March 26, 2026 · Health & Human Services · 15,447 words · 24 speakers · 216 segments
Senate Health and Human Services have come to order. Mr. Brown, please call the roll.
Senators Bright.
Here.
Cutter.
Present.
Doherty.
Here.
Frizzell.
Excused.
Weissman.
Good afternoon.
Judah.
Present.
Mr. Chair Mullica. Hey, our members. Our first item on the agenda is confirmation hearing for the Colorado Health Care Affordability and Sustainability Apprise. We have Ryan Westrom, Manat Singh, Ryan Thornton, Julie Nickel, Rain Henry, Hillary Jorgensen. If I called your name, come on up, please.
Sorry.
And we can pull up chairs if we can on the sides, please. How many chairs do we need?
You're a rock star.
Thank you, Hillary. If I can count.
No, you can't.
What? Ms. Leone is here to introduce them.
Thank you, Mr. Chair. My name is Shay Lyon. I am the Chase Board Coordinator at the Department of Healthcare Policy and Financing. It's my pleasure to introduce and present Ms. Rain Henry, Ms. Hilary Jorgensen, Ms. Julie Nichol, Ms. Manat Singh, Mr. Ryan Thornton, and Mr. Ryan Westrom for recommendation to the Chase Board. The Chase Board oversees and advises on the hospital provider fee. This hospital fee increased reimbursement to Colorado hospitals by more than $483 million this past year for care provided to Coloradans served by Medicaid, funds health care coverage for more than 438,000 Coloradans through expansions to Medicaid and CHIP, improves quality of hospital care, and reduces the need to shift public payer costs to private insurance. My role as Chase Board Coordinator includes giving administrative support to the Chase Board and related support boards, subcommittees, and work groups, drafting and publishing agendas, meeting minutes, board presentations, and other materials in collaboration with board chairs and subject matter expert staff, maintaining the board schedules and working timelines, creating, maintaining, and regularly updating the Chase Public Accountability Dashboard, and serving as liaison with the Governor's Boards and Commission's Office staff for recruitment, appointment, and confirmation of board members. Would you like me to introduce the members all together or one at a time?
We could also just go and hear from them if you want, Ms. Lyon, if that's all right with you.
I'm sorry, do what?
We can just go through and just hear from them real quick if that's all right with you.
Absolutely.
Okay. Okay. Thank you for that, Ms. Lyon. We're going to start off with Ms. Jorgensen. If you just want to tell us your name and why you want to serve on this board, Ms. Jorgensen.
Thank you Mr Chair and committee My name is Hillary Jorgensen and I am really honored to be for confirmation today with the Chief Spirit I know many of you I in honor of this committee often I currently the current at International Class disability condition and I spent pretty much my entire career in health policy and I think I have worked on every iteration of the hospital for HIV since its inception. I'm a little bit afraid to think about how long that means I have been doing this work, but I really want to serve on the Chase Board for two reasons. The first is that we are entering, some would say we are in, a period of incredible difficulty for our healthcare system. And we need people on the Chase Board who are dedicated and committed to both ensuring our hospitals stay open and also the expansion populations that the hospital provider fee funds get the care that they need. The second reason I am interested in serving on the Chase Board is one of the expansions that the hospital provider fee funds is the Medicaid buy-in for looking at adults with disabilities. I have actually been on this program and there was a time in my life it was the only way I could get health insurance and keep working and so I think I just bring a really unique perspective to the bill and I really appreciate you taking the time to entertain my and my colleagues confirmations today. Thank you.
Thank you, Ms. Jorgensen. Ma'am, if you want to state your name and why you want to serve on the board,
Thank you. My name is Julie Nickel.
You want to bring it a little closer to you, Ms. Nickel?
You can drag it towards you a little bit.
You have some. There you go.
Normally my voice is. So my name is Julie Nickel, and I am the Chief Financial Officer for the Metro Denver Region for UC Health. I am a long-time student of health care policy. I have a Ph.D. in health care policy and management, And I really am very passionate about working in collaboration with other stakeholders to improve the cost and quality of care for the citizens of this state that we have the privilege of serving in our institutions. So thank you.
Thank you, Ms. Nichol. Ma'am, if you want to just state your name and why you want to serve on this board.
Thank you, Chair and members of the committee, and good afternoon. My name is Manet Singh. I'm the Executive Director of the Colorado Consumer Health Initiative. I have nearly two decades now of experience working in health policy and advocacy locally, regionally, and statewide. I'm honored to be sitting here to confirm my appointment on the Chase Board. Prior to joining CCHI, I worked a lot on the public funding of graduate medical education, on health care affordability and accessibility in workforce production. I worked on initiatives to try and bring in physicians where we need them and to train future medical professionals to serve the patients that they are committed to. I originally came to Colorado for grad school and have since called it home, and I'm deeply committed to the patients and all of the residents of Colorado and their affordable and accessible health care. As an executive leader in consumer health care advocacy, I'm committed to being an ambassador and champion for change to improve the quality, cost, and affordability for care for all Coloradans, particularly those most vulnerable. and serving on this board would allow me to further serve Coloradans with my organizational perspective and experience as an employer and an individual especially given the current state of uncertainty in healthcare sustainability Thank you for considering my experience and passion for this work and for reviewing my application for the Chase Board Thank you Ms Singh Ma if you want to just state your name and why you want to serve on this board
Absolutely. Can you hear me?
Yep.
Awesome. Good afternoon, Ms. Chair and members of the committee. My name is Rain Henry. I've worked for the Department of Health Care Policy and Financing since July of 2015, primarily focused on hospital and specialty care policy and benefit management. My work involves creating, amending, updating, implementing policies for hospitals, including benefit coverage, enrollment requirements, alignment with CMS certification and state licensure, adherence to federal conditions participation, and the technical details around claims payment. My interest in the board is because my work includes hospital claims counterpart to the supplemental funding provided by the Chase board. Our policies impact each other, and both elements of HICPA's overall payment need to be represented on the board. Thank you for your consideration.
Thank you so much, Ms. Henry. Sir, if you want to just introduce yourself and tell us why you want to serve on this board.
Good afternoon, Mr. Chair and members of this committee. Thank you for the opportunity to speak with you today. My name is Ryan Westrom, and I am honored to seek reappointment to the Colorado Health Care and Sustainability Enterprise Board for another term, Serving alongside my fellow Chase members to help improve access and quality to care for Colorado's most vulnerable population is very important and truly meaningful, and I look forward to hopefully continuing that for the next four years. I currently serve as the Vice President of Finance for the Colorado Hospital Association, bringing 15 years of experience in hospital finance and reimbursement with a deep expertise in Medicaid and the hospital provider fee. Prior to joining CHA, I worked at the University of Colorado Hospital as well as a Medicare fiscal intermediary with a focus on hospital finance and reimbursement. For these reasons, I am grateful for the opportunity to serve and would be honored to continue contributing to the Chase Board. Thank you for your time this afternoon, and I would welcome any questions that you may have for me.
Thank you, Mr. Westrom. Next up, sir, if you want to introduce yourself and tell us why you want to serve on this board.
Yeah, thank you, Chair, and thank you to the senators for your service to our great state. My name is Ryan Thornton. I'm the CEO of Mountain Ridge Hospital, formerly known as North Suburban, for some of you. I've been a nurse for about 25 years. I have a real passion for combining the business realities, the government realities, and the bedside realities to find a better way to provide access for all Coloradans and great quality care at a high value that we can all afford. Really thankful to be sitting here today and to have the opportunity to give back to the state that's given me so much. Thank you.
Thank you, Mr. Thornton, and thank you for the work that you do for my community that I represent. And so thank you for being here. Any questions for these nominees?
I do have one question, and this is for Ms. Henry. Um, with, with you working for HICPF and HICPF also kind of overseeing this board, I guess I'm just, I'm curious of the role you play, um, with, with that. And I guess I would just be concerned. Is there any conflict there with HICPF already overseeing this board and then you also being on the board?
Uh, there shouldn't be one. Um, the, like I said, the work that I do is the counterpart to this. So I work with claims payment. Also there for the board, there should be two HICPF representatives. so I would be one of the two.
Okay. Perfect. And so, um, I guess, so just to be clear you coming at this kind of with a clear lens not not necessarily just Hick lens potentially Yes thank you for the question Yeah perfect Any further questions for these nominees
Is there any objection to have one motion? Seeing none, Madam Vice Chair.
Thank you, Mr. Chair. I move to the full Senate with a favorable recommendation, the appointment of Ryan Lindstrom. Manat Singh, Ryan Thornton, Julie Nichol, Rain Henry, and Hillary Jorgensen to the Colorado Healthcare Affordability and Sustainable Enterprise.
That is a proper motion. Mr. Brown, please call the roll.
Senators Bright.
Yes.
Cutter.
Yes.
Doherty.
Yes.
Weissman.
Yes.
Judah.
Aye.
Mr. Chair Malika.
Yes. Congratulations. That passes unanimously. Senator or Madam Vice Chair.
