Newsletter-June-2021

Newsletter (September 2020)

Newsletter (June 2021)

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Photo Credit: Kevin J. Beaty/Denverite

In This Issue


An Eviction Crisis Is on the Horizon

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There are several factors contributing to the uncertain status of the CDC Eviction Moratorium, which has protected thousands of renters nationwide from eviction during the pandemic. The moratorium is currently set to expire at the end of June; in March, it was extended for another three months less than a week before its expiration date. The moratorium is also being challenged in federal courts. 

On top of that, states, jurisdictions, and judges are all interpreting the moratorium differently because it is an unusual use of CDC authority. Denver is applying CDC guidelines to bar landlords from filing evictions for nonpayment of rent. Meanwhile, in Jefferson County, sheriffs are actively evicting people who are behind on rent. Landlords also use other strategies to evict tenants, including lease violations, because the moratorium only prevents evictions for nonpayment of rent. 

Governor Polis allowed the State of Colorado’s eviction moratorium to expire, so as soon as the federal moratorium is lifted, renters will be expected to pay the sum of what they owe in rent. Colorado Legal Services and other housing advocates are expecting a significant spike in evictions and bankruptcies as a result. Check out this CPR article for a list of resources available to Colorado renters and answers to commonly asked questions about the moratorium. 

Denverites will also have access to legal representation during eviction proceedings in September after the City Council recently passed an eviction legal defense fund. Previously, tenants were represented in less than 1% of eviction cases. The Colorado Legislature also passed a bill that grants tenants additional eviction protections this session, SB21-173


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Emerging from the Pandemic Starts with Small Steps

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Mental Health Center of Denver recently posted on their blog about post-pandemic anxiety and strategies to manage the unease many people feel about being in close proximity with others as things begin to re-open. Jen Jackson, a licensed clinical social worker and assistant program manager with MHCD, recommends that rather than avoiding social activities, “repetition and easing back into things may solve some discomfort”. 

Project ECHO Colorado is also launching a new 6-week ECHO series for healthcare workers titled “Past the Pandemic: Mental Well-Being for You and Your Patients”. The series aims to provide concrete strategies to navigate pandemic-related stress, prevent burnout, and promote mindfulness. It will occur weekly on Tuesdays from 12:00-1:00 beginning on June 29th.


Takeaways from the Access to Specialty Care Engagement Network (ASCENT) Cohort

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The purpose of this three-year grant program funded by Kaiser Permanente Colorado was to improve access to specialty care for uninsured or Medicaid-insured adults in Colorado. The 5-organization cohort sought to tackle this pervasive barrier to care by connecting specialty care safety net programs in Colorado, coordinating patient referrals to specialty care practices, and offering e-consults. MHHA and other ASCENT cohort members are reflecting back on the progress achieved and identifying major takeaways from the cohort’s work, which began in 2018. 

The Colorado Health Institute recently published several materials summarizing the ASCENT Cohort’s work: 

From the Colorado Health Institute

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Ensuring Access to Monoclonal Antibody Treatment for COVID-19

Mile High Health Alliance is working on a statewide initiative led by CU Anschutz with the goal of ensuring that people in Colorado who test positive for COVID-19 and are eligible have access to monoclonal antibody (mAb) treatments. MAb Colorado is working to reach both providers and patients about the availability of mAb treatment, which has FDA approval under Emergency Use Authorization to treat mild-to-moderate COVID-19. Research has demonstrated that mAb treatment is a highly effective method of preventing severe COVID-19 symptoms in individuals who have recently contracted COVID-19, and it is available to people who are deemed high risk for severe COVID-19 symptoms and meet eligibility criteria.

We want to learn more about awareness of monoclonal antibodies (mAbs) as a treatment for COVID-19 among people in Colorado, and are collecting feedback via a 10-minute community survey. Participants will receive a $25 gift card.


MHHA Hosts Active Bystander Training to Stop AAPI Hate

In response to the widely documented rise in anti-Asian hate incidents occurring in our communities and throughout the United States, MHHA teamed up with Defend Yourself, an anti-violence program based in Washington, D.C., to learn and practice effective bystander intervention and de-escalation tactics. Thanks to our member and partner organizations who joined us for the training. We look forward to working together to build a future where people of all identities can thrive, and where hate is not tolerated. 


