This section presents an overview of the state’s geography and demographics, data on the social determinants of health affecting the MCH population, an overview of the infrastructure that supports the delivery of Title V services, and statutes and regulations related to MCH. For additional background data on the MCH population, see the MCH Snapshot. Given the impacts of COVID-19, much of the data included in this section has and will continue to shift as the pandemic persists.

 

Geography

Colorado is located in the Rocky Mountain region of the United States. Colorado has the highest mean elevation of any state with more than a thousand mountain peaks over 10,000 feet high including 58 that are over 14,000 feet. The Continental Divide runs from north to south through west central Colorado and bisects the state into the eastern plains and western slopes.

The state is further divided into five regions: the Front Range, the Western Slope, the Eastern Plains, the Central Mountains, and the San Luis Valley. Eighty-eight percent of the state’s population lives along the Front Range, which includes the metropolitan areas of Denver, Boulder, Fort Collins, Greeley, Colorado Springs and Pueblo, and Grand Junction on the Western Slope.  In total, there are 64 counties in the state with 17 designated as urban, 24 rural, and 23 frontier counties. Frontier counties have a population density of six or fewer persons per square mile (See map). In Colorado’s 47 rural and frontier counties, residents’ health may be impacted by more limited local provider options, lack of specialty health care, the difficulty of travel to health care due to long distances and weather conditions, limited public transit options, a scarcity of resources and services, and fewer economic opportunities.

 

 

There are two sovereign Indian nations in Colorado, the Southern Ute Indian Tribe and the Ute Mountain Ute Tribe. Both tribes have reservations located in the southwest corner of the state. These tribes have their own governance separate from state and local governments. The Census Bureau reports that 57,578 people who identify as American Indian/Alaska Native alone live in Colorado. The Census Bureau also shows there are 135,472 people who identify as American Indian/Alaska Native alone or in combination with one or more races living in Colorado.

Population and demographics

Colorado ranks 21st among states in population size. The total state population in 2021 is 5,865,397. In terms of Colorado’s MCH population, 21 percent of the state’s population is female ages 15-44 and 32 percent are children and youth ages 0-25. Of the overall population of children and youth, approximately 340,000 are identified as having special health care needs. Estimates from the American Community Survey (2019) of the U.S. Census Bureau show that 67.5 percent of Coloradans ethnically identify as white non-Hispanic and 21.8 percent identify their ethnicity as Hispanic. Categories by race include white (83.7%), Black/African-American (4.2%), Asian and Native Hawaiian/Pacific Islander (3.4%), American Indian and Alaska Native (1.0%), and people who report another race (3.6%) or more than one race (4.0%).

 

Approximately 17 percent of Colorado residents ages five years and older speak a language other than English at home; 69 percent of those speaking another language in the home speak Spanish. Two percent of households in Colorado are estimated to be linguistically isolated, i.e., all members 14 years and older have at least some difficulty with English.

 

Although Colorado is a mid-sized state, it has had one of the fastest growth rates of all states and migration continues to be an important factor in the state's population growth. Between 2020 and 2025, Colorado's population is expected to grow from 5,813,209 to 6,120,737. While natural increase (births minus deaths) will contribute 106,364 persons, net migration will result in nearly twice as many people, contributing 201,165 to the total increase of 307,529.

 

Employment

Employment, income, housing, food security, and transportation are all closely linked to health and wellness and should be considered in understanding the overall health status of the MCH population in Colorado. As of April 2021, Colorado’s unemployment rate was 6.4 percent. This was higher than the national unemployment rate for the same time period, 6.1 percent.  Colorado’s unemployment ranking was the 35th lowest in the nation. The state unemployment rate has been steadily declining since reaching a high of 12.1 percent in April 2020 (at the start of the COVID-19 pandemic).

 

Income and poverty

Colorado has an income advantage. The median household income in Colorado is $77,127, higher than the national median of $65,712 which is the 9th highest among all 50 states. However, the median household income does fluctuate significantly among Colorado’s counties. Douglas County, located just south of Denver along the Front Range, has the highest median household income at $119,730. Bent County, located in southeast Colorado, has the lowest at $30,900.

