Bill Tracker

This bill concerns a prohibition against requiring compensation to a health-care
staffing agency if a contracted health-care facility hires the health-care
staffing agency's employee as a permanent employee of the health-care
facility. This bill gives the health care employee or facility hiring the
employee to sue the health-care stafing agency for not more than $5,000 and
damages.

Bill Reengrossed on 2/6/23 in House to make bill applicable to all health care
facilities and not just nursing homes and assisted living centers.

The League believes that efficient and economical
delivery of care can be enhanced by such cost control methods as the
reduction of administrative costs. This bill would substantially reduce
administrative costs of healthcare facilities.

The bill strikes outdated language from the
legislative declaration in Section 25.5-6-402, C.R.S., concerning Prader-Willi
syndrome.

Assessment of No Fiscal Impact The bill makes nonsubstantive changes to
state statute that will not affect the operations of Medicaid or any other state
program. Thus, the bill will not affect state or local revenue or expenditures
and is assessed as having no fiscal impact. 

League believes that "U.S. health care policy goals should include the
equitable distribution of services, efficient and economical delivery of care,
advancement of medical research and technology.” The Healthcare team
believes updating the definition of Prader Willi syndrome in Colorado law is
consistent with advancement of medical research and technology. 

The bill requires health professionals, students, and trainees to obtain
informed consent from sedated or unconscious patients before performing
intimate examinations, unless in emergency situations when it is medically
necessary. In addition to patient consent, students or trainees may only
perform intimate examinations if it is related to the planned procedure to be
performed, the patient has recognized them as part of the care team, and they
are under direct supervision. The bill outlines the process for obtaining
patient consent and subjects non-compliant professionals and health-care
facilities to disciplinary action or sanctions by their regulator or the
Department of Public Health and Environment (CDPHE). The bill also
specifies that limitations on liability damages does not apply to violations by
health professionals. Health-care facilities can develop their own consent
forms or use the form to be developed by CDPHE. 

Fiscal info: For FY 2023-24, the bill requires an appropriation of $32,915 to
the Department of Public Health and Environment. 

The League supports “a health care system that provides
access to affordable, quality health care for all Americans and protects
patients’ rights.” The Healthcare team believes this bill protects patients'
rights.

Bill summary: The report of the Blue Ribbon Commission for Health Care Reform in 2008 and in in September, 2021, the HB19-1176 Health Care Cost Savings Task Force report was delivered to the CO Assembly.  The 2021 report by the Colorado School of Public Health (CSPH) found that “a fully publicly financed and privately delivered health care system could yield significant health care savings.”

To achieve better, more affordable, and fairer health care, the people of Colorado need answers to very important questions regarding universal health care and how and whether universal health care can and should be implemented in Colorado; and it is important to have an analysis of model legislation to implement universal health care in order to determine whether such a system would achieve the goals of better, more affordable, and fairer health care for all Coloradans.

The bill creates a task force of qualified individuals and state department heads to advise the Colorado School of Public Health.  The report of the task force will be delivered to the House of Representative committee on health and insurance and the Senate Committee on health and human services, or their successor committees by December 1, 2023.

Per a March 9 Denver Post article.“If it comes back with high benefit, it’s something we can take action on,” said Democratic Rep. Dafna Michaelson Jenet, who chairs the House’s Public and Behavioral Health and Human Services committee. “If it’s a really bad idea, we can go back to the drawing board.”

HB23-1209 Analyze Statewide Publicly Financed Health-Care is the next logical step to provide additional data that will build on the good work of the CSPH.

Statement of Position on Health Care:  The League supports the single payer concept as a viable and desirable approach to Implementing League positions on equitable access affordability, and financial feasibility.  Although the League prefers a health care financing system that includes all residents of the US.  In the absence of a federal program that achieves the goals of universal, affordable access to essential health services, the League supports health care programs financed by states which includes continuation of federal funding and comply with League principles.

The League is opposed to a strictly private market based model of financing the health care system.  The League is also opposed to the administration of the health care system solely by the private sector or the states.

Sample supporter groups: Cobalt and Planned Parenthood Rocky Mountains,  Colorado Consumer Health Initiative, Colorado Foundation for Universal Healthcare, Health Care for All Colorado, Young Invincibles,  Progress Now Colorado,  Among others.

