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November 14-15, 2005
Wyo. Oil and Gas Conservation Commission Building
Casper, Wyoming
Senator Charles K. Scott, Co-Chairman
Representative Doug Osborn, Co-Chairman
Senator Pat Aullman
Senator John Barrasso
Senator Ken Decaria
Senator Mike Massie
Representative Bruce Barnard
Representative Bob Brechtel
Representative Elaine Harvey
Representative John Hastert
Representative Jerry Iekel
Representative Burke Jackson
Representative Marty Martin
Representative Layton Morgan
None
Gerald W. Laska, Staff Attorney
Please refer to
Appendix 1 to review the Committee Sign-in Sheet
for a list of other individuals who attended the meeting.
Co-Chairman Scott called the meeting to order at 8:10 a.m. The following sections summarize the Committee proceedings by topic. Please refer to Appendix 2 to review the Committee Meeting Agenda.
Dr. Brent Sherard, Director, and Dr. David Barber, Environmental Epidemiologist, Wyoming Department of Health, presented a summary of the environmental health study submitted previously to the Committee. The study, required by 2005 legislation, was to review gaps and overlaps in state agencies' environmental health responsibilities. In conducting the study, the department contracted with a facilitator from the University of Wyoming, created a task force and held numerous public meetings.
The Department may make proposals for legislation in the 2007 general session, but no legislation is urgently needed in the 2006 budget session. Top priorities will be funding for local environmental health officers and a program to oversee and certify meth lab cleanup. Dr. Sherard noted that the U.S. Center for Communicable Diseases considers Wyoming a model of state-local cooperation.
Representative Hastert presented the proposed bill to the committee. The bill would increase all tobacco taxes by 40% and continually appropriate the increase to the Medicaid program.
Loretta Wolf, American Cancer Society, presented the results of a survey of state registered voters regarding a tobacco tax increase (Appendix 3). She also provided a copy of the "Wyoming Cancer Control Plan 2006-2010" published by the Wyoming Comprehensive Cancer Control Consortium. The poll showed strong support for an increase in tobacco taxes.
Dan Sullivan (Altria Corporation) and Tom Jones (Wyoming Wholesalers Association) spoke against a tax increase.
Representative Hastert made a motion, seconded by Senator Massie, that the Committee sponsor the bill. The motion passed on a vote of 10-3-1. Senators Aullman, Massie and Scott and Representatives Barnard, Harvey, Hastert, Iekel, Jackson, Morgan and Osborn voted aye; Senator Decaria and Representatives Brechtel and Martin voted no; Senator Barrasso was excused.
Senator Massie presented the bill to the committee. The bill would fine tune eligibility criteria, add $10 Million in funding and provide the department of health $93,000 and a part-time position to administer the program.
Senator Massie made a motion, seconded by Representative Iekel, that the Committee sponsor the bill. The committee made the following amendments:
Page 4-line 18 After "priority" insert "when practical".
Page 5-line 17 Insert: "(d) The loan repayment program shall be a standard budget item in the department's biennial budget request.".
The motion to sponsor the bill as amended passed on a vote of 11-2-1. Senators Aullman, Decaria, and Massie and Representatives Barnard, Brechtel, Harvey, Hastert, Iekel, Jackson, Martin and Morgan voted aye; Senator Scott and Representative Osborn voted no; Senator Barrasso was excused.
Kathy Emmons, Director, reported to the Committee on recent activities of the Department of Workforce Services. She distributed to the Committee a copy of draft rules for the Apprenticeship Utilization Program (Appendix 5), Workforce Development Training Fund Monthly Report (Appendix 6) and Pre-Hire Training Grants Summary (Appendix 7).
Senator Massie presented the bill to the Committee and distributed an explanation of the proposal (Appendix 8). The bill would open the current child health insurance program to specified parents of eligible children, subject to federal approval.
