Joint Committee Committee on Joint Health and Human Services (01/26/2012)

Final
STAFF SUMMARY OF MEETING

COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES

Date:	01/26/2012	ATTENDANCE

Time:	01:37 PM to 04:13 PM	Acree	X
		Aguilar	X
Place:	LSB A	Bradford	E
		Brown	X
This Meeting was called to order by		Fields	E
	Representative Summers	Foster	E*
		Joshi	X
This Report was prepared by		Kefalas	X
	Amanda King	Kerr J.	X
		Lundberg	X
		Massey	X
		McCann	X
		Mitchell	E*
		Newell	X
		Nicholson	X
		Peniston	X
		Roberts	X
		Schafer S.	X
		White	X
		Young	X
		Summers	X
		Boyd	E

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

Bills Addressed:		Action Taken:
JBC SMART Act Briefing Waiting List for Developmental Disabilities Services Briefing Behavioral Health Transformation Council Briefing		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

01:39 PM -- JBC SMART Act Briefing

Representative Summers provided an overview of the meeting's schedule, which included a briefing with the Joint Budget Committee (JBC) in accordance with House Bill 10-1119, a briefing on the status of the waiting list for services for individuals with developmental disabilities as required by House Bill 08-1101, and a briefing by the Behavioral Health Transformation Council as required by Senate Bill 10-153.

Representative Gerou introduced members of the JBC staff. She provided introductory remarks about the JBC. She explained the work the JBC is doing with the Legislative Audit Committee to review and address the outstanding audit recommendation for Department of Health Care Policy and Financing. Representative Gerou asked that the JBC SMART Act liaisons have the opportunity to meet with the committees prior to committee making their budget recommendation in future years. The committee and the JBC members discussed the SMART Act process. The committee and the JBC members discussed the budget recommendations made by the Senate Health and Human Services Committee specifically related to imposing new copayments for certain Medicaid services. The committee and JBC members received copies of the letters containing the Senate Health and Human Services Committee's SMART Act budget recommendations (Attachments A through C) and the letters containing the House Health and Environment Committee's SMART Act budget recommendations (Attachments D through F). The committee and the JBC members continued to discuss the SMART Act process.

02:21 PM

The committee and JBC members discussed the Department of Health Care Policy and Financing's R-13 budget request related to the Colorado Benefits Management System (CBMS) Electronic Document Management System, specifically the timing of the budget request and the systems required by federal health care reform legislation.

Representative Gerou discussed a grant program the JBC is looking to create to provide funding for services for individuals with development disabilities to address an issue from legislation that was passed two years ago. She explained efforts to address the overlap between the Department of Human Services and Department of Health Care Policy and Financing and the need for some restructuring between the two departments related to services for individuals with developmental disabilities. The committee and JBC members discussed issues related to changing the oversight role of the Department of Human Services and Department of Health Care Policy and Financing for services for individuals with developmental disabilities and long-term care for seniors, including the process that will be utilized to implement such a change. The committee and JBC members discussed the Department of Human Services R-3 budget item related to Temporary Aid to Needy Families (TANF) funding.

02:45 PM

Representative Gerou stated that the Amendment 35 dollars are going to be utilized as they were originally intended. Representative Gerou and the committee discussed the recommendation made by the House Health and Environment Committee related to the funding of school-based health centers, which is included in the Department of Public Health and Environment budget.

02:51 PM -- Waiting List for DD Services

Megan Davisson, JBC staff, provided an overview of the memorandum provided to the committee concerning consideration of developmental disability wait lists and appropriation to the Developmental Disability Services Cash Fund (Attachment G). The committee and Ms. Davisson discussed the information contained in the memorandum, including the length of time people spend on wait lists, the average cost per placement, the funds necessary to eliminate the wait lists, issues related to aging population and aging caregivers, and emergency placements. Ms. Davidson addressed questions related to the regional center waiting list that are not included in the information contained in the memorandum.

03:04 PM -- Chris Collins, Executive Director of Alliance, provided an overview of the Alliance, which is a statewide nonprofit association of community centered boards and service provider organizations. She discussed the 2007 legislative interim committee to improve the system that provides long-term health care services and supports to persons with developmental disabilities and the legislation put forth by the interim committee to address the wait lists. She discussed the new resources put forth by the Governor to address developmental disability issues. Ms. Collins addressed how the need for an emergency placement occurs.

03:10 PM -- Carol Meredith, The ARC, stated she is parent of an individual with developmental disabilities. She testified about emergency placements. She explained the issues caused by the wait lists and specifically the waiting list for emergency services. She described issues related to law enforcement, paramedic, and emergency room costs when those systems are utilized in crisis situation for individuals with developmental disabilities in need of emergency services. Ms. Meredith responded to questions about solutions for the waiting list issues. She discussed the need for system reform to reduce the panic for those in need of services. Ms. Meredith discussed the need for a crisis behavioral health intervention team and respite services in response to a question from Representative Summers.

Ms. Collins addressed questions about community capacity and work force needs to provide services to individuals with developmental disabilities, whether a comprehensive needs assessment has been completed in relation to developmental disability services, and the need for respite services.

Ms. Meredith discussed legislation that was enacted two years ago related to the health insurance mandate for children with autism. Ms. Meredith responded to questions about the need for services for people with autism and the criteria used to determine if someone qualifies for services.

03:34 PM -- Behavioral Health Transformation Council

Reggie Bicha, Executive Director of the Department of Human Services, provided an overview of the Behavioral Health Transformation Council. Mr. Bicha introduced Dr. Lisa Clements, Director of the Office of Behavior Health of the Department of Human Services, and Tom Dillingham, Executive Director of the Federation for Families. An informational packet was provided to the committee (Attachments H through J).

Dr. Clements provided the history of the creation of the council, including an explanation of the planning process related to behavioral health care system transformation and the implementation of Senate Bill 10-153, which created the policy framework for behavioral health transformation and established the council. She described the council membership.

03:44 PM

Mr. Dillingham reviewed the priorities of the council, which include improving behavioral health prevention and early intervention services, improving services to the high-risk and high-need populations, and reducing recidivism in the criminal justice population. He reviewed the accomplishments of the council, which include but are not limited to publishing the Behavioral Health High Utilizers Report, developing and implementing a policy to streamline behavioral health paperwork, implementing the Supported Employment Initiative to increase employment and education opportunities for individuals with serious mental illness, and obtaining grants for various projects.

Dr. Clements described the System of Care Expansion Planning Grant that was awarded to Colorado and goals related to the System of Care Planning Grant. Representative Kefalas asked how the work of the council is improving people's lives. Mr. Dillingham provided testimonials about individuals who have been involved in the behavioral health system and described the need for wrap-around method of care in Colorado. Dr. Clements addressed questions about the impact the council is having on individuals with behavioral heath needs, including improving employment opportunities for individuals with mental illness. She described the efforts of the council related to the partnerships the council has with various state departments to address winnable battles, trauma informed care, and adolescent behavioral health; the integration of behavioral health and physical health; and staffing and patient care at the Colorado mental health institutes.

The committee dialogued about the efforts of the council. The committee, Dr. Clements, and Mr. Dillingham dialogued about the professional development and work force needs related to behavioral health services.

04:13 PM

The committee adjourned.