House Finance [Apr 23, 2026 - Upon Adjournment]

Representative Brooks. Present.

Present. Brooks.

Garcia. Here.

Heartsock. Here.

Stewart. Here. Weinberg.

Satone. Yes. Mr. Chair.

Thank you, Mr. Chair. Good morning, members. I am delighted to be here to present House Bill 14-14 with my good colleague, Representative Camacho. So this bill will help ensure that Coloradans have timely access to their own medical records at a fair cost. Currently, accessing your personal medical records in Colorado can sometimes be a cumbersome and prohibitively expensive process. In Colorado, when an individual or legal guardian requests medical records, the cost is only $6.50 per request. However, when an attorney requests those same medical records on an individual's behalf, the cost can often balloon to thousands of dollars. There are many circumstances in which an individual is unable to request their own medical records and must rely on an attorney to do so. This is particularly true for individuals who are living with disabilities, non-English speakers, or those recovering from traumatic brain injuries. One patient's experience highlights this problem, and you will hear from this patient today, Mr. Paul Gonzalez. After being rear-ended in a devastating car crash, he spent months hospitalized fighting through a long and painful recovery from a traumatic brain injury. When he was finally released, he hired an attorney to address unresolved legal issues, but when the attorney requested his medical records, he was met with a bill of $6,000 to access his own medical information. Additionally, after paying high costs to access these records, individuals can sometimes wait months, sometimes years, to receive the records. These delays can interrupt continuity of care, postpone benefit decisions, and create challenges in time-sensitive legal matters. For example, a Colorado family that was injured in a catastrophic building collapse and the significant delay in receiving medical records impacted the family's ability to access justice by forcing the trial date to be scheduled a full year later. House Bill 1414 places a reasonable cap on costs when an attorney requests medical records on behalf of an individual and sets clear expectations for a timely delivery. I want to elevate and lift up our partners the trial attorneys hospitals our friends at Copic and medical record companies who all came to the table to help us find a fair compromise and I strongly urge your support of House Bill 1414.

any questions for the bill sponsors representative hartson thank you mr chair and thank you sponsors

who's paying that bill? Representative Camacho.

I answered the question I hoped you'd ask. So if you'd ask it again, I will answer it. All right, thanks. Thank you. The question is not centered on the hospitals, but an individual provider, a single provider, or if you had multiple single providers outside the scope of a hospital. If that single provider, who is on the hook for, if you get into this large cases of where you're talking about, and the individual provider has been treating their patient of record, and now there's some case where they need all these records, who's footing that bill because you said that the records belong to the consumer. Part of it I agree with, but the other part is that provider responsible for maintaining updating and everything on those records because it in their business Who pays that fee if it exceeds the cost to that provider to get those records and everything else to whether it's a lawyer or whoever else is requesting them?

Madam Speaker. Thank you.

And I would add, Representative Hartzik, that we are not changing the statute currently in place that allows for reasonable fees under that cap of $400 or 664 pages. Currently, a provider may charge $18.53 for the first 10 pages, an additional 85 cents per page for the next 30, and 57 cents per page for each additional page. So the current statute will remain in place, and I will add that I think our statute really speaks to a day when paper records are what were provided. Now we have electronic medical records and certainly much easier for providers to produce without the same sort of cost burden. Any follow-up? Providers might disagree, but it's okay. Any other questions from the committee?

Thank you, Mr. Chair. And I may have addressed it, but I missed it. So I see the Colorado Medical Society and the Colorado Hospital Association are both in amend. Do you know what the issues are with why they're in an amend position? Or should we wait for if they have a witness?

Representative Zocay?

for over 664 pages? Representative Camacho.

Follow-up, Representative Zokai. Thank you, Mr. Chair.

Representative Camacho Thank you Mr Chair That a great question but it not really the subject of this bill It kind of the subject of this bill Fair. It's not what this bill is trying to address.

Thank you, Mr. Chair. I think that it's a shame that people are getting charged all this money for digital records when these records belong to the person. And I understand that this is kind of more of a Band-Aid. What I envision for the future, and I was trying to work this out with the governor's office over the last couple of years, is when we were updating our contract with Epic, I believe, the records company, they were doing a massive computer update and we're a client as well as several other states are, that they can easily make a customer portal for people to get their records on their own. And that's what we really should do. I mean, is this just an interim fix? And should that be where we go next, where people actually have access to their own records? because to pay for your own records every single time you want those records, if you don't have an insurance company with a portal or something like that, how are you supposed to get them? So is that what the next step would be? Representative Camacho.

Representative Garcia.

President Camacho. As written, the bill does require the notification and does require the 30 days. So for the 30 days, as was mentioned by my co-prime, is really for an enforcement mechanism because you want to avoid that situation where someone's waiting months or years to get their records. So in the event that you pass that 30-day period, that would be the enforcement mechanism is the records would then be free.

Representative Kamal. Thank you, Representative Woodrow, and thank you for the clarifying question. I think I understand now. So you're asking if you are invoking the seven-day notice for the additional 30 days, and you meet by producing those records within that additional 30 days, so 60-day period, do you still have to pay for the records? The answer is within the statutory framework here, yes. if on day 61 after you properly provided notice and attempted to and did not provide the records, then they would be free. But again, those records would be capped at $400 or on the current statutory scheme if it's under 664 pages.

