Joint Committee Committee on Joint Health and Human Services (01/23/2014)

Final
STAFF SUMMARY OF MEETING

COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES

Date:	01/23/2014	ATTENDANCE

Time:	01:36 PM to 05:07 PM	Conti	X
		Crowder	*
Place:	HCR 0107	Everett	E
		Fields	X
This Meeting was called to order by		Ginal	X
	Representative Primavera	Hill	X
		Humphrey	X
This Report was prepared by		Joshi	X
	Dave DeNovellis	Kefalas	X
		Landgraf	X
		Lundberg	X
		McNulty	X
		Newell	X
		Nicholson	*
		Primavera	X
		Schafer	X
		Singer	E
		Stephens	X
		Swalm	E
		Tyler	X
		Wilson	X
		Young	X
		McCann	X
		Aguilar	X

		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Presentation from the Joint Budget Committee Pursuant to Joint Rule 25 Presentation on the Status of the Waiting Lists for Services for Individuals with Developmental Disabilities Presentation of the Annual Report of the Colorado Health Benefit Exchange Presentation by the Colorado Health Institute		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

01:37 PM -- Presentation from the Joint Budget Committee Pursuant to Joint Rule 25

Representative Primavera, chair, called the meeting to order.

Representative Gerou, member of the Joint Budget Committee (JBC), presented the 2014-15 budget briefing for the Department of Health Care Policy and Financing (HCPF), the Department of Human Services (DHS), and the Department of Public Health and Environment (CDPHE). The briefing documents can be found on the JBC website at http://www.tornado.state.co.us/gov_dir/leg_dir/jbc/jbchome.htm. Representative Gerou introduced the other JBC members and staff. She discussed the 2014-15 requested appropriations for HCPF.

01:45 PM

Representative Gerou continued to discuss HCPF's requested appropriations for 2014-15. She and Eric Kurtz, JBC staff member, responded to committee questions about Medicaid provider rates for primary care and specialty care providers.

01:56 PM

Mr. Kurtz responded to committee questions about funding for technology upgrades, direct provider payments, and medical service premiums. Representative Gerou and Senator Steadman spoke about whether the JBC would choose across-the-board increases or targeted increases for provider payments.

02:05 PM

Representative May noted that the JBC would share the department responses with the committee and would appreciate any feedback. The committee continued to discuss the requested provider reimbursement rates.

02:13 PM

Senator Kefalas and Representatives Gerou and McNulty discussed the state's Earned Income Tax Credit.

02:18 PM

Representative Gerou discussed the requested appropriations for behavioral health programs, as well as the transfer of developmental disability programs from DHS to HCPF. Mr. Kurtz responded to committee questions and discussed how provider rates are set. He stated that most rates are discretionary and are set by the General Assembly.

02:29 PM

The committee discussed requests that may affect the Community Living Advisory Group.

02:34 PM

Representative Gerou discussed the requested appropriations from CDPHE and responded to committee questions regarding marijuana use prevention.

02:39 PM

Representative May gave an overview of the requested appropriations for DHS.

02:47 PM

Representative May continued to discuss the DHS requested appropriations, including the long-term services and supports waiver demonstration projects. Representative Duran and Representative McNulty discussed the Re-hire Colorado program.

03:00 PM

Carolyn Kampman, JBC staff member, came to the table to respond to questions about the operational budgets for mental health institutions. The committee discussed requests from the Division of Youth Corrections and the Office of the Child's Protection Ombudsman.

03:10 PM -- Presentation on the Status of the Waiting Lists for Services for Individual

Megan Davisson, Joint Budget Committee, came to the table to discuss the waiting list for individuals with developmental disabilities. She distributed a memorandum to the committee (Attachment A). She responded to committee questions regarding the memorandum and the waiting lists.

140123 AttachA.pdf

03:17 PM -- Marijo Rymer, representing ARC of Colorado, and Chris Collins, representing Alliance Colorado, came to the table to discuss the waiting lists. They distributed a briefing paper concerning the waiting list to the committee (Attachment B). Ms. Rymer spoke about the Medicaid waivers for individuals with developmental disabilities and responded to committee questions regarding potential and suggested legislation.

