appropriated Costs
1
$7,547 $9,434 $9,434 $9,434
FTE – Personal Services 0.4 FTE 0.5 FTE 0.5 FTE 0.5 FTE
DORA Subtotal $194,051 $46,726 $46,726 $46,726
Cash Funds $186,504 $37,292 $37,292 $37,292
Centrally Appropriated Costs $7,547 $9,434 $9,434 $9,434
Grand Total $6,597,502 $8,800,641 $9,697,165 $72,476,605
Total General Fund $4,174,792 $501,369 $1,367,305 $29,278,466
Total Cash Funds $486,207 $789,871 $740,050 ($1,189,337)
Total Federal Funds $1,447,646 $6,984,734 $7,020,428 $43,855,550
Total Centrally Appropriated Costs $488,857 $524,667 $569,382 $531,926
Total FTE 6.0 FTE 7.8 FTE 10.3 FTE 8.6 FTE
1
Centrally appropriated costs are not included in the bill's appropriation.
Page 10
February 16, 2024 HB 24-1045
Judicial Department
The Judicial Department is responsible for implementing the Behavioral Health Diversion Pilot
Program, which is assumed to begin July 1, 2024, and repeals June 30, 2028. Additionally, the
Judicial Department will have cost savings resulting from the reentry services provided by HCPF.
Behavioral Health Diversion Pilot Program. Based on previous grants from the Diversion
Funding Committee, the department requires $100,000 per judicial district. The bill requires
between 2 and 5 districts to participate resulting a range of costs between $200,000 and
$500,000. For the purposes of the fiscal note, it is assumed that 5 districts will participate. It is
also assumed that some grant funds will be used to reimburse counties for the added workload
(see Technical Note).
Reentry services. The Judicial Department partially funds the reentry services provided by the
BHA. These costs will be offset by reentry services provided by HCPF for the county jail
population.
Department of Labor and Employment
CDLE is responsible for providing vocational services to the participants of the Behavioral Health
Diversion Pilot Program. This will involve working directly with the participants to develop an
individualized plan. Based on past experience with diversion pilot programs, it is assumed that
40 participants per district will progress far enough in the program to receive these services.
CDLE will contract with local workforce centers at a rate of $6,000 per participant to create the
plans. An administrator (0.8 FTE) will administer the program, working directly with the
workforce centers and traveling to locations as required. The bill requires between 2 and 5
districts to participate resulting a range of costs between $725,000 and $1,660,000. For the
purposes of the fiscal note, it is assumed that 5 districts will participate.
Department of Higher Education
When the individualized plans developed by CDLE involve seeking higher education, DHE will
develop individualized plans for seeking financial aid. DHE administrative costs are estimated at
$100,000 per year for this work. These costs are mostly fixed and do not vary significantly
depending on the number of judicial districts participating in the pilot.
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February 16, 2024 HB 24-1045
Department of Health Care Policy and Financing
The bill requires HCPF to provide two new services: reentry services and partial hospitalization
services.
Reentry services. The bill requires HCPF to provide reentry services, pending federal approval.
SB 22-196 instructed HCPF to study the impact of providing these services. The following
estimates were based on the preliminary findings of the study:
State incarcerated population. Serving the state incarcerated population immediately prior
to release is estimated as the equivalent of serving about 1,400 members year-round at an
annual cost of around $6,000. Because the work of requesting federal approval cannot begin
until after the bill is passed, the fiscal note assumes that HCPF cannot meet the
implementation date specified in the bill and that implementation will begin no sooner than
FY 2025-26.
County jail population. Compared to the state prison population, the county jail population
is much larger and less consistent; it is estimated as the equivalent of serving about 14,000
members at an annual cost of around $5,500. Given the logistics of serving this large and
variable population, many of whom are incarcerated for brief periods of time, the fiscal note
assumes that HCPF cannot meet the implementation date specified in the bill and that
implementation will begin no sooner than FY 2027-28. As specified in the bill, HCPF will not
seek federal authorization to provide MAT to this population but will provide them through
a contract with an opioid treatment program paid from the General Fund.
