Senate Committee on Health & Human Services (04/30/2015)

Final
STAFF SUMMARY OF MEETING

SENATE COMMITTEE ON HEALTH & HUMAN SERVICES

Date:	04/30/2015	ATTENDANCE

Time:	01:32 PM to 06:22 PM	Aguilar	*
		Martinez Humenik	*
Place:	SCR 353	Newell	X
		Crowder	X
This Meeting was called to order by		Lundberg	X
	Senator Lundberg

This Report was prepared by
	Elizabeth Haskell
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Conf 15- State Board Of Health HB15-1358 HB15-1360 SB15-285		Refer to the Full Senate Referred to the Committee of the Whole Referred to the Committee of the Whole Postponed Indefinitely

01:32 PM -- State Board Of Health

Janelle Orsborn, Nadeen Ibrahim, and Ricky Brown, appointees to the State Board of Health, came to the table. The appointment letter may be found in Attachment A. Their applications and resumes are available at the State Archives.

150430 AttachA.pdf

Ms. Orsborn introduced herself and described her background and interest in public health. She discussed her reasons for wanting to serve on the board. Ms. Ibrahim introduced herself and described her background and interest in public health. She discussed her reasons for wanting to serve on the board. Mr. Brown, who is being reappointed, discussed his previous experience on the board and told the committee why he would like to continue as a member. Committee questions and discussion followed about the benefit of having members who represent different generations serving on the board.


BILL:	Conf 15- State Board of Health
TIME:	01:47:21 PM
MOVED:	Crowder
MOTION:	Refer the appointment of Janelle Orsborn, Nadeen Ibrahim, and Ricky Brown to the State Board of Health to the full Senate with a favorable recommendation and a recommendation that it be placed on the consent calendar. The motion passed on a vote of 5-0.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	Yes


Final YES: 5 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:48 PM -- HB 15-1358

Senator Kefalas and Senator Lundberg presented House Bill 15-1358, concerning permanent differential response program for child abuse or neglect cases of low or moderate risk. The Differential Response Pilot Program, administered in selected counties and overseen by the Department of Human Services, identifies low- and moderate-risk cases of abuse or neglect and diverts families to voluntary services rather than referring them to potentially adversarial court intervention. The bill continues the Differential Response Pilot Program as a permanent program and removes the pilot program reporting requirements and repeal date.

01:53 PM -- Pat Ratliff, Colorado Counties Inc., spoke in support of the bill. She spoke about the pilot program being implemented by counties. She told the committee that counties are not required to create a differential response program.

01:57 PM -- Angela Lytle, Arapahoe County Department of Human Services, spoke in support of the bill. She told the committee about how the program has changed how counties respond to child protection concerns. She explained that families who receive services and supports while remaining intact appear to have better outcomes. Ms. Lytle told the committee that the program appears to reduce the rate at which families return to the child welfare and judicial systems and has allowed caseworkers to provide support to families rather than just investigating reports of abuse.

02:02 PM

Committee discussion followed about the following topics: the Larimer County pilot program's outcomes, the Program Evaluation of the Colorado Consortium on Differential Response Final Report prepared by the Social Work Center at Colorado State University, evaluating programs administered in other counties, and caseworker retention.

02:10 PM -- Laura Soloman, Colorado Department of Human Services (DHS), spoke in support of the bill. She told the committee that DHS supports the differential response program. Ms. Soloman responded to questions about how the department will track the data collected from the counties, such as reentry into the system. Committee discussion followed about the role of caseworkers.

02:15 PM

Senator Kefalas and Senator Lundberg made closing comments.


BILL:	HB15-1358
TIME:	02:17:58 PM
MOVED:	Martinez Humenik
MOTION:	Refer House Bill 15-1358 to the Committee of the Whole. The motion passed on a vote of 5-0.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	Yes


Final YES: 5 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:19 PM -- HB 15-1360

Senator Lundberg presented House Bill 15-1360, concerning acupuncturist practice of injection therapy. The bill allows licensed acupuncturists to practice injection therapy, which is the injection of sterile herbs, vitamins, minerals, homeopathic substances, or other similar substances into acupuncture points using a hypodermic needle. To practice injection therapy, an acupuncturist must complete the required training as specified by the director of the Division of Professions and Occupations in the Department of Regulatory Agencies. In addition, the bill permits acupuncturists to obtain substances for injection therapy from a registered prescription drug outlet, registered manufacturer, or registered wholesaler.

02:20 PM -- Scott Richardson, Acupuncture Association of Colorado, spoke in support of the bill. He told the committee about the injection therapy used by acupuncturists. Mr. Richardson responded to questions about the types of substances injected by acupuncturists.

