House Committee on Health and Human Services (02/19/2009)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:	02/19/2009	ATTENDANCE

Time:	01:35 PM to 05:07 PM	Acree	X
		Gerou	X
Place:	LSB A	Green	*
		Kefalas	X
This Meeting was called to order by		Kerr J.	X
	Representative Riesberg	McGihon	X
		Nikkel	X
This Report was prepared by		Primavera	*
	Kelly Stapleton	Swalm	X
		Gagliardi	E
		Riesberg	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
HB09-1196 HB09-1252 HB09-1232 HB09-1191 HB09-1209		Amended, Referred to Finance Referred to the Committee of the Whole Postponed Indefinitely Amended, Referred to the Committee of the Whole Committee Vote - Final Action Failed

01:35 PM -- House Bill 09-1196

Representative Gerou presented House Bill 09-1196 which allows the use of moneys in the Nursing Home Penalty Cash Fund to be used for measures that improve the quality of life for residents in nursing facilities. A handout from the Colorado Culture Change Coalition was provided to the committee (Attachment A).

01:39 PM -- Ginny Brown, Legislative Liaison, Department of Health Care Policy and Financing (DHCPF), and Julie Collins, Fiscal Analyst, Department of Health Care Policy and Financing, explained how the moneys in the Nursing Home Penalty Cash Fund are used, stating that one use of the money is to relocate residents from nursing homes that are closed. She stated that in the current fiscal climate that money from the fund may be needed to relocate nursing home residents. Ms. Brown stated that the department has worked very hard to consolidate the number of boards which have to report to the executive director of DHCPF. She stated one concern with the bill is the creation of another board and suggested that further discussion with the sponsor of the bill regarding the topic would alleviate the department's concerns.

01:48 PM -- Ruth McKee, consumer and advocate for Colorado Culture Change Coalition (CCCC), testified in support of the bill. Ms. McKee spoke about her mother's experience in a skilled nursing home. She said she learned about culture change or 'resident-centered care' during this experience. She stated that resident-centered care improves the quality of life for seniors. Ms. McKee provided a brief description of 'resident-centered care', or culture change.

01:53 PM -- Carmen Bowman, Colorado Culture Change Coalition, spoke in support of the bill. She stated that resident-centered care entails creating an environment where residents fill like they are living 'at their home' rather than in an institution.

01:59 PM -- Penny Cook, Manager, Long-term Ombudsman Program, Denver Regional Council of Governments (DRCOG), spoke in support of the bill. She stated that money in the Nursing Home Penalty Cash fund is currently restricted for the use of relocation of nursing home residents. She stated that one of the ways the moneys may be used is to improve the quality of life of the elderly living in residential facilities.

02:01 PM -- Billie Bliesner, resident of la long-term care facility, spoke in support of the bill. She explained to the committee how culture change has positively affected her life. She stated that choices are important. She stated that before resident-centered care, she felt like she was living in an institution, whereas now she feels like she lives in a place that is more like her home.

02:05 PM -- Beth Ertz, President, Board of Directors, Colorado Culture Change, spoke in support of the bill.

02:18 PM

Representative Gerou provided a wrap-up to the bill and responded to questions from committee members. There was some discussion regarding whether creating the board was necessary.


BILL:	HB09-1196
TIME:	02:22:52 PM
MOVED:	Gerou
MOTION:	Moved to adopt prepared amendment L.001 (Attachment B). Representative Gerou explained the amendment. The amendment passes on a 8-1 roll call vote.
SECONDED:	Kerr J.
		VOTE
	Acree	Yes
	Gerou	Yes
	Green	Excused
	Kefalas	Yes
	Kerr J.	Yes
	McGihon	Yes
	Nikkel	Yes
	Primavera	No
	Swalm	Yes
	Gagliardi	Excused
	Riesberg	Yes

Not Final YES: 8 NO: 1 EXC: 2 ABS: 0 FINAL ACTION: PASS


BILL:	HB09-1196
TIME:	02:31:25 PM
MOVED:	Gerou
MOTION:	Moved to refer amended House Bill 09-1196 to the Committee on Finance. The motion passed on a 9-0 roll call vote.
SECONDED:	Kefalas
		VOTE
	Acree	Yes
	Gerou	Yes
	Green	Excused
	Kefalas	Yes
	Kerr J.	Yes
	McGihon	Yes
	Nikkel	Yes
	Primavera	Yes
	Swalm	Yes
	Gagliardi	Excused
	Riesberg	Yes

Final YES: 9 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: PASS

02:33 PM

The committee took a brief recess.

