Click here for Fiscal Note

This information is prepared as an informational service only and should not be relied upon as an official record of action taken by the Colorado General Assembly.

Second Regular Session

Sixty-first General Assembly

LLS NO. 98­0241.01 BWM HOUSE BILL 98­1149

STATE OF COLORADO

BY REPRESENTATIVES Morrison, Epps, Sinclair, Snyder, and Tool;

also SENATOR Wham.

REREVISED

HEWI

A BILL FOR AN ACT

CONCERNING THE CREATION OF THE COLORADO HEALTH CARE TASK FORCE, AND, IN CONNECTION THEREWITH, ABOLISHING THE JOINT REVIEW COMMITTEE FOR THE MEDICALLY INDIGENT AND THE MEDICAL ASSISTANCE REFORM ADVISORY COMMITTEE AND REPLACING SUCH COMMITTEES WITH THE COLORADO HEALTH CARE TASK FORCE.

Bill Summary

(Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments that may be subsequently adopted.)

Abolishes the joint review committee for the medically indigent and the medical assistance reform advisory committee.

Makes legislative findings that, with recent changes in the health care system, members of the general assembly must obtain information on which to base policy decisions in this area. Declares that the purpose of this act is to create a method for members of the general assembly to obtain the information necessary to respond to required legislative changes affecting the health care system in Colorado.

Creates the Colorado health care task force for a period of 5 years. Specifies that the task force shall consist of 6 members of the general assembly, 3 from each house, to be appointed by the speaker of the house of representatives and the president of the senate, and 5 public members representing the health care industry, employers, and consumers of health care services.

Specifies that legislative members of the task force shall serve without compensation, but shall be reimbursed for all necessary expenses incurred in the performance of their duties and, in addition, shall receive $50 per diem for each day spent in attendance at meetings of the task force.

Details the subject matter to be studied by the task force and authorizes the task force to recommend necessary legislation to the general assembly. Requires such recommended legislation to be treated in the same manner as recommendations from legislative interim committees. Authorizes the legislative council to accept and expend federal funds, grants, gifts, and donations for purposes of the task force's activities.

Abolishes the task force on July 1, 2003.


Be it enacted by the General Assembly of the State of Colorado:

SECTION 1.  26­15­107, Colorado Revised Statutes, is REPEALED AND REENACTED, WITH AMENDMENTS, to read:

26­15­107.  Colorado health care task force ­ legislative declaration ­ creation ­ duties ­ repeal. (1) (a)  Legislative declaration. THE GENERAL ASSEMBLY HEREBY FINDS AND DETERMINES THAT:

(I)  RECENT MAJOR SHIFTS IN THE WAY HEALTH CARE IS ORGANIZED, DELIVERED, AND PAID FOR HAVE CREATED INCREASED PUBLIC CONCERN ABOUT THE ABILITY OF COLORADANS TO GET AND KEEP GOOD, AFFORDABLE HEALTH INSURANCE COVERAGE;

(II)  RELATIONSHIPS AMONG PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, PATIENTS, AND PAYORS ARE CHANGING;

(III)  IN COLORADO, THE DOMINANT FORM OF HEALTH INSURANCE COVERAGE IS NOW MANAGED CARE, AND MORE AND MORE CONSUMERS IN THIS STATE ARE VOICING CONCERNS ABOUT THEIR ABILITY TO GET TIMELY ACCESS TO QUALITY CARE AS THEY SEE A NARROWING OF THEIR CHOICES OF HEALTH CARE PROVIDERS;

(IV)  EMPLOYEES ARE BEING ASKED TO PAY A LARGER AND LARGER SHARE OF THE COST OF THEIR COVERAGE, LEADING TO INCREASES IN THE NUMBER OF WORKING FAMILIES THAT CANNOT AFFORD HEALTH INSURANCE; AND

(V)  EMPLOYERS ARE CONCERNED ABOUT RECENT TRENDS THAT POINT TO ANOTHER ROUND OF SIGNIFICANT RATE INCREASES.

