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February 22, 2024 HB 24-1066
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 24-0671
Rep. Hamrick; Garcia
Sen. Michaelson Jenet;
Gonzales
Date:
Bill Status:
Fiscal Analyst:
February 22, 2024
House Health & Human Services
Shukria Maktabi | 303-866-4720
shukria.maktabi@coleg.gov
Bill Topic: PREVENT WORKPLACE VIOLENCE IN HEALTH -CARE SETTINGS
Summary of
Fiscal Impact:
☐ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☐ Local Government
☐ Statutory Public Entity
The bill requires certain health facilities to establish a workplace violence prevention
committees and prevention plans for their employees. The bill increases state
expenditures beginning in FY 2024-25.
Appropriation
Summary:
For FY 2024-25, the bill requires an appropriation of $451,895 to multiple state
agencies.
Fiscal Note
Status:
The fiscal note reflects the introduced bill.
Table 1
State Fiscal Impacts Under HB 24-1066
Budget Year
FY 2024-25
Out Year
FY 2025-26
Revenue - -
Expenditures General Fund $451,895 $539,835
Centrally Appropriated $100,464 $151,440
Total Expenditures $552,359 $691,276
Total FTE 5.8 FTE 9.0 FTE
Transfers - -
Other Budget Impacts General Fund Reserve $67,784 $80,975
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February 22, 2024 HB 24-1066
Summary of Legislation
The bill enacts the “Violence Prevention in Health-care Settings Act” and the “Violence
Prevention in Behavioral Health Settings Act.” These acts protect health care staff in hospitals,
emergency departments, nursing care facilities, assisted living residences, federally qualified
health centers (FQHCs), and comprehensive community behavioral health centers.
Each facility must establish a workplace violence prevention committee that documents and
reviews violent incidents, develops and implements prevention plans for their employees, offers
immediate post-incident services, and submits biannual incident reports to the Department of
Public Health and Environment (CDPHE) or the Behavioral Health Administration (BHA). These
departments must post reports received on their websites.
The bill specifies the required components of facility workplace violence prevention committees
and plans, prohibits facilities from discouraging staff reporting incidents to law enforcement,
and protects persons who choose to either report a workplace violence incident, advise a staff
member of the right to report, or choose not to report an incident.
State Expenditures
The bill increases state General Fund expenditures in the CDPHE and the Department of Human
Services (CDHS) by $550,000 in FY 2024-25 and by $700,000 in FY 2025-26 and ongoing. The bill
also increases workload for the BHA and the Department of Corrections (DOC), and may
increase costs in the Department of Health Care Policy and Financing (HCPF). The Department of
Personnel and Administration (DPA) may also be impacted. Expenditures are shown in Table 2
and detailed below.
Table 2
Expenditures Under HB 24-1066
FY 2024-25 FY 2025-26
Department of Public Health and Environment
Personal Services $74,092 $168,486
Operating Expenses $2,048 $5,120
Capital Outlay Costs $26,680 -
Centrally Appropriated Costs
1
$25,395 $61,916
FTE – Personal Services 1.6 FTE 4.0 FTE
CDPHE Subtotal $128,214 $235,522
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February 22, 2024 HB 24-1066
Table 2
Expenditures Under HB 24-1066 (Cont.)
FY 2024-25 FY 2025-26
Department of Human Services
Personal Services $293,988 $351,648
Operating Expenses $5,376 $6,400
Capital Outlay Costs $33,350 -
Trainer Certifications $16,362 $8,181
Centrally Appropriated Costs
1
$75,069 $89,524
FTE – Personal Services 4.2 FTE 5.0 FTE
CDHS Subtotal $424,145 $455,753
Total $552,359 $691,276
Total FTE 5.8 FTE 9.0 FTE
1
Centrally appropriated costs are not included in the bill's appropriation.
Department of Public Health and Environment. The department requires 4.0 FTE to establish
processes and manage incident data provided by facilities.
Staff. CDPHE requires administrative assistant staff to receive and review reports from
approximately 980 facilities twice per year. The fiscal note assumes staff can review, redact,
and post two reports per day. Administrative costs are prorated for a March 2025 start date
when internal systems are expected to be established and first reports are received by
facilities. CDPHE also requires 0.2 FTE to establish and manage the IT system for receiving
data and posting data online beginning in October 2024. Additionally, in the first year,
CDPHE requires 0.1 FTE from July 2024 to October 2024 to establish workplace violence
reporting requirements and processes, including holding four stakeholder meetings at an
average of 50 hours per meeting. Standard operating and capital outlay costs are included.
