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I_OpioidSubstance_2017A 10/31/2017 01:14:09 PM Committee Summary

Final

STAFF SUMMARY OF MEETING



OPIOID AND OTHER SUBSTANCE USE DISORDERS

Date: 10/31/2017
ATTENDANCE
Time: 01:14 PM to 04:00 PM
Buck
X
Jahn
X
Place: RM 271
Kennedy
X
Moreno
X
This Meeting was called to order by
Navarro
X
Representative Pettersen
Priola
X
Singer
X
This Report was prepared by
Tate
X
Elizabeth Haskell
Lambert
X
Pettersen
X
X = Present, E = Excused, A = Absent, * = Present after roll call, R = Remote Participation
Bills Addressed: Action Taken:
Call to Order & Opening Comments

Bill 1 - Prevention of Opioid Misuse

Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing

Bill 3 - Measures to Address Opioid Crisis in Colorado

Bill 4 - Expand Access to Behavioral Health Providers

Bill 5 - Medicaid Inpatient/Residential SUD Treatment

Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
Committee Discussion Only

Recommendation(s) Approved

Recommendation(s) Approved

Recommendation(s) Approved

Recommendation(s) Approved

Recommendation(s) Approved

Recommendation(s) Approved





01:13 PM -- Call to Order & Opening Comments



Representative Pettersen called the meeting to order. The meeting agenda (Attachment A) and the following bill drafts and corresponding fiscal notes were distributed to the committee members:



17Opioid1031AttachA.pdf17Opioid1031AttachA.pdf



17Opioid1031AttachL.pdf17Opioid1031AttachL.pdf 17Opioid1031AttachM.pdf17Opioid1031AttachM.pdf



01:16 PM



Bill Zepernick, Legislative Council Staff, provided the committee with an overview of the interim committee process and discussed the process for amending bill drafts.




01:17 PM -- Bill 1 - Prevention of Opioid Misuse



Kristen Forrestal, Office of Legislative Legal Services (OLLS), presented Bill 1 (Attachment B) and provided an overview of the bill. The bill implements several policies related to the prevention of opioid and substance misuse, including:

      • establishes the Opioid and Other Substance Use Disorders Study Committee as an ongoing year-round study committee through July 1, 2023, with the committee authorized to meet up to six times per year and to refer up to six bills per year;
      • directs the University of Colorado Hospital Authority to develop and implement continuing medical education activities to help prescribers of pain medication to safely and effectively manage patients with chronic pain, and prescribe opioids when appropriate;
      • allows school-based health centers to apply for grants from the school-based health center grant program in the Department of Public Health and Environment (CDPHE) to include treatment for opioid and other substance use disorders; and
      • directs the Department of Health Care Policy and Financing (HCPF) to award grants to organizations to operate a screening, brief intervention, and referral to treatment (SBIRT) program that meet certain requirements starting on July 1, 2018.

    Ms. Forrestal discussed amendments 1, 2, 3, and 4 (Attachments N,O, P, and Q). Committee discussion ensued on each of the amendments.



    17Opioid1031AttachN.pdf17Opioid1031AttachN.pdf 17Opioid1031AttachO.pdf17Opioid1031AttachO.pdf



    17Opioid1031AttachP.pdf17Opioid1031AttachP.pdf 17Opioid1031AttachQ.pdf17Opioid1031AttachQ.pdf



    01:31 PM



    The committee continued to discuss the issues raised by the amendments, including: the center for research into substance use disorder prevention; a year-round opioid study committee; school based health programs; and the recommendation that the Department of Health Care Policy and Financing provide online training to women of childbearing age about the risk of alcohol-exposed pregnancies.



    01:38 PM --
    Bethany Pace-Danley, Peer Assistance Services, testified in support of the bill. She specifically addressed her support for amendment 4.



    01:42 PM --
    Dr. Robert Valuck, Colorado Consortium for Prescription Drug Abuse Prevention, testified in support of the bill.

