Health Care Task Force (10/19/2009)

Final
STAFF SUMMARY OF MEETING

HEALTH CARE TASK FORCE

Date:	10/19/2009	ATTENDANCE

Time:	09:03 AM to 04:45 PM	Apuan	X
		Foster	X
Place:	HCR 0112	Harvey	A
		Kerr J.	X
This Meeting was called to order by		Lundberg	A
	Senator Boyd	Massey	X
		McCann	*
This Report was prepared by		Schwartz	*
	Elizabeth Burger	Frangas	X
		Boyd	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Limited English Proficiency Report Colorado Ambulatory Surgical Center Medicaid Eligibility Modernization Medical Food Coverage Update on the CRICC Public Testimony Discussion of Draft Legislation		- - - - - - -

09:03 AM -- Limited English Proficiency Report

Dr. Louis Hampers, Section Chief, Pediatric Emergency Medicine, The Children's Hospital, Dr. Sandeep Wadhwa, Medical Director, Department of Health Care Policy and Financing, and Francosie Mbabazi, Director, Colorado Progressive Coalition Health Justice introduced themselves and provided a brief introduction to their presentation. Ms. Mbabazi described the Colorado Progressive Coalition Health Justice and its members. She provided a report "Ensuring the Quality and Safety of Care for Limited English Proficient Patients in Colorado" to the committee (Attachment A). Ms. Mbaabzi described the report to the committee. Ms. Mbabazi stated that in situations of emergency, the need for a high level interpreter can be crucial in ensuring quality health care.

09:12 AM

Dr. Wadhwa spoke about the Health Disparities program in Colorado. He stated that approximately 40 percent of the clients in the Medicaid program are Hispanic. He described the consumer engagement group that addresses health disparities in Colorado. Dr. Hampers stated that The Children's Hospital took an internal study of the physicians and the results were quite interesting. He reported that about 19 of the residents reported that they speak Spanish fluently and about 32 residents reported that they avoid limited English proficient families. He stated that the hospital projected that the 19 residents who reported speaking Spanish fluently spent approximately 44 hours a week translating for limited English proficient families. Dr. Hampers spoke to the barriers of why some hospitals do not incorporate translators into the process including that interpreters slow the process down, a family member did not request an interpreter, and the treating physician is not reimbursed for the translation services provided. Dr. Hampers provided data on the cost differences between individuals who received no translator and the medical decisions which accompanied those individuals, versus individuals who spoke English and the accompanying medical decisions. He stated that the cost differences were quite high for individuals with language barriers. The data showed that when an interpreter was provided, there was about a 19 percent additional cost, but without any type of an interpreter, there was approximately a 34 percent additional cost.

09:28 AM

Dr. Hampers described how much time was spent by a physicians when an interpreter was used telephonicly versus an in-person interpreter. He stated that in the study that The Children's Hospital reported, that most physicians thought that telephonic interpretation would not be preferred by a family member. He stated that the report showed that many families did not have any preference regarding on-site or telephonic interpreters. Committee members asked several questions of the panel.

09:44 AM -- Colorado Ambulatory Surgical Center

Megan Boelter, Colorado Ambulatory Surgical Center Association (CASCA) and Dr. Craig Bakken, Rocky Mountain Gastroenterology Associates and CASCA board member, introduced themselves to the committee. Ms. Boelter provided a handout to the committee (Attachment B). Ms. Boelter stated that ambulatory surgical centers contribute approximately $1.53 billion to the economy and of that, about $195 million in taxes. She spoke to the low rate of hospital-acquired infections in ambulatory surgical centers. Dr. Bakken spoke to some of the measures ambulatory surgical centers take in order to keep the low rate of hospital-acquired infections.

10:01 AM -- Medicaid Eligibility Modernization

Sue Williamson, Deputy Director, Office of Client and Community Relations, Department of Health Care Policy and Financing, spoke to Health Resources and Services Administration (HRSA) State Health Access Grant that the department recently was awarded. She provided a fact sheet on the grant to the committee (Attachment C). She described the grant and stated that the grant is for five years. Ms. Williamson stated that the grant may only be used for health care expansion efforts which include expanded programs in Medicaid and infrastructure. Ms. Williamson stated that some of the money from the grant will be used towards implementing the Colorado Health Care Affordability Act, for example, an outreach retention program for new Medicaid populations. She described some of the other programs that the grant will fund. She stated that the grant will help the department implement streamlining the application process for Medicaid participants, a benefit design program for Medicaid participants, and establish a three-share health coverage plan

.

