Health Policy and Public Health

Keystone Policy Center works with diverse stakeholders to ensure equitable outcomes by identifying and working toward action-oriented solutions to confront health challenges. Keystone has a proven track record of working with consumers, policymakers, practitioners, communities, businesses, payers, and agencies to address substance use disorders and mental health needs, plan for an aging population, get better value out of our health systems, and prevent chronic and communicable diseases.

Throughout Keystone’s history, its team has developed collaborative processes to confront complex national, state and local health policy issues. In each case, Keystone has leveraged its expertise and maintained its commitment to working with a broad array of stakeholders to develop collaborative solutions to tough policy challenges.

Featured Projects

Developing an Integrated Health Care Model

The Keystone Policy Center began working with the Colorado Behavioral Healthcare Council starting in 2015 and four Community Mental Health Centers who were participating in a Bi-Directional Integration Demonstration and Practice-Based Research Pilot Program. Through this program, the CMHCs piloted models of bi-directional integrated care by integrating primary care and prevention services into the community behavioral health setting. The successes, challenges, and lessons learned from this pilot program will inform the future of comprehensive integrated care in the CMHC settings across the state. Click here to learn more.

Transition Planning for Children with Intellectual and Developmental Disabilities

Keystone worked with the Colorado Department of Health Care Policy and Financing, the Colorado Department of Education, and a legislatively created task force to address youth with intellectual and developmental disabilities (IDD) transitioning from services in the educational setting to receiving services through Medicaid and the Division of Vocational Rehab. The task force submitted its findings and recommendations to improve transitions for youth and their families to the Health and Human Services Committee of the Colorado Senate, the Public Health and Human Services Committee of the Colorado House of Representatives, and the Colorado Joint Budget Committee in January 2019.

Substance Abuse Assessment

Keystone partnered with the Colorado Behavioral Healthcare Council and substance abuse providers to conduct a statewide needs assessment related to Colorado’s substance abuse disorder services. Keystone conducted research and interviewed key stakeholders to determine what funded substance abuse disorder services were supported in Colorado; the challenges involved in providing those services; and the barriers people encounter to accessing them. Keystone’s work resulted in recommendations to inform public policy strategies to strengthen Colorado’s efforts to address substance abuse in the state.

Colorado Commission on Affordable Health Care

Faced with the challenges growing health care costs pose to families and Colorado, state lawmakers created the Colorado Commission on Affordable Health Care to comprehensively study the major and fundamental drivers of health care costs and make recommendation to ensure all Coloradans can access affordable and high-quality health care. The Keystone Policy Center staffed the commission to provide programmatic and administrative support, which includes but is not limited to organizing and facilitating statewide meetings, web development, fundraising, communications, and report development. The commission, which also explored possible solutions, delivered regular reports to state policymakers on its findings, culminating with a final report to the Colorado General Assembly and Governor’s Office in late 2017.

Recreational Marijuana Implementation

Following Colorado’s decision in 2012 to legalize recreation marijuana, Centennial State policymakers wanted to gather information about the state’s progress implementing Amendment 64 as well as the policy ramifications. The Keystone Policy Center and Rebound Solutions worked with the Governor’s Office and other key stakeholders to study Colorado’s regulatory framework and to assess metrics in public safety, health, human services, revenue, and other areas affected by marijuana legalization.

The Keystone Policy Center’s work, which surveyed a complex and diverse set of stakeholders, yielded a high-level roadmap for state and local leaders to confront the effects of marijuana legalization. The Keystone Policy’s Center research offer insights not only into Colorado’s work implementing marijuana legalization, but also into the challenges and opportunities other states considering similar policy decisions could face.

Past Projects

Healthcare-Associated Infections

The Keystone Policy Center has extensive experience working in partnership with the Centers for Disease Control and Prevention, the Association of State and Territorial Health Officials, and stakeholders across the country to identify better ways to confront and reduce healthcare-associated infections. Keystone’s research and stakeholder outreach has focused on finding collaborative and proven ways to help hospitals, health officials, and policymakers confront this persistent problem, which the CDC estimates cause more than 99,000 deaths per year.