The level at which Colorado families can be economically self-sufficient generally requires an income above 200 percent of the federal poverty level, sometimes higher depending on geographic location. One in four (26.4%) Coloradoans live with incomes below 200 percent of the federal poverty level. Among children younger than 18 years of age, one-third (33%) live in families with incomes below 200 percent of the federal poverty level ($53,000 for a family of four). Racial and ethnic minorities have much higher rates of children who live in low-income families than the majority population; 53 percent of Black, 53 percent of Hispanic, and 52 percent of American Indian children live in low-income families versus 21 percent of their white and 30 percent of their Asian counterparts.

Housing

Having safe, stable and affordable housing contributes to optimal health by allowing money to be directed to healthy food, recreation, and health care. Among occupied housing units in Colorado, 34.1 percent are rented. In renter-occupied units, half (49.9%) pay 30 percent or more of the household income to rent. The median rent in Colorado is $1,369. The median home value for owner-occupied units in Colorado is $394,600 (2019) compared to $255,200 in 2014.

Some communities are not able to find safe and affordable housing, which means they are more likely to live in poor quality homes. Poor housing conditions and environmental toxins can be detrimental to health, especially during early childhood. Severe housing problems are indicative of housing quality. Sixteen percent of households in Colorado experience at least one of four severe housing problems (incomplete kitchen facilities, incomplete plumbing facilities, more than one person per room, and cost burden greater than 50%).

Nutrition security

Having access to nutritious food influences healthy eating. People who live in neighborhoods where grocery stores are not being built have limited access to fresh, healthy food such as fruits and vegetables. Among women who recently had a baby, 7.9 percent ate less than they felt they should because of lack of money for food.48 Among Colorado families with children ages 0-17 years, 4.4 percent sometimes or often could not afford enough to eat. The Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are programs that have been demonstrated to positively impact food security and nutrition outcomes. Six in ten Coloradans who are eligible for SNAP are enrolled. This is lower than the national average of 73 percent for SNAP enrollment. Half (53%) of Coloradans eligible for WIC are enrolled.

 

Transportation

Transportation is necessary to travel to work and school, access healthy food and medical care, and foster community connections. When transportation systems don't provide access to all communities, some groups have a harder time accessing resources. Direct transportation and by-products can also impact health. Most Coloradans commute to work in a single occupancy vehicle (74.2%). Less than one in ten use public transport (3.2%), walk to work (2.7%), bike to work (1.1%) or work from home (9.1%). About 2 percent of working Coloradans do not have a vehicle.

 

Air quality

Many forms of transportation lead to air pollution thus impacting air quality, especially in low-income neighborhoods. Blacks experience the highest air pollution exposure (index of 41), while Native Americans experience the lowest air pollution (index of 27). A recent report ranks two of Colorado’s metropolitan areas in the top 25 for poor air quality (based on ozone and particle pollution). Denver-Aurora is ranked 8th and Fort Collins is ranked 17th. Poor air quality can be a greater burden on older and younger populations, those with chronic conditions (asthma or other chronic lung disease, cardiovascular disease or diabetes), and those with low socioeconomic status.

 

Climate change

Colorado has shown signs of climate change. A changing climate results in warmer temperatures, drier air, and changing weather patterns. These changes increase the risk for fire, drought, and heat, which impact health. The Colorado Health Institute built a Health and Climate Index based on 24 variables related to health and climate. Southeastern Colorado is the state’s most vulnerable region (it is prone to heat and drought and has higher shares of sensitive populations). Southwestern Colorado is the state’s least vulnerable region.

 

Education

Education is critical to the health and well-being of the MCH population. Higher levels of education can lead to employment with strong incomes resulting in the ability to live in healthy neighborhoods. Overall, Colorado has a highly educated population. Two in five (42.7%) Coloradans age 25 and older have a college degree or more, and Colorado is ranked 2nd among all states in the percentage of the population with a college degree.

Yet inequities in educational opportunities exist among different racial and ethnic groups. Many of these opportunities are affected by systemic inequities like community disinvestment and school poverty. Over half (53.4%) of Asians have a college degree or higher, as do 49.0 percent of white, non-Hispanics. One in four (27.6%) Black/African Americans, and one in six (18.5%) Hispanics have a college degree or higher.