02:25 PM -- Larry Sarner, Colorado Citizens for Science in Medicine, spoke against the bill. He spoke about the regulation of acupuncturists and his opinion that the question of allowing acupuncturist to practice injection therapy should be discussed during the sunset process. He spoke about other states that allow or prohibit this procedure. Mr. Sarner provided a handout to the committee (Attachment B) regarding the current state policy on the use of injection therapy by acupuncturists.

150430 AttachB.pdf

02:31 PM -- Linda Rosa, Institute for Science and Medicine, testified in opposition to the bill. She stated that the types of Chinese herbs used in injection therapy include a variety of substances including minerals and human body parts. She provided three handouts to the committee (Attachments C, D, and E) supporting her position on the issue.

150430 AttachC.pdf

150430 AttachD.pdf

150430 AttachE.pdf

02:37 PM -- Valerie Hobbs, Acupuncture Association of Colorado, spoke in support of the bill. She spoke about her experience teaching acupuncture and provided several letters to the committee from patients who have benefited from acupuncture (Attachment F). Ms. Hobbs responded to questions from the committee about whether she provides informed consent to patients and whether she tells the patients about the possible effects of the procedure she performs.

150430 AttachF.pdf

02:47 PM

Senator Lundberg made closing comments. Committee discussion followed concerning injection therapy.


BILL:	HB15-1360
TIME:	02:51:46 PM
MOVED:	Lundberg
MOTION:	Refer House Bill 15-1360 to the Committee of the Whole. The motion passed on a vote of 4-1.
SECONDED:
		VOTE
	Aguilar	No
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	Yes
	Lundberg	Yes


Final YES: 4 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:08 PM -- SB 15-285

Senator Neville presented Senate Bill 15-285, concerning a woman's right to accurate healthcare information. The bill creates the Women's Reproductive Information Guarantee for Health and Transparency Act, specifying terms related to abortions performed in Colorado. Under the bill, an abortion may not be performed or induced without the voluntary and informed consent of a patient who would be undergoing the procedure. In order to fulfill the informed consent requirements, a healthcare provider must share the following information with the patient at least 24 hours before an abortion is performed:

the name of the physician who will perform the abortion;
a thorough and accurate description of the proposed method for performing the abortion, including information on the probably gestational age and anatomical and physiological characteristics of the fetus;
a description of immediate and long-term physical and psychological risks involved in the abortion procedure;
a description of alternatives to abortion;
a description of medical assistance benefits that may be available for prenatal care, childbirth, and neonatal care, in addition to information on the liability of the father for child support; and
any other medical or other information that a reasonable patient would consider important for making a decision.

Additionally, the bill requires that at least 24 hours prior to an abortion the healthcare provider give the patient the opportunity to receive a current picture of the ultrasound portraying the entire body of the unborn child. In addition, the healthcare provider must provide:

an oral description of all relevant features of the ultrasound, with audible heartbeat, if present;
a written and oral description of whether or not the pregnancy is viable;
a list of all known ultrasound providers within a ten-mile radius of the abortion provider, in order to allow a patient to seek a second opinion;
a description of the probable gestational age of the unborn child;
a description of the development of the unborn child's nerve endings and the unborn child's ability to feel pain at each stage of development; and
a statement that the patient may withdraw consent to the abortion at any time.

Any person who recklessly violates any provision of the bill commits an unclassified misdemeanor and is subject to a fine of up to $100,000. A person who suffers a loss or injury as a result of any violation of the bill may bring a cause of action against the healthcare provider.

03:11 PM -- Rick Thielen, Life Choices, spoke in support of the bill. He told the committee about the services Life Choices offers, including free pregnancy testing and ultrasounds. Mr. Thielen responded to questions from the committee about the information his agency provides to pregnant woman. Committee discussion and questions continued about sharing information with pregnant women and the type of information Life Choices provides to teenagers who visit Life Choices facilities.

03:25 PM

Committee discussion continued about the services provided by Life Choices.

03:36 PM -- Kevin Paul, Planned Parenthood, spoke in opposition to the bill. He stated that the bill is unnecessary since woman have access to medical records and ultrasounds under the Health Insurance Portability and Accountability Act. He also stated that he opposed the civil penalties provided for in the bill. Mr. Paul responded to questions from the committee regarding standards of care and Planned Parenthood's policies.

03:45 PM

Committee discussion followed about government's role in compelling speech, the current system of allowing access to medical information, other states' policies regarding information that is required to be provided prior to an abortion, and Planned Parenthood's internal policies.

03:50 PM -- Valim Demos, representing herself, spoke in opposition to the bill. She spoke about her experience as a survivor of rape while serving in the military.

