Health Benefit Exchange (12/07/2011)

Final
STAFF SUMMARY OF MEETING

HEALTH BENEFIT EXCHANGE

Date:	12/07/2011	ATTENDANCE

Time:	09:08 AM to 10:32 AM	Aguilar	X
		Gardner D.	X
Place:	HCR 0112	Kerr J.	E
		Lundberg	E
This Meeting was called to order by		McCann	X
	Senator Boyd	Nicholson	E
		Roberts	*
This Report was prepared by		Summers	X
	Christie Lee	Gardner B.	X
		Boyd	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Confirmation of Executive Director Discussion of the Grant Proposal		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

09:09 AM -- Confirmation of Executive Director

Senator Boyd called the committee to order.

09:11 AM

Gretchen Hammer, Chair, Colorado Health Benefit Exchange Board, gave an update on the board's activities since it last met with the committee. She discussed the creation of the governing documents and talked about the board officer positions that have since been created. Ms. Hammer also talked about the subcommittees that have been created, including the Governance Subcommittee, Personnel Subcommittee, Finance Subcommittee, Rules and Regulations Review Subcommittee, Implementation and Technology Subcommittee, and the Level One Grant Review Subcommittee. She explained that Richard Betts chaired the subcommittee that was created to select the Executive Director of the Exchange.

09:15 AM

Ms. Hammer talked about the board's recent activities regarding Exchange planning: solidifying the business concept of the Exchange (how the Exchange will operate as a marketplace in Colorado); addressing the system alignment issues with regard to technology; how health plans will be designed and sold in the Exchange; and setting up the Small Business Health Options Programs (SHOPs).

09:16 AM

Richard Betts, Executive Director Search Subcommittee Chair, talked about the other members who served on the subcommittee and the number of applicants who applied for the position. He explained that of the 30 they received, the subcommittee looked for certain criteria in terms of education, background, and basic tenants they felt the applicants needed to have in order to move on to the next level. After applying that criteria, the subcommittee reduced the number of applicants down to seven. Mr. Betts briefly talked about those seven applicants and their various skills. He explained that the subcommittee and the board have decided to nominate Patty Fontneau. The committee was provided Ms. Fontneau's resume (Attachment A). He discussed her broad background and experience that made her a good fit for the position and also talked about the awards she has received.

09:20 AM

Patty Fontneau, nominee for the Executive Director of the Health Exchange, came to the table and introduced herself to the committee. In response to the question of why she wanted the job, Ms. Fontneau explained that she was interested in the position due to its impact on Colorado in a number of areas.

09:22 AM

Representative B. Gardner talked about the challenge of bringing together the two distinct views that exist surrounding how the Exchange should look and asked Ms. Fontneau to talk about how she will be bringing those two distinct views together. Ms. Fontneau stated that she believes there are more than two views and explained that she would handle it as a business by communicating, listening, and negotiating. She talked about the political aspect, and noted that she will work with the committee, as well as others outside the committee and the Exchange board, to understand the competing views. Mr. Betts added that there are nine voting members on the Exchange board and that one of their primary focuses is consensus building.

09:25 AM

Senator Roberts expressed her concerns with the Executive Branch and Federalism in the Exchange building process and the importance of the separation of powers and asked Ms. Fontneau for her view on the subject. Ms. Fontneau stated that she believes there are certain issues that belong at the state level, including the Exchange. She commented on checks and balances. Senator Roberts explained that the legislature created the Exchange, and asked Ms. Fontneau what she would do if, for example, the Governor's Office asked her to do something, and whether she respects each branch's boundaries. Ms. Fontneau stated that Senate Bill 11-200 will be the driving force behind the Exchange.

09:29 AM

Representative Summers asked about her relationship with the Governor and how comfortable she is working with him and handling disagreements with him. Ms. Fontneau talked about her experience working with the Governor on the Denver Chamber for a few months 10 or 11 years ago. She stated that she would be comfortable working with the Governor. Representative B. Gardner followed up regarding her comments that Senate Bill 11-200 would be the governing document and pointed out that her job was created by Senate Bill 200 and not by Federal Patient Protection and Affordable Care Act (PPACA). Senator Aguilar asked Ms. Fontneau to talk about her work experience aside from the business arena. Ms. Fontneau talked about her community affiliations on page three of her resume.

