H_HI_2020A 01/21/2020 01:38:43 PM Committee Summary

Rick Garcia, Department of Local Affairs (DOLA), briefed the committee on House Bill 19-1009, which increased funding for rental assistance vouchers and supportive services for individuals with behavioral and mental health disorders. He provided a handout (Attachment B).

Wendy Hawthorne, DOLA, told the committee that the Division of Housing recently released the Recovery-Oriented Housing Request for Application, which will make up to 71 tenant-based rental assistance vouchers available, as well as funding for supportive services.

Jill Hunsaker Ryan, Colorado Department of Public Health and Environment (CDPHE), presented for the SMART Act Hearing and distributed a handout (Attachment C). She discussed the mission and vision of CDPHE, organizational structure, and its budget and funding sources. Ms. Hunsaker Ryan discussed the different divisions within CDPHE and presented on the department's Wildly Important Goals (WIGs).

Mr. John Putnam, CDPHE, responded to questions about where air quality measurements are taken and how regulations are tailored to specific locations. He responded to a question about the impact of emissions from neighboring states to air quality monitoring.

Ms. Hunsaker Ryan discussed the WIG of improving air quality.  She discussed rulemaking to decrease greenhouse gas emissions and methane emissions. She discussed the plan for reducing ozone levels related to new regulatory actions.

Ms. Hunsaker Ryan discussed the WIG of increasing childhood immunizations. She discussed successes towards the goal of increasing measles vaccination. Ms. Hunsaker Ryan responded to questions about the information included in CDPHE's new immunization information campaign. She responded to questions about herd-immunity, waning vaccine effectiveness, and the difference in vaccination rates from 2018 to 2019. Ms. Hunsaker Ryan discussed why CDPHE needed more funding to increase Measles, Mumps, and Rubella (MMR) vaccination rates. Ms. Hunsaker Ryan discussed strategies local public health departments were taking to increase MMR immunization rates.

Ms. Hunsaker Ryan discussed the third WIG of reducing obesity rates. She discussed the reasons for the obesity rate increase, including increase in portion sizes and increase in sugar consumption and obesity reduction strategies.

She presented on the last WIG of reducing the suicide rate. She discussed the collaborative effort among state departments to meet this goal, and presented data on the resources directed towards youth suicide prevention versus, and responded to a question about the "Man Therapy" initiative. Committee discussion and questions followed about the use of governmental agencies for mental health resources and using other community gatekeepers to reach the public. Ms. Hunsaker Ryan discussed some of the root causes of suicide and discussed the importance of security and connectivity to mental health.

Ms. Hunsaker Ryan responded to a question about the challenges veterans face accessing mental health services.  Ms. Hunsaker Ryan continued discussing suicide prevention measures, including wrap-around services for those discharged from hospitals and increasing the safe storage of guns.

Ms. Hunsaker Ryan discussed other priority issues for CDPHE including vaping and per- and polyfluoroalkyl substances (PFAS) chemicals.  She mentioned that CDPHE has launched a youth focused website to address vaping, and discussed the emerging contaminant of PFAS chemicals, used in firefighting foam, and the health impacts from this chemical. CDPHE has been conducting testing for PFAS and notifying water providers about the ability to test for this chemical. CDPHE wants to test water systems and break the chain of contamination when it is found in an elevated level.

Ms. Hunsaker Ryan discussed legislative priorities for CDPHE including allowing the department to promulgate rules related to PFAS and to have legislative clarity around landfill enforcement.  Ms. Hunsaker Ryan went through the regulatory agenda for CDPHE from 2019 including newborn hearing screening, zero emission vehicles, and medical marijuana registry. She then discussed the 2020 legislative outlook including revisiting the regional state improvement plan regarding ozone, greenhouse gas monitoring, and advance medical directives.

Ms. Hunsaker Ryan provided a statutory update on the newborn screening panel. Screening for Spinal Muscular Atrophy was added to the newborn screening panel. Ms. Hunsaker Ryan concluded by summarizing the CDPHE operating principle.

Maureen Welch, representing herself, spoke about issues facing the IDD population and the facilities that provide care. She discussed the issues with finding services on the CDPHE webpage and looking at reviews for providers. Ms. Welch responded to questions from the committee. Ms. Hunsaker Ryan responded to a question from the committee about the CDPHE webpage for finding services being inaccessible.

Randy Kuykendall, CDPHE, responded to the question about the CDPHE website and allowing the survey results for health facilities to be accessible online.

Pam Long, representing herself, discussed her concern about the number of children in the state with autism and distributed a handout (Attachment D). Theresa Wrangham, National Vaccine Information Center, discussed concerns relating to CDPHE's transparency about vaccinations. Phil Silberman, Colorado Health Choice Alliance, discussed his concern about the lack of CDPHE's focus on the number of Coloradans with chronic illnesses and CDPHE's increased focus on individuals who don't vaccinate their children.  The panel responded to questions from the committee.

