HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM COMMITTEE

February 04, 2003 Hearing Room 50

3:00 PM Tapes 16 - 17

MEMBERS PRESENT: Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Susan Morgan, Vice Chair

Rep. Alan Bates

Rep. Jeff Kruse

Rep. Jeff Merkley

MEMBER EXCUSED: Rep. Randy Miller

STAFF PRESENT: Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

ISSUES HEARD: Informational Meeting - Invited Testimony

Jean Thorne, Director of Department of Human Services

“Department of Human Services and Relationship of Services to the Oregon Health Plan”

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 16, A
001	Chair Westlund	Calls the meeting to order 3:12pm introduces Jean Thorne of the Department of Human Services and asks the committee administrator to go over items presented at the Dais and opens the informational meeting.
INFORMATIONAL MEETING
010	Rick Berkobien	Gives a presentation of material at the dais.
025	Jean Thorne	Department of Human Services, gives an overview of who she is and what she will cover today. (EXHIBITS A, B, C, D)
252	Rep. Kruse	Asks if most of these other Federal grants capped.
258	Thorne	Responds about the cap on Federal grants.
270	Berkobien	Asks if she could please describe maintenance of effort.
275	Thorne	Gives description of maintenance of effort.
302	Rep. Bates	Asks questions on matched funds, and what the general fund money looks like.
329	Thorne	Reiterates question as she understood it and states she will get the information for the members later.
340	Berkobien	Asks questions about Medicaid eligibility.
345	Thorne	Answers questions about Medicaid eligibility.
395	Rep. Kruse	Asks if she has you seen the detail of the proposal and asks if we could see them.
401	Thorne	Yes, we can get that for you.
TAPE 17, A
003	Chair Westlund	Asks the members to hold their questions for the end of the session.
007	Thorne	Continues presentation.
101	Chair Westlund	Asks if she could elaborate about what she means about developing policy.
106	Thorne	Discussed that she will get to that question on the next page. Continues presentation.
366	Rep. Morgan	Asks if those in the Citizen Alien Waived Emergency Medical (CAWEM) category, stay on that for very long.
374	Thorne	Answers about the citizen alien waived emergency medical category.
379	Rep. Morgan	Asks if the 18,700 is a high, medium or low number of people that were involved in this last December.
381	Thorne	Responds to the number involved.
383	Rep. Kruse	Asks if this is a separate pot of money from other Medicaid funds.
385	Thorne	Yes, it is required.
387	Rep. Kruse	Comments that anyone who meets these Federal requirements and presents we do.
389	Thorne	Responds that it has to be classified as an emergency.
392	Rep. Kruse	Asks if it is the Federal definition of emergency.
395	Lynn Read	Gives information about definitions of Federal emergencies.
400	Chair Westlund	Asks if they present with or without the CAWEM (Citizen-Alien-Waived-Emergency-Medical)funds, is a Federally funded hospital going to treat them under any circumstance.
405	Thorne	Yes, hospitals have an obligation to perform on an emergency.
TAPE 16, B
001	Rep. Bates	Makes comments to Thorne and the other members about cost shifts and emergencies.
012	Rep. Anderson	Asks if in the CAWEM category if it mostly women.
015	Thorne	Responds yes, that 75-80 percent are labor and delivery costs, and we do not cover prenatal care in CAWEM.
074	Chair Westlund	Asks what on these pages on (EXHIBIT A) is mandated.
075	Thorne	Responds with the items that are mandated.
176	Rep. Kruse	Comments that there is a Medicaid mandate, but it is for re-construction right.
078	Thorne	Comments this is full benefit, but there is only 64 women in this.
082	Rep. Anderson	Could you please go over the numbers on the last two pages. (EXHIBIT C)
088	Thorne	Goes over the numbers.
101	Rep. Merkley	On the Oregon supplemental income program, second bullet on Medicare, on those two items the levels 15–17, asks if they were eliminated during the E-Board process.
114	Thorne	Answers questions about items eliminated and elaborates on cuts.
117	Rep. Merkley	The impact on the homes that we have heard about, asks if that is an issue that DHS is immersed in.
120	Thorne	Replies that it is more of a reimbursement issue and gives more detail.
147	Rep. Merkley	On the medically needy, asks if that was a House Bill 5100 decision also.
