House Committee on Public Health Care & Human Services (02/03/2015)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Date:	02/03/2015	ATTENDANCE

Time:	01:34 PM to 06:43 PM	Conti	X
		Danielson	X
Place:	HCR 0107	Everett	X
		Ginal	X
This Meeting was called to order by		Joshi	X
	Representative Primavera	Keyser	X
		Landgraf	X
This Report was prepared by		Melton	X
	Elizabeth Burger	Moreno	X
		Tyler	X
		Windholz	X
		Singer	X
		Primavera	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
HB15-1097 HB15-1036 HB15-1078 HB15-1111 HB15-1082		Referred to Appropriations Postponed Indefinitely Amended, Referred to the Committee of the Whole Amended, Referred to Appropriations Referred to the Committee of the Whole

01:36 PM -- HB 15-1097

Representative McCann introduced House Bill 15-1097. The bill dissolves an existing temporary commission called the Fetal Alcohol Spectrum Disorders (FASD) Commission and recreates it as a Type 2 agency within the Department of Human Services beginning July 1, 2015. She responded to questions from the committee.

01:45 PM -- Eileen Bisgard, FASD Commission, testified in support of the bill and distributed a handout to the committee (Attachment A). She discussed the bill's fiscal note and responded to questions from the committee regarding the bill's fiscal note and the potential effects of not continuing the commission.

150203 AttachA.pdf

01:59 PM -- Dr. Sharon Langendoerfer, FASD Commission, discussed FASD, how such disorders are caused, and how the disorders manifest in children. She stated that learning and behavior disorders are sometimes caused by alcohol exposure in utero. She responded to questions from the committee.

02:08 PM -- Gianfranco Zizza, representing himself, testified in support of the bill.

02:10 PM -- Julene Zizza, National Organization on Fetal Alcohol Syndrome - Colorado, testified regarding her family's experience with FASD and regarding the importance of the commission in providing services to families affected by FASD. She responded to questions from the committee.

02:25 PM -- Matt Cloven, ARC of Larimer County and ARC of Colorado, testified in support of the bill. He described various families' experience obtaining supports for children with FASD and discussed the importance of continuing the FASD Commission. He responded to questions from the committee. Representative McCann responded to questions from the committee regarding county services provided to children in the dependency and neglect system.

02:37 PM -- April Montgomery, March of Dimes, testified in support of the bill and urged continuation of the commission.

02:40 PM -- Robert Chase, representing himself, testified regarding the health effects of alcohol and marijuana on pregnant woman.

02:44 PM

Representative McCann gave concluding remarks regarding the bill.


BILL:	HB15-1097
TIME:	02:45:13 PM
MOVED:	Singer
MOTION:	Refer House Bill 15-1097 to the Committee on Appropriations. The motion passed on a vote of 11-2.
SECONDED:	Ginal
		VOTE
	Conti	Yes
	Danielson	Yes
	Everett	No
	Ginal	Yes
	Joshi	No
	Keyser	Yes
	Landgraf	Yes
	Melton	Yes
	Moreno	Yes
	Tyler	Yes
	Windholz	Yes
	Singer	Yes
	Primavera	Yes

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

02:46 PM -- HB 15-1036

Representative Tate introduced House Bill 15-1036. The bill requires the Department of Revenue to promulgate rules requiring licensed medical marijuana centers to display signs warning pregnant women about the dangers of using marijuana while pregnant. Additionally, the bill prohibits a center employee from recommending medical marijuana to a pregnant woman. He testified that it is important for women to know that there is risk associated with the use of medical marijuana when pregnant. He responded to comments from the committee regarding how physicians treat women who are using medical marijuana and become pregnant.

02:55 PM -- Dr. Brent Keeler, Colorado Medical Society, testified in support of the bill. He responded to questions from the committee.

02:59 PM -- Dr. Steve Wright, representing himself, testified in support of the bill. He stated that the concept of the bill is good and should move forward.

03:02 PM -- Dr. Sharon Langendoerfer, March of Dimes, testified in support of the bill.

03:03 PM -- Mary Patrick, Drug Policy Alliance, testified in opposition to the bill. She discussed a recent report on marijuana issued by the Department of Public Health and Environment and the report's findings related to the use of marijuana while pregnant or breastfeeding. She discussed the policy issues related to displaying warning signs at medical marijuana facilities

03:07 PM -- Jessica LeRoux, representing medical marijuana patients, spoke in opposition to the bill and discussed the provision of the bill that prohibits a medical marijuana center employee from recommending medical marijuana to a pregnant women.

