House Committee on Health, Insurance, & Environment (02/06/2014)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Date:	02/06/2014	ATTENDANCE

Time:	01:36 PM to 05:26 PM	Fields	*
		Ginal	X
Place:	HCR 0107	Humphrey	X
		Joshi	X
This Meeting was called to order by		Landgraf	X
	Representative McCann	McNulty	X
		Primavera	X
This Report was prepared by		Singer	*
	Amanda King	Swalm	X
		Schafer	X
		McCann	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
HB14-1099 HB14-1117 HB14-1134 HB14-1054		Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole Postponed Indefinitely Amended, Referred to Appropriations

01:36 PM -- HB 14-1099

Representative McCann reopened the testimony phase on House Bill 14-1099, concerning prescription drugs in the practice of optometry. Testimony on the bill was also taken on Thursday, January 30.

01:37 PM -- Lauren Larson, representing the Department of Regulatory Agencies, testified in opposition to the bill. She provided a copy of her testimony and a handout (Attachments A and B). Ms. Larson responded to questions about the U.S. Drug Enforcement Administration registration card designations, whether the department's concerns could be resolved, federal enforcement of the drug schedule, and whether optometrists are prescribing or dispensing certain drugs. Ms. Larson responded to questions about whether there has been reported abuse due to optometrists prescribing certain prescription drugs.

140206 AttachA.pdf

140206 AttachB.pdf

01:51 PM -- Kathi Williams, representing Colorado Optometric Association, testified in support of the bill. She discussed the process for providers to purchase certain prescription drugs from wholesalers.

01:56 PM

Representative Schafer discussed Amendment L.002 (Attachment C). She responded to questions about the amendment.

140206 AttachC.pdf


BILL:	HB14-1099
TIME:	01:58:25 PM
MOVED:	Schafer
MOTION:	Adopt amendment L.002 (Attachment C). The motion passed without objection.
SECONDED:	Ginal
		VOTE
	Fields	Excused
	Ginal
	Humphrey
	Joshi
	Landgraf
	McNulty
	Primavera
	Singer
	Swalm
	Schafer
	McCann

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

01:59 PM

Representative Schafer made concluding remarks about the bill. The committee discussed the bill.


BILL:	HB14-1099
TIME:	02:00:17 PM
MOVED:	Schafer
MOTION:	Refer House Bill 14-1099, as amended, to the Committee of the Whole. The motion passed on a vote of 11-0.
SECONDED:	Ginal
		VOTE
	Fields	Yes
	Ginal	Yes
	Humphrey	Yes
	Joshi	Yes
	Landgraf	Yes
	McNulty	Yes
	Primavera	Yes
	Singer	Yes
	Swalm	Yes
	Schafer	Yes
	McCann	Yes

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

02:02 PM -- HB 14-1117

Representative Schafer presented House Bill 14-1117. The bill creates the Premature Birth Commission in the Department of Public Health and Environment (DPHE). The commission is tasked with developing strategies the state may use to reduce premature births. Under the bill, the executive director of the DPHE will appoint up to 12 members to the commission by July 1, 2014, and the commission must meet at least once by July 31, 2014. Commission members will be professionals and experts working in the maternal and child health field. The commission serves without compensation or reimbursement. By December 1, 2014, the commission must present recommendations to the DPHE. The DPHE will be responsible for submitting a final report to the General Assembly by January 31, 2015. The commission will be repealed on February 1, 2015. Representative Schafer relayed statistics concerning premature births, including the economic impact of premature births.

02:11 PM

Representative Schafer responded to questions about whether there would be rural involvement on the commission, the mission of the commission, and whether legislation is necessary to achieve the desired results. Representative Ginal discussed the March of Dimes.

02:20 PM -- Scott Matthews, representing the March of Dimes, testified in support of the bill. He discussed the March of Dimes' efforts to address premature births.

02:24 PM -- Eliza Schultz, representing DPHE, testified in support of the bill. She discussed the fiscal note. Ms. Schultz responded to questions about the timeline for the required report.

02:26 PM -- Cassidy Dellemonache, representing the Arc of Colorado, testified in support of the bill and encouraged the inclusion of a representative of the developmentally disabled community on the commission.

02:28 PM

The committee discussed the bill. Representative Schafer made final comments on the bill.


BILL:	HB14-1117
TIME:	02:32:19 PM
MOVED:	Schafer
MOTION:	Refer House Bill 14-1117 to the Committee of the Whole. The motion passed on a vote of 10-1.
SECONDED:	Ginal
		VOTE
	Fields	Yes
	Ginal	Yes
	Humphrey	Yes
	Joshi	No
	Landgraf	Yes
	McNulty	Yes
	Primavera	Yes
	Singer	Yes
	Swalm	Yes
	Schafer	Yes
	McCann	Yes

Final YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:33 PM -- HB 14-1134

Representative Joshi presented House Bill 14-1134. The bill requires health care insurance navigators to register with the Division of Professions and Occupations in the Department of Regulatory Agencies (DORA). Specifically, the bill does the following:

sets the education and training requirements for navigators;
disqualifies a navigator from registering if he or she has a prior felony conviction or a misdemeanor conviction involving fraud or dishonesty;
requires navigators to submit fingerprints for a Colorado Bureau of Investigation and Federal Bureau of Investigation fingerprint-based criminal history record check;
outlines prohibited practices and establishes disciplinary actions that may be taken by DORA; and
requires navigators to register within 90 days of the effective date of the bill.

