House Committee on Health and Environment (03/22/2012)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND ENVIRONMENT

Date:	03/22/2012	ATTENDANCE

Time:	01:43 PM to 03:26 PM	Bradford	X
		Brown	X
Place:	LSB A	Fields	X
		Joshi	E*
This Meeting was called to order by		Kefalas	X
	Representative Summers	Kerr J.	E*
		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:
SB12-127 SB12-128 HB12-1294		Amended, Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole

01:44 PM -- Senate Bill 12-127

Representative Summers presented Senate Bill 12-127 concerning the participation of providers of long-term care in Medicaid care coordination programs. The bill requires that the Department of Health Care Policy and Financing allow long-term care providers to participate if it establishes a program of health homes for chronic conditions. It also requires the Department of Health Care Policy and Financing to permit long-term care providers to contract with regional care collaborative organizations either as health homes or to provide primary, specialty, or long-term care supports. Representative Summers discussed the legislative declaration contained in the bill. Representative Summers responded to questions about whether the bill would include people with developmental disabilities and whether regional care collaborative organizations can already contract with long-term care providers.

01:57 PM -- Laura Landwirth, Leading Age Colorado, testified in support of the bill. She discussed the background behind Senate Bill 12-127. Ms. Landwirth responded to questions about the bill, including why the bill is needed.

02:03 PM -- Terri Hurst, Colorado Behavioral Healthcare Council, testified in support of the bill. She stated that currently community mental health centers are not allowed to be primary care medical providers within the regional care collaborative organizations. She stated that bill would allow community mental health centers to serve as health care homes for the clients they serve.

02:05 PM -- Marijo Rymer, The Arc of Colorado, testified in support of the bill. She discussed how a person with developmental disabilities could benefit from the bill. Ms. Rymer responded to a question about the Accountable Care Collaborative model.

02:11 PM

Representative Summers made additional comments about the bill. He explained amendment L.005 (Attachment A), which would include hospice and palliative care centers as organizations that could be considered health homes.


BILL:	SB12-127
TIME:	02:14:19 PM
MOVED:	Summers
MOTION:	Moved amendment L.005 (Attachment A). The motion passed without objection.
SECONDED:	Kefalas
		VOTE
	Bradford
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.
	Young
	Acree	Excused
	Summers

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION:

02:15 PM

The committee discussed the bill, including concerns about the bill related to persons with developmental disabilities.


BILL:	SB12-127
TIME:	02:17:18 PM
MOVED:	Summers
MOTION:	Moved to refer Senate Bill 12-127, as amended, to the Committee of the Whole. The motion passed on a vote of 12-0, with one member excused.
SECONDED:	Kefalas
		VOTE
	Bradford	Yes
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	Yes
	Peniston	Yes
	Schafer S.	Yes
	Young	Yes
	Acree	Excused
	Summers	Yes

YES: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

02:18 PM -- Senate Bill 12-128

Representative Summers presented Senate Bill 12-128 concerning achieving efficiencies in the Medicaid long-term care programs through greater utilization of alternative care facilities. The bill allows the Department of Health Care Policy and Financing to create an enhanced reimbursement program in which an alternative care facility will receive a temporary increase in the Medicaid per diem reimbursement rate for a client discharged from a nursing facility. It also authorizes the department to create a program to identify Medicaid clients who are at risk of a nursing facility placement and redirect them to alternative care facilities and services. The bill requires the Department of Health Care Policy and Financing to develop criteria for program participation and to submit a written report to legislative committees of reference on the design, implementation, and outcomes of any program created as part of the annual reporting process. Representative Summers discussed the federal Money Follows the Person Grant and the legislative declaration contained in the bill.

02:24 PM -- Robert Semro, Bell Policy Center, testified in support of the bill. He provided a written statement of his comments to the committee (Attachment B).

02:28 PM -- Laura Landwirth, Leading Age Colorado, testified in support of the bill. She provided a handout to the committee concerning prior initiatives to study reimbursement methodologies for alternative care facilities (Attachment C). She discussed the alternative care facilities tiered rate study authorized by House Bill 10-1053 that will be released soon by the Department of Health Care Policy and Financing. Ms. Landwirth and Representative Summers responded to questions about when the findings of the study will be released.