03:12 PM -- Sadie Lane, Colorado Moms for Marijuana International, spoke in opposition to the bill and discussed research related to the use of marijuana during pregnancy. She responded to questions from the committee.

03:18 PM -- Teri Robnett, Cannabis Patients Alliance, testified regarding her concerns with the bill. She spoke regarding the stigmatization that could occur if a pregnant woman chooses to use cannabis, and discussed the medical research related to marijuana use during pregnancy.

03:22 PM -- Robert Chase, Colorado Coalition for Patients and Caregivers, discussed the differences between recommending and prescribing medical marijuana and discussed medical research related to the use of marijuana during pregnancy.

03:31 PM

Representative Tate gave concluding remarks regarding the bill and the status of the research related to the use of marijuana during pregnancy.


BILL:	HB15-1036
TIME:	03:32:00 PM
MOVED:	Landgraf
MOTION:	Lay over House Bill 15-1036 until May 15, 2015. The effect of this motion is to postpone indefinitely House Bill 15-1036. The motion passed on a vote of 12-0, with one member excused.
SECONDED:	Moreno
		VOTE
	Conti	Excused
	Danielson	Yes
	Everett	Yes
	Ginal	Yes
	Joshi	Yes
	Keyser	Yes
	Landgraf	Yes
	Melton	Yes
	Moreno	Yes
	Tyler	Yes
	Windholz	Yes
	Singer	Yes
	Primavera	Yes

Final YES: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:43 PM -- HB 15-1078

The committee reconvened after a brief recess.. Representative Nordberg and McCann presented House Bill 15-1036. The bill requires the Department of Human Services or a county department of human or social services that has legal custody of a child or youth to report the child or youth's disappearance to the National Center for Missing and Exploited Children and to law enforcement immediately or no later than 24 hours after learning of the disappearance. Representative Nordberg distributed and explained amendments L.001 and L.002 (Attachments B and C).

150203 AttachB.pdf

150203 AttachC.pdf

03:51 PM -- Mary Berg, Jefferson County Department of Human Services, testified in support of the bill with the amendments. She said that the bill will allow current practice and statute to align. She said the bill will provide assurance that county departments will follow up in cases of missing persons under the bill. She responded to questions from the committee regarding the time period for reporting.

03:57 PM -- Becky Zal-Sanchez, National Association of Social Workers - Colorado, testified in support of the bill. She discussed the frequency with which youth run away from foster care placements and noted that many young people who run away become victims of human trafficking. She responded to questions from the committee.


BILL:	HB15-1078
TIME:	04:02:11 PM
MOVED:	Singer
MOTION:	Adopt amendment L.001 (Attachment B). The motion passed without objection.
SECONDED:	Ginal
		VOTE
	Conti
	Danielson
	Everett
	Ginal
	Joshi
	Keyser
	Landgraf
	Melton
	Moreno
	Tyler
	Windholz
	Singer
	Primavera

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB15-1078
TIME:	04:02:43 PM
MOVED:	Singer
MOTION:	Adopt amendment L.002 (Attachment C). The motion passed without objection.
SECONDED:	Conti
		VOTE
	Conti
	Danielson
	Everett
	Ginal
	Joshi
	Keyser
	Landgraf
	Melton
	Moreno
	Tyler
	Windholz
	Singer
	Primavera

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

04:03 PM

Representatives Nordberg and McCann gave concluding remarks regarding the bill.


BILL:	HB15-1078
TIME:	04:04:32 PM
MOVED:	Landgraf
MOTION:	Refer House Bill 15-1078, as amended, to the Committee of the Whole. The motion passed on a vote of 13-0.
SECONDED:	Ginal
		VOTE
	Conti	Yes
	Danielson	Yes
	Everett	Yes
	Ginal	Yes
	Joshi	Yes
	Keyser	Yes
	Landgraf	Yes
	Melton	Yes
	Moreno	Yes
	Tyler	Yes
	Windholz	Yes
	Singer	Yes
	Primavera	Yes

Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:06 PM -- HB 15-1111

Representative McCann introduced HB 15-1111. The bill creates the Colorado Maternal Mortality Review Committee for the purpose of reviewing maternal mortality cases that occur in Colorado. She described how the data regarding maternal deaths can lead to recommendations regarding treatment options. Representative McCann distributed and explained amendment L.003 (Attachment D).

