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Mar 19, 2020

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Advocates, federal and state officials take action during the coronavirus outbreak

by | Mar 19, 2020

CCLP Statement, Family Economic Security, Health

The coronavirus outbreak is an existential threat to the health and financial security of all Americans, but for people who were facing poverty before the pandemic proliferated, the threat is even more urgent.

That’s why Colorado Center on Law and Policy and our advocacy partners are urging officials on a statewide and federal government level to take immediate action to ensure that COVID-19 does not plunge those already facing health inequities and social and economic barriers further into the depths of poverty and hopelessness.

Earlier this week, the Colorado Health Policy Coalition — consisting of Colorado-based health care providers, advocates, nonprofits and community organizations — sent letters to Colorado’s Congressional delegation, Colorado Gov. Jared Polis, Lt. Gov. Dianne Primavera and all members of the Colorado General Assembly. The Coalition is co-chaired by CCLP’s Allison Neswood. Fortunately, many of these and other recommended interventions have already been approved by officials. More will hopefully be implemented shortly after this blog is posted.

CCLP’s Public Benefits Attorney, Sara Lipowitz, joined partners with Hunger Free Colorado, Colorado Coalition for the Homeless and the Colorado Blueprint to End Hunger in sending Gov. Polis several recommendations to strengthen safety net programs that provide food, shelter and security during this crisis.

CCLP’s Jack Regenbogen joined more than two dozen organizational partners in urging Colorado Gov. Jared Polis to declare a 90-day moratorium on evictions and foreclosures. Regenbogen also recently weighed in on Denver Mayor Michael Hancock’s moratorium on eviction enforcement.

Other CCLP directors are also working deligently with partners and state legislators on policies to secure the health and well-being of families facing devastation.

Here are just some of the actions that we are recommending in our Focus Areas of Food, Health, Housing and Income:

Food – We joined the Colorado Health Policy Coalition in asking Colorado’s Congressional Delegation to support an appropriation of $500 million to the Special Supplemental Nutrition Program for Women Infants and Children to provide nutritious food for expectant women or mothers with young children who lose their jobs or are laid off due to the ongoing emergency. The coalition has also requested $400 million to the Emergency Food Assistance Program to help local food banks meet increased demand during the emergency. They are also asking the government to suspend work requirements for the Supplemental Nutrition Assistance Program (or SNAP) since many people will likely be unemployed in the weeks and months to come.

Among the recommendations to the governor, we joined our partners in recommending fully staffed phone services for Supplemental Nutrition Assistance Programs (or SNAP) in every county during business hours; implementing a statewide intake hotline for all benefits programs; and encouraging SNAP applicants to file online and over the telephone, temporarily waiving in-person signatures and other requirements.

Health – With an estimated 425,200 Coloradans currently without any health coverage, the delegation asked Colorado’s Congressional delegation to pass legislation that lets states extend Medicaid eligibility to uninsured people for the purposes of COVID-19 diagnostic testing and treatment.
On a statewide level, the Coalition asked the General Assembly to promote enrollment of Medicaid eligible individuals in communications about COVID-19 and through a combination of a broad mass-media outreach campaign and targeted local efforts in collaboration with Coalition members. The coalition also recommends expanding the Colorado Indigent Care Program to the fullest extent possible under applicable federal guideline to ensure that more Coloradans will have access to emergency COVID-19 testing, treatment and care.

The coalition also urges the administration to halt pending dis-enrollments in Medicaid and CHP+ as much as possible and advocate with federal partners to expedite access to coverage and health services for affected individuals. Currently, an estimated 30,000 enrollees are slated to lose their eligibility at the end of the month – including some in high-risk categories or nursing home settings.

Housing – With roughly 30,000 especially vulnerable people experiencing homelessness in Colorado, we’ve joined our partners in asking the governor to increase the number of motel vouchers offered as an alternative to community shelters for those displaying signs of illness.

Recently, CCLP’s Jack Regenbogen joined our partners in urging Gov. Polis to use his authority to take broader action to protect individuals facing eviction during this time of crisis. Additionally, financial assistance will be needed to prevent a massive flood of evictions and foreclosures once the courts resume operations.

