House Committee on Health and Environment (02/16/2012)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND ENVIRONMENT

Date:	02/16/2012	ATTENDANCE

Time:	01:36 PM to 05:00 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	E*
This Report was prepared by		McCann	E
	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:
HB12-1126 HB12-1141 HB12-1140		Amended, Referred to Appropriations Committee Vote - Final Action Failed Amended, Referred to Appropriations

01:37 PM -- House Bill 12-1126

Representative Gerou presented House Bill 12-1126, concerning on-site wastewater treatment systems. The bill updates statutes related to the regulation of on-site wastewater treatment systems. The bill eliminates references to certain terms. Under the bill, the Water Quality Control Division in the Department of Public Health and Environment must periodically advise the Water Quality Control Commission of changes in technology and practice that could warrant revision of pertinent rules. The bill addresses local boards of health rules related to on-site wastewater treatment systems. The bill clarifies certain duties of the owners and on-site wastewater treatment systems fees. Representative Gerou explained that it allows new technologies to be implemented. She stated that amendments would be offered to address issues with cesspools and the fiscal impact.

01:41 PM -- Ed Church, Colorado Professionals in On-site Wastewater, testified in support of the bill. He explained how the bill could allow new technologies to be utilized and improve water quality. Mr. Church and Representative Gerou responded to questions about from the committee about the bill. Mr. Church discussed how counties would be involved in determining treatment levels. Representative Gerou explained how wastewater ends up in a leach field and how the bill would allow new technologies to be utilized to improve on-site wastewater treatment systems.

01:55 PM -- Roy Laws, Colorado Professionals in On-site Wastewater, testified in support of the bill. He stated the bill allows local communities the tools and flexibility to protect public health and water quality. Mr. Laws responded to questions about whether the bill would increase the cost of home building and whether each city would be deciding which chemicals would be used in the process. Representative Gerou clarified that typical chemicals are not used to treat wastewater, but that the technologies use a natural processes. Mr. Laws responded to a question about the language in the bill concerning the determination of a liability.

02:03 PM -- Lane Drager, Colorado Association of Local Public Health Officials, testified in support of the bill. He explained that biological systems would be utilized in the on-site wastewater treatment systems and how the bill would allow for more flexibility with on-site wastewater treatment systems.

02:08 PM -- Dave Akers, Colorado Department of Public Health and Environment, testified in support of the bill with the potential amendments. Mr. Akers responded to questions about the language contained in the bill concerning determinations of liability. Representative Brown described his experience with on-site wastewater treatment systems.

02:11 PM -- Garin Vorthmann, Colorado Farm Bureau, testified in support of the bill. She testified that potential amendments would resolve concerns about the impact on existing septic systems.

02:12 PM -- Andy Karsian, Colorado Counties, Inc., testified in support of the bill.

02:14 PM

Representative Gerou explained amendment L.001 (Attachment A), which defines the term septic tank and addresses issues with phasing out cesspools. Representative Gerou responded to a question about whether local boards of health include city boards of the health.


BILL:	HB12-1126
TIME:	02:16:18 PM
MOVED:	Summers
MOTION:	Moved amendment L.001 (Attachment A). The motion passed without objection.
SECONDED:	Brown
		VOTE
	Bradford	Excused
	Brown
	Fields	Excused
	Joshi
	Kefalas
	Kerr J.
	Massey	Excused
	McCann	Excused
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 4 ABS: 0 FINAL ACTION: Pass Without Objection

02:18 PM

Representative Gerou explained amendment L.002 (Attachment B).


BILL:	HB12-1126
TIME:	02:19:21 PM
MOVED:	Summers
MOTION:	Moved amendment L.002 (Attachment B). The motion passed without objection.
SECONDED:	Kerr J.
		VOTE
	Bradford	Excused
	Brown
	Fields	Excused
	Joshi
	Kefalas
	Kerr J.
	Massey	Excused
	McCann	Excused
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 4 ABS: 0 FINAL ACTION: Pass Without Objection

02:19 PM

Representative Gerou provided closing comments on the bill.

