House Committee on Public Health Care & Human Services (03/11/2014)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Date:	03/11/2014	ATTENDANCE

Time:	01:30 PM to 05:19 PM	Conti	*
		Everett	X
Place:	HCR 0107	Ginal	X
		Joshi	X
This Meeting was called to order by		Landgraf	X
	Representative Primavera	McCann	*
		Schafer	X
This Report was prepared by		Singer	*
	Elizabeth Burger	Stephens	X
		Tyler	X
		Wilson	X
		Young	X
		Primavera	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Presentation by the National Conference of State Legislatures on Child Support Enforcement HB14-1192 SB14-062 HB14-1290 SB14-018		Witness Testimony and/or Committee Discussion Only Postponed Indefinitely Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole Witness Testimony and/or Committee Discussion Only

01:34 PM -- Presentation by the National Conference of State Legislatures on Child Support Enforcement

Rochelle Finzel, National Conference of State Legislatures, provided the committee with an overview of child support enforcement methods and distributed a handout to the committee (Attachment A). She explained that states recover child support payments on behalf of families who are receiving public assistance, and discussed recent reforms in child support enforcement. She explained that states have changed their approach from being merely being a collection agency to providing additional support to families. She discussed various evidence-based strategies for child support, including right sized orders, which improves the likelihood that payments will continue to be made. She explained that if the order is set too high, compliance decreases while arrears increase. Another strategy, debt reduction, is a process whereby a state settles a portion or all of the child support debt owed to the state by a noncustodial parent. Family distribution is a strategy that increases the amount of child support that goes directly to the family or child may help increase collections. In addition, Ms. Finzel noted that research shows that noncustodial fathers who are involved with their children are more likely to pay child support and those fathers who pay child support are more likely to stay involved in their children's lives. Finally, she explained that consistent child support payments can help custodial families achieve economic stability.

14HsePHS0311AttachA.pdf

01:44 PM

Ms. Finzel discussed other programs related to child support enforcement, including fatherhood programs and programs that work directly with military families. She discussed recent legislative activity in the states, including creating task forces to research best practices, enacting policies that relate specifically to custody and visitation for military families, and connecting noncustodial parents to employment programs.

01:47 PM

Ms. Finzel responded to questions from the committee regarding drivers' license suspensions as a result of failure to pay child support, child support debt reduction policies, states that have created task forces to review child support enforcement policies, and states that have the most effective child support enforcement programs. She further responded to questions from the committee regarding reductions in welfare participation since the enactment of welfare reform and studies of child support enforcement methods.

01:58 PM -- HB14-1192

Representative Joshi discussed House Bill 14-1192. The bill repeals Colorado Health Benefit Exchange, effective January 1, 2015. The committee previously heard witness testimony on the bill February 25, 2014. Representative Joshi gave concluding remarks regarding the bill.

01:59 PM -- Dave DeNovellis, Legislative Council Staff, responded to questions from the committee regarding the amount of federal grant money that has been awarded to and expended by Colorado's health insurance exchange. He further addressed whether the state would have to repay grant funds that were used to establish the state exchange.

02:05 PM

Representative Joshi gave concluding remarks regarding the bill. Various members commented on the bill.


BILL:	HB14-1192
TIME:	02:17:24 PM
MOVED:	Joshi
MOTION:	Refer House Bill 14-1192 to the Committee on Health, Insurance, and Environment. The motion failed on a vote of 5-8.
SECONDED:	Everett
		VOTE
	Conti	Yes
	Everett	Yes
	Ginal	No
	Joshi	Yes
	Landgraf	Yes
	McCann	No
	Schafer	No
	Singer	No
	Stephens	No
	Tyler	No
	Wilson	Yes
	Young	No
	Primavera	No

YES: 5 NO: 8 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	HB14-1192
TIME:	02:19:23 PM
MOVED:	Young
MOTION:	Postpone House Bill 14-1192 indefinitely. The motion passed on a vote of 8-5.
SECONDED:	Schafer
		VOTE
	Conti	No
	Everett	No
	Ginal	Yes
	Joshi	No
	Landgraf	No
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	Yes
	Tyler	Yes
	Wilson	No
	Young	Yes
	Primavera	Yes

Final YES: 8 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:20 PM -- SB14-062

Representatives Gardner and Foote introduced Senate Bill 14-062. The bill creates a process by which a parent whose parental rights have been terminated by the county courts can have those rights reinstated under certain limited conditions. Representative Gardner described the criteria that must be met in order for the reinstatement to occur. Representative Foote further described the provisions of the bill that he believes ensure proper oversight and safeguards for the reestablishment of the parent-child legal relationship. Representative Foote and Representative Gardner responded to questions from the committee.

