See the references list for more information on sources used in the “Colorado by the numbers” infographics.

 

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 MCH services, and statutes and regulations related to the MCH population. For additional background data, see the most current MCH Snapshot. For a list of references, see Overview of the State Reference List.

 

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.1  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.2 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 33,768 people who identify as American Indian/Alaska Native alone (non-Hispanic) live in Colorado.3

 

Population and demographics

Colorado ranks 21st among states in population size.4 The total state population in 2021 was 5,831,165.5 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 0-25.6 Of the total population of children and youth, approximately 340,000 are identified as having special health care needs.7,8 Estimates from the Decennial Census (2020) of the U.S. Census Bureau show that 3.5 percent of Coloradans identify as Asian/Pacific Islander alone non-Hispanic, 0.6 percent as American Indian and Alaska Native alone non-Hispanic, 3.8 percent as Black/African-American alone non-Hispanic, 0.5 percent as some other race alone non-Hispanic, 4.5 percent as two or more races non-Hispanic, 21.9 percent as Hispanic, and 65.1 percent as white alone non-Hispanic.9

 

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.10 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.11

 

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 5,782,915 to 6,110,279. While natural increase (births minus deaths) will contribute 105,148 persons, net migration will result in nearly twice as many people, contributing 222,215 to the total increase of 327,363.12

 

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 May 2022, Colorado’s unemployment rate was 3.5 percent, slightly lower than the national unemployment rate for the same time period, 3.6 percent.13 Colorado’s unemployment ranking was tied for the 28th lowest in the nation.14 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 $77,12715, higher than the national median of $65,712 which is the 9th highest among all 50 states.16 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 $30,900.17

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%) Coloradans 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 minoritized populations have much higher rates of children who live in low-income families than the majority population; 53 percent of Black, 51 percent of Hispanic, and 49 percent of American Indian children live in low-income families versus 20 percent of their white and 29 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.X

Some Coloradans 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 1.5 persons per room, and cost burden greater than 50%).X As of January 2021, there were an estimated 8,544 people in Colorado experiencing homelessness; 2,447 of these were persons in households with at least one adult and one child.X

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, 5.4 percent ate less than they felt they should because of lack of money for food.X Among Colorado families with children ages 0-17 years, 3.5 percent sometimes or often could not afford enough to eat.X 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. Almost six in ten Coloradans who are eligible for SNAP are enrolled.X This is lower than the national average of 70 percent for SNAP enrollment.X Half (53%) of Coloradans eligible for WIC are enrolled.X

 

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).X A recent report ranks two of Colorado’s metropolitan areas in the top 25 for poor air quality (based on ozone). Denver-Aurora is ranked 7th and Fort Collins is ranked 18th.X 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 36 variables related to health and climate. Douglas, Teller, and western Colorado counties had the highest risk scores for climate-influenced environmental exposures such as wildfire, flooding, drought, extreme heat. La Plata County has the state’s highest risk score for environmental exposure.X

 

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.X

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.X

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 (41 states have higher rates of high school graduationX). 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.X

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, six in ten (59.6%) high school students participate in extracurricular activities at school.X One in three (35.9%) high school students participate in organized community services as a non-paid volunteer during the past 30 days.X Among parents with young children, 57.8 percent report having a somewhat strong or very strong sense of belonging to their local community.X

 

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.X The majority of Colorado parents (81.9%) 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 (73.3% vs. 89.4%, respectively).X Seven in ten (73.5%) of high school students have an adult to go to for help with a serious problemX, 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, one in three (33.3%) were teased because of their actual or perceived race or ethnic background, and one in four (28.3%) because of their actual or perceived sexual orientation.X Among parents with young children, 7.5 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, 83.3 percent experienced it in daily life, 18.7 percent in a doctor’s office, clinic, or other health care setting, 12.7 percent at work or school, and 4.7 percent when interacting with law enforcement.X 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 2022 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 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;CF
• Colorado has enacted a law (SB20-215) 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.
• Connect for Health Colorado is still among the most robust exchanges in the country, with eight carriers offering plans in 2022.
• In the individual/family market, there are 257 on-exchange plans available in Colorado for 2022, up from 159 in 2021 and just 130 in 2020 (however, plan availability varies considerably from one area to another)
• A total of 198,412 people enrolled in 2022 plans during open enrollment.X

 

