Apr 17, 2023

As a CCLP policy fellow, Milena helps organize and coordinate public policy development, assisting in coalition-building, community outreach, legislation, litigation, and administrative advocacy.

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Behavioral health bill would provide services to Colorado youth

by | Apr 17, 2023

On Friday, March 23, 2023, Milena Castaneda, one of CCLP’s Policy Fellows, provided testimony to the Senate Health & Human Services Committee for Senate Bill 23-174, Access to Certain Behavioral Health Services. CCLP is in support of SB23-174.


Madam Chair and members of the Senate, thank you for the opportunity to speak to you today.

My name is Milena Castaneda, and I am a Policy Fellow at the Colorado Center on Law and Policy. Accessing behavioral health services has been a nearly impossible task for our youth for many years, but this is especially true for those who need such services but do not have a behavioral diagnosis. Having a sick relative, being on state benefits, in the state’s foster care system, or even having an unstable family dynamic and home life are detrimental to a youth’s developmental state and emotional capacity.

Obtaining a behavioral health diagnosis is often easier said than done. As a previous outpatient and inpatient behavioral health social worker I have seen in person how having and not having essential services affect our youth, both before and during the pandemic. When I was an inpatient bed specialist for a behavioral health hospital, I saw so many kids go through our crisis center for these similar reasons. Often times our evaluating clinicians would provide a vague behavioral health diagnosis, such as a mood disorder, to justify their need for treatment, because they would not have received the services otherwise. Regularly would I see young people and their families take time off of work and/or school, come to our crisis center and ask for a behavioral health evaluation to obtain a diagnosis just so they can go to a case manager to assist them with life changing needs. These visits could have been avoided if such prevention-focused services were already in place.

As a case manager I have helped kids and their families obtain state benefits to ensure they have food, housing, and some bills paid for to alleviate the stress the families were facing. I have seen how a child goes from constant survival mode to a relaxed state of mind, with less thoughts of suicide knowing that their and their family’s needs are being met.

Having preventative behavioral health services will ultimately provide this safety net that has been missing within our state’s behavioral health system. While we continue to create a new behavioral health system this type of access will be a stating factor. This will show to our youths and other states that we see and hear our youths are hurting and we are going to be doing something about it. This bill is how we provide such action. We can decrease the need for crisis services for our young people if we have these preventative measures in place.

Though this testimony is reflective of my personal experience, CCLP is also in support of this bill, and we ask you to strongly consider this bill as a necessary life saving measure for our youth people.

Thank you for your time and consideration.



Milena Castaneda

Policy Fellow

Colorado Center on Law and Policy


SB23-174 was signed into law on May 20, 2023.

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To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.


Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.


Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.


Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.