HOUSE BILL 24-1185 BY REPRESENTATIVE(S) Bird, Sirota, Taggart, Amabile, Brown, Jodeh, Lieder, Marshall, Ricks, Snyder, Vigil, McCluskie; also SENATOR(S) Zenzinger, Bridges, Kirkmeyer, Cutter, Exum, Michaelson Jenet, Priola. C ONCERNING A SUPPLEMENTAL APPROPRIATION TO THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING . Be it enacted by the General Assembly of the State of Colorado: SECTION 1. Appropriation to the department of health care policy and financing for the fiscal year beginning July 1, 2023. In Session Laws of Colorado 2023, section 2 of chapter 474, (SB 23-214), amend Part VI as follows: Section 2. Appropriation. NOTE: This bill has been prepared for the signatures of the appropriate legislative officers and the Governor. To determine whether the Governor has signed the bill or taken other action on it, please consult the legislative status sheet, the legislative history, or the Session Laws. ________ Capital letters or bold & italic numbers indicate new material added to existing law; dashes through words or numbers indicate deletions from existing law and such material is not part of the act. APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ PART VI DEPARTMENT OF HEALTH CARE POLICY AND FINANCING (1) EXECUTIVE DIRECTOR'S OFFICE (A) General Administration Personal Services 17 67,531,800 68,189,142 (729.9 FTE) (743.2 FTE) Health, Life, and Dental 10,436,584 10,639,237 Short-term Disability 98,551 100,903 S.B. 04-257 Amortization Equalization Disbursement 3,290,125 3,356,675 S.B. 06-235 Supplemental Amortization Equalization Disbursement 3,290,125 3,356,675 Salary Survey 3,665,128 PERA Direct Distribution 187,621 Temporary Employees Related to Authorized Leave 5,978 Workers' Compensation 184,274 Operating Expenses 17 3,597,390 3,636,640 Legal Services 1,813,521 2,321,911 PAGE 2-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ Administrative Law Judge Services 544,650 Payment to Risk Management and Property Funds 252,280 567,472 Leased Space 17 3,925,908 Payments to OIT 11,702,619 11,745,467 IT Accessibility 2,933,182 CORE Operations 134,190 General Professional Services and Special Projects 18,19 62,110,610 55,727,983 175,704,536 55,934,068 27,835,794 a 3,403,275 b 88,531,399 (I) 171,223,036 57,463,718 27,486,963 a 3,413,734 b 82,858,621(I) a Of this amount, $16,333,116 $15,541,411 shall be from the Home- and Community-based Services Improvement Fund created in Section 25.5-6-1805 (1), C.R.S., $10,125,994 $10,617,255 shall be from the Healthcare Affordability and Sustaina bility Fee Cash Fund created in Section 25.5-4-402.4 (5)(a), C.R.S., $396,149 $397,299 shall be from the Medicaid Nursing Facility Cash Fund created in Section 25.5-6-203 (2 )(a), C.R.S., $271,930 $272,717 shall be from the Adult Dental Fund created in Section 25.5-5-207 (4)(a), C.R.S., $228,765 $229,613 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., $199,955 $200,560 shall be from the Primary Care Fund created in Section 24-22-117 (2)(b)(I), C.R.S., $121,294 $121,688 shall be from the Nursing Home Penalty Cash Fund created in Section 25.5-6-205 (3)(a), C.R.S., $56,395 $56,577 shall be from the Service Fee Fund created in Section 25.5-6-204 (1)(c)(II), C.R.S., $52,505 shall be from the Colorado Autism Treatment Fund cre ated in Section 25.5-6-805 (1), C.R.S., and $49,691 $49,843 shall be from the Breast and Cervical Cancer Prevention and Treatment Fund created in Section 25.5-5-308 (8)(a)(I), C.R .S. b Of this amount, $922,619 $921,207 shall be from statewide indirect cost recoveries, $886,931 $891,958 shall be transferred from the Colorado Benefits Management System, Health Care and Economic Security Staff Development Center line item appropriation in this department, $889,945 $893,397 shall be transferred from the Department of Human Services from the Health Care and Economic Security Staff Development Center line item appropriation, $576,886 $579,733 shall be transferred from the Department of Higher Education from the Fee-for-service Contracts with State Institutions for Speciality Education Programs line item, $88,650 $89,195 shall be from the Department of Personnel and Administration, $23,541 shall be from the Department of Early Childhood, and $14,703 shall be from the Department of Public Health and Environment from the Women, Infants, and Children Supplemental Food Grant line item. PAGE 3-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ (B) Transfers to/from Other Departments Transfer to Department of Education for Public School Health Services 202,194 101,097(M) 101,097 Transfer to Department of Early Childhood for Early Intervention 9,457,463 4,634,158(M) 4,823,305 Transfer from Department of Early Childhood for Nurse Home Visitor Program 3,010,0001,505,000 a 1,505,000(I) Transfer to Department of Local Affairs for Host Home Regulation 136,096 68,048(M) 68,048 Transfer to Department of Local Affairs for Home Modifications Benefit