Final
STAFF SUMMARY OF MEETING

HEALTH CARE TASK FORCE

Date:09/14/2009
ATTENDANCE
Time:08:40 AM to 11:24 AM
Apuan
*
Foster
X
Place:HCR 0107
Harvey
A
Kerr J.
X
This Meeting was called to order by
Lundberg
*
Senator Boyd
Massey
X
McCann
X
This Report was prepared by
Schwartz
X
Kelly Stapleton
Frangas
X
Boyd
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
Cover Kids 2010
Update from the Colorado Dental Association
Update from the Colorado Department of Public Health and Enviironment on the H1N1 Virus
Report Regarding Recommendations from the Home Care Placement Agency Task Force
Update from CoverColorado on Long-Term Funding Recommendations
Draft Legislation
-
-
-
-
-
-

8:35 AM -- Senator Boyd called the meeting to order. She stated that the task force would be proposing legislation later in the morning.

08:41 AM -- Cover Kids 2010

Tara Trujillo, Director of Health Programs, Colorado Children's Campaign, introduced herself and provided several handouts to the committee including a power point handout of her presentation, an Executive Summary of the barriers that keep Colorado's eligible children and families out of Medicaid and the Children's Basic Health Plan (CHP+), a fact sheet from Cover All Kids by 2010, and a fact sheet on the demographics of the uninsured children in Colorado (Attachments A, B, C, and D respectively).

090914AttachA.pdf 090914AttachB.pdf 090914AttachC.pdf 090914AttachD.pdf

08:47 AM

Ms. Trujillo described the mission of the Cover All Kids by 2010 initiative. She explained that the initiative began in 2006 and at least 40 organizations are part of the coalition. She stated that more than 12 percent of Colorado's kids are uninsured, which is about 153,000 children. She spoke to the number of children who are eligible but not enrolled in Medicaid and in CHP+, which is approximately 78,000 children. Ms. Trujillo described some of the reasons why children are eligible but not enrolled in CHP+. Members asked several questions regarding how children get enrolled and stay enrolled. Mr. Trujillo spoke to the barriers of enrollment.


09:01 AM

Ms. Trujillo spoke to past legislation regarding children's health insurance. She spoke to the objectives of the initiative which include:
09:09 AM

Sharon Bridgeforth, Metro Organization for People, introduced herself and provided a handout to the task force (Attachment E). She relayed two stories of individuals who had health insurance and went into bankruptcy because they could not either afford the co-pays or their coverage was terminated.

090914AttachE.pdf

09:15 AM -- Update from the Colorado Dental Association

Charlie Hebler, Dr. Jeffrey Hurst, former president of the Colorado Dental Association, and Jennifer Goodrum, Director of Government Relations, Colorado Dental Association, introduced themselves. Ms. Hebler described the recent event that the Colorado Mission of Mercy (COMOM) and the dental association put on, which was a 2-day, 100 chair, dental clinic that provided free dental care to about 1,600 individuals in Colorado. Ms. Hebler provided a handout to the task force describing COMOM (Attachment F). Dr. Hurst stated that all the equipment and the time was donated. Ms. Goodrum relayed several stories about individuals seeking care.

090914AttachF.pdf

09:28 AM

Dr. Hurst stated that he recently spoke with Representative Diana DeGette and she indicated to Dr. Hurst that she plans to introduce an amendment to the national health care reform legislation that will increase the reimbursement rates to dentists. He stated the number of dentists who provide care to Medicaid participants has significantly decreased. He stated that 18 counties in Colorado have no Medicaid provider for dentistry. He stated that eight counties only have one Medicaid provider. He pointed out that many individuals who end up in the hospital for a myriad of reasons could have avoided hospitalization with proper dental care.

09:39 AM

Dr. Eric Van Zytveld, Board Member, Colorado Foundation of Dentistry for the Handicapped, spoke to the issues that many handicapped individuals face in seeking dental care. He spoke to the low reimbursement rates to providers. He spoke to the cut in funding to the "dental house calls" program. Dr. Van Zytvell asked the task force to help restore the funding for this program. Marion Blado, Volunteer Coordinator, Rowan Community, stated she coordinates care for the residents of a long-term care facility. She spoke to the services that the Colorado Foundation of Dentistry for the Handicapped Mobile Dentistry Service provides to the residents.

