New legislation aims to tackle opioid crisis in Colorado

New legislation aims to tackle opioid crisis in Colorado

By Faith Miller (May 1, 2019)

In 2017, a group of Colorado legislators first convened the Opioid and Other Substance Use Disorders Interim Study Committee — or “opioid summer camp,” as Dr. Robert Valuck calls it.

For the last two summers while the Assembly was on recess, the lawmakers studied the opioid crisis and worked with experts like Valuck to develop legislation.

“None of these people voted straight party-line stuff,” says Valuck, who directs the Colorado Consortium for Prescription Drug Abuse Prevention and spoke at a recent conference on opioids. “It was really like, ‘Look, is this a sensible thing to be doing or not? … And is it going to really affect Coloradans in a positive way? Then let’s do it. If not, then don’t.’”

Below, we highlight several bills addressing the opioid crisis, all of which (excepting Senate Bill 013) came out of that “opioid summer camp.”

House Bill 1009

This bill, titled “Substance Use Disorders Recovery,” would expand the state’s housing voucher program to include people with substance use disorders. It would also require that recovery facilities have a state license, and create an “opioid crisis recovery fund” for settlement money the state receives from suing pill manufacturers.

Sponsored by Reps. Chris Kennedy, D-Lakewood, and Jonathan Singer, D-Longmont, the bill passed the House on April 27 and headed to the Senate, where Sens. Kevin Priola, R-Henderson, and Brittany Pettersen, D-Lakewood, are sponsors.

House Bill 1287

“Treatment for Opioids and Substance Use Disorders” would direct the Department of Human Services to implement an online behavioral health capacity tracking system, which would show available spots at mental health facilities and substance use treatment programs across the state. It would also create a grant program to fund substance use treatment programs in underserved areas of the state.

The bill passed the House, and was approved by the Senate Judiciary Committee on April 29. It’s sponsored by Reps. Daneya Esgar, D-Pueblo, and James Wilson, R-Fremont County, along with Sens. Priola and Pettersen.

Senate Bill 008

“Substance Use Disorder Treatment in Criminal Justice System,” also sponsored by Priola and Pettersen, would allow people who had been receiving medication-assisted substance use treatment in a local jail to continue that treatment after being transferred to the state Department of Corrections. It would also create a simplified process for sealing certain drug felonies, and jump-start additional responses to addressing substance use in the criminal justice system.

Reps. Kennedy and Singer are House sponsors. The bill passed the Senate and the House, but the Senate must approve amendments. 

Senate Bill 013

“Medical Marijuana Condition Opioids Prescribed For” would add any condition for which doctors would normally prescribe an opioid to the list of “disabling conditions” that qualify for medical marijuana. Minors would need the approval of two doctors, and couldn’t smoke their prescription on school grounds.

The bill passed the Senate on Feb. 12, and the House on April 29. Sponsors include Sens. Vicki Marble, R-Fort Collins, and Joann Ginal, D-Fort Collins, along with Reps. Edie Hooton, D-Boulder, and Kim Ransom, R-Littleton.

Senate Bill 227

“Harm Reduction Substance Use Disorders” would explicitly authorize schools to carry naloxone, a drug that can reverse opioid overdoses. It would also allow hospitals to serve as syringe exchange sites, expand the household medication take-back program, and create mobile response teams to provide medication-assisted substance use treatment in jails.

The bill was sponsored by Pettersen and Sen. Julie Gonzales, D-Denver. In the House, it was sponsored by Kennedy, along with Rep. Leslie Herod, D-Denver. The bill passed and was sent to the governor.

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Colorado governor’s office unveils roadmap for saving Coloradans money on health care

Colorado governor’s office unveils roadmap for saving Coloradans money on health care

By Meghan Lopez & Blair Miller (April 4th, 2019)

DENVER – Colorado’s governor, lieutenant governor and a host of lawmakers and health care stakeholders on Thursday detailed the roadmap they plan to follow in order to try and reduce the cost of health care services across the state.