Administration 313,881 156,941(M) 156,940 Transfer to Department of Public Health and Environment for Facility Survey and Certification 8,477,125 3,153,491(M) 5,323,634 Transfer to Department of Public Health and Environment for Prenatal Statistical Information 5,887 2,944(M) 2,943 Transfer to Department of Regulatory Agencies for Nurse Aide Certification 324,041 147,369(M) 14,652 b 162,020 PAGE 4-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ Transfer to Department of Regulatory Agencies for Reviews 3,750 1,875(M) 1,875 21,930,437 a This amount shall be transferred from the Department of Huma n Services from the Nurse Home Visitor Program line item appropria tion. b This amount shall be transferred from the Department of Regulatory Agencies from the Payments to Department of Health Care Poli cy and Financing line item appropriation. (C) Information Technology Contracts and Projects Medicaid Management Information System Maintenance and Projects 113,944,537 16,701,016 11,042,019 a 12,204 b 86,189,298 (I) 107,405,662 10,680,890 a 80,011,552(I) Colorado Benefits Management Systems, Operating and Contract Expenses 20,21 56,067,055 11,608,377 (M) 6,470,009 c 1,657 b 37,987,012 71,701,801 11,640,267(M) 8,141,042 c 12,126,323 b 39,794,169 Colorado Benefits Management Systems, Health Care and Economic Security Staff Development Center 20,21 2,142,862 679,389(M) 377,956 d 73 b 1,085,444 Office of eHealth Innovations Operations 6,465,845 3,372,367 3,093,478(I) (3.0 FTE) All-Payer Claims Database 5,562,903 4,598,136964,767(I) 184,183,202 193,279,073 PAGE 5-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ a Of this amount, $7,499,883 shall be from the Healthcare Affordab ility and Sustainability Fee Cash Fund created in Section 25.5 -4-402.4 (5)(a), C.R.S., $1,702,568 $1,341,439 shall be from the Home- and Community-based Services Improvement Fund created in Section 25.5-6-1805 (1), C.R.S., $1,241,667 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., and $597,901 shall be from the Department of Health Care Policy and Financing Cash Fund crea ted in Section 25.5-1-109, C.R.S. b These O F THESE amounts $12,124,666 SHALL BE TRANSFERRED FROM THE D EPARTMENT OF H UMAN S ERVICES , AND $13,934 shall be transferred from the Old Age Pension State Medical Program line item appropriation in the Other Medical Services division of this department. c Of this amount, $6,000,483 $6,020,757 shall be from the Healthcare Affordability and Sustai nability Fee Cash Fund created in Section 25.5-4-402.4 (5)(a), C.R.S., $1,650,000 SHALL BE FROM THE H OME - AND C OMMUNITY - BASED S ERVICES I MPROVEMENT F UND CREATED IN S ECTION 25.5-6-1805 (1), C.R.S., and $469,526 $470,285 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S. d Of this amount, $356,991 shall be from the Healthcare Affordability and Sustainab ility Fee Cash Fund created in Section 25.5-4-402. 4 (5)(a), C.R.S. and $20,965 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S. (D) Eligibility Determinations and Client Services Contracts for Special Eligibility Determinations 12,039,555 1,129,071 (M) 4,343,468 a 6,567,016 1,134,071(M) 4,338,468 a County Administration 132,209,721 22,999,538 (M) 26,966,487 b 82,243,696 121,943,046 20,478,568(M) 26,174,302 b 75,290,176 Medical Assistance Sites 1,531,968 402,984 c 1,128,984(I) Administrative Case Management 869,744 434,872(M) 434,872 Customer Outreach 3,461,519 1,394,139(M) 336,621 c 1,730,759 Centralized Eligibility Vendor Contract Project 6,122,400 2,279,719 c 3,842,681 (I) 8,096,880 2,801,253 c 5,295,627(I) Connect for Health Colorado Eligibility Determinations 10,642,710 4,757,291 d 5,885,419(I) Eligibility Overflow Processing Center 1,904,677 285,320(M) 190,849 c 1,428,508 PAGE 6-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ Returned Mail Processing 3,298,808 985,808(M) 244,919 e 111,942 f 1,956,139 Work Number Verification 3,305,114 1,089,815(M) 545,013 c 1,670,286 175,386,216 167,094,021 a Of this amount, $4,338,468 T HIS AMOUNT shall be from the Healthcare Affordability and Sustainability F ee Cash Fund created in Sectio n 25.5-4-402.4 (5)(a), C.R.S., an d $5,000 shall be from the Colorado Autism Treatment Fund created in Section 25.5-6-805 (1), C.R.S. b Of this amount, $18,871,933(I) shall be from local funds and $8,094,554 $7,302,369 shall be from the Healthcare Affordability an d Sustainability Fee Cash Fund created in Section 25.5-4-402.4 (5)(a), C.R.S. c These amounts shall be from the Healthcare Affordability and Su stainability Fee Cash Fund creat ed in Section 25.5-4-402.4 (5)( a), C.R.S. d This amount represents public funds certified as expenditures incurred by Connect for Health Colorado that are eligible for fe deral financial participation under the Medicaid program. e Of this amount, $206,183 shall be from the Healthcare Affordability and Sustainability Fee Cash Fund created in Section 25.5-4 -402.4 (5)(a), C.R.S., and $38,736 