While the prevalence of college graduates in Colorado is high among Asian and white non-Hispanics, the percentage of high school students who graduate overall is relatively low (43 states have higher rates of high school graduation. Inequities in graduation rates mimic the disparities in college graduation attainment among adult Coloradans, with American Indians or Alaska Natives having the lowest high school graduation rate and Asians having the highest.

Social connectedness and civic engagement

Participation in civic life or religious organizations has been shown to positively impact individual longevity and well-being. In Colorado, two in three (67.3%) high school students participate in extracurricular activities. Two in five (44.0%) high school students participate in organized community services as a non-paid volunteer during the past 30 days. Among parents with young children, 57.8 percent report having a somewhat strong or very strong sense of belonging to their local community.

 

Social and emotional support

Social support can help improve quality of life and decrease emotional distress, while limited social support can negatively impact well-being. Overall, 19.6 percent of Colorado family households are headed by a single adult and may lack needed support systems. The majority of Colorado parents (83.5%) report that they have someone to turn to for day-to-day emotional support with parenting or raising children. Hispanic parents are less likely to report having emotional support with parenting compared to white, non-Hispanic parents (75.9% vs. 89.3%, respectively). Seven in ten (72.7%) of high school students have an adult to go to for help with a serious problem, which has been demonstrated in research as a critical protective factor in avoidance of risky behaviors.

 

Racism

Racism and discrimination are two other social determinants of health that negatively impact health, though the data describing these issues in Colorado is limited. Among high school students who were teased in the past year, three in ten (32.5%) were teased because of their actual or perceived race or ethnic background, and two in ten (21.8%) because of their actual or perceived sexual orientation. Among parents with young children, 4.7 percent reported experiencing discrimination or harassment because of their race, ethnicity or culture since their baby was born. Of those parents who reported experiencing this discrimination or harassment, 75.9 percent experienced it in daily life, 27.5 percent at work or school, 13.6 in a doctor’s office, clinic, or other health care setting, and 12.2 percent when interacting with law enforcement. Beyond explicit acts of racism and discrimination, systemic and historical inequities contribute to persistent differences in health outcomes as measured in housing conditions, access to health care, educational opportunity, economic empowerment and environmental quality.

 

Health insurance marketplace

Colorado was an early adopter passing legislation in 2011 to create a state-run health insurance exchange, Connect for Health Colorado. Colorado is now among just 15 states/jurisdictions (including DC) that are running their own exchanges and enrollment platforms for 2021 coverage. Affordability of health care in Colorado, as in most of the country, continues to be a challenge; on average, health care costs reflect 28% of median household income. Here is a summary of current events related to Colorado’s health insurance marketplace:

 

• Colorado opened a special enrollment period for uninsured residents, which continues through August 15, 2021.
• Colorado has implemented a permanent 2.5 month open enrollment period; enrollment runs from November 1 to January 15 each year, expanding the federal platform’s annual enrollment period of November 1 to December 15;
• Colorado’s individual market insurers propose average rate increase of 1.4% for 2022; four insurers plan to expand coverage areas.
• Colorado has enacted an “easy enrollment program” similar to the one Maryland has implemented; which will debut in early 2022.
• Colorado has enacted a law (SB215) aimed at making health coverage more affordable in the individual market.
• Colorado implemented a reinsurance program starting in 2020. It pays a larger portion of claims in areas where premiums are highest, in an effort to make coverage more affordable in those areas.
• Colorado’s “public option” bill was signed into law in June 2021, although it’s essentially a standardized plan with premium reduction targets. Stakeholders are working on the plan design, which will be available for the 2023 plan year, in the individual and small group markets.
• Average approved premiums in the individual market decreased by 20% for 2020, with the decrease based in large part on the state’s new reinsurance program.
• There are currently eight health insurers participating in Colorado’s exchange.
• More than 179,661 people (a record high) enrolled in 2021 plans.
• Rates grew slowly in 2015 and 2016, sharply in 2017 and 2018, and slowly in 2019. They declined sharply for 2020, and declined slightly for 2021.