Department of Human Services. The CDHS requires staff and certification costs to implement
the workplace violence prevention measures at two state-run hospitals. Based on information
provided by the Risk Management Division in DPA, these CDHS facilities have a higher rate of
workplace violence.
Staff. The Colorado Mental Health Hospital in Fort Logan and the Colorado Mental Health
Hospital in Pueblo require 5.0 FTE between the two hospitals. This includes 2.0 FTE training
staff who will train approximately 1,900 employees on the new policies; 2.0 FTE program
assistant staff to assist in handling reporting of incidents and associated data entry; and
1.0 FTE to manage the staff and administer the prevention committee and associated plan. Page 4
February 22, 2024 HB 24-1066
Staff costs are prorated for a September 1, 2024, start date and include standard operating
and capital outlay costs.
Certification of trainers. The two facilities will have initial costs of $16,362, and ongoing
costs of $8,181 for the two trainers to receive training certification.
Behavioral Health Administration. The BHA will have increased workload to receive biannual
reports from behavioral health facilities, and post the de-identified data online. As the BHA
already receives a high-level of reporting from behavioral health facilities, this workload is
expected to be minimal and can be accomplished within existing appropriations.
Department of Corrections. The department will have increased workload to implement the
workplace violence prevention measures. This workload is expected to be minimal for the
department and can be accomplished within existing appropriations.
Department of Health Care Policy and Financing. Assuming administrative costs increase for
providers at FQHCs and Community Mental Health Centers, the department may be required to
pay increased facility rates. These costs are indeterminate and will be addressed through the
annual budget process.
Department of Personnel and Administration. This analysis assumes the bill’s increased
transparency of and training on workplace violation incidents will decrease the state’s overall
liability in these cases. Because the bill does not specify what post-incident services are required
to be provided to state employees, the fiscal note also assumes that the Colorado State
Employees Assistance Program will not be required to provide these services. No change in
appropriations is required.
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.
Effective Date
The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming
no referendum petition is filed.
State Appropriations
For FY 2024-25, the bill requires total appropriations of $451,895 from the General Fund, of
which:
$102,820 is appropriated to the Department of Public Health and Environment, and 1.6 FTE;
$349,076 is appropriated to the Department of Human Services, and 4.2 FTE; and
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February 22, 2024 HB 24-1066
Departmental Differences
Department of Public Health and Environment. The CDPHE assumes it requires 9.4 FTE to
manage incident data provided by facilities, based on the assumption that each report requires
10 hours to review, redact, and post twice per year. The fiscal note assumes that two reports can
be processed per day, at 4 hours per report, which can be accomplished with 3.8 FTE.
Department of Human Services. The CDHS assumes it requires an additional 4.5 FTE to
implement the bill above what is included in this analysis. This includes 3.0 FTE training staff,
based on an assumption that training will require five days per staff member, the maximum ratio
of learners to instructors is 10:1, and that one staff person will design the curricula and manage
the training team. The fiscal note assumes that two full-time trainers and their supervisor can
manage this workload. The DHS also assumes it requires 1.0 FTE administrative assistant to assist
the violence prevention program and 0.5 FTE project manager to facilitate quality assurance and
incident reporting. The fiscal note assumes this workload can be accomplished by 2.0 FTE
program assistants and existing staff.
Department of Personnel and Administration. The DPA estimates that it will have $2.5 million
in additional costs per year for employee support services and increased liability. Specifically, the
DPA estimates that it requires about $200,000 and 2.0 FTE to provide mental health services
through the Colorado State Employee Assistance Program (CSEAP). The fiscal note does not
include this staffing because CSEAP services are already available to state employees who
request them and the bill does not specifically list the program as a required source of post-
incident services.
The DPA estimates increased risk management costs of $2.3 million, based on the assumption
that by mandating policies and standards for preventing workplace violence, state hospitals
would create a standard of care against which claimants could claim negligence, and that,
further, publicized safety plans and reports will highlight state hospitals’ safety incidents and
potentially invite civil claims. The DPA requests $270,000 General Fund to cover liability claims
and $2.1 million to cover workers’ compensation claims in FY 2024-25. In future fiscal years,
these costs would be addressed through the Risk Management Division’s actuarial analysis that
informs the annual budget process, and borne by affected state agencies. The fiscal note does
not include these DPA estimates because, as stated above, it assumes that increased prevention
strategies and supports for employees will lower overall liability risk for the state associated with
violence in state-run health facilities. Also, the bill does not directly change any relevant cause of
action or standards associated with negligence or workers’ compensation claims.
State and Local Government Contacts
Behavioral Health Administration Corrections Counties
Early Childhood Higher Education Human Services
Labor Public Health and Environment 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 the General Assembly website.