Tuesday, February 26, 2013

Healthy Concern, Pt. 1

HB13-1068

On Site Inspections of Medicaid Providers

By Rep. Young and Sen. Roberts

Close Inspection

Compliance bills are ones advocated for by state departments that keep Colorado law aligned with federal law. 1068 is one of those. 

Inside the 2010 federal Affordable Care Act is a bit that gives state agencies that administer Medicaid the authority to check in on their providers without giving advance notice of the inspection visit. The Department of Health Care Policy and Finance is responsible for delivering Medicaid to Coloradoans, and they are the major actors behind 1068 and its intent to comply with federal law. 

Under current law the Department must provide 10 day advance notice of any inspection, audit, or on-site visits to a Medicaid provider. 

In Committee

1068 was routed to the House Public Health Care and Human Services Committee chaired by Rep. Primavera and vice chaired by Rep. Young (the sponsor of the bill). As Young explained, after the bill was introduced many stakeholders took issue with the language not being tight enough and having the potential to negatively affect them. Together, the Department and concerned parties worked together to re-draft the bill to a state agreeable to all. Completely altering a bill is called a strike below because it wipes clean everything below the enacting clause portion. 

The enacting clause


The introduced version of the bill can be found here, and the engrossed version can be found here.   

Witnesses lined up to testify in support of the bill as amended (the new version) included the Colorado Hospital Association, the Colorado Association of Medical Equipment Suppliers, former Representative Young (not to be confused with current Representative Young), and of course the Department of Health Care Policy and Financing. All of them were involved in remaking the bill. 

Although no party was terribly specific about the changes that were made, Rep. Young explained that most of the new language was borrowed from the federal version of the law. It includes specifics on categories of risk for providers, pre-enrollment and post enrollment site visits, and an important section that ensures inspectors will not be paid on commission for violations they uncover. 

Everyone harmonized on the bill. With few questions from committee members the strike below amendment passed unanimously, the bill passed to the committee of the whole unanimously which sent it to third readings, and earlier today 1068 passed the House third reading vote unanimously too. It's now off to the Senate where I predict smooth sailing clear to Hickenlooper's hands. 

More Ahead

1068 is not the only health care related bill this session. Among many more that I plan to keep track of are 
  • 1115 which repeals the outdated program CoverColorado
  • 008 which eliminates a waiting period in the CHP+ program
  • 026 which updates the Michael Skolnik Medical Transparency Act
  • 044 which deals with prepaid inpatient health plans
  • 1175 which limits Medicaid expansion -- Postponed Indefinitely on 2/19/13 --
  • 1196 which requires enhanced reporting by the Department
  • 1199 regarding fee collection for nursing home providers -- Passed thirds in the House, now in the Senate --

Sunday, February 24, 2013

Social Media Privacy Protection, Pt. 2

HB13-1046 by Rep. Williams and Sen. Ulibarri

Employee User Name Password Protection

 

Catching Up

We last left this bill as it was being introduced in January. The bill is essentially an employee protection mechanism designed to prevent employers from spying on social media (Facebook, Twitter, etc) by prohibiting the forced, or coerced, disclosure of login passwords. 

Committee Work

1046 arrived in the Business, Labor, Economic & Workforce Development committee chaired by its sponsor, Rep. Williams, on February 12th. You can check out the full audio recording of the hearing here, or read on for the summary. The bill survived, but many substantial amendments were added to it. While presenting her bill, Rep. Williams situated herself facing the committee and Rep. Kraft-Tharp (the Vice Chair) became acting Chair.

Of the concerned parties lined up to testify

  1. The Colorado Dept. of Corrections 
  2. The Colorado Dept. of Labor and Employment
  3. The Colorado Defense Lawyers Association
  4. The Colorado Association of Police Chiefs
  5. The Employment Lawyers Association
All would support it if certain amendments were passed. 

The Dept. of Corrections wanted an exemption, arguing that being able to monitor their staff's social media was crucial for workplace safety in a dangerous prison environment. Things like inmate+staff relationships are prohibited, and the current best way to discover their existence is through social media.  The Association of Police Chiefs wanted the same exemption; both were granted it. 


Shaded text denotes an amendment


Another amendment was introduced by Williams which clarified that employees needn't add their coworkers or bosses to their social media contact list, nor ease their privacy settings to make their profiles more accessible. It passed as well.



Shaded text denotes an amendment

The final slice of the amendment pie came with a clarification that the Dept. of Labor and Employment is to be the sole enforcer of the legislation, and to be the one promulgating rules and penalties for it. Fines for employers found to be in violation of the law range from $1,000 to $5,000 in addition to anything else the department deems appropriate. After a bit of back and forth between committee members, it was unanimously approved.



Shaded text denotes an amendment


Par For Course

1046 is the norm for most agreeable bills. Stakeholders withhold their full support until changes they want are included as amendments. Occasionally differences are ironed out ahead of the hearing, but things evolve quickly in the General Assembly and digestion times are short. 

