House Committee on Health and Environment (04/19/2012)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND ENVIRONMENT

Date:	04/19/2012	ATTENDANCE

Time:	02:45 PM to 06:20 PM	Bradford	E
		Brown	E*
Place:	LSB A	Fields	X
		Joshi	X
This Meeting was called to order by		Kefalas	X
	Representative Summers	Kerr J.	X
		Massey	X
This Report was prepared by		McCann	X
	Amanda King	Peniston	X
		Schafer S.	X
		Young	X
		Acree	X
		Summers	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB12-078 SB12-060		Amended, Referred to Legislative Council Referred to Appropriations

02:46 PM -- Senate Bill 12-078

Representative Summers announced that the follow-up presentation on the developmental disabilities wait list will not be occurring this session. The State of the States in Developmental Disabilities 2011 (Attachment A) was distributed to the committee.

02:48 PM

Representative Schafer presented Senate Bill 12-078 concerning protections for at-risk adults. The bill clarifies definitions and modifies requirements concerning the mistreatment, self-neglect, and exploitation of at-risk adults. Among other things, the bill removes the requirement that an abuse reporter follow an oral report with a written report within 48 hours. In addition, it directs each county to require each protective services employee to undergo a fingerprint background check. The background checks are at the employee's expense, unless the county department chooses to pay for them. The bill creates the Elder Abuse Task Force. Two statements of support (Attachments B and C) were distributed to the committee.

02:52 PM -- Charles Carter, National Active and Retired Federal Employees Association, testified in support of the bill. He provided a written statement to the committee (Attachment D). He discussed examples of elder abuse that have occurred in the state. He discussed issues with the fiscal impacts of similar bills, staffing concerns, guardianships, and voluntary reporting. Mr. Carter responded to questions about the bill.

03:09 PM -- Tammy Conover, Colorado Bar Association, testified in support of the bill. She discussed the importance of passing a bill to address the problem of elder abuse. Ms. Conover responded to questions about whether the bill would create any liability for some professions, the penalties for false reporting and failing to report elder abuse, and whether family members should be included in the people who are encouraged to report elder abuse. Ms. Conover continued to respond to questions about adult protective service teams and background check requirements. Representative Schafer and Ms. Conover discussed reporting by family members. Ms. Conover responded to questions about mandatory reporting requirements for elder abuse and whether incidents of elder abuse are currently being tracked.

03:24 PM -- David Blake and Timothy Sokas, Attorney General's Office, testified against the bill. Mr. Blake stated that if certain amendments were adopted to require mandatory reporting, the position of the Attorney General's office would change. Mr. Sokas discussed his experience working on cases of abuse of at-risk adults and the need for mandatory reporting in cases of abuse of at-risk adults. Mr. Blake responded to questions about the definitions for "at-risk adults." Mr. Blake responded to questions about mandatory reporting, elder abuse, and his position on the bill. Mr. Sokas discussed a situation in a group home in which mandatory reporting would have been beneficial. Representative Schafer made comments about the stakeholders' understanding of the costs related to mandatory reporting.

03:41 PM -- Scott Storey, District Attorney for the First Judicial District, and Sean Clifford, First Judicial District Attorney's Office, testified in support of the bill. Mr. Storey discussed the Elder Abuse Unit in his office and the types of elder abuse cases that are prosecuted. He discussed the need for the task force authorized by the bill to further look at the issue of elder abuse. He discussed changing the definition of "at-risk adult." Mr. Clifford discussed his experience prosecuting elder abuse cases and the definitions of "at-risk adults." Mr. Storey responded to questions about his position on the bill and what happens in elder abuse cases when the victim is incapacitated. Mr. Clifford further discussed prosecuting elder abuse cases.

04:00 PM -- Renee Rivera, National Association of Social Workers - Colorado Chapter, testified in support of the bill. She discussed the need for an elder abuse task force. Ms. Rivera responded to questions about underreporting of elder abuse, the availability of data from other states related to elder abuse, and the definition of "at-risk adults."

04:08 PM

Mr. Clifford and Mr. Storey responded to questions about the definition of "at-risk adults." Mr. Clifford responded to questions about the number of family members prosecuted for financial abuse. Mr. Storey responded to questions about the budget for the Elder Abuse Unit.

