Colorado lawmakers grapple with doing the people’s work when the people can’t be there

Colorado lawmakers grapple with doing the people’s work when the people can’t be there

Historic budget cuts are on the line as lawmakers seek to balance public access with pandemic precautions at the state Capitol

By John Herrick (May 15, 2020)

Temperature checks. A closed cafeteria. Spaced seating. Lawmakers in masks separated by plexiglass. This may be the new normal at the state Capitol when the legislature reconvenes as soon as May 26.  

The public health measures are needed for lawmakers to continue doing their work safely during the COVID-19 pandemic, which shut down the legislature on March 14. Since then, the respiratory disease has killed more than 1,000 people in Colorado.  

The pandemic also has blown an estimated $3.3 billion hole in the state’s $30-plus billion budget due to the loss of sales and income tax revenue as businesses remain on standby and unemployment spikes. The seven lawmakers on the Joint Budget Committee have voted over the last two weeks to withhold a 3% pay increase for state workers, table capital construction projects and cut more than $100 million to higher education, among other cuts totaling more than $700 million. The committee is considering more cuts to the senior property tax exemption, the state’s contribution to the public employee’s retirement fund, K-12 funding, suicide prevention, substance use disorder treatment, mental health services, vaccine outreach, and health coverage for the uninsured and immigrants. 

But even as decisions that will affect most Coloradans are debated, public access to the Capitol and in-person access to lawmakers will be limited to prevent the spread of the new coronavirus. The options being discussed include encouraging lobbyists not to gather in the halls outside the chambers and limiting seating in committee rooms and the public gallery above the House and Senate floors.

To make their voices heard, advocates say they are sending emails to lawmakers and hosting town halls and online forums. Some have been calling, texting and sending letters. Others say they are banding together and leveraging their networks. But, even so, they say, it’s not quite the same. 

“I definitely think there will be something lost. In-person communication is the best way to get to know someone,” said Dusti Gurule, the executive director of the advocacy organization Colorado Organization for Latina Opportunity and Reproductive Rights, or COLOR. “I hope it is something that [lawmakers] are thinking about — transparency and the voice of who is most impacted.” 

Questions remain about how to conduct legislative business during the pandemic. Democrats want to allow members who fear for their health to participate remotely despite objections from Republicans who say the Colorado constitution forbids it. Even if lawmakers allow remote participation by voting to amend procedural rules, it’s unclear how those tuning in from home would speak in floor debates, offer amendments or vote. And it’s still unclear whether reporters will have access to the floor of the House and Senate chambers, where they currently work during the session, in part given the need to spread lawmakers out to achieve social distancing. Unlike the current mandate for businesses in Colorado, lawmakers are planning to recommend — rather than require — that the public not enter the building with a temperature over 100.4 degrees Fahrenheit and wear non-surgical face masks. 

“Do we have the ability to turn somebody away because they have a fever? Those are big questions,” said Sage Naumann, the spokesperson for the Senate GOP. “It’s really hard for the government to do that. That’s why you can’t be turned away for your opinions. That’s why you can’t be turned away for what you look like or the God you worship … People have a right to have their voices heard.”

Despite the two-month-long recess, much legislative work has occurred with little or no public notice. In part due to budget cuts, lawmakers have already abandoned big policy priorities without a vote, including a bill to set up a state-run health insurance plan known as the “Colorado Option” and a paid family and medical leave program, which advocates have demanded for the past six years and say is needed now more than ever. 

From afar, Amie Baca-Oehlert, president of the Colorado Education Association, said she has been watching the Joint Budget Committee cutting funding for education. She said this has created a lot of anxiety and despair. But she’s hopeful teachers are watching and will make their voices heard before further cuts are made. In previous years, the Colorado Education Association has organized rallies with thousands of teachers traveling to the Capitol. 

“In some ways, I think that there actually is the opportunity to have more eyes on them than normal because we have so many people who are in stay-at-home situations because they are not working,” Baca-Oehlert said. “My hope is that the public would tune in.”

