Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:04/24/2006
ATTENDANCE
Time:01:36 PM to 04:51 PM
Berens
X
Cloer
X
Place:HCR 0112
Green
X
Kerr A.
X
This Meeting was called to order by
Kerr J.
X
Representative McGihon
Lundberg
X
Riesberg
X
This Report was prepared by
Soper
X
Whitney Gustin
Stafford
X
Sullivan
X
Weissmann
X
Frangas
X
McGihon
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
SB06-217
SB06-141
SB06-165
SB06-059
SB06-131
SB06-044
SB06-128
SB06-212		Referred to the Committee of the Whole
Referred to Finance
Amended, Referred to Appropriations
Amended, Referred to Appropriations
Amended, Referred to Appropriations
Amended, Referred to Appropriations
Referred to Appropriations
Referred to the Committee of the Whole


01:37 PM -- Senate Bill 06-217

Representative T. Carroll, sponsor, presented the bill regarding a distinguished foreign teaching physician license that may be renewed annually. He stated the bill will allow Colorado to compete in bringing top-notch international physicians to practice and teach in the state. He described Colorado's and the United States' shortage of highly qualified physicians.

The following persons testified:

01:45 PM -- Dr. Richard Krugman, University of Colorado School of Medicine, described the anticipated shortage of physicians nationwide. This shortage is expected to occur around 2010 to 2015. Currently, the University of Colorado has 12 physicians (about 1 percent of the medical faculty) who would qualify for the proposed license. Dr. Krugman stated the school is concerned now with retaining these foreign physicians. He discussed reasons for the projected physician shortage and the specialties most likely to experience a shortage.







01:52 PM -- Dr. Wade Smith, Denver Health Medical Center, spoke in support of the bill. He described difficulties in recruiting trauma care providers. These providers work very long hours on the most urgent medical cases. Dr. Smith described qualifications and testing of foreign physicians practicing in Colorado.

01:59 PM -- Dr. Mory Ziegler, The Children's Hospital, discussed the hospital's recruitment of a foreign congenital heart surgeon. This physician serves not only Children's Hospital but other Colorado hospitals as well.

02:01 PM -- Susan Miller, Colorado Medical Board, described the board's review and strict scrutiny of foreign physicians. She stated that in 12 years, the board has not received any complaints against distinguished teaching physicians. If a complaint were received, standard licensing procedures would be followed.


02:07 PM

Representative T. Carroll made concluding remarks. He described Denver Health as an elite teaching facility.
BILL:SB06-217
TIME: 02:08:58 PM
MOVED:Stafford
MOTION:Refer the bill to the Committee of the Whole. The motion passed 13-0.
SECONDED:Green
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
Yes
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
Yes
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS











02:09 PM -- Senate Bill 06-141

Representative Riesberg, sponsor, presented the bill establishing the "Health Care Transparency Act," requiring hospitals and ambulatory care centers to annually report financial, resource, patient, and staffing information. He stated 50 percent of hospitals' budgets are from the state and federal governments. He described current hospital reporting practices and stated hospital costs account for the greatest health care expense. He discussed the state's nursing shortage and nurses' unwillingness to work in hospitals. Representative Riesberg stated the information required by the bill will help the state regulate hospitals and ambulatory care centers at appropriated levels. He answered questions about how the bill might impact the quality and cost of health care.

The following persons testified:

02:25 PM -- Herman Schreivocal, Lincoln Community Hospital, spoke in opposition to the bill and described currently required federal cost reports. He stated he does not see how the bill will improve quality of care.

02:28 PM -- Peter Freytag, Colorado Hospital Association, spoke in opposition to the bill. He described a number of reports and a web site currently published by the association. The reports are all voluntary and available to the public. He described the numerous reporting requirements under the bill. Mr. Freytag answered questions about hospital costs associated with the bill's reporting requirements.

 02:36 PM -- Pamela Spehn, Jennifer Jenkins, and Mitch Ackerman, Service Employees International Union (SEIU) Nurse Alliance of Colorado, came to the table to testify in favor of the bill together. Ms. Jenkins discussed problems associated with nurse understaffing, including increased medical errors. Ms. Spehn discussed nurse-patient ratio issues. She stated hospitals typically site costs when responding to nurse understaffing complaints. She stated that appropriate staffing levels save money by reducing medical errors and improving nurse retention. Mr. Ackerman discussed Colorado's uninsurance rates and insurance costs. He stated Colorado has the most profitable hospital environment. He described a study of the affects of nurse staffing levels. Ms. Jenkins answered questions about SEIU's goals. A notebook was distributed to members (Attachment A).