In addition, the bill requires organizations employing navigators to report all unauthorized releases of customer's personally identifiable information to DORA and requires DORA to submit this information to the General Assembly. The DORA is also required to maintain a list of registered navigators. The registration of navigators is repealed September 1, 2024, following a sunset review.

02:39 PM

Representative Joshi responded to questions about the roles and regulation of health insurance brokers and health care insurance navigators. He responded to questions about the lack of federal requirements concerning background checks for navigators, the number of navigators in other states who were found to be felons, and whether there is currently any recourse if a navigator is found to be a felon. Committee discussion continued about background checks for navigators.

02:47 PM --

Rachel Foster, representing Colorado Community Health Network and Salud Family Health Centers, testified in opposition to the bill. She discussed the process for hiring health care insurance navigators, also known as health coverage guides. Ms. Foster responded to questions about background checks for health coverage guides.

02:54 PM --

Kathleen Hallgren, representing the Bell Policy Center, testified in opposition to the bill. She provided a handout (Attachment D).

140206 AttachD.pdf

02:56 PM --

Charlotte Kaye, representing the Colorado Consumer Health Institute, testified in opposition to the bill. She discussed consumer feedback about health coverage guides.

02:57 PM --

George Lyford, representing the Colorado Center on Law and Policy, testified in opposition to the bill. He discussed the role of health care insurance navigators and the current certification process for navigators. Mr. Lyford responded to questions about the scope of the current background checks, the budget for the health care insurance navigator program, and the reporting requirements in the bill.

03:06 PM --

Adela Flores-Brennan, representing Connect for Health Colorado, responded to questions about health insurance brokers, health care insurance navigators, and whether there are federal requirements for background checks. In response to a question, Ms. Flores-Brennan explained the Connect for Health Colorado certification requirements for health coverage guides.

03:14 PM

Representative Joshi made final comments about the bill.


BILL:	HB14-1134
TIME:	03:17:17 PM
MOVED:	Joshi
MOTION:	Refer House Bill 14-1134 to the Committee on Finance. The motion failed on a vote of 5-6.
SECONDED:	McNulty
		VOTE
	Fields	No
	Ginal	No
	Humphrey	Yes
	Joshi	Yes
	Landgraf	Yes
	McNulty	Yes
	Primavera	No
	Singer	No
	Swalm	Yes
	Schafer	No
	McCann	No
YES: 5 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	HB14-1134
TIME:	03:18:03 PM
MOVED:	Fields
MOTION:	Postpone House Bill 14-1134 indefinitely. The motion passed on a vote of 6-5.
SECONDED:	Schafer
		VOTE
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Landgraf	No
	McNulty	No
	Primavera	Yes
	Singer	Yes
	Swalm	No
	Schafer	Yes
	McCann	Yes
Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:19 PM -- HB 14-1054

Representative Peniston presented House Bill 14-1054 and distributed a handout (Attachment E). The bill prohibits minors under 18 years of age from using artificial tanning devices unless a minor has a written prescription from a physician authorizing the use. Owners and operators of tanning facilities that allow minors to use artificial tanning devices without a prescription will be subject to a fine of up to $200 per offense. Fine penalties will be credited to the Department of Public Health and Environment. The State Board of Health may adopt rules, at its discretion, to implement the bill. Owners and operators must require appropriate documentation certifying a doctor's prescription. The department must also establish clear guidelines for appropriate proof-of-age documentation.

140206 AttachE.pdf

03:28 PM

Representative Peniston responded to question about whether the bill would restrict emancipated minors from using tanning beds and whether the bill would restrict the use of spray tanning.

03:31 PM -- Angela Oberlin, representing herself, testified in support of the bill. She discussed her experience with tanning and melanoma. Ms. Oberlin responded to questions about her tanning experience.

03:36 PM -- Ron Bullard, representing himself, testified in support of the bill. He discussed losing his wife to melanoma. Mr. Bullard responded to questions about whether the safety of tanning beds has improved.

03:40 PM -- Dr. Jan Kief, representing the Colorado Medical Society, testified in support of the bill. She provided two handouts (Attachments F and G). She discussed melanoma, artificial tanning statistics, and a number of studies related to artificial tanning. Dr. Kief responded to questions about whether there is already public awareness about the dangers of artificial tanning, the development of skin cells at different ages, and spray tanning.

