Bill Tracker

Concerning facilitating the integration of international medical graduates into the Colorado health-care workforce.

Background:

• By 2030, Colorado is expected to have a statewide shortage of over 2,400 physicians.
• As of January 2022, Colorado has 123 areas designated as primary care health professional shortage areas.
• As of 2017, there were approximately 3,000 immigrants in Colorado whose health-related undergraduate degrees were underutilized, 2,000 of whom received their education outside of the U.S.

Bill description:

The bill creates two programs for international medical graduates (IMG) - the IMG Assistance Program and the Clinical Readiness Program.

• IMG Assistance Program. Purpose is to provide direct services to IMGs, including a review of an IMG's education, training, and experience to recommend appropriate next steps for integrating IMGs into the state's health-care workforce; technical support through the credential evaluation process; and scholarships to assist in defraying the medical licensure process.
• Clinical Readiness Program. Purpose is to provide curriculum for and assessments of IMGs to help them build the skills necessary to enter a medical residency program.

The bill makes other changes that allow IMGs to get medical licenses.

• reduces the length of postgraduate clinical training that an IMG must complete to qualify for a medical license from up to 3 years to one year.
• allows an IMG to obtain a reentry license if the IMG has a current or expired international medical license and meets Colorado medical board-specified qualifications and requirements, including an assessment of the IMG's competency to practice.

Status: Introduced 1.13.22. Health & Insurance Committee referred amended bill to Appropriations 2.9.22.

LWVUS POSITIONS: The LWVUS believes that a basic level of quality health care at an affordable cost should be available to all U.S. residents. The League believes that health care services could be more equitably distributed by providing for training health care professionals in needed fields of care. The LWVUS believes that immigration policies should meet the economic, business and employment needs of the United States.

(HB22-1050 provides for additional health care professionals to meet the state shortage of qualified health care professionals, including in rural areas of the state. It helps Colorado to meet its economic, business, and employment health care needs.)

Section 1 of the bill makes legislative declarations and findings
regarding the shortage of health-care providers in the state, the presence
of qualified, internationally trained medical professionals in the state, the
ability of those professionals to assist the state in addressing health-care
workforce needs, the barriers to entry into the health-care workforce these

professionals face, and the need to reduce those barriers to facilitate the
integration of these professionals into the state's health-care workforce.
Section 2 establishes the following 2 programs in the department
of labor and employment (CDLE) to assist international medical
graduates (IMGs) seeking to integrate into the state's health-care
workforce:
  • The IMG assistance program, the purpose of which is to
provide direct services to IMGs, including a review of an
IMG's education, training, and experience to recommend
appropriate next steps for integrating IMGs into the state's
health-care workforce; technical support through the
credential evaluation process; and scholarships to assist in
defraying the medical licensure process; and
  • The clinical readiness program, the purpose of which is to
provide curriculum for and assessments of IMGs to help
them build the skills necessary to enter a medical residency
program.
Section 2 also directs the executive director of CDLE to include
in its annual report to the general assembly pursuant to the State
Measurement for Accountable, Responsive, and Transparent (SMART)
Government Act information about the IMG assistance program, the
clinical readiness program, and any progress made in addressing barriers
IMGs face in securing positions in medical residency programs.
Section 3 authorizes the executive director of the department of
regulatory agencies (DORA), subject to available funding, to award
funding to medical residency programs to provide additional residency
positions dedicated to qualified IMGs and directs the executive director
of DORA to report on any funding awarded for this purpose as part of
DORA's annual report to the general assembly pursuant to the State
Measurement for Accountable, Responsive, and Transparent (SMART)
Government Act.
With regard to requirements for licensure under the Colorado
Medical Practice Act (act):
  • Section 4 defines IMG for purposes of the act;
  • Section 5 reduces the length of postgraduate clinical
training that an IMG must complete to qualify for a
medical license from up to 3 years to one year; and
  • Section 6 allows an IMG to obtain a reentry license if the
IMG has a current or expired international medical license
and meets Colorado medical board-specified qualifications
and requirements, including an assessment of the IMG's
competency to practice.

• May 09, 2022: Senate Appropriations Committee Report
• May 05, 2022: House Appropriations Committee Report
• February 09, 2022: House Health & Insurance Committee Report

Background:

Torture has a devastating impact on the health outcomes of survivors. Several studies characterize torture as one of the main predictors of depression, post-traumatic stress disorder, and anxiety among survivors.

Survivors of torture are two to three times more likely to experience chronic pain as a direct consequence of the torture they endured. Other common medical problems include gastrointestinal issues, lung infections, skin abrasions, and lower back pain.

Federal eligibility for services through the federal office of refugee resettlement within the department of health and human services does not depend on a person's immigration status, and there is no time limit for receiving such services. However, survivors of torture often do not qualify for Medicaid due to the person's pending immigration status.

Survivors of torture with pending immigration status often struggle to access the medical and mental health services they need.

Bill description:

Beginning January 1, 2023, the bill requires the Department of Health Care Policy and Financing (HCPF) to provide Medicaid benefits to individuals living in Colorado who have been tortured in another country and are under the care of a rehabilitative service provider, regardless of immigration status and without federal funding, unless federal funding becomes available. The Medical Services Board must adopt rules to implement the bill, including rules specifying outreach.

Status: Introduced 1.20.22. Health & Insurance Committee referred amended bill to Appropriations 2.16.22.