In this instance, law enforcement agencies became aware the bill existed, had their analysts look over it, and found that they needed to step in to prevent a major upset to their way of doing business. By making a strong but reasonable case for exemption they were able convince the committee of necessity without the sponsor feeling it would undermine the purpose of the bill. 

1046 moves on to the Appropriations Committee March 1st along with 14 other bills. In Appropriations, the deal is usually this: if a bill will cost the state even slightly more money than exists in current revenue streams it will likely die. 1046 is projected to expend $23,064 from the Employment Support Fund each fiscal year. However, since fines range from $1,000-$5,000 per infringement, and there is no sure way to predict how many infringements there will be, 1046 has the possibility of generating revenue by fining more than it costs to administer. Here is the official document breaking down the numbers, called the Fiscal Note.

Saturday, February 9, 2013

New Features

Guides

New to the site are a series of guides to aid in understanding the fundamentals of the General Assembly. 

Here is a summary of the general process.

Here is a guide to understanding committees of reference. 

Coming soon will be a page on lobbyists and a page on state finances. In the meantime enjoy the read!

Tuesday, February 5, 2013

Afterschool Activity

A Pair Of Bills

HB13-1047 by Rep. Sue Schafer, "Extracurricular Participation Across School Districts"

and 

HB13-1095 by Rep. Amy Stephens, "Homeschool Students' Participation in Activities"

 

Briefly

These two bills were heard in Monday's Education committee (2/4/13). The committee is composed of 13 members: 7 Democrats, 6 Republicans. The chair is Democrat Rep. Millie Hamner. 

I like both of these bills because they demonstrate how expertly legislation can be made and passed. The sponsors did everything right: when drafting the bills they consulted with primary stakeholders, before bringing it before the committee it was evident that each committee member had been brought into the fold to see if they had problems with the bills and how those could be resolved, it was bipartisan featuring a strong Republican and Democrat harmonizing, and finally the presentation of the bills was professional and to the point. 

Clarifying Law

During testimony by the Colorado High School Activities Association (CHSAA), the primary force behind the bill, we discovered that due to ambiguities in decade old law, high schools across the state were operating student draw to their after-school activities on somewhat shaky ground. 

For homeschool students, parents could simply choose a public school for their child to participate in after-school activities without talking with the administration of that school. For public school students whose school didn't offer the activity they desired, the student could go to another school within the district that did offer it, but again without consulting that school. Most importantly though, there was a loophole which made possible "coach chasing" where athletic students of a particular high school could opt in to another high school's activities because they wanted to play under a different, more successful coach.  Combined with an ambiguous clause that might require homeschool students to enroll in courses to participate in after-school activities, there is a growing public perception of unfairness according to Rep. Stephens. That's what the two bills meant to fix by clearly stating that parents must consult with schools when their students mean to opt in to after-school activities. The decision cannot be solely made by the parents.


In Support

1047 and 1095 brought the same groups of stakeholders to the table. In fact, the bills were meant to be joined into one but due to the constitutional provision that each bill must be single-subject, they could not. CHSAA strongly supported both, as did representatives of Academy School District 20 and Cherry Creek School District. All parties explained the frustrating nature of current law and that the bills were need to solidify what they had been practicing for the previous 10 years.

In discussion with the committee members it was clarified that homeschool students that opt in to after-school activities do not bump other students off the list to participate, and, that the bills would clarify they do not need to take courses at the high school of their choice in order to participate in the activities. 


The Vote

Both bills passed the committee with near unanimous votes. Rep. Chris Holbert did not get onboard for 1047 because he had received some emails disparaging the idea of schools being involved in the discussions with parents. 

They're headed for the Committee of the Whole with minor amendments attached. I predict they will fare just fine there and be in the Senate by next week.   

Monday, February 4, 2013

Academic Freedoms From Seattle

HB13-1089 by Rep. Stephen Humphrey, "Academic Freedoms Act"

 

The Bill

Many times, legislators identify something going on in schools that they believe should be improved. Rep. Moreno wants to expand the school meals program, Rep. Fields wants to improve school attendance, and Rep. Humphrey wants to allows teachers to foster classroom debate about established scientific knowledge solely on the topics of global warming, evolution, and human cloning. 

His bill would create the Academic Freedoms Act, an effort to help both k-12 and Higher Ed students develop critical thinking skills. From the bill:
 
TEACHERS TO FIND MORE EFFECTIVE WAYS TO PRESENT SCIENCE CURRICULUM WHERE IT ADDRESSES SCIENTIFIC CONTROVERSIES.
PUBLIC SCHOOL AUTHORITIES AND ADMINISTRATORS MUST PERMIT TEACHERS TO HELP STUDENTS UNDERSTAND, ANALYZE, CRITIQUE, AND REVIEW IN AN OBJECTIVE MANNER THE SCIENTIFIC STRENGTHS AND SCIENTIFIC WEAKNESSES OF EXISTING SCIENTIFIC THEORIES COVERED IN A GIVEN COURSE.
Also extremely important is this passage:
 