Income – Noting that the Coronavirus Response Act recently approved by the House of Representatives only covers about 20 percent of the U.S. population, the Colorado Health Policy Coalition urged the Colorado Delegation to support emergency paid leave provisions to protect all workers. Coalition partners also expressed disappointment that employers with 500 employees or more were exempted from providing paid leave and that Congress was not able to develop solutions to help small employers to ensure their workers don’t go without an income. They recommended provisions in the final relief package that would require all employers to allow employees to accrue seven days of paid sick leave and to make an additional 14 days available in the event of a public health emergency – including the current coronavirus.

The Coalition also asked Gov. Polis to waive in-person case management and recertification requirements for Coloradans who receive Basic Cash Assistance from Temporary Assistance for Needy Families, a support program for families typically earning less than $6,000 a year. They’ve also recommended encouraging applicants to file online or through the telephone and granting BCA benefits beyond 60 months – waiving the state requirement that recipients engage in a meaningful effort to find work since the coronavirus may well hamper such efforts in the short term.

Furthermore, the Coalition asked to support unemployment insurance provisions that provide $1 billion in 2020 for emergency grants for states to process unemployment benefits, ensure that displaced workers can apply for benefits online or by the phone.

There’s been talk that the Administration will send checks of $1,000 or more to every American (essentially, a temporary universal basic income). But money alone will not stabilize the situation or ensure anyone’s health and financial security. Quick and decisive action is needed on several fronts. As anyone who has followed this crisis knows, developments are moving quickly. While many of these interventions are already law, we hope that others will become reality as well.

We’ll continue to keep you posted through our Facebook and Twitter feeds. Also visit our website to sign up for CCLP emails for the latest on how you can help minimize the effects of the coronavirus outbreak for Coloradans experiencing poverty.

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HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

Health First Colorado is the name given to Colorado’s Medicaid program. Medicaid provides public, low-cost health insurance to qualifying adults and children. It is an entitlement program funded by the federal, state, and county governments and is administered by counties in Colorado. Those who are required to pay must pay a small co-pay when receiving certain health care services.

State Department: Department of Health Care Policy and Financing

Eligibility: Most adults 18 to 64 are eligible for Medicaid in Colorado if their household income is at or below 133% of the federal poverty limit (FPL). Pregnant women are eligible with incomes of up to 195% FPL, while children under 18 may be eligible if the live in a household with income at or below 142% FPL. Some adults over 65 may also be eligible for Medicaid.

Program Benefits: Through Medicaid, low-income Coloradans are eligible for a range of health care services at little to not cost. Services provided include doctors visits, prescription drugs, mental health services, and dental care. Co-pays for certain individuals may be needed for certain services.

Program Funding and Access: Colorado funds our Medicaid program through state and federal dollars. Medicaid is an entitlement program, which means that all who are eligible for Medicaid can access the program, regardless of the funding level in a given year. This does not mean that it is always easy to access Medicaid, even when eligible. And since the program is administered by counties, funding levels for county staff and other administrative roles can make it easier or harder for Coloradans to access the program. On top of this, not all medical providers accept Medicaid which limits the ability of Coloradans to seek health services even if enrolled, such as if the nearest provider is a 2+ hour drive away.

Note: This data is from before the pandemic and does not reflect changes in enrollment rules during the COVID-19 pandemic and public health emergency.

Statewide Program Access 2015-19: Over the study period of this report, an average of 89.0% of the population at or below 133% of FPL (i.e., the population who is likely to be eligible for Medicaid) were enrolled in Medicaid in Colorado.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

The Supplemental Nutrition Assistance Program or SNAP helps low-income Coloradans purchase food by providing individuals and families with a monthly cash benefit that can be used to buy certain foods. SNAP is an entitlement program that is funded by the federal and state governments and administered by counties in Colorado.

State Department: Department of Human Services

Eligibility: Currently, Coloradans qualify for SNAP if they have incomes below 200% FPL, are unemployed or work part-time or receive other forms of assistance such as TANF, among other eligibility criteria. Income eligibility for SNAP was different during the study period of this report than today—it was 130% FPL back in 2019 for example. The US Department of Agriculture uses the population at or below 125% FPL when calculating the Program Access Index (or PAI) for SNAP. We follow this practice in our analysis despite Colorado currently having a higher income eligibility threshold.