“Too many Coloradans have to worry about caring for themselves or a loved one, as well as whether or not they can pay the bills,” Lt. Gov. Dianne Primavera said. “Our roadmap puts us on a path toward lower health care costs for all Coloradans.”

Primavera is leading the Office of Saving People Money on Health Care. She and Gov. Jared Polis laid out a series of bills and other initiatives – both short- and long-term – they say will help keep costs down for Coloradans.

They praised the steps already taken in the state to reduce uninsured rates from nearly 16% in 2013 to 6.5% this year. But said that the falling uninsured rates haven’t led to lower costs, particularly in mountain counties and other rural parts of the state.

Polis praised the legislature’s passage of HB19-1001, the hospital price transparency bill that aims to study the cost of care in Colorado. He also urged lawmakers from both parties to back some of the measures he is supporting this session, including the establishment of a reinsurance pool, more regulations of certain emergency rooms, and a Canadian prescription drug importation program, among others.

Aside from the short-term goals, the governor’s office said some of its long-term goals including launching a state-backed health insurance option and expanding the rural health care workforce and behavioral health system across the state. Polis said the Behavioral Health Task Force would be established this month and would have a strategic plan statewide by June 2020.

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OPINION | While D.C. dithers over health care, Colorado offers common-sense solutions

By Chris Kennedy (March 26, 2019)

Years ago folks right here in Colorado and across the country found common ground in the fact that they were paying too much for too little health care coverage — if they were able to qualify for coverage at all. Momentum was building and change was coming, manifesting in the Affordable Care Act, which was signed into law nine years ago this month to bring the nation’s health care system in line with needs of consumers across the country. 

The ACA was arguably one of the most influential, significant and far-reaching pieces of health care legislation of the 21st century. The bill was by no means a cure-all. But in Colorado we have been working to continue improving the state’s health care system in the spirit of reducing costs and increasing access for all.

Gov. Jared Polis recently created the Office for Saving People Money on Health Care by executive order. We are working on bills to create an affordable state health care option, stop surprise billing, prevent the sale of junk insurance plans and more. We are proud to say that in the 2019 legislative session our state is working to provide some welcome hope and opportunity for advocates for affordable, high-quality health care like myself. 

For many of the folks I speak to in my district, it’s that affordable piece that has been hard to come by. That’s why I sponsored House Bill 1001, along with Sens. Dominick Moreno and Bob Rankin, which is now heading for the governor’s desk to be signed into law. 

This bipartisan bill requires hospitals to disclose the actual costs of many of their expenditures to provide transparency and help lower costs for consumers. Hospital care currently accounts for about 40 percent of the total health care costs in the state.These annual financial reports will be compiled by the Department of Health Care Policy and Financing, along with the Colorado Healthcare Affordability and Sustainability Enterprise Boards.

After a review process, these reports would be publicly available to help patients and policy makers have a better understanding of where money is going. This type of accountability and financial insight will be particularly helpful in determining how to reduce costs in rural communities where health care costs are skyrocketing. It will also provide information around the rates hospitals are charging patients with insurance versus the uninsured. Finally, employers and insurance carriers can also use this data to choose the most efficient hospitals to contract with and pass the savings along to employees and individuals.

We are also hopeful that requiring hospitals to reveal additional background on their staffing and operating overhead will increase competition in the industry and help consumers make more informed choices. Many other industries already have similar requirements that have driven innovative solutions to increase efficiency and drive down costs. 

At a time when politicians in Washington D.C., have been working tirelessly to roll back critical health care provisions like the ACA, I’m very proud to be a lawmaker in a state like Colorado where we are working to make health care more accessible and transparent — not less. All that’s needed is lawmakers to come to the table to find common-sense solutions that improve the health care system for all Coloradans — and all Americans.

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Colorado Senate tentatively OKs hospital transparency bill

By the Associated Press (March 13th, 2019)

Colorado’s Senate has tentatively endorsed legislation requiring hospitals to disclose many of their expenditures to help lower health care costs.

