HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM COMMITTEE

 

 

March 5, 2003 Hearing Room 50

3:00 PM Tapes  48 - 49

 

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. Gordon Anderson

                                                Rep. Laurie Monnes Anderson       

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

ISSUES HEARD:                     Informational Meeting

                                                Seth Bernstein, Ph.D. Accountable Behavioral Health Alliance

                                                Bruce Abel, LaneCare

                                                “Mental  Health Organizations: Programs and Individuals Served”

 

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 48, A

001

Chair Westlund

Calls meeting to order 3:13 pm and asks that Rick Berkobien explain the materials at the Dais.

INFORMATIONAL MEETING

006

Rick Berkobien

Gave an overview of the material at the Dais. (EXHIBIT A), (EXHIBIT B), (EXHIBIT C).

035

Chair Westlund

Introduces Seth Bernstein, Ph.D. Accountable Behavioral Health Alliance and Bruce Abel, LaneCare and opens the informational meeting. (EXHIBIT D)

045

Seth Bernstein

Introduces himself and Bruce Abel and begins presentation.

101

Chair Westlund

Looking at (EXHIBIT D) and asks what the logic is behind this complicated situation.

145

Bernstein

Responds to the questions on (EXHIBIT D).

150

Bruce Abel

Adds to the response.

155

Chair Westlund

Questions regarding Family Care.

158

Bernstein

Responds regarding Family Care.

160

Chair Westlund

Asks if Family care is then overlaid on top of Multnomah and Washington Counties.

165

Bernstein

Comments that this is really out of my area.

170

Abel

Comments that in some counties there is a single fully capitated health plan and elaborates.

175

Rep. Bates

Elaborates his understanding about fully capitated groups.

185

Abel

Responds yes that his comments and understanding is correct. Gives more elaboration.

200

Rep. Bates

Asks follow up questions about fully capitated health plans in regard to mental health.

208

Bernstein

Responds to the follow up questions.

216

Abel

Makes additional comments to the questions asked.

226

Chair Westlund

Under that explanation, you should have another box for COIS.

228

Abel

Responds yes and elaborates.

238

Chair Westlund

With Family care what are they doing different.

257

Rep. Greenlick

Asks if there is a difference in which professional you are insuring.

275

Bernstein

Comments about the differences.

278

Rep. Greenlick

Makes additional comments about the different coverage’s.

280

Abel

Responds that, that is a reasonable way to look at it.

287

Rep. Bates

Makes comments with concern and confusion.

353

Bernstein

Comment that by the end of the day, we will have more detail that will hopefully make this more clear.

360

Chair Westlund

Thanks Rep. Bates for his comment because he has the same concern and elaborates.

375

Rep. Bates

Comments that they think they have patients in two capitated plans.

374

Bernstein

One MHO and one fully capitated and elaborates.

378

Chair Westlund

Depending on the offering in the geographic area.

380

Rep. Bates

Would recommend that the map you look at is still confusing because Family care should not be on this map as they do not provide these services.

400

Rep. March

Comments that he thinks it is for a specific population determined by the county.

404

Berkobien

Makes comments about why he thinks Family Care might fit in.

TAPE 49, A

005

Chair Westlund

Comments that he know that Family Care was in various parts of the state at various times.

010

Rep. Greenlick

Makes additional comment to help clarify.

017

Chair Westlund

Comments on what other regions offer.

023

Berkobien

Makes comments about brining in someone that has created a web site that will help us clarify the issues.

031

Rep. Greenlick

Comments that the prime issue is, what is the population issues based in your capitation rate.

033

Abel

Asks if he is talking about their membership.

035

Rep. Greenlick

Comments that it is not sick people.

040

Bernstein

OHP members in their counties enrolled in managed care.

041

Rep. Greenlick

In your county you have in your capitation rate, 100 percent to the OHP members open or not for a capitated health benefit.

043

Rep. Merkley

Asks as we have come to understand medical condition as a disease of the brain are we finding any process through which these structures are moving together.

052

Bernstein

Comments that on a quarterly basis he has a meeting with top management of IHN and on a monthly basis we get together with staff and focus on complex case managed and elaborates.

064

Abel

Responds to Rep. Merkley in more detail.

087

Bernstein

Adds more information.