Okay. And then I'm wondering if maybe there is like a sheet of the numbers that you have because just a quick calculation. when I looked up what the cost would be based on the original statue of 630 pages, that cost for the records is $538. And so when I read that or when I see that, I'm like, huh. Like, if it's more expensive under the cap of 664 pages. so I'm just I guess I'm just saying this just seems backwards the way that the formula works based on if the original statute and cost takes place

Thank you Mr. Chair, I'm looking through some of our fancy charts here and to be honest that's a fair criticism looking at it, there is a reason why it is there and then I never typically do this but I will defer to witnesses behind the answer to that one so I think

so I think maybe for whatever witness is going to come up here if they can maybe explain why the threshold is 664 pages and not actually lower where the cost is actually capped at $400 per the original statute I will make sure to pass that on to witnesses behind me if they have not heard you

Mr. Chair, pleasure as always to be here. Jason Hopfer. The pleasure is all on this side of the dance. My name is Jason Hopfer. I'm here today on behalf of the Colorado Hospital Association, representing 100 hospitals and health systems across the state. CHA would like to begin by sincerely thanking Speaker McCluskey and Representative Camacho for their willingness to engage stakeholders before this bill was introduced and for continued collaboration in preparation for today's hearing. We would also like to acknowledge CTLA for their responsiveness to hospitals' feedback. I don't think I've ever said that before. CHA is here today in support of the amendment being offered and upon adoption will move from an amend to a monitor position. Colorado hospitals are committed to timely transparent access to patient records and provide these records routinely and professionally every day The amendment for you addresses several provisions that were essential in making this bill operationally workable and aligned with how medical record requests are actually processed today. These changes resolved the provisions that conflicted with federal law, created unworkable operational requirements, and put legally protected information at risk. They represent the necessary changes for this bill to function in the real world. We appreciate the sponsors' receptiveness to our feedback and thank them. Thank you very much.

I would specifically like to thank Chair Woodrow and the committee members for the opportunity to speak today. My name is Elizabeth McElhenney, and I'm the Legislative Affairs Director for the Alliance for Health Information Operations and Standards. AHIOS members partner with Colorado health care organizations and providers to fulfill medical record requests on their behalf. I'm here to respectfully request support of the amendments that will be offered to HB 1414. And I would like to also begin by sincerely acknowledging the sponsor's commitment to including us in the process, That collaboration matters, and we do not take it for granted. The current amendments meaningfully clarify our operational obligations, and we appreciate that progress. At the same time, we do remain concerned that the bill's fee provisions shift a substantial portion of the cost to respond to medical record requests back onto healthcare providers. When revenue available to health information departments and their partners is constrained, two things do suffer. investment in technology systems that safeguard sensitive patient data, and the specialized workforce required to handle that data responsibly. Colorado has made landmark commitments to patients through SB 25129, which strengthens SHIELD law protections for patients and providers related to reproductive and gender-affirming health care, and HB 251309, which codifies gender-affirming health care and statutes. Fulfilling the promise of these laws requires trained professionals who understand exactly what information can be disclosed to whom and under what circumstances, professionals whose positions do depend upon sustainable funding. We welcome the opportunity to share our operational expertise as we move forward. Thank you.

Thank you, Mr. Chair and members of the committee for taking testimony on this bill today. My name is Sam Cannon, and I am here on behalf of the Colorado Trial Lawyers Association, asking you all to support House Bill 261414. I'm here as an attorney who regularly works with clients in personal injury cases attempting to access their own medical records after serious injuries. When we request records on behalf of patients, they get billed in a way that they don't if they request their own records. and one thing I want to be clear about is even though my firm will advance the costs of these records the ethical rules governing attorneys don't allow us to simply pay for them out of our own pockets and so ultimately even if there's a delay in us advancing them ultimately the clients and therefore the patients are bearing the costs of these requests you often the clients we dealing with are seriously injured If nothing else, they're dealing with medical treatment to get their lives back together. Sometimes if they have brain injuries or they're catastrophic physical injuries, the patients are simply unable to get the records themselves. And so these costs, when they mount into potentially thousands of dollars, can have a real difference on patients' lives. And that's true when we get a bill for that much money, and it's also true if the response to that is, as it often is, is to ask the client to spend their own time and their own resources to collect the records themselves. It's a bad situation. It does bring us to one of the points that was raised by Representative Zokai. the reason for attorneys being billed when they request records on behalf of patients I agree with the representative that that is imperfect however there is a court decision out of Washington DC that means that is the current state of the law under HIPAA and so that is the situation we are dealing with even though I also agree that there should be no difference That is the state of where things stand right now. In addition to the costs, the delays can be damaging, significantly damaging, in terms of not getting records when you expect them, not getting records when you need them, and potentially delaying people's cases or getting their lives back together for months or even years in the worst cases. So this bill, I think someone described it as a band-aid. I'm not sure I would go that far. I think this is a significant step in the right direction in helping patients access their own medical records for a reasonable fee in a reasonable timeframe. And so we would ask for it to be supported. I do have information I can use to answer some of the other questions, but it might be best to leave that for the question and answer