09:51 AM -- Update on the H1N1 Virus

Chis Lindley, Director of the Office of Emergency Planning, Colorado Department of Public Health and Environment, introduced himself and provided a handout entitled "Providing Care at Home During Pandemic Flu" to the task force (Attachment G). He stated that a vaccine for the H1N1 flu virus is not available yet, but will be available mid-October. He indicated that the flu vaccine for influenza will include the H1N1 vaccine and that most individuals will not need a double dose of the vaccine as previously thought. He encouraged individuals to get a flu shot, for individuals who feel sick to stay home, and for all people to stay informed. Mr. Lindley spoke to the prioritization of individuals who should receive the vaccine including pregnant women, caregivers, emergency medical technicians and health care workers, then individuals 6 months of age to 25 years old.

090914AttachG.pdf

09:58 AM -- Home Care Placement Agency Report

Representative Frangas described the charge of the Home Care Placement Agency Task Force which was established under House Joint Resolution 09-1022 to study whether home care placement agencies should be regulated. He spoke to the preliminary report from the task force and highlighted the recommendations in the report (Attachment H). He stated that the general consensus of the task force was to recommend licensure of home care placement agencies. Representative Kerr asked how that state would fund licensure. Representative Frangas stated that the home care placement agencies would pay a fee and that the funding would not be passed onto the consumer. Representative Massey asked if the Department of Regulatory Agencies (DORA) or the Department of Public Health and Environment (DPHE) had an opinion on the matter. Senator Schwartz stated that DORA and DPHE would be the oversight entities.

090914AttachH.pdf

10:17 AM

Committee members discussed the various models of licensure and which department would have the authority to regulate home care placement agencies as well as home care workers. A copy of a memorandum prepared by Legislative Council staff regarding regulation of home care placement agencies was provided to the task force (Attachment I).

090914AttachI.pdf



10:33 AM

Jesi Dobosz, Legislative Liaison, Colorado Department of Public Health of Environment, spoke to the licensure of home care agencies and the discussion around licensure of home care placement agencies. She stated that the department pursued licensure for home care agencies in 2008. She stated that the business model of a home care placement agency (as an employment placement agency) prohibits the department from having oversight authority over the home care placement agencies' independent contractors. She stated that the department would have difficulties assuring the same level of consumer protection that it can provide under licensure of home care agencies because of the lack of oversight authority of independent contractors. She acknowledged that there are concerns over the lack of oversight of home care placement agencies and the individuals who work in the homes of the elderly. Ms. Dobosz stated that the department established a registry for home care placement agencies. Ms. Dobosz reiterated that the department does not necessarily have regulatory authority over 'independent contract workers' and struggles with how it would enforce penalties for home care placement agencies or the workers placed by the agency.

10:50 AM

Fran Coleman spoke to the committee which agency can appropriately regulate home care placement agencies and their workers. She spoke to the licensure and registry system that was established after Senate Bill 08-153 passed. She spoke to the need to license home care placement agencies and expressed her concern that the department was not enforcing the requirement for home care placement agencies to register. Ms. Dobosz stated that the department does not have any funding to verify registration.

10:59 AM -- Update from CoverColorado on Long-Term Funding Recommendations

Barbara Crawford, attorney for CoverColorado, and Susan Bragg-Gamble, Executive Director, CoverColorado, introduced themselves. Ms. Bragg-Gamble explained that she spoke to the task force in August about the funding mechanism for CoverColorado, specifically whether funding from the Unclaimed Property Tax Fund would be sustainable in the future. She indicated to the committee that the board had received data indicating the Unclaimed Property Fund would be able to provide its share of funding for CoverColorado into fiscal year 2012. She stated that the board for CoverColorado recently met to discuss the funding mechanisms for the program. Ms. Bragg-Gamble stated that the board recommended to manage program costs which they hope will slow the expenditures for the program. Ms. Bragg-Gamble said that the board would like to establish a provider reimbursement schedule be based on Medicare reimbursement rates. She stated that the board felt that many providers would be open to the idea of a reimbursement schedule because they would get paid for some services for which they would otherwise not be paid. She also indicated that part of any agreement with a provider would be to prohibit balance billing.


