House Committee on Health, Insurance, & Environment (05/01/2014)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Date:	05/01/2014	ATTENDANCE

Time:	01:40 PM to 04:16 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	*
	Amanda King	Swalm	X
		Schafer	X
		McCann	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB14-155 SB14-003 SB14-159		Amended, Referred to Appropriations Referred to Appropriations Referred to Appropriations

01:41 PM -- SB 14-155

Representative Duran and Representative May presented Senate Bill 14-155. The bill creates a grant program to fund scientific research on the use of marijuana, its component parts, and industrial hemp, as a part of medical treatment and establishes the Health Research Subaccount of the Medical Marijuana Program Cash Fund. The Department of Public Health and Environment (DPHE) has continuous spending authority over the subaccount and may transfer up to $10 million from the Medical Marijuana Program Cash Fund to the subaccount between July 1, 2014, and June 30, 2019, depending on the cost of approved health research projects.

The DPHE will receive a transfer of $200,000 per fiscal year from the $10 million for the administration of the grant program. The grant program may solicit, apply for, and accept moneys from foundations, private individuals, and all other funding sources to expand the scope or timeframe of authorized medical marijuana studies. While the grant program is in effect, the alternative target reserve for the Medical Marijuana Program Cash Fund will be 16.5 percent of the amount in the fund excluding the $10 million for this bill.

The State Board of Health (board) will establish rules for the administration of the program based on criteria specified in the bill. The executive director of the DPHE will appoint a scientific advisory council of at least six, but no more than twelve, members to provide policy guidance and scientific oversight and review. The chief medical officer of the DPHE will serve as chair of the council and members will be reimbursed for their travel expenses. The council will make recommendations for grant recipients, amounts, and duration to the DPHE and the board. The board has the authority to approve or disapprove grant recommendations. A grant award can not exceed three years without renewal.

By January 1, 2016, and annually thereafter, the grant program will report to the board on the progress of the medical marijuana studies and address what diseases or conditions are being studied, the number of patients enrolled, and any scientifically valid preliminary findings.

The attorney general is required to seek authority from the federal government to permit Colorado institutions of higher education to contract with the National Institute of Drug Abuse to cultivate marijuana for use in research studies funded by the grant program.

01:42 PM

Representative May distributed a letter of support from National Jewish Health (Attachment A). Representative Duran responded to questions about whether the grant program would be eligible for federal grant funds. Representative May responded to questions about whether the federal government will allow the state to conduct marijuana research. Representative May discussed how the Colorado Constitution limits the use of the money in the Medical Marijuana Program Cash Fund. Representative Duran responded to questions about which studies will be funded.

140501 AttachA.pdf

01:48 PM -- Chris Chiari, representing himself, testified in support of the bill. He discussed having melanoma and the need for medical marijuana research.

01:50 PM -- Teri Robnett, representing the Cannabis Patients Alliance, testified in support of the bill. She stated that the funded studies should look at the benefits of medical marijuana and that priority for funding should be given to Colorado and United States institutions. She stated that she appreciates that there is a patient representative on the advisory council. Ms. Robnett responded to questions about the therapeutic benefits of medical marijuana and which diseases are frequently treated with medical marijuana.

01:57 PM -- Heidi Baskfield, representing Children's Hospital Colorado, testified in support of the bill. She discussed the need for further research of cannabinoids.

01:58 PM -- Dr. Mike Van Dyke, representing DPHE, testified in support of the bill. He stated that the bill is a responsible use of the money in the Medical Marijuana Program Cash Fund to benefit medical marijuana patients. He stated the research will help the board make decisions about whether to add certain medical conditions to the medical marijuana treatment list.

02:00 PM -- Robert Chase, representing the Colorado Coalition for Patients and Caregivers, testified against the bill. He discussed Colorado's constitutional provisions concerning medical marijuana. Mr. Chase stated that cannabinoids should be studied. He expressed his concerns about the DPHE administration of the Medical Marijuana Program. Mr. Chase responded to questions about whether he has concerns about the studies that will be conducted under the bill. He stated he is afraid the money will be misspent and continued to discuss the DPHE. Representative Landgraf commented on the bill. Representative May discussed the role of the board in the grant process.

02:18 PM -- Greg Duran, representing himself, testified in support of the bill. He discussed his experience with vertigo.

02:21 PM

Representative Duran and Representative May responded to questions about the bill. The committee discussed the bill. Representative May made concluding remarks about the bill.


BILL:	SB14-155
TIME:	02:27:44 PM
MOVED:	Schafer
MOTION:	Refer Senate Bill 14-155 to the Committee on Appropriations. The motion passed on a vote of 10-0, with one member excused.
SECONDED:	Ginal
		VOTE
	Fields	Yes
	Ginal	Yes
	Humphrey	Yes
	Joshi	Yes
	Landgraf	Yes
	McNulty	Excused
	Primavera	Yes
	Singer	Yes
	Swalm	Yes
	Schafer	Yes
	McCann	Yes

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

02:30 PM -- SB 14-003

Representative Pettersen presented Senate Bill 14-003. The bill creates a grant program in the Department of Human Services (DHS) to provide funding to counties participating in the existing Cliff Effect Pilot Program under the Colorado Child Care Assistance Program (CCCAP). Counties may use grant funding to pay for costs of serving families and administrative expenses under the pilot program. Receipt of grant funding under the pilot program does not affect a county's CCCAP block grant. The bill creates the Colorado Child Care Assistance Cliff Effect Pilot Program Fund, consisting of moneys annually appropriated by the General Assembly, for the grant program. The DHS must develop an application process for awarding grants and report on pilot program outcomes to the General Assembly by October 1, 2019.