Thank you, Mr. Chair. I move that the confirmations be placed on the consent calendar.
Is there any opposition to the consent calendar? Seeing none, you will be placed on the consent calendar. Thank you all for your service in the state of Colorado. Much appreciated. Members, we will move on to the bills that we have before us. We have House Bill 1002 that is up first, provider participation in health insurance with Senator Ball and Senator Pelton.
Oh, okay, sorry. Oh, Dream Team. Okay. Okay.
Who would like to start us off?
Senator Pelton. Thank you, Mr. Chair. Thank you so much for your time today to present House Bill 1002, which is aimed at improving access to behavior health care services in Colorado and strengthening the workforce. This actually started on a conversation that we had on a train in Durango that Senator Ball and I had, and I want to thank him so much for the work that he's helped me put in on this bill. I joined this bill because in my community there are a lot of challenges accessing behavioral health services. One big issue I've heard from providers is the delay in being credentialed with insurance carriers. When providers are not able to have their applications to be in network process in a reasonable timeline, it impacts their ability to provide services for individuals in my community to access services. Coloradans are 11 times more likely to see an out-of-network therapist than a comparable physical health specialist. This creates higher out-of-pocket costs, delay in care, and other negative consequences for patients and families. Another issue that I've heard about from my constituents is many times the providers they reach out to their insurance directories are not available, not accepting new patients, or not actually in-network. These ghost networks make it harder for patients to find care. The U.S. Senate Committee on Finance conducted a secret shopper survey to understand ghost networks and released a report titled Major Majority Study Findings, Medicare Advantage Plan Directories Haunted by Ghost Networks. Staff reviewed these directories from 12 different plans in a total of six states, calling 10 systematically selected providers from each plan for a total of 120 calls. Only 50% of the calls made to Colorado provided listed results in a possible appointment for a patient. This is why I'm bringing this forward with Senator Ball today to take a first step to address these pressing issues.
Thank you, Senator Pilton. Senator Ball.
Thank you, Mr. Chair, and thank you, members of the committee. Thank you also to my co-prime sponsor. It's great to see some Army-Navy partnership in this building. Colleagues, this is a great bill. It does a number of things, and they're all really focused on improving access and improving our health care system. First, the bill tackles timely credentialing by directing insurance carriers to complete credentialing for mental health and substance use providers within 60 days. This uses the same framework established in Senate Bill 21-126, which required that physician-level providers are credentialed in 60 days. Second, we're addressing the ghost network issue that my colleague spoke about. we're requiring insurance carriers to confirm provider participation every year, which is important because that will catch some of these providers who are listed but really aren't part of the network. Third, we're supporting pre-licensed providers by allowing them to be reimbursed for services that are delivered under the supervision of licensed behavioral health providers. And then lastly, at the request of NASW, and I want to give them a special shout-out for working together on this portion because this was the portion that brought me into the bill, is we are revising the hours that a social work candidate needs to complete from 3,360 hours down to 3,000. And I'll just put a plug on that piece because this really came from I used to work with a lot of social workers, have a lot of friends who are social workers. I've never met a social worker who is happy with the LCSW process. And NASW has been a great partner in starting to look at potential ways that we can make changes and align that process with producing great social workers and making it a little easier to become a social worker. So taken together, these provisions create a clear, standardized, and practical framework. We ask for a yes vote and are happy to take any questions.
Thank you, Senator Ball. Does the committee have any questions for the sponsors?
I do have a question. Senator Ball, you brought up the hours, and I'm not familiar. I'm familiar with the nursing hours and even the advanced practice nursing hours. but it's my understanding that LCSWs have prescriptive authority as well. Do they or do they not?
I'm under assumption.
I think LCSWs do not have prescriptive authority.
Positive?
I am told they do not. You're told? Okay. Okay. Then that's my question. Okay.
Thank you, Senator Ball. Any further questions for these witnesses? Seeing none, we will go to the witness phase. You have one in the amend, and then the rest are four. Are you all right if we just call everyone up there? I think there's seven total. Let the record reflect, Senator Frizzell has joined us. Online, do we have Katie Rawlinson?
In person, Cara Achievers?
Dr. Ryan Burkhart.
Kelly Herb-Zeger.
Amanda Carlson.
On line, Janelle Ramzel.
and Debbie Kinder.
Ms. Chevers, we'll start off with you.
If you want to just state your name, who you represent, you'll have three minutes to testify. Start when you're ready.
Wonderful. Thank you so much. My name is Kara Chevers. I'm the Vice President of Coverage Policy at Inseparable. Inseparable is a mental health advocacy organization founded in the principle that our mental health is inseparable from our physical health and I here today in strong support of House Bill 26 This bill tackles a problem many Coloradans know all too well. We have insurance coverage and mental health and substance use disorder care, but we aren't able to find a provider and network when we need one. Coloradans with commercial insurance use out-of-network therapists 11 times more often than a comparable physical health care provider. This was found through a randomized control study by RTI in 2024. Last year, the U.S. Senate Finance Committee did a secret shopper survey to understand ghost networks in a number of Mountain West states, and it found that in Colorado, only half of the providers listed in the provider directory resulted in a possible appointment. This is deeply concerning, especially when one in five Coloradans experience a mental health condition, and more than half of those seeking care report that they couldn't get an appointment when they needed one. This is not just a patient access issue, though. It's also one of the workforce. Mental health providers face long and unpredictable credentialing timelines, unclear participation requirements, and inconsistent reimbursement, especially for supervised pre-licensed candidates. This bill doesn't mandate that providers take commercial insurance, but it does remove some of the barriers that make it harder or impossible in some cases for the providers that do want to do so. The bill addresses these problems in a few ways. First, it sets a clear 60-day credentialing timeline standard, aligning mental health providers with existing standards for physicians. This will ensure that mental health providers can expect clear standards and timelines in response to their application to join an insurance network. Colorado would join a number of other states that have already put this requirement into place, including Illinois, New Mexico, Oklahoma, Virginia, New York, Wyoming, and several others. Inseverable recently looked at mental health parity data submitted to the division and found that carriers report credentialing mental health providers in as few as one single day. But sometimes it can take as long as four to six months. And one carrier reported that it took 227 days to review an application to join a network, which is seven and a half months. When providers aren't in network, patients are harmed. Second, it also ensures that services provided by supervised pre-licensed candidates that are reimbursed by insurers, helping to expand their workforce, reduce patient wait times, and support early career clinicians. If a student and then a candidate can establish a caseload or a patient panel, they're much more likely to stay in their community and contribute to that community. This is also not a new practice. When the division posted information on its website a few years ago after surveying carriers, 11 of the 17 carriers that were providing coverage in the state at the time stated that they were reimbursing for pre-license candidate services. So this bill will streamline that requirement and clarifies how providers go about doing so. Finally, it improves issues with GOATS networks by requiring regular verification of provider participation in network and timely access to the directories. So patients can rely on the list that they're given by their insurance companies. For these reasons, I respectfully urge your support for House Bill 26-1002.
Thank you. Thank you, Ms. Cheevers. Next up, Ms. Erbzager, if you want to just state your name, who you represent, and you will have three minutes.
Start when you're ready. Thank you. Mr. Chair and committee members, thanks for the opportunity to speak this afternoon. My name is Kelly Erbzager, and I serve as the Director of Policy and Advocacy at the Colorado Rural Health Center. CRHC serves as Colorado's nonprofit, nonpartisan State Office of Rural Health and Rural Health Association, supporting hospitals and clinics in Colorado frontier and rural counties I here today speaking in strong support of House Bill 1002 I excited about this bill I know my members are and I grateful to the sponsors because we know it will benefit both rural health providers and the communities they serve. Rural Coloradans face significantly less access to mental health services. There are fewer providers overall and even fewer who are in network. Folks often have to travel longer distances and have longer wait times, and if you're lucky enough to have a provider nearby, there is a greater reliance on a small number of providers who are already stretched thin. Ghost networks are especially harmful in rural communities as patients are told providers are available, but they're unreachable, they're not accepting new patients, or they're not actually a network. So as a result, rural Coloradans have poorer mental health outcomes than their urban counterparts. The adult suicide rate in rural Colorado is 56% higher, and the youth suicide rate is 31% higher than in urban Colorado. To help combat these tragic statistics, rural Colorado hospitals and clinics are thinking creatively and doing their best to recruit and retain behavioral health providers and integrate them into practice settings. But unfortunately, carrier delays and administrative burdens are presenting significant barriers that have real-life consequences for rural communities. So if and when a rural health facility achieves the difficult and time-consuming task of recruiting a mental health provider, credentialing delays can stretch for months. During that time, providers cannot see patients in network, so care is effectively unavailable to many people who rely on their insurance. Additionally, many behavioral health professions require candidates to complete substantial supervised clinical hours after graduate school before they can become fully licensed. That means there is a period when these providers are qualified, supervised, and actively seeking patients, but the payment system doesn't consistently support their work. That matters in rural communities for several reasons. For one, rural practices often do not have the financial cushion to absorb unreimbursed care. Second, new graduates who want to stay or return to rural communities need sustainable pathways to practice there. If supervised, pre-licensed providers cannot be reimbursed, small practices may be less able to hire them, train them, or keep them in their communities. In other words, the problem is not just whether Colorado trains enough providers, it's whether rural Colorado communities can afford to bring them into practice and keep them there. So losing even one provider to credentialing delays or reimbursable care can leave an entire community without access. So 1002 directly addresses those barriers for both patients and providers, which will result in improving mental health outcomes, saving our health care system money by reducing ED visits and supporting rural economies. I'd ask for you to please vote yes on 1002. Thank you.
