HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

March 24, 2003   Hearing Room 50

3:00 pm Tapes  67 - 68

 

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

                                                Sen. Jackie Winters

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

ISSUES HEARD:                     Informational Meeting

                                                Peter Davidson

                                                “Reorganizing Mental Health Funding and Comment on Committee

                                                OHP Cost-Containment Recommendations”

 

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 67, A

001

Chair Westlund

Calls meeting to order and (talks about direction, see tape) introduces Peter Davidson, opens the informational meeting and asks staff to go over the material at the dais.

INFORMATIONAL MEETING

010

Berkobien

Presents material at the dais. (EXHIBIT A)

020

Peter Davidson

Introduces himself and presents testimony. (EXHIBIT B)

075

Rep. Greenlick

Asks how was that 95 percent distributed in terms of state and county funds.

085

Davidson

Responds with the percentages of how it was distributed and continues presentation.

TAPE 68, A

039

Chair Westlund

Asks where does the call center fit into this program.

045

Davidson

Responds with information about call center programs.

087

Rep. Greenlick

Makes comments about the analogy of Christopher Reeves recovery.

099

Davidson

Comments on his analogy.

109

Rep. Greenlick

Makes comments about his experience with people with schizophrenia in Multnomah Co.

110

Davidson

Responds to that population of people in his program.

123

Rep. Greenlick

Asks if he has a model, as this is a new program.

140

Davidson

Responds no, and elaborates.

148

Rep. Greenlick

What proportion of the people discussed

155

Davidson

Less than half need this model and elaborates.

184

Rep. Merkley

Comments about homeless public safety center discussed.  Asks how housing fits into his model.

195

Davidson

Responds about housing and how it would fit in the model.

209

Rep. Merkley

Asks if housing is still a big part of the problem.

220

Davidson

Responds about housing and continues presentation.

291

Rep. Greenlick

Asks for clarification about his analogy about children in cabs.

295

Davidson

Responds to his analogy about cabs.

308

Rep. Greenlick

Comments that isn’t it true that some of the most successful day treatment programs use taxi to transport to and from the home.

316

Davidson

Responds to vouchering a cab and the key is that natural system support is functioning normally.

325

Rep. Greenlick

Children live in dysfunctional environments all the time.

340

Davidson

Responds we need to treat system as a whole not the individual child and comments that therapy is not a replacement for a stable home.

351

Rep. Greenlick

How do we build a community mental health system with out regard to what our physiological and theoretical approach is and what does that say about the fact that we have a mental health system in crisis and we have families and society in crisis and what we are trying to figure out how to create a marginally successful community mental health system without regard to the fact that lots of kids live in horribly dysfunctional families and continue to live in them.

377

Davidson

Agrees with Rep. Greenlick and elaborates about having one system instead of one for children and adults, and gives suggestions about what he thinks we need for a system.  Continues presentation.

TAPE 67, B

168

Rep. Greenlick

Comments about clinical trials for drugs.

173

Davidson

Comments yes, that it is very different and elaborates.

175

Rep. Greenlick

Asks for an example of what he is saying.

180

Davidson

Gives and example.

195

Rep. Greenlick

Ask if he is saying by the very nature of depression, anxiety or bi-polar disorder that it is not possible to do clinical research to test effectiveness at the same time.

198

Davidson

Responds and elaborates that, that is not what he is saying.

237

Rep. Kruse

Asks how we get to a point that we are prescribing that many psychotropic drugs.

244

Davidson

Responds to why we are prescribing so many different drugs.

281

Rep. Greenlick

Comments that he thinks Davidson’s description of both the research and proper physiotherapy is idiosyncratic and elaborates.

300

Davidson

Explains that it is occurring and comments that he does not think that is ok at all and elaborates.

320

Rep. Greenlick

Apologizes, he thought he was saying he thought the science wasn’t developed adequately to develop guidelines.

324

Davidson

Comments that we are not even close to what we need for pain control.

329

Rep. Greenlick

Trying to deal with your questions that you can’t have a drug list defined by physiatrist to guide the treatment of disorders based on and effectiveness and that the science in not any good.

331

Davidson

Responds to how he feels about those prescribing to these disorders.

371

Rep. Bates

Comments that the question from Rep. Kruse was good and elaborates about the differences between someone that works with the people on the streets and those that know from studies what happens. 

TAPE 68, B

020

Rep. Kruse

Makes comments about medications that we are giving people.  Asks if this is the way we get to disease management.

034

Davidson

Responds yes, and that information is in (EXHIBIT B)

036

Rep. Kruse

Asks basically what you are doing on the front end is identifying environments factors.

043

Davidson

Refers to his chart (EXHIBIT B) and elaborates.

049

Rep. Greenlick

Comments how disease management programs are created is by having physicians and scientists and pharmacist get together and work out the models that work.

052

Rep. Kruse

Adds this is where this would happen in the treatment section and elaborates.

058

Davidson

Comments that some need some kind of training and others need other kind of training.

060

Rep. Kruse

Comments that even with similar life experiences with a different genetic makeup the reactions can be different as well.

064

Davidson

Makes comments about life management regardless of the disease.

077

Chair Westlund

Asks for thoughts on the integration of Mental Health and Physical Health, how do you see that working.

080

Davidson

Responds to the question and elaborates.

176

Chair Westlund

Calls meeting to a close and adjourns at 4:50pm

 

EXHIBIT SUMMARY

 

A – Informational, Oregon Health Plan Recommendations, Staff, 20 pp

B – Informational, prepared testimony, Peter Davidson, 9 pp