House Committee on Health and Human Services (03/04/2010)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:	03/04/2010	ATTENDANCE

Time:	01:31 PM to 04:13 PM	Acree	X
		Apuan	*
Place:	LSB A	Gerou	X
		Kefalas	X
This Meeting was called to order by		Kerr J.	X
	Representative Riesberg	Primavera	*
		Roberts	X
This Report was prepared by		Swalm	*
	Kelly Stapleton	Tyler	X
		Gagliardi	X
		Riesberg	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB10-014 SB10-009 SB10-115 HB10-1252		Referred to the Committee of the Whole Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole

01:31 PM -- Senate Bill 10-014

Representative Solano presented Senate Bill 10-014 which was recommended by the Legislative Oversight Committee Concerning Persons with Mental Illness in the Criminal Justice System. She stated the bill makes several technical changes to clarify the role of family advocates in the juvenile justice family advocacy demonstration program. She stated that it also adds transitional services for juveniles to the demonstration project.

01:34 PM -- Chris Habgood, Division of Behavioral Health, Department of Human Services, spoke in support of the bill and provided a program profile to the committee (Attachment A).

01:35 PM -- Thomas Dillingham, Executive Director, Federation of Families for Children's Mental Health, spoke in support of the bill. He stated that he oversees the Jefferson County program site. He stated that the bill clearly defines what a family advocate is and defines what a family system navigator is.

01:37 PM -- Lacey Beruman, National Alliance on Mental Illness, spoke in support of the bill. She concurred with Mr. Dillingham's testimony.

01:38 PM

Representative Solano stated that the bill adds transitional services to the program. She spoke to the need for transitional services for juveniles coming out of the criminal justice system.


BILL:	SB10-014
TIME:	01:39:20 PM
MOVED:	Gagliardi
MOTION:	Moved to refer Senate Bill 10-014 to the Committee of the Whole. The motion passed on a 11-0 roll call vote.
SECONDED:	Acree
		VOTE
	Acree	Yes
	Apuan	Yes
	Gerou	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Primavera	Yes
	Roberts	Yes
	Swalm	Yes
	Tyler	Yes
	Gagliardi	Yes
	Riesberg	Yes
Final YES: 11 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:40 PM -- Senate Bill 10-009

Representative Gagliardi presented Senate Bill 10-009 which was recommended by the Economic Opportunity Poverty Reduction Task Force. The bill adds developing a model for ongoing assessment of progress towards reducing poverty and increasing economic opportunity in Colorado to the task force's duties. Representative Gagliradi briefly explained the purpose of the Economic Opportunity Poverty Reduction Task Force. Representative Gerou spoke to the revised fiscal note. Representative Gagliardi stated that the task force will have to go without a legislative economist. She commented that the task force will be seeking funds to hire an economist.

01:48 PM -- BJ Iacino, Colorado Coalition for the Homeless, spoke in support of the bill. She spoke to the Economic Opportunity Poverty Reduction Task Force and its goals. She described the poverty levels in the United States and stressed the need to continue studying poverty in order to make more informed policy decisions. Committee members asked several questions of the witness regarding poverty levels in the United States, specifically in Colorado. Ms. Iacino stated that it is important to review various causes of poverty in order to make informed public policy decisions.

02:00 PM

Representative Riesberg spoke to amendment L.002 which adds language to the bill (Attachment B). He pointed out that although the amendment adds "mental and physical disabilities" to the bill, the placement of the amendment in the bill would not have that affect. Amendment L.002 was not offered.


BILL:	SB10-009
TIME:	02:00:26 PM
MOVED:	Gagliardi
MOTION:	Moved to refer Senate Bill 10-009 to the Committee of the Whole. The motion passed on a 9-2 roll call vote.
SECONDED:	Kefalas
		VOTE
	Acree	Yes
	Apuan	Yes
	Gerou	Yes
	Kefalas	Yes
	Kerr J.	No
	Primavera	Yes
	Roberts	Yes
	Swalm	No
	Tyler	Yes
	Gagliardi	Yes
	Riesberg	Yes

Final YES: 9 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:06 PM -- Senate Bill 10-115

Representative Merrifield and Representative Primavera presented Senate Bill 10-115 which removes the requirement that a licensed health care facility get permission to redispense or donate unused medication. The bill states that a facility is allowed to redispense unused medication to another patient in the facility, or donate it to a non-profit entity serving disaster victims. Representative Merrifield stated that House Bill 10-1061, which also allowed unused medications to be donated, was postponed indefinitely and the language from that bill was merged into this bill.

