SENATE COMMITTEE ON HEALTH POLICY

 

 

January 24, 2005                                                                                              Hearing Room HR B

1:00 PM                                                                                                                            Tapes 4 - 5

Corrected 9/28/2005

MEMBERS PRESENT:         Sen. Laurie Monnes Anderson, Chair

Sen. Jeff Kruse, Vice-Chair

Sen. Peter Courtney

Sen. Gary George

Sen. Bill Morrisette

 

STAFF PRESENT:                 Rick Berkobien, Committee Administrator

Brittany Kenison, Committee Assistant

 

 

MEASURES/ISSUES HEARD & WITNESSES:

SB 222 – Public Hearing

      Robert Nikkel,Office of Mental Health and Addiction Services, Oregon Department of Human Services

      Bob Repine,Oregon Department of Housing and Community Services

      Frank Moore,Health Services of Linn County, Association of Oregon Community Mental Health Programs

      Doris Cameron-Menard,National Alliance for Mentally Ill of Oregon

      Jane Lokan, resident of Clackamas County

      John McCully, Oregon Psychiatric Association

 

Informational Meeting

“Overview and Perspectives of Mental Health and Substance Abuse Treatment Insurance Parity”

            Erinn Kelley-Siel, Office of the Governor

            Mike Becker, Regence Blue Cross Blue Shield of Oregon

            Kathy Loretz, Public Employee’s Benefit Board

            Becky Child, Representative of Mental Health Association

            Angela Kimble, National Alliance for the Mentally Ill

            Representatives of Health Care Provider Network

 

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 4, A

010

Chair Monnes Anderson

Calls meeting to order at 1:02 PM.  Opens public hearing on SB 222.

SB 222 – PUBLIC HEARING

012

Rick Berkobien

Committee Administrator. Explains SB 222 and proposed -1 amendment (EXHIBIT A).

040

Robert Nikkel

Administrator, Health Services, Office of Mental Health and Addiction Services, Oregon Department of Human Services. Submits and presents written testimony in support of SB 222 (EXHIBIT B).

055

Bob Repine

Oregon Department of Housing and Community Services. Submits and presents written testimony in support of SB 222 (EXHIBIT C).  Gives background of relationship with the Oregon Department of Human Services (DHS).

115

Chair Monnes Anderson

Asks Repine to explain the process for a home to become eligible for community housing.

120

Repine

Explains the application process.

130

Chair Monnes Anderson

Asks if there are zoning issues that could stop or delay the process.

135

Repine

Believes that there are no issues with zoning.

140

Sen. George

Asks Berkobien what happens to proceeds after community housing properties are disposed of.

145

Berkobien

Defers to Nikkel.

155

Nikkel

Answers that proceeds go back to DHS to fund other community housing.

156

Sen. George

Clarifies that the money will then go to community housing for the mentally ill.

160

Nikkel

Affirms.

161

Sen. Kruse

Asks in the last four years, how many facilities are involved and what is the wait list for housing and state hospital.

165

Nikkel

Comments that there are 14,000 units short for people with mental illness.  Adds that they are trying to catch up.

175

Repine

Remarks that since 2000, 300-350 units have been involved.  Also, 1,000 units have been made since 1990. Comments that there is still a great need.

180

Sen. Courtney

Asks where are the homeless.

190

Nikkel

Comments that most are on the street and usually with no permanent residence.

195

Repine

Recognizes that there are a large number of homeless people who are mentally ill.  Remarks on an aggressive 10 year plan that the department is starting to help these people.

210

Sen. Courtney

Clarifies that “homeless” is living on the streets.

215

Nikkel

Affirms.

217

Sen. George

Asks how many of the homeless may have been housed by state facilities that are now closed.

223

Nikkel

Remarks on recent study finding what happened to people who were part of a facility that closed and then reopened.  Found a 95% success rate of people back in program or moved to lesser levels of care.

235

Sen. George

Clarifies that the number of mentally ill that are homeless stated on the SMS report includes people that have never been properly diagnosed and their needs properly addressed.

245

Nikkel

Affirms and adds the difficulty of diagnosing some.  Comments on need for outreach approaches.

250

Sen. Morrisette

Asks at what point do you classify someone as mentally ill.

