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Jun 11, 2024

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CCLP’s 2024 legislative wrap-up, part 2

by | Jun 11, 2024

Equity work, Family Economic Security, Health, Housing, Income, Legislative Updates, Research and Policy Analysis

The gold top of the Colorado Capitol building with the American and Colorado state flags flying. The sky is cloudy and has an ominous tone to the photo.

Preserving affordable communities

CCLP supported housing and transit initiatives centering community priorities and furthering a path toward affordability for all renters in Colorado, including mobile home park residents. Another one of our priority bills falls under this category, HB24-1294, Updates to the Mobile Home Park Act.

In 2019, CCLP led the passage of the Mobile Home Park Act, adding further protections in 2020 and 2022. This year’s bill again builds on these protections by bringing greater transparency in “Rent-to-Own” agreements, providing greater language access for limited-English proficient residents, creating efficiencies in the dispute resolution and enforcement program, clarifying enforcement of park rules and regulations, ensuring notices and park meetings are accessible, and bringing other technical corrections to the original Mobile Home Park Act.

In recent legislative sessions, housing advocates have been pushing for tenant rights bills in one of the hardest states to find affordable housing. Many iterations of these bills finally passed this year, an incredible feat for countless hours of conversations, research, stakeholdering, and the like. HB24-1175, Local Governments Rights to Property for Affordable Housing, was signed into law on May 30, 2024, on the heels of the Governor’s veto just last year. This new law allows local governments to have a right of first refusal or offer when purchasing property to provide long-term affordable housing. Additionally, HB24-1098, Cause Required for Eviction of Residential Tenant, also known as For Cause Eviction, became law after failing to pass the Senate last year. Cause is now required for a landlord to not renew a lease and proceed with an eviction. The effect of this bill will be to keep more Coloradans housed.

Anti-discrimination housing bills were also a hot topic this year. HB24-1007, Prohibit Residential Occupancy Limits, prohibits local governments from establishing residential occupancy limits based on familial relationship, but does allow them to implement limits based on demonstrated health and safety concerns. Occupancy limits have previously been used to discriminate against families with children and also limits the supply of available affordable housing. HB24-1318, Modify Rental Premises Person with Disability, removes the provision that allowed landlords to ask individuals with disabilities to restore the interior of their housing premises upon their departure. This has long been an unseen issue for the disability community, as a person with a disability shouldn’t have to restore premises when previous accommodations or modifications were made for accessibility purposes.

There was an increase in transit bills this year to encourage Coloradans to use more public transit in and around their communities. SB24-032, Methods to Increase the Use of Transit, creates a statewide transit pass exploratory committee intended to produce a viable proposal for a statewide transit pass, and other programs like an ozone season transit grant program and a youth fare-free transit grant program. SB24-182, Support Surface Transportation Infrastructure Development, will support the development of surface transportation infrastructure and provide funding and operational flexibility needed to support the development of transit and train infrastructure. It will also provide transportation services to new Transit-Oriented Development projects, thus reducing both the number of drivers on the road and the pollution they create, while also lowering the cost of living, by improving access to affordable transportation options. CCLP is proud to have supported these bills, ensuring more affordable, accessible, and safe communities across Colorado.

 

Reducing health care costs

CCLP aimed to keep the health care industry accountable, ensuring it provides Coloradans with the care and coverage they need, honoring their commitment to the public good. Our final priority bill, SB24-060, Prescription Drugs Affordability Board (PDAB) Exempt Orphan Drugs, would have exempted certain drugs from review by the PDAB. CCLP opposed this bill on the basis of our support for comprehensive drug price review. Existing advantages for drugs with an orphan designation (a drug for a rare disease or condition[1]) have led manufacturers to focus disproportionately on rare conditions in the chase for greater profit, despite the impact on access for patients.[2] Thankfully, health advocates successfully blocked passage of that bill, and CCLP put support behind an alternative bill, HB24-1399, Discounted Care for Indigent Patients, which provides additional opportunities for input from patients and manufacturers.

In recent years, behavioral and mental health has been a topic of conversation among health advocates. Several of these types of bills were brought to the Colorado legislature with some, but not all, passing.