But sometimes the public may not know to tune in. A gathering of more than two elected officials is considered a quorum and subject to open-meeting laws. But many of these public meetings are not being announced and may go unnoticed, said Jeff Roberts, executive director of the Colorado Freedom of Information Coalition. 

“There are lots of conversations happening that the press and public has no inkling about,” Roberts said. “That’s the nature of what’s happening right now. These discussions are not happening at the Capitol. Or if they are happening at the Capitol, the press may not be allowed in there.” 

Besides, he said, not everyone has access to adequate internet or a computer to watch and participate in committee hearings remotely. 

The lack of remote access is just another iteration of a longstanding lack of access to state lawmakers among some communities in Colorado. Regular sessions are held during the day when working people may not be able to take time off. Others may not be able to drive hours to Denver. 

“Most of our people have always had an access issue,” said Jenny Davies, the co-founder of Progressive Promotions, a liberal advocacy group. “The structure of the legislature definitely privileges people who have more freedom and economic flexibility.” 

Committee meeting audio is available on each committees’ page on the Colorado General Assembly’s website. The Open Media Foundation films and records House and Senate floor debates and makes them available on the Colorado Channel website

On Monday, the eight-member Executive Committee plans to begin finalizing a plan for how to manage the pandemic for the second half of the session. And lawmakers say they are confident they can strike the right balance between public access and safety. 

“The public is such an important part of this. The legislature is the people’s house. We are there to be transparent and accountable to the people of this state,” said Rep. Chris Kennedy, a Democrat from Lakewood who has been helping work on the plan for remote participation among lawmakers. He said there will have to be greater emphasis placed on calling, texting and acknowledging written forms of communication. 

“I think that we don’t lose a lot as long as every legislator puts in the effort.” 

Read more on ColoradoIndependent.com

Democrats Say Pandemic Proves The Need For Paid Leave And Affordable Insurance, But It May Ruin Their Bills

Democrats Say Pandemic Proves The Need For Paid Leave And Affordable Insurance, But It May Ruin Their Bills

By Andrew Kenney (April 14, 2020)

Before the pandemic suspended normal life in Colorado, state lawmakers were getting ready to debate bills on two very big topics: health insurance reforms and paid leave for workers.

The COVID-19 crisis has lent a new sense of urgency to both those issues — while also making it less likely that lawmakers will act on them before the November elections.

“That’s not something that Republicans are celebrating or spiking the football. We realize that our colleagues on the other side of the aisle wanted to advance policies that they consider to be good, but the financial reality is probably working against those two bills,” said Republican Senate Minority Leader Chris Holbert.

The state option bill was the talk of Colorado’s health care world just a few months ago, attracting hundreds of thousands of dollars in opposition spending from health industry groups. Gov. Jared Polis put his muscle behind it, saying in his State of the State address that hospitals needed to give up some of their profits. Polis’ goal is to create a new state-backed insurance option, with strict rules around its cost to consumers, and force hospitals to accept it.

“If it doesn’t happen this year, it would be disappointing, but it certainly would make sense to focus on other things,” said Democratic Rep. Dylan Roberts of Avon, a sponsor of the “state option” health bill. “However, a public health crisis makes it abundantly clear that more people need access to health treatment.”

More than 16 million people have filed for unemployment since the pandemic started taking off in the US. Because many Americans’ health insurance is tied to their work, that suggests a huge number of people are losing their coverage in the middle of a public health crisis.  

Budget overshadows other issues

The legislature is scheduled to return from its current recess on May 18. Colorado’s Supreme Court has ruled the session can continue past its original end date in order to make up for lost days during the pandemic. But it’s unclear how lawmakers might use that time. 

“If the epidemic is still raging and we’re still looking at pretty significant distancing measures, then we’re going to limit the scope of what we do,” said Democratic House Assistant Majority Leader Rep. Chris Kennedy of Lakewood, co-sponsor of the state option bill.

The General Assembly must pass the state’s budget before the state’s next fiscal year begins on July 1. Once they’ve done that though, lawmakers could temporarily adjourn once again, depending on the severity of the outbreak.

