Source: https://cbaclelegalconnection.com/tag/health-law/
Timestamp: 2019-04-25 08:20:34+00:00

Document:
The Colorado Court of Appeals issued its opinion in Interest of Ray v. People on Thursday, February 21, 2019.
Mental Health—Certification for Short-Term Treatment—Physician—National Instant Criminal Background Check System—Firearm Prohibitions—Court Order.
Ray voluntarily sought mental health treatment from a hospital. After he was admitted, a physician certified Ray for involuntary short-term mental health treatment under C.R.S. § 27-65-107, finding that he was a danger to himself or others and would discontinue mental health treatment absent such a certification. That certification caused Colorado officials to report Ray to the National Instant Criminal Background Check System (NICS) as a person subject to federal firearm prohibitions. The certifying physician terminated the mental health certification days after it was entered, and Ray was discharged from the hospital. Ray petitioned the probate court for removal from the NICS. The probate court denied the petition.
On appeal, Ray argued that because he was involuntarily certified by a physician, rather than a court, Colorado officials should not have reported his certification to the NICS. Colorado law requires certain persons and entities to make NICS reports for persons with respect to whom a court has entered an order for involuntary certification for short-term mental health treatment. The plain meaning of the term “court order” does not encompass certification by a professional person. Therefore, the certification made by the physician does not meet the plain definition of a court order.
The order was reversed and the case was remanded for the probate court and the parties to take reasonable steps to cause any record of Ray’s certification submitted by them under CRS § 13-9-123(1)(c) to be rescinded.
The Colorado Supreme Court issued its opinion in In re Marriage of Rooks on Monday, October 29, 2018.
In this dissolution of marriage proceeding, the supreme court reviewed how courts should resolve disagreements over the disposition of a couple’s cryogenically preserved pre-embryos when that couple divorces. The court held that because the underlying interests at stake are the equivalently important, yet competing, right to procreate and right to avoid procreation, courts should strive, where possible, to honor both parties’ interests in procreational autonomy. Thus, courts should look first to any existing agreement expressing the spouses’ intent regarding disposition of the couple’s remaining pre-embryos in the event of divorce. In the absence of such an agreement, courts should seek to balance the parties’ respective interests in receipt of the pre-embryos. In balancing those interests, courts should consider the intended use of the party seeking to preserve the pre-embryos; a party’s demonstrated ability, or inability, to become a genetic parent through means other than use of the disputed pre-embryos; the parties’ reasons for undertaking in vitro fertilization in the first place; the emotional, financial, or logistical hardship for the person seeking to avoid becoming a genetic parent; any demonstrated bad faith or attempt to use the pre-embryos as unfair leverage in the divorce process; and other considerations relevant to the parties’ specific situation. However, courts should not consider whether the party seeking to become a genetic parent using the pre-embryos can afford a child. Nor shall the sheer number of a party’s existing children, standing alone, be a reason to preclude preservation or use of the pre-embryos. Finally, courts should not consider whether the party seeking to become a genetic parent using the pre-embryos could instead adopt a child or otherwise parent non-biological children. The court reversed the judgment of the court of appeals and remanded the case with directions to return the matter to the trial court to apply the announced balancing framework.
The Colorado Court of Appeals issued its opinion in Marchant v. Boulder Community Health, Inc. on Thursday, August 23, 2018.
Hospital Lien Statute—Statutory Penalties—Summary Judgment.
Marchant’s daughter was struck by an automobile and received medical treatment from Boulder Community Health, Inc. (BCH) for which she was billed $27,681.10. Cardon Outreach, LLC (Cardon), as agent for BCH, filed a statutory lien in that amount “upon the net amount payable . . . as damages on account of such injuries,” without first billing the daughter’s insurance company. BCH subsequently made an insurance adjustment to reduce the bill and billed the insurer, which paid $6,999.36, leaving a balance of $777.74. Cardon amended the lien to that amount. Marchant paid the balance, and the lien was released. Later, Marchant, as guardian of her daughter, filed an amended complaint alleging violation of the hospital lien statute, C.R.S. § 38-27-101, regarding her right to seek damages of twice the amount of the hospital lien filed.
The parties filed cross-motions for determination of a question of law, and the trial court ruled that C.R.S. § 38-27-101(7) only provides standing for a lawsuit if the plaintiff is subject to an improper lien at the time the legal action is filed. The trial court granted defendants’ motion for summary judgment.