 

Since 2015, Colorado’s insured rate has remained consistent: About 93.5 percent of Coloradans have health insurance coverage. However, this consistency masks some instability in the health insurance market. According to the Colorado Health Access Survey, one in six Coloradans experienced churn (a change in insurer) in 2019. In Colorado, 59.8 percent of residents had private insurance, 19.9 percent are enrolled in Medicaid or Child Health Plan Plus (CHP+), and 13.7 percent are enrolled in Medicare. The uninsured rate dropped by more than 50 percent from 14.3 percent in 2013 to 6.5 percent in 2019, compared to the national rate of 8.5 percent. Of the 6.5 percent who are uninsured in Colorado, 37.8 percent were insured for part of the year. The uninsured rate was highest among Coloradans ages 30-49 years at 10.7 percent. Only 4.3 percent of children ages 0-18 years are uninsured. The uninsured rate among White non-Hispanics is 5.7 percent. By contrast, 10.1 percent of Hispanics in Colorado are uninsured. The uninsured rate for Coloradans with incomes at or below 100 percent of the federal poverty level (8.2%) was double the rate among those with incomes greater than 400 percent of the federal poverty level (4.1%).

 

Several programs are available to reach low-income families and those without health insurance. Pregnant women and children living in households at or below 260 percent of the federal poverty level are eligible for health insurance coverage either through Child Health Plan Plus (CHP+) or Medicaid. As of May 2021, 558,230 children are enrolled in Medicaid and 59,526 children are enrolled in CHP+. As of 2019, 22.2 percent of those eligible for Medicaid or CHP+ are not enrolled.

The state’s Medicaid program implemented the Accountable Care Collaborative (ACC) program in 2011 to build a comprehensive statewide network to support a medical home infrastructure for all enrolled members. This program originally included seven Regional Care Collaborative Organizations to support community-based solutions to care. The responsibility of each Regional Care Collaborative Organization was to develop a comprehensive network of primary care medical providers, build relationships with specialists, collect and analyze data to support population health, and provide care coordination for members. Beginning July 2018, new contracts integrated the Regional Care Collaborative Organization infrastructure with the state’s Behavioral Health Organizations, creating a new regional network of Regional Accountable Entities. Seven Regional Accountable Entities across the state now support a network of primary care and behavioral health providers; manage and coordinate member care; connect members with non-medical services; and report on costs, utilization and outcomes for their population of members. 

 

Effective July 1, 2020, the Colorado Department of Health Care Policy and Financing transitioned the work of the Healthy Communities Program to the Regional Accountable Entities. This transition resulted in the ending of contracts with 25 entities throughout the state and consolidating that work among the seven RAEs and two managed care entities that are responsible for ensuring the coordination of care for our Medicaid members. Historically, the Healthy Communities Program provided outreach to new EPSDT-eligible members and pregnant women enrolled in Medicaid and children and pregnant women enrolled in Child Health Plan Plus (CHP+). This outreach is now performed by the Regional Accountable Entities and Managed Care Entities, which aligns with their existing scopes of work and reduces duplication of effort.   

 

Health care services for low-income and uninsured persons in Colorado include 20 Community Health Centers that operate 222 clinic sites in 42 counties and provide care to patients living in 62 of the state’s 64 counties. Colorado Community Health Centers provide care to over 852,000 people (one in seven Coloradans). Ninety-two percent of patients at community health centers have family incomes below 200% of the federal poverty level. Children’s Hospital Colorado and the University of Colorado School of Medicine form the largest pediatric specialty care network in Colorado, serving over 200,000 children and youth annually, with roughly 50% enrolled in Medicaid or CHP+. Children and youth from every county in the state receive care either onsite at the main campus in metro Denver, and/or through approximately 40 Network of Care and Special Outreach locations, as well as through telehealth (more than 1000 telehealth visits per week), which allowed many children and youth with special health care needs to maintain their care throughout the current pandemic.  The Hospital has served as a hub for information regarding the pandemic for the pediatric community as well as a source for vaccinations for families, youth and teachers throughout the State.

 

Health information exchange

Colorado, like many states, has more than one regional health information exchange. The first health information exchange in Colorado was Quality Health Network (QHN), which is based out of Grand Junction and serves the Western Slope. QHN has been fully operational since 2004 and has focused on advancing health information exchange in the western parts of the state.