10:14 AM -- Medical Food Coverage

Harvey Karchmer, Pamlab LLC, introduced himself and provided a handout to the committee (Attachment D). He described medical foods which are foods formulated to be consumed or administered under the supervision of a physician and intended for the specific dietary management of a disease or condition. He stated that individuals who use medical foods do so because it helps meet nutritional requirements of which cannot be met by diet alone. He stated that recent evidenced supports the use of a prescription medical food containing a combination of L-methylfolate, the active form of folate, along with the active forms of Vitamin B12 and B6 in certain patients. Mr. Karchmer spoke to the medical foods covered under Medicaid in other states.

10:25 AM

Mr. Karchmer asked the committee to reinstate Medicaid coverage of L-methylfolate containing prescription medical food without prior authorization so long as product is used in a therapeutic regimen to manage serious illness. He stated that the products are rebateable under Medicaid. Committee members asked several questions. Senator Foster volunteered to speak with the department regarding reinstating the coverage of medical foods under Medicaid.

10:38 AM -- Update on the Colorado Regional Integrated Care Collaborative (CRICC)

Dr. Marshall Thomas, President, Colorado Access and Stephanie Denning, Public Programs, Operations Manager, Kaiser Permenente Colorado introduced themselves and provided two handouts to the committee (Attachments E and F respectively). Dr. Thomas described the pilot program regarding regional integrated care collaborative. He stated that it is intended to improve the quality of care received by Colorado Medicaid's highest-need, highest-cost clients. He provided further details regarding the intended goals of the program which are to decrease the cost of care by decreasing inappropriate emergency room visits, unnecessary speciality care, admissions for ambulatory care, and hospital readmissions.

10:46 AM

Dr. Thomas described the general population attributes of the pilot program participants. He stated that there are approximately 2,357 members, at an average of 45 years old with a majority being female. He stated that the population has one of five chronic conditions including diabetes, hypertension, chronic obstructive pulmonary disease, osteoarthritis, and asthma. He stated that these patients are expected to cost approximately 3.3 times as much as the average adult Medicaid recipient. Dr. Thomas detailed a success story of a participant in the pilot program.

10:53 AM

Dr. Thomas spoke to the preliminary outcomes of the pilot program which are:

an increase in use of a single primary care physician;
an increase in pharmacy compliance;
a decrease in emergency room visitation; and
a decrease in readmissions to the hospital.

Ms. Denning spoke to the Kaiser Permanente program. She described the populations served by the program indicating that approximately 300 individuals have been enrolled in the program to date. She stated that common medical conditions seen in the program include diabetes, heart failure, hypertension, mental retardation, obesity, and seizures. She indicated that key efforts of the program include making a connection with care teams; bonding new members with a primary care physician; providing a heath risk assessments for each person; providing initial health exams as soon as possible after enrollment; customizing individual care plans; and coordination with external providers such as behavioral health providers. She described challenges with the program, including adjusting workflows for maximum efficiency and effectiveness; reaching new members; and helping new members learn about being in the Kaiser Permanente system. She described some of the success stories for the program.

11:07 AM

Committee members asked several questions to the panel.

11:08 AM -- Public Testimony

Janet Stephens, Colorado Hospital Association (CHA), spoke to previous testimony regarding ambulatory surgical centers (ASCs). Ms. Stephens wanted to clarify that if an individuals needs more than 24 hours of care, it would be beneficial for the patient to go to a hospital rather than an ASC. She stated that it reduces the possibility of issues resulting from transferring a patient. Ms. Stephens spoke to Draft Bill 9 which addresses funding for CoverColorado by establishing a fee schedule with hospitals and health care providers. She stated that CHA supports the bill. Ms. Stephens also stated that CHA supports the two amendments which will be offered to the draft bill.

11:13 AM

Fran Coleman, Coleman Consulting, spoke to Draft Bill 6 which proposes to license home care placement agencies. Ms. Coleman described the bill to the committee. She asked the committee to support the bill. Ms. Coleman responded to Representative McCann's question regarding whether home care placement agencies' services may be reimbursed through insurance. Ms. Coleman responded to Senator Foster's question regarding whether home care placement agencies must carry worker's compensation insurance by stating that they do not. There was discussion among the committee members regarding whether Medicaid reimburses home care placement agencies' services. Ms. Coleman stated that other states reimburse home care placement agency services under Medicaid.