On appeal, plaintiff contended that the trial court misinterpreted the hospital lien statute. The parties agreed that when the lien was filed it violated the hospital lien statute. However, the lien did not violate the statute at the time the lawsuit was commenced. The statute clearly applies only to liens that violate the statute at the time a complaint is filed. Thus, the statute does not allow plaintiff to seek damages.
The Tenth Circuit Court of Appeals issued its opinion in Hall v. Conoco, Inc. on April 10, 2018.
The appeal questioned the causation and exclusion of expert testimony. The district court excluded testimony from two of Hall’s causation experts and granted summary judgment to ConocoPhillips.
The first testimony that was excluded was that of Dr. Gore. Dr. Gore rendered a differential diagnosis for the cause of Ms. Hall’s leukemia. Dr. Gore considered three potential causes: benzene, smoking, and idiopathic (unknown) causes. Dr. Gore stated the cause was benzene because he ruled out smoking. However, he did not expressly rule out the possibility of idiopathic causes.
The district court concluded that Dr. Gore’s differential diagnosis, while an acceptable method for determining cause, was not reliable because he failed to justify benzene as the cause and he failed to rule out “idiopathic causes” for Ms. Hall’s leukemia. This reasoning was in the discretion of the district court.
The Tenth Circuit began its review by assuming, as the district court did, that benzene emissions could have caused Ms. Hall’s acute myeloid leukemia with inverse 16. Ms. Hall bore the burden of proving that benzene emissions from ConocoPhillips actually caused her disease.
One of Ms. Hall’s experts, Dr. Mitchell, created an air model to estimate benzene concentrations near where Ms. Hall had lived. Dr. Gore used Dr. Mitchell’s estimations and the number of years she lived near the refinery to calculate Ms. Hall’s cumulative exposure to benzene. He used this calculation to opine that benzene was the cause of Ms. Hall’s leukemia. The district court, acted within its discretion and identified two flaws with Dr. Gore’s methodology: Dr. Gore could not reliably use the highest hourly average-emission level to calculate Ms. Hall’s cumulative exposure to benzene, and Dr. Gore’s calculation was based on mistakes involving the extent of Ms. Hall’s exposure to benzene.
For the first flaw, Dr. Gore used the highest hourly average-emission level provided by Dr. Mitchell air model, but he did not provide adequate support for using the highest level. Dr. Gore claimed Dr. Mitchell instructed him to use the highest level, but Dr. Mitchell’s testimony states that he was not qualified to determine which level should be used and that the level would best be determined by an oncologist. Dr. Gore did not have any other support for using the highest level, except for his claim that Dr. Mitchell assured him that the highest level was the metric used in the industry.
The district court concluded that neither Dr. Gore nor Dr. Mitchell were qualified to choose the concentration level and that neither could defend the use of the highest hourly average-emission level. Without support for using the highest level of exposure, Dr. Gore’s calculation was questioned, and in turn his ability to rule that benzene was the potential cause was reasonably questioned by the district court. The Tenth Circuit concluded that the district court acted within its discretion relation to the reliability of Dr. Gore’s decisions to use the highest average-emission level.
In the district court’s opinion, Dr. Gore’s omission for ruling out any possible idiopathic causes was a fatal error in the differential diagnosis.
Ms. Hall made the following arguments, which the Tenth Circuit rejected. Ms. Hall argued that the district court misunderstood the concept of “idiopathic” causes. Ms. Hall defined “idiopathic” as a diagnosis by exclusion, meaning only if all known factors are ruled out, leaving no known plausible factors, can the leukemia be considered idiopathic. Using this view, the Tenth Circuit stated that it would be illogical for Dr. Gore to “rule out” idiopathic causes.
Ms. Hall also argued that the Tenth Circuit did not require differential diagnoses to rule out idiopathic causes. The Tenth Circuit Court of Appeals found that the district court could have regarded Dr. Gore’s differential diagnosis as unreliable, and that the district court did not abuse its discretion in excluding Dr. Gore’s opinion based on his differential diagnosis.