Starting in 2010, CORHIO began offering health information exchange services to providers in communities along the Front Range, Eastern Plains and some of the mountain towns. CORHIO and QHN are working jointly on innovative projects to link their two fully functional health information exchange technology platforms. When completed, the entire state will have a cohesive and comprehensive source of health information exchange to improve patient care.

The Colorado Community Managed Care Network works closely with both health information exchanges as a health center controlled network comprised of 20 community health centers with over 190 clinic sites (including school based clinics, pharmacies, and mobile units). The organization was founded as a non-profit in 1994 to respond proactively to the advent of mandatory Medicaid managed care, and has evolved with Colorado’s changing health care landscape. Areas of focus now include managed and accountable care, health information technology, and clinical quality improvement programming.

 

Located within the Governor’s Office, Colorado’s Office of eHealth Innovation works closely with all three health information entities and is responsible for defining, maintaining, and evolving Colorado's Health IT strategy concerning care coordination, data access, healthcare integration, payment reform and care delivery.

 

See Section III.C. Five Year Needs Assessment Summary for more information on health.

 

State health agency roles and responsibilities

The Colorado Title V Maternal Child Health program is administered by the Colorado Department of Public Health and Environment (CDPHE).  The mission of CDPHE is to advance Colorado’s health and protect the places where we live, learn, work, and play. The vision of CDPHE is a healthy and sustainable Colorado where current and future generations thrive.

 

The Colorado Department of Public Health and Environment is one of 16 cabinet-level departments whose executive director is appointed by the governor. Jill Hunsaker Ryan is the department’s executive director. The department serves Coloradans by providing public health and environmental protection services that promote healthy people in healthy places. Public health professionals use evidence-based practices in the public health and environmental fields to create the conditions in which residents can be healthy. In addition to maintaining and enhancing core programs, the department continues to identify and respond to emerging issues affecting Colorado's public and environmental health.

 

The department pursues its mission through broad-based health and environmental protection programs and activities. These include chronic disease prevention; control of infectious diseases; family planning; injury and suicide prevention; general promotion of health and wellness; provision of health statistics and vital records; health facilities licensure and certification; laboratory and radiation services; emergency preparedness; air and water quality protection; hazardous waste and solid waste management; pollution prevention; and consumer protection. The statutory authority for the department is found predominantly in Title 25 of the Colorado Revised Statutes.

 

The 2019-2023 CDPHE Strategic Plan is supported by other department-wide plans (such as the Quality Improvement Plan, Workforce Development Plan and Emergency Preparedness Plans) and the department’s management system. CDPHE used guidance and requirements from the SMART (State Measurement for Accountable, Responsive and Transparent Government) Act, Governor’s Office, and the Public Health Accreditation Board (PHAB) standards in creating the plan to align with best practices. Additionally, in April 2021, CDPHE declared racism a public health crisis with a formal proclamation.

 

The Prevention Services Division is CDPHE’s largest division. The Division improves the health, well-being, and equity of all Coloradans through health promotion, prevention, and ensuring access to health care. The Division includes the following programmatic branches: the Children, Youth and Families Branch, the Health Services and Connections Branch, the Healthy Living and Chronic Disease Prevention Branch, the Nutrition Services Branch, the Violence, Injury, Suicide Prevention and Mental Health Promotion Branch. The MCH program is administered by the Children, Youth and Families Branch and collaborates with and leverages programs across the Prevention Services Division and other CDPHE programs/work units to address the needs of the MCH population.

 

Colorado MCH includes state strategies and also works with local public health agencies to improve the health of Coloradans using population-based and infrastructure-building strategies. The Colorado MCH mission is to optimize the health and well-being of mothers and children by employing primary prevention and early intervention public health strategies.The use of evidence based practices, dedication to quality and process improvement, commitment to core services as well as emerging trends in public health, and anti-racism lens are just a few of the key qualities influenced by the specific interests of CDPHE, the Prevention Services Division and the Children, Youth and Families Branch.

 

Statutes and Regulations

The first regular session of the 73rd General Assembly ended June 8, 2021. The theme of the session was pandemic recovery and building for the future.

 

Colorado received funding from federal relief bills such as the American Rescue Plan Act (ARPA) to support pandemic relief, infrastructure projects, and stimulating the economy. Legislators had an additional $3.8 billion, $2 billion of which was appropriated at the end of the session and $1.8 billion which will be appropriated in the 2022 session.