11:38 AM

Bill Dahlquist and Debbie Savage, National Private Duty Association, spoke in opposition to Draft Bill 6 which proposes to license home care placement agencies and Draft Bill 7 which proposes to license home care workers. Ms. Savage spoke to the licensure process of home care agencies which resulted with the passage of Senate Bill 08-153. Mr. Dahlquist stated that the two draft bills do not protect seniors. He stated that the licensure of home care placement agencies would give the appearance of protecting seniors, but in reality there is no enforcement mechanism in the draft bill that would hold home care placement agencies accountable. He stated that there is no way for a home care placement agency to control their independent contractors. He stated that it is not reasonable to allow seniors to believe that individuals coming into their home have been regulated and appear legitimate without any real enforcement mechanism.

11:47 AM

Mr. Dahlquist spoke to Representative McCann's question regarding reimbursement of home care placement agencies with private health insurance. He estimated that 5 percent of his clientele carry long-term care insurance policies. He stated that the argument to license home care placement agencies because of the lack of reimbursement is not necessarily accurate. He stated that the certification requirements to qualify for Medicaid reimbursement is quite high. He stated that most home care placement agencies would not meet these requirements and therefore would not be eligible for reimbursement under Medicaid. There was further discussion regarding regulation of home care placement agencies.

12:04 PM

The committee recessed.

01:32 PM -- Discussion of Draft Legislation

Senator Boyd gave an overview of committee procedures for considering draft legislation. She explained that the committee is only permitted to recommend eight bills. She explained that the committee will consider each bill, vote on each bill, and determine sponsorship after the eight bills to be recommended have been determined. Two handouts related to a single-payer health plan were distributed to the committee (Attachments G and H)

01:34 PM

Christy Chase, Office of Legislative Legal Services, came to the table to explain Draft Bill 1 (Attachment I). Draft Bill 1 prohibits health insurance carriers from using gender as a rating factor in setting individual health insurance premiums. Ms. Chase responded to a question from Representative Massey regarding whether language could be added to the bill to prohibit cost-shifting.


BILL:	Discussion of Draft Legislation
TIME:	01:39:06 PM
MOVED:	Boyd
MOTION:	Include Draft Bill 1 (Attachment I) as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 9-1 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	Yes
	Kerr J.	No
	Lundberg	Yes
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 9 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:40 PM

Kristen Forrestal introduced Draft Bill 2 (Attachment J). Draft Bill 2 makes telemedicine eligible for reimbursement under the state Medicaid program, and makes other changes related to the reimbursement of telemedicine services and home health providers. Ms. Forrestal responded to questions from Representative McCann regarding statutory language related to the purchase or lease of telemedicine equipment.

01:43 PM

Betsy Murray, Home Care Association, came to the table to respond to Representative McCann's questions regarding telemedicine equipment. Representative Massey clarified that the bill was requested by the Department of Health Care Policy and Financing.


BILL:	Discussion of Draft Legislation
TIME:	01:44:25 PM
MOVED:	Massey
MOTION:	Include Draft Bill 2 (Attachment J) as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 10-0 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	Yes
	Kerr J.	Yes
	Lundberg	Yes
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 10 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:45 PM

Jerry Barry, Office of Legislative Legal Services, came to the table to explain Draft Bill 3 (Attachment K). Draft Bill 3 adds to the list of optional services provided to Medicaid recipients screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other substance abuse services. Representative Massey commented on the cost savings associated with SBIRT activities. Webster Hendricks, Colorado Department of Human Services, came to the table to explain the SBIRT program and discuss the costs and cost savings associated with the SBIRT program.


BILL:	Discussion of Draft Legislation
TIME:	01:48:42 PM
MOVED:	Massey
MOTION:	Include Draft Bill 3 (Attachment K) as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 9-1 roll call vote.
SECONDED:
		VOTE
	Apuan	No
	Foster	Yes
	Harvey	Yes
	Kerr J.	Yes
	Lundberg	Yes
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 9 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:49 PM

Christy Chase, Office of Legislative Legal Services, explained Draft Bill 4 (Attachment L). She explained that the bill allows the Division of Insurance to adopt rules to standardize health insurance policy and explanation of benefit forms. Representative Massey commented on the bill. An amendment was distributed to the committee (Attachment M).


