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Safer at Home, but Still Uncertain: Colorado Plans for the Year Ahead

As of today — Friday, May 8 — at least 945 Coloradans have died as a result of COVID-19. More than 500 of them were residents of nursing homes or senior living facilities. Some 18,370 people had been diagnosed with the disease, and experts suspect many more remain undiagnosed. Outbreaks at meatpacking plants, jails, and among people experiencing homelessness are reminders that the virus is very much still among us — and that some Coloradans remain particularly vulnerable to the disease because of social and economic conditions.

It is against this backdrop that Colorado is continuing to transition from stay-at-home orders to a state of affairs officials are calling Safer at Home. Even the counties that maintained stay-at-home orders after the state lifted its order on April 26 — Denver, Adams, Arapahoe, Boulder, Broomfield, Pitkin, and Jefferson — will let their orders expire on Saturday. And at least 16 of the state’s 64 counties, most of them rural, have requested an even looser set of guidelines.

But the state’s patchwork shift to less stringent restrictions feels more like an uncertain balancing act than a triumphant return to “normal.”

While we know more and more about the virus itself, we don’t know exactly what its trajectory over the next few years will look like. Reopening could come with a spike in cases. We can predict how policies might affect the course of the virus, but the truth is that there will always be uncertainty.

Communities and their policymakers will continue to weigh what restrictions — and just how many infections and deaths — they can accept as they attempt to balance public safety with painful economic realities.

One of those realities: Nearly 420,000 of the state’s 5.75 million residents (more than 13% of the workforce) have filed for unemployment since the crisis began. Job losses will likely bring housing and food insecurity as well as mental and physical health challenges for many.

This balancing act means policies and regulations will likely to be in flux for the foreseeable future. And as state and local governments loosen restrictions in the coming months, public health will increasingly rest on how organizations and people interpret and act on guidance.

This uncertainty makes it difficult for policymakers, let alone businesses, families, and individuals, to plan for the future with any precision.

Impossible Cuts to the State’s Budget

But it is planning time. The legislature’s pause is over. State lawmakers are preparing to receive their Updated Quarterly Revenue Forecast on May 12. The forecast tells them how much money the state budget will have in the coming fiscal year, which starts in July. They have the consequential and unenviable task of cutting the state’s budget by more than $3 billion.

Lobbyists and representatives from the state’s nonprofits, associations, health care providers, and others are scrambling to make the case for preserving funding for their programs—or for cutting programs they’d rather didn’t exist.

As we discussed last week, the cuts the state is considering aren’t theoretical, and they’re not just trimming fat. The state’s already-underfunded public schools, key environmental programs, and health insurance benefits are all on the cutting block. These are programs that directly support the well-being of Colorado residents. Legislators have rejected one of the most dramatic budget-cutting proposals: Ending the Child Health Plan Plus insurance program.

Policymakers aren’t taking the decisions lightly. Marianne Goodland, a reporter for Colorado Politics, described a staffer for the legislature’s Joint Budget Committee crying as she proposed cutting a program meant to support kids with intellectual disabilities. It seems inevitable that by next week, we will be looking at a budget that cuts programs that play an important role in some Coloradans’ lives.

Health care providers and policymakers are also planning for a new reality. The state is forecasting that Medicaid rolls will continue to grow through December 2020, eventually reaching as many as 1.8 million people — nearly a third of the state’s population, and significantly higher than the previous record-high enrollment of about 1.3 million people in 2017. Medicaid enrollment had been declining slightly over the course of the past few years, so state officials and clinics need to rapidly shift priorities and plans to reflect Coloradans’ evolving needs — and ability to afford health care and coverage.

Supporting Coloradans in the Present

But even as the future is unclear, many people and organizations are responding with grace to the current conditions of a world with COVID-19. A few examples:

  • Doctor’s offices and other health care providers launched telehealth programs incredibly quickly to meet the needs of a socially distanced population. In a brief to be published next week, CHI examines how a set of policy changes around telehealth have allowed health care practices around the state to offer care via video chat or phone. Some clinics went from having no visits remotely to conducting 75% of visits or more remotely in a matter of weeks. The question now is which of these policies will remain in place.
  • Some providers are taking even more creative approaches to expand access to care: The CovidLine, administered by Clinica Colorado in Westminster, has recruited dozens of volunteer providers to offer free health care for people without insurance who are concerned they might have COVID-19.
  • As concerns grow about the behavioral health issues as a result of COVID-19, the Metro Denver Partnership for Health has updated its Let’s Talk Colorado campaign to reduce stigma and share information about mental health challenges.
  • The state has created a COVID-19 Health Equity Task Force focused on understanding and addressing the disproportionate impact of the disease on communities of color. There may be opportunities for this group to address policies that have led to other long-standing but frequently ignored health disparities in our state.
  • A new project connects people with RVs to frontline COVID-19 workers so they can isolate in place but remain close to their families.

And that is not to mention the work of nurses, doctors, medical assistants, and other health care workers who are supporting those who are sick — and each other.

The takeaway this week is that we are still learning about the challenges we face even as we have to make decisions about them. Despite some promising signs, and even as Stay-at-Home Orders become a thing of the past in Colorado, the work of ending the pandemic and dealing with its aftermath is still closer to the start than the finish line.


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