Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Date:02/27/2014
ATTENDANCE
Time:01:34 PM to 04:17 PM
Fields
X
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
X
Amanda King
Swalm
*
Schafer
X
McCann
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
HB14-1257
HB14-1271
SB14-021		Referred to the Committee of the Whole
Amended, Referred to the Committee of the Whole
Amended, Referred to Legislative Council


01:34 PM -- HB 14-1257

Representative Nordberg presented House Bill 14-1257. The bill gives the Office of the State Auditor the authority to conduct a full performance audit of the Colorado Health Benefit Exchange. Upon completion of a performance audit, the Office of the State Auditor must submit a written report to the Legislative Audit Committee with any findings and recommendations. Performance audits of the exchange may be conducted at the discretion of the state auditor. Representative Nordberg distributed two handouts (Attachments A and B).

140227 AttachA.pdf140227 AttachA.pdf140227 AttachB.pdf140227 AttachB.pdf

01:37 PM

Representative McNulty made comments about the Legislative Audit Committee and the bill. Representative Nordberg responded to questions about the parameters of the audit and extending the state auditor's authority to audit a non-state entity. He responded to questions about the audits of the exchange that have been conducted by the federal government and the type of audit that would be performed under the bill. Representative McNulty discussed the functions of the Legislative Audit Committee. Representative Nordberg responded to questions about the timing of the audit and the frequency of which future audits would occur. The committee discussed the funds that the exchange has spent and whether the Legislative Audit Committee would need to authorize future audits of the exchange.


01:50 PM -- Dianne Ray, representing the Office of the State Auditor, testified on the bill. She stated that the Office of the State Auditor is conducting a limited audit on the exchange that is scheduled to be released in December 2014. She responded to questions about performance audits, financial audits, and the current audit of the exchange. She responded to questions about what information would be reviewed if the bill was enacted, the state auditor's authority to audit an instrumentality of the state, and the standards that would be used for the audit. Ms. Ray responded to questions about the impact of the audit on the exchange staff, the audit process, and whether the privacy of records would be reviewed. She responded to questions about the workload impact of the audit on the Office of the State Auditor's staff, the current audit's time frame, and whether the background check process is typically audited.

02:05 PM -- Patty Fontneau, representing Connect for Health Colorado, testified on the bill. She clarified information about the amount of federal money received by the exchange, who is performing the background checks for the exchange, and the changes to the accounting technology. Ms. Fontneau discussed the previous audits and reviews of the exchange. She provided a handout (Attachment C). Ms. Fontneau discussed the oversight of the exchange by the Legislative Health Benefit Exchange Implementation Review Committee and the exchange's board of directors. She discussed the exchange's self-sustainability plan and the enrollment fee. She stated that the exchange receives benchmarking data from the federal government. Ms. Fontneau responded to questions about the results of the previous audits, who pays for the audits, and whether the previous audits are publicly available. She stated that the exchange is subject to the Colorado Open Records Act. She stated that an independent contractor performs the background checks for the exchange. She responded to questions about the amount of federal funds received by the exchange.

140227 AttachC.pdf140227 AttachC.pdf

02:25 PM

Ms. Fontneau responded to questions about whether a state audit would be beneficial to the exchange and whether amending the bill to require a meeting between the exchange staff and the state auditor prior to the audit would be helpful. She responded to questions about the best practices for an exchange. Ms. Fontneau stated that Colorado's enrollment fees are among the lowest in the country. She responded to questions about the current audit requirements for the exchange, whether other states are doing legislative audits, how many other states operate state exchanges, and whether a state audit could help strengthen the exchange. Representative Nordberg responded to questions about how many other states are conducting performance audits on their exchanges. Ms. Fontneau commented on the other states that are conducting state audits of their exchanges and responded to a question about the impact the state audit would have on the exchange's staff.

02:45 PM -- Mark Grueskin, representing Connect for Health Colorado, testified on the bill. He provided a handout (Attachment D). He discussed that the exchange is an instrumentality of the state, the statutory authority of the state auditor to conduct audits, and whether the audit can be paid for from the General Fund. Mr. Grueskin responded to questions about whether the exchange is subject to the Colorado Open Records Act and how the audit would be paid for.

140227 AttachD.pdf140227 AttachD.pdf

02:49 PM

Ms. Ray returned to the table to respond to questions about how audits are paid for and the ability of the Office of the State Auditor to bill audited entities.

02:51 PM

The committee took a brief recess.

03:03 PM

Representative McCann called the committee back to order. Representative Nordberg made concluding remarks regarding the bill. Committee members commented on the bill.
BILL:HB14-1257
TIME: 03:06:23 PM
MOVED:McNulty
MOTION:Refer House Bill 14-1257 to the Committee of the Whole. The motion passed on a vote of 9-2.
SECONDED:Joshi
VOTE
Fields
No
Ginal
Yes
Humphrey
Yes
Joshi
Yes
Landgraf
Yes
McNulty
Yes
Primavera
Yes
Singer
Yes
Swalm
Yes
Schafer
No
McCann
Yes
Final YES: 9 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:08 PM -- HB 14-1271

Representative Melton presented House Bill 14-1271. Current law provides civil immunity for mental health providers who have a duty to warn a specific person or persons when a patient has communicated to a provider a serious threat of imminent physical violence against a person or persons. The bill repeals and reenacts this statute to extend that immunity to organizations that provide mental health services and to extend the duty to warn to include a warning to specific entities that, if damaged or attacked, would pose harm to public health and safety. This civil immunity from liability applies only to situations where a patient has communicated to a mental health provider a serious threat of imminent physical violence to an entity or entities. Representative Melton distributed and discussed amendment L.001 (Attachment E).

