Page 1 April 24, 2024 SB 24-221 Legislative Council Staff Nonpartisan Services for Colorado’s Legislature Fiscal Note Drafting Number: Prime Sponsors: LLS 24-1178 Sen. Roberts; Kirkmeyer Rep. Catlin; Lukens Date: Bill Status: Fiscal Analyst: April 26, 2024 Senate Health & Human Services Kristine McLaughlin | 303-866-4776 kristine.mclaughlin@coleg.gov Bill Topic: FUNDING FOR RURAL HEALTH CARE Summary of Fiscal Impact: ☐ State Revenue ☒ State Expenditure ☐ State Transfer ☐ TABOR Refund ☐ Local Government ☐ Statutory Public Entity The bill appropriates funds to CDHE to expand its rural health-care workface initiative and to HCPF to make payments to rural hospitals. The bill increases state expenditures in FY 2024-25 only. Appropriation Summary: For FY 2024-25, the bill includes appropriations of $2,608,696 to multiple state agencies. Fiscal Note Status: The fiscal note reflects the introduced bill. Table 1 State Fiscal Impacts Under SB 24-221 Budget Year FY 2024-25 Out Year FY 2025-26 Revenue - - Expenditures General Fund $2,608,696 - Transfers - - Other Budget Impacts General Fund Reserve $391,304 - Page 2 April 24, 2024 SB 24-221 Summary of Legislation The bill provides funding for the Rural Health Care Workforce Initiative in the Department of Higher Education (CDHE) and for the Department of Health Care Policy and Financing (HCPF) to make payments to rural hospitals. Rural Health Care Workforce Initiative. Senate Bill 22-172 established the Rural Health-Care Workforce Initiative in CDHE to expand the number of health-care professionals practicing in rural or frontier counties through support for higher education institutions establishing or expanding a health-care professional rural track. The Rural Program Office (office) at the University of Colorado provides institutional support for institutions operating a rural track and manages the initiative’s reporting. The bill requires the office to develop and annually revise a data-driven funding allocation formula to be used by the CDHE when making allocations to the initiative. CDHE must include information about the allocation formula as part of its annual reporting on the initiative to the General Assembly. The bill appropriates $866,677 to the CDHE for the initiative in FY 2024-25, which has roll-forward spending authority through FY 2025-26. Rural Hospital Payments. The bill appropriates $1,742,029 to HCPF to make payments to rural hospitals, as defined in the bill. State Expenditures CDHE will expend the $867,000 over FY 2024-25 and FY 2025-26 to support the Rural Program Office’s requirements under the bill and to expand initiative funding. The office in the University of Colorado will have an increase in workload to create a data-driven funding allocation formula and support universities that receive additional funding for their rural track. In FY 2024-25, HCPF will expend the funds the bill appropriates, $1.7 million, to make payments to rural hospitals. It is assumed that the payments will be made equally to the rural hospitals. Other Budget Impacts 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. Effective Date The bill takes effect upon signature of the Governor, or upon becoming law without his signature. Page 3 April 24, 2024 SB 24-221 State Appropriations For FY 2024-25, the bill includes a General Fund appropriation of $2,608,696 in the following amounts: $866,667 to the Department of Higher Education; and $1,742,029 to the Department of Health Care Policy and Financing. State and Local Government Contacts Health Care Policy and Financing Higher Education 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.