Senate Committee on Health and Human Services (02/18/2009)

Final
STAFF SUMMARY OF MEETING

SENATE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:	02/18/2009	ATTENDANCE

Time:	11:15 AM to 12:53 PM	Carroll M.	X
		Lundberg	X
Place:	SCR 356	Mitchell	*
		Morse	*
This Meeting was called to order by		Newell	X
	Senator Boyd	Schultheis	*
		Tochtrop	X
This Report was prepared by		Boyd	X
	Elizabeth Burger
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB09-179 SB09-159 SB09-164		Amended, Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole Amended, Referred to Appropriations

11:15 AM -- Senate Bill 09-179

Senator Tochtrop introduced Senate Bill 09-179. The bill modifies certain provisions of communicable disease control laws. Among other changes, the bill requires that pregnant women receive an HIV test, either during gestation or at the time of delivery. A pregnant woman may decline the test. Senator Tochtrop distributed amendment L.002 (Attachment A). She described the bill's provisions.

11:19 AM -- Dr. Ned Calonge, Department of Public Health and Environment, discussed the bill's requirement that pregnant women be tested for HIV, noting that state law currently requires a similar test for syphilis. He responded to questions from Senator Carroll regarding how transmission of HIV can been prevented from a mother to a child. He responded to questions from Senator Lundberg regarding whether statute allows individuals to opt out of mandatory testing for syphilis, noting that the bill's provisions will create an opt out for that test as well. He responded to additional questions from Senator Schultheis regarding why a woman's refusal to be tested would be noted in her medical record.

11:24 AM -- Chris Urbina, Denver Public Health, testified in support of the bill. He stated that Denver implemented a policy of HIV testing for pregnant woman several years ago, and that since the implementation of the policy, no infants of HIV infected mothers have been infected. He stated the bill also clarifies issues related to the treatment of individuals with tuberculosis.

11:26 AM -- Kay Kinzie, Children's Hospital, testified in support of the bill. She emphasized that HIV can be transmitted both through pregnancy and through breast-feeding, and thus it is important that, at whatever time a woman presents for care, she is tested for HIV infection so that transmission to the child can be prevented. She responded to questions from Senator Schultheis regarding the risks to health care providers if pregnant woman are not offered testing.

11:32 AM -- Jacqui Kilmer, Colorado Organizations Responding to AIDS and Colorado AIDS Project, testified that there is a need to update statutory processes related to communicable diseases. She stated that testing is a critical tool in the prevention of transmission of HIV and AIDS. She testified that the provision allowing a woman to opt out of testing is very important and protects a woman's right to refuse testing.

11:36 AM -- Susan Townsend, Colorado Chapter - American Academy of Pediatrics, testified in support of the bill, and support of the HIV testing of the mothers.

11:37 AM

Senator Tochtrop gave concluding remarks regarding the bill.


BILL:	SB09-179
TIME:	11:38:13 AM
MOVED:	Tochtrop
MOTION:	Adopt prepared amendment L.002 (Attachment A). The motion passed without objection.
SECONDED:
		VOTE
	Carroll M.
	Lundberg
	Mitchell
	Morse
	Newell
	Schultheis
	Tochtrop
	Boyd

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


BILL:	SB09-179
TIME:	11:38:41 AM
MOVED:	Tochtrop
MOTION:	Refer Senate Bill 09-179, as amended, to the Committee of the Whole. The motion passed on a 8-0 roll call vote.
SECONDED:
		VOTE
	Carroll M.	Yes
	Lundberg	Yes
	Mitchell	Yes
	Morse	Yes
	Newell	Yes
	Schultheis	Yes
	Tochtrop	Yes
	Boyd	Yes

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

11:40 AM -- Senate Bill 09-159

Senator Sandoval introduced Senate Bill 09-159. She distributed amendment L.001 (Attachment B). A handout concerning the bill was distributed to the committee (Attachment C). The bill requires all individual and group health insurance policies that offer dependent coverage to offer the coverage for unmarried children under the age of 30. Current law requires that this coverage be offered to unmarried children under the age for 25. Senator Sandoval responded to questions from Senator Schultheis, stating that she is in favor of access to health care coverage throughout a person's life. She responded to additional questions from Senator Newell, stating that the intent of the bill is that the parents would pay for the cost of the coverage. She responded to additional comments from Senator Lundberg regarding the effect of the bill on health insurance premiums.

