House Committee on Public Health Care & Human Services (03/25/2014)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Date:	03/25/2014	ATTENDANCE

Time:	01:36 PM to 03:46 PM	Conti	X
		Everett	X
Place:	HCR 0107	Ginal	*
		Joshi	X
This Meeting was called to order by		Landgraf	X
	Representative Primavera	McCann	X
		Schafer	X
This Report was prepared by		Singer	X
	Elizabeth Burger	Stephens	*
		Tyler	*
		Wilson	X
		Young	X
		Primavera	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Presentation by the DHS on State Regional Centers HB14-1306 HB14-1309 SB14-051		Witness Testimony and/or Committee Discussion Only Referred to Appropriations Amended, Referred to Appropriations Referred to Finance

01:37 PM -- Presentation by the Department of Human Services on State Regional Centers

Representative Primavera called the meeting to order. Reggie Bicha, Executive Director of the Department of Human Services, began the presentation on the future of Colorado's regional centers for individuals with developmental disabilities. A copy of his presentation was distributed to the committee (Attachment A). He reviewed the statutes regarding the regional centers and described the clients served by the regional centers, noting that the mission of the regional centers has changed over time. He discussed the gender breakdown, age range, and length of stay of the clients in the state's regional centers.

14HsePHS0325AttachA.pdf

01:44 PM

Director Bicha reviewed the differences between Waiver Group Homes and Intermediate Care Facilities. He discussed the capacity at each of Colorado's regional centers and responded to questions from the committee regarding the return of former clients to the centers. He responded to questions from the committee regarding the purpose and role of the regional centers and the department's goal of transitioning regional center clients to community living settings. He discussed the percentage of individuals who transition out of the regional centers and are able to obtain jobs.

02:04 PM

Director Bicha discussed the Olmstead decision, which requires states to serve individuals in the least restrictive settings that will meet their needs. He discussed House Bill 14-1338, which concerns the state regional centers. He described statutes related to the imposition of legal disability and the necessity of a court order for admittance to a regional centers, except in emergencies or for the purposes of temporary respite care. Director Bicha discussed the obligation of the department to provide care in community centers and how individuals are discharged from regional centers. He further outlined the process of realigning regional center services and the current capacity of the centers.

02:11 PM

Director Bicha discussed an audit of the regional centers that was released in December 2013 and the findings of the audit. He noted that 159 individuals were deemed ready for transition into the community from the regional centers. Of that number, 66 individuals have successfully transitioned to private providers and 93 individuals remain in the regional centers. Mr. Bicha discussed efforts to communicate with stakeholders regarding the issues surrounding the regional centers and described individuals who have successfully transitioned out of the regional centers.

02:17 PM

Viki Manley, Department of Human Services, responded to questions from the committee regarding the 2013 audit of the regional centers and the transition of certain clients from the regional centers into the community. Director Bicha responded to questions from the committee regarding the guardians appointed for clients at the regional centers. Ms. Manley responded to questions from the committee regarding the number of FTE employed by the regional centers.

02:26 PM -- HB14-1306

Representative Gerou introduced House Bill 14-1306. The bill requires the Department of Health Care Policy and Financing to make supplemental payments to hospice care providers in FY 2013-14 and FY 2014-15. The department is required to promulgate rules on the amount and distribution of the supplemental payments. She discussed the department's efforts to obtain federal matching funds for a hospice rate increase in Medicaid. She explained that the money for the supplemental payments to hospices has already been included in FY 2014-15 long bill, and discussed the importance of increased funding for hospices. She responded to questions from the committee regarding funding for the payments in the FY 2014-15 long bill and the provisions of HB 14-1306 requiring the adoption of rules to distribute the payments.

02:36 PM -- MaryKathryn Hurd, Department of Health Care Policy and Financing, responded to questions from the committee regarding the department's rule making process. Representative Gerou responded to questions from the committee regarding supplemental appropriations for FY 2013-14 and the cost savings associated with end-of-life care.

02:41 PM -- Edie Busam, Colorado Center for Hospice and Palliative Care, testified that there are a number of issues affecting payments for hospice care, and stated that hospices across the state are experiencing significant issues with reduced payments from Medicare and Medicaid. She discussed studies that show cost saving associated with hospice services. She responded to questions from the committee regarding bereavement programs provided by hospices. Representative Gerou responded to questions from the committee regarding the total amount that will be provided to hospices under the bill.

