HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

April 28, 2003 Hearing Room D

8:30 A.M. Tapes  97 – 98

 

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 2120 – Work Session

                                                HB 2165 – Work Session

                                                HB 2609 – Work Session

                                                HB 2828 – Work Session

                                                HB 3574 – Work Session

                                                SB 878 – Public Hearing and Work Session

                                                SB 74A – Public Hearing

                                                SB 192 – Public Hearing and 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 97, A

004

Chair Kruse

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

HB 2120 – WORK SESSION

008

Sandy Thiele-Cirka

Administrator. Summarizes bill and -6 amendments dated 4/23/03 (EXHIBIT A).

031

Gordon Fultz

Association of Oregon Counties. Speaks to and supports resolutions made by -6 amendments.

046

Donna Middleton

Director, Oregon Commission on Children and Families. Notes joint participation with public health and mental health. Supports -6 amendments.

056

Janet Carlson

Marion County Commissioner. Notes statue codifies current joint approval processes. Supports -6 amendments.

069

Rep. Tomei

MOTION:  Moves to ADOPT HB 2120-6 amendments dated 4/23/03.

070

 

VOTE:  6-0-1

EXCUSED:  1 - Monnes Anderson

071

Chair Kruse

Hearing no objection, declares the motion CARRIED.

072

Rep. Tomei

MOTION:  Moves HB 2120 to the floor with a DO PASS AS AMENDED recommendation and be placed on the CONSENT CALENDAR.

075

 

VOTE:  6-0-1

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

EXCUSED:  1 - Monnes Anderson

085

Chair Kruse

The motion CARRIES.

090

Chair Kruse

Closes work session on HB 2120 and opens work session on HB 2165.

HB 2165 – WORK SESSION

092

Thiele-Cirka

Summarizes bill and -3 amendments dated 4/25/03 (EXHIBIT B).

112

Rep. Tomei

MOTION:  Moves to ADOPT HB 2165-3 amendments dated 4/25/03.

113

 

VOTE:  6-0-1

EXCUSED:  1 - Monnes Anderson

114

Chair Kruse

Hearing no objection, declares the motion CARRIED.

115

Rep. Tomei

MOTION:  Moves HB 2165 to the floor with a DO PASS AS AMENDED recommendation and be placed on the CONSENT CALENDAR.

123

 

VOTE:  6-0-1

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

EXCUSED:  1 - Monnes Anderson

130

Chair Kruse

The motion CARRIES.

131

Chair Kruse

Closes work session on HB 2165 and announces HB 2251 will not be heard. Opens work session on HB 2609.

HB 2609 – WORK SESSION

140

Thiele-Cirka

Summarizes bill and -1 amendments, dated 4/23/03 (EXHIBIT C) and  -2 amendments, dated 4/25/03 (EXHIBIT D).

165

Jim Gardner

Pharmaceutical Researchers and Manufacturers of America (PhRMA). Discusses changes created by -1 amendments. Addresses issue of evidentiary determination of drug quality.

208

Bruce Goldberg

Administrator, Office of Health Policy. Notes bill denies state authority to approve drugs based on price. Comments on fiscal responsibility of state. Suggests language to further amend -1 amendments. 

231

Marsha Keith

MERCK Company. Discuses inserting word “nausea” via -2 amendments.

245

Gardner

Clarifies language in lines 15 through 17 of -1 amendments (EXHIBIT C).

266

Chair Kruse

Inquires on opposition to bill.

273

Goldberg

Comments on language regarding absence of evidence as it applies to drugs outside of mental health, HIV and cancer.

284

Rep. Tomei

Inquires on possible changes to address concerns.

287

Goldberg

Suggests changes to bill and amendments.

292

Rep. Anderson

Inquires on managed care as it provides greater discretion.

298

Goldberg

Comments on fully capitated health plans and future of health care.

312

Chair Kruse

Notes suggests changes forgoes research regarding evidentiary selection.

323

Goldberg

Comments on evidence available to state for review.

333

Chair Kruse

Comments on previous legislation regarding prescription drugs.

353

Goldberg

Notes differences between prior authorization and preferred drug lists. Notes use of management tools in absence of evidence.

386

Chair Kruse

Discusses evidence as it relates to physician choice.

403

Goldberg

Concurs with use of cost as determents when evidence of superior quality is absent.

417

Gardner

Addresses issue of legislative intent regarding evidentiary standard. Submits written testimony (EXHIBIT E).

457

Rep. Anderson

Inquires on availability of evidence.

464

Gardner

Discusses available evidence regarding clinical effectiveness.

493

Rep. Anderson

Inquires on balance between effectiveness and cost.

TAPE 98, A

024

Gardner

Discusses clinical effectiveness by class.

038

Rep. Tomei

Inquires on addition of nausea.

042

Keith

Notes nausea is as common a side effect as others currently  listed.

052

Rep. Westlund

Notes broad scope of side effects in regard to expanding list.

074

Chair Kruse

Orders committee to stand at ease. Reconvenes meeting.

090

Rep. Westlund

MOTION:  Moves to ADOPT HB 2609-1 amendments dated 4/23/03.