Program Benefits: SNAP participants receive a monthly SNAP benefit that is determined by the number of people in their household and their income. Benefit amounts decrease as income increases, helping households avoid a sudden loss of SNAP when their incomes increase, even by a minor amount. Benefits are provided to an Electronic Benefit Transfer (EBT) card that can be used to purchase eligible food items, such as fruits and vegetables; meat, poultry, and fish; dairy products; and breads and cereals. Other items, such as foods that are hot at their point of sale, are not allowable purchases under current SNAP rules.

Program Funding and Access: SNAP, like Medicaid, is a federal entitlement program. This means that Colorado must serve any Coloradan who is eligible for the program. As such, funding should not be a limit to how many Coloradans can be served by the program. However, funding for administration of SNAP at the state and county level can limit the ability of county human service departments to enroll those who are eligible. Other program rules and administrative barriers can make it difficult for Coloradans to receive the benefits they are legally entitled to receive.

Statewide Program Access 2015-19: Over the study period of this report, an average of 61.1% of the population at or below 125% of FPL (i.e., the population who is likely to be eligible for SNAP) were enrolled.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

The Special Supplemental Nutrition Program for Women, Infants, and Children, also know as WIC, provides healthcare and nutritional support to low-income Coloradans who are pregnant, recently pregnant, breastfeeding, and to children under 5 who are nutritionally at risk based on a nutrition assessment.

State Department: Department of Public Health and Environment

Eligibility: To participate in WIC you must be pregnant, pregnant in the last six months, breastfeeding a baby under 1 year of age, or a child under the age of 5. Coloradans do not need to be U.S. citizens to be eligible for WIC. In terms of income, households cannot have incomes that exceed 185% FPL. Families who are enrolled in SNAP, TANF, Food Distribution Program on Indian Reservations (FDPIR), or Medicaid are automatically eligible for WIC. Regardless of gender, any parents, foster parents, or caregivers are able to apply for and use WIC services for eligible children.

Program Benefits: WIC provides a range of services to young children and their parents. These include funds to purchase healthy, fresh foods; breastfeeding support; personalized nutrition education and shopping tips; and referrals to health care and other services participants may be eligible for.

Program Funding and Access: WIC is funded by the US Department of Agriculture. The state uses these federal funds to contract with local providers, known as WIC Clinics. In most cases, these are county public health agencies, but that is not the case in all Colorado counties. Some WIC Clinics cover multiple counties, while others are served by multiple clinics. Private non-profit providers are also eligible to be selected as a WIC Clinic.

Statewide Program Access 2015-17: Between 2015 and 2017, an average of 52.2% of the population eligible for WIC were enrolled in the program in Colorado.

Financial Security:
Colorado Works

Colorado Works is the name given to Colorado’s program for Temporary Assistance to Needy Families or TANF. It is an employment program that supports families with dependent children on their path to self-sufficiency. Participants can receive cash assistance, schooling, workforce development and skills training depending on the services available in their county.

State Department: Department of Human Services

Eligibility: In general, Coloradans are eligible to enroll in TANF if they are a resident of Colorado, have one or more children under the age of 18 or pregnant, and have very low or no income. For example, to be eligible to receive a basic cash assistance grant through TANF, a single-parent of one child could not earn more than $331 per month, with some exclusions—and would only receive $440 per month (as of 2022). That said, there are other services provided by counties through TANF that those with incomes as high as $75,000 may be eligible for. In addition to these, participants in TANF are required to work or be pursuing an eligible “work activity” or work-related activity. Any eligible individual can only receive assistance if they have not previously been enrolled in TANF for a cumulative amount of time of more than 60 months—this is a lifetime limit that does not reset. Counties may have additional requirements and offer benefits that are not available in other counties in Colorado.

Program Benefits:  While the exact benefits that one is eligible for under TANF can vary, all qualified participants are eligible to receive a monthly cash payment, call basic cash assistance. Other than cash assistance, counties are have a lot of choice in how to use their TANF funding; generally a use of TANF funds is appropriate so long as it advances one or more of the four purposes of the program: (1) provide assistance to needy families so that children can be cared for in their own homes or in the homes of their relatives; (2) end the dependence of needy families on government benefits by promoting job preparation, work, and marriage; (3) prevent and reduce the incidence of out-of-wedlock pregnancies; and (4) encourage the formation and maintenance of two-parent families.

It is important to note that those eligible for TANF are also eligible for many of the other programs we’ve included in this report, such as SNAP, Medicaid, and CCCAP.