02:30 PM -- Roberta Long-Twyman, League of Women Voters, testified in support of the bill. She stated that the bill will create an additional avenue to permanence for children in the child welfare system.

02:32 PM -- Pat Ratliff, Colorado Counties Inc., testified in support of the bill.

02:35 PM -- Benjamin Waters, Mile High United Way, testified in support of the bill.

02:36 PM -- Sarah Ehrlich, Denver Human Services, testified in support of the bill. She described specific provisions of the bill related to periodic reviews of the placement and the advisement of the benefits the child may lose or gain as a result of the reinstatement of the parent's parental rights. Ms. Ehrlich responded to questions from the committee regarding allegations of sexual assault and how those cases would be handled.

02:41 PM -- Megan Davis, Boulder County, testified in support of the bill. She gave an example of a family that could benefit from the bill's provisions.

02:45 PM -- Dorothy Macias, Office of the Child's Representative, noted that the bill's provisions won't be used often, but that there may be certain situations in which the reinstatement of parental rights is appropriate. She noted that the child's best interests are the driving criteria for making decisions regarding placements. She described a child who could potentially benefit from the bill. She responded to questions from the committee.

02:56 PM

Representative Foote read a portion of a letter from the Colorado Criminal Justice Reform Colation into the record (Attachment B).

14HsePHS0311AttachB.pdf

02:57 PM

Representative Gardner and Representative Foote gave concluding remarks regarding the bill.


BILL:	SB14-062
TIME:	03:00:28 PM
MOVED:	Young
MOTION:	Refer Senate Bill 14-062 to the Committee of the Whole. The motion passed on a vote of 13-0.
SECONDED:	Landgraf
		VOTE
	Conti	Yes
	Everett	Yes
	Ginal	Yes
	Joshi	Yes
	Landgraf	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

03:01 PM -- HB14-1290

Representative Becker introduced House Bill 14-1290, which concerns the operation of remotely located telepharmacy outlets. She distributed amendment L.004, a strike-below amendment (Attachment C), and described its provisions. Amendment L.004 amends the definition of "other outlet" to include a telepharmacy outlet; amends the definition of "supervision" to allow for a pharmacist to supervise a pharmacy technician at a telepharmacy outlet; and defines a telepharamacy outlet as a remote pharmacy site that is registered as an other outlet, is located more than 20 miles from the nearest prescription drug outlet, is connected via computer, video, and audio to a central pharmacy, and has a pharmacy technician on site who is under the supervision of a licensed pharmacist In addition, the amendment authorizes the State Board of Pharmacy to adopt rules governing telepharmacy. Representative Becker responded to questions from the committee regarding stakeholder support for the bill.

14HsePHS0311AttachC.pdf

03:07 PM -- Brad Young, Rx Plus Pharmacies, testified in support of the bill and described the process of drafting the legislation. He noted that amendment L.004 contains language that is acceptable to all stakeholders, and that he believes the State Board of Pharmacy has the ability to implement appropriate controls over telepharmacy. Representative Becker and Mr. Young discussed how a telepharmacy would work in a rural area. They continued to respond to committee questions regarding oversight of pharmacies and pharmacists, how telepharmacies would be established in rural communities, and how telepharmacies differ from mail order pharmacies.

03:28 PM -- Val Kalnins, Colorado Pharmacists Society, testified in support of the bill and described how a telepharmacy may be established in a rural community. He responded to questions from the committee regarding the differences in education levels and the scope of practice of pharmacists and pharmacy technicians.

03:36 PM -- Ronne Hines, Department of Regulatory Agencies, testified regarding the history of regulation of "other outlets." She described how other outlets operate, and stated that adding telepharmacy to Colorado's statutes would allow Colorado to keep pace with modern technology.

