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