The CHI Weekly Legislative Update: February 17

An emerging theme for the 2012 legislative session—the level and role of government regulation and oversight—gained traction last week with the introduction of two health-related bills. Both House Bill 12-1268 and House Bill 12-1294 seek to limit or modify government agency oversight of health facilities.

Currently, the Colorado Department of Public Health and Environment (CDPHE) is responsible for licensing health facilities, including hospitals, rehabilitation centers, community mental health centers, community clinics, facilities for persons with developmental disabilities, nursing care facilities, hospice care, assisted living residences and home care agencies.

In this role, CDPHE establishes and enforces licensure standards. One component of licensure is meeting building and fire safety code requirements. CDPHE conducts construction plan reviews and inspections to determine compliance with building and fire safety code. HB 1268 transfers the responsibility for inspecting health care facilities for building and fire safety standards from CDPHE to the Colorado Department of Public Safety, which performs similar reviews of public school buildings. The second bill, HB 1294, proposes several modifications to the regulatory processes of CDPHE and the Department of Human Services (DHS). Some of the changes proposed by HB 1294 include:

  • Shifting oversight of community residential homes from the current joint responsibilities between CDPHE and DHS to sole oversight by DHS.
  • Requiring both departments to develop and institute abbreviated, periodic inspections for facilities and homes for which no significant deficiencies or substantiated complaints have been reported.
  • Narrowing the definition of community clinic.
  • Development of a performance incentive system to reduce license renewal fees.
  • Allowing evidence of accreditation or certification by another federal or state government entity to satisfy the state licensure process.

In his State of the State address earlier this year, Governor Hickenlooper called for government to be effective, efficient and elegant. In its legislative declaration, HB 1294 references the governor’s goal and declares the purpose of the bill is to facilitate that goal by “eliminating duplication and unnecessary government oversight and regulation of health facilities”.

Both bills invite discussion on the role and place of government in regulating health facilities, the appropriate level of oversight and how oversight is determined and enforced. In addition, these bills question the alignment between the state’s regulatory processes and current and emerging health care practices and models. HB 1268 is currently scheduled for a hearing with House Health and Environment Committee on February 21 and HB 1294 with House Economic and Business Development on February 23.