SENATE COMMITTEE ON HEALTH POLICY
February 07, 2005 Hearing Room B
1:00 P.M. Tapes 10 - 11
Corrected 9/30/05
MEMBERS PRESENT: Sen. Laurie Monnes Anderson, Chair
Sen. Jeff Kruse, Vice-Chair
Sen. Peter Courtney
Sen. Bill Morrisette
MEMBER EXCUSED: Sen. Gary George
STAFF PRESENT: Rick Berkobien, Committee Administrator
Brittany Kenison, Committee Assistant
MEASURES/ISSUES HEARD:
SB 189 – Public Hearing
Hepatitis C - Informational Meeting
SB 400 – Public Hearing
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 10, A |
||
|
003 |
Chair Monnes Anderson |
Calls meeting to order at 1:02 p.m. Opens public hearing on SB 189. |
|
SB 189 – PUBLIC HEARING |
||
|
005 |
Rick Berkobien |
Committee Administrator. Explains SB 189. |
|
020 |
Lorraine Duncan |
Department of Human Services. Submits and presents written testimony in support of SB 189 (EXHIBIT A). |
|
055 |
Duncan |
Submits written testimony on behalf of Jay Rosenbloom, MD, PhD in support of SB 189 (EXHIBIT B). |
|
060 |
Dr. Paul Cieslak |
Manager, Communicable Disease Section. Submits and presents written testimony in support of SB 189 (EXHIBIT C). |
|
095 |
Sen. Kruse |
Asks if anyone discovered the correlation between thimerosal and increase in autism |
|
097 |
Cieslak |
Answers no, but adds speculation about diagnostic. |
|
105 |
Sen. Morrisette |
Clarifies that less thimerosal is being used with vaccines. |
|
110 |
Cieslak |
Answers that kids are getting almost no thimerosal in their vaccines. |
|
112 |
Sen. Morrisette |
Asks how prevalent the thimerosal in influenza vaccine. |
|
115 |
Cieslak |
Explains how they are not using multi dose viles. |
|
120 |
Chair Monnes Anderson |
Asks if Occupational Safety and Health Administration (OSHA) did not approve the thimerosal free syringe. |
|
125 |
Duncan |
Explains that the needles were not OSHA compliant. |
|
135 |
Sen. Kruse |
Refers to influenza vaccine and asks if there is a price difference between single and the multi dose viles. |
|
138 |
Duncan |
Answers that it is approximately one to two dollars difference. |
|
140 |
Sen. Kruse |
Indicates that the cost savings adds up. |
|
142 |
Chair Monnes Anderson |
Affirms. |
|
145 |
Bernard Bueffel |
MD. Submits and presents written testimony in support of SB 189 (EXHIBIT D). |
|
190 |
Sen. Kruse |
Asks if shortage during the past year was with bulk needles as well as single shot needles. |
|
195 |
Bueffel |
Notes that single shot syringes are less readily availability because they are not in as much demand. Also comments on a company that did not have as many needles as said. |
|
200 |
Sen. Kruse |
Remarks on creating regulations to prevent unnecessary shortages. |
|
210 |
James Lace |
MD, Oregon Medical Association. Submits and presents written testimony in support of SB 189 (EXHIBIT E). |
|
240 |
Chair Monnes Anderson |
Comments on correlation of autism and thimerosal. Closes public hearing on SB 189. Opens informational meeting on Hepatitis C. |
|
HEPATITIS C - INFORMATIONAL MEETING |
||
|
245 |
Mel Kohn |
State Epidemiologist, Office of Disease Prevention & Epidemiology, Oregon Department of Human Services. Submits and presents report on “State of Oregon Hepatitis C Strategic Plan” (EXHIBIT F). |
|
315 |
Sen. Morrisette |
Asks what percent of the population has Hepatitis C. |
|
320 |
Kohn |
Reports that two percent is infected. |
|
325 |
Sen. Morrisette |
Asks to report how many in the prison system have Hepatitis C. |
|
330 |
Kohn |
Answers that 30 percent are infected with Hepatitis C. |
|
335 |
Morrisette |
Asks if there is a treatment program for infected inmates after they are released to prevent further infection of the general population. |
|
335 |
Kohn |
Recognizes importance of issue, but defers to Lorren Sandt to address later. |
|
340 |
Kohn |
Continues discussing effects of Hepatitis C. |
|
375 |
Kohn |
Points out that on page 12 and 13 in the report, there is a list of people who participated in the report. Explains that groups are broke down into five sub topics to strategize. |
|
405 |
Kohn |
Refers to page 21 to explain the key guide and the layout. |
|
TAPE 11, A |
||
|
003 |
Lorren Sandt |
Managing Ambassador, Hepatitis C Caring Ambassadors Program. Submits written testimony about the Hepatitis C Report (EXHIBIT G). |
|
025 |
Sandt |
Reviews statistics for human, societal and fiscal costs. |
|
045 |
Sandt |
Summarizes and concludes. |
|
050 |
Sen. Morrisette |
Comments on previous testing procedures for Hepatitis C in the Department of Corrections (DOC) ands asks is problem has been rectified. |
|
060 |
Sandt |
Understands that DOC is working very hard to solve the issue. |
|
062 |
Chair Monnes Anderson |
Asks what the Hepatitis C treatment consists of. |
