III.B. Overview of the State - Colorado - 2024

Search Term:

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-four 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.3 In total, there are 64 counties in the state with 17 designated as urban, 24 rural, and 23 frontier counties.4 Frontier counties have a population density of six or fewer persons per square mile.4 In Colorado’s 47 rural and frontier counties, residents’ health may be impacted by more limited local provider options, lack of specialty healthcare, 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.5 The Colorado State Demography Office reports that 37,367 people who identify as American Indian/Alaska Native alone non-Hispanic live in Colorado. The State Demography Office also reports there are 60,442 people who identify as American Indian/Alaska Native alone Hispanic living in Colorado.6

Tourism

Tourism is a major driver of Colorado’s economy, which generates earnings, employment, and taxes across the state. Several counties across the state contain attractive travel destinations and cite tourism as their primary economic driver. The state is divided into eight travel regions (Canyons and Plains, Denver and Cities of the Rockies, Mountains and Mesas, Mystic San Luis Valley, Pikes Peak Wonders, Pioneering Plains, Rockies Playground, and The Great West). For a list of counties within each region, see page 23 of the reference cited for this section. When comparing travel earnings in relation to total earnings, the Rockies Playground, The Great West, and Mountains & Mesas (8.1%) regions had the top three highest proportions.7

 

Population and demographics

Colorado ranks 21st among states in population size.8 The total state population in 2022 was 5,857,513. In terms of Colorado’s MCH population, 21 percent of the state’s population is females ages 15-44 and 32 percent are children and youth ages 0-25.9 Of the overall population of children and youth, approximately 375,000 are identified as having special health care needs.10 The two major racial and ethnic groups in Colorado are composed of white non-Hispanic persons and persons of any race who are of Hispanic origin or ethnicity. Estimates from the Colorado State Demography Office (2021)  show that 22.2 percent of Coloradans identify their ethnicity as Hispanic. Categories by race include white alone (67.1%), Black/African-American alone (4.1%), Asian alone (3.4%), Native Hawaiian/Other Pacific Islander alone (0.2%), American Indian and Alaska Native alone (0.6%), and people who report two or more races (2.5%).11

Approximately 16 percent of Colorado residents ages five years and older speak a language other than English at home; 67 percent of those speaking another language in the home speak Spanish.12 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.13

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 5,784,156 to 6,034,548. While natural increase (births minus deaths) will contribute 90,586 persons, net migration will contribute 159,806 to the total increase of 250,392.14

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 2023, Colorado’s unemployment rate was 2.8 percent. This was lower than the national unemployment rate for the same time period, 3.4 percent.15  Colorado’s unemployment ranking was 16th in the nation.16

Income and poverty

Colorado has an income advantage.  The median household income in Colorado is $82,254, higher than the national median of $53,91317 which is the 9th highest among all 50 states.18 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 $30,900.19

The level at which Colorado families can be economically self-sufficient generally requires an income above 200 percent of federal poverty level, sometimes higher depending on geographic location.20 One in four (26.4%) Coloradoans live with incomes below 200 percent of the federal poverty level.21 Among children younger than 18 years of age, one-third (28%) live in families with incomes below 200 percent of the federal poverty level.22 ($60,000 for a family of four23).

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, 33.2 percent are rented. In renter-occupied units, more than half (53.3%) pay 30 percent or more of the household income to rent. The median rent in Colorado is $1,491. The median home value for owner-occupied units in Colorado is $466,200 (2021) compared to $314,200 in 2016. This is a 48 percent increase in median home value in five years.24

“The cost of living is super high. Luckily, we were able to secure a house through the affordable housing program. Families need more affordable options for housing.” - Health eMoms participant25

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.26 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%).27 As of January 2022, there were an estimated 10,397 people in Colorado experiencing homelessness; 2,151 of these were persons in households with at least one adult and one child.28

