S_HHS_2016A 01/28/2016 01:31:27 PM Committee Summary

01:31 PM -- SB 16-009



Senator Grantham, bill sponsor, presented Senate Bill 16-009. He explained that the bill clarifies the current practice of dental referrals. He told the committee that the bill repeals a current prohibition against certain referral practices and replaces it with language similar to the fee sharing restriction in place for physicians. Specifically, a dentist or dental hygienist may face disciplinary action for the following under the bill:

• dividing a fee with or paying a person in exchange for the person sending or bringing a patient to the licensee, recommending the licensee to a patient, or agreeing to such an arrangement; and
• presenting a bill or requesting payment for services rendered by a person other than the licensee.

01:36 PM -- Dr. Jason Ehtessabian, Colorado Dental Association, testified in support.



01:40 PM -- Graig Bears, Comfort Dental Group, Inc., spoke in support of the bill.





01:43 PM



Senator Grantham made closing comments and discussed amendment L.001 (Attachment A).



160128 AttachA.pdf

01:51 PM -- SB 16-069



Senator Garcia, bill sponsor, presented Senate Bill 16-069 and discussed the goals of the program the bill establishes. The bill requires the Colorado Department of Public Health and Environment (CDPHE) to establish rules governing the scope of practice of community paramedicine, including the issuance of an endorsement in community paramedicine to emergency medical service providers. In addition, agencies managing and offering community paramedicine services must be licensed by CDPHE.



The bill sets minimum standards for community paramedicine agencies that must be incorporated in rules promulgated by the State Board of Health. These rules must be based on the report issued by the Community Paramedicine/Mobile Integrated Healthcare Task Force and address areas such as staffing, educational, and training requirements. The bill creates the Community Paramedicine Agencies Cash Fund to receive fee payments from licensed agencies. A person operating a community paramedicine agency without a license commits a misdemeanor offense and is also subject to civil penalties.



The bill also creates the Community Assistance Referral and Education Services (CARES) Program in the CDPHE. Under the CARES Program, licensed ambulance services, local fire departments, and fire protection districts may establish a program that provides community outreach on health issues and services, and health education to local residents. In addition, these agencies may provide referrals for low-cost medication programs and alternative resources to the 911 system. They may partner with hospitals, licensed home care agencies, other medical care facilities including licensed community paramedicine agencies, primary care providers, other health care professionals, or social services agencies to provide program services and ensure nonduplication of services.



01:56 PM -- Sophia San Miguel, self, spoke against the bill.



02:00 PM -- Christopher Montera, Eagle County Paramedic Services, spoke in support of the bill and provided background information about the provisions of the bill.



02:03 PM -- Anne Montera, Caring Anne Consulting, spoke in support of the bill and provided background information about the provisions of the bill. Ms. Montera responded to questions from the committee.



02:16 PM -- Collen Casper, Colorado Nurses Association, spoke in support of the bill.



02:19 PM -- Steven Clapham, Colorado Professional Fire Fighters, spoke in support of the bill and responded to questions from the committee.



02:25 PM



Committee discussion and questions followed regarding whether the bill will change the scope of practice for paramedics.



02:31 PM -- Garry Briese, Executive Director , Colorado State Fire Chiefs, testified in support of the bill. Rich Martin, Colorado State Fire Chiefs, was also at the table. Mr. Briese responded to questions.



02:37 PM



Senator Garcia responded to questions about whether the bill would require all paramedics to be licensed as a community paramedic. Jennifer Berman, Office of Legislative Legal Service, responded to questions from the committee.













02:39 PM



Bill Zepernick, Colorado Legislative Council Staff, responded to questions about the cost of licensure.



02:44 PM -- Chris Howes, Colorado Medical Society, spoke in support of the bill. He stated that Children's Hospital also supported the bill.



02:45 PM -- Aubrey Hill, Colorado Coalition for the Medically Underserved, spoke in support of the bill and provided a handout to the committee (Attachment B).



160128 AttachB.pdf



02:48 PM -- Mike Lening, American Medical Response, testified in support of the bill.



02:49 PM -- Randy Kuykendahl, CDPHE, stated that CDPHE maintains a neutral position on the bill and has worked closely with stakeholders regarding this program. He discussed CDPHE's concern that the bill provide clear direction the program parameters. Mr. Kuykendahl responded to questions from the committee regarding the cost of regulation. Discussion followed about licensing the provider agencies and the fact that CDPHE cannot charge governmental agencies, such as fire departments, a fee for licensure.



03:00 PM



Committee discussion continued about providing clarity to the department about the scope of the program.

03:01 PM -- Dan Eamon, Longmont Community Health Network, stated that he was supportive of the integrated health care model, but expressed his concerns about the provisions of the bill. Mr. Eamon responded to questions from the committee.



03:15 PM



Ms. Berman responded to questions about the CARES program created in the bill, and the paramedic endorsement. Committee discussion followed about whether existing community programs receive reimbursement for the services they provide.



03:24 PM



Committee discussion followed about whether the bill will allow community agencies to provide services that they are currently prohibited from providing.



03:29 PM -- Tim Dienst, Emergency Medical Services Association of Colorado, testified in support of the bill and responded to committee questions.



03:38 PM -- Ellen Caruso, Home Care Association of Colorado, spoke in support of the bill. Ms. Caruso responded to questions from the committee.



03:43 PM -- Gail Finley, Colorado Hospital Association, testified in support of the bill.















03:49 PM



Senator Garcia made closing comments. Committee discussion followed. Senator Crowder presented amendment L.004 (Attachment C). Committee discussion followed.



160128 AttachC.pdf

03:55 PM -- SB 16-002



Senator Lundberg, bill sponsor, presented Senate Bill 16-002. Senator Lundberg explained that the bill directs the Secretary of State to submit to the voters, at the November 2016 statewide election, the question of whether the Colorado Health Benefit Exchange, which operates under the name Connect for Health Colorado, can impose a tax to support its ongoing operations. He told the committee that Connect for Health Colorado currently charges insurance companies a 3.5 percent administrative fee based on the premium amount of health plans sold through the exchange. He explained that Senate Bill 16-002 requires a vote of the people to allow the continued collection of this administrative fee since it is a tax and not a fee. Senator Lundberg responded to questions from the committee.



04:04 PM



Committee discussion followed about the provisions of the bill.



04:09 PM -- A.W. Schnellbacher, AARP Colorado, spoke in opposition to the bill. Mr. Schnellbacher responded to questions from the committee.



04:16 PM



Senator Lundberg made closing comments.

04:23 PM



Senator Lundberg adjourned the meeting.