02:11 PM -- Arlene Miles, Colorado Health Care Association, spoke in support of the bill. She explained that she recently received a call asking if one of their nursing homes would box up their unused medications and send them to Haiti. Representative Kerr asked if there were any reporting requirements detailed in the bill. Ms. Miles stated that the donations made to a non-profit are to be reviewed by a licensed pharmacist, but outside of that, there are no reporting requirements. Representative Kerr commented that he has concerns that the medications will be sold on the black market. Ms. Miles responded that any unused medications to be donated cannot be narcotics.


BILL:	SB10-115
TIME:	02:17:05 PM
MOVED:	Primavera
MOTION:	Moved to adopt prepared amendment L.005 (Attachment C). The motion passed without objection.
SECONDED:	Kefalas
		VOTE
	Acree
	Apuan
	Gerou
	Kefalas
	Kerr J.
	Primavera
	Roberts
	Swalm
	Tyler
	Gagliardi
	Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

02:22 PM

Representative Primavera provided concluding remarks on the bill.


BILL:	SB10-115
TIME:	02:22:34 PM
MOVED:	Primavera
MOTION:	Moved to refer Senate Bill 10-115, as amended, to the Committee of the Whole. The motion passed on a 11-0 roll call vote.
SECONDED:	Gagliardi
		VOTE
	Acree	Yes
	Apuan	Yes
	Gerou	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Primavera	Yes
	Roberts	Yes
	Swalm	Yes
	Tyler	Yes
	Gagliardi	Yes
	Riesberg	Yes
Final YES: 11 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:24 PM -- House Bill 10-1252

Representative Primavera presented House Bill 10-1252 which requires that breast cancer screening with mammography be individualized for each patient and that if a health care provider deems it medically appropriate, a breast cancer screening with mammography be covered by the patient's insurer. Additionally, the bill requires that insurance companies cover breast cancer screening with mammography based on breast cancer risk factors established by Susan G. Koman for the Cure rather the the United States Preventative Services Task Force. She stated that last year House Bill 09-1204 expanded the required coverage for preventive health care services provided under individual and small group health insurance policies based on recommendations by the U.S. Preventive Services Task Force. She stated that this summer the U.S. Preventative Task Force came out with new recommendations for breast screening with mammography and that prior to the recent recommendation, breast cancer screening with mammogram was recommended annually. The recent recommendations by the U.S. Preventative Task Force recommends that women over the age of 50 screen every 2 years. She stated this was a substantial change from the recommendation that women over the age of 40 be screened annually. She stated that the task force's recommendations are a guide.

02:29 PM -- Dana Dzwonkowski, American Cancer Society, spoke in opposition to the bill. She stated that the bill falls short of adequately protecting women's health. Ms. Dzwonkowski stated that the American Cancer Society has publically disagreed with the U.S. Preventative Task Force's recommendations concerning breast cancer screening. She stated that the American Cancer Society supports annual mammographies starting at age 40. She stated that the amendment will be offered that has language that would require health insurance companies to cover breast screening with mammography for individuals who are at risk. She stated their concern is that health insurance carriers will interpret this language to mean "high risk" and that coverage of mammographies will be denied. She stated that the U.S. Prevention Task Force has overstated the damage that mammographies can cause to women. She also stated there have been several technological improvements to mammography screening. She stated that the bill may create significant barriers for women over 40 from receiving coverage.

02:41 PM -- Michele Ostrander, Susan G. Koman Fund, spoke in opposition to the bill. Ms. Ostrander stated that the recent recommendations that were put forth by the task force were confusing and not helpful. She concurred with Ms. Dzwonkowski's testimony regarding annual screening with mammography for women 40 and over.

02:47 PM -- Vicki Tosher, Colorado Breast Cancer Coalition, spoke in support of the bill. She stated that she is a breast cancer survivor. She relayed her personal story regarding how she learned she had breast cancer. She stated that a mammogram did not catch her cancer. She expressed concern that without passage of the bill, women under 50 may not be covered by their health insurance plans for breast cancer screening. Ms. Tosher stated that she agrees with the U.S. Preventative Task Force's recommendations. She explained to the committee that she thinks the the federal government did a poor job explaining their scientific findings regarding breast cancer screening with mammography.