BILL:	Discussion of Draft Legislation
TIME:	01:51:50 PM
MOVED:	Massey
MOTION:	Adopt Amendment 1 (Attachment M) to Draft Bill 4. The motion passed without objection.
SECONDED:
		VOTE
	Apuan
	Foster
	Harvey
	Kerr J.
	Lundberg
	Massey
	McCann
	Schwartz
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	Discussion of Draft Legislation
TIME:	01:53:54 PM
MOVED:	Massey
MOTION:	Include Draft Bill 4 (Attachment L), as amended, as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 10-0 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	Yes
	Kerr J.	Yes
	Lundberg	Yes
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 10 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:55 PM

Kristen Forrestal, Office of Legislative Legal Services, explained Draft Bill 5 (Attachment N). Draft Bill 5 requires entities issuing individual insurance policies in the state to provide the same coverage for maternity care as is currently mandated for all group policies. Amendment 1 was distributed to the committee (Attachment O). The amendment broadens the scope of the bill to encompass reproductive services, including contraceptive counseling, drugs, and devices. Representative Frangas explained the amendment. Representative Frangas responded to questions from Senator Lundberg regarding the scope of the amendment. The committee discussed whether the amendment would require health insurance companies to cover abortions.


BILL:	Discussion of Draft Legislation
TIME:	01:58:53 PM
MOVED:	Harvey
MOTION:	Amendment proposed Amendment 1 (Attachment O) to Draft Bill 5, to add language providing that coverage for abortion services is not mandated. The motion passed on a 6-4 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	No
	Harvey	Yes
	Kerr J.	Yes
	Lundberg	Yes
	Massey	Yes
	McCann	No
	Schwartz	Yes
	Frangas	No
	Boyd	No
Not Final YES: 6 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	Discussion of Draft Legislation
TIME:	02:03:02 PM
MOVED:	Frangas
MOTION:	Adopt Amendment 1 (Attachment O), as amended. The motion passed on a 6-4 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	No
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Not Final YES: 6 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	Discussion of Draft Legislation
TIME:	02:03:52 PM
MOVED:	Frangas
MOTION:	Include Draft Bill 5 (Attachment N), as amended, as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 6-4 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	No
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 6 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:06 PM

Kristen Forrestal, Office of Legislative Legal Services, explained Draft Bill 6 (Attachment P). The bill requires that, by 2012, home care placement agencies be licensed. Representative Frangas responded to questions from Representative Kerr regarding the bill's potential cost and whether the bill should be proposed through the sunrise process. Representative Massey commented on the abuse of seniors by family members. Senator Lundberg commented on the licensure of home care placement agencies, and the potential for licensure to increase costs. Representative Frangas commented on his belief that the bill will not increase costs for consumers. Ms. Forrestal responded to questions from Representative McCann regarding the bill's requirements that home care placement agencies provide certain information to home care consumers and whether the bill would have to be amended if Draft Bill 7 is adopted by the task force. Ms. Forrestal responded to questions from Representative Kerr regarding the amount of the licensing fee that would be paid by home care placement agencies.


BILL:	Discussion of Draft Legislation
TIME:	02:24:34 PM
MOVED:	Frangas
MOTION:	Include Draft Bill 6 (Attachment P) as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion failed on a 3-7 roll call vote.
SECONDED:
		VOTE
	Apuan	No
	Foster	No
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	No
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	No
Final YES: 3 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL

02:25 PM

Senator Schwartz asked that Draft Bill 7 (Attachment Q) be withdrawn, and stated that she would pursue a sunrise review regarding the regulation of personal care service workers. Seeing no objection, the bill was withdrawn. Draft bills 8 and 11 were withdrawn prior to the meeting.