Staff. HCPF will need 5.0 FTE to oversee the program. As with previous complex waivers, 2.0
FTE ongoing and 1.0 term-limited FTE are required to oversee the waiver process, conduct
stakeholder and provider outreach, and manage the ongoing benefit once approved by the
federal government. The other 2.0 FTE will be dedicated to the unique data issues related to
this population and their high turnover rate. Of this staff, 1.0 FTE will not start until a year
before county jail implementation.
Systems costs. HCPF will need to hire a contractor to make the systems changes required to
provide services to a new population. It is estimated to require about 5,000 hours in FY
2024-25 and 2,000 hours annually until FY 2026-27.
Cost savings. These costs will partially offset by a reduction in services under the DOC, the
Judicial Department and the BHA. See the corresponding agency narratives in this analysis.
Partial hospitalization services. The bill instructs HCPF to provide partial hospitalization
services. These are classified as level 2.5 services on the system used by HCPF and its SUD
treatment providers, the American Society of Addiction Medicine (ASAM) level of care criteria.
Providing level 2.5 services will drive a cost increase that will be partially offset by a reduction in
utilization of higher level services. The bill specifies that services must be implemented no later
than July 1, 2026; however, given that implementation of these services can begin July, 1, 2024,
this earlier implementation date is assumed.
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February 16, 2024 HB 24-1045
Costs. Based on utilization of other levels of care, it is assumed that 2,000 members would
benefit from level 2.5 services, which would provide 10 days of partial hospitalization
annually. Managed Care Organizations (MCEs) assessed the per member per day cost at
$320.
Savings. The HCPF portion of the per member per day rate for level 3.1 services is $190 and
3.5 is $425. The savings shown above assumes that all level 3.1 clients could substitute level
2.5 services for up to 6 days and all level 3.5 clients could substitute for up to 3.5 days. It
should be noted that the room and board portion of the level 3.1 rate is paid by the BHA. By
reducing the demand from Medicaid clients, the BHA will be able to service more
non-Medicaid clients, assuming funding for the BHA program remains constant.
Department of Corrections
The DOC provides health care services to their incarcerated population. Costs for these services
will be partially offset by the reentry services for state incarcerated populations provided by
HCPF under the bill. When providing health care services for the total length of incarceration,
DOC costs are estimated to be $132 million per year. It is assumed that the availability of
services through HCPF will offset no more than 4 percent of these DOC costs, resulting in a
decrease in DOC expenditures of up to $5.3 million per year starting in FY 2025-26.
Behavioral Health Administration
The Behavioral Health Administration will have a reduction in costs as a result of HCPF’s reentry
services program and increased costs to provide the following services.
Behavioral Health Diversion Pilot Program. The bill requires the BHA to compile a list of
approved assessors for the program. This work is absorbable under the assumption that the
BHA only needs to coordinate with DORA to compile a list of assessors that have met the
licensing requirements.
Reentry services. The reentry services provided by HCPF starting in FY 2027-28 will partially
offset the services currently being provided by the BHA. The bill requires the BHA to license
county jails to provide services under HCPF’s program.
Current program offset. The BHA currently provides select reentry services to the county
jail population at a cost of $25 million annually. It is assumed that HCPF will offset 70
percent of these costs after the county jail portion of their reentry services is implemented.
About 40 percent of the BHA’s program is funded through the Correction Treatment Cash
Fund. This portion of the savings can be seen under the Judicial Department section.
