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News

Nov 21, 2023

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Recent articles

CCLP testifies in support of TANF grant rule change

Apr 15, 2024

CCLP's Emeritus Advisor, Chaer Robert, provided written testimony in support of the CDHS rule on the COLA increase for TANF recipients. If the rule is adopted, the cost of living increase would go into effect on July 1, 2024.

CCLP’s legislative watch for April 5, 2024

Apr 5, 2024

For the 2024 legislative session, CCLP is keeping its eye on bills focused on expanding access to justice, removing administrative burden, preserving affordable communities, advocating for progressive tax and wage policies, and reducing health care costs.

Systemic failure in Colorado’s PHE Unwind

by | Nov 21, 2023

Community Insight, COVID-19, Health, Legal Advocacy

During this post-COVID year of Medicaid renewals, known as the Public Health Emergency (PHE) Unwind, Colorado is terminating members at rates that are among the highest in the country.  Many of these terminations are for procedural—as opposed to eligibility-based—reasons. Thousands of eligible children and adults have lost coverage due to errors and delays in county processing, leading to missed surgeries, postponed treatments, and unfilled prescriptions. Chronically flawed Medicaid communications about vital issues —such as which documents a recipient needs to submit, when a termination will occur, or the due date for filing an appeal — create enormous confusion and stress for the members who receive them, and extra work for county offices who must respond to member questions that arise.

Failures of communication aren’t mere inconveniences — these issues undermine the constitutional rights of Medicaid recipients. In cases of Medicaid denials or terminations, legal due process protections require the member receive adequate notice of the decision made.  This notice, usually in the form of a letter, must include the date the termination or denial will go into effect, a clear and accurate reason for the decision, and an opportunity for a hearing.

Advocacy by the disability community and actions by the federal Centers for Medicare and Medicaid Services (CMS) have resulted in some important policy changes, listed below. Much more is needed, particularly when it comes to communications, but these changes are a first step in addressing problems caused by chronic underinvestment in eligibility systems and an archaic online benefit management platform. To their credit, state eligibility staff members have hustled to implement those changes, update county workers, and address individual problems brought to their attention. They will need a lot more resources to prevent a public health catastrophe, however. 

Colorado applied for, and received, special waivers from the federal agency (CMS) to allow the following policy changes throughout the PHE Unwind. 

  • Counties have an additional 60 days to process renewal packets for people with disabilities who are on programs that provide long-term services and support. This policy is triggered when someone has not returned their renewal packet or if the county has received the packet through the mail, in person, or through PEAK (the online portal) but has not yet touched it. (However, if the packet has been processed but other requested information is outstanding, the person can still be terminated.) 
  • Thousands of children and others who could have been approved based on information already available to the county but were terminated during the first months of the PHE Unwind, have had coverage restored. All who are eligible for those so-called “ex parte” renewals should see their coverage fully restored as of mid-November and should have received a letter in the mail or in PEAK that informed them of their eligibility. The state should also be ensuring that this group actually returns to care, potentially by informing primary care practices about those reinstatements. 
  • All people who request a Medicaid hearing during the 60-day appeal period will have their benefits restored or maintained for the duration of the appeal process and will not risk having the value of benefits recouped — even if they lose their appeal. This is usually the quickest way to get benefits back on after they’ve been lost. 

Through our collaboration with Covering Kids and Families, enrollment assisters, and disability advocates, CCLP will continue to help surface problems in the PHE Unwind process and push for improvements. Stay tuned for additional policy developments in the coming months.   

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Recent articles

CCLP testifies in support of TANF grant rule change

Apr 15, 2024

CCLP's Emeritus Advisor, Chaer Robert, provided written testimony in support of the CDHS rule on the COLA increase for TANF recipients. If the rule is adopted, the cost of living increase would go into effect on July 1, 2024.

CCLP’s legislative watch for April 5, 2024

Apr 5, 2024

For the 2024 legislative session, CCLP is keeping its eye on bills focused on expanding access to justice, removing administrative burden, preserving affordable communities, advocating for progressive tax and wage policies, and reducing health care costs.

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.