House Committee on Public Health Care & Human Services (03/19/2013)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Date:	03/19/2013	ATTENDANCE

Time:	01:33 PM to 04:36 PM	Conti	X
		Everett	X
Place:	HCR 0107	Joshi	X
		Landgraf	X
This Meeting was called to order by		May	X
	Representative Primavera	McCann	*
		Schafer	X
This Report was prepared by		Singer	*
	Elizabeth Burger	Stephens	*
		Tyler	X
		Wilson	X
		Young	X
		Primavera	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB13-167 SB13-194 SB13-149 HB13-1238		Referred to Appropriations Referred to Appropriations Referred to the Committee of the Whole Amended, Referred to Appropriations

01:34 PM -- Senate Bill 13-167

Representative Gerou introduced Senate Bill 13-167. The bill updates statutory terminology from "intermediate care facilities for the mentally retarded" to "intermediate care facilities for individuals with intellectual disabilities." The bill also changes which state agency is authorized to collect the provider fee from intermediate care facilities. Under current law, the fee may be levied by the Department of Human Services. The bill allows the Department of Health Care Policy and Financing to collect the provider fee. She noted that the provider fee was enacted in 2003, but never collected, and the change in methodology created by the bill will allow the fee to be collected. Representative Gerou explained that the bill is technical in nature.

01:40 PM -- Marijo Rymer, ARC of Colorado, testified in support of the bill and transferring the administration of the fee to the Department of Health Care Policy and Financing. She responded to questions from the committee regarding the bill's change in terminology.


BILL:	SB13-167
TIME:	01:46:17 PM
MOVED:	Young
MOTION:	Refer Senate Bill 13-167 to the Committee on Appropriations. The motion passed on a vote of 11-0, with 2 members excused.
SECONDED:	Conti
		VOTE
	Conti	Yes
	Everett	Yes
	Joshi	Yes
	Landgraf	Yes
	May	Yes
	McCann	Excused
	Schafer	Yes
	Singer	Excused
	Stephens	Yes
	Tyler	Yes
	Wilson	Yes
	Young	Yes
	Primavera	Yes

Final YES: 11 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: PASS

01:47 PM -- Senate Bill 13-194

Representative Gerou introduced Senate Bill 13-194. The bill repeals the Low Income Telephone Assistance Program (LITAP). Representative Gerou explained the rationale behind the repeal of the program, and discussed the potential federal compliance costs to the state if the program is not repealed. She noted that a recent audit suggested that the program be repealed, and explained other federal subsidy programs for cell phone users. She referenced a fact sheet on the bill distributed by the Department of Regulatory Agencies (Attachment A).

130319 AttachA.pdf

01:52 PM -- Lynn Notarianni, Colorado Public Utilities Commission, testified in support of the bill, stating that the bill represents the best path forward to assist customers to access telephone service in light of increasing costs to administer the program. She explained that both the LITAP and the federal program Lifeline work in tandem to provide support to low-income Coloradoans. Recent federal changes to eligibility requirements are driving costs to the Department of Regulatory Agencies, which will in turn increase costs to Colorado consumers as the LITAP is funded by a surcharge on consumers' telephone bills. She explained that the changes will increase the program's administrative costs by almost $900,000.

01:58 PM -- Julie Kerksick, Department of Human Services, testified that the bill is the best step forward in light of the changes made at the federal level. She noted that some of the federal eligibility changes are being driven by a need to control fraud and abuse in the program. Ms. Kerksick discussed the current eligibility
criteria for the program, and noted that the new eligibility criteria allow individuals who qualify for the Supplemental Nutrition Assistance Program and the Medicaid program to qualify for the program, which will greatly expand the number of potential applicants for the program.

02:03 PM

Ms. Notarianni responded to questions from the committee regarding why there has been an increase in the participation in the federal Lifeline program and a decline in participation in the LITAP program. She clarified that the surcharge paid by consumers will cease if the LITAP program is repealed. She explained the administration of the federal Lifeline program and how the federal Lifeline program is marketed. Ms. Notarianni responded to questions regarding how consumers enrolled in the LITAP program will be notified if the program is repealed.


BILL:	SB13-194
TIME:	02:12:17 PM
MOVED:	Young
MOTION:	Refer Senate Bill 13-194 to the Committee on Appropriations. The motion passed on a vote of 13-0.
SECONDED:	Schafer
		VOTE
	Conti	Yes
	Everett	Yes
	Joshi	Yes
	Landgraf	Yes
	May	Yes
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	Yes
	Tyler	Yes
	Wilson	Yes
	Young	Yes
	Primavera	Yes

Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:14 PM

The committee recessed briefly.

02:18 PM -- Senate Bill 13-149

Representative Kagan introduced Senate Bill 13-149. The bill, as amended in the Senate, reestablishes the All-Payer Health Claims Database Advisory Committee with 26 members. The advisory committee's role is to support the mission of the All-Payer Health Claims Database (APCD). The advisory committee is scheduled to sunset July 1, 2013. He explained that the advisory committee will have fulfilled its statutory charge by that date, but that the stakeholders believe that the advisory committee could continue to provide an important advisory role to the database continuing into the future. He responded to questions from the committee regarding the membership of the advisory committee.

