Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:02/05/2009
ATTENDANCE
Time:01:33 PM to 05:32 PM
Acree
*
Gerou
*
Place:LSB A
Green
*
Kefalas
X
This Meeting was called to order by
Kerr J.
X
Representative Riesberg
McGihon
X
Nikkel
X
This Report was prepared by
Primavera
X
Kelly Stapleton
Swalm
X
Gagliardi
X
Riesberg
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
HB09-1111
HB09-1097
HB09-1111
HB09-1028
HB09-1084
HB09-1119		Referred to Appropriations
Postponed Indefinitely
Referred to Appropriations
Amended, Referred to the Committee of the Whole
Postponed Indefinitely
Amended, Referred to Appropriations


01:33 PM -- House Bill 09-1111

Representative Massey introduced House Bill 09-1111 which creates the Primary Care Office within the Department of Public Health and Environment (DPHE) to access and address unmet health care needs across the state. Representative Massey spoke to the duties of the new office. He explained that the loan repayment program is currently administered by Collegeinvest in the Department of Higher Education. He stated that the bill would move those responsibilities to the DPHE.

01:40 PM -- Dr. Ned Calonge, Chief Medical Officer, Department of Public Health and Environment, testified in support of the bill. He stated that the Primary Care Office is a federally funded program designed to help the state help itself. He stated that the bill allows the department to charge fees on the Conrad 30 J-1 Visas. The bill also recruits health care providers to practice in rural communities. Dr. Calonge stated that the Department of Higher Education is amenable to having DPHE take over the responsibilities of administering the program. He stated that the return on investment is worth the expenditure. Dr. Calonge spoke to the credentials of foreign-trained physicians. There was some discussion regarding the request for a 1.5 FTE.

01:55 PM -- Terri Hurst, Policy Analyst, Colorado Rural Health Center, testified in support of the bill. Ms. Hurst provided her written testimony to the committee (Attachment A). Ms. Hurst spoke to Health Professional Shortage Area (HPSA) designations. She stated that these health centers do not solely rely on Medicaid payments. She explained that a HPSA designation allows any physician practicing in a designated HPSA area to receive a 10 percent bump in Medicare reimbursement. She stated that it is because of the enhanced reimbursement feature of the HPSA designation that rural community health centers are able to survive.

09HouseHHS0205AttachA.pdf

01:59 PM -- Ross Brooks, Colorado Community Health Network, testified in support of the bill.

02:02 PM -- Stephen Kopanos, Mental Health America of Colorado, testified in support of the bill. He asked the committee to add an advocacy position for mental health to the Primary Care Office.

02:06 PM -- Lorez Meinhold and Regina Kilkenny, Colorado Health Foundation, testified in support of the bill. Ms. Meinfold provided a journal titled "Health Elevations," to the committee. The journal has several articles which highlight the need for physicians in rural communities and ways to address the shortages (Attachment B). A map on the HPSA designated areas was provided to the committee (Attachment C).

(Attachment B can be viewed at State Archives) 09HouseHHS0205AttachC.pdf


02:12 PM

The committee took a brief recess.

02:14 PM -- House Bill 09-1097

Representative Acree presented House Bill 09-1097 which would create an alternative medical assistance program. She stated that while the bill was important, at this time, due to the financial constraints on the budget, she requested that the committee postpone House Bill 09-1097 indefinitely.
BILL:HB09-1097
TIME: 02:16:06 PM
MOVED:Acree
MOTION:Moved to postpone House Bill 09-1097 indefinitely, at the sponsor's request. The motion passed on a 9-0 roll call vote.
SECONDED:Gagliardi
VOTE
Acree
Yes
Gerou
Yes
Green
Excused
Kefalas
Yes
Kerr J.
Yes
McGihon
Excused
Nikkel
Yes
Primavera
Yes
Swalm
Yes
Gagliardi
Yes
Riesberg
Yes
Final YES: 9 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: PASS




02:24 PM -- House Bill 09-1111

The committee took up House Bill 09-1111. Representative Massey provided a wrap-up to the bill.
BILL:HB09-1111
TIME: 02:26:35 PM
MOVED:Gagliardi
MOTION:Moved to refer House Bill 09-1111 to the Committee on Appropriations. The motion passed on a 10-0 roll call vote.
SECONDED:Acree
VOTE
Acree
Yes
Gerou
Yes
Green
Excused
Kefalas
Yes
Kerr J.
Yes
McGihon
Yes
Nikkel
Yes
Primavera
Yes
Swalm
Yes
Gagliardi
Yes
Riesberg
Yes
Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS




02:32 PM -- House Bill 09-1028

Representative Riesberg spoke to House Bill 09-1028 and stated that it came out of the interim Health Care Task Force. He asked Representative Frangas to describe the original intent of the bill and then describe the strike below. Representative Frangas stated that the original bill was to create an accountability board in the Department of Health Care Policy and Financing (DHCPF) for the Colorado Indigent Care Program (CICP). He stated that the intent of the bill is to establish a complaint process for those who access the CICP program. He explained to the committee that the department does not have to authority to engage with clients in addressing complaints because the program is a financing mechanism, rather than an entitlement program. Representative Riesberg stated that the indigent care population is told that they are getting some care and to not complain about receiving it. He spoke to the financial benefits that could come out of a dialogue with the clients that are served. He stated that the money that will be shifted from the Comprehensive Primary Care Grant fund to the newly established accountability board is a worthwhile investment. Representative Frangas spoke to the strike below, amendment L.001 (Attachment D). He stated that the Medical Services Board currently take complaints by individuals served by the program. There was some discussion regarding the strike below and the difference between the original bill. Representative Gerou asked why the bill needed a strike below since it was vetted through the Health Care Task Force. Representative Frangas stated that the current financial crisis is what spurred the change.

09HouseHHS0205AttachD.pdf

02:51 PM -- Donna Sablan, client of the Colorado Indigent Care program, testified in support of the bill. She stated she was turned away from the University of Colorado Hospital. She stated that she tried to file a complaint, but that the department told her that they did not have the authority to process the complaint. She stated there was no where to go. There was some discussion regarding the circumstances of Ms. Sablan's case.

03:02 PM -- Barbara Smith, client of the Colorado Indigent Care program, testified in support of the bill. Ms. Smith recounted her personal story. She stated she is a certified nurse. She stated she has a nervous system disorder. She stated that she has been on controlled substances for five years. She stated that she had difficulties filling her prescriptions. She stated that she moved counties and because of that she did not see her previous provider and that when she tried to get her prescription filled in the new county, she was unable to get it filled. Currently, Ms. Smith is being treated through the Department of Human Services - Vocational Rehabilitation.

03:15 PM -- Julie Reiskin, Colorado Cross Disability Coalition (CCDC), testified in support of the bill. She stated that CCDC has supported establishing an accountability board for quite some time. Ms. Reiskin provided a packet including her written testimony in support of the bill and data concerning the CICP to the committee (Attachment E). Ms. Reiskin spoke to the financing of the pilot program. There was some discussion regarding the fiscal note impact.

03:31 PM -- Rebecca Jones, Deacon, Colorado Episcopal Diocese, Hunger for Justice, Lutheran Advocacy, and Colorado Catholic Conference, testified in support of the bill. Chris Sandoval, member of the public policy group, Episcopal Diocese, testified in support of the bill.

03:36 PM -- Ross Brooks, Chief Operating Officer, Colorado Community Health Network (CCHN), testified neutral to the bill. He stated that CCHN objects to using the Comprehensive Primary and Preventative Care (CPPC) grant fund moneys for establishing an accountability board. He stated that CPPC provides primary care to the uninsured, and it is unrealistic that $2 million will establish a board for a program that has over $300 million in funds.

03:42 PM -- Chris Underwood, Division Director, Department of Health Care Policy and Financing, direct oversight of CPPC program. He explained the CICP program, as well as the CPPC grant program. He stated the CICP is essentially a grant program. There was some discussion regarding how individuals lodge complaints against providers. Mr. Underwood clarified that the bill does not establish a complaint board, but allows an entity (hospitals or health care clinics) to apply for a grant that would evaluate how to establish an accountability board. He stated that the General Assembly decides the role of the CICP program, which is a financing vehicle for individuals needing care.


04:08 PM

Representative Frangas provided a wrap-up to the bill.
BILL:HB09-1028
TIME: 04:10:45 PM
MOVED:Green
MOTION:Moved to adopt prepared amendment L.001 (Attachment D). Amendment L.001 is a strike below. The motion passed without objection.
SECONDED:Gagliardi
VOTE
Acree
Gerou
Green
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:HB09-1028
TIME: 04:13:06 PM
MOVED:Green
MOTION:Moved to refer amended House Bill 09-1028 to the Committee of the Whole. The motion passed on a 6-5 roll call vote.
SECONDED:Gagliardi
VOTE
Acree
No
Gerou
Yes
Green
Yes
Kefalas
Yes
Kerr J.
No
McGihon
No
Nikkel
No
Primavera
Yes
Swalm
No
Gagliardi
Yes
Riesberg
Yes
Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS




04:25 PM -- House Bill 09-1084

House Bill 09-1084 was put back on the table. For witness testimony, see committee summary from February 2, 2009. Representative Gagliardi stated that the fiscal note had not change, but that with amendments, she expected that it would be significantly reduced.
BILL:HB09-1084
TIME: 04:26:12 PM
MOVED:Gagliardi
MOTION:Moved to refer prepared amendment L.002 (Attachment F). The motion passed without objection.

