HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

March 24, 2003   Hearing Room D

8:30 A.M. Tapes 62 – 64

 

MEMBERS PRESENT:            Rep. Jeff Kruse, Chair

Rep. Billy Dalto, Vice-Chair

Rep. Carolyn Tomei, Vice-Chair

Rep. Gordon Anderson

Rep. Jeff Barker

Rep. Laurie Monnes Anderson

Rep. Ben Westlund

 

STAFF PRESENT:                  Sandy Thiele-Cirka, Committee Administrator

Mara McGraw, Committee Assistant

 

MEASURES HEARD:                     HB 2124 – Work Session

                                                HB 2126 – Work Session

                                                HB 2240 – Work session

                                                HB 2018 – Public Hearing

                                                HB 2462 – 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 62, A

007

Chair Kruse

Calls meeting to order at 8:45 A.M. and opens work session on HB 2124.

HB 2124 – WORK SESSION

009

Sandy Thiele-Cirka

Administrator. Summarizes bill and -1 amendment dated 3/20/03 (EXHIBIT A). Submits budget overview (EXHIBIT B).

031

Rep. Monnes Anderson

MOTION:  Moves to ADOPT HB 2124-1 amendments dated 3/20/03.

032

 

VOTE:          6-0-1

EXCUSED:  1 - Westlund

033

Chair Kruse

Hearing no objection, declares the motion CARRIED.

035

Rep. Tomei

Questions if Oregon Commission on Children and Families (OCCF) supports the -1 amendment.

045

Donna Middleton

Director, OCCF. Speaks to current process of local partners participating in budget decisions.                                        

066

Rep. Tomei

Questions if the bill and the -1 amendment impact the budget.

071

Middleton

Explains budget process.

076

Rep. Tomei

Clarifies impact on local and state commissions.

079

Middleton

Notes budget is not impacted. Reports additional support and length of process due to bill.

085

Chair Kruse

Explains impact is in next biennium.

088

Rep. Tomei

Questions which biennium.

089

Chair Kruse

Clarifies 2005-07 budget.

094

Rep. Anderson

MOTION:  Moves HB 2124 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means by prior reference.

097

 

VOTE:         6-0-1

AYE:            In a roll call vote, all members present vote AYE.

EXCUSED:  1 - Westlund

099

Chair Kruse

The motion CARRIES.

100

Chair Kruse

Closes work session on HB 2124 and opens work session on HB 2126.

HB 2126 – WORK SESSION

103

Thiele-Cirka

Summarizes bill and -1 amendments dated 2/17/03 (EXHIBIT C) and -2 amendments dated 3/4/03 (EXHIBIT D). Notes conceptual amendments.

130

Chair Kruse

Notes subsequent referral.

134

Rep. Monnes Anderson

Submits vote explanation.

146

Chair Kruse

Speaks to -2 amendment regarding Head Start. Speaks to -1 amendment regarding funding. Speaks to removal of emergency clause and addition of effective date.  

 

Rep. Barker

MOTION:   Moves to ADOPT HB 2126-1 amendments dated 2/17/03.

186

 

VOTE:          6-0-1

EXCUSED:  1 - Westlund

187

Chair Kruse

Hearing no objection, declares the motion CARRIED.

188

Rep. Barker

MOTION:  Moves to ADOPT HB 2126-2 amendments dated 3/4/03.

189

 

VOTE:          6-0-1

EXCUSED:  1 - Westlund

190

Chair Kruse

Hearing no objection, declares the motion CARRIED.

193

Rep. Barker

MOTION:  Moves to SUSPEND the rules for the purpose of consideration of conceptual amendments.

194

 

VOTE:          6-0-1

EXCUSED:  1 - Westlund

195

Chair Kruse

Hearing no objection, declares the motion CARRIED.

196

Rep. Barker

MOTION:  Moves to AMEND HB 2126 on page 4, line 29, after "programs," delete "funded with state alcohol and drug abuse funds," and on page 5, line 7, after "February 1," change "2005 to 2007," and on page 5, line 7, after "Seventy," change "third to fourth," and on page 5, line 9, delete "Section 7," and on page 5, line 9, insert "This 2003 Act takes effect July 1, 2005. ".

210

Rep. Anderson

Inquires on Head Start.

212

Chair Kruse

Clarifies Head Start is removed with -2 amendments.

217

 

VOTE:          6-0-1

EXCUSED:  1 - Westlund

218

Chair

Hearing no objection, declares the motion CARRIED.

219

Rep. Barker

MOTION:  Moves HB 2126 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means by prior reference.

224

Rep. Tomei

Provides vote explanation.

227

Rep. Monnes Anderson

Comments on budget issues.