    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:45:20 PM
    MOVED: Lambert
    MOTION: Adopt amendment 1 (Attachment N). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:47:01 PM
    MOVED: Lambert
    MOTION: Amend amendment 2 - Line 7, strike "2019, 2020, and" and substitute "2019 and 2020". Line 8, strike 2021 (Attachment O). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:50:41 PM
    MOVED: Lambert
    MOTION: Adopt amendment 2, as amended (Attachment O). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection
    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:52:10 PM
    MOVED: Lambert
    MOTION: Amend amendment 3 - Line 4, strike "BEHAVIORAL HEALTH THERAPY," and substitute "EDUCATION" (Attachment P). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:52:41 PM
    MOVED: Lambert
    MOTION: Adopt amendment 3, as amended (Attachment P). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:52:57 PM
    MOVED: Lambert
    MOTION: Amend amendment 4 - Line 24, strike "FIFTY" and substitute "SEVENTY FIVE" (Attachment Q). The motion passed without objection.
    SECONDED: Priola
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:53:37 PM
    MOVED: Lambert
    MOTION: Adopt amendment 4, as amended (Attachment Q). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 1 - Prevention of Opioid Misuse
    TIME: 01:54:00 PM
    MOVED: Lambert
    MOTION: Refer Bill 1, Prevention of Opioid Misuse, as amended, to the Legislative Council (Attachment B). The motion passed on a vote of 10-0.
    SECONDED: Singer
    VOTE
    Buck
    Yes
    Jahn
    Yes
    Kennedy
    Yes
    Moreno
    Yes
    Navarro
    Yes
    Priola
    Yes
    Singer
    Yes
    Tate
    Yes
    Lambert
    Yes
    Pettersen
    Yes
    Final YES: 10 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: PASS





    01:55 PM



    Representative Pettersen assigned the following co-prime sponsors to the bill: Representatives Pettersen and Navarro, and Senators Priola and Jahn. She announced that the bill will be introduced in the House of Representatives first, and all other committee members will be listed as co-sponsors. Representative Pettersen noted that OLLS staff with check with Senator Aguilar after the meeting to determine on which bills she would like to be listed as a co-sponsor. There was no objection to including a safety clause on the bill. There was no objection to giving OLLS permission to make technical changes to the bill, if necessary.





    02:00 PM -- Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing




    Kristen Forrestal, OLLS, presented Bill 2 (Attachment D) and amendments 2, 3, 5, 6,7, 8, 9, and 10 (Attachments R, S, T, U, V, W, X, and Y). The bill limits to a seven-day supply, the number of opioid pills that a health care provider may prescribe to a patient. At the discretion of the provider, the prescription may include one refill for an additional seven-day supply. The bill includes a number of exceptions to the limitation and allows for a health care provider to electronically prescribe opioids.



    17Opioid1031AttachR.pdf17Opioid1031AttachR.pdf 17Opioid1031AttachS.pdf17Opioid1031AttachS.pdf



    17Opioid1031AttachT.pdf17Opioid1031AttachT.pdf 17Opioid1031AttachU.pdf17Opioid1031AttachU.pdf



    17Opioid1031AttachV.pdf17Opioid1031AttachV.pdf 17Opioid1031AttachW.pdf17Opioid1031AttachW.pdf



    17Opioid1031AttachX.pdf17Opioid1031AttachX.pdf 17Opioid1031AttachY.pdf17Opioid1031AttachY.pdf



    With certain exceptions, the bill also requires health care providers or their designees, to query the Prescription Drug Monitoring Program (PDMP) prior to prescribing the first refill prescription for an opioid. When querying the PDMP, each health care provider or designee is required to identify his or her area of health care specialty or practice.





    02:10 PM



    Ms. Forrestal discussed each amendment and responded to committee questions.



    02:16 PM --
    Dr. Don Stader, Colorado Medical Society, testified in support of the bill.

    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:19:42 PM
    MOVED: Lambert
    MOTION: Adopt amendment 2 (Amendment R). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:20:53 PM
    MOVED: Singer
    MOTION: Adopt amendment 3 (Amendment S). The motion passed without objection.
    SECONDED: Kennedy
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:21:09 PM
    MOVED: Singer
    MOTION: Adopt amendment 5 (Amendment T). The motion passed without objection.
    SECONDED: Kennedy
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:21:34 PM
    MOVED: Lambert
    MOTION: Adopt amendment 6 (Amendment U). The motion passed without objection.
    SECONDED: Buck
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:21:56 PM
    MOVED: Lambert
    MOTION: Adopt amendment 7 (Amendment V). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:22:27 PM
    MOVED: Lambert
    MOTION: Adopt amendment 8 (Amendment W). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:22:41 PM
    MOVED: Kennedy
    MOTION: Amend amendment 9 - Page 1, line 9, strike "AND THIRD"; line 37, strike "OR THIRD". Page 2, line 29, strike "OR THIRD" (Amendment X). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection





    02:23 PM



    Dr. Valuck commented on the provisions of amendment 9.

