House Committee on Health and Environment (02/02/2012)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND ENVIRONMENT

Date:	02/02/2012	ATTENDANCE

Time:	01:39 PM to 03:00 PM	Bradford	E
		Brown	X
Place:	LSB A	Fields	E*
		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:
HB12-1047 HB12-1065		Referred to the Committee of the Whole Amended, Referred to Finance

01:42 PM -- House Bill 12-1047

Representative Kefalas presented House Bill 12-1047, concerning the waiver of non-safety licensing standards for kinship foster care. The bill allows county directors of social services to waive certain non-safety licensing standards for kinship foster care. Representative Kefalas explained that the bill does not have a state fiscal impact and that the legislation is permissive. Representative Kefalas responded to a question about whether the bill would provide a net cost savings to counties.

01:48 PM -- Pat Ratliff, Colorado Counties, Inc., introduced Barbara Drake, Douglas County Department of Human Services, and Toni Rozanski, City and County of Denver Department of Human Services. Ms. Ratliff explained how the bill would be beneficial to counties and that it would eliminate a 60-day delay in some situations. Ms. Rozanski expressed support for the bill and indicated that the bill helps in the county's efforts to seek permanency for children. Ms. Drake expressed support for the bill and explained what types of non-safety licensing standards could be waived if the bill is enacted. Ms. Ratliff responded to questions about the bill not allowing for appeals and explained that by not allowing for appeals, the bill allows the program to be permissive rather than an entitlement. Ms. Ratliff and Ms. Drake responded to questions about the safety of kinship placements. Ms. Drake responded to questions about what is included in the non-safety criteria and stated that these issues would be looked at on a case-by-case basis. Ms. Ratliff stated the bill would allow federal rules to be waived at the county level rather than the state level as is currently permitted. Ms. Ratliff responded to questions about why the bill is limited to kinship placements.

02:02 PM -- Shari Shink, Rocky Mountain Children's Law Center, Katie Facchinello, Every Child Matters Colorado, Dr. Gail "Skip" Barber, Colorado Association of Family and Children's Agencies, and Becky Miller Updike, Child Protection Ombudsman, expressed their support of the bill. Ms. Updike explained the history of the Office of Colorado's Child Protection Ombudsman. Ms. Updike stated the bill expands placement options for counties.

02:05 PM

Representative Kefalas provided concluding remarks on the bill.


BILL:	HB12-1047
TIME:	02:06:48 PM
MOVED:	Kefalas
MOTION:	Moved to refer House Bill 12-1047 to the Committee of the Whole. The motion passed on a vote of 11-0.
SECONDED:	Schafer S.
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	Yes
	Peniston	Yes
	Schafer S.	Yes
	Young	Yes
	Acree	Yes
	Summers	Excused

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

02:10 PM -- House Bill 12-1065

Representative Lee presented House Bill 12-1065, concerning the deadline for an advanced practice nurse (APN) who was granted prescriptive authority prior to July 1, 2010, to develop an articulated plan for purposes of retaining prescriptive authority. The bill requires an APN who has prescriptive authority to develop an articulation plan for safe prescribing that documents how the APN intends to maintain ongoing collaboration with physicians and guides the APN's prescriptive practice. APNs who were granted prescriptive authority prior to July 1, 2010, were required to develop their articulation plans by July 1, 2011. If they failed to meet the July 1, 2011, deadline, their prescriptive authority expired. House Bill 12-1065 would allow the State Board of Nursing, on a case-by-case basis, to extend the deadline for developing an articulation plan until no later than July 1, 2012. Representative Lee presented amendment L.002 (Attachment A) that further extends the deadline to September 30, 2012, adds language about collaborative agreements with physicians, removes the case-by-case review by the State Board of Nursing, and establishes a $300 fine for the APNs who receive an extension from the State Board of Nursing. The committee was provided an unofficial preamended version of House Bill 12-1065 (Attachment B) that incorporates the language contained in amendment L.002. Representative Lee responded to questions about the $300 fine.

