S_HHS_2016A 04/21/2016 01:33:53 PM Committee Summary

Date:	04/21/2016	ATTENDANCE
Time:	01:33 PM to 05:52 PM	Aguilar	X
		Martinez Humenik	X
Place:	SCR 352	Newell	X
		Crowder	X
This Meeting was called to order by		Lundberg	X
	Senator Lundberg
This Report was prepared by
	Elizabeth Haskell
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
HB16-1227 HB16-1047 HB16-1034 HB16-1360		Referred to Appropriations Amended, Referred to Finance Referred to Appropriations Amended, Referred to the Committee of the Whole

01:34 PM -- HB 16-1227



Senator Crowder, co-prime bill sponsor, presented House Bill 16-1227. This bill, as amended by the House Committee on Public Health Care and Human Services and the House Appropriations Committee, specifies that a teen parent is not required to submit an application for child support establishment as a condition of receiving child care assistance. However, the county can require the parent to submit an application for child support establishment in order to receive child care assistance once they no longer qualify as a teen parent. Once the teen parent is determined to be eligible for child care assistance, a county may also require them to regularly attend informational sessions on the benefits of child support establishment and the benefits of two-parent engagement in the child's life. These sessions are to be provided by county child support staff at no cost to the teen parent.



This bill also states that a county cannot require an application for child support establishment as a condition of receiving child care assistance if the applicant submits a statement indicating that he or she has been the victim of domestic violence, a sexual offense, harassment, or stalking. The information and evidence that are required to be submitted with the statement are also specified.



Counties are permitted to provide information on the importance of establishing child support to anyone who chooses not to engage in child support establishment. The Colorado Department of Human Services (DHS) must establish rules and criteria to be reported and ensure that case management systems are capable of accommodating the provisions of this bill.



01:36 PM -- Cindy Sovine Miller, Florence Crittenton High School, testified in support of the bill.



01:38 PM -- Jazelle Aldridge, representing herself, testified in support of the bill.



01:41 PM -- Pat Ratliff, Colorado Counties, Inc., testified in support of the bill.



01:43 PM -- Jennifer Douglas, New Legacy Charter School, testified in support of the bill.





01:45 PM -- Kanise Hampton, representing herself, testified in support of the bill.



01:46 PM -- Jenny Macias, Hope House of Colorado, testified in support of the bill.



01:50 PM



Senator Hill, co-prime bill sponsor, commented on the bill.



01:50 PM -- Minna Castillo Conen, Mile High United Way, testified in support of the bill.



01:52 PM -- Benjamin Waters, Opportunity Coalition, testified in support of the bill.



01:52 PM -- Abby Eschler, SafeHouse Denver, spoke in support of the bill.



01:56 PM -- Lydia Waligorski, Colorado Coalition Against Domestic Violence, spoke in favor of the bill.



01:58 PM -- Bill Jaeger, Colorado Children's Campaign, testified in support of the bill.



02:00 PM -- Melissa Feeler, Aurora Public School, testified in support of the bill.



02:01 PM -- Jodi Doyle, Aurora Public School, testified in support of the bill.



02:04 PM



Senator Crowder made closing comments. Committee members commented on the bill.

BILL:	HB16-1227
TIME:	02:05:06 PM
MOVED:	Crowder
MOTION:	Refer House Bill 16-1227 to the Committee on Appropriations. The motion passed on a vote of 5-0.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	Yes
Final YES: 5 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:09 PM -- HB 16-1047



Senator Newell, bill sponsor, presented House Bill 16-1047 and provided two handouts to the committee (Attachments A and B). This reengrossed bill enacts the Interstate Medical Licensure Compact (compact) and authorizes the Governor to enter into the compact on behalf of Colorado. Under the compact, physicians licensed in a member state may obtain an expedited license in other member states, allowing them to practice in Colorado or in another member state. The compact is governed by the Interstate Medical Licensure Commission (interstate commission). The compact outlines the process for obtaining an expedited license, including:



160421 AttachA.pdf160421 AttachB.pdf



• eligibility requirements;

• the designation of a state of principal licensure;

• the application, issuance, and renewal processes; and

• the fees charged by member states.