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S. f Of this amount, $111,929 shall be transferred from the Department of Human Services from the Colorado Benefits Management Syst em, Ongoing Expenses line item and $13 shall be transferred from the Old Age Pension State Medical Program line item appropriation in the Other Medical Services division of this department. (E) Utilization and Quality Review Contracts Professional Services Contracts 27,236,877 7,301,755(M) 2,112,987 a 17,822,135 a Of this amount, $1,922,919 shall be from the Healthcare Affordab ility and Sustainability Fee Cash Fund created in Section 25.5- 4-402.4 (5)(a), C.R.S., $88,750 shall be from the Adult Dental Fund created in Section 25.5-5-207 (4)(a), C.R.S., $64,443 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., and $36,875 shall be from the Medicaid Nursing Facility Cash Fund created in Section 25.5-6-203 (2)(a), C.R.S. (F) Provider Audits and Services Professional Audit Contracts 4,281,019 1,645,679(M) 565,801 a 2,069,539 a Of this amount, $404,395 shall be from the Healthcare Affordability and Sustainability Fee Cash Fund created in Section 25.5-4 -402.4 (5)(a), C.R.S., $102,988 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., $45,998 shall be from the Primary Care Fund creat ed in Section 24-22-117 (2)(b)(I), C.R.S., and $12,420 shall be from the Medicaid Nursing Facility Cash Fund created in Section 25.5-6-203 (2)(a), C.R.S. PAGE 7-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ (G) Recoveries and Recoupment Contract Costs Estate Recovery 1,165,841 582,920 a 582,921(I) Third-Party Liability Cost Avoidance Contract 8,417,842 2,777,888(M) 1,431,033 b 4,208,921 9,583,683 a This amount shall be from estate recoveries. b This amount shall be from the Healthcare Affordability and Su stainability Fee Cash Fund creat ed in Section 25.5-4-402.4 (5)(a) , C.R.S. (H) Indirect Cost Recoveries Indirect Cost Assessment 922,619 198,368 a 107,638 b 616,613(I) 921,207 196,956 a a Of this amount, $161,171 shall be from the Healthcare Affordability and Sustainability Fee Cash Fund created in Section 25.5-4- 402.4 (5)(a), C.R.S., $11,677 shall be from the Medical Nursing Facility Cash Fund created in Section 25.5-6-203 (2)(a), C.R.S., $8,469 shall be from the Home- and Community-based Ser vices Improvement Fund created in Section 25.5-6-1805 (1), C.R.S., $7,358 shall be from the Adult Dental Fund created in Section 25.5-5-207 (4)(a), C.R.S., $5,422 shall be from the Primary Care Fund created in Section 24-22-117 (2)(b)(I), C.R.S., $1,526 shall be from the Service Fee Fund created in Section 25.5-6-204 (1)(c)(II), C.R.S., $1,412 shall be from the Colorado Autism Treatment Fund created in Section 25.5-6-805 (1), C.R.S., and $1,333 shall be from the Breast and Cervical Cancer Prevention and Treatment Fund created in Section 25.5-5-308 (8)(a)(I), C.R.S. b Of this amount, $67,763 shall be from transferred from the Colora do Benefits Management System, Health Care and Economic Secur ity Staff Development Center line item appropriation in this department, $22,605 shall be transferred from the Department of Higher Education from the Fee-for-service Contracts wit h State Institutions for Speciality Education Programs line item, and $17,270 shall be transferred from the Department of Human Services from the Health Care and Economic Security St aff Development Center line item appropriation. 599,228,589 595,549,353 PAGE 8-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ (2) MEDICAL SERVICES PREMIUMS Medical and Long-Term Care Services for Medicaid Eligible Individuals 22 I NDIVIDUALS 22,22a 11,436,527,075 2,002,981,129 (M) 1,181,193,165 a 1,248,057,642 b 99,768,813 c 6,904,526,326 11,356,534,508 2,004,189,064(M) 1,279,975,630 b 99,768,814 c 6,791,407,835 a This amount shall be from the General Fund Exempt Account created in Section 24-77-103.6 (2), C.R.S. b Of this amount, $968,840,933 $998,964,280 shall be from the Healthcare Affordability and Sustai nability Fee Cash Fund created in Section 25.5-4-402.4 (5)(a ), C.R.S., $66,885,026 $76,250,120 shall be from recoveries and recoupments, $54,416,000 $49,215,400 shall be from the Health Care Expansio n Fund created in Section 24-22-117 (2)(a)(I), C.R.S., $53,965,220 $53,612,013 shall be from the Medicaid Nursing Facility Cash Fund created in Section 25. 