HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

April 07, 2003 Hearing Room D

8:30 A.M. Tapes 77 – 79

 

MEMBERS PRESENT:            Rep. Jeff Kruse, Chair

Rep. Billy Dalto, Vice-Chair

Rep. Carolyn Tomei, Vice-Chair

Rep. Gordon Anderson

Rep. Jeff Barker

Rep. Ben Westlund

 

MEMBER EXCUSED:             Rep. Laurie Monnes Anderson

 

STAFF PRESENT:                  Sandy Thiele-Cirka, Committee Administrator

Mara McGraw, Committee Assistant

 

MEASURES HEARD:                     HB 2943 – Public Hearing

                                                HB 2964 – Public Hearing

                                                HB 2970 – Public Hearing

                                                HB 3508 – Public Hearing

                                                HB 3122 – Public Hearing

                                                HB 3285 – Public Hearing

                                                HB 3394 – Public Hearing

                                                HB 3411 – 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 77, A

004

Chair Kruse

Calls meeting to order at 8:39 A.M. and opens public hearing on HB 2943.

HB 2943 – PUBLIC HEARING

009

Chair Kruse

Introduces bill.

019

Sandy Thiele-Cirka

Administrator. Summarizes bill. Submits executive summary of similar program (EXHIBIT A).

025

Duane Meissner

Constituent. Submits written testimony in support of bill (EXHIBIT B). Suggests amendment language to include psychotropic drugs for mentally illnesses. Relates personal experience with prescription drugs pricing.

103

Rep. Betsy Johnson

House District 31. Testifies in support of HB 2943. Supports addition of 25 most commonly used psychotropic drugs. 

116

Rep. Alan Bates

House District 5. Testifies in support of HB 2943. Presents history of bill. Reviews pricing policy. Suggests website to offer competitive price information.

146

Chair Kruse

Inquires on amendment strategies.

150

Rep. Bates

Proposes amendment language.

156

Chair Kruse

Closes public hearing on HB 2943 and opens public hearing on HB 2964.

HB 2964 – PUBLIC HEARING

162

Rep. Bates

Discusses impediment to low income dental practices. Presents history of bill and summarizes specific aspects of dental practice ownership.

203

Chair Kruse

Inquires on percent ownership for medical practices.

206

Rep. Bates

Reports no ceiling on ownership.

208

Chair Kruse

Inquires on quality of care.

210

Rep. Bates

Notes high quality of care. Comments on military model of ownership policies.

219

Rep. Tomei

Questions Kaiser dental practices.

222

Rep. Bates

Reports methods of practice for Kaiser dentists.

237

Chair Kruse

Closes public hearing on HB 2964 and opens public hearing on HB 2943.

HB 2943 – PUBLIC HEARING

249

Jim Gardner

Pharmaceutical Research Manufacturers of America (PhRMA). Submits internet information on pricing (EXHIBIT C). Relates intent of bill. Speaks to PhRMA’s efforts to increase access to patient assistance programs. Comments on price competition for generic drugs.

319

Rep. Tomei

Questions increased access for patient assistance programs.

320

Gardner

Explains tools used to increase access.

331

Rep. Anderson

Questions drug distribution through physician offices.

339

Gardner

Explains policy.

352

Tom Holt

Representing Oregon State Pharmacists Association. Testifies in opposition to bill. Explains pharmacy perspective on pricing and profit margins. Conveys cost is determined by supply, retailers and manufacturers. Notes price shopping impacts patient-pharmacists relationship and quality of care for uninsured patients. Offers amendment language.  

439

Chair Kruse

Questions price variations between wholesale companies.

457

Holt

Responds that Costco attempts to drive business with loss leaders and their use of wholesale purchasing power.

471

Chair Kruse

Comments on price variations.

TAPE 78, A

014

Rep. Anderson

Questions large operations trade techniques.

022

Holt

Relates differences between small and large pharmacy operations.

031

Rep. Anderson

Questions effectiveness of purchasing pools.

041

Holt

Comments on impact of pool purchasing on pharmacies.

051

Rep. Westlund

Questions current buying consortiums by independent pharmacies.

056

Holt

Reports data on buying groups. Notes class of trade determines wholesale cost.

