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