The budget could have a big impact on the fates of other major bills. Forecasters have cut $1 billion from the state’s expected revenues already, and as the pandemic drags on, further damage may force deep cuts to the budget. That could make the cost of setting up a public insurance option or a paid leave program unaffordable until things improve.

In the meantime, lawmakers are connecting by phone and Zoom to suss out whether their bills can move forward.

“Our bandwidth as a general assembly is going to be significantly narrower than we thought it would be a month ago,” Gray said. “The path for anything gets harder when you have significantly narrower bandwidth.”

Read the full story on cpr.org

For more news on this topic visit ColoradoPolitics.com

State Lawmakers Unveil ‘Colorado Affordable Health Care Option’

State Lawmakers Unveil ‘Colorado Affordable Health Care Option’

By Shaun Boyd (March 5, 2020)

DENVER (CBS4) – After years of talking about a public health insurance option, state lawmakers have introduced a bill to create the Colorado Affordable Health Care Option. It is a public-private insurance plan.

Under the bill, the state would force insurance companies to sell the plan in every county and every hospital would accept it or risk losing their license. The state would also set reimbursement rates based largely on a percentage of what Medicare pays.

“The Colorado Health Care Option will hold corporate health care profits accountable,” said Representative Dylan Roberts, lead sponsor of the bill.

Initially, the plan would be open to about 8 percent of Coloradans who buy their own insurance. Eventually, it would be expanded to the small group market. Co-sponsor Representative Chris Kennedy said the goal is to force down premiums for everyone.

“Now is not the time for tinkering around the edges and working on small policies to make small differences,” said Rep. Kennedy.

Heidi Baskfield with Children’s Hospital said government price controls could force hospitals to shift costs to employer based insurance, driving up premiums for everyone.

“Only coming after hospitals for what is a much larger health care issue is tinkering around the edges,” said Baskfield.

Amanda Massey with the Colorado Alliance of Health Insurers warned too of unintended consequences. She says insurers will lose money administering the plan for the state and some might leave Colorado.

“I think insurers will have to make very difficult decisions,” said Massey.

Roberts isn’t convinced. The state option, he said, only impacts about 300,000 Coloradans who buy their own insurance now. He said those who switch to the state option will see a 9-20 percent reduction in premiums.

“We cannot tell the people of Colorado that the status quo is okay. The Colorado Option is the first guarantee that they will have an affordable choice on the individual market,” said Roberts.

No one has to switch to the state plan but if they don’t, they could end up paying even more than they do now. Most of those who buy their own insurance get federal tax subsidies and those would drop. The bill sponsors are seeking a federal waiver to address that, as well as working on republican support for the bill.

Read the full story on Denver.CBSLocal.com

Gov. Polis unveils his updated roadmap to saving people money on health care

Gov. Polis unveils his updated roadmap to saving people money on health care

By Meghan Lopez (February 28, 2020)

DENVER — Surrounded by health care advocates and fellow Democrats, Governor Jared Polis unveiled his updated Roadmap to Saving Coloradans Money on Health Care.

Last time around, the road map included six things: increase hospital price transparency, establish a reinsurance pool, negotiate to drive down the cost of health insurance, lower hospital prices, reduce out-of-pocket costs and lower the cost of prescription drugs.

During Thursday’s unveiling, the Governor touted the accomplishments of last session in all six of these areas while admitting there is still a lot of work to be done.

“When it comes to health care, there is no silver bullet; there is a lot of hard work that your legislators and public officials and others need to do,” Gov. Polis said.

This time around, the newly unveiled roadmap includes five areas he would like to expand upon: adopting a public option, expanding insurance purchasing alliances, increasing drug price transparency, supporting primary and preventative care availability and implementing behavioral health reforms.

“It isn’t just one simple answer that solves it, it is a combination of many, many strategies coordinated between the Governor’s office and the legislature to try to make these changes and we’re going to be working on this for many years,” said Rep. Chris Kennedy, who co-sponsored some of last year’s health care bills.