    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:26:19 PM
    MOVED: Priola
    MOTION: Adopt amendment 9, as amended (Amendment X). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:26:37 PM
    MOVED: Singer
    MOTION: Adopt amendment 10 (Amendment Y). The motion passed without objection.
    SECONDED: Kennedy
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection
    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:28:44 PM
    MOVED: Moreno
    MOTION: Amend Bill 2, Page 7, Line 8, strike "SEVEN" and substitute "FOURTEEN". The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 2 - Clinical Practice Measures for Safer Opioid Prescribing
    TIME: 02:29:54 PM
    MOVED: Lambert
    MOTION: Refer Bill 2, Clinical Practice Measures for Safer Opioid Prescribing, as amended, to the Legislative Council (Attachment D). The motion passed on a vote of 9-1.
    SECONDED: Tate
    VOTE
    Buck
    No
    Jahn
    Yes
    Kennedy
    Yes
    Moreno
    Yes
    Navarro
    Yes
    Priola
    Yes
    Singer
    Yes
    Tate
    Yes
    Lambert
    Yes
    Pettersen
    Yes
    YES: 9 NO: 1 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: PASS





    02:30 PM



    Representative Pettersen assigned the following co-prime sponsors to the bill: Senators Tate and Aguilar, and Representatives Pettersen and Kennedy. She announced that the bill will be introduced in the Senate first, and Senators Jahn and Lambert will be listed as co-sponsors. There was no objection to including a safety clause on the bill. There was no objection to giving OLLS permission to make technical changes to the bill, if necessary.





    02:33 PM -- Bill 3 - Measures to Address Opioid Crisis in Colorado



    Yelana Love, OLLS, presented Bill 3 (Attachment F) and amendments 7 and 8 (Attachment Z and AA). The bill enacts several changes regarding opioid use and public health and safety. First, concerning the use of syringes, the bill:



    17Opioid1031AttachAA.pdf17Opioid1031AttachAA.pdf

        • exempts supervised injection facilities from state laws regarding public nuisance;
        • allows county and district public health agencies to create and operate clean syringe exchange programs without prior approval of the county or district board of health;
        • allows clean syringe exchange programs to be operated in a hospital; and
        • exempts individuals who provide clean syringes in accordance with a clean syringe exchange program from civil liability resulting from the syringe exchange.

    Second, the bill allows schools and school districts to enact policies under which a school may obtain opiate antagonists for administering to persons overdosing on an opiate. A trained employee or agent of a school may administer the opiate antagonist in accordance with the school or school district policy. Third, the bill removes synthetic opiates from the list of schedule II drugs and creates new, unspecified drug felonies for the unlawful distribution, manufacturing, dispensing, or sale of synthetic opiates. The bill exempts labeling by a pharmacists from the definition of unlawful dispensing. Under current law, unlawful distribution, manufacturing, dispensing or sale of a schedule II drug may be a level 1, 2 or 3 drug felony, depending on the amount of the drug involved and whether or not it involves a minor. Unlawful possession of a schedule II drug is a level 4 drug felony.



    02:39 PM --
    Dr. Don Stader, Colorado Chapter - American College of Emergency Physicians, testified in support of the bill and supervised injection sites.



    02:41 PM --
    Dr. Robert Valuck, Colorado Consortium for Prescription Drug Abuse Prevention, testified in support of supervised injection sites.