LWVUS POSITIONS: The LWVUS believes that a basic level of quality health care at an affordable cost should be available to all U.S. residents.

The League of Women Voters believes that immigration policies should be responsive to those facing political persecution or humanitarian crises.

Beginning January 1, 2023, the bill grants a survivor of torture
who is receiving care and rehabilitation services from a rehabilitative
service provider eligibility for medical assistance without federal
financial participation.

• February 16, 2022: House Health & Insurance Committee Report

The bill prohibits an employer from taking adverse action against
an employee or an applicant for employment based on the employee's or
applicant's COVID-19 immunization status. The bill allows an aggrieved
employee or applicant for employment to file a civil action for injunctive,
affirmative, and equitable relief and, if the employer acted with malice or
wanton or willful misconduct or has repeatedly violated the law, the court

may also award punitive damages and attorney fees and costs.
Additionally, the bill specifies that the COVID-19 vaccine is not
mandatory, that the state cannot require any individual to obtain a
COVID-19 vaccine, and that government agencies and private businesses,
including health insurers, cannot discriminate against clients, patrons, or
customers based on their COVID-19 vaccination status. A person
aggrieved by a violation of these prohibitions may file a civil action for
injunctive and other appropriate relief and may be awarded punitive
damages and attorney fees and costs for wanton, willful, or repeated
violations.

• April 06, 2022: House Health & Insurance Committee Report

Concerning improving access to health benefits for economically insecure Colorado families by enhancing public health programs, and, in connection therewith, making an appropriation.

Background: 

Organizations who worked to get this bill introduced: Colorado Immigrant Rights Coalition (CIRC), Colorado Children’s Campaign, Colorado Center on Law and Policy (CCLP), Colorado Organization for Latina Opportunity & Reproductive Rights (COLOR), Planned Parenthood. (LWVCO would have the opportunity to sign on.) 

Bill/effort is also known as “Cover All Coloradans”. 

Per their one-pager: 

Expanding access to all children and pregnant and postpartum people, regardless of immigration status, is fundamental to achieving health equity in Colorado. Communities of color in Colorado experience some of the biggest disparities in health care including:  

Wide disparities by race and ethnicity in insurance coverage, despite efforts to expand access Higher rates of preventable, pregnancy-related deaths
Fear of enrolling in coverage for mixed status families  

Bill description: 

The bill makes the following changes to health insurance coverage for low-income pregnant people and children in low-income families: 

• Provides full health insurance coverage for Colorado pregnant people who would be eligible for Medicaid and the children's basic health plan (CHIP) if not for their immigration status and continues that coverage for 12 months postpartum at the CHIP federal matching rate 
• Provides comprehensive health insurance coverage to all Colorado children who would be eligible for Medicaid and CHIP if not for their immigration status 
• Requires the state department of health care policy and financing to create an outreach and enrollment strategy for enrolling eligible groups into new coverage options 
• Makes comprehensive lactation supports and supplies, including breast pumps, a covered benefit for perinatal people on Medicaid and CHIP 
• Draws down federal funds to improve perinatal and postpartum support and requires that priorities for the funds be determined through a stakeholder process 
• Permanently authorizes an existing survey of birthing parents, run by the state department of public health and environment, and increases the ability of the survey to collect and report on the experiences of birthing people of color in Colorado 
• Creates a special enrollment period for health insurance coverage due to pregnancy so that an eligible person can sign up for insurance as soon as the person becomes pregnant 
• Improves the quality of health insurance coverage available through the health insurance affordability enterprise 

Status: Introduced 3.9.22 and assigned to Public & Behavioral Health & Human Services Committee. Hearing scheduled for 3.25.22. No Fiscal Note as of 3.22.22. 

League positions: 

Support equal rights for all under state and federal law regardless of race, color gender, religion, national origin, age, sexual orientation, or disability.  

Promote a health care system for the United States that provides affordable access to a basic level of quality care for all U.S. residents  

Ensure fair treatment under the law for all persons.  

The bill makes the following changes to health insurance coverage
for low-income pregnant people and children in low-income families:
  • Provides full health insurance coverage for Colorado
pregnant people who would be eligible for medicaid and
the children's basic health plan (CHIP) if not for their

immigration status and continues that coverage for 12
months postpartum at the CHIP federal matching rate;
  • Provides comprehensive health insurance coverage to all
Colorado children who would be eligible for medicaid and
CHIP if not for their immigration status;
  • Requires the state department of health care policy and
financing to create an outreach and enrollment strategy for
enrolling eligible groups into new coverage options;
  • Makes comprehensive lactation supports and supplies,
including breast pumps, a covered benefit for perinatal
people on medicaid and CHIP;
  • Draws down federal funds to improve perinatal and
postpartum support and requires that priorities for the funds
be determined through a stakeholder process;
  • Permanently authorizes an existing survey of birthing
parents, run by the state department of public health and
environment and increases the ability of the survey to
collect and report on the experiences of birthing people of
color in Colorado;
  • Creates a special enrollment period for health insurance
coverage due to pregnancy so that an eligible person can
sign up for insurance as soon as the person becomes
pregnant; and
  • Improves the quality of health insurance coverage available
through the health insurance affordability enterprise.

• May 03, 2022: Senate Appropriations Committee Report
• April 28, 2022: Senate Health & Human Services Committee Report
• April 19, 2022: House Appropriations Committee Report
• March 25, 2022: House Public & Behavioral Health & Human Services Committee Report