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January 22, 2024 SB 24-018
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 24-0461
Sen. Simpson;
Michaelson Jenet
Rep. Amabile; Winter T.
Date:
Bill Status:
Fiscal Analyst:
January 22, 2024
Senate Health & Human Services
Brendan Fung | (303-866-4781)
brendan.fung@coleg.gov
Bill Topic: PHYSICIAN ASSISTANT LICENSURE COMPACT
Summary of
Fiscal Impact:
☒ State Revenue
☒ State Expenditure
☐ State Transfer
☒ TABOR Refund
☐ Local Government
☐ Statutory Public Entity
The bill enters Colorado into the Physician Assistant Licensure Compact, pending
adoption of the compact by seven states. The bill increases state expenditures starting
in FY 2024-25 and revenue starting in FY 2025-26.
Appropriation
Summary:
For FY 2024-25, the bill requires an appropriation of $78,750 to the Department of
Regulatory Agencies.
Fiscal Note
Status:
The fiscal note reflects the introduced bill.
Table 1
State Fiscal Impacts Under SB 24-018
Budget Year
FY 2024-25
Out Year
FY 2025-26
Out Year
FY 2026-27
Revenue Cash Funds - $587,675 -
Total Revenue - $587,675 -
Expenditures Cash Funds $78,750 $127,326 $242,134
Centrally Appropriated $9,226 $20,242 $18,157
Total Expenditures $87,976 $147,568 $260,291
Total FTE 0.5 FTE 1.1 FTE 1.7 FTE
Transfers - - -
Other Budget Impacts TABOR Refund - $569,113 -
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January 22, 2024 SB 24-018
Summary of Legislation
The bill enters Colorado into the Physician Assistant Licensure Compact, which allows licensed
physician assistants (PAs) in a participating state to more easily obtain a license and practice in
another participating state, including via telehealth. The compact takes effect when seven
member states have enacted the compact into law.
Physician Assistant Licensure Compact. Member states and PAs must meet specific conditions
established in the compact to participate. Requirements for member states include licensing
PAs, conducting criminal background checks, establishing a process to grant compact privileges,
receiving and investigating complaints, appointing a delegate to the compact commission, and
participating in the commission’s data reporting system, among others.
The compact sets parameters for the sharing of disciplinary information between states and
does not limit a licensing state’s ability to handle violations and enforcement. It also establishes
procedures for legal proceedings and rulemaking related to the compact.
Compact Commission. The bill establishes the Physician Assistant Licensure Compact
Commission to oversee the compact. The commission is comprised of delegates from member
states who adopt and enforce rules, elect officers of an executive committee, facilitate
implementation of the compact, hire employees, maintain financial records, and approve a
state’s participation in the compact. It must meet at least once per year, include one
representative from each participating state, and prepare an annual report. The commission is
funded with grants, gifts, and donations, and may levy an annual assessment on each
participating state and fees on licensees to cover expenses.
Background
Interstate compacts are a constitutionally authorized, legally binding, legislatively enacted
contract among participating states. States joining the compact agree to recognize a valid,
unencumbered license issued by another participating state via a compact privilege. Licensure
mobility is facilitated through a “privilege to practice” model, which allows individual licensees to
seek a compact privilege in any participating state they choose. PAs using a compact privilege to
practice in another state must adhere to laws and regulations of practice in that state and are
under the jurisdiction of the state’s regulatory board in which they are practicing.
Assumptions
The fiscal note assumes that the compact will take effect by July 1, 2024, following its enactment
by several state legislatures during the 2024 session. As of January 2024, the compact has been
enacted in three states and legislation has been filed in twelve other states. The fiscal note
further assumes that the program will require 18 months to set up and that compact privileges
will be available beginning January 2026.
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January 22, 2024 SB 24-018
It is assumed that the costs of the compact in Colorado will be paid through a biennial fee levied
on all licensed physician assistants in the state, regardless of their participation in the compact.
Further, the fiscal note assumes that 30 percent of physician assistants, or 1,650 licensees, will
participate in the compact, beginning in FY 2025-26. Some revenue and expenditure impacts
could shift between fiscal years if the compact is implemented sooner or later than this date.