Reading & Resources


Newsletter-March-2021

Newsletter (September 2020)

Newsletter (March 2021)

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In This Issue


This Week Marks One Year of Working Remotely for MHHA Staff

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The COVID-19 pandemic has left an indelible and unique mark upon each of us. This has been a difficult year, and there is more to understand and act on as we move forward. Despite these challenges, spring is around the corner and the delivery of vaccines gives us optimism. 

As our work spaces changed, so did the substance of our work, our ways of life, and the world around us. While working from home has presented its fair share of challenges, it has also had some bright spots. We met colleagues’ kids and pets during Zoom meetings and enjoyed the sunshine during conference calls. 

As our work continues here at MHHA, we are committed to building a future that is healthier and more equitable for everyone.


MHHA Named a Recipient of COPIC Medical Foundation Grant

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A recent grant from COPIC Medical Foundation will support the continuation of our Orange Flag Project, a pilot which will use historic, predictive, and real-time data to inform emergency department personnel of a patient’s high utilization of emergency services to aid in care coordination. 

During the 2021 funding cycle, COPIC Medical Foundation granted a total of $775,000 to five organizations with initiatives designed to reduce fragmentation across care settings. A top concern in patient safety, breakdowns in coordinated care can lead to readmissions, missed diagnoses, delayed treatment, duplicative testing, and reduction in quality of care leading to general patient and provider dissatisfaction. The COPIC Medical Foundation is a nonprofit organization affiliated with COPIC, a leading medical liability insurance provider.


What Happens When the Public Health Emergency Ends?

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As Chiquita Brooks-LaSure awaits confirmation as the head of Centers for Medicare and Medicaid Services (CMS) under the Biden Administration, MHHA is planning for and working on the future of Medicaid at the state and local level. Since Secretary Azar’s declaration of a federal Public Health Emergency (PHE) in response to the novel coronavirus on January 31st, 2020, the Department of Healthcare Policy and Financing (HCPF) has submitted a host of waivers allowing for increased flexibilities and temporary regulations that are in effect for the duration of the COVID-19 PHE. 

The MHHA team is documenting how these CMS-approved Colorado-specific state actions to address COVID-19 have affected Colorado’s Medicaid and CHP+ members and providers. These efforts will inform advocacy with HCPF regarding which temporary rules and flexibilities Colorado should seek to adapt or make permanent, a process we are planning alongside providers, stakeholders, and organizational partners.

There are a few changes of particular interest to us. For one, the Maintenance of Eligibility requirement mandates continuous enrollment for Medicaid members, suspending Medicaid’s regular eligibility renewal and redetermination process. While this protects Colorado’s Medicaid population with continuous coverage until the end of the PHE, we are concentrating on what efforts will be necessary to ensure that the massive re-determination effort slated to occur at the end of the PHE is successful. Another notable change is the expansion of funding for wraparound services and supports, which aligns with efforts to support interventions related to social and economic barriers to health.

The healthcare sector has also adapted to the pandemic with increased flexibilities around telehealth use, which was initially ushered in by temporary waivers approved by CMS. Telehealth is now reimbursed at the same rate as in-person visits and includes both audio-only and chat correspondence, which made telehealth a viable option for Coloradans without broadband access or the technology required for video visits. These telehealth-related temporary flexibilities were made permanent via the passage of SB20-212 during the last legislative session. In the current legislative session, HCPF is proposing a telehealth bill to adjust the parity requirement included in this statute, giving them more flexibility to address the differences in how telehealth is delivered via various providers and platforms. 

We would appreciate hearing any additional insights you may have about how Medicaid and CHP+ have changed in response to the pandemic for either providers or individuals insured through these programs. Please email india@milehighhealthalliance.org to connect with us.


MHHA Signs On to Denver Flavor Ban

Denver is considering a ban on all flavored tobacco products in an effort to counteract the frightening rise in youth tobacco use. According to Flavors Hook Kids Denver, the coalition leading the push for a flavor ban in the city, one in four high school students has used an e-cigarette in the past month. Additional data points to flavored products as a primary cause of the rise in young people using tobacco in the past few years: 97% of youth e-cigarette users reported trying a flavored product within the past 30 days.   

