HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

April 30, 2003 Hearing Room D

8:30 A.M. Tapes  99 – 101

 

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 2251 – Work Session

                                                SB 434 – Public Hearing and Work Session

                                                SB 436 – Public Hearing and Work Session

                                                SB 162A – Public Hearing and Work Session

                                                SB 163 – Public Hearing and Work Session

                                                SB 164 – Public Hearing and Work Session

                                                SB 393 – 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 99, A

004

Chair Kruse

Calls meeting to order at 8:45 A.M. and opens work session on HB 2251.

HB 2251 – WORK SESSION

010

Grant Higginson MD

State Public Health Officer, Department of Human Services (DHS). Reports all interested parties agree to -2 amendments, dated 4/28/03 (EXHIBIT A). Summarizes scope of bill.

115

Rep. Monnes Anderson

Inquires on definition of public health crisis.

117

Higginson

Directs to language in bill that provides definition.

125

Rep. Monnes Anderson

Inquires on issues related to release of information.

138

Higginson

Explains access privileges to health records.

152

Rep. Dalto

Request information on immediate action taken during impending health crisis.

156

Higginson

Explains actions are relative to particular needs of specific crisis. Offers examples of protocols.

173

Rep. Anderson

Inquires on federal funding.

177

Higginson

Discusses current federal grant dollars and federal model on emergency preparedness. Notes fiscal impact.

196

Rep. Monnes Anderson

Inquires on the Health Insurance Portability and Accountability Act (HIPAA) regulations.

199

Higginson

Notes amendments language ensures there is no conflict with HIPAA.

205

Chair Kruse

Comments on ability to respond at low crisis level.

211

Higginson

Concurs intent of bill.

215

Rep. Anderson

MOTION:  Moves to ADOPT HB 2251-2 amendments dated 4/28/03.

216

 

VOTE:  6-0-1

EXCUSED:  1 - Westlund

217

Chair Kruse

Hearing no objection, declares the motion CARRIED.

218

Rep. Anderson

MOTION:  Moves HB 2251 to the floor with a DO PASS AS AMENDED recommendation.

225

 

VOTE:  6-0-1

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

EXCUSED:  1 - Westlund

229

Chair Kruse

The motion CARRIES.

REP. KRUSE will lead discussion on the floor.

230

Chair Kruse

Closes work session on HB 2251 and opens public hearing on SB 434a and SB 436.

SB 434A AND SB 436 – PUBLIC HEARING

242

Sen. Joan Dukes

Senate District 16. Testifies in support of SB 434A and SB 436. Submits written testimony for SB 436 (EXHIBIT B). Notes definition and treatment of intractable pain. Discusses policies and protocols in effective pain management. Summarizes impact and scope of bills.

403

Rep. Anderson

Inquires on liability issues.

428

Sen. Dukes

Reports on Board of Medical Examiners (BME) role in monitoring prescription of narcotics. Notes other training efforts directed at physicians.

TAPE 100, A

003

Allen Chino, PhD

Pain Management Commission. Testifies in support of SB 436. Relates barriers to effective pain management treatment. Discusses issues related to addiction and suede addiction.

052

Rep. Tomei

Inquires on addictive behavior and remedy.

055

Chino

Comments on behaviors that appear to indicate addiction. Reports methods to control addictions.

061

Rep. Tomei

Requests further clarity.

062

Chino

Discusses issues reported by physicians prescribing narcotics and tools to manage abuses.

080

Rep. Monnes Anderson

Comments on access to narcotics.

091

Chino

Comments on motivation and intent of bill. Cautious committee on using examples of abuse to drive statue.

106

Rep. Anderson

Inquires on term of care.

115

Chino

Defines intractable pain and goal of treatment.

129

Rep. Gary Hansen

House District 44. Discusses work with Pain Management Commission. Addresses impact of bills on treatment and clients.

153

Chino

Submits video tape presentation.

378

Rep. Tomei

Inquires on psychologists prescriptive rights.

379

Rep. Hansen

Notes bills do not include psychologists prescriptive rights. Comments on personal experience with treatment of pain. 

429

Rep. Barker

Inquires on ability of BME to investigate.

439

Chino

Discusses good practice policies and procedures.

459

Kathy Hahn

Chair, Pain Management Commission. Notes commissions support of bills.