    BILL: Bill 3 - Measures to Address Opioid Crisis in Colorado
    TIME: 02:42:45 PM
    MOVED: Lambert
    MOTION: Adopt amendment 7 (Attachment Z). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 3 - Measures to Address Opioid Crisis in Colorado
    TIME: 02:43:30 PM
    MOVED: Pettersen
    MOTION: Adopt amendment 8 (Attachment AA). The motion passed without objection.
    SECONDED: Lambert
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 3 - Measures to Address Opioid Crisis in Colorado
    TIME: 02:44:15 PM
    MOVED: Singer
    MOTION: Refer Bill 3, Measures to Address Opioid Crisis in Colorado, as amended, to the Legislative Council (Attachment F) . The motion passed on a vote of 10-0.
    SECONDED: Lambert
    VOTE
    Buck
    Yes
    Jahn
    Yes
    Kennedy
    Yes
    Moreno
    Yes
    Navarro
    Yes
    Priola
    Yes
    Singer
    Yes
    Tate
    Yes
    Lambert
    Yes
    Pettersen
    Yes
    Final YES: 10 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: PASS





    02:45 PM



    Representative Pettersen assigned the following co-prime sponsors to the bill: Representatives Singer and Navarro, and Senators Lambert and Jahn. She announced that the bill will be introduced in the Senate first, and all other committee members, except Representative Buck, will be listed as co-sponsors. There was no objection to including a safety clause on the bill. There was no objection to giving the Office of Legislative Legal Services permission to make technical changes to the bill, if necessary.







    02:49 PM -- Bill 4 - Expand Access to Behavioral Health Providers



    Christy Chase, OLLS, presented Bill 4 and reviewed amendments number 1 and 2 (Attachments BB and CC). Under current law, the Colorado Health Service Corps Program (CHSC) offers loan repayment for certain eligible health care providers who serve in federally-designated health professional shortage areas. The thirteen-member CHSC Advisory Council reviews applications and makes recommendations to the Primary Care Office in the Colorado Department of Public Health and the Environment (CDPHE), which administers the program. The bill adds behavioral health care providers and candidates for licensure to the list of health care providers eligible for loan repayment. Candidates for licensure must serve at least two years after obtaining a license, plus the time spent obtaining supervised experience hours. In addition, the Primary Care Office must create and administer state-designated health professional shortage areas. The bill removes the requirement that the CHSC loan repayment recipients must serve in a health professional shortage area as designated by the federal government.



    17Opioid1031AttachBB.pdf17Opioid1031AttachBB.pdf 17Opioid1031AttachCC.pdf17Opioid1031AttachCC.pdf



    Scholarship program. Beginning in FY 2018-19, the bill creates a scholarship program to cover the costs of obtaining certification as an addiction counselor for individuals who agree to serve in a state or federally designated health professional shortage area for at least six consecutive months. Scholarships may cover up to the full costs of educational materials and direct expenses and must be paid to the academic institution or state-approved trainer.



    Advisory council. The advisory council must review applications and make recommendations to the Primary Care Office. The bill adds two members to the council: a representative of a substance use disorder service provider and a licensed or certified addiction counselor. When considering applications from behavioral health care providers for loan repayment through the CHSC and the newly-created scholarship program, the advisory council must give priority to applicants who are practicing with a non-profit or public employer.



    The bill clarifies what must be included in the existing biennial program report, specifies that CDPHE must include the report as part of its SMART Act hearing. Beginning in FY 2018-19, the General Assembly must annually appropriate $2.5 million from the Marijuana Tax Cash Fund for loan repayment for behavioral health care providers and candidates for licensure, and for scholarships to addiction counselors.



    02:55 PM --
    Miller Hudson, 3rd Judicial District Attorney's Office, discussed the drug epidemic in Las Animas and Huerfano Counties.



    02:59 PM --
    Jennifer Miles, Colorado Providers Association, testified in support of the bill.



    03:00 PM --
    Frank Cornelia, Colorado Behavioral Health Care Council, testified in support of the bill.