02:28 PM -- Phil Kalin, Center for Improving Value in Health Care (CIVHC), explained that CIVHC is the administrator of the APCD and described the background of the APCD. He described the types of information that will be available through the database. He stated that the APCD should have an officially constituted advisory committee and gave examples of how the advisory committee will inform decisions about the APCD. He responded to questions from the committee regarding the information in the database, and ratings of providers. He further responded to questions from the committee regarding the interaction between the APCD and the health insurance exchange and the types of health plans that provide information to the APCD.

02:49 PM -- Marc Reece, Colorado Association of Health Plans, testified that the health plans have worked collaboratively with CIVHC on the bill. He discussed efforts by the industry to standardize claim information within the database.

02:52 PM

Representative Kagan responded to questions from the committee regarding the foundations that provided funding for the APCD.

02:54 PM -- Saul Larsen, Department of Regulatory Agencies, responded to questions from the committee regarding the bill's legislative reporting requirements. Representative Kagan responded to additional questions regarding the advisory committee and reporting requirements related to the advisory committee and the APCD.

02:58 PM -- Robert Chase, representing himself, testified in support of a single-payer health care system.

03:00 PM

The committee discussed potential amendments to the bill.

03:01 PM

Mr. Kalin returned to the table to respond to questions from the committee about how the meetings of the advisory committee are noticed.

03:03 PM

Representative Kagan gave concluding remarks regarding the bill.


BILL:	SB13-149
TIME:	03:04:23 PM
MOVED:	Young
MOTION:	Refer Senate Bill 13-149 to the Committee of the Whole. The motion passed on a vote of 9-4.
SECONDED:	Tyler
		VOTE
	Conti	Yes
	Everett	No
	Joshi	No
	Landgraf	No
	May	Yes
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	Yes
	Tyler	Yes
	Wilson	No
	Young	Yes
	Primavera	Yes

Final YES: 9 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:13 PM -- House Bill 13-1238

Representative McCann introduced House Bill 13-1238 and explained that there was a strike-below amendment to the bill, L.003 (Attachment B). She explained that the original bill would have transferred money from the Medical Marijuana Cash Fund to the Department of Human Services for marijuana and prescription drug abuse treatment each year for the next four years. Amendment L.003 removes this transfer. It further requires the state and local medical marijuana licensing authorities to publish a report on their websites regarding the number of license applications that are denied, pending, approved, and withdrawn. The amendment also clarifies that a state license for a medical marijuana facility is conditioned upon approval of the local licensing authority and expires if the applicant does not receive local licensing authority approval within one year of the state's approval. An applicant that has been issued a conditional state license can continue to operate the business while an application is pending with the local licensing authority. Representative McCann explained that the amendment will allow the Department of Revenue to be more efficient in its inspections and licensing of medical marijuana facilities. Representative McCann and Representative Primavera discussed the bill's fiscal note.

130319 AttachB.pdf

03:23 PM -- Laura Harris, Medical Marijuana Enforcement Division, Department of Revenue, discussed the difficulties experienced by the Department of Revenue in communicating with the local licensing authorities regarding medical marijuana licensing applications. She explained that the amendment will allow the department to generate a stable revenue cycle and determine whether fees need to be adjusted to meet the department's expected expenditures. She responded to questions from the committee regarding the provisions of amendment L.003, and how it allows the department to collect licensing fees up front. Ms. Harris responded to question from the committee regarding the dual state and local licensing structure.

03:32 PM

Ms. Harris explained the process of obtaining a license to operate a medical marijuana center. Committee discussion continued about the local and state licensing processes and the fees for licensing. Ms. Harris responded to committee questions about the number of centers that have been issued a provisional state license and are waiting for local approval of their license. She responded to questions from the committee about the fiscal impact of the bill. The committee discussed the moneys in the Medical Marijuana Program Cash Fund and whether that money could be used for licensing and enforcement activities. Ms. Harris further responded to questions from the committee regarding uncollected license fees. Committee discussion continued.

04:06 PM -- Michael Dohr, Office of Legislative Legal Services, walked the committee through the provisions of amendment L.003 (Attachment B). He explained that section 2 of the amendment will allow the state to collect its licensing fee up front, prior to the local licensing authority issuing its approval.

04:17 PM -- Clare Pramuk, Legislative Council Staff, came to the table to respond to questions from the committee regarding amendment L.003's effect on the bill's fiscal impact.

04:21 PM -- Robert Chase, Colorado Coalition for Patients and Caregivers, spoke to amendment L.003 and its differences from the original bill. He discussed the original bill, and his belief that, as proposed, it was unconstitutional.

04:30 PM

Representative McCann gave concluding remarks regarding the bill.


BILL:	HB13-1238
TIME:	04:30:46 PM
MOVED:	McCann
MOTION:	Adopt amendment L.003 (Attachment B). The motion passed on a vote of 7-6.
SECONDED:	Young
		VOTE
	Conti	No
	Everett	No
	Joshi	No
	Landgraf	No
	May	Yes
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	No
	Tyler	Yes
	Wilson	No
	Young	Yes
	Primavera	Yes

YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	HB13-1238
TIME:	04:32:32 PM
MOVED:	McCann
MOTION:	Refer House Bill 13-1238, as amended, to the Committee on Appropriations. The motion passed on a vote of 7-6.
SECONDED:	Schafer
		VOTE
	Conti	No
	Everett	No
	Joshi	No
	Landgraf	No
	May	Yes
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	No
	Tyler	Yes
	Wilson	No
	Young	Yes
	Primavera	Yes

Final YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:36 PM

The committee adjourned.