Reinsurance was one of the biggest health care pieces to come out of the Colorado capitol last legislative session. It is an effort to bring down health insurance premiums for everyone by helping insurance companies cover the claims of the most expensive clients, including those with chronic or complex conditions.

However, in the months after the program was implemented, while many people saw their premiums go down, some Coloradans experienced the opposite.

“Their premiums did go down, but in some cases, their federal tax credit went down even more, so we’re working on finding federal funding sources to backfill them to make sure no one was harmed by that,” Rep. Kennedy said.

Part of the reason he believes the reinsurance program didn’t lower costs for everyone is because the health care system as a whole is complicated and something he considers to be patchwork.

Despite this, Rep. Kennedy believes the reinsurance program was an important first step to providing immediate relief to consumers.

This year, the governor is pushing for legislators to pass a bill to adopt the public option, where the state would offer a health insurance plan.

Opponents of the idea, like Rep. Patrick Neville, R-Douglas County, believe this idea is taking health insurance in the wrong direction that could end up costing people more money.

“They all might sound like a good idea, but in aggregate, that’s going to increase prices throughout the state,” Rep. Neville said.

He believes the public option would move the state one step closer to a single-payer system that could put some doctors out of business.

Instead, what he would like to see done is alleviating some of the compliance costs in health care and adding more price transparency, so people understand exactly what they are paying for. In fact, he predicts a shortage of health care providers if the public option passes.

Democratic lawmakers are also considering bills like covering the cost of fertility treatment. But with all the things Democrats are hoping to add, there are questions over how to cut costs while adding coverage options.

“It’s very important to get the big things done to reduce costs. You can do a few small things with the savings, like expand coverage and access with some of the savings as long as the bulk of them are passed along to consumers,” Gov. Polis said. “But, if you don’t generate the savings, there’s no savings to go to things like (fertility treatment coverage), so as we look at reducing savings to Colorado and I think a small part of that can go back into improving quality of healthcare, but obviously most of that needs to help the bottom line of consumers.”

Rep. Neville, on the other hand, disagrees with the Governor’s assessment and says this question of how to add more services while cutting overall costs highlights the problem.

“I don’t think there is a balance and that’s a fact that we have to face. The more we add, the higher the cost coverage is going to go and that’s a big reason why the healthcare costs of soared through Obamacare,” he said.

For Rep. Kennedy, though, the cost is not the only thing that matters. He argues that lower costs won’t help if they don’t cover enough. Ultimately, he believes Medicaid for All is the long-term solution to the state and country’s many health care challenges.

As President Trump and Democratic candidates discuss their ideas for health care, in the end, Gov. Polis says the state of Colorado can’t afford to wait for the federal government, so it will be up to lawmakers to decide how the state should combat the rising cost of health care.

Read the full story on TheDenverChannel.com

Major Grant Awarded for Rural Substance Use Treatment Center in Salida

Major Grant Awarded for Rural Substance Use Treatment Center in Salida

Special to Daily Record (February 14, 2020)

“A 13,000 square mile donut hole, smack dab across the middle of our state,” is how Brian Turner, CEO of Solvista Health, describes the gap in appropriate behavioral health services for a massive swath of Colorado.

“Our state ranks in the top 10 nationally for alarming rates of drug and alcohol problems, and yet we are also among the highest for unmet treatment needs,” says Turner.  “We have never had the appropriate higher levels of care available in rural Colorado and people are forced to travel all the way to Denver, Colorado Springs or Grand Junction for help. It’s time that changes.”

Turner announced that Solvista Health was recently awarded a $700,000 grant to help build a comprehensive Regional Assessment Center to treat mental health and substance use needs in the region. The grant is made possible through Colorado House Bill 19-1287, which passed last legislative session at the Colorado State Capitol and targeted treatment in rural and frontier counties. The bill was crafted by the Opioid and Substance Use Disorder Interim Committee of the legislature and had broad bipartisan support, including passing the State Senate by unanimous vote.

“Fighting for rural Colorado is a constant battle here at the Capitol,” said Representative Jim Wilson. “It is great to win one once in a while, particularly one of this magnitude, for my community.”

