House Committee on Health, Insurance & Environment (03/21/2013)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE & ENVIRONMENT

Date:	03/21/2013	ATTENDANCE

Time:	01:32 PM to 04:19 PM	Conti	*
		Fields	*
Place:	HCR 0107	Ginal	X
		Humphrey	X
This Meeting was called to order by		Joshi	X
	Representative McCann	Primavera	X
		Stephens	*
This Report was prepared by		Swalm	*
	Amanda King	Young	X
		Schafer	X
		McCann	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB13-151 SB13-172 HB13-1239 HB13-1245		Amended, Referred to Finance Referred to Appropriations Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

01:33 PM -- Senate Bill 13-151

Representative Primavera presented Senate Bill 13-151 concerning the continuation of the regulation of massage therapists. The bill continues the regulation of massage therapists until September 1, 2022, and implements the recommendations of the sunset review on the Massage Therapy Practice Act. A key recommendation of the sunset review is to repeal registration requirements and implement licensing requirements for massage therapists. Licensing allows for increased grounds for disciplinary action by the Director of the Division of Professions and Occupations in the Department of Regulatory Agencies such as failure to report an adverse action taken by another jurisdiction, failure to meet standards of care, and commission of a crime related to the practice of massage therapy. All active massage therapy registrations become active massage therapy licenses on July 1, 2014, and all pending applications for registrations are considered applications for licensure. The bill also:

authorizes the director to issue letters of admonition and confidential letters of concern when a disciplinary action is not warranted;
allows licensure for an applicant who has obtained a degree or diploma from an out-of-state school approved by the director;
prohibits a massage therapist whose license has been revoked or surrendered from reapplying for at least two years;
authorizes the director to enter into a confidential agreement with a massage therapist who has mental or physical condition or illness;
allows for disciplining a massage therapist who has a mental or physical condition or disability that may endanger the health and safety of clients who fails to notify the director or fails to act within agreed upon limitations; and
requires the director to adopt rules regarding generally accepted standards of massage therapy care.

01:37 PM -- Jean Robinson, Associated Bodywork and Massage Professionals, testified in support of the bill. She discussed the history of the Massage Therapy Practice Act, the change from registration to licensure outlined in the bill, and the Department of Regulatory Agencies' director model. She discussed the licensing fees for massage therapists and how massage therapists were regulated prior to the adoption of the Massage Therapy Practice Act.

01:42 PM

The committee took a brief recess.

01:45 PM

Representative McCann called the committee back to order. Representative Primavera presented amendment L.003 (Attachment A) and responded to a question about the amendment.

130321 AttachA.pdf


BILL:	SB13-151
TIME:	01:45:37 PM
MOVED:	Primavera
MOTION:	Adopt amendment L.003 (Attachment A). The motion passed without objection.
SECONDED:	Young
		VOTE
	Conti
	Fields	Excused
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

01:49 PM

Representative Stephens presented amendment L.004 (Attachment B). Representative McCann ruled the amendment did not fit under the title and that it was a settled question. Representative Primavera commented on amendment L.004.

130321 AttachB.pdf

01:52 PM

Representative Primavera provided concluding remarks.


BILL:	SB13-151
TIME:	01:52:37 PM
MOVED:	Primavera
MOTION:	Refer Senate Bill 13-151, as amended, to the Committee on Finance. The motion passed on a vote of 7-4.
SECONDED:	Schafer
		VOTE
	Conti	Yes
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Primavera	Yes
	Stephens	No
	Swalm	No
	Young	Yes
	Schafer	Yes
	McCann	Yes

Final YES: 7 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:53 PM -- Senate Bill 13-172

Representative Ginal presented Senate Bill 13-172 concerning the continuation of the regulation of acupuncturists. The bill continues the regulation of acupuncturist until September 1, 2022, and implements the recommendations of the sunset review on the acupuncturists licensing program. The bill makes the following changes:

adds the word "modern" to the practice definition;
revises the language regarding the practice of acupuncture as it relates to other healing arts to allow for the overlap of scopes of practice;
repeals the provisions that subject an acupuncturist to discipline for working while afflicted with an infectious disease;
amends grounds for discipline to removed words addiction and dependence;
authorizes the director to enter into a confidential agreement with an acupuncturist who has a mental or physical condition or illness;
allows for disciplining an acupuncturist who has a mental or physical condition or disability that may endanger the health and safety of clients who fails to notify the director or fails to act within agreed upon limitations;
allows letters of admonition to be sent by first class rather than certified mail;
prohibits an acupuncturist whose license has been revoked or surrendered from reapplying for at least two years; and
removes the requirement that supervising acupuncturists report the names and addresses of the students they supervise to the Director of the Division of Professions and Occupations in the Department of Regulatory Agencies.