The Senate voted Wednesday. Another vote will send the bill to the House, which has approved it, to consider Senate amendments.

Sponsors include Democratic Rep. Chris Kennedy and Sen. Dominick Moreno and Republican Sen. Bob Rankin.

It would require hospitals to provide financial reports to the state, which would compile annual reports on uncompensated care costs.

Kennedy says hospital care accounts for nearly 40 percent of total health care costs in Colorado.

He argues the legislation would, in part, allow policymakers to better understand why rural health insurance premiums, which reflect cost, are some of the highest in the nation.

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Halfway Point of Session

Halfway Point of Session

By Colorado House Democrats (March 8th, 2019)

We are at the halfway point of session and the Colorado House Democrats have been prioritizing lowering health care costs for all Coloradans. Take a look at the bills Representative Daneya Esgar, HD 46, Representative Chris Kennedy, Representative Dylan Roberts, and Representative Julie McCluskie have introduced to help with that mission.

Posted by Colorado House Democrats on Friday, March 8, 2019

We are at the halfway point of session and the Colorado House Democrats have been prioritizing lowering health care costs for all Coloradans. Take a look at the bills Representative Daneya Esgar, HD 46Representative Chris KennedyRepresentative Dylan Roberts, and Representative Julie McCluskie have introduced to help with that mission.

Bill At State Legislature Would Cut Premiums Paid To Hospitals & Doctors

Bill At State Legislature Would Cut Premiums Paid To Hospitals & Doctors

By Shaun Boyd (February 27th, 2019)

DENVER (CBS4) – It may be the boldest move yet to lower our health care costs in Colorado. Some state lawmakers want to limit how much doctors and hospitals are reimbursed on the individual market.

They say it will lower premiums by 15-30 percent as early as next year. For Brin Goldberg, who lives on the Western Slope, it would be life changing.

“I was in the ER for about an hour. I received an IV of fluids, some pain reliever and a blood test and was charged $8,000.”

Health care costs in Colorado’s mountain communities are among the highest in the country. Tamara Drangstveit, a health care advocate at the Family and Intercultural Resource Center in Breckenridge, says Coloradans in Summit County spend on average 30-40 percent of their income on health care.

“When I tell you that health insurance in Summit County is a crisis, I’m not using hyperbole.”

It’s why Summit County Rep. Julie McCluskie and Mesa County Rep. Janice Rich have teamed up on bill that could dramatically lower the cost of health care on the Western Slope. It’s a top priority for Gov. Jared Polis, who attended a press conference about the bill.

“It’s really a win-win because, guess what, when prices come down, families can afford insurance.” He says fewer uninsured Coloradans lowers health care costs for everyone.

The bill is aimed at around 5 percent of people with chronic conditions who make up about 50 percent of health care costs. When their claims reach a certain amount, insurance companies would pay providers and hospitals less money for their care.

The money insurers save would then be passed onto everyone in lower premiums. Katherine Mulready with the Colorado Hospital Association says some hospitals will be forced to cut services.

“We don’t believe that the government should tell private insurance companies how much to pay hospitals, doctors, nurses and other medical providers.”

But McCluskie says the health care system doesn’t operate under free market principals now. Medicare and Medicaid reimbursement rates are set by the government. She also says bill makes exceptions for struggling hospitals, primary care and mental health providers.

“We are working aggressively to get this passed and into place so that by January of 2020 our working families will experience a reduction in health insurance premiums and we can take the pressure off what so many Coloradans are facing.”

Coloradans like Brin Goldberg, who begged lawmakers to pass the bill, said, “It would mean so much for me and other community members to be able to rest assured that we don’t have to continue to ask ourselves, how much is our mental and physical health worth.”

The bill only applies to people who are insured on the individual market – about 30 percent of Coloradans. The Colorado Medical Society has not yet taken a position on the bill. If it passes, the state would need a waiver from the federal government before implementing it.