Thank you, Ms. Erbsager. Next up, Ms. Carlson, if you want to state your name and who you represent, you'll have three minutes to testify.
Start when you're ready. Thank you. Good afternoon, Mr. Chair and members of the committee. My name is Amanda Carlson. I am the Policy and Advocacy Manager at Colorado Consumer Health Initiative. CCHI is a non-profit, non-partisan, membership-based organization that serves in the interests of Coloradans who face structural barriers to high-quality, affordable, and accessible health care. Coincidentally, I'm also a social worker and a constituent of the House and Senate sponsors. I'm here to express our support of HB 1002 and ask for your yes vote on this bill. While access and affordability issues exist across the spectrum of health care services, we hear time and again from our community members that these barriers are especially high when accessing mental health care. Insurance companies slow, confusing, and inconsistent processes prevent qualified mental health providers from joining insurance networks and getting paid for their work. As a result, fewer providers are available to patients and the mental health workforce is smaller than it should be. This results in limited options for patients lack of culturally competent providers and higher costs for out care Coloradans are 18 times more likely to be forced to use an out provider for mental health than for physical care For consumers, navigating the health care system can be difficult enough without having to chase down providers within their networks for time-sensitive care. Insurance directories frequently list providers who are unavailable, not accepting new patients, or not actually in network. This is an avoidable barrier for consumers seeking vital mental health services. HB 1002 takes important steps to improve in-network mental health care, quicken the approval process for provider applications, and in turn reduce costs for Coloradans. This bill will verify provider participation in their networks and make sure patients have accurate information about who's offering care. We have an opportunity to update Colorado law with these clear common-sense rules and standards for credentialing, billing, and reimbursement of mental health providers, eliminating ghost networks. This will expand the mental health workforce and mean more Colorado families will be able to get the vital mental health care they need. I respectfully ask for your support of HB 1002 and appreciate your consideration.
Thank you, Ms. Carlson. Next up online, Ms. Katie Rawlinson. If you want to unmute yourself, state your name, and you'll have three minutes to testify. Start when you're ready.
Thank you, Chair and members of the Senate Committee. Excuse me. My name is Kate Rawlinson, and I'm testifying in support of HB 26102. But I'm requesting that you extract Amendment L001, passed by the House. My son, 33-year-old son, had the misfortune to develop a no-fault brain disability in his late teens. I'm also here as the lead of the Colorado Mad Moms, a coalition of over 400 caregivers and mental health advocates. HB 1002, as you have heard, will effectively address several insurance and provider concerns that need to be improved or fixed. That's good. However, a significant change made during the stakeholder process that harms people with mental illness and their families is the Amendment 001. Originally, the bill put in place a six-month deadline for insurance carriers to clean up their long directories of misinformation on their websites. These ghost networks delay access to vital health care, especially when in crisis, as our families often are. Amendment L-001 now gives carriers 12 months to contact their providers. Since the bill takes effect January 1, 2027, insurance carriers are given two years to continue to spread disinformation on their websites. As you've heard from Inseparable, in Colorado, 50% of those providers do not exist or no longer accept those insurance carriers. My question for you is, who does the bill as amended serve? I receive phone calls on a weekly basis from mothers in crisis looking for help panicking, trying to navigate our broken mental health care system and find a provider for their loved one. You know how it feels. When you have a critically ill family member and must deal with insurance companies and potential care providers waiting for a human being to answer your phone, answer your call, or call you back, multiply that tenfold when dealing with a mental health crisis. I'd like for you to take a moment to put yourself in the shoes of a caregiver or a person you love having a mental health crisis. So you start calling these providers. Imagine you're a single parent, your loved is in her room yelling at voices she hears telling her to harm herself or your son is trying to leave home to walk your neighborhood gesticulating wildly with his hands because that calms him down but it doesn't calm down your neighbors or your husband is decompensating rapidly and has put a hole in the wall with his fist or your wife is saying she wants to die those are common events and families like ours. So you're calling one provider after another to learn if they accept your insurance and when you can bring your loved one in for treatment. So I have a question. Why are we allowing insurance carriers?
Thank you, Ms. Rawlinson. Thank you for your testimony today. Thank you. Next up online, do we have Debbie Kinder? If you want to unmute yourself, state your name and who you represent, and you'll have three minutes to testify. Start when you're ready.
My name is Debbie Kinder and I'm a member of Colorado Mad Moms. I urge you to support HB 26, 1002, provider participation and health insurance. Finding a mental health care provider who participates within a health care insurance plan is a daunting task. By the time our son reached the tender age of six, he had already exhibited high-risk behaviors and depression. I vividly remember telling him as he laid motionless on the couch that we were going to get him some help. He met my gaze and said, no one can help me. I felt as though I was looking into the soul of an old man in a little boy's body. No person seeking help should be put in the position of being told, I don't know why you called me. I haven't been in your network for some time. Yet that is precisely the kind of responses we get. Patients don't need the runaround from their insurance companies. This bill places the responsibility on health insurance companies to ensure that their provider lists are accurate and up to date. Federal legislation passed a few weeks ago was co-sponsored by Senator Michael Bennett. The Requiring Enhanced and Accurate Lists of Real Healthcare Providers Act works to ensure Medicare Advantage plans maintain accurate provider directories. Passing HB 26-1002 would go beyond federal legislation and ensure that all Coloradans' health insurance plan clean up their directories. Thank you.
Thank you, Ms. Kinder. Next up, we have Janelle Ramsel. If you want to unmute yourself, state your name, and you'll have three minutes to testify. Start when you're ready.
All right, just one second. Good afternoon, Mr. Chair and members of the committee. My name is Janelle Ramsell and I am the Chief Legal Officer of Regis University. I'm also a member of the Independent Higher Education Coalition, IHEC, which represents Regis, Colorado College and the University of Denver. I'm here to speak in support of Bill 1002. While this legislation focuses on social work training its broader potential is what truly excites us If passed it creates a pathway for our students to achieve credentialing sooner allowing them to accept insurance payments earlier in their career This is a critical win for both workforce development and mental health access. Specifically, allowing uncredentialed therapists to register as providers is a game changer. While it adds a minor administrative workload, the tradeoff is invaluable. our interns must bill Medicaid under their supervisor's name and credentials. Moving to individual registration provides a necessary layer of professional protection for those supervisors. Furthermore, this shift could revolutionize how our students approach their internships, potentially allowing them to establish private practices while still in training. We look forward to adapting our model to qualify individual sites for these EMERGING PRACTITIONERS. I URGE A FAVORABLE REPORT ON THIS BILL.
THANK YOU. NEW SPEAKERS, DR. RYAN BURKHART, IF YOU WANT TO UNMUTE YOURSELF, STATE YOUR NAME AND WHO YOU REPRESENT AND YOU'LL HAVE THREE MINUTES TO TESTIFY START WHEN YOU'RE READY.
GOOD AFTERNOON, MR. CHAIR, THANK YOU SO MUCH FOR THE OPPORTUNITY TO SPEAK ON 1002. MY NAME IS DR. RYAN BURKHART. I SERVE IN MANY ROLES WITHIN THE STATE OF COLORADO IN TERMS of mental health. I'm the executive director of the Colorado Counseling Association. I'm dean of one of the largest counseling programs in the country. I'm also a clinical supervisor. In these roles, I get to see really the entire lifespan of a mental health professional from their first moment in class all the way through to graduation, all the way through the licensure process, and then through CCA. I really kind of stick with them even beyond licensure to the rest of their career. And really, 1002 is speaking to some very, very important aspects of mental health in Colorado, and I urge you to support this bill. Over the last decade, I have graduated thousands of students, supervised dozens of mental health professionals seeking licensure and starting private practices, and I've advocated for tens of thousands of mental professionals in Colorado as they dedicate their professional careers towards helping others find relief from mental illness and the impairment that comes. The reality is each time the complexity, the untimely reimbursement rates, the low reimbursement rates of insurance carriers have acted as great deterrents in our profession. Because of all of these complications and all of these things that 1002 is trying to address, what happens a lot of times is you'll have mental professionals who just actually avoid taking insurance altogether and they do what's called cash pay only and that means that they will only take only see clients only provide services to clients who'll pay cash and are not using third-party payers whether it's medicaid bcbs so on and so forth this causes a lot of issues for providing services to coloradans it really makes a lot of mental health services in Colorado available only to those who can afford cash pay any effort any efforts that we make any changes that we make to address the complexity of third-party reimbursement rates three third-party reimbursement policies and procedures any efforts we make to address how long it takes just to get credentialed with these third-party payers is a significant step in the right direction it allows us to have more and more mental health providers who would seek to become credentialed or paneled with these third payers and then subsequently offer mental health services that people can bill insurances for and really afford HB 1002 is a necessary step in the right direction. It places important guardrails on an overly regulated and burdensome insurance system and will ultimately attract more mental health professionals to accept insurance reimbursements, increasing access to mental health services. Thank you for your time.