The bill creates limits on facility fees charged to patients.  Facility fees are charges that are being imposed on patients more and more often by large hospital systems that own freestanding clinics and providers.  They can range from hundreds to thousands of dollars in addition to charges for actual services, and typically come as a surprise to the patient when they receive the bill.

This bill was heavily amended when heard in the Health and Insurance Committee.  The newly structured bill is now focused more narrowly on gathering critical data about facility fees, increasing transparency for consumers, and limiting facility fees in common-sense situations.

On or before December 1, 2023, the State Department shall issue a report detailing the impact of facility fees on the Colorado health-care system.

The League of Women Voters policy position supports a basic level of quality health care at an affordable cost. Surprise billing creates health care which is unaffordable, therefore unavailable, to many residents of the Colorado. This bill addresses this issue and its many ramifications.

LWVCO Supports this bill.

This bill changes oversight of hospital finances from the Health Department to the State department. 

Requires concise and accurate reporting to the patients of the services billed. They have a right to get a detailed report and have a contact person.

All hospitals will be required to submit annually a transparency report. It includes cost, compensation and expenditures as well as transfer of cash, investments or assets including the hospital parent organization. Disclosure of investments transferred to entities outside of the state.

Narrative report of major planned and completed projects and capital investments of > $25 Million.

Salary and total compensation of top five administrative position of each nonprofit hospitals. Duties, base compensation, bonus/incentive plan. Public hospitals may be required to report this if not already included in their reporting system.

LWVCO Position: Efficient and economical delivery of care be enhanced by cost-control measures. Research on health care financing policy affects equitable access to health care.

LWVCO Supports this bill.

Bill Status:Bill was introduced on 3/29/23 as assigned to Public and
Behavioral Health and Human Services.

On 4/11, the House committee of Public and Behavioral Health and Human Services referred the amended bill to appropriations. It was scheduled to be heard in Appropriations on 4/21.

Sponsors: Rep. Dafna Michael Jenet, Senator Jeff Bridges, & Senator
Bob Gardner

Bill Summary: This bill delineates procedures for the department of health
care policy and financing to study the behavioral health needs of children and
youth and to analyze how directed payment authority can be used to create an
adequate network of services for children and youth . It requires that each
managed care authority pays at least the state department established fee
schedule rates for services needed to stabilize these children and youth.

League Positions: The League of Women Voters of the United States believes
that a basic level of quality health care at an affordable cost should be
available to all US residents . Every US resident should have access to
affordable, quality in- and out-patient behavioral health care, including
needed medications and supportive service that is integrated with, and
achieves parity with, physical health care –LWV Impact on Issueew 2022-
2024 page 140.

LWVCO supports this bill.

The bill changes the time frame required for funeral directors to file
a certificate of death with the state registrar from 5 days to 48 hours,
with limited exceptions. The bill requires that a qualified individual
complete the medical certification within 36 hours after a death
unless an inquiry to the coroner is required. The Colorado
Department of Public Health and Environment (CDPHE), upon
request, must provide a certified death certificate to an applicant
with a direct and tangible interest in the certified copy within 24
hours.

The bill increases expenditures from the Vital Statistics Record Cash
Fund $67,510 in '23-24 and $72,000 in '24-25Total FTE 0.8 FTE in
'23 & 1.0 FTE in '24

Over the years, the League developed a comprehensive position
supporting a health care system that provides access to affordable,
quality health care for all Americans and protects patients’ rights.
Being able to receive a death certificate in a timely manner should
be part of patient right. Many many areas of planning that occur
after a death from burial plans to financial plans require a death
certificate toproceed. It is only right that the death certificate be
provided in a timely manner. The old law of 5 days is simply too
slow.

Beginning in FY 2024-25, the bill creates the Colorado Multidisciplinary Health Care Provider Access Training Program (program) and Advisory Committee. Colorado Multidisciplinary Heath Care Provider Access Training Program. The program is created in the University of Colorado (CU) Anschutz Medical Campus to develop and implement training opportunities in geriatric medicine for
two clinical graduate students in each of the following fields of study: advanced practice provider;

dentistry; medicine; nursing; occupational therapy; osteopathic medicine; pharmacy; physical therapy; psychology; social work; and speech language pathology.