02:48 PM -- Linda Hayes, Nurse Alliance, spoke in support of the bill. She described hospitals' responses to requests for additional nurses. She described reasons why nurses do not walk out from their jobs due to unfavorable working conditions.

02:54 PM -- Carrie Curtiss, Colorado Consumer Health Initiative, spoke in support of the bill. She stated the bill will give patients information necessary to make good health care decisions. She stated transparency is good for patients and the health care system. She answered questions about the adequacy of current voluntary hospital reporting practices.

03:00 PM -- Patricia Geiger, citizen, discussed her experience seeking charge information from hospitals. She described personal risks associated with hospitalization.














03:03 PM

Committee members discussed the bill, and Representative Riesberg made concluding remarks.
BILL:SB06-141
TIME: 03:06:39 PM
MOVED:Riesberg
MOTION:Refer the bill to the Committee on Finance. The bill passed 7-6.
SECONDED:Green
VOTE
Berens
No
Cloer
No
Green
Yes
Kerr A.
Yes
Kerr J.
No
Lundberg
No
Riesberg
Yes
Soper
Yes
Stafford
No
Sullivan
No
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS


03:08 PM -- Senate Bill 06-165

Representative Gardner, sponsor, presented the bill allowing statewide implementation of telemedicine consultations for Medicaid patients. He answered questions about the technology used in telemedicine.

The following persons testified:

03:15 PM -- Erin Denholm, Home Care Association of Colorado, described how telemedicine works. She answered questions about diagnoses and monitoring health conditions via telemedicine.

03:21 PM -- Cameron Graham, AARP, described the bill as an opportunity to reduce cost and improve the quality of health care.

03:23 PM -- Janet Stephens, Colorado Health and Hospital Association, described two Colorado hospitals' interest in telemedicine.












03:25 PM

Committee members discussed the bill, and Representative Gardner made concluding remarks. Representative McGihon distributed and discussed amendment L.004 (Attachment B).
BILL:SB06-165
TIME: 03:28:37 PM
MOVED:Cloer
MOTION:Adopt L.004 (Attachment B). The motion passed without objection.
SECONDED:Green
VOTE
Berens
Cloer
Green
Kerr A.
Kerr J.
Lundberg
Riesberg
Soper
Stafford
Sullivan
Weissmann
Frangas
McGihon
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection
BILL:SB06-165
TIME: 03:28:52 PM
MOVED:Stafford
MOTION:Refer the bill, as amended, to the Committee on Appropriations. The bill passed 12-0.
SECONDED:Green
VOTE
Berens
Excused
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
Yes
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
Yes
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:32 PM -- Senate Bill 06-059

Representative Frangas, sponsor, presented the bill creating a pilot program providing dental screenings to children beginning in first grade. He distributed and discussed L.007 (Attachment C).

The following persons testified:

03:33 PM -- Phyllis Albritton, Delta Dental Foundation, spoke in support of the bill. She stated screening young children will help curtail dental disease before it advances and becomes painful.

03:38 PM -- Ben Davis, Colorado Consumer Health Initiative, spoke in support of the bill. He stated Colorado currently has 300,000 children without dental insurance.
BILL:SB06-059
TIME: 03:40:33 PM
MOVED:Frangas
MOTION:Adopt L.007 (Attachment C). The motion passed without objection.
SECONDED:Cloer
VOTE
Berens
Cloer
Green
Kerr A.
Kerr J.
Lundberg
Riesberg
Soper
Stafford
Sullivan
Weissmann
Frangas
McGihon
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection



















03:40 PM

Representative Frangas made concluding remarks. He stated the bill will save money in the long run.
BILL:SB06-059
TIME: 03:41:46 PM
MOVED:Frangas
MOTION:Refer the bill, as amended, to the Committee on Appropriations. The bill passed 12-1.
SECONDED:Cloer
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
No
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
Yes
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 12 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS


03:43 PM -- Senate Bill 06-131

Representative McFadyen, sponsor, presented the bill authorizing the Department of Health Care Policy and Financing to conduct a feasibility study for a new pricing model for certain nursing facilities. She distributed L.012 to committee members (Attachment D).

The following persons testified:

03:47 PM -- Jeff Jerebker, Pinon Management, spoke in support of the bill. He described the current nursing facility reimbursement system as old and out-of-date. He discussed the bill's provisions regarding the lifting of the eight percent cap on reimbursement increases. He answered questions about his position on L.012.

03:51 PM -- Becky Mizel, Pueblo Extended Care, discussed her work at Extended Care to improve care and issues related to low Medicaid reimbursements.

03:53 PM -- Janet Snipes, Holly Heights Nursing Home and Colorado Healthcare Association, spoke in support of the bill.