Thank you, Dr. Burkhart. Does the committee have any questions for these witnesses? Seeing none, thank you so much for being here. That exhausts the witnesses before me for House Bill 1002. Is there anyone online or in person who wishes to testify on House Bill 1002? Seeing none, the witness face is closed. Welcome back, sponsors. Do you have any amendments? Any amendments from the committee? Seeing none, the amendment phase is closed. Wrap up. Senator Ball.
Thank you, Mr. Chair. And thank you, members of the committee. This is a good bill. I encourage you to vote yes. I'll just say a couple comments on some of the testimony. There were amendments that were adopted in the House to get this bill through on the timeline for the Ghost Networks piece. And I don't think, we heard some comment on that from folks testifying in the amend. I think it makes all of the groups that have engaged come to a good place with the bill, so we'll honor that and encourage an aye vote.
Senator Pelton. Thank you, Mr. Chair. Just like my good co-prime said, this is a really good bill moving forward. I mean, I have been on several mental health bills, even when I was a county commissioner working in this, coming up to the legislature to testify on behavioral health, and especially in my communities in rural Colorado is a challenge. And I think this is the first step forward to really help rural Colorado. So I just ask for an aye vote.
Thank you, Senator Pelting. Any closing remarks from the committee? We're going to be in a brief senatorial five. We are back. Madam Vice Chair.
Thank you, Mr. Chair. I move House Bill 26-1002 to the Committee of the Whole with a favorable recommendation.
That's a proper motion. Mr. Brown, please call the roll.
Senators Wright.
Yes.
Cutter.
Yes.
Doherty
Yes
Rizal
Aye
Weissman
Yes
Judah
Aye
Mr. Chair Mullica
Yes, congratulations. That passes unanimously. Madam Vice Chair
Thank you, Mr. Chair. I move that the bill be placed on the consent calendar.
Is there any opposition to the consent calendar? Seeing none, this bill will be placed on the consent calendar. Congratulations. Thank you for coming to Senate Health and Human Services, Senator Ball and Senator Pelton. next up members we have house bill 1044 i do see one of the sponsors here i believe or was here and the other sponsor has been messaged Do you want to start without him Senator Benavidez or do you want to wait We'll be in a senatorial five. Okay. Thank you. Thank you. We are back with our sponsors for House Bill 1044. Who wants to start us off? Senator Exum.
Thank you, Mr. Chair, and thanks for hearing House Bill 1044. Colorado continues to see persistent and unacceptable disparities in maternal health outcomes, especially in the black birthing parents who face higher rates of severe maternal morbidity and maternal health death. Key challenges include implicit and explicit bias in obstructive care, contributing to delayed treatment, dismissal of symptoms, and preventable harm. A lack of consistent provider training on cultural competency and equitable and maternal care. Insufficient transparency and reporting these discriminations, delinquent decision-making or denial of care contributes to severe maternal morbidity or death. The bill before you today, House Bill 1044, strengthens Cotterall's response to maternal health inequities by improving provider training and increasing transparency. All the while centering respectful maternity care, the bill focuses on addressing racial disparities, particularly in black birthing parents, through education, data collection, and reporting. The bill does three things, three major things. It requires the state medical board to consider requiring doctors and nurses as part of their continual medical education, learn more about cultural competency and equity in maternal care to help reduce problems faced by many black women when giving birth. It requires maternal parents to be given birthing parents' bill of rights, outlining their rights to be free from harm and mistreatment, rights to dignity, privacy, and confidentiality, rights to have a family member present during birth, rights to equity and high-qualityness, quality care, among others. Maternal parents and other companions can also take a standardized, anonymous survey about the quality of their care they receive to give feedback and track data. It codifies the Maternal Health Task Force within CDPHE, requires the task force to have at least one black maternal health advocate on its 50-member board, and requires CDPHP to report to the General Assembly every three years on maternal health outcomes and equity, including outcomes for black birthing parents and suspected or known causes of any despairing outcomes of black birthing parents. There were several amendments made in the House to this bill with no physical note, and I urge the committee to support this bill and welcome any questions that you may have. Thank you.
Thank you, Senator Axel.
Senator Benavides. Thank you, Mr. Chair and members of the committee. I think Senator Exum summed up the bill very well. When I was asked to be on this bill, you know, we had passed a bill a few years ago on this issue, but honestly I never really understood this issue well enough. And so some of the statistics, they track statistics by how many deaths for 100,000 live births. And to give you an example, the least, and these are numbers from 2023, which was the last full year that they had numbers. And this is not Colorado, it's countrywide. And the least were Asian mothers, that there were 10.7 deaths for every 100,000 live births. For Hispanics, it was 12.4 deaths for every 100,000. For white mothers, it was 14.5 deaths for every 100,000. For black and African-American mothers, it was 50.3. That's why this is so important. This is across the board that for many of the reasons that Senator Exum pointed out, that there's still disparity in the care that people receive. For black women, you know, whether it's this sense that black women can tolerate more pain but are not believed when they're told something, because the leading causes of death are things like preeclampsia that turns into eclampsia if it's not treated. That's a rise in high blood pressure while that's happening. And if there's measures that this can be looked into that can help women, They can have them have continuing care before they give birth, and they can monitor remotely things like that to help prevent it. But there's a consistency throughout this country that we don't listen to the patients. We don't listen to the community that helps them, and we have to do more about that. And the task force that CDPHE has will help us address that. But this is a huge need in our community and our country, and it needs to be addressed. So I join my co and this is a good and necessary bill and I urge you to support it Thank you Senator Benavidez Does the committee have any questions for the sponsors Seeing none we will move on to the witness phase
In person, we have Daron Turner. Come on up, ma'am. Ms. Shawn Taylor. And then online, can we pull up Shana Oliver? Velveeta Golightly Howell? And Mrs. Felicia Embry? Felicia Embry? No, Felicia Embry. Perfect. We will start off with you, Ms. Turner, if you just want to state your name and who you represent. You'll have three minutes to testify. Start whenever you're ready. There's a button on the neck right there. And then just slide it a little closer to you. Can you hear me? Yep. Okay.
My name is Deron Turner.
Bring it a little closer to you, Ms. Turner. Okay. There you go.
My name is Doron Turner, and I'm representing myself, but I'm also representing or working with Metro Caring because I've worked with Metro Caring for quite some time now. And for me, I've had four children. I had our oldest in 1999 at University Hospital, and we had just moved here from Oklahoma. it's interesting to me that they talk about things from a space of black folks specifically not feeling pain in the same way. And I know that when I had our oldest, because our oldest I had in the hospital, the other three I had at home because I felt more comfortable. and the thing is what needs to be looked at is people just being treated as human when you don't see a person as a human being you can't treat them with respect and care and so that's one of the things I would say in reference to being in support of this bill I mean if I go into a hospital and I say I'm in pain and they ask me the levels and I give them the levels and they disregard that, that's not looking at me with respect as they would someone else. And that's one of the things that has to change. But also, I would say, with black women facing double the mortality risk of their rural white counterparts, because I hope what this bill is addressing as well is black women that live in rural areas. and they're much more likely to die because of preventable things like some of the things like C-sections, unnecessary C-sections. I know that with my experience in the hospital, I was told when I got to the hospital, if I didn't have my child within half an hour of getting there, that they were going to do a C-section. and I had to really me and my husband we really had to advocate for me having our son naturally which I did because he 26 years old right now But yeah I just think it necessary that we work towards protecting all women but also protecting black women because we're a part of this process as well. Thank you.
Thank you, Ms. Turner. Next up, Ms. Taylor, if you want to state your name and who you represent, you'll have three minutes to testify. Start when you're ready.
Good afternoon, Chair.
Yep, there you go.