Licensing services. Beginning one year prior to HCPF’s estimated implementation date for
county jail reentry services. The BHA will begin licensing county jails to provide these
services. This is estimated to require: Page 13
February 16, 2024 HB 24-1045
• 300 hours of legal services prior to implementation and 900 hours annually post
implementation;
• 1.3 FTE to assess and issue licenses to approximately 50 facilities and respond to any
complaints; and
• one-time and ongoing funds to update and maintain the Behavioral Health
Administration Licensing and Designation Database and Electronic Records System
(LADDERS).
Withdrawal Management Facilities. Beginning July 1, 2025, the bill requires the BHA to collect
data on admittance denials at withdrawal management facilities. Beginning January 1, 2025 the
BHA will approve the facilities’ admission criteria.
$19,000 in FY 2024-25 and $5,000 annually thereafter is required for systems changes for the
data collection.
0.5 FTE is required to analyze the data and annually review admission criteria for the
approximately 50 facilities in Colorado. First year costs are prorated for the January 1 start
date. Standard operating and capital outlay expenses are included.
Application support services. The bill requires the BHA to provide application support services
to providers seeking to become behavioral health safety net providers. Based on previous
contracts for provider technical support, this will require an annual $500,000 contract. The bill
specifies that services must be implemented no later than July 1, 2025. Because implementation
can begin July, 1, 2024, that implementation date is assumed
Contingency management grant program. The bill creates the Contingency Management
Grant Program. It is assumed that program will distribute $1.25 million in grants annually. Based
on past grant programs, this is estimated to require 1.0 FTE. Implementation will begin July 1,
2024. Per the bill, the program ends July 1, 2027.
Opioid Treatment Workgroup. The BHA is responsible for convening the Opioid Treatment
Workgroup. It is assumed that they will meet once a month from October 2024 through
September 2025 and the BHA will cover meeting costs, including hiring a meeting facilitator to
organize discussions, a venue, and a catering company for a total of about $3,000 per meeting.
Department of Early Childhood
As described in the State Transfers section above, the bill requires appropriations from the
General Fund to the Colorado Child Abuse Prevention Trust Fund to support initiatives to reduce
prenatal substance exposure ($150,000 per year starting in FY 2024-25) and to convene a
stakeholder taskforce on identify strategies for increasing access to child care for families
seeking substance use disorder treatment and recovery services ($50,000 per year in FY 2024-25
and FY 2025-26 only). It is assumed that annual spending from the trust fund will equal the
annual amount moved into the fund for these purposes. Page 14
February 16, 2024 HB 24-1045
Department of Regulatory Agencies
The bill requires DORA to produce two one-time reports, and to oversee and enforce several
changes to state-regulated insurance plans. Costs are paid from the Division of Insurance Cash
Fund
Reporting requirements. DORA requires a contract to produce the required report for 500
hours at $300 per hour. The contractor will analyze the network adequacy of SUD treatments.
Insurance plan regulation. DORA requires 0.5 FTE to implement, ensure compliance, and
respond to complaints. The bill amends the practice of pharmacy to include exercising
prescriptive authority for any FDA- approved product or medication for opioid use disorder in
accordance with federal law, if authorized through a collaborative agreement. Additionally, this
bill requires the State Board of Pharmacy, the Colorado Medical Board, and the State Board of
Nursing to develop a protocol for pharmacists to prescribe, dispense, and administer medicated
assisted treatment.
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 for all
affected departments.
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 December 2023 LCS revenue forecast. A forecast of state revenue subject to TABOR
is not available beyond FY 2025-26. 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.
General Fund reserve. Under current law, an amount equal to 15 percent of General Fund
appropriations must be set aside in the General Fund statutory reserve. Based on this fiscal note,
the bill is expected to increase the amount of General Fund held in reserve by the amounts
shown in Table 1, decreasing the amount of General Fund available for other purposes.