02:30 PM

Christy Chase, Office of Legislative Legal Services, explained Draft Bill 9 (Attachment R). Amendments 1 and 2 were distributed to the committee (Attachments S and T). The bill authorizes the Board of Directors of the CoverColorado program to establish a schedule of fees for compensating health care providers that provide services to CoverColorado enrollees. Senator Boyd explained that the bill implements some of the recommendations of the CoverColorado Long Term Funding Task Force. Representative Kerr asked whether or not CoverColorado would become insolvent if the bill is not passed. Senator Boyd explained the current funding sources for the CoverColorado program. Suzanne Bragg-Gamble, Executive Director of CoverColorado, came to the table to discuss funding for CoverColorado. She explained that the current funding structure for the program is not sustainable over the long term. Ms. Bragg-Gamble responded to questions from Representative Frangas regarding whether the legislation will give the CoverColorado Board of Directors the authority to increase premiums for members, responding that the board already has the authority to raise and lower premiums. She further responded to questions from Representative Frangas regarding whether the CoverColorado Board of Directors has reduced premiums for members in previous years, responding that it has. Ms. Bragg-Gamble responded to questions from Senator Schwartz regarding the insurance assessment that partially funds the CoverColorado program. Ms. Bragg-Gamble further responded to questions from Representative McCann regarding the process for determining the provider fee schedule and whether the schedule will result in funding cuts for providers.


BILL:	Discussion of Draft Legislation
TIME:	02:46:23 PM
MOVED:	Boyd
MOTION:	Adopt Amendment 1 (Attachment S) to Draft Bill 9. The motion passed without objection.
SECONDED:
		VOTE
	Apuan
	Foster
	Harvey
	Kerr J.
	Lundberg
	Massey
	McCann
	Schwartz
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	Discussion of Draft Legislation
TIME:	02:47:50 PM
MOVED:	Boyd
MOTION:	Adopt Amendment 2 (Attachment T) to Draft Bill 9. The motion passed without objection.
SECONDED:
		VOTE
	Apuan
	Foster
	Harvey
	Kerr J.
	Lundberg
	Massey
	McCann
	Schwartz
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	Discussion of Draft Legislation
TIME:	02:48:30 PM
MOVED:	Boyd
MOTION:	Include Draft Bill 9 (Attachment R), as amended, as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 7-3 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 7 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:49 PM

Bob Lackner, Office of Legislative Legal Services, explained Draft Bill 10 (Attachment U). A handout in support of the bill was distributed to the task force (Attachment V). The bill authorizes counties, regions, and municipalities to include within their master plans for long-range physical development a community health element. The bill enumerates items that may be included in the community health element. Senator Boyd commented on the impetus for the bill and emphasized that the bill is permissive. She responded to questions from Representative Massey regarding whether Colorado Counties and the Colorado Municipal League have had input into the bill draft. The committee discussed the permissive nature of the bill and whether there was a current prohibition on including community health elements in master plans. Mr. Lackner noted that the bill will create statutory authorization for counties and municipalities to include community health elements in their master plans.


BILL:	Discussion of Draft Legislation
TIME:	02:58:41 PM
MOVED:	Boyd
MOTION:	Include Draft Bill 10 (Attachment U) as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 6-4 roll call vote.
SECONDED:
		VOTE
	Apuan	No
	Foster	Yes
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 6 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:59 PM

Brita Darling, Office of Legislative Legal Services, explained Draft Bill 12 (Attachment W). She explained that the bill requires the Department of Health Care Policy and Financing to enter into a contract with a single entity for the administration of dental services under Medicaid. Ms. Darling explained that Medicaid dental services are primarily provided to children and that the contract is distinct from the existing contract to provide dental services under the Children's Basic Health Plans. Ms. Darling responded to questions from Representative Massey regarding the length of the contract. Representative McCann commented on access to dental services for children in rural areas of the state. Representative McCann proposed an amendment to Draft Bill 12 to strike lines 1 through 16 on page 3, essentially removing the specific requirements of the contract. Representative McCann responded to questions from Representative Kerr regarding the impact of the bill on Medicaid funding.


BILL:	Discussion of Draft Legislation
TIME:	03:06:25 PM
MOVED:	McCann
MOTION:	Adopt a conceptual amendment to Draft Bill 12 to remove the specific requirements of the contract and to remove the safety clause. The motion passed without objection.
SECONDED:
		VOTE
	Apuan
	Foster
	Harvey
	Kerr J.
	Lundberg
	Massey
	McCann
	Schwartz
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	Discussion of Draft Legislation
TIME:	03:07:10 PM
MOVED:	McCann
MOTION:	Include Draft Bill 12 (Attachment W), as amended, as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 10-0 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	Yes
	Kerr J.	Yes
	Lundberg	Yes
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 10 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:08 PM