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, 3.9 percent ate less than they felt they should because of lack of money for food.29 Among Colorado families with children ages 0-17 years, 3.3 percent sometimes or often could not afford enough to eat.30 Among low-income Coloradans, 5 percent do not live close to a grocery store.31 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. Seven in ten (73%) Coloradans who are eligible for SNAP have access to SNAP benefits.32 This is lower than the national average of 82 percent for SNAP enrollment.33 As of November 2022, the Colorado average for comparing the total number of WIC infant and child participants to the total number of WIC-eligible Medicaid infant and child participant averaged 43 percent.34

“SNAP has been a tremendous help to us. Some months we worry about not being able to buy diapers, but we have made it by so far.”- Health eMoms participant25

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 (63.7%) or due to the pandemic work from home (23.7%). Less than one in ten use public transport (1.3%), walk to work (2.3%), bike to work (0.8%). About 2 percent of working Coloradans do not have a vehicle.35

Air quality

Many forms of transportation lead to air pollution thus impacting air quality, especially in low-income neighborhoods. Latinos experience the highest air pollution exposure (index of 52), while Native Americans experience the lowest air pollution (index of 37).36 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 6th and Fort Collins is ranked 15th. 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.37

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. Counties in western Colorado are the state’s most vulnerable region (it is prone to wildfire, flooding, drought, and extreme heat ). Counties in southeast and eastern Colorado are the state’s least vulnerable region.38

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. More than half (52.7%) of Coloradans age 25 and older have a associate’s degree or higher, and Colorado is ranked 3rd among all states in the percentage of the population with a college degree.39

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. Three in five (62.9%) Asians have an associate’s degree or higher, as do 57.8 percent of white, non-Hispanics. One in three (34.5%) Black/African Americans and one in four (28.4%) Hispanics have an associates degree or higher.40-43

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 44). Inequities in graduation rates mimic the disparities in college graduation attainment among adult Coloradans, with Native Hawaiians or Other Pacific Islanders having the lowest high school graduation rate and Asians having the highest.45

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, three in five (59.6%) high school students participate in extracurricular activities. One in three (35.9%) high school students participate in organized community services as a non-paid volunteer during the past 30 days.46 Among parents with young children, 54.2 percent report having a somewhat strong or very strong sense of belonging to their local community.47

“Emotional support typically stemmed from friends that were also mom’s [sic] - nice chatting with people you trust/respect who have been through a lot of the same things that come with being a mama! I am a member of a MOPS group at (a church) and they have been very helpful for me. There are about 50 other moms in my group and they are amazing and we all support each other.”- Health eMoms participant25

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, 5.4 percent of Colorado family households are headed by a single adult and may lack needed support systems.48 The majority of Colorado parents (79.0%) 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 (67.3% vs. 88.3%, respectively).49 Seven in ten (73.5%) high school students have an adult to go to for help with a serious problem,46  which has been demonstrated in research as a critical protective factor in avoidance of risky behaviors.

“The care and emotional support I received and still receive has helped me survive this year.” - Health eMoms participant25

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.46 Among parents with young children, 19 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, 12.7 percent at work or school, 18.7 in a doctor’s office, clinic, or other health care setting, and 4.7 percent when interacting with law enforcement.50

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 18 states/DC that are running their own exchanges and enrollment platforms for 2023 coverage. Here is a summary of milestones and 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;51
  • Connect for Health Colorado is among the most robust exchanges in the country, with six carriers offering plans in 2023.52
  • In the individual/family market, there were 166 on-exchange plans available in Colorado for 2023, up from 132 in 2020 (however, plan availability varies considerably from one area to another).52
  • A total of 201,758 people enrolled in 2023 plans during open enrollment.52
  • 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 Easy Enrollment Program (referred to as a Tax Time Enrollment) debuted in 2022. The program lets Colorado residents indicate on their state tax returns that they would like Connect for Health Colorado to determine, based on the information on their tax return, whether they might be eligible for free or subsidized health coverage. If so, the exchange contacts the person to help them enroll in coverage — Medicaid, CHP+, or a subsidized private plan in the individual market. It also allows for enrollment outside of the open enrollment period.