 

Bills were introduced this session to address gun violence, regulate marijuana concentrates, expand rights for agricultural workers, create a state public health option, raise fees for transportation infrastructure, address the fragmented behavioral health system, increase economic mobility, reduce evictions, support affordable housing, and much more. 

 

Included below are descriptions of bills passed during the 2021 session that are aligned with Colorado MCH strategies. Click here for a full list of state statutes relevant to MCH efforts.

 

Improve access to supports

 

Behavioral Health Recovery Act

SB21-137, passed by the House June 8, provides $112 million for a variety of behavioral health activities to address substance use prevention, harm reduction, criminal justice response, treatment, and recovery, including the medication-assisted treatment expansion pilot program, and the maternal and child health pilot program. Further, the bill requires screening for perinatal mood and anxiety disorders for caregivers of children enrolled in Medicaid; provides additional funding for the perinatal substance use data linkage project and school-based health centers; and creates a statewide behavioral health care coordination infrasture.

 

Child Find Responsibilities

SB21-275, passed by the House June 3, changes which state agency is responsible for performing the evaluation for eligibility for children referred for Early Intervention services. Part C of child find, part of the federal "Individuals with Disabilities Education Act", requires states to find, identify, locate, evaluate, and serve children with disabilities from birth through 2 years of age. The bill moves the responsibilities for these evaluations from the Department of Education to the Department of Human Services, effective July 1, 2022.

 

Increase economic mobility

 

Income Tax

HB21-1311, passed by the House June 7, eliminates certain tax breaks and uses the savings to support working families by increasing the Earned Income Tax Credit and implementing the federal Child Tax Credit. Both credits are available in 2022.

 

Creation of Financial Empowerment Office

SB21-148, sent to the governor June 10, creates the Financial Empowerment Office in the Department of Law. The purpose of the office is to grow the financial resilience and well-being of Coloradans through community-derived goals and strategies. This includes expanding access to safe and affordable banking and credit, and free individual financial counseling and coaching, as well as developing stronger consumer protections.

 

General Fund Loan Family Medical Leave Program

SB21-251, signed by the governor June 14, creates a one-time state transfer of $1.5 million from the General Fund to the Family and Medical Leave Insurance Fund to assist the Division of Family and Medical Leave Insurance in the Department of Labor and Employment with expenses of set up before the division receives premium revenue.

 

Reduce racial inequities

 

CO Department of Public Health & Environment Contract Pay to Grantees Up Front

HB21-1247, signed by the governor June 7, allows CDPHE to dispense up to 25% of the annual award to grantees at the start of the contract. This will make it easier for community-based organizations - that are often best positioned to address health disparities in our communities - to work with CDPHE.

 

Equity Strategic Plan Address Health Disparities

SB21-181, passed by the House May 28, renames and expands the current grant program in the Office of Health Equity to the Health Disparities and Community Grant Program. It authorizes the office to award grants to reduce health disparities in underrepresented communities through policy and systems changes regarding the social determinants of health and adds an annual appropriation to the grant program. The office is required to publish a report concerning health disparities and inequities in Colorado and recommend strategies to address such inequities with the collaboration of the Health Equity Commission and other stakeholders.

 

Protection of Pregnant People in Perinatal Period

SB21-193, sent to the governor June 11, primarily addresses the treatment of a person with the capacity for pregnancy while incarcerated. The bill directs the training of staff in a correctional facility or a jail, and sets requirements for the treatment of pregnant persons such as providing healthy foods, counseling, and treatment while in custody. 

 

Remove Barriers to Certain Public Opportunities

SB21-199, sent to the governor June 16, removes various requirements that Coloradans prove legal immigration status to access state or local public benefits, such as medical or housing assistance.

 

Increase social emotional well-being

 

Reproductive Health Care Program

SB21-009, sent to the governor June 10, directs the Department of Health Care Policy and Financing to administer a reproductive health care program to qualifying individuals who are not eligible for coverage under Medicaid only because of their citizenship or immigration status. The services are to include: services related to the administration and monitoring of these products, including management of side effects (e.g., tobacco screening).