03:11 PM -- Dr. Wendy Horn, Colorado Radiological Society, spoke in support of the bill. Dr. Horn stated her concerns that women between the ages of 40 and 49 would not have coverage for breast cancer screening with mammography due to the recent recommendations from the U.S. Preventative Task Force if the bill does not pass.

03:16 PM -- Dr. Terese Kaske, Colorado Radiological Society, spoke in support of the bill. She provided a handout with statistics regarding the age at which women may detect breast cancer with mammography screening (Attachment D).

03:19 PM -- Dr. Christina Finlayson, Professor and Director of the Breast Cancer Clinical Interests at the University of Colorado Health Sciences Center, spoke in support of the bill. She stated that one of the U.S. Preventative Task Force's recommendation was to get a mammogram for breast cancer screening. She responded to Representative Swalm's question regarding the cost of a mammography, stating a mammogram costs approximately $175. She commented that an increase of a $10 copay reduces the number of women who have breast screening with mammography. She stated that when the country started screening women for breast cancer at the age of 40, the deaths as a result of breast cancer decreased. She stated that mammography is only one tool in the tool box and stated that she prefers to screen women at age 40 given the cost/benefit ratio.

03:37 PM -- Robin Kovachy, Medical Oncologist, spoke in support of the bill. She stated there are different types of mammograms, such as a diagnostic or screening mammograms. She provided statistics to the committee regarding the outcomes of the different types of mammograms. She highlighted some of the criticisms of the U.S. Preventative Task Force's study that led to the recommendations.

03:41 PM -- Marc Reece, Colorado Association of Health Plans (CAHP), spoke in support of the bill as amended. He stated that the members of CAHP have indicated that they plan to cover mammograms when a physician finds it medically necessary. He stated that CAHP members want to continue to screen women in their 40s and that detecting breast cancer early is significantly less expensive than treating stage five breast cancer.

03:47 PM -- Susan Cox, Kaiser Permanente, spoke in support of the bill as amended. She stated that Kaiser's policy is to screen women for breast cancer if a decision between a woman and her physician is to do so and that will not change as a result of the recent recommendations by the U.S. Preventative Services Task Force.


BILL:	HB10-1252
TIME:	03:51:05 PM
MOVED:	Primavera
MOTION:	Moved to adopt prepared amendment L.001 (Attachment E). It changes the effective date of the bill and removes the bill's fiscal impact. The bill passed without objection.
SECONDED:	Gagliardi
		VOTE
	Acree
	Apuan
	Gerou
	Kefalas
	Kerr J.
	Primavera
	Roberts
	Swalm
	Tyler
	Gagliardi
	Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB10-1252
TIME:	03:52:25 PM
MOVED:	Primavera
MOTION:	Moved to adopt prepared amendment L.002 (Attachment F). The amendment requires coverage for an annual breast cancer screening with mammography for individuals deemed to be at risk. The motion passed without objection.
SECONDED:	Gagliardi
		VOTE
	Acree
	Apuan
	Gerou
	Kefalas
	Kerr J.
	Primavera
	Roberts
	Swalm
	Tyler
	Gagliardi
	Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

04:03 PM

Representative Primavera provided concluding remarks on the bill.


BILL:	HB10-1252
TIME:	04:03:22 PM
MOVED:	Primavera
MOTION:	Moved to refer House Bill 10-1252, as amended, to the Committee of the Whole. The motion passed on a 10-1 roll call vote.
SECONDED:	Gagliardi
		VOTE
	Acree	Yes
	Apuan	Yes
	Gerou	No
	Kefalas	Yes
	Kerr J.	Yes
	Primavera	Yes
	Roberts	Yes
	Swalm	Yes
	Tyler	Yes
	Gagliardi	Yes
	Riesberg	Yes
Final YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:08 PM

Representative Riesberg spoke to a report provided by the Colorado Division of Behavioral Health regarding the Colorado Fetal Alcohol Spectrum Disorders Commission (Attachment G). He asked the committee to evaluate how many reports the General Assembly receives. Committee members suggested that the reports be provided via a link on the internet. The committee adjourned.