477

Rep. Monnes Anderson

Inquires on physician ability to get second opinion.

478

Hahn

Reports physician’s ability to seek second opinion is not impacted.

TAPE 99, B

026

Kathleen Haley

Executive Director, BME. Submits packet on intractable pain law and requirements (EXHIBIT C). Discusses BME position and concerns. Addresses issues regarding treatment of intractable pain. Notes BME supports SB 434 and opposes SB 436.

099

Carol Misrack

Oregon State Pain Management Coordinator. Comments on patient advocate issues. Notes physicians use BME regulations as a reason for not treating intractable pain. Notes need for training and education. 

148

Chair Kruse

Closes public hearing on SB 434 and SB 436 and opens work session on SB 434.

SB 434 – WORK SESSION

151

Rep. Tomei

MOTION:  Moves SB 434 to the floor with a DO PASS recommendation.

159

 

VOTE:  7-0-0

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

162

Chair Kruse

The motion CARRIES.

REP. TOMEI will lead discussion on the floor.

166

Chair Kruse

Closes work session on SB 434 and opens work session on SB 436.

SB 436 – WORK SESSION

168

Rep. Anderson

Requests more info from BME.

174

Haley

Notes reasons BME does not support SB 436.

185

Chair Kruse

Notes specific language about retaining patients.

189

Haley

Reports BME concerns.

202

Rep. Dalto

Expresses concern over liability issues.

216

Haley

Addresses issues with use of one form for treatment.

231

Misrack

Addresses policy issues in treatment.

245

Rep. Dalto

Requests further clarity on form.

247

Haley

Reports copy of form is included in testimony (EXHIBIT C).

261

Misrack

Discusses other contracts between physicians and patients.

270

Rep. Monnes Anderson

Notes concern over form. Expresses need for physicians and agency to agree on formatting.

289

Rep. Anderson

Requests consensus among interested parties.

300

Sen. Dukes

Explains tools to ensure proper formatting and charting issues. Notes BME has control over the creation and modification of BME.

337

Rep. Monnes Anderson

Points out BME could oversee issue by rule.

342

Sen. Dukes

Comments on BME policy.

374

Chair Kruse

Suggests conceptual amendment.

411

Rep. Kruse

MOTION:  Moves to SUSPEND the rules for the purpose of conceptually amending SB 436.

412

 

VOTE:  7-0-0

413

Chair Kruse

Hearing no objection, declares the motion CARRIED.

418

Rep. Kruse

MOTION:  Moves to FURTHER AMENDED SB 436 on page 2, line 10, by deleting "in a form provided and approved by the" and on page 2, line 11, by deleting "board".

421

 

VOTE:  7-0-0

422

Chair Kruse

Hearing no objection, declares the motion CARRIED.

425

Rep. Barker

MOTION:  Moves SB 436 to the floor with a DO PASS AS AMENDED recommendation.

512

 

VOTE:  6-1-1

AYE:               6 - Barker, Dalto, Monnes Anderson, Tomei, Westlund, Kruse

NAY:               1 - Anderson

519

Chair Kruse

The motion CARRIES.

REP. BARKER will lead discussion on the floor.

TAPE 100, B

032

Chair Kruse

Closes work session on SB 436 and opens public hearing on SB 162.

SB 162A – PUBLIC HEARING

037

Thiele-Cirka

Summarizes bill.

047

Greg Garcia, ND

Chair, Oregon Board of Naturopathic Examiners. Testifies in support of bill. Discusses impact of specific language in bill. 

070

Rep. Monnes Anderson

Inquires on accreditation.

073

Garcia

Reports agency accrediting colleges.

077

Chair Kruse

Closes public hearing on SB 162A and opens work session on SB 162A.

SB 162A – WORK SESSION

079

Rep. Tomei

MOTION:  Moves SB 162A to the floor with a DO PASS recommendation and be placed on the CONSENT CALENDAR.

067

 

VOTE:  6-0-1

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

EXCUSED:  1 - Westlund

093

Chair Kruse

The motion CARRIES.

094

Chair Kruse

Closes work session on SB 162A and opens public hearing on SB 163.

SB 163 – PUBLIC HEARING

095

Garcia

Summarizes bill.

105

Rep. Tomei

Inquires on specific language in bill.