    BILL: Bill 4 - Expand Access to Behavioral Health Providers
    TIME: 03:03:10 PM
    MOVED: Jahn
    MOTION: Adopt amendment 1 (Attachment BB). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 4 - Expand Access to Behavioral Health Providers
    TIME: 03:03:54 PM
    MOVED: Jahn
    MOTION: Adopt amendment 2 (Attachment CC). The motion passed without objection.
    SECONDED: Lambert
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION:


    BILL: Bill 4 - Expand Access to Behavioral Health Providers
    TIME: 03:04:13 PM
    MOVED: Jahn
    MOTION: Refer Bill 4, Expand Access to Behavioral Health Providers, as amended, to the Legislative Council (Attachment H). The motion passed on a vote of 10-0.
    SECONDED: Singer
    VOTE
    Buck
    Yes
    Jahn
    Yes
    Kennedy
    Yes
    Moreno
    Yes
    Navarro
    Yes
    Priola
    Yes
    Singer
    Yes
    Tate
    Yes
    Lambert
    Yes
    Pettersen
    Yes
    Final YES: 10 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: PASS





    03:05 PM



    Representative Pettersen assigned the following co-prime sponsors to the bill: Representatives Singer and Navarro, and Senators Tate and Jahn. She announced that the bill will be introduced in the Senate first, and all other committee members will be listed as co-sponsors. There was no objection to including a safety clause on the bill. There was no objection to giving the Office of Legislative Legal Services permission to make technical changes to the bill, if necessary.





    03:06 PM -- Bill 5 - Medicaid Inpatient/Residential SUD Treatment



    Brita Darling, OLLS, presented Bill 5 (Attachment J) and amendment 1 (Attachment DD). The bill adds inpatient and residential substance use disorder treatment as a benefit under the Colorado Medicaid Program, conditional upon federal approval. The Department of Health Care Policy and Financing (HCPF) must seek necessary federal approval by October 1, 2018.



    17Opioid1031AttachDD.pdf17Opioid1031AttachDD.pdf



    03:11 PM -- Dr. Don Stader, Colorado Medical Society, testified in support of the bill.



    03:12 PM --
    Tonya Wheeler, Advocates for Recovery in Colorado, testified in support of the bill.



    03:14 PM --
    Jennifer Miles, COPA, testified in support of the bill. She discussed Senate Bill 16- 202 and how the provisions in Bill 5 may affect the implementation of SB 16-202. Committee comments followed.



    03:18 PM --
    Frank Cornelia, Colorado Behavioral Healthcare Council, commented on the bill.



    03:24 PM --
    Dr. Aleah Horstman, Arapahoe House, testified in support of the bill.



    03:26 PM --
    Dr. Robert Valuck, Colorado Consortium for Prescription Drug Abuse Prevention, testified in support of the bill.

    BILL: Bill 5 - Medicaid Inpatient/Residential SUD Treatment
    TIME: 03:27:31 PM
    MOVED: Pettersen
    MOTION: Adopt amendment 1 (Attachment DD). The motion passed without objection.
    SECONDED: Kennedy
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 5 - Medicaid Inpatient/Residential SUD Treatment
    TIME: 03:28:37 PM
    MOVED: Kennedy
    MOTION: Refer Bill 5, Medicaid Inpatient/Residential Substance Use Disorder Treatment, to the Legislative Council (Attachment J). The motion passed on a vote of 10-0.
    SECONDED: Buck
    VOTE
    Buck
    Yes
    Jahn
    Yes
    Kennedy
    Yes
    Moreno
    Yes
    Navarro
    Yes
    Priola
    Yes
    Singer
    Yes
    Tate
    Yes
    Lambert
    Yes
    Pettersen
    Yes
    Final YES: 10 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: PASS





    03:29 PM



    Representative Pettersen assigned the following co-prime sponsors to the bill: Representatives Pettersen and Navarro, and Senators Priola and Jahn. She announced that the bill will be introduced in the House of Representatives first, and all other committee members will be listed as co-sponsors. There was no objection to including a safety clause on the bill. There was no objection to giving the Office of Legislative Legal Services permission to make technical changes to the bill, if necessary.





    03:32 PM -- Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment



    Brita Daring, OLLS, presented Bill 6 (Attachment L) and amendments 1, 2, 4, 5, 6, and 7 (Attachment EE, FF, GG, HH, II, and JJ). The bill makes several changes to substance use treatment under health insurance plans and the state Medicaid program. For both private health insurance and Medicaid, these changes include prohibiting requirements that covered persons:



    17Opioid1031AttachEE.pdf17Opioid1031AttachEE.pdf 17Opioid1031AttachFF.pdf17Opioid1031AttachFF.pdf



    17Opioid1031AttachGG.pdf17Opioid1031AttachGG.pdf 17Opioid1031AttachHH.pdf17Opioid1031AttachHH.pdf



    17Opioid1031AttachII.pdf17Opioid1031AttachII.pdf 17Opioid1031AttachJJ.pdf17Opioid1031AttachJJ.pdf

        • get prior authorization in order to receive medication-assisted treatment (MAT); and
        • undergo step therapy that requires the use of an opioid medication prior to providing coverage for a non-opioid prescription drug recommended by a patient's health care provider.



