Jan 27, 2021

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Q&A: CCLP Attorney Allison Neswood

Families USA’s 2021 Coverage Health Advocate of the Year during the organization’s Health Action Conference has recognized a Colorado Center on Law and Policy (CCLP) attorney and advocate, Allison Neswood, Esq. 
 
In bestowing the honor, Families USA cited Allison’s work at CCLP as “exemplary efforts championing innovative routes to better health and health coverage, particularly for Coloradans facing inequities in our system.” 

With the conference kicking off this week, Allison discussed the award, her role at CCLP and how the organization is working with its partners to advance health equity in Colorado. 

QuestionHow would you describe your work at CCLP? 

Allison NeswoodMy work at CCLP is focused on access to quality health care and health equity. I work on a range of issues from addressing cost and other barriers to health coverage and hospital care; to ensuring that people targeted by racism have a say in how our nonprofit hospitals invest in community health; to improving access to public programs — including for immigrants and their families. I’ve also gained expertise in hospital financing and the use of provider payments to drive improvements in health equity through my seat on the Colorado Healthcare Affordability and Sustainability Enterprise Board and as a Fellow in Families USA’s new Health Equity in Health System Transformation Academy.  

As an attorney, a lot of my work is on the enforcement side. This involves engaging in rule-making and other administrative processes to ensure that health care programs – especially Medicaid – meet the needs and legal rights of the eligible population in Colorado. I also work on state legislation to improve how health care and health-supporting systems work for people in Colorado who are struggling to make ends meet.

Question: Your promotion to Deputy Director of Strategic Priorities was in part to recognize and formalize your leadership on equity at CCLP. Can you talk about the role and what equity work means to you? 

AN: As a Navajo woman, our equity work at CCLP has always been very important to me. I have appreciated the space CCLP has given me to grow in this area and to develop an equity analysis for our work, in partnership with colleagues from CCLP and from several partner organizations, including through the Health Equity Advocacy Cohort, an eight-year, field-building project of The Colorado Trust.  

Over several months last year, we revised CCLP’s mission, vision, and core values and went through a strategic planning process. One of our main goals was to incorporate a commitment to equity — and racial equity in particular — as central to economic and health justice. The Deputy Director position was created so I would have a leadership role in steering continued implementation of that commitment.  

Specific implementation efforts have included creating an equity-centered decision tool to use when we are considering taking a position on a bill or taking up a new issue and developing a model for community-centered policy making, through which people impacted by poverty and discrimination will have a greater role in the development of the poverty agenda we advance at CCLP.   

Equity work is complex and emotional work. One reason for this is that it involves disrupting deeply ingrained cultural beliefs and stories that reject the systemic nature of poverty and its disproportionate impact on people of color and, instead, attribute failure and success in our society solely to individual attributes like work ethic.  

The truth — that we have created and maintain poverty and poor health outcomes in our communities using discriminatory policies propped up by bias and hate — is harder for many to reckon with and for people of color it is a reckoning that is long overdue. But it is an essential step towards justice and it is what Black, Indigenous and other communities of color deserve. I am deeply grateful to the people inside and outside CCLP who are joining me on this journey.   

QuestionCan you talk about the work Families USA is recognizing with this award? 

AN: The award recognizes work that improves access to health coverage. CCLP focuses on this issue because affordable, comprehensive coverage promotes health by improving access to critical care and by increasing financial security. For people with low incomes, just having health insurance reduces rates of depression, eviction and bankruptcy.  

The award from Families USA comes following legislative efforts we co-led in 2020 that will make state health insurance subsidies available to Coloradans regardless of their immigration status, and that will allow uninsured Coloradans to connect to health coverage through the income-tax filing process. I was proud to work with our partners on these efforts that will decrease the administrative burden of applying for coverage and improve affordability, especially for those who have been denied access to coverage thus far. 

QuestionWhat does it mean to you to receive this national recognition? 

AN: I was very surprised to receive this award and deeply honored. The people of Families USA provide such valuable technical assistance to health care and health equity advocates across the country, and they are just so impressive.  

Beyond that, I am immensely grateful to my colleagues both from CCLP and from a range of partner organizations that have helped me to grow and that have done this work alongside me. I can’t name everyone who deserves to be mentioned but Karla Gonzales Garcia, Erin Miller, Caitlin Westerson, Rayna Hetlage, Julie Reiskin, Christina Yebuah, and Bethany Pray have all played a particularly large role in my success as a health coverage advocate.  

They have helped me to develop my expertise and advance policy, to sharpen my equity analysis, to have confidence in myself, and to seek strength and inspiration in the example of resilience set by our communities and by so many past and present leaders of color. In my view, this award also honors the mentors I’ve mentioned and those I haven’t who are fighting for social justice across our state.  

QuestionAny closing thoughts? 

ANI feel so much gratitude for CCLP and my CCLP colleagues. It has been nearly seven years since I started working at CCLP. Since then, I have leveraged CCLP’s network and reputation to grow my skills, to hone my voice, and to build my community in Colorado.   

Beyond that, my colleagues help me to trust — and even sometimes find joy — in the struggle for economic and health justice. CCLP staff are skilled policy wonks, brave advocates, hard workers and sources of inspiration. They are committed to the notion that the work of building a more perfect union is not done until the slow violence of poverty is eradicated and everyone has a safe home, enough healthy food, quality health care, and savings to fall back on and to invest in their dreams. And they do the work too. However slow, however stressful, however frustratingly incremental, my colleagues do the work and inspire me to do the same.   

Learn more about CCLP and the Families USA award in this news release.

Recent articles

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

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.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

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.

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

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.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

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.