The compact allows member states to investigate and discipline physicians, including as part of joint investigations with other member states. The interstate commission is required to maintain a database of all licensed physicians in member states. Member states are required to report certain disciplinary actions and complaints against licensed physicians to the interstate commission. In addition, member states are required to share information about disciplinary actions and complaints at the request of another member state.



Nationally, the compact becomes effective and binding upon enactment of the compact by at least seven states. Under the bill, the interstate compact takes effect in Colorado once the compact is fully operational nationally and member states are able to issue licenses to physicians through the compact. Colorado representatives to the interstate commission may begin participating upon passage of this bill. The compact outlines the processes for member states to withdraw from the compact voluntarily, or for the interstate commission to terminate the membership of a state that defaults on its obligations under the compact.



The Colorado Medical Board must facilitate the licensure of physicians under the compact, including obtaining a set of fingerprints from an applicant for a fingerprint-based criminal history record check. Physicians licensed under the compact are subject to the Michael Skolnik Medical Transparency Act of 2010.



Committee discussion followed about the provisions of the bill.



02:16 PM -- Fred Thomas, Children's Hospital Colorado, testified in support of the bill.



02:20 PM -- Ellen Stern, Children's Hospital Colorado, testified in support of the bill.



02:24 PM



Committee discussion followed about the cost of the program.



02:26 PM -- Tanah Wagenseller, Colorado Community Health Network, testified in support of the bill.



02:29 PM -- A.W. Schnellbacher, AARP Colorado, testified in support of the bill.











02:32 PM



Senator Newell made closing comments and distributed amendment L.005 (Attachment C).



160421 AttachC.pdf

BILL:	HB16-1047
TIME:	02:33:30 PM
MOVED:	Newell
MOTION:	Adopt amendment L.005 (Attachment C). The motion passed without objection.
SECONDED:
		VOTE
	Aguilar
	Martinez Humenik
	Newell
	Crowder
	Lundberg
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

BILL:	HB16-1047
TIME:	02:34:11 PM
MOVED:	Newell
MOTION:	Refer House Bill 16-1047, as amended, to the Committee on Finance. The motion passed on a vote of 4-1.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	No
Final YES: 4 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:47 PM -- HB 16-1034



Senator Garcia, bill sponsor, presented the bill. Under current law, first responders are overseen by the Department of Public Safety (DPS). The reengrossed bill renames "first responders" as "emergency medical responders" and requires the Colorado Department of Public Health and Environment (CDPHE) to begin a voluntary registration program on July 1, 2017. The CDPHE will create and administer the registration program, including promulgating rules for training programs and continued competency requirements, and will be responsible for investigating complaints and taking disciplinary action if necessary. This registration program replaces the DPS certification program. The bill adds the registration program to the programs that can be funded from the Emergency Medical Services Account in the Highway Users Tax Fund.



Emergency medical responders must be registered in order to provide care unless acting as a good samaritan. To be registered as an emergency medical responder, at a minimum, a person must be certified through a nationally recognized emergency responder certification organization, and submit to a fingerprint-based criminal history record check. The bill provides for the provisional registration of applicants whose fingerprint-based criminal history record check has not been completed. The CDPHE will develop additional registration requirements and may set fees as part of its rulemaking process.



02:49 PM -- Paul Cooke, DPS, testified in support of the bill.



02:52 PM -- Michelle Reese, CDPHE, spoke in support of the bill.



02:55 PM -- Rich Martin, State Emergency Medical and Trauma Advisory Council and Colorado State Fire Chiefs, spoke in support of the bill.



02:57 PM



Senator Garcia made closing comments.