5-6-203 (2)(a), C.R.S., $35,815,837 $42,649,089 represents public funds certified as expenditures incurred by public emergency medical transportation providers, $31,553,583 $30,883,582 shall be from the Adult Dental Fund created in Section 25.5-5-207 (4)(a), C.R.S., $24,590,506 $24,106,011 represents public funds certified as expenditures incurred by public hospitals and agencies that are eligible for federal financial participation under the Medicaid program, $2,086,005 $1,604,850 shall be from the Tobacco Tax Cash Fund created in section 24-22-117 (1)(a), C.R.S., and meets the requirement to a ppropriate a portion of the revenues collected from the imposition of additional state cigarette and tobacco taxes to the Old Age Pension program for health related purposes pursuant to Section 21 of Article X of the State Constitution, $4,743,123 $113,850 shall be from the Home- and Community-based Services Improvement Fund created in Section 25.5-6-1805 (1), C.R.S., $1, 740,843 shall be from the Colorado Autism Treatment Fund created in Section 25.5-6-805 (1), C.R.S., $1,102,525 shall be from the Medicaid Buy-In Cash Fund created in Section 25.5-6-1404 (3)(b), C.R.S., $857,151 shall be from the Tobacco Education Programs Fund created in Section 24-22-117 (2)(c)(I), C.R.S., $700,000 shall be fr om an intergovernmental transfer from Denver Health, $545,648 $574,148 shall be from the Breast and Cervical Cancer Prevention and Treatment Fund created in Section 25.5-5-308 (8)(a)(I), C .R.S., $200,460 shall be from the Service Fee Fund created in Section 25.5-6-204 (1)(c)(II), C.R.S., and $14,782 $244,676 shall be from the ARPA Home- and Community-Based Services Account created in Section 25.5-4-402.4 (5)(c)(I)(A), C.R.S., within the Healthcare Affordability and Sust ainability Fee Cash Fund creat ed in Section 25.5-4-402.4 (5)( a), C.R.S. c Of this amount, $88,640,762 $88,640,763 shall be transferred from the Department of Higher Ed ucation from the Fee-for-service Contracts with State Institu tions for Speciality Education Programs line item, $9,969,877 shall be transferred from the Old Age Pension State Medical Program line item appropri ation in the Other Medical Services division of this department, and $1,158,174 shall be transferred from Public School Health Services line item in the Other Medical Services divi sion of this department. (3) BEHAVIORAL HEALTH COMMUNITY PROGRAMS Behavioral Health Capitation Payments 1,207,509,714 282,270,782 (M) 90,368,457 a 834,870,475 1,152,693,941 275,120,854(M) 88,913,362 a 788,659,725 PAGE 9-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ Behavioral Health Fee-for-service Payments 10,973,366 2,431,933 (M) 661,577 a 7,879,856 12,626,201 2,973,141(M) 746,370 a 8,906,690 1,218,483,080 1,165,320,142 a Of these amounts, $90,990,350 $89,628,286 shall be from the Healthcare Affordability and Sustai nability Fee Cash Fund created in Section 25.5-4-402.4 (5)(a) , C.R.S., and $39,684 $31,446 shall be from the Breast and Cervical Cancer Prevention and Treatment Fund created in Section 25.5-5-308 (8)(a)(I), C.R .S. (4) OFFICE OF COMMUNITY LIVING (A) Division of Intellectual and Developmental Disabilities (1) Administrative Costs Personal Services 3,469,613 1,858,480(M) 1,611,133 (39.5 FTE) Operating Expenses 281,510 164,636(M) 116,874 Community and Contract Management System 137,480 89,362(M) 48,118 Support Level Administration 58,350 28,920(M) 255 a 29,175 3,946,953 a This amount shall be from the Healthcare Affordability and Su stainability Fee Cash Fund creat ed in Section 25.5-4-402.4 (5)(a) , C.R.S. (2) Medicaid Programs 23 Adult Comprehensive Services 24 771,570,563 752,788,451 Adult Supported Living Services 25 93,765,842 91,038,265 PAGE 10-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ Children's Extensive Support Services 26 62,870,839 62,163,555 Children's Habilitation Residential Program 27 14,689,243 13,967,626 Case Management for People with Disabilities 28, 29 115,903,041 104,655,935 1,058,799,528 496,310,150 a 24,021,961 b 538,467,417 c 1,024,613,832 487,372,575 a 20,466,425 b 516,774,832 a Of this amount, the (M) notation applies to $495,021,532 $486,190,391. b Of this amount, $15,336,398 $9,231,169 shall be from the Home- and Community-based Services Improvement Fund created in Section 25.5-6-1805 (1), C.R.S., $ 8,630,325 $11,042,517 shall be from the Healthcare Affordability and Sustainability F ee Cash Fund created in Sectio n 25.5-4-402.4 (5)(a), C.R.S., $55 ,237 $192,738 shall be from the ARPA Home- and Community-Based Services Account created in Section 25.5-4- 402.4 (5)(c)(I)(A), C.R.S., within the Healthcare Affordability and Sustainability Fee Cash Fund created in Section 25.5-4-402.4 (5)(a), C.R.S., and $1 shall be from the Health Ca re Expansion Fund created in Section 24-22-117 (2)(a)(I), C.R.S. c Of this amount, the (I) notation applies to $46,007,477. (3) State-only Programs 30 Family Support Services 11,048,853 State Supported Living Services 5,193,524 State Supported Living Services Case Management 5,061,041 Preventive Dental Hygiene 31 69,823 Supported Employment Provider and Certification Reimbursement 303,158 21,676,399 21,676,399 PAGE 11-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ 1,084,422,880 1,050,237,184 (5) INDIGENT CARE PROGRAM Safety Net Provider Payments 226,610,307 111,039,051 a 115,571,256(I) Pediatric Specialty Hospital 10,764,010 5,274,365(M) 5,489,645 Appropriation from Tobacco Tax Cash Fund to the General Fund 305,324 305,324 b Primary