Senator Massie made a motion, seconded by Representative Iekel, that the Committee sponsor the bill. Dan Sullivan (Foundation for Health Care), Rick Schum (Wyoming Blue Cross-Blue Shield) and Tim Summers (Wyoming AARP) spoke in favor of the bill. The Committee amended the bill as follows:
Page 4-line 10 After "(3,720)" insert "for the 2007-2008 biennium and the total enrollment for future biennia shall be set in the respective budget bill".
Page 4-after line 16 Insert: "Section 2. There is appropriated three million three hundred fifty thousand dollars ($3,350,000.00) in federal funds and one million six hundred fifty thousand dollars ($1,650,000.00) in general funds to the department of health for case service expenditures to implement the purposes of this act. Three hundred thirty five thousand dollars ($335,000.00) is appropriated and three full-time positions are authorized to the department of health to administer the provisions of this act."
The motion to sponsor the bill as amended passed on a vote of 13-0-1. Senators Aullman, Decaria, Massie and Scott and Representatives Barnard, Brechtel, Harvey, Hastert, Iekel, Jackson, Martin and Morgan and Osborn voted aye; Senator Barrasso was excused.
Senator Massie presented the bill to the Committee. The bill would provide grants to Wyoming hospitals to assist them in becoming certified by the American Nurses Association Magnet Hospital Program.
Dan Perdue (Wyoming Hospital Association), Sherlyn Kaiser (Wyoming Medical Center) and Anne Ladd (Wyoming Health Care Commission) spoke in support of the bill. The committee discussed the bill. On Chairman Scott's recommendation, the Committee agreed to postpone consideration of the bill to the January meeting and to request testimony from the Community College Commission on the number of recent nursing graduates and enrollees, and from the Wyoming Board of Nursing on the status of the nursing shortage, licensing reciprocity and the bill's potential effect on nurse recruitment.
The Committee recessed for lunch at 12:00 noon and reconvened at 1:35 p.m.
Senator Massie presented the bill to the Committee, assisted by Marilyn Patton and Beverly Campbell, Department of Family Services. The bill would: provide for the quality rating of early childhood schools and incentives for the professional development of child care staff; create an early childhood education support program in the Department of Family Services; provide sliding scale funding to early childhood education programs based on the program's quality rating and the family income level of participating children; require reports to the Committee; appropriate $14 Million and authorize five positions.
The Committee discussed the bill. Senator Scott expressed concern that the bill would not pass as drafted due to problems from Article 16, Section 6 of the Wyoming Constitution and the bill's provision of assistance to persons who are not poor and programs that do not serve the poor. Beverly Campbell and Julie Sapp, Governor's Policy Analyst, responded that the program was a high priority of those surveyed in the Children and Families Initiative and that assistance to all early education programs and children would allow those programs to survive and serve the poor.
On Chairman Osborn's recommendation, the Committee decided to postpone further consideration of the bill to the January meeting. Senators Scott and Massie, and Representatives Iekel, Osborn and Brechtel volunteered to work on revising the bill.
Kurt Zunker, Wyoming Drug Court Association, and Judge Michael Huber, 7th District Circuit Court, addressed the Committee. Mr. Zunker presented his proposed statutory changes (Appendix 9). They advocated increased funding, placing the drug courts permanently within an agency or the judicial branch and removal of the case cost and participant caps.
Senator Scott noted that the proposed bill did not address those matters but expanded the courts' jurisdiction to other social problems. Dean Jessup, Department of Health Substance Abuse Division, stated that the bill opens the courts too much and is not in keeping with the original intent of the drug courts' specialized focus. Julie Sapp stated that an increase in the case cost limit to $211,000 is in the Governor's proposed budget.
On Senator Scott's recommendation, the Committee decided to postpone further consideration of the bill to the January meeting. Senator Scott volunteered to revise the bill in accord with the committee's discussion.
Marilyn Patton, Department of Family Services, and Gerald Maas, Department of Education, presented the bill to the Committee. The bill would expand a pilot program and provide grants up to $65,000 to school districts which develop health programs in accordance with the specified requirements in the bill.
