HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM COMMITTEE

March 3, 2003 Hearing Room 50

3:00 PM Tapes 44 - 45

MEMBERS PRESENT: Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Jeff Kruse

Rep. Jeff Merkley

Rep. Alan Bates

MEMBERS EXCUSED: Rep. Randy Miller

Rep. Susan Morgan, Vice Chair

GUEST MEMBERS: Rep. Mitch Greenlick

Rep. Laurie Monnes Anderson

STAFF PRESENT: Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

ISSUES HEARD: Informational Meeting - Invited Testimony

Robert Nikkel, Department of Human Services

“Overview of the State’s Mental Health and Chemical Dependency

Treatment Services”

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 44, A
001	Chair Westlund	Calls meeting to order 3:10 p.m. introduces Robert Nikkel, of Department of Human Services.
INFORMATIONAL MEETING
015	Berkobien	Gives an overview of the materials presented at the Dais.
020	Robert Nikkel	Introduces himself as Manager of Community Services for the Office of Mental Health and Addiction Services and begins presentation. (EXHIBIT A – C)
035	Chair Westlund	Asks if Federal funds are available for forensic populations.
040	Nikkel	Federal funds are generally unavailable for people in State Institutions between the ages of 21 to 64 and elaborates.
055	Chair Westlund	Makes additional comments about Federal funds to the forensic population.
065	Nikkel	Responds about Federal funds.
070	Rep. March	Asks if Oregon is planning on taking advantage of the Katie Beckett option.
085	Nikkel	Comments that they have looked into it and elaborates.
090	Chair Westlund	Asks for definition of the Katie Beckett Amendment.
095	Nikkel	Gives definitions to the best of his knowledge.
201	Rep. Bates	Asks about civilly committed patients in 16 or less beds receive a Medicaid match, do you know when that program began and what the policy behind the program was.
204	Nikkel	Responds about the Medicaid match for civilly committed patients. Continues presentation.
255	Chair Westlund	Asks if the community hospitals are costing more than the State Hospital.
265	Nikkel	Responds to the cost between hospitals.
293	Rep. Bates	Comments to make sure he is clear on the conversation about community hospitals
302	Nikkel	Agrees with the comments from Rep. Bates.
305	Rep. Bates	Continues his comments.
318	Berkobien	Asks if the local hospitals are that much more efficient than the State Hospital.
325	Nikkel	Responds and agrees.
349	Rep. Bates	Asks if Nikkel is aware of the capacity problem involved in the system right now and elaborates.
355	Nikkel	Responds and continues presentation.
TAPE, 45 A
110	Chair Westlund	Do you have any idea what it costs for in terms of the capital improvements and maintenance lag.
113	Nikkel	Comments that he does not have those figures, he will check with Dr. Mazerheart and have him send the information. Continues presentation.
135	Rep. Monnes Anderson	Asks what the match is.
138	Nikkel	Responds that it is the same.
167	Rep. Bates	When people leave these hospitals, how do you manage that without them being recycled back into the system again.
171	Nikkel	Comments that discharge planning happens as soon as the person steps in the door.
185	Berkobien	Asks if you base the numbers on those who don’t enter into the community again or stay in the community ex number of days.
195	Nikkel	Responds yes, they look at all of the above to make those determinations and continues.
247	Rep. Bates	Asks what is the cost on a per bed day compared to the State Hospital.
274	Nikkel
276	Rep. Bates.	Asks if he has any knowledge if there is people in the hospital with civil admission that should be brought down to the community level.
278	Nikkel	Responds to brining people down to the community level.
280	Rep. Bates	The size of the State Hospital has been decreasing lately, has the price per bed increased or decreased lately.
285	Nikkel	Comments that he will research the information and get back to them with the answers. Continues presentation.
340	Rep. Greenlick	Asks who at Portland State is being trained for evidence base.
345	Nikkel	Gives name of those doing social work.
351	Rep. Greenlick	Are physiatrist and folks at OHSU being trained.
