Date: 03/04/2009

Final
BILL SUMMARY for HB09-1103

SENATE COMMITTEE ON HEALTH AND HUMAN SERVICES

Votes: View--> Action Taken:
Page 3, after line 1, insert the following "If it
Refer House Bill 09-1103, as amended, to the Commi
Strike the Effective Date Clause of the bill and r		PASS
PASS
Pass Without Objection


11:56 AM -- House Bill 09-1103

Senator Newell introduced House Bill 09-1103. The bill authorizes the Department of Health Care Policy and Financing to seek federal approval to allow an applicant who meets certain requirements to be presumptively eligible for Medicaid long-term care services. Senator Newell described her reasons for bringing the bill, stating that Colorado is a national leader in promoting home- and community-based services. She stated the bill will help to reduce costs for the state by reducing client moves between long-term care facilities, ensuring that a client's health needs do not escalate because care is delayed during the eligibility determination period, and allowing clients to receive home- and community-based services instead of nursing home services if that level of care is appropriate. Senator Tochtrop commented on the level of care provided by nursing homes.

12:01 PM -- Barbara Prehmus, Department of Health Care Policy and Financing, testified in support of the bill. She described the eligibility requirements for Medicaid-funded long-term care services. She stated that the financial review of eligibility is a major obstacle in the eligibility determinations. Ms. Prehmus explained that the bill will permit the department to seek federal approval to determine a person presumptively eligible for long-term care services.

12:05 PM -- Chris Underwood, Department of Health Care Policy and Financing, testified regarding the process of obtaining federal approval to implement presumptive eligibility for long-term care services. He described the differences in the cost of home- and community-based services and nursing home services. He stated that a pilot program on long-term care presumptive eligibility found that there was about a 1 percent error rate in presumptive eligibility determinations. He stated that the department is not estimating the cost savings associated with presumptive eligibility now, but that the bill is meant to start a conversation with the federal government about seeking approval to implement presumptive eligibility. Mr. Underwood responded to questions from Senator Mitchell regarding delays in eligibility determinations for long-term care. Ms. Prehmus responded to questions from Senator Schultheis regarding the delays in gathering appropriate income documentation, stating sometimes individuals in need of long-term care do not have family members to assist them in gathering the appropriate documents.


12:17 PM

Mr. Underwood responded to questions from Senator Lundberg regarding the anticipated costs of a presumptive eligibility system, and whether changes to the Colorado Benefits Management System will be required. Senator Carroll noted that the bill was authorizing the department to ask the federal government for permission to implement the bill, and that the implementation of the program may drive costs in the future.

12:21 PM -- Pat Ratliff, Colorado Counties Inc., testified in support of the bill. She noted that when an individual enters long-term care in a nursing home, Medicaid will pay retroactively. She discussed a potential amendment to the bill to specify that counties are not responsible for any sanctions that may be assessed if a person is later determined to be ineligible for the program.

12:24 PM -- Julie Reiskin, Colorado Cross Disability Coalition, testified in support of the bill and distributed a handout (Attachment B). She gave an example of one of her clients who could benefit from presumptive eligibility for long-term care. She responded to questions from Senator Schultheis regarding how presumptive eligibility will allow clients to gather the necessary documentation to comply with the eligibility requirements of the program.

09SenateHHS0304AttachB.pdf

12:30 PM -- Susan Langley, Denver Hospice, testified that navigating the Medicaid system can be exhausting, especially for individuals who are need of hospice services. She stated that many individuals do not have the luxury of time it takes to gather the necessary eligibility documentation. She stated that there are times when the hospice is not reimbursed for services because the eligibility process is not finished by the time the person dies.

12:34 PM -- Robert Semro, Colorado Consumer Health Initiative, testified in support of the bill. He testified that the need for long-term care services can be immediate. He stated that immediate access to long-term care services can make a measurable difference in a person's quality of life and health, and delays in care can increase costs if a person's health care needs increase while care is delayed.


12:37 PM

Senator Newell gave concluding remarks regarding the bill.
BILL:HB09-1103
TIME: 12:37:46 PM
MOVED:Newell
MOTION:Strike the Effective Date Clause of the bill and replace it with a Safety Clause. 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:HB09-1103
TIME: 12:38:30 PM
MOVED:Newell
MOTION:Page 3, after line 1, insert the following "If it is determined that a recipient was not eligible for medical benefits after the recipient had been determined to be eligible based upon presumptive eligibility, the state department shall not pursue recovery from a county department for the cost of medical services provided to the recipient, and the county department shall not be responsible for any federal error rate sanctions resulting from such determination." The motion passed on a 6-2 roll call vote.
SECONDED:
VOTE
Carroll M.
Yes
Lundberg
No
Mitchell
Yes
Morse
Yes
Newell
Yes
Schultheis
No
Tochtrop
Yes
Boyd
Yes
Not Final YES: 6 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:HB09-1103
TIME: 12:40:04 PM
MOVED:Newell
MOTION:Refer House Bill 09-1103, as amended, to the Committee of the Whole. The motion passed on a 7-1 roll call vote.
SECONDED:
VOTE
Carroll M.
Yes
Lundberg
Yes
Mitchell
Yes
Morse
Yes
Newell
Yes
Schultheis
No
Tochtrop
Yes
Boyd
Yes
Final YES: 7 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS



12:41 PM

The committee recessed.