Representative Ginal provided a handout (Attachment C) and booklet (Attachment D) to the committee.

130321 AttachC.pdf

130321 AttachD.pdf

01:58 PM -- Valerie Hobbs, Acupuncture Association of Colorado, testified in support of the bill. She discussed the education requirements for acupuncturists. Ms. Hobbs responded to a question about reciprocity.

02:03 PM -- Anne Chew, Acupuncture Association of Colorado, testified in support of the bill. Ms. Chew responded to a questions about New Mexico's licensure requirements and whether the bill offers patient protections.

02:08 PM -- Dino Ioannides and Ellen Graham, Department of Regulatory Agencies, responded to questions about the complaints that have been filed against acupuncturists.

02:11 PM

Representative Ginal made concluding remarks on the bill.


BILL:	SB13-172
TIME:	02:12:04 PM
MOVED:	Ginal
MOTION:	Refer Senate Bill 13-172 to the Committee on Appropriations. The motion passed on a vote of 8-3.
SECONDED:	Young
		VOTE
	Conti	Yes
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Primavera	Yes
	Stephens	Yes
	Swalm	No
	Young	Yes
	Schafer	Yes
	McCann	Yes

Final YES: 8 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:13 PM -- House Bill 13-1239

Representative McCann presented House Bill 13-1239 concerning the creation of a statewide youth development plan. The bill requires the Tony Grampsas Youth Services Board to convene a group of interested parties to create a statewide youth development plan to identify key issues and align strategic efforts to achieve positive outcome for all youths. Specifically, the plan must:

identify initiatives and strategies, organizations, and gaps in coverage that affect youth development outcomes;
identify services, funding, and partnerships necessary to ensure successful transition to adulthood;
determine what is necessary in terms of community involvement and development;
identify existing youth service organizations, including demographics of youths served, current services, and capacity;
identify successful youth development strategies nationally and in Colorado; and
create a shared vision of how a strong youth development network can be created and measured.

The plan must include a baseline measure of youth activities, which may include data and resources collected on youth risk behaviors such as those contributing to injury and violence; sexual behaviors contributing to unintended pregnancy and sexually transmitted diseases; alcohol, tobacco, and drug use; unhealthy dietary behaviors; and inadequate physical activity. Data may also be used from various state agencies.

Representative McCann discussed statistics concerning youth-related crime and violence. She discussed the relocation of the Tony Grampsas Youth Services Board to the Department of Human Services by House Bill 13-1117. Representative McCann discussed amendment L.003 (Attachment E). She responded to questions about the amendment and the Tony Grampsas Youth Services Board.

130321 AttachE.pdf

02:39 PM -- Rose Barcklow and Lena Peschanskaia, Department of Public Health and Environment, testified in support of the bill. Ms. Peschanskaia discussed how the bill would eliminate duplication of services. Ms. Barcklow responded to questions about the Tony Grampsas Youth Services Program grantees. Representative Stephens and Representative McCann discussed possibly amending the funding formula for the grant program of the Tony Grampsas Youth Services Program.

02:45 PM -- Andy Johnson, Department of Human Services, testified in support of the bill. He discussed the youth-related programs in the Department of Human Services and the development of a statewide youth development plan. Mr. Johnson responded to questions about what models would be used to develop the statewide youth development plan and how different populations and departments would be included in the plan. Representative McCann responded to a suggestion to include the Department of Labor in the bill.

02:54 PM -- Connie Rule, Boys and Girls Clubs, testified in support of the bill. Ms. Rule discussed the Boys and Girls Clubs and the youth the organization serves. She discussed the need for a holistic approach to youth development. Ms. Rule responded to a question about whether non-profit organizations could accomplish the goals of the legislation. Representative Stephens discussed the activities of the Boys and Girls Clubs.

03:01 PM -- Gregory Zeis, representing himself, testified in support of the bill. He provided a handout to the committee (Attachment F). He discussed Tony Grampsas Youth Services Program grants. Mr. Zeis responded to questions about parental involvement in youth programs.

