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