Keystone’s work has resulted in recommendations that have strengthened public health’s responses to healthcare-associated infections. One recent report — based on in-person stakeholder meetings in Colorado, New York, and Tennessee as well as more than 80 stakeholder interviews of health care practitioners, consumer representatives, public health officials, and other healthcare-associated infection experts in California, Illinois, Massachusetts, Nevada, Pennsylvania, South Carolina, and Washington — explored how policy strategies, including public reporting laws, could affect healthcare-associated infection rates.

Colorado Strategic Action Planning Group on Aging

Colorado, which boasts one of the fastest-growing aging populations in the United States, is collaborative working to prepare for the needs of the state’s growing aging population. As part of these efforts the Colorado General Assembly created the Strategic Action Planning Group on Aging (SAPGA).

Keystone worked with SAPGA to develop a series of recommendations to help Colorado prepare for its growing aging population. Keystone provided the Planning Group with assistance as it developed its strategic plan, drafted the plan itself, and communicated with the public about its urgency and importance.

Photos from the Final Report’s unveiling

Audio from the Final Report’s unveiling

Affordable Care Act Premiums in Colorado

The Keystone Policy Center worked with the elected leaders and other policymakers in Colorado’s Summit and Eagle counties to address the effects of the changes in geographic rating under the Affordable Care Act. In February 2014, the Kaiser Family Foundation released a study that found Garfield, Eagle, Pitkin, and Summit counties had the highest health care premiums in the country. The Keystone Policy Center conducted interviews with national experts, insurers, and other states to identify the issues and opportunities. Keystone developed a series of option for county commissioners that led to a policy change to consolidate the higher health cost regions into larger rating areas to spread the risks and the costs of providing health care more equitably over a larger population.

Colorado Community Health Care Needs

In partnership with Tri-County Health Network and their partners in the counties of San Miguel, Ouray, and West Montrose, the Keystone Policy Center designed a three-part process in 2014 to determine the current health care issues and needs in communities across the region as well as help create a plan to target resources and funding to meet the identified community needs. Keystone identified and analyzed data received from English and Spanish surveys, interviews, and other health assessments and developed materials for each community around specific health needs determined through the process.

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Colorado Personal Belief Exemption Policy for Vaccinations

In partnership with the Colorado Department of Public Health and Environment- Immunization Section, the Colorado Children’s Immunization Coalition, and with support from The Colorado Trust, the Keystone Policy Center designed and facilitated a series of meetings to better understand the state’s current immunization landscape, the impacts of Colorado’s current personal belief exemption policy for immunizations, and to generate potential recommendations to address the challenges with the current policy.

Through the summer and fall of 2013, Keystone facilitated 10 sector specific focus group meetings, key informant interviews, and three stakeholder meetings in which recommendations were developed for decision-makers and partners involved in the state’s personal belief exemption policy for immunizations. These recommendations helped to inform legislation regarding the state’s personal belief exemption for immunizations (House Bill 14-1288).

Personal Belief Exemption Stakeholder Engagement Report [PDF]

Meningococcal Vaccination for Children

The Centers for Disease Control and Prevention and the Keystone Policy Center worked together in 2011 to gather input from the public and national stakeholders to inform decision-making related to the childhood immunization schedule. The Keystone-led process engaged 277 local stakeholders and interested members of the public in a pilot project designed to get input regarding the values that could inform Advisory Committee on Immunization Practices recommendations about whether or how to add new vaccines to the childhood immunization schedule. Participants had a general discussion about vaccines that protect children from rare but severe illnesses and a specific discussion about recently licensed and soon-to-be licensed meningococcal vaccines for infants.

The four public meetings were part of a process that also engaged national-level stakeholders in the same discussion. National stakeholder meetings involved participants from a number of organizations, including the American Academy of Pediatrics, the American Academy of Family Physicians, the National Association of Pediatric Nurse Practitioners, the Heritage Foundation, the National Meningitis Association, Meningitis Angels, and Women in Government.