Christy Chase, Office of Legislative Legal Services, explained Draft Bill 13 (Attachment X), which creates the "Colorado Consumer Products Safety Act." The act prohibits a manufacturer from knowingly selling, offering for sale, or distributing for sale or use in Colorado any cosmetic product or children's product that contains a chemical identified as causing cancer or reproductive toxicity. Senator Boyd responded to questions from Representative Massey regarding whether the bill should instead set out certain requirements related to labeling. Ms. Chase explained that federal law preempts states from enacting state labeling laws that differ from federal laws. Ms. Chase responded to questions from Representative Kerr regarding oversight of consumer products by the federal government and the bill's enforcement provisions. Senator Boyd and Senator Foster dialogued regarding how consumers will become aware of the carcinogens banned by the bill, and whether the ban will apply to products purchased from out of state. Representative McCann discussed language in the bill's legislative declaration. Members of the committee discussed the fines assessed for violating the bill's provisions.


BILL:	Discussion of Draft Legislation
TIME:	03:29:17 PM
MOVED:	Boyd
MOTION:	Include Draft Bill 13 (Attachment X) as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion failed on 5-5 tie roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	No
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	No
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Not Final YES: 5 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: TIE

03:32 PM

Brita Darling, Office of Legislative Legal Services, explained Draft Bill 14 (Attachment Y). The bill directs the Department of Human Services to enter into a contract with a nonprofit entity for the provision of initial triage services through a coordinated and integrated crisis response system for persons experiencing mental health or substance abuse crisis. Representative Frangas commented on the need for the bill. Amendment 1 was distributed to the committee (Attachment Z). Senator Lundberg discussed the bill's funding source. Jerry Barry, Office of Legislative Legal Services, came to the table to discuss how the bill will be funded, stating that the passage of the bill and its appropriation are contingent upon the passage of a bill repealing the tax exemption for precious metal bullion and coins. Representative Frangas responded to questions from Senator Harvey regarding how the tax on the purchase of metal bullion and coins is assessed currently. Representative Kerr discussed the bill's funding source. Senator Lundberg and Senator Harvey further commented on the tax exemption for metal bullion and coins. Senator Schwartz suggested that the bill be amended to remove its funding provisions.


BILL:	Discussion of Draft Legislation
TIME:	04:02:29 PM
MOVED:	Harvey
MOTION:	Adopt a conceptual amendment to Draft Bill 14 to remove the bill's provisions regarding funding. The motion passed on a 8-2 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	Yes
	Kerr J.	Yes
	Lundberg	Yes
	Massey	Yes
	McCann	No
	Schwartz	Yes
	Frangas	No
	Boyd	Yes
Not Final YES: 8 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	Discussion of Draft Legislation
TIME:	04:03:38 PM
MOVED:	Frangas
MOTION:	Adopt Amendment 1 (Attachment Z) to Draft Bill 14. The motion passed without objection.
SECONDED:
		VOTE
	Apuan
	Foster
	Harvey
	Kerr J.
	Lundberg
	Massey
	McCann
	Schwartz
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	Discussion of Draft Legislation
TIME:	04:04:24 PM
MOVED:	Frangas
MOTION:	Include Draft Bill 14 (Attachment Y), as amended, as one of the 8 bills recommended by the Health Care Task Force to Legislative Council. The motion passed on a 10-0 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	Yes
	Kerr J.	Yes
	Lundberg	Yes
	Massey	Yes
	McCann	Yes
	Schwartz	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 10 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:05 PM

Leah Bassity, Office of Legislative Legal Services, explained Draft Resolution 1 (Attachment AA). She explained that the resolution expresses support for a single-payer health care system in Colorado. Senator Foster discussed her reasons for bringing the resolution forward. Representative Massey discussed whether Senator Foster's resolution was broad enough to incorporate federal legislation that may be adopted concerning health care cooperatives. The committee members discussed their positions on single-payer health care.


BILL:	Discussion of Draft Legislation
TIME:	04:23:50 PM
MOVED:	Foster
MOTION:	Adopt Draft Resolution 1 (Attachment AA). The motion failed on a 4-6 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	Yes
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	No
	McCann	Yes
	Schwartz	No
	Frangas	Yes
	Boyd	No
Final YES: 4 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: FAIL

04:24 PM

Senator Boyd explained that the committee has adopted nine bills, but may only recommend a total of eight bills to Legislative Council. She explained that Draft Bill 5 (Attachment N) and Draft Bill 10 (Attachment U) received the fewest committee votes; both bills were passed on votes of 6 to 4. Representative Massey suggested that Senator Boyd turn Bill 10 into a resolution. Senator Boyd stated that she preferred to vote on which bill should go forward.