255

Nikkel

Remarks they can diagnose once there is enough time spent with the person.  Comments on the 24 hour service crisis centers with staff that can diagnose patients.

270

Sen. Morrisette

Asks if there is a tracking system once they have been diagnosed.

275

Nikkel

Answers yes.

280

Chair Monnes Anderson

Clarifies the difference between diagnosis of drug use and mentally ill.

282

Nikkel

States that often it is both and should have integrated state system.

295

Chair Monnes Anderson

Asks who oversees system once the mentally ill are enrolled.

300

Nikkel

Answers that few people are in a 24 hour home, most are living independently.

315

Chair Monnes Anderson

Asks if there are homes that have wanted to get involved but cannot.

320

Nikkel

Comments how Counties are the key organizers for prospective providers.

335

Repine

Comment on the diversity of people who want to start these housing units.

355

Sen. Morrisette

Asks what the raising rate for liability insurance is for homeowners.

360

Repine

Reports that insurance has risen three times for construction.

370

Sen. Morrisette

Wants to know what is being done to prevent the increase.

375

Nikkel

Comments that they have been looking at several options and will get information for the committee.

395

Frank Moore

Public Health Administrator, Health Services of Linn County, Association of Oregon Community Mental Health Programs. Submits and reviews written testimony in support of SB 222 (EXHIBIT D).

430

Sen. George

Comments on the number of days of incarceration dropped by 72.1 %. Asks if that number has been configured into the corrections budget.

440

Moore

States that he is not aware of any reports that have done so.

445

Sen. Courtney

Asks Moore to clarify statement in testimony that refers to the correlation between the Department of Corrections and mental health.

460

Moore

Affirms that the number of incarceration refers to people in local jails.

465

Sen. Courtney

Asks if people in the local jail are considered to be part of the criminal justice system.

470

Moore

Affirms.

TAPE 5, A

015

Sen. Courtney

Asks Moore to clarify that there are people in jail who have been diagnosed as mentally ill.

020

Moore

Advises how that is not always true. Describes two different populations in the jail system to differentiate criminals and mentally ill.

030

Moore

Discusses how people can get stuck in the Department of Corrections because of delays with mental health procedures.

040

Nikkel

Presents specifics of study in California when outreach programs where put in place.

050

Doris Cameron-Menard

National Alliance for Mentally Ill of Oregon. Submits written testimony in support of SB 222 (EXHIBIT E).

075

Jane Lokan

Former State Representative, resident of Clackamas County.  Submits and presents written testimony in support of SB 222 (EXHIBIT F).

125

Lokan

Discusses concerns of SB 222.

190

Nikkel

Comments that the most cost effective way of moving out of state hospital, is moving into adult foster home. Also comments on identifying the definition of a care provider.

210

Sen. George

Questions the content of SB 222 on page one, line seven and nine.

225

Sen. Kruse

Clarifies content of line seven and nine of SB 222.

235

Nikkel

Adds that the intent is for housing for people with mental illness.

245

Chair Monnes Anderson

Recognizes that they received a letter from Irene Fischer Davidson, director, Clackamas County Department of Human Services, in support of SB 222, and submits as testimony (EXHIBIT G).  Closes public hearing at 1:47 PM. Opens information meeting.

MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT INSURANCE PARITY, OVERVIEW AND PERSPECTIVES OF, INFORMATIONAL MEETING

265

Erinn Kelly-Siel

Advisor to Governor for health and human services.  Explains that parity refers to insurance coverage for mentally ill/chemically dependant.  Gives overview of current parity.

300

Kelly-Siel

Discusses mental health parity to solve issues.  Explains that a group of diverse individuals are meeting to discuss the issue of mental health parity.  Submits a list of all attendees to the meeting for testimony. (EXHIBIT H).

320

Kelly-Siel

Presents overview of issues and building mental health parity solutions.

355

Kelly-Siel

Comments that the next meeting should start on working toward solutions.

360

Chair Monnes Anderson

Asks how many times will the group will meet and how long until a recommendation.

365

Kelly-Siel

Remarks that they will meet for 3-4 weeks.

370

Chair Monnes Anderson

Comments on one or two bills that have been introduced and what recommendations can be incorporated from the group.