149	Thorne	Responds yes.
152	Rep. Morgan	Asks if some people qualify for more than one of these categories.
159	Thorne	Answers yes it is correct to some degree and elaborates.
169	Rep. Morgan	How many individuals are covered in these programs.
171	Thorne	Responds.
173	Rep. Tomei	When you gave us the these figures asks if this is the average monthly case load.
178	Thorne	Responds that it was the December 2002 case load.
183	Berkobien	The qualified Medicare beneficiaries, asks isn’t there a payment to the Medicare as part of that, what benefits do they get.
197	Thorne	Answers questions and continues presentation.
281	Rep. Morgan	Asks why there was such a large growth in TANF (Temporary Assistance to Needy Families) and Oregon Health Plan.
292	Thorne	Answers the question about the areas of large growth.
328	Rep. Morgan	Asks if all the people that were receiving the drug and alcohol counseling are in this category.
335	Thorne	Answers question about drug and alcohol counseling being in the category.
352	Chair Westlund	Asks if in 1999-2001 we were pushing the envelope as to the definition or lack there of, of maintenance of effort, which pushed more into TANF.
365	Thorne	Comments.
371	Rep. Kruse	Looking at the growth in the medically needy, one would assume that a huge portion of those folks are there for mental health drugs, asks if there is any coalition.
379	Thorne	Comments that half of the drugs in this expenditures are for MH drugs.
392	Rep. Kruse	Asks if this is where a lot of this growth is, because this is the only place some of the folks end up.
401	Thorne	Continues comments
TAPE 17, B
007	Rep. March	Asks if this category is where the anti rejections and AIDS drugs are.
012	Thorne	Responds about the category of anti rejection and AIDS drugs. Continues presentation.
016	Rep. Anderson	The Federal government picks up $.62 out of each dollar, and yet the providers are paid less in this State than in others.
025	Rep. Bates	Comments that Rep. Anderson is correct, but is talking about Medicaid and elaborates.
035	Rep. Monnes Anderson	Asks how our numbers compare per capita to other states.
060	Lynn Read	Comments about how we compare with other states.
080	Thorne	Refers to Lynn Read from the audience to answer the question.
107	Rep. Kruse	Asks how we compare with other states in Medicare.
111	Thorne	Will see if she can get that information for us.
112	Rep. Merkley	The E-Board’s action that reduced or eliminated mental health coverage this summer, asks if that was a part of the medically needy program.
115	Thorne	Answers about the eliminated coverage this summer.
135	Rep. Merkley	Had folks that thought they were going to lose their medically needed medication asks is that true.
137	Thorne	Comments about he cuts eliminated in January. Continues presentation.
200	Chair Westlund	Questions one of the last statements and elaborates.
210	Thorne	Agrees with what he said and continues.
235	Chair Westlund	Could we get what the federal requirement is in regards to meeting the poverty level and what we actually fund to, and what the actual case load would be if we took it down to the Federal minimum.
237	Thorne	Responds to the questions and assures she will give him the information in a couple of days.
253	Rep. Merkley	Mentioned 3 questions and would like answers on Thursday.
255	Rep. Anderson	Asks about a comment said earlier about the Federal Government moving toward Managed Care, what was the context to that statement, did I hear that right.
259	Thorne	Responds to the questions about the Federal Government moving toward Managed Care.
322	Chair Westlund	Appreciates Rep. Anderson’s question and elaborates.
335	Rep. Anderson	Asks if patients are accessing care in OHP and from the Veterans Administration, how much duplication is there.
340	Thorne	Perhaps Lynn can get the answers for that question.
360	Rep. Bates	Has questions that could be answered Thurs.
383	Chair Westlund	Comments and talks about tomorrow agenda.
	Chair Westlund	Calls meeting to close and adjourns at 4:58pm

EXHIBIT SUMMARY

A – Informational – DHS, Medicaid Cost Containment Report 1, Jean Thorne, 22 pp

B – Informational – DHS, Medicaid Cost Containment Report 2, Jean Thorne, 60 pp

C – Informational – DHS, Presentation Packet, Jean Thorne, 28 pp

D – Informational – DHS, Overview of funds Legislature adopted, Jean Thorne, 7 pp