THE STATE BOARD, ANY LOCAL BOARD OF EDUCATION,  SCHOOL ADMINISTRATOR, OR TEACHER IN A PUBLIC SCHOOL MUST NOT PROHIBIT ANY PUBLIC SCHOOL TEACHER IN THIS STATE FROM HELPING STUDENTS UNDERSTAND, ANALYZE, CRITIQUE, AND REVIEW IN AN OBJECTIVE MANNER THE SCIENTIFIC STRENGTHS AND SCIENTIFIC WEAKNESSES OF EXISTING SCIENTIFIC THEORIES COVERED IN A GIVEN COURSE.
The two points. First, every school authority must allow teachers to, as it's understood, "teach the controversy". Second, no authority can stop a teacher from doing so. This effectively directs what a teacher may or may not do, something that is the sole responsibility of the locally elected school board

In Committee

1089 was assigned to the House Education committee composed on 13 members. 7 members are Democrats, 6 are Republican, and the Chair is Democrat Rep. Millie Hamner. As the usual flow of committees go, Rep. Humphrey made a short case for the bill he was sponsoring. What made this a less than convivial encounter was the initial questioning by Democratic members before the witness testimony phase even began. 

Rep. Fields began by asking what the consequences were if a teacher failed to create an environment of debate on these science topics. Humphrey responded that the bill had no enforcement, only encouragement for teacher to do so. Rep. Court then explained that teachers are already encouraged to do exactly what the bill is asking; why is the bill necessary then? Humphrey offered an explanation that sometimes students are afraid to ask their teacher about the controversies surrounding the subjects of global warming, evolution, and cloning, and that his bill was needed to allow students to complain to higher authorities if debate-friendly environments were not made. Other Democrats on the committee echoed their colleagues in asking why the bill would only apply to science courses and not English, Math, or History.

The witness testimony phase of the hearing began by Humphrey allowing opponents to his bill speak first. Jane Urschel of the Colorado Association of School Boards, known as CASB, simply stated that the bill violated article 9, section 15 of the Colorado Constitution by taking away the rights of local school boards to dictate what goes on in classrooms. Up next was Karen Wick of the Colorado Education Association, essentially the teacher's union. CEA represents over 38,000 school district employees. She elaborated on what Urschel said but went into depth explaining how school boards pull together experts to craft school curriculum. According to her, 1089 would severely confuse that process and undermine academic standards already in place. 

Here something telling of a freshman legislator occurred; Rep. Landgraf found the notion of subject experts dictating what schools do and do not teach to be putting children in a box and asked how that would be good for education. The Chair of the committee actually had to pause things at that point and explain to Landgraf that that's how curriculum is determined in Colorado.    

Finally in the opposition camp was Katie Navin of Colorado Alliance for Environmental Education, a non-profit that influences the teaching of environmental issues in schools. Her main contention with 1089 was that it asked teachers to "explore the strengths and weaknesses of scientific theories", arguing that evolution and global warming are facts, not theories. Rep. Chris Holbert expressed his belief that global warming is a hoax that he doesn't believe in. 

The first in line to support the bill was Scott Horak of the Christian Outdoorsman. I strongly encourage you to listen to what can only be described as a 10 minute pseudo-scientific rant beginning at the 1 hour 37 minute mark of the audio recording.   

Origin Of The Matter

By now you might have an inclination where this bill is headed. Where it came from, though, is surprising. After Horak concluded his remarks, another witness, Joshua Youngkin of the Discovery Institute, revealed that it was his Seattle, Washington based organization that wrote the language of the bill and brought it to Rep. Stephen Humphrey to pass in the Colorado Legislature. A quick review of the Discovery Institute reveals it to be a strange think-tank falsifying the work of Charles Darwin and advocating the intelligent design of the universe. 

Insisting that the language of the bill was "bulletproof", Youngkin explained the bill was designed to give students the ability to discuss the "question of climate change" and allow them to review information in an objective manner and make up their own minds. He explained to Rep. Buckner that textbook theories of evolution are not true and that current scientific education is only teaching one side of the controversy. Most interesting of all, Youngkin stated that the bill gives teachers the right to teach as they see fit, and, goes on to actually quote Charles Darwin, "...a fair result can only be obtained by carefully balancing the arguments and facts on both sides of the question".  

To The Vote

This bill came down to a cordial party line vote.  7 to 6, all the Democrats against and all the Republicans for, 1089 was PI'ed (postponed indefinitely, killed).

Afterthoughts 

Did Humphrey reach out to the Discovery Institute or did they track him down? How frequently do out of state interests have a driving role in Colorado lawmaking? Youngkin mentioned that the Discovery Institute managed to pass a similar bill to 1089 in Louisiana back in 2008. 

Is it concerning that freshman legislators sitting on the Education committee demonstrate a poor understanding of the fundamental framework for curriculum building? The Democratic party swept the House in recent elections- is this bill symptomatic of why the Republican party lost its previous majority hold? This session is witnessing a strong Republican "tacking to the right" of their legislative agenda, one that I predict will continue the trend of failing initial committee hearings.