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 in 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. 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.

 

 

Population and demographics

Colorado ranks 21st among states in population size. The total state population in 2020 was 5,842,100. Twenty-one percent of the state’s population are females ages 15-44 and 33 percent are children and youth ages 0-25. Of the overall population of children and youth, approximately 370,000 (19.3%) identified as having special health care needs. The two major racial and ethnic groups in Colorado are White non-Hispanic persons and persons of any race who are of Hispanic origin or ethnicity. Estimates from the American Community Survey (2018) of the U.S. Census Bureau show that 67.8 percent of Coloradans identify their ethnicity as White non-Hispanic and 21.7 percent identify their ethnicity as Hispanic. Categories by race include White (84.1%), Black/African-American (4.2%), Asian and Native Hawaiian/Pacific Islander (3.3%), American Indian and Alaska Native (1.0%), and people who report another race (3.5%) 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. Three 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 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 5,842,076 to 6,252,913. While natural increase (births minus deaths) will contribute 135,548 persons, net migration will result in nearly twice as many people, contributing 275,289 to the total increase of 410,837.

 

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 February 2020, Colorado’s unemployment rate was at a historic low of 2.5 percent. This was lower than the national unemployment rate for the same time period, 3.5 percent. Colorado’s unemployment ranking was the 16th lowest in the nation. The state unemployment rate had been steadily declining since reaching 3.3 percent in September 2018. However, as the COVID-19 pandemic evolved, unemployment rates for March and April 2020 rose dramatically to 5.2% and 12.2%, respectively. The unemployment rate in April 2020 was a historic high for Colorado. The rate dropped two percentage points to 10.2% in May 2020. The preliminary rate for June 2020 inched up slightly to 10.5%.

 

Income and poverty

Colorado has an income advantage. The median household income in Colorado is $71,953, higher than the national median of $60,336 which is the 11th highest among all 50 states. However, the median household income fluctuates significantly among Colorado’s counties. Douglas County, located just south of Denver along the Front Range, has the highest median household income at $115,314. Costilla County, located in Colorado’s San Luis Valley, has the lowest at $30,593.

 

When ranking the states by the percentage of persons living below 100 percent of the federal poverty level, Colorado has the 6th lowest poverty rate in the nation. When focusing on children living in families with incomes below 100 percent, 11.9 percent of children in Colorado live in poverty. This is lower than the national rate of 18.0 percent. Disparities in poverty exist by race, as 6.2 percent of White non-Hispanic children live in poverty, 16.8 percent of Black, 13.9 percent of Hispanic, and 10.0 percent of Asian children.

 

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, 34.9 percent are rented. In renter-occupied units, half (51.3%) pay 30 percent or more of the household income to rent. The median rent in Colorado is $1,289. The median home value for owner-occupied units in Colorado is $373,300 (2018) compared to $283,800 in 2015. This is a 31% increase in median home value in three years.

 

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. Almost one in five (16.5%) households in Colorado experiences at least one of four housing problems (overcrowding, high housing costs, lack of kitchen facilities, or lack of plumbing facilities).

 

Food 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, 7.1 percent ate less than they felt they should because of lack of money for food. Among Colorado families with children ages 1-14 years, 22.8 percent often or sometimes relied on only a few kinds of low-cost food because they were running out of money to buy food. Among low-income Coloradans, 5 percent do not live close to a grocery store. 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. The pandemic has only exacerbated food insecurity in Colorado. In April, Colorado saw a 15% increase in the number of Coloradans utilizing SNAP benefits to buy groceries compared to the previous month - from 439,355 people using the benefit to 507,074. The Colorado Department of Human Services is expecting that number to continue to increase as the pandemic persists.

 

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 (74.9%). Less than one in ten use public transport (2.8%), walk to work (3.0%), or bike to work (1.2%). 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. Coloradans who are Black experience the highest air pollution exposure (index of 64), while Coloradans who are Native American experience the lowest air pollution (index of 39). 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 10th and Fort Collins is ranked 19th. 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 (41.7%) 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 (56.9%) of Asians have a college degree or higher, as do 48.0 percent of White, non-Hispanics. One in four (28.5%) Black/African Americans, and one in six (16.8%) 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 (44 states have higher rates of high school graduation). Disparities in graduation rates mirror 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, seven in ten (68.2%) high school students participate in extracurricular activities. Two in five (43.6%) high school students participate in organized community services as a non-paid volunteer during the past 30 days.

