In this series of Policy Perspectives, ADVOCACYDENVER is providing synopses of meetings of the Colorado Commission on Medicaid. This edition covers the meeting held on October 7, 2026 at 10am. The Colorado Commission on Medicaid is working toward the goal of creating a sustainable Medicaid program for the state. The Commission will present their final report to the General Assembly and Governor in December.  

Agenda & Materials: 

The meeting agenda and materials can be found HERE.  

Recording of the meeting can be found HERE.

Present for this Meeting:

• Senator Judy Amabile (D), Chair  
• Representative Kyle Brown (D), Vice Chair 
• Senator Jeff Bridges (D)  
• Representative Carlos Barron (R) (departed at 4:30 pm) 
• Senator Lisa Frizell (R) (participating remotely) 
• Representative Lindsay Gilchrist (D) 
• Senator Barbara Kirkmeyer (R) (departed at 10:40 am; returned at 12:40 pm) 
• Senator Kyle Mullica (D)  
• Representative Emily Sirota (D) 
• Representative Rick Taggart (R)  

I. Call to Order and Opening Remarks  

Commission Chair Amabile called the meeting to order at 10:02 am. The Commission facilitator pointed members to materials for the day and reminded all in attendance that the work of the Commission is ultimately about people. (The main slide deck for this meeting can be found HERE.) The facilitator told the Commission that she has compiled results from all stakeholder feedback into two documents. (Find the compiled stakeholder input HERE. Find the compiled docket of suggested sustainability measures HERE.)  

The facilitator identified that the focus of today’s meeting is Behavioral Health. She then identified five themes about Behavioral Health that are prominent in the stakeholder feedback the Commission has received: 

1. Care keeps people out of costlier places. 
2. Hard to get into, hard to stay in.  
3. Administrative burden is a cost.
4. Providers asked for targeted fixes, not blanket cuts. 
5. People want to see evidence. 

(See slide 4 of the main slide deck for this meeting.) 

The facilitator closed this section by identifying her commitment to ensuring that accountability is built into the recommendations in the Commission’s report. (See slide 6 of the main slide deck for this meeting.)

II. Department of Health Care Policy and Financing (HCPF) and Behavioral Health Administration Presentation on Behavioral Health Spending Growth 

Health Care Policy and Finance (HCPF) Executive Director Gretchen Hammer, Behavioral Health Administration (BHA) Commissioner Stephanie Beasley, and HCPF Deputy Medicaid Director and Office Director for Colorado Medicaid and CHP+ Behavior Health Initiatives and Coverage Cristen Bates presented this section of the meeting. (The slide deck they used for this part of the meeting can be found HERE.)  

Director Hammer introduced Commissioner Beasley and Deputy Director Bates and said that they would lead this presentation. Commissioner Beasley began by identifying the three functions of the BHA: system reform, purchasing service, licensing & regulating providers. Senator Amabile asked if there a strategy for the number of entities BHA regulates. Beasley stated that if an entity meets the standards, it can be a licensed BH entity. Hammer added that licensure and contracting are not the same. The state can make strategic decisions about which entities contract with the BHA. Amabile then asked Beasley to identify the strategy that BHA uses for contracting with entities. Beasley stated that the Behavioral Health Administrative Service Organizations (BHASOs) are responsible for contracting within their region. (Colorado has four regional BHASOs.) Taggart stated that the distinction between licensing and contracting isn’t clear to providers. Licensed providers believe they will automatically receive a contract, which causes conflict.  

Mullica stated that he would like to go back to the presentation. He said he sees collaboration between HCPF and BHA, but duplication of effort and services also exist. He hopes that Beasley and Bates will address this in their presentation. Kirkmeyer then asked about how the BHA determines network adequacy. Beasley said that BHASOs determine network adequacy using several indicators. Kirkmeyer followed up about how the BHA determines that the BHASOs do this. Beasley said that BHA does this and oversees the BHASOs. Beasley’s assessment of statewide BH adequacy is that “We have work to do.” 

Deputy Director Bates then shared how HCPF has expanded BH services since 2018 and the state created the BHA in 2022. (See slide 2.) “The policy direction has been consistent: expand access, strengthen the continuum, and make accountability more explicit.” With this expansion has come the implementation of a Prospective Payment System (PPS) for all Comprehensive Safety Net Providers (CSNP) in July 2024. Bates asked the Commission if they had any questions about PPS or CSNPs. 

Amabile asked for clarity about overhead for the CSNPs. She stated that she has heard that some get 15% overhead and some get 40% overhead.  Bates answered that there is no limit on overhead in statute right now. Every cost is reviewed to determine if it is allowed. If it’s allowed, it’s allowed. Many indirect rates account for no-show appointments, trainings, etc. Kirkmeyer asked for verification about 40% overhead rates. Hammer said that HCPF will research to confirm. Kirkmeyer asked Bates about the average overhead rate for CSNPs. Bates said she does not have that information but will get it to the commission.  Kirkmeyer then asked if there were any caps on overhead rates for CSNPs. Bates stated that there is no cap on indirect or overhead costs. Amabile followed by asking Bates about how many CSNPs are necessary for the state. Bates said that HCPF does not have an estimate of this but could develop an estimate.   

Beasley moved on to “BHA by the Numbers” (slide 3).  She said that the numbers are showing improvement in BH adequacy across the state. Colorado is seeing a decrease in the number of people referred, a decrease in the number of children in care, and a decrease in the number of days from patient contact to seeing a provider. Over 95% of the calls to 988 are answered in less than a minute. Bates then moved on to “Who We Serve” (slide 4). BHA serves a BH population that is broader than the BH population served by Medicaid.  Amabile asked for clarification about the overlap across various types of Medicaid enrollment and an explanation of how the Medicaid providers fit in across the BHA network of CSNPs. Bates answered that if you are on a Medicaid waiver for BH, you are not in the expansion population. She will provide additional clarification to the Commission. Hammer added that federal match rates vary according to the individual served, even when multiple individuals receive the same service. Kirkmeyer asked about how the PPS system impacts the volume of services delivered by the CSNPs.  Bates said that usually when an individual receives more services, the cost per service goes down.

Right now we are seeing significant increases in the amount of costs under the PPS model. We expect this to stabilize over time, but we do need to better examine what is and what is not allowable. Kirkmeyer asked for numbers to quantify the amount of the increase in PPS. Bates said that she does not have that number right now. Kirkmeyer pushed back by asking Bates for an estimate because Bates said there was a significant increase. Bates said that she does not have this information with her today. 

Beasley presented the BHA part of the “Who We Are” slide (slide 4). Unlike Medicaid, BHA is not a member-based agency. BHA is meant to create capacity and a system that is adequate to serve the state. BHASOs serve 276 provider organizations, including 20 CSNPs. BHA spends the most on emergency and crisis services. Amabile asked Beasley about the percentage of BHA costs that are related to substance use and the percentage that are related to serious mental illness (SMI). Beasley said that she will get that breakdown to Amabile. Kirkmeyer asked Beasley for her thoughts about the adequacy of BHA providers across the state.  Beasley said that BHA publishes a quarterly adequacy report. Kirkmeyer pushed in for an answer. Bates said that we have a need to understand our data and refine our services for high-acuity, youth substance use, and crisis response, among others. Amabile said that members of the Commission are hearing from providers that there is significant grift happening in the provider space. The Commission is trying to get at this. Do we have too many providers? Are we contracting with the correct providers?  

Mullica asked if any providers contracting with both a RAE and a BHASO? If so, what does this look like? Is there duplication in licensing? Etc.?  Hammer said that this does happen. Beasley said that BHA does pay out for some Medicaid claims through BHASOs because we always bill commercial insurance first. Mullica said, “We’re going to have to figure out how to tighten our belts.” To put providers through contracting, licensing, and other processes twice is inefficient. Hammer said that we could expand this question to the entire health care system. Individual providers often contract with multiple entities. Mullica about how many BHA patients are Medicaid members. Beasley said that she does not have that figure. She explained some circumstances in which people might be doubly enrolled. Bates said that about 24% of Medicaid patients receive BH services. Taggart asked if any segment of the Medicaid population (e.g., expansion population, waiver population) use BH services at a much higher rate. Bates agreed to get this analysis to the Commission. 

Mullica opened a conversation about restructuring, streamlining, and possibly combining BHA and HCPF. What is stopping the integration of BHA into HCPF? Is there anything that a RAE does that would legally prevent them from doing what a BHASO does? Beasley said that we need to investigate how we can better align these agencies and reduce administrative burden for providers and members. The functions of the agencies are different, however. BHA establishes a network and capacity for the state. BHASOs’ role is to ensure that across Colorado people receive the care they need in a timely manner. BHA is not a member-based agency. Mullica said that why he appreciates this point, he still does not understand why we need a separate agency for these functions. Hammer said that the Commission will hear about this in a panel that is coming up today. 

Bates moved on to the “Where the Growth Is” slides (slides 6 & 7) and pointed the Commission to a fact sheet in their packets. (This fact sheet is available HERE.) Bates said that while SUD costs are increasing, this growth was expected because we created a new benefit. Within SUD, we are seeing unstainable growth in individual and group psychotherapy services, peer and supportive services, and substance use ASAM residential. Bates said that peer and supportive services are very effective, but they are only beneficial when they are a part of evidence-based programs, part of a broader service plan, and managed by a licensed clinical expert. We know this isn’t happening in all instances and we need to immediately catch and stop this. HCPF is already working on doing this. Gilchrist asked about the efficacy of partial hospitalization or intensive outpatient programs. Bates said that we see better outcomes for many patients in these programs, and in doing so, keep people out of residential programs that come at a much higher cost. We would like to see the growth concentrated in outpatient programs and decrease in residential programs.  

Bates shifted to “Administration and Delivery” (slide 8). She reviewed the benefits of a managed care system. RAEs are able to terminate contracts with providers more easily than HCPF can.  Bridges asked about how closely HCPF and BHA watch cost increases from individual providers. Bates said that this is an area where HCPF and BHA need to coordinate and have been coordinating but also could be doing better. Some ways to monitor providers are administratively burdensome for providers, but they are necessary. We have priced out the cost of some of these actions and they will save us money. Bridges followed up by asking about how often payments go out to providers. Bates said that provider payments are made withing 90 days of when HCPF receives the claim (not the date of service). We often pay within 30 days. Hammer added that HCPF does have the opportunity to conduct pre-payment review of claims.  

Taggart asked to return to the “Where the Growth Is” slides. He said that when HCPF shares that there is 124% growth but does not present an analysis of why the growth is occurring. This makes the work of the Commission very challenging. The Commission may choose an action that doesn’t help or may make the situation worse. Brown clarified that the growth in Substance Use ASAM Residential is because of legislation passed in 2018.

The growth is faster than anticipated. Bates answered, “Correct.” She added that HCPF also over-corrected for earlier slower-than-expected growth. Brown asked if the growth in Peer and Supportive Services is also due to a bill. Bates answered, “Yes.” She also said that Medicaid requires that we have licensed providers. Peers are not licensed providers. HCPF has allowed for this and didn’t put restrictions on it, other than a licensed provider needs to sign off on the peer counselor. HCPF has seen misuse of this process, but HCPF opened the gates without restrictions. There is value in peer services, but we need to adjust our policies to ensure that we’re only paying for services connected to clinical teams.  

Hammer moved to “Actions to Address Growth” (slide 11). Hammer reviewed the actions that HCPF is currently taking and then shared actions being taken by RAEs (slide 12).  All actions taken are based on evidence that HCPF is seeing. Sirota said that Commission members are hearing from agencies and providers that these changes are not adequately communicated. Amabile asked Hammer to articulate how these actions are saving money because RAEs receive capitated payments that are predetermined. Hammer said that the Office of State Planning and Budget (OSPB) has requested that HCPF not share estimates of costs saved through these actions. HCPF is still working on establishing authority to take the actions from MSB or the federal government and cannot articulate savings until they have the authority to make the changes. Mullica expressed frustration with OSPB over this decision. Hammer said that the FY26-27 budget process will be open and transparent. Only the current year’s savings from action plans are not being shared. Mullica again articulated his frustration. Amabile asked if a policy gets changed in the middle of the year, would the RAEs give money back to the state. Hammer replied, “Yes.” 

Amabile asked if there is a plan to streamline the shared work of the BHA and HCPF. Beasley answered that the two agencies will be working on streamlining care coordination. But the function of the BHA is different from the function of HCPF. The BHA team is working on system mapping to identify efficiencies. Brown asked Beasley to make the case for the work that the BHA does. Beasley said that the BHA has four years under its belt and has established BH infrastructure for the state. BHA is one year into the BHASO model, and that is decreasing wait time for people to access service. BHA’s work is not done. Gilchrist emphasized the importance of work that BHA and HCPF have done to ensure care is available for high-acuity youth  

III. Behavioral Health Panel A 

Senator Amabile called a panel of representatives of RAEs and BHASOs to the front of the room. Panelists included:

• Meg Taylor, Chief Behavioral Health Officer, Rocky Mountain Health Plans (RMHP is both a RAE and a BHASO)  
• Patrick Gordon, Chief Executive Officer, RMHP 
• Daniel Darting, Chief Executive Officer, Signal Behavioral Health Network (Signal is a BHASO) 
• Lauren Snyder, Executive Director, People First Behavioral Health Alliance  

Gordon started the panel’s presentation by sharing that RMHP is able to give the perspective of both a RAE and BHASO since it serves in both roles. He wants to help clarify the distinction between a RAE and a BHASO. Medicaid is a coverage program; it is an insurance program. BHASOs are not coverage programs. BHASOs do not have eligibility or claims like with an insurance provider. RMHP contracts with both HCPF and BHA. The contracts are distinct because the federal and state regulations are distinct, the purposes are distinct. The distinctions matter, but it’s also important to consider the amount of integration between the programs. Being both a RAE and a BHASO requires some amount of creative thinking in how RMHP delivers services to people.  