02:36 PM -- Eileen Doherty, Colorado Gerontological Society, testified in support of the bill. She described one person's experience of transitioning out of a nursing home. Ms. Doherty responded to questions about what entities would be responsible for payments to facilities, individuals transitioning from nursing facilities to alternative care facilities, and payment and reimbursement rates.

02:44 PM -- Corky Kyle, Colorado Assisted Living Association, testified in support of the bill. Mr. Kyle responded to questions about the potential costs and savings related to the bill.

02:49 PM

Representative Summers described amendment L.003 (Attachment D), which would include language in the bill about the prior studies that have been conducted related to an enhanced reimbursement methodology and some of the strategies that have been discussed in the past related to enhanced reimbursement rates for alternative care facilities.


BILL:	SB12-128
TIME:	02:54:57 PM
MOVED:	Summers
MOTION:	Moved amendment L.003 (Attachment D). The motion passed without objection.
SECONDED:	Kefalas
		VOTE
	Bradford
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.	Excused
	Young
	Acree
	Summers

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

02:56 PM

Representative Summers provided closing comments on the bill. The committee dialogued about the bill, including the availability of data from both the tiered rate study and the federal Money Follows the Person Program.


BILL:	SB12-128
TIME:	02:58:57 PM
MOVED:	Summers
MOTION:	Moved to refer Senate Bill 12-128, as amended, to the Committee of the Whole. The motion passed on a vote of 12-0, with one member excused.
SECONDED:	Kefalas
		VOTE
	Bradford	Yes
	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: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

02:59 PM

The committee took a brief recess.

03:04 PM

Representative Summers called the committee back to order.

03:04 PM -- House Bill 12-1294

The committee resumed discussion of House Bill 12-1294, concerning modifications to the system of regulation of health care facilities currently regulated by the Department of Public Health and Environment, which was last discussed by the committee on March 20, 2012. Representative Liston explained amendment L.027 (Attachment E), which creates the health care facility stakeholder forum. Representative Liston responded to questions about who will pay for the staffing of the forum. Christy Chase, Office of Legislative Legal Services, responded to questions about amendment L.027. The committee and Representative Liston continued to dialogue about the amendment.


BILL:	HB12-1294
TIME:	03:11:01 PM
MOVED:	Summers
MOTION:	Moved amendment L.027 (Attachment E). The motion passed without objection.
SECONDED:	Acree
		VOTE
	Bradford
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.	Excused
	Young
	Acree
	Summers

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

03:13 PM

Representative Summers moved to reconsider amendment L.022 (Attachment F), which was adopted by the committee at its March 20, 2012, meeting.


BILL:	HB12-1294
TIME:	03:13:30 PM
MOVED:	Summers
MOTION:	Moved to reconsider amendment L.022 (Attachment F). The motion passed without objection.
SECONDED:	Brown
		VOTE
	Bradford
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.	Excused
	Young
	Acree
	Summers

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

03:13 PM

Representative Summers discussed amendment L.028 (Attachment G), which amends language in amendment L.022 to change a reference to the health care facility stakeholder forum.


BILL:	HB12-1294
TIME:	03:14:00 PM
MOVED:	Summers
MOTION:	Moved amendment L.028 (Attachment G). The motion passed without objection.
SECONDED:	Brown
		VOTE
	Bradford
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.	Excused
	Young
	Acree
	Summers

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


BILL:	HB12-1294
TIME:	03:14:26 PM
MOVED:	Summers
MOTION:	Moved amendment L.022, as amended, (Attachment F). The motion passed without objection.
SECONDED:	Kefalas
		VOTE
	Bradford
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.	Excused
	Young
	Acree
	Summers

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

03:15 PM

Representative Liston further discussed the bill. Kirk Mlinek, Legislative Council Staff, was asked to the table to responded to questions about the fiscal note. A memo about the fiscal impact of amendments adopted to date on House Bill 12-1294 (Attachment H) was provided to the committee. The committee and Representative Liston continued to dialogue about the bill.


BILL:	HB12-1294
TIME:	03:25:05 PM
MOVED:	Summers
MOTION:	Moved to refer House Bill 12-1294, as amended, to the Committee of the Whole. The motion passed on a vote of 12-0, with one member excused.
SECONDED:	Brown
		VOTE
	Bradford	Yes
	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: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:26 PM

The committee adjourned.