03:54 PM -- Arlene Miles, Colorado Healthcare Association, spoke in support of the bill. She described the current cost-based reimbursement system and the need to work toward a new system. She stated the bill adds parity among the different nursing facilities.
BILL:SB06-131
TIME: 04:02:15 PM
MOVED:Stafford
MOTION:Adopt L.012 (Attachment D). The motion passed without objection.
SECONDED:Berens
VOTE
Berens
Cloer
Green
Kerr A.
Kerr J.
Lundberg
Riesberg
Soper
Stafford
Sullivan
Weissmann
Frangas
McGihon
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

BILL:SB06-131
TIME: 04:03:16 PM
MOVED:Stafford
MOTION:Refer the bill, as amended, to the Committee on Appropriations. The bill passed 12-1.
SECONDED:Sullivan
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
No
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
Yes
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 12 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS


04:04 PM -- Senate Bill 06-044

Representative Green, sponsor, presented the bill expanding the Colorado Indigent Care Program (CICP) by increasing the income eligibility criteria from 185 percent of the federal poverty level to 250 percent FPL. She distributed L.005 to committee members (Attachment E).

The following persons testified:

04:09 PM -- Jennifer Miles, Colorado Community Health Network (CCHN), spoke in support of the bill. She stated CCHN clinics are able to care for only one in four of the state's uninsured persons. She responded to questions from the committee regarding additional persons that could be served in community health centers through the bill.

04:14 PM -- Carrie Curtiss, Colorado Consumer Health Initiative, testified in support of the bill. She stated the bill will benefit uninsured Coloradans statewide.

04:15 PM -- Cindy Sovine, Colorado Health and Hospital Association, testified in support of the bill. She described cost-savings associated with preventive care.

04:16 PM -- AW Schnellbacher, spoke in support of the bill. He stated the bill will expand health care to the uninsured and to the rural areas of the state. He addressed questions about Referendum C.
BILL:SB06-044
TIME: 04:20:46 PM
MOVED:Green
MOTION:Adopt L.005 (Attachment E). The motion passed without objection.
SECONDED:Cloer
VOTE
Berens
Cloer
Green
Kerr A.
Kerr J.
Lundberg
Riesberg
Soper
Stafford
Sullivan
Weissmann
Frangas
McGihon
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection










04:21 PM

Representative Green made concluding remarks.
BILL:SB06-044
TIME: 04:21:38 PM
MOVED:Green
MOTION:Refer the bill, as amended, to the Committee on Appropriations. The bill passed 12-1.
SECONDED:Weissmann
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
No
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
Yes
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 12 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS


04:23 PM -- Senate Bill 06-128

Representative Riesberg, sponsor, presented the bill creating a Medicaid pilot program to improve services to persons with disabilities.

The following persons testified:

04:24 PM -- Mark Simon, spoke in support of the bill and distributed a copy of his testimony to committee members (Attachment F). He described a similar Boston program that has saved money and experienced high client satisfaction.

04:28 PM -- Dan Tuteur, Colorado Community Managed Care Network, spoke in support of the bill. He distributed a summary document (Attachment G) and a copy of testimony by Dr. Barry Martin (a copy was not made available to staff).

04:32 PM -- Mike McCarty, Colorado Cross Disability Coalition, spoke in support of the bill. He stated that if the proposed program does not work out, it repeals five years after implementation.











04:33 PM -- Kelly Stahlman, Family Voices, spoke in support of the bill. She described the concept of a medical home for kids.
BILL:SB06-128
TIME: 04:37:48 PM
MOVED:Riesberg
MOTION:Refer the bill to the Committee on Appropriations. The bill passed 13-0.
SECONDED:Stafford
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
Yes
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
Yes
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS


04:39 PM -- Senate Bill 06-212

Representative McGihon, sponsor, presented the bill allowing dental hygienist practices to employ dentists. She stated the bill will impact the practice of dental hygienists throughout the state.

The following persons testified:

04:41 PM -- Patricia Armbruster, Colorado Dental Hygienists Association, and Claire Silk, Dental Hygienists Proprietors, came to the table to testify in support of the bill together, Ms. Armbruster answered questions about the number of free-standing hygienist practices in Colorado.

04:44 PM -- Dr. Rhett Murray and Dr. Jeff Hurst, Colorado Dental Association, came to the table to testify in support of the bill together. Dr. Murray answered questions about negotiations between the Dental Association and the Dental Hygienists Association.















04:47 PM
BILL:SB06-212
TIME: 04:48:00 PM
MOVED:McGihon
MOTION:Refer the bill to the Committee of the Whole. The bill passed 13-0.
SECONDED:Stafford
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
Yes
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
Yes
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS


04:51 PM

The committee adjourned.