Okay, thank you. Mr. Chair and members of the committee, my name is Paul Gonzalez, and I'm here to testify in support of House Bill 1414 as a patient who has struggled to attend my medical records and was grossly overcharged for my own information. Three years ago, I was hit in a car accident. Rice suffered a traumatic brain injury that left me in induced a coma. I was in the hospital for three months. When I was discharged, I stepped on my couch for about a year because I was unable to walk and was only able to move by a wheelchair. When I was finally back home, I hired an attorney, Sam Cannon, to help me navigate the system and get the support I needed while I was recovering from my TVI. I was relearning how to walk and complete tasks necessary for daily life. But when Sam requested my medical records to move forward with my case and benefits, we were quoted $6,000 just to obtain my own information. $6,000 for records that already exist belonging to me and were essential in order to access care, benefits, and justice is outrageous. Because I was already buried in medical bills, I tried to get my records myself. I couldn do it online It was confusing time confusing and exhausting So since I was still in my wheelchair I asked my brother if he could day off work pick me up, and drive me to the hospital hours away to go and physically get my records. The whole process of requesting the records, receiving that high-end voice, and trying to get them myself, and eventually going in person took months. As someone who has recovered from a traumatic injury, it was horrible and very unreasonable. This law would have changed that outcome. It's too late for the bill to help me. Nothing can take back the pain of those months, but I hope you can relieve this financial burden for others. No one should be asked to pay outrageous amounts for their own information. Thank you for your time.

Representative Garcia. Thank you, Mr. Chair. Mr. Hopford, it's great to see you here. No? Okay.

I do have a question. If you know what the average record size is that has been requested?

In working on this bill, Representative Garcia, I asked that in a varied vibe. by a variety of different categories. I mean, from the hospital focus, the large number was not where we were actually focused. We were more focused on issues around redaction, frankly, and requirements at the federal and state level for specific authorization from patients, if not made by themselves. And I'd be happy to walk you through those lists of different scenarios that happens. But that was more of our focus than, say, the number. What they've done, what this bill does is take 25.1.801, which is the statutory reasonable fee structure, and then caps it at that max level of 656, I can't remember that exact number, 65, excuse me, pages at $400, which I went to law school, so forgive my math skills, but my understanding that caps out at where that would end up today. But for us, what we are really focused on is there are costs associated with some of these records. When we are when because I struggled with the same like, why is it if I ask for myself as a patient, I would get it for six dollars, 50 cents. If I asked on behalf of a client, it would be different. I struggled with that, too. I found out the same answer that we just heard from Mr. Cannon. Did I get that right? Yeah. So here this bill is is changing that. So attorneys are getting a similar accommodation. It may not be under HIPAA, but we're trying to bring that down. But there are scenarios where it's HIV status, other shield laws that require the hospital to ask for specific permission to provide that if it's not requested by the patient directly.

Thank you for that. So I guess along the same lines of that question, Mr. Hopper, page 2, lines 13 through 17, subsection E, is what basically what I understand is what addresses that concern that you have around the redaction or withholding or the segregation of submitting the records. I guess a question that I have for you is can you tell me an instance, can you think of an instance where this section would actually not apply?

So I think a couple scenarios one if the attorney came and asked for you know information around the patient's car wreck and only asks for that. We'd have to redact the other issues, but not that. But if a patient asks for the information directly, we're not going to have to go through the redaction process because they've asked for and given the specific waivers. But HIPAA requires, for example, under 42 CFR 2.31, which is around substance use disorder, we have to ask the patient directly, are you okay with us giving that to your attorney? That's a HIPAA requirement. It's a federal requirement. And there's a variety of other ones around HIV status, psychotherapy notes, other non-discrimination requirements that all require us to go do that. So really, the distinction comes down to what the request is being made by the attorney, what information, if they've gotten specific waivers. If I was the lawyer doing this, I would get the specific waivers from my clients so that I wouldn't have to go through that process. But I think there'll be ways in which the lawyers are addressing these issues. You made dialogue, Representative.

So if they didn't have an HIV status test, for example, we wouldn't have to go ask for it because we wouldn't be providing it because it wouldn't be in the record. Okay, I guess what I'm seeing here is like this seems like this subsection here seems like it is taking the intention of this bill and narrowing it so small that anytime an attorney comes and says,

I guess let me back up and try to be clear about our intention, because that is not the intention. Our intention is, one, to provide the records in a timely manner. I do want to say you were asking about the seven-day part as well. That is changing in the amendments.

So you're basically saying 60 days you're going to get the records, period, or we're going to do them for free. Our intention though is that there are cases in which we know we going to have to go do redactions And then we know it going to take more staff time to do those things And that where we trying to find some place to say okay this is going to cost us more than not We need to figure that part out. But our intention is not to make it a blanket for everything. That is not what we're trying to do. And if we need to continue to work on that, I'm happy to talk to the proponents more about that. But that is not – we're trying to find a balance between having voluminous requests that have a lot of redaction that we might have to do, which came from certain hospitals, frankly, that do it themselves. There's also a difference in the hospital side between AHS, who's here testifying as well, who many of our hospitals contract with and that they do the work on the data side, and then other individual hospitals we have that do it themselves. And frankly, this request was really coming from them, not from those providers themselves. It was coming from specific hospitals that do their own document and data retention and delivery.

If Mr. Cannon wants to weigh in on that conversation.

