HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

April 24, 2003 Hearing Room 50

3:15 PM Tapes  101 - 102

 

MEMBERS PRESENT:            Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Jeff Merkley

Rep. Alan Bates

 

MEMBERS EXCUSED:            Rep. Randy Miller

Rep. Susan Morgan, Vice-Chair

Rep. Jeff Kruse

 

 

GUEST MEMBERS:               Rep. Mitch Greenlick

                                                Rep. Monnes Anderson

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

 

MEASURES/ISSUES HEARD: HB  3624 - Public Hearing

 

 

 

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 101, A

003

Vice Chair March

Calls the meeting to order and opens the public testimony.

HB 3624 - PUBLIC HEARING

008

Berkobien

Gives information about the materials presented at the dais. (EXHIBIT A)

019

Jim Russell

Mid Valley Behavioral Care Network begins testimony.

025

Bob Beckett

Executive Director of Jefferson Behavioral Health, representing Josephine, Coos Curry, Douglas, Jackson and Klamath Counties.

030

Jim Russell

Begins testimony by asking about the Mental Health Organizations not specifically being addressed at this point and continues.

048

Chair Westlund

Comments as soon as we get this through the pipe line and on its merry way we will be working on the Mental Health Issues.

061

Beckett

Thanks the committee for all of their efforts on this issue and in the stakeholders group.

075

Lynne Marie Crider

Board Member of the Oregon Health Action Campaign begins testimony.

088

Mary Lou Hennrich

Board member for the Oregon Health Action Campaign.

095

Crider

  • Supports the intent of the HB 3624 to increase the number of Oregon Health Plan enrollees that are in Managed Care, from the stand point of cost containment and in terms of delivering quality services to enrollees.
  • Supports the way the bill endeavors to create more flexibility in contracting for pre-paid medical services.
  • Support the portion of the bill that would allow contract for management of services by the fully capitated plans for some folks that are enrolled in fee for service.

Would like to discuss section one, which requires applicants to enroll in fully capitated health plans where available in the geographical area and elaborates.

130

Chair Westlund

Asks if she feels there should be some exceptions to the process.

136

Crider

Responds yes and elaborates.

140

Chair Westlund

Agrees and comments we should strengthen these things up and elaborates.

150

Crider

Agrees with the statements and give a more detail explanation of her comments.

155

Rep. Merkley

Comments on testimony from last week regarding special needs and asks are you comfortable with those exemptions.

161

Hennrich

Comments that it is difficult to come up with a one size fits all program for the whole state and elaborates.

200

Chair Westlund

Makes comments about how they can help us through the rest of this process.

205

Crider

Their last comments are in regards to the sections that endeavor to establish systems for setting reimbursement rates for providers, and we do feel that adequate reimbursement rates are necessary to ensure access for enrollees.  They are concerned that in the Co-Chair budget, this would dies-enroll 150,000 people from the plan and we need to beware of the risks.

228

Chair Westlund

Makes comments that this is a delivery system for the largest amount of people we can buy back.

237

Crider

Makes additional comments to the advocacy of services and it looks like the bill addresses fully capitated rates for hospitals but not primary care providers.

248

Chair Westlund

Makes comments that, that is a fair comment and may be something we need to look at.

250

Crider

Comments that it just seems like that the access to primary care providers is what is most lacking.

258

Chair Westlund

Makes comments about PPO’s fit into this bill.

261

Rep. Greenlick

Asks if she has specific comments on page

267

Crider

Was actually referring to the lack of anything that addresses reimbursement rates for physicians that are in fee for service.

271

Chair Westlund

Comments what we are trying to get to with this section.  We could possibly go through a major rewrite on this section after working with all of you.

285

Rep. Greenlick

Comments that her point is talking about fee for service hospitals and not fee for service physicians.

288

Crider

Was not aware that section eight states that it will encompass all providers.

291

Chair Westlund

Makes comments about what section ten is trying to state.

318

Rev. Carolyn Palmer

Special Concerned Ministries, Public Policy Director extends a thank you for all of the committee’s hard work on this issue.  Begins her testimony around the concerns that she has.

Concerned about the fee for service clients, would like to see a pretty strong clause the states that the pay is coming from Medicare and elaborates.

TAPE 102, A

030

Chair Westlund

Makes comments about the story she related about a single mother of a child with Acute Asthma.

040

Palmer

Continues presentation regarding people on fee for service.

049

Rep. March

We have discussed this prior, about the language their needs to be exception language for those special case needs folks.  Would like to talk about the first point that she made.

065

Palmer

Asks what they mean by standard population.

069

Rep. March

Gives a definition about the standard population.

