S_HHS_2020A 01/22/2020 10:01:45 AM Committee Summary

The members of the Joint Budget Committee (JBC) came to the table. Representative Esgar provided an overview of the Staff Budget Briefing Summary FY 2020-21.  This document may be accessed at: https://leg.colorado.gov/sites/default/files/fy20-21brfsum-12-23-19.pdf .  She introduced members of the JBC staff and noted that the JBC staff works for all members of the General Assembly.

Senator Rankin discussed the budget request from the Colorado Department of Public Health and Environment (CDPHE).  He discussed CDPHE's request for funding to target and raise the states' measles, mumps, and rubella vaccination rate among kindergarteners.  He also discussed other budget priorities for CDPHE including: alternative funding for various administrative positions currently funded by the Preventative Health and Health Services Block Grant; a 0.5 percent provider rate increase for local public health agencies; the elimination of the Waste Grease Program in the Hazardous Materials and Waste Management Division, since the program is duplicative with local municipal programs; and the elimination of funding for two external boards: the Stroke Advisory Board and the Colorado Coroners Standards and Training Board.  

Senator Moreno discussed the budget items related to the Department of Health Care Policy and Financing (HCPF) starting on page 32 of the Staff Budget Briefing Summary FY 2020-21.  He spoke about the reduction in the Medicaid caseload and responded to questions about the recent decline in Medicaid enrollment. Committee discussion followed about factors that reduce Medicaid eligibility.

Senator Moreno discussed HCPF's budget requests including the variety of enhancements that HCPF wants to make to its customer service protocols; funding for initiatives to ensure appropriate utilization of drugs and to control pharmacy and physician administered drug expenditures; and administrative costs related to the implementation of bundled payments for episodes of care.  He discussed costs related to the implementation of inpatient treatment for substance use disorders.  Senator Moreno discussed the budget requests related to long-term care utilization and management and funding for coordinating care for people with a high-cost diagnosis of chronic pain, anxiety, or depression.  Committee questions followed about Medicare reimbursement rates and the HCPF rate review committee.

Representative Esgar presented the budget requests from the Department of Human Services (DHS).  She discussed the budget request related to the funding for operating and staffing the Mental Health Institute at Pueblo and funding related to a variety of issues at youth services centers.  She continued to discuss the budget request from DHS.  Committee comments and questions followed about the number of child welfare workers needed to manage the child welfare caseload and the difficulty county departments of human services face retaining caseworkers in a tight labor market.

Committee members discussed decreases in various funding requests and the Governor's objective of cutting state spending.  JBC members reassured the committee that they are reviewing the executive departments' suggested budget cuts to be sure that they are not cutting services. Committee discussion followed about services for veterans, the elderly population, and families.

Margaret Froelke, representing herself, spoke about her family's experience caring for her developmentally delayed son and her plans for his future care.

Bob Froelke, representing himself, spoke about the challenges individuals with an intellectual or developmental disability (IDD) face.

Brennan Froelke, representing himself, responded to questions from the committee.

Committee questions and comments followed.

Erica Tafoya, representing herself, spoke about her family's experience providing care for her brother and his desire to live alone.  She discussed the services her brother receives under the Supported Living Services Home- and Community-Based Waiver.

Vanessa Perez, representing herself, spoke about her experience and the services she recieves as a person with an IDD.

Maureen Welch, representing herself, spoke about her experience as the mother of a child with an IDD.

Danielle Short, representing herself, discussed her experience as the parent of a child with down syndrome and the services her child receives through the Home- and Community-Based Waiver for children and her concerns for her son's future.

Tauni Couch, representing herself, discussed her experience as a parent of an adult child with down syndrome and as a day program provider.

Alyssa Restivo, representing herself, discussed her family's experience caring for a family member with an IDD.

Rosie Wartner-Chaney, representing herself, discussed her experience as a host home provider.

Brian Matthews, representing himself, spoke about his experience as a person with disabilities.

Bonnie Silva, Department of Health Care Policy and Financing, presented the update on House Bill 14-1051 and provided a handout (Attachment A).  She reviewed the long-term services and support programs administered by HCPF.  She discussed the progress the department has made in moving individuals off of the IDD waiver waitlist and the department's strategic plan to provide services to a larger portion of the IDD population. 

She discussed the estimated cost associated with reducing the IDD waiver waiting list over the next six years and the department's roadmap to improve access and case management and to evaluate and improve benefits.

Ms. Silva responded to questions.

Cheryl Wicks, Mosaic, discussed the progress made over the past few years in moving individuals off of the waiting list and the need to further fund the waiver to reduce the waiting list. A handout was distributed (Attachment B).

Randy Brodersen, North Metro Community Services, spoke about the challenges service providers and patients face finding direct care providers.  He discussed the source of payments for direct care providers who provide services to individuals with IDD.

Committee questions followed.  Ms. Silva spoke about the barriers the department faced trying to eliminate the waitlist by 2020, including the number of individuals actually needing services was greater than originally estimated.

Jordan Steffen, Child Protection Ombudsman of Colorado (CPO), presented on the history and role of the CPO and distributed a handout (Attachment C).  She explained that the role of the CPO is to be independent, impartial, and provide credibility and confidentiality in the investigative process.

She discussed the various populations who call the CPO, the number of calls received overtime, and the information and resource offered by the CPO to callers who need assistance from other agencies.

She discussed CPO compliance letters and the CPO investigations process.  She discussed CPO investigations conducted in 2019 and  the CPO Issue Brief addressing the Division of Youth Services' Rulemaking Process.  She discussed the CPO's strategic and public policy initiatives.