Recent polling data also suggests that a majority of Denver voters are in favor of banning the sale of all flavored tobacco products. A survey of nearly 700 Denverites conducted by Campaign for Tobacco-Free Kids, American Heart Association and Kaiser Permanente found that 65% were in favor of a flavor ban ordinance. The Mile High Health Alliance is one of many organizations that have signed on in support of the flavor ban to create a healthier environment for our youth. Check out this fact sheet for more information about the campaign and the list of organizational partners. We will continue to provide updates on this initiative as it is introduced and progresses through the legislative process.


What Are Colorado Legislators and the Biden-Harris Administration Doing to Advance Equity?

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Five Draft Bills in the Colorado Legislature with Equity Impacts

  1. Continuation of Necessary Document Program: Extends funding for a program that was slated to end in 2021. The Necessary Document Program helps low income Coloradans acquire documentation of their identity, immigration, or citizenship status, which is essential for accessing healthcare, public benefits, and other important services.
  2. “Fix 2006”: A bill passed in 2006 barred people without legal documentation (or who lived with people unable to legally verify their presence) from obtaining professional and commercial licenses. This initiative aims to repeal the 2006 bill, which will allow undocumented individuals to hold occupational and commercial licenses in Colorado and and provide them with access to basic state and local public support services (fact sheet). 
  3. Reproductive Health Care Program: This program would allow people who are undocumented to access contraceptives and counseling services. There is evidence from other states that increasing access to contraceptives results in considerable cost savings, in addition to providing an important healthcare benefit.  
  4. Residential Tenancy Procedures: Extends protections for tenants, including several actions related to eviction and court proceedings. For one, the bill requires that landlords give 14 days’ notice prior to starting eviction proceedings rather than 10. The bill also includes regulation regarding landlords’ ability to increase rent. 
  5. Multilingual Ballot Access For Voters: This bill ensures that voters have access to the ballot in their primary language. It creates a multilingual ballot hotline to provide access to qualified translators or interpreters in all of the languages in which the most recent Census was offered. 

Biden-Harris

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Biden-Harris: Top 5 Equity-Related Executive Actions

  1. Advancing Racial Equity and Support for Underserved Communities Through the Federal Government: Revokes President Trump’s EO that limited federal agencies’ ability to offer EDI training and directs all agencies to review the equity implications of their practices and policies and deliver a report within 200 days. 
  2. Ensuring an Equitable Pandemic Response and Recovery: Among other things, this EO established the COVID-19 Health Equity Task Force, headed by Dr. Marcella Nunez-Smith. The Task Force is charged with providing recommendations to the President for mitigating the health inequities caused or exacerbated by the COVID-19 pandemic and for preventing such inequities in the future.
  3. Restoring Faith in our Legal Immigration Systems & Strengthening Integration and Inclusion Efforts for New Americans: Directs an immediate review of public charge regulations implemented during the Trump Administration. 
  4. Supporting the Reopening and Continuing Operation of Schools and Early Childhood Education Providers: Includes a requirement that the Secretary of Education collect data disaggregated by race, disability, English-language-learner status, and free or reduced lunch status to assess the impact of the COVID-19 pandemic on students and educators. 
  5. Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation: Affirms anti-discrimination laws and the recent Supreme Court decision upholding that Title VII of the Civil Rights Act of 1964 prohibits discrimination on the basis of sexual orientation or gender identity.

Reading-Listening


Reading & Listening


Newsletter-December-2020

Newsletter (September 2020)

Newsletter (December 2020)

jkld

In This Issue

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2020 Census Wrap Up
Medicaid Enrollment Reverses Course in 2020
Vaccine Hesitancy Is Widespread: How Do We Combat It?
Helpful Resources
Want To What We’re Reading


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Happy Holidays from the MHHA Staff !

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2020 Census Wrap Up

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By leveraging and activating existing community partners in high need and under-resourced communities in Southwest Denver, Montbello, and Northeast Denver, we successfully distributed over 20,000 pieces of collateral during our Census outreach work this year. 

We used various strategies to reach Denver’s hard-to-count populations, including hosting community COVID-19 testing events, partnering with food distribution sites, training Promotores and trusted community leaders, commissioning chalk artists to promote the Census in three hard to count neighborhoods, aerial messaging, social media posts and ads, phone banking, and extensive literature distribution by more than 40 community partners. One of our Facebook ads directed towards Spanish-speaking families and those with young children in Denver reached nearly 13,000 individuals and produced over 2,000 clicks to 2020census.gov. 

