Joint Committee Committee on Joint Health and Human Services (01/19/2012)

Final
STAFF SUMMARY OF MEETING

COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES

Date:	01/19/2012	ATTENDANCE

Time:	01:36 PM to 04:15 PM	Acree	X
		Aguilar	X
Place:	LSB A	Bradford	X
		Brown	E
This Meeting was called to order by		Fields	X
	Representative Summers	Foster	X
		Joshi	X
This Report was prepared by		Kefalas	X
	Amanda King	Kerr J.	X
		Lundberg	X
		Massey	E
		McCann	X
		Mitchell	X
		Newell	X
		Nicholson	X
		Peniston	X
		Roberts	E
		Schafer S.	X
		White	X
		Young	X
		Summers	X
		Boyd	X

		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Introduction Unimplemented DHS Audit Items Dept of Human Services SMART Act briefing		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

01:38 PM -- Introduction

Representative Summers reviewed the committee schedule for the meeting and future meetings of the health committees with regards to the SMART Act requirements and other required briefings.

01:41 PM -- Unimplemented DHS Audit Items

Kerri Hunter, Deputy State Auditor, introduced herself and Cindi Radke, audit manager with the State Auditor's Office. Ms. Hunter stated that they would be discussing the outstanding audit recommendation contained in the report provided to the committee (Attachment A).

Ms. Radke presented the outstanding audit recommendations made to the Department of Human Services (DHS) that have not yet been fully implemented. She described the three finding classifications used by the Auditor's Office, which are material weakness, significant deficiency, and deficiency in internal control. She stated that the report presented to the committee contains 38 recommendations. She stated that there are no material weaknesses contained in the report, which is the most severe of the findings classifications. There are 20 items that carry a significant deficiency and 18 items that carry a deficiency in internal control. Ms. Radke reviewed the 20 items that carry a significant deficiency classification.

The committee, Ms. Hunter, and Ms. Radke dialogued about the outstanding audit recommendations, including the relationship they have with federal audits, the process used for testing controls, the relationship between the Colorado Financial Reporting System (COFRS) and the County Financial Management System (CFMS), and the severity of the issues contained in the audit report.

02:10 PM

The committee, Ms. Hunter, and Ms Radke continued to dialogue about the impact the outstanding audit recommendations have on people on public assistance, the risk of federal sanctions, and what recourse the legislature has to make sure these recommendations are implemented. The committee discussed what should be done with the information presented by the State Auditor's staff, including creating more awareness of the issues, eliminating redundancies with federal audits, and conversing with the executive director of DHS about why the audit recommendations have not been implemented.

02:20 PM -- Dept of Human Services SMART Act briefing

Executive Director Reggie Bicha, Department of Human Services (DHS), introduced himself to the committee.

Representative Summers asked about the status of the unimplemented audit item 81 concerning eligibility documents for the Colorado Child Care Assistance Program that had a deficiency in internal control classification in 2009 and then a significant deficiency in 2010. Mr. Bicha explained the progress that has been made by DHS in implementing the audit findings, the process of implementation, and the efforts being made by DHS to manage and address audit findings. The committee and Mr. Bicha dialogued about the audit findings and the efforts DHS is making to rectify the audit findings.

02:41 PM

Mr. Bicha reviewed the three documents provided to the committee, which were DHS FY 2012-13 Strategic Plan Overview (Attachment B), DHS Summary of FY 2012-13 Funding Requests (Attachment C), and DHS Strategic Plan (Attachment D). He explained the administrative and supervisory roles of DHS, the areas DHS inspects or licenses, and the programs that DHS operates and funds. He explained the way the strategic plan was developed, including the outreach that occurred. He outlined the strategic imperatives and strategic initiatives contained in the DHS FY 2012 Strategic Plan Overview. He provided an overview of the C-Stat strategy, which will collect timely data, increase transparency, conduct regular executive meetings to identify new performance measures, and support continuous quality improvement. He continued to explain the proposed integration of an Office of Early Childhood Education that would bring together over 20 programs to help parents help their children.