Since 2015, Colorado’s insured rate has remained consistent: About 93.4 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, 9.5 percent of Coloradans experienced churn (a change in insurer) in 2021. In Colorado, 56.1 percent of residents had private insurance, 25.6 percent are enrolled in Medicaid or Child Health Plan Plus (CHP+), and 11.5 percent are enrolled in Medicare. The uninsured rate dropped by more than 50 percent from 14.3 percent in 2013 to 6.6 percent in 2021t. Of the 6.6 percent who are uninsured in Colorado, 6.1 percent were insured for part of the year. The uninsured rate was highest among Coloradans ages 19-64 years at 9.0 percent. Only 3.9 percent of children ages 0-18 years are uninsured. The uninsured rate among White non-Hispanics is 4.0 percent. By contrast, 14.4 percent of Hispanics in Colorado are uninsured. The uninsured rate for Coloradans with incomes at or below 100 percent of the federal poverty level (9.2%) compared to those with incomes above the federal poverty level (6.3%).X

 

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 2022, 588,201 children are enrolled in Medicaid and 49,071 children are enrolled in CHP+.X As of 2019, 22.2 percent of those eligible for Medicaid or CHP+ are not enrolled.X In 2021, 36 percent of live births in Colorado were paid for by Medicaid.

 

Colorado Medicaid programs impacting MCH populations include Programs for Children, Programs for Pregnant People,  and Programs for Parents and Caretakers. The Affordable Care Act expanded Medicaid eligibility for all adults (including parents and adults without dependent children) with incomes below 133 percent of the federal poverty level (FPL).  From January 2021 through January 2022, Medicaid enrolled more than 146,000 members and children represented 21% of the increase in enrollment. In that time period, 32,161 members also locked into a higher benefit category, such as Medicaid versus CHP+. Colorado Medicaid executed over 20 emergency waivers, rules, and State Plan Amendments to improve access and to reduce provider administrative burden including expanded access to behavioral health services, reimbursement for services provided via telemedicine and developing a rural support fund for rural hospitals beginning in the fall of 2021. Also, during the 2021 legislative session some of the emergency waivers and rules were passed into law.  For example, under the COVID emergency waivers, Medicaid allowed for televisits in the home, including therapies such as occupational and physical therapy.  Following the emergency waiver this rule was passed into law making it possible for families with children and youth with special needs to choose to receive care in their home through telehealth visits. This both reduced the exposure to COVID for children with medical complexity and also allowed families to avoid traveling longer distances to receive care and reduced lost work time. This was particularly important for families in rural areas of Colorado.

 

Since 2014, with Medicaid expansion, children and youth with special health care needs in Colorado have had the ability to be part of the Medicaid Buy-In Program for Children with Disabilities. This program allows qualifying families of children with a disability to “buy-into” Colorado Medicaid for that child. Family income must be below 300% of the Federal Poverty Level. Eligible families receive Medicaid benefits by paying a monthly premium on a sliding scale based on their adjusted income. As of June 2021,1,484 children and youth participate in the program annually.

 

Colorado’s Medicaid program also offers waivers for children and youth who meet certain criteria. Of the Medicaid members who qualify for Long Term Services and Supports based on functional needs, 10% are children and youth with special health care needs. This table provides an overview of the children’s waiver programs and this table shows adult waiver programs. There are currently no waitlists for any of Colorado Medicaid’s children’s waivers and all but one of the adult waivers, based on legislation passed in 2014. 
 

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. 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 Regional Accountable Entities and two Managed Care Entities that are responsible for ensuring the coordination of care for 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 230 clinic sites in 45 counties and provide care to patients living in 63 of the state’s 64 counties. Colorado Community Health Centers provide care to over 847,000 people (one in seven Coloradans). Ninety-one percent of patients at community health centers have family incomes at or below 200% of the federal poverty level.X Children’s Hospital Colorado and the University of Colorado School of Medicine form the largest pediatric specialty care network in Colorado, serving over 283,000 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 pandemic.

 

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.

 

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). CDPHE is one of 22 cabinet-level entities 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 Department’s most recent strategic plan was released in June 2022. 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.