02:52 PM

Ms. Hurd returned to the table to clarify the amount of increased provider payments that was recently approved by the federal government, and how this funding relates to House Bill 14-1306 and an increase in Medicaid provider rates that is included in the FY 2014-15 long bill.


BILL:	HB14-1306
TIME:	02:57:21 PM
MOVED:	Landgraf
MOTION:	Refer House Bill 14-1306 to the Committee on Appropriations. The motion passed on a vote of 13-0.
SECONDED:	Young
		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

03:00 PM -- HB14-1309

Representative Gardner introduced House Bill 14-1309. In 2010, the General Assembly authorized the executive director of the Department of Corrections to enter into a lease-purchase agreement for the purchase of a day surgery center to be located at the Denver Reception and Diagnostic Center. The bill authorizes the department to use the day surgery center building as an auxiliary medical facility and the executive director to execute any necessary amendments to or modifications of the lease-purchase agreement. Representative Gardner distributed amendment L.002 (Attachment B). Representative Gardner responded to questions from the committee regarding the bill's fiscal note and the appropriations that may or may not be required by the legislation.

14HsePHS0325AttachB.pdf

03:09 PM -- Wayne Peel, Department of Corrections, testified in support of the bill and offered to respond to committee questions. He stated that the bill allows the department to use the facility in the most economical way possible. He responded to questions from the committee regarding the number of individuals who are on dialysis and the intent of the department to use the facility as a dialysis center.


BILL:	HB14-1309
TIME:	03:13:27 PM
MOVED:	Young
MOTION:	Adopt amendment L.002 (Attachment B). The motion passed without objection.
SECONDED:	McCann
		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


BILL:	HB14-1309
TIME:	03:14:11 PM
MOVED:	Young
MOTION:	Refer House Bill 14-1309, as amended, to the Committee on Appropriations. The motion passed on a vote of 13-0.
SECONDED:	Wilson
		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

03:15 PM -- SB14-051

Representative Saine introduced Senate Bill 14-051. The bill eliminates different standards of access to adoption records for adoptees, birth parents, and adoptive parents, as well as their descendants, based on the law in existence on the date the adoption was finalized. Generally, the bill retains current policy that adoption records are confidential from the general public, unless the requesting party is eligible under statute to access the records or the court finds good cause for their release. Current policy is also retained that allows eligible relatives of a deceased birth parent or a deceased adult adoptee to access adoption records concerning that person.

03:18 PM -- Kathy Aderhold, representing herself, testified in support of the bill and regarding her experience relinquishing a child for adoption. She noted that most birth parents were not provided with copies of the surrender documents, and the documents that the birth mother signed generally required that the birth mother not contact the child. Ms. Aderhold stated that birth mothers are advocating for open access to adoption records by adult adoptees and explained that eight states are considering similar legislation. She noted that adult adoptees from certain time periods have access to the records and the bill's intent is to create equal access to records for all adult adoptees.

03:25 PM -- Shayne Madsen, representing herself, testified in support of the bill and distributed a handout to the committee (Attachment C). She shared her personal experience as an adult adoptee and noted that records were related to her adoption were closed. Ms. Madsen stated that the bill is intended to allow all adult adoptees the same access to records. She responded to questions from the committee regarding why adult adoptees who were born from 1951 to 1967 are allowed access to records while those born in other years are not.

03:31 PM -- Samantha Jadin, representing herself, testified in support of the bill and discussed her personal experience as an adoptee. She spoke regarding the importance of openness and transparency regarding adoptions, and discussed the efforts to allow open access to adoption records.

03:34 PM -- Rich Uhrlaub, Adoptees in Search, testified in support of the bill and noted the various group that support the legislation. He responded to questions from the committee regarding the changes that were made to the bill in the Senate and the liability of counties that are in possession of adoption records.

03:42 PM

Representative Saine gave concluding remarks regarding the bill. Members of the committee commented on the bill.


BILL:	SB14-051
TIME:	03:44:33 PM
MOVED:	Young
MOTION:	Refer Senate Bill 14-051 to the Committee on Finance. The motion passed on a vote of 12-0, with one member excused.
SECONDED:	Ginal
		VOTE
	Conti	Yes
	Everett	Yes
	Ginal	Yes
	Joshi	Yes
	Landgraf	Yes
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	Yes
	Tyler	Yes
	Wilson	Excused
	Young	Yes
	Primavera	Yes

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

03:46 PM

The committee adjourned.