084

Rep. Merkley

Comments that he read this as an underlying structure on which both an OHP Standard categorical could be place and an expanded population could be placed because there is no common that divides those, asks if he is mis reading this.

090

Rep. March

Comments that we have not touch on all the technical pieces yet.

095

Rep. Merkley

Comments what this bill does not address and asks if it will all be addressed elsewhere.

101

Palmer

Makes comments about the monthly fee for prescriptions for some folks.

128

Rep. March

Comments that, that is the expanded population that he would like to cover.

140

Palmer

Continues presentation.

184

Chair Westlund

Thanks Carolyn for coming to testify and states that it is a real important part of the legislative process.

209

Palmer

Makes a few additional comments about people she is in contact with and shares some feelings from her heart.

225

Rep. Greenlick

Comments about the intent under line nine section two page two of HB 3624.

235

Chair Westlund

Makes additional comments.

242

Rep. Greenlick

Agrees and continues comments on the language in the HB.

247

Chair Westlund

Comments it depends on what exceptions we make and on premiums and co-pays.

262

Laura Woodruff

Introduces herself and begins her testimony.

345

Mike Volpe

States his concern about this bill.  Has a concern about the Co-Chairs budget and what it will not be covering.

398

Chair Westlund

Makes comments about the Co-Chairs budget and what will be covered and what will not.

TAPE 101, B

015

Volpe

Makes additional comments and discusses the long term care system in Oregon.

037

Chair Westlund

Makes comment about the Managed Care program to put his mind at ease.

051

Volpe

Asks if that person then assigned to a physician or does the person get to choose the physician.

053

Chair Westlund

Comments that the patient has the choice.  We understand that this will not make everyone happy and elaborates.

060

Volpe

Comments that they are just thinning the soup.

070

Chair Westlund

Disagrees and comments that he feels that the individual can still receive some of the best medical care on the face of the planet.

078

Volpe

Disagrees with the chair and makes comments about his situation.

080

Chair Westlund

Comments that maybe the middle ground is that your physician would find her way into the Managed Care System.

085

Volpe

Comments that then he will have to have each doctor take a look at the system and then decide to be a part of it or not.

095

Chair Westlund

Comments that the bottom line is that we need to encourage more physicians to get involved in Managed Care.

105

Rep. Bates

Makes comments about the wavered populations it goes directly with what the chair was talking about and comments that if we can’t find enough in the delivery system we have and those wavered populations that will not be covered any more, and that is where we will have our real loss.  The categorical’s, those that we have to cover, we have barely have enough money to cover their pharmaceuticals and durable medical goods, alcohol and drug dependency and mental health issues, we have found enough to pay for that, but we need more revenue to go beyond that.  Asks if he is on Medicare.

129

Volpe

Comments that he is on Medicaid and Medicare.

130

Rep. Bates

He would expect then that your physicians are dealing with have also refused to take Medicare as well as Medicaid and that they are using the Medicaid as a supplemental to that.

130

Volpe

Comments that that is correct.

131

Rep. Bates

Comments that we need to encourage those physicians to work with us and to get them into Managed Care so that people like you can continue your relationship with your current physicians, I personally feel that they will step up to that if we structure Managed Care in a proper way, and we are working on changing that structure and comments on the real issue that we face right now.  I would guess the most important thing you are getting out of Medicaid right now is medications because Medicare does not have that benefit for you.

142

Volpe

That is correct and comments that Medicaid picks up the percentage that Medicare does not.

145

Rep. Bates

Comments that we understand that and we do not want you to lose that and the work this committee has done is to prevent this from happening.

149

Volpe

Asks that we allow as many physicians as possible into the process as you can.

140

Rep. Merkley

Comments that one of the points being made is that health care is not like shopping for other things, and we need to wrestle with when we provide exceptions for people who have long standing relationships with medical providers.  Gives more elaboration about solving the problems.

173

Volpe

Would be very happy to come back and work with them on this process.

179

Tina Kitchin

Medical Director for Seniors and People with Disabilities.  Not here to testify on this bill but would like to make one small correction.  People who are on the DHS waivers are categorically eligible and are not at risk of losing their OHP services.

194

Palmer

Asks if they have some doctors that they can approach about this fee for service and asks that they make this a part of their decision process.

235

Jacqueline Zimmer-Jones

Makes comments for clarification about those categorically eligible not being at risk.

288

Chair Westlund

Calls meeting to a close and adjourns  4:58 pm

 

 

EXHIBIT SUMMARY

 

A – HB 3624, DHS New Release, staff, 2 pp

B – HB 3624, Provisions and Background, staff, 2 pp