As a result of our collaborative outreach efforts, we educated an estimated 87,000 people about the importance of the Census and how to complete it. By the time we reached the October 15th deadline, Denver had a 69.3% self-response rate, on par with the 70.0% statewide average self-response rate.


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Medicaid Enrollment Reverses Course in 2020

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Medicaid Enrollment Reverses Course in 2020

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We have all experienced innumerable things that have made this year unprecedented. Medicaid enrollment trends are no exception. Between 2017 and 2019, Colorado saw around 25,000 people disenroll from Medicaid, a 12% decline. By contrast, in 2020, statewide Medicaid enrollment numbers increased by more than 75,000 between March and October. 

In the spring, the Department of Health Care Policy and Financing (HCPF) estimated that half a million Coloradans would enroll in Medicaid by the end of the year due to rising unemployment and their requirement to refrain from disenrolling anyone for the duration of the federal public health emergency. 

While we aren’t seeing new enrollee totals approaching the 500,000 mark anticipated by HCPF, a steady upward trend in enrollment is occurring in Denver County and statewide. In fact, we are seeing similar upticks throughout the nation.

Perhaps the lower-than-expected enrollment increase we are seeing so far is because many eligible Coloradans are unaware that they qualify. The lower totals may also indicate people’s hesitation to enroll in Medicaid or other public benefits due to public charge fears or the stigma associated with safety net programs. 

In order to combat this stigma and reach all uninsured Coloradans, we have been working alongside HCPF and other organizations across the state on outreach and enrollment efforts. The current open enrollment period ends on January 15th

HCPF’s new landing page, We’re Here for YOU, Colorado! has information for people and providers. MHHA also participated in a nation-wide coordinated enrollment push on December 10th. Partner organizations have been asked to take the lead on different parts of the campaign; HCPF is investigating whether there might be resources to support this effort.

Here is a quick breakdown of Medicaid income eligibility limits: a qualifying household’s income must not exceed 133% of the federal poverty level, which equates to about $1,415 per month for a single individual and $2,904 per month for a family of four. In addition, individuals making up to $4,253 per month and families of four with an annual household income up to $8,733 can still qualify for financial help to cover their monthly premiums through the insurance marketplace.

Connect for Health Colorado offers free assistance from their certified enrollment experts to individuals and families seeking insurance coverage. Please direct people to their website to ensure they are covered in 2021.


Vaccine Hesitancy Is Widespread: How Do We Combat It?

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A poll of 1,008 Coloradans by Healthier Colorado in late November found that 40% of respondents did not intend to receive the COVID-19 vaccine. They reported that 39% of white respondents, 44% of Latinx respondents, 48% of Black respondents, 34% of people with a college degree, and 69% of people with a high school education or less were not willing to receive the COVID-19 vaccine. 

Pew Research Center data indicate that willingness to receive the COVID-19 vaccine has plummeted across racial and ethnic groups nationwide since the spring, making it clear that vaccine hesitancy is a problem everywhere.

Healthcare workers are not exempt from this uncertainty. A national survey of nearly 13,000 nurses in October found that 36% would not voluntarily receive the COVID-19 vaccine, and 31% were unsure. Reasons for increased vaccine skepticism include concerns about politics influencing the development and approval process, the “warp speed” timeline, and the lack of diversity in clinical trials. 

Vaccine hesitancy also has historic roots for the African American population. Deidre Johnson, the executive director of the Center for African American Health, was recently interviewed for a 9News article about racial and ethnic disparities in flu vaccination rates. She stated that, “All of these disparities, whether it’s flu vaccine or the COVID issues, they’re all deeply rooted in systemic racism… Our system is creating exactly what it was designed to do.” 

We are facing rising mistrust and misinformation about the COVID-19 vaccine as initial doses are arriving in Colorado. In order to create an equitable pandemic response and achieve herd immunity, we need tailored community-specific messaging to combat misinformation, earn trust, and spread the message about the importance of getting vaccinated. 