In addition to the exclusion of two experts, Ms. Hall also challenged the district court’s granting of summary judgment to ConocoPhillips by arguing that the circumstantial evidence was sufficient to avoid summary judgment. The circumstantial evidence presented by Ms. Hall failed to create a genuine issue of material fact on causation because of the need for expert testimony on the link between her disease and benzene exposure, and quantification of Ms. Hall’s exposure to benzene.
The Tenth Circuit determined that circumstantial evidence was not a sole justification for avoiding a summary judgment. The Circuit determined that Ms. Hall’s theory would require both expert testimony and quantification of her exposure to benzene. Because the expert testimonies of Dr. Gore and Dr. Calvey were excluded, Ms. Hall lacked both of these requirements, and the district court did not err in granting summary judgment to ConocoPhillips on causation.
The Tenth Circuit Court of Appeals upheld the district courts’ exclusion the testimony of Dr. Gore and Dr. Calvey and the summary judgment on causation issued to ConocoPhillips.
The Colorado Supreme Court issued its opinion in Colorow Health Care, LLC v. Fischer on Monday, June 11, 2018.
Health Care Availability Act—Statutory Construction—Alternative Dispute Resolution.
C.R.S. § 13-64-403 of the Health Care Availability Act governs arbitration agreements between patients and healthcare providers. Under C.R.S. § 13-64-403(4), such agreements must contain a certain notice to patients to help ensure that they enter the agreements voluntarily, and the notice must be emphasized by at least 10-point font and bold-faced type. The agreement here contained the notice in 12-point font, but it was not bold-faced. The court of appeals determined the statute requires strict compliance and that the agreement therefore failed for lack of bold-faced type.
The supreme court held that C.R.S. § 13-64-403 requires only substantial compliance. The court further concluded the agreement here substantially complied with the formatting requirements of C.R.S. § 13-64-403, notwithstanding its lack of bold-faced type. Accordingly, the court reversed the court of appeals’ judgment and remanded the case for further proceedings consistent with the opinion.
Since Friday, May 18, 2018, Governor Hickenlooper has signed 22 bills into law. To date, he has signed 251 bills and sent two to the Secretary of State without a signature. Some of the bills signed this week include a bill to continue the Colorado Civil Rights Division and Commission, a bill to implement “employment first” recommendations regarding people with disabilities, a bill extending and renaming the affordable housing tax credit, a bill allowing for equipment grants for rural fire departments, and more. The bills signed since Friday are summarized here.
HB 18-1319 – “Concerning the Extension of Services for a Successful Adulthood for Former Foster Care Youth who are Between the Ages of Eighteen Years and Twenty-one Years, and, in Connection Therewith, Making an Appropriation,” by Reps. Jonathan Singer & Dave Young and Sen. Bob Gardner. The bill allows county departments of human or social services to extend the provision of certain services for a successful adulthood to foster care youth between the ages of 18 and 21 who have exited the foster care system, including assistance with employment, housing, education, financial management, mental health care, and substance abuse treatment.
HB 18-1400 – “Concerning an Increase in Fees Paid by Stationary Sources of Air Pollutants, and, in Connection Therewith, Prioritizing the Use of the Revenues Generated by the Fee Increases to Reduce Permit Processing Times and Making an Appropriation,” by Reps. KC Becker & Hugh McKean and Sens. Cheri Jahn & Ray Scott. The bill increases statutory caps on the fees paid by stationary sources of air pollutants.
SB 18-039 – “Concerning the Wildfire Matters Review Committee, and, in Connection Therewith, Deferring the Date on which the Committee is Scheduled to Repeal and Making an Appropriation,” by Sens. Matt Jones & John Cooke and Reps. Tony Exum & Dan Thurlow. The wildfire matters review committee (WMRC) is currently scheduled to repeal on July 1, 2018. The bill defers the repeal date to September 1, 2025.
SB 18-145 – “Concerning the Implementation of Employment First Advisory Partnership Recommendations to Advance Competitive Integrated Employment for Persons with Disabilities, and, in Connection Therewith, Making an Appropriation,” by Sen. John Kefalas and Rep. Joann Ginal. The bill requires the Department of Labor and Employment and the State Medical Services Board in the Department of Health Care Policy and Financing to promulgate rules that require all providers of supported employment services for persons with disabilities to obtain a nationally recognized supported employment training certificate or earn a nationally recognized supported employment certification relating to supported employment services.
