December 2, 1998
The following people graciously attended the meeting and gave their input on upcoming bills affecting the disabled:
Bill Hanna, DHS
Julie Reiskin, CCDC
Patty Thompson, MHA
Dean Woodward, HCPF
Bob Hagedorn is sponsoring a bill regarding privacy and confidentiality in the release of medical records. The bill uses the National Association of Insurance Commissioners model.
The restraint and seclusion bill that died in Appropriations last year is back again. The Hospital Association is opposing this bill again. The bill has been changed to exclude emergency room life and death situations. It still requires patients be checked on every 15 minutes if they are restrained. Hospitals are already required to do 15 minute checks under 2710 regulations.
The fiscal note on the bill last year was for child care training. DHS will not be adding a fiscal note this year because child care training has already been dealt with. CCDC would like the CBA's support of this bill.
Dave Owens is sponsoring a bill that would codify the Governor's Council on People With Disabilities. The bill is combined with a parking enforcement bill that would require a handicapped placard to have the holder's driver's license number on the placard. A one dollar "donation" paid when obtaining placards would go to fund the Governor's Council. CCDC would like the CBA's support on this bill.
Mo Keller and Ken Arnold are sponsoring a bill that would allow adopted children to receive Medicaid.
While no bill is pending, a group is looking at how to get children out of home placement services without their parent's needing to go through the dependency and neglect process in order to receive the services. This group is looking at how best to accomplish this, including Medicaid eligibility, the Children's Health Fund, and what can be accomplished with and without legislation.
The Mental Health Association will be watching an involuntary placement bill, as well as a bill allowing patients to sue their HMO when they are denied care. Patty Thompson did not feel the HMO bill was likely to go anywhere.
HCPF will be watching several possible bills. Morrison will probably carry a bill to create a 12 month Medicaid eligibility lock-in for people going into HMOs. Currently, there is a six month period of guaranteed eligibility, even if income eligibility is lost. (The House HEWI Committee postponed this bill indefinitely on 1/15.) Doug Linkhart is interested in carrying a bill to keep people with HIV/AIDS who work on Medicaid or allow them to purchase Medicaid.
There may be a bill to charge a sliding fee scale to parents of severely disabled children under the Model 200 program. The Joint Budget Committee dislikes the fact that parents' income is not considered, so parents with large incomes may be getting services, while low-income parents are on a waiting list.
A bill is being considered that would impose civil monetary penalties on providers who commit billing fraud.
Morrison will again sponsor a bill to set up a legislative committee to discuss health policy in Colorado.
HB 1166 would increase the personal needs allowance from the current $34 people in nursing homes are allowed to keep. How to finance this is an issue.
Mo Keller is carrying a bill to reduce the Medicaid resources level for children to TANF levels.
HCPF is also concerned with two other issues: The Title 21 program for children's health care is not being used by enough people. There is a small monthly fee of $9.00 and the program covers people from Medicaid eligibility level up to 185% of the poverty level. The program can get two for one federal money. Family planning services for people with income up to 150% of the poverty level is currently funded by money from the general fund which goes to the state Health Department. If the money could be run through Medicaid, Colorado would fund %90 of the program.
DHS supports expansion of Medicaid to include substance abuse treatment. Sen. Wham may carry a bill if DHS can figure out how to fund this proposal.
AND medical screenings - currently, only MDs or DOs can screen and are reimbursed only $22.50. A bill to allow nurses, nurse practitioners and physicians assistants to perform the exam is being initiated by DHS. The Colorado Coalition for the Homeless is supporting a bill which would add health care benefits to AND.
Joyce Lawrence is carrying a bill to require pre and post employee screening of mental health institution employees so those who have lied on their applications about violent crime convictions may be fired. It may expand to cover all DHS institutions.