02:35 PM

Representative Pettersen provided a handout to the committee (Attachment B). She responded to questions about the bill, whether there would be matching federal funds for the pilot program, and the child care assistance pilot program that was enacted in 2012. Representative Pettersen responded to questions about how many counties will be eligible for the pilot program and how the counties will be chosen to participate in the pilot program.

140501 AttachB.pdf

02:44 PM -- Rich Jones, representing the Bell Policy Center, testified in support of the bill. He distributed a copy of his testimony and a handout (Attachments C and D). Mr. Jones responded to questions about the pilot program and whether other states have similar programs. He discussed how the counties will be selected to participate in the pilot program.

140501 AttachC.pdf

140501 AttachD.pdf

02:59 PM

Representative Pettersen responded to a question about the optional 36-month age limitation for participation in the pilot program. Mr. Jones responded to questions about the bill's fiscal note, whether adjustments could be made to the parent co-payments so there is more of a slope to the decreasing CCCAP benefits, and the existing data and research concerning families experiencing the cliff effect. The committee continued to dialogue with Mr. Jones about the bill and the cliff effect.

03:20 PM -- Chaer Robert, representing the Colorado Center on Law and Policy, testified in support of the bill. She provided a county-specific self-sufficiency standard handout to each committee member (Attachment E). She discussed the handout, the parent co-payments for CCCAP, and the cliff effect. Ms. Robert responded to questions about the data she provided to the committee and the cost of child care.

140501 AttachE.pdf

03:28 PM -- Bill Jaeger, representing the Colorado Children's Campaign, testified in support of the bill. He discussed the two-generation strategy of the CCCAP and the lack of continuity in child care that the cliff effect can create.

03:31 PM -- Bridget Kaminetsky, representing 9 to 5 Colorado, testified in support of the bill. She stated that child care is one of the biggest expenses for families. She discussed how affordable and reliable child care can be a barrier to obtaining and maintaining employment.

03:33 PM -- Gini Pingenot, representing Colorado Counties, Inc., testified in support of the bill. She responded to questions about whether counties can currently change their payment systems to minimize the cliff effect and why none of the counties have participated in the existing pilot program. She stated that four counties are considering applying for the grant program if Senate Bill 14-003 is enacted.

03:39 PM

Representative Pettersen responded to questions about whether the strategies used in the pilot program will be evaluated.


BILL:	SB14-003
TIME:	03:42:54 PM
MOVED:	McNulty
MOTION:	Amend reengrossed bill, page 4, line 22, strike "SHOULD" and substitute "SHALL". The motion passed without objection.
SECONDED:	Schafer
		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

03:39 PM

Representative Pettersen explained amendment L.007 (Attachment F).

140501 AttachF.pdf


BILL:	SB14-003
TIME:	03:44:09 PM
MOVED:	McCann
MOTION:	Adopt amendment L.007 (Attachment F). The motion passed without objection.
SECONDED:	Schafer
		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

03:45 PM

The committee discussed the bill.


BILL:	SB14-003
TIME:	03:53:19 PM
MOVED:	Schafer
MOTION:	Refer Senate Bill 14-003, as amended, to the Committee on Appropriations. The motion passed on a vote of 8-3.
SECONDED:	Fields
		VOTE
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Landgraf	Yes
	McNulty	Yes
	Primavera	Yes
	Singer	Yes
	Swalm	No
	Schafer	Yes
	McCann	Yes

Final YES: 8 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:54 PM -- SB 14-159

Representative Primavera presented Senate Bill 14-159. The Medical Clean Claims Task Force (task force) was created under House Bill 10-1332 to develop a standardized set of payment rules and claim edits to be used by payers and health care providers in Colorado when claims are undisputed (clean claims). This bill modifies the deadlines for developing and implementing the standard payment rules and claim edits and adds a year-long public review period to test the long-term governance process for the rules and edits. The new deadlines are as follows:

December 31, 2014 - task force reports to the executive director of the HCPF and the House and Senate health committees on a set of recommended rules and edits;
January 1, 2015 - December 31, 2015 - task force makes rules and edits available for public review and comment;
January 31, 2016 - task force submits final rules and edits to the executive director of the Department of Health Care Policy and Financing (HCPF) and the House and Senate health committees;
January 1, 2016 - December 31, 2016 - task force assists users with questions on rules and edits; and
January 1, 2017 - all payers except insurance plans subject to the "Employee Retirement Income Security Act of 1974" implement and use rules and edits.

The executive director of the HCPF is directed to work with the federal Department of Health and Human Services to encourage and facilitate the use of the rules and edits nationally. The task force is repealed on December 31, 2016.

Representative Primavera provided two handouts to the committee (Attachments G and H).

140501 AttachG.pdf

140501 AttachH.pdf

04:01 PM -- Barry Keene, representing the Clean Claims Task Force, testified in support of the bill and provided a handout (Attachment I). He discussed the task force's need for legal services. Mr. Keene responded to questions about why the task force needs to be extended, the position of the health insurance plans on the bill, and why the task force does not use the Attorney's General Office for its legal needs.

140501 AttachI.pdf

04:12 PM -- Clare Pramuk, Legislative Council Staff, stated that Mr. Keene had accurately explained the bill's fiscal note concerning legal fees.

04:13 PM

Representative Primavera made concluding remarks about the bill.


BILL:	SB14-159
TIME:	04:13:59 PM
MOVED:	Primavera
MOTION:	Refer Senate Bill 14-159 to the Committee on Appropriations. The motion passed on a vote of 11-0.
SECONDED:	Swalm
		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

04:15 PM

Representative McCann made announcements about the committee's schedule and adjourned the committee.