094

Rep. Dalto

Notes position of Pharmacists Association.

099

 

VOTE:  5-1-1

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

NAY:               1 - Tomei

EXCUSED:     1 - Monnes Anderson

100

Chair Kruse

The motion CARRIES.

102

Rep. Westlund

MOTION:  Moves HB 2609 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means by prior reference.

105

Rep. Tomei

Notes current fiscal impact of bill to state.

123

 

VOTE:  5-1-1

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

NAY:               1 - Tomei

EXCUSED:     1 - Monnes Anderson

128

Chair Kruse

The motion CARRIES.

129

Chair Kruse

Closes work session on HB 2609 and opens work session on HB 2828.

HB 2828 – WORK SESSION

138

Martin Taylor

Oregon Nurses Association. Explains bill. Notes other amendments. Submits and summarizes  -4 amendments, dated 4/25/03 (EXHIBIT F). Supports bill.

192

J. L. Wilson

Co-Chair, Management Labor Advisory Committee (MLAC). Notes organizations history, structure and decision making process. Comments on previous workers compensation reforms. Testifies in opposition to bill.

259

Rep. Tomei

Requests information on specific issues of objection.

263

Wilson

Addresses maintaining integrity of 1990 agreements.

276

Rep. Dalto

Clarifies objection relates to MLAC process not Nurse Practitioners.

279

Wilson

Notes bill overturns 1990 reforms. Comments on setting precedent which opens door to other professions.

312

Rep. Tomei

Inquires on members of MLAC in opposition.

314

Wilson

Explains decision.

329

Chair Kruse

States concerns.

337

Rep. Tomei

MOTION:  Moves to ADOPT HB 2828-4 amendments dated 4/25/03.

340

Rep. Tomei

Comments on need for changes in health care.

349

 

VOTE:  6-0-2

EXCUSED:  1 - Monnes Anderson, Westlund

350

Chair Kruse

Hearing no objection, declares the motion CARRIED.

363

Rep. Tomei

MOTION:  Moves HB 2828 to the floor with a DO PASS AS AMENDED recommendation.

357

Rep. Dalto

Comments on MLAC objections.

365

Chair Kruse

Comments on workers compensation system.

375

Rep. Anderson

Explains concerns regarding 30 day time limit.

396

 

VOTE:  4-1-2

AYE:               4 - Barker, Dalto, Tomei, Kruse

NAY:               1 - Anderson

EXCUSED:     2 - Monnes Anderson, Westlund

402

Chair Kruse

The motion CARRIES.

MONNES ANDERSON will lead discussion on the floor.

413

Chair Kruse

Closes work session on HB 2828 and opens work session on HB 3574.

HB 3574 – WORK SESSION

420

Thiele-Cirka

Summarizes bill and -2 amendments, dated 4/23/03 (EXHIBIT G). Notes lack of fiscal prevents rescind of referral.

467

Chair Kruse

Closes work session on HB 3574 and opens public hearing on SB 878.

TAPE 97, B

SB 878 – PUBLIC HEARING

025

Modesto Jimenez

Member, Klamath Tribe, representing Klamath Indian Health. Submits written testimony in support of bill.(EXHIBIT H). Notes impact of budget cuts.

047

Jim Edge

Acting Assistant Administrator, Office of Medical Assistance Programs (OMAP), Department of Human Services (DHS). Submits written testimony in supports of bill (EXHIBIT I). Details DHS involvement in Indian health issues. Notes no fiscal impact to state as funding is federal.

057

Rep. Anderson

Inquires on percent of Native Americans eligible for Oregon Health Plan (OHP).

062

Edge

Presents data.

075

Chair Kruse

Speaks to tribal benefits from Casinos.

100

Verne Buerner

Administrative Officer, Northwest Portland Indian Health Board. Submits written testimony in support of bill (EXHIBIT J). Presents history of bill and overview of Indian health issues.

131

Jackie Murcer

Executive Director, Native American Rehabilitation Association (NARA). Testifies in support of bill. Presents overview of agency and Indian health disparity.  

148

Rep. Anderson

Inquires on population served.

151

Murcer

Explains tribal membership and communities served.

155

Chair Kruse

Closes public hearing on SB 878 and opens work session on SB 878.

SB 878 – WORK SESSION

157

Rep. Tomei

MOTION:  Moves SB 878 to the floor with a DO PASS recommendation and be placed on the CONSENT CALENDAR.

161

 

VOTE:  5-0-2

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

EXCUSED:  2 - Dalto, Monnes Anderson

167

Chair Kruse

The motion CARRIES.

168

Chair Kruse

Closes work session on SB 878 and opens public hearing on SB 74A.

SB 74A – PUBLIC HEARING

172

Thiele-Cirka

Summaries bill.

186

Senate President  Peter Courtney

Senate President, Senate District 11. Submits written testimony in support of bill.(EXHIBIT K). Presents overview of disease and history of bill.

235

Tim Kelsh

Constituent. Submits written testimony in support of bill (EXHIBIT L). Relates personal experience with insurance coverage for daughters disease.