02:20 PM


BILL:	HB12-1126
TIME:	02:20:46 PM
MOVED:	Kefalas
MOTION:	Moved to refer House Bill 12-1126, as amended, to the Committee on Appropriations. The motion passed on a vote of 9-0 with 4 members excused.
SECONDED:	Acree
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Excused
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Excused
	McCann	Excused
	Peniston	Yes
	Schafer S.	Yes
	Young	Yes
	Acree	Yes
	Summers	Yes

YES: 9 NO: 0 EXC: 4 ABS: 0 FINAL ACTION: PASS

02:22 PM -- House Bill 12-1141

Representative Levy presented House Bill 12-1141, concerning the expansion of the scope of practice of additional trained health care professionals to include five-point auricular acudetox. The bill expands the scope of practice for mental health professionals who have completed specific training to perform the Five-Point Acupuncture Detoxification Association Auricular Acupuncture Protocol (NADA protocol) in conjunction with a chemical dependency, mental health, or behavioral health treatment program. The bill specifics which mental health professional would be included in the bill. Representative Levy described the situations in which the NADA protocol could be used. Representative Levy distributed amendment L.005 (Attachment C) and the Legislative Council memo addressing the fiscal assessment of proposed amendment HB1141_L.005 (Attachment D). Representative Levy responded to questions about the types of supervision required for various treatments, which professions would be allowed to perform the NADA protocol, and whether there is opposition to the bill.

02:38 PM -- Dino Ioannides, Department of Regulatory Agencies, testified on the bill. He responded to questions about the concerns the Department of Regulatory Agencies had with the introduced bill related to supervision and how amendment L.005 (Attachment C) would addresses the concerns, the definition of indirect supervision included in the bill, the various professions that would or would not be included in bill, whether there are other professions that do not require direct supervision to perform invasive procedures, and whether passage of the bill would endorse the NADA protocol. Representative Levy stated that some states do not require any supervision for the NADA protocol.

02:47 PM -- Chris Habgood, Department of Human Services, testified on the bill. He stated that the Department of Human Services has concerns about the bill related to having a treatment protocol in statute. Mr. Habgood responded to questions about the treatment expectations the bill may create and clarified the concerns of the Department of Human Services.

02:57 PM -- Dr. Libby Stuyt, representing herself, testified about her experience using the NADA protocol. She provided the committee with a packet of letters (Attachment E). Dr. Stuyt responded to questions about the NADA protocol.

03:22 PM -- Carol Lease, Empowerment Program, testified in support of the bill. She stated her belief that the bill would expand access to effective treatment. Ms. Lease responded to question about how the NADA protocol is utilized by the Empowerment Program.

03:24 PM -- MK Christian, Empowerment Program, testified in support of the bill. She described her experience as an acupuncturist administering the NADA protocol. Ms. Christian responded to questions about the need to expand the number of professionals who can perform the the NADA protocol and whether the Empowerment Program would be providing training.

03:29 PM -- Marie Cook, Empowerment Program, testified in support of the bill. Ms. Cook responded to questions about whether people were not able to utilize the treatment due to lack of providers.

03:32 PM -- Michelle Long, Empowerment Program, testified in support of the bill and described her experience as someone who is receiving the NADA protocol.

03:33 PM -- Kelly Baldwin, Empowerment Program, testified in support of the bill and described her experience as someone who is receiving the NADA protocol.

03:34 PM -- Greg Shin, Acupuncture Association of Colorado, stated that amendment L.005 (Attachment C) addresses concerns the Acupuncture Association of Colorado has with the bill. Mr. Shin responded to questions about whether there are concerns about expanding which professions can perform the NADA protocol, what is dry needling, and whether there is need to expand who can perform the NADA protocol.

03:40 PM -- Fran Ricker, Colorado Nurses Association, testified against the bill. She discussed her concerns with including treatment protocols in statute, the supervision element of amendment L.005 (Attachment C), and how the bill could create confusion. Ms. Ricker and Representative Levy responded to questions about whether nurses can currently perform the NADA protocol with training. Representative Levy responded to a question about whether the NADA protocol is acupuncture.


BILL:	HB12-1141
TIME:	03:51:21 PM
MOVED:	Kefalas
MOTION:	Moved L.005 (Attachment C). The motion passed without objection.
SECONDED:	Schafer S.
		VOTE
	Bradford	Excused
	Brown
	Fields	Excused
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann	Excused
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 3 ABS: 0 FINAL ACTION: Pass Without Objection

03:52 PM

Representative Levy provided closing comments on the bill. The committee dialogued about the bill, including the concerns raised about the bill, the need to get feedback from other professions, and whether there is a shortage of providers.

04:00 PM

The committee took a brief recess.

04:04 PM

The committee came back to order.


