H_PBH_2021A 05/04/2021 01:30:54 PM Committee Summary

Representative Snyder, bill sponsor, introduced SB21-022. The Department of Health Care Policy and Financing, which administers the state’s Medicaid program, has a process for auditing Medicaid providers to ensure correct payment for services rendered. Current law requires the auditor to provide a written notice and records request at least ten business days prior to commencing the audit. The bill requires the auditor to provide this notice through both email and certified mail. In addition, the auditor must provide the contractor with instructions, correspondence timetables, a department contact, and if applicable, information on the contractor being used to conduct the audit.

Representative McKean, bill sponsor, gave opening comments on the bill.

Nicole Schiavone, representing herself, testified in support of the bill.

Representative Snyder and Representative McKean gave final remarks on the bill.

Kevin Patterson, CEO, Connect for Health Colorado, introduced the presentation (Attachment A) to the committee. He gave an overview of the Open Enrollment Report (Attachment B).

Mr. Patterson gave an overview of the enrollment period and the key takeaways from the report. He spoke about the impacts on health insurance in Colorado from the American Rescue Plan.

Brian Braun, CFO, Connect for Health Colorado, answered questions from the committee.

Mr. Patterson answered a question from the committee.

Representative Williams, bill sponsor, introduced SB21-101. The bill continues the regulation of direct-entry midwives by the Division of Professions and Occupations in the Department of Regulatory Agencies (DORA), which repeals September 1, 2021, for seven years. In addition, the bill permits direct-entry midwives to work in birth centers and repeals a reporting requirement during registration renewal. The bill makes several adjustments to the authority of direct-entry midwives by:

• permitting direct-entry midwives to apply for additional authority administer group B streptococcus prophylaxis;
• removes a requirement that direct-entry midwives renew any additional authority once approved by the division director;
• directs DORA to develop rules regarding direct-entry midwives in training; and
• permits DORA to order a physical or mental examination of a direct-entry midwife if there is reasonable cause to believe that the direct-entry midwife is subject to a disability that renders them unable to treat patients.

The bill also requires the Department of Public Health and Environment to include on the birth certificate worksheet form whether a live birth occurred after a transfer to a hospital by a direct-entry midwife.

Representative Caraveo, bill sponsor, gave opening comments on the bill.

Bill sponsors responded to questions from committee members.

Ms. Jennifer Barr, Colorado Midwives Association, testified in support of the bill. Mrs. Demetra Seriki, A Mothers Choice Midwifery, testified in support of the bill. Samantha Espinoza, Colorado Children's Campaign, testified in support of the bill. Mrs. Melissa Sexton, Colorado Midwives Association, testified in support of the bill.

Ms. Barr responded to questions from the committee.

Ms. Kia Ruiz, representing herself, testified in support of the bill.

Submitted written testimony can be found in Attachment C.

Representative Caraveo and Representative Williams gave final comments on the bill.

Committee members gave final remarks on the bill.

Representative Pelton,
bill sponsor, introduced and gave opening comments on SB21-039.



The bill phases out sub-minimum wage employment for private businesses;
creates a buy-in option for the Developmental Disabilities Medicaid waiver
program; makes additional changes to the services offered through the waiver
program; and continues the Employment First Advisory Partnership, as discussed
below.



Employer phase-out of subminimum wage.  The bill phases out subminimum
wage employment for employers that hold a special certificate from the
U.S. Department of Labor authorizing them to pay employees less than minimum
wage if their earning capacity is impaired by age, physical or mental disability,
or injury.



Employers with such a special certificate must submit a transition plan
to the Colorado Department of Labor and Employment (CDLE) by June 30, 2022,
that describes the employer's plans to phase out subminimum wage employment
and support their subminimum wage employees in pursuing competitive employment,
supported employment, or integrated community activities related to each
individual's employment goals.  The plan must include measurable benchmarks,
be informed by evidence-based practices and effective employment models,
and be updated annually and resubmitted to the CDLE until the employer
is no longer paying subminimum wages.  CDLE must collaborate with
employers to create a process for approving transition plans.  The
process for approving transition plans must ensure that employers have
until July 1, 2025, to eliminate subminimum wage employment so that individuals
working in these jobs have time to transition.



Employers without a special certificate as of June 30, 2021, may not employ
individuals for less than the minimum wage after that date.  Regardless
of special certificate, employers may not hire any new employees at subminimum
wages after June 30, 2021.  On and after July, 1 2025, an employer
cannot pay an employee less than the applicable federal or state minimum
wage, whichever ishigher.



Employment First Advisory Partnership recommendations.  The bill
requires the Employment First Advisory Partnership to develop actionable
recommendations for addressing barriers to phasing out subminimum wage
employment, and to deliver these recommendations to the General Assembly
by April 1, 2022.

The recommendations must address:

• payment reform
  for employment-related services;
• adequate reimbursement
  rates for employment-related services to ensure high-quality support services;
  
• unit caps on employment-related
  services; and
• federal Medicaid
  waiver and state regulatory barriers.In addition, the partnership, which
  is scheduled to repeal on September 1, 2021, is continued indefinitely.
  

Changes to state Medicaid programs. By January 1, 2023, the Department
of Health Care Policy and Financing (HCPF) must seek federal approval for
additional Medicaid waiver services for adults with intellectual and developmental
disabilities to support their ability to gain competitive employment. These
services include support to provide line-of-sight supervision and ongoing
benefits counseling to support higher earnings.  In addition, HCPF
must seek to remove job coaching and job development from the service plan
authorization limits, allowing these services to be authorized without
regard to an individual’s service limit.




The bill also requires HCPF to seek federal authorization to implement
a buy-in program for the Developmental Disabilities waiver by January 1,
2023, and must implement the buy-in program within three months of receiving
approval.  Services currently included in the developmental disabilities
waiver program include:

• behavioral services;
  
• day habilitation
  services;
• dental;
  
• home delivered
  meals;
• non-medical transportation;
  
• peer mentorship;
  
• prevocational
  services;
• residential habilitation
  services and supports;
• specialized medical
  equipment and supplies;
• supported employment;
  
• transition set
  up; and
• vision.

Representative Caraveo, bill sponsor, gave opening remarks on the bill.

The bill sponsors responded to questions from committee members.

Ms. Jennifer Levin, The Arc of Colorado, testified in support of the bill.  Mr. Bob Lawhead, Colorado Developmental Disabilities Council, testified in support of the bill.  Mr. Michael Hoover, Colorado Developmental Disabilities Council, testified in support of the bill. Mr. Lloyd Lewis, representing himself, testified in support of the bill.

Mr. John Klausz, Mountain Valley Developmental Services, testified in support of the bill.  Mr. Brian Wilson, representing himself, testified in support of the bill.  Mrs. Ellen Jensby, representing Alliance, testified in support of the bill.  Mrs. Jensby responded to questions from the committee.

Submitted written testimony can be found in Attachment D.

Representative Caraveo, introduced and explained amendment L.002 (Attachment E).

Representative Caraveo and Representative Pelton gave final comments on the bill.

Committee members made final comments on the bill.