SENATE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

 

February 7, 2001                                                                                                     Hearing Room B

1:00 PM                                                                                                                        Tapes 22 - 24

 

MEMBERS PRESENT:         Sen. Bill Fisher, Chair

Sen. Margaret Carter, Vice-Chair

Sen. Gary George

Sen. Frank Shields

Sen. Ken Messerle

 

STAFF PRESENT:                 Rick Berkobien, Administrator

Andrew Morris, Committee Assistant

 

MEASURE/ISSUES HEARD:           SB 235 Public Hearing

SB 245 Public Hearing and Work Session

SB 246 Public Hearing

Introduction of committee bill (LC 2574 will be SB 659)

 

These minutes are in compliance with Senate and House Rules.  Only text enclosed in quotation marks reports a speaker’s exact words.  For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE 22, A

004

Chair Fisher

Calls meeting to order at 1:10 p.m. and opens a public hearing on      SB 235.

SB 235 PUBLIC HEARING

006

Rick Berkobien

Administrator.  Explains SB 235 to the committee. 

025

Susan King

Oregon Nurses Association (ONA).  Testifies in support of SB 235.  Presents (EXHIBIT A) to the committee.  States that have been proposed by the Health Division which the ONA is in agreement with. 

041

Jeff Metcalf

Family Nurse Practitioner.  Testifies in support of SB 235.  Comments on his practice.  States that it is difficult to get death certificates signed in rural areas where doctors are not readily available.  Relates a personal experience.  Explains the process of having a death certificate signed. 

083

Chair Fisher

Asks if a death certificate must be signed before a body can be transported.

091

Metcalf

Responds he is unsure.

104

King

States that bodies are often transferred without a signed death certificate, but many funeral homes do not accept the body without the signed certificate. 

120

Chair Fisher

States the bill could save time and money.

131

Sen. Carter

Asks why only doctors have been able to sign death certificates.

136

King

Responds current law states that only physicians may sign death certificates.

140

Chair Fisher

Asks about practitioners role in assisted suicide.

148

King

Responds that practitioners are not involved with assisted suicide, and this bill would not change that.

170

Grant Higginson

Health Division.  Presents testimony on SB 235 (EXHIBIT B).  Comments on proposed language changes.  Explains the requirements in filling out death certificates.  States there are agreements on the proposed amendments.

229

Chair Fisher

Comments on nurse practitioners and physician assistants and asks if physician assistants could also sign a death certificate.

243

Higginson

Responds that nurse practitioners work independently and physician assistants work under physicians.

264

Sen. Carter

Asks if hospice nurses sign death certificates.

268

Higginson

Responds that is not legal under the current law.

280

Chair Fisher

Introduces letters provided by King in (EXHIBIT A).

302

Chair Fisher

Closes the public hearing on SB 235 and opens a public hearing on    SB 245

SB 245 PUBLIC HEARING

305

Berkobien

Explains SB 245 to the committee. 

341

King

Testifies in support of SB 245.  Explains the background behind the bill.

373

Metcalf

Testifies in support of SB 245.  Comments on patient care.  States that people recover faster when they can receive services in their home.  Relates a personal experience.  Discusses current procedures. 

TAPE 23, A

000

Metcalf

Explains home health care. 

020

Chair Fisher

Asks about patients that receive Medicaid services.

025

Metcalf

Responds he is willing to work with physicians to get approval for Medicaid.  Discusses having doctors sign orders after services were delivered.

046

Sen. Carter

Asks about the financial impact of the bill.

048

Metcalf

Responds the bill would allow for time and money to be saved. 

063

Carolyn Concia

Geriatric Nurse Practitioner.  Testifies in support of SB 245.  Comments on her practice of making home visits to people who are homebound.  States there are 12,000 people in Multnomah County who are homebound.  States there is a delay while patients wait for a doctor to sign orders.

100

Hersh Crawford

Office of Medical Assistance Programs (OMAP).  Presents testimony on SB 245 (EXHIBIT C).  States that SB 245 does not apply to the Medicaid because in order to receive matching funds, a physician must sign the medical orders.  States that besides the Medicaid issue, OMAP does not have any issue with the bill.

