House Committee on Health and Human Services (01/16/2006)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:	01/16/2006	ATTENDANCE

Time:	02:20 PM to 05:05 PM	Berens	X
		Clapp	E
Place:	HCR 0112	Cloer	X
		Green	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	X
		Weissmann	X
		Frangas	X
		Boyd	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Asbestos Control Program Sunset Hearing Dental Advisory Committee Sunset Hearing HB06-1029		- - Laid Over

02:25 PM -- Colorado Asbestos Control Act Sunset Hearing

Brian Tobias and Julie Kreps, Department of Regulatory Agencies (DORA), came to the table to present the department's sunset review of the Colorado Asbestos Control Act. Mr. Tobias discussed criteria used to evaluate programs under review. Balancing public safety with least restrictive regulations is the primary goal. Ms. Kreps discussed the Asbestos Control Program. Asbestos is highly useful for its heat and fire resistance. When it becomes airborne, however, it causes very serious health problems. A variety of professionals evaluate construction projects, conduct abatements, and determine the safety level of completed projects. The program's permitting processes include trigger levels for the program's requirements. She answered questions about different types of asbestos and corresponding levels of regulation. Copies of a draft bill were distributed to members (Attachment A). She reviewed proposed programmatic changes, including continuing the program until 2013, imposing conflict of interest prohibitions, and repealing a number of obsolete provisions. Mr. Tobias answered questions about the department's administrative recommendations. Such recommendations are not typically included in sunset bills.

02:44 PM

Howard Roitman and Dr. Ned Calonge, Department of Public Health and Environment (DPHE), came to the table to testify. Mr. Roitman stated the department's support for DORA's recommendations. Dr. Calonge discussed the health effects of the two different types of asbestos. The mineral can increase individual risk for cancer up to 45 times. He stated the longer the asbestos fiber, the worse the health effects. At this time, however, general opinion is that the different types of asbestos should not be regulated differently. Based upon the department's research, none of the 50 states regulates different types of asbestos differently. Representative Lundberg discussed his findings regarding construction businesses' opinion of the asbestos program and the different types of asbestos and their health risks. Dr. Calonge stated that although there are differences of opinion within the scientific community, the majority opinion holds that there is no compelling evidence at this time to regulate the two types of asbestos differently.

03:00 PM

David Ouimette, Stationary Sources Program, DPHE, answered questions about DORA's recommendations, including ensuring consistency among soil and air quality standards and providing testing and training in Spanish.

The following member of the public testified.

03:05 PM -- Robert Szynskie, RLM, Engineering, discussed Spanish language training and suggested a five-year sunset date.

03:11 PM

Representative Lundberg discussed his wishes for "due diligence" on the part of DPHE to carry out the asbestos program to best of their ability.


BILL:	Asbestos Control Program Sunset Hearing
TIME:	03:11:05 PM
MOVED:	McGihon
MOTION:	Amend draft bill (Attachment A), page 4, lines 10 and 11, replace "one-, three-, or five-year period established by the commission by rule" with "period not to exceed five years". Make conforming amendments throughout the bill. The motion passed without objection.
SECONDED:	Weissmann
		VOTE
	Berens
	Clapp	Excused
	Cloer
	Green
	Lundberg
	McGihon
	Riesberg
	Soper
	Stafford
	Sullivan
	Weissmann
	Frangas
	Boyd
Not Final YES: 0 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	Asbestos Control Program Sunset Hearing
TIME:	03:13:18 PM
MOVED:	McGihon
MOTION:	Recommend the draft bill, as amended, for introduction. The motion passed 9-2-2.
SECONDED:	Frangas
		VOTE
	Berens	Yes
	Clapp	Excused
	Cloer	Excused
	Green	Yes
	Lundberg	No
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	Yes
	Sullivan	No
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 9 NO: 2 EXC: 2 ABS: 0 FINAL ACTION: PASS

03:14 PM

Representative McGihon was assigned sponsorship of the bill.

03:15 PM

Julie Kreps, Department of Regulatory Agencies, discussed the Dental Advisory Committee as it was established in 1997. She stated the committee was never initiated because the Children's Basic Health Plan (AKA the Child Health Plan Plus or CHP+) was also created in 1997 and largely addressed the issues the committee was formed to undertake . The department's recommendation is therefore to allow the committee to sunset. A draft bill was distributed to members (Attachment B).

03:19 PM

Diane Brunson and Dr. Ned Calonge, Department of Public Health and Environment, came to the table to testify. Ms. Brunson discussed dental issues and services provided by the Children's Basic Health Plan and the Department of Health Care Policy and Financing. Committee members commented on the decision to not form the Dental Advisory Committee as required by statute. Ms. Brunson described another committee recently formed to address senior dental issues and services.


BILL:	Dental Advisory Committee Sunset Hearing
TIME:	03:27:41 PM
MOVED:	Soper
MOTION:	Recommend the draft bill (Attachment B) for introduction. The motion passed 11-0-2.
SECONDED:	Weissmann
		VOTE
	Berens	Yes
	Clapp	Excused
	Cloer	Excused
	Green	Yes
	Lundberg	Yes
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	Yes
	Sullivan	Yes
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Final YES: 11 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: PASS

03:29 PM

Bill sponsorship was assigned to Representative Soper.