 

The Prevention Services Division is one of CDPHE’s largest divisions with over 200 employees. 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. The Prevention Services Division is currently finalizing a strategic plan. Colorado’s MCH Director, MCH Deputy Director of State Implementation and MCH Racial Equity Specialist are participating in the Division’s strategic planning process. The priorities reflected in the strategic plan align with the MCH framework and include:

• Priority 1: Increase access to safe, healthy and connected communities
• Priority 2: Expand meaningful community inclusion and improve racial equity
• Priority 3: Increase social and emotional wellbeing
• Priority 4: Increase equitable economic opportunities and access

 

Colorado MCH includes state strategies and also works with 54 local public health agencies serving 64 counties to improve the health of Coloradans using population-based and infrastructure-building strategies. In Colorado, the 3,482 local governments across the state including counties, municipalities, special districts and public school districts have local control. Colorado has a decentralized public health system in which each of its 64 counties are required to either operate a local public health agency or participate in a district public health agency. The MCH program is state supported and county administered with an emphasis on state and local partnerships to promote “one MCH” statewide.

 

The Colorado MCH Framework includes a vision to increase community and family resilience.The use of evidence based practices, dedication to quality and process improvement, commitment to core public health services, as well as emerging issues 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 second regular session of the 74th General Assembly ended May 11th, 2022.

 

Bills this session were introduced to create a more robust behavioral health system and workforce, support people experiencing behavioral health crises, expand access to care for the underserved, increase economic stability and recover from the financial effects of the pandemic, prevent crime, reduce justice-involvement for young people, among many others.

 

Included below are descriptions of bills passed during the 2022 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

 

Child Care Support Programs

SB22-213: This bill recognizes the importance of improved access to child care and thereby provides $99 million dollars in additional funding in FY 2022-23 for a variety of child-care related programs, such as: the Child Care Sustainability Grant Program, Emerging and Expanding Child Care Grant program, and the Employer-Based Child Care Facility Grant Program. This bill also creates the Family, Friend, and Neighbor training and grant program in the Department of Early Childhood to support community-based and non-profit organizations that provide training programs and information on accessing state programs to providers, and grants to eligible providers.

 

Medical Assistance Income Eligibility Requirements

SB22-052: This bill increases the eligibility level for children and pregnant people under the Children’s Basic Health Plan (CHP+) and Medicaid to align with federal law. In doing so, this bill increases the income eligibility percentage from 250% to 260% of the federal poverty line in order to expand coverage for more low income children and pregnant people.

 

 Colorado 2-1-1 Collaborative Funding

HB22-1315: This bill allocates funding in perpetuity in order to allow the Department of Human Services to award grants to the Colorado 2-1-1 collaborative organizations. Colorado 2-1-1 is a confidential, multilingual service connecting people to vital resources across the state. The funding will allow the organizations to expand their ability to include: providing services in over 300 languages, researching and curating the Colorado 2-1-1 Collaborative database of community based organizations, dispatching ride-shares to callers in need of transportation, and quality and control measures to increase caller satisfaction.

 

Grant Program Providing Responses to Homelessness

HB22-1377: This bill creates in the Department of Local Affairs, the Connecting Coloradans Experiencing Homelessness with Services, Recovery Care, and Housing Supports Grant Program. This program is to provide grants to local governments and community partners to better support their efforts in connecting unhoused people with various services such as: vocational opportunities, recovery care, and temporary and permanent housing. This grant funding will also enable eligible entities to better expand the safety net of resources for unhoused people, and purchase or convert underutilized properties in communities into transitional or supportive housing. 

 

Investments in Care Coordination Infrastructure

SB22-177: This bill charges the Behavioral Health Administration to improve care coordination infrastructure and adds a requirement to include a cloud-based platform to allow for providers that do not have access to an electronic medical record to still participate in the care coordination infrastructure. The new care coordination infrastructure shall also: train new and existing health navigators on the behavioral health safety net system services for children, youth and adults, ensure individuals know where to access in person or virtual supports, reduce the administrative burden for providers, and more.

 

Increase economic mobility

 

 Improve Access to Critical Services for Low-Income Households 

HB22-1380: This bill increases funding programs providing essential services such as fuel assistance payments, extends the supplemental nutrition assistance program, and charges the Department of Human Services to start implementation of a work management system in order to streamline the application process for public assistance programs like Supplemental Nutrition Assistance Program (SNAP), Medicaid, and Colorado Works (TANF) to allow for improved access to program services. This bill also creates the community food access program in the Colorado Department of Agriculture (CDA) in order to improve access to and lower prices for healthy foods in low-income and underserved areas of the state by supporting local food retailers. As part of this program, CDA is charged with creating the Community Food Access Program, and as a part of this program, managing the Small Food Business Recovery and Resilience grant program in order to support small food retailers and family farms.