 

Helpful Resources

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Colorado’s Draft Vaccine Distribution Plan

Polis Outlines Colorado’s Distribution Plan (Video)

“A Dose of Reality” Podcast Series About Vaccine Mistrust 

Colorado Census Response Rates By County

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What We’re Reading

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The Internet’s Public Health Moment: What the 2020 US presidential election can teach us about the need for new knowledge in the digital age

Hate Motivated Behavior: Impacts, Risk Factors, and Interventions

Equity in the Age of Telehealth: Considerations for California Policymakers




Newsletter-September-2020

Newsletter (September 2020)

Newsletter (September 2020)

jkld

In This Issue

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Message from the Executive Director
Health and Wellness, COVID / Census Events
Aurora/Mile High Health Alliance e-Consult Webinar Series
What Can Orange Flag Do For You?
“Are You Ready For Your Flu Shot?”
TRUA: Denver’s New Housing Assistance Program
Nominations Open for KUSA Award


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Collaboration . . . is about the ideas that never existed until after everyone enters the room. 

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Message from the Executive Director

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Achieving better health through collaboration says as much or more about how the Mile High Health Alliance pursues its priorities as it does about the purpose of our programs and activities. Our work is simultaneously broad and narrow – understanding the big picture in order to implement iterative changes that result in tangible impact.  

In the health sector there are often confounding variables that lead to improved individual, family, and community outcomes. As a result, evaluation of collaborative activities is frequently rooted in contribution analysis: understanding the relative role that each organization, activity, and program contributes to the success of an effort. No  one organization can claim sole credit for achieving the goal, but each organization can identify how, but for their participation, the achievement would not have been possible.

Please enjoy this quarterly newsletter, which highlights some of the ways through which MHHA is fostering and engaging in collaborative efforts to improve the health of Denver residents.


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MHHA Collaboration Efforts

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Health and Wellness, COVID / Census Events

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Over the past several months, Stephanie has partnered with the Denver Indian Center, the mobile health van operated by Servicios de La Raza, Martinez Dental Services, and promotoras in Montebello to host two COVID19 health and wellness events. Among the two events, the community and partners provided services and COVID-19 tests to over 200 individuals, including A1C screenings sponsored by the Barten Institute and screenings Oral health screenings. They also provided 250 pieces of Census outreach material and information in the form of Swag Bags. Each Swag Bag contained information about the Census, Immigrant service information, fabric masks, school supplies, pens, notebooks, hand sanitizer, and more. Necessary resources are provided by the community, organizations, and the generosity of individuals looking to better their community. 

If you are looking to collaborate, provide resources, or be involved with the next COVID19 health and wellness event, save the date for Saturday, September 19, 2020. There, we will be providing resource Swag Bags, cardiovascular and diabetes screening (A1C), COVID19 testing, and more. For more information, contact Stephanie Salazar Rodriguez @ stephanie@milehighhealthalliance.org.


Aurora/Mile High Health Alliance e-Consult Webinar Series

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Since the beginning of the pandemic, telehealth and virtual encounters have become a significant topic. However, e-Consult is rarely included. I bet you’re wondering…..aren’t they the same thing? Actually, the two are quite different. The Mile High Health Alliance and the Aurora Health Alliance were both working on addressing the access to specialty care problem, but never together. Through these discussions, we decided to collaborate and create three webinars focusing on e-Consult. Each e-Consult webinar focused on three unique areas: Statewide PerspectiveColorado Perspective, and Next Steps for Health Alliances

First off, what is the difference between Telehealth and an e-Consult? Telehealth is a technology platform where physicians can deliver health care, health education, and health information services and communicate remotely between their patients. An e-Consult is not the communication between physicians and patients but the consulting between two physicians. The importance of using e-Consult is the elimination of a potential visit or online conversation with the specialist. Eureka!!! One positive solution to minimizing the gap to specialty care access. 

So why have a webinar series? The short answer is to bring like-minded people who understand the need for specialty care access and to find feasible solutions where any health alliances can implement these strategies. We presented the challenges currently being faced, best practices, current work being done throughout the states, and patient experiences. At the end of our webinar series, we developed concrete solutions in which Alliance throughout Colorado can implement. 

PowerPoint information for the three webinar series can be accessed by clicking the links below.


What Can Orange Flag Do For You?

