Public Partnerships

During the past year, Colorado has experienced two significant changes to the state agency partner infrastructure, a new Department of Early Childhood and the creation of a Behavioral Health Authority.

The new Colorado Department of Early Childhood was codified in law when Governor Polis signed HB22-1295. This bill establishes the functions of the Department of Early Childhood, a new executive level agency in Colorado, and moves early childhood, child health, and family support programs from other state agencies to the Department. While the MCH program remains within CDPHE, the explicit inclusion of child health in the mission of the new Department creates an opportunity for ongoing and enhanced partnership across programs serving young children and their families. To support this alignment, the MCH Director serves as the CDPHE representative on Colorado’s Early Childhood Leadership Commission. Since its inception, the Commission has been charged with advising and making recommendations to the Office of Early Childhood, within the Colorado Department of Human Services. Over the past year, the Commission has been responsible for the development of a transition plan to inform the development of the new Department. The MCH and CYSHCN Directors serve on the Program Quality and Improvement Subcommittee of the Early Childhood Leadership Commission, which provides oversight for the implementation of the state’s Early Childhood Comprehensive Systems grant.

In April 2021 Governor Polis signed HB 21-1097 into law, marking a major step forward in the efforts to create a better mental health system in Colorado. Based on this legislation, the Behavioral Health Authority is mandated to address the following:

• Receiving, coordinating, and distributing funds for community behavioral health programs
• Overseeing the quality of services and setting standards of care
• Monitoring and evaluating behavioral health outcomes across the state
• Provide the infrastructure for the state to implement the remaining blueprint recommendations from the Governor’s Behavioral Health Task Force.

The legislation also explicitly recognizes that children and youth are unique and have needs that differ from adults. Children and youth are often involved with multiple systems, and it is essential to support the entire family’s wellness. Because of this, the Behavioral Health Authority will include a children-specific structure to ensure that the children, youth, and families receive the support they need. The CYSHCN Director participated in a care coordination policy group that developed a set of recommendations for the implementation of the Behavioral Health Authority and will continue to collaborate with the new Behavioral Health Authority to implement these recommendations.

MCH has had multiple existing collaborations to support the maternal population with the Office of Behavioral Health, which will now be incorporated into the newly formed Behavioral Health Administration. State staff have worked together to promote messages from both the pregnancy-related depression campaign and the Tough as a Mother campaign, helping to highlight and destigmatize the intersection of maternal mental health and maternal substance use/misuse. MCH and Office of Behavioral Health staff strengthened this partnership when they were jointly selected for a public health fellowship through the 2020 Mom program, providing the opportunity to participate in monthly learning sessions with other fellows across the country working in maternal health. This continued partnership has led to leverging of resources, including the co-leading of toxicology best practice guidelines to be used in birthing facilities to support more consistent and equitable practices. Upcoming collaborations include the creation of story telling videos for the pregnancy-related depression campaign by leveraging the Tough as a Mother storytelling software, and the development of a new curriculum for perinatal mental health and allied professionals that will focus on the intersection of maternal mental health and substance use. This training will help to ensure that all perinatal mental health professionals are well equipped to screen for and talk to patients about their substance use, helping to address one of the leading causes of maternal mortality and morbidity.

Other Partnerships

The Colorado Perinatal Care Quality Collaborative (CPCQC) is the state’s designated perinatal quality collaborative and the entity responsible for implementing Alliance for Innovation in Maternal Health (AIM) patient safety bundles in Colorado. CDPHE and CPCQC have worked together to improve maternal health for many years, and have a strong working relationship. CPCQC centers its work around addressing sources of care disparities by partnering with providers and patients to implement patient safety and quality improvement projects to reduce variations in care. Through funding provided by the ERASE Maternal Mortality grant from the CDC, CDPHE has a contract with the CPCQC to support implementation of the AIM Opioid Use Disorder patient safety bundle, in alignment with Maternal Mortality Review Committee recommendations to improve systems to address substance use. In addition, CPCQC provides backbone support for the Maternal Mental Health Collaborative and CDPHE staff have served in key roles on the leadership team for the collaborative for many years.

Over the past three years, Colorado’s early hearing detection and intervention system has experienced significant changes. During the summer of 2021, a coalition of newborn hearing stakeholders raised concerns to CDPHE about the gaps in the state’s current system. Based on these concerns, the MCH program is contracting with a facilitator to convene public and private partners throughout the summer and fall of 2022 to identify existing gaps, opportunities to fill the gaps and additional resources that may be needed to strengthen the state’s early childhood detection and hearing intervention system. Focus groups include audiologists, primary care providers, early interventionists, midwives, ENT specialists, hospital providers and screeners, Colorado Hearing (CO-Hear) Coordinators. In addition to providers, staff from the Colorado Department of Human Services (Early Intervention Colorado and Colorado Commission for the Deaf, Hard of Hearing, and Deafblind, which receives Colorado’s Early Hearing Detection and Invention Grant from the Health Services and Resources Administration) are participating, in addition to staff from CDPHE (MCH/CYSHCN and the Center for Health and Environmental Data, which houses the newborn hearing screening data system). Recommendations for future action to strengthen the system will be developed by October 2022, in time for advocacy organizations to advance legislative action, as needed.

The establishment of the Colorado Office of eHealth Innovation (OeHI) and the eHealth Commission in 2015 were necessary to meaningfully organize public-private partnerships to advance the health of Coloradans. The MCH Director helped update the a white paper, Advancing a Coordinated Ecosystem for a Social Health Information Exchange (S-HIE) in Colorado, that has been endorsed by the eHealth Commission and guides the state’s efforts to support the infrastructure for an interoperable social-health information exchange. OeHI staff have been tasked with assisting in implementation of the state’s S-HIE approach as part of behavioral health reform, which includes creating a centralized gateway for information for patients and providers that facilitates access and navigation of behavioral health care services and support. The CYSHCN Director participated on the workgroup focused on the development of a resource and referral platform for clients receiving behavioral health services and the MCH Director continues to serve on the care coordination subcommittee of the eHealth Commission to ensure alignment with MCH efforts to ensure access to supports.

For a description of MCH partnerships with the Colorado Department of Health Care Policy and Financing, the state’s designated Medicaid agency, refer to section III.E.2.b.v.b. Title V MCH – Title XIX Medicaid Inter-Agency Agreement.