(b)  THE GENERAL ASSEMBLY, THEREFORE, HEREBY DECLARES THAT THE FACTORS DESCRIBED IN THIS SUBSECTION (1) REQUIRE THAT MEMBERS OF THE GENERAL ASSEMBLY OBTAIN INFORMATION AND HAVE A SUFFICIENT LEVEL OF KNOWLEDGE TO ENABLE THEM TO MAKE APPROPRIATE POLICY DECISIONS REGARDING HEALTH CARE IN THIS STATE. THE PROVISIONS OF THIS SECTION ARE ENACTED TO ALLOW MEMBERS OF THE GENERAL ASSEMBLY TO GATHER INFORMATION FROM INTERESTED PERSONS IN ORDER TO FORMULATE LEGISLATION NECESSARY FOR THE PROPER OPERATION OF THE HEALTH CARE SYSTEM IN THIS STATE.

(2)  Creation ­ membership. (a)  IN ORDER TO STUDY THE HEALTH CARE SYSTEM IN THIS STATE, THERE IS HEREBY CREATED THE COLORADO HEALTH CARE TASK FORCE. THE TASK FORCE SHALL CONSIST OF ELEVEN MEMBERS SELECTED AS FOLLOWS:

(I) (A)  FIVE MEMBERS SHALL BE APPOINTED BY THE GOVERNOR, FOUR OF WHOM SHALL BE REPRESENTATIVES OF THE HEALTH CARE INDUSTRY AND EMPLOYERS THAT PURCHASE HEALTH CARE COVERAGE FOR THEIR EMPLOYEES. ONE SHALL BE A REPRESENTATIVE OF CONSUMERS OF HEALTH CARE.

(B)  IN MAKING THE FOUR APPOINTMENTS FROM THE HEALTH CARE INDUSTRY AND EMPLOYERS, THE GOVERNOR SHALL CONSIDER RECOMMENDATIONS FROM GROUPS SUCH AS THOSE REPRESENTING MEDICAL PROFESSIONALS INCLUDING, BUT NOT LIMITED TO, MEDICAL DOCTORS, NURSES, DENTISTS AND OTHER ALLIED HEALTH PROFESSIONALS, AND LARGE AND SMALL EMPLOYERS, SELF­INSURED EMPLOYERS, PUBLIC AND PRIVATE FOR PROFIT AND NONPROFIT HOSPITALS, MANAGED CARE ORGANIZATIONS, HEALTH INSURANCE CARRIERS, HEALTH MAINTENANCE ORGANIZATIONS, ORGANIZATIONS CONCERNED WITH INDIGENT CARE, AND PUBLIC AND PRIVATE MENTAL HEALTH SERVICES PROVIDERS. NO TWO OF SUCH MEMBERS SHALL BE FROM THE SAME SEGMENT OF THE INDUSTRY.

(C)  IN MAKING THE CONSUMER APPOINTMENT, THE GOVERNOR SHALL CONSIDER RECOMMENDATIONS FROM GROUPS SUCH AS THOSE REPRESENTING SENIOR CITIZENS AND THOSE CONDUCTING ADVOCACY IN THE HEALTH CARE AREA ON BEHALF OF PATIENTS.

(II)  THREE MEMBERS OF THE HOUSE OF REPRESENTATIVES, TWO OF WHOM SHALL BE APPOINTED BY THE SPEAKER OF THE HOUSE OF REPRESENTATIVES, AND ONE OF WHOM SHALL BE APPOINTED BY THE MINORITY LEADER OF THE HOUSE OF REPRESENTATIVES;

(III)  THREE MEMBERS OF THE SENATE, TWO OF WHOM SHALL BE APPOINTED BY THE PRESIDENT OF THE SENATE, AND ONE OF WHOM SHALL BE APPOINTED BY THE MINORITY LEADER OF THE SENATE.

(b)  THE TERM OF OFFICE OF EACH MEMBER OF THE TASK FORCE SHALL BE FOR TWO YEARS AND SHALL COMMENCE ON JULY 1, 1998, AND ON JULY 1 EVERY TWO YEARS THEREAFTER. INITIAL APPOINTMENTS TO THE TASK FORCE SHALL BE MADE BY JULY 1, 1998.

(c)  LEGISLATIVE MEMBERS OF THE TASK FORCE SHALL SERVE WITHOUT COMPENSATION BUT SHALL BE REIMBURSED FOR ALL NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES AND, IN ADDITION, SHALL RECEIVE FIFTY DOLLARS PER DIEM FOR EACH DAY SPENT IN ATTENDANCE AT MEETINGS OF THE TASK FORCE.

(d) THE TASK FORCE SHOULD CONSIDER THE APPOINTMENT OF SUB-COMMITTEES TO ASSIST IN ADVISING THE TASK FORCE.