 

Economic Mobility Program

SB22-182: This bill codifies in statute and funds the Economic Mobility Program in CDPHE. CDPHE’s Maternal Child Health program began piloting the tax outreach project in the summer of 2021, and this bill provides additional funding under the newly codified Economic Mobility Program for two more years. The purpose of the program is to improve long-term health and educational outcomes through improved economic mobility for Coloradans by increasing uptake of economic supports, including tax credits.

 

 Colorado Household Financial Recovery Program

HB22-1359: This bill charges the State Treasurer to establish the Colorado Household Financial Recovery Pilot Program in order to facilitate lending to individuals and households disproportionately impacted by the pandemic who face financial insecurity and difficulty accessing affordable loans. The funds can be used for: establishing a loan loss reserve to incentivize lenders, make payments to lenders to buy down the interest rate on loans to impacted households, to award grants to nonprofit, community-based organizations to conduct outreach to eligible individuals and households to participate in the program, and financial institutions to administer the program.

 

Reduce racial inequities

 

Reduce Justice-Involvement for Young Children

HB22-1131: This bill acknowledges the disparities in incarceration and prosecution of children of color and thereby creates a pre-adolescent services task force in the Colorado Department of Human Services in order to examine gaps in services provided for juveniles if the minimum age of prosecution were raised from 10 years - 13 years of age. Specific listed duties for the task force include: make recommendations for how existing or potential funding may be utilized to provide services outside of the juvenile justice system, and how services may instead be provided by existing agencies or organizations outside of the juvenile justice system. The task force will create a report with the recommendations by December 30th, 2022 to various relevant House and Senate committees.

 

Health Benefits for Colorado Children and Pregnant Persons

HB22-1289: This bill recognizes the disparities in birth outcomes among Black, Indigenous, People of Color (BIPOC) communities in Colorado which can be associated with the lack of proper healthcare coverage and experiences with discrimination within the medical establishment. This bill expands state-funded health and medical care (Medicaid and Children’s Basic Health Plan) to cover low income pregnant people (extends to 12 months post-partum), and children less than 19 years of age regardless of immigration status. This bill also makes CDPHE’s health survey for birthing people permanent (Health eMoms), in order to better understand various social determinants of health and experiences of discrimination, and their impact during and after pregnancy.

 

 Tribal Governments Included in State Programs

SB22-104: This bill directs the Office of the Colorado Commission on Indian Affairs (established in 24-44-102 CRS), in consultation with the Ute Mountain Tribe and the Southern Ute Native American Tribe (Colorado’s two federally recognized tribes), to prepare and submit a report to the Legislative Council (provides research support to the General Assembly). The report shall include: identification of opportunities for Tribal Governments to be included in programs of the State as a partner, and making recommendations on other ways for the State to facilitate or provide those opportunities.

 

Native American Boarding Schools Research Program

HB22-1327: This bill recognizes the resulting intergenerational trauma and cycles of violence Native American boarding schools had on Native American communities, and specifically, Native American Children. This bill creates the Federal Indian Boarding School Research Program in the State Historical Society in order to research the events, physical and emotional abuse, deaths that occurred at the boarding school, and help identify burial sites. The Historical Society, in collaboration with the Southern Ute Tribe, the Ute Mountain Ute Tribe, and the Colorado Commission on Indian Affairs, shall review the research, and make recommendations such as: to better support and provide services for tribal members’ healing, a process for repatriation of any identified Native American remains in a culturally appropriate manner, and allowing tribal blessings to occur at the sites.

 

Increase social emotional well-being

 

 Behavioral Health-care Continuum Gap Grant Program

HB22-1281: This bill creates the Behavioral Healthcare Continuum Gap Grant program in Colorado’s new Behavioral Health Administration, to provide grants to local governments, community-based, and nonprofit organizations to support and increase behavioral health services in underserved areas that are children, youth, and family-oriented. Grants should specifically be used for community investment purposes such as prevention, treatment, and trauma recovery, and grants for children, youth and family services such as establishing access points for care in a family resource center. This bill also requires the Behavioral Health Authority to develop a behavioral healthcare services assessment tool to identify regional gaps and unmet needs in behavioral health and substance use disorder services in underserved populations.