09:37 AM

Senator Roberts asked Ms. Fontneau to talk about the parts of her background that will help build the Exchange and handle the issue of fraud in the system. Ms. Fontneau talked about her experience building and opening the TIAA-CREF service company. She stated that fraud will need to be kept in mind when building the Exchange system. However, her biggest concern is ultimately creating sustainability by January 2015. Ms. Fontneau stated that the Exchange must be efficient, effective, well run, and streamlined. Senator Roberts asked for examples of how she will attempt to curb fraud within the system. Ms. Fontneau stated that some elements to curb fraud will need to go into the design, some into quality control, and some into the ongoing management phase and therefore, she cannot respond until these areas are developed.

09:43 AM

Representative McCann talked about providing adequate coverage to the uninsured and underinsured while at the same time ensuring adequate coverage. He asked how Ms. Fontneau will ensure affordable and adequate coverage. Ms. Fontneau said there will have to be an appropriate number of insurers and enough participants. She added that she will have to wait and see what is proposed first and then examine what the costs are and the flexibility that is given. Mr. Betts also commented on that issue. Senator Roberts asked Ms. Fontneau to talk about the mandates regarding essential health benefits. Ms. Fontneau talked about the PPACA guidelines regarding essential health benefits. Ms. Fontneau stated that when the federal government issues the essential health benefit requirements, she will obtain input from the board. Senator Roberts encouraged a significant conversation around mandates and talked about responding to the regulations.

09:49 AM

Senator Roberts talked about her rural district and explained that 15 percent of population of the state resides in 80 percent of the land mass in Colorado. She asked how Ms. Fontneau plans to include those people in the Exchange in regards to outreach. Ms. Fontneau talked about geographic diversity of the Exchange board members. Senator Boyd stated that while Ms. Fontneau is working directly for the board, the committee still needs to be included and asked her how she will communicate with the committee in the future. Ms. Fontneau explained that she would be contacting the committee regularly.

09:53 AM

Representative B. Gardner expressed his concerns with the IT component of the Exchange. Ms. Fontneau stated that no decisions have been made regarding IT and talked about the subcommittee of the Exchange Board that was created on IT. Representative Summers asked who she would turn to for help when looking for information on various subjects regarding the Exchange. Ms. Fontneau explained that she has a long list starting with the Exchange Board and the committee. Beyond that, she said she has a network from her work in the community along with a number of mentors to turn to as well.

10:01 AM

Senator Roberts asked about salary range Ms. Fontneau is requesting and whether she would still want the Executive Director job if the Supreme Court strikes the PPACA down. Ms. Fontneau said she has negotiated a salary range of $180K to $200K with the board. She added that she believes the Exchange is a good business decision and has bipartisan support. She said that she would want to continue in the job even if the PPACA is struck down by the court.. Representative B. Gardner commented on the salary piece.

10:10 AM

Senator Aguilar asked for Ms. Fontneau's perspective on the grant. A discussion regarding the grant proposal ensued.


BILL:	Confirmation of Executive Director
TIME:	10:14:18 AM
MOVED:	Gardner B.
MOTION:	Move to approve the appointment of Patty Fontneau as Executive Director of the Colorado Health Benefit Exchange. The motion passed 7-0.
SECONDED:
		VOTE
	Aguilar	Yes
	Gardner D.	Yes
	Kerr J.	Excused
	Lundberg	Excused
	McCann	Yes
	Nicholson	Excused
	Roberts	Yes
	Summers	Yes
	Gardner B.	Yes
	Boyd	Yes
Final YES: 7 NO: 0 EXC: 3 ABS: 0 FINAL ACTION: PASS

10:15 AM -- Discussion of the Grant Proposal

Gretchen Hammer, Chair, Health Benefit Exchange Board, came to the table to discuss the level one grant proposal and distributed a copy to the members of the committee (Attachment B). She walked the committee through the grant proposal.

10:19 AM

Ms. Hammer talked about the 11 core functions of the Exchange. She stated that the Exchange Board will review and take action on December 12, 2011, and the committee will take action on the December 15, 2011. Representative McCann asked when the grant needs to be submitted. Ms. Hammer responded that it must be submitted by December 30, 2011. Ms. Hammer advised the committee members that if there is a question or suggestion on the proposal before the December 15 they could direct them to her.

10:24 AM

Representative B. Gardner talked about the grant approval process. Senator Boyd explained that the chair and vice chair can approve the grant alone without a committee meeting if they agree. Representative B. Gardner proposed holding a meeting regardless in order to allow questions and objections from the committee members. A discussion ensued on whether to hold a meeting next week. Senator Boyd agreed that a meeting is important and announced that the committee would be meeting on December 15 at 9 a.m. in HCR 0112.

10:32 AM

The committee adjourned.