House Committee on Health and Human Services (03/06/2006)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:	03/06/2006	ATTENDANCE

Time:	01:40 PM to 05:13 PM	Berens	X
		Cloer	X
Place:	HCR 0112	Green	X
		Kerr	X
This Meeting was called to order by		Lundberg	X
	Representative Boyd	McGihon	*
		Riesberg	X
This Report was prepared by		Soper	X
	Whitney Gustin	Stafford	X
		Sullivan	E
		Weissmann	*
		Frangas	X
		Boyd	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB06-005 SB06-134 SB06-097 SB06-121		Referred to the Committee of the Whole Referred to the Committee of the Whole Referred to the Committee of the Whole Referred to the Committee of the Whole

01:41 PM -- Senate Bill 06-005

Representative Solano, sponsor, presented the bill requiring health plans who cover mental health services to do so whether or not the services are voluntary or court-ordered. She distributed a bill summary to committee members (Attachment A). She answered questions about whether or not the bill represents an insurance mandate.

The following persons testified:

01:47 PM -- Vanessa Hannemann, Colorado Association of Health Plans, described the association's collaboration with the interim Committee for the Continuing Examination of the Treatment of Persons with Mental Illness who are Involved in the Justice System. She answered questions about current insurance coverage of mental health services.

01:50 PM -- Harriet Hall, Jefferson Center for Mental Health, she described the history of and the work done by the Committee for the Continuing Examination of the Treatment of Persons with Mental Illness. She read testimony from a member of the interim committee.

01:54 PM -- Pilar Ingargiola, CSI, discussed research done to support the work of the interim committee. CSI representatives traveled around the state to conduct focus groups and run surveys to gain an understanding of criminal justice and mental health issues. The proposed bill represents one of the recommendations to come from CSI's work. Ms. Ingargiola answered questions about the demographic groups that participated in the focus groups.

01:59 PM -- Susan Cox, Kaiser Permanente, discussed Kaiser's policies regarding court-ordered treatment. She stated Kaiser does not deny coverage based solely upon whether or not services are court-ordered.

02:01 PM -- Libby Stoddard, citizen, discussed her family's experience with insurance coverage and court-ordered treatment.

02:03 PM -- Lilly Boyce, Federal Family for Children's Mental Health, discussed her family's experience with the juvenile justice system and insurance coverage of mental health treatment.

02:06 PM

Representative Solano made concluding remarks. Representative Stafford discussed her work with the Committee for the Continuing Examination of the Treatment of Persons with Mental Illness.


BILL:	SB06-005
TIME:	02:07:54 PM
MOVED:	Stafford
MOTION:	Refer the bill to the Committee of the Whole. The bill passed 12-0-1.
SECONDED:	Green
		VOTE
	Berens	Yes
	Cloer	Yes
	Green	Yes
	Kerr	Yes
	Lundberg	Yes
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	Yes
	Sullivan	Excused
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

02:09 PM -- Senate Bill 06-134

Representative Boyd, sponsor, presented the bill eliminating the asset test for the Colorado Works program, the state's cash assistance program. She discussed other the programs whose asset tests have already been eliminated. They include the Low-income Energy Assistance Program (LEAP) and Medicaid. She stated the bill will allow Colorado Works recipients to save for the future and be better prepared for self-sufficiency. She answered questions about how many more people will be eligible for Colorado Works if there is no asset test. She described assets that are already disregarded when Colorado Works eligibility is determined. Representative Boyd answered questions about future costs of continuing the asset test. Representative Stafford discussed 1996 federal welfare reform that limited persons to a lifetime maximum of five years on Colorado Works. Representative Boyd stated the average time of enrollment on Colorado Works is eight months.

The following persons testified:

02:25 PM -- Lynnae Flora, Jefferson County Human Services, spoke in opposition to the bill. She stated she would favor raising the current asset test rather than eliminating it. She stated the bill's current language may allow fraud to occur. She answered questions about how the bill may financially impact Jefferson County. Committee members discussed a possible sunset on the bill's provisions and potential welfare fraud.