SB 18-254 – “Concerning Reforms to Child Welfare Services, and, in Connection Therewith, Making and Reducing an Appropriation,” by Sens. Kent Lambert & Dominick Moreno and Reps. Dave Young & Bob Rankin. The bill addresses numerous reforms to the funding structure for the state’s child welfare services.
HB 18-1003 – “Concerning Measures to Prevent Opioid Misuse in Colorado, and, in Connection Therewith, Making an Appropriation,” by Rep. Brittany Pettersen and Sens. Cheri Jahn & Kevin Priola. The bill establishes in statute the opioid and other substance use disorders study committee, consisting of 5 senators and 5 representatives from the General Assembly, and provides for tasks for the committee to address.
HB 18-1007 – “Concerning Payment Issues Related to Substance Use Disorders,” by Reps. Chris Kennedy & Jonathan Singer and Sens. Kent Lambert & Cheri Jahn. The bill requires all individual and group health benefit plans to provide coverage without prior authorization for a five-day supply of at least one of the federal food and drug administration-approved drugs for the treatment of opioid dependence for a first request within a 12-month period.
HB 18-1360 – “Concerning the Expansion of the Number of Directors on the Board of Directors of the State Historical Society,” by Reps. Faith Winter & Polly Lawrence and Sens. Beth Martinez Humenik & Nancy Todd. The bill increases the number of directors of the Board of the State Historical Society from 9 to 13.
SB 18-022 – “Concerning Clinical Practice Measures for Safer Opioid Prescribing,” by Sens. Jack Tate & Irene Aguilar and Reps. Brittany Pettersen & Chris Kennedy. The bill restricts the number of opioid pills that a health care practitioner, including physicians, physician assistants, advanced practice nurses, dentists, optometrists, podiatrists, and veterinarians, may prescribe for an initial prescription to a seven-day supply and allows each health care practitioner to exercise discretion to include a second fill for a seven-day supply, with certain exceptions.
SB 18-024 – “Concerning Modifications to the Colorado Health Service Corps Program Administered by the Department of Public Health and Environment to Expand the Availability of Behavioral Health Care Providers in Shortage Areas in the State, and, in Connection Therewith, Making an Appropriation,” by Sens. Cheri Jahn & Jack Tate and Reps. Brittany Pettersen & Jonathan Singer. The bill modifies the Colorado health service corps program administered by the primary care office in the Department of Public Health and Environment.
SB 18-270 – “Concerning Establishing a Statewide Program to Coordinate Referrals of High-risk Individuals in Need of Behavioral Health Transition Services, and, in Connection Therewith, Making an Appropriation,” by Sens. Cheri Jahn & Tim Neville and Reps. Brittany Pettersen & Cole Wist. The bill establishes the community transition specialist program in the office of behavioral health in the Department of Human Services. The program coordinates referrals of high-risk individuals to transition specialists by certain behavioral health facilities and programs. High-risk individuals are under an emergency or involuntary hold, have a significant mental health or substance use disorder, and are not in consistent behavioral health treatment.
HB 18-1208 – “Concerning the Expansion of the Income Tax Credit for Child Care Expenses that is a Percentage of a Similar Federal Income Tax Credit,” by Reps. Crisanta Duran & Faith Winter and Sen. Beth Martinez Humenik. The bill expands the state child care income tax credit by allowing a resident individual with an AGI that is less than or equal to $150,000 to claim a credit that is equal to 80% of the individual’s federal credit.
HB 18-1255 – “Concerning the Creation of a Childhood Cancer Awareness License Plate, and, in Connection Therewith, Making an Appropriation,” by Reps. Crisanta Duran & Terri Carver and Sens. John Cooke & John Kefalas. The bill creates the childhood cancer awareness license plate. A person becomes eligible to use the plate by providing a certificate confirming that the person has made a donation to an organization chosen by the Department of Revenue based on the organization’s assistance to children with cancer.
HB 18-1256 – “Concerning Continuation of the Regulation of Civil Rights Issues, and, in Connection Therewith, Implementing the Recommendation in the Department of Regulatory Agencies’ 2017 Sunset Review and Report on the Colorado Civil Rights Division and the Colorado Civil Rights Commission to Continue the Division and Commission and Making an Appropriation,” by Reps. Crisanta Duran & Leslie Herod and Sen. Bob Gardner. The bill implements the recommendation of the Department of Regulatory Agencies in its sunset review of the Colorado Civil Rights Division and the Colorado Civil Rights Commission to continue the Commission and the Division and their respective functions for 9 years, through September 1, 2027.