Any representative Hartsook Thank you Mr Chair And I guess for the two folks most on the health care facilities and hospital side can you kind of walk us through, because we've heard questions and comments about providing EMRs, electronic medical records, and that it's a very simple process, kind of a push of a button. Section 1 deals with hospitals. I get that's who you're representing, but can you walk through the process, in particular section two, which is your individual providers, there's very specific processes. It's just not a matter of clicking a button, EMR pulls up, and hitting send. There's manual review that has to go through these records. Can you explain to the committee the specific things they need to look for, even in the hospital, which is going to still provide the same look through if you're an individual provider, what you have to be aware of, what you have to look at before it can be released so you don't violate HIPAA, and a whole variety of other privacy records that are out there. Can you, whoever wants to take a shot at that would be great. Thanks.

Yeah, Ms. McElhenney.

Representative Hartzell.

I do believe so. It's consistent with federal law, so there is that benefit as well.

Any amendments Representative Camacho Yes Mr Chair We have one amendment Amendment L which I believe has already been distributed to everyone So therefore I move Amendment L-001.

Oh, cool.

Second by Representative Garcia.

Thanks, Mr. Chair. L001 clarifies the existing fee structure and statute applies to any request under 664 pages. It also adds an inflation adjuster to the $400 cap. That cap will be adjusted every two years and the Secretary of State will publish the adjusted limit on its website. It also extends the timeline from 15 to 30 days for a healthcare entity to provide an invoice, clarifies that healthcare entity must provide the medical records upon payment of the invoice, modifies the 30-day timeline extension to mirror HIPAA's requirements, and adds a definition of force majeure. Any questions on L001?

No

Thank you, Mr. Chair Thank you, members of the committee This is one of those bills that addresses an issue that we have in the law and also just a fundamental right to someone's access to their own health records I want to thank all of the people who helped make this bill possible There's very close collaboration between entities that represent hospitals and lawyers, and that doesn't tend to happen all the time, but it did happen on this bill in a way that makes it very finely tuned to make this a reasonable solution for it that aligns Colorado law with current procedures and also provides, again, or closes a gap in the ability for patients to access their medical records in a cost-effective and timely manner. And for that, we ask for a yes vote.

Thank you, Mr. Chair. I appreciate what you're trying to do in this bill. I think it's definitely necessary. I do agree with some of my colleagues who mentioned just the idea that we shouldn't even have a cost for these records in general when you're trying to access your own personal records, whether it's you yourself personally or through your attorney and your representation. I think that there are certain things here that I would like to see addressed, particularly subsection E of section one. I think that creates an unintentional blanket loophole to not have to charge the $400. I also want to just address the page number. It takes 449 pages with the current fee structure for the cost to be $400. So there is this sweet spot between 449 pages and 664 pages where it costs more than the $400. And so I think I'm curious to know why it was 664 pages. Why would it not have been capped at the threshold where it originally would cost 400 pages, which is 449 pages? Because then I think anyone requesting records in that little sweet spot will end up having to pay more than those who are getting a record request for 10,000 pages. Yeah. But again, I think this is a necessary step, and I will be yesterday.

Thank you. I move House Bill 1414 to the Cal with a favorable recommendation.

As amended.

No

Yes

Yes

Yes

Yes

Yes

Yes

No

Yes

Yes

oh there she is

thank you Mr. Chair members of this wonderful committee we are here to talk about House Bill 1100, which is guardianship for incapacitated adults. I am incredibly grateful, starting off, for my co-prime, for our advocates, and I want to give a shout out to our bill drafter and our fiscal analyst who have been through the ringer on this bill, and we are so, so deeply grateful for them. This is the second step today in a process that has many additional steps. and so before kind of kicking off the technical pieces that we'll be bringing you today before we ask you to route us on to appropriations I will just say that from a human standpoint a bill like this is incredibly necessary currently in Colorado guardianship takes one single form We just heard from witnesses in the previous bill who had been in a car accident and experienced a traumatic brain injury. These, you know, 10 years ago, these folks were my clients at Craig Hospital. And people like this sometimes need some support while they're recovering, but they may not need support forever. They may not need support on every level. Someone might just need financial support. Someone might need medical guardianship. And right now in Colorado, we don't allow for these different levels of support that folks need. It's kind of a one-size-fits-all, and that is one of the biggest things that this bill tries to address. It's young kids who are turning 18 with developmental disabilities who may need different levels of support or may go through different levels of need throughout different periods of their lives or guardianship may take the form of a family member until that family member passes away. And we want to make sure that we are doing everything that we can to provide folks in these situations with the opportunity for as much autonomy and the least restrictive environment possible So I know we in finance We not really talking about a ton of the substance of the bill but I do want to talk about why this is important and why we are asking for a yes vote today to continue this process onto the Appropriations Committee. I know you will look at the fiscal note. You will see that there is one. And we are continuing to work through how to ensure that we are able to make the necessary changes to statute and continue to support our different departments financially as they work through these changes. So we do have a plan, and we would ask for your yes vote today, and I will turn it over to my co-prime.

Okay, committee, questions for the bill's sponsors. Representative Gonzales.

Thank you, Mr. Chair. Thank you for the question. You will also see that there is state revenue. Obviously, it's much smaller. It's in the form of probate fees that will be collected. Probate fees are a big part of the financial process that the judicial department goes through when guardianship is kind of being determined and contemplated from a court perspective. And so we do have a plan in our next committee once we get another revised fiscal note based on the amendments today that will hopefully knock the fiscal note from the judicial department down to a level that will be manageable by kind of right-sizing some of those probate fees that already exist to help offset those costs. You will not see that today though.

Representative Stewart. Thank you, Mr. Chair. Thank you for the question. That may be a question that you want to ask one of our panelists or our fiscal analyst afterwards. Yeah.