02:47 PM -- House Bill 09-1252

Representative Roberts presented House Bill 09-1252 which establishes a pilot program in the San Luis Valley, Colorado that is similar to the pilot program that was established under House Bill 07-1022 that created the Local Access to Health Care Pilot Program in Pueblo, Colorado. She stated that witnesses will testify as to the nature of the pilot program in the San Luis Valley.

02:49 PM -- Chris Adams, The Adams Group, testified in support of the bill. Mr. Adams explained the establishment of the Local Access to Health Care Pilot Program in Pueblo. He stated that many individuals, such as restaurant workers, or other low-income individuals that do not qualify for Medicaid, need access to health care, but cannot afford it. He stated that the pilot program is modeled off a similar program in Michigan called Access Health. He stated that the program is not a health insurance program, but is a non-profit coverage plan providing health care access. He explained that the program in Pueblo is administered through the county commissioner's association. He stated that this bill expands the program to the San Luis Valley area. Mr. Adams explained how coverage, financing, and benefits are provided under the bill. He also provided an explanation to the committee as to why the program is not considered health insurance. Some members expressed concern that the bill was similar to a limited benefit plan. Mr. Adams stated that the premium is less costly than a limited benefit plan. Mr. Adams responded to committee questions regarding the impacts and results of the Health Access pilot program in Pueblo and the Access Health in Michigan.

03:25 PM -- Gwen Heller, San Luis Valley Regional Medical Center, spoke in support of the bill. Ms. Heller spoke to the geographical and economic diversity in the San Luis Valley. She stated that the small group market has a large presence in the community. She stated that approximately 25 percent of the population is uninsured and considered the working poor according to federal poverty levels. Ms. Heller stated that the pilot program is expected to serve approximately 4,800 individuals in the San Luis Valley. Ms. Heller spoke to the unique situation in rural communities and that a health assistance program is needed in the area. She stated that the Colorado Access Trust has indicated it will provide a grant to get the program off the ground.

03:48 PM -- Russ Johnson, Chief Executive Officer, San Luis Medical Center, spoke in support of the bill. He concurred with previous testimony. He emphasized the lack of access to health insurance is a significant problem. He stated that individuals everyday are using emergency rooms as their primary care physicians. He addressed Representative McGihon's concerns about increasing the underinsured by stated that the bill prohibits individuals who are currently insured from leaving their plan to join the program.

04:05 PM -- Greg Glischinski, American Association of Retired People (AARP), spoke in support of the bill. He stated he is a small business owner and asked the committee to consider the bill. He stated that the bill will benefit the business community.

04:09 PM

Representative Roberts provided a wrap-up to the bill. She provided information from the Health Access pilot program in Pueblo. Representative Roberts emphasized that rural communities are uniquely situated communities and that the bill is the communities attempt at coming up with a local solution. She emphasized that the bill is a community effort where providers are coming to the table saying they want to participate. She stated that the intent of the pilot program is to increase access to health care. She reiterated that there is no cost to the state and that something is better than nothing.


BILL:	HB09-1252
TIME:	04:19:26 PM
MOVED:	Swalm
MOTION:	Moved to refer House Bill 09-1196 to the Committee of the Whole. The motion passed on a 8-2 roll call vote.
SECONDED:	Gerou
		VOTE
	Acree	Yes
	Gerou	Yes
	Green	Yes
	Kefalas	Yes
	Kerr J.	Yes
	McGihon	No
	Nikkel	Yes
	Primavera	No
	Swalm	Yes
	Gagliardi	Excused
	Riesberg	Yes

Final YES: 8 NO: 2 EXC: 1 ABS: 0 FINAL ACTION: PASS

04:23 PM -- House Bill 09-1232

Representative Roberts spoke to end-of-life directives. She provided a handout titled "Getting the Most Out of the Medical Orders for Scope of Treatment (MOST) Process and Form" (Attachment C). She asked that the bill be postponed indefinitely due to the fiscal note, but stated that she intends to bring the bill back next year for discussion.

04:28 PM -- Dr. David Koets, Center for Hospice and Palliative Care, spoke in support of the bill. He stated that although the bill will not be going forward this year, it will give the Colorado Advance Directive Consortium time to perfect the bill. He stated that end-of-life directives are an important issue.