150203 AttachD.pdf

04:15 PM -- Jessica Anderson, American College of Nurse Midwives, testified in support of the bill and listed the leading causes of death for pregnant and postpartum women.

04:17 PM -- Karen Trierweiler, Colorado Department of Public Health and Environment, responded to questions from the committee regarding the costs of the bill.

04:19 PM -- Dr. Brent Keeler, Colorado Medical Society, testified on the bill and discussed the need for education on maternal mortality. He discussed the mental health needs of pregnant women.

04:23 PM -- Dorotha Cicchinelli, March of Dimes, testified in support of the bill and discussed her work with women who have suffered a pregnancy loss. She explained efforts to reduce maternal mortality.

04:30 PM -- Dick Brown, American College of Obstetrics and Gynecology, offered to answer committee questions.

04:30 PM -- Leo Boyle, Colorado Midwives Association, offered to answer committee questions.


BILL:	HB15-1111
TIME:	04:31:07 PM
MOVED:	Singer
MOTION:	Adopt amendment L.003 (Attachment D). The motion passed without objection.
SECONDED:	Melton
		VOTE
	Conti
	Danielson
	Everett
	Ginal
	Joshi
	Keyser
	Landgraf
	Melton
	Moreno
	Tyler
	Windholz
	Singer
	Primavera

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

04:31 PM

Representative McCann gave concluding remarks regarding the bill.


BILL:	HB15-1111
TIME:	04:34:49 PM
MOVED:	Singer
MOTION:	Refer House Bill 15-1111, as amended, to the Committee on Appropriations. The motion passed on a vote of 7-6.
SECONDED:	Ginal
		VOTE
	Conti	No
	Danielson	Yes
	Everett	No
	Ginal	Yes
	Joshi	No
	Keyser	No
	Landgraf	No
	Melton	Yes
	Moreno	Yes
	Tyler	Yes
	Windholz	No
	Singer	Yes
	Primavera	Yes

Final YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:36 PM

The committee recessed briefly.

04:36 PM -- HB 15-1082

Representative Melton introduced House Bill 15-1082 and distributed amendment L.005 and L.006 (Attachments E and F) and two handouts regarding the bill (Attachments G and H). The bill requires that any disciplinary proceeding against a mental health professional be commenced within five years of an alleged act or failure to act. He responded to questions from the committee.

150203 AttachE.pdf

150203 AttachF.pdf

150203 AttachG.pdf

150203 AttachH.pdf

04:44 PM -- Ronne Hines, Department of Regulatory Agencies (DORA), responded to questions from the committee regarding the length of time physicians must maintain records. She testified that, as drafted, the department opposes the bill, and noted that the department has not had a chance to review amendment L.005 (Attachment G). She responded to questions from the committee regarding the statute of limitations for filing complaints against physicians. She clarified that no other profession regulated by DORA has a statute of limitations in which complaints must be filed.

04:50 PM -- Sara Shirk, Colorado Cross Disability Coalition, testified in opposition to the bill.

04:52 PM -- Aubrey Ellen Shomo, Mental Patients Anti-Defamation Alliance, testified in opposition to the bill. She described the abuse she suffered in her youth, and the court proceedings surrounding these issues. She stated that people who are traumatized have difficulty reporting complaints against mental health professionals, and testified in opposition to time-barring complaints.

05:06 PM -- Jennifer Hill, Colorado Mental Wellness Network, testified in opposition to the bill. She noted that similar statutes of limitation do not exist for other medical professions and spoke regarding the importance of allowing patients to heal. She discussed the difficulties she has experienced obtaining her mental health records.

05:09 PM -- Michael Lott-Manier, Mental Health America of Colorado, testified regarding his concerns that the bill creates a disparity between the disciplinary processes for medical and mental health professionals. He spoke in support of the mental health professionals who work in Colorado and regarding the provisions of amendment L.005 (Attachment E). He responded to questions from the committee.

05:26 PM -- Dr. Reo Leslie, Colorado Mental Health Professionals Association and Colorado School for Family Therapy, testified in support of the bill and distributed a handout to the committee (Attachment I). He noted that the law differentiates between mental health and physical health providers in certain instances, such as in the provision of medical records. He discussed the need for the bill, including for protection of professionals from harassment by former clients. He listed other reasons for the bill, including saving resources and public and consumer protection. He noted that some of the abuses in the system need to be addressed by criminal law rather than through the administrative rules governing mental health professionals. He responded to questions from the committee.