Good afternoon, Chair and members of the community. My name is Shawn Taylor. I'm with Families Forward Resource Center. Thank you for the opportunity to testify today in support of House Bill 26-1044 and the advancement of black maternal health equity in Colorado. I also want to thank English Representative Joseph, Senator Exum, and Senator Benavides for sponsoring this important legislation. I serve as the Executive Director at Families for Resource Center, the only Healthy Start initiative in the state of Colorado, where we provide direct services and support to black birthing families across Colorado in service to perinatal health equity. I would like to focus my remarks on representation and intentional inclusion both within state level public health structures and within health systems themselves. I have had the opportunity to participate on the Colorado Department of Public Health and Environment Committee, focused on maternal health, more specifically the Maternal Mortality Review Committee. through this experience, I have seen how the composition of a committee directly shapes its priorities, its interpretation of data, and ultimately its recommendations when black maternal health advocates are present. Conversations become more precise and more grounded. Data are not viewed solely through a clinical or administrative lens. They are examined alongside lived experience. Both maternal health advocates bring crucial expertise, insight into how biases, implicit or explicit, can influence clinical decision making, community-informed understanding of barriers to timely respectful care, Trust-based relationships with families who may otherwise be reluctant to engage with formal systems. Practical equity-centered solutions that are both culturally responsive and operationally feasible. Our presidents meaningfully shift decisions from general concern about disparities to concrete strategies for prevention and accountability. Representation is not symbolic. it improves policy and programming qualities. I would also like to encourage attention to the representation within health systems, particularly in maternal mobility that could create as a result of this legislation. Also, when advocates are included, reviews are more likely to consider communication quality, quality informed consent patients reported concerns, not solely clinical indicators. Potential biases and dismissal of symptoms can be more rigorously examined. Recommendations are more likely to address structural drivers and inequity rather than focusing exclusively on individual provider errors. Thank you for your time and your attention to this crucial issue Thank you Ms Taylor Next up online Ms Oliver if you want to unmute yourself state your name and who you represent and you have three minutes to testify Start when you ready Thank you
I'm a Denef mother of four living in Denver. We are tribal-affiliated members of the Navajo Nation.
I gave birth to all my children in Denver hospitals, and my experiences reflect the compounding injustices, both environmental and medical, that Black and Indigenous mothers face. Black and Indigenous families are more likely to live near highways, industrial facilities, and other sources of pollution and environmental toxins. Research shows that prenatal exposures to these risks increases the risk of preterm birth, low birth weight, and maternal complications. I delivered my first child at Denver General where a severed vein during labor put me at risk of needing a blood transfusion. One of the lasting consequences of that experience is that I have a varicose vein on my right side from my vaginal area down my leg all the way to my foot. The nurse was very rough with me while preparing me for my delivery of my firstborn. And the doctor wasn't even at the hospital when I was admitted. I never went back to Denver General. I switched to Rose Medical, but the mistreatment continued. My husband, a black American, and I were accused of child abuse because of the slate gray nivis my children were born with, which disappears as they grow. Black and Native American maternal mortality rates have increased in recent years. For black women, that rate has doubled in the past two decades. This is driven by one factor, racism. We face its cumulative health effects in our hospitals and in our neighborhoods. Addressing Black maternal health equity must include addressing the environmental burdens on our communities. We urge your support for House Bill 26-1044, Improved Black Maternal Health Equity. Thank you.
Thank you, Ms. Oliver. Next up, Ms. Golightly-Hal, if you want to unmute yourself, state your name and who you represent, you'll have three minutes to testify. Start when you're ready.
Good afternoon, Honorable Chair and members of the committee. My name is Velveta Golightly Howell, and I am the founder and CEO of Sister to Sister International Network of Professional African American Women Incorporated, a Colorado incorporated and based tax exempt public charity. Our nonprofit was privileged to serve as the principal community organization to offer input into the drafting and design of HB 1044. As a former civil rights official within the federal government and a longtime Colorado attorney, I can tell you that black maternal mortality in our state is not a medical anomaly. It is a civil rights failure. that demands bold legislative action starting with HB 1044. Black mothers Colorado die and nearly die at rates far higher than white mothers, and pregnant women of color are two to three times more likely to suffer severe maternal morbidity, even with the same income in insurance. Colorado's own Maternal Mortality Review Committee has found that discrimination and bias contribute to roughly two-thirds of maternal deaths. This is not a coincidence. It is a pattern our system allows. I'd like to share with you one story that illustrates that pattern. Three years ago, at an intimate sister-to-sister, Inc., Black maternal health community gathering, A black, highly educated woman shared her experience with her first pregnancy. Early in the second trimester, she and her husband raised concerns with their white male OBGYN and his staff about possible complications. The physician dismissed them, ran only one basic test, and told her she was fine and just experiencing anxiety. Throughout the pregnancy, they continued to ask for further monitoring. They were repeatedly dismissed and no additional tests were ordered. At delivery, the doctor discovered that she had been carrying twins and that one baby had suffered distress in the womb and died. This isn't an isolated bad doctor story. It reflects a pattern. When black women speak, their voices must be heard, not labeled as anxious, dramatic, or noncompliant. So with this said, I would just ask you to support House Bill 1044. Thank you.
Thank you, Ms. Golately Howe. Does the committee have any questions of these witnesses? Seeing none, thank you so much for being here today. Next up online, can we pull up Ms. Dawn Fritz? Ms. Elaine Pratt? Come on up, Ms. Prep. Ms. Carolyn Alexander? Joe Carolyn Alexander? Nope. Ms. Alyssa Hardy? I'll ask, is there anyone else online or in person who wishes to testify on House Bill 1044? Opposition? Or for? Amend? This is proponents, and so as soon as we're done with this, we'll get you up, sir. You'd like to testify in support of the bill? Okay, come on up. Thank you Perfect ma We start off with you If you haven signed up yet after you done with your testimony, there's a little QR code that you can scan in just to sign up to testify just for the record, okay? But if you want to introduce yourself, state your name and who you represent, and you'll have three minutes to testify. Start when you're ready.
Good afternoon. My name is Prisayi Gomez. I'm the Community Organizing Manager at Metro Caring, a Denver anti-hunger organization. We work alongside families every day who navigate food insecurity, housing stability, and barriers within the health care system, and I'm here in support of 1044. Our work is grounded in the belief that food access, health, and dignity are not privileges. They're a right every person in our state has, and we clearly see how systemic racism across our food system, healthcare system, and broader economy shapes who has access to those rights and who does not. Through our Baby Cafe program, we host a no-cost weekly lactation support where more than 100 families have come through. Parents can walk in without an appointment, receive professional lactation care, share a healthy meal, and connect with others in a space built on trust, cultural responsiveness, and dignity. What we see is that when care is rooted in equity, when parents are listened to, believed, supported, outcomes improve. Parents stay engaged in care. They ask questions. They advocate for themselves. They feel confident feeding their babies. These are not small shifts. This is what it looks like when systemic begins to repair harm. But we also see the gaps. We see parents who have been dismissed in clinical settings, whose pain was not taken seriously, whose experiences reflect a long history of racism in maternal health care. And today we are seeing parents, black parents, show up in this building and relieve deeply personal trauma just to be heard, just to move one step closer to change. They should not have to carry that burden alone. This bill acknowledges that these disparities are not accidental. And while many providers enter this line of work with good intentions, intentions alone do not change outcomes. Without accountability, those intentions may not be translated into equitable care. Black women are too often dismissed, not believed, and forced to navigate harm in systems that should be protecting them. This has to change. Black women must be listened to, believed, and protected. As our state officials, I urge you to do your job. on behalf of our community and support 1044. Thank you.
Thank you, Ms. Gomez. Next up, Ms. Pratt, if you want to introduce yourself, state your name, who you represent, and you'll have three minutes to testify. Start when you're ready.
Okay, can you hear me?
Yes, ma'am.
All right. Okay, my name is Elaine Pratt. I live in Lakewood, Colorado. I am a teen parent from the age of 13. My adult children are 52, 48, 40, and 29. This bill, HB 26-1044, would have helped me in 1974 and at my other birth ages to feel like a human and not to be feeling less than or judged by my color and because I was a teenager. It also would have helped me to be less anxious and less fearful and tearful My first child was a fast C and it was planned by the doctor schedule I was not informed in enough time that my child was breached, or what would have my baby's mortality been if it hadn't been discovered, and it was discovered last minute. The morbidity and her death rate is extremely high and overlooked in black African American races. This bill would impact and help the health care system be more focused and have a more of an accountable method for black maternal health equity. I would love to ask that you support this bill. And before I go to the very ending part, I would like to share a little story with you about three patients that were in the hospital. There was an Asian, a black, and a Spanish. The doctor only asked the black person had they had any drugs or alcohol in their body. No one else was asked. Can you imagine how that feels? or how that would feel to your wife or someone that you know or partner or otherwise. To the ending of this, I would say that if you guys would support this bill and realize that there are many different shades of blacks, we come in lighter shades and we come in darker shades, and they're not always easy to tell. This bill would help a lot of that to help things come together and to be done more professional and accountable. Please support this bill.
Thank you, Ms. Pratt. Online, we have Ms. Dawn Fritz. If you want to unmute yourself, state your name and who you represent, and you'll have three minutes to testify. Start when you're ready. Thank you.
