STAFF SUMMARY OF MEETING
COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES
|01:35 PM to 03:26 PM
|This Meeting was called to order by
|This Report was prepared by
X = Present, E = Excused, A = Absent, * = Present after roll call
|Review of Funding Levels Under HB09-1101
Final Report on Senate Bill 08-217 Centennial Care Choices
01:36 PM -- Review of funding levels for the Developmental Disabilities Services Cash Fund pursuant to House Bill 08-1101
Representative Riesberg called the meeting to order. Pursuant to House Bill 08-1101, the Joint Senate and House Health and Human Services Committee and the Joint Budget Committee convened to review the status of the waiting list for services for individuals with developmental disabilities.
01:40 PM -- Christine Thomas, Department of Human Services, spoke to committee regarding the waiting list for services for individuals with developmental disabilities. Ms. Thomas spoke to a memorandum provided by the department with regard to the waiting list for services (Attachment A). Ms. Thomas responded to committee questions regarding whether the waiting list for services has decreased, the current number of individuals on the waiting list, and the level of funding that would be required to eliminate the waiting list for services for individuals with developmental disabilities. There was discussion regarding the definition of "developmental disability." Ms. Thomas stated that the definition is in statute as well as within rule.
01:48 PM -- Amanda Bickle, Joint Budget Committee Staff, spoke to the funding levels needed to eliminate the waiting list for services for individuals with developmental disabilities. A memorandum from the Joint Budget Committee (JBC) with recommendations for FY 2009-10 funding for services for people with developmental disabilities was distributed to members of the committee (Attachment B). She stated that there is no General Fund increase available for FY 2009-10; instead, there is a decrease in General Funds. She stated that because of the decrease in funding, there is no appropriation available to transfer into the Developmental Disabilities Cash Fund. Ms. Bickle responded to committee questions regarding recommendations made by the JBC with regard to the waiting list.
02:00 PM -- Marijo Rymer, Executive Director, Arc of Colorado, spoke to the status of the waiting list for services for people with developmental disabilities. Ms. Rymer spoke to the failed ballot initiative that would have raised the sales and use tax to fund services for individuals with developmental disabilities. She reiterated that the waiting list is growing. She provided data to the committee that approximately 9,000 people with developmental disabilities have care givers that are over the age of 60. Ms. Rymer urged the committee to consider a realistic plan that would address the waiting list for services. She spoke to an ad hoc committee of stakeholders that is preparing to release recommendations regarding the definition of 'developmental disability.'
02:12 PM -- Roger Jensen, Fremont County, Alliance, spoke to the status of the waiting list for services for individuals with developmental disabilities. A handout regarding the waiting list for services was provided to the committee (Attachment C). Mr. Jensen asked the committee when state revenue increases to consider an action plan that has been developed by Alliance. He stated that the action plan would address the waiting list and provide funding over several years.
02:19 PM -- Representative Pommer commented that in order to increase funding, something else would have to be cut from the budget. Committee members commented on the waiting list for services. There was discussion regarding the Medicaid buy-in program, which is included in House Bill 09-1293.
Representative Riesberg spoke to the requirements under House Bill 08-1101. He stated that the committee met its obligation required under the bill.
02:30 PM -- The committee took a brief recess.
02:34 PM -- Report on Senate Bill 08-217 Centennial Care Choices
The committee reconvened. A copy of the Centennial Care Choices report was provided to the committee (Attachment D). Joan Henneberry, Executive Director of the Department of Health Care Policy and Financing, began the overview of the final report of Senate Bill 08-217, which aimed at providing options for uninsured Coloradoans through the establishment of a new health insurance product known as a value benefit plan (VBP). Executive Director Henneberry explained the process as outlined by the bill. The bill stated that the Colorado Division of Insurance, in collaboration with the Governor's office and the Department of Health Care Policy and Financing, were required to prepare a request for information (RFI) to be issued to health insurance carriers with the intent of designing affordable VBPs that met specific requirements in the bill. She stated that some parameters of the design included healthy living incentives, preventative care, a simple and transparent design, efficient delivery of health care, and network adequacy. On December 15, 2008, Executive Director Henneberry and Insurance Commissioner Marcy Morrison provided an update to the Joint Health and Human Services Committee regarding the status of the RFI. Executive Director Henneberry stated that the health insurance carriers were very cooperative in providing information to the department. She spoke to the executive summary of the report issued and stated that while the insurance carriers were very cooperative and creative, low-income individuals most likely would not be able to afford VBPs unless some kind of subsidy was provided. She stated that the VBPs did include what the bill asked for, but the plans would be too expensive for low-income families.
02:39 PM -- Ms. Henneberry described the VBPs that the health insurance carriers presented in the RFI. She stated that most of the plans had affordable preventative care plans, but did not provide affordable coverage for more expensive treatments. She stated that the VBPs could lead to under-insurance. She spoke to the trade off of providing preventative care versus overall comprehensive care.
02:43 PM -- Executive Director Henneberry spoke to the recommendations from the report. Again, she reiterated that without some type of subsidy, most low-income families would not be able to afford the VBPs that the health insurance carriers presented.
02:46 PM -- Commissioner Marcy Morrison, Division of Insurance, Department of Regulatory Agencies, stated that the division gained a lot of information from the organizational meetings. Executive Director Henneberry responded to committee questions regarding the differences between the various proposals offered by the health insurance carriers. Representative Gagliardi asked about the specifics of the requirements under the bill, specifically asking about the website that was supposed to be established. Insurance Commissioner Morrison detailed how the funds appropriated for the process were used within the Division of Insurance, noting that the $29,000 was used for actuaries for the proposals submitted. Executive Director Henneberry explained that the proposals were posted on each of their respective websites.
03:05 PM -- Senator M. Carroll asked the Ms. Henneberry and Ms. Morrison to comment on whether it was beneficial to provide little coverage, such as a preventative care package, or nothing at all. Both Insurance Commissioner Morrison and Executive Director Henneberry responded to the question stating that was a policy decision to be made by the General Assembly. There was discussion regarding the benefits of providing little coverage, such as a bare bones preventative care plan which may leave a person under-insured. Executive Director Henneberry stated that without more funds for some type of subsidy, a comprehensive design, or a VBP, was not a viable option at this time.
03:13 PM -- Executive Director Henneberry discussed the various RFIs that were submitted. She stated that the committee members have hard choices to make. There was further discussion regarding under-insurance and its effect on uncompensated care costs.
The committee adjourned.