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.