State Revenue
The bill will increase state cash fund revenue by about $588,000 in FY 2025-26, primarily to the
Division of Professions and Occupations Cash Fund within the Department of Regulatory
Agencies (DORA) to cover the costs of implementing and administering the compact, as well as
to the Department of Public Safety for background checks. On an ongoing basis, revenue will
increase to DORA by about $522,000 every two years starting in FY 2027-28, assuming the fee is
charged as part of the two-year renewal cycle for PA licenses. These impacts are shown in
Table 2 and discussed in more detail below.
Table 2
Fee Impact on Physician Assistants
Fiscal Year
1
Type of Fee Proposed Fee Number Affected Total Fee Impact
FY 2025-26
Compact Privilege Fee $95 5,500 $522,500
CBI Background Check Fee $39.50 1,650 $65,175
FY 2025-26 Total Fee Revenue $587,675
FY 2027-28 Compact Privilege Fee $95 5,500 $522,500
FY 2027-28 Total Fee Revenue $522,500
1
The Compact Privilege Fee is assumed to be charged biennially. Fee revenue is not anticipated in FY 2024-25 or
FY 2026-27.
Fee impact on physician assistants. Colorado law requires legislative service agency review of
measures which create or increase any fee collected by a state agency. The bill increases
licensing fees and background check fees on PAs, as show in Table 2 above.
License fees – DORA. Beginning in FY 2025-26 and every two years thereafter, DORA will
collect about $522,000 in additional fees to cover compact related costs. As shown in
Table 2, the fiscal note estimates a $95 fee every two years. This compact privilege fee
amount is an estimate only; actual fees will be set administratively by DORA based on cash
fund balance, estimated program costs, and the estimated number of licensees subject to
the fee. The table below assumes that all licensed PAs will pay an increased fee, regardless of
their participation in the compact.
Fingerprint-based background check fees – DPS. This bill increases state cash fund
revenue from fingerprint-based criminal history background checks to the CBI Identification
Unit Cash Fund in the DPS by $65,175 starting in FY 2025-26. This assumes 1,650 checks will
be conducted in FY 2025-26, when the state begins granting compact privileges. Revenue Page 4
January 22, 2024 SB 24-018
will minimally increase in future years for additional compact participants. The current fee for
background checks is $39.50, which includes $11.25 for a Federal Bureau of Investigation
(FBI) fingerprint-based check, which is passed on to that federal agency. The federal portion
of this fee is excluded from the state TABOR limit, meaning $46,613 is subject to TABOR. The
background check is required only upon initial participation in the compact.
State Expenditures
The bill increases state expenditures in DORA and DPS by about $88,000 in FY 2024-25, about
$148,000 in FY 2025-26, and about $260,000 in FY 2026-27, paid from the Division of
Professions and Occupations Cash Fund and the CBI Identification Unit Cash Fund. Expenditures
are shown in Table 3 and detailed below.
Table 3
Expenditures Under SB 24-018
FY 2024-25 FY 2025-26 FY 2026-27
Department of Regulatory Agencies
Personal Services $34,440 $53,101 $65,730
Operating Expenses $640 $1,024 $1,280
Capital Outlay Costs $6,670 - -
Legal Services - - $153,624
Computer Programming $35,000 $2,500 $2,500
Travel $2,000 $4,000 $4,000
Compact Membership Dues - $15,000 $15,000
Centrally Appropriated Costs
1
$9,226 $14,574 $18,157
FTE – Personal Services 0.5 FTE 0.8 FTE 1.0 FTE
FTE – Legal Services - - 0.7 FTE
DORA Subtotal $87,976 $90,199 $260,291
Department of Public Safety
Personal Services - $18,024 -
FBI Pass Through - $18,563 -
Processing Costs - $15,114 -
Centrally Appropriated Costs
1
- $5,669 -
FTE – Personal Services - 0.3 FTE -
DPS Subtotal - $57,370 -
Total Cost $87,976 $147,568 $260,291
Total FTE 0.5 FTE 1.1 FTE 1.7 FTE
1
Centrally appropriated costs are not included in the bill's appropriation.