067

Rep. Barker

Inquires on pricing restrictions outside of Veterans Administration and Indian Health.

074

Holt

Explains policy on trade classes and subsequent pricing structure. Explains buying group membership.

084

Rep. Dalto

Inquires on wholesale companies.

085

Holt

Lists wholesale companies in Oregon.

091

Chair Kruse

States intent regarding bill. Comments on status on bill. Chair closes public hearing on HB 2943 and opens public hearing on HB 2970.

HB 2970 – PUBLIC HEARING

119

Thiele-Cirka

Summarizes bill.

132

Joy Soares

Safety Net Access Developer, CareOregon. Submits booklet on primary care services (EXHIBIT D). Offers history of safety net clinics, programs and policies. Speaks to clinic capacity and impact of budget reductions.

177

Paul Logan

Executive Director, North West Human Services, Salem. Speaks to challenges in staffing safety-net clinics. Note impact of budget reductions and failure of Measure 28. States many costs are not reimbursed.

248

Tina Kotek

Children First for Oregon. Submits written testimony in support of bill (EXHIBIT E). Relates services provided by and impact of school-based health centers. Comments on need for core funding for school-based health centers.

299

Rep. Anderson

Inquires on local school-based health center in Illinois Valley.

304

Kotek

Identifies clinic.

312

Vice-Chair Dalto

Closes public hearing on HB 2970 and opens public hearing on HB 2964.

HB 2964 – PUBLIC HEARING

317

Thiele-Cirka

Summarizes bill and -1 amendment dated 4/3/03 (EXHIBIT F). 

337

Steven Duffin

Dentist and President, Capitol Dental Care. Testifies in support of bill. Notes bill makes dentistry ownership consistent with other medical professions. Comments on quality of care.

367

Mike Shirtcliff

Dentist and President/CEO of Northwest Dental Service and Advantage Dental. Testifies in support of bill. Presents history on bill and dentistry ownership. Comments on rural dentistry.

450

Shirtcliff

Continues presentation on bill. Speaks to Attorney General opinion regarding minority ownership.

TAPE 77, B

033

Rep. Tomei

Questions the tax break for dentistry ownership.

035

Shirtcliff

Speaks to corporate classes and subsequent tax structures for each class.

038

Rep. Tomei

Questions the infused capital.

047

Shirtcliff

Comments on current tax laws.

058

Rep. Tomei

Requests elaboration on incorporation.

060

Shirtcliff

Explains minority ownership by non-dentist.

064

Barney Speight

Government Relations, Kaiser Permanente. Testifies in support of bill. Presents history on bill. Discusses ownership and management of dentistry practices. Speaks to lack of consensus on bill.

137

Rep. Tomei

Clarifies dental school and North West Medical Team compliance with law.

140

Speight

Explains educational aspects of programs which exempt them from law. Notes community health clinics operating dental clinics would not be in compliance with Attorney General’s decision. Notes bill will clarify assets and ownership.

162

Rep. Tomei

Questions the impact of amendments regarding compliance.

164

Speight

Responds and identifies issues relating to minority ownership of dental practices by non-dentists.

181

Rep. Anderson

Inquires on possible Board of Dentistry rule changes.

186

Shirtcliff

Discusses ability of board to enact rules related to ownership.

199

Speight

Speaks to Attorney General opinion as it relates to Board of Dentistry ability to enact rules on minority ownership.

208

Rep. Anderson

Requests additional clarification relating to the Board of Dentistry.

212

Speight

Notes previous board flexibility and current Attorney General decision.

226

Rep. Anderson

Inquires on positional difference between Kaiser and North West Medical Teams.

232

Speight

Speaks to model in which assets, management and employment of non-dentists in dental practice is managed by outside agent.

257

Rep. Barker

Notes previous Oregon Dental Association (ODA) support. Inquires on reason for change in support.

265

Duffin

Defers to ODA.

276

Jay Wylan

Peritonitis and Chairman, Government Relations Council, Oregon Dental Association (ODA). Testifies in opposition to specific section of bill. Submits written testimony on behalf of Joset Lubisich (EXHIBIT G). Speaks to impact of corporate ownership.

390

Rep. Westlund

Questions the managed care component.

410

Wylan

Speaks to quality of care.

