SENATE COMMITTEE ON HEALTH POLICY

 

 

February 09, 2005                                                                                                   Hearing Room B

1:00 P.M.                                                                                                                     Tapes  12 - 13

 

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:        

Introduction of Committee Measures – Work Session

Healthcare Cost Containment Bills – Informational Meeting

SB 450 – Public Hearing

SB 407 - 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 12, A

003

Chair Monnes Anderson

Calls meeting to order at 1:04 p.m.  Opens work session for introduction of committee measures.

INTRODUCTION OF COMMITTEE MEASURES – WORK SESSION

004

Rick Berkobien

Committee Administrator. Introduces LC 1154 (EXHIBIT A), LC 1156 (EXHIBIT B), LC 1157 (EXHIBIT C), LC 1807 (EXHIBIT D), LC 2335 (EXHIBIT E).

005

Sen. Kruse

MOTION:  Moves LC's:  1154, 1156, 1157, 1807, 2335 BE INTRODUCED as committee bills.

015

 

VOTE:  5-0-0

 

Chair Monnes Anderson

Hearing no objection, declares the motion CARRIED.

025

Chair Monnes Anderson

Closes work session on introduction of committee measures and opens public hearing on SB 450.

HEALTHCARE COST CONTAINMENT BILLS – INFORMATIONAL MEETING

040

Chair Monnes Anderson

Comments on press conference of cost containment bills and notes dates of related testimony and bills.

070

Chair Monnes Anderson

Closes informational meeting on healthcare cost containment bills and opens public hearing on SB 450.

SB 450 – PUBLIC HEARING

075

Martin Taylor

Director, Health Policy and Government Relations, Oregon Nurses Association.  Presents and submits informational packet on preventing wrongful surgeries in support of SB 450 (EXHIBIT F).  Provides background of bill.

085

Sarah Breckenridge

Manager-Surgical Services, Providence hospital, Newberg Oregon.  Explains procedure when patient has a surgery and the duties of nurses.

130

Dagmar Rockstroh

Registered Nurse.  Speaks about experience starting out a technician.  Adds that she later went back to school for nursing. Explains the difference between the two jobs.

165

Sen. Morrisette

Asks where the majority of nursing experience came from.

175

Rockstroh

Explains that the educational part comes from nursing school, and believes it to be crucial part for the focus her job. 

190

Sen. Morrisette

Clarifies that experience comes from both school and in the operating room to receive instruction from the surgeon.

200

Rockstroh

Clarifies that surgeon and nurse work together in the operating room.

205

Sen. Morrisette

Refers to line five of the bill. Asks for clarification.

210

Breckenridge

Clarifies.  Explains that nurses create an individual plan of care for each patient.  Adds that it is not the job of the physician, they are concentrating on the procedure.

250

Chair Monnes Anderson

Refers to line 11 of the bill where it notes that the circulating nurse is to remain in the operating room.  Asks if nurses may leave if they need something.

255

Breckenridge

Answers that yes, they can leave related to the procedure.  Clarifies that duration means from the time patient enters the operating room until they leave.

260

Chair Monnes Anderson

Reviews line 11 again and notes her interpretation.

265

Breckenridge

Clarifies intent of bill.

275

Taylor

Clarifies that circulating nurses can leave.

285

Sen. Kruse

Asks for the difference between a circulating and supervisory nurse.

288

Breckenridge

Provides duties of each position.

305

Sen. Kruse

Clarifies that supervisory nurse does not have to be in the operating room during the duration of the procedure.

306

Breckenridge

Affirms.

310

Sen. Kruse

Clarifies that a supervisory nurse could be assigned to a surgery and not be near the hospital.

315

Breckenridge

Clarifies that supervisory nurse is assigned to a team and that they would never have assignment if they are gone.

320

Sen. Kruse

Clarifies that supervisory nurse is assigned during their shift.

322

Breckenridge

Affirms.

325

Sen. Morrisette

Asks if there is anything in the bill that would prevent a technician from being a second circulator.

330

Breckenridge

Answers no.

335

Deborah Turner

Association of Surgical Technologists.  Testifies in support of SB 450.  Expresses concern of experience of a surgical nurse.  Requests to oversee qualifications of this new position.

365

Breckenridge

Explains that hospitals are required to set standards for proper training.  Explains how it is difficult to set timeline. Expresses need to access individual nurses and to set learning levels.

405

Sen. Morrisette

Asks what it means to be experienced and if it includes schooling and/or experience.

415

Taylor

States that hospitals in Oregon have been responsible in hiring experienced nurses.