11:05 AM -- Draft Legislation

Representative McCann asked that legislation be drafted that would:
- restrict gender ratings in health insurance; and
- establish a dental carve out in Medicaid.

Representative Massey requested legislation be drafted that would:
- clean up language from the Senate Bill 07-196, which concerns health information technology;
- implement Screen, Brief Intervention, and Referral to Treatment (SBIRT Colorado) for substance abuse (Attachment J); and
- allow association health plans to provide health insurance coverage across state lines.

090914AttachJ.pdf

Representative Frangas requested legislation be drafted that would:
- restore funding cuts for health services including mental health and the Old Age Pension Fund;
- mandate that individual health insurance policies provide maternity coverage; and
- regulate home care placement agencies.

Senator Schwartz stated she would like legislation drafted to require licensure of home care workers.

Senator Foster stated that she would like legislation drafted to provide affordable universal health care coverage with option to opt into any system the federal government establishes.

Senator Boyd stated that she would like legislation drafted that would:
- address the funding mechanism Ms. Bragg-Gamble spoke to regarding CoverColorado;
- establish community and municipal planning and coordination for health care services;
- establish a scholarship program in the University of Colorado - School of Medicine that would recruit primary care physicians to work in underserved areas.

11:24 AM

Senator Boyd adjourned the meeting.

09:15 AM -- Update from the Colorado Dental Association

Charlie Hebler, Dr. Jeffrey Hurst, former president of the Colorado Dental Association, and Jennifer Goodrum, Director of Government Relations, Colorado Dental Association, introduced themselves. Ms. Hebler described the recent event that the Colorado Mission of Mercy (COMOM) and the dental association put on, which was a 2-day, 100 chair, dental clinic that provided free dental care to about 1,600 individuals in Colorado. Ms. Hebler provided a handout to the task force describing COMOM (Attachment F). Dr. Hurst stated that all the equipment and the time was donated. Ms. Goodrum relayed several stories about individuals seeking care.

090914AttachF.pdf

09:28 AM

Dr. Hurst stated that he recently spoke with Representative Diana DeGette and she indicated to Dr. Hurst that she plans to introduce an amendment to the national health care reform legislation that will increase the reimbursement rates to dentists. He stated the number of dentists who provide care to Medicaid participants has significantly decreased. He stated that 18 counties in Colorado have no Medicaid provider for dentistry. He stated that eight counties only have one Medicaid provider. He pointed out that many individuals who end up in the hospital for a myriad of reasons could have avoided hospitalization with proper dental care.


09:39 AM

Dr. Eric Van Zytveld, Board Member, Colorado Foundation of Dentistry for the Handicapped, spoke to the issues that many handicapped individuals face in seeking dental care. He spoke to the low reimbursement rates to providers. He spoke to the cut in funding to the "dental house calls" program. Dr. Van Zytvell asked the task force to help restore the funding for this program. Marion Blado, Volunteer Coordinator, Rowan Community, stated she coordinates care for the residents of a long-term care facility. She spoke to the services that the Colorado Foundation of Dentistry for the Handicapped Mobile Dentistry Service provides to the residents.
BILL:Update from the Colorado Dental Association
TIME: 02:34:52 PM
MOVED:Massey
MOTION:Interview Sgt. Joel, Staberg, Weissmann.
SECONDED:
VOTE
Apuan
Absent
Foster
Harvey
Absent
Kerr J.
Lundberg
Absent
Massey
McCann
Schwartz
Frangas
Boyd
Not Final YES: 0 NO: 0 EXC: 0 ABS: 3 FINAL ACTION: Pass Without Objection