Read Full Story at CBS Denver

Cigarettes all over again? Colorado has the highest youth vaping rate in the country.

Cigarettes all over again? Colorado has the highest youth vaping rate in the country.

By Jennifer Brown (Feb 27th, 2019)

Jim Lynch mastered the fake yawn, stretching out his arm and bringing it to his mouth during class, then pausing to pull a drag from the Juul tucked up the sleeve of his sweatshirt. The high school junior held the vapor in his mouth for 10 seconds, waiting for it to evaporate before he took another breath.

It’s called “ghosting,” and the result is no vapor puff. No scent of mint or mango, his go-to Juul flavors.  

All was cool until the day Lynch, a student at Wheat Ridge High School, got caught by his choir teacher, who returned to the room sooner than expected and in time to see Lynch exhale a cloud. The otherwise well-behaved kid got an afternoon of detention. 

Colorado has the highest rate of vaping teenagers in the nation at 27 percent, double the national average, according to the Healthy Kids Colorado Survey. Local communities — particularly in mountain and rural towns, where rates are the worst — are desperate to take matters into their own hands. 

Legislation nearly to the governor’s desk could give them far broader powers, including the authority to raise the legal age for sale of nicotine products to 21 and require stores to purchase licenses in order to sell cigarettes or vape products.

“If an adult wants to smoke, that is their business,” said Rick Ritter, executive director of the Otero County Health Department in Southern Colorado. “But it is illegal for kids to smoke. They don’t make the smartest decisions. They think what they do now will not affect them later in life. My message is, it will.”

After Lynch got caught by his teacher, the 17-year-old knew it was time to kick the habit he’d started in eighth grade, when a friend offered him a smoke as they walked home from school. He was buying Juul pods online for about $10 each, going through one pod about every three days. 

“My thoughts were, ‘When is the next time I can step outside and smoke or go to the bathroom to Juul,’ ” said Lynch, who quit two months ago. “I stopped focusing on what I wanted to do after school.” 

Each pod contains as much nicotine as a pack of cigarettes. But when Lynch’s dad found out he was vaping, the teen told him it was just flavored smoke with no nicotine — and his dad believed him. Lynch told his father he only did it to look cool, and that part was no lie.

“It’s 100 percent one of the things to do to be cool and fit in,” he said.

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Cities could impose tax on cigarettes under bill

By Charles Ashby (February 8th, 2019)

DENVER — Local governments would be able to assess their own taxes on tobacco products without losing what revenues they already receive from the state under a bill working its way through the Colorado Legislature.

Under current law, local governments that assess their own fees, licenses or taxes on the sale of any tobacco product forgo their portion of cigarette tax revenues collected by the state, 27 percent of which are distributed to municipalities and counties based on sales in their jurisdictions.

House Bill 1033, which cleared the Colorado House and now awaits debate in the Senate, would change that.

But the two sponsors of the bill didn’t introduce it so local government can find a new revenue source. They introduced it to allow counties and statutory cities to ban the sale of e-cigarettes to minors, as home-rule municipalities are already allowed to do.

Local governments that want to keep minors from the so-called practice of vaping would jeopardize their tobacco tax revenues, so it’s become a disincentive to ban the practice, said Lakewood Democratic Reps. Kerry Tipper and Chris Kennedy, who jointly introduced the bill.

“We’re trying to give parity amongst all local governments,” Tipper said. “For example, we had a young lady, I think she was 16 or 17 years old, who testified from Eagle County that her friends and many of the kids she knows in school as young as 11 get access to these e-cigarettes. It’s unbelievable.”

That measure isn’t the only one related to nicotine that the Legislature is considering. House Bill 1076, which has not yet been heard in committee, would add electronic smoking devices that contain nicotine to the Colorado Clean Indoor Act, which banned smoking in most public places.