Submitted by Ellen Buckley, Co-chair
Summaries of Bills of Interest:
HB 1025: CONCERNING IDENTIFICATION OF DRIVERS WHO MAY NOT BE QUALIFIED TO DRIVE. Identifies reports filed by peace officers, licensed medical professionals, or a driver's immediate family as documentation on which the division of motor vehicles within the department of revenue may rely for evidence that a driver is incompetent or otherwise not qualified to drive. Grants civil immunity to a person who files a report in good faith.
HB 1074/SB 49: A BILL FOR AN ACT CONCERNING EXPANSION OF THE CRIME OF ETHNIC INTIMIDATION, AND, IN CONNECTION THEREWITH, CHANGING THE NAME OF THE CRIME TO A HATE CRIME: Adds physical and mental disability to the list under hate crimes legislation.
*HB 1085: A BILL FOR AN ACT CONCERNING THE ASSET TEST FOR DETERMINING ELIGIBILITY FOR CHILDREN UNDER THE MEDICAL ASSISTANCE PROGRAM, AND MAKING AN APPROPRIATION THEREFOR. Makes the resource standard for determining medicaid eligibility for children the same as the standard used for determining eligibility under the Colorado works program. Makes an appropriation.
*HB 1088: A BILL FOR AN ACT CONCERNING MEDICALLY NECESSARY THERAPY FOR CHILDREN UP TO FIVE YEARS OF AGE, AND, IN CONNECTION THEREWITH, SPECIFYING COVERAGE FOR THE CARE AND TREATMENT OF MEDICALLY DIAGNOSED CONGENITAL DEFECTS AND BIRTH ABNORMALITIES. Clarifies that insurance benefits available to newborn children shall include the coverage of all medically necessary care and treatment of medically diagnosed congenital defects and birth abnormalities for the first 31 days of the newborn's life. Clarifies that copayment, deductible, and aggregate dollar limit provisions for coverage of an infant diagnosed with congenital defects and birth abnormalities shall be no higher than generally applicable under the policy to all other sicknesses, diseases, and conditions otherwise covered by the policy. Requires each individual and group health plan to provide medically necessary physical, occupational, and speech therapy for the care and treatment of a child's congenital defects and birth abnormalities up to 5 years of age. A BILL FOR AN ACT CONCERNING THE PROTECTION OF PERSONS FROM RESTRAINT. Establishes minimum standards for the use of restraint on persons in certain facilities. Defines "restraint", "emergency", and "agency". Identifies the circumstances under which an agency may use restraint. Excludes certain facilities and lawful restraint of certain persons from the requirements of the act. Specifies the duties of an agency when applying restraint. Requires that agency staff be appropriately trained in the use of restraint. Requires agencies to document the circumstances surrounding the use of any type of restraint. Provides a review process for the use of restraint. Requires agencies to adopt rules for the procedure of using restraint.
*HB 1116: A BILL FOR AN ACT CONCERNING THE PROVISION OF SERVICES TO CHILDREN WHOSE MENTAL ILLNESS PLACES THEM AT RISK OF OUT-OF-HOME PLACEMENT. Creates the "Child Mental Health Treatment Act". Authorizes a parent or guardian who believes his or her minor child is at risk of out-of-home placement to apply for mental health treatment services. Defines "child at risk of out-of-home placement" as a child who has been diagnosed as being mentally ill but for whom an action in dependency or neglect is not appropriate. Specifies that mental health agencies shall evaluate and clinically assess the child's need for mental health services and, when warranted, provide the treatment services as may be necessary and in the best interests of the child and the child's family. Specifies that the mental health agency shall be responsible for providing the treatment services, including in-home family mental health treatment, family preservation services, residential treatment, or post-residential follow-up services. Identifies the funding for such mental health services, including medicaid, children's health plan, and service fees. Specifies that service fees are to be enforced in the same manner as child support obligations.
HB 1166: A BILL FOR AN ACT CONCERNING PERSONAL NEEDS FUNDING FOR MEDICAID RESIDENTS IN NURSING CARE FACILITIES. Changes the personal needs allowance by increasing the minimum amount payable to a resident of a nursing facility or an intermediate care from $34 to $50.