11:49 AM -- Gary Sulley, representing himself and his family, relayed his family's experiences with his son's health and lack of access to health insurance. He stated that the bill will allow him to provide health care coverage for his son until his son is able to support himself.

11:52 AM -- Dominic Sulley, representing himself, testified in support of the bill. Mr. Gary Sulley responded to questions from Senator Tochtrop regarding whether his son could obtain health insurance if the bill does not pass.

11:56 AM -- Ed Bagwell, Teamsters, testified in support of the bill. He relayed his family's experience seeking access to health insurance for an older child.

11:59 AM -- Mark Randell, representing himself, testified in support of the bill. He spoke to how the bill will help his son to access health insurance when he is older.

12:01 PM -- Dennis Gallagher, representing himself, testified in support of the bill. He stated that there are costs associated with a lack of coverage for young adults.

12:03 PM -- Ben Price, Colorado Association of Health Plans, testified regarding the association's concerns with the bill. First, he stated that the bill will create an additional burden on employers to track the dependency status of an employee's family members. He stated the bill could increase the administrative costs of the bill, causing employers to reduce benefits, or eliminate coverage for dependents. He described current state insurance rating provisions for dependents. He stated the bill could drive adverse selection, and that options in the individual market and CoverColorado may help provide access to coverage for adults between the ages of 25 and 30.

12:07 PM -- Jerry McElroy, Kaiser Permanente, testified regarding the effect of House Bill 05-1101 on his organization. House Bill 05-1101 extended coverage to adults under the age of 25. He explained that the bill increased costs for health insurance plans, and gave an incentive for some larger employers to self-fund their plans. He stated that if Senate Bill 09-059 becomes law, he would request that the requirement that parents pay for the policy be removed, and that the bill's effective date be made a date certain. He discussed the effect of health insurance mandates on the cost of health insurance.

12:11 PM -- Travis Berry, Colorado Competitive Council, testified in opposition to the bill. He stated support for the concept of the bill, but noted that employers are not required by any law to offer health insurance to their employees or their dependents. He stated his concern that the bill will prompt employers to drop coverage for dependents. He stated that there are other options for individuals to access health insurance, including CoverColorado. He responded to questions from Senator Newell regarding options for individuals with high health needs, noting that CoverColorado is an option for such individuals.

12:18 PM -- Andrea Harkins, Colorado Group Insurance Association, testified regard the bill. She noted that employers who are self-insured do not have to comply with state mandates, and thus are not subject to the provisions of the bill. She explained that the bill will primarily affect smaller employers and may cause them to drop health care coverage altogether. She stated that employers should not be burdened with the cost of coverage of adults over the age of 25. She stated that the bill will not solve the health care crisis and will have a minimal impact on the number of uninsured.

12:23 PM

Senator Sandoval gave concluding remarks regarding the bill. She discussed Michelle's Law, which is a federal law concerning health insurance coverage for adults up to age 25 with medical needs. She stated that amendment L.001 adds language to the bill to comply with Michelle's Law.


