HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

April 18, 2003 Hearing Room D

8:30 A.M. Tapes  93 – 94

 

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:                          HB 2120 – Work Session

                                                HB 2165 – Work Session

                                                HB 3394 – Work Session

                                                HB 2251 – Work Session

                                                HB 2609 – Work Session

                                                HB 3378 – Work Session

                                                HB 2943 – Work Session

                                                HB 3411 – Work Session

 

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 93, A

005

Chair Kruse

Calls meeting to order at 8:45 A.M. and opens work session HB 2120.

HB 2120 – WORK SESSION

011

Janet Carlson

Marion County Commissioner. Submits written testimony in support of bill (EXHIBIT A). Presents -5 amendments, dated 4/17/03 (EXHIBIT B). Discusses Comprehensive Plan (EXHIBITC) and Service Plan (EXHIBIT D). Details findings and efforts of workgroup. 

150

Gordon Fultz

Association of Oregon Counties. Submits written testimony on behalf of local partners (EXHIBIT E). Discusses local concerns related to service plans and coordinated plans. Notes interest in coordinating a birth to death plan.

220

Sue Nelson

Deputy, Health Services, Department of Human Services (DHS). Notes language in -5 amendments may not address DHS concerns regarding disapproval and approval process.

241

Chair Kruse

States intent regarding bill. Closes work session on HB 2120 and opens work session on HB 2165.

HB 2165 – WORK SESSION

274

Sandy Thiele-Cirka

Administrator. Summarizes bill and -2 amendments, dated 4/16/03 (EXHIBIT F).

294

Kathleen Haley

Executive Director, Board of Medical Examiners (BME). Notes Board intent regarding bill. Notes conceptual agreement between interested parties.

312

Bruce Bishop

Hospital Association. Notes further amendments are in draft.

323

Chair Kruse

Inquires on consensus on proposed amendments.

326

Scott Gallant

Oregon Medical Association (OMA). Reports agreement of interested parties pending amendments are drafted correctly. Notes potential conflict in draft amendments.

352

Rep. Monnes Anderson

Inquires on process issue.

357

Chair Kruse

Clarifies need for new amendments. Closes work session on HB 2165 and opens work session on HB 3394.

HB 3394 – WORK SESSION

370

Thiele-Cirka

Summarizes bill, -1 amendments, dated 4/15/03 (EXHIBIT G), -2 amendments, dated 4/18/03 (EXHIBIT H) and -3 amendments, dated 4/18/03 (EXHIBIT I).

408

Rep. Alan Bates

House District 5. Summarizes changes to bill. Notes importance of personal injury protection (PIP) funding.

426

John Powell

State Farm Insurance Companies. Discusses support for -2 amendments.

450

Rep. Bates

Accepts -2 amendments. Agrees to forgo -3 amendments.

455

Chair Kruse

Addresses differences between amendments.

464

Rep. Tomei

Inquires on fiscal impact.

470

Rep. Bates

Reports bill with -2 amendments has no fiscal impact.

471

Chair Kruse

Notes fiscal will be rescinded.

478

Rep. Barker

MOTION:  Moves to ADOPT HB 3394-2 amendments dated 4/18//03.

480

 

VOTE:  5-0-2

EXCUSED:  2 - Anderson, Westlund

481

Chair Kruse

Hearing no objection, declares the motion CARRIED.

483

Rep. Barker

MOTION:  Moves HB 3394 to the floor with a DO PASS AS AMENDED recommendation and the SUBSEQUENT REFERRAL to the committee on Ways and Means BE RESCINDED.

492

 

VOTE:  5-0-2

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

EXCUSED:  2 - Anderson, Westlund

500

Chair Kruse

The motion CARRIES.

REP. BATES will lead discussion on the floor.

511

Chair Kruse

Closes work session on HB 3394 and opens work session on HB 2251

TAPE 94, A

HB 2251 – WORK SESSION

033

Thiele-Cirka

Summarizes bill and -1 amendments, dated 4/16/03 (EXHIBIT J).

045

Grant Higginson

State Public Health Officer, DHS. Offers overview of bill. Notes need to limit authority to serious health crisis. Discusses efforts of work group. Reports minor changes needed in amendments.

074

Chair Kruse

Closes work session on HB 2251 and opens work session on HB 2609.

HB 2609 – WORK SESSION

087

Jim Gardner

Pharmaceutical Researchers and Manufacturers of America (PhRMA). Submits SB 819 (EXHIBIT K). Addresses issues related to carve out provisions. Discusses preferred drug lists and physician charter of freedom. Comments on intent of SB 819.  

196

Rep Tomei

Inquires on specific section of SB 819.

203

Gardner

Discusses formulary used to create preferred drug list.

223

Thiele-Cirka

Submits written testimony on behalf of Governors office (EXHIBIT L).

226

Bruce Goldberg

Administrator, Office of Health Policy and Research. Discusses preclusion of cost effective drugs. Suggests legislature neither expand nor contract priority drug list.