Amabile asked Gordon to clarify a statement he made that there is no overlap in care coordination between the RAE and the BHASO. Does the same person act as care coordinator within your RAE and BHASO roles? Or does one cover an aspect for a member and another aspect for the same person? Gordon answered that high intensity services cost a lot to deliver with fidelity. The ability of the BHA to deliver financing to the system, especially to safety net providers, is essential. BHA can cover some services that Medicaid does not cover. Care coordination serves unique people in different settings. There is not a lot of overlap between care coordination as a RAE and as a BHASO, though they have many functions that are complimentary. 

Mullica asked Gordon to further explain the efficiencies provided by being both a RAE and BHASO. Mullica said that as a policymaker, the system feels “really inefficient” to him. Gordon answered that, “You can’t begin to promote the integration of behavioral health in clinical settings or on the ground if systems aren’t integrated.” He went on to say that, “We’re not here to talk about how to organize state programs or agencies… We’re here to talk about the what, not the who.” He said that HCPF and the BHA both serve important and distinct functions.  

Amabile returned to her question about care coordination and asked for further clarification. She said that while she heard that there is not overlap in care coordination between the BHASO and the RAE, she wonders if there is overlap with the BHA. Taylor answered that there are very distinct programs in the BHA with specific roles for care coordinators. What the BHASOs do is more general. We work together to connect people.

Amabile asked how someone would know to call the RAE or the BHASO. She said that she hears that RAEs and BHASOs are conducting outreach, but she also regularly hears from 400 families who are dealing with serious mental illness. They are not receiving outreach or care coordination. No one is helping them. What are you doing to help these families who need services? We are spending a lot of money on this. Gordon stated that he thinks Amabile is right to question care coordination. The system is not perfect. If you are engaging with a care coordinator, you are less likely to need to access acute care. But establishing trust with a care coordinator matters.  

Darting said that he would share the perspective of the BHASO he represents, Signal. BHASOs ensure that essential BH services are available to those who need them or can’t afford them. If HCPF and BHA were to be combined, we would still need the ability to provide BH services to non-Medicaid members. Coordination and integration of some BHA and HCPF functions makes total sense. He urged the Commission to fully implement all components of BHA initially planned, which is not currently happening. The problem is that we have only started on some of the many things that the BHA was designed to do. Amabile said that she is hearing Darting’s and others’ requests that we need to do more for BH, but we have a huge budget crunch. She is not hearing that we are going to be filling the needs of those who are the neediest; she is not hearing about people as much as we need to hear.  

Mullica asked Darting to clarify his call that HCPF and BHA better serve the state: “You spoke about… that there’s a lot of room to be better…  When is that happening?” He asked Darting to share his thoughts about integrating BH and physical health. Darting said that he agrees with the commitment to integrated health care. It saves money and leads to better outcomes. He said that providers need better and more cohesive support from agencies in the executive branch, and the General Assembly to provide a budget that supports one cohesive system, not budget lines scattered across many entities. Mullica asked that if the BHA is not accomplishing its goal, why are we continuing to move forward with it? Darting replied, “If we start over again… We never follow through… We will see results when we follow through…” He is not convinced that we need more money. We need to be thoughtful about how we use our investments.  

Kirkmeyer stated that BHA is supposed to be creating a system of care for the state. “Where is the system of care?…  We’re not even close.” BHASOs and RAEs are complimentary, but they work with the same providers. How adequate is our statewide network? We want to get as many services as we can within the budget that we have. Gordon answered that our system of care is not where it needs to be. The state has BH deserts, particularly in rural areas. With Medicaid we need to strike a balance between access, cost, and quality. “There are plenty of opportunities to make the program more efficient, but it will entail some difficult decisions and actions. 

Snyder started by saying that People First Behavioral Health Alliance is a newly formed organization made up of BH providers, payers, and advocates. The organization is here today to bring solutions and options to the Commission. She said that we do not have an adequate care network. BH spending beyond BHA and HCPF is significant. Counties spend a great deal on BH as well. People First sees value in the BHA and supports it continuation, though in a much contracted form. The policy and regulatory structure should stand. We don’t want to just move BHA functions to HCPF without eliminating duplication. People First also recommends changes to payment and benefit design. These changes include peer support services, including caps on hours, limits on groups sizes, and utilization management. Mullica asked Snyder to share her thoughts on oversight for peer support services by licensed providers. Snyder answered that we need better regulations for this role. Kirkmeyer asked Snyder to share the percent of peer support spend that is going to unlicensed versus licensed providers. Snyder said that she is not in a position to have that information. Taggart asked Snyder about moving all state-sponsored BH programs and budget lines to the BHA. Why has this not taken place? The previous BHA commissioner said it was too political to do this, and that the General Assembly would need to do this. If our Executive branch won’t do what the blueprint says, “I’m ready to do it.” The Commission briefly discussed what this change would entail, as well as how to strategically make cuts to programs. Snyder closed by saying that as we have fewer and fewer dollars to spend, “we need to get straight on our priorities.” Serving those in the most need and with the most significant mental health challenges must be our priority. People First sent a more complete list of recommendations to the Commission. 

IV. Behavioral Health Panel II 

A second BH panel came to the front of the room. This panel consisted of:

• Breeah Kinsella, Chief Executive Officer, Colorado Providers Association (COPA) 
• Dr. Kelly Phillips-Henry, Chief Executive Officer, Aurora Mental Health & Recovery, a Comprehensive Safety Net Provider 
• Dana Erpelding, Vice President, Behavioral Health Operations, Vail Health 
• Teri Smith, Chief Executive Officer, K’enekt, Peer Support Services 
• Yvonne Maina, Coalition on Refugee and Immigrant Mental Health 

Kinsella started by saying that COPA runs a credentialing program for peer and family specialists in Colorado. She shared handouts with the Commission and said that this panel would start with the providers present. She welcomes questions from the Commission after the providers speak. 

Phillips-Henry started by saying that Aurora Mental Health & Recovery is a Comprehensive Safety Net Provider (CSNP), and Essential Safety Net Provider (ESNP), and a certified Community Behavioral Health Clinic. She described what a month looks like for a high-acuity patient. For the client she described, Aurora Mental Health & Recovery provided nine services in a month that they billed and thirteen services that they did not bill. They bundled services to do this. They also provided additional non-billable services. She said it would be very difficult to sustain this intensive level of care in a fee for service system. Under the Prospective Payment System (PPS), Aurora is able to provide for the whole continuum of services a client needs. She stated that any cuts made to BH spend by the state need to maintain the PPS system. Aurora and other comprehensive providers have been under four payment models in the last eight years. They need stability.  

Amabile stated that although CSNPs are supposed to take all patients, we know that they do not do so. She understands why, too. Should we lower payments for CSNPs with the condition that they not take the most challenging cases? Could we send those cases to the most intensive care settings? Amabile shared that she had received outreach from a constituent who tried to have Aurora place a hold on their family member but the facility told the family that a hold was not medically necessary. The individual subsequently died. Phillips-Henry said that the requirement of no refusal is something CSNPs are committed to, though it is appropriate to do so when we don’t have the services the client needs. Problem solving and focusing on continuity of care and support from state agencies are part of the work here. She said that today, providers are able to see patients on virtual platforms that can help sustain continuity of care for patients with the highest needs. Gilchrist asked what providers need to take on these clients with high levels of need, particularly those that are violent.  Phillips-Henry said that highly specialized care can be provided online. Doing so takes resources and creative thinking.  She emphasized that client choice in their care must be considered both ethically and because of stipulations in the law. Amabile shared her frustration that the people with the most significant mental health challenges are not getting the care they need. Brown expressed his disappointment with how Phillips-Henry answered Amabile’s question about a person who was denied care at Aurora and subsequently died. Phillips-Henry said that she has to be careful about how she answers such questions because of HIPAA. Brown said that there has been no personal health information shared so HIPAA is not relevant. Phillips-Henry said that the law dictates whether or not any provider can place a hold on a patient.  

Erpelding stated that Eagle County was a BH desert with no brick and mortar facilities in the county. Prior to 2020 Vail Health went through years of planning and the county implemented a marijuana tax to fund creation of a BH clinic. Priorities changed in 2020 because of COVID. Every provider added was immediately fully booked with patients. Vail then sought out funding sources and built a crisis program and inpatient program in the county from the ground up. Today, about 40 percent of Vail’s patients come from Mesa County and it serves communities all across the Western Slope. Vail is operating at a loss because Medicaid does not cover costs. There is still an inadequate BH network across the state. Mullica referenced a bill in 2025 for licensing under the Vail Hospital’s license. He asked if licensing complications and other regulations like this take away from the work of serving patients. Erpelding explained what happened and why the licensing change was needed, and that streamlining administrative and regulatory processes would be helpful. 

Smith said that she is the founder and CEO of a peer support provider. Organizations that provide peer support can obtain from the state the designation as a Recovery Support Services Organization (RSSO). Kirkmeyer asked about the kind of training is needed to get the RSSO license. Smith said that RSSO is a license an individual can obtain. K’enekt is licensed as a Behavioral Health Entity (BHE). The RSSO license requires 60 hours of training. Once the 60 hours are complete, the individual can work for a licensed provider and start working on their practical hours, 250 practical hours are needed for the license. These practical hours are always under supervision of a licensed provider who can bill Medicaid. Mullica asked how many peer support counselors can work under a licensed provider to bill Medicaid. Smith said that there is no cap on the number of peer counselors a licensed provider can supervise. Taggart asked Smith to say what she feels would be an appropriate ratio. Smith said that 2 licensed providers to 10 peer support counselors is a ratio she has had that has worked well. Smith said that many providers take advantage of this. She will not defend poor quality or oversight, but will defend the peer support work. Kirkmeyer asked how many patients can a peer counselor see at a time. Smith said 20 to 30 is reasonable.  

Taggart asked Kinsella if COPA is in a position to make recommendations about these ratios? Kinsella answered “yes.” She shared a packet of recommendations with the Commission. COPA is recommending that peer support counselors be required to be licensed and that COPA has established a credential for these counselors. She expressed concerns about Qualified Behavioral Health Assistant (QBHA) and how the guardrails for billing for QBHAs are non-existent. She is concerned that any controls placed on billing for Peer Support Services will be ineffective in cutting costs without controls also being put in place for QBHAs. Taggart asked for clarification about QBHAs. Kinsella said that QBHA is separate credential but there is no accountability, code of ethics, etc. This credential was created for those who are pursuing clinical licensing. Kirkmeyer asked about the requirements for the COPA peer support credential. Kinsella explained the requirements and said that RSSOs can only employ peer support counselors with the credential. Providers do not need to be RSSOs to provide or bill for peer support services, however. 

Maina shared that changes to Medicaid have “intensely and immensely” impacted whether and how immigrant and refugee communities can access BH services. Immigrants and refugees are fearing having providers come into their communities. We are seeing immigrants and refugees becoming unable to access BH care, which will likely lead to uncompensated increases in emergency room use. The Coalition has identified four areas of concern for the Commission: access to care, integration, coherence, and equity. Immigrants and refugees are in need of expanded access to services rather than increased restrictions.  

Kirkmeyer asked how Medicaid provided for peer support services prior to the legislation in 2021 that authorized Medicaid payment for them, and how much peer support providers are paid per hour. Kinsella pointed out the hourly wages for peer support counselors is between $22 to $25 per hour. Anecdotally, wages vary wildly by agency and can be exorbitant. Kirkmeyer asked how we can stop this. Kinsella answered, “Training, policy, and enforcement.” Amabile asked how much Medicaid pays for peer services. Smith said that the highest rate her organization receives is $28 per hour from one of the RAEs. She added that organizations are continually changing billing codes in search of higher payment rates, as is happening when organizations are billing for QBHAs rather than peer support. She also added that organizations are billing for peer support groups at individual rates, and billing for peer support services and QBHAs for the same individual working with the same group. Commission members spoke extensively about how some providers are taking advantage of this billing strategy, particularly those who are owned by private equity firms. Erpelding added that some outpatient providers are taking advantage of similar strategies. She also added that the Commission should consider strengthening non-emergency transportation for rural areas of the state. This has been a challenge for Vail Hospital when releasing BH patients. 