110

Chair Westlund

Makes comments that he thinks this is very helpful.  This committee is really interested in that interface and relation between the MHO’s and the fully capitated health plans in any given area.

116

Abel

Continues presentation.

148

Bernstein

Continues presentation.

186

Berkobien

Asks for mental health, what is to prevent the organizations from reaching out to them at the fullest.

196

Bernstein

Responds about how the manage and evaluate their services.

211

Berkobien

Internally as people really need outreach and you need to go out and find them, is that part of that documentation and assurances that you are giving to the state about being proactive.

217

Bernstein

Comments in more detail about how they run their organization, the reports they generate and continues presentation.

287

Rep. Greenlick

Asks if there is any link to alcohol and drug use.

296

Bernstein

Comments to the link to alcohol and drugs.

322

Berkobien

Asks about percentages of those with co-occurring mental health problems.

330

Abel

Comments about co-occurring mental health problems and the percentages.

344

Bernstein

Continues presentation.

TAPE 48, B

024

Chair Westlund

Asks what the letters stand for in the material.

026

Bernstein

Gives an explanation of the letters.  Continues presentation.

077

Chair Westlund

Asks how they are paid.

080

Bernstein

Relates information about how they are paid.

090

Chair Westlund

Asks if the county cuts them a check.

094

Bernstein

States that no, the state cuts them a check.

143

Rep. Bates

Asks in their system in the county level are they capitated for out patient care and who pays for that.

152

Bernstein

Responds yes, and makes comments about their system and who pays for it.

164

Rep. Bates

Asks at the county level you are seeing a patient that you hospitalize, it doesn’t come out of your local budget it comes out of the overall budget for the entire group and what hospitals do you use to hospitalize in your group.

170

Bernstein

Elaborates and explains.

180

Rep. Bates

Why did you decide to set up an organization in which you can get someone off your books by hospitalizing them and elaborates.

187

Bernstein

Explains why they are set up that way.

200

Rep. Bates

Asks if they saw a significant variation amongst the counties and what the program looks like on the ground and how many people are being hospitalized, and that are rolling out or was it rather uniformed.

208

Bernstein

Asks for clarification of the questions.

209

Chair Westlund

Clarifies by saying cost per member, per month, per county.

220

Rep. Bates

Comments about the vast difference between counties and would like to know what their best practices are.

225

Bernstein

Responds to the vast difference with other counties and elaborates.

244

Chair Westlund

Asks if the patients can go to Pioneer in Prineville.

248

Bernstein

Comments about where the patients can go.

265

Rep. Bates

Talks more about how the system works and has concerns that he elaborates.

297

Bernstein

Talks about the meetings that they have to review cases and discuss how they handled them to better assess how to make the system work best.

308

Chair Westlund

Makes comments to Bernstein about his presentation.

318

Abel

Has the answers to the question above and begins his presentation. (EXHIBIT E)

TAPE 49, B

090

Chair Westlund

Asks what the population of Lane County is.

093

Abel

Responds with the population of Lane County.

094

Chair Westlund

Makes comments about Lane County having all the items available to make this Managed Care program viable.

100

Abel

Continues presentation.

162

Rep. Bates

Comments that he has heard rumbles that they do as much paperwork as they see patients and asks do you think that is true statewide and if it is are those paperwork requirements Federal, State or County.

169

Abel

Comments about requirements and continues.

179

Rep. Bates

Would like to see what those requirements are and elaborates.

180

Abel

Comments it would be a tremendous benefit to everyone if you could find that.

182

Rep. March

Asks presumably they are documenting the fee for service for you also right.

185

Abel

Responds to documenting fee for service and other requirements.

190

Bernstein

Makes some ending statements about how to make the mental health system work better.

318

Rep. Anderson

Asks if the funds are coming from Federal sources or other sources.

325

Bernstein

Responds about funds and where they come from.

343

Abel

Makes additional comments to add to the presentations and makes a closing statement.

390

Chair Westlund

Makes three final comments closes the meeting and adjourns. 4:58 pm

 

 

EXHIBIT SUMMARY

 

A – Informational, prepared testimony, staff, 3 pp

B – Informational, prepared testimony, staff 2 pp

C – Informational, study, staff, 2 pp

D – Informational, prepared testimony, Seth Bernstein, 8 pp

E – Informational, Mental Health Organization, Bruce Abel, 14 pp