HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

 

January 20, 2003   Hearing Room D

8:30 A.M.     Tapes 2 – 4

 

MEMBERS PRESENT:            Rep. Jeff Kruse, Chair

Rep. Billy Dalto, Vice-Chair

Rep. Carolyn Tomei, Vice-Chair

Rep. Laurie Monnes Anderson

Rep. Gordon Anderson

Rep. Jeff Barker

Rep. Ben Westlund

           

STAFF PRESENT:                  Sandy Thiele-Cirka, Administrator

Mara McGraw, Assistant

 

ISSUES HEARD:                     INFORMATIONAL MEETING

                                                Overview of the Department of Human Services (DHS)

·         Review of HB 5100 Budget Reductions

 

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 2, A

006

Chair Kruse

Calls meeting to order at 8:35 A.M. and opens informational meeting. 

INFORMATIONAL MEETING

007

Chair Kruse

Introduces overview of Department of Health and Human Services (DHS) and HB 5100 reductions. 

015

 

 

 

 

200

 

 

 

 

 

 

 

 

 

400

Jean Thorne

Acting Director of the DHS.  Offers DHS overview and overview of HB 5100 reductions, special session cuts, November rebalance and December revenue forecast (EXHIBIT A).  Provides a context for DHS and the budget relating to the General Fund.  Begins presentation by reviewing:

  • federal funding;
  • merge of mental health and addiction services; 
  • operation and service delivery; 
  • general funds related to federal match requirements; 
  • entitlement programs and eligibility standards;
  • delays in expansion;
  • provider fees reduction;
  • target reductions;
  • current law suits and settlement agreements;
  • Oregon Health Plan 2 (OHP2) waivers; and
  • budget reduction actions (EXHIBIT B)

Introduces assistant directors to speak on specific departmental reductions.

TAPE 3, A

047

Chair Kruse

Questions implementation of HB 510 reductions.

054

Thorne

Continues presentation. Comments on Measure 28 and impact on DHS.

073

Chair Kruse

Questions if current statues require specific date. 

076

Thorne

Responds and explains the funds in mandated program reductions relating the timing of the reductions.

099

Rep. Monnes Anderson

States desire to put a face to issue. Refers to Hood View facility closure and pending lawsuit. Questions approach toward displaced clients.

112

Thorne

Explains DHS transition planning and downsizing related to federal match. References the biennium budgeting. Emphasizes sustainability regarding cuts to health programs.

169

Rep. Westlund

Provides brief recap of legislative reductions.

173

Thorne

Concurs.

203

Rep. Dalto

Requests data regarding reorganization savings.

206

Thorne

Defines figures and savings targets regarding reinvestment and reorganization. Offers example of current employment vacancies.

222

Chair Kruse

Requests clarification on dollar amounts.

224

Thorne

Responds with uncertainty as to exact figures.

226

Chair Kruse

Explains figures were target for reorganization during the 2001 session.

233

Rep. Dalto

Requests clarification on “reinvesting.”

235

Thorne

Details costs of reorganization and service integration relating to staff and management training, networking computer systems, and co-location of services. Provides details of the reorganization process.

286

Rep. Dalto

Inquires on reorganization goals relating to reduction of cost or improvement of service delivery.

291

Thorne

Responds and identifies the focus to improve services and reduce costs. 

312

Chair Kruse

Directs members to HB 5100 reduction handout (EXHIBIT C).

324

Ramona Foley

Assistant Director for Children, Adults and Families, and Interim Assistant Director for Community Human Services, DHS. Introduces self. 

329

Jim Nealy

Deputy Director for Human Services, introduces self.

332

Foley

Speaks to merger between Adult Services with Services to Children and Families and commitment to consistency within and between programs.

350

Nealy

Explains matrix (EXHIBIT B) regarding elimination of emergency assistance. Notes the program could start up again with next biennium.

374

Chair Kruse

Questions the dollar figure relating to continuation of services in 2003-2005 and dollar figures for current reductions.

381

Nealy

Responds the programs are being substantially reduced in the reorganization. Explains reductions of employment related day care regarding Jobs program, and Temporary Assistance to Needy Families (TANF) grants (EXHIBIT B).  Continues TANF discussion.

452

Chair Kruse

Requests clarification on TANF’s current budget and how the federal reductions impact Oregon’s funding match.

454

Nealy

Explains relationship of General Fund to TANF block grant. Notes the reductions do not eliminate federal funds.

465

Foley

Details TANF cuts. Contrasts figures for services to children removed from the home versus services to intact families. Emphasizes and details largest system reductions (EXHIBIT B).  Explains loss of General Funds; including staff.

TAPE 2, B

056

Foley

Explains reduction in foster care payments and adoption rates (EXHIBITB). States that Oregon as one of the top in the nation in foster care and adoption assistance.

102

Chair Kruse

Requests information on federal funding stream reductions.

102

Foley

Explains General Fund reductions. Details several reductions.

129

Chair Kruse

Requests clarification regarding cuts to residential treatment programs.