02:36 PM -- Char Robert, All Families Deserve a Chance Coalition, spoke in favor of the bill and distributed a document to committee members (Attachment B). She stated retirement savings are currently included in Colorado Works eligibility determinations.

02:42 PM -- Rich Jones, The Bell Policy Center, spoke in support of the bill and distributed two documents to committee members (Attachments C and D). He stated Ohio and Virginia have eliminated the asset tests for their cash assistance programs. He answered questions about changes other states have made to their asset test requirements.

02:53 PM -- Terry McMaster, Lutheran Advocacy Ministry, listed the communities of faith who support the bill. She discussed Colorado's experience in eliminating the Medicaid asset test.

02:56 PM -- Dara Burwell, 9 to 5 National Association of Working Women, discussed a variety of experiences persons have had in applying for Colorado Works. She stated some people have assets that are inaccessible (e.g., burial plots) but still disqualify the applicant from Colorado Works.

03:01 PM -- Nan Moorehead, Denver Department of Human Services, answered questions about the demographics of persons who will benefit from the bill. She stated the fiscal note reflects the additional caseload Denver expects under the bill. She described Colorado's asset spend-down requirements. She stated Denver's Colorado Works enrollees are 50 percent child-only cases. Representative Stafford discussed penalties for early withdrawal of 401k monies.

03:09 PM

Representative Frangas asked that persons in the audience who support the bill please stand. Approximately ten people did so.

03:10 PM -- Janis Baron, Legislative Council Staff, distributed a table illustrating expected increases in the Colorado Works case load under the bill (Attachment E). She answered questions about the amount of time it will take to determine Colorado Works eligibility if the asset test is eliminated. Representative Lundberg discussed the bill's fiscal note. Ms. Baron answered questions about caseload growth under the bill.

03:20 PM

Representative Stafford discussed her consideration of a sunset date for the bill. Representative Boyd made concluding remarks. Committee members commented on the bill. Representative Lundberg discussed the "cliff effect" of the current asset test. Representative Boyd discussed the current five-year limit for Colorado Works enrollment. Representative Soper discussed Americans' personal savings habits. Representative Kerr stated his uncertainty about the bill's consequences. Representative Boyd stated the bill passed 33 to 2 in the Senate.


BILL:	SB06-134
TIME:	03:29:38 PM
MOVED:	Boyd
MOTION:	Refer the bill to the Committee of the Whole. The bill passed 10-2-1.
SECONDED:	Green
		VOTE
	Berens	Yes
	Cloer	Yes
	Green	Yes
	Kerr	No
	Lundberg	No
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	Yes
	Sullivan	Excused
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 10 NO: 2 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:31 PM -- Senate Bill 06-097

Representative Berens, sponsor, presented the bill requiring reports of certain incidents at long-term care facilities. He described his observations upon visiting a nursing home. He stated the bill requires reports of abuse to law enforcement officials. He answered questions about the bill's definition of long-term care facilities. He stated it does not include nursing homes.

The following persons testified:

03:37 PM -- Sheila Hicks, Colorado Cross Disability Coalition, discussed the current voluntary nature of reporting by long-term care facilities. She stated her desire for the bill to include home care agencies and enforcement mechanisms.

03:40 PM -- Andi Leopoldus, ARC Alliance, spoke in support of the bill. She stated nursing home and hospitals are already subject to reporting requirements. Information about reported incidents in these facilities are published on line by the Department of Public Health and Environment.

03:43 PM -- Frank Lay, Colorado Alliance for Retired Americans, spoke in support of the bill. He described problems persons have experienced in long-term care facilities, including physical and verbal abuse. Representative Green described an example of physical abuse that occurred at a nursing home.

03:46 PM

Representative Green discussed her view of nursing homes. Committee members discussed the bill.