Amabile asked further about PPS and overhead rates for CSNPs. She asked for clarity. Phillips-Henry said that Aurora Mental Health & Recovery does not directly bill for peer services, but per encounter. Many services are bundled into an encounter. Aurora’s rate is $400 per encounter. Mullica asked Phillips-Henry to share Aurora’s overhead rate. She answered that they set their rate according to a federal indirect rate, which they currently have set at 24%. Mullica asked about how much income this overhead generates for Aurora. Phillips-Henry estimated that Aurora’s overhead amounts to $15 million per year. She added that they must return all profit from RAE payments to the RAEs. They earn no profit from RAEs. Amabile shared that she received a text from a constituent that Aurora’s overhead rate listed in their cost report was 33% last year and 44% the year prior. Phillips-Henry answered that she does not have that information in front of her. Amabile and Kirkmeyer agreed that the PPS may perpetuate exorbitantly high overhead rates and other ways that providers are taking advantage of the payment system. Phillips-Henry said that PPS is a federal model that is used by 40 states. It tries to account for the higher costs of caring for high-acuity patients. Much evidence shows that this payment model helps patients. Mullica asked whether PPS should allow for overhead rates that are higher than 40%. We need to direct as much to patients as possible. Amabile agreed with Mullica and added that she does not believe the system is serving high-acuity patients, as she previously shared during this meeting. 

V. HCPF Action Plan Presentation

Executive Director Hammer shared HCPF’s Current Fiscal Year Action Plans with the Commission. (The slide deck for this portion of the meeting is HERE.) These action plans are intended to reduce costs for the current fiscal year. Action Plans are focused in four areas:

1. Driving administrative efficiencies 
2. Aligning benefits and services to maximize impact and value 
3. Ensuring program integrity and fiscal accountability 
4. Maximizing federal and non-general fund resources.

Hammer reviewed specific cost-savings strategies within each of the major areas.  

Taggart asked why the hiring freeze is not extending to instances for which interviews had occurred but no offer extended. Hammer said that this was a judgement call by the department and only applied to a small number of instances. Taggart encouraged Hammer to discontinue this exemption to the hiring freeze. 

Amabile asked Hammer to provide an estimate of the cost savings expected from the action plans. Hammer said she is unable to do so. (In the opening section of the meeting, Hammer stated that OSPB had asked her not to give estimates of savings from action plans.) Mullica expressed his frustration with this. Hammer said that not all areas of savings have been priced out and are not yet certain to happen because they require federal approval. She said that sharing the action plans today is meant as a “temperature check” to see if the Commission believes HCPF is taking the rights steps to cut costs. Mullica said that it is impossible to give that assessment without an estimate of the savings expected. Taggart asked for clarification on how the Medical Service Board’s (MSB) current work interacts with the work of the commission. Hammer said that the MSB is authorized to set policy including assisting the Executive Director in keeping costs within the allotted budget. Hammer stated that HCPF is considering many other cost-saving actions that are still being examined for conformity with laws and regulations. 

VI. Commission Member Working Session 

The Commission facilitator directed members to what she refers to as the “Docket,” the compiled set of recommendations received from stakeholders. (Click HERE to view the Docket.) Items included in the docket have been sorted and labeled by several variables, including but not limited to who has authority to make the change, the type of change (administrative, services, waivers, etc.), anticipated savings, etc. The Commission discussed how it will evaluate and consider each of the recommendations. The Commission decided that each member will evaluate each recommendation on their own and determine whether they want to consider the item; they need more information; or they consider the recommendation a “no-go.” They will send their recommendations to the facilitator who will compile and share the evaluations. If one member of the Commission wants to consider a recommendation, the Commission will discuss the recommendation. The Commission also discussed the specificity of each recommendation it puts forth. Some will ultimately need to be formally adopted by another body (e.g., the General Assembly, the Medical Services Board). They ultimately decided that some recommendations will need to be more general in nature, with specifics worked out by other bodies. They also considered whether recommendations will be short-term or long-term in nature. They ultimately decided that they need to consider both, though they acknowledged that they need to focus more on long-term, structural, and system issues.

VI. County Administration and the HB26-1429 Transition

The Commission called a panel forward to discuss HB26-1429. (The slide deck for this panel is located HERE.) Panelists included:

• Shelley Banker, Director of the Office of Economic Security, Colorado Department of Human Services. 
• Jamie Ulrich, Weld County Human Services Director 
• Deb Ruttenberg, Grand and Jackson Counties Human Services Director and President of the Colorado Human Services Directors Association 
• Tamara Pogue, Summit County Commissioner 
• Sarah Barnes, Colorado Children’s Campaign 

All panelists are members of an Implementation Working Group (IWG) established to guide the implementation of HB26-1429.  

HB26-1429 requires HCPF, the Department of Human Services (DHS), and the Department of Early Childhood (CDEC) to establish aligned requirements for county departments of human or social services through a performance-based contract. Ultimately, this bill will create a new service delivery model for Medicaid, Children’s Basic Health Plan (CHP+), Supplemental Nutrition Assistance Program (SNAP), childcare assistance program (CCCAP), Temporary Assistance for Needy Families (TANF), and adult financial programs. Panelists updated the Commission on implementation of HB26-1429. They have met several targets and will have an Implementation Plan submitted in January 2027. Monthly legislative reports and updates on implementation are available HERE.  

The Commission questioned the panelists about how the IWG is proceeding and whether they feel that the Group is working in a manner that will lead to meaningful change that leads to cost-savings that maintain adequate support for people who need it. Representatives of the counties on the panels said that they are not receiving adequate data from the IWG facilitator to make informed decisions. They also discussed that a change may be needed from what is stated in the bill to how the state deals with fraud. Commission members expressed concern with the ability of the IWG to meet the January 2027 deadline. At the request of several panelists, Commission members offered some suggestions to help the IWG shape the recommendations it puts forward. Mullica asked the panelists to ensure they consider how to better use technology to advance efficiencies. Panelists expressed concerns with the ability of the state to have the needed technology available in the timeframe given in the bill. Members of the Commission expressed similar concerns and the impact on individuals accessing the services they need in a timely manner. 

VII. Public Testimony 

The Commission heard testimony from 18 individuals. These include providers and representatives of provider agencies, including peer support service providers; parent caregivers; and representatives of advocacy organizations. Topics covered included:

• The need for a forensic audit of HCPF 
• Family caregiver soft caps 
• Peer support services oversight and accountability measures 
• Peer support licensing 
• Olmstead provisions and PETI 
• Regulatory complexities 
• Agency and provider overhead and profit margins 
• Caps on homemaker services   
• Provider rates 
• Maintaining coverage for immigrants and refugees. 

IX. Adjourn 

Senator Amabile adjourned the meeting at 6:21 pm.

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

The post Colorado Medicaid Commission Meeting Summary – October 7, 2026 appeared first on AdvocacyDenver.

In this series of Policy Perspectives, ADVOCACYDENVER is providing synopses of meetings of the Colorado Commission on Medicaid. This edition covers the meeting held on September 17, 2026 at 10am. The Colorado Commission on Medicaid is working toward the goal of creating a sustainable Medicaid program for the state. The Commission will present their final report to the General Assembly and Governor in December.  

The Commission continues to seek stakeholder feedback from people who use, provide, pay for, or work in the Medicaid program. If you wish to provide feedback through the long-form survey, click HERE. If you prefer a shorter survey, you can respond HERE.

Agenda & Materials: 

The meeting agenda and materials can be found HERE.  

Recording of the meeting can be found HERE.

Present for this Meeting: 

• Senator Judy Amabile (D), Chair 
• Representative Kyle Brown (D), Vice Chair 
• Representative Carlos Barron (R) (departed at 6:00 pm) 
• Senator Jeff Bridges (D) (joined the meeting at 10:50 am; departed at 5:07 pm) 
• Senator Lisa Frizell (R) (departed at 5:07 pm) 
• Representative Lindsay Gilchrist (D) 
• Senator Barbara Kirkmeyer (R) (departed at 5:30) 
• Senator Kyle Mullica (D) 
• Representative Emily Sirota (D) (participating remotely) 
• Representative Rick Taggart (R)  

I. Call to Order and Opening Remarks  

Senator Amabile started the meeting by acknowledging that members of the Commission want to start identifying solutions. She asked Commission members to approach today’s meeting with a focus on solutions. Representative Brown added that the problems with Medicaid sustainability are dire and that the Commission is in a no-win situation. Members are faced with “choosing the least worst options.” He added that all members of the Commission are committed to finding the best solutions for a sustainable Medicaid system in Colorado.

II. Department of Health Care Policy and Financing and Office of State Planning and Budgeting Presentation 

Mark Ferrandino, Director of the Office of State Planning and Budgeting (OSPB), and Gretchen Hammer, Executive Director of Health Care Policy and Finance (HCPF), presented to the Commission. Director Ferrandino began by sharing an examination of overexpenditures for fiscal year 25-26 (FY25-26) and a preliminary forecast for FY26-27 and FY27-28 expenditures. Click HERE for the slides for this section. 

HCPF overspent its FY25-26 budget by $157.9 million. Colorado is not unique in this overexpenditure for FY25-56. The largest area of overexpenditure was Medical Services Premiums ($200 million). Largest areas of underexpenditure were Other Medical Services (-$27 million) and Office of Community Living (-$24.3 million). 

Growth in Medicaid expenditures for FY25-26 was +$159 million / +2.8 % compared to FY24-25. Forecasts continue to show significant growth in General Fund expenditures for FY26-27 (+$443 million / +7.7%) and FY27-28 (+$918 million / +16.1%). The state is not seeing a growth in enrollment, but rather a growth in usage. Overall, the percentage of the state’s General Fund spent on HCPF and Medicaid has grown significantly since 2020. This is an unsustainable trajectory for the state. Nationally, Colorado is among states with the highest growth rate in percentage of General Fund spending on Medicaid. Within HCPF, Behavioral Health, Community-Based Long-Term Care, and the Office of Community Living are where Colorado has seen the highest rates of increased expenditures since 2018. 

Members of the Commission asked Director Ferrandino several clarifying questions. The Governor’s office will submit its suggestions for spending cuts as a part of the proposed budget it submits to the Joint Budget Committee (JBC) at the beginning of November. Director Ferrandino stated that the cuts will focus on the areas of highest growth. Senator Amabile closed this section of the meeting by stating that the Commission intends to look at solutions broadly, for the entire Medicaid system in Colorado, not just for the areas of highest growth. In particular, she added, Community-Based Long-Term Care and the Office of Community Living serve those who are the most vulnerable in our state. Representative Taggart added that the General Assembly must also consider measures of outcomes as it works to identify where cuts should be made. 

III. Where Things Stand 

HCPF Executive Director Hammer began her presentation to the Commission. Click HERE for the slides that Hammer used. Her focus was examining growth in Medicaid program expenditures between FY20-21 and FY25-26. She identified three areas with the most growth: Acute Care Services (+ $3.0 billion / + 54%; increase largely driven by pharmacy expenditures), Behavioral Health (+ $733 million / + 93%), and Community-Based Long-Term Care (+ $2.5 billion / + 124%). Hammer identified that to some extent, Colorado has seen growth in these areas because of changes in state policy and intentional changes in expenditures. (See slide 3). Nationally, other states are experiencing growth in the same areas of care. Hammer stated that HCPF “takes accountability for the cost growth and responsibility for the previous year overexpenditure and the forecasted increased expenditure in this fiscal year.” She went on to say that HCPF is committed to working collaboratively with the General Assembly and stakeholders to create solutions to ensure sustainability. 

Hammer presented an overview of HCPF’s $157.9 million General Fund overexpenditure for FY25-26. (See slide 6) and the projected budget shortfall of $1.03 billion ($442.5 million in General Fund) for FY26-27.  Senator Kirkmeyer asked for a deeper examination of some areas of overspend and a look at the costs of lawsuits which have not been included in this analysis. Hammer stated that they will get deeper into some areas during this presentation and that she will have HCPF staff prepare information on the costs of lawsuits for the Commission. Representative Mullica stated that the numbers provided by HCPF to him at different times and in this presentation today are not adding up. He stated that he is also frustrated by the projections for cost increases in FY26-27 caused by forecasting errors by HCPF.  

Hammer stated that these increases remain as projections, and that HCPF needs to take action today to reduce these costs.  HCPF staff members are already starting to create action plans for cost savings in four areas: 

1. Driving administrative efficiencies
2. Aligning benefits and services to maximize impact and value
3. Ensuring program integrity and fiscal accountability
4. Maximizing federal and non-general fund resources. 

Hammer spent some time explaining preliminary plans for each area. (See slides 8-25.) The Commission spent some time discussing the plans. Highlights of this conversation include conversation about pharmacy benefits and rebates. Pharmacy costs continue to rise although the percentage of pharmacy rebates paid to the state continue to drop. The remainder of pharmacy rebates go to the federal government. Specialty drug costs, which are substantial and growing, are difficult to predict.  

Senator Kirkmeyer asked for the dollar amount that HCPF is anticipating saving on the various areas of the action plans. Executive Director Hammer answered that these figures are not yet available. HCPF anticipates having them by the next Commission meeting and will present them. Hammer stated that her intention today was to get some direction from the Commission on the action plans and then bring the figures to the next meeting. 

Senator Kirkmeyer asked Director Ferrandino about any direction that the former HCPF Executive Director received from the Governor’s office about projected savings that have not materialized. Director Ferrandino stated that the Governor’s office has spent much time discussing various concerns about the former Executive Director, though not to a level that was sufficient to resolve the concerns. 

Director Ferrandino left the meeting at 11:50 am. 