(e)  THE LEGISLATIVE COUNCIL STAFF SHALL BE MADE AVAILABLE TO ASSIST THE TASK FORCE IN CARRYING OUT ITS DUTIES UNDER THIS SECTION.

(f) (I)  ALL EXPENDITURES INCURRED IN THE CONDUCT OF THE ACTIVITIES OF THE TASK FORCE UNDER THIS SECTION SHALL BE APPROVED BY THE CHAIR OF THE LEGISLATIVE COUNCIL AND PAID BY VOUCHERS AND WARRANTS DRAWN AS PROVIDED BY LAW FROM FUNDS ALLOCATED TO THE LEGISLATIVE COUNCIL FOR LEGISLATIVE STUDIES FROM APPROPRIATIONS MADE BY THE GENERAL ASSEMBLY.

(II)  IN CONDUCTING THE ACTIVITIES OF THE TASK FORCE UNDER THIS SECTION, THE LEGISLATIVE COUNCIL MAY ACCEPT AND EXPEND FEDERAL FUNDS, GRANTS, GIFTS, AND DONATIONS FOR PURPOSES OF THIS SECTION.

(g)  THE TASK FORCE SHALL MEET AT LEAST SIX TIMES PER YEAR.

(3)  Duties. (a)  IN CARRYING OUT ITS DUTIES AND FUNCTIONS UNDER THE PROVISIONS OF THIS SECTION, THE TASK FORCE SHALL CONSIDER, BUT NEED NOT BE LIMITED TO, THE FOLLOWING:

(I)  EMERGING TRENDS IN COLORADO HEALTH CARE AND THEIR IMPACTS ON CONSUMERS, INCLUDING BUT NOT LIMITED TO:

(A)  CHANGES IN RELATIONSHIPS AMONG HEALTH CARE PROVIDERS, PATIENTS, AND PAYORS;

(B)  RESTRICTIONS IN HEALTH CARE OPTIONS AVAILABLE TO CONSUMERS; AND

(C)  PROFESSIONAL LIABILITY ISSUES ARISING FROM SUCH RESTRICTIONS.

(II)  THE EFFECT OF RECENT SHIFTS IN THE WAY HEALTH CARE IS ORGANIZED, DELIVERED, AND PAID FOR ON THE ABILITY OF COLORADANS TO OBTAIN AND KEEP GOOD, AFFORDABLE HEALTH INSURANCE COVERAGE;

(III)  THE EFFECT OF MANAGED CARE ON THE ABILITY OF CONSUMERS TO OBTAIN TIMELY ACCESS TO QUALITY CARE;

(IV)  THE OPERATION OF THE PROGRAM FOR THE MEDICALLY INDIGENT IN ORDER TO GIVE GUIDANCE AND DIRECTION TO THE STATE DEPARTMENT IN THE DEVELOPMENT AND OPERATION OF SUCH PROGRAM;

(V)  THE SHARE OF HEALTH CARE COVERAGE COSTS BEING PAID BY EMPLOYEES AND EMPLOYERS, AND THE FUTURE TRENDS FOR HEALTH CARE COVERAGE RATES;

(VI)  THE ROLE OF PUBLIC HEALTH PROGRAMS AND SERVICES;

(VII)  THE SOCIAL AND FINANCIAL COSTS AND BENEFITS OF MANDATED HEALTH CARE COVERAGES.

(b)  THE TASK FORCE SHALL MAKE SUCH RECOMMENDATIONS AS IT DEEMS NECESSARY TO THE GENERAL ASSEMBLY CONCERNING MATTERS STUDIED UNDER THIS SECTION. IF ANY RECOMMENDATION REQUIRES A STATUTORY CHANGE OR ADDITION, AN AFFIRMATIVE VOTE BY A MAJORITY OF THOSE MEMBERS OF THE COMMITTEE WHO ARE ALSO MEMBERS OF THE GENERAL ASSEMBLY SHALL BE REQUIRED IN ORDER TO AUTHORIZE THE PREPARATION OF ANY RECOMMENDATIONS AS LEGISLATION. LEGISLATION RECOMMENDED BY THE TASK FORCE SHALL BE TREATED AS LEGISLATION RECOMMENDED BY AN INTERIM LEGISLATIVE COMMITTEE FOR PURPOSES OF ANY INTRODUCTION DEADLINES OR BILL LIMITATIONS IMPOSED BY THE JOINT RULES OF THE GENERAL ASSEMBLY.