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February 16, 2024 HB 24-1045
Local Government
Behavioral Health Diversion Pilot program. The program affects local governments in several
ways, as described below. The exact impact to any particular jurisdiction will depend on the
amount of work required to develop the local redirection program and the number of
individuals who participate in it:
District attorneys. The bill increases district attorney workload to participate in the
development of the pilot programs and to handle more diversion cases. It is assumed that
these costs will be reimbursed through the grant program. Because it is not known how
many individuals will be diverted into community-based treatment in lieu of the criminal
justice system, these impacts have not been estimated.
Denver County Court. For misdemeanors and petty offenses committed in Denver County,
criminal fine and court fee revenue is collected by Denver County Court, and probation
supervision is provided by the court. To the extent that this bill results in more individuals
diverted out of the criminal justice system, revenue and workload will decrease. Because the
court has discretion when sentencing misdemeanors and petty offenses, the precise
reduction to Denver County has not been estimated. Please refer to the State Revenue
section above for information about fine penalty ranges and court fees.
County jails. Under current law, a court may sentence an offender to jail for a class 1 petty
offense and most misdemeanors. The range of the term of incarceration generally ranges
from 0 to 18 months. This bill may result in fewer individuals being convicted of these
offenses and sentenced to a term of incarceration in county jail. Because the courts have the
discretion of incarceration or imposing a fine, the precise impact at the local level cannot be
determined. Estimated costs to house an offender in a county jail vary.
Reentry services. County jails will be impacted by the reentry services program provided by
HCPF starting in FY 2027-28. Costs may decrease if the program funds efforts currently funded
at the county level. Workload will increase as a result of the licensing requirements of the
program and costs may increase in the event a county jail is not issued a license and has to
contract with another facility.
Technical Note
The fiscal note assumes that HCPF will receive federal authorization to provide all of the reentry
services specified in the bill except for administering MAT in a jail setting, which the bill specifies
not to be included in the federal authorization request. The bill may require additional
amendments to align with federal requirements in order for federal authorization to be
approved, however. If federal authorization is not received for reentry services, the fiscal impact
to HCPF will decrease by the amounts shown in Table 3 for reentry services: $1.0 million in
FY 2024-25, $3.3 million in FY 2025-26, $4.2 million in FY 2026-27, and $68.3 million in
FY 2027-28 and ongoing. Page 16
February 16, 2024 HB 24-1045
Effective Date
The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming
no referendum petition is filed, except for Section 22 which takes effect July 1, 2025.
State Appropriations
For FY 2024-25 the bill requires appropriations totaling $6,108,645 multiple state agencies as
described below.
Judicial Department. The bill requires a General Fund appropriation of $500,000 to the
Judicial Department.
Department of Labor and Employment. The bill requires a General Fund appropriation of
$1,267,443 to the CDLE and 0.7 FTE.
Department of Higher Education. The bill requires a General Fund appropriation of
$83,092 to the DHE and 0.9 FTE.
Department of Health Care Policy and Financing. The bill requires an appropriation of
$1,961,202 and 2.7 FTE to HCPF, paid from the following funds:
$413,853 from the General Fund;
$99,703 from the Healthcare Affordability and Sustainability Cash Fund; and
$1,447,646 from federal funds.
Behavioral Health Administration. The bill requires a General Fund appropriation of
$1,910,404 the BHA in the Department of Human Services and 1.3 FTE.
Department of Early Childhood. The bill requires an appropriation of $200,000 from the
General Fund to the Child Abuse Prevention Trust Fund, to be further appropriated to the
Department of Early Childhood.
Department of Regulatory Agencies. The bill requires an appropriation of $186,504 from
the Division of Insurance Cash Fund to DORA and 0.4 FTE.
Page 17
February 16, 2024 HB 24-1045
State and Local Government Contacts
Behavioral Health Administration Connect for Health Colorado Corrections
Denver County Courts County Clerks Counties
District Attorneys Early Childhood Governor
Health Care Policy and Financing Higher Education Human Services
Information Technology Judicial Labor
Law Personnel Public Defender
Public Health and Environment Public Safety Regulatory Agencies
Revenue Sheriffs
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.