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March 20, 2024 HB 24-1066
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Revised Fiscal Note
(replaces fiscal note dated February 22, 2024)
Drafting Number:
Prime Sponsors:
LLS 24-0671
Rep. Hamrick; Garcia
Sen. Michaelson Jenet;
Gonzales
Date:
Bill Status:
Fiscal Analyst:
March 20, 2024
House Appropriations
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 $103,618 to the Colorado
Department of Public Health and Environment. The Department of Human Services
also requires an appropriation of $670,005, which may be provided in this bill.
Fiscal Note
Status:
The fiscal note reflects the introduced bill, as amended by the House Health & Human
Services. It has also been updated to reflect new information about costs in the
Department of Human Services.
Table 1
State Fiscal Impacts Under HB 24-1066
Budget Year
FY 2024-25
Out Year
FY 2025-26
Revenue - -
Expenditures General Fund $773,623 $816,162
Centrally Appropriated $164,412 $203,737
Total Expenditures $938,035 $1,019,899
Total FTE 9.2 FTE 11.5 FTE
Transfers - -
Other Budget Impacts General Fund Reserve $116,043 $122,424
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March 20, 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 program that documents and
reviews violent incidents, develops and implements prevention policies for their employees,
offers post-incident supports, and submits annual incident reports to the Department of Public
Health and Environment (CDPHE) or the Behavioral Health Administration (BHA). These
departments must annually publish a comprehensive report on incidences of workplace
violence.
The bill specifies the required components of facility workplace violence prevention programs
and policies, 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 $940,000 in FY 2024-25 and by $1.1 million 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 $88,742 $126,826
Operating Expenses $1,536 $2,560
Capital Outlay Costs $13,340 -
Centrally Appropriated Costs
1
$22,156 $34,951
FTE – Personal Services 1.2 FTE 2.0 FTE
CDPHE Subtotal $125,774 $164,337
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March 20, 2024 HB 24-1066
Table 2
Expenditures Under HB 24-1066 (Cont.)
FY 2024-25 FY 2025-26
Department of Human Services
Personal Services $552,161 $654,163
Operating Expenses $10,240 $12,160
Capital Outlay Costs $66,700 -
Trainer Certifications $40,905 $20,453
Centrally Appropriated Costs
1
$142,256 $168,786
FTE – Personal Services 8.0 FTE 9.5 FTE
CDHS Subtotal $812,262 $855,562
Total Costs $938,035 $1,019,899
Total FTE 9.2 FTE 11.5 FTE
1
Centrally appropriated costs are not included in the bill's appropriation.
Department of Public Health and Environment. The CDPHE requires staff to establish
processes and manage incident data provided by facilities.
Staff. CDPHE requires 2.0 FTE of administrative assistant staff to receive, review, and analyze
data from reports provided by approximately 980 facilities annually. Administrative costs are
prorated for a March 2025 start date to allow time for onboarding, training and process
development. Additionally, in the first year, CDPHE requires 0.1 FTE 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. But, because accredited
hospitals have been required to comply with violence prevention standards established by the
Joint Commission since 2022, this bill can be seen as codifying existing requirements for these
state-run hospitals. However, no resources have been requested by, or provided to, the CDHS
for this purpose through the annual budget process. Given this, the fiscal note estimates the
costs of complying with the requirements, and the General Assembly may use this bill as a
vehicle to provide funding to the CDHS for this work. If funding is not provided in this bill, the
CDHS will be required to shift resources from other functions or request funding through the
budget process in the future. Costs in the CDHS are outlined below.
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March 20, 2024 HB 24-1066
Staff. The Colorado Mental Health Hospital in Fort Logan and the Colorado Mental Health
Hospital in Pueblo require 9.5 FTE between the two hospitals. This includes 5.0 FTE training
staff who will train approximately 1,900 employees on the new policies; 3.0 FTE program
assistant staff to assist in handling reporting of incidents and associated data entry; and
1.5 FTE to manage the staff and administer the prevention committee and associated plan.
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 $40,905, and ongoing
costs of $20,453 for the five trainers to receive training certification.
Behavioral Health Administration. The BHA will have increased workload to receive reports
from behavioral health facilities, and publish the de-identified data. 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.
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March 20, 2024 HB 24-1066
State Appropriations
For FY 2024-25, the bill requires a General Fund appropriation $103,618 to the Colorado
Department of Public Health and Environment, and 1.2 FTE.
In addition, to provide funding to the Department of Human Services for its compliance with
existing violence prevention standards for accredited hospitals (which align with the
requirements in this bill), the General Assembly may appropriate $670,005 General Fund and
8.0 FTE to the Department of Human Services for FY 2024-25.
Departmental Differences
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
Counties Early Childhood Higher Education
Human Services Labor Personnel
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.