(4)  Repeal of section. THIS SECTION IS REPEALED, EFFECTIVE JULY 1, 2003.

SECTION 2.  Repeal.  26­4­704, Colorado Revised Statutes, is repealed as follows:

26­4­704.  Medical assistance reform advisory committee. (1)  In order for the agency responsible for developing an alternative plan for a nontraditional medical assistance program for the state, in accordance with section 26­4­702, to obtain sufficient input in developing such plan, there is hereby established a medical assistance reform advisory committee. The membership of the committee shall consist of fourteen members who shall be selected as follows:

(a)  The speaker and the minority leader of the house of representatives and the president and minority leader of the senate shall each appoint one legislative member to serve on the committee and shall jointly appoint one of those members to serve as the chair of the committee;

(b)  The speaker of the house of representatives and the president of the senate shall jointly appoint three members, each of whom shall respectively represent providers who participate in the medical assistance program, consumers under the medical assistance program or consumer advocates therefor, and members of the general public;

(c)  The governor shall appoint seven members, who shall be selected from among representatives of the groups described in paragraph (b) of this subsection (1).

(2)  Appointments to the committee shall be made no later than January 1, 1994. The members of the committee shall serve without compensation.

(3)  The advisory committee shall meet with the agency responsible for developing the alternative plan in accordance with section 26­4­702 on a monthly basis to review and provide input on the development of such plan.

SECTION 3.  26­4­112 (2), Colorado Revised Statutes, is amended to read:

26­4­112.  Legislative declaration. (2)  The general assembly further finds that, with recommendations from the medical assistance reform advisory committee created in section 26­4­704, AS IT EXISTED PRIOR TO THE EFFECTIVE DATE OF THIS SUBSECTION (2), AS AMENDED, the office of state planning and budgeting has studied the alternative methods of providing medical assistance taking into account cost­efficiency, continued receipt of federal moneys, and minimal impact on the quality of medical assistance for poor persons in this state.

SECTION 4.  26­4­113 (1) (b), Colorado Revised Statutes, is amended to read:

26­4­113.  Statewide managed care system ­ implementation required ­ repeal. (1)  Rules. (b)  It is the general assembly's intent that the state department eliminate administrative rules and functions that are unnecessary and unrelated to the implementation of the statewide managed care system. The rules and functions shall be reduced according to the schedule for implementing the statewide managed care system in subsection (2) of this section. The state department shall take into consideration recommendations from managed care providers, recipients or their advocates, AND health care coverage cooperatives and the medical assistance reform advisory committee in eliminating unnecessary and unrelated rules and functions.

SECTION 5.  26­4­703 (7) (a), Colorado Revised Statutes, is amended to read:

26­4­703.  Cost­containment and utilization control plan. (7) (a)  For services described in subparagraphs (I) to (III) of paragraph (b) of this subsection (7), the department shall release a formal request for information, developed with reasonable criteria and standards, for the provision of comprehensive services in order to provide the opportunity for affected medical assistance recipients and providers to provide input and make recommendations to the department with respect to the factors described in sub­subparagraphs (A) to (J) of subparagraph (I) of paragraph (d) of subsection (1) of this section during the request for information process. The department shall consult with the medical advisory council created in section 26­4­108 and with the medical assistance reform advisory committee created in section 26­4­704 during the request for information process. Nothing in this subsection (7) shall be construed to preclude the executive director of the department from establishing ad hoc advisory committees to obtain input and recommendations during the request for information process.

SECTION 6.  The introductory portion to 26­15­105 (1), Colorado Revised Statutes, is amended to read:

26­15­105.  Report concerning the program. (1)  The executive director shall prepare an annual report to the joint review committee created pursuant to section 26­15­107 concerning the medically indigent program. The report shall be prepared following consultation with contract providers in the program, state department personnel, and other agencies, organizations, or individuals as it deems appropriate in order to obtain comprehensive and objective information about the program. The report shall contain a plan for a delivery system to provide medical services to medically indigent persons of Colorado in a manner which assures access to services, appropriateness of care, prudent utilization of state resources, and accountability to the health, environment, welfare, and institutions committees of the house of representatives and senate of the general assembly. The executive director shall submit the report to the health, environment, welfare, and institutions committees of the house of representatives and senate of the general assembly no later than February 1 of each year. The report shall include recommendations regarding the following:

SECTION  7.  Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.