2019 Legislative Priorities:
HB19-1009: Substance Use Disorder Recovery
Housing instability often leads to negative physical and mental health, and often makes it harder to access health care especially for those recovering from substance use disorders. This bill will expand the housing voucher program to include those with a substance use disorder, create a licensing program for recovery residences in Colorado, and create an opioid crisis recovery fund for money the state receives from any litigation.
Strikes state statute that financially penalizes localities when they even attempt to license, tax, or assess a fee to cigarettes. Also expressly authorizes counties and statutory cities to regulate tobacco products, e-cigarettes, and nicotine products as they see fit. We know that increasing prices and licensing has immediate impact on teen smoking rates, overall health outcomes, and associated healthcare costs
Human trafficking is a statewide concern that has direct impact on local communities, law enforcement, and orgs that provide services to human trafficking survivors. Other than the front range, many areas of the state have limited training resources available to identify human trafficking and providing services to human trafficking survivors. This bill will provide materials and trainings (train-the-trainer, direct, online) to law enforcement, orgs providing services to victims, schools personnel (parents and students), and other agencies that would benefit.
HB19-1161: Comprehensive Physical Education Instruction
Our schools face many barriers to providing quality physical education. HB19-1161 would allow schools and school districts to apply for a 3-year grant to help them overcome these hurdles and implement a comprehensive PE program. Baseline and formative data will be collected throughout the pilot, with post-data collection analysis. These proof points will support how quality Physical Education impacts student health, academic success, and social-emotional well-being and will help inform policy in the future.
Alters the number of individuals on the child welfare allocations committees to those appointed by county commissioners from 8 to 10, with the two additional appointees coming from 2 counties with the greatest percentage of state’s child welfare caseload. Addressing and adding in the voices from communities with the greatest needs in this area just makes sense.
Hospitals account for 34% of Colorado dollars spent on health care. Transparency is the first step in understanding cost-drivers in the health care system, with an ultimate goal of lowering them in the future. This bill will require each hospital in the state to annually report on their expenditures to HCPF and the Colorado healthcare affordability and sustainability enterprise board, and these reports will be made publicly available as well.
HB19-1010: Freestanding Emergency Departments Licensure
When Coloradans walk into FSEDs for emergency services, they deserve to know that FSEDs are adequately adept to provide those services as a matter of public safety. Proper licensure would allow for better distinction and regulation of FSEDs in the future, without impeding on CCECs that provide care to rural or ski resort areas. This allows the board to set these licensure requirements, fees, and safety standards.
HB19-1083: Athletic Trainers License
To align with 46 other states who license athletic trainers, this bill changes the terms describing the regulation of athletic trainers from “registration” to “license” and “licensure” and from “registrant” and “registered athletic trainer” to “licensee”. Simple changes that make sense to allow professional liability coverage from them outside of their primary state, and to be able to participate in interstate compact and licensure reciprocity.
MAT treatment programs have been proven effective in treating individuals with opioid use disorder by decreasing opioid use, opioid-related deaths, criminal activity, infectious disease transmission, and increases social functioning and retention in treatment. The pilot programs in Routt and Pueblo county saw expanded access to MAT services (since there are often inadequate to no providers) and this bill seeks to extend the pilot another two years, increase funding, and extend the pilot to San Luis Valley which has seen increases in opioid overdose deaths since 2010 & 2 other counties that have a substantial need. This bill will also move the program from the college of nursing to the center for research into substance use disorder prevention, treatment and recovery support strategies. These are all crucial steps towards combatting the opioid crisis across the state and getting individuals into the care they need with providers.
SB19-005: Import Prescription Drugs From Canada
Prescription drug costs continue to rise and be unpredictable in Colorado as we can pay twice as much as Canadian consumers pay for patented Rx drugs and 20% more for generic drugs. Canada already has a rigorous regulatory system in place to license Rx drugs, and under federal law the Secretary of the U.S. Department of Health and Human Services can approve wholesale importation of Rx drugs from Canada if its shown to be safe and less costly. HCPF will analyze the costs, benefits of importing prescription drugs from Canada and this could provide Coloradans access to safe and more affordable prescription drugs.