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The Orange Flag Project proposes to address the lack of a proactive, coordinated, multi-sector framework to reduce excessive Emergency Department and hospital use in the Denver metro area. Despite the availability of a health information exchange through CORHIO, ED personnel still cannot easily access the data they need to identify high utilizer patients, have insufficient standardized response protocols, and limited connections to available cross-sector community resources.

Here is an overview of the goals for each phase of the project:

1. Identify a target population– In alignment with Regional Accountable Entity (RAE) Key Performance Indicators (KPI), Hospital Transformation Program quality measures, and Governor Polis’s Wildly Important Goals, the target population will consist of high health system users who have potentially manageable factors that if addressed could mitigate future ED and hospital use.

2. Protocols- The first set of protocols will address actions ED providers take when receiving the Orange Flag push notification in the patient’s emergency health record (EHR). The second set addresses the notification of the care team, providing alternative intervention to the ED. 

3. Technology- Create an interoperable algorithm to identify at-risk patients and alert the ED staff in real-time.

4. Evaluation- Establish process measures to track patients who received the intervention and evaluate the project’s effectiveness as a whole.

Collaboration

So far, preliminary meetings have been conducted with stakeholders in various positions of the healthcare industry. Interest has been identified from health systems (Denver Health, Kaiser Permanente, St. Josephs, and UC Health), public health organizations (Denver Public Health), government networks (the Department of Health Care Policy and Financing, Region 5 Regional Accountable Entity-CO Access), as well as community-based health centers (Stout St. Health Center from CCH).

Regional Convening

This past May, MHHA was selected as a host organization for the 2020 Regional Complex Care Convenings. In addition to receiving a grant to progress this work, the contract with the National Center for Complex Health and Social Needs provides technical support and convening expertise. The Orange Flag project was chosen along with 5 other projects across the country, all with parallel goals of increasing collaboration within the health sector (link).

MHHA and the National Center will convene stakeholders before the end of Q2 in 2021 to solidify the relationships needed to develop and implement a plan for the pilot Orange Flag project. Through the convening, the group will work to form a shared understanding of the approach and project components, identify data available to support the project’s efforts, and form an action plan. Meetings with the other regional host sites will also occur quarterly to share successes and discuss how to overcome barriers.

Project Updates

The project is currently in the first phase of development; meetings are taking place with representatives from HCPF and CO Access. The aim is to incorporate Orange Flag into various previously identified priorities of these governing bodies. Alignment is vital to the success and sustainability of the project.

One of the convening goals is to create an environment that fosters collaboration between organizations in the Metro Denver Area, which will ultimately lead to better health for our entire community. The effort to identify and recruit other key stakeholders with interest and influence in the issue areas the project proposes to address is ongoing.

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Things You Don’t Want To Miss

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Are You Ready For Your Flu Shot?

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Health experts are warning about the possibility of a “twindemic” of COVID-19 and flu this fall and winter. Hospitals could be overwhelmed by a flood of patients sick with the flu, which presents another barrier to caring for individuals infected with COVID-19. It is more important than ever to get this year’s flu shot, in addition to consistently wearing masks, physically distancing, and practicing regular handwashing. Two vaccines have been licensed for the use during the 2020-21 flu season and will be available soon in Denver doctor’s offices and clinics, including from several drive-thru flu shot clinics opening across the Front Range. Use VaccineFinder to find out where to get vaccinated near you.


TRUA: Denver’s New Housing Assistance Program

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You may already be familiar with the Temporary Rental and Utility Assistance program, but if you are not aware of it, here’s some information you don’t want to miss. The TRUA program assists residents of the City & County of Denver who are facing a housing crisis or hardship due to circumstances beyond their control. The financial assistance given is a grant that helps mitigate displacement and or eviction to help residents stabilize their housing conditions. Individuals can qualify for TRUA regardless of legal status, but they must be Denver residents and meet an income limit. MHHA plans to broaden our outreach and navigation services to our existing community engagement activities, as well as develop specific outreach to our members and partners who are not familiar with available programs and services.


Nominations Open for KUSA Award

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The Kathy Underhill Scholarship Award was created in honor of the founding CEO of Hunger Free Colorado. It recognizes a community leader who works to eliminate hunger in Colorado using a health equity lens. Visit the page linked in the next section to submit a nomination before the October 5th deadline.

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Helpful Resources !!!