BILL:	SB09-159
TIME:	12:25:16 PM
MOVED:	Tochtrop
MOTION:	Adopt prepared amendment L.001 (Attachment B). The motion passed on a 5-2 roll call vote, with one member excused.
SECONDED:
		VOTE
	Carroll M.	Yes
	Lundberg	No
	Mitchell	Excused
	Morse	Yes
	Newell	Yes
	Schultheis	No
	Tochtrop	Yes
	Boyd	Yes

Not Final YES: 5 NO: 2 EXC: 1 ABS: 0 FINAL ACTION: PASS


BILL:	SB09-159
TIME:	12:25:49 PM
MOVED:	Tochtrop
MOTION:	Refer Senate Bill 09-159, as amended, to the Committee of the Whole. The motion passed on a 5-2 roll call vote, with one member excused.
SECONDED:
		VOTE
	Carroll M.	Yes
	Lundberg	No
	Mitchell	Excused
	Morse	Yes
	Newell	Yes
	Schultheis	No
	Tochtrop	Yes
	Boyd	Yes

Final YES: 5 NO: 2 EXC: 1 ABS: 0 FINAL ACTION: PASS

12:26 PM -- Senate Bill 09-164

Senator Newell introduced Senate Bill 09-164. The bill creates the Child Welfare Training Academy in the Department of Human Services. The bill is a recommendation of the Child Welfare Action Committee, which was formed in 2008 in response to a number of fatalities of children in the child welfare system. Senator Carroll stated that minimal improvements have occurred in the previous year, and that the bill will provide comprehensive training for child welfare workers and supervisors. She distributed amendment L.002 (Attachment D) to the committee. She discussed the bill's fiscal note.

12:31 PM -- Bob Cooper, Tennyson Center for Children, testified that the fiscal situation of the state is bad, but that children in the child welfare system must be protected. He discussed the current training requirements for county case workers, stating that workers are often performing core duties of the job prior to receiving the required training. He stated the current system is not doing enough to protect children.

12:35 PM -- Dr. Skip Barber, Colorado Association of Family and Children's Agencies, testified that the bill is a recommendation of the Child Welfare Action Committee, and stated that the bill is an important step forward. He discussed the training and educational backgrounds of county caseworkers. He emphasized the importance of training for the workers, noting that they are responsible for making critical and difficult decisions.

12:37 PM -- George Kennedy, Colorado Department of Human Services, testified in support of the bill. He discussed the department's vision for the training academy. A handout concerning the training academy was distributed to the committee (Attachment E). He emphasized that the training will be offered on a consistent basis.

12:39 PM -- Art Atwell, Colorado Department of Human Services, offered to answer committee questions.

12:40 PM -- Cheryl Ternes, Arapahoe County Department of Human Services, testified that, from the county's perspective, the legislation is very important. She stated that adequate training is important to staff retention.

12:41 PM -- Adoree Blair, children's advocate, testified in support of the bill. She testified that training resources for child welfare caseworkers have declined over time. She stated that qualified case workers are important for children, but whether or not children receive adequate caseworker services is luck of the draw. She testified that the devolved child welfare system in the state creates pockets of good and bad services, and that standardization is important.

12:43 PM -- Pat Ratliff, Colorado Counties Inc., testified in support of the bill, stating that improved training will improve services and help reduce employee turnover. Senator Lundberg asked whether the training will include information on the constitutional rights of children and families in during their contact with the child welfare system.

12:48 PM

Senator Newell gave concluding remarks regarding the bill. She stated that the child welfare system will still face challenges, but that the bill is a step towards improving and creating consistency in the system.


BILL:	SB09-164
TIME:	12:50:32 PM
MOVED:	Newell
MOTION:	Adopt prepared amendment L.002 (Attachment D). The motion passed without objection.
SECONDED:
		VOTE
	Carroll M.
	Lundberg
	Mitchell
	Morse
	Newell
	Schultheis
	Tochtrop
	Boyd

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


BILL:	SB09-164
TIME:	12:51:30 PM
MOVED:	Newell
MOTION:	Refer Senate Bill 09-164, as amended, to the Committee on Appropriations. The motion passed on a 6-1 roll call vote, with one member excused.
SECONDED:
		VOTE
	Carroll M.	Yes
	Lundberg	Yes
	Mitchell	Excused
	Morse	Yes
	Newell	Yes
	Schultheis	No
	Tochtrop	Yes
	Boyd	Yes

Final YES: 6 NO: 1 EXC: 1 ABS: 0 FINAL ACTION: PASS

12:52 PM

The committee recessed.