Good afternoon, Chair and members of the committee. Thank you for this opportunity to advocate for our children and families. My name is Dawn Fritz, and I'm Colorado PTA's Director of Legislative Engagement. I'm proud to represent our nation's oldest and largest child advocacy organization today. Colorado PTA supports House Bill 1044. At PTA, we understand that children do not live in silos. Their ability to learn, grow, and succeed in school is deeply connected to the health and well-being of their families. When families experience inequitable treatment, barriers to care, or preventable harm within the systems meant to serve them, the effects ripple directly into children's lives. Promoting maternal health is vital to the well-being of the entire family. PTA supports policies and programs that address the high maternal mortality rate in the United States and improve maternal health, especially during pregnancy, childbirth, and the postpartum period. We believe meaningful progress requires clear commitment to examining and addressing the disparate impacts the health care systems have on Black women, Black pregnant people, and their families. This bill represents a step toward improving oversight, increasing meaningful transparency, and ensuring that inequities are not ignored. It reflects a commitment to fairness and continuous improvement in the systems that impact families during some of the most critical moments of their lives. PTA believes families deserve systems that treat them with dignity and respect. They deserve assurance that when inequities are identified, they are addressed. They deserve confidence that the institutions serving them are continuously working to improve We are committed to advocating for policies that protect children uplift families and promote environments where all can thrive Supporting this bill is consistent with that mission. Thank you for your time and consideration and work on behalf of Colorado's families. And thank you for consideration of PTA's position.
Thank you, Ms. Fritz. Next up, we have Ms. Hardy. if you want to unmute yourself, state your name and who you represent. You'll have three minutes to testify. Start when you're ready. Good afternoon, chair and members of the committee.
My name is Elise Hardy. I am the director of programs at Families for Resource Center. I am representing myself as well as the organization that I direct in Denver, Colorado. I am the partner of Sean Taylor, who you heard from earlier, and we are, again, the Healthy Start site of Colorado. I am also a full-spectrum doula, lactation counselor, and a Black woman who has lived experience, witnessed, and carried the weight of inequities in maternal health care. I'm here today in strong support of House Bill 26-1044 because many of us, this is not just policy is personal. In Colorado, as you know, black women are two to three times more likely to die from pregnancy-related causes than white women, and black infants are more than twice likely not to make it to their first birthday. These are not just statistics. These represent mothers who should be here, families that should be whole, and communities that deserve better. House Bill 26-1044 is critical because it strengthens accountability, improves data collection, and invests in culturally responsive community-based solutions like doula care and care navigation. It recognizes that improving outcomes requires more than clinical care. It requires trust, respect, and systems that truly see us. My understanding of this is not just professional, it's deeply personal. I have navigated my own reproductive health journey while living with fibroids, dense breast tissue, and an undiagnosed autoimmune disease, all conditions that disproportionately impact Black women. I know what it feels like to be in pain and not immediately believed. I know what it feels like to have to advocate for myself in spaces where I should have felt safe and heard. and I know the emotional toll of carrying both the physical experience and the uncertainty that comes with not always being heard. The experience has changed me. It deepened my commitment to this work and sharpened my understanding of what so many Black women face every day, not just during pregnancy, but across their entire reproductive health journey. As a doula, I have sat in rooms
where Black women's concerns were dismissed, where their voices were minimized, and where they had to fight to be taken seriously. And I have also witnessed the transformation that happens when they are supported, believed, and advocated for. At Family Support Resource Center, through our programs, full-spectrum doula support, perinatal education, lactation counseling, and community health workers, resource navigation families consistently report confidence and stronger mental health and just wholly feeling supported. I urge you to support this bill and take a step toward equity, accountability, and justice. Thank you for your time and for
listening. Thank you, Ms. Hardy. Does the committee have any questions for these witnesses? Seeing none, thank you so much for being here. Ms. Gomez, I'll just remind If you could just sign up with that QR code in the back. I think we just have one more. Sir, if you want to come on up. You want to just state your name, who you represent, and you'll have three minutes to testify. I start whenever you're ready, sir.
Thank you, Mr. Chair and members of the committee. My name is Tom Perrill. I'm a physician and president of Democrats for Life of Colorado, but I'm here today on my own behalf to testify in favor of the bill with one amendment suggestion. As I listen to the testimony, I'm in 100% agreement with the goals of the legislation and the observations of the people that preceded me. What I noticed is a lack of education amongst my medical professionals sensitivity, cultural sensitivity to the issues facing the black community and people of color. But one thing that is missing that potentially has a huge impact on the infant and maternal mortality in the black community in particular is the issue that black women disproportionately are subject to abortions, particularly late abortion. And we know through the literature with this is underappreciated in the medical community and beyond, that surgical abortions cause premature birth and subsequent pregnancies. Their associated recent data suggests a 40% increase in incidence of C-section. There's also evidence for increased placental abnormalities, including placenta previa and placenta accreta complex syndrome. And why is that relevant? because if black women are having three to four times as many late abortions and surgical abortions as white women, you'd expect them to have substantially more increased incidence of premature birth, which is associated directly with infant mortality, maternal mortality, placental abnormalities, and C-sections, which all increase maternal mortality. So I would suggest that in addition to the requirements of the bill that something be added to suggest that the medical community be made aware and in translation make their patients aware of this connection because it's something that's under-publicized and few people are aware or talk about because they're afraid that it might impact the innocence of abortion and abortion rights. But this is something that is much greater than that. It affects infant and maternal mortality in the black community, in particular and something that should be included in the bill. Thank you so much.
Thank you, sir. Does this committee have any questions for this witness? Seeing none, thank you so much. Anyone else online or in person who wishes to testify on House Bill 1044? Seeing none, the witness phase is closed. Sponsors, welcome back. Do you have any amendments?
No amendments, Mr. Chair.
Any amendments from the committee? Seeing none, the amendment phase is closed. Who would like to wrap us up?
I'll start, if I may. You know, listening to the witnesses, I want to thank all of them for coming in and talking to us about this. A couple of things that I wanted to mention that sometimes is overlooked, and in the bill you see there was also a change to the report date This is every three years we supposed to get a report and it was changed to October and it was at CDPHE's request to give them time to go through all of the information to get us a good report. But this will be the first report we've had in a while with sufficient data on Colorado, because all of the numbers we've given you have been national numbers. One other issue that has come up is that oftentimes people think that this is because black women have more, that they experience financial issues as far as living in poverty, and there is a high percentage that are on Medicaid, but that's across the board for all women that live in poverty and have Medicaid. But many states have expanded Medicaid coverage for perinatal term. That's the time immediately before birth and the time after that to 12 months for perinatal care, which is extremely important because some of these don't arise. But often people think because they're poor women that's part of the reason. but clearly this is not an issue of poverty. This is an issue of how women are being treated. I'll give you a great example. You all have heard of Serena Williams. When she had her first child in 2017, she had embolism, and she was telling people she had clots. She had to keep telling them, and they ignored her. and she had had a cesarean. She knew that she had a hematoma and she kept asking for that, wanting them to do a CT scan and they wouldn't do it. She ended up having that hematoma burst and she had to have several surgeries after that. This is a woman who is well known to everybody and she still couldn't get the care that she was asking for because she wasn't believed. And that's the struggle that women have, particularly black women. So I wanted to point that out to you, and that this is a real issue. It's not something that we can continue to ignore. We are, the U.S. has the highest rate of mortality in this area of any industrialized country. Some of them are at 1.6 deaths in 100,000. were at, I think, nationwide, when you average them all in, just over 18%. But that's a huge difference. We should not have those kinds of deaths during childbirth. So I, again, thank all the witnesses and would urge a yes vote.
Thank you, Senator Benavidez.
Senator Exum. Thank you, Mr. Chair. and I want to thank my co-prime sponsor, Senator Benavides, for joining me on this bill, and thank you for your attention this afternoon. I'll just reiterate just a couple of things about seeing people with dignity and respect, and especially in this field, is very, very important to me. I'm one of 11 children. My mother has gone on to a much higher place than we are here, but I think that she's a saint. and this is very, very important to me and should be important to the community that treating people with dignity and respect and believe in them when they come in with complaints about whatever it may be And you just heard from Senator Benavides that a highly respected, well-known black female was treated with indignity and not with respect when she stated the problems that she was having. So people need to be believed, they need to be treated with respect and dignity in this area so we can at least reduce the amount of morbidity deaths among the black community. Thank you.
Thank you, Senator Axel. Any closing remarks from the committee?
Seeing none, Madam Vice Chair. Thank you, Mr. Chair. I move House Bill 26-1044 to the Committee of the Whole.
That's a proper motion. Mr. Brown, please call the roll.
Senator Bright.
No.
Cutter is excused. Doherty.
Yes.
Frizzell.
Aye.
Weissman.
Yes.
Judah.
Aye.
Mr. Chair Mullica.
Yes.
And that passes on a vote of 5 to 1.
Thank you, committee. Thank you. Next up, members, we have House Bill 1024 with Senator Frizzell.
Senator Marchman was messaged.
You want to wait for Senator Fizzele? Okay, we'll be in a senatorial five. Okay. Thank you. Thank you. Thank you Thank you. Thank you. Senate will come back to order. Next, we have House Bill 1024, and I see our sponsors are before us.
Who would like to start?
Senator Frizzell.
Thank you, Madam Chair.
