House Committee on Health and Human Services (03/13/2006)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:	03/13/2006	ATTENDANCE

Time:	01:42 PM to 04:43 PM	Berens	X
		Cloer	X
Place:	HCR 0112	Green	*
		Kerr	X
This Meeting was called to order by		Lundberg	X
	Representative Boyd	McGihon	X
		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:
SB06-135 SB06-171 SB06-145 SB06-087		Referred to Appropriations Referred to Appropriations Amended, Referred to the Committee of the Whole Postponed Indefinitely

01:42 PM -- Senate Bill 06-135

Representative Plant, sponsor, presented the bill expanding income eligibility for the Children's Basic Health Plan (AKA Child Health Plan Plus or CHP+) from 185 percent of the Federal Poverty Level (FPL) to 200 percent FPL. He stated the bill creates state-only funding CHP+ for children whose family income falls between 185 and 200 percent FPL from July 1, 2005 to February 1, 2006.

The following persons testified.

01:46 PM -- Pat Ratliff, Colorado Counties, Inc., spoke in support of the bill.


BILL:	SB06-135
TIME:	01:47:39 PM
MOVED:	Cloer
MOTION:	Refer the bill to the Committee on Appropriations. The bill passed 12-0-1.
SECONDED:	Stafford
		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

01:50 PM -- Senate Bill 06-171

Representative Lindstrom, sponsor, presented the bill transferring certain authorities of the State Board of Health to other Government entities.

The following persons testified.

01:52 PM -- Howard Roitman, Colorado Department of Public Health and Environment, discussed the reasons why the bill was introduced. It resulted from a study of Board of Health responsibilities that might be better overseen by other government entities. He stated the new oversight entities will do substantially the same work as the Board of Health currently does but with greater expertise.

01:55 PM -- Laura Davis, member, State Board of Health, spoke in support of the bill. She stated the bill will promote better oversight of drinking water quality and solid waste. She stated most Board of Health members expressed a neutral position on the bill.

01:58 PM

Representative Lindstrom made concluding remarks.


BILL:	SB06-171
TIME:	01:58:41 PM
MOVED:	McGihon
MOTION:	Refer the bill to the Committee on Appropriations. The bill passed 12-0-1.
SECONDED:	Weissmann
		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

02:01 PM -- Senate Bill 06-145

Representative McCluskey, sponsor, presented the bill allowing local governments to impose a fee on certain medical providers for the purpose of obtaining federal financial participation under the Medicaid program. He distributed amendments L.006 and L.008 and a document from Children's Hospital to committee members (Attachments A, B, and C)). He stated the bill allows private hospitals to certify spending like public hospitals currently do.

The following persons testified.

02:08 PM -- Betsy Murray, Homecare Association of Colorado, spoke in support of the bill.

02:09 PM -- Carrie Curtiss, Colorado Consumer Health Initiative, spoke in support of the bill. She stated there is approximately $50 million of federal dollars that is going untapped by Colorado.

02:11 PM -- Pat Ratliff, Colorado Counties, Inc., spoke in support of the bill.

02:13 PM -- Scott Wasserman, Service Employees International Union (SEIU), spoke in support of the bill.

02:15 PM -- Cindy Sovine, Colorado Health and Hospital Association (CHA), spoke in support of the bill. She did state, however, that there are many unknowns because the proposed actions have not been done nationally. She answered questions about CHA's position on the bill if amendments are not adopted. Ms. Sovine and Representative Lundberg discussed concerns regarding the distribution of federal dollars that are gained through the bill's processes.

02:24 PM -- Don Vancil, Keisler Vancil, stated, as a financial officer for the Department of Health Care Policy and Financing, he came up with the concept of certifying public hospital expenditures to pull down federal dollars. He distributed a document to committee members (Attachment D). He addressed questions about distribution of federal dollars to hospitals utilizing the bill's mechanisms. He answered questions about Children's Hospital's unreimbursed Medicaid costs ($49 million in 2003). Mr. Vancil described steps currently taken by public hospitals to receive additional federal dollars.

02:38 PM

Representative McCluskey stated the bill's provisions will not go forward until they receive federal approval. He answered questions about the Taxpayers' Bill of Rights (TABOR) and its impact on the bill's provisions. He discussed amendments L.006 and L.008. He described them both as technical amendments that address issues related to hospital reimbursement and federal approval.


BILL:	SB06-145
TIME:	02:45:06 PM
MOVED:	Stafford
MOTION:	Adopt L.008 (Attachment B). The motion passed without objection.
SECONDED:	Cloer
		VOTE
	Berens
	Cloer
	Green
	Kerr
	Lundberg
	McGihon
	Riesberg
	Soper
	Stafford
	Sullivan	Excused
	Weissmann
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	SB06-145
TIME:	02:46:11 PM
MOVED:	Cloer
MOTION:	Adopt L.006 (Attachment A). The motion passed without objection.
SECONDED:	Stafford
		VOTE
	Berens
	Cloer
	Green
	Kerr
	Lundberg
	McGihon
	Riesberg
	Soper
	Stafford
	Sullivan	Excused
	Weissmann
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	SB06-145
TIME:	02:46:42 PM
MOVED:	Cloer
MOTION:	Refer the bill, as amended, to the Committee of the Whole. The bill passed 12-0-1.
SECONDED:	Stafford
		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

02:47 PM -- Senate Bill 06-087

Representative Frangas, sponsor, presented the bill requiring that a patient be informed of the requirement that a positive test result on certain diseases be reported to the Department of Public Health and Environment (DPHE). Amendments L.007 and L.008 were distributed to committee members (Attachment G and H).