140123 AttachB.pdf

03:27 PM

Ms. Rymer stated that school budgets significantly affect the state's and counties' ability to provide developmental disability services. She discussed the intersection of federal and state rules regarding Medicaid waivers for individuals with developmental disabilities.

03:29 PM

Ms. Collins gave the committee an overview of Alliance Colorado and discussed the requested appropriations that affect developmental disabilities services. She discussed how waivers are currently transforming. Ms. Collins and Ms. Rymer responded to committee questions regarding the availability of providers, barriers to services, and respite care.

03:39 PM

The committee took a brief recess.

03:47 PM -- Presentation of the Annual Report of the Colorado Health Benefit Exchange

The committee came back to order.

Gretchen Hammer, chair of Colorado Health Benefit Exchange board, and Patty Fontneau, executive director of Connect for Health Colorado (exchange), presented the exchange's 2013 Annual Report (Attachment C). They also provided an additional exchange handout to the committee (Attachment D). Ms. Hammer gave the committee an overview of the exchange board's activity in 2013. Ms. Fontneau discussed the exchange's 2013 activities. She discussed the exchange's plan for self-sufficiency by January 2015.

140123 AttachC.pdf

140123 AttachD.pdf

03:58 PM

Ms. Fontneau discussed the exchange's enrollment numbers and the amount and types of plans available. She spoke about the operations of the exchange, including technology testing and deployment, privacy and security, insurance affordability, and customer service and support.

04:05 PM

Ms. Fontneau gave an overview of the exchange's marketing and outreach efforts throughout 2013. She spoke about the exchange's financials, including the amount of federal grants received through 2013. Ms. Fontneau noted that more than half of the enrollments from October 1 and December 31 occurred in the last two weeks of December.

04:12 PM

Ms. Fontneau said that nearly 175,000 people and small businesses have created accounts through the exchange. She spoke about the average tax credit enrollees were receiving, and whether those credits were being applied towards premiums or if people were electing to receive the total credit when filing their income tax returns. Ms. Fontneau discussed the exchange's metrics, including the ages of enrollees, business options, and financial assistance for enrollees. She spoke about the goals and planned activities for the exchange in 2014.

04:20 PM

Ms. Fontneau responded to questions regarding the number of people enrolled in the exchange who were previously enrolled in CoverColorado. Representative McNulty and Ms. Fontneau discussed the exchange's advertising budget and where it has been spent. Ms. Fontneau said that the exchange spent $6 million on advertising and marketing from May 2013 to December 2013. She said that she anticipates spending $2 million more for marketing and outreach though March 2014.

04:30 PM

Ms. Fontneau responded to committee questions regarding insurance requirements, the enrollment process, and the Medicaid determination. She responded to committee questions about how the exchange is working with insurance carriers and the certification and security processes for agents, brokers, and guides.

04:45 PM

Ms. Fontneau and Ms. Hammer responded to committee questions regarding enrollment numbers throughout the separate counties. Ms. Fontneau responded to committee questions regarding chiropractic coverage. She stated that while chiropractic coverage is not one of the mandated essential health benefits, some plans do offer chiropractic coverage.

04:48 PM -- Presentation by the Colorado Health Institute

Amy Downs and Tasia Sinn, representing the Colorado Health Institute (CHI), gave an overview of the organization. They distributed a handout to the committee (Attachment E). Ms. Downs stated that CHI is nonpartisan and does not take positions on bills. She discussed CHI's five key research areas including coverage, new models of health care delivery, the health care work force, community health, and legislation and policy. Ms. Downs said that CHI's 2014 research agenda includes health reform implementation, local health decisions in communities, and value in health care.

04:55 PM

Ms. Downs discussed the uninsured rate throughout the state and reasons for being uninsured. She discussed CHI's current research and their upcoming 2014 events.

05:03 PM

Ms. Downs responded to committee questions about CHI's survey methodology and said that they make calls until they have 10,000 completed surveys and work with a data company to properly rate the results. She responded to committee questions regarding health outcomes, and health care access and utilization.

05:07 PM

The committee adjourned.