03:29 PM -- House Bill 06-1029

Representative Lundberg, sponsor, presented the bill regarding Medicaid reform and distributed two background information documents to members (Attachments C and D). He discussed the need for Medicaid reform, estate recovery, and cost savings associated with the bill. He answered questions about how he envisions dollars to flow under his proposed legislation. He stated the essence of the program is to determine the level of service needed by an enrollee and for Medicaid to cover 50 percent of care. He answered questions about enrollees whose health care needs change. Representative Green discussed Medicaid's Home- and Community-Based Services program. She stated the program provides a variety of health care options for Medicaid enrollees.

03:46 PM

Representative Lundberg answered questions about how Medicaid enrollees might be able to afford to pay for half of their medical expenses. Representative Stafford stated her support for the bill. She asked about how the bill's provisions might be accommodated by the Colorado Benefits Management System (CBMS). Representative Lundberg answered questions about cost-savings associated with the bill. He stated that if anyone enrolls in the proposed program, the state will save money. He also stated that if the bill passes, he will ensure that it is implemented by the Department of Health Care Policy and Financing. Representative Reisberg discussed his concerns with the bill, including explaining the program to eligible seniors. Representative Lundberg discussed the proposed program's flexibility and opt-in and opt-out provisions. He answered questions about situations in which a spouse dies and leaves unpaid medical bills. He stated the federal government requires the state to pursue estate recovery after an enrollee, his/her spouse, and any other dependents die.

04:06 PM

Representative Berens discussed cost savings associated with the bill. Representative Lundberg discussed his belief that Medicaid limits enrollees medical choices. He stated Medicaid favors nursing home care over home- and community-based services. Representatives McGihon and Lundberg discussed medical services available to Medicaid enrollees. Representative Green discussed coverage of home- and community-based services by Medicaid and Medicaid eligibility criteria. Committee members discussed scenarios that may occur under the bill. Representative Stafford discussed the need for reform and meeting the state's fiscal challenges. Representative Lundberg answered questions about the bill's impact on estate recovery.

The following person testified.

04:26 PM -- Julie Reiskin, Colorado Cross Disability Coalition, discussed the availability of non-nursing home care and the benefits of consumer-directed care. She gave examples of ways consumer-directed care saves money such as purchasing wheel chair kill switches available inexpensively at Radio Shack. She made suggestions for changing the bill or improving upon the current consumer-directed care program. She answered questions about family caregivers. Representative Stafford stated her support for consumer-directed care and enrollee responsibility in determining their care. Ms. Reiskin answered questions about how the bill might address prescription drug coverage and the needs of persons who are dually eligible for Medicaid and Medicare.

04:42 PM

Representative Lundberg made concluding remarks. He stated the decision on the bill boils down to giving seniors more options for care and allowing the state a way to save money. Representative Cloer moved and discussed amendment L.001 (Attachment E). Representative Lundberg stated his support for the amendment. Representatives Cloer and Berens discussed issues related to power of attorney.


BILL:	HB06-1029
TIME:	04:49:31 PM
MOVED:	Cloer
MOTION:	Adopt amendment L.001 (Attachment E). The motion passed 8-4-1.
SECONDED:	Stafford
		VOTE
	Berens	Yes
	Clapp	Excused
	Cloer	Yes
	Green	No
	Lundberg	Yes
	McGihon	No
	Riesberg	No
	Soper	No
	Stafford	Yes
	Sullivan	Yes
	Weissmann	Yes
	Frangas	Yes
	Boyd	Yes
Not Final YES: 8 NO: 4 EXC: 1 ABS: 0 FINAL ACTION: PASS

04:50 PM

Representative Cloer moved and discussed amendment L.002 (Attachment F). Upon Representative Lundberg's request, the sponsor withdrew the amendment.

04:51 PM

Committee members discussed their positions on the bill.


BILL:	HB06-1029
TIME:	04:59:04 PM
MOVED:	Lundberg
MOTION:	Refer the bill, as amended, to the Committee on Appropriations. The motion failed 5-7-1.
SECONDED:	Stafford
		VOTE
	Berens	Yes
	Clapp	Excused
	Cloer	Yes
	Green	No
	Lundberg	Yes
	McGihon	No
	Riesberg	No
	Soper	No
	Stafford	Yes
	Sullivan	Yes
	Weissmann	No
	Frangas	No
	Boyd	No
Not Final YES: 5 NO: 7 EXC: 1 ABS: 0 FINAL ACTION: FAIL


BILL:	HB06-1029
TIME:	05:02:12 PM
MOVED:	Weissmann
MOTION:	Postpone the bill indefinitely. The motion failed 6-6-1.
SECONDED:	McGihon
		VOTE
	Berens	No
	Clapp	Excused
	Cloer	No
	Green	Yes
	Lundberg	No
	McGihon	Yes
	Riesberg	Yes
	Soper	Yes
	Stafford	No
	Sullivan	No
	Weissmann	Yes
	Frangas	No
	Boyd	Yes
Not Final YES: 6 NO: 6 EXC: 1 ABS: 0 FINAL ACTION: TIE

05:05 PM

The committee adjourned.