Thank you, Mr. Chair. So just following up on that, and I realize you said go to the fiscal analyst, but you're saying we're going to increase the probate fees to offset that note. But then, I mean, doesn't that put the burden on the families? They're the ones paying those probate fees. Is that correct?

Yes, Representative. Thank you, Mr. Chair. Yes, Representative Marshall. To the extent that they are able, but there is clear indigency existing in the statute and with the courts so that individuals who are in need of these services but are indigent would not be paying those fees, they would be waived.

Thank you, Mr. Chair. To follow up on that as well, I do want to point out that currently in the fiscal note that you're looking at, the probate fees are simply contemplated from existing guardianship cases, which is a very small amount. There are many, many more probate cases that would also be affected if we raise the fees writ large. And in Colorado, and again, I would encourage you to follow up with one of our panelists as well, but in Colorado, we actually haven't raised probate fees in a really, really long time. and we're well below the national average where we have some of the cheapest probate fees in the country. So really we're looking to kind of right-size those in order to support the increased workload of the Judicial Department. Representative Espinosa.

we have looked and compared to other states, and we will not be moving anywhere towards the top of the probate fees, even with the proposed adjustment. We just don have the mathing until we get this amendment through to be able to articulate exact numbers of what that fee would be A follow Representative Marshall Yeah so I mean just based on your statement I had a follow question So I mean these are the same IDD people that were already hitting

well, any of those individuals who are currently in the system would be grandfathered into the additional fees that they have with regard to this. My understanding is probate is a one-time fee. They're not charged every time they're going to court or making annual reports. That's not part of the fees that would be charged. So first of all, for a whole subset, they would not have any increase themselves. Secondly, for the individuals coming into the system, as I said, a large number comes through the public guardianship as indigent individuals who don't have other family members to support them. And so those would be also exempt from these fees. And I think that's a large part of the population with IDD. To the extent that family members do have assets, again, because these are adults, they would be evaluated independently on their capacity to either pay those fees or not pay those fees. It does not fall to the family simply because they are stepping in as the guardian. It would only be the capacity of the individual if they had access to funds which would make them out of the indigency category.

Thank you, Mr. Chair. I noticed there were several counties in an amend position. Does your amendment address most of those or all those concerns that they might have? Representative Espinoza. Thank you, Madam Vice Chair.

Yes, we met one-on-one with Boulder and representatives of the State Office of Public Guardian and Denver who had those questions and concerns, and these amendments specifically have been tailored to their concerns. And my understanding is they'll be moving into a monitor position based on this amendment. Representative Zoka.

And apologies that I haven't reconciled all of L2 with L1 yet. Can you just point out to me where in L2 we're changing the fee structure? Representative Stewart. Thank you, Mr. Chair.

And to be clear, we are not Representative Zocchi. We will be doing that in the subsequent committee. Okay, any other questions from the committee?

Is it fair to say that the amendment that was done in the Judiciary Committee still tries to adhere closely to the Uniform State Law?

Yes, that has been my goal and objective, is to make sure that the changes we make will not take this out of uniformity, but does tailor the needs to our particular Office of Public Guardianship and the existing needs of our community. So the critical input of the Uniform Law Commission is to update terminology and to reduce the nature of too many guardianships, which were so broad, and introduce and provide for the existence of limited guardianships, which is what we're doing as a huge policy here. So from a policy perspective, we're going from one-size-fits-all guardianship. If you get a guardian, all your life is controlled by that guardian, to now a tailored limited guardianship, which only those areas where you need to have some assistance would be covered, and so it allows for greater flexibility. And I appreciate that.

Representative Espinosa?

Do you have any understanding of why the protective arrangement instead of a guardianship was so pricey? We'd love to know.

Okay, thank you, because that's sort of my big head-scratcher. Obviously, what was done in judiciary was done in judiciary. I just really wish you luck going through the process and maybe in future sessions getting to the bottom of why judiciary would be something that would appear to everyone with a modicum of common sense to be less expensive, to actually be more expensive, and hopefully future legislatures can get to the bottom of that.

Thank you. I think this will be a task serving on judiciary that I'm continuing to pursue in terms of my relationship with the judiciary in terms of how they deal with these issues. But I would also note the other thing that we have done in conjunction with the Office of Public Guardian Suggestions is we have added guardians ad litem as an alternative in our amendments. So you'll see that in the amendments that we're going to bring forward today, in part because there are circumstances sometimes when an individual is too incompetent to be able to even request an attorney. And so a guardian ad litem in that circumstance is much more effective than having an attorney appointed. So we also tried to reduce judiciary's concern by reducing that obligation. And only at the request of an individual is an attorney the first primary person. Now it would be in the court's discretion to ascertain who's the appropriate person to represent the individual. Okay, thank you for that.

Molly Kirkham Jack Johnson Megan Baker and Michael Neal If you can kick us off on this end, hit the little button in front of you. It's the tiny little button. We make it impossible. There you go.

