Bill Summary for Bill Number SB09-244

Date: 03/19/2009

Final
BILL SUMMARY for SB09-244

SENATE COMMITTEE ON HEALTH AND HUMAN SERVICES

Votes: View-->	Action Taken:
Adopt a conceptual amendment to strike the bill's Adopt prepared amendment L.003 (Attachment V). Th Adopt prepared amendment L.005 (Attachment A). Th Refer Senate Bill 09-244, as amended, to the Commi	FAIL PASS Pass Without Objection PASS

01:40 PM -- Senate Bill 09-244

Senator Shaffer introduced Senate Bill 09-244. The bill requires all health insurance policies that are subject to state regulation to provide coverage for the assessment, diagnosis, and treatment of autism spectrum disorders (ASD). He distributed amendment L.005 (Attachment A) and an unofficial preamended version of the bill including the amendment (Attachment B). He explained that he has been working closely with the health insurance plans on the bill and has made changes to the bill in response to the health plans' concerns. Senator Shaffer discussed the bill's fiscal note. Senator Shaffer responded to questions from Senator Boyd regarding removal of the term "medically necessary" from the bill. He responded to additional questions from Senator Newell regarding insurance coverage for autism in other states, the cost of the coverage, how the bill will change current insurance coverage for autism, and costs to state social services system if autism treatment is not obtained early in life.

02:02 PM -- Ben Price, representing the Colorado Association of Health Plans, testified in opposition to the bill. He stated that successful treatment for autism can be elusive. He discussed his concerns with the bill, including concerns relating to the credentialing and qualifications of providers of autism treatment services. He stated that the bill warrants more discussion with all of the involved parties. Mr. Price responded to questions from the committee regarding health insurance data and the time necessary for the health plans to review the bill.

02:16 PM -- Tony Gagliardi, representing the National Federation of Independent Business, testified that health insurance is a great concern of his members. He stated that small businesses are often caught in the middle of discussions on mandated coverages for health insurance. He stated his hope was that the parties could reach an agreement on the bill's provisions. He stated his opposition to the bill. He responded to questions for Senator Tochtrop regarding data on health insurance coverage offered by small business. Mr. Gagliardi clarified that the bill would not apply to all health insurance plans.

02:25 PM -- Jandel Allen-Davis, representing Kaiser Permanente, described Kaiser Permanente's approach to treating children with autism. She stated that Kaiser Permanente cannot support the bill and outlined the organization's reason for opposing the bill. She discussed applied behavioral analysis, stating that the medical literature has not shown it to be more effective than other treatments for autism. She distributed a handout concerning applied behavioral analysis (Attachment C). She responded to questions from Senator Mitchell regarding the data on applied behavioral analysis therapy.

02:37 PM -- Susan Cox, representing Kaiser Permanente, responded to questions from Senator Carroll regarding the treatments for autism that are currently covered by Kaiser Permanente. Senator Shaffer discussed the changes made to the bill by amendment L.005. Dr. Allen-Davis responded to questions from Senator Carroll regarding autism treatment requirements in other states and from Senator Boyd regarding delegation of medical services. Ms. Cox discussed the potential cost increases to Kaiser Permanente as a result of the bill, and the resulting cost increases to state employee's health insurance coverage. She distributed a handout related to autism legislation in other states, and estimates of the cost increases of that legislation (Attachment D). She listed states that have considered, but not passed, similar legislation. She further noted that the bill does not apply to employers who self-insure their plans. She responded to questions from Senator Carroll regarding whether the cost estimates attributed to the legislation include estimates for the costs of the services that are currently being provided by Kaiser Permanente. She committed to continuing to work on the bill over the summer.

03:05 PM -- Ed Steinberg, Assistant Commissioner for the Colorado Department of Education, testified in support of the bill. He stated that the department believes the bill is a great benefit to students and adults with ASD. He responded to questions from Senator Lundberg regarding whether or not the State Board of Education supports the bill, stating that the board has not yet taken a position on the bill.

03:07 PM -- Perry Pearce, representing the Colorado Competitive Council, testified in opposition to the bill and distributed a copy of his testimony to the committee (Attachment E). Mr. Pearce testified that while his organization is sympathetic to the families struggling with autism, it believes the increased cost of the coverage will lead to more employers dropping health insurance for their employees. He stated that health care costs need to be controlled, and that the bill is a step in the wrong direction. Mr. Pearce responded to questions from Senator Newell regarding costs to employers and employees associated with caring for family members with autism.

03:18 PM -- Dr. Phil Strain, representing himself, distributed a copy of his testimony to the committee (Attachment F). He discussed the effects of autism and stated that the lifetime cost of care for each individual with autism ranges from $2 to $4 million. He discussed applied behavioral analysis as a treatment for autism. He gave estimates of cost savings that could accrue through the services provided by the bill. He responded to questions from Senator Newell regarding "medical" and "behavioral" services for autism and certified treatment providers, and from Senator Mitchell regarding studies of the efficacy of applied behavioral analysis.