The award was made by AspenPointe MSO and the Colorado Office of Behavioral Health, who are championing an infusion of resources to tackle the opioid epidemic and substance abuse statewide. The grant will specifically support the development of a withdrawal management and recovery center for substance abuse.

“While Solvista Health and other providers have been working hard to expand a variety of treatment options in the region, this will be the first of its kind providing a higher level of care,” said Turner. “Research shows an undeniable connection between substance use, mental health, and overall health. So, we have teamed up with our local partners and community leaders to design an option that will provide an integrated, comprehensive approach.”

Solvista Health is hoping to raise $6.5 million to realize the full vision of a Regional Assessment Center that will serve Chaffee, Custer, Fremont, Lake, Park, and surrounding counties. The facility will be located on the Heart of the Rockies Regional Medical Center campus in Salida and is an example of the growing collaboration between the two nonprofit organizations. The cooperation doesn’t end there. Planning has been underway largely through the Region 13 Substance Abuse Regional Coalition (SARC) and will continue with increased engagement and feedback from community members.

“We are thrilled to be a partner in this effort alongside so many others,” said Dave Henson, Executive Director for Chaffee County Department of Human Services. “Over 50 public and private organizations signed on in support of this grant proposal across the region. We recognize the power of collaboration and share the goal of making our communities a healthy, thriving place for everyone to live, work and play.”

Construction is expected to begin this summer with a goal of opening by early 2021. Tax-deductible contributions can be made by contacting gwenf@solvistahealth.org.

Read the full story on CanonCityDailyRecord.com

County redistricting bill seeks to avoid appearance of partisan gerrymandering

County redistricting bill seeks to avoid appearance of partisan gerrymandering

By Marianne Goodland (January 27, 2020)

In 2018, voters said “enough” to the potential for partisan gerrymandering at the state and congressional level.

They approved, by better than 2:1 margins, Amendments Y and Z, which set up independent commissions, to be comprised of Republicans, Democrats and unaffiliated voters, who would handle the creation of new congressional (Y) and legislative (Z) district maps after the 2020 Census.

So who draws districts for county commissioners? As it turns out, it’s the commissioners themselves.

Assistant House Majority Leader Chris Kennedy, D-Lakewood, and Rep. Colin Larson, R-Littleton, think copying the system set up for Y and Z is a good idea, and that forms the basis for House Bill 1073, which will be heard in the House State, Veterans and Military Affairs Committee on Thursday.

The bill is drawing strong opposition from some of Colorado’s counties due to concerns it is an unfunded mandate.

And Kennedy admits it is.

The bill as it currently stands would apply only to the state’s largest counties that have five commissioners: Arapahoe, El Paso and Weld. An additional seven — those with populations that exceed 70,000 — could eventually be included, including Boulder, Jefferson and Mesa, if those counties choose to go to five commissioners (they all have three now, but some are considering going to five).

The only large counties that would be exempt: Broomfield and Denver, which are combined city/county but are governed by city councils, not county commissions.

Under the bill, a 7-member independent commission, assisted by nonpartisan staff, would take charge of drawing district maps. The commission would be made up of two Democrats, two Republicans and three unaffiliated voters, and maps would be approved by a simple majority. Kennedy said creating the 12-member commissions set up in Y and Z would be too unwieldy.

The commissions would use criteria in this order:

  • equal population and the Voting Rights Act;
  • communities of interest, political subdivisions and compactness;
  • competitiveness; and
  • no protection for incumbents.

Under the bill, the maps commission would meet in public meetings and the maps would be subject to judicial review.

Another provision of the bill would change current state law to allow for larger precincts, up to 4,000 people each, to address another problem: constant redrawing of precinct maps every time the population surges.

In Jefferson County, that’s meant redrawing precinct maps every two years, which is allowed under the law, for whenever a precinct exceeds 2,000 people.

“It’s the Wild West,” Kennedy recently told Colorado Politics, when asked why he wants to change the system.