BILL:	SB06-097
TIME:	03:49:08 PM
MOVED:	Cloer
MOTION:	Refer the bill to the Committee of the Whole. The bill passed 12-0-1.
SECONDED:	Kerr
		VOTE
	Berens	Yes
	Cloer	Yes
	Green	Yes
	Kerr	Yes
	Lundberg	Yes
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	Yes
	Sullivan	Excused
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:50 PM -- Senate Bill 06-121

Representative Riesberg, sponsor, presented the bill allowing surrogate decision-makers to help persons choose health care benefits. He stated the implementation of Medicare Part D created a need for the bill's provisions. He described an example of someone who is going without his medications because he has not been able to choose a Medicare Part D insurance plan. He answered questions about provisions for appealing surrogate decision makers and/or the decisions they make on behalf of someone else. He distributed two documents to committee members (Attachments F and G).

The following persons testified:

03:58 PM -- Valerie Corzine, Legal Center for People for Disabilities and Older People, described how she became aware of the need to have surrogate decision makers for some people who are eligible for Medicare Part D. She stated current guardianship proceedings would protect persons who wish to remove a surrogate decision maker. She answered questions about the characteristics and number of persons who may benefit from the bill. She discussed the immunity of surrogate decision makers, training for decision makers, current assistance available to persons who are trying to decide upon a Medicare plan, the population targeted by the bill, and medical treatment decisions.

04:18 PM -- Carl Glatstein, Elder Law Section, Colorado Bar Association, spoke in support of the bill. He stated the bill addresses the needs of truly isolated individuals who do not otherwise have proxy decision makers. He answered questions about protections against incompetence of decision makers.

04:22 PM -- Cameron Graham, AARP, described AARP's initial concerns with the bill and protections for persons who lack cognitive capacity. He stated choosing a Medicare Part D plan is one of the most difficult health-related decisions to make. He answered questions about AARP's role in helping seniors choose Part D plans.

04:26 PM -- Frank Lay, Colorado Alliance for Retired Americans, described his study and knowledge of Medicare Part D insurance plans. He described how persons can become enrolled in a Part D plan that does not serve their needs. Representative Riesberg answered questions about the bill's provisions.

04:33 PM -- Sheila Hicks, Colorado Cross Disability Coalition, discussed difficulties in choosing an appropriate Part D plan. She expressed concerns regarding the scope of the bill and the qualifications of surrogate decision makers. She answered questions about the implications of being determined incapable of make health benefit decisions.

04:43 PM

Representative Riesberg made concluding remarks. He stated the bill fills a void in Colorado law. Representative Cloer moved a conceptual amendment to require two physicians instead of one to make determinations regarding a patient's decisional capacity. Representative Riesberg stated only one physician is required to determine a proxy decision maker for a patient's other health-related decisions.


BILL:	SB06-121
TIME:	04:53:39 PM
MOVED:	Cloer
MOTION:	Adopt a conceptual amendment to require two physicians instead of one to make determinations regarding a patient's decisional capacity.
SECONDED:	Berens
		VOTE
	Berens	Yes
	Cloer	Yes
	Green	No
	Kerr	Yes
	Lundberg	Yes
	McGihon	No
	Riesberg	No
	Soper	No
	Stafford	Yes
	Sullivan	Excused
	Weissmann	No
	Frangas	No
	Boyd	No
Not Final YES: 5 NO: 7 EXC: 1 ABS: 0 FINAL ACTION: FAIL

04:57 PM

Committee members commented on the bill. Representatives Frangas, Green, and Cloer stated their concerns with the bill. Representative Green described an amendment she may offer on the bill at a later time.


BILL:	SB06-121
TIME:	05:02:56 PM
MOVED:	Riesberg
MOTION:	Refer the bill to the Committee of the Whole. The bill passed 7-5-1.
SECONDED:	Boyd
		VOTE
	Berens	No
	Cloer	No
	Green	Yes
	Kerr	No
	Lundberg	No
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	No
	Sullivan	Excused
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 7 NO: 5 EXC: 1 ABS: 0 FINAL ACTION: PASS

05:13 PM

The committee adjourned.