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