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H_HIE_2016A 05/05/2016 01:36:07 PM Committee Summary

Final

STAFF SUMMARY OF MEETING



HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Date: 05/05/2016
ATTENDANCE
Time: 01:36 PM to 05:38 PM
Brown
X
Buckner
*
Place: HCR 0107
Esgar
X
Humphrey
X
This Meeting was called to order by
Joshi
X
Representative McCann
Klingenschmitt
X
Landgraf
X
This Report was prepared by
Lontine
*
Amanda King
Primavera
X
Ransom
X
Ryden
*
Ginal
X
McCann
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
SB16-199

SB16-170

SB16-069

SB16-161
Amended, Referred to Finance

Postponed Indefinitely

Amended, Referred to Finance

Referred to Finance





01:37 PM -- SB 16-199



Representative DelGrosso and Representative Ginal, co-prime bill sponsors, presented Senate Bill 16-199. The bill, as amended by the Senate Health and Human Services Committee, requires that contracts between the Department of Health Care Policy and Financing (HCPF) and organizations providing a program of all-inclusive care for the elderly (PACE organizations) include the negotiated monthly capitated rate for services. The rate must be less than the amount that would have been paid for services to the PACE participant under the regular Medicaid state plan if the person were not enrolled in PACE. In addition, the bill requires HCPF, with the participation of PACE organizations, to develop an actuarially sound upper payment limit methodology that meets federal requirements and other standards. HCPF must contract with an actuary with relevant experience concerning Medicaid and PACE. Until the upper payment limit methodology is developed, the bill requires that the percentage of the upper payment limit used to determine the monthly capitated rate not be less than the percentage negotiated with providers for FY 2016-17. HCPF is not required to develop the new methodology if sufficient gifts, grants, or donations are not received for this purpose.





The bill also creates the state PACE ombudsman in the Office of the Long-term Care Ombudsman in the Department of Human Services (DHS). PACE organizations are required to post information in their facilities and provide written notice to PACE participants about contacting the PACE ombudsman. The bill sets forth procedures for the state PACE ombudsman, including duties, access to PACE organization records, and penalties for retaliating against PACE participants or employees who communicate or share information with the state PACE ombudsman. For FY 2016-17 through FY 2020-21, the state PACE ombudsman will not operate if sufficient gifts, grants, and donations are not received to cover the costs of the ombudsman. The PACE Ombudsman Fund is created in the DHS to receive these gifts, grants, and donations. Lastly, the bill establishes a stakeholder group to develop legislation for introduction during the 2017 legislative session concerning the creation of a system of local PACE ombudsmen to work in conjunction with the state PACE ombudsman.



01:46 PM



Representative DelGrosso and Representative Ginal answered questions from the committee. Representative DelGrosso referenced amendment L.012 (Attachment A). Representative Lontine distributed amendment L.013 (Attachment B).



160505 AttachA.pdf160505 AttachA.pdf160505 AttachB.pdf160505 AttachB.pdf



01:58 PM --
Jennifer Anderson, Attorney General's Office, testified in support of the bill. Ms. Anderson answered questions from the committee.



02:04 PM --
Mike Feeley, InnovAge, testified in support of the bill. Mr. Feeley answered questions from the committee



02:21 PM



Committee discussion with Representative DelGrosso, Representative Ginal, and Mr. Feeley ensued.



02:29 PM --
Elisabeth Arenales, Colorado Center on Law and Policy, testified in support of the bill, if amended.



02:33 PM --
Adela Flores-Brennan, Colorado Consumer Health Initiative, testified in support of the bill.



02:35 PM



Ms. Arenales answered questions from the committee.



02:41 PM --
Zach Lynkiewicz, HCPF, testified in a neutral capacity on the bill.



02:45 PM --
Shane Mofford, HCPF, testified in a neutral capacity on the bill. Mr. Mofford answered questions from the committee.



02:57 PM



Mr. Lynkiewicz and Mr. Mofford answered questions from the committee.





03:03 PM --
Bev Dahan, InnovAge, testified on the bill. Ms. Dahan answered questions from the committee.