HB 18-1008 – “Concerning the Financing of the Division of Parks and Wildlife’s Aquatic Nuisance Species Program, and, in Connection Therewith, Creating an Aquatic Nuisance Species Stamp for the Operation of Motorboats and Sailboats in Waters of the State, Increasing Penalties Related to the Introduction of Aquatic Nuisance Species into the Waters of the State, and Combining Two Separate Funds Related to the Aquatic Nuisance Species Program into One Fund,” by Reps. Daneya Esgar & Jeni James Arndt and Sens. Don Coram & Kerry Donovan. The bill updates a legislative declaration concerning aquatic nuisance species to encourage the federal government to dedicate sufficient funding and resources to the detection, prevention, control, and eradication of aquatic nuisance species for federally owned or managed aquatic resources and water infrastructure in Colorado, and makes other changes.
HB 18-1423 – “Concerning Grants to Provide Equipment to Rural Fire Protection Districts,” by Reps. Donald Valdez & Larry Liston and Sens. Leroy Garcia & Larry Crowder. The division of fire prevention and control in the department of public safety is currently authorized to use money in the local firefighter safety and disease prevention fund to provide grants for equipment and training to increase firefighter safety and prevent occupation-related diseases. The bill transfers $250,000 from the general fund to be used for these purposes.
SB 18-143 – “Concerning Measures to Increase Revenue for the Parks and Wildlife Division, and, in Connection Therewith, Setting Certain Hunting, Fishing, Parks, and Recreation Fees,” by Sens. Stephen Fenberg & Don Coram and Reps. Jeni James Arndt & James Wilson. The bill makes several statutory changes concerning hunting and fishing, including raising the amount of residential and nonresidential license fees, stamp fees, and surcharges for certain hunting and fishing activities.
SB 18-042 – “Concerning the Creation of the Agricultural Workforce Development Program, and, in Connection Therewith, Making an Appropriation,” by Sens. Kerry Donovan & Larry Crowder and Reps. Marc Catlin & Barbara McLachlin. The bill requires the commissioner of agriculture to create, by rule, the agricultural workforce development program to provide incentives to agricultural businesses to hire interns. Qualified agricultural businesses may be reimbursed an amount not to exceed 50% of the actual cost of hiring a qualified intern. The rules must include specified criteria for qualifying businesses and interns participating in the program. Qualified internships must include at least 130 hours of work experience and cannot exceed 6 months in duration. The program is repealed on July 1, 2024.
SB 18-085 – “Concerning Providing Financial Incentives for Educators to Work in Rural Areas, and, in Connection Therewith, Making an Appropriation,” by Sen. Nancy Todd and Rep. Barbara McLachlan. Current law allows the Department of Higher Education to provide up to 20 financial stipends annually, not to exceed $6,000 each, to teachers in rural schools or school districts who are seeking certification as a national board certified teacher, seeking certification as a concurrent enrollment teacher, or furthering their professional development plan through continuing education, and who commit to employment in a rural school for a minimum of 3 years. The bill increases the number of available stipends to 60 and expands it to include teachers completing an approved alternative licensure program leading to initial licensure and full-time employment in a rural school or school district that serves rural schools and individuals completing the required course work leading to certification and employment in a rural school or a rural school district that serves rural schools.
SB 18-229 – “Concerning Criminal History Record Checks for Educator Preparation Program Students Seeking Field Experiences in Schools, and, in Connection Therewith, Making an Appropriation,” by Sen. Beth Martinez Humenik and Reps. Kim Ransom & Barbara McLachlan. The bill permits a student in an educator preparation program who is seeking field experiences in a school to submit his or her fingerprints to the Colorado Bureau of Investigation for the purpose of performing a fingerprint-based criminal history record check for the student. Upon completion of the fingerprint-based criminal history record check, the bureau must forward the results to the Department of Education. If the fingerprint-based criminal history record check of a student performed pursuant to this section reveals a record of arrest without a disposition, the department is required to perform a name-based criminal history record check of that student.

References: v. 
 § 27
 § 13
 v. 
 § 38
 § 38
 v. 
 v. 
 § 13
 § 13
 § 13
 § 13