140227 AttachE.pdf140227 AttachE.pdf


03:11 PM

Representative Melton responded to questions about the duty of mental health providers to report certain information, whether additional professionals should be included in the list of mental health providers who have a duty to warn, and what is considered an institution under the bill. He responded to questions about whether a targeted building would be covered by the bill and who a mental health professional would contact when a building is the target of a threat.

03:17 PM -- Jerry Rhodes, representing the Cunningham Fire Protection District, testified in support of the bill. He discussed the reporting requirements for emergency medical services personnel and Colorado events that targeted a location.

03:22 PM -- Dr. Reo Leslie, Jr., representing the Colorado Mental Health Professionals Association, testified in support of the bill. He discussed public safety, the limitation of liability for mental health professionals, and interventions for people in need of mental health services. Dr. Leslie responded to questions about the reporting requirements for mental health professionals and whether reporting requirements may deter patients from sharing information with a provider. He responded to questions about the liability for a mental health professional if they do not report a threat, the time frame for reporting a threat, and the confusion that exists about the current reporting requirements. Dr. Leslie provided a handout to the committee (Attachment F).

140227 AttachF.pdf140227 AttachF.pdf

03:36 PM -- Moe Keller, representing Mental Health America of Colorado, testified in a neutral capacity. She discussed person-first language.
BILL:HB14-1271
TIME: 03:40:48 PM
MOVED:Schafer
MOTION:Adopt amendment L.001 (Attachment E). The motion passed without objection.
SECONDED:Singer
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



03:41 PM

Representative Melton made concluding comments about the bill. The committee discussed the bill.
BILL:HB14-1271
TIME: 03:44:29 PM
MOVED:Schafer
MOTION:Refer House Bill 14-1271, as amended, to the Committee of the Whole. The motion passed on a vote of 10-0, with one member excused.
SECONDED:Fields
VOTE
Fields
Yes
Ginal
Yes
Humphrey
Yes
Joshi
Yes
Landgraf
Excused
McNulty
Yes
Primavera
Yes
Singer
Yes
Swalm
Yes
Schafer
Yes
McCann
Yes
Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:45 PM

The committee took a brief recess.

03:56 PM -- SB 14-021

Representative McCann called the committee back to order. Representative Wright presented Senate Bill 14-021. The bill extends the repeal date of the Continuing Examination of the Treatment of Persons with Mental Illness Who Are Involved in the Criminal and Juvenile Justice Systems (MICJS) Legislative Oversight Committee and the MICJS Task Force. The bill renames the MICJS Legislative Oversight Committee, MICJS Task Force, and MICJS Cash Fund. The bill expands the MICJS Task Force membership to 32 members. The bill allows members of the MICJS Legislative Oversight Committee to receive compensation and reimbursement for expenses directly related to fulfilling their duties. The bill specifies areas of study for the MICJS Task Force to include:


04:00 PM

Representative Wright discussed an amendment that was adopted in the Senate that removed language allowing reimbursement for MICJS Task Force members. He discussed reinstating the reimbursement for the public members of the MICJS Task Force. The committee discussed reimbursing the MICJS Task Force members and that the bill allows MICJS Legislative Oversight Committee members to be reimbursed.

04:01 PM -- Susan Walton, representing the MICJS Task Force, testified in support of the bill. She discussed the MICJS Task Force. In response to questions, Ms. Walton discussed housing issues for people with mental illness who have been involved in the criminal justice system. She discussed barriers to accessing medication and other benefits for people leaving the criminal justice system. She responded to questions about whether the task force is studying issues concerning children who are involved in the foster care system and whether MICJS Task Force members currently receive reimbursements. Ms. Walton stated the MICJS Task Force does not have staff support.

04:11 PM

Representative Wright discussed the MICJS Task Force members who would be added by the bill. He discussed amendment L.007 (Attachment G). Representative Wright responded to questions about the MICJS Task Force members who would be reimbursed if the amendment is adopted.

140227 AttachG.pdf140227 AttachG.pdf
BILL:SB14-021
TIME: 04:15:16 PM
MOVED:Schafer
MOTION:Adopt amendment L.007 (Attachment G). The motion passed without objection.
SECONDED:Fields
VOTE
Fields
Ginal
Humphrey
Joshi
Landgraf
Excused
McNulty
Primavera
Singer
Swalm
Schafer
McCann
YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection



04:16 PM

The committee discussed where to refer the bill.
BILL:SB14-021
TIME: 04:16:55 PM
MOVED:McNulty
MOTION:Refer Senate Bill 14-021, as amended, to the Committee on Legislative Council. The motion passed on a vote of 10-0, with one member excused.
SECONDED:Swalm
VOTE
Fields
Yes
Ginal
Yes
Humphrey
Yes
Joshi
Yes
Landgraf
Excused
McNulty
Yes
Primavera
Yes
Singer
Yes
Swalm
Yes
Schafer
Yes
McCann
Yes
Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

04:17 PM

The committee adjourned.