  • SB24-001 continues the Youth Mental Health Services Program “I Matter” indefinitely. This program, established in 2021 and originally set to repeal in June 2024, provides access to mental health and substance disorder services for youth.[3]
  • SB24-007, Behavioral Health First Aid Training Program, will establish a series of trainings on how to respond to challenges or crises in the office of suicide prevention.
  • As many Coloradans know, health care systems and insurances are often difficult to navigate. Selecting the right plan can be a challenge. SB24-080, Transparency in Health-Care Coverage will require health insurance carriers to comply with federal transparency laws and to make available an internet-based self-service tool that provides real-time responses to a covered person’s questions concerning carrier prices that are based on cost-sharing information.

Unfortunately, those that did not pass this year include HB24-1066, Prevent Workplace Violence in Health-Care Settings and HB24-1040, Gender-Affirming Health-Care Provider Study. HB24-1066 would have established workplace violence prevention committees in health-care facilities to document and review workplace violence incidents and develop and regularly review a workplace violence prevention plan for the facility, as well as provide trainings and offer post-incident services to affected staff. Due to budget constraints, this is just one of the many bills unable to move forward in legislature. HB24-1040 would have required the Department of Public Health and Environment to conduct a gender-affirming health-care provider study, researching resources available, threats received, number of patients to provider ratio, and the types of services patients seek.

Other notable bills

While CCLP created a platform of five policy areas to focus on this legislative session, CCLP also supported several bills which fell into multiple categories or fell outside our policy priorities:

  • SB24-053, Racial Equity Study will establish the Black Coloradan racial equity commission to conduct a study to determine, and make recommendations related to, any historical and ongoing effects of slavery and subsequent systemic racism on Black Coloradans that may be attributed to Colorado state practices, systems, and policies to address these effects.
  • Similarly, HB24-1444, Federal Indian Boarding School Research Program, will recreate and reenact the 2022 bill that created the original program as it was repealed at the end of 2023. The program will be required to conduct research regarding the physical abuse and deaths that occurred at federal Indian boarding schools in Colorado and to provide recommendations to better understand the abuse that occurred and to support healing in tribal communities. Both bills urge Coloradans to recognize the systemic racism and harm done to these communities throughout our state’s history.

Other health-related bills we supported included:

  • HB24-1262, Maternal Health Midwives, which will update the title of these professionals, create a study to review maternal and infancy facility and provider closures, and recommend best practices to protect communities.
  • HB24-1355, Measures to Reduce the Competency Wait List, which will reduce the competency wait list by creating a wraparound care program as a community-based alternative to competency proceedings. This is to increase the success of eligible individuals referred from the criminal justice system by connecting the individuals to necessary wraparound care coordination services, resulting in case dismissal, continuity of care, and increased social stability.

Last year, CCLP heavily focused on consumer protections in relation to medical debt. This year, HB24-1380, Regulation of Debt-Related Services, was introduced to make certain actions done by a debt collector or collection agency are subject to the “Colorado Fair Debt Collection Practices Act” unfair or deceptive trade practices under the “Colorado Consumer Protection Act.” This bill ensures there is an increase in consumer protections in transactions with debt-related services. For example, such debt collectors must list the original creditor, then the name of the collector to be a plaintiff in any debt collection legal action. CCLP knows debt can be a leading cause of poverty and this bill will continue to protect Coloradans from aggressive debt collectors and agencies.

Conclusion

As with most statutory changes, now begins the process of creating smooth processes for implementation. One such process is rulemaking. Rulemaking is often an essential step toward making a policy into real change. Rules fill in the details of programs and policies and help them function smoothly and fairly (or not).[4] For advocates, implementation is just as critical as the legislative process. This is the time to educate the public and provide resources about how a bill will or will not affect them. Oversight of implementation is critical to ensure the policy will work as intended.

But what happens if a bill does not pass? Many times, coalitions will continue to fight for a bill — looking for ways in which the bill can pass in future years, or even seeing if change can be made in other, nonlegislative ways. Either way, anti-poverty advocates involve themselves at every step of the way, ensuring community voices and concerns are uplifted.

With our 26th legislative session in the books, we want to thank our fantastic sponsors, incredible coalition partners, and amazing community members willing to share their experiences to make definitive change to ensure every Coloradan has what they need to succeed.

**********

[1] https://www.fda.gov/patients/rare-diseases-fda

[2] https://copolicy.org/news/cclps-legislative-watch-for-april-5-2024/

[3] https://www.imattercolorado.org/about.html

[4] Pray, B. (2022). On Rulemaking in Health and Public Benefits. Internal CCLP report: unpublished

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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.