Joint Rule 25 Hearing with the JBC
COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES
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01:33 PM -- Joint Rule 25 Hearing with the JBC
Representative Hamner made opening comments and referenced the FY 2016-17 Staff Budget Briefing Summary (Attachment A). Representative Young introduced the members of the Joint Budget Committee (JBC) and the JBC staff. He discussed the budget request for the Colorado Department of Public Health and Environment (CDPHE) as shown on page 39 of Attachment A. He discussed the family planning budget item and the General Fund for clean water sectors budget item.
Senator Lambert discussed the need for legislative changes for some of the budget items being requested for CDPHE. He explained that JBC recommendations needing legislative approval are the creation of separate cash funds for each clean water sector, and allowing the monitoring and collection of data of the health effects of marijuana to be done at a regional level rather than at the county level. Senator Steadman responded to questions about fines collected for water quality violations that are deposited into the cash fund and the fee structure for these water programs. Committee discussion followed about the statutory provisions governing the fee structure for the clean water sectors, and the insolvency of the Water Quality Control Fund. Senator Lambert told the committee that the JBC briefing documents for CDPHE provided additional information about these issues.
The committee discussed increasing emergency cash fund spending authority for the emergency medical technician grant program.
Representative Young directed the committee's attention to page 13 of Attachment A. He discussed the budget request for the Department of Health Care Policy and Financing (HCPF). He explained the funding sources for HCPF, including General Funds and federal funds. He discussed the Medicaid provider rate review process as established by Senate Bill 15-228.
Senator Steadman addressed the proposed provider rate reduction of one percent for most Medicaid providers. He stated that there are some exceptions to this reduction including nursing home rates, pharmacy rates, and primary care physician rates. Committee discussion followed about the enhanced rates that were in place for primary care physicians for the past two years. Senator Steadman explained that these rates were temporary and that the Governor's budget eliminates the enhanced rates.
Representative Young discussed the federal Medicare Modernization Act as it relates to Colorado Medicaid clients who are dually eligible for Medicare and Medicaid. Committee discussion followed. The committee revisited the issue of decreased Medicaid rates for primary care physicians and access to care for many Medicaid patients.
Committee discussion continued about the potential to cut other areas of the budget rather than cutting Medicaid provider fees. The committee discussed the expansion of Medicaid eligibility and the resulting increase in the Medicaid caseload. The committee dialogued with members of the JBC about the cost of insurance premiums, reducing the cost of providing medical care, and the Hospital Provider Fee.
Representative Young referred to the Colorado Department of Human Services (DHS) proposed budget highlighted on page 20 of Attachment A. He highlighted the increased funding to counties to expand county child welfare staff. Discussion followed about the need for these caseworkers and the need for additional state employees to monitor the distribution of this funding and to train new child welfare staff. Representative Young spoke about DHS' request to use the funding to hire additional types of child welfare professionals rather than just case workers. Committee discussion followed about placing ancillary workers in the county child welfare system when the recent audit specifically identified the need for child welfare caseworkers. Committee discussion continued about the need for additional county child welfare workers, and the proposed community provider rate reduction.
Committee discussion continued about the increased funding for child welfare case workers.
Committee members focused their attention on the methodology used to determine federal work participation rates for recipients of Colorado Works benefits and the recent news report that Colorado will be fined for not meeting federal participation rates. The committee discussed Colorado's efforts to meet work targets that determine participation and suggested that the federal government's targets do not adequately represent Colorado's efforts in this area. It was pointed out that 22 other states are out of compliance with federal work participation rates. Discussion about the cost of federal sanctions ensued.
JBC members discussed a variety of issues involving the Division of Youth Corrections (DYC), including: staffing levels; youth violence within DYC; DYC medication distribution policies; and services provided to Intellectual and Developmentally Disabled (IDD) clients within DYC. Discussion about how DYC serves IDD clients followed. Committee discussion followed about the establishment of centers for independent living in Department of Labor and Employment. The committee dialogued about behavioral health issues as they relate to individuals held in DYC and the corrections system. The committee discussed the increase in court ordered competency hearings and restoration services. Members of the JBC discussed budget items that are funded by retail marijuana tax revenue including: intensive residential treatment of substance use disorders; sober living homes; and supported employment for people with severe substance use disorders.
Representative Young discussed a town hall meeting conducted by the Office of Community Living in HCPF. He explained that during the meeting consumers expressed concerns about IDD services, waitlists, and the use of the supports intensity scale. Committee dialogue followed about the use of the supports intensity scale and the Colorado Benefits Management System.