BILL:	HB16-1034
TIME:	02:58:14 PM
MOVED:	Crowder
MOTION:	Refer House Bill 16-1034 to the Committee on Appropriations. The motion passed on a vote of 5-0.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	Yes
Final YES: 5 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:02 PM -- HB 16-1360



Senator Lundberg, bill sponsor, presented House Bill 16-1360 and distributed amendments L.011 and L.012 (Attachments D and E). The reengrossed bill implements the recommendations made by the Department of Regulatory Agencies (DORA) in its sunset review of the regulation of direct-entry midwives, with some modifications. It continues the regulation of direct-entry midwives by the Division of Professions and Occupations in the DORA for seven years, through September 1, 2023. In addition, the bill makes the following changes to the scope of practice for direct-entry midwives:



160421 AttachD.pdf160421 AttachE.pdf



• permits direct-entry midwives to suture first- and second-degree perineal tears, if the registrant demonstrates to the director that he or she has received specific training, and to obtain and administer local anesthesia for the procedure;

• makes changes to the disclosure form that direct-entry midwives must provide to clients;

• requires direct-entry midwives to inform parents of the importance of critical congenital heart defect screening, and requires a direct-entry midwife to refer parents to a health care provider who can provide the screening if the direct-entry midwife is unable to perform the screening;

• prohibits a direct-entry midwife from providing care to a pregnant woman who has had a previous delivery by cesarean section;

• allows a direct-entry midwife to enter into a confidential agreement to voluntarily limit his or her practice if a physical or mental illness or condition renders him or her unable to practice direct-entry midwifery safely;

• adds prohibited practices for direct-entry midwives concerning the failure to notify DORA of such an illness or conditions affecting his or her ability to practice midwifery or noncompliance with practice limitations under a confidential agreement; and

• repeals the requirement that the director send letters of admonition via certified mail.



The bill also requires DORA to convene a stakeholder group to review data that is reported by direct-entry midwives. The stakeholder group must report to specified legislative committees by January 31, 2017. Finally, the bill requires DORA to establish a working group to investigate ways of managing risks in the practice of midwifery, including the need for, and access to, professional liability insurance. The working group must report its findings to DORA by October 1, 2016, and DORA must report any recommendations for legislation as a result of the report to certain legislative committees by November 1, 2016.



03:04 PM -- Janet Schwab, representing herself, testified in opposition to the bill and distributed a handout to he committee (Attachment F). Ms. Schwab responded to questions from the committee.



160421 AttachF.pdf



03:16 PM -- Linda Rosa, Colorado Home Birth Consumers, testified in opposition to the bill and responded to questions. She provided a handout to the committee (Attachment G).



160421 AttachG.pdf









03:25 PM -- Alanna Lynch, representing herself, testified against the House amendment to the bill that prohibits a direct-entry midwife from providing care to a pregnant woman who has had a previous delivery by cesarean section



03:29 PM -- Shelby Parker, representing herself, testified against the House amendment to the bill that prohibits a direct-entry midwife from providing care to a pregnant woman who has had a previous delivery by cesarean section. Ms. Parker responded to questions.



03:33 PM -- Lindsey Bonner, representing herself, testified in support of the bill as introduced.



03:37 PM -- Larry Sarner, Colorado Citizens for Science in Medicine, testified in opposition to the bill. Mr. Sarner responded to questions from the committee.



03:41 PM -- Yvette Gentry, representing herself, spoke in opposition to the bill. Ms. Gentry responded to questions from the committee.



03:44 PM -- Jan Lapetino, Colorado Midwives Association (CMA), spoke in support of the bill. Ms. Lapetino responded to questions.



03:52 PM -- Dr. Warren Johnson, CMA, spoke in support of the bill. Dr. Johnson responded to questions from the committee.



04:01 PM



Committee discussion and questions continued.



04:04 PM -- Aubre Tompkins, CMA, spoke in support of the bill.



04:08 PM -- Heather Pollack-Green, CMA, spoke in support of the bill as introduced. Ms. Pollack-Green responded to questions from the committee.