Care Fund Program 59,118,641 7,000,000 22,494,290 c 29,624,351(I) Children's Basic Health Plan Administration 3,864,405 1,325,491(H) d 2,538,914 Children's Basic Health Plan Medical and Dental Costs 175,334,025 19,291,864 305,324 e 40,607,383 (H) f 115,129,454 168,474,027 24,009,625 34,299,762(H) f 109,859,316 475,996,712 469,136,714 a This amount shall be from the Healthcare Affordability and Su stainability Fee Cash Fund creat ed in Section 25.5-4-402.4 (5)(a) , C.R.S. b This amount shall be from the Tobacco Tax Cash Fund created in Section 24-22-117 (l)(a), C.R.S. This appropriation partially m eets the requirement to appropriate a portion of the revenues collected from imposition of additional state cigarette and tobacco taxes to the General Fund pursuant to Section 21 o f Article X of the State Constitution. c This amount shall be from the Primary Care Fund created in Section 24-22-117 (2)(b)(I), C.R.S. d Of this amount, $1,320,189 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., and $5,302 shall be from the Healthcare Affordability and Sustainability Fee Cash Fund created in Section 25.5-4-402.4 (5)(a), C.R.S. e This amount shall be from General Fund Exempt Account pursuant to Section 24-22-117 (1)(c)(I)(B), C.R.S., and is not subject t o the statutory limitation on General Fund appropriations imposed by Section 24-75-201.1, C.R.S. PAGE 12-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ f Of this amount, $27,365,620 $21,778,993 shall be from the Healthcare Affordability and Sustai nability Fee Cash Fund created in Section 25.5-4-402.4 (5)(a) , C.R.S., $12,724,462 $10,822,536 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., $417,300 $437,775 shall be from the Colorado Immunization Fund created in Section 25-4-2301, C.R.S., $100,000 $1,260,457 shall be from recoveries and recoupments, and $1 shall be from the Health Care Expansion Fund created in Section 24 -22-117 (2)(a)(I), C.R.S. (6) OTHER MEDICAL SERVICES Old Age Pension State Medical Program 10,000,000 10,000,000 a Senior Dental Program 3,990,358 3,962,510 27,848 b Commission on Family Medicine Residency Training Programs 9,490,170 4,429,684(M) 220,500 c 4,839,986 Medicare Modernization Act State Contribution Payment 257,069,930 257,069,930 251,754,405 251,754,405 Public School Health Services Contract Administration 2,000,000 1,000,000(M) 1,000,000 Public School Health Services 161,383,372 78,719,855 d 82,663,517 (I) 192,429,050 91,181,029 d 101,248,021(I) Screening, Brief Intervention, and Referral to Treatment Training Grant Program 32 1,500,000 1,500,000 e Reproductive Health Care for Individuals Not Eligible for Medicaid 3,614,490 3,614,490 PAGE 13-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ Payments to Denver Health and Hospital Authority 1,000,000 1,000,000 Rural Provider Access and Affordability Fund, Created in Section 25.5-1-207 (6)(a), C.R.S. 1,000,000 1,000,000 State-only Payments for Home- and Community-Based Services 46,817,018 46,817,018 f 32,424,528 32,424,528 f (4.0 FTE) (8.3 FTE) 497,865,338 509,203,001 a This amount shall be from the Old Age Pension Health and Medical Care Fund created in Section 25.5-2-101 (2), C.R.S. b This amount shall be from the Department of Health Care Policy and Financing Cash Fund created in Section 25.5-1-109, C.R.S. c This amount shall be transferred from the Department of Highe r Education from the Fee-for-service Contracts with State Institu tions for Speciality Education Programs line item. d This amount represents funds certified as public expenditures incurred by school districts or boards of cooperative educationa l services that are eligible for federal financial participation under Medicaid. e This amount shall be from the Marijuana Tax Cash Fund created in Section 39-28.8-501 (1), C.R.S. f This amount O F THIS AMOUNT , $18,563,377 shall be from the Home- and Community-based Services Improvement Fund created in Section 25.5-6-1805 (1), C.R.S. C.R.S., AND $13,861,151 SHALL BE FROM THE ARPA H OME - AND C OMMUNITY -B ASED S ERVICES A CCOUNT CREATED IN S ECTION 25.5-4-402.4 (5)(c)(I)(A), C.R.S., WITHIN THE H EALTHCARE A FFORDABILITY AND S USTAINABILITY F EE C ASH F UND CREATED IN S ECTION 25.5-4-402.4 (5)(a), C.R.S. (7) DEPARTMENT OF HUMAN SERVICES MEDICAID-FUNDED PROGRAMS (A) Executive Director's Office - Medicaid Funding 33 14,481,177 7,240,589(M) 7,240,588 PAGE 14-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ (B) Office of Children, Youth and Families - Medicaid Funding (1) Division of Child Welfare Administration 305,372 133,055(M) 172,317 Child Welfare Services 14,113,853 6,915,788(M) 7,198,065 14,419,225 (2) Division of Youth Services 667,368 327,011(M) 340,357 (C) Office of Economic Security - Medicaid Funding (1) Administration 240,000 72,180(M) 47,820 a 120,000 a This amount shall be from the Healthcare Affordability and Su stainability Fee Cash Fund creat ed in Section 25.5-4-402.4 (5)(a) , C.R.S. (2) Food and Energy Assistance Systematic Alien Verification for Eligibility 28,307 14,154(M) 14,153 (D) Behavioral Health Administration - Medicaid Funding (1) Community Behavioral Health Administration 544,302 272,151(M) 272,151 (2) Community-based Mental Health Services Children and Youth Mental Health Treatment Act 134,980 66,140(M) 68,840 (E) Office of Behavioral Health - Medicaid Funding8,320,198 4,077,703(M) 4,242,495 PAGE 15-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ (F) Office of Adults, Aging and Disability Services - Medicaid Funding (1) Administration 412,894 206,447(M) 206,447 (2) Regional Centers for People with Developmental Disabilities Regional Centers 57,341,694 26,208,527(M) 1,888,903 a 29,244,264 Regional Center Depreciation and Annual Adjustments 691,725 345,863(M) 345,862 Regional Centers Electronic Health Record System 680,382 340,191(M) 340,191 58,713,801 a This amount shall be from the Service Fee Fund created in Section 25.5-6-204 (1)(c)(II), C.R.S. (3) Aging Programs Community Services for the Elderly 1,001,800 490,900(M) 510,900 (G) Other Federal Medicaid Indirect Cost Reimbursement for Department of Human Services Programs 500,000500,000(I) a Department of Human Services Indirect Cost Assessment 22,762,498 11,381,249 (M) 11,381,249 22,891,822 11,445,911(M) 11,445,911 23,262,498 23,391,822 PAGE 16-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ a This amount reflects estimated Medicaid federal indirect cost re imbursements for Department of Human Services programs and is shown for informational purposes only. 122,226,550 122,355,874 TOTALS PART VI (HEALTH CARE POLICY AND FINANCING) 33a $15,434,750,224 $3,310,749,743 $1,181,498,489 a $1,768,567,113 b $105,145,754 $9,068,789,125 c $15,268,336,776 $3,294,923,851 $1,788,004,336 b $117,280,880 $8,886,629,220 c a Of this amount, $1,181,193,165 shall be from the General Fund Exempt Account created in Section 24-77-103.6 (2), C.R.S., and $ 305,324 shall be General Fund Exempt pursuant to Section 24-22-117 (1)(c)(I)(B), C.R.S. Said $305,324 is not subject to the statutory limitation on General Fund appropriations imposed by Section 24-75-201.1, C.R.S. b Of this amount, $18,871,933 contains an (I) notation. c Of this amount, $466,207,161 $428,886,610 contains an (I) notation. FOOTNOTES -- The following statements are referenced to the numbered footnotes throughout section 2. 17 Department of Health Care Policy and Financing, Executive Direct or's Office, General Administration, Personal Services; Operati ng Expenses; Leased Space -- These line items include $588,486 total funds, including $202,545 General Fund, and 6.4 FTE for the purpose of expanding and strengthening operational compliance and program oversight and accountability. It is the General Assembly's intent that none of the $588,486 total funds be used for the Recovery Audit Contractor program or related appeals. 18 Department of Health Care Policy and Financing, Executive Director's Office, General Administration, General Professional Servi ces and Special Projects -- Of this appropriation, $2,921,400 $3,171,400 total funds, including $1,460,750 $1,585,750 General Fund, remains available for expenditure until the close of the 2024-25 fiscal year. 19 Department of Health Care Policy and Financing, Executive Director's Office, General Administration, General Professional Ser vices and Special Projects -- This line item includes $62,000 total funds, including $31,000 General Fund, the purpose of which is the autism waiver progr am evaluation required by Section 25.5-6-806 (2)(c)(I), C.R.S. It is the General Assembly's intent that the Department also use the $62,000 total funds t o evaluate the new behavioral PAGE 17-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ therapy benefit through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program. 20 Department of Health Care Policy and Financing, Executive Dir ector's Office, Information Technology Contracts and Projects, C olorado Benefits Management Systems, Operating and Contract Expenses and Colorado Benefits Management Systems, Health Care and Economic Security Staff Deve lopment Center -- In addition to the transfer authority provid ed in Section 24-75-108, C.R.S., the Department is authorized to transfer up to 5.0 percent of the total appropriations within the line items designated with this footnote. The Department is also authorized to transfer up to 5.0 percent of the tot al appropriations within the line items designated with this footnote to line item appropriations within the Department of Human Services, Office of Information Technology Services, Colorado Benefits Management System subsection. 