H_JUD_2018A 01/03/2018 09:07:44 AM Committee Summary

Deputy State Auditor Monica Bowers, Office of the State Auditor (OSA), provided handouts to the committee and explained the role of the State Auditor  (Attachments B, C, and D).  She discussed the various audits conducted by OSA throughout the year and provided an overview of the outstanding audit recommendations for the health departments.

 

Attachment C

Auditor Dianne Ray, OSA, discussed the audit of three information technology systems in the Colorado Department of Public Health and Environment (CDPHE).  She told the committee that the full audit was confidential and provided to CDPHE, but was not publicly available due to security concerns.  She stated that CDPHE did agree with the recommendations presented in the audit.

Brad Walcher, OSA, discussed the status of outstanding audit recommendations as of June 30, 2017 (Attachment C).  He specifically discussed the audit recommendations pending for the Department of Health Care Policy and Financing.

Mr. Walcher discussed the Department of Human Services' outstanding audit recommendations and responded to questions from the committee.

Mr. Walcher told the committee that CDPHE and Connect for Health Colorado have no outstanding audit recommendations.  He pointed out how to look up audits on the website.

Dr. Larry Wolk, Executive Director, CDPHE, provided a handout to the committee and discussed the organization and activities of CDPHE (Attachement E).  He discussed the vision and mission of the department.  He spoke about the department's strategic plan and aligning this plan with various health reports, such as the Colorado Health Environmental Assessment, Health Colorado Shaping a State of Health.  He discussed the department's current top priorities, including: substance use disorder; mental illness and pregnancy-related depression; child and adult obesity; childhood immunization; air quality; and water quality.  He discussed the efforts of the department to reduce Colorado's suicide rate.  Dr. Wolk continued by discussing the progress the department has made in air quality and responded to questions from the committee.

Dr. Wolk continued to respond to questions from the committee about air quality issues, the department's Man Therapy initiative, and the way the department establishes current priorities.  He responded to questions about immunization forms for the personal belief exemption and the Prevention Services Division.

Dr. Wolk continued his presentation.  He discussed the goals of the department, including improving employee engagement, promoting health equity and environmental justice, and preparing for and responding to all emerging issues.

Dr. Wolk spoke about the department's customer service outreach efforts and the resulting policy changes.  He presented CDPHE's FY 2018-19 decision items listed on pages 36 and 37 of Attachment E.  He also discussed the department's legislative priorities.  Dr. Wolk responded to questions.

Dr. Wolk and the committee dialogued about the medical marijuana registry and the Suicide Prevention Commission.  Committee discussion and questions continued.

Dr. Wolk continued to respond to questions and comments from committee members.

Pam Long, Colorado Coalition for Vaccine Choice (CCVC), provided three handouts to the committee (Attachments F, G, and H) and made remarks about CCVC's concerns about the way CDPHE handles the guidance provided to school districts regarding the personal exemption from vaccinations.

Kathy Sincere, CCVC, discussed her concerns about the immunization forms used by school districts.

Phil Silberman, CCVC, discussed his concerns about the information technology systems of CDPHE and the recent audit of CDPHE's technology systems.

Ms. Long discussed her concerns about the number of incidents of autism in Colorado and referred to Attachments G and H.

Ms. Long and Mr. Silberman responded to questions from the committee.

Marguerite Salazar, Executive Director, Colorado Department of Regulatory Agencies, provided a handout to the committee regarding high risk reinsurance (Attachment I).

Mike Conway, Interim Insurance Commissioner, Colorado Division of Insurance (DOI), presented on the DOI study of high risk reinsurance. He explained the findings of the report (The full report is available on the DOI website at https://drive.google.com/drive/folders/0B_UoCf17OVmWTUxxOUFuMzRmVGs).  He discussed the decisions the General Assembly would need to make to establish a reinsurance program.

Peg Brown, Deputy Director, DOI, explained that reinsurance is insurance for insurance companies against risks for unusually expensive claims.  She discussed the various types of business models used for reinsurance.

Commissioner Conway discussed the options for funding reinsurance pools.

Ms. Brown discussed the requirements for approval of a 1332 waiver and the other states that have used 1332 waivers to implement reinsurance programs.

Commissioner Conway discussed the federal cost sharing reductions and federal activity to address the funding loss to carriers due to the elimination of cost sharing reduction payments.  He responded to questions from the committee.

Ms. Brown responded to questions about other states' 1332 waivers.  Commissioner Conway responded to committee comments and questions about the funding of a reinsurance program, 1332 waivers, premium increases, and the population expected to benefit from a reinsurance program.

Director Salazar commented on committee questions.  Ms. Brown responded to questions about cost shifting under reinsurance programs, the history of high risk pools, and current reinsurance programs offered to insurers.

Rachel Richards, Pitkin County, presented her concerns about the cost of insurance in mountain areas of the state.  She spoke about the efforts that western counties have taken to help control the premium costs for local residents.

Dan Gibbs, Summit County, presented his concerns about the cost of health insurance premiums in the rural areas of the state. He discussed the total spending on health care services in Colorado. He discussed the uninsured rate in rural areas of the state. Mr. Gibbs and Ms. Richards responded to questions. The committee dialogued with Mr. Gibbs and Ms. Richards about options to control the cost of health care premiums.