 

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, 22.2 percent of Colorado family households are headed by a single adult and may lack needed support systems. The majority of Colorado parents (82.4%) 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 (73.8% vs. 89.8%, respectively). Three-quarters (73.5%) 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. The impact of the COVID-19 pandemic on social and emotional wellbeing of Coloradans cannot be ignored. The Colorado’s Crisis Services line experienced a more than 30 percent increase in average monthly volume, or an average of more than 20,000 calls per month since March. In March, April and May, the crisis line had its three highest-volume months in the history of the crisis line that launched in August 2014.

 

Racism

Racism and discrimination are two other social determinants of health that negatively impact health. Among high school students, one in ten (9.7%) have been a victim of teasing or name-calling because of their actual or perceived race or ethnic background, and one in twenty (4.9%) because of their actual or perceived sexual orientation in the past year. 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. Colorado COVID-19 data show differences in health outcomes by race and ethnicity. As of July 2020, Black Coloradans accounted for 5.1% of coronavirus cases analyzed by CDPHE and 6.7% of the overall deaths related to COVID-19, despite the state’s Black population standing at 4.2% of Colorado’s total. Hispanic Coloradans, of all races, accounted for 36% of cases and 22% of COVID-19 deaths, while representing 21.7% of the state's population. This compared to White, non-Hispanic, Coloradans accounted for 33.1% of cases and 62.1% of deaths, but make up about 67.8% of the state’s population.

 

Health insurance

Colorado has a state-run health insurance exchange, Connect for Health Colorado. The state passed legislation in 2011 to create the exchange, and is among just 13 states (including DC) that are running their own exchanges and enrollment platforms for 2020 coverage.

Colorado has permanently extended open enrollment, so it runs from November 1 to January 15 every year. In states that use the federal enrollment platform, enrollment will continue to run from November 1 to December 15.

Colorado was also one of only a few states where exchange enrollment increased every year from 2014 through 2019 (there are some discrepancies between state and federal data, but according to federal data, enrollment has trended upwards each year in Colorado), although enrollment dropped a bit in 2020.

Although some carriers exited the Colorado exchange at the end of 2016, Connect for Health Colorado is still among the most robust exchanges in the country, with eight carriers offering plans for 2020. There are 130 on-exchange plans available in Colorado in 2020.

As a result of the coronavirus pandemic, nearly all of the state-run exchanges opened special enrollment periods to allow uninsured residents to sign up for health coverage (HealthCare.gov, which is the exchange platform that’s used in 38 states, is not offering a COVID-specific special enrollment period).

Colorado’s COVID-19 special enrollment period ended April 30 with more than 14,000 people enrolled in plans through the exchange during that window. That special enrollment period was for anyone who didn’t have minimum essential coverage — so it was not an opportunity for people to change their existing coverage, but it was an opportunity for people with plans that aren’t considered minimum essential coverage to switch to a real insurance policy. COVID-19 special enrollment period has ended, but enrollment remains open for people with qualifying events (including loss of an employer-sponsored plan)

Before the pandemic, a record number of Coloradans were insured, with 93.5 percent insured as of September 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%). Affordability of health care continues to be a challenge; on average, health care costs reflect 28% of median household income. Given the impacts of COVID-19, these data likely have and will continue to shift as the pandemic persists.

 

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. Only 5.7% of those eligible for Medicaid or CHP+ are not enrolled. As of April 2020, 481,105 children were enrolled in Medicaid and 79,030 children were enrolled in CHP+. As of June 2020, 495,019 children were enrolled in Medicaid and 75,295 children were enrolled in CHP+. In June, leadership from the Department of Health Care Policy and Financing provided an overview of the impact of COVID-19 on the Medicaid and CHP+ programs, membership and associated service delivery systems.