118

Chair Fisher

Asks if a physician could sign orders at a later date to receive Medicaid funds.

125

Crawford

Responds that federal requirements do not call for a physician to authorize services ahead of time.

129

Sen. Carter

Asks about funds coming from the general fund.

131

Crawford

Responds if the bill required Medicaid to be included in the bill, then the state could not receive matching funds for services prescribed by nurse practitioners only.  States the bill does not intend this, so there will not be a fiscal impact.

145

Chair Fisher

Comments on the intent of SB 245.  Closes the public hearing on SB 245 and opens a work session on SB 245.

SB 245 WORK SESSION

150

Sen. Carter

MOTION:  Moves SB 245 to the floor with a DO PASS recommendation.

 

 

VOTE:  5-0

AYE:               5 – Carter, George, Messerle, Shields, Fisher

178

Chair Fisher

The motion CARRIES.

SEN. CARTER will lead discussion on the floor.

180

Chair Fisher

Closes the work session on SB 245 and opens a public hearing on      SB 246.

SB 246 PUBLIC HEARING

195

Berkobien

Explains SB 246 to the committee.

235

King

Testifies in support of SB 246 (EXHIBIT D).  Gives personal background.  Comments on the background of SB 246.  States the bill seeks to extend the authority of the Board of Nursing.  Comments on commitment to treatment. 

315

King

Comments on the scope of practice for nurse practitioners. 

328

Sue Davidson

Ph.D., Oregon Nurses Association.  Testifies in support of SB 246 (EXHIBIT F).  States the bill would allow for the Board of Nursing to have influence over curriculum. 

398

Metcalf

Reads testimony in support of SB 246 (EXHIBIT E).  States concerns over the current system.

TAPE 22, B

000

Metcalf

Continues testimony.

027

Chair Fisher

Asks how internet diplomas affect Oregon.

032

Metcalf

Responds that he is unsure, but internet diplomas are becoming a trend.

053

King

States that the ONA supports the Board of Nursing on SB 246.  Comments on the board’s responsibilities. 

075

Chair Fisher

Asks for the financial impact on the board of nursing.

079

King

Responds the board would need consulting fees.  Comments on her past work on the board and accrediting undergraduate programs.  Comments on current requirements.  States the board supports current graduate programs.

150

Kathleen Potempa

Ph.D., Dean, Oregon Health Sciences University (OHSU).  Reads testimony against SB 246 (EXHIBIT G).  Reviews the boards and associations that accredit OHSU’s nurse practitioner programs.  States that the accreditors have the expertise that is required to make curriculum decisions.  States that curriculum changes depending on the needs of the field.

237

Potempa

Continues reading testimony. 

280

Carol Howe

Director, nurse-midwifery, OHSU.  Reads testimony against SB 246 (EXHIBIT H).  States OHSU is in the top ten for nurse practitioner programs in the country.  Explains the accreditation process.  States that OHSU already meets the required standards. 

372

Sen. Messerle

Asks about other schools in Oregon that have nurse practitioner programs.

375

Potempa

Responds that the University of Portland also has nurse practitioner programs.

391

Sen. Shields

Asks how the bill affects nurse practitioner programs.

410

Potempa

Responds that it give the board of nursing the power to not allow new program development.

421

Sen. Shields

Asks if the board of nursing would disagree with accrediting entities.

430

Potempa

Responds she is unsure, but accrediting boards and associations are more qualified to make accrediting decisions.  States the board members may not have the experience to make accrediting decisions.

TAPE 23, B

014

Sen. Carter

Asks about people that may enter into a practitioner program, but are not qualified.

021

Potempa

Responds by explaining the admission process.  Comments on the educational requirements. 

083

Sen. Carter

Asks about people who may enter the program without having undergraduate degrees.

095

Howe

Responds that the students would have to complete an intense three-year program before entering and graduating from the practitioner program.  Comments on accreditation.  States that a local board may not have an understanding of the national requirements and activities. 

133

Chair Fisher

Asks for the education requirements to be on the Board of Nursing. 

134

Potempa

Responds they are not required to have advanced degrees.  States that when a person graduates from a practitioner program, they have seven and a half years of education. 