 

Health-care Practice Transformation

HB22-1302: This bill creates the Primary Care and Behavioral Health Statewide Integration Grant Program to be administered by the Department of Health Care Policy and Financing to provide grants for implementation of evidence-based clinical integration care models. Grants can go to physical and behavioral health care providers to develop outpatient health care infrastructure, increase access to health care, invest in early behavioral health-related interventions, address the behavioral health workforce, and develop and implement alternative payment models. This bill also provides some funding to the existing Regional Health Connector Program, which is a community-based workforce of people who live and work in the community to build and strengthen connections between health care systems, community organizations, public health agencies, and more.

 

Behavioral Healthcare Services for Children

SB22-147: This bill recognizes the impact the COVID-19 pandemic has had on children and aims to increase the availability of behavioral health supports and make them more easily accessible for children and their families. This bill supports and codifies in statute, the Colorado Pediatric Psychiatry Consultation and Access Program (CoPPCAP) in the University of Colorado. The program shall support primary care providers to identify and treat mild to moderate behavioral health conditions in practices or in School Based Health Centers (SBHCs), provide peer-to-peer consultations with primary care providers, support all patients regardless of ability to pay, and more. This bill also appropriates additional funding to the existing SBHC grant program in CDPHE to increase its ability to respond to the behavioral health needs of children utilizing SBHCs.

 

Compensation Requirements for Members of the General Assembly

SB22-184: This bill allows legislators to be absent in cases of a long-term illness, extends parental leave for up to 12 weeks, and adds an additional 4 weeks in cases of serious health related complications due to pregnancy or childbirth without a loss of compensation.

 

Increase prosocial connection

 

Department of Early Childhood and Universal Preschool Program  

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. The bill also creates the Social Emotional Learning Programs Grant Program to fund school districts in their efforts to increase social emotional learning initiatives among teachers and parents, in addition to developing emotional self-monitoring and management among children in order to better positive emotional and prosocial connectedness among children, parents, and teachers.

 

 Children’s Mental Health Programs

HB22-1369: This bill recognizes the role protective factors such as trusted adults have on reducing the negative impact adverse childhood experiences (ACEs) have on the behavioral health outcomes of children. This bill therefore charges the newly formed Department of Early Childhood to contract with a Colorado-based nonprofit to provide children’s mental health programs. The nonprofit should have pre-existing infrastructure to connect families to essential services, care coordination, and psychotherapy for the child and parent or caregiver.

 

Create safe and connected built environments

 

Department of Early Childhood and Universal Preschool Program  

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. The bill also creates the Social Emotional Learning Programs Grant Program to fund school districts in their efforts to increase social emotional learning initiatives among teachers and parents, in addition to developing emotional self-monitoring and management among children in order to better positive emotional and prosocial connectedness among children, parents, and teachers.

 

 Children’s Mental Health Programs

HB22-1369: This bill recognizes the role protective factors such as trusted adults have on reducing the negative impact adverse childhood experiences (ACEs) have on the behavioral health outcomes of children. This bill therefore charges the newly formed Department of Early Childhood to contract with a Colorado-based nonprofit to provide children’s mental health programs. The nonprofit should have pre-existing infrastructure to connect families to essential services, care coordination, and psychotherapy for the child and parent or caregiver.

 

Promote positive child & youth development

 

 Youth Delinquency Prevention and Intervention Grants  

HB22-1003: Signed by the Governor on May 19, this bill recognizes the importance of providing up-front services and treatment in order to prevent youth from entering or further progressing through the juvenile justice system– a system that disproportionately targets Black, Indigenous, and Youth of Color (BIPOC). This bill creates a youth delinquency prevention grant program for organizations and agencies that work with youth, and youth crime prevention and intervention in order to best support their efforts and infrastructure to prevent youth from entering the juvenile justice system.

 

Tony Grampsas Youth Services Program

SB22-037: This bill makes adjustments to the Tony Grampsas Youth Services Program by allowing youth prevention and intervention services to be provided by community-based programs in order to provide funding to local organizations to prevent youth crime and violence, and substance misuse. This bill also removes state agencies and state operated programs from the eligible entities to receive this funding.

 

Organizational Charts

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