“When it comes to the way counties draw their maps, the only rule is equal population and the Voting Rights Act,” he explained. That means the county commissioners are drawing their own districts. In most of the state, it’s not a big deal, he said, since the three commissioners run county-wide but have to live in the districts they represent. Kennedy said there’s no evidence that the system for drawing districts has been abused, so his bill is intended to be proactive.

In the counties with five commissioners, either home rule or one larger than 70,000 people, there are three options for how commissioners are selected. It’s either five who are elected by the voters in the districts in which they live (Arapahoe and El Paso), five where commissioners must live in their districts but are elected county-wide (Adams), or three who live in the districts they represent and two more who are at-large (Weld).

Jefferson County has three commissioners but talk in the county around going to five has been around for years, Kennedy said. But going to five has also raised concerns about gerrymandering.

Kennedy advocates for five commissioners, all required to live and be elected from the district they represent. Given the size of Jefferson County, “you can’t possibly get around” to the whole county, he said. In order to help Jeffco go to five, Kennedy said he wanted to offer them the protection against gerrymandering.

Kennedy believes larger counties will have the staffing, and even some have GIS software that can handle the map-drawing process.

“I believe because we have unanimous support” for state and congressional redistricting (from the General Assembly in 2018), it makes sense to model county redistricting in the same way, he said.

Kennedy and Larson met with stakeholders last week, including representatives from Arapahoe, Boulder, El Paso and Jefferson counties as well as from the County Clerks Association.

“This restores faith in the system” and matches what voters intended with Y and Z, Larson told the group.

Arapahoe County spokesman Luc Hatlestad told Colorado Politics that the county’s commissioners have already voted to oppose the bill, citing chiefly its unfunded mandate as well as concerns about the amount of time such a process would require. They estimated it would cost about $21,000 to pay the retired county judges who would choose the mapping commission members.

In fact, the bill’s fiscal note comes in with a much larger figure: $75,000 to $135,000 per county, but that also includes paying for staff time, computer equipment and software, legal expenses and travel and per diem costs.

Read the full story on ColoradoPolitics.com.

State says hospitals raking in record profits with no end in sight to cost-shifting

State says hospitals raking in record profits with no end in sight to cost-shifting

By Marianne Goodland (January 23, 2020)

The Department of Health Care Policy and Financing released a report Thursday that accused several Front Range “mega” hospital systems of price-gouging Colorado consumers to fatten their own wallets. 

The announcement came one day before a Joint Budget Committee hearing on costs for a public option plan and the state’s 2019 reinsurance program, which are expected to exceed initial estimates by hundreds of millions of dollars.

And at least one lawmaker in Thursday’s news conference used the time to strike back at the hospitals and others who are running a six-figure ad campaign decrying aspects of the public option plan released last November.

The HCPF report, an analysis of Colorado hospital cost-shifting, claimed hospitals, primarily large for-profit and non-profit hospitals in the Front Range, have failed to reduce health care costs, despite state efforts going back more than a decade to reduce the burden of uncompensated care. The report is a final one that follows a draft report from January 2019

Cost-shifting has long been blamed as one reason for the rising cost of health care. It takes place when a hospital shifts uncompensated costs from those who can’t pay for their health care to those with private insurance, which Lt. Gov. Dianne Primavera said Thursday drives up health care premiums for everyone. 

But since the hospital provider fee went into place in 2009, the costs for uninsured health care have dropped by half, according to the report. Hospitals have reduced their losses by $385 million, the report said. 

According to a 2009 letter from the Colorado Hospital Association, “By increasing hospital reimbursement rates and covering the uninsured, we will reduce the rate of rising healthcare costs,” the letter said. 

The exact opposite has happened, according to Primavera and HCPF Executive Director Kim Bimestefer. Hospital per-patient profits are soaring, from $500 per patient in 2009 to three times that amount in 2018. “Despite significant reductions in uncompensated care and significant increases in Medicaid and Medicare” provider payments, “hospitals are persistently increasing the price of care,” according to a fact sheet distributed Thursday.