Coloradans suffer from high health care costs and a dearth of competition in many areas. This bill provides an opportunity to study a state-backed option and analyze various factors with the ultimate goal of creating an affordable, competitive state-backed option for health care coverage regardless of income level or geographic location.
HB19-1168: State Innovation Waiver Reinsurance Program
This bill creates the Colorado Reinsurance program to provide reinsurance payment to health insurers to aid in paying high-cost insurance claims in order to lower overall premiums especially for rural and high-cost areas of the state. It also authorizes the commissioner of insurance to seek approval from the federal government to waive the applicable federal requirements, provide federal funds or both enable the state to implement the reinsurance program making the program contingent upon the waiver or funding approval.
Extends dental services to all eligible enrollees of CHP+, which includes children and pregnant women. Oral health is an indicator of overall health, and we also know that when parents gain access to oral health care (and the financial barrier/insurance is removed) their children are more likely to have excellent/good teeth, are more likely to see a dentist for preventative care, and are less likely to go without dental care. A pregnant mother’s oral health has lifelong effects on their children’s oral health, and a child’s oral health effects school readiness, attendance, and lifelong achievement.
HB19-1044: Advance Behavioral Health Orders Treatment
This bill seeks to create a similar order for behavioral health as exists for the medical scope of treatment by allowing adult individuals to control scopes of treatment by communicating their behavioral health history, decision, and preferences. Individuals with behavioral health disorders are in need of a consistent method for identifying/communicating critical behavioral health treatment history/decisions/preferences that each sector of the health community will recognize so that they can enhance patient-centered, compassionate care, continuity and communication across all health settings.
Creates the Colorado maternal mortality review committee, which will review maternal deaths, identify causes of maternal mortality and develop recommendations to address preventable maternal deaths – i.e. legislation, policies, rules, and best practices to support the health and safety of the pregnant and postpartum population in CO and prevent maternal deaths. Women of color die during or after childbirth at much higher rates than white women, this bill allows us to begin to understand the root causes of this.
SB19-003: Educator Loan Forgiveness Program
Colorado has a shortage of teachers and educators often in rural or isolated areas of the state. Educational loan repayment or forgiveness can incentivize teachers to these areas. Colorado students across the state deserve excellent teachers and we know a quality education has implications for lifelong achievements. Also, these drawn-in teachers deserve the financial incentives to make their career work as well as alleviate the longterm stress and anxiety associated with student debt.
Coloradans suffer from high health care costs and a dearth of competition in many areas. This bill provides an opportunity for a pilot program for individuals in a designated area to partake in the group medical plans offered to state employees. These individuals would be limited to Garfield/Eagle counties within the designated service area, and to a limited number of individuals whose income is between 400-500% below the poverty line. This bill would also allow health care cooperatives in the state to incorporate consumer protections such as coverage for preexisting conditions and to encourage consumers to help control health care costs by negotiating rates on a collective basis directly with providers.
We know that we cannot incarcerate ourselves out of the opioid epidemic or substance, and often those incarcerated for drug-related offenses need treatment options. This bill is comprehensive in its approach. A couple things it does is it looks to study alternatives to incarceration for those that need treatment instead of jail for drug-related offenses, and also looks to provide behavioral & substance use treatment (MAT) to those who may already be incarcerated.
SB19-009: Financial Incentives For Rural Educators
Colorado has a shortage of teachers and educators, often in rural or isolated areas of the state. This bill will remove the limitation on the number of stipends and increases annual amount to $4k for students enrolled in teacher prep programs who agree to teach in a rural school or district. It also will eliminate the number of stipends to educators in rural schools and rural school districts who are seeking certain certifications. This bill benefits Colorado’s rural students as they will continue to receive a quality education that has lifelong implications around health and success, as well as for the teachers to alleviate stress/anxiety around finances, and an investment in future teachers.
This bill requires the Department of Public Health and Environment to create and administer a statewide electronic system that allows qualified individuals to upload and access advance medical directives (i.e. the medical orders for scope of treatment). It is the responsibility of the adult or authorized surrogate decision maker to ensure the advance medical directive uploaded to the system is accurate and current. This bill requires the department to create rules to administer treatment and must contract with one or more health info organization networks. They would also address the consistency of care.