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+). Moving forward, this outreach will be 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 21 Community Health Centers that operate 208 clinic sites in 42 counties and provide care to patients living in 63 of the state’s 64 counties. Colorado Community Health Centers provide care to over 830,000 people (more than 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. In the summer of 2019, Children’s Hospital Colorado was providing approximately 30 telehealth visits on average per week. In the summer of 2020, that average increased to over 3000 telehealth visits per week, a hundred fold increase as a direct result of COVID-19.

 

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 Statutes and Regulations

The 2020 legislative session came to a close on June 15, 2020. The COVID-19 pandemic wreaked havoc on the state’s budget and severely limited the enactment of legislation that would benefit the health and wellbeing of the MCH population.

 

Bills were introduced this session to add peer specialists as a reimbursable provider type, to require secure storage of firearms, prohibit the sale of flavored nicotine products, and diversify the K-12 workforce. Unfortunately, Colorado, like the rest of the country, faced drastic economic changes as a result of COVID-19. The legislature went into recess for 73 days during the lockdown period. When lawmakers returned, they eliminated bills that could be put off for another year or had costs that the state couldn't afford. The state’s Joint Budget Committee was forced to cut $3.3 billion from the state’s budget, resulting in cuts to public health programming, such as family planning, suicide prevention, comprehensive sexual education, and marijuana education campaigns. In addition, significant cuts were made to education, human services, Medicaid, and corrections. Bills were passed to remove appropriations from recent policy wins, such as funding wraparound services for children and youth, creating a behavioral health capacity tracking system, and grants to counties for the community substance use and mental health services programs.

 

Included below are descriptions of bills that were passed during the 2020 session that are most relevant to current Colorado MCH efforts. Click here for a full list of existing state statutes relevant to MCH efforts.

 

Promote positive child and youth development

 

School-Based Health Center Grant Program

The School-Based Health Center Grant Program (defined in CRS 25-20.5-502) was protected from cuts. Legislators cited the importance of access to behavioral health when making cut decisions. In addition, funds from the federal CARES Act were directed to the SBHC grant program via HB20-1411 (up to $750,000). Funds must be spent by December 30, 2020.

 

Nicotine Product Regulation

HB20-1001, sent to the Governor July 2, 2020, requires all tobacco retailers have a license to sell tobacco products, raises the minimum legal sales age of tobacco products to 21 to align state statute with federal change, and addresses online sales and vending machines - all designed to reduce access to tobacco products for youth. Further, the bill changes the minors in possession law to prohibit sales to minors, not possession by minors. This is an important equity change as youth of color are cited for possession at rates higher than their white counterparts.

 

Supports for Early Childhood Educator Workforce

HB 20-1053, sent to the Governor Jun 22, 2020, directs the Department of Human Services to develop and promulgate rules concerning standards for licensing early care and education programs that facilitate the recruitment and retention of Colorado's early childhood educator workforce and creates the School-readiness Quality Improvement Program and the Early Childhood Mental Health Consultation Program

Creates (defined in CRS 26-6.5-401) to increase the number of qualified and appropriately trained mental health consultants who will consult with professionals working with children across a diversity of settings, as well as other adults, including family members, who directly interact with and care for children.

 

Cigarette Tobacco and Nicotine Products Tax

HB20-1427, sent to the Governor July 2, 2020, refers a question to the voters on the November 2020 ballot for new and increased taxes. Revenue from the taxes

is distributed to fund health care, tobacco education, preschool, and other programs.

 

School Entry Immunization

SB20-163, signed by the Governor June 26, 2020, codifies a definition of “non-medical exemption” to mean an immunization exemption based upon a religions believed whose teachings are opposed to immunizations or a personal belief that is opposed to immunizations and directs the Department of Public Health and Environment to modify school entry immunization documents and processes.

 

Improve access to supports

 

Substance Use Disorder Treatment In Criminal Justice System

HB20-1017, sent to the Governor June 29, 2020, requires opioid antagonists are made available to people leaving corrections, local jails and human services facilities; requires people released from county jails are enrolled in Medicaid upon release from custody; requires the Department of Corrections to work with the Office of Behavioral Health and Economic Security in the Department of Human Services to develop resources for inmates post release to prepare for reintegration into their communities; and allows for the creation, maintenance or expansion of criminal justice diversion programs.