 

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 most recent Colorado Health Access Survey (2021), 9.5 percent of Coloradans experienced churn (a change in insurer). 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 2021. 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%).53

 

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 March 2023, 611,167 children are enrolled in Medicaid and 46,177 children are enrolled in CHP+.54 As of 2019, 22.2 percent of those eligible for Medicaid or CHP+ are not enrolled.55 In 2022, 35.6 percent of live births in Colorado were paid for by Medicaid.56

 

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% of the federal poverty level (FPL). From January 2022 through January 2023, Medicaid enrolled more than 173,000 members and children represented 17% of the increase in enrollment.

 

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.

 

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, as a result of legislation passed in 2014. 
 

Medicaid also offers the Prenatal Plus program, which is a special program for at-risk pregnant people during their pregnancy through 60 days postpartum. Services include case management, behavioral health services, and nutrition counseling. These services are meant to lower risk for negative maternal and infant health outcomes due to social determinants of health and other non-medical parts of a member's life that could affect their pregnancy. There are currently ten Prenatal Plus providers across the state as of June 2023.

 

There is also a program for pregnant people struggling with substance use disorder, called Special Connections. Special Connections helps pregnant people and their families have healthier pregnancies and healthier babies by providing case management, counseling, and health education during pregnancy and up to one year after delivery. There are currently seven Special Connections programs in the state of Colorado as of June 2023.

 

Home visiting services are also available to Health First Colorado members during their first pregnancy through their child’s second birthday through the Nurse Home Visitor Program. The evidence-based home visiting model supported through this program is Nurse Family Partnership. In 2022, 313 Health First Colorado families enrolled in Nurse Home Visitor Program services.
 

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 are responsible for coordinating physical and behavioral health care for members and administering Health First Colorado’s capitated behavioral health benefit. The RAEs develop, contract, and manage a network of primary care physical health providers and behavioral health providers to ensure member access to appropriate care. Current contracts between the Department of Health Care Financing and the Regional Accountability Entities will end on June 30, 2025. The Department of Health Care Policy and Financing is currently engaged in the planning and program design process for the new contracts.

 

Health care services for low-income and uninsured persons in Colorado include 20 Community Health Centers that operate 238 clinic sites in 46 counties and provide care to patients living in 63 of the state’s 64 counties. Colorado Community Health Centers provide care to over 855,000 people (one in seven Coloradans). Ninety percent of patients at community health centers have family incomes at or below 200% of the federal poverty level.57 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).

 

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 (now Contexture) began offering health information exchange services to providers in communities along the Front Range, Eastern Plains and some of the mountain towns.

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. CDPHE 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.

 

CDPHE 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.

 

Colorado’s most recent Public Health Improvement Plan was released in June 2022. CDPHE’s new strategic plan was released in July 2023. The Prevention Services Division’s current strategic plan was developed in 2022. The external-facing priorities reflected in the strategic plan directly align with the MCH framework:

  • 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

 

The MCH program, administered by the Children, Youth and Families Branch, 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 56 local public health agencies serving 64 counties to improve the health of Coloradans using population-based and infrastructure-building strategies. In Colorado, the 4,562 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 align efforts. This allows for centralized coordination, support, and technical assistance, and a responsiveness to the unique needs and strengths of local communities.

 

The Colorado MCH Framework is grounded in the program’s strategic anchors–racial equity, community inclusion, and moving upstream–which guide efforts to impact seven priorities and three health impact areas.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 first regular session of the 74th General Assembly commenced on January 9th, 2023, which is earlier than previous years to accommodate the inauguration, and ended at midnight, on May 8, 2023, at the 120-day cap, as directed by the Colorado Constitution.

 

Bills this session were introduced to repeal a 40-year prohibition on local governments from enacting rent control measures, various gun control bills marking an historic change to gun control in Colorado, and ensuring reproductive rights were further codified in statute, and more.

 

Included below are descriptions of bills passed during the 2023 session that are aligned with Colorado MCH strategies. Click here for a full list of state statutes relevant to MCH efforts.