03:07 PM --
Anne Meier, State Long-term Care Ombudsman, answered questions from the committee.

BILL: SB16-199
TIME: 03:09:27 PM
MOVED: Brown
MOTION: Adopt amendment L.012 (Attachment A). The motion passed without objection.
SECONDED: Klingenschmitt
VOTE
Brown
Buckner
Esgar
Humphrey
Joshi
Klingenschmitt
Landgraf
Lontine
Primavera
Ransom
Ryden
Ginal
McCann
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection





03:10 PM



Representative DelGrosso commented on amendment L.013 (Attachment B). Representative Lontine discussed amendment L.013. Committee discussion about amendment L.013 with Representative DelGrosso and Representative Ginal ensued.

BILL: SB16-199
TIME: 03:16:25 PM
MOVED: Lontine
MOTION: Adopt amendment L.013 (Attachment B). The motion failed on a vote of 3-10.
SECONDED: Primavera
VOTE
Brown
No
Buckner
No
Esgar
No
Humphrey
No
Joshi
No
Klingenschmitt
No
Landgraf
No
Lontine
Yes
Primavera
Yes
Ransom
No
Ryden
No
Ginal
No
McCann
Yes
YES: 3 NO: 10 EXC: 0 ABS: 0 FINAL ACTION: FAIL





03:17 PM



Representative Ginal made concluding remarks about the bill.

BILL: SB16-199
TIME: 03:18:32 PM
MOVED: Brown
MOTION: Refer Senate Bill 16-199, as amended, to the Committee on Finance. The motion passed on a vote of 13-0.
SECONDED: Ginal
VOTE
Brown
Yes
Buckner
Yes
Esgar
Yes
Humphrey
Yes
Joshi
Yes
Klingenschmitt
Yes
Landgraf
Yes
Lontine
Yes
Primavera
Yes
Ransom
Yes
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS



03:20 PM -- SB 16-170



Representative Arndt, bill sponsor, presented Senate Bill 16-170. As amended by the Senate Health and Human Services Committee, the bill requires the board of Connect for Health Colorado to provide information to the public about the process for an individual who is eligible for Medicaid to purchase a health benefit plan from an insurer participating in the state's health exchange.



03:23 PM



Committee members made comments about the bill.



03:25 PM --
Cindy Sovine-Miller, representing herself, testified in support of the bill. Ms. Sovine-Miller answered questions from the committee.



03:28 PM --
Julie Mowry, Rocky Mountain Health Plans, testified in a neutral capacity.



03:30 PM --
Meg Dubray, Connect for Health Colorado, testified in opposition to the bill. Ms. Dubray answered questions from the committee.





03:36 PM



Committee discussion with Ms. Sovine-Miller, Ms. Mowry, Ms. Dubray, and Representative Arndt ensued.



03:39 PM



Representative Landgraf explained amendment L.004 (Attachment C). Committee discussion about amendment L.004 occurred. Representative Arndt made comments about amendment L.004. Further committee discussion ensued.



160505 AttachC.pdf160505 AttachC.pdf

BILL: SB16-170
TIME: 03:41:17 PM
MOVED: Landgraf
MOTION: Adopt amendment L.004 (Attachment C). The motion failed on a vote of 6-7.
SECONDED: Ransom
VOTE
Brown
Yes
Buckner
No
Esgar
No
Humphrey
Yes
Joshi
Yes
Klingenschmitt
Yes
Landgraf
Yes
Lontine
No
Primavera
No
Ransom
Yes
Ryden
No
Ginal
No
McCann
No
YES: 6 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL: SB16-170
TIME: 03:42:53 PM
MOVED: Brown
MOTION: Postpone Senate Bill 16-170 indefinitely. The motion passed on a vote of 9-4.
SECONDED: Ginal
VOTE
Brown
Yes
Buckner
Yes
Esgar
Yes
Humphrey
No
Joshi
Yes
Klingenschmitt
No
Landgraf
No
Lontine
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 9 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS



03:44 PM -- SB 16-069



Representative Pabon, bill sponsor, presented Senate Bill 16-069. The bill requires the Colorado Department of Public Health and Environment (CDPHE) to establish rules governing the scope of practice of community integrated health care service, including the issuance of an endorsement in community integrated health care service to emergency medical service providers. In addition, agencies managing and offering community integrated health care services must be licensed by CDPHE beginning July 1, 2018.