110

Garcia

Explains language as it relates to licensing of physicians.

118

Chair Kruse

Closes public hearing on SB 163 and opens work session on SB 163.

SB 163 – WORK SESSION

122

Rep. Barker

MOTION:  Moves SB 163 to the floor with a DO PASS recommendation and be placed on the CONSENT CALENDAR.

125

 

VOTE:  6-0-1

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

EXCUSED:  1 - Westlund

129

Chair Kruse

The motion CARRIES.

130

Chair Kruse

Closes work session on SB 163 and opens public hearing on SB 164.

SB 164 – PUBLIC HEARING

132

Garcia

Summarizes bill.

151

Chair Kruse

Closes public hearing on SB 164 and opens work session on SB 164.

SB 164 – WORK SESSION

154

Rep. Barker

MOTION:  Moves SB 164 to the floor with a DO PASS recommendation and be placed on the CONSENT CALENDAR.

155

 

VOTE:  6-0-1

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

EXCUSED:  1 - Westlund

162

Chair Kruse

The motion CARRIES.

163

Chair Kruse

Closes work session on SB 164 and opens public hearing on SB 393.

SB 393 – PUBLIC HEARING

166

Thiele-Cirka

Summarizes bill.

173

Art Keil

Oregon Association of Naturopathic Physicians (OANP). Submits written testimony in support of bill (EXHIBIT D). Details Naturopathic physician training as it relates to definition of “physician” for the purpose of allowing Naturopaths to perform physical exams for high school sports participants. Explains bill does not impact current scope of practice. 

241

Aris Campbell, ND

Legislative Chair, OANP. Submits written testimony in support of bill (EXHIBIT E). Details educational criteria and requirements for naturopathic medical students.

301

Rep, Monnes Anderson

Inquires on colleges offering training.

305

Campbell

Reports colleges across the west coast.

311

Rep. Tomei

Inquires on student’s ability to study at hospitals.

319

Campbell

Explains residency opportunities.

342

Rep. Anderson

Inquires on surgical procedures performed by naturopathic physicians.

347

Campbell

Reports procedures. Notes status as family practice doctors.

370

Keil

Notes other procedures performed by naturopathic physicians. Discusses hospital privileges.

386

Campbell

Notes goal to integrate conventional and naturopathic medicine.

405

Rep. Monnes Anderson

Inquires on liability issues.

410

Campbell

Addresses training and ability of naturopathic physicians to attend to sports medicine.

426

Scott Gallant

Oregon Medical Association (OMA). Testifies in opposition to bill. Provides history of issue. Discusses specific objections with bill.

TAPE 101. A

010

Gallant

Continues testimony on bill.

048

Chair Kruse

Inquires on diagnostic tests for sports physicals.

050

Gallant

Can not answer question. Reiterates policy issue.

069

Chair Kruse

Comments on athletic related deaths. 

077

Gallant

Reiterates concerns over policy issue.

092

Rep. Monnes Anderson

Details procedures involved in a sports physical.

101

Rep. Barker

Notes other medical professionals that provide sports physicals.

108

Gallant

Discusses policies related to athletic medicine.

131

Rep. Barker

Notes naturopathic physicians qualify as physicians as defined by statue.

154

Chair Kruse

Closes public hearing on SB 393 and opens work session on SB 393.

SB 393 – WORK SESSION

156

Rep. Tomei

MOTION:  Moves SB 393 to the floor with a DO PASS recommendation.

159

 

VOTE:  5-1-1

AYE:               5 - Barker, Monnes Anderson, Tomei, Westlund, Kruse

NAY:               1 - Anderson

EXCUSED:     1 - Dalto

163

Chair Kruse

The motion CARRIES.

REP. TOMEI will lead discussion on the floor.

165

Chair Kruse

Closes work session on SB 393 and adjourns meeting at 11:01 A.M.

 

EXHIBIT SUMMARY

 

A – HB 2251, -2 amendments, dated 4/28, staff, 32 pp.

B – SB 436, written testimony, Sen. Joan Dukes, 4 pp.

C – SB 436, written testimony, Kathleen Haley, 23 pp.

D – SB 393, written testimony, Art Keil. 4 pp.

E – SB 393, written testimony, Aris Campbell, 2 pp.