Within Behavioral Health, the areas that have had the most growth are Peer and Support Services, Residential Substance Use Disorder (SUD), and Outpatient Psychotherapy. Hammer stated that HCPF is focused on slowing these areas of cost growth within Behavioral Health. Senator Kirkmeyer emphasized the need for accurate fiscal notes when the General Assembly considers funding new programs. In 2021, the bill authorizing Peer and Support Services had a fiscal note that anticipated a General Fund expenditure of $35,000. In FY24-25, the General Fund expenditure for these services was close to $150 million. Amabile added that the Commission ought not seek to cut entire programs but rather make sure that programs are adequately serving people and are well-regulated. 

IV. Long-Term Services and Supports (LTSS) Presentation  

Bonnie Silva, Director of the Office of Community Living at HCPF joined Executive Director Hammer to present to the Commission. In this presentation, Silva and Hammer presented an overview of a series of fact sheets on Long Term Services and Supports (LTSS) to the Commission. (Click HERE for the fact sheets covered during this presentation.) 

SIlva began by reviewing the scope and size of LTSS in Colorado. Approximately 100,000 people in Colorado are on Medicaid waivers that include LTSS. All LTSS recipients have a disability that requires a level of care that, if not for the LTSS provided, would necessitate them to live in an institutional setting. Silva also explained how LTSS fit into the suite of services that are available to Medicaid recipients in Colorado, how individuals qualify for waivers and LTSS, and how the state provides services (agency-based, in-home support services (IHSS), and consumer directed attendant support services (CDASS)). Silva gave two hypothetical examples of LTSS recipients to show the different services they would receive. 

Colorado has made significant investments into its LTSS system. As a result, Colorado scores 5th overall for LTSS performance and has increased the percentage of LTSS members receiving services in community settings from 78% to 84%. A good deal of the increases in costs of LTSS to Colorado can be attributed to this growth in enrollment. Senator Amabile asked Silva to identify the driver of this growth. Silva stated that it is not one single factor. Some growth can be attributed to expanded options for family caregivers and some to increased awareness of the availability of LTSS through waivers.  

Cost for LTSS has grown along with enrollment and increases in usage. LTSS now accounts for 48% of the General Fund spend for Medicaid and serves approximately 8% of the Medicaid population. Although HCPF is implementing sustainability actions, costs for FY26-27 are expected to exceed the budgeted amount by $245 million. The primary drivers of this increase include higher participation in:

1. Personal Care and Homemaker Services under Community First Choice (CFC
2. Community Connector
3. Long Term Home Health
4. Enrollment. 

Senator Amabile asked Silva to assess the efficacy of the cuts to Medicaid that the General Assembly made last session. Hammer responded that we are only in the third month of this fiscal year. It is too early to make any assessment of the cuts, though HCPF is monitoring these cuts very closely. Silva continued and added that projections of increased costs are due to growth outpacing projections, particularly for homemaker services for EBD waiver recipients and personal care services for children’s waivers. Silva attributed much of this growth to implementation of Care First Choice (CFC) and providers marketing to members. HCPF has just passed rules prohibiting these marketing behaviors.  

Silva shared that HCPF is working on developing an action plan for cost savings and is currently engaging in stakeholder outreach as a part of developing this plan. Silva updated the Commission on implementation of cuts made during the last legislative session. These include provider rate reductions, homemaker limits, community connector reductions, HCBS soft caps, weekly caregiver caps, and PETI for DD waiver recipients.

Hammer concluded this section of the meeting by acknowledging that HCPF is committed to both the short-term actions discussed today and longer-term sustainability measures that the Commission and General Assembly adopt. Both are a necessary component of ensuring Medicaid sustainability for Coloradans. Hammer identified six key areas to consider for longer-term redesign of Colorado’s Medicaid system: 

1. Eligibility & Enrollment
2. Benefit & Service Design
3. Utilization & Authorization
4. Provider Reimbursement
5. Delivery System & Care Models
6. Provider Participation, Accountability, & Quality 

V. Families and Advocates Panel  

A panel of family caregivers and advocates presented to the Commission. These included Nicole Bishop, Margaret Williams, and Charlene Wiley. Ms. Bishop began the presentation and shared how she is able to live independently through the waiver buy-in program. Ms. Williams shared her experiences as a family caregiver for her son Christopher, who is on an EBD waiver. She emphasized the self-determination that CDASS has provided to acquire care for Christopher. Ms. Wiley shared her experiences as a caregiver for her daughter who participates in the waiver buy-in program. Commission members concluded this section by asking several clarifying questions of the panelists. 

VI. Case Management Agencies and Providers Panel  

A panel made up of representatives of case management agencies and providers presented to the Commission. Panelists included Matt VanAuken, CEO of Developmental Pathways; Victoria Stewart, Area Vice President of Operations, Aveanna Home Healthcare; Dr. Cassie Littler, Director, Webb Pediatric Specialty Clinic, Denver Health; and Jodi Walters, CEO of Imagine!, a HCBS provider. 

Mr. VanAuken began the presentation and shared that the 15 case management agencies in Colorado serve all 100,000 individuals in the state who receive LTSS, and process over 2 million billable actions per year for those members. All transactions are fee-for-service and must be processed individually. Only 17–20% of intake work results in payments to these agencies. VanAuken stated that from his perspective, most stakeholder engagement of members by state agencies is perfunctory. He would like to see members being given a stronger voice in the system that provides their own care, and a stronger unified leadership structure for HCPF. He also shared that systems and processes are unnecessarily complex and misaligned, which complicates the case management process and is burdensome to members. The 15 case management agencies in the state have been meeting and are putting together a list of recommendations to share with the Commission. 

Ms. Walters then gave her presentation and began by stating that providers want to work with the Commission to ensure a sustainable Medicaid system for the state. She shared that payments for Medicaid services are highly complex and result in hundreds of payment structures, rates, and procedures. Provider rates are not simple pass-through payments.

There are no separate administrative payments to provider agencies, although administrative requirements are highly complex. Administrative overhead rates must be evaluated against the functions and risks taken on by the provider agency. Walters’ recommendations to the Commission focused on simplifying the entire system. The complexities of the system have costs to members, providers, and agencies, and reduce our capacity to provide a high level of care to all. 

Dr. Littler stated that she and pediatricians from across Colorado are committed to working with the Commission to ensure high-quality care for the state’s most vulnerable children. For pediatricians that serve children with complex health needs, the work of caring for the child extends well beyond the time of the office visit. Doctors do not receive compensation for this time outside of clinic visits. Reducing complexities in the system and supporting high-quality care coordination would help to reduce the burden on families and doctors.  

Ms. Stewart emphasized that the state needs to have a singular comprehensive assessment tool to ensure that members’ needs are addressed in a coordinated and efficient manner. She added that care coordination is needed to ensure that all providers work efficiently and within regulatory boundaries. Providers must be paid adequately so agencies can maintain a competent network of providers across the state. Stewart stated that personal care services were not available through children’s waivers prior to the switch to Community First Choice.  CFC made these services available for these waivers, which amounts to a policy change. The policy change resulted in the growth of delivery and cost of personal care, not targeting and marketing by providers.  

The Commission asked questions of the panel. Senator Frizzell asked Mr. VanAuken to cite some examples of perfunctory stakeholding by state agencies. He said that redesign of case management system included conversation that sounded more like, “We are going to do this…” rather than “What should we be doing?” Case management agencies and members need a seat at the table when solutions are developed, not after they are chosen. 

Senator Kirkmeyer asked panelists if any of their organizations were owned by a private equity firm. Aveanna Home Healthcare is owned by a private equity firm. Kirkmeyer then asked Ms. Stewart if Aveanna collects 50 percent overhead and if other private equity-owned agencies do so as well. Stewart stated that Aveanna does not collect that much and their margin is very slim; she declined to speak on behalf of other agencies. Ms. Walters added that most provider agencies are in this work for the right reason.  She supports the newly established provider accountability rules. Mr. VanAuken said that provider agencies that are comprehensive and provide benefits and training to their staff are a very different thing than those that are not comprehensive. Those that are not comprehensive should be paid at a different rate. 

Senator Kirkmeyer stated that changes resulting in savings over time won’t solve our needs right now. She said that immediate cuts are needed and asked the panel to consider what a freeze or discontinuation of Community First Choice would mean for providers and families. Mr. VanAuken said that this cut would be catastrophic for some families and mediocre for others.  

Representative Taggart requested that Director Bonnie Silva continue to engage in deep stakeholding even as the Commission continues its work. The voices of providers and members are key to the Commission’s work, though the Commission does not have the time in its meeting schedule to hear from all stakeholders as well as needed. 

Representative Brown asked Ms. Walters to go into more detail on one of her ideas for simplifying case management. Walters stated that HCPF is held publicly responsible for all LTSS, although other state agencies carry out some services. Right now there is no clarity when departments are at odds on what a member needs. A clearer line of authority would better serve members and result in efficiencies. 

Senator Frizzell asked Dr. Littler to explain how we can better judge any positive results of early preventative care for children. Justifying the cost of these services will help the Commission in its decision-making. Dr. Littler agreed that early prevention of some things, like heart health, may not be apparent for years and years. Things that are more readily apparent include Kindergarten readiness, on-time graduation from high school, etc. These indicators are valid. 

Senator Amabile asked the panel to consider duplication and inefficiencies in care coordination that may exist. Dr. Littler answered and said that she agrees with this concern. She feels that care coordination is best when it is provided upon request of the family or member. Amabile continued to ask for an explanation of what is attractive about Medicaid for provider agencies when margins are so slim or non-existent. Stewart stated that the most reputable agencies are creative and work to adjust withing ever-changing boundaries. Some agencies, however, are more likely to take advantage of the system and members. Dr. Littler added that there are opportunities for agencies and providers to make money off of the Medicaid system. Many choose not to maximize their profit in pursuit of providing the care that members need. A focus on documenting the outcomes for members would help to better distinguish which providers and agencies are better serving members. 

Representative Taggart stated that he would like to be better informed about care coordination. In recent years, HCPF has added substantial funding for care coordination, but the General Assembly has not received information that documents the cost savings realized by this investment. Dr. Littler said that care coordination is vital to families seeking care for their children across many agencies and providers.  

Senator Kirkmeyer stated that the Commission needs to hear where cuts can occur, rather than people telling them that their own program is the most important and merits saving. She asked for more people to come forward to suggest cuts. She asked if the state can end Community First Choice for people who are not on waivers. Mr. VanAuken replied that he cannot make recommendations for cuts because his organization is contracted by the state to provide services. He recommends that advocates, families, organizations, and HCPF come to the table to suggest cuts. The Office of Community Living is currently working on completing this sort of stakeholding and will be bringing recommendations to the Commission at a later date.

VII. Committee Discussion  

The next Commission meeting is scheduled for October 7. The topics covered in this meeting will include: 

A deep dive on Behavioral Health 

Hearing from some counties about immediate sustainability measures 

Discussion of the Action Plan that HCPF presented today and longer-term sustainability measures, though in a more structured format.  

VIII. Public Testimony 

The Commission heard testimony from 31 individuals. These included providers and representatives of provider agencies; representatives of advocacy organizations, including ADVOCACYDENVER Executive Director Pamela Bisceglia and Arc of Colorado Executive Director Elizabeth Moran; Medicaid members, including waiver recipients and buy-in members; parents; family caregivers; and representatives of associations. Topics covered included: 

• CHASE funds 
•  Family caregiver soft caps 
• PETI for DD waiver recipients 
• Calls HCPF accountability and the need for an independent audit of HCPF 
• Extension of the Commission’s work beyond December 2026 
• Avoiding additional service cuts to those with IDD 
• PASA fees 
• Preserving the Medicaid buy-in program 
• Equity in program cuts measured by impact on individuals rather than dollars 
• Health First Colorado buy-in rates 
• HCPF integrity and accountability 
• Streamlining processes and cutting out the agencies in the middle 
• Provider rates. 

IX. Close 

Senator Amabile adjourned the meeting at 6:49 pm. 

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

The post Colorado Medicaid Commission Meeting Summary – September 17, 2026 appeared first on AdvocacyDenver.

The Colorado Commission on Medicaid met on September 2, 2026. In this series of Policy Perspectives ADVOCACYDENVER is providing this synopsis of this and subsequent meetings as the Commission works toward its goal of creating a sustainable Medicaid program for the state. The Commission will present their final report to the General Assembly and Governor in December.

The Commission continues to seek stakeholder feedback from people who use, provide, pay for, or work in the Medicaid program. If you wish to provide feedback through the long-form survey, click HERE. If you prefer a shorter survey, you can respond HERE.

Agenda & Materials

The meeting agenda and materials can be found here.

The main slide deck for this meeting can be found here.

Recording of the meeting can be found here.

Present for this Meeting:

• Senator Judy Amabile (D), Chair
• Representative Kyle Brown (D), Vice Chair
• Representative Carlos Barron (R)
• Senator Lisa Frizell (R)
• Representative Lindsay Gilchrist (D)
• Senator Barbara Kirkmeyer (R) – Entered meeting at 12 noon. Left @ 4:00 pm.
• Senator Kyle Mullica (D)
• Representative Emily Sirota (D)
• Representative Rick Taggart (R)

Absent:

• Senator Jeff Bridges (D)

Note: The facilitator modified the agenda from what was posted on the Commission website. The summary below represents the modified agenda as included in the meeting slide deck. New for this meeting, the facilitator labeled each section of the meeting as a “Block” (Block A, Block B, etc.).