04:15 PM -- Lia Rhodes, Gold Leaf Care Givers, and Erin Nichols, herself, testified in support of the bill. Ms. Nichols discussed her experience working with elderly clients and reporting cases to Adult Protective Services. Ms. Nichols responded to questions about mandatory reporting requirements under Medicaid. Ms. Rhodes discussed the lack of infrastructure for elder abuse cases and her experience trying to report a case of elder abuse. Ms. Nichols and Ms. Rhodes discussed including family members as mandatory reporters.

04:24 PM -- Sam Polizzotto, Colorado Alliance for Retired Americans, testified in support of the bill. He discussed the need to protect seniors.

04:29 PM -- Dennis Valentine, AARP, testified in support of the bill. He stated that AARP would support mandatory reporting.

04:33 PM -- Jennifer Ballentine, Life Quality Institute and Colorado Center for Hospice and Palliative Care, testified in support of the bill. She discussed the need to further amend the bill to address advance medical directives or palliative plans of care. Ms. Ballentine responded to questions about her suggestions to amend the bill.
04:41 PM -- Jon Jennett, National Private Duty Association - Colorado Chapter, testified in support of the bill. Mr. Jennett responded to questions about the task force membership.

04:45 PM -- Cary Johnson, First Judicial District Attorney's Office, testified on the bill. He noted that Colorado is one of the few states that does not currently have a mandatory reporting requirement for elder abuse. He discussed a case of financial exploitation of a senior. Mr. Johnson responded to questions about whether the voluntary or mandatory reporting of elder abuse should be written or oral.

04:55 PM -- Gini Pingenot, Colorado Counties Inc., testified in support of the bill. She discussed the costs of mandatory reporting, the process that occurs when a report is made to Adult Protective Services, case load levels, and the lack of federal funding for Adult Protective Services. Ms. Pingenot responded to questions about the potential costs to counties for mandatory reporting, the costs related to mandatory reporting of child abuse, trends related to rural versus urban counties, existing laws related to reporting of elder abuse, and the number of adult protection teams in the state. Ms. Pingenot responded to questions about the potential amendments.

05:09 PM -- Ann Toll, The Meyer Law Firm and Boulder County Elder Justice Coalition, testified on the bill. She provided a handout to the committee (Attachment E). She discussed the need to include home care professionals in the list of mandatory reporters. Ms. Toll responded to questions about the brochure she provided to the committee. She further discussed the various types of elder abuse that can occur.

05:20 PM -- Joscelyn Gay, Colorado Department of Human Services, testified on the bill. She discussed the number of reports, types of cases, and other statistics related to elder abuse that occurs in Colorado. She discussed the current responses that occur when a report is made concerning elder abuse. Ms. Gay responded to questions about adult protection teams and the current budget for adult protection services.

05:29 PM

Representative Schafer explained amendment L.020 (Attachment F), which concerns criminal history records checks.


BILL:	SB12-078
TIME:	05:31:03 PM
MOVED:	Schafer S.
MOTION:	Moved amendment L.020 (Attachment F ). The motion passed without objection.
SECONDED:	Summers
		VOTE
	Bradford	Excused
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

05:31 PM

Representative Schafer explained amendment L.022 (Attachment G), which concerns sufficient funding at the state and county levels for the implementation of a reporting system.


BILL:	SB12-078
TIME:	05:31:56 PM
MOVED:	Schafer S.
MOTION:	Moved amendment L.022 (Attachment G). The motion passed without objection.
SECONDED:	Summers
		VOTE
	Bradford	Excused
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

05:33 PM

Representative Schafer explained amendment L.023 (Attachment H), which concerns the definition of financial institution.


BILL:	SB12-078
TIME:	05:33:16 PM
MOVED:	Schafer S.
MOTION:	Moved amendment L.023 (Attachment H). The motion passed without objection.
SECONDED:	Summers
		VOTE
	Bradford	Excused
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

05:33 PM

Representative Schafer explained amendment L.025 (Attachment I), which concerns the definition of "at-risk adult" and mandatory reporting requirements. Richard Sweetman, Office of Legislative Legal Services, discussed amendment L.025. The committee and Mr. Sweetman discussed the definition of "at-risk adult." Representative Schafer responded to a question about how the amendment addresses reporting cases of financial exploitation. Mr. Blake returned to the table to respond to questions about the amendment related to the definition of "at-risk adult" and the reporting of cases of financial exploitation. Mr. Blake responded to questions about whether crimes against elders would be subject to current statutes and whether sentencing enhancement currently exists for such crimes. The committee and Mr. Blake continued to discuss the definition of "at-risk adult."