As more studies come out, we’re finding that e-cigarettes produce dangerous second-hand smoke that often contains nicotine and volatile organic compounds – especially dangerous to children. This bill will update the Clean Indoor Air Act with the definition of “electronic smoking device” (ESD) to include e-cigarettes and similar devices within the scope of the act.
HB19-1154: Patient Choice of Pharmacy
This bill prohibits a carrier that offers or issues a health benefit plan that covers pharmaceutical services, including Rx coverage, or a PBM from:
- Limiting/restricting a person’s ability to select a pharmacy/pharmacist
- Imposing a copayment fee, or other cost-sharing requirement for selecting a pharmacy of the covered person’s choosing
- Imposing other conditions that restrict a person’s ability to use a pharmacy of their choosing
- Denying a pharmacist/pharmacy the right to participate in any of its pharmacy network contracts in this state or as a contracting provider in the state if the pharmacy has a valid license in CO and agreed to specified conditions
HB19-1160: Mental Health Facility Pilot Program
Creates a 3-year mental health facility pilot program to provide residential care, treatment, and services to persons with a mental health diagnosis and a physical health diagnosis. This is in an effort to create a new licensed facility model to provide a variety of services to individuals with dual diagnosis in a less costly setting that also prepares the person to live on their own if possible. Two entities will apply to CDPHE that meet requirements around providing integrated care services, demonstrates cost savings for the state medical assistance program, is willing to contribute 1/3 of increased costs due to the pilot, and more. Reports will be prepared to analyze each applicant’s pilot program.
SB19-108: Juvenile Justice Reform
Establishes a committee on juvenile justice reform in the governor’s office – the duties of this committee (included but not limited to):
- Adopting a validated risk and needs assessment tool to be used by juvenile courts, probations, and parole department
- Selecting a mental health screening tool for juvenile offenders
- Selecting a risk screening tool for district attorneys when determining eligibility for diversion
- Developing a plan for measuring the efficacy of these tools
Division of youth services that are already working on the detention of juvenile offenders and alternatives to detention and this adds to their working list of goals. In terms of juvenile probation requires the state court administrator to develop statewide systems for graduated responses and incentives to change behaviors/address violations, and develop statewide standards for probation supervision.
Many students who qualify for the federal Free and Reduced Lunch Program still have to pay a fee for each lunch they eat. For many families, even that small fee is too much. Families often end up in collections and students often choose not to eat if they can’t afford the fee. Several years ago, Colorado passed a bill to remedy this by having the state cover the small fee for students in kindergarten through the 5th grade, and last year a bill increased the number of kids who receive a free lunch, expanding the program to students through 8th grade. This bill requires the general assembly to make an appropriation for the program, clarifies that all students in sixth thru eighth grade participating in the federal reduced price school lunch program are eligible for the program, and extends the grades of eligibility for the program to students thru the 12th grade. This bill helps ensure that every hungry kid is getting to eat and that families are not sent to collections over school debt.
HB19-1174: Out-of-network Health Care Services
Health care facilities, carriers, and providers must provide consumers with disclosures about the potential impact of receiving services from an out-of-network provider or health care facility. Covered individuals deserve access to accurate information about their health care bills and payments in order to ensure they’re able to make informed decisions about their health care and financial obligations.
Encourages any person that owns, operates, or manages a public place to place functional automated external defibrillators (AEDs) in sufficient quantities to ensure reasonable availability for use during perceived sudden cardiac arrest emergencies. A $75,000 contract will be awarded to a nonprofit organization for the purpose of acquiring and distributing AEDs to public places.
HB19-1177: Extreme Risk Protection Orders
Allows for a family member, household member, or a law enforcement officer to petition to the court for a temporary extreme risk protection order (ERPO) – the petitioner must show there is evidence that a person poses a significant risk to self or others by having a firearm in their custody or by possessing, purchasing, or receiving a firearm. Sets up court hearing timelines, ERPO rules, and seizing of firearms accordingly.
Mothers and their children have better physical and psychological outcomes when families remain together. Substance use disorder treatment that supports the family as a unit has proven to be effective for maintaining maternal drug abstinence and child well-being. This bill does a multitude of things ranging from amending existing programs that provide access to substance use disorder treatment to pregnant and parenting women. It also creates child care pilot programs for parenting women engaged in substance use disorder treatment.