The following persons testified.

02:53 PM -- Dr. Richard Vogt, Public Health Directors and Tri-County Health Department, spoke in opposition to the bill. He distributed two documents, including a copy of his testimony, to committee members (Attachments F and G). He stated the bill's provisions are impracticable and will increase health care costs. He suggested changing the bill to conform with HIPAA (federal Health Insurance Portability and Accountability Act) confidentiality disclosure requirements. He also suggested requiring displaying a poster notifying patients of reporting requirements. He describing current law on "notifiable diseases" (those illnesses that must be reported to DPHE). Representative Frangas posed questions to the witness regarding patients' right to know about disclosure of diagnoses to DPHE and health record confidentiality. Dr. Vogt described processes currently followed if someone were to be diagnosed with avian influenza or another notifiable illness. He discussed patient confidentiality issues. He discussed the Colorado Electronic Disease Reporting System and periodic changes to the list of notifiable diseases.

03:20 PM -- Dr. Debra Hall, citizen, spoke against the bill. She stated the bill effectively allows voluntary reporting of transmissible diseases. She described her work with pregnant women. She stated the bill may negatively affect partner notification and the health of a fetus. She answered questions about disclosure of information to patients.

03:28 PM -- Dr. Don Parsons, Colorado Public Health Association, spoke in opposition to the bill. He stated there are approximately 65 notifiable diseases. He stated he thinks the bill will, de facto, make testing and notification of certain diseases voluntary. Such a situation will prevent health care providers from carrying out their responsibilities. He stated health care literacy can only be addressed through conversations between patients and providers and not through forms or posters. He answered questions about the time frame for responding to notifiable diseases.

03:46 PM -- Becky Fuller, citizen, spoke in support of the bill. She described her and her family's experience with a reportable condition. She described patients' expectation of confidentiality of medical records. She answered questions about public disclosure of health care information. Representative Frangas answered questions about the bill's affect on the reporting of communicable diseases.

04:06 PM -- Sheila Hicks, Colorado Cross Disability Coalition, spoke in support of the bill. She described her experience with disease notifications from the state department of health. She stated the bill would not prevent people from going to the doctor and being tested.

04:12 PM -- Dr. Ned Calonge, Chief Medical Officer, Department of Public Health and Environment, answered questions about anonymous testing for certain diseases and current law regarding disease reporting. He stated the question posed by the bill is whether the balance between personal rights and public health needs to be changed. He answered questions about patient notification of positive test results.

04:28 PM

Representative Frangas and other committee members discussed L.008. Comments included concerns with the likelihood that patients will refuse testing and treatment of communicable diseases.


BILL:	SB06-087
TIME:	04:33:55 PM
MOVED:	Frangas
MOTION:	Adopt L.008 (Attachment H). The motion passed 9-3-1.
SECONDED:	Lundberg
		VOTE
	Berens	Yes
	Cloer	Yes
	Green	No
	Kerr	Yes
	Lundberg	Yes
	McGihon	No
	Riesberg	No
	Soper	Yes
	Stafford	Yes
	Sullivan	Excused
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Not Final YES: 9 NO: 3 EXC: 1 ABS: 0 FINAL ACTION: PASS

04:35 PM

Representative Frangas made concluding remarks. He stated the bill strikes a balance between patients' right to know and public health interests. Representative Stafford discussed her appreciation for the hard work on the bill. Representative McGihon stated her agreement with Representative Stafford.


BILL:	SB06-087
TIME:	04:38:40 PM
MOVED:	Frangas
MOTION:	Refer the bill, as amended, to the Committee of the Whole. The motion failed 5-7-1.
SECONDED:	Weissmann
		VOTE
	Berens	No
	Cloer	No
	Green	No
	Kerr	No
	Lundberg	Yes
	McGihon	No
	Riesberg	Yes
	Soper	No
	Stafford	No
	Sullivan	Excused
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Not Final YES: 5 NO: 7 EXC: 1 ABS: 0 FINAL ACTION: FAIL


BILL:	SB06-087
TIME:	04:41:03 PM
MOVED:	Stafford
MOTION:	Postpone the bill indefinitely. The motion passed 9-3-1.
SECONDED:	McGihon
		VOTE
	Berens	Yes
	Cloer	Yes
	Green	Yes
	Kerr	Yes
	Lundberg	No
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	Yes
	Sullivan	Excused
	Weissmann	No
	Frangas	No
	Boyd	Yes
Final YES: 9 NO: 3 EXC: 1 ABS: 0 FINAL ACTION: PASS

04:43 PM

The committee adjourned.