04:22 PM -- Pam Campos, representing herself, spoke in support of the bill as introduced.



04:25 PM -- Melissa Dickard, representing herself, spoke in support of the bill as introduced.



04:28 PM -- Karen Robinson, CMA, spoke in support of the bill as introduced. Ms. Robinson responded to questions from the committee.



04:34 PM -- Heather Thompson, Elephant Circle, spoke in support of the bill as introduced.



04:38 PM -- Allison Record, representing herself, spoke in support of the bill as introduced.



04:41 PM -- Indra Lusero, representing herself, spoke in support of the bill.



04:47 PM -- Jill Bergmann, representing herself, testified in support of the bill.







04:51 PM -- Pauli Durrow, representing herself, spoke in support of the bill as introduced and provided a handout to the committee (Attachment H).



160421 AttachH.pdf



04:55 PM -- Dick Brown, American Congress of Obstetricians and Gynecologists - Colorado Section, spoke in support of the bill.



04:59 PM -- Dr. Brent Keeler, American Congress of Obstetricians and Gynecologists - Colorado Section, spoke in support of the bill as amended.



05:02 PM -- Dr. Steven Holt, American Congress of Obstetricians and Gynecologists - Colorado Section, spoke in support of the bill. Dr. Holt responded to questions from the committee.



05:10 PM -- Nathan Wenneker, representing himself, spoke in support of the bill.



05:13 PM -- Barbie Burrage, representing herself, spoke in support of the bill.



05:16 PM -- Gina Gerboth, CMA, addressed concerns about midwife training in regard to sutures.



05:19 PM -- Tiffany Miller, representing herself, testified in support of the bill.



05:21 PM



Lauren Larson, DORA, Saul Larsen, DORA, and Jacquline Arcelin, DORA, came to the table and responded to questions about data collected by DORA and about the suture provision in the bill.





05:29 PM



Senator Lundberg made closing comments. Senator Aguilar distributed and discussed amendments L.015, L.019, and L.020 (Attachments I, J, and K).



160421 AttachI.pdf160421 AttachJ.pdf160421 AttachK.pdf

BILL:	HB16-1360
TIME:	05:39:17 PM
MOVED:	Lundberg
MOTION:	Adopt amendment L.011 (Attachment D). The motion passed without objection.
SECONDED:
		VOTE
	Aguilar
	Martinez Humenik
	Newell
	Crowder
	Lundberg
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

BILL:	HB16-1360
TIME:	05:50:02 PM
MOVED:	Lundberg
MOTION:	Adopt amendment L.012 (Attachment E). The motion passed without objection.
SECONDED:
		VOTE
	Aguilar
	Martinez Humenik
	Newell
	Crowder
	Lundberg
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

BILL:	HB16-1360
TIME:	05:50:12 PM
MOVED:	Aguilar
MOTION:	Adopt amendment L.015 (Attachment I). The motion passed without objection.
SECONDED:
		VOTE
	Aguilar
	Martinez Humenik
	Newell
	Crowder
	Lundberg
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

BILL:	HB16-1360
TIME:	05:50:26 PM
MOVED:	Aguilar
MOTION:	Adopt amendment L.019 (Attachment J). The motion failed on a vote of 2-3.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	No
	Newell	Yes
	Crowder	No
	Lundberg	No
YES: 2 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: FAIL

BILL:	HB16-1360
TIME:	05:51:08 PM
MOVED:	Aguilar
MOTION:	Adopt amendment L.020 (Attachment K). The motion passed on a vote of 4-1.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	No
YES: 4 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

BILL:	HB16-1360
TIME:	05:51:44 PM
MOVED:	Lundberg
MOTION:	Refer House Bill 16-1360, as amended, to the Committee of the Whole. The motion passed on a vote of 5-0.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	Yes
Final YES: 5 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

05:52 PM



The meeting adjourned.