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.