 

Reducing Racial Inequities

 

Affidavit to Support Eligibility of Public Benefits: HB23-1117 acknowledges the strain unnecessary familial separation has on immigrant families, and removes the prohibitory language in current law, which states that immigrants cannot sponsor another individual to come to the US.

 

Deceptive Trade Practice Pregnancy-related Service: SB23-190 recognizes the deceptive messaging and advertising ‘crisis pregnancy centers' provide to people seeking abortion services. Classifies “deceptive trade practice” to also include misleading information about a clinic providing abortion related services to abortion seeking individuals when they in fact do not provide such services. This bill also subjects a health care provider to disciplinary action if they administer an “abortion reversal drug” unless the Colorado Medical Board, the State Board of Pharmacy, and the State Board of Nursing find that this is an acceptable practice and standard to engage in.

 

Coverage for Doula Services: SB23-288 recognizes the association between doula support and positive perinatal outcomes for pregnant people who use doula services, especially for lower-income individuals, people of color, and people who experience language and/or cultural barriers to accessing pregnancy care. This bill requires the Department of Health Care Policy and Financing to start a stakeholder process and promote the expansion and utilization of doula services for pregnant and postpartum medicaid recipients. Requires the Department to seek federal authorization for Medicaid providers to provide doula services for pregnant and postpartum people by July 1, 2024. Also creates a doula scholarship program for individuals interested in seeking doula training and certification and requires the department to contract with an independent entity to conduct a review of the potential health care costs and benefits of including coverage for doula services for pregnant and postpartum people covered by health benefit plans.

 

Increase Prosocial Connection

 

Employment of School Mental Health Professionals: SB23-004 recognizes the need for school based therapists, given students reporting of increased feelings of sadness or hopelessness, and that schools are crucial partners in supporting the health and well-being of students.

 

Disproportionate Discipline in Public Schools: SB23-029 recognizes the disproportionate disciplinary practices in schools against Black and Hispanic students, which often pushes students of color into the criminal justice system. The legislature charged the Department of Education to convene the “School Discipline Task Force” with the intention to study and make recommendations regarding school district discipline policies and practices. Various representatives will sit on this new task force from state agencies, and community organizations. The task force is responsible for: identifying alternative approaches to discipline like positive behavioral intervention and supports, bullying intervention, behavior intervention plans, all of which contribute to increasing prosocial connection policies among students, as an alternative to utilizing school discipline policies.

 

Reduce Child and Incarcerated Parent Separation: SB23-039 recognizes the importance of reducing unnecessary child and incarcerated parent separation which can negatively impact a child’s mental health and academic achievement. This bill requires the Colorado Department of Human Services to promulgate rules that facilitate communication and family time between children and their parents who are incarcerated, and sets criteria for engagement. Requires the Department of Corrections to submit an annual report to the Judiciary Committees of both chambers and other relevant committees, concerning parents who are incarcerated, along with other metrics.

 

Create Safe and Connected Built Environments

 

Gun Safety: raises the age to buy any firearm to 21 from 18 and makes it illegal to sell any gun to someone younger than 21 (SB23-169); mandates a three-day waiting period between buying and receiving a gun (HB23-1219); and expands the state’s red flag law (SB23-170); and makes it easier to sue gun manufacturers (SB23-168).

 

Sunset Continue Community Crime Victims Services Grant Program: SB23-160 extends the repeal of the grant program, created in §25-20.5-801 CRS to September 1, 2029 with the requirement of another sunset review prior to repeal. The Long Bill appropriated a one-time, $4 million increase to the program with the goals of increasing and scaling up the impact of the program and services for survivors of crime across the state.

 

Reporting of Emergency Overdose Deaths: HB23-1167 clarifies and extends the current “Good Samaritan law” to provide immunity for individuals who did not report the overdose, but sought help or directly aided another individual suffering from an emergency drug or alcohol overdose. This bill recognizes the importance of immunity from prosecutorial charges in preventing overdoses and overdose fatalities in the state.