SB 6: A BILL FOR AN ACT CONCERNING PAYMENTS FOR CONTINUING CARE. Requires health maintenance organizations ("HMO's") to pay for continuing care services provided by an out-of-network provider if: _ The beneficiary is returning to the same location where the beneficiary resided prior to hospitalization; _ The beneficiary has a continuing care contract or rental agreement with the facility at that location; _ The service is one that the HMO would be liable for if provided by an in-network provider; _ The beneficiary needs the level of care provided by the continuing care provider; and _ The provider is willing to accept payment according to the same terms as an in-network provider. Establishes a cause of action for an HMO's violation of the requirement. If an HMO collects a higher premium because a beneficiary is in a special needs category, requires HMO's to reimburse the continuing care provider based on the adjusted amount.
SB 62: A BILL FOR AN ACT CONCERNING THE REQUIREMENTS FOR APPROVAL OF AN INDEPENDENT LIVING CENTER BY THE DEPARTMENT OF HUMAN SERVICES. Specifies requirements that independent living centers must meet as a condition of approval to provide independent living services to clients pursuant to a contract with the department of human services.
SB 67: A BILL FOR AN ACT CONCERNING THE PROVISION OF HEALTH CARE TO PERSONS IN THE AID TO THE NEEDY DISABLED PROGRAM WHO ARE NOT RECEIVING MEDICAID. Creates a state-funded health and medical care program to provide health care for recipients of aid to the needy disabled (AND) who are not receiving medicaid.
SB 79: A BILL FOR AN ACT CONCERNING PARKING PROVISIONS FOR PERSONS WITH PHYSICAL DISABILITIES. For parking enforcement purposes, requires the department of revenue ("department") to clearly identify on the vehicle registration card if the owners are persons with disabilities. Requires a non-temporary disabled parking placard to have clearly printed on it the driver's license number or identification card number of the disabled person.
Allows for revocation of a disabled license plate or placard for misuse upon a sworn statement by an authorized parking enforcement official. Requires the department to deny the reissuance of a disabled license plate or placard for one year for a first violation of the parking privilege statute and for 5 years for a second or subsequent violation. In a jurisdiction that allows disabled parking regardless of time limitations, limits disabled parking on state highways to 6 hours. Prohibits local governments from limiting such privilege to less than 4 hours on any public street. Requires posting of such time limits. Prohibits a person without a disability from using a disabled parking space unless it is for the direct benefit of a person with a disability and a disabled license plate or placard is displayed. Increases fine. Creates a traffic infraction for blocking access to curb ramps or passenger loading zones that are adjacent to a disabled parking space. Creates criminal and civil penalties for fraudulently obtaining, possessing, using, or transferring a disabled parking placard or for knowingly making, possessing, using, or transferring a counterfeit placard. Doubles the penalty for a person who receives remuneration for committing such a violation. Requires a court to send certification of an entry of judgment to the department for certain violations. Requires the department to provide notification about possible revocation. Provides that, upon a third entry of judgment against a vehicle owner, the department shall withhold the owner's vehicle registration until the judgment is paid. Requires the department to revoke a license plate or placard upon a third entry of judgment. Applies to violations committed on or after July 1, 1999. Makes conforming amendments.
SB 087: A BILL FOR AN ACT CONCERNING THE RIGHTS OF HEALTH INSURANCE POLICY BENEFICIARIES. Not directly disability-related, but requires insurers to cover insureds in expanded ways – reasonable emergency medical services, choice or providers and some access to specialty care.
SB 98: A BILL FOR AN ACT CONCERNING A PILOT PROGRAM FOR PERSONS WITH A CHRONIC ILLNESS. Establishes a pilot program to provide medicaid eligibility for persons diagnosed with HIV whose assets or income exceed current limitations. Requires the department of health care policy and financing to apply for federal waivers for the program.