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

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