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Colorado hospital transparency bill advances when hospitals drop years-long opposition, agree to support it

Colorado hospital transparency bill advances when hospitals drop years-long opposition, agree to support it

By Ed Sealover (February 1st, 2019)

A bill to require hospitals to open up their financials for state and public inspection passed through the Colorado House of Representative on Thursday after the trade group for state hospitals agreed to support it — the second major instance this week of a business group dropping years-long opposition to a proposal that seems almost definite to pass through the newly Democratic-controlled Legislature.

The Colorado Hospital Association gave its support to House Bill 1001 after sponsoring Rep. Chris Kennedy, D-Lakewood, added five amendments during debate on the House floor this week to allow institutions to shield proprietary information on acquisition prices for facilities and physician practices and to limit their mandate to turn over per-hospital financial audits when the audit is done on a parent company as a whole. While the changes got CHA on board with the bill, it did little to convince skeptical Republicans who believe the measure’s increased regulations will lead to increased costs and a continuing lack of consumer transparency; Rep. Matt Soper of Delta was the only GOP representative who joined Democrats in voting to move the bill on to the Senate on Thursday.

Still, the agreement between the CHA and Kennedy to get hospitals behind a bill that requires them to open for public viewing everything from their surgical revenues to their overall costs of building new facilities to the amount of unreimbursed care they provided — all so that consumers, employers and state regulators can examine ways to pressure the industry to bring down costs — was a major step in the debate over health costs.

“This bill demonstrates hospitals’ commitment to finding solutions to Colorado’s health-care affordability crisis, and it’s an important first step — but certainly not the last one — to expand transparency into how the health-care market works,” CHA senior vice president Katherine Mulready said in a statement after the amendments were added to the bill on Tuesday.

Newly inaugurated Gov. Jared Polis has made health-care affordability his top priority during his first month in office, so much so that he issued an executive order last week creating an Office of Saving People Money on Health Care, listing passage of the hospital transparency act as one of its primary aims.

While health-care costs are rising across the board, many business leaders in particular have begun to focus on hospitals as a particular sore spot. A Colorado Business Group on Health study that Denver Business Journal detailed last year showed that privately insured patients are paying 66 percent more on average than Medicaid and Medicare patients at facilities throughout the state and that some common procedures cost as much as seven times the rate of Medicare reimbursement as they are billed to private payers.

House Minority Leader Patrick Neville, R-Castle Rock, criticized HB 1001 because it allows state regulators to see aspects of hospitals’ finances to which they’ve never had access before, but it does very little to increase transparency to consumers of why the costs on their bills can be so high.

Kennedy said that because only a limited number of consumers price-shop when getting health care — and then, it’s largely on elective procedures — he believes that allowing state-government leaders to understand hospitals’ pricing and spending can help them to craft policies that can bring down costs for all residents.

The CHA’s backing of HB 1001 came the same week that major business groups such as the Colorado Chamber of Commerce and National Federation of Independent Business dropped what had been three years of opposition to a proposal to prohibit employers from asking on application forms whether job seekers have criminal records. The groups went neutral on the “ban the box” bill after getting several concessions from its authors, including a provision that disputes involving criminal-record inquiries must go to a state administrative board rather than be adjudicated in court.

Read Full Story at Denver Business Journal

Colorado House sends hospital transparency bill to Senate

Colorado House sends hospital transparency bill to Senate

By the Associated Press (January 31st, 2019)

Colorado’s House has passed legislation to require hospitals to provide annual reports on their spending and their uncompensated patient care costs.

Democratic Rep. Chris Kennedy’s bill is designed to allow state officials to study why privately insured individuals are paying more for care while the state and federal governments are spending hundreds of millions of dollars to support hospitals, especially in rural areas.

Kennedy says hospital care comprises about 40 percent of total health care costs in Colorado. His bill directs the Department of Health Care Policy and Financing to compile the annual transparency report.

John Batholomew, the department’s chief financial officer, testified at a bill hearing that in 2017, Colorado’s hospital prices were 23 percent above the national average.

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