 

Mental Health Educational Resources

HB20-1113, sent to the Governor July 2, 2020, makes enhancements to Safe2Tell by requiring the Dept of Law to: work with stakeholders when developing training materials for appropriate Safe2Tell responses; provide Safe2Tell informational material to additional types of youth-related organizations for free, subject to available appropriations; and devise a process and standard protocols for mental health and substance abuse tips to Safe2Tell to be transferred to the Colorado Crisis Hotline.

 

Health Care Coverage Easy Enrollment Program

HB20-1236, signed by the Governor July 6, 2020, establishes a program that gives taxpayers the option of being evaluated through information provided in their tax filings for eligibility in Medicaid, CHP+, or a health benefit plan offered through the exchange for which a premium tax credit or cost-sharing reduction is available.

 

Food Pantry Grant Program

HB20-1422, signed by the Governor June 22, 2020, creates the food pantry assistance grant program to aid Colorado food pantries and food banks in the purchase of foods to meet the needs of their clientele, which has expanded significantly as a result of the COVID-19 public health emergency.

 

Substance Use Disorder Recovery

SB20-028, signed by the Governor June 30, 2020,  modifies the definition of "child abuse or neglect" in regards to substance exposure in the Colorado Children's Code to include any newborn child who is affected by alcohol or drug exposure and where factors are present that threaten the health or welfare of the newborn child. There is an exception for when substances are taken as prescribed while being monitored by a licensed health care provider (i.e. medication assisted treatment).

 

Reimbursement for Telehealth Services

SB20-212, sent to the Governor June 19, 2020, expands Medicaid reimbursement for telehealth services to new providers, and establishes requirements for state-regulated health insurance carriers and home care agencies related to the delivery of telehealth services.

 

Increase economic mobility

 

Adjust Tax Expenditures For State Education Fund

HB20-1420, sent to the Governor June 19, 2020, makes several changes to Colorado’s tax code and sends the savings to the State Education Fund. The bill impacts the Earned Income Tax Credit by making it equal to a percentage of the federal earned income tax credit, increases the percentage from 10% to 20% beginning in 2023 and specifies that for income tax years commencing on or after January 1, 2020, taxpayers filing with an individual taxpayer identification number are eligible for the earned income tax credit.

 

Cost of Living Adjustment for Colorado Works Program

SB20-029, signed by the Governor July 2, 2020, allows a participant enrolled in the Colorado works program on or at any time within one month after the effective date of the bill to receive a one-time $500 basic cash assistance (BCA) payment in addition to the amount of BCA a participant currently receives.

 

Implementation Of CO Colorado Secure Savings Program

SB20-200, sent to the Governor June 22, 2020, directs the implementation of the Colorado Secure Savings Program, a state-facilitated, privately administered auto individual retirement account (IRA) program. It further directs the state to create a statewide, coordinated approach to financial education to raise the level of financial knowledge among state residents.

 

Reduce racial inequities

 

Suppressing Court Records of Eviction Proceedings

HB20-1009, signed by the Governor March 20, 2020, requires a court to suppress records of eviction proceedings and actions for termination, and provide notice of such suppression to the defendant, until an order granting the plaintiff possession of the premises is issued.

 

CROWN Act of 2020

HB20-1048, signed by the Governor March 6, 2020, enacted the "Creating a Respectful and Open World for Natural Hair Act of 2020," which specifies that, for purposes of anti-discrimination laws in the context of public education, employment practices, housing, public accommodations, and advertising, protections against discrimination on the basis of one's race include hair texture, hair type, or a protective hairstyle commonly or historically associated with race, such as braids, locs, twists, tight coils or curls, cornrows, Bantu knots, Afros, and headwraps.