03:59 PM -- Natalie Decker, Colorado Family Action, spoke in support of the bill. Ms. Decker responded to questions about her organization's mission and informed consent practices for medical procedures. Committee discussion ensued.

04:18 PM -- Dr. Aaron Lazorwitz, representing himself, spoke in opposition to the bill. Dr. Lazorwitz responded to questions from the committee about the amount and subject matter of the information provide to women who visit his medical clinic.

04:26 PM -- Sheryll Bolton, Life Choices, spoke in support of the bill. She told the committee about her work with the Life Choices as a nurse trained to perform ultrasounds. Ms. Bolton responded to questions from the committee about the services provided by Life Choices.

04:34 PM -- Andrea Shpall, Anti-Defamation League, spoke in opposition to the bill. She discussed her concern about the bill's provision that would impose a mandatory delay on women who are seeking abortion.

04:37 PM -- Lisa Koets, Life Choices, spoke in support of the bill and about the support she provides to woman who have undergone an abortion.

04:41 PM -- Corrine Rivera Fowler, Colorado Organization for Latina Opportunity and Reproductive Rights, spoke in opposition to the bill. She told the committee about other groups that oppose the bill.

04:50 PM -- Donna Jack, representing herself, spoke in support of the bill. She spoke about the need for pregnant woman to receive as much information as possible about the options available to them. Ms. Jack responded to questions from the committee.

04:57 PM -- Karen Middleton, NARAL Pro-Choice Colorado, spoke in opposition to the bill and stated that her organization believes that the bill will punish women.

05:03 PM

Senator Neville responded to questions from the committee about the specific provisions of the bill.

05:05 PM -- Janet Ellis, represented herself, spoke in support of the bill.

05:07 PM -- Michael Norton, Colorado Family Action, spoke in support of the bill. Mr. Norton spoke about similar laws in other states.

05:14 PM

Committee discussion and questions followed about informed consent procedures.

05:24 PM -- Carisa Weaver, representing herself, spoke in opposition to the bill.

05:29 PM

Committee discussion ensued regarding access to information.

05:30 PM

Senator Neville made closing comments. He reviewed the provisions of the bill. Senator Neville responded to questions from the committee about the development of the bill.

05:40 PM

Committee discussion continued.

05:45 PM

Senator Aguilar presented amendment L.021 (Attachment G). She reviewed the provisions of the amendment. Committee discussion followed.

150430 AttachG.pdf


BILL:	SB15-285
TIME:	05:50:27 PM
MOVED:	Aguilar
MOTION:	Adopt amendment L.021 (Attachment G). The motion failed on a vote of 2-3.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	No
	Newell	Yes
	Crowder	No
	Lundberg	No


YES: 2 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: FAIL

05:50 PM Senator Aguilar presented amendment L.014 (Attachment L). The Chairman ruled that amendment L.014 did not fit under to bill title. Committee members commented on the bill. 150430 AttachL.pdf
BILL:	SB15-285
TIME:	05:44:30 PM
MOVED:	Crowder
MOTION:	Refer Senate Bill 15-285 to the Committee of the Whole. The motion failed on a vote of 2-3.
SECONDED:
		VOTE
	Aguilar	No
	Martinez Humenik	No
	Newell	No
	Crowder	Yes
	Lundberg	Yes


YES: 2 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: FAIL

05:51 PM

Senator Aguilar presented and discussed Amendment L.022 (Attachment H).

150430 AttachH.pdf


BILL:	SB15-285
TIME:	05:52:06 PM
MOVED:	Aguilar
MOTION:	Adopt amendment L.022 (Attachment H). The motion failed on a vote of 2-3.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	No
	Newell	Yes
	Crowder	No
	Lundberg	No


YES: 2 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: FAIL

05:52 PM

Senator Aguilar presented amendment L.016 (Attachment I) and amendment L.018 (Attachment J). Committee discussion followed. The amendments were withdrawn.

150430 AttachI.pdf

150430 AttachJ.pdf

06:00 PM

Senator Aguilar presented amendment L.013 (Attachment K). Committee discussion followed.

150430 AttachK.pdf
BILL:	SB15-285
TIME:	06:04:31 PM
MOVED:	Aguilar
MOTION:	Adopt amendment L.013 (Attachment K). The motion failed on a vote of 2-3.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	No
	Newell	Yes
	Crowder	No
	Lundberg	No


YES: 2 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	SB15-285
TIME:	06:18:28 PM
MOVED:	Aguilar
MOTION:	Postpone Senate Bill 15-285 indefinitely. The motion passed on a vote of 3-2.
SECONDED:
		VOTE
	Aguilar	Yes
	Martinez Humenik	Yes
	Newell	Yes
	Crowder	No
	Lundberg	No


Final YES: 3 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS

06:18 PM

The committee adjourned.