 

Portable Screening Report for Residential Leases: HB23-1099 recognizes the importance of increasing access and reducing barriers to attaining affordable housing, inclusive of barriers to be considered for housing. The bill attempts to address barriers such as application fees for apartments and other rental units. HB23-1099 allows prospective renters to pay for the preparation of one screening report that is acceptable to all landlords and leasing offices so as to remove the barrier of paying these fees for every apartment/housing unit a tenant is applying for.              

 

Improve Access to Supports

 

Medicaid Reimbursement for Community Health Worker Services: SB23-002 directs the Department of Health Care Policy and Financing (HCPF) to request federal approval for community health workers to be covered through Medicaid. CDPHE will participate in a public stakeholder process to solicit feedback on this request. The bill also creates the definition of “community health worker,” and directs HCPF to outline the qualifications and training for these professionals to receive reimbursement. HCPF is also required to consult with CDPHE about its registry of health navigators, who would qualify as community health workers. CDPHE’s health navigator registry will transition to the broader community health worker registry, which will serve as the registry to qualify for reimbursement through Medicaid.

 

Multi-year Continuous Eligibility for Medicaid CHP+: HB23-1300 allows the state to provide continuous Medicaid and Child Health Plan Plus (CHP+) coverage to children from birth to age 3 and to provide 12 months of coverage for Coloradans leaving state prison. The bill also creates a study of how to improve the state Medicaid program to support Coloradans’ health, food security, and housing stability.

 

Increasing Access to Reproductive Health Care: SB23-189 makes various changes to improve insurance coverage of reproductive health care services and access to family planning. These changes include requiring large employer plans to cover the total cost of abortion services without cost-sharing and prohibiting insurance carriers from imposing cost-sharing for covered treatment for sexually-transmitted infections or requiring prior authorization for HIV treatments. The bill also directs the CDPHE Family Planning Program to convene a stakeholder collaborative to identify gaps in family planning access and publish recommendations by December 15, 2023.

 

Protections for Accessing Reproductive Health Care: SB23-188 codifies HB22-1279: Reproductive Health Equity Act, by prohibiting insurers that issue medical malpractice insurance from taking action against an applicant or a named insured provider from engaging in any sort of protected health care activity so long as the activity did not violate state law; prohibits an employer (carrier) from taking disciplinary action against a provider if they provide a legally protected health care activity; prohibits a licensing or credentialing authority from refusing to credential a provider solely based on their participation or provision over a legally protected health care activity; prohibits a regulator to deny licensure, registration, or certification to an applicant or impose disciplinary action based solely on the applicant’s participation or provision of a legally protected health care activity nor revocation, surrender, or relinquishment of the individual’s license, certification, registration; prohibits courts, etc., from issuing a subpoena in connection with a proceeding in another state concerning an individual engaging in a legally protected activity; prohibits an out of state civil action against a person or entity for engaging or attempting to engage in a legally protected health care activity, includes prohibiting another state from applying their law to a case heard in a Colorado court; prohibits a peace officer from arresting a provider issuing protected health care services, and prohibits other legal actions such as an ex parte order, summons, extradition, and more.

 

Doula Services: SB23-288 and an approved budget request, coverage for doula services and donor breast milk will be taking effect by July 2024 for eligible Medicaid members. There will be a stakeholder process starting in 2023.

 

Expanded Lactation Benefit: Medicaid is creating an expanded lactation benefit that includes coverage for lactation consultant services, per HB22-1289.

 

Increase Social and Emotional Well-being 

 

Disordered Eating Prevention: SB23-014 recognizes the impact of disordered eating across Colorado communities. This bill establishes the Disordered Eating Prevention Program within the CDPHE branch that administers the MCH program. The Program will align ongoing work on disordered eating by collaborating with schools and other government programs, conducting public outreach, and maintaining a public resource with key information about risk and prevention of disordered eating. 