So, committee members,
we are bringing House Bill 1024 to you today. Back in 2000, Colorado enacted this Colorado Safe Haven Law, and that allows for parents to surrender an infant up to 72 hours old. And this law, since that time, since 2000 when it was enacted, has saved approximately about 96 children. have been abandoned or given up through this mechanism. So there still are, unfortunately, illegal abandonments that occur. And many, many states have worked to change their safe haven laws to update them, so to extend that time frame. And Colorado is one of only six states remaining that limit their safe haven law to 72 hours. You have 10 states that are between 4 and 29 days, 22 states are 30 days, and 12 states allow more than 31 days. So this bill, 1024, makes one big change. It extends the time a mother has to safely relinquish her baby from 72 hours to 30 days. And I remember after giving birth to my children, it's just a really intense time. Your hormones are all over the place. You're exhausted. you're recovering physically I was overwhelmed maybe other people aren't overwhelmed but I was overwhelmed and to make a decision so crucial and so important under those circumstances is I think not it's just not reasonable so that's one reason why I thought this I'm very grateful to Representative Kelty for bringing the bill in the House. It's been something she's been very, very passionate about, and I was very pleasantly surprised and honored when she asked me to take this bill in the Senate and shepherd it forward. So, you know, again, this bill, this policy recognizes that decisions made in a rush or in a crisis situation or when you're exhausted or overwhelmed are just not always the best decisions. And by extending this window to 30 days, we give mothers time, time to stabilize, time to just kind of let everything calm down and for clarity to emerge. So with that, I'd like to turn it over to my co-prime sponsor.
Senator Marshman. Thank you, Madam Chair, and thank you, Committee, for hearing the bill. I too want to thank my co-prime. She covered the bill. This is a really easy change from 72 hours from three days to 30 days. This bill acknowledges the reality of just postpartum hormones and all of that that exists there. and trying to rush that decision in three days can be challenging. So what this bill does is really just strengthen the purpose of Safe Haven, which is all about protecting life. When women know they're not trapped by an impossible clock, they're more likely to seek help rather than act out of panic or desperation. I just want to run through a few of the organizations that we've done stakeholding with on this. obviously Safe Haven Colorado Office of Child's Representative, Office of Respondent Parents Council CDHS Planned Parenthood, Soul to Soul Elephant Circle Color, Cobalt CCI, Arapahoe County, El Paso County Be the Source and Raise the Future so this has had a lot of stake holding across the board I hope we can earn your support and I look forward to hearing from our witnesses Thank you sponsors Members any questions
Seeing none, we will call up our first panel. When I call your name, if you could please come up to the table. Whitney Frost, Colleen Enos, Dr. Thomas Pirelli, and Kelly Bernato. And I apologize if I pronounced anyone's name wrong. Thank you. If you could tell us your name, who you're with, and your three minutes begins now. Sure.
Chair and members of the Senate committee, thank you for the opportunity to speak today. My name is Kelly Bernardo. I'm a board-certified women's health nurse practitioner from Fort Collins and a board member of the Colorado Safe Haven for Newborns. I'm reading this statement on behalf of myself as well as Dr. Brian Bost, who is also a board member and a physician trained in internal medicine and pediatrics. We are both medical professionals who have been directly involved in safe haven surrenders, and we are here to support the extension of Colorado's safe haven surrender period to 30 days. At its core, this bill is about health equity, which we've heard tons of about today already. Evidence consistently shows that infant abandonment and neonaticide are most strongly associated with structural factors such as poverty, lack of access to prenatal and postpartum care, housing instability, rural isolation, intimate partner violence, and untreated postpartum mental health conditions. These are not impulsive decisions. They are crisis decisions made under profound inequity. In Colorado, since the Safe Haven Law was enacted in 2000, over 100 newborns have been safely surrendered, while more than 40 infants have been illegally abandoned. Of those illegally abandoned infants, over 80% did not survive. These deaths were preventable. A 72-hour window, surrender window, assumes stability, privacy, transportation, and emotional clarity, conditions many parents in crisis simply do not have. From a medical perspective, the first weeks after birth are a time of profound physiologic and emotional change. Serious postpartum mental health conditions frequently emerge after the first several days postpartum, particularly following rapid hormonal shifts and cumulative sleep deprivation. Extending the surrender window to 30 days allows decisions to be made with greater clarity, safety, and dignity, and not with panic. This is also about parents' rights. Safe haven laws exist to protect parents from criminalization when they make a legal, selfless decision to protect their child. And when the surrender window is unrealistically short, the law fails the very people it was designed to serve. And finally, this is about children's rights. Every newborn has the right to safety, timely medical care, and the opportunity to reach their full potential. and extending this surrender period does not separate families. It reduces unsafe abandonment and saves lives. Importantly, Colorado is an outlier, as we heard. The majority of states allow safe haven surrender at 30 days or longer and national child health organizations support aligning safe haven laws with clinical and public health evidence. This bill does not mandate new actions, expand penalties, or remove safeguards. It simply aligns Colorado law with medical reality, national norms, and compassion. This is not a political issue it is a public health issue a child safety issue a health equity issue I urge you to support this measured life update to Colorado safe haven law Thank you, and I'm happy to take any questions after you.
Thank you. If you could please state your name, who you represent, and your three minutes begins.
Thank you, Chair and members of the committee. My name is Colleen Enos, and I represent myself. I support HB 26, 1024, and I would urge a yes vote. We've all heard the stories of mothers giving birth in the bathroom and leaving the baby in the trash. Baby Moses laws or safe haven laws were created to prevent infant abandonment and death. New mothers need support. They can be in crisis after giving birth. The postpartum phase after childbirth can last for several weeks. Intense hormonal and emotional changes happen during that time. Giving mothers in crisis more time after the birth of their baby to make such an important decision is a common sense thing to do. 39 states already give women 30 days or longer to make that decision. So Colorado is clearly the outlier here. Over 5,000 mothers and babies have been helped in the last five years nationwide. And that's according to the National Safe Haven Alliance. We protect mothers and children in Colorado in many different ways. We give health care, housing, and food assistance. Giving women time to think things through is a simple way to expand protection and give mothers in crisis help. I'm speaking as a mom of eight. Giving that extra time matters, and it protects women and children. I would urge yes vote on HB 26-1024. Thank you.
Thank you. If you could please set your name, who you represent, and your three minutes begins.
Chair, members of the committee, thank you for the opportunity to speak today. My name is Whitney Frost. I'm a maternal mental health expert with over 15 years of experience in this field. I'm testifying in support of expanding Colorado's safe haven surrender window from 72 hours to 30 days. This policy change is fundamentally about maternal mental health. The first days after childbirth are an acutely vulnerable period. Many parents experience extreme stress responses, including postpartum anxiety, depression, and even psychoses. These conditions often do not appear immediately after birth. Symptoms frequently intensify over the first several weeks. A 72-hour window simply does not reflect the clinical trajectory of postpartum mental health challenges. Expanding the safe haven period to 30 days gives parents experiencing these conditions a realistic and humane time frame to recognize their symptoms, seek help, and make a safe, voluntary decision. It prevents an arbitrary deadline from compounding fear, shame, and a crisis-driven decision. This expansion is especially critical for parents in Colorado's rural communities. These mothers face higher rates of maternal mental health conditions, in part because access to perinatal mental health, OBGYN services, and behavioral health resources are limited or geographically distant. Long travel times provider shortages and reduced anonymity when seeking help all create additional barriers crisis points may develop later simply because assessment support and follow care are harder to reach A longer safe haven window recognizes these structural inequities It ensures that rural parents who may be isolated, overwhelmed, or delayed in receiving care still have access to a safe, legal option if their mental health deteriorates after the first few days. States that have expanded their safe haven timelines have seen reductions in unsafe abandonment events and improved engagement with safe haven protections. These outcomes track with better maternal mental health stabilization, particularly among populations with limited access to care. By aligning Colorado's statute with the clinical realities of postpartum mental health and with the lived realities of rural families, You will create a more equitable, compassionate, and life-preserving system for both parents and infants. I urge the committee to support the expansion. Thank you.
Thank you.
