Colorado Legislative Council Staff

STATE and LOCAL

REVISED FISCAL NOTE

Cash Fund Exempt and Federal Fund Expenditure Impact

Local Expenditure Impact

(Replaces Fiscal Note dated January 19, 1998)


Drafting Number:

Prime Sponsor(s):

LLS 98-221

Rep. Keller

Sen. Wham

Date:

Bill Status:

Fiscal Analyst:

February 18, 1998

House Appropriations

Steve Tammeus (866-2756)

 

TITLE:            CONCERNING THE PROTECTION OF PERSONS FROM RESTRAINT.


Summary of Legislation


STATE FISCAL IMPACT SUMMARY

FY 1998/99

FY 1999/2000

State Revenues

General Fund

Other Fund



 



 

State Expenditures

General Fund

Federal Funds

Cash Funds Exempt



Potential Increase

Potential Increase



Potential Increase

Potential Increase

FTE Position Change

None

None

Local Government Impact Increases the operating costs of some Child Welfare and Child Care providers which are funded by county, state, and federal funds.


            This bill, as amended by the House HEWI Committee (House Journal, February 4, 1998, pages 369 - 374), establishes minimum standards for the use of restraint on persons in certain state-operated or state-licensed facilities.


            The bill prescribes conditions when restraint may be used and the purposes for which it may be used. The amended bill provides that if the use of restraint in skilled nursing and nursing care facilities licensed under state law is in accordance with certain existing federal regulations, there shall be a conclusive presumption that such use of restraint is in accordance with the provisions of the amended bill. The amended bill also provides that if the use of restraint on a person with a developmental disability is in accordance with certain existing state laws, there shall be a conclusive presumption that such use of restraint is in accordance with the provisions of this amended bill.


            The bill requires applicable agencies to ensure that procedures are maintained for the proper use and documentation of physical, mechanical, and medical restraint. The bill requires all agencies to ensure that staff in facilities utilizing restraint are trained in the appropriate use of restraint. Each agency is required to ensure that a review process is established for the appropriate uses of restraint.

            The bill requires each agency to adopt regulations that establish procedures for the use of restraint if the agency does not currently have regulations that meet the minimum requirements established by the bill. The bill will become effective upon the signature of the Governor.


            The bill will affect local government, state, and federal expenditures. Therefore, it is assessed as having a fiscal impact.



State Expenditures


            The provisions of the amended bill will not affect the Department of Public Health and Environment; or the Division of Youth Corrections, the Division of Developmental Disabilities, the Division of Mental Health, and the Division of State and Veteran Nursing Homes under the Department of Human Services.


            However, Child Welfare and Child Care providers negotiate their service rates with the county departments of social services, subject to the availability of appropriated funds. These provider costs are funded by county, state, and federal funds. The Department of Human Services believes that the provisions of the amended bill will increase the operating costs of some Child Welfare and Child Care providers. In that event, providers would recover those cost increases through negotiation of higher service rates that are paid by county, state, and federal funds. The amounts of those increases have not been estimated.



Local Government Impact


            Section 26-20-104 (c) of the amended bill requires an agency, when using restraint, to ensure that an agent or employee has continuous clear view of the face of the individual. Section 26-20-105 of the amended bill requires all agencies to ensure that staff in facilities using restraint are trained in the appropriate use of restraint.


            Child Welfare and Child Care providers currently utilize an accepted method of restraint that requires two persons to be involved in the restraint. The current practice is to avoid eye contact to not visually stimulate the person being restrained. The Department of Human Services believes the provisions of Section 26-20-104 (c) will require a third person to become involved in the restraint which may increase the personal services cost of the Child Welfare provider. The department also believes that some level of additional staff training will also be required which will also affect the operating expenses of some providers.


            Child Welfare and Child Care providers negotiate their service rates with the county departments of social services, subject to the availability of appropriated funds. These provider costs are funded by county, state, and federal funds. The Department of Human Services believes that the provisions of the amended bill will increase the operating costs of some Child Welfare and Child Care providers. In that event, providers would recover those cost increases through negotiation of higher service rates that are paid by county, state, and federal funds. The amounts of those increases have not been estimated.



Spending Authority


            This fiscal note would imply that no new state appropriation or spending authority is required for FY 1998-99 to implement the provisions of the amended bill.



Departments Contacted


            Public Health and Environment         Human Services         Health Care Policy and Financing

            Law                                                    OSPB