02:20 PM -- Fran Ricker, Colorado Nurses Association, testified on the bill. The committee was provided an informational packet (Attachment C). She explained why the bill was needed, including the history of the original requirements. She explained why the original deadline for filing an attestation of an APN's articulation plan was missed by APNs, which included the type of notification that occurred by the State Board of Nursing, administrative difficulties, and lack of understanding of the requirements. She described what is occurring in the industry related to APNs losing their prescriptive authority and expressed concerns about the case-by-case review to allow for an extension of the deadline. She discussed the $300 fine that would be added by amendment L.002. Ms. Ricker responded to questions about the fee included in the fiscal note. Representative McCann encouraged members of the Colorado Nurses Association to contact their legislators when issues arise with a state agency.

02:35 PM -- Kennetha Julien, Department of Regulatory Agencies, responded to questions about the fee included in the fiscal note. She explained that the bill as originally drafted would have required rules to be promulgated and had a compressed time frame for implementation, both resulting in additional costs to the department. Ms. Julien stated that the Department of Regulatory Agencies is not supporting the amendment as a whole and is neutral on the provisions further extending the deadline, making a grammatical correction, and including collaborative agreements. She responded to questions about the portions of the proposed amendment that are not supported the Department of Regulatory Agencies, which include the removal of the case-by-case review and the inclusion of the $300 fine. She explained the process that occurred after the initial statute was enacted to allow APNs with existing prescriptive authority to be grandfathered in without needing to meet additional educational requirements. She stated that 300 APNs did not meet the original deadline and that approximately 125 APNs whose prescriptive authority expired have reapplied for prescriptive authority under the new requirements. She explained what happened with those APNs who reapplied after their initial prescriptive authority expired. Ms. Julien responded to questions about why the Department of Regulatory Agencies does not support the removal of the case-by-case review or the inclusion of the $300 fine. She responded to questions about Colorado's use of articulated plans and the department's position on rule-making related to the bill.

02:45 PM

Representative Lee discussed the purpose of removing the case-by-case review, the elimination for the need for rule making, and the inclusion of the $300 fine.

02:48 PM

Ms. Ricker returned to the table to further discuss issues related to the expiration of prescriptive authority for APNs who did not meet the original deadline.

02:51 PM

Representative Joshi explained amendment L.003 (Attachment D), which amends L.002 (Attachment A) to remove the $300 fine. Ms. Julien responded to a question about the Department of Regulatory Agencies's position on amendment L.003.

Christy Chase, Office of Legislative Legal Services, explained amendment L.003. The committee dialogued with Representative Lee about amendment L.003.


BILL:	HB12-1065
TIME:	02:54:07 PM
MOVED:	Joshi
MOTION:	Moved amendment L.003 (Attachment D). The motion passed without objection.
SECONDED:	Schafer S.
		VOTE
	Bradford	Excused
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB12-1065
TIME:	02:54:48 PM
MOVED:	Massey
MOTION:	Moved amendment L.002 (Attachment A), as amended. The motion passed without objection.
SECONDED:	Kerr J.
		VOTE
	Bradford	Excused
	Brown
	Fields
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB12-1065
TIME:	02:55:39 PM
MOVED:	Kerr J.
MOTION:	Moved to refer House Bill 12-1065, as amended, to the Committee on Finance. The motion failed on a vote of 3-10.
SECONDED:	Kefalas
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	No
	Joshi	No
	Kefalas	Yes
	Kerr J.	Excused
	Massey	No
	McCann	No
	Peniston	No
	Schafer S.	No
	Young	No
	Acree	No
	Summers	No

YES: 3 NO: 10 EXC: 2 ABS: 1 FINAL ACTION: FAIL


BILL:	HB12-1065
TIME:	02:57:37 PM
MOVED:	Massey
MOTION:	Moved to reconsider the previous motion. The motion passed on a vote of 12-0.
SECONDED:	Kerr J.
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	Yes
	Peniston	Yes
	Schafer S.	Yes
	Young	Yes
	Acree	Yes
	Summers	Yes

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


BILL:	HB12-1065
TIME:	02:59:01 PM
MOVED:	Kerr J.
MOTION:	Moved to refer House Bill 12-1065, as amended, to the Committee on Finance. The motion passed on a vote of 12-0.
SECONDED:	Massey
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	Yes
	Peniston	Yes
	Schafer S.	Yes
	Young	Yes
	Acree	Yes
	Summers	Yes

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

03:00 PM

The committee adjourned.