BILL:	Discussion of Draft Legislation
TIME:	04:26:15 PM
MOVED:	Boyd
MOTION:	Include Draft Bill 10 (Attachment U), rather than Draft Bill 5 (Attachment N), as the final bill recommended by the Health Care Task Force to Legislative Council. The motion failed on a 3-7 roll call vote.
SECONDED:
		VOTE
	Apuan	Yes
	Foster	No
	Harvey	No
	Kerr J.	No
	Lundberg	No
	Massey	Yes
	McCann	No
	Schwartz	No
	Frangas	No
	Boyd	Yes
Final YES: 3 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL

04:27 PM

As a result of the failure of the previous vote, it was determined that Bill 5 (Attachment N) would be the final bill recommended by the task force.

04:28 PM

The task force discussed the sponsorship for Draft Bill 1. The task force determined that the bill will be introduced as a House Bill, and Representatives Schafer and McCann will be co-prime House sponsors. Senator Carroll and Schwartz will be co-prime Senate sponsors. Representatives Frangas, Apuan, and Massey and Senators Foster and Boyd will be cosponsors. The committee agreed that the bill should not contain a safety clause and to allow the bill drafter permission to make technical changes.

04:30 PM

The task force discussed the sponsorship for Draft Bill 2. The task force determined that the bill will be introduced as a House Bill, and Representative Massey will be the prime House sponsor. Senator Foster will be the prime Senate sponsor. Representatives Kerr, Frangas, and McCann and Senators Lundberg, Boyd, and Schwartz agreed to be cosponsors. The task force agreed that the bill should not contain a safety clause and to allow the bill drafter permission to make technical changes.

04:32 PM

The task force discussed the sponsorship for Draft Bill 3. The task force determined that the bill will be introduced as a House Bill, and Representative Massey will be the prime House sponsor. Senators Boyd and Schwartz will be co-prime Senate sponsors for the bill. Representatives McCann, Frangas, and Kerr and Senator Foster agreed to be cosponsors. The task force agreed that the bill should not contain a safety clause and to allow the bill drafter permission to make technical changes.

04:34 PM

The task force discussed the sponsorship for Draft Bill 4. The task force determined that the bill will be introduced as a House Bill, and Representative Massey will be the prime House sponsor. Senator Foster will be the Senate prime sponsor. Representatives Apuan, Frangas, and Kerr and Senators Schwartz and Boyd agreed to be cosponsors. The task force agreed that the bill should not contain a safety clause and to allow the bill drafter permission to make technical changes.

04:35 PM

The task force discussed the sponsorship for Draft Bill 5. The task force determined that the bill will be introduced as a House Bill, and Representatives Frangas and McCann will be co-prime House sponsors. Senate Foster will be the prime Senate sponsor, and Senator Boyd agreed to be a cosponsor. The task force agreed that the bill should not contain a safety clause and to allow the bill drafter permission to make technical changes.

04:36 PM

The task force discussed the sponsorship for Draft Bill 9. The task force determined that the bill will be introduced as a Senate Bill, and Senator Boyd will be the prime Senate sponsor. Representative Massey will be the prime House sponsor. Senators Schwartz and Foster and Representative Apuan agreed to be cosponsors. The task force agreed that the bill should contain a safety clause and to allow the bill drafter permission to make technical changes.

04:37 PM

The task force discussed the sponsorship for Draft Bill 12. The task force determined that the bill will be introduced as a House Bill, and Representative McCann will be the prime House sponsor. Senators Schwartz and Foster will be co-prime Senate sponsors. Representatives Massey and Apuan and Senator Boyd agreed to be cosponsors. The committee previously amended the bill to remove the safety clause.

04:39 PM

The task force discussed the sponsorship for Draft Bill 14. The task force determined that the bill will be introduced as a House Bill, and Representative Frangas will be the prime House sponsor. Senator Boyd will be the prime Senate sponsor. Senators Schwartz and Foster and Representatives Apuan and Massey agreed to be cosponsors. The task force agreed that the bill should contain a safety clause and to allow the bill drafter permission to make technical changes.

04:41 PM

Senator Boyd thanked the committee and the meeting was adjourned.