I.           Open and Orient (Block A) 

• The meeting began with a review of the agenda for today’s meeting.  
• The facilitator identified when the Commission will receive answers to several questions they asked at previous meetings. (See slide 4 of main slide deck.) Some will be answered at today’s meeting and others at future meetings. 
• The facilitator reviewed feedback gathered from surveys and office hours on issues relevant to today’s topics.  (See slides 5-12 of main slide deck.) Highlights include: o Where to look before cutting care (slide 8): Administrative layers, Contracts and overhead, Duplication in coordination, Look outside the program. o What people call waste (slide 9): Administrative; Fraud, but specifically fraud in billing practices by providers. 

 Follow-up question: What does HCPF say about provider fraud, as suggested by survey respondents? The facilitator stated that she will get a response to this question from HCPF for a future meeting. 

• How are rates set? (Slide 10). o Federal money (Slide 11)—Most survey respondents don’t know about how to obtain more federal dollars. A few respondents made the following suggestions: Administrative claiming; Dual eligibility; Local match; and A disallowance to verify (correcting audit mistakes). 
• The facilitator presented several implications for today’s meeting taken from this feedback (Slide 12):  
  • Listen for the administrative dollar. o Program integrity is not about members. 
  • The rate is not the only rate. 
• Commission members asked for the following information in addition to what is on Slide 12:
  • A follow-up on the list of contractors previously given to the Commission.  The Commission would like a complete listing of all contracts that HCPF has with subcontractors; what work is included in each contract; contract amount ($$); contract end date, etc. They would also like to 

know if any contracts are covering tasks for which the legislature allotted staffing, and, if so, has HCPF retained these staff members?  

II.       The Money as the Department Describes It (Block B) 

• HCPF Interim Executive Director Gretchen Hammer and HCPF Chief Financial Officer Josh Block presented and answered questions from the commission about sources of funding for Medicaid in Colorado.  
• Block began the presentation by stating, “This is complicated…” Understanding the sources of funding for various Medicaid functions is not simple. Maximizing the federal funds the state receives is not something that is straightforward.  Block continued by stating that at its simplest, Medicaid is a system of paying for services with a mix of federal funds and state funds. Federal funds never come without state funds. State expenditures are necessary to draw down federal dollars. 
• Block continued by reviewing the types of state funds available in Colorado. These include: general funds; local funds; provider fees; intergovernmental cash transfers; CHASE fees; cash funds; and on and on. In part because of TABOR, Colorado has many rules that govern what funds can be used and how. Pages 13 of this document includes detailed descriptions of some of these funds. Block stated that all federal funds are actually federal match funds. There is no single federal match rate. The match rate will vary across programs and populations served. Pages 1-2 of this document include further details on this issue. 
• Block then turned to discussing provider rates, drawing from pages 3-19 of this document. He went on to explain how provider rates are set. They are not connected to federal match rates, nor is there any single methodology that determines how rates are set. Provider rates are dependent on the type of provider and state and federal laws. HCPF does not have independent authority to set most provider rates. Some are set by the Joint Budget Committee and the General Assembly. Some are cost-based rates (pharmacy and others) or bundled rates (rates for a bundle of services – i.e., a course of chemotherapy). Others use a fee schedule, especially when the provider rate is not defined in statute or some other way. These are not directly connected to Medicare rates. The fee schedule is set by the General Assembly as a practice in CO, but not required. The MSB can also take action to reduce or modify these rates. The Medical Provider Rate Advisory Committee (MPRAC) makes recommendations but cannot set rates on its own. Ultimately, it is up to the General Assembly to take action based on recommendations from MPRAC. MPRAC provides a 

structure and expertise for the state to review rates. Senator Amabile asked, “Is 

MPRAC necessary? Is this possibly an opportunity to streamline?” Hammer, Block and other members of the Commission responded, “How would we otherwise get an expert insight into provider rates?” Medicaid capitation rates are a form of managed care in which HCPF pays managed care organizations in advance on a per member rate. These must be based on what we actually expect the MCO to spend per patient. Therefore, capitation rates are not under the control of the legislature. The Commission requested that HCPF provide models of potential savings for switching more payments to managed care or capitation.  (Editorial note: pages 9-19 of the document for this section is a full listing of provider rate suggestions made by MPRAC between 2023-2025, and what rates were ultimately enacted by the General Assembly. Identifying the most frequent provider types for individuals with disabilities is pretty easy to do in this format. I encourage you to look at the details provided and see how far off the legislature has been from recommendations made for those who serve the disability community.) 

• Block then began to explain how HCPF approaches maximization of Federal matching dollars. (See pages 1-2 of this document.) HCPF claims that its program is already built around maximizing federal funds, and its strategy to do so is laid out in the document provided. Maximizing federal match dollars can often require action by the General Assembly or the Medical Services Board. A list of what federal matching dollars are potentially available to states does not exist. At times, accepting federal funds comes with risk. Higher match rates can be (often are) temporary and always require something from the state. 
• Members of the Commission closed this portion of the meeting with several questions for Hammer and Block: o Question: The amount of CHASE fee expenditures per member for buy-in members is much higher than for other members also supported by CHASE fees. Why is this? Hammer: The difference lies in the type of services being provided and the type of provider. Services for waiver buyin members are, by design, intended to keep people out of institutions. These services are more expensive but also ultimately save the state money by keeping people out of institutions. Home-based care is expensive. The waiver population in the buy-in program costs the state 

25% of what the waiver population that is not in the buy-in program costs. 

o Question: How are we judging quality and effectiveness? Hammer: HCPF will come back to share the metrics it uses. 

III.   How the State Knows the Money Is Spent Properly (Block C) 

• HCPF Chief Operating Officer Ralph Choate and a member of his staff presented pages 14-16 of this document to the Commission.  
• Choate began by stating that program integrity is not just the responsibility of HCPF’s fraud, waste, and abuse team. Rather, program integrity is everyone’s responsibility. Provider education is at the core of program integrity. After reviewing the handout, the Commission asked several questions: oQuestion: We know that you have these systems in place. Are you adding more things to integrity processes? Are any drawing on new technology? What are some other ways we can improve? Choate: Some additional integrity processes are include in the handouts. He would like additional emphasis on ensuring all who are dual eligible for Medicaid and Medicare, are enrolled in both and that Medicare is always billed first. The Commission would like for HCPF to find a way to better understand how many are eligible for dual enrollment but are not dually enrolled. Ensuring that any third party liable for expenses pays first is another necessary focus to save funds. Providers need to bill third party private insurance or other responsible parties first. Program Program Integrity efforts can now include extrapolation audits thanks to legislation passed in 2026. These audits use a sample of payments for a provider to determine fraud or error rate across all payments to that provider. HCPF can then ask for return of provider payments based on the sample error rate. Question: How do we get an estimate of these savings to use for our budgeting process? Choate: We are working on developing that and will send you our progress so far. 

IV.   Eligibility Changes and Risks (Block D) 

The Commission postponed this section of the meeting because they are behind their anticipated schedule. They want to take advantage of the panelists who are in the room first. 

V.       The Rural Framework (Block E) 

• This section drew primarily from a whitepaper included in today’s handouts. With support and involvement of the Buell Foundation, an Independent Rural Health group has come together and wrote this paper. They are continuing to work together to advance rural health in the state. See pages 2-3 for a listing of who is involved. Buell Foundation CEO Steve ErkenBrack and three other authors presented this section to the Commission. 
• Commission members had several other documents related to rural health in their packets today. While they didn’t address these directly, they did inform the overall conversation.  
• ErkenBrack began this portion of the meeting by stating that the sustainability of rural health providers is an existential concern for Colorado’s rural communities. The funding problem for rural health providers is acute and there are no quick fixes. The group they have put together is advocating for local autonomy: allow rural providers and the communities they serve to decide which services are most important within a budget. More fee-for-service and service controls will not solve the problem. ErkenBrack estimates that implementing local control in rural areas would take 5 years to fully implement and would have to adhere to existing federal and state regulations. He also suggested that the Commission examine Maryland’s hospital payment system. Maryland uses a public utility funding model for hospitals in which all services receive the same payment regardless of who is paying. Medicaid, Medicare, and private insurance all pay the same amount for the same service. The fee-forservice system does not work in rural communities because it incentivizes rural providers to provide services and target patients that are most profitable, not those that are most needed to ensure healthy communities. 
• The Commission asked the Rural Health group to put together recommendations for specific steps to take to implement this idea. The group agreed to do so and will return their answer to the Commission in 6 weeks. 

VI.   … and Safety Nets (Block E) 

• Denver Health CEO Donna Lynne and Lincoln Health (Hugo, CO) CEO Kevin Stansbury presented this portion of the meeting. Lynne prepared a slide deck and a fact sheet for the Commission, though this portion of the meeting was very much an open conversation rather than a presentation. 
• Lynne opened by stating that HR1 implications are top of mind for Denver Health. HR1 is estimated to ultimately cause 20,000 Denver Health patients to lose their insurance coverage. Most will become uninsured and the hospital will still need to treat them. Denver Health will maintain all emergency services but will likely need to cut back on its primary care services to many of its patients to balance its budget. Lynne argues that this will end up costing much, much more in the end because people will lose preventative healthcare. Lynne also pointed out to the Commission that Denver Health is the only entity in the state that serves as both a Managed Care Organization and the provider of that care. She said that there are some benefits to this arrangement. 
• Stansbury stated that what Lincoln Health does most is primary care and management of chronic conditions. They do this because Lincoln is the only one in its area who does it, not because it’s profitable. 
• Both Lynne and Stansbury agree that what is necessary is long-term, fundamental change in how Colorado supports and funds hospitals. 
• Lynne stated that commercial insurance providers are a huge problem for Denver Health. Patients covered by commercial insurance are a small portion of Denver Health’s patient mix as compared to most other hospitals in the state. As a result, commercial insurers try to negotiate their rates down and say “You’re not that important to us.” Stansbury says that his small rural hospital has the same problem. He says that some commercial insurers pay Lincoln Health less than what it receives from Medicaid for the same services.  
• Lynne says that Denver Health would like to collect on state directed payments that the governor’s office will not allow them to collect from the federal government. The governor argues that doing so would be too risky and would trigger audits and subsequent clawback of funds. Denver Health argues that they could mitigate for these risks. Further, Denver Health would like to use a per diem rate methodology for some services, which they predict will provide them with an additional $500 million in federal funds. Again, the governor’s office will not allow this. 
• Both Lynne and Stansbury agree that the state should seriously examine a uniform payment model (the utility model from Maryland) as discussed in the last section of the meeting. Stansbury says that if the state considers going in this direction, a trial in obstetrics would be the right starting point.  

The Commission returned to V. Eligibility Changes & Risks (Block D), which it previously skipped. 

• HCPF Chief Financial Officer Josh Block returned to present and answer questions. He directed the commission to pages 3-6 of this document and pages 10-11 of this document. 
• Block stated that because of HR1 requirements kicking in on October 1, the Hospital Provider Fee income will begin to drop. Additional reductions will occur each year until 2032. Because Hospital Provider Fees are CHASE funds in Colorado, CHASE fees will eventually no longer be sufficient to fund what they are supposed to fund. We will likely reach this point in the next two years. State statute dictates how Colorado will handle this shortfall. Services will be cut or eliminated in an order specified by statute. (The handouts contain details for the anticipated cuts.) Commission members asked BIock for options. Block stated that changing the statute is in the purview of the General Assembly but any changes would also have to conform to federal regulations. Representative Brown requested a more expansive conversation on this issue that includes additional stakeholders, to be held at a future meeting. The Commission also requested additional analysis by HCPF as to what other options for cuts could look like (i.e., percentage cuts across the board as opposed to fully dropping any one category of funding.) 
• Representative Taggart requested that at the next meeting HCPF provide its response to the suggestion of implementing uniform provider rates (utility model) brought up in prior conversations today. He also would like information on how Oregon is using the Rural Healthcare Transformation Fund for projects that are not new or innovative. (An assertion made earlier in the meeting is that the fund can be used for existing programs and services (sustainability), whereas HCPF has stated that it must be used for only new programs and services (innovation) per federal rules.) 

I. Public Comment (Block F) 

• The Commission heard public comment from 16 people. These included Arc of Aurora Executive Director Hanne Railey, CCDC Co-Executive Director Hillary Jorgenson, representatives of several behavioral health provider professional organizations, directors of several behavioral health clinics, a representative of Impacted Caregivers of Colorado, several family caregivers, a host home provider, a DD waiver recipient, and a representative of Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR). Topics covered included:
  • Waivers, home and community based services and supports (HCBS), and long-term services and supports (LTSS).
  • The buy-in program for waivers o Host homes.
  • PETI for those on the DD waiver.
  • The Colorado Single Assessment and its revision.
  • Transparency about how RAEs are spending funds.
  • Provider rates, particularly those for behavioral health services, and the financial “architecture” of Medicaid. Many highlighted how provider rates intersect with the financial viability of clinics and other service providers, as well as access to care for members.
  • Immigrant Coloradans who will lose health care coverage by the end of the year as a result of HR 1. 

II. The First Recommendation for Consideration (Block G) 

• The facilitator asked the Commission for ideas for cost-savings that it may have identified during this meeting. She mentioned that they have identified reducing administrative layers, maximizing the federal match, and dual enrollment. Senator Amabile brought forward that she would like the Commission to consider cost sharing, such as copays for certain services. 