House Assistant Majority Leader Chris Kennedy, D-Lakewood, at one point held up a mailer that’s part of a six-figure ad campaign by the Partnership for America’s Health Care Future and Colorado’s Health Care Future on the public option proposal. “It makes my blood boil when I received this in my mailbox, saying contact your state legislator to protect the status quo…. This came out of your premium dollars!” he thundered. 

That campaign is backed by the Colorado Hospital Association and health insurers and targets a public option proposal that they claim will shift $1.5 billion in health care costs over a five-year period to Coloradans who have their own health insurance.

Colorado’s Health Care Future also claims the public option will jeopardize access to health care in rural hospitals and critical care facilities and could result in 13 rural hospitals closing.

Read the full story at ColoradoPolitics.com

Find more coverage at DenverPost.com and Colorado Sun.com 


Legislative committee advances five substance abuse bills

Legislative committee advances five substance abuse bills

By Michael Karlik (October 30th, 2019)

Legislators are eyeing new mandates on providers of healthcare, as laid out in five bills forwarded to the General Assembly on Monday.

The Opioid and Other Substance Use Disorders Study Committee formed in 2017 to review substance-use disorders, medication-assisted treatment and gaps in the system of care.

Bill 1 would limit co-payments that acupuncturists and physical or occupational therapists could charge, as well as requiring insurance carriers to cover acupuncture and physical therapy visits in their plans.

The bill also makes permanent the requirement of opioid prescribers to limit new patients to a seven-day supply and to check with the state’s prescription drug monitoring program before refilling a prescription. Pharmacies upload prescriptions for some categories of medications to the program for providers to check before assigning drugs to patients.

Elsewhere in the package of legislation, insurance companies would be required to cover treatment for substance-use disorders.

Legislators also addressed opioid addiction within the criminal justice system, requiring jails and the Department of Corrections to provide treatment to those with an addiction, and to continue their treatment throughout their incarceration.

For the general population of Colorado, Bill 2 would extend legal protections to people who deliver expired opioid-countering drugs like naloxone, as well as requiring insurance to pay for such drugs if administered in a hospital.

Finally, legislators would direct millions of dollars into a range of programs. Individual placement and support programs would receive $2 million per year. Housing assistance would increase five-fold, to $5 million. A tweak to the definition of child abuse would include any instance of a baby being born affected by alcohol or other substance, unless prescribed. 

“There is not one silver bullet to address the opioid epidemic; it’s a complex, enormous problem,” said Sen. Brittany Pettersen, D-Lakewood, said in a statement. “While today we passed the most impactful package we’ve seen yet, I know that our work isn’t done, and we are committed to continuing the work to address this crisis.”

Deaths due to opioids, either by prescription or heroin, numbered 9.8 per 100,000 Coloradans in 2017. That is nearly a 400% increase from 1999. Methamphetamine deaths were a distant second, and all drug deaths combined placed Colorado slightly below the national average of 21.7 overdose deaths per 100,000 people.

Read Full Story at ColoradoPolitics.com

Thinking Outside The Bottle

By Cory Phare (October 30th, 2019)

When the 72nd Colorado General Assembly launches its legislative session Jan. 8, it will have the opportunity to pass an innovative approach to stemming the opioid crisis: making alternative pain-management treatment as affordable as potentially addictive prescriptions.

On Tuesday, the legislature’s bipartisan Opioid and Substance Use Disorders Interim Study Committee advanced to the house a bill that would force insurers to cover opioid alternatives such as acupuncture, physical and occupational therapy and less-addictive drugs.

“In Colorado, we’re really on the cutting edge here,” said Rep. Chris Kennedy (D-Lakewood), the bill’s sponsor. “There are a lot of leads that people have been following on both the state and federal level, but this is taking it one step further. Rather than making it harder to get opioids, we want to make it easier to get alternative treatments for pain management.”

The committee, on which Kennedy serves as co-chair, is also planning to advance four other bills related to prevention, harm reduction, criminal-justice reform and recovery. This is the committee’s third round of attempting a comprehensive approach to address opioid addiction across the state, Kennedy said.

“This package of bills is unlike others we’ve seen before, both locally and nationally,” he said.