 

Family Planning Service For Eligible Individuals

SB21-025, sent to the governor June 10, directs the Department of Health Care Policy and Financing to adopt a state plan amendment to increase income eligibility limits for family planning services up to 260% of the Federal Poverty Level – aligning with the state Children's Health Insurance Plus (CHP+) eligibility limits for pregnant people. The bill defines family planning services - and includes in the definition preventive services such as tobacco utilization screening, counseling, testing, and cessation services.

 

Insurance Coverage Mental Health Wellness Exam

HB21-1068, passed by the Senate May 27, adds a requirement, as part of mandatory health insurance coverage of preventive health care services, that health plans cover an annual mental health wellness examination of up to 60 minutes that is performed by a qualified mental health care provider. The requirement takes effect for large employers January 1, 2022, and January 1, 2023 for individual and small group policies.

 

Rapid Mental Health Response for Colorado Youth

HB21-1258, sent to the governor June 11, establishes the Temporary Youth Mental Health Services Program within the Office of Behavioral Health in the Department of Human Services. The program reimburses providers for providing up to three mental health sessions to youth screened into the program. The office must develop a portal that has an age-appropriate mental health screening; allows providers to register and share appointment availability; connects youth to providers who will accept the youth’s insurance; and allows a youth to schedule an appointment regardless of insurance status. The program repeals in one year.

 

Increase prosocial connection

 

Gender Identity Expression Anti-discrimination

HB21-1108, signed by the governor May 20, modifies the definition of sexual orientation and adds gender expression and gender identity to statutes prohibiting discrimination against members of a protected class. It prohibits discrimination based on gender expression or gender identity in areas including employment, housing, financial services, health care, funeral arrangements, access to and participation in public services, education, youth services, criminal justice, and transportation.

 

Bullying Prevention and Education in Schools

HB21-1221, signed by the governor June 7, updates the requirements for the Department of Education’s model bullying prevention and education policy and requires school districts to incorporate this policy in their discipline code. When updating its model bullying prevention and education policy, the bill requires the department to utilize a stakeholder process that includes parents of students who have been bullied.

 

Create safe and connected built environments

 

Update Division Housing Function & Local Development

HB21-1009, signed by the governor May 10, updates functions in the Division of Housing in the Department of Local Affairs to include research into approaches for transit oriented development that includes increased housing density near employment, education and town centers.

 

Regulation of Family Child Care Homes

HB21-1222, signed by the governor June 7, is a built environment win for access to childcare in communities. In many communities, child care in family child care homes is a "conditional use" requiring a lengthy public hearing process in front of local planning commissions and city councils. This conditional use process is in addition to any other regulatory and permitting processes for childcare. This bill reduces barriers to childcare close to home by forcing municipalities to treat family child care homes a residential land use that cannot be subject to any greater restrictions than a residential dwelling.

 

Environmental Justice Disproportionate Impacted Community

HB21-1266, passed by the Senate June 8, directs the Air Quality Control Commission to establish a fee on greenhouse gas emissions and to adopt and implement rules limiting greenhouse gas emissions. It also creates the environmental justice ombudsperson position to advocate for and be a liaison to disproportionately impacted communities.

 

Create Outdoor Equity Grant Program

HB21-1318, passed by the Senate June 4, creates an outdoor equity board and grant program in the Department of Natural Resources using revenue from lottery proceeds. The goal is to increase access and opportunity for underserved youth and their families to experience Colorado's open spaces, state parks, public lands, and other outdoor areas.

 

Promote positive child & youth development

 

 Maternal Health Providers

SB21-194, sent to the governor June 17, is part of the birth equity package with SB21-193. The bill requires health insurers to cover certain labor and delivery costs; directs the state’s Maternal Mortality Review Committee to improve data reporting on race, ethnicity and other factors; and expands Medicaid coverage of postpartum services from 60 days to 12 months.

 

Early Childhood System

HB21-1304, sent to the governor June 17, sets up a new executive agency for early childhood and tasks the Early Childhood Leadership Commission with approving a plan to transition to the agency, as well as to guide the state’s new universal preschool program.

 

Organizational Charts

To learn more about the Colorado MCH program, see the MCH Program Infrastructure infographic, Prevention Services Division chart, and overall CDPHE chart.