Dr. John Bender, Colorado Academy of Family Physicians, discussed the decrease in deaths from vaccine preventable diseases once the vaccines became available. Emily Wright, Colorado Parents for Vaccinated Communities, spoke about the importance of increasing vaccination rates. The panel responded to questions from the committee.

Ms. Hunsaker Ryan came back to the table to respond to committee questions.

Chris Wells, CDPHE, responded to questions about the advance directive database development and implementation.

Ms. Hunsaker Ryan responded to questions about chronic diseases. Mr. Wells discussed the department's resources related to chronic diseases and responded to questions about the security of CDPHE's data. Ms. Hunsaker Ryan responded to a question about the cost-effectiveness of the suicide prevention initiatives.

Lindsey Meyers, CDPHE, discussed CDPHE implementing evidence-based suicide prevention strategies.  Ms. Hunsaker Ryan responded to a question about studying the causes of autism.

Michelle Barnes, Colorado Department of Human Services (CDHS), presented for their SMART Act hearing and distributed a handout (Attachment E). Ms. Barnes presented the mission and vision of CDHS, and described the budget request for the various offices within CDHS. Ms. Barnes discussed the eight pieces of legislation that CDHS is working on this legislative session. She described five pieces of legislation in detail.

Dr. Robert Werthwein, CDHS, discussed the role of the Office of Behavioral Health (OBH). Mr. Werthwein discussed two main goals of OBH: completing the blueprint to reform the behavioral health system and expanding the capacity for medication assisted treatment (MAT). 

Mr. Werthwein presented a map on showing locations where MAT is available by county. He discussed OBH's initiative to increase the number of jails capable of delivering MAT. Mr. Werthwein discussed the goal of reducing the waitlist for inpatient restoration treatment through two strategies: reducing inpatient restoration length of stay and increasing referrals to community-based restoration treatment. He discussed the four routes for restoration. He discussed the department's fines for exceeding the timely access to restoration time frame. Mr. Werthwein discussed the four statutory required updates CDHS is required to provide. The statutory updates are related to substance use disorder services, the behavioral health crisis response system, the community transition specialist program, and medication consistency program.

Dr. Werthwein responded to questions from the committee.

Minna Castillo Cohen, CDHS, discussed the number of children receiving child welfare services in their home. Ms. Castillo Cohen discussed the WIG of decreasing the average daily out-of-home population. She stated that Colorado has the lowest number of children living in congregate care than ever before. Ms. Castillo Cohen discussed the Family First Initiative which seeks to strengthen and preserve families and place children in the least restrictive, most family-like setting. She discussed how Family First was implemented and the timeline of its implementation in Colorado. Ms. Castillo Cohen discussed the WIG from 2018 of reducing the use of seclusion in their centers, and Colorado's success in meeting this goal.

Ms. Castillo Cohen presented on the statutory required updates on the Child Welfare Hotline and the Colorado State Youth Development Plan. Ms. Castillo Cohen responded to questions from the committee about the breakdown of the Lookout Mountain facility into separate small youth centers.

Yolanda Webb, CDHS, described the services offered through the Office of Community Access and Independence (OCAI). She described those served by their office. She described CDHS' goal of ensuring Coloradans served in the OCAI programs are safe and receive the services of their choice in a timely manner. She discussed the goals of decreasing examiner processing time in the disability determination services, increasing the transition goals met in the month at the Division of Regional Center Operations, and reducing the fall rate at the Veterans Community Living Centers. Ms. Webb provided the statutory update on the respite care task force and the long-term care ombudsman program. Ms. Webb responded to questions from the committee about the Veterans Community Living Center at Fitzsimons and the types of complaints received about the facility.

Mary Anne Snyder, CDHS, discussed the creation of the Office of Early Childhood.  She discussed CDHS' goal of increasing the number of children and families who are ready for school when entering kindergarten. She discussed the following ways the office is focusing on accomplishing that goal: increasing the number of high quality providers, increasing course completions in professional development information system for child care providers in rural communities, and completing the preschool development grant needs assessment and statewide strategic plan to identify the gaps in family support services statewide.

Dr. Ki'i Powell, Director, CDHS, presented. She discussed the goal of improving the economic security of Coloradans by increasing the number of people served by Colorado Works who entered employment, and increasing outreach partners for Supplemental Nutrition Assistance Program applications. She provided an update on the timeliness of processing benefits related to a class action lawsuit the division was involved in.

Theresa Wrangham, National Vaccine Information Center, discussed the shortage of foster care families and her concern about requiring foster families to be fully vaccinated.

Maureen Welch, representing herself, discussed CDHS posting meeting information, documents, and agendas that allow the public to be involved.

Kristina Heyl, Early Childhood Leadership Commission (ECLC), presented on the activities of the ECLC and distributed a handout (Attachment F). She discussed its creation in 2010 and reauthorization, organizational structure, and accomplishments. She discussed the Early Childhood Colorado Framework which outlined the strategies to get to the outcomes the ECLC is seeking. Ms. Heyl present on ECLC's monitoring and measuring progress in Colorado's Early Childhood Areas of Opportunities. Ms. Heyl responded to questions from the committee about aligning services.