2024 Legislative Session Summary
By John Seward, Vice Chair for Advocacy
In the words of EMSAC’s lobbyist, Chris Howes, “It was the year of the deal at the State Capitol.” During Colorado’s 120-day 74th General Assembly more than 700 bills were debated by the legislature’s 100 senators and representatives. This was a session that saw sweeping and historic legislation concerning taxation, education, transportation funding, energy development, and air quality.
EMS solvency and property taxes
Property taxes were the hot-button issue, after the failure of Proposition HH last November and attempts at solutions in a special session at the end of 2023. Lawmakers promised their constituents solutions, but if they were delivered is a matter of debate.
SB24-233, introduced in the waning days of the session, reduces valuations for residential and commercial property and creates separate valuation systems for school districts and all other local governments. Proponents hope the bill will mollify conservative interest groups that are pushing ballot measures that could damage state and local finances. But leaders of those groups have said they’re keeping their options open, and there was no deal by the time the session concluded.
We remain concerned that property valuation changes will cause reductions in revenue for municipal, county and special district EMS agencies. Lawmakers promised there would be limited impact on emergency services, we will just have to wait and see.
Mental health
We were involved in important work on behavioral health and other human services issues. But SB24-059, a costly measure that sought to establish a statewide system of behavioral health care for children and youth lost in the Senate.
EMS solvency and insurance payments
This session, working with the bipartisan bill sponsors team of Rep. Karen McCormick and Rep. Matt Soper and Sen. Kyle Mullica and Sen. Mark Baisley, we advocated HB24-1218. The bill sought to end the practice of surprise billing in ambulance service and resolve ongoing struggles between EMS agencies and insurance companies.
Not surprisingly the bill was opposed by the health insurance industry. While lots of hard work went into the drafting and lobbying for the bill, ultimately lawmakers just did not understand how EMS billing works and needed more time to learn. We are excited to bring legislators into ambulance stations and firehouses before the next session to help them learn more about EMS and our billing woes.
EMS solvency and local taxes
We partnered with the State Fire Chiefs to advocate SB24-194. It gives ambulance and fire protection districts the authority to ask voters to enact sales taxes, opening up new revenue options for EMS agencies. Previously only counties, municipalities, health services districts and metropolitan districts (and the state) could ask voters to approve a sales tax (or a change to it).
EMS education and training
HB24-1103 sought to ban use of the term “Excited Delirium,” an attack on academic freedom and a de facto legislation of medicine. EMSAC secured amendments to the bill that enabled EMS education programs to continue appropriate behavioral health education. EMSAC was steadfast in its position that while the term “Excited Delirium” has caused enormous harm, forbidding words does not make change, instead, we must all listen to the past and learn from it, to continue to be steadfast advocates for our patients.
EMS solvency and HUTF fees for EMS
The Highway User Tax Fund (HUTF) EMS fee is the $2 fee collected on the registration of motor vehicles; it funds the EMS provider grants in the Colorado Department of Public Health and Environment (CDPHE).
We paid particular attention to the state budget this year, advocating increased funding for EMS programs. Efforts to increase the HUTF EMS Fee in response to a State Emergency Medical and Trauma Services Advisory Council (SEMTAC) recommendation, were stifled by Gov. Jared Polis, who saw a fee increase as a tax and opposed the idea. This despite a recommendation from his own advisory council to increase the fee. We did team up with CDPHE to secure some movement in the governor’s position late in the session, but all was for naught with no success by the time lawmakers went home.
Gov. Polis needs to decide how much he cares about funding of emergency medical response. We will continue the fight to bring about an increase to the decades-old HUTF EMS fee to help fund EMS in Colorado and fulfill the SEMTAC recommendation.
EMS solvency and Medicaid ambulance rates
The 2024-2025 state budget emerged from both chambers in late April and after a ton of work by the Joint Budget Committee, a balanced budget passed including $42.88 billion in total spending, $16 billion in general fund expenditures, $11.52 billion cash funds, and $12.52 billion federal funds. The budget includes 3 % raises for state employees and 2% increase in Medicaid provider rates. Almost two-thirds of the total budget increase was seen in the budget lines for the Department of Healthcare Policy and Financing, which runs Medicaid, and the Department of Human Services which oversees the Behavioral Health Administration. We advocated hard for Medicaid provider increases in an effort to raise ambulance reimbursement rates.
Our lobbying and government relations team at Howes Wolf was hard at work every day beneath the gold dome advancing the EMS agenda. Together with our coalition of EMS advocacy partners at Mutch Government Relations and the Capstone Group, we kept emergency medical services at the center of discussion and debate among the state’s senators and representatives. As we enter the interim we will remain hard at work advancing the EMS agenda, including ongoing work with the EMS System Sustainability Task Force. We eagerly await the next legislative session to continue advocating for its members and partners and will began planning discussions for it this summer.