|
065 |
Sandt |
Explains the treatments available. |
|
065 |
Chair Monnes Anderson |
Asks how long the treatment takes |
|
067 |
Sandt |
Responds that the treatment can take six months to a year. |
|
068 |
Chair Monnes Anderson |
Comments on the importance of addressing the rising number of infected and action steps from Oregon Department of Human Services that does not require money. |
|
070 |
Sen. Kruse |
Comments on changing lifestyle when people are in early stages of Hepatitis C. Asks if other approaches taken, are with early interventions of the disease. |
|
095 |
Kohn |
Explains that they are working on trying to address intervention program with resources. Member of company has been working on Hepatitis C intervention/prevention program. |
|
110 |
Sen. Kruse |
Comments on importance of intervention and prevention programs because it is more cost efficient short and long term. |
|
113 |
Chair Monnes Anderson |
Asks what the cost is for six months treatment for one person. |
|
115 |
Sandt |
Answers that it is $24,000 to $36,000 per year. Reports that Texas has implemented testing and it currently costs $8.50. Also comments that once patients reach a certain level, it is more costly to treat. |
|
125 |
Chair Monnes Anderson |
Asks how much a transplant costs. |
|
126 |
Sandt |
Answers approximately $300,000 and notes that it does not include life long care needed. |
|
128 |
Sen. Morrisette |
Comments that in his personal experience, they test for Hepatitis A and B only. Asks if they do not test for Hepatitis C because it is an insurance issue. |
|
130 |
Kohn |
Answers how the testing can vary. |
|
145 |
Sen. Morrisette |
Clarifies that some general practitioners can choose to test for Hepatitis C, or is it related to suspicion. |
|
150 |
Kohn |
Explains how the general testing works and when they test for Hepatitis C. |
|
155 |
Sen. Kruse |
Asks for information on how Texas lowered the price of testing. |
|
160 |
Sandt |
Offers to return information to the committee. |
|
165 |
Chair Monnes Anderson |
Comments on need to find possible federal grants to help. |
|
167 |
Sandt |
Comments on bill being introduced to help address funds and education issue |
|
185 |
Chair Monnes Anderson |
Asks for solution coming from the committee. |
|
187 |
Sandt |
Urges for awareness and getting risk factors out, would make huge difference. Noted that organization asked Governor for proclamation for May for “hepatitis awareness month.” Asks committee members to participate. |
|
200 |
Sen. Kruse |
Comments on need to address the issue. |
|
205 |
Chair Monnes Anderson |
Comments on committee support. |
|
215 |
Chair Monnes Anderson |
Closes informational meeting on Hepatitis C. Opens public hearing on SB 400. |
|
SB 400 – PUBLIC HEARING |
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|
217 |
Sen. Ben Westlund |
Senate District # 27. Testifies in support in SB 400. |
|
250 |
Sen. Westlund |
Discusses current issues that led to create SB 400. |
|
280 |
Sen. Kruse |
Refers to patient safety commission created during the 2003 legislative session to protect patients. Asks Sen. Westlund if he has had discussion from this group regarding the issues addressed under SB 400. |
|
290 |
Sen. Westlund |
Comments that he has not spoke with them. Adds that OPR should also address the issue. |
|
300 |
Chair Monnes Anderson |
Comments that the safety commission is not ready to testify. |
|
302 |
Sen. Morrisette |
Asks what OPR stands for. |
|
303 |
Sen. Westlund |
Answers that the OPR stands for Oregon Public Research. |
|
320 |
Sen. Westlund |
Summarizes and concludes. |
|
340 |
Sen. Kruse |
Asks if a workgroup would be proper way to handle issue. |
|
345 |
Sen. Westlund |
Affirms |
|
350 |
Sen. Morrisette |
Asks if Sen. Westlund is responsible for the constituents whose emails he has been receiving in support of this bill. |
|
355 |
Sen. Westlund |
Answers no. |
|
365 |
Rick Berkobien |
Committee Administrator. Notes that Consumer Union has a website to search for lawmakers. |
|
385 |
Paul Cieslak |
MD, Manager, Communicable Disease Section. Submits and presents written testimony in opposition of SB 400 (EXHIBIT H). Notes that he is in opposition of the bill, not the issue of hospital infections. |
|
005 |
Cieslak |
Continues discussion of concerns of SB 400. |
|
TAPE 10, B |
||
|
015 |
Anne Eades |
Infection Control Practitioner, Association of Professionals and Infection Control and Epidemiology (APIC). Submits and presents written testimony in support of SB 400 (EXHIBIT I). |
|
025 |
Eades |
Explains that currently there are hospital staff for prevention of infections. Explains their roles and the procedures. |
|