140206 AttachF.pdf

140206 AttachG.pdf

03:52 PM -- Hoss Dagher, representing the Skin Cancer Task Force, testified in support of the bill. He discussed his experience operating a tanning booth. Mr. Dagher responded to questions about the existing regulations for operating tanning beds and scientific factors in creating spray tan.

04:04 PM -- Dr. Robert Dellavalle, representing the Skin Cancer Task Force, testified in support of the bill. He discussed other states that have banned indoor tanning for minors.

04:08 PM -- Dr. Joe Chorny, representing the Colorado Dermatological Society, testified in support of the bill. He discussed melanoma statistics.

04:10 PM -- Dr. Matthew Mahlberg, representing the Colorado Dermatological Society, testified in support of the bill. He discussed his experience treating patients with skin cancers. He stated that artificial tanning is a carcinogenic exposure.

04:14 PM

Dr. Mahlberg and Dr. Dellavalle responded to a question about the survival rate of individuals diagnosed with melanoma. In response to questions, Dr. Dellavalle discussed the possible causes for increases in skin cancer, the number of skin cancer cases that are attributable to indoor tanning, the field of dermatology, and whether anything can be done to make artificial tanning safe. Dr. Dellavalle discussed the psychological effects of tanning and responded to a question about whether spray tanning is safe. Dr. Mahlberg responded to questions about the treatments for melanoma and tanning salon practices for minors.

04:33 PM -- Dr. Emily Stevens, representing the Colorado Dermatological Society, testified in support of the bill. She discussed her experience with artificial tanning as a teenager. Dr. Stevens responded to questions about the need for education about tanning.

04:39 PM -- Sonja Lunder, representing the Environmental Working Group, testified in support of the bill. She relayed statistics related to state laws on tanning bed access.

04:42 PM -- R. J. Ours, representing the American Cancer Society, testified in support of the bill with amendments and distributed a handout to the committee (Attachment H). He discussed the prevalence of melanoma in the state and noted that the rates of melanoma have increased in the last 20 years. Mr. Ours responded to questions about whether teenagers have found other ways to tan in states that have established similar bans and the regulation of tanning devices and tanning salons.

140206 AttachH.pdf

04:53 PM -- Dwayne Jones, representing At the Beach, testified in opposition to the bill. He discussed the economic impact of tanning salons and the voluntary teenage tanning policy of At the Beach. Mr. Jones responded to questions about the regulation of tanning salon, the marketing efforts of At the Beach, and whether At the Beach operates in states that currently ban artificial tanning for minors. Mr. Jones responded to questions about the percentage of his company's clientele who are teenagers and the voluntary parental consent policy.

05:03 PM -- Mr. Dagher returned to the table to respond to questions about how many of his clients used sunscreen prior to tanning and whether sunscreen can cause cancer.

05:07 PM

Representative McNulty discussed Amendment L.002 (Attachment I). Representative Peniston commented on the amendment.

140206 AttachI.pdf


BILL:	HB14-1054
TIME:	05:11:16 PM
MOVED:	McNulty
MOTION:	Adopt amendment L.002 (Attachment I). The motion failed on a vote of 5-6.
SECONDED:	Swalm
		VOTE
	Fields	No
	Ginal	No
	Humphrey	Yes
	Joshi	Yes
	Landgraf	Yes
	McNulty	Yes
	Primavera	No
	Singer	No
	Swalm	Yes
	Schafer	No
	McCann	No

YES: 5 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: FAIL

05:12 PM

Representative Peniston discussed Amendment L.001 (Attachment J).

140206 AttachJ.pdf
BILL:	HB14-1054
TIME:	05:14:48 PM
MOVED:	Schafer
MOTION:	Adopt amendment L.001 (Attachment J). The motion passed without objection.
SECONDED:	Fields
		VOTE
	Fields
	Ginal
	Humphrey
	Joshi
	Landgraf
	McNulty
	Primavera
	Singer
	Swalm
	Schafer
	McCann

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

05:16 PM

Representative Peniston discussed Amendment L.004 (Attachment K).

140206 AttachK.pdf


BILL:	HB14-1054
TIME:	05:16:56 PM
MOVED:	Primavera
MOTION:	Adopt amendment L.004 (Attachment K). The motion passed on a vote of 6-4, with one member excused.
SECONDED:	Schafer
		VOTE
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Landgraf	Excused
	McNulty	No
	Primavera	Yes
	Singer	Yes
	Swalm	No
	Schafer	Yes
	McCann	Yes

YES: 6 NO: 4 EXC: 1 ABS: 0 FINAL ACTION: PASS

05:18 PM

Committee discussion occurred on the bill.


BILL:	HB14-1054
TIME:	05:25:09 PM
MOVED:	Schafer
MOTION:	Refer House Bill 14-1054, as amended, to the Committee on Appropriations. The motion passed on a vote of 6-5.
SECONDED:	Fields
		VOTE
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Landgraf	No
	McNulty	No
	Primavera	Yes
	Singer	Yes
	Swalm	No
	Schafer	Yes
	McCann	Yes

Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS

05:26 PM

The committee adjourned.