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In Like a Lion: March Sees a Surge in Health Care Bills

In Like a Lion: March Sees a Surge in Health Care Bills

We’re past the halfway point of the 2015 legislative session, which means the pressure is on to move bills forward. The budget discussion is nearing, as the Joint Budget Committee continues its figure-setting work in an attempt to introduce the Long Bill in the Senate on March 23. The Long Bill – a term unique to Colorado – is an extensive document that lays out the proposed state budget department by department and line by line for the upcoming fiscal year. Both the House and Senate hope to clear their schedules as much as possible in advance of long days discussing this complex proposal.

One bill we’ve been waiting for concerns prescriptive authority for advanced practice nurses (APNs). It was recently introduced and is up for discussion tomorrow in the Senate Health and Human Services Committee.

Senate Bill 197 seeks to lower the time requirement for APNs to qualify as medication prescribers from 3,600 hours to 1,000 hours. It would also allow APNs with prescriptive authority to serve as mentors for APNs in training. Currently, mentors must be licensed physicians. The bill has bipartisan sponsors in both chambers: Larry Crowder (R) and Cheri Jahn (D) in the Senate, and Yeulin Willett (R) and Rhonda Fields (D) in the House. We’re hearing that nurses generally favor the bill while many doctors oppose it.

Sen. Irene Aguilar (D) and Rep. Joann Ginal (D) plan to introduce legislation to create universal health care coverage in Colorado through an innovation waiver made available under Section 1332 of the Affordable Care Act. Aguilar and Ginal sponsored a resolution in 2013 to ask voters to create a cooperative to establish universal coverage, but the legislation failed to pass the Senate. The politics look even tougher in the Senate this year, but the sponsors have the option to run a citizen initiative in 2016.

We’re also awaiting a date for the next hearing of House Bill 1088, which seeks to create a farm-to-school grant program. It passed the House Education Committee but must get through Appropriations to make it to the House floor.

A lot has happened since our last blog:

The House Public Health Care and Human Services Committee passed Senate Bill 116, which aims to prevent police officers from accidentally being stuck by needles during a pat-down, on a 12-1 vote. The bill would accomplish this by offering exemption from drug possession charges if a person who is about to be searched informs the officer that he or she has a needle or other sharp object in their clothing. The committee also sent Senate Bill 128, which would broaden reporting of sexual assaults following forensic testing, forward on a unanimous vote.

The Senate Health and Human Services Committee passed two bills unanimously last week: House Bill 1032, broadening the types of mental health professionals who can treat minors 15 years and older, and House Bill 1075, allowing registered naturopathic doctors to treat children under age two.

HB 1032 was recommended for the Senate’s consent calendar, which is reserved for non-controversial bills with broad support. Both bills passed their final reading in the Senate with no amendments and are on their way to the governor. These bills join two others that were sent for an official signature. Senate Bill 53 provides emergency supplies of naloxone, a proven anti-overdose drug, to first responders, friends and family of people with substance use disorders, while Senate Bill 71 allows pharmacists to substitute medication equivalent to that prescribed by doctors.

We’d be remiss not to mention two CHI events from last week: a Legislative Links and Learn on health care waivers and our inaugural Brews and Views panel on the implications of the King v. Burwell case in Colorado. We enjoyed conversations with legislators and colleagues around these issues. You can check out a recording of the waiver presentation and #KingInCO on Twitter for a recap. Also, check back for a blog on the King case.

This week, the Senate Finance Committee killed House Bill 1079, a bill to appropriate general fund money for the Department of Health Care Policy and Financing’s teen pregnancy and dropout prevention program. Rep. Don Coram (R) sponsored the bill in the House. It failed on a 3-2 party-line vote, and it may have fallen victim to the politics surrounding another Coram bill, the more controversial House Bill 1194, which seeks $5 million in funding for long-acting reversible contraception.

The House Public Health Care and Human Services Committee advanced three bills. House Bill 1214, which bans potentially addictive pain medication whenever an abuse-deterrent version is available and forbids higher cost-sharing for such drugs, passed 11 to 2. HB 1087, proposing to launch a pilot program for alcohol and substance abuse detox centers, passed 8 to 5 and is going to Appropriations. And Senate Bill 19, which would require a comprehensive audit of the state’s health exchange, Connect for Health Colorado, passed 13 to 0 and is on its way to the House floor.

Bills on deck for hearings this week, including several that were recently introduced:

Today (March 11):

The House Finance Committee will hear House Bill 1143, which seeks tax incentives for people aged 75 and older who outfit their homes so they can remain there longer. The bill has passed the House Health, Insurance and Environment Committee but faces questions about its substantial price tag. The Senate State, Veterans and Military Affairs Committee will hear House Bill 1015, which would allow interstate compacts to let emergency medical service providers practice across state lines.

Thursday (March 12):

The House Health, Insurance and Environment Committee will consider House Bill 1151, which would set a floor for Medicaid provider reimbursement rates. The proposed floor is 60 percent of the equivalent Medicare rate, or 60 percent of the “average fair market rate” if there is no comparable code under Medicare. If the bill passes, it will proceed to Appropriations. The Committee will also hear House Bill 1238, aiming to grant tax credits to health care professionals practicing in underserved areas.

The Senate Health and Human Services Committee is scheduled to discuss several bills. Of particular interest is the APN-focused SB 197, mentioned in the introduction. House Bill 1182, which concerns expanding the scope of practice for nurse aides, is up for debate, as is Senate Bill 192, which would allow pharmacists to provide therapeutic alternative drugs to patients in nursing care facilities or long-term-care hospitals.

Friday (March 13):

The House Public Health Care and Human Services Committee has a full day scheduled. House Bill 1233 asks for the creation of a nine-member task force to study respite care services in the state. House Bill 1232 proposes permission for a broader set of organizations – currently limited to schools – to stock epinephrine auto-injectors, which counter the effects of severe allergic reactions. Employees of the organizations in question would have to complete training to use the auto-injectors. House Bill 1242 would require that hospitals ask patients or their guardians to designate a caregiver within 24 hours of arriving at the hospital.

Finally, the Senate Appropriations Committee will hear House Bill 1067, which would require continuing professional development for licensed psychologists.