130321 AttachF.pdf

03:06 PM -- Lacey Beruman, Federation of Families, testified in support of the bill.

03:08 PM -- Cheng Wu, representing himself, testified in support of the bill. He discussed the youth population of Colorado. Mr. Wu responded to questions about the data sources he used for his testimony.

03:16 PM

Representative McCann further discussed amendment L.003 and responded to a question about the fiscal note. The committee discussed the amendment and potential additional amendments to the bill. The bill and amendment were laid over until later in the day.

BILL:	HB13-1239
TIME:	03:30:40 PM
MOVED:	McCann
MOTION:	Adopt amendment L.003 (Attachment E). This motion was withdrawn.
SECONDED:	Young
		VOTE
	Conti
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION:

03:31 PM

Representative Primavera recessed the committee.

03:34 PM

Representative Primavera called the committee back to order. Representative McCann withdrew amendment L.003. The bill was laid over until the next committee meeting.

03:35 PM -- House Bill 13-1245

Representative McCann presented House Bill 13-1245 concerning funding mechanisms for the Colorado Health Benefit Exchange (exchange). The bill creates two funding mechanisms to support the operation of the exchange, including:

a fee assessed on health insurers operating in the individual and small group markets; and
a premium tax credit to encourage contributions to the health exchange from insurance carriers.

The Colorado Health Benefit Exchange Board of Directors may assess a fee on small group and individual market health insurance carriers beginning on January 1, 2014. The fee is limited to $1.80 per month per health benefit plan on carriers in the individual market and per month per policyholder on carriers in the small group market. The Commissioner of Insurance is required to promulgate rules for the collection and assessment of the fee on carriers.

The bill creates a tax credit against the premium tax owed by insurance carriers that make a contribution of funds to the exchange. The tax credit is not capped and may be claimed by a carrier against its quarterly premium tax payment beginning in the 2014 tax year. To claim the credit, a carrier must follow the rules promulgated by the Commissioner of Insurance and complete the specified process for becoming a qualified taxpayer.

Representative McCann discussed amendment L.006 (Attachment G), but stated additional amendments are necessary so the amendment would not be offered.

130321 AttachG.pdf

03:42 PM -- Gretchen Hammer and Patty Fontneau, Colorado Health Benefit Exchange, testified in support of the bill. Ms. Hammer discussed the Colorado Health Benefit Exchange and the multi-revenue strategy of the exchange. Ms. Fontneau discussed the funding mechanism outlined in the bill, and state that the bill is only a piece of the self-sufficiency plan of the exchange. Ms. Fontneau responded to questions about the overall look of the exchange for the next two to three years, the cost comparison to states planning to participate in the federally operated exchange, and how adverse selection is being addressed by the exchange.

03:57 PM

Representative Primavera stated that Lacey Burman, Foundation of Families, had to leave, but expressed support of the bill.

03:57 PM -- Tony Gagliardi, National Federation of Independent Business, testified on the bill. He stated the if Colorado would have defaulted to the federal model it would have brought much higher costs, and stated that he did not want to state a position on the bill until all of the amendments have been presented. He discussed that any funding source for the exchange must address choice, competition, and cost-effectiveness.

03:59 PM -- Marc Reece, Colorado Association of Health Plans, testified on the bill. He discussed adverse selection protections included in the exchange. Mr. Reece responded to questions about how the exchange will address health costs and cost-shifting that occurs in the health care system.

04:07 PM -- Travis Berry, Colorado Competitive Council, testified on the bill. He discussed cost-shifting in the health care system and the assessment outlined in the bill. Mr. Berry responded to questions about the involvement of stakeholders in drafting amendments to the bill.

04:12 PM -- Debra Judy, Colorado Consumer Health Initiative, and George Lyford, Colorado Center on Law and Policy, testified on the bill. Ms. Judy discussed the involvement of the Colorado Consumer Health Initiative with the Colorado Health Benefit Exchange. Mr. Lyford stated the entire state stands to benefit from the success of the exchange. He stated he is in support of the concept of the bill and will work with the sponsor on amendments.

04:17 PM

Representative McCann requested that the bill be laid over for amendments and final action. Representative Primavera laid the bill over to a future date and adjourned the committee.