 

School Mental Health Assessment: HB23-1003 recognizes the opportunity to better connect students with care and resources in their school and/or community with the goal to reach them before a mental health crisis. Therefore, this bill charges the Behavioral Health Administration to coordinate the sixth through twelfth grade mental health screening program to identify potential risks related to unmet mental or emotional health needs among students in these grades. This provides support and resources to address the student’s mental or emotional health concerns and sets criteria for parental consent, and other requirements of the screening program.

 

Alternatives in Criminal Justice System and Pregnant Persons: HB23-1187 recognizes the importance of exploring alternatives to incarceration of a pregnant or postpartum individual and to reduce separation after birth. Aims to improve the health and welfare of pregnant persons in the justice system, so as to reduce the likelihood of negative health and social outcomes for the pregnant/postpartum individual and newborn child. Sets criteria for the court to consider for alternative forms of incarceration such as: diversion, deferred judgment and sentence, or furlough.

 

Promote Positive Child and Youth Development

 

Task Force to Prioritize Grants Target Population: HB23-1223 creates a new task force in CDPHE to establish shared goals, objectives, and guidelines for government agencies and community-based organizations in order to reduce youth violence, suicide, and delinquency risk factors for priority communities with the highest prevalence of these risk factors. Also requires the task force to consult with the following entities: city and county officials, law enforcement, district attorneys, local education providers, local and regional public health administrators, and any local community based organization that have received state-level grants in the area of youth suicide, violence prevention and intervention, and reducing youth risk factors.

 

Special Education Services for Students in Foster Care: HB23-1089 specifies that students in foster care, including students with a disability, are residents of the school they attended at the time of placement into foster care, so long as the student continues to attend school. This bill also requires the Colorado Department of Human Services to convene a work group with the purpose of identifying issues related to foster youth education, transportation, stability, and to recommend any regulatory or legislative changes prior to the 2025 legislative session.

 

Reduce Justice Involvement for Young Children: HB23-1249 recognizes the importance of community-based alternatives to serving youth and serving youth through local collaborative management programs in order to reduce future victimization, specifically youth under the age of 13 years. Adds criteria for the Colorado Department of Human Services to include in their report to the work group for criteria for placement of juvenile offenders, Judiciary committees in both chambers, and other relevant committees such as: number of youth that received services from a county department. Requires a Local Collaborative Management Program (as defined in §24-1.9-101 CRS) to create one or more individualized service and support teams to refer youth to services and to establish a service and support plan for the youth after meeting with them, their family, and other relevant individuals.

 

Increase Economic Mobility

 

Employer Notice of Income Tax Credits: HB23-1006 recognizes the importance of targeted tax credits like the Earned Income Tax Credit, the Child Tax Credit, and the Child and Dependent Care Tax Credits. These are designed to uplift working Coloradans and children, but many qualifying families are losing out because of lack of information and awareness. This bill requires employers to notify all employees of the availability of the aforementioned tax credits.

 

Earned Income and Child Tax Credits: HB23-1112 recognizes the important roles  The Earned Income Tax Credit (EITC) and the Child Tax Credit (CTC) have in reducing child and household poverty, boosting food security, incentivizing employment, and more. This bill will increase the state’s EITC to 38% of the federal credit for tax year 2024 and permanently expand our state’s CTC to include families with qualifying children who have low or no income to report.

 

Colorado Adult High School Program: SB23-003 creates the Colorado Adult High School Program in the Colorado Department of Education, which will be a pathway for adults in the state who have not earned a high school diploma to attend high school and earn a diploma and/or earn industry-recognized certificates or college credits. This program will operate through a partnership between the Department of Education and a local non-profit to provide these services at no cost.

 

Child Care Contribution Tax Credit Renewal: HB23-1091 renews the Child Care Contribution Tax Credit for an additional three years. Child care providers rely on the donations incentivized by this tax credit (an estimated $60 million yearly, statewide) to fund their core programs, increase quality and wages, improve access to care for families, expand their capacity, and provide professional training and career pathway support for staff.

 

 

 

 

 

Back
To Top