Page 1
May 4, 2024 SB 24-221
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Revised Fiscal Note
(replaces fiscal note dated April 26, 2024)
Drafting Number:
Prime Sponsors:
LLS 24-1178
Sen. Roberts; Kirkmeyer
Rep. Catlin; Lukens
Date:
Bill Status:
Fiscal Analyst:
May 4, 2024
House Appropriations
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 an appropriation of $866,567 to the Department of
Higher Education. No appropriation is required from the Rural Hospital Cash Fund
which is continuously appropriated to the Department of Health Care Policy and
Financing.
Fiscal Note
Status:
The revised fiscal note reflects the reengrossed bill.
Table 1
State Fiscal Impacts Under SB 24-221
Budget Year
FY 2024-25
Out Year
FY 2025-26
Revenue - -
Expenditures General Fund $866,667 -
Cash Funds $1,742,029 -
Total Expenditures $2,608,696 -
Transfers General Fund ($1,742,029) -
Cash Funds $1,742,029 -
Net Transfer/Diversion $0 -
Other Budget Impacts General Fund Reserve $130,000 -
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May 4, 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 creates the Rural Hospital Cash Fund and continuously
appropriates the fund to HCPF to make equal payments to rural hospitals, as defined in the bill.
On July 1, 2024, the bill transfers $1,742,029 from the General Fund to the fund.
State Transfers
In FY 2024-25 only, the bill transfers $1,742,029 from the General Fund to the newly created
Rural Hospital Cash Fund.
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 $1.7 million in the Rural Hospital Cash Fund to make equal
payments to 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. Page 3
May 4, 2024 SB 24-221
Effective Date
The bill takes effect upon signature of the Governor, or upon becoming law without his
signature.
State Appropriations
For FY 2024-25, the bill includes a General Fund appropriation of $866,667 to the Department of
Higher Education. No appropriation is required for the Department of Health Care Policy and
Financing since the Rural Hospital Cash Fund is continuously appropriated.
Departmental Difference
CDHE estimates that it will require 0.5 FTE to distribute the additional payments in line with the
formula that will be developed by the University of Colorado. Since the program is already
operational, the fiscal note assumes that making additional payments and conforming to a new
distribution formula can be accomplished within existing resources.
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.