419

Rep. Westlund

Comments on percent of Oregon Health Plan (OHP) patients seen by dentists.

430

Rep. Anderson

Inquires on differences between dentistry and medical practices.

449

Wylan

Concurs that small practices are more susceptible to influence. Comments on funding issues.

TAPE 78, B

005

Jane Myers

Oregon Dental Association (ODA). Testifies in opposition to bill (EXHIBIT H). Addresses ODA change in support for bill. Notes ODA supports bill without clause regarding non-dentist ownership. Explains concerns over non-dentist ownership. Relates national examples of impact on practices owned by non-dentists. Explains claims collections and contractual agreements. 

117

Rep. Barker

Inquires on capital infusion to rural dentistry. Questions ODA’s opposition.

131

Myer

Explains current capital models available.

181

Ronald Short

Dentists and President, Board of Dentistry. Submits written testimony in support of bill (EXHIBIT I). Notes board supports the -1 amendment. Discusses minority ownership of dental practices.

247

Rep. Tomei

Questions board membership.

252

Short

Explains membership.

258

Doug Barber

Willamette Dental Group. Testifies in support of bill and -1 amendment. Introduces next witness.

267

Gene Skourtes

President, Willamette Dental Group. Submits written testimony in support of bill (EXHIBIT J). Speaks to impact of non-dentist ownership. Notes low profit margins.

319

Chair Kruse

Closes public hearing on HB 2964 and opens public hearing on HB 3508.

HB 3508 – PUBLIC HEARING

323

Thiele-Cirka

Summarizes bill.

341

Gail Shibley

Administrator, Office of Pubic Health Services, Department of Human Services (DHS). Submits written testimony in opposition to bill (EXHIBIT K). Explains operation and regulation of radiation services. Speaks to impact of bill on training for dental radiology.

429

Beryl Flutcher

Director of Professional Affairs, ODA. Testifies in support of bill. Provides summary of bill.

TAPE 79, A

005

Flutcher

Continues presentation. Speaks to issues related to classroom and other training provisions. Addresses over-regulation issues.

056

Myer

Submits written testimony in support of bill (EXHIBIT L). Notes need for statute.

064

Rep. Anderson

Inquires on fiscal impact.

067

Flutcher

Notes decreased need for staff time by DHS. States bill changes training requirements only.

075

Rep. Anderson

Inquires on differences between dentistry and other medical practices regarding radiation levels.

078

Flutcher

Reports radiation levels and restrictions on radiology operation.

090

Rep. Tomei

Inquires on radiation comparison for other medical procedures.

096

Rep. Anderson

Explains radiation levels for dentistry.

101

Chair Kruse

Closes public hearing on HB 3508.

HB 3122 – PUBLIC HEARING

106

Chair Kruse

Opens public hearing on HB 3122 and closes public hearing on HB 3122.

HB 3285 – PUBLIC HEARING

108

Chair Kruse

Opens public hearing on HB 3285 and closes public hearing on HB 3285.

HB 3394 – PUBLIC HEARING

109

Chair Kruse

Opens public hearing of HB 3394 and closes public hearing on HB 3394.

HB 3411 – PUBLIC HEARING

111

Chair Kruse

Opens public hearing on HB 3411 and closes public hearing on HB 3411. Adjourns meeting at 10:45 A.M.

 

EXHIBIT SUMMARY

 

A – HB 2943, Executive Summary, staff, 6 pp.

B – HB 2942, written testimony, Duane Meissner, 1 p.

C – HB 2943, written testimony, Jim Gardner, 10 pp.

D – HB 2970, A Guide to Eliminate Gaps in Access to Primary Care Services, Joy Soares, 72 pp.

E – HB 2970, written testimony, Tina Kotek, 2 pp.

F – HB 2964, -1 amendments, dated 4/3/03, staff, 1 p.

G – HB 2964, written testimony, Joset Lubisich, 1 p.

H – HB 2964, written testimony, Jane Myer, 14 pp.

I – HB 2964, written testimony, Ronald Short, 2 pp.

J – HB 2964, written testimony, Gene Skourtes, 1 p.

K – HB 3508, written testimony, Gail Shibley, 2 pp.

L – HB 3508, written testimony, Jane Myer, 8 pp.