House Committee on Public Health Care & Human Services (01/14/2014)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Date:	01/14/2014	ATTENDANCE

Time:	01:35 PM to 04:17 PM	Conti	X
		Everett	X
Place:	HCR 0107	Ginal	X
		Joshi	X
This Meeting was called to order by		Landgraf	X
	Representative Primavera	McCann	X
		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:
Introduction of Fiscal Analysts and Bill Drafters Presentation on Hospice Services in Colorado Colorado Licensing of Controlled Substances Act Sunset Review Hearing		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Introduce Draft Bill

01:35 PM -- Introduction of Fiscal Analysts and Bill Drafters

Representative Primavera called the committee to order and reviewed a memorandum outlining the operating procedures for the committee (Attachment A).

14HsePHS0114AttachA.pdf

01:37 PM

Representative Primavera gave an overview of the committee's calendar for January.

01:39 PM

Bill Zepernick, Legislative Council Staff, provided an overview of the fiscal note preparation process. He described changes to the fiscal note form.

01:42 PM

Brita Darling, Office of Legislative Legal Services, introduced herself and described the services available to the members through the bill drafting office.

01:48 PM -- Presentation on Hospice Services in Colorado

Edie Busam, Colorado Center for Hospice and Palliative Care, introduced herself to the committee and provided a handout (Attachment B).

14HsePHS0114AttachB.pdf

01:49 PM

Beth Davis, Colorado Center for Hospice and Palliative Care, began the presentation on hospice services. She noted that hospice is a holistic, integrated service that focuses on the patient and family. Ms. Busam gave an overview of the fiscal issues facing hospice services and described a state supplemental budget request for funding. She described policy changes that the organization is working on at the federal level.

01:55 PM

Ms. Davis discussed Medicare hospice utilization in the state by county. She relayed a number of statistics related to hospice utilization. Ms. Davis responded to questions from the committee regarding utilization of hospice services in Colorado and nationally.

02:08 PM

Ms. Davis described a recent article describing the discharging practices of some hospices. The presenters responded to questions from the committee regarding regulations related to hospice discharges. Ms. Davis described statistics related to the demographic make-up of hospice patients. Ms. Busam gave an update on the Child Life Limiting Illness Waiver, and described efforts by the Center for Hospice and Palliative Care and state departments to implement the waiver. She noted that the waiver is on track to be implemented July 1, 2014.

02:15 PM

Ms. Davis described the various levels of hospice care available. She gave an overview of the challenges facing the hospice industry, including challenges with federal regulations, and the endangered viability of small and medium care providers due to recent cuts in reimbursement. She discussed opportunities for hospice organizations to collaborate with accountable care collaboratives. The panelists played a video of a family member's experience with hospice.

02:32 PM -- Colorado Licensing of Controlled Substances Act Sunset Review Hearing

Bryan Jameson, Department of Regulatory Agencies, discussed the sunset review of the Colorado Licensing of Controlled Substances Act. A copy of the review and the draft bill reflecting the report's recommendations were distributed to the committee (Attachments C and D). He explained that the act regulates the licensing of addiction treatment programs that compound, administer, or dispense controlled substances to treat substance abuse and addiction. He responded to questions from the committee regarding the staff that oversees the program and the licensing fees.

14HsePHS0114AttachC.pdf

14HsePHS0114AttachD.pdf

02:43 PM

Mr. Jamison described the report's recommendations regarding the act. The recommendations are as follows:

Recommendation 1 - continue the Colorado Licensing of Controlled Substances Act until 2025;
Recommendation 2 - grant the Department of Human Services wider disciplinary discretion in implementing the act;
Recommendation 3 - expand Prescription Drug Monitoring Program access to the staff at facilities that treat addiction with controlled substances;
Recommendation 4 - direct the Office of Behavioral Health to provide secure online access to the central registry to facilities that treat addiction with controlled substances; and
Recommendation 5 - direct the Department of Human Services to administratively establish license fees for facilities regulated by the act.

The report also contains a recommendation to implement a formal, accurate, objective record keeping and tracking system for complaints and final agency actions.

02:57 PM

Mr. Jameson continued to walk the committee through the report's recommendations and responded to questions from the committee. The committee discussed recommendation 3 and access to information through the Prescription Drug Monitoring Program. The committee discussed the potential costs associated with recommendation 4. The committee discussed recommendation number 5 and the current licensing fees, the statutory authorization for the fees, and how the fees should be adjusted.

03:28 PM

Denise Vincioni, Office of Behavioral Health, Department of Human Services, responded to questions from the committee regarding the licensing of addiction treatment programs that use controlled substances. She noted that for certain controlled substances used for drug treatment, one must obtain a narcotic treatment license from the federal Drug Enforcement Agency. She described the licensing process and the state component of the licensing process. She responded to various committee questions regarding the recommendations related to access to the central registry and the Prescription Drug Monitoring Program. She further responded to questions regarding the number of narcotic treatment programs in the state, how such programs are staffed, and continuing education requirements for the staff. She described how methadone is dispensed and the credentials of the treatment staff at such facilities. She discussed recommendation 3 regarding access to the Prescription Drug Monitoring Program by treatment program staff.

03:55 PM

Representative Primavera referred the committee to the draft bill and asked for amendments. Representative Landgraf moved an amendment to cap the annual increase in licensing fees at 10 percent. Jane Ritter, Office of Legislative Legal Services, responded to committee questions regarding the amendment and walked the committee through the provisions of the bill. Ms. Vincioni returned to the table to respond to questions from the committee regarding compounding controlled substances and access to the central registry. Representative Landgraf withdrew the motion.


BILL:	Colorado Licensing of Controlled Substances Act Sunset Review Hearing
TIME:	04:06:55 PM
MOVED:	Landgraf
MOTION:	Amend page 4 of the draft bill, lines 16 through 18, to specify that the fee may not increase more than 10 percent annually after the first year. The motion was withdrawn.
SECONDED:	Conti
		VOTE
	Conti
	Everett
	Ginal
	Joshi
	Landgraf
	McCann
	Schafer
	Singer
	Stephens
	Tyler
	Wilson
	Young
	Primavera

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Withdrawn

04:09:16 PM

The committee discussed an amendment to allow the medical director of a treatment facility to designate staff who may access the Prescription Drug Monitoring Program.


BILL:	Colorado Licensing of Controlled Substances Act Sunset Review Hearing
TIME:	04:09:16 PM
MOVED:	Landgraf
MOTION:	Amend page 3, line 23, strike "Treatment staff at facilities that treat"' and substitute "The medical director, or his or her designee, at a facility that treats". The motion passed without objection.
SECONDED:	Young
		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:	Colorado Licensing of Controlled Substances Act Sunset Review Hearing
TIME:	04:13:39 PM
MOVED:	McCann
MOTION:	Introduce the draft sunset bill on the Colorado Licensing of Controlled Substances Act, as amended. The motion passed on a vote of 11-0, with two members absent.
SECONDED:	Schafer
		VOTE
	Conti	Yes
	Everett	Yes
	Ginal	Yes
	Joshi	Absent
	Landgraf	Yes
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	Absent
	Tyler	Yes
	Wilson	Yes
	Young	Yes
	Primavera	Yes

FINAL YES: 11 NO: 0 EXC: 0 ABS: 2 FINAL ACTION: PASS

04:15 PM

Representative Primavera announced that Representative McCann and Representative Ginal would be the co-prime sponsors of the bill. Representatives Young, Schafer, Tyler, and Primavera were added as co-sponsors.

04:17 PM

The committee adjourned.