III. Close

• Senator Amabile adjourned the meeting at 5:02 pm. 

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

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The 2026 Colorado legislative session adjourned on May 13. In this issue of Policy Perspective, we provide a summary of ADVOCACYDENVER’s 12 priority bills for this session. ADVOCACYDENVER strongly supported 11 of these bills and opposed one. We then show you how every member of the Colorado Legislature voted on these bills and provide them with a “grade” – the percentage of votes each member cast that were aligned with our position on these bills—and information on whether not Governor Polis has signed each bill into law.

ADVOCACYDENVER recognizes that none of the bills we supported is perfectly aligned with all our values and priorities. This is the nature of all legislation that is established through negotiation and compromise. Very often, we would have preferred to have additional funding dedicated to a particular piece of legislation, or expansion capacity for state agencies to carry out monitoring and enforcement included in a bill, etc. In particular, we would have preferred to avoid all cuts to Medicaid included in this year’s budget. Given Colorado’s fiscal realities, we understand that even legislators who led or supported these bills or introduced specific budget cuts likely would have preferred the same. That said, ADVOCACYDENVER believes that each of the bills we supported this year offers a meaningful change from the status quo and offers a path to continued improvement in future years.

We will close this Policy Perspective with recognition of legislators who showed strong support for the disability community through their leadership and their votes.

ADVOCACYDENVER’s Priority Bills for 2026

HB26-1040 Sterilization Rights of Person with Disabilities

Prior to the enactment of this bill, Colorado was one of only two states that allowed forced sterilization of people with disabilities. This legislation ended this practice except in cases where there is an imminent threat to the individual’s life and health.

Status: Passed and signed by Governor Polis.

HB26-1043 Transportation Network Company Discriminatory Practices

This bill strengthens accountability and reporting requirements for consumers’ complaints of discrimination when using transportation network companies, such as Uber and Lyft. The legislation requires companies to include on their apps a place where consumers can report complaints when they are denied a pickup by a driver. Companies then must provide monthly reports of these complaints to the state, with all personal information removed. The state may also fine companies if it is found that they discriminate against people with disabilities or fail to submit monthly reports.

Status: Passed and signed by Governor Polis.

HB26-1045 Disabilities Housing Protections

HB26-1045 puts protections into state law for renters who have service animals, including both assistance animals and emotional support animals. While such protections have previously existed at the federal level, this law permits the state to enforce these protections.

Status: Passed and signed by Governor Polis.

HB26-1096 Colorado Medicaid Access to Primary Care Services

This bill would have allowed primary care providers (PCPs) who accept Medicaid to charge Medicaid recipients cash fees for services rendered. The PCP would then only accept Medicaid payments as an ordering, prescribing, and referring provider. ADVOCACYDENVER opposed this bill.

Status: Passed by House but lost in Senate committee.

HB26-1141 Discriminatory Practices in Public Schools

HB26-1141 identifies public elementary and secondary schools and public institutions of higher education as places of public accommodation and bans discrimination in these accommodations for protected classes. Protected classes include disability, race, creed, color, sex, sexual orientation, gender identity, gender expression, marital status, national origin, ancestry, pregnancy, and parental status. Public institutions of higher education are required to establish grievance procedures and designate an individual to serve as a coordinator responsible for enforcing these procedures.

Status: Passed and signed by Governor Polis.

HB26-1147 Host Home for People with Intellectual & Developmental Disabilities

HB26-1147 requires the state to create a database containing information about host homes and their service agencies. The database must be made available and accessible by HCPF, the department of public health and environment, and service provider agencies. Information may only be shared with the public upon determination of HCPF and in ways consistent with state and federal privacy laws. The bill clarifies that host homes are residential settings and prohibits local governments from imposing additional regulations on host homes other than those in place for other residential properties.

Status: Passed and signed by Governor Polis.

HB26-1328 Medicaid Nonemergency Medical Transportation

This bill establishes a new oversight structure and procedures for nonemergency medical transportation (NEMT) under Medicaid. Some changes to NEMT included in the bill include the establishment of a Transportation Community Advisory Board, requirements for verification of Medicaid member’s eligibility for NEMT services during scheduling, requirements for HCPF rulemaking, and a timeline for implementation.

Status: Passed and signed by Governor Polis.

HB26-1382 Support of Coloradans with Disabilities

HB26-1382 creates the Colorado Disability Funding Authority, which will assume the responsibilities of the current Colorado Disability Funding Committee. The Authority will award grants or contracts to entities that assist individuals with disabilities obtain or retain disability benefits or other innovative programs that improve the quality of life of persons with disabilities. The legislation also creates a statutory requirement that fees collected from the sale of license places in retired styles and unique vehicle registration numbers be dedicated for support of this authority.

Status: Passed and signed by Governor Polis.

HB26-1425 Applied Behavior Analysis Services

This bill creates the Colorado Behavior Analyst Licensing Board. The board is authorized to license behavior analysts and assistant behavior analysts (registered behavior technicians). Beginning July 1, 2028, individuals who provide behavior analysis must be licensed. The bill also establishes a requirement for the licensure of applied behavior analysis clinics, to be overseen by the Department of Human Services.

Status: Passed and signed by Governor Polis.

SB26-023 School Finance Act

SB26-023 sets statewide base per pupil funding for the 2026-27 budget year at $8900.40, an increase of $208.60 from 2025-26. The bill also adjusts funding formulas to ensure that districts do not receive less funding this year than they did last year; that require rulemaking for determination of the district of residents for a child with a disability for circumstances not described under law; and that provide additional funding for students with disabilities in out-of-home placements.

Status: Passed and signed by Governor Polis.

SB26-125 Disability Rights Protections in Public Schools

SB26-125 puts federal laws relating to disability rights protections into state law. Specifically, the bill incorporates Section 504 of the Rehabilitation Act of 1973, the Individuals with Disabilities in Education Act, and the American with Disabilities Act. In doing so, the bill requires mediation efforts at the local level prior to enforcement by the State Department of Education. Should a school district intentionally violate the provisions of the bill and demonstrate an unwillingness to enter corrective action, the State Board of Education may withhold state funds from the district.

Status: Passed and signed by Governor Polis.

SB26-149 Pathways for Individuals with Mental Health Disorder

This bill creates new pathway for some individuals with mental health disorders who commit certain violent crimes. Overall, individuals who are not competent to stand trial and who are charged with a Victim’s Right Act crime, unlawful sexual conduct or indecent exposure, can be placed for involuntary treatment outside the criminal system or in an enhanced protective placement.

Status: Passed and signed by Governor Polis.

ADVOCACYDENVER 2026 Legislative Report Card

* Bill sponsor
— Excused or absent for this vote

Special Recognitions

ADVOCACYDENVER wishes to recognize these legislators for their notable support of the disability community during the 2026 legislative session.

Members of the Joint Budget Committee

• Representative Emily Sirota (D – Arapahoe & Denver), Chair
• Senator Jeff Bridges (D – Arapahoe, Denver, & Jefferson), Vice Chair
• Senator Judy Amabile (D – Boulder)
• Representative Kyle Brown (D – Boulder & Broomfield)
• Senator Barbara Kirkmeyer (R – Larimer & Weld)
• Representative Rick Taggart (R – Mesa)

Starting late last fall, the members of the Joint Budget Committee (JBC) began to craft a budget for the state that addresses a significant shortfall in funds available to spend—close to $1.5 billion. The budget initially proposed by the governor made severe cuts to Medicaid that disproportionately impacted those with intellectual and developmental disabilities. Throughout their interactions, we observed that all members of the JBC were keenly aware of the need to “do as little harm as possible” and to pursue accountability for Health Care Policy and Financing (HCPF), the state agency that oversees Medicaid. ADVOCACYDENVER does not wholly agree with the resulting budget, which still disproportionately impacts children and adults with intellectually and developmental disabilities. The damage was less severe than it could have been, however, thanks to the persistence, collaboration, and concern of these six legislators.

Lead Bill Sponsors

• Senator Judy Amabile (D – Boulder)
• Representative Jennifer Bacon (D – Denver)
• Representative Andrew Bosenecker (D – Larimer)
• Senator Jeff Bridges (D – Arapahoe, Denver, & Jefferson)
• Representative Kyle Brown (D – Boulder & Broomfield)
• Representative Chad Clifford (D – Arapahoe)
• Senator Lisa Cutter (D – Jefferson)
• Representative Meg Froelich (D – Arapahoe & Denver)
• Senator Cathy Kipp (D – Larimer)
• Senator Chris Kolker (D – Arapahoe & Jefferson)
• Senator Barbara Kirkmeyer (R – Larimer & Weld)
• Representative Meghan Lukens (D – Eagle, Moffat, Rio Blanco, & Routt)
• Senator Janice Marchman (D – Boulder & Larimer)
• Senator Kyle Mullica (D – Adams)
• Representative Amy Paschal (D – El Paso & Teller)
• Representative Jacque Phillips (D – Adams)
• Representative Gretchen Rydin (D – Arapahoe & Jefferson)
• Representative Emily Sirota (D – Arapahoe & Denver)
• Representative Rebekah Stewart (D – Jefferson)
• Representative Ty Winter (R – Baca, Bent, Crowley, Huerfano, Kiowa, Las Animas, Otero, Prowers, & Pueblo)
• Representative Yara Zokaie (D – Larimer)

These 21 legislators served as the lead sponsors of the 11 priority bills we supported. Lead sponsorship of a bill means much more than placing your name on a piece of legislation. It’s hard work to sponsor a bill! ADVOCACYDENVER wishes to thank these legislators for putting in the effort and dedicating much time on the floor and behind the scenes to build awareness and support for issues that are important for our community.

Bipartisan Sponsors of SB26-149

• Senator Judy Amabile (D – Boulder)
• Senator Cleave Simpson (R – Alamosa, Archuleta, Conejos, Costilla, Dolores, La Plata, Mineral, Montezuma, Montrose, Ouray, Rio Grande, Saguache, San Juan, & San Miguel)
• Representative Jarvis Caldwell (R – El Paso)
• Representative Julie McCluskie (D – Chaffee, Grand, Jackson, Lake, Park, & Summit)

These four legislators worked in a bipartisan manner to address a sensitive concern in our criminal justice system. They worked together to ensure that mentally ill and disabled individuals who are a significant threat to others receive the treatment they need. In doing so, they also protected victims from further harm and trauma. Ultimately, both houses of the Colorado General Assembly voted unanimously in support of this legislation—a testament to the effort these bill sponsors did to build support and consensus on this issue.

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

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In this edition of Policy Perspective, ADVOCACYDENVER shares some details on the second of two proposed pieces of legislation that would provide additional protection’s for students in Colorado. ADVOCACYDENVER stands in support of this legislation.

A group of federal laws establish the rights and protections for students with disabilities who attend public schools. These include Section 504 of the Rehabilitation Act of 1973 (Section 504), the Individuals with Disabilities Education Act (IDEA), and the Americans with Disabilities Act (ADA). Since their enactment, these laws have been clarified in numerous decisions by federal district courts and the U.S. Supreme Court and in rules and regulations issued by the federal government. Collectively, federal law provides robust, though certainly imperfect, guidance and requirements for schools as they provide a free and appropriate education (FAPE) to each student with a disability from ages 3 to 21. Further, federal law provides clear accountability processes for students and their families to use when schools fail to meet their obligations for students with disabilities.

The earliest of the laws above, Section 504, establishes fundamental civil rights for students with disabilities:

“No otherwise qualified individual with a disability in the United States… shall solely by reason of her or his disability, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance…” 29 USC 794(a).

Since the creation of the U.S. Department of Education (ED) in 1980, complaints about violations of these civil rights have been investigated and resolved by the Office for Civil Rights (OCR), a unit within the ED. The complaint process through OCR is notoriously slow and has been backlogged for many years. Cuts to the ED and OCR by the current administration, along with its shifts in federal priorities, have further exacerbated the challenge of resolving OCR complaints. By the government’s own reporting, OCR received over 9,200 new complaints between March and September 2025 and opened investigations on only 635 of those complaints. During this same period, OCR resolved over 7,000 backlogged cases. About 90 percent of the dated cases were not actually resolved. Rather, ED outright dismissed these cases.

Aside from submitting complaints to OCR, families have the option of pursuing civil litigation in federal court against schools that violate anti-discrimination laws. Doing so usually requires families to put up substantial financial resources and to find an attorney who specializes in education law. As such, families who are marginalized are rarely able to pursue this option.

Four members of the Colorado General Assembly, Senator Chris Kolker (D-Arapahoe & Jefferson Counties), Senator Janice Marchman (D-Boulder & Larimer Counties), Representative Jennifer Bacon (D-Denver), and Representative Jacque Phillips (D-Adams County) are putting forth a bill this session to help provide Colorado’s students with disabilities and their families the opportunity to pursue state-level enforcement of the civil rights established in Section 504. SB26-125: Disability Rights Protections in Public Schools, if enacted, would enshrine these civil rights in state law and provide state-level procedures to follow when students and families experience discrimination based on disability in public schools in Colorado.

Bill sponsor Senator Chris Kolker has stated,

The federal government has decimated the oversight and investigation pathways for 504 and ADA complaints. Now, Colorado will step in to protect the rights of our disabled students and staff by enshrining these protections into our state law. This bill is paramount for the protection of those with disabilities in our public education system, and I am proud to be a co-sponsor.