247

 

VOTE:            4-2-1

AYE:               4 - Anderson, Barker, Dalto, Kruse

NAY:               2 - Monnes Anderson, Tomei

EXCUSED:     1 - Westlund

251

Chair Kruse

The motion CARRIES.

232

Chair Kruse

Closes work session on HB 2126 and opens work session on HB 2240.

HB 2240 – WORK SESSION

254

Thiele-Cirka

Summarizes bill, the -1 amendments dated 3/11/03 (EXHIBIT E) and the -2 amendments dated 3/20/03 (EXHIBIT F). Submits written testimony from Jane Myers, representing the Oregon Dental Association (EXHIBIT G).

279

Rep. Anderson

Comments on -2 amendments.

301

Rep. Anderson

MOTION:  Moves to ADOPT HB 2240-2 amendments dated 3/20/03.

303

Rep. Monnes Anderson

Request Board testify relating to the rule.

305

Jo Ann Bones

Executive Director, Board of Dentistry. Addresses board’s ability to develop rule. Notes the board opposes the -1 amendments.

335

Rep. Monnes Anderson

Inquires on limited access settings.

342

Bones

States the need for statutory change. Explains request from Board of Dentistry.

361

Rep. Tomei

Inquires on relationship between Board of Dentistry and ODA.

363

Bones

Defines role of each agency.

317

Rep. Tomei

Questions the areas of concerns regarding the amendment.

391

Rep. Anderson

Speaks to issues between ODA and Board of Dentistry regarding dental quality and expanding role of hygienists.

429

Rep. Monnes Anderson

Discusses patient access issues.

465

Rep. Anderson

Discusses scope of authority over dental assistants.

TAPE 63, A

029

Bones

Explains roles of hygienists and assistants altered by amendments.

043

Rep. Anderson

Notes difference between office care and limited access practices. Comments on quality of care.

076

Bones

Explains hygienists can not have their own practice.

077

Rep. Anderson

Notes limited access permit practices.

080

Bones

Defines limited access dental practice.

087

Rep. Tomei

Questions the work performed by assistant under supervision of hygienist.

090

Bones

Explains duties performed by assistants.

113

Rep. Westlund

Questions the impact with and without -2 amendments.

118

Bones

Explains specifics of impact without amendments.

149

Rep. Dalto

Inquires on limited access situations as it relates to use of assistants by hygienists.

155

Bones

Explains hygienists may act as independent contractors.

202

Rep. Tomei

Questions the general supervision of dental assistants.

218

Bones

Explains language as it relates to supervision.

230

Rep. Anderson

Clarifies hygienists in regard to four-handed dentistry.

244

Chair Kruse

Speaks to patient management in limited access situations.

265

Rep. Barker

Comments on use of assistants in limited access settings.

300

 

VOTE:            3-4-0

AYE:               3 – Anderson, Dalto, Westlund

NAY:               4 - Barker, Monnes Anderson, Tomei, Kruse

301

Chair Kruse

The motion FAILS.

307

Chair Kruse

Orders committee to stand at ease.

Tape reflects silence during stand at ease.

325

Chair Kruse

Explains options regarding HB 2240.

342

Rep. Tomei

MOTION:  Moves HB 2240 to the floor with a DO PASS recommendation.

347

 

VOTE:         7-0-0

AYE:            In a roll call vote, all members present vote AYE.

355

Chair

The motion CARRIES.

MONNES ANDERSON will lead discussion on the floor.

360

Chair Kruse

Closes work session on HB 2240 and opens public hearing on HB 2018.

HB 2018 – PUBLIC HEARING

362

Thiele-Cirka

Summarizes bill.

381

Vern Saboe M.D.

President, Chiropractic Association of Oregon. Submits written testimony in support of bill (EXHIBIT H). Addresses three mechanisms by which insurance agencies restrict access.

TAPE 62, B

010

Saboe

Continues presentation on insurance mechanisms used to restrict access. Comments on SB 55, companion bill.

061

Rep. Westlund

Inquires on auto insurance and managed care systems.

064

Saboe

Explains use of passive managed care panels.

083

Rep. Barker

Questions review process

087

Saboe

Explains assessment process used by insurance companies.

094

Michael Freeman

Epidemiologist. Notes bills attempt to prevent restrictions on access to provider of choice. Discusses injuries as they related to managed care.

160

Rep. Dalto

Inquires on comment related to chiropractic care.

162

Freeman

Explains role and participation of chiropractors and restrictions in receiving care.

174

William Dallas

President, Western States Chiropractic College. Testifies in support of bill. Relates personal story relating to patient restrictions in accessing provider of choice. Notes personal background in insurance and flaws in insurance system.

264

Rep. Barker

Comments on use of independent medical exam. Suggests cooperative effort between providers.

