Colorado Lawmakers Adjourn ‘Progressive’ Session on HealthcareColorado lawmakers have introduced new legislation which funds numerous departments including the Department of Health Care Policy and Financing. With the funds for the 2023-2024 budget, the HCPF plans to focus on Medicaid, health equity, behavioral health, and more. To learn more details and how this could affect you, continue reading.

The legislature approved appropriations of $15.5 billion ($4.5 billion from general fund) to the Department of Health Care Policy and Financing (HCPF), $2.3 billion ($1 billion from general fund) to the Department of Human Services (CDHS), and $884 million ($126 million from general fund) to the Department of Public Health and Environment (CDPHE) for the FY 2023-2024 state budget, representing a collective 5% and 10% increase for total and general fund appropriations, respectively, from the previous year.

In interviews with State of Reform, lawmakers on key healthcare-related committees offered their thoughts on the main health legislation passed this session—measures ranging from expanding access to reproductive and maternal healthcare to promoting in-demand nursing professions.

The chair of the Senate Health and Human Services Committee, Sen. Rhonda Fields (D – Aurora), described the session as progressive, impactful, and meaningful.

“We’re creating greater access [for] the people of Colorado,” Fields said. “[The committee] had over 96 hours of testimony, and we heard over 45 bills. And so some bills that gathered in committee were successful, and then some did not do so well. But overall when I look at what we’ve done, I’m very, very pleased.”

She said she would continue to look into ways to improve foster care, behavioral health access, and culturally responsive trauma care in the interim.

Medicaid and health equity

Fields sponsored and helped pass Senate Bill 288, which will authorize HCPF to look into ways of promoting the expansion and utilization of doula services for pregnant and postpartum Medicaid recipients. The state will seek federal authorization to provide Medicaid doula benefits and create a scholarship program to support doula training and certification.

She said the measure was significant because it will offer prenatal and postnatal support to new mothers across the state.

The budget outlines an increase of $328.6 million in total funds ($114.2 million from the general fund) for an additional 0.5% across-the-board rate increase for Medicaid providers.

This includes reforming Medicaid reimbursement rates for nursing facility services by incentivizing access to care for Coloradans with complex needs, attaching funding to quality outcomes, and holding nursing facility providers financially accountable by increasing financial transparency.

One of the critical reforms to emerge from the session is SB 222, which eliminates all Medicaid copays with the exception of emergency department services and was signed by Gov. Jared Polis in April. Studies have shown high cost-sharing leads to poor adherence to medication, healthcare utilization, and health outcomes.

The legislature also approved a restructuring of the state’s hospital community benefit system to better reflect the actual need of its communities.

House Bill 1243 requires hospitals to engage the communities they directly serve and submit a public report on how their spending will be administered to meet local health needs, including a summary of their tax exemptions.

HCPF will establish a minimum annual community investment target and community benefit requirements for hospitals to meet aimed at improving community benefit accountability and effectiveness.

Meanwhile, HB 1183 amends the state’s step therapy protocols by requiring HCPF to grant Medicaid prior authorization exceptions for severe and complex medical conditions based on approval from a prescribing provider.

Behavioral health

The chair of the House Public and Behavioral Health and Human Services Committee, Rep. Dafna Michaelson Jenet (D – Aurora) told State of Reform about the progress made on mental health.

Michaelson Jenet sponsored a number of bills this session that includes a program to treat the high-acuity behavioral health needs of children in the state’s care and public school-based mental health assessments.

“We know that the depression [and] anxiety rates [for students] are going up and the suicide rate continues to plod along in a pattern that we don’t want to see,” Michaelson Jenet said. “So one of the questions was, ‘How do we get to kids so that they know that they have access to free therapy through the I Matter program?’ One of the ways is through these assessments in schools for students from sixth to 12th grade.

If your school opts into this program and you go through this assessment and screen for therapy, you will be connected to the I Matter program, or [to] your personal insurance or your personal therapist or social worker—whatever [and] whoever you want to be connected to. But the crux of the issue is [that] we do have an answer. We do have a solution—[students] can get therapy and that’s huge.”

Michaelson Jenet’s HB 1269 requires the Behavioral Health Administration (BHA) to submit a report on the number of children in state custody who had extended stays or boarding to CDHS. The report will inform the department’s plan for building health system capacity for high-acuity beds and residential treatment.

Addressing the departure of BHA Commissioner Morgan Medlock, Michaelson Jenet assured the work on behavioral health equity would continue without Medlock’s leadership.

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