21 Department of Health Care Policy and Financing, Executive Dir ector's Office, Information Technology Contracts and Projects, C olorado Benefits Management Systems, Operating and Contract Expenses and Colorado Benefits Management Systems, Health Care and Economic Security Staff Deve lopment Center -- Of this appropriation, $2,500,000 remains available for expenditure until the close of the 2024-25 state fiscal year. 22 Department of Health Care Policy and Financing, Medical Services Premiums, Medical and Long-Term Care Services for Medicaid Eli gible Individuals -- The appropriation is based on the assumption that anesthesia rate s for services delivered by anesthesiologists and nurse anesth esiologists are not subject to rebalancing of any codes above 100 percent of Medicare and these codes are subject to the common policy community provider rate adjustment. 22a D EPARTMENT OF H EALTH C ARE P OLICY AND F INANCING , M EDICAL S ERVICES P REMIUMS , M EDICAL AND L ONG -T ERM C ARE S ERVICES FOR M EDICAID E LIGIBLE I NDIVIDUALS -- T HE APPROPRIATION INCLUDES $10,425,342 TOTAL FUNDS , INCLUDING $5,212,671 G ENERAL F UND , FOR THE PURPOSE OF INCREASING PEDIATRIC BEHAVIORAL THERAPY RATES TO 100 PERCENT OF THE BENCHMARK RATES IDENTIFIED BY THE M EDICAID P ROVIDER R ATE R EVIEW A DVISORY C OMMITTEE FOR THE BILLING CODES 97151, 97153, 97154, 97155, AND 97158. 23 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, Medicaid Programs - It is the General Assembly's intent that expenditures for these services be recorded only against the Long Bill group total f or Medicaid Programs. 24 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, Medicaid Programs, Adult Comprehensive Services -- Of this appropriation, cash fund s appropriated from the Home- and Community-based Services Impr ovement Fund remain available for expenditure until the close of the 2024-25 state fiscal year. 25 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, Medicaid Programs, Adult Supported Living Services -- Of this appropriation, cash funds appropriated from the Home- and Community-based Services I mprovement Fund remain available for expenditure until the close of the 2024-25 state fiscal year. PAGE 18-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ 26 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, Medicaid Programs, Children's Extensive Support Services -- Of this appropriation, cash funds appropriated from the Home- and Community-based Serv ices Improvement Fund remain available for expenditure until the close of the 2024-25 state fiscal year. 27 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, Medicaid Programs, Children's Habilitation Residential Program -- Of this appropriatio n, cash funds appropriated from the Home- and Community-base d Services Improvement Fund remain available for expenditure until the close of the 2024-25 state fiscal year. 28 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, Medicaid Programs, Case management for People with Disabilities -- Of this appropriation, cash funds appropriated from the Home- and Community-bas ed Services Improvement Fund remain available for expenditure until the close of the 2024-25 state fiscal year. 29 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, Medicaid Programs, Case management for People with Disabilities -- Of this appropriation, $168,000 General Fund is appropriated for financial clos eout activities for Case Management Agencies and Single Entry Points, and is available for expenditure until the close of the 2024-25 state fiscal year. 30 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, State-only Programs - It is the General Assembly's intent that expenditures for these services be recorded only against the Long Bill group total f or State-only Programs. 31 Department of Health Care Policy and Financing, Office of Community Living, Division of Intellectual and Developmental Disabi lities, State-only Programs, Preventive Dental Hygiene - It is the General Assembly's intent that this appropriation be used to provide special dental servi ces for persons with intellectual and developmental disabilities. 32 Department of Health Care Policy and Financing, Other Medical Services, Screening, Brief Intervention, and Referral to Treatm ent Training Grant Program -- It is the General Assembly's intent that this appropriation be used to sustain the grant program for screening, brief interv ention, and referral to treatment for individuals at risk of substance abuse that is authorized in Section 25.5-5-208, C.R.S., in accordance with the requirement s set forth in that section. 