Elizabeth Morand, Executive Director at the Arc of Colorado. Thanks so much for having me. I going to defer to my colleague Jack Johnson on some of the more technical issues with this one And I too am going to speak largely to the why of this bill and why it so important The Arc of Colorado led the efforts that you heard Representative Espinosa talk about a couple of years ago with the Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act, that very large bill, and I am heartened to see that many of the elements of that bill are in this bill. One of the things that I particularly like about this bill that is absent even from the uniform bill is a bill of rights because lots of our laws speak to what the rules and responsibilities are, the fiduciary, those sorts of things. But they lack what I think is an essential element, which is what are your rights when you are subject to a guardian? What can you do, can't you do? What rights can the guardian take away, what they can't? And then also what rights the court has the authority to take away or restrict you on? So what I want to share with you are just a couple of things that came out of our previous stakeholder engagement back two years ago. What we learned is that 80% of Coloradans who were surveyed indicated that no one had ever even suggested a less restrictive alternative. One of the things that this bill does that I am heartened by is it provides clear direction about prioritizing less restrictive alternatives. specifically under Colorado law. We have what's called supported decision making and supported decision making agreements. That law was passed in 2021. The fact that folks don't know that there are less restrictive alternatives and to some of the discussion points that were brought up just earlier, when we think about if we engage less restrictive alternatives, that should keep folks out of the court completely, which means the judiciary isn't processing annual reports, isn't doing reviews, isn't engaging at all because families are able to work with either an attorney or a recognized support decision-making agreement to create what we call integrated supports, which are some paid supports, community supports, family supports, right, integrating supports to make it so that they can live as independently and as autonomously as possible. What I want to share with you just really quick are some of the quotes that came out of that survey. We ask them, has someone who you care about who's been subject to guardianship, which can be any of us at any point, have experienced neglect, exploitation, fraud, overly protective and reasonable restrictions, or had their rights violated? Here are some of the answers. The individual is restricted from seeing family, given no contact with family and friends, given no choice about how their money is spent, no choice of community or allowed to go to the church they would like to go to. Individual has been made to be isolated from all their support systems, no longer allowed to make or take part in decision making, including preferences, placed in a nursing home although it didn't have any serious health condition, so forth and so on. These are concerning. I think this law fixes it. I encourage your yes vote. Thank

Hi. I want to thank the chat committee members. and I'm Molly and I work as an arts lesson and policy advocate. The arts supports this bill and we also support families with IDD. I'm also part of Speaking for Ourselves and People First, which is all self-advocacy groups. And I'm in support of the arts. And I think I know, and to be honest, I know there's some roadblocks that we know that might not happen. but what I just asking is that you just listen with an open heart um and i think to me guardianship can be invisible silence push aside that what people can feel like if they don have opportunities to talk it's kind of like to me it's like putting someone in a box so you're saying you know you have a disability it could be this way but we it's more of a fact that when you put people away or when you do guardianship. To me, that means they're less equal than someone else. And that's what this bill will do, is make the bill right. Like Elizabeth said, there is no bill right. So the bill now protects the guardian, not the person with this bill. That's why we need a bill right, because it don't give them that voice. It gives them dignity. It gives them fairness. It allows them to be in the least restrictive environment. And it's that connection. It allows them to connect to the community, the family, the friends. That's what I think is the most important thing is to remember. This bill is not just about numbers or doing the right thing. It's about looking someone in the eye and seeing them as a person and allowing them to be part of that discussion. Without a people cannot decide what they do. To me, it's almost like someone else is driving your car. So when you're in a guardianship, you're in the back seat. You don't control the steering wheel. But if you have that support, you can still be involved in that road life. Can you like driver lessons? I'm not here to say that guardianship is bad. I know people need it. What we're just trying to do is make sure that if they honor it, that they have least restrictive environment, that they're still seen as a human. and it gives strength and right this ensures that they have access to an attorney again it's what at the end of the day I think it's about dignity and I think that's what I think it comes down to is you know it's a person and I think that's the most important thing to remember and what I don't and to me it kind of reminds me of I was like I'm Frank Pope I'm in spite of everything I still would believe people get a really good heart and I think that's what this bill is about. Being in dignity, giving them that choice, giving them respect, and most importantly seeing them as someone who is valued. Every voice matters. Every person matters. Every life matters. Please vote yes to be that, to allow them to take charge. Thank you.

Thank you, Mr. Chair, members of the committee. My name is Jack Johnson. I'm an attorney at Disability Law Colorado testifying in support of House Bill 1100. I'm mostly here to answer any of the technical or substantive questions related to L2 or the original bill or the future funding scheme that is yet to be determined. But one thing I did want to talk about is specifically to the portion of filing fees. So in Colorado law, the way our probate filing fees are structured is under CRS 1332-102. The probate filing fees are broken out into several different types of filings. So things like filings for trusts, things like docket fees, fees like first-time registration fees. And what we had suggested, which is definitely not finalized given the math that we still need to have to do in the consultation with some of the fiscal staff, is adjusting some of those fees to better generate revenue for what we see as a very critical cost. It doesn't necessarily have to come directly out of filing fees for people with disabilities or their families who are getting guardianships because the probate filing fee structure breaks down probate fees into a lot of different areas But what it does have to do is try to fix what we see has been a really growing problem in people civil rights, which is that when guardianships were first discussed and contemplated under the law, what was mostly contemplated was people who were aging, who required guardians to help them support them at the end of life as they navigated things like dementia or elder care. What the reality has come to is that every year we see more and more young people who are subject to guardianship. And that is because of a lot of factors, including factors like early diagnosis of people with disabilities, different types of family and support structures in place, as well as a higher prevalence of severe and persistent mental illness that requires guardianships in order to manage care and navigate housing. But because of that, we're taking an old rigid structure that says you have a guardian or you don't and trying to apply it to someone who is actively growing and changing and maturing rather than deteriorating in their capacity. And so the reason this law is so important is because when you have a structure that is so rigid, not only does it not work for these young people or these people with disabilities whose capacity is changing throughout their life. But it also puts judges and the judicial branch in a tough spot where you have to act in a binary rather than a spectrum in which you can appoint a guardian for a certain amount of time with limited time limits, limited capacity on what they can restrict, such as medical decision-making guardianship or guardianship over financial capacities. And in doing so, you leave gaps on both ends of the spectrum. And so we think this is really important to help people who need guardianship have a guardian and for people who need less restrictive alternatives to have that. And I'm happy to answer any questions. Thank you.