03:39 PM -- Dr. Stephen Block, Executive Director of Denver Options, testified that the bill will both help children and support the business community. He stated that there is no way to avoid the costs associated with autism. He responded to previous witnesses' comments related to the therapies that could be provided as a result of the bill. He stated that it is clear that providing early intervention services to children with autism avoids long-term costs.

03:49 PM -- Dr. Cordelia Robinson, Director of JFK Partners at the University of Colorado School of Medicine, read the testimony of a colleague, Dr. Ann Reynolds, in support of the bill (Attachment G).

03:52 PM -- Greg Goodman, representing himself, referenced a packet of information in support of the bill that was distributed to the committee (Attachment H). He stated that the data shows that it is hard to determine a correlation between mandates and health insurance premium cost increases.

(Attachment H can be viewed at State Archives)

04:03 PM -- Tasha Aper, representing herself, distributed a copy of her testimony to the committee (Attachment I). Senator Tochtrop distributed information on Colorado's health insurance mandates (Attachment J). Ms. Aper discussed the benefits of early and intensive applied behavioral analysis therapy.

04:06 PM -- Jill Tappert, representing herself, testified in support of the bill and distributed a copy of her testimony to the committee (Attachment K). She discussed the services her daughter receives to address her autism, including applied behavioral analysis therapy. She discussed the cost of obtaining treatment for her daughter.

04:17 PM -- Dr. David Hatfield, representing himself, distributed a copy of his testimony to the committee (Attachment L). He described applied behavioral analysis therapy and the manifestations of the disease. He discussed the qualifications of individuals who provide applied behavioral analysis therapy. He stated that there is already a national model for certification, and that certifying behavioral analysts is more appropriate than setting up a licensing structure for these individuals.

04:30 PM -- Angela West, representing herself, testified in support of the bill and described her family's experience with autism.

04:31 PM -- Jeff Johnson, representing himself, testified in support of the bill and distributed a handout in support of the bill (Attachment M).

04:33 PM -- Carol Meredith, representing herself, testified in support of the bill and distributed a handout of her testimony (Attachment N).

04:35 PM -- Mark Mannino, representing himself, testified in support of the bill.

04:38 PM -- Betty Lehman, representing the Colorado Autism Society, responded to previous committee questions regarding what is considered "medically necessary." She discussed the cost of the coverage and the need for treatment services for individuals with autism.

04:44 PM

Senator Boyd closed witness testimony. Individuals who signed up in support of the bill but who did not get a chance to testify included: Cami Learned, Lu Etta Loeber, Janice Panting, Erin Genullis, Adrienne Paradis (a copy of her testimony is included as Attachment O), Shelly Roney, Tom Tolt (a copy of his testimony is included as Attachment P), Emmy Conroy (a copy of her testimony is included as Attachment Q), John Sandoval, Angelique Layton (a copy of her testimony is included as Attachment R), Helena Huckabee (a copy of her testimony is included as Attachment S), Karen Brass, Monica Britton (a copy of her testimony is included as Attachment T), Rebecca Betancourt (a copy of her testimony is included as Attachment U), and Ken Gordon. Senator Shaffer gave concluding remarks regarding the bill. Senator Mitchell distributed a copy of amendment L.003 (Attachment V). The amendment specifies that the Medicaid program must cover the same services authorized by the bill in its Home- and Community-Based Services for Children with Autism waiver program.


BILL:	SB09-244
TIME:	04:47:17 PM
MOVED:	Tochtrop
MOTION:	Adopt prepared amendment L.005 (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:	SB09-244
TIME:	04:48:35 PM
MOVED:	Mitchell
MOTION:	Adopt prepared amendment L.003 (Attachment V). The motion passed on a 6-2 roll call vote.
SECONDED:
		VOTE
	Carroll M.	No
	Lundberg	Yes
	Mitchell	Yes
	Morse	Yes
	Newell	Yes
	Schultheis	Yes
	Tochtrop	No
	Boyd	Yes

Not Final YES: 6 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	SB09-244
TIME:	04:56:35 PM
MOVED:	Schultheis
MOTION:	Adopt a conceptual amendment to strike the bill's provisions and add the bill's topic as an item of study for the Health Care Task Force during the 2009 interim. The motion failed on a 3-5 roll call vote.
SECONDED:
		VOTE
	Carroll M.	No
	Lundberg	Yes
	Mitchell	Yes
	Morse	No
	Newell	No
	Schultheis	Yes
	Tochtrop	No
	Boyd	No

Not Final YES: 3 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	SB09-244
TIME:	05:06:20 PM
MOVED:	Tochtrop
MOTION:	Refer Senate Bill 09-244, as amended, to the Committee on Appropriations. The motion passed on a 5-3 roll call vote.
SECONDED:
		VOTE
	Carroll M.	Yes
	Lundberg	No
	Mitchell	No
	Morse	Yes
	Newell	Yes
	Schultheis	No
	Tochtrop	Yes
	Boyd	Yes

Final YES: 5 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS

05:10 PM

The committee recessed briefly.