    For private health insurance, the bill also requires that insurers cover transdermal lidocaine patches for chronic pain. In addition, health plans that provide a benefit for physical therapy, acupuncture, or chiropractic care cannot subject those services to dollar limits, deductibles, copayments, or coinsurance that are higher than those for primary care services for covered persons who are diagnosed with chronic pain and who have or have had a substance use disorder diagnosis. For Medicaid, the bill also requires that the brand-name intranasal opioid antagonist Narcan and its generic version be covered.





    03:36 PM



    Representative Kennedy provided an overview of the stakeholder process involved in this bill and explained the amendments. Committee discussion followed about the amendments.



    03:44 PM --
    Tonya Wheeler, Advocates for Recovery Colorado, testified in support of the bill.



    03:45 PM --
    Angela Bonaguidi, Colorado Organization for the Treatment of Opioid Dependence, testified in support of the bill. She discussed concerns about amendment 7.



    03:46 PM -- Sara Orrange, Colorado Association of Health Plans, presented the association's concerns about the bill.



    03:52 PM -- Frank Cornelia, COHC, spoke in support of the bill.

    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:53:27 PM
    MOVED: Kennedy
    MOTION: Adopt amendment 1 (Attachment EE). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:54:42 PM
    MOVED: Kennedy
    MOTION: Adopt amendment 2 (Attachment FF). The motion passed without objection.
    SECONDED: Jahn
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:55:03 PM
    MOVED: Kennedy
    MOTION: Adopt amendment 4 (Attachment GG). The motion passed without objection.
    SECONDED: Priola
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:55:20 PM
    MOVED: Kennedy
    MOTION: Adopt amendment 5 (Attachment HH). The motion passed without objection.
    SECONDED: Priola
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:55:40 PM
    MOVED: Kennedy
    MOTION: Adopt amendment 6 (Attachment II). The motion passed without objection.
    SECONDED: Priola
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection


    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:55:57 PM
    MOVED: Kennedy
    MOTION: Adopt amendment 7 (Attachment JJ). The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection
    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:56:58 PM
    MOVED: Kennedy
    MOTION: Amend Bill 6, Page 4, after Line 26, insert language establishing an effective date for the bill of January 1, 2019. The motion passed without objection.
    SECONDED: Singer
    VOTE
    Buck
    Jahn
    Kennedy
    Moreno
    Navarro
    Priola
    Singer
    Tate
    Lambert
    Pettersen
    YES: 0 NO: 0 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: Pass Without Objection
    BILL: Bill 6 - Payment Issues Relating to Substance Use Disorder Treatment
    TIME: 03:56:40 PM
    MOVED: Kennedy
    MOTION: Refer Bill 6, Payment Issues Relating to Substance Use Disorder Treatment, as amended, to Legislative Council (Attachment L). The motion passed on a vote of 7-3.
    SECONDED: Singer
    VOTE
    Buck
    No
    Jahn
    Yes
    Kennedy
    Yes
    Moreno
    Yes
    Navarro
    No
    Priola
    Yes
    Singer
    Yes
    Tate
    No
    Lambert
    Yes
    Pettersen
    Yes
    YES: 7 NO: 3 EXC: 0 ABS: 0 REMOTE PARTICIPATION: 0 FINAL ACTION: PASS





    03:56 PM



    Representative Pettersen assigned the following co-prime sponsors to the bill: Representatives Kennedy and Singer, and Senators Lambert and Jahn. She announced that the bill will be introduced in the House of Representatives first, and Representative Pettersen will be listed as a co-sponsor. There was no objection to giving OLLS permission to make technical changes to the bill, if necessary.





    03:56 PM



    Representative Pettersen adjourned the meeting.




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