Thank you, Chair Woodrow. Thank you, members of Plus Finance. My name is Michael Neal. I rise in strong support of HB 261100 on behalf of Colorado Cross Disability Coalition and myself. I think what we're dealing with very clearly here is an overburden, an overreactive court system that does do and can only do at this point a guardianship or a non-guardianship. from that black and white perspective, doesn't cover the needs of and abilities of folks. We need to be pressing the envelope about, you know, I don't have diagnosed IDD, but I do have learning disabilities. And so there are certain things that even I would consider myself not an expert at that I do need some support from my communities for, but certainly not all things. And so moving to a supported decision-making process, I think is a crucial situation. Some folks may be able to handle money, but not necessarily going to their doctors, or at least not as well without companionship and someone to remind them of particular issues that they may be having. Someone may need help to drive, but not other things. So I do encourage this shift to supported decision-making. I do, I am saddened that we are not fiscally able to get all the way to the point where we need to be. But I really do encourage an aye vote. If one were to even nitpick at all about this bill and to go back and question why we might actually, you know, want to amend a little tiny bits of things, it is this. when we are looking at the what the court can do and can strike down there are two particular pieces that I do worry about slightly which is the court's ability to restrict vote and the ability to curtail reproductive health and ability to procreate sections which are on page six towards the bottom just before section three. I would definitely question whether or not those are the limitations that we really need the court to decide. I think that we need to be living in an era of what is called in the disability community the dignity of risk. And so I think we're getting to a really good point that we're balancing safety and the dignity of risk. But I would definitely take a look at this and edge on the dignity of risk in those few areas where we're not quite there yet. But I still ask for a fervent and strong eye vote on HB 26 1100.

Thank you Mr. Chair So this is a question to the ARC representative The IDD community Is getting hit very very hard In fact we had a colleague that pointed out that The ARC was in full support Of the stripping The caregiver money away and turned out that's not what the family said and we had a complete reversal by the ARC the day before a press conference and I was told it was because the ARC had other priorities and I see this thing as $1.4 million. Is this one of the other priorities that took preference over the support to the families?

Thank you, Mr. Chair, and thank you, Rep. Marshall, for the opportunity to address what I believe is misinformation. To the first point about us, this narrative that we have sort of done a pivot here, we have been in, with the Medicaid cuts specifically, we have been working on those budgets, looking at the impact of those cuts for the better part of eight months now, working with a handful of other organizations and also working with families, stakeholders, self-advocates like my colleague, making sure we're engaging to say we saw what the governor put down to say these are cuts. Pickpuff, you need to go make these cuts. All of that starting with HR1 and working its way down So we were aware that those cuts were coming We were aware that there was a great possibility that there were going to be cross cuts And the IDD community is the largest part of that budget and so would have been taking the largest hit. And so we worked with stakeholders and our larger network to say, what we want to do is make sure that we are presenting a united front in the sense of we don't want us to say, don't cut us, cut them. Well, don't cut them, cut them. And really look at it on a line-by-line item, looking at each thing to say where are the things that we know are going to get cut and what can we do to advocate for the least, the smallest impact. This is probably a much longer conversation that I would really like to have with you and some of those families who I know feel like we have done a pivot, and I assure you we have not. We oppose the cuts completely, but we also recognize that we're going to get cut. Those Medicaid cuts are coming down the pipe. How can we mitigate that impact as much as possible? I really appreciate your question earlier when you asked about how is this going to impact the IDD community, the increase of probate costs, because absolutely the DD community is disproportionately impacted by the cuts. No doubt about that. But your question toward the end was, did we contemplate this? Would we rather see the money go here? No, sir. No, sir. The cuts that are being made to Medicaid that are impacting our family caregivers and not just that group. but the entire disability community is devastating. And I don't think the state as a whole should be prioritizing things over people. But that seems to be where we've landed. And so the efforts the ARC has made, we are aligned with those groups that are angry, and I understand their anger, but we are much more aligned than we are different. and I would welcome a conversation with you and with some of those folks who are upset.

Thank you, Mr. Chair. I would like to move L2 to House Bill 1100, and then Rep. Espinosa can explain it.

Oh, I'm sorry. Hold on. I withdraw that. I want to move L2 to the Judiciary Committee report.

