HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

March 25, 2003 Hearing Room 50

3:00 PM Tapes 69 - 70

MEMBERS PRESENT: Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Susan Morgan, Vice-Chair

Rep. Jeff Kruse

Rep. Jeff Merkley

Rep. Alan Bates

MEMBERS EXCUSED: Rep. Randy Miller

GUEST MEMBERS: Rep. Mitch Greenlick

Rep. Laurie Monnes Anderson

Rep. Carolyn Tomei

STAFF PRESENT: Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

ISSUES HEARD: Informational Meeting - Invited Testimony Only

Terry W. Coplin, Lane Individual Practice Association

Rob Rockstroh, LaneCare

Bruce Abel, LaneCare

“Physical and Mental Health Collaboration in Lane County;

Comments on House Audit Committee’s 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, 69 A
003	Chair Westlund	Calls meeting to order introduces the guests for invited testimony and opens the informational meeting.
INFORMATIONAL MEETING
025	Rob Rockstroh	Director, Lane County Health and Human Services. Informs the committee he is working with Sen. Winters on a committee which is developing the “Perfect Human Delivery Service”.
034	Bruce Abel	Manager, Lane Care in Lane County. (EXHIBIT A)
038	Terry Copeland	CEO, Land Individual Practice Association (LIPA). States LIPA covers physical health care in Lane County managing thirty thousand lives.
045	Rep Kruse	Asks how many fee for service clients are there.
075	Terry Coplin	Answers six to nine thousand.
079	Bruce Abel	Explains Lane County is having discussions with the Office of Mental Health and Addiction Services (OMPAS) on integrating multiple funds and multiple contracts to save on administration and other costs.
100	Chair Westlund	Asks how can they be served better.
124	Coplin	Offers recommendations.
152	Chair Westlund	Asks when people roll off the manage care program, what do they roll off too.
161	Coplin	Responds many people are entirely off the plan.
164	Rep. Kruse	Asks if all three options have the same package does that change the dynamics.
176	Coplin	States there is a possibility of risk.
188	Abel	Comments on the risks that are taken.
203	Rep. Kruse	Asks for clarification on the appropriation of funds.
220	Rob Rockstroh	Answers buying beds and paying for administration costs.
235	Rep. Kruse	Inquires about the population in the state hospital that will not do well in the community.
270	Rockstroh	Responds the possibility of placing high end clients in a wing of the jail.
283	Rep. Kruse	States he never thought the county would be willing to do that.
285	Chair Westlund	Comments on the way Lane County is working.
292	Rockstroh	Informs the committee that they send juveniles out of county for service and they are trying to stop.
303	Rep. Tomei	Asks for definition of Psychotic Security Review Board (PSRB).
315	Rockstroh	Defines PSRB and elaborates
330	Rep. March	Offers another definition of PSRB.
334	Rep. Bates	Reiterates what has been said for better understanding that they are trying to: Keep people out of hospitals Acquire beds in county with Medicaid match Receive funds at county level Cut administrative costs Bring revenue into one setting
390	Rockstroh	Agrees and comments about Physicians Association and Mental Health Associations.
TAPE, 70 A
005	Abel	Informs the committee about their interests as far as meeting the mental health needs of their community.
033	Coplin	Comments about the direction this committee is going integrating vertically and horizontally and offers prepared materials (EXHIBIT B).
060	Rep. Tomei	Asks questions about the acronyms in Terry Coplin’s testimony relating to drugs, mental status and care programs.
101	Rep. Greenlick	Asks how do you develop systematic care management.
117	Rockstroh	Describes the development of systematic care management.
148	Rep. Greenlick	States it seems they have a better way of managing patients with bipolar as diabetics and other patients because they are working at the ground level.
155	Rockstroh	Acknowledges and notes their intent is to put the service delivery and the money together as much as possible.
176	Abel	Clarifies the importance of allocation and monitoring of system coordination.
224	Rep. Bates	Asks for clarification of the diagnosis codes.
240	Coplin	Answers they pertain to mental health, physical health and pharmaceuticals.
260	Rep. Bates	Asks whether or not the percentages will flow to LaneCare as there is better control of these people when they gain more control of their lives.
218	Coplin	Comments that 80 percent of the mental health care is provided by the primary physician.
280	Rep. Bates	Asks if the 80 percent of patients have significant depression.
390	Coplin	Responds affirmatively.
310	Abel	Comments that they have the best data in the state (EXHIBIT C).
342	Coplin	Shares his concern with the horizontal integration.
358	Chair Westlund	Asks if they assume such risks where does the savings come from.
387	Coplin	Answers the state assumes risk for a fee for service population.
399	Chair Westlund	Asks how they are paid.
400	Coplin	Describes they are paid per employee per month.
TAPE, 69 B
020	Rep. Monnes Anderson	Notes the need for clarification in understanding their case management model.
026	Coplin	Describes further the case management system.
066	Rep. Tomei	Asks if they also provide mental health coverage.
072	Coplin	Explains contracting with the ones who provide those services.
077	Rep. March	Asks for a study or documentation on a breakdown for those items.
082	Abel	Describes the need for legal ways to reduce documentation.
118	Chair Westlund	Asks how many different employers they serve.
123	Coplin	Answers three corporate entities and a number of businesses.
129	Chair Westlund	Asks how many fee for service patients are in Lane County.
130	Coplin	Indicates somewhere between six and nine thousand.
133	Chair Westlund	Asks the size of Lane County.
142	Rep. Bates	Asks for characterization of the relationship between commercial carriers that are managed and Medicare.
152	Coplin	Answers fifty percent of costs is prenatal related.
185	Rep. Bates	Asks if you assume some of the duties of Oregon Medical Assistance Program (OMAP) do you have any idea what federal regulations would still stand in your way.
193	Coplin	Comments on which duties they could assume
220	Rep. Bates	Asks if you are asked for a reverse RFP could you come up with one and explain what the costs would be.
226	Coplin	Responds yes.
228	Rep. Greenlick	Asks how confident are you that you can get the forensic component and the mental ill together and make it go.
245	Rockstroh	Responds they : are the only county in the state that owns a psychiatric hospital own several acute facilities own some residential facilities work with the Sheriff’s office very well and has a mental health staff internally have a jail capacity that can be converted into a forensic unit If we can’t do it now we won’t be able to for several years.
277	Chair Westlund	Expresses appreciation and thanks to the guests for their testimony.
285	Chair Westlund	Closes committee meeting and adjourns at 4:48

EXHIBIT SUMMARY

A – Informational, prepared testimony, Bruce Abel, 4 pp.

B – Informational, prepared testimony, Terry W. Coplin, 1 p.

C – Informational, prepared testimony, Bruce Abel, 1 p.