BILL:	HB09-1232
TIME:	04:31:48 PM
MOVED:	Riesberg
MOTION:	Moved to lay over House Bill 09-1232 to August 27, 2009. The effect of the motion is to postpone the bill indefinitely. The motion passed on a 10-0 roll call vote.
SECONDED:	Kerr J.
		VOTE
	Acree	Yes
	Gerou	Yes
	Green	Yes
	Kefalas	Yes
	Kerr J.	Yes
	McGihon	Yes
	Nikkel	Yes
	Primavera	Yes
	Swalm	Yes
	Gagliardi	Excused
	Riesberg	Yes

Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

04:33 PM -- House Bill 09-1191

Representative McCann presented House Bill 09-1191 which addresses liens for medical assistance by the Department of Health Care Policy and Financing against third parties. The bill states that the liens for medical assistance cannot exceed the amount of medical assistance provided, and are to the fullest extent allowed under federal law. Representative McCann stated that the bill brings the state in compliance with federal law. Representative McCann spoke to amendment L.001 (Attachment D). She also provided a letter from the Colorado Trial Lawyers Association in support of the bill (Attachment E).

04:37 PM -- Gary Ashby, Manager of Benefits Coordination, Department of Health Care Policy and Financing, spoke in support of the bill. He explained the need to change the statute.


BILL:	HB09-1191
TIME:	04:41:45 PM
MOVED:	McGihon
MOTION:	Moved to adopt prepared amendment L.001 (Attachment D). The motion passed without objection.
SECONDED:	Primavera
		VOTE
	Acree
	Gerou
	Green
	Kefalas
	Kerr J.
	McGihon
	Nikkel
	Primavera
	Swalm
	Gagliardi	Excused
	Riesberg

Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB09-1191
TIME:	04:42:25 PM
MOVED:	McGihon
MOTION:	Moved to refer amended House Bill 09-1191 to the Committee of the Whole. The motion passed on a 10-0 roll call vote.
SECONDED:	Acree
		VOTE
	Acree	Yes
	Gerou	Yes
	Green	Yes
	Kefalas	Yes
	Kerr J.	Yes
	McGihon	Yes
	Nikkel	Yes
	Primavera	Yes
	Swalm	Yes
	Gagliardi	Excused
	Riesberg	Yes

Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

04:43 PM -- House Bill 09-1209

House Bill 09-1209 was put back on the table. For witness testimony, see committee summary from February 16, 2009.


BILL:	HB09-1209
TIME:	04:51:37 PM
MOVED:	Green
MOTION:	Moved to adopt prepared amendment L.006 (Attachment F). Representative Green explained the amendment. The motion failed on a 4 to 6 roll call vote.
SECONDED:	McGihon
		VOTE
	Acree	Yes
	Gerou	No
	Green	Yes
	Kefalas	No
	Kerr J.	No
	McGihon	Yes
	Nikkel	No
	Primavera	Yes
	Swalm	No
	Gagliardi	Excused
	Riesberg	No

Not Final YES: 4 NO: 6 EXC: 1 ABS: 0 FINAL ACTION: FAIL


BILL:	HB09-1209
TIME:	05:01:22 PM
MOVED:	Green
MOTION:	Moved to adopt prepared amendment L.007 (Attachment G). Representative Green explained the amendment. The motion failed on a 5-5 roll call vote.
SECONDED:	McGihon
		VOTE
	Acree	No
	Gerou	No
	Green	Yes
	Kefalas	Yes
	Kerr J.	No
	McGihon	Yes
	Nikkel	No
	Primavera	Yes
	Swalm	No
	Gagliardi	Excused
	Riesberg	Yes

Not Final YES: 5 NO: 5 EXC: 1 ABS: 0 FINAL ACTION: TIE


BILL:	HB09-1209
TIME:	05:06:11 PM
MOVED:	Green
MOTION:	Moved to refer amended House Bill 09-1209 to the Committee of the Whole. The motion failed on a 5-5 roll call vote.
SECONDED:	McGihon
		VOTE
	Acree	No
	Gerou	No
	Green	Yes
	Kefalas	Yes
	Kerr J.	No
	McGihon	Yes
	Nikkel	No
	Primavera	Yes
	Swalm	No
	Gagliardi	Excused
	Riesberg	Yes

Not Final YES: 5 NO: 5 EXC: 1 ABS: 0 FINAL ACTION: TIE

05:07 PM

The bill was laid over to March 2, 2009. The committee adjourned.