354	Nikkel	Makes comment about how good the program is at OHSU.
357	Rep. Greenlick	Makes additional comment to make his statement clear.
365	Nikkel	Comments and continues presentation.
390	Rep. March	Comments that he hears from his Sheriff, that the State hospital is running out of beds.
399	Nikkel	Comments about the system and the methamphetamine epidemic.
410	Rep. March	I guess we need beds and are losing patients in the jails very rapidly.
TAPE, 44 B
007	Rep. Greenlick	Asks questions about block grants and how they related to the Oregon Health plan as a piece of mental health services.
018	Nikkel	Makes comments about block grants.
027	Rep. Greenlick	Asks how do they integrate with services.
032	Nikkel	Give more explanation.
037	Rep. Greenlick	Asks when Multnomah county gave up on mental health services and gave them back to the state, does that have anything to do with the block grants.
043	Nikkel	Responds about the county giving up on mental health services.
046	Chair Westlund	Asks if he could flush this out a bit.
053	Nikkel	Gives more detail and continues presentation. (EXHIBIT A) and (EXHIBIT B).
110	Rep. Merkley	Asks question on (EXHIBIT A).
113	Nikkel	Responds no and elaborates.
119	Rep. Greenlick	Asks if you could put some numbers on these graphs for more clarification.
122	Nikkel	Responds with the numbers on the graph.
190	Berkobien	Comments about a pilot project that Oregon participated in about almost immediate application and renewal of OHP for folks coming out of jail and prison, could you give us the status on that.
195	Nikkel	Gave the status on the pilot project. Continues presentation.
273	Rep. Merkley	Could you elaborate on the idea of the environment of not having safe housing being an issue .
278	Nikkel	Comments on those that do not have safe housing and how it effects those with mental illness in the system.
293	Rep. Merkley	Asks if someone because they are poor and maybe evicted there moving from apartment to apartment the continuity of care gets broken up and then without continuity of care the disease might get worse, then they are more likely to get evicted, is this what we are talking about.
296	Nikkel	Agrees and continues.
341	Berkobien	Asks about research and discussion about hospital costs when you increase in pharmaceuticals specially in psychiatric, have we ever looked dollars that have been saved in certain areas, is there an offset.
353	Nikkel	Responds that he is not sure we have done that, he will look into it.
367	Rep. Greenlick	Makes comments about a parity with mental health and A & D services and insurance as an issue here, do you see this as a factor here.
367	Nikkel	Not clear how it would effect the mental .health care system and elaborates. Continues presentation.
375	Rep. Greenlick	Comments that he did not talk about the alcohol and drug as an issue.
389	Nikkel	Responds no, that he chose to focus primarily on the mental health system and will touch briefly on the alcohol and drug system.
TAPE, 45 B
030	Rep. Greenlick	That is the allusive block grant I was interested in, it is very important that we don’t lose that as we move things around. I am interested in the agreement between OMAP and OMHAS.
040	Nikkel	Does not have the detail on that and will bring the information to you.
045	Rep. March	Asks if he would talk more about civil commitment.
052	Nikkel	Responds about civil commitment.
085	Rep. Kruse	Asks if there is a disconnect in the civil commitment arena between Adults and juveniles.
090	Nikkel	Responds yes and elaborates.
101	Rep. Kruse	Makes comments about juveniles in the civil commitment arena.
128	Berkobien	Can you think of a stand out state because of their community mental health system and why they might stand out over others.
132	Nikkel	Responds about which state stands out in his opinion.
143	Rep. Kruse	Asks if there is one or two things unique about Ohio.
145	Nikkel	Responds about what is unique with Ohio.
	Chair Westlund	Thanks the invited guest calls meeting to a close and adjourns 4:45pm.

EXHIBIT SUMMARY

A – Informational, Mental Health Organizations, Robert Nikkel 1 p

B – Informational, Chart, Robert Nikkel, 5 pp

C – Informational, Mental Health Services, Robert Nikkel 5 pp