271

Chair Kruse

Inquires on clinical differences between drugs.

283

Goldberg

Explains determination on differences between drugs.

299

Chair Kruse

Inquires on ability for physician to make the call on prescribing drugs.

302

Goldberg

Discusses public policy as it relates to cost.

319

Jim Edge

Acting Assistant Administrator, Office of Medical Assistance Programs (OMAP). Addresses exclusion of specific drugs on preferred drug list.

336

Rep. Tomei

Inquires on exclusion process.

338

Edge

Details the SB 819 mandate regarding exclusion of specific drugs from consideration on the priority list.

344

Rep. Tomei

Inquires on percent excluded.

347

Edge

Discusses carve-out drugs from managed care. Notes increase in expenditure exclusions via bill. Expresses DHS concern over cost savings.

391

David Pollock

Medical Director, Office of Mental Health and Addictions Services, DHS. Discusses efforts of stakeholder group. Notes conflicting policies and management interventions. Comments on drug effectiveness. Addresses issues related to cost savings and restrictions of bill.

TAPE 93, B

019

Tom Holt

Oregon State Pharmacists Association. Submits written testimony in opposition to bill (EXHIBIT M). Discusses federal guidelines regarding prescribing generic versus brand drugs for Medicaid/Medicare. Comments on Federal Drug Administration (FDA) policy regarding drug differences.

056

Rep. Westlund

Inquires on superior versus equivalent drugs.

066

Holt

Reports on scale used to rate drugs. Notes generic drugs are not intended to be superior but replicas that are more cost effective.

081

Rep. Westlund

Inquires on page and line number of citation.

082

Holt

Reports information.

088

Rep. Tomei

Requests clarification on superior status for preferred drug lists.

093

Holt

Clarifies generic drugs are disallowed on list due to equivalent not superior status.

097

Rep. Tomei

Inquires on requirements for preferred drugs.

100

Holt

Explains implication of policy as bill is written.

105

Rep. Tomei

Illustrates cost differences.

108

Holt

Concurs with example and presents other examples of cost differentials between generic and brand.

122

Pam Harkins

Associate State Director, American Association of Retired Persons (AARP). Submits written testimony in opposition to bill (EXHIBIT N). Presents examples of impact of drug cost on seniors.

160

Chair Kruse

Submits written testimony from ALO-CIO (EXHIBIT O) and orders committee to stand at ease. Reconvenes and announces language conflicts in bill. Closes work session on HB 2609 and opens work session HB 3378.

HB 3378 – WORK SESSION

182

Thiele-Cirka

Summarizes bill. Submits written testimony from Department of Consumer and Business Services (EXHIBIT P).

206

Joel Ario

Insurance Administrator, Department of Business and Consumer Services. Reports department can mandate plan. Notes specific concerns over language in bill.

253

Chair Kruse

Presents scenario on mandates. Comments on discretionary aspect of fund.

265

Ario

Requests mandate remain in section three. Reports employee choice. Notes discretion of employee regarding mandates and deductible as separate issues. Discusses benefit structure and emphasizes mandates should be applied evenly.

311

Chair Kruse

Comments on defined contribution plans. Addresses assumptions under high deductibles.

325

Ario

Clarifies high deductibles as they relate to benefit structures.  Presents alternative scenarios. Restates department position on mandates.

365

Chair Kruse

Inquires on ability of employee to purchase individual supplemental insurance.

374

Ario

Notes current law prohibits such purchase but bill allows purchase of individual plans. Reports on group purchase of individual plans. Notes disparity when individual purchase is allowed in group market. Comments on provisions that can be made in legislation.

TAPE 94, B

001

Craig Urbane

Oregon Medical Insurance Pool (OMIP). Submits written testimony on behalf of Rocky King (EXHIBIT Q). Details several concerns. Notes difference between OMIP and employer markets. Comments on impact of individual coverage clause on OMIP.

035

Chair Kruse

Inquires on bill as it compares to Family Health Insurance Assistance Program (FHIAP).

039

Urbane

Notes mandates are below benchmark OMIP can use to subsidize.

044

Chair Kruse

Closes work session on HB 3378 and opens work session on HB 2943.

HB 2943 – WORK SESSION

061

Thiele-Cirka

Summarizes bill and -1 amendments, dated 4/16/03 (EXHIBIT R).

061

Gardner

Discusses changes made by amendments. Notes bill sponsor approves amendments.

086

Rep. Tomei

MOTION:  Moves to ADOPT HB 2943-1 amendments dated 4/16/03.

089

Rep. Monnes Anderson

Comments on legislative involvement with drug priority lists.

099

 

VOTE:  5-1-1

AYE:               5 - Anderson, Barker, Dalto, Tomei, Kruse

NAY:               1 - Monnes Anderson

EXCUSED:     1 - Westlund

100

Chair Kruse

The motion CARRIES.