BILL:	SB12-078
TIME:	05:46:39 PM
MOVED:	Summers
MOTION:	Moved a conceptual amendment to amend amendment L.025 (Attachment I), page 1, line 2, strike "SIXTY" and substitute "SEVENTY". The motion passed on a vote of 9-3, with one member excused.
SECONDED:	Brown
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	No
	Kerr J.	Yes
	Massey	Yes
	McCann	Yes
	Peniston	No
	Schafer S.	Yes
	Young	No
	Acree	Yes
	Summers	Yes

YES: 9 NO: 3 EXC: 1 ABS: 0 FINAL ACTION: PASS

05:47 PM

The committee continued to discuss amendment L.025, the need for an updated fiscal note related to mandatory reporting requirements, and whether or not the bill should be referred to the Legislative Council Committee.


BILL:	SB12-078
TIME:	05:55:51 PM
MOVED:	Schafer S.
MOTION:	Moved amendment L.025 (Attachment I), as amended. The motion passed on a vote of 10-2, with one member excused.
SECONDED:	Summers
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	No
	Peniston	Yes
	Schafer S.	Yes
	Young	No
	Acree	Yes
	Summers	Yes

YES: 10 NO: 2 EXC: 1 ABS: 0 FINAL ACTION: PASS

05:56 PM

Representative Schafer explained amendment L.026 (Attachment J), which concerns reporting of abuse by community-centered board staff. Mr. Sweetman responded to questions about the amendment. Representative Summers further discussed the amendment. Mr. Blake returned to the table to discuss the amendment.


BILL:	SB12-078
TIME:	06:02:09 PM
MOVED:	Schafer S.
MOTION:	Moved amendment L.026 (Attachment J). The motion passed without objection.
SECONDED:	Summers
		VOTE
	Bradford	Excused
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

06:03 PM

The committee dialogued regarding mandatory reporting and the related costs.


BILL:	SB12-078
TIME:	06:06:49 PM
MOVED:	Schafer S.
MOTION:	Moved to refer Senate Bill 12-078, as amended, to the Legislative Council Committee. The motion passed on a vote of 10-2, with one member excused.
SECONDED:	Summers
		VOTE
	Bradford	Excused
	Brown	No
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	Yes
	Peniston	Yes
	Schafer S.	Yes
	Young	No
	Acree	Yes
	Summers	Yes

YES: 10 NO: 2 EXC: 1 ABS: 0 FINAL ACTION: PASS

06:09 PM -- Senate Bill 12-060

Representative Summers announced that Senate Bill 12-161, concerning measures to reduce health care costs in correctional facilities, is laid over until the committee meeting on Tuesday, April 24.

Representative Gerou presented Senate Bill 12-060, concerning improving Medicaid fraud prosecution. The bill requires the Departments of Health Care Policy and Financing and Law to prepare annual reports on Medicaid client and provider fraud, respectively, for certain legislative committees. The reports are to detail the number of Medicaid client and provider fraud investigations, actions undertaken to make recoveries and prosecute fraud, amounts recovered, trends in methods used to commit Medicaid fraud, and policies adopted by the state and county to detect and prevent Medicaid fraud. The bill also specifies that recoveries of fraudulently obtained Medicaid benefits are to be deposited in the County Social Services Fund, and any amounts not required to be reimbursed to the federal government for a share proportional to the amount of federal funds initially paid may be retained by the county. Representative Acree made comments on the bill.

06:14 PM -- Sam Polizzotto, Colorado Alliance of Retired Americans, testified in support of the bill.

06:15 PM -- Timothy Sokas, Attorney General's Office, testified in support of the bill. He explained how much money the Attorney General has recovered through the Medicaid Fraud Unit. Mr. Sokas responded to questions about the costs of the Medicaid Fraud Unit.

06:17 PM -- Gini Pingenot, Colorado Counties, Inc., and Janet Sullivan, Jefferson County Department of Human Services, testified in support of the bill.


BILL:	SB12-060
TIME:	06:19:24 PM
MOVED:	McCann
MOTION:	Moved to refer Senate Bill 12-060 to the Committee on Appropriations. The motion passed on a vote of 11-0, with 2 members excused.
SECONDED:	Summers
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	Yes
	Peniston	Yes
	Schafer S.	Excused
	Young	Yes
	Acree	Yes
	Summers	Yes

YES: 11 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: PASS

06:20 PM

The committee adjourned.