Thank you, Mr. Chair, members of the committee. L2 is doing exactly what we described in our opening, that is it is really attempting to reduce the costs on the fiscal note in large part, but it is also making some technical amendments at the request of our communities communities that have come to talk to us Both the Office of Public Guardian and the representatives of the IDD community have engaged in this process We have as a result of that modified and added guardian as an alternative to attorney in the appropriate circumstances. We've eliminated the term proactive arrangement services, protective arrangement services, throughout the bill. That's what a lot of these changes are, and then making it conforming throughout the bill. We have, so mostly it's that, and then really trying to address the concern of how do we minimize court interaction and be more clear. One of the big requests that was made was tightening and clarifying the notice requirements to who has to be informed, because that was a financial concern to the parties, and we determined that that was unnecessary. so they were simply now required to make an attempt to notify the people who might be able to ensure that the right person is being pointed as a guardian if there is someone who's closer in relationship to the individual that it wouldn't fall to a stranger who could exercise undue influence or undue pressure on the individual subject to the guardianship so those were clarifications that we made throughout the bill i think um and the major those are the major issues that came out of those discussions that we had.

Thank you, Mr. Chair. Thank you to the committee and to all of our wonderful witnesses and stakeholders. All I will reiterate is the deep necessity of this bill for the disability community and our continued commitment to ensure that we are going to be able to get this across the finish line financially. So we would ask for an aye vote.

Thank you, and thank you, committee, for listening to us today. I would reiterate, and thanks, first of all, for our witnesses who came forward to try to put a little more of a human face on to why this is important not only to us and to bring the states into more of an alignment with other states which have more fully adopted the complete Uniform Law Commission report. I would say we are working in good faith with the Judiciary Department, but even in a recent text that I just received from the liaison, I would submit that liaison is not fully understanding the issue of what we've been working on because there's a reference to conservatorship. Conservatorship is not touched on this bill whatsoever, and I think there's a failure to understand that we've also reduced the mandatory attorney costs. That was another argument that was made. I would just let you know if you hear those issues from the judiciary, that is not in our bill. There's not mandatory in all circumstances attorney, but there is currently in the law a right to attorney if you're subject to a guardianship, and we're just clarifying how that would be effectuated in certain circumstances because as an individual whose rights may be taken away from you, because that's what we're talking about in guardianship, that the state is coming in and imposing another person or an agency to be in charge of your life, that we want to do that in a way that is the least restrictive, and we want to make it clear to the courts and to the parties coming forward in part to encourage more guardians to step forward because what we also know is some families don want guardianship that requires them to take full control of their person life So we believe that this may encourage even more guardianships which will provide protections to the individuals and families who, at least in my own community, so often do this without any support or guidance. I know families in my community and myself included often step into the role of guardians without understanding the provisions that could be there to help them at the state. So I think it's really important to ensure that we get this law statute modernized and we take the first step towards making a holistic process system. And we do believe that the court will find, much of the chair's response, that this doesn't increase costs but will reduce costs in the long run and therefore hopefully even get more support when we come back for the rest of the uniform law statute.

Thank you, Mr. Chair. I made a quick assumption. I hadn't had the hand up yet. You had it at like 75 minutes. I have a constituent that is very strongly engaged in these issues and strongly reached out to me to oppose it. I'm normally very, very receptive to uniform law code stuff. So I was feeling pushed because of, you know, this is a constituent I normally rely on for information and guidance on these. But after hearing a lot of the hearing on my own, I've come to the conclusion I cannot be a yes on this. I don't know if I'm more disturbed that we are more willing to spend money on film subsidies than the IDD community, or more disturbed that we would pursue this with $1.4 million in an environment where we are slashing the people that rely on this money to survive. I guess one benefit when you say, well, we're going to increase the probation fees on the people that are seeking these, if they're indigent, they can get the fees waived. We will have a lot more indigent IDD people, so I can tell them, well, at least you can have your probate fees waived now that you're indigent. We call this a deep necessity. I don't see that compared to what else we're looking at at the budget this year. So it's very difficult to get to a yes on this. And when we say, oh, it won't increase any costs on the judiciary, when you have custom products going through the judiciary's hands constantly, it increases staff time. If they have one item and they know what it is, it's easy because they know what they're looking at constantly. You can laugh, you can smile, but it's true. And someone who's been in the judiciary or clerk may know that. So I'm a no.

Thank you, Mr. Chair, and thank you, sponsors. You know I'm not afraid to support our most vulnerable communities across the state, but we're in finance today. I can't get there quite yet today just because of the fiscal no. I know there's some changes coming with the appropriations. So when you incorporate those changes and appropriations in the law floor, I'm happy to revisit and discuss with you guys. But when we're talking about millions of dollars overall, and as my colleague from Douglas said, we're making cuts elsewhere. While I understand the intent, I just think right now we have to kind of see where the dice fall, especially with the changes you're But, again, I'm happy to revisit it once it comes back to the floor.

Sure, thank you. I'm going to split the difference between my colleagues here. I do have fiscal concerns, you know, fiscal no concerns. But then also I do have prioritization concerns that I just can't get behind. I believe that, you know, we've talked about this. want to go through the long bill process and just prioritization of where we're at. I believe these are things that we need to be consistent with. We need to be, we need to come to grips with and take all of that into consideration as we bring other policy forward. Thank you.

I move House Bill 1100 as amended to the Committee on Appropriations Second by Representative Camacho Please pull the committee Representative Brooks No Camacho Yes Garcia

Respectfully, no.

Marshall. No.

Weinberg. Yes.

Mr. Chair. Yes. That passes 7-4. Have fun at a prop's. All right, folks, that wraps up our business for the week in house finance. We'll see you back on Monday. Until then, we stand adjourned. Thank you.