Thank you, Madam Chair and members of the committee. My name is Tom Perrill. I'm a physician and president of Democrats for Life of Colorado, but I'm here today representing myself on HB 26-1024. Infant mortality is recognized as one of the most pressing concerns in our state, disproportionately affecting people of color, and neonatal homicide is a significant factor. The most vulnerable time for infants is within the first day of life when the death rate from homicide has historically been 10 times greater than any other time during life. However, the infant homicide rate remains unacceptably high during the ensuing month after birth. Neonatal homicide is frequently perpetrated by the mother who might be young, unmarried, have lower educational attainment. It may involve a mother who has concealed her untended pregnancy or denied her pregnancy and had limited or no prenatal care and sometimes reflects a non-hospital birth. Commonly, the relationship with the father is ended or is in the process of ending. It may arise from the realization that the mother has limited available resources to care for the child. Most women implicated in neonatal homicide regret their decision and would have benefited from a clear plan when they became overwhelmed. During the period between 1989 and 1998, the overall homicide rate for infants was 8.3 per 100,000 person-years, but on the first day of life it was 222 per 100,000 person-years. This shocking fact led to the proliferation of safe-haven laws since 1999, which attempt to provide vulnerable women and their newborn babies with a clear alternative. Safe-haven laws allow a parent to legally surrender an infant who might otherwise be abandoned or endangered. Some form of safe-haven law have been enacted in all 50 states, as you heard, and Puerto Rico. They vary in detail, but they share a common goal to reduce neonatal endangerment. Since their institution, the estimated 5,200 infants nationally, and as you heard, 100 infants locally have been safely surrendered, and this attests to the need for this kind of legislation. there's been an associated drop in the neonatal homicide rate by 66%. While correlation does not prove causation, it is safe to assume that safe haven laws have been an important factor in this reduction. Extending Colorado safe haven laws to 30 days does not claim to solve all infant homicides or the scourge of infant mortality. Most tragedies occur later in infancy and require broader prevention strategies, but a 30-day window for relinquishment meaningfully aligns the law with the period when crisis is still acute, judgment may be impaired, and a last resort option can make the difference between life and death. HB 26-1024 adds another compassion option for at-risk mother and deserves your bipartisan support. It is not an end run around established adoption law and procedures. Rather, it is a proven instrument to decrease infant mortality. In my testimony, I also rebuffed some of the opposition's arguments. They conflate adoption with an infant homicide prevention strategy, and I think that's where the opposition is misguided. Thank you so much.
Thank you so much. Are there any questions for this panel? Seeing none, thank you so much for your time. Our next panel is Sarah Wagner, Wendy Buxton Andrade, I'm so sorry, Nathan Fisher, and then April Jenkins is here for questions only. Who would like to begin? Perfect. If you could say your name, who you represent, and your three minutes will begin.
Thank you. My name is Sarah Wagner. I am with Colorado Safe Haven for Newborns nonprofit. Thank you, Madam Chair and the Senators of the Committee, and thanks to Senators Frizzell and Marchman for carrying this important legislation. Again, my name is Sarah Wagner, Executive Director of Colorado Safe Haven for Newborns. We are a nonpartisan, nonprofit organization focused on bringing awareness to Colorado's safe haven law and bringing training and materials to safe haven surrender locations across the state. I'm here in strong support of House Bill 26-1024, which updates Colorado's safe haven law by extending the surrender window from 72 hours to 30 days. Right now, as you've already heard, Colorado is one of only six states that still limits the surrender time frame to 72 hours. That limit was set more than 20 years ago when safe haven laws were brand new and designed to create urgency around infant safety. As states have gained experience, most have updated their laws to better reflect the realities of their first month postpartum. Today, the vast majority, actually 39 states, have updated their timelines to at least 30 days. In fact, National Safe Haven Alliance is proposing a federal standard of a minimum of 30 days and no more than 60 days, which places Colorado's current limit far outside that national norm. It is my understanding that El Paso County is currently in support of this bill. Published CDHS reports from 2001 to 2024 show that El Paso County accounts for at least 25 of Colorado's recorded safe haven cases, nearly 30% statewide. So more than three times of any other county That experience gives them a unique on perspective on why a 30 window is needed Our organization is committing to working alongside state organizations on the implementation and training rollout for this important update. We already hold in-hospital trainings for health care workers on the safe haven law and protocols, and we would lead the charge in updating the time frame information and updating that information with those trainings and with the safe haven surrender locations and personnel. In conversations about this bill, a couple of practical questions came up. First, some worried that a longer window would lead to more surrenders, and there is no evidence for that. After Virginia expanded its law in 2022, paired with a public awareness campaign, the state reported no significant increase in safe surrenders
and has had zero illegal abandonments since then. Second, some suggested that the 30 days keeps infants in an abusive situation longer. That actually misunderstands the law. Safe haven only applies when an infant is unharmed. If there is abuse, neglect, or danger, existing child protection laws still apply, and this bill does not change that. A 30-day window gives families more time to access support, understand their options, and make a safer decision. I urge your support. Thank you.
Thank you so much. If you could please state your name, your three minutes will begin.
Good afternoon, Chair and members of the committee. My name is Wendy Buxton Andrade, and I am here representing Mental Health Colorado in the support of House Bill 26-1024. For 73 years, Mental Health Colorado, the nonpartisan, nonprofit organization, has been acting as our state's leading advocate for Coloradoans' mental health and ending health-based discrimination. During the first 72 hours after the birth of a child, a birthing person is often overwhelmed with the experience and postpartum conditions have not set in. The risk to the individual and the child is heightened during the first 30 days of their lives. This extension will allow a person who is struggling with mental health issues to make a more thought-out decision to safely relinquish their child to a person of trust and to not have to go through the courts or human services. This extended consideration period will save the lives of children and also improve outcomes for the birthing person who may be in a place of despair with an unwanted pregnancy or in a situation where they cannot care for a child. Many face a decision that will change their lives forever This is not a decision that should be rushed Giving a person 30 window will allow postpartum conditions to manifest and stabilize and increase the likelihood of sound decision-making. Please vote yes on House Bill 26-1024 to support our most vulnerable humans and allow a birthing person to relinquish their child in a timely manner, protecting vulnerable children from harm and aligning the state of Colorado with other states that have already enacted the 30-day time period. Thank you.
Ms. Jenkins, you're here for questions only,
but would you like to testify? No, I'll just be here for questions only.
Perfect. So I'm going to go on to Mr. Fisher. If you could please state your name and who you represent.
Thank you, Madam Vice Chair, members of the committee. My name is Nathan Fisher, and I serve as the Associate Director of the Colorado Catholic Conference, which is the united voice of the four bishops of Colorado. Safe Haven laws provide a compassionate and secure option for mothers in crisis who are unable to care for their newborns, regardless of their socioeconomic background or demographic. HB 1024 has no cost to the state. At a time when our state is facing revenue issues, this is an easy, cost-effective measure to pass and help mothers and newborns. 1024 allows relinquishment time to be extended from 72 hours up to 30 days. giving more options to individuals who want to relinquish the child. This will also put Colorado closer to the status quo nationally with this time frame. Safe Haven law statistics show that since 1999, over 5,200 babies were saved across the country through Safe Haven relinquishment. However, 1,600 babies were also illegally abandoned in that time in dumpsters, backpacks, and other places. Of those infants, 608 were found alive and 900 were found deceased unnecessarily. Too often we hear tragic stories of newborns left in dangerous situations or heartbrokenly lost to abandonment. This legislation offers a vital lifeline. It provides a no-questions-asked option allowing a distressed parent to legally and safely relinquish a newborn at a designated secure location. Some might ask why this is necessary. The answer is simple. To save lives and offer hope. To send a signal that our lawmakers are prioritizing mothers and newborns. What this law does ensure is that the public is aware of their options for newborns in the places where the infrastructure addresses the needs of the child, while maintaining protection for the mother. Safe Haven Laws act as a compassionate last resort. They embrace both mother and child, offering a path that protects the child's safety, while providing the mother with a way to ensure her child will find love and stability, rather than despair. This bill represents a tangible, practical, and life-affirming solution that transcends political divides. It turns our shared goal of saving lives into concrete action. On behalf of the Colorado Bishops we respectfully ask you to vote yes on House Bill 1024 Thank you Thank you Members any questions for this panel All right Seeing none thank you so much for your time
Is there anyone else in the room or online who wishes to testify? Seeing none, the witness phase is closed. Sponsors. Are there any amendments? No amendments. So we will close the amendment phase. wrap up. Senator Marchman.
Thank you, Madam Chair, and thank you committee for hearing from us. I just want to say thank you also to our witnesses for coming out today. That was really compelling testimony, and I didn't get a chance to finish the I was doing some math with the 5200 since inception. I didn't finish it yet, but I think the prospects are very good that if we change this from three days to 30 days we will be in a situation where we are able to save more babies from being abandoned and possibly dying. So I would urge your aye vote on this bill. Thank you.
Senator Frizzell. Thank you and I would also like to thank the witnesses that came forward to speak on this bill today. You know, we've heard a lot about this bill. It's really pretty straightforward and I believe kind of common sense policy just to modernize Colorado's safe haven law and I would ask for an aye vote. Thank you. Members, are there any closing
comments? Okay, seeing none. Senator Frizzell, a
proper motion would be to the Committee of the Whole. Thank you, Madam Chair. I move House Bill 1024 to the Committee of the Whole with a favorable
recommendation. That is a proper motion. Mr. Brown, please call the roll.
Senators Bright
Yes
Cutters excused
Doherty
Yes
Frizzell
Aye
Weissman
Yes
Judah
Aye
Congratulations. That passes five to zero. Senator Frizzell.
Unanimously. Let's go that way. That's a better...
I like that, yes. More celebratory.
Thank you, Madam Chair. I move that House Bill 1024 be added to the consent calendar.
That is a proper motion. Is there any objection? Seeing none, congratulations. You are on the consent calendar. That concludes the business for the Health and Human Services Committee. Thank you so much for...