130

Foley

Details reductions from 24 hour residential programs.

143

James Toews

Acting Assistant Director for Seniors and People with Disabilities, DHS.  Explains decision making around reductions and discussions with federal reductions (EXHIBIT D). Identifies and details partnerships. Explains relationship to federal Medicaid waiver program reapplication process.  Reports efforts to preserve specific services.

235

Rep. Tomei

Requests savings figures.

236

Toews

Speaks to rate reductions and roll back rates to 1999-01 levels. Details Oregon Project Independence (OPI) reductions.

288

Rep. Dalto

Inquires on OPI reductions during the last 2 years.

290

Toews

Explains OPI cuts.

308

Rep. Barker

Requests figure regarding number of people impacted by reductions.

312

Toews

Discusses impact on client population. Details cuts as they apply to Social Security/Disability Benefits (SSI/SSDI) (EXHIBIT B). Explains ranking of impairment (1-17) according to activities of daily living (ADL’s).  Continues presentation.

392

Chair Kruse

Questions cuts at level 10.

393

Toews

Defers answer to later testimony. 

404

Sandy Thiele-Cirka

Administrator.  Submits ADL description (EXHIBIT C).

412

Toews

Notes DHS attempt to preserve services to 24 hour care in developmental disabilities (EXHIBIT B).  Reports reductions as they impact clients living with their families.

457

Chair Kruse

Inquires on Staley agreement.

466

Toews

Explains Staley agreement and relationship to current cuts and reports DHS is aware of risks.

417

Chair Kruse

Questions cost of settlements compared to cost services.

482

Toews

Explains moving target cut dates. Continues.

TAPE 3, B

048

Rep. Dalto

Questions total people impacted by HB 5100 cuts.

057

Toews

Explains levels 10-14 (EXHIBIT C). Offers figure on people and dollars  involved and reduction delays.

077

Chair Kruse

Questions logistical information regarding client requests and rights for a hearing if denied services.

086

Toews

Explains loss of OHP and other services. Details federal standards on hearing rights related to level cuts.  Reports assessment of eligibility is hearable, service/program cuts are not hearable and the hearings process.

135

Chair Kruse

Questions federal relationship and determination of hearing rights related to cuts.

149

Toews

Explains mandatory versus optional services with regard to elimination of an entire program. Restates assessments as contestable but eligibility figures and guidelines are not contestable. Explains level for eligibility is now at level 10 (EXHIBIT E).

169

Chair Kruse

Questions impact on Medicaid waiver relating to elimination of Medically Needy program.

174

Toews

Defers to Thorne.

175

Thorne

Explains Medically Needy program as optional. 

178

Chair Kruse

Requests additional information on Medicaid waivers.

181

Thorne

Explains states can choose to cover. Defines populations covered.  Details specific populations and income levels covered in Oregon.  Explains program can be eliminated at will if not tied to waivers.

189

Chair Kruse

Requests matrix on Medicaid programs related to specific waivers.

224

Lynn Read

Acting Administrator, Oregon Medical Assistance Program (OMAP), DHS. Introduces self.

225

 

 

250

 

 

 

 

300

Barry Kast

Assistant Director for Health Services, DHS.  Introduces self. 

Explains:

  • employees and services staffed;
  • grants, revenue and general fund;
  • community as the client;
  • role of regulatory work;
  • client based services of OMAP and relationship to OHP;
  • community partnerships;
  • cuts as statutory requirements; and
  • school based health services.

360

Chair Kruse

Requests clarification regarding certification of state workers.

388

Kast

Explains relationship between state and local cuts.

402

Rep. Monnes Anderson

Inquires about tracking and data from school based cuts.

412

Kast

States inability to answer but will provide information to committee.

416

Chair Kruse

Comments on administrative functions supported by General Fund.

TAPE 4, A

008

Kast

States school based health centers are part of larger safety net.

013

Chair Kruse

Comments on alternative funding sources.

022

Kast

Discusses procedural constraints that impact budget cuts due to OHP fund merger. Comments on mental health infrastructure. Explains restrictions in cuts and potential litigation.

101

Chair Kruse

Questions litigation outside of Multnomah County.

104

Kast

Explains current litigation in connection to mental health and addictions cuts.  Details choice to preserve community crisis system over hospital beds.  Relates need to choose cuts that can be implemented.

136

Chair Kruse

Inquires if DHS has proposed alternative reductions.

160

Thorne

Explains HB 5100 reductions are related to serious impacts in services.  Describes proposed cuts dependent on passage of Measure 28.

186

Chair Kruse

Requests discussion on alternatives funding. Adjourns the meeting at 10:34 A.M.

 

 

 

 

EXHIBIT SUMMARY

 

A – Informational, DHS Overview, Jean Thorne, 27 pp.

B – Informational, DHS Budget Reductions Actions, Jean Thorne, 12 pp.

C – Informational, HB 5100, staff, 2 pp.

D – Informational, Medically Needy Fact Sheet, James Toews, 1 p.

E – Informational, Characterization of Survival Levels, James Toews, 3 pp.