Representative Harvey, seconded by Senator Scott, made a motion that the Committee sponsor the bill. The Committee made the following amendments:
Page 2-lines 8 and 13 Insert "school" before "districts".
Page 2-line 21 After "($65,000.00)" insert "or ten dollars ($10.00) per student, whichever is greater".
Page 4-lines 18 and 19 Delete "superintendent and an elected member of a school district board of trustees" and insert "a teacher, a school nurse and a student appointed by the state superintendent of public instruction".
Page 5-line 13 After "panel." insert "Those members who are not full-time employees of the state or full-time employees of a school district shall receive a salary of one hundred twenty-five dollars ($125.00) per day."
Page 9-after line 9 Insert "(b) If a school district receives a grant pursuant to this chapter, the school facilities commission shall consider whether the district's schools have sufficient space to accomplish the purposes specified in paragraphs (a)(iii) and (vii) of this section and shall review the school district's five (5) year plan and any capital construction projects of that school district for those purposes.".
The motion to sponsor the bill as amended passed on a vote of 13-1. Senators Aullman, Decaria, Massie and Scott and Representatives Barnard, Harvey, Hastert,, Iekel, Jackson, Martin and Morgan and Osborn voted aye; Representative Brechtel voted no.
Marilyn Patton and Julie Sapp presented the bill to the committee. They stated that the purpose of the bill is to make the results of the Children and Families Initiative permanent and to create statutory goals and measurement criteria for Wyoming's health, human services and education programs. The Committee discussed whether the proposed legislation is unnecessary because state and local governments could track information and enter into cooperative agreements under current law. Marilyn Patton stated that the bill would provide for long-term statistical tracking and allow trend analysis through successive administrations.
Chairman Scott decided to table the bill until the following day so the department representatives and staff could draft changes to the bill. However, the following day the Committee decided to postpone further consideration of the bill until the January meeting.
Co-Chairman Osborn called the meeting to order at 8:10 a.m.
The Committee was addressed by a panel that included: Senator Scott; Chris Muirhead, Carol Jenkins and Anne Ladd, Wyoming Healthcare Commission; Dr. Geoff Smith, Casper radiologist; and Larry Biggio, Wyoming Chief Information Officer. They described the Commission's year-long study of a statewide health care information technology system and the hub-and-spoke system the Commission recommends, connecting hospitals and other health care providers to a centralized hub that would contain patient data. Ms. Ladd distributed a description of the proposed system (Appendix 10). The estimated total cost would be $171 Million, which would come from state appropriation, federal and private grants, and user fees. The bill contains approximately $60 Million in appropriations.
Senator Scott presented the draft legislation. The Committee discussed the overall start-up and continuing costs, privacy and security issues. The Committee made the following amendments:
Page 2-line 12 Insert "electronic" before "medical".
Page 2-line 13 Delete first "health".
Page 3-line 15 Insert and renumber "(vi) "Personal health record" means that part of an electronic record that an individual may access and make available to others, and includes a record of the sources of information and those persons to whom it has been transferred;".
Page 7-line 14 Delete "number" insert "percentage".
Page 9-line 23 After "Any" insert "non-profit".
Page 10-line 5 After "Rural" insert "non-profit".
Page 10-lines 7 through 8 Delete.
Page 10-line 15 Delete "(e)" insert "(f)".
Page 12-line 3 After "providers" insert "treating the individual".
Page 13-line 7 Insert at beginning of line "Subject to legislative appropriation,".
Page 14-line 19 Delete second "to" and insert "and copy".
Page 15-line 1 Insert at beginning of line "Except when the patient has opted not to make his information available,".
Page 16-line 10 Delete "on an as needed basis".
The motion to sponsor the bill as amended passed on a vote of 14-0. Senators Aullman, Barrasso, Decaria, Massie and Scott and Representatives Barnard, Brechtel, Harvey, Hastert,, Iekel, Jackson, Martin and Morgan and Osborn voted aye.