101

Rep. Tomei

Inquires on workgroup membership.

104

Gardner

Details workgroup membership.

111

Rep. Tomei

MOTION:  Moves HB 2943 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means.

119

 

VOTE:  6-0-1

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

EXCUSED:  1 - Westlund

122

Chair Kruse

The motion CARRIES.

126

Chair Kruse

Closes work session on HB 2943 and opens work session on HB 3411.

HB 3411 – WORK SESSION

128

Thiele-Cirka

Summarizes bill and -1 amendment, dated 4/17/03 (EXHIBIT S).

147

Rep. Jeff Merkley

House District 47. Provides overview of bill. Presents data on early childhood care. Discusses proposed conceptual changes in -1 amendments regarding fiscal impact. Relates intent of bill.

199

Rep. Monnes Anderson

Expresses concern over abuses of policy.

211

Rep. Tomei

Inquires on section of proposed -2 amendments, dated 4/17/03 (EXHIBIT T) eliminated from -1 amendments.

217

Rep. Merkley

Clarifies intent of policy.

231

Michael Buckley

Acting Administrator, Self-Sufficiency Program, DHS. Explains employment exemptions under Temporary Assistance to Needy Families (TANF). Notes child development and parenting classes required during exemption period.

258

Tamara Brickman

Employment Department. Clarifies intent of bill and amendments.

272

Rep. Monnes Anderson

Restates question on abuses.

283

Rep. Merkley

Speaks to TANF regulation regarding child care stipend.

297

Buckley

Speaks to employment department regulation regarding child care stipend.

309

Rep. Merkley

Notes impact of waiver on parents who choose to remain home for extended period.

317

Buckley

Notes funding requirement.

326

Rep. Monnes Anderson

Notes funds are federal block grants.

335

Rep. Tomei

MOTION:  Moves to ADOPT HB 3411-1 amendments dated 4/17/03.

338

 

VOTE:  6-0-1

EXCUSED:  1 - Westlund

339

Chair Kruse

Hearing no objection, declares the motion CARRIED.

340

Rep. Kruse

MOTION:  Moves to SUSPEND the rules for the purpose of conceptually amending the -1 amendment to HB 3411.

342

 

VOTE:  6-0-1

EXCUSED:  1 - Westlund

343

Chair Kruse

Hearing no objection, declares the motion CARRIED.

344

Rep. Kruse

MOTION:  Moves to ADOPT HB 3411-1 amendments dated 4/17/03 and that the measure be FURTHER AMENDED on page 2, line 23, by deleting lines 23 through 26 after line 23 text "section 1 of this 2003 Act."

352

 

VOTE:  6-0-1

EXCUSED:  1 - Westlund

354

Chair Kruse

Hearing no objection, declares the motion CARRIED.

356

Rep. Tomei

MOTION:  Moves HB 3411 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means by prior reference.

366

Rep. Merkley

Speaks to intent regarding fiscal impact.

376

Buckley

Reports funding as it relates to General Fund. Explains current exemption policy.

402

Chair Kruse

Notes funding limitation requires approval by Ways and Means.

430

 

VOTE:  6-0-1

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

EXCUSED:  1 - Westlund

435

Chair Kruse

The motion CARRIES.

437

Chair Kruse

Closes work session on HB 3411 and adjourns meeting at 10:39 A.M.

                       

EXHIBIT SUMMARY

 

A – HB 2120, written testimony, Janet Carlson, 2 pp.

B – HB 2120, -5 amendments, dated 4/17/03. staff, 21 pp.

C – HB 2120, Comprehensive Plan, Janet Carlson, 34 pp.

D – HB 2120, Service Plan, Janet Carlson, 14 pp.

E – HB 2120, written testimony, Gordon Fultz, 3 pp.

F – HB 2165, -2 amendments, dated 4/16/03, staff, 2 pp.

G – HB 3394, -1 amendments, dated 4/15/03, staff, 1 p.

H – HB 3394, -2 amendments, dated 4/18/03, staff, 1 p.

I – HB 3394, -3 amendments, dated 4/18/03, staff, 1 p.

J – HB 2251, -1 amendments, dated 4/16/03, staff, 31 pp.

K – HB 2609, SB 819, Jim Gardner, 6 pp.

L – HB 2609, written testimony, Erin Kelley-Siel, 2 pp.

M – HB 2609, written testimony, Tom Holt, 7 pp.

N – HB 2609, written testimony, Pam Harkins, 2 pp.

O – HB 2609, written testimony, Lynn-Marie Crider, 2 pp.

P – HB 3378, written testimony, Joel Ario, 1 p.

Q – HB 3378, written testimony, Rocky King, 2 pp.

R – HB 2942, -1 amendments, dated 4/16/03, staff, 1 p.

S – HB 3411, -1 amendments, dated 4/17/03, staff 3 pp.

T – HB 3411, -2 amendments, dated 4/17/03, staff, 6 pp.