09HouseHHS0205AttachF.pdf
SECONDED:Green
VOTE
Acree
Gerou
Green
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:HB09-1084
TIME: 04:28:27 PM
MOVED:Gagliardi
MOTION:Moved to adopt prepared amendment L.003 (Attachment G). Representative Gagliardi stated that the amendment will reduce the fiscal note significantly. The motion passed without objection.

09HouseHHS0205AttachG.pdf
SECONDED:Green
VOTE
Acree
Gerou
Green
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:HB09-1084
TIME: 04:30:30 PM
MOVED:Gagliardi
MOTION:Moved to adopt prepared amendment L.004 (Attachment H). Representative Gagliardi explained the amendment to the committee. Jennifer Evans, Department of Health Care Policy and Financing, stated that the amendment would allow providers to report their costs of Medicaid audit to the department. The motion passed without objection.

09HouseHHS0205AttachH.pdf
SECONDED:McGihon
VOTE
Acree
Gerou
Green
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:HB09-1084
TIME: 04:33:49 PM
MOVED:Gagliardi
MOTION:Moved to adopt prepared amendment L.005 (Attachment I). Representative Gagliardi explained the amendment. There was some discussion regarding the amendment. The motion failed on a 3 to 7 vote.

09HouseHHS0205AttachI.pdf
SECONDED:Kefalas
VOTE
Acree
No
Gerou
No
Green
No
Kefalas
Yes
Kerr J.
No
McGihon
No
Nikkel
No
Primavera
No
Swalm
Excused
Gagliardi
Yes
Riesberg
Yes
Not Final YES: 3 NO: 7 EXC: 1 ABS: 0 FINAL ACTION: FAIL


BILL:HB09-1084
TIME: 04:59:30 PM
MOVED:Gagliardi
MOTION:Moved to refer amended House Bill 09-1084 to the Committee on Appropriations. The motion failed on a 5-6 roll call vote.
SECONDED:Green
VOTE
Acree
No
Gerou
No
Green
Yes
Kefalas
Yes
Kerr J.
No
McGihon
Yes
Nikkel
No
Primavera
No
Swalm
No
Gagliardi
Yes
Riesberg
Yes
Not Final YES: 5 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:HB09-1084
TIME: 05:05:20 PM
MOVED:Kerr J.
MOTION:Moved to postpone House Bill 09-1084 indefinitely. The motion passed on a 7-4 roll call vote.
SECONDED:Gerou
VOTE
Acree
Yes
Gerou
Yes
Green
No
Kefalas
Yes
Kerr J.
Yes
McGihon
No
Nikkel
Yes
Primavera
Yes
Swalm
Yes
Gagliardi
No
Riesberg
No
Final YES: 7 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS




05:07 PM -- House Bill 09-1119

House Bill 09-1119 was put back on the table. For witness testimony, see committee summary from February 2, 2009. Jerry Barry, Office of Legislative Services discussed the strike below, amendment L.007 (Attachment J). A handout of each county with total population was provided to the committee (Attachment K).

09HouseHHS0205AttachJ.pdf 09HouseHHS0205AttachK.pdf

05:17 PM -- Chris Habgood, Division of Behavioral Health, Department of Human Services, spoke to the strike below.
BILL:HB09-1119
TIME: 05:28:29 PM
MOVED:McGihon
MOTION:Moved to adopt prepared amendment L.007 (Attachment J). The motion passed without objection.
SECONDED:Green
VOTE
Acree
Gerou
Green
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:HB09-1119
TIME: 05:29:12 PM
MOVED:McGihon
MOTION:Moved to refer amended House Bill 09-1119 to the Committee on Appropriations. The motion passes 6-5 on a roll call vote.
SECONDED:Kefalas
VOTE
Acree
No
Gerou
No
Green
Yes
Kefalas
Yes
Kerr J.
No
McGihon
Yes
Nikkel
No
Primavera
Yes
Swalm
No
Gagliardi
Yes
Riesberg
Yes
Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS


05:31 PM

The committee adjourned.