Read Full Story at Red.MSUDenver.edu

How copays are contributing to the opioid epidemic in Colorado

How copays are contributing to the opioid epidemic in Colorado

By Anusha Roy (September 30th, 2019)

DENVER — A copay could be the tipping point for someone to become addicted to opioids, depending on a patient’s health insurance, according to Dr. Jonathan Clapp, a pain specialist with Porter Adventist Hospital. He said he’s seen this problem first-hand.

“Say a patient comes into my office, and they have a knee problem that could be addressed with physical therapy. If we could work on strengthening and flexibility, we could fix the problem,” he said. “But because it can sometimes cost $80 out-of-pocket for every physical therapy session, it’s really hard for someone to afford that.”

That’s when doctors get caught between trying to treat pain and not bankrupting their patients, according to Clapp.

“Before we can get other things approved, and wait two or three days in a best-case scenario to get the right medicine, we still had to expose them to these medications, and it may have just ruined their life,” Clapp said. “It’s very hard for us to live with.”

For two years, Clapp reached out to lawmakers to change this, and in the process, he began working with State Rep. Chris Kennedy (D-Lakewood) to work on a potential new law that would change insurance policies in Colorado that are regulated by the state.

Kennedy said one prong of the proposal would work on making non-opioid medication and less-addictive opioid medications more affordable. 

“Oxycodone would probably still be cheaper, but the hope is we are closing the gap,” Kennedy said.

The second prong would include giving the Colorado Division of Insurance the authority to identify other treatments like physical therapy, occupational therapy and acupuncture as good alternatives for pain that might otherwise lead to an opioid prescription. 

The goal, according to Kennedy, is to require insurance companies to make these kinds of treatments more affordable, including limiting out-of-pocket costs and insurance deductibles.

Kennedy said physical therapy is considered an essential health benefit under the Affordable Care Act, so it’s offered in every Colorado insurance plan right now. but the concern is the cost.

Read Full Story at 9News.com

Denver-area hospitals made a record $2 billion in profits in 2018, according to a new report

Denver-area hospitals made a record $2 billion in profits in 2018, according to a new report

By John Ingold (September 13th, 2019)

For 25 years, health care analyst Allan Baumgarten has been studying the hospital market in Colorado, and his new report will show something it never has before: Denver-area hospitals surged past the $2 billion mark in profits in 2018.

The 27 metro-area hospitals Baumgarten includes in his report made just over $2 billion in pre-tax profits in 2018, compared with $1.7 billion in 2017 and $1.3 billion in 2016, according to his calculations.

The latest number represents a 19.3% profit margin for the hospitals, as a percent of net patient revenues, and it’s a full percentage point higher than the 18.1% margins hospitals reported in 2017, according to Baumgarten’s findings. The money the hospitals made from patient care increased 9.2% for Denver-area hospitals in 2018, while the hospitals’ cost of treating those patients increased only 4.1%. Inpatient hospital days — a measurement of patient volume — creeped up only about 1%.

“That’s the kind of spread a Wall Street analyst would find very impressive,” Baumgarten said Thursday at a meeting of the Colorado Business Group on Health, where he presented a first-look at his every-other-year report. The final report will be available in the coming weeks.

“That’s not a lot of growth,” he said of the patient volume figure. “That’s not a lot of increased utilization. That suggests to me that it’s not utilization that’s driving increased revenues, it’s the prices.”

Many hospitals outside of the metro area also turned solid — but not record — profits, according to the report. The 28 largest non-metro hospitals collectively made $769 million in pre-tax profits in 2018, down slightly from the $781 million they made in 2017. Their margins also fell, to 13.2% from 14.3%.

In a statement, a spokeswoman for the Colorado Hospital Association said the association had identified “numerous significant errors” in an earlier version of Baumgarten’s data and had concerns about the accuracy of his figures. The spokeswoman, Julie Lonborg, said the association has not received a final report from Baumgarten and could not comment on specifics.

But she confirmed that hospitals saw increased profit overall in 2018.

“This is partially a function of Colorado’s strong economy and a focus on controlling costs as we work on improved affordability,” Lonborg wrote in an email.

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