Specifically, SB26-125 would:

• Establish in state law the rights and protections granted to students with disabilities by Section 504, IDEA, and the ADA. The rights and protections enumerated in these federal laws are more specific and, at times, extend beyond what is currently written into state law.
• Require districts to establish a grievance process for disability-related discrimination complaints they receive. Following the grievance procedures articulated in Section 504 fulfills this requirement. 
• Require schools to investigate and intervene in cases of disability-based harassment.
• Gives the Colorado Department of Education the authority to investigate and resolve complaints of disability-based discrimination in public schools. Students and families may submit a complaint after completing a district’s grievance process or if the district has not resolved the grievance within 60 days. 
• Allows the Colorado Department of Education to implement corrective measures and conduct monitoring for compliance if a district is found to be in violation.
• Requires each school district to provide annual training on disability rights to relevant staff on an annual basis.

The Senate Education Committee unanimously passed SB26-125 in March, and the bill has been waiting to be heard by the Senate Appropriations Committee since that time. Given the state’s budget challenges this year, the Appropriations Committee may be challenged to find the funding for the bill’s relatively meager $668,000 price tag.

ADVOCACYDENVER is in strong support of SB26-125. Our reasons for doing so, which are consistent with our reasons for supporting HB26-1141, include:

• The bill would make up for a serious gap in the enforcement of federal laws that prohibit disability-based discrimination in public schools. The bill would do so by both enshrining federally established civil rights and protections into state law and by creating a process for resolving complaints at the state level. This process helps to ensure that students with disabilities in Colorado are welcome, safe, and well-served in our schools. 
• By starting with a grievance process, the bill would provide all Colorado families, regardless of background, with a more accessible point of entry into resolution of disability-based discrimination complaints.
• The grievance process will allow for collective problem-solving and serves to promote collaborative relationships between families and schools. Students and families are tethered to the same schools for years at a time. Grievance processes can help to avoid the development of contempt between families and schools that can linger on and on. That said, when families feel the discrimination is severe enough and blatant enough, they can forego the grievance process and enter the formal complaint process right away.
• Grievance processes conduced at a district level are far less expensive than ongoing investigations and litigation. As such, the bill would possibly save districts and families a substantial amount of money over time.
  Finally, the bill would not preclude any federal or civil action. State processes would be put on hold should any federal investigation start.
• Families would still be able to pursue civil litigation against school districts should they feel it is warranted.

ADVOCACYDENVER is concerned by the presumption in the bill’s fiscal note that the legislation excludes Colorado’s Universal Preschool Program. Section 504 and IDEA are explicit on this matter: All public school programs that receive federal financial assistance may not discriminate against students with disabilities between the ages of 3 and 21. While excluding the Universal Preschool Program from the provisions or SB26-125 would save costs for the state, doing so violates a core tenet of existing federal law.

Note from the Executive Director:  The Colorado Department of Early Childhood proposed a fiscal note of 1 million dollars in order for the supervising agency and preschool sites to develop nondiscrimination policies and procedures in relation to children with disabilities.   According to the 2023 Memorandum of Understanding between the Colorado Department of Education and the Colorado Department of Early Childhood Education, these nondiscrimination policies and procedures should already be in place, and all preschool staff should have received training. ADVOCACYDENVER is concerned that with their testimony, The Colorado Department of Early Childhood admits that they are not in compliance with state and federal law. 

https://www.cde.state.co.us/communications/mou-cde-cdec-preschoolspecialeducationservices

Pamela Bisceglia, Executive Director
ADVOCACYDENVER

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

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This edition of Policy Perspective, provides some details on one of two proposed pieces of legislation that would provide additional protection for students in Colorado. ADVOCACYDENVER stands in support of this legislation.

Federal and state laws protect Colorado’s students in PK-12 schools and institutions from discrimination across a wide range of characteristics. Among these laws, Title VI of the Civil Rights Act prohibits discrimination based on race, color, or national origin in all schools that receive federal funding. Title IX of the Education Amendments of 1972 prohibits sex-based discrimination in these same schools. The Colorado Anti-Discrimination Act and other state statutes prohibit discrimination in public schools that is based on disability, race, creed, color, sex, sexual orientation, gender identity, gender expression, religion, or national origin.

Although these laws have been enacted for years, enforcement of these laws is notoriously slow, inconsistent, and costly for both families and school districts. Federal databases show that the Office of Civil Rights (OCR) in the U.S. Department of Education, which handles all discrimination complaints about schools for the federal government, currently has 223 open investigations for the state of Colorado alone. Some of these investigations were opened as far back as 2014. In fact, ADVOCACYDENVER has a complaint that has been pending since 2020. These delays have been further exacerbated by severe staffing cuts made at OCR by the Trump administration since January 2025.

Aside from submitting complaints to OCR, families have the option of pursuing civil litigation against schools that violate anti-discrimination laws. Doing so usually requires families to put up substantial financial resources and to find an attorney who specializes in education law. As such, families who are marginalized are rarely able to pursue this option.

Two members of the Colorado General Assembly, Representative Jennifer Bacon (D-Denver) and Senator Chris Kolker (D-Arapahoe & Jefferson County) put forth a bill this session to help provide families and schools with tools to and enforcement procedures when they are discriminated against in the state’s public schools and universities. HB26-1141: Discriminatory Practices in Public Schools, if enacted, would allow state-level enforcement of anti-discrimination laws in ways that are currently not authorized in state law.

Specifically, HB26-1141:

• Defines and clarifies discriminatory education practice beyond what is currently contained in state law.
• Allows a person who is alleging discrimination in education in both public schools and higher education institutions to file a complaint with the Colorado Civil Rights Division.
• Allows the Colorado Civil Rights Division and the state Attorney General to file complaints on behalf of groups of students.
• Requires school districts to first offer families a mediation process before the Civil Rights Commission initiates an investigation into the complaint. Families may decline the mediation offer.
• Requires the Civic Rights Commission to coordinate with the Colorado Department of Education in investigating disputes, as well as determining and implementing how these disputes are to be resolved.
• Requires institutions of higher education to designate a Title VI coordinator and to establish procedures to resolve Title VI disputes.

The House Education Committee passed HB26-1141 in February, and the bill has been waiting to be heard by the House Appropriations Committee since that time. Given the state’s budget challenges this year, the Appropriations Committee may be hard pressed to find the funding for the bill’s relatively meager $815,000 price tag.

Colorado House Assistant Majority Leader and bill sponsor, Representative Jennifer Bacon (D-Denver) stated,

“Colorado schools should be a safe place for children to learn and grow, and if they experience discrimination based on their race, sexual orientation or disability, they should absolutely have a path to righting the wrongs made against them. This bill would create a positive learning environment and ensure access to the quality education that Colorado children deserve, uplifting all students and preparing them for success.”

“It’s really important for state governments to make up for the lack of federal enforcement by strengthening civil rights protections.”

ADVOCACYDENVER is in strong support of HB26-1141. Our reasons for doing so include:

• The bill would make up for a serious gap in federal enforcement of discrimination law in schools and universities by enacting a state process. This process helps to ensure that ALL of Colorado’s students are welcome, safe, and well-served in our schools.
• By starting with a mediation process, the bill would provide all Colorado families, regardless of background, with a more accessible point of entry into resolution of discrimination complaints. Families will not need to hire attorneys to file a claim or engage in mediation.
• Mediation also allows for collective problem-solving and serves to promote collaborative relationships between families and schools. Students and families are tethered to the same schools for years at a time. Mediation can help to avoid the development of acrimonious relationships that can linger on and on. That said, when families feel the discrimination is severe enough and blatant enough, they can forego the mediation and enter the formal complaint process right away.
• The mediation process is far less expensive than ongoing investigations and litigation. As such, the bill would possibly save districts and families a substantial amount of money over time.
• Finally, the bill would not preclude any federal or civil action. State processes would be put on hold should any federal investigation start. Families would still be able to pursue civil litigation against school districts should they feel it is warranted.

In an upcoming issue of Policy Perspective, we will cover the companion bill to HB21-1141. SB-125: Disability Rights Protections in Public Schools would provide state-level protections to students with disabilities that are currently only available through federal law.

ADVOCACYDENVER encourages you to make sure that your voice is heard in the legislative process by writing or calling your state legislators. Tell your story about how legislative decisions will impact your life. To find the names and contact information for your state legislators, look here.

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

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An Interview by Paul Baumann

For this issue of Policy Perspective, I had a conversation with Senator Judy Amabile (D-Boulder), a member of the Colorado General Assembly Joint Budget Committee (JBC). A primary responsibility of the JBC is to prepare the state’s budget for consideration by the Colorado House and Senate. Since the state is facing a budget shortfall of over $1 billion, the JBC will be making numerous budget cuts, including significant cuts to Medicaid. Senator Amabile and I focused our conversation on this issue of importance for Colorado’s disability community.

We have heard that significant cuts to Medicaid in Colorado are necessary and cannot be avoided. Can you please help us understand why this is the case?

We have a situation where Medicaid costs are growing a lot faster than our population plus inflation. It’s growing too fast for us to keep up without surpassing TABOR caps and crowding out everything else. “If we don’t do something, within a few years Medicaid costs will crowd out everything else in the budget.”

Colorado has expanded Medicaid benefits beyond what some other states do, and these expanded benefits are beyond what we can cover. For example, we pay family caregivers. Few states do this, and it results in fewer providers available through agencies in our state. Family caregivers may be better for many individuals, but we also need a provider network for people without family caregivers available to them.

Overall, we are not cutting people off from Medicaid, we are “just slowing growth… but to families, that’s a distinction without a difference.”

What are your priorities for Medicaid budget cuts? What should be preserved? Why?

I want to be sure “that we are spreading cuts across recipients… not all directed at one group.” It’s also important to me to make cuts “in a way that allows people to get the services they need to keep their kids healthy.”

I am particularly concerned about maintaining “robust mental health care” as a part of Medicaid. “I don’t want to go back to how it was, even 5 years ago.”

Would you please expand on that?

“There are smarter ways” for Colorado to go about providing mental health services. Right now, the state has mental health programs for teachers, for police, for children, for all these groups, and they all operate independently. I’d like for us to set up a “mental health system that serves all groups.” Take a look at other medical specialties, like cancer care. “There’s no cancer care that is only for the police, or children, or anyone else… Cancer care is cancer care.” We need that for mental health.

Mental health also has “parity problems” with other healthcare areas, even though the law says that reimbursement for mental health and substance use treatment services must be treated equally to physical health services.

We also have to be sure that we are spending Medicaid dollars effectively. For example, “talk therapy is often considered something that anyone can do. That’s not true.” Talk therapy requires deep expertise. “Not everyone can do it.” We need to recognize that when funding mental health services within Medicaid.

What would you like to say to an individual or family who faces uncertainty because of these cuts? How can they ensure their voices get heard in the budget process?

We need a plan from the Department of Health Care Policy and Financing (HCPF)—and a plan for a rollout. Announcing cuts day by day does not work. Families need time to be able to plan and “make adjustments… My heart breaks for these families.” They need some level of certainty.

We appreciate families showing up at hearings. “They make a difference.” So does meeting with legislators in person. Legislators and their staff are genuinely feeling for these families.

How can Colorado protect the long-term stability of Medicaid? Has HCPF presented a plan and are you satisfied with that plan?

We have seen “pieces of a plan” from HCPF, “but that’s not a plan… They are looking at different ways to roll things out.”

Members of the JBC “are trying to be thoughtful about what we are doing.” So is HCPF. “We are listening. We are hearing. We are making adjustments. At the end of the day, it is hard. It’s going to hurt.”

I appreciate the disability rights groups that have come to the table. They have helped us identify which cuts would be most harmful, and which would be less harmful.

What would you like to see as part of a Medicaid sustainability plan from HCPF?

I would like to see Colorado consider “utilization management tools” that help us control costs for the rest of the Medicaid population. An example of this could be a copay for certain types of services. This would encourage choices that save costs. For instance, a $10 copay for emergency room visits would likely encourage people to see a doctor in their office prior to needing an emergency room visit. That’s a significant cost savings. “We’re not doing that in Medicaid. We need to be creative.”

I would like to consider reorganizing HCPF, the Department of Human Services, and several other offices to promote efficiencies and less “siloing.” These departments all work independently but often on very similar concerns for clients. Better coordination would ensure efficiency where it is possible, which would bring about better care. “It’s not organized in the best way possible.”

Yes, there’s administrative bloat, fraud, abuse. We’re working on addressing these, which will bring some savings. But these savings alone “won’t bend the curve” enough to solve the shortfall we face.

As these and other bills move forward, a key part of committee hearings is public testimony. We encourage you to provide testimony for bills that are important to you. Look here to sign up to testify in person, remotely, or in writing.

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

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Each year, the Colorado Legislature meets for a 120-day session to revise and create laws and to develop and adopt an annual budget for the state. Monday, March 16 marked the 60th day of the 2026 legislative session.

In this issue of The Policy Perspective, I want to share with you some of the current policy developments that are happening in our state legislature. Below you will find several mid-session highlights on several key issues that impact Colorado’s disability community.

2026-2027 Budget

Colorado faces a significant budget shortfall of nearly $1 billion for 2026-2027. Because of requirements in Colorado’s constitution, the legislature must approve a balanced budget and may not raise taxes without voter approval. As a result, the legislature will be making cuts this year and is severely limiting new spending.