303

Katie Kelsh

Phenylketonuia (PKU) patient. Submits written testimony in support of bill (EXHIBIT M). Relates personal experience with disease.

340

Rep. Tomei

Inquires on medical diet.

343

Katie Kelsh

Reports dietary restrictions and formula used.

387

Tim Kelsh

Notes consequences of disease.

416

Michael Skeels, Ph. D.

Administrator, Health Services, Office of Oregon State Public Health Labs. Submits written testimony in support of bill (EXHIBIT N). Discusses screening and treatment of PKU.

483

Chair Kruse

Inquires on number of detections.

488

Skeels

Reports figures.

TAPE 98, B

020

Cary Harding, MD

Assistant Professor of Pediatrics and Molecular Genetics, Oregon Health Sciences University (OHSU). Discusses treatment of PKU and metabolic disorders. Addresses connection between screening and treatment.

038

Kathleen Huntington

Medical Nutritional Therapist, OHSU. Submits PowerPoint presentation (EXHIBIT O). Discusses need for medical foods in treatment of PKU, including issues related to disparity in medical access and education.

068

Rep. Dalto

Inquires on access to medical foods.

071

Huntington

Details treatment and distribution of medical foods and formula.

083

Chair Kruse

Inquires on Medicaid coverage.

084

Huntington

Reports coverage by Medicaid.

085

Skeels

Notes Oregon Medical Assistance Program (OMAP) support via Medicaid.

086

Huntington

Continues PowerPoint presentation.

122

Rep. Tomei

Inquires on composition of medical beverage.

123

Huntington

Describes properties of medical beverage. Addresses costs associated with coverage of medical needs for PKU population. Continues PowerPoint presentation. Addresses cost to state for treatment versus special education and other medical costs.

175

Michelle Hunter

Testifies in support of bill. Relates personal experience with PKU.

204

Jennifer Jones

Behavioral Therapist. Reads written testimony in support of bill (EXHIBIT P).

245

Joanne Rogovoy

State Director, Program Services, March of Dimes. Submits written testimony in support of bill  (EXHIBIT Q). Discusses screening and treatment issues.

268

Peggy Anet

Health Insurance Association of America. Submits written testimony (EXHIBIT R). Discusses need for sunset clause on health mandates.

324

Rep. Tomei

Inquires on submitted figures.

325

Anet

Reports figures are for Oregon.

326

Chair Kruse

Stares intent regarding sunset clause. Closes public hearing on SB 74A and opens public hearing on SB 192.

SB 192 – PUBLIC HEARING

364

Thiele-Cirka

Summarizes bill.

378

Madeline Olson

Assistant Administrator, Health Services, Office of Mental Health and Addiction Services. Submits testimony in support of bill (EXHIBIT S). Discusses addition of staff to increase collaboration between agencies.

393

Chair Kruse

Closes public hearing on SB 192 and opens work session on SB 192.

SB 192 – WORK SESSION

395

Rep. Dalto

MOTION:  Moves SB 192 to the floor with a DO PASS recommendation.

399

 

VOTE:  5-0-2

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

EXCUSED:  2 - Monnes Anderson, Westlund

403

Chair Kruse

The motion CARRIES.

404

Rep. Tomei

MOTION:  Moves SB 192 be placed on the CONSENT CALENDAR.

405

 

VOTE:  5-0-2

EXCUSED:  2 - Monnes Anderson, Westlund

407

Chair Kruse

Hearing no objection, declares the motion CARRIED.

411

Chair Kruse

Closes work session on SB 192 and adjourns meeting at 10:44 A.M.

 

EXHIBIT SUMMARY

 

A – HB 2120, -6 amendments, dated 4/23/03, staff 18 pp.

B – HB 2165, -3 amendments, dated 4/25/03, staff, 6 p.

C – HB 2609, -1 amendments, dated 4/23/03, staff, 1 p.

D – HB 2609, -2 amendments, dated 4/25/03, staff, 1 p.

E – HB 2609, written testimony, Jim Gardner, 4 pp.

F – HB 2828, -4 amendments, dated 4/25/03, staff, 19 pp.

G – HB 3574, -2 amendments, dated 4/23/03, staff, 5 pp.

H – SB 878, written testimony, Modesto Jimenez, 3 pp.

I – SB 878, written testimony, Jim Edge, 2 pp.

J – SB 878, written testimony, Verne Buerner, 25 pp.

K – SB 74, written testimony, Senate President, Peter Courtney, 3 pp.

L – SB 74, written testimony, Tim Kelsh, 6 pp.

M – SB 74m written testimony, Katie Kelsh, 5 pp.

N – SB 74, written testimony, Michael Skeels, Ph. D., 2 pp.

O – SB 74, PowerPoint presentation and written testimony, Kathleen Huntington, 6 pp.

P – SB 74, written testimony, Jennifer Jones, 1 p.

Q – SB 74, written testimony, Joanne Rogovoy, 3 pp.

R – SB 74, written testimony, Peggy Anet, 4 pp.

S – SB 192, written testimony, Madeline Olson, 1 p.