169

Katharine Parker

Mid-wife.  Presents testimony in opposition to SB 246 (EXHIBIT I).  Gives personal background.  States disagreement with the proposal.  Explains the board wants to prevent OHSU from developing a new program. 

270

Parker

Asks for continued support from the state legislature. 

288

Chair Fisher

Closes SB 246 and opens a work session to introduce committee bills.

INTRODUCTION OF COMMITTEE BILLS

296

Berkobien

Explains LC 2574 to the committee.

302

Sen. Carter

MOTION:  Moves LC 2574 BE INTRODUCED as a committee bill.

 

 

VOTE:  3-0-2

AYE:               3 - Carter, Messerle, Fisher

EXCUSED:     2 - George, Shields

305

Chair Fisher

Hearing no objection, declares the motion carried. 

310

Chair Fisher

Closes the work session to introduce committee rules and reopens the public hearing on SB 246.

SB 246 PUBLIC HEARING

317

Fran Hicks

Professor, OHSU.  Reads testimony in opposition to SB 246 (EXHIBIT J).  States that current statutes provide sufficient oversight.  States that Oregon is a leader in the nation in nursing programs and the bill could change that. 

389

Anita Lee Wynn

University of Portland.  Testifies in opposition to SB 246.  Comments on people who enter nurse practitioner programs without a lot of experience.  Relates a personal experience.  States that if the board of nursing became involved, it may take away the flexibility the school has.

TAPE 24, A

030

Chair Fisher

Asks if there is a possibility of developing a program to make sure that graduates are capable completing assigned work.

035

Wynn

Responds no.  States that faculty should make decisions about if a student is capable or not or participating in a program.

050

Sen. Shields

Asks if a nurse practitioner should have a nursing background.

063

Wynn

Responds it would be helpful, but it is not necessary.

094

Hicks

States that 25 percent of nurses by 2007 will be second career people. 

114

Pamela Harris

Dean, Linfield-Good Samaritan School of Nursing.  Presents testimony against SB 246 (EXHIBIT K).  States agreement with previous testimony. 

133

Brian DeLashmutt

Representing the ONA.  Testifies in support of SB 246.  Reviews the language in SB 246.  States the board would not be involved with more than approving curriculum.  States that the board should be able to have the same role in graduate programs that it has in undergraduate programs.  States the bill is not about a particular program, but covers future programs. 

190

Chair Fisher

Asks why it has taken so long for this issue to come up.

195

DeLashmutt

Responds the issue came up when a new program was proposed at OHSU.  Reviews the function of the board of nursing. 

217

Chair Fisher

Asks if other professions do not need a law like this, why should this be pursued.

228

DeLashmutt

Responds there is only one medical and dental school in the state.

248

Chair Fisher

States he does not want to hold back the educational process.

255

Sen. Shields

Asks if the issue should be litigated. 

263

DeLashmutt

Responds that if the committee does not pass the bill he will seek other avenues, such at the attorney general, to change the statute.

272

Sen. Shields

Suggests working on a compromise.   

293

Chair Fisher

Enters letters against SB 246 into the record (EXHIBIT L).  Adjourns the meeting at 3:24 p.m.

 

Submitted By,                                                                           Reviewed By,

 

 

 

Andrew Morris,                                                                        Rick Berkobien,

Committee Assistant                                                                 Administrator

 

EXHIBIT SUMMARY

 

A – SB 235, Letters, Susan King, 5 pp.

B – SB 235, Written testimony, Grant Higginson, 2 pp.

C – SB 245, Written testimony, Hersh Crawford, 1 p.

D – SB 246, Letters, Susan King 2 pp.

E – SB 246, Written testimony and letter, Jeff Metcalf, 2 pp.

F – SB 246, Written testimony, Sue Davidson, 2 pp.

G – SB 246, Written testimony, Kathleen Potempa, 2 pp.

H – SB 246, Written testimony, Carol Howe, 2 pp.

I – SB 246, Written testimony, Katharine Parker, 2 pp.

J – SB 246, Written testimony, Fran Hicks, 2 pp.

K – SB 246, Written testimony, Pamela Harris, 1 p.

L – SB 246, Letters, Staff, 2 pp.