Meningococcal Vaccines For Children: 2011 Public & Stakeholder Engagement [PDF]

H1N1 Public Engagement

At the request of the Centers for Disease Control and Prevention (CDC), the Keystone Policy Center assembled a 14-member team of professionals to design and execute a national public engagement initiative to help the agency develop guidance for local, state, federal and private health organizations in meeting the challenge of the H1N1 virus in the fall and winter, 2009-2010 flu season.

During the summer of 2009 the team managed ten public meetings, two web engagements, and one stakeholder meeting that brought more than 2,000 members of the public and key stakeholders into dialogue with CDC staff and among one another regarding the optimal scale and pace of the vaccination program.

The Public Engagement Project on the H1N1 Pandemic Influenza Vaccination Program Final Report [PDF]

National Vaccine Safety System Stakeholder Engagement

Vaccine safety remains extremely controversial, with the benefit of prevention of major diseases weighed against the concern by some stakeholders that vaccines may lead to long-term debilitating injury or disability. At the request of the National Vaccine Program Office of the U.S. Department of Health and Human Services, the Keystone Policy Center facilitated an extensive process of stakeholder engagement and dialogue from 2007 to 2010. Keystone designed and implemented a strategy to seek input from organized stakeholders to inform deliberations of the Vaccine Safety Working Group regarding potential strategies for improving the U.S. vaccine safety system.

The Research Integrity Roundtable

The product of 18 months of stakeholder dialogues, the roundtable’s 2012 report, “Improving the Use of Science in Regulatory Decision-Making: Dealing with Conflict of Interest and Bias in Scientific Advisory Panels, and Improving Systematic Scientific Reviews,” built on the Bipartisan Policy Center’s groundbreaking 2009 report, “Science for Policy Project: Improving the Use of Science in Regulatory Policy.” Keystone’s work focused on the following questions:

  • How should scientific advisory panels be composed and how should the qualifications of prospective panelists be vetted?
  • How should concerns about biases and conflicts of interest of advisory panelists be handled?
  • Which studies should agencies review when examining the scientific literature related to a regulatory policy issue, and how should those studies be evaluated and weighted?
  • How should contending views regarding the relevance of particular scientific results to a regulatory issue and the credibility of those results be addressed?

Research Integrity Rountable Report [PDF]

LiveWell Colorado Strategic Planning

The Keystone Policy Center designed and facilitated a strategic planning effort from September through December 2009 for LiveWell Colorado, a multi-million dollar nonprofit organization dedicated to improving the health and wellness of Coloradans by reducing obesity. The organization’s inaugural board of directors included Colorado’s lieutenant governor, the president of Colorado’s Health Foundation, Kaiser Permanente, Colorado Department of Public Health and Environment, and other prominent health leaders. The strategic planning process sought the input and guidance of more than 800 interested stakeholders.

Enhancing Healthcare Infection Control Assessment and Outbreak Response

Following the recent Ebola outbreak and the needs it highlighted for more robust infection control assessment and response plans, the Keystone Policy Center is partnered with the Association of State and Territorial Health Officials and the Centers for Disease Control and Prevention to convene a national effort to identify best practices and valuable implementation steps. Through a combination of site visits in select states and extensive regional meetings involving cross-sector teams from states and other participating jurisdictions, Keystone  designed and facilitated a dialogue focused on determining strategies for optimizing the capacities of public health agencies in responding to infectious disease incidents. The discussions culminated in a report providing guidance at the national, regional and state levels, as well as state-specific action plans.

Zika Planning & Engagement in Los Angeles County

The Keystone Policy Center partnered with Los Angeles County to host a series of community workshops to examine strategies to inform local responses to the Zika virus and other vector borne illnesses. Keystone’s work — which built on extensive work developing collaborative strategies to confront public health challenges and building public engagement — informed Los Angeles County’s strategy, investment, and communications for vector control, public health, and preparedness.