Representative McCann asked about the proposed inclusion of the Tony Grampsas Youth Services Program Board within DHS. Mr. Bicha explained the efforts DHS is taking to look at the needs of youngsters in Colorado throughout the age continuum. He also discussed the various prevention efforts of DHS.

Mr. Bicha explained DHS' long-term services and supports redesign goals to achieve sustainability. He explained the issues with waitlists, waivers, and fragmentation in the system. He explained the budget request for $4,877,540 for program costs to provide services for 173 people with developmental disabilities to address high demand and access to services. The committee dialogued with Mr. Bicha about the budget request, the need for services for people with development disabilities, and the current fee-for-service model.

03:20 PM

Mr. Bicha and the committee continued dialogue about employment opportunities available to persons with developmental disabilities.

Mr. Bicha explained the department-wide streamlining effort, which includes the review of DHS administrative rules. Senator Lundberg asked about the rules for child care programs. Mr. Bicha responded about the implementation of rules for child care programs. Senator Lundberg and Mr. Bicha dialogued about private child care provider rules.

03:38 PM

Mr. Bicha reviewed the caseload for the Colorado Works/TANF program and food assistance cases. He outlined the collaborative efforts to achieve economic security and the legislative initiative contained in Senate Bill 12-042, concerning bringing certain statutory provisions related to child support in compliance with federal law. He also explained the budget request of a $6,282,522 reduction in Temporary Assistance for Needy Families (TANF). Senator Newell and Mr. Bicha dialogued about the budget request concerning the TANF program.

03:48 PM

Mr. Bicha explained the comprehensive child welfare outcome-focused strategy. He explained the partnerships with the Casey Family Program and Annie E. Casey Foundation in this effort. He outlined the two legislative initiatives related to this strategy. The first bill he described was Senate Bill 12-033, concerning adding the review of near fatalities to the responsibilities of the department of human services child fatality review team. The second bill he described was Senate Bill 12-066, concerning expanding those person eligible as guardians in the guardianship assistance program to include persons ascribed by the family as having a family-like relationship with the child. He explained the like-kin relationship used in Colorado related to child placements.

Mr. Bicha explained the long-term care goals and strategies and the economic security goals and strategies of DHS. He explained the efforts by DHS to provide timely food assistance and the efforts to increase by 3 percent the percentage of people enrolled in the Colorado Works Program that have employment earnings. Senator Boyd asked how the Colorado Works Program goal is related to the budget item to decrease TANF funds. Mr. Bicha explained the efforts DHS is taking around employment through various partnerships.

Senator Newell asked Mr. Bicha to explain the three branch effort to look at child placement. Mr. Bicha explained the program.

Representative Kefalas asked about the Supplemental Nutrition Assistance Program participation rates. Mr. Bicha responded that DHS will be addressing participation rates and error rates through the C-Stat strategy measures. Representative Kefalas and Mr. Bicha continued to dialogue about the participation rate goals.

Mr. Bicha reviewed the strategic goals of timely assessments, timely permanency, and addressing re-entry with regards to child welfare. He discussed the efforts to improve the state's mental health facilities. He outlined the behavioral health goals and strategies, including improving the time it takes for the completion a competency evaluation for someone in the criminal justice system. He explained the efforts to improve access to substance abuse services. He explained the budget request of $75,000 to complete a feasibility study for an electronic health records and new pharmacy system for the state's mental health facilities. Mr. Bicha reviewed the operational efficiencies to reduce the frequency of audits. Mr. Bicha discussed the DHS strategy concerning consistency related to child care rules. He reviewed the issues related to the statewide case management and payroll system (CHATS).

04:09 PM -- Youlon Savage, Chair of the State Board of Human Services (board), explained the make up of the board and the responsibilities of the board. He stated the board's support of the DHS management philosophy.

Senator Foster thanked Mr. Savage for appearing before the committee and for his dedication to the board.

04:13 PM -- Jennifer Politi, policy analyst and coordinator for the Colorado Human Services Directors Association, discussed the relationship the association has had with DHS under Mr. Bicha's leadership.

04:15 PM

The committee adjourned.