050 |
Sen. Morrisette |
Asks Eades to comment that, currently, there are no national standards for collecting and comparing infection rates. |
|
052 |
Eades |
Explains that the Centers for Disease Control has national surveillance program, but the program only supports 300 members. Also explains that the center has there own standards for the members to follow. Comments that most hospitals may go by the programs, but there are not recognized as a member. |
|
065 |
Sen. Morrisette |
Asks if a uniform procedure for collecting data is a goal. |
|
067 |
Eades |
Explains how the center uses the information. Notes that APIC is in favor of standardizing definitions. |
|
080 |
Sen. Morrisette |
Asks Eades if she feels that there is not a check and balance system. |
|
090 |
Eades |
Believes that infection problem is an emerging problem. Comments on the decrease of infection rates. |
|
100 |
Sen. Courtney |
Refers to the last paragraph of exhibit I. Asks Eades to clarify. Also refers to bill on page 2 line 10. Comments on other states and their use of approaches to the issue at hand. |
|
130 |
Chair Monnes Anderson |
Comments on the safety commission to help on these issues. |
|
135 |
Sen. Morrisette |
Asks Mel Kohn how this relates to the health department and if so, what is the department doing to address the issue. |
|
140 |
Mel Kohn |
Explains that it related to the previous question asked by the committee, whether or not it is a systemic issue. |
|
155 |
Sen. Morrisette |
Asks what the responsibility is of the public health department to see that public health is protected in hospitals. |
|
160 |
Kohn |
Responds that they work closes with hospitals. |
|
163 |
Sen. Morrisette |
Asks if they have an oversight responsibility. |
|
168 |
Kohn |
They do have an oversight responsibility to protect the public’s health. |
|
170 |
Sen. Morrisette |
Asks at what point does the department address the issue. |
|
171 |
Kohn |
Explains when the department steps in to address issues. |
|
175 |
Sen. Morrisette |
Clarifies that the department does have statutory authority with hospitals. |
|
175 |
Kohn |
Answers yes, but notes that issue is out of his area. |
|
210 |
Chair Monnes Anderson |
Asks if it is Cielsak department needs to address the question. |
|
211 |
Kohn |
Affirms |
|
212 |
Sen. Morrisette |
Clarifies that they do have a punitive responsibility. |
|
218 |
Kohn |
Affirms. |
|
220 |
Sen. Morrisette |
Comments on previous discussion with Chief Medical Officer of Oregon, and if he can call an emergency. Asks what authority the officer has. |
|
240 |
Kohn |
Explains that he does not have exact answer |
|
242 |
Chair Monnes Anderson |
Interjects and states that they will continue discussion with the safety commission present. |
|
245 |
Eades |
Comments on Sen. Courtney’s previous question regarding the meeting with Cieslak and notes the agenda of the meeting. |
|
260 |
Bruce Bishop |
Oregon Association of Hospitals and Health Systems. Testifies for SB 400. Comments on national and local efforts to make hospitals safe. |
|
275 |
Jim Carlson |
Oregon Health Care Association. Testifies in opposition of SB 400. Adds that the bill refers to facilities, so it also represents nursing as well. Adds that there is a website with infections statistics. |
|
310 |
Carlson |
Comments that if the bill passes then it would be duplications of website information. |
|
320 |
Chair Monnes Anderson |
Comments that if long term hospitals keep a database, then hospitals could possibly have one also. |
|
325 |
Carlson |
Explains nursing facilities comprehensive statues. |
|
340 |
Sen. Kruse |
Comments on data collection difference between nursing facilities and hospitals. |
|
360 |
Carlson |
Expresses support of the Patient Safety Commission from the start, but believes that it would be inappropriate for the commission to address the issue. |
|
363 |
Chair Monnes Anderson |
Asks if Carlson is a member of the Patient Safety Commission. |
|
365 |
Carlson |
Answers that one of licensed nurse administrators is a member and adds that the association has financial supported the commission. |
|
367 |
Chair Monnes Anderson |
Closes public hearing on SB 400. Adjourns meeting at 2:26 p.m. |
EXHIBIT SUMMARY
A. SB 189, written testimony, Lorraine Duncan, 2 pp
B. SB 189, written testimony from Jay Rosenbloom, Lorraine Duncan, 1 p
C. SB 189, written testimony, Paul Cieslak, 3 pp
D. SB 189, written testimony, Bernard Bueffel, 1 p
E. SB 189, written testimony, James Lace, 2 pp
F. Hepatitis C, report, Mel Kohn, 36 pp
G. Hepatitis C, written testimony, Lorren Sandt, 6 pp
H. SB 400, written testimony, Paul Cieslak, 2 pp
I. SB 400, written testimony, Anne Eades, 9 pp