The bill sets minimum standards for community integrated health care service agencies that must be incorporated in rules promulgated by the State Board of Health. These rules must be based on the report issued by the Community Paramedicine/Mobile Integrated Healthcare Task Force and address areas such as staffing, educational, and training requirements. The bill creates the Community Integrated Health Care Service Cash Fund to receive fee payments from licensed agencies. A person operating a community integrated health care service agency without a license commits a misdemeanor offense and is also subject to civil penalties.



The bill also creates the Community Assistance Referral and Education Services (CARES) Program in the CDPHE. Under the CARES Program, licensed ambulance services, local fire departments, fire protection districts, fire protection authorities, special district authorities, health care business entities, and community integrated health care service agencies may establish a program that provides community outreach on health issues and services, and health education to local residents. In addition, these agencies may provide referrals for low-cost medication programs and alternative resources to the 911 system. They may partner with hospitals, licensed home care agencies, other medical care facilities including licensed community integrated health care service agencies, primary care providers, other health care professionals, or social services agencies to provide program services and ensure nonduplication of services.





The community integrated health care service agencies licensure program repeals September 1, 2021, and is subject to a sunset review conducted by the Colorado Department of Regulatory Agencies.



03:49 PM



Representative Pabon answered questions from the committee.



03:54 PM -- Chief Ken Watkins, Colorado State Fire Chiefs and Colorado Professional Fire Fighters, testified in support of the bill. He answered questions from committee.



04:00 PM -- Chris Montera, Eagle County Paramedicine Services, testified in support of the bill. He answered questions from the committee.



04:12 PM



Committee discussion with Chief Watkins, Mr. Montera, and Representative Pabon continued.



04:16 PM --
Michael Nicoletti, CDPHE, testified in opposition to the bill.



04:19 PM --
Randy Kuykendall, CDPHE, testified in opposition to the bill. Mr. Kuykendall answered questions from the committee.



04:25 PM --
Gail Finley, Colorado Hospital Association, testified in support of the bill.



04:26 PM --
Anne Montera, Central Mountain Regional Emergency Medical and Trauma Advisory Council, testified in support of the bill.



04:29 PM --
Tim Dienst, Emergency Medical Services of Colorado, testified in support of the bill. Mr. Dienst answered questions from the committee.



04:39 PM --
Aubrey Hill, Colorado Coalition for the Medically Underserved, testified in support of the bill.



04:42 PM --
Ellen Caruso, Home Care Association, testified in a neutral capacity on the bill.



04:45 PM --
Betsy Murrary, Home Care Association, testified in a neutral capacity on the bill.



04:45 PM --
John Welton, Colorado Nurses Association, testified in a neutral capacity on the bill.



04:48 PM --
Gini Pingenot, Colorado Counties, Inc., testified on the bill.





04:52 PM



Representative Pabon explained amendment L.012 (Attachment D). Representative Pabon answered questions from the committee.



160505 AttachD.pdf160505 AttachD.pdf

BILL: SB16-069
TIME: 04:52:16 PM
MOVED: Esgar
MOTION: Adopt amendment L.012 (Attachment D). The motion passed on a vote of 9-4.
SECONDED: Ginal
VOTE
Brown
Yes
Buckner
Yes
Esgar
Yes
Humphrey
No
Joshi
No
Klingenschmitt
No
Landgraf
Yes
Lontine
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
Yes
McCann
Yes
YES: 9 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS





04:54 PM



Representative Pabon explained amendment L.014 (Attachment E).