BILL:	HB12-1141
TIME:	04:04:00 PM
MOVED:	Peniston
MOTION:	Moved to refer House Bill 12-1141, as amended, to the Committee of the Whole. The motion failed on a 5-5 vote with 3 members excused.
SECONDED:	Schafer S.
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Excused
	Joshi	No
	Kefalas	Yes
	Kerr J.	No
	Massey	No
	McCann	Excused
	Peniston	Yes
	Schafer S.	Yes
	Young	Yes
	Acree	No
	Summers	No

YES: 5 NO: 5 EXC: 3 ABS: 0 FINAL ACTION: TIE


BILL:	HB12-1141
TIME:	04:05:17 PM
MOVED:	Kerr J.
MOTION:	Moved to postpone House Bill 12-1141 indefinitely. The motion failed on a vote of 3-7 with 3 members excused.
SECONDED:	Joshi
		VOTE
	Bradford	Excused
	Brown	No
	Fields	Excused
	Joshi	Yes
	Kefalas	No
	Kerr J.	Yes
	Massey	No
	McCann	Excused
	Peniston	No
	Schafer S.	No
	Young	No
	Acree	No
	Summers	Yes

YES: 3 NO: 7 EXC: 3 ABS: 0 FINAL ACTION: FAIL

04:05 PM

The bill was removed from the table.

04:07 PM -- House Bill 12-1140

Representative Jones presented House Bill 12-1140, concerning the duties of the Department of Public Health and Environment as coordinator for suicide prevention programs throughout the state. Current law designates the Department of Public Health and Environment as the coordinator of suicide prevention programs throughout the state. The bill requires the department, in its coordinator role, to work with hospitals to determine the appropriate materials to distribute when a minor has attempted suicide or has exhibited a suicidal gesture. The bill includes information about when the materials would be provided and what should be included in the materials. Representative Jones distributed amendment L.001 (Attachment F) to the committee. He described the amendment, which makes the bill permissive with regards to the collaboration with hospitals, includes both adults and minors, and includes reporting requirements. He stated the groups that are supporting the bill, if it is amended by amendment L.001 (Attachment F).

04:11 PM -- Matt Vogl, Suicide Prevention Coalition, testified in support of the bill. He shared several suicide statistics, including that Colorado is currently ranked sixth in the nation for suicide deaths. The committee dialogued with Representative Jones about why the legislation was being run as a bill and not a resolution.

04:18 PM -- Kathy Valentine, Hope Coalition of Boulder County, testified in support of the bill. She described one family's experience after their son attempted suicide. Ms. Valentine responded to questions about the type of follow-up care that is occurring after suicide attempts and the mass media's messages about suicide. The committee dialogued about the need for awareness and education about the risk factors for suicide.

04:30 PM -- Sean Weller, representing himself, testified in support of the bill. He discussed the research that the Colorado Youth Advisory Council has done on suicide. He discussed the need to provide education about the risk factors for suicide. He described his experience of having a brother who has suicidal thoughts. Mr. Weller responded to questions about whether the Colorado Youth Advisory Council could assist with the implementation of the bill.

04:41 PM -- Patricia Clark, The Second Wind Fund, Inc., testified in support of the bill. She discussed the efforts of The Second Wind Fund, Inc. to address suicide. She described her experience as a parent of teenagers who have had friends who have died from suicide or who have had suicidal thoughts.

04:48 PM -- Jarrod Hindman, Colorado Department of Public Health and Environment, responded to questions about how the reporting requirements would be changed by House Bill 12-1140.

04:51 PM -- Michael Lott-Manier, Mental Health America of Colorado, testified in support of the bill and provided a handout to the committee (Attachment G).


BILL:	HB12-1140
TIME:	04:53:49 PM
MOVED:	Massey
MOTION:	Moved amendment L.001 (Attachment F). The motion passed without objection.
SECONDED:	Acree
		VOTE
	Bradford	Excused
	Brown
	Fields	Excused
	Joshi
	Kefalas
	Kerr J.
	Massey
	McCann	Excused
	Peniston
	Schafer S.
	Young
	Acree
	Summers

YES: 0 NO: 0 EXC: 3 ABS: 0 FINAL ACTION: Pass Without Objection

04:54 PM

The committee took a brief recess.

04:58 PM

The committee came back to order.


BILL:	HB12-1140
TIME:	04:58:59 PM
MOVED:	Summers
MOTION:	Moved to refer House Bill 12-1140, as amended, to the Committee on Appropriations. The motion passed on a vote of 11-0 with 2 members excused.
SECONDED:	Acree
		VOTE
	Bradford	Excused
	Brown	Yes
	Fields	Yes
	Joshi	Yes
	Kefalas	Yes
	Kerr J.	Yes
	Massey	Yes
	McCann	Excused
	Peniston	Yes
	Schafer S.	Yes
	Young	Yes
	Acree	Yes
	Summers	Yes

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

05:00 PM

The committee adjourned.