Senator Scott described the issue to the Committee and presented the draft legislation. The bill would provide a moratorium on licensing of medical specialty centers while the Healthcare Commission studied their impact on cost and quality of care. The Committee discussed the bill and received comments from the public. Senator Aullman made a motion, seconded by Representative Brechtel, that the Committee sponsor the bill. The Committee made the following amendments:
Page 1-line 16 Delete "for-profit".
Page 3-line 9 Delete "medical specialty center" and insert "hospital".
Page
3-line 10 Delete "January 1,
2008" and insert: "April
1, 2007 if the hospital or medical specialty center:
(i) Allows patients to
remain in the facility for twenty-four (24) hours or longer;
(ii) Is in a community or
within fifteen (15) miles of a community which already has a hospital; and
(iii) Is not an institution listed in W.S. 35‑2‑913(b)".
Page 4-line 18 After "physician" insert "and hospital".
Page 5-lines 15 through 22 Delete.
Page 6-line 11 Delete "July 1, 2008" and insert "November 1, 2006".
Page 6-line 13 Delete "One hundred thousand dollars ($100,000.00) and insert "One hundred seventy-five thousand dollars ($175,000.00)".
The motion to sponsor the bill as amended passed on a vote of 10-4. Senators Aullman, Barrasso,, Massie and Scott and Representatives Brechtel, Harvey, Hastert, Martin and Morgan and Osborn voted aye; Senator Decaria and Representatives Barnard, Iekel and Jackson voted no.
Senator Massie presented the bill to the Committee. The bill would extend the Wyoming Healthcare Commission by three years, reduce the bi-monthly reporting requirement to semi-annually, authorize administrative subpoenas and adjust the Commission's responsibilities.
Senator Massie made a motion, seconded by Representative Barnard, that the Committee sponsor the bill. The Committee made the following amendments:
Page
8-line 8 Insert and renumber: "Section 4. The governor shall appoint
a task force to examine proposals for reducing the percentage of Wyoming
citizens without health insurance and reducing the cost of private health
insurance. The task force shall consist
of at least two (2) but not more than five (5) members of the health care
commission and at least five (5) but not more than (9) members of the
public. Task force members shall be
appointed by the governor. The task
force shall report to the commission, which shall make a preliminary report to
the joint labor, health and social services interim committee by November 10,
2006 and a final report by October 1, 2007.".
Page 8-line 14 After "commission" insert "in
cooperation with the department of health".
The motion to sponsor the bill
passed on a vote of 14-0. Senators
Aullman, Barrasso, Decaria, Massie and Scott and Representatives Barnard,
Brechtel, Harvey, Hastert,, Iekel, Jackson, Martin and Morgan and Osborn voted
aye.
The Committee recessed for lunch at 12:15 noon and reconvened at 1:45 p.m.
Roxanne Homar, State Pharmacist, presented a report on the implementation of the new Medicare Part D prescription drug program. She discussed the state budget impact, mandated changes to the state Medicaid program. She described the Department of Health's education and outreach to Wyoming residents potentially affected by the new program.
Jack Tarter, Wyoming Veterans Home, and Earl DeGroot, Western Management Services, reported to the Committee on a study of the need for an additional veterans retirement home in Wyoming. Mr. DeGroot made a Powerpoint presentation (Appendix 12) showing the results of a statewide survey conducted for the Veterans Commission. The study's conclusion was that nursing home services for veterans need to be expanded, and that the expansion should be addressed by 1) using federal funds for a contract nursing home program; 2) encouraging the VA to expand their individual contract nursing home program; or 3) build a second traditional state nursing home for veterans.
There being no further business, Co-Chairman Osborn adjourned the meeting at 4:00 p.m.
Respectfully submitted,
Senator Charles K. Scott, Co-Chairman Representative Doug Osborn, Co-Chairman