150203 AttachI.pdf

05:33 PM -- Jim Carr, representing himself, clarified that the bill does not apply to psychiatrists and psychiatric nurses. He clarified that the bill, as amended by amendment L.005, applies only to issues concerning billing and records and does not apply to fee disputes. He stated that any complaint filed against a mental health professional that is over seven years old is difficult to prove, and it's difficult to prosecute such cases. He responded to questions from the committee.

05:43 PM -- Denis Lane, Center for Ethical Studies, testified in support of the bill

05:45 PM -- Mike Holtby, representing himself, testified in support of the bill noting that he disposed of records older than seven years when he retired. He expressed concerns regarding his ability to defend himself against complaints that are made related to issues older than seven years.

05:50 PM -- J. Delaine Taylor, representing herself, testified in support of the bill and explained that individuals with severe mental health issues are the most likely to file complaints with DORA and have limited ability to have clear judgement in such instances.

05:54 PM -- Brett Ploessel, representing himself, testified in support of the bill. He responded to questions from the committee regarding electronic health records.

05:57 PM -- Dr. Eric Nelson, Colorado Mental Health Professional Association and Aurora Mental Health, testified in support of the bill, stating the bill is a balance between consumers and professionals.

05:59 PM -- Dr. Mark Kilmer, Colorado Mental Health Professional Association, testified in support of the bill and regarding the burden placed on professionals when grievances are filed years after the original incident.

06:03 PM -- Pam Mills, representing herself, testified in support of the bill and regarding her experience serving on a licensing board for mental health professionals. She noted that any person could file a grievance and the burden is on the practitioner to disprove the claims.

06:07 PM -- Carol O'Dowd, Colorado Association of Psychotherapists, testified in support of the bill and stated that the bill will reduce the time that is spent by mental health professionals and DORA staff addressing frivolous complaints.

06:09 PM -- James Hoysick, Colorado Mental Health Professional Association, testified in support of the bill. He responded to questions from the committee.

06:14 PM -- Eliselda Bustillos, Colorado School for Family Therapy and Latino Counseling, testified in support of the bill and stated that it is a large concern that clients can file grievances many years later when professionals may not have records to defend themselves.


BILL:	HB15-1082
TIME:	06:19:14 PM
MOVED:	Melton
MOTION:	Adopt amendment L.005 (Attachment E). The motion failed on a vote of 6-7.
SECONDED:	Singer
		VOTE
	Conti	No
	Danielson	Yes
	Everett	No
	Ginal	No
	Joshi	No
	Keyser	No
	Landgraf	No
	Melton	Yes
	Moreno	Yes
	Tyler	Yes
	Windholz	No
	Singer	Yes
	Primavera	Yes

YES: 6 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	HB15-1082
TIME:	06:19:46 PM
MOVED:	Melton
MOTION:	Adopt amendment L.006 (Attachment F). The motion passed on a vote of 7-6.
SECONDED:	Singer
		VOTE
	Conti	No
	Danielson	Yes
	Everett	No
	Ginal	Yes
	Joshi	No
	Keyser	No
	Landgraf	No
	Melton	Yes
	Moreno	Yes
	Tyler	Yes
	Windholz	No
	Singer	Yes
	Primavera	Yes

YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	HB15-1082
TIME:	06:23:34 PM
MOVED:	Joshi
MOTION:	Adopt amendment L.003 (Attachment J) as a substitute to amendment L.006. The motion failed on a vote of 4-9.
SECONDED:	Everett
		VOTE
	Conti	No
	Danielson	No
	Everett	Yes
	Ginal	No
	Joshi	Yes
	Keyser	Yes
	Landgraf	Yes
	Melton	No
	Moreno	No
	Tyler	No
	Windholz	No
	Singer	No
	Primavera	No

YES: 4 NO: 9 EXC: 0 ABS: 0 FINAL ACTION: FAIL

150203 AttachJ.pdf


BILL:	HB15-1082
TIME:	06:37:13 PM
MOVED:	Melton
MOTION:	Refer House Bill 15-1082 to the Committee of the Whole. The motion passed on a vote of 12-1.
SECONDED:	Landgraf
		VOTE
	Conti	Yes
	Danielson	Yes
	Everett	Yes
	Ginal	Yes
	Joshi	Yes
	Keyser	Yes
	Landgraf	Yes
	Melton	Yes
	Moreno	Yes
	Tyler	No
	Windholz	Yes
	Singer	Yes
	Primavera	Yes

Final YES: 12 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

06:43 PM

The committee adjourned.