160505 AttachE.pdf160505 AttachE.pdf

BILL: SB16-069
TIME: 04:54:40 PM
MOVED: McCann
MOTION: Adopt amendment L.014 (Attachment E). The motion passed without objection.
SECONDED: Esgar
VOTE
Brown
Buckner
Esgar
Humphrey
Joshi
Klingenschmitt
Landgraf
Lontine
Primavera
Ransom
Ryden
Ginal
McCann
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection





04:55 PM



Representative Pabon explained amendment L.015 (Attachment F). Committee discussion about amendment L.015 occurred. Representative Pabon answered questions from the committee about amendment L.015.



160505 AttachF.pdf160505 AttachF.pdf

BILL: SB16-069
TIME: 05:00:42 PM
MOVED: McCann
MOTION: Adopt amendment L.015 (Attachment F). The motion passed on a vote of 7-6.
SECONDED: Esgar
VOTE
Brown
No
Buckner
Yes
Esgar
Yes
Humphrey
No
Joshi
No
Klingenschmitt
No
Landgraf
No
Lontine
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
Yes
McCann
Yes
YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS





05:01 PM



Representative Pabon made concluding remarks on the bill. Committee members made comments about the bill.

BILL: SB16-069
TIME: 05:07:59 PM
MOVED: Esgar
MOTION: Refer Senate Bill 16-069, as amended, to the Committee on Finance. The motion passed on a vote of 8-5.
SECONDED: McCann
VOTE
Brown
No
Buckner
Yes
Esgar
Yes
Humphrey
No
Joshi
No
Klingenschmitt
No
Landgraf
Yes
Lontine
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 8 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS



05:09 PM -- SB 16-161



Representative Primavera, bill sponsor, presented Senate Bill 16-161. The reengrossed bill requires athletic trainers to be registered with the Division of Professions and Occupations (DPO) in the Department of Regulatory Agencies (DORA), and reinstates the Athletic Trainer Practice Act as it existed prior to its 2015 repeal, by:

      • specifying educational background, certifications, and examination requirements;
      • providing DORA with the ability to set fees and schedule renewals of registrations;
      • establishing the grounds for disciplinary proceedings and authorizing the DPO director to take disciplinary actions; and
      • establishing a class 2 misdemeanor for conviction of the offense of practicing without an active registration, and a class 1 misdemeanor for a subsequent offense.





In addition, the bill makes some changes to the act, including recodification, terminology modifications, and the following substantive changes:

      • adding title protection for the abbreviation A.T.C. (athletic trainer certified) to limit its use to registered athletic trainers;
      • requiring evidence of current national certification at registration and, if required by the DPO director, at renewal; and
      • adding as grounds for discipline the failure of an athletic trainer to practice pursuant to the direction of a Colorado-licensed or otherwise lawfully practicing health care professional and the failure to practice in a manner that meets generally accepted standards of athletic training practice.



Entities involved with youth sports teams are not required to employ an athletic trainer and school coaches are not required to be athletic trainers. The bill repeals on September 1, 2026, following a sunset review.



05:14 PM



Representative Primavera answered questions from the committee.



05:16 PM --
Jim Turk, University of Northern Colorado and the Colorado Athletic Trainer Association, testified in support of the bill.



05:19 PM --
Mark Peters, Colorado Athletic Trainer Association, testified in support of the bill. He provided a handout (Attachment G) to the committee. Mr. Peters answered questions from the committee.



160505 AttachG.pdf160505 AttachG.pdf



05:26 PM



Mr. Turk answered questions from the committee.



05:28 PM --
Bridget Younger, Colorado Athletic Trainer Association and Children's Hospital Colorado, testified in support of the bill. She provided a handout to the committee (Attachment H). Ms. Younger answered questions from the committee.



160505 AttachH.pdf160505 AttachH.pdf





05:33 PM



Representative Primavera made concluding remarks on the bill. Committee members made comments about the bill.

BILL: SB16-161
TIME: 05:35:18 PM
MOVED: Primavera
MOTION: Refer Senate Bill 16-161 to the Committee on Finance. The motion passed on a vote of 10-3.
SECONDED: Esgar
VOTE
Brown
Yes
Buckner
Yes
Esgar
Yes
Humphrey
No
Joshi
Yes
Klingenschmitt
No
Landgraf
Yes
Lontine
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 10 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS



05:38 PM



The committee adjourned.


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