Currently, the most significant proposed cuts to the state’s budget are directed at Medicaid.

Several disability community-serving organizations have released a Community Guide that contains recommendations for Medicaid spending in Colorado for 2026-2027. The Guide provides discussion of how budget changes will impact people with disabilities, families, and providers.

As budget discussions move forward in the legislature, ADVOCACYDENVER encourages you to make sure that your voice is heard in the budget process by writing or calling your state senators and representatives. Tell your story of how budget decisions will impact your life. To find the names and contact information for your state legislators, look here.

Senate and House Bills

ADVOCACYDENVER has been following and is in strong support of the following bills:

HB 26-1040 The Sterilization Rights of a Person with Intellectual and Developmental Disibilities

Colorado is one of only two states that allows forced sterilization of people with disabilities. This legislation would end this practice except in cases where there is an imminent threat to the individual’s life and health. This bill has passed the House and the Senate and should be sent to the Governor for signature in the near future.

HB26-1141 Discriminatory Practices in Public Schools

HB26-1141 institutes Title IV and Title VI of the Federal Civil Rights Act of 1964 into state law. In doing so, the law creates mechanisms for enforcement of civil rights protections at the state level.

This bill has been passed by the House Education Committee and is waiting to be heard by the House Finance Committee before consideration by the entire House.

HB26-1043 Transportation Network Company Discriminatory Practices

This bill would strengthen accountability and reporting for consumers’ complaints of discrimination when using transportation network companies, such as Uber and Lyft. These companies would be required to include on their apps a place where consumers can report complaints when they are denied a pickup by a driver. Companies then must provide monthly reports of these complaints to the state, with all personal information removed. The state may also fine companies should they discriminate against people with disabilities or fail to submit monthly reports.

This bill has passed committee and is waiting to be brought to the floor for consideration by the House.

HB26-1045 Disability Housing Protections

HB26-1045 would put protections into state law for renters who have service animals, including both assistance animals and emotional support animals. While such protections have previously existed at the federal level, this law would permit the state to enforce these protections.

This bill has passed the House and is waiting to be heard by the Senate Committee on Local Government & Housing.

HB26-1147 Host Home for People with Intellectual & Developmental Disabilities

HB26-1147 requires the state to create a database containing information about host homes and their service agencies. The database must be made available and accessible by host home providers, service agencies, and those looking for host homes. The bill requires HCPF to allow for submission of complaints on its website and to establish a process for tracking each complaint and its resolution.

This bill was passed by the House Health & Human Services Committee and is waiting to be heard by the House Appropriations Committee before moving to the full House.

SB26-125 Disability Rights Protections in Public Schools

SB26-125 puts federal laws relating to disability rights protections into state law. Specifically, SB26-125 incorporates Section 504 of the Rehabilitation Act of 1973 and the American with Disabilities Act. In doing so, the law requires mediation efforts at the local level prior to enforcement by the State Department of Education.

This bill has been passed by the Senate Education Committee and is waiting to be heard by the Senate Appropriations Committee before consideration by the full Senate.

As these and other bills move forward, a key part of committee hearings is public testimony. We encourage you to provide testimony for bills that are important to you. Look here to sign up to testify in person, remotely, or in writing.

Since joining ADVOCACYDENVER last September, I have spent much of my time tracking national, state, and local policy developments, especially those that are important to the disability community. I am thrilled to get do this work every day and see my role with ADVOCACYDENVER as a natural “next step” in my 30+ year career in education and state policy. As a parent of a child with a disability, I also have a personal commitment to the work that extends well beyond that of a “job.”

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

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Due to the continued federal government shutdown, people who rely on Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children program (WIC) may not receive their full food benefits starting on November 1, 2025.

Nationally, SNAP feeds more than 4 million people with disabilities. WIC provides necessary nutrition for young children that supports their healthy development and growth. Even short disruptions to these benefits can be very harmful for both of these groups.

In this issue of the Policy Perspective:

• Find out how Colorado and the City and County of Denver are addressing this crisis.
• Learn about food resources that are available. 
• Learn how to engage your members of Congress to encourage them to restore funding for SNAP and WIC as soon as possible.

What are Colorado and Denver doing to address this crisis?

Governor Polis has proposed using $10 million in General Fund revenue to support food banks and pantries, and $7.5 million for WIC. These funds are sufficient to supplement SNAP benefits for six weeks and WIC for four weeks.

Colorado and Denver both have websites through which users can search for food resources. 

• Denver – Food Assistance 
• Colorado – Supplemental Nutrition Assistance Program (SNAP)

What food resources are available while SNAP and WIC are paused?

Several websites allow you to search for available food resources that are close to you. You will need to either enter your zip code or address to see what is available close to you. Several of these also allow you to filter your search for organizations that deliver to your home, should you need this service. You can also find organizations that will help with specialized dietary needs or offer specific types of resources, such as a food bank, a meal service, or emergency food support. 

• Feeding Colorado
• Hunger Free Colorado
• Food Bank of the Rockies
• FoodFinder
• Find Help

Contact your members of Congress to request that they restore funding for SNAP and WIC as soon as possible.  

Congress has the power to prevent this crisis. Send a message now urging them to take action today to protect food assistance programs before it’s too late 

How to contact your members of Congress!

Policy Perspective is a publication of ADVOCACYDENVER. If you have any questions, please contact Paul Baumann, Policy Outreach Specialist, at pbaumann@advocacydenver.org or 303.974.2535.

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Colorado’s 2022 legislative session came to a close on May 11th. In a year where continued COVID recovery and an upcoming midterm election loomed, legislators across the aisle came together and championed efforts to advance inclusion, options, and services for individuals with disabilities. Thanks to the exhaustive work of self-advocates, families, community advocates and policymakers alike, five key bills made their way to the governor’s desk and will be highlighted below. 

These summaries are not exhaustive.

For the full content of each bill, please visit: http://leg.colorado.gov/bills. 

House Bill 22-1376: Supportive Learning Environments for K-12 Students

In an effort to increase transparency and address the emotional and physical wellbeing of students, HB22-1376 aims to improve policies and data collection in relation to issues including chronic absenteeism, suspensions, expulsions, referrals to law enforcement, and perhaps most importantly for students with disabilities, the use of physical restraint (including handcuffing) and seclusion. The Colorado Department of Education will be required to compile and accessibly share data annually while maintaining student privacy standards. Colorado’s Peace Officers Standards and Training (POST) Board will develop and distribute a model policy for the hiring, training, and evaluation of School Resource Officers (SROs).

HB22-1376 also provides updated definitions, new provisions, and protections regarding restraint and seclusion including that:

• The Colorado Department of Education has the authority to enforce complaint decisions regarding the improper use of restraint and/or seclusion. 
• Schools must provide written notice to parents and guardians for physical restraints lasting for more than a minute (see full bill text for specific reporting requirements and timeline for implementation).
• Seclusion rooms must include either a window, or video camera if a window is not feasible, to facilitate continual monitoring.
• Seclusion rooms must be safe spaces and not otherwise used for storage, custodial, or office space.

Representative Mary Young (D) – “Thanks to AdvocacyDenver, the Arc of Colorado, Stand for Children and the Children’s Campaign for all of their work that led to the successful passing of HB22-1376. Schools play a crucial role in fostering safety, connectedness, and healthy conditions for students’ learning and development. HB22-1376 will make data about students’ experiences at school more transparent and ensure that students receive targeted support and learn in an environment that is positive, safe, and inclusive. This bill lays a foundation for understanding our learning environments across the state and will provide actionable information to improve the student and educator experience.”

House Bill 22-1107: Inclusive Higher Education Opportunities

In 2016 Colorado legislature established a 5-year pilot for three colleges and universities to run inclusive higher education programs for students with intellectual and developmental disabilities (IDD). Programs focus on four key areas: academic growth, social development, independence, and career advancement. As of 2022, 70 students with IDD have enrolled in these programs where they participate in traditional courses, live on campus, and work towards future career goals. Students who complete their respective program earn a Comprehensive Higher Education Certificate rather than a traditional diploma.

HB22-1107 authorizes a grant program where schools across the state can apply for funding to establish, or expand existing, inclusive higher education opportunities. It requires that the administering entity awards grants to maximize “access and opportunity for all students regardless of demographic or geographic diversity.” The bill also provides for reporting and evaluation of the long-term outcomes of those funded programs and the students who participate.

Representative Mary Bradfield (R) – “As a retired teacher I was happy to support this legislation that expands access to higher education for all learners in Colorado. A good education and the future doors it opens are crucial to the success of our youth.  I’m proud to see these opportunities being given our students with intellectual and developmental disabilities.” 

House Bill 22-1114: Transportation Services for Medicaid Waiver Recipients

Access to reliable, affordable transportation is a major barrier for many individuals with disabilities when trying to reach vital services, employment, and their communities at-large. For those who rely on transportation services available under a Medicaid home- and community-based waiver the options are limited and “often inefficient and overburdened.” 

HB22-1114 seeks to expand the available options for Medicaid waiver recipients by authorizing and reimbursing transportation network companies such as Uber and Lyft to provide nonmedical transportation. This authorization will occur no later than July 2024 after a state reporting process to identify a reimbursement system, compliance with federal law and waiver requirements, and best practices.

Representative Alex Valdez (D) – “HB22-1114 improves the lives of people with intellectual and developmental disabilities by eliminating barriers when it comes to choices in transportation. Many adults with disabilities lack sufficient access to reliable, accessible, and safe modes of public and private transportation. This bill addresses these barriers by offering the same choices in transportation that are already available to people without IDD.  Covering private transportation under certain Medicaid waiver services will allow people with IDD to participate more fully in their communities, employment, recreation, and relationships.”

House Bill 22-1320: Achieving A Better Life Experience Savings Account

Income and asset limits for assistance programs like Supplemental Security Income (SSI) and Medicaid have significantly hindered individuals with disabilities’ ability to save money, make large purchases, and plan for the future. Since 2017, Coloradoans who were determined disabled before the age of 26 have had access to tax-free Achieving a Better Life Experience (ABLE) accounts that allow an individual and their families to save and invest without losing eligibility for those needs-based benefits.  

HB22-1320 makes three major modifications to the existing law that improves accessibility and benefits for those who are eligible:

• A person other than the account owner (such as a family member or other support) can establish and administer an account on behalf of the individual with a disability.
• As of January 2023, accounts will be protected from “Medicaid claw-backs”, or the practice of the state claiming and retrieving funds for reimbursement of Medicaid expenses upon a beneficiary’s death.
• Contributions made to an ABLE account may be deducted when determining state taxable income.

Representative Colin Larson (R) – “I was honored to work with Rep. Cathy Kipp and Senators Zenzinger and Woodward on this bipartisan bill.  It is a historic step forward for providing financial stability, certainty, and independence for thousands of  individuals with disabilities and their families. By bringing tax deductibility to and ending the claw-back provisions for 529 ABLE accounts, Coloradoans with disabilities can now earn and save without fear of losing the services they rely on.”

House Bill 22-1303: Increase Residential Behavioral Health Beds

Ensuring appropriate care for the mental and behavioral health needs of all Coloradoans has been an issue for the state both prior to and compounded by the COVID-10 pandemic. Lack of available beds in treatment facilities has left many, including those with a dual diagnosis and those awaiting competency restoration, without access to critical stabilization and longer-term care.   

HB22-1303 appropriates nearly $42 million in federal funds received by the state through the American Rescue Plan Act for renovations and the creation of at least 16 additional inpatient beds at the Fort Logan mental health institute and at least 125 additional beds at residential facilities across the state. Beds at Fort Logan must first be used to address the backlog of those awaiting competency services before accepting civil patients. Residential facility beds are prioritized for those with severe mental illness or co-occurring diagnoses.

Statute includes additional provisions such as:

• Minimum standards for services at mental health residential facilities including assistance with medication and activities of daily living, case management services, life skills trainings, and non-medical transportation.
• Future establishment of admissions criteria, discharge planning, quality assurance monitoring, and federal compliance for mental health residential facilities.
• Licensing entities and timelines, including that aa of July 1, 2023, the Behavioral Health Administration will be responsible for licensing of those facilities.

Senator Jim Smallwood (R) – “HB22-1303 is critically important, bi-partisan legislation that should make real progress statewide helping adults with urgent behavioral health needs who need long-term services and support. We have heard from citizens and law enforcement for years about the lack of facilities to provide integrated care to these populations and specifically, individuals awaiting competency restoration services.”

Additional Successes to Celebrate

• Senate Bill 22-127 appropriates $80 million to the Department of Education for special education programs across the state. The bill provides an increased per-student distribution of $1,750 and requires that amount to increase by the rate of inflation each budget year beginning in 2024.
• Key language in the amendments of House Bill 22-1278 (creation of the Behavioral Health Administration) ensures that people with co-occurring IDD and mental health diagnoses are not turned away from services due to their primary diagnosis or need for assistance with activities of daily living.

Kaley Day is an Advocate for Adults with AdvocacyDenver.

She is a graduate of the University of Denver, and a sibling to a young man with disabilities. Kaley publishes Policy Perspective featuring interviews with state policymakers and community members on issues that affect the work and mission of AdvocacyDenver.

For questions or comments, contact Kaley at kday@advocacydenver.org

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