2
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January 22, 2024 SB 24-018
Department of Regulatory Agencies. Expenditures in DORA will increase by about $88,000 in
FY 2024-25, about $90,000 in FY 2025-26, and about $260,000 in FY 2026-27. Costs will be paid
from the Division of Professions and Occupations Cash Fund.
Staff. Starting in FY 2024-25, DORA will require 0.5 FTE for a Program Management II
and Technician IV to oversee compact implementation, conduct rulemaking, and
administer the program. Starting in FY 2025-26, DORA will require an additional 0.4 FTE
for a Technician III and Criminal Investigator I to process compact privilege applications
and investigate complaints. Staff costs and FTE are prorated in the first year based on a
start date of September 1, 2024 and in the second year based on a start day of January 1,
2026.
Information technology systems. In FY 2024-25, DORA will require $35,000 to install
data interfaces between the state licensing system and the compact data system,
implemented by the Office of Information Technology. Ongoing maintenance costs are
estimated at $2,500 per year starting in FY 2025-26.
Travel. Starting in FY 2024-25, costs in DORA will increase by $2,000 for travel to each
compact commission meeting. Costs are based on similar meetings held by the
department and include airfare, meals, lodging, incidentals, and mileage. The fiscal note
assumes that there will be one meeting in FY 2024-25 and two meetings per year in
future years.
Membership dues. The fiscal note assumes that DORA will have to pay an annual due to
participate in the compact. Starting in FY 2025-26, this cost is estimated at $15,000 per
year.
Legal services. DORA will require 50 hours of legal services in FY 2024-25 for compact
rulemaking, which can be accomplished within current appropriations. Starting in
FY 2026-27 after the compact is fully implemented, DORA will require 1,200 hours of
legal services on an ongoing basis for costs related to disciplinary referrals from other
states, as well as increased litigation and appeals from PAs facing adverse action against
their license. Legal services are provided by the Department of Law at a rate of $128.02
per hour.
Department of Public Safety. This bill increases overall expenditures from the CBI Identification
Unit Cash Fund in DPS by about $57,000 in FY 2025-26, as described below. Actual costs may
vary and depend on the number and timing of PAs requesting fingerprint-based background
checks.
Personal services. In FY 2025-26, DPS will require 0.2 FTE Fingerprint Examiner II and
0.1 FTE Technician II to process an assumed 1,650 fingerprint background applications. A
Fingerprint Examiner II can process 8,250 requests per year, and a Technician II 16,500.
Training costs for this FTE is included. Page 6
January 22, 2024 SB 24-018
Federal Bureau of Investigation pass-through. The DPS passes $11.25 of every
application on to the federal government. With 1,650 applications, this equates to
$18,563 per year.
Processing costs. There are the following costs associated with each background check
application: $6.10 dedicated to equipment maintenance; $1.55 for print digitization;
$0.88 to access the Colorado Crime Information Center for information pertinent to the
background check; and $0.58 printing and postage costs.
Judicial Department. Starting in FY 2025-26, trial courts in the Judicial Department may
experience an increase in workload to adjudicate civil cases or appeals challenging jurisdictional
decisions or handling compact proceedings. The fiscal note assumes that PAs with a compact
privilege and participating states will comply with the law and any increase will be minimal.
Department of Personnel and Administration. The bill may increase workload starting in
FY 2025-26 for administrative law judges in the Office of Administrative Courts to hear cases
challenging disciplinary actions by DORA. This workload is expected to be minimal and 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 3.
Other Budget Impacts
TABOR refunds. The bill is expected to increase the amount of state revenue required to be
refunded to taxpayers by $569,113 for FY 2025-26. 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.
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 an appropriation of $78,750 and 0.5 FTE from the Division of
Professions and Occupations Cash Fund to the Department of Regulatory Agencies, of which
$35,000 is reappropriated to the Office of Information Technology.
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January 22, 2024 SB 24-018
State and Local Government Contacts
Information Technology Judicial Law
Personnel Public Safety 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.