33 Department of Health Care Policy and Financing, Department of Human Services Medicaid-Funded Programs, Executive Director's O ffice - Medicaid Funding -- The appropriation in this Health Care Policy and Financing line item corresponds to the Medicaid funding in the Department o f Human Services, Executive Director's Office, General Administration. As such, the appropr iation contains amounts that co rrespond to centralized appropria tion amounts in the Department of Human Services. Consistent with the headnotes to the Long Bill, the Department of Human Services is authorized to transfer t he centralized appropriations to other line item appropriations in the Department of Human Services. In order to aid budget reconciliation between the Depart ment of Health Care Policy PAGE 19-HOUSE BILL 24-1185 APPROPRIATION FROM ITEM & SUBTOTAL TOTAL GENERAL FUND GENERAL FUND EXEMPT CASH FUNDS REAPPROPRIATED FUNDS FEDERAL FUNDS $$$$$ $ $ and Financing and the Department of Human Services, the Department of Health Care Policy and Financing is hereby authorized to make line item transfers out of this appropriation to other Department of Human Services Medicaid-funded programs appropriations in this section (7) in amounts equal to the centralized appropriation transfers made by the Department of Human Services for Medicaid-funded programs in the Department of Human Services. 33a Department of Health Care Policy and Financing, Totals; Department of Higher Education, College Opportunity Fund Program, Fe e-for-service Contracts with State Institutions, Fee-for-service Contracts with State In stitutions for Specialty Education Programs; and Governing Boar ds, Regents of the University of Colorado -- The Department of Higher Education shall transfer $800,000 to the Department of Health Care Policy and Financing for administrative costs and family medicine residency placements associated with care provided by the faculty of the health sciences center campus at t he University of Colorado that are eligible for payment pursuant to Section 25.5-4-401, C.R.S. If the federal Centers for Medicare and Medicaid services continues to allow the Department of Health Care Policy and Financing to make supplemental payments to the University of Colorado School of Medicine, the Department of Higher Education shall transfer the amount approved, up to $88,640,763, to the Department of Health Care Policy and Financing pursuant to Section 23-18-304(1)(c), C.R.S. If permission is discontinued, or is granted for a lesse r amount, the Department of Higher Education shall transfer any portion of the $88,640,763 that is not transferred to the Department of Health Care Policy and Financing to the Regents of the University of Colorado. PAGE 20-HOUSE BILL 24-1185 SECTION 2. Appropriation to the department of health care policy and financing for the fiscal year beginning July 1, 2022. (1) For the 2022-23 state fiscal year, $24,956,492 is appropriated to the department of health care policy and financing and is for the payment of overexpenditures of line item appropriations contained in Part VI of section 2 of chapter 507 (HB 22-1329), Session Laws of Colorado 2022, as follows: (a) $20,329,789 from the general fund for medical and long-term care services for Medicaid eligible individuals; (b) $474,709 from the healthcare affordability and sustainability fee cash fund created in Section 25.5-4-402.4 (5)(a), C.R.S., for behavioral health capitation payments; (c) $2,927,608 from the general fund, for adult comprehensive services; and (d) $1,224,386 from the healthcare affordability and sustainability fee cash fund created in Section 25.5-4-402.4 (5)(a), C.R.S., for adult supported living services. (2) In accordance with section 24-75-109 (4)(a), C.R.S., all restrictions on funds for the department of health care policy and financing for the 2023-24 state fiscal year for the amounts and items of appropriation listed in this section are released. SECTION 3. Appropriation to the department of health care policy and financing for the fiscal year beginning July 1, 2023. In Session Laws of Colorado 2023, amend section 5 (3) of chapter 277, (HB 23-1215), as follows: Section 5. Appropriation - adjustments to 2023 long bill. (3) For the 2023-24 state fiscal year, $516,950 is appropriated to the department of health care policy and financing for use by the executive director's office. This appropriation is from the general fund. To implement this act, the office may use this appropriation for general professional services and special projects. O F THE MONEY APPROPRIATED IN THIS SUBSECTION NOT EXPENDED PRIOR TO JULY 1, 2024, UP TO $433,700 IS FURTHER APPROPRIATED TO THE DEPARTMENT FOR THE 2024-25 STATE FISCAL YEAR FOR THE SAME PURPOSE . PAGE 21-HOUSE BILL 24-1185 SECTION 4. Safety clause. The general assembly finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, or safety or for appropriations for the support and maintenance of the departments of the state and state institutions. ____________________________ ____________________________ Julie McCluskie Steve Fenberg SPEAKER OF THE HOUSE PRESIDENT OF OF REPRESENTATIVES THE SENATE ____________________________ ____________________________ Robin Jones Cindi L. Markwell CHIEF CLERK OF THE HOUSE SECRETARY OF OF REPRESENTATIVES THE SENATE APPROVED________________________________________ (Date and Time) _________________________________________ Jared S. Polis GOVERNOR OF THE STATE OF COLORADO PAGE 22-HOUSE BILL 24-1185