283

Saboe

Notes proposed amendment language underway to address protections of insurance system and consumer. Suggests unbiased independent review.

296

Rep. Westlund

Inquires on managed care under current law relating to auto insurers.

305

Saboe

Reports managed care can not be imposed on consumer by auto insurers.

308

Rep. Westlund

Inquires on preferred provider options (PPO) for auto insurance.

313

Saboe

Addresses PPO as they relate to closed panel systems.

347

Freeman

Comments on managed care and patient access as they relate to reduced premiums. Notes cost shift to private sector.

374

Rep. Westlund

Comments on loss of commercial health insurance due to rising premium costs. Relates cost containment to Oregon health care crisis.

423

Rep. Dalto

Comments on PPO’s.

TAPE 63, B

004

Saboe

Explains PPO option as it relates to auto insurance premium savings.

038

Rep. Westlund

Comments on cost savings in regard to informed consumers. 

054

Freeman

Explains initial savings and options to opt out of coverage. Notes importance of cost controls in balance with consumer choice. 

083

John Powell

Representing State Farm Insurance. Notes advertising and rate filing is regulated in Oregon. Comments on current statute regarding coverage. Provides insurance premium data. Notes status of law if bill is passed.

140

Shawn Miller

National Association of Independent Insurance (NAII). Testifies in opposition to bill. Notes broad language regarding managed care. Notes containing costs would be illegal if bill passed. Reports bill is not in consumers’ best interest.  

194

Jack Barnes

Farmers Insurance. Testifies in opposition HB 2462.

198

Lana Butterfield

State Accident Insurance Fund Corporation (SAIFCO). Testifies in opposition to HB 2462.

209

Chair Kruse

Closes public hearing on HB 2018 and opens public hearing on HB 2462.

 

 

 

HB 2462 – PUBLIC HEARING

212

Thiele-Cirka

Summarizes bill. Submits written testimony form Senator Avel Gordly (EXHIBIT I).

219

Chair Kruse

Comments on related bills.

236

James Edge

Acting Assistant Administrator, Office of Medical Assistance Programs (OMAP), Health Services, Department of Human Services (DHS). Submits written testimony (EXHIBIT J). Reports on constitutionality of bill. Notes current documents required by Oregon Health Plan (OHP) applicants in an effort to meet current residency requirements.

289

Chair Kruse

Questions constitutional issue.

298

Edge

Defers to legislative counsel. Explains DHS position on bill based on constitution and federal regulations.

311

Chair Kruse

Notes citations (EXHIBIT I) refer to U.S. Constitution. Notes impression that requirements could be waived.

230

Rep. Westlund

Questions the state’s ability to better define and tighten up current residency requirements.

338

Edge

Remarks on possibilities of tightening residency requirements.

364

Rep. Barker

Inquires on resident requirements for OHP.

369

Edge

Identifies federal requirements.

283

Rep. Barker

Questions the quantity of residency abuses.

395

Edge

Reports abuses are not significant issue.

406

Rep. Tomei

Notes documents required to establish residency.

414

Edge

Explains consumers’ written statement as appropriate document.

429

Chair Kruse

Speaks to ability to waive requirements.

437

Rep. Anderson

Inquires on documents for other states health plan. 

457

Edge

Notes all states conform to federal regulations.

467

Chair Kruse

Comments on portability of Medicaid. Requests language from OMAP.

TAPE 64, A

041

Scott Taylor

Assistant Director, Oregon Department of Corrections. Submits written testimony including proposed amendment language (EXHIBIT K). Speaks to issues of former inmates accessing OHP after release. Suggests alternative forms of identification.

070

Chair Kruse

Explains intent in working with Department of Corrections.

078

Rep. Westlund

Inquires on Oregon Trail card.

080

Chair Kruse

Explains electronic food stamps. Closes public hearing on HB 2462 and adjourns meeting at 10:37 A.M.

 

EXHIBIT SUMMARY

 

A – HB 2124, -1 amendments, dated 3/20/03, Staff, 1p.

B – HB 2124, budget overview, Staff, 4 pp.

C – HB 2126, -1 amendments, dated 2/17/03, Staff, 1 p.

D – HB 2126, -2 amendments, dated 3/4/03, Staff, 1 p.

E – HB 2240, -1 amendments, dated 3/11/03, Staff, 1 p.

F – HB 2240, -2 amendments, dated 3/20/03, Staff, 1p.

G – HB 2240, written testimony, J, Myers, 10 pp.

H – HB 2018, written testimony, V. Saboe, 1 p.

I – HB 2462, written testimony, Senator A. Gordly, 3 pp.

J – HB 2462, written testimony, J. Edge, 2 pp.

K – HB 2462, written testimony, S. Taylor, 4 pp.