390

Michael Becker

Director of Pubic Policy, Regence Blue Cross BlueShield  of Oregon (BCBSO). Submits and reviews written testimony (EXHIBIT I).

455

Becker

Reviews Regence BCBSO statistics and submits as testimony (EXHIBIT J).

TAPE 4, B

030

Becker

Continues to review Regence BCBSO statistics.

060

Becker

Reviews chart “Utilization of State Mandated Mental Health Benefits.”

075

Becker

Reviews chart for mental health utilization rates.

080

Sen. George

Asks if population reflects the general population in the statistics.

090

Becker

Remarks that they did not choose groups as these are the only two groups of parity in Oregon.

100

Sen. George

Asks if there are other reports from other states to compare Oregon’s data.

105

Becker

Responds to the utilization of benefits used.

110

Chair Monnes Anderson

Asks in the study if there is a break down of the different mental illnesses and which are more common.

120

Becker

Replies that it does not have that specific information but may be done.

125

Chair Monnes Anderson

Comments on importance of information as it relates to cost.

130

Becker

Adds that he will have to consult to get information.

133

Sen. Kruse

Comments on care mange tools and qualifications for a diagnosis and the formula involved.

145

Becker

Remarks that type of care manage tools used.

150

Kathy Loretz

Director of Operations, Public Employees Benefit Board (PEBB). Submits written testimony (EXHIBIT K).

155

Loretz

Gives PEBB background.

175

Loretz

Discusses mental health parity program:

·         Explains 2002 mental health benefits comparison

·         Regence mental health benefits from 2003 forward

·         Regence mental health parity agreement

·         Reconciliation Process

205

Loretz

Continues to discuss mental health parity program:

·         2003 Results

·         Looking forward

220

Sen. Morrisette

Asks if it is common to receive a refund from Regence for overpay.

225

Loretz

Answers that she is only aware of procedure for this organization.

230

Becker

Affirms Loretz’s answer.

240

Berkobien

Asks if there is a satisfaction survey to know if people like how the system operates.

245

Loretz

Answers that she will have to retrieve information for the committee.

250

Becky Child

Consumer Survivor. Presents background of organizations and current views of mental health parity.

290

Angela Kimble

National Alliance for the Mentally Ill. Submits and presents written testimony (EXHIBITS L).

345

Kimble

Continues speaking in support of mental health parity.

380

Kimble

Discusses why mental treatment is good for businesses.

420

Kimble

Reviews federal studies and the cost of parity.

TAPE 5, B

005

Kimble

Summarizes and concludes.

015

John McCully

Representative of Oregon Psychiatric Association.  Notes that they are in support of SB 222. Discusses views in opposing parity.

035

McCully

Summarizes and concludes.

050

Chair Monnes Anderson

Comments that there will be continuing discussion on mental health parity.

055

Sen. Courtney

Notes that SB 1 will be on mental health parity.

065

Chair Monnes Anderson

Closes informational meeting. Adjourns meeting at 2:30 PM.

 

EXHIBIT SUMMARY

 

A.     SB 222, proposed -1 amendment 01/21/2005, staff, 1 p

B.     SB 222, written testimony, Robert Nikkel, 2 pp

C.     SB 222, mental health housing chart, Bob Repine, 6 pp

D.    SB 222, written testimony, Frank Moore, 2 pp

E.     SB 222, written testimony, Doris Cameron-Menard, 1 p

F.      SB222, written testimony, Jane Lokan, 2 pp

G.    SB 222, written testimony, Irene Fischer-Davidson, 1 pp

H.    Mental Health and Substance Abuse Treatment Insurance Parity, Overview and Perspectives of, list, Erinn Kelley-Siel, 1 p

I.       Mental Health and Substance Abuse Treatment Insurance Parity, Overview and Perspectives of, written testimony, Michael Becker, 1 p

J.      Mental Health and Substance Abuse Treatment Insurance Parity, Overview and Perspectives of, statistics, Michael Becker, 4 pp

K.    Mental Health and Substance Abuse Treatment Insurance Parity, Overview and Perspectives of, slide presentation, Kathy Loretz, 11 pp

L.     Mental Health and Substance Abuse Treatment Insurance Parity, Overview and Perspectives of, written testimony, Angela Kimball, 3 pp