 

Prohibit Housing Discrimination Source of Income

HB20-1332, sent to the Governor June 19, 2020, adds discrimination based on source of income as a type of unfair housing practice and prohibits a person from refusing to rent, lease, show for rent or lease, or transmit an offer to rent or lease housing based on a person's source of income. "Source of income" is defined to include any source of money paid directly, indirectly, or on behalf of a person, including income from any lawful profession or from any government or private assistance, grant, or loan program.

 

Healthy Families and Workplaces Act

SB20-205, sent to the Governor June 29, 2020, requires employers to provide each of their employees paid sick leave for employees to take for reasons related to the COVID-19 pandemic in the amounts and for the purposes specified in the federal "Emergency Paid Sick Leave Act" in the "Families First Coronavirus Response Act". Additionally, beginning January 1, 2021, the act requires all employers in Colorado to provide paid sick leave to their employees, accrued at one hour of paid sick leave for every 30 hours worked, up to a maximum of 48 hours.

 

Law Enforcement Integrity 

SB20-217, signed by the Governor June 19, 2020, requires local law enforcement and the Colorado State Patrol to use body-worn cameras and release recordings to the public, and to conduct data reporting about certain incidents and contacts with the public; the POST Board must revoke peace officer certification for certain violations; state and local law enforcement are prohibited from certain enforcement actions in

response to public demonstrations; removes immunity for local law enforcement peace officers and requires those agencies to indemnify officers acting in good faith; limits the acceptable use of force by all peace officers and creates a duty to report excessive use of force; allows the Attorney General to intervene in instances where a government authority engages in a pattern or practice that deprives persons of their constitutional rights.

 

Increase social emotional well-being

 

Excused Absences in Public Schools for Behavioral Health

SB20-014, signed by the Governor March 23, 2020, requires school districts to adopt a written policy for the schools districts’ attendance requirements to include excused absences for behavioral health concerns.

 

Bills Impacting LGBTQ Persons

LGTBQ persons, particularly youth, face discrimination at rates much higher than their cis gender peers. Two bills were introduced and subsequently voted down this session that sought to minimize the experience of LGTBQ youth. The Equality and Fairness in Youth Sports Act (HB20-1273) sought to keep gay and transgender youth out of sports and Protect Minors from Mutilation and Sterilization (HB20-1114) sought to make it a a crime for a health care professional to administer a drug or hormone or perform a surgical procedure for the purposes of facilitating gender affirmation on a young person. Neither bill made it through their first committee hearing. Alternatively, SB20-221, supported LGBTQ persons and communities by successfully making the victim's actual or perceived gender, gender identity, gender expression, or sexual orientation irrelevant in a criminal case. The bill creates a protective hearing if a party claims that such evidence is relevant and wants to use it in a criminal case.

 

Increase prosocial connection

 

Public Assistance Program Recipient Disqualification

SB20-206, signed by the Governor July 2, 2020, clarifies that a recipient of a public assistance program who is found to have committed an intentional violation is only disqualified from participating in the public assistance program in which the recipient is found to have committed the intentional violation (rather than banned from all programs).

 

Unemployment Insurance

SB20-207, sent to the Governor June 29, 2020, directs that when determining whether an individual qualifies for unemployment insurance, the Department of Labor and Employment must consider whether the individual has separated from employment or has refused to accept new employment because:

• the employer requires the individual to work in an environment that is not in compliance with the CDC guidelines applicable to the employer's business and workplace at the time of the determination; state and federal laws, rules, and regulations concerning disease mitigation and workplace safety; an executive order issued by the governor requiring the employer to close the business or modify the operation of the business; and any public health order issued by the department of public health and environment or a local government;
• the individual is the primary caretaker of a child enrolled in a school that is closed due to a public health emergency or of a family member or household member who is quarantined due to an illness during a public health emergency;
• or the employee is immunocompromised and more susceptible to illness during a public health emergency.

 

Create safe and connected built environments

 

Allow Home Child Care in Homeowners' Association Community

SB20-126, sent to the Governor June 15, 2020, prevents a common interest community from prohibiting a homeowner from operating a licensed family child care home, unless operating a licensed family child care home contradicts other association regulations such as landscaping or parking.

 

Organizational Charts

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