Program Funding and Access: Colorado funds its TANF program through funds received from the federal government through the Temporary Assistance for Needy Families block grant. Most of the federal funds are allocated by the state to counties, which are required to provide a 20% match of state funding. Federal and state rules allow the state and counties to retain a portion of unspent funds in a TANF reserve.

Statewide Program Access 2015-19: Over the study period of this report, an average of 50.7% of the population at or below 100% of FPL (i.e., the population who is likely to be eligible for TANF) were enrolled in TANF in Colorado.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

The Colorado Child Care Assistance Program provides child care assistance to low-income families and caregivers living in Colorado in the form of reduced payments for child care. It is a program funded by the federal, state, and county governments and is administered by counties in Colorado. The share owed by parents/caregivers is determined on a sliding scale based on the family’s income.

State Department: Department of Early Childhood Education

Eligibility: Counties set eligibility for families separately, but must serve families with incomes at or below 185% of the Federal Poverty Limit. Families accepted to the program are no longer eligible once their income exceeds 85% of the state median income. Parents or caregivers must be employed, searching for work, or engaged in another approved activity to be eligible for CCCAP. Parents and caregivers enrolled in Colorado Works (Temporary Assistance to Needy Families or TANF) or in the child welfare system are also eligible to participate in CCCAP. Generally, CCCAP serves families with children under 13, although children as old as 19 may be eligible under certain circumstances.

Program Benefits: If a family is eligible for CCCAP and has income, they may likely have to pay a portion of their child’s or children’s child care costs each month. The amount that families owe is based on their gross income, number of household members, and the number of children in child care in the household. As such, households tend not to experience a benefit cliff with CCCAP when they see their incomes increase

Program Funding and Access: Colorado funds the CCCAP program using federal dollars it receives from the Child Care and Development Block Grant program. The state allocates federal and state funds to counties using a formula that takes into account factors like current caseloads and the number of eligible residents. Assistance is available until the county’s funds are spent, so the number of families that can be served is often a function of how much funding is available and the income and composition of the household that applies. It is not uncommon for counties to overspend or underspend their allocations of funds. The state reallocates unspent funds from counties who underspent to those who overspent. While underspending could indicate a problem with the way a county administers its CCCAP program, it could just as likely be a sign that there are few providers in the county who participate in CCCAP—or a lack of providers generally.

Statewide Program Access 2015-19: Over the study period of this report, an average of 10.8% of the population at or below 165% of FPL and younger than age 13 (i.e., the population who is likely to be eligible for CCCAP) were enrolled in CCCAP.

Housing:
HUD rental assistance programs

The US Department of Housing and Urban Development (HUD) has three housing assistance programs that we look at together: Housing Choice Vouchers (Section 8), Project-based Section 8, and Public Housing. In Colorado, these programs provided assistance to over 90% of the households who received federal housing assistance from all HUD programs. Through federally funded, local or regional public housing agencies (PHAs) are the agencies that administer these programs, through not all are available in all counties. These are not the only programs available in Colorado that assist households afford the cost of housing, such as units funded through federal and state tax credit programs.

State Department: Department of Local Affairs

Eligibility: Generally, households with incomes under 50% of the area median income (AMI) of the county they live in are eligible for these rental assistance programs, although PHAs have discretion to select households with incomes at higher percentages of AMI. That said, HUD requires that 75% of new vouchers issued through the Housing Choice Voucher/Section 8 program in a given year are targeted to households with incomes at or below 30% of AMI. PHAs are also able to create criteria that give priority to certain types of households who are on waiting lists for these programs.

Program Benefits: These rental assistance programs help households afford the cost of housing by reducing their housing costs to around 30% of their household income. In the case of the Housing Choice Voucher program, the PHA pays the voucher holder’s landlord the remaining portion of the rent.

Program Funding and Access: Funding and access are both challenges for these rental assistance programs. In addition to limitations on the number of public housing units or housing vouchers a PHA can manage or issue, lack of funding compared to the need constrains the ability of PHAs to assist low-income households. In 2020, Coloradans were on waitlists for Housing Choice Vouchers for an average of 17 months. Waitlists also exist for the other rental assistance programs.

Statewide Program Access 2015-19: Over the study period of this report, an average of 21.1% of renter households with incomes at or below 50% AMI (i.e., the population who is likely to be eligible for HUD rental assistance programs) were living in subsidized housing.