03:38 PM -- Chris Gassen, Board of Pharmacy, Department of Regulatory Agencies, responded to questions from the committee regarding how many telepharmacies may be established as a result of the bill and how telepharmacies would determine which drugs to stock.


BILL:	HB14-1290
TIME:	03:41:02 PM
MOVED:	Schafer
MOTION:	Adopt amendment L.004 (Attachment C). The motion passed without objection.
SECONDED:	Everett
		VOTE
	Conti
	Everett
	Ginal
	Joshi
	Landgraf
	McCann
	Schafer
	Singer
	Stephens
	Tyler
	Wilson
	Young
	Primavera

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

03:43 PM -- Mr. Gassen returned to the table to respond to questions from the committee regarding the individuals who may establish telepharmacies.


BILL:	HB14-1290
TIME:	03:44:50 PM
MOVED:	Young
MOTION:	Refer House Bill 14-1290, as amended, to the Committee of the Whole. The motion passed on a vote of 12-0, with one member excused.
SECONDED:	Schafer
		VOTE
	Conti	Yes
	Everett	Yes
	Ginal	Yes
	Joshi	Yes
	Landgraf	Yes
	McCann	Excused
	Schafer	Yes
	Singer	Yes
	Stephens	Yes
	Tyler	Yes
	Wilson	Yes
	Young	Yes
	Primavera	Yes

Final YES: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:45 PM -- SB14-018

Representatives Hamner and Young introduced Senate Bill 14-018. The bill expands current law's prohibition on furnishing tobacco products to persons under 18 years of age to include all nicotine products. They distributed examples of the products that would be affected by the bill. They responded to questions from the committee regarding whether the bill will prohibit the distribution of tobacco cessation products to minors and whether the bill bans rolling papers.

03:54 PM -- April Montgomery, March of Dimes, testified in support of the bill. She stated that tobacco and nicotine products contribute to premature births. Representative Young responded to questions from the committee regarding pending legislation that bans the sale of tobacco products to individuals under age 21.

03:59 PM -- Gabe Kaplan, Colorado Department of Public Health and Environment, testified in support of the bill and discussed the costs to the state associated with tobacco use. He described new nicotine products that have entered the market, and a fact sheet regarding the bill was distributed to the committee (Attachment D). Representative Young and Mr. Kaplan responded to questions from the committee regarding enforcement of the bill's provisions. Mr. Kaplan responded to questions from the committee regarding when many nicotine-only products began to enter the market. Representative Stephens commented on the increase in the use of dissolvable nicotine products among youth. The committee discussed whether current law would ban products that contain both tobacco and nicotine.

14HsePHS0311AttachD.pdf

04:21 PM -- Kris Forrestal, Office of Legislative Legal Services, came to the table to respond to committee questions.

04:22 PM -- Grier Baily, Colorado Wyoming Petroleum Marketers Association, testified in support of the bill. He discussed the warning signs required by the bill and responded to questions about the warning signs. Representative Young discussed the statutory requirements for the warning signs. Mr. Baily responded to questions about who pays for the warning signs, the need for transparency for consumers at points of sale, and the enforcement of current statutes. Representative Hamner stated that bill would provide clarification to retailers. Mr. Baily responded to a question about whether the state offers a sign that includes nicotine in the required language.

04:41 PM -- Donna Viverette, Colorado Association of Local Public Health Officials and Jefferson County Public Health, testified in support of the bill. She discussed hookah use among minors and the minors' ease of access to nicotine products. She stated that nicotine dependance can occur after two days of use. Ms. Viverette responded to questions about how minors access nicotine products and enforcement of the current statute.

04:55 PM -- R.J. Ours, American Cancer Society Cancer Action Network, testified in opposition to the bill. He stated that the bill could cause unintended consequences and the changes in the bill are not necessary at this time. He responded to questions from the committee regarding his organization's opposition to the bill.

05:02 PM

Representatives Hamner and Young gave concluding remarks regarding the bill.

05:19 PM

The bill was laid over of action at a future committee meeting.

05:19 PM

The committee adjourned.