The bill encourages the program to provide annual training for students, faculty, and health care providers to review patientcentered geriatric approaches, technologies, and processes. Students who complete the program receive
a certificate, and a letter authorizing the student to become a trainer in other parts of the state.

THERE ARE ONLY NINETY-SIX PHYSICIANS TRAINED IN GERIATRICS ACROSS THE STATE, AND TWO HUNDRED EIGHTY-NINE PHYSICIANS TRAINED IN GERIATRICS ARE NEEDED BY 2050 TO SERVE THE TEN PERCENT OF COLORADANS WHO WILL BE OVER SIXTY-FIVE YEARS OF AGE; The bill increases state expenditures in the CU School of Medicine by $784,269 in FY 2023-24 ( to set up the training program),and by $1.9 million in FY 2024-25, to implement the program. It will be paid from the General Fund.

The Health-care team recommends Ammending this bill to include a requirement that a provider successfully receiving the certificate of training reside in Colorado for specified time preiod. We don't want Clorado to pay for training of providers who then quickly move out of state.

The League of Women Voters of the United States believes that a basic level of quality health care at an affordable cost should be available to all U.S. residents. Other U.S. health care policy goals should include the equitable distribution of services, efficient and economical delivery of care BASIC LEVEL OF QUALITY CARE: Every U.S. resident should have access to a basic level of care that includes the prevention of disease, health promotion and education, primary care (including prenatal and reproductive health), acute care, long-term care, and mental health care

EQUITY ISSUES: The League believes that health care services could be more equitably distributed by: Allocating medical resources to underserved areas. Providing for training health care professionals in needed fields of care. 

The bill prohibits the Department of Health Care Policy and Financing
(HCPF) from requiring prior authorization, fail first, or step therapy
requirements for any prescription drug indicated to treat a serious mental
health disorder. The bill applies to drugs provided under a contract between
HCPF and a health maintenance organization. Serious mental health disorder
is defined to include schizophrenia, schizo-affective disorder, bipolar
disorder, or major depressive disorder.

Individuals living with schizophrenia subject to formulary 12 restrictions are
more likely to be hospitalized, with twenty-three percent 13 higher inpatient
costs. Similar effects are observed for patients with 14 bipolar disorder. Prior
authorization requirements for atypical 15 antipsychotics are associated with
a twenty-two percent increase in the 16 likelihood of imprisonment.
Policies that restrict access to medications, including prior 18 authorization,
step therapy protocol, and fail first requirements may 19 diminish access to
necessary medications and ultimately result in 20 significant human,
economic, and social cost.

The bill increases state expenditures in HCPF by an estimated $9.8 million in
FY 2023-24, $10.7 million in FY 2024-25, and $11.7 million in FY 2025-26,
with costs paid from the General Fund, the Healthcare Affordability and
Sustainability Cash Fund, and federal funds.

LWV Positions:
• The state of Colorado should bear some financial responsibility
for funding programs to guarantee access to health care.
• The League of Women Voters of the United States believes that
a basic level of quality health care at an affordable cost should be
available to all U.S. residents. Other U.S. health care policy goals
should include the equitable distribution of services.

Summary of Bill: Bill authorizes individuals who have Midwife Certification from the American Midwifery Certification Board to obtain a license from the State Board of Nursing.

      The Certified Midwife may apply for and obtain provisional and full prescriptive authority.  Certified Midwives will be regulated by the Board of Nursing.

      State Board of Nursing will have 12 members; 1 Certified Midwife and 1 Advanced Practice Register Nurse (non-midwife).

      Advanced Practice RN/Certified Midwife who has prescriptive authority will be limited to patients/medications appropriate to their role/patient population.

      This bill follows closely to the rules of the Advanced Practice Registered Nurse guideline and policies.

      Of note: Certified Nurse Midwives have a master degree and must meet the experience guidelines set forth by the American Board of Midwifery.

League Position: Promote the health care that provides the basic level of quality care.  Prevention of disease, health promotion, Education and prenatal/maternity care.

Fiscal: 0.2 FTE this fiscal year.  0.5 FTE next year.

LWVCO supports this bill.