TAPE 13, A

005

Sen. Kruse

Comments that proper wording is needed for the bill.  Comments on the new ambulatory surgical centers and how the bill may impact them.  Asks if circulatory nurse needs be present at center and addresses needs to be clear when it comes to actually surgery.

020

Breckenridge

Comments on different evasive procedures and different sedations.

025

Taylor

Comments on the clarity that the bill will provide.

040

Sen. Kruse

Comments that bill is not clear enough for him.

045

Martin

Clarifies duties for circulatory nurse to prevent surgery error.

070

Sen. Morrisette

Comments on personal surgery and importance of preventing surgery error.

080

Jo Bell

Director, Legislative Support Services for the Oregon Association. Submits and presents written testimony for SB 450 without a stated position (EXHIBIT G).  Discusses how current procedures are similar to what is outlined in SB 450.

100

Bell

Discusses concerns about SB 450.

155

Bell

Summarizes and concludes.

160

Scott Gallant

Director of Government Affairs for the Oregon Medical Association.  Submits and presents written testimony in support of SB 450 (EXHIBIT H).  Comments that many concerns are similar to Bell’s. Discusses concerns.

205

Gallant

Summarizes and concludes.

210

Sen. Morrisette

Asks to explain the federal standards for the Joint Commission to the Accreditation on Healthcare Organizations (JCAHO).

215

Gallant

Affirms that JCAHO operators under federal standards.

248

Sen. Morrisette

Asks to define JCAHO.

250

Bell

Explains that it stands for the Joint Commission to the Accreditation on Healthcare Organizations (JCAHO).

255

Sen. Morrisette

Clarifies that Gallant is suggesting using the federal standards for the bill.

260

Gallant

Affirms.  Explains that most hospitals are JCAHO certified.

270

Chair Monnes Anderson

Notes that she will not hold work session and advises that parties get together to clarify bill.

280

Sen. Kruse

Requests that a circulating nurse be defined as well as surgery, major or minor in the bill.

290

Chair Monnes Anderson

Requests that the impact on ambulatory surgical centers should be included in the bill as well.

295

Sen. Morrisette

Comments that he would like the experience of a circulating nurse to be defined.

300

Chair Monnes Anderson

Closes the public hearing on SB 450 and opens public hearing on SB 407.

SB 407 – PUBLIC HEARING

305

Rick Berkobien

Committee Administrator.  Explains bill.

315

Damiana Merryweather

Oregon Psychological Association.  Introduces herself.

320

David Wade

Oregon Psychological Association.  Introduces himself and submits written testimony in support of SB 407 (EXHIBIT I).  Also submits report on “Evaluation of the Psychopharmacology Demonstration Project: A Retrospective Analysis” (EXHIBIT J), an article on “Psychology’s First Prescribes” written by Melissa Dittmann (EXHIBIT K) and a report conducted by the Department of Defense on  “Prescribing Psychologists” (EXHIBIT L).

340

Paul Feldman

Oregon Psychological Association.  Introduces himself.

350

Wade

Begins discussing support of SB 407.

410

Wade

Continues to discuss points of support for SB 407.

TAPE 12, B

020

Wade

Continues to discuss issues that would be solved by SB 407.

030

Sen. David Nelson

Senate District #29.  Testifies in support of bill.  Explains current issues and the importance getting patients the right treatment.

045

Sen. Morrisette

Comments that he did introduce a bill regarding children and regulating medications.

060

Wade

Continues to discuss support of SB 407.

110

Wade

Continues to give reason of support for SB 407.

170

Sen. Kruse

Refers to the bill. Asks to clarify where to standardize listed comes from.

175

Robert Julien

Licensed physician, Lake Oswego, Oregon.  Submits and presents written testimony in support of SB 407 (EXHIBIT M).

185

Sen. Kruse

Asks who will be supervising the prescribing psychologists.

190

Julien

Answers by a physician.

195

Sen. Kruse

Refers to section 2, subsection 4 and to page 2 line 13.  Questions the authority being taken away from the Board of Psychological Examiners.

215

Wade

Clarifies duties of authority Board of Psychological Examiners.

220

Sen. Kruse

Comments that the bill will be taking away authority from Board of Psychological Examiners.

225

Berkobien

Asks if there have been reports from New Mexico’s program.

228

Julien

Answers that there has not been yet, or from Louisiana

235

Merryweather

Comments that they have requested amendments for lines 2 and 3.

248

Wade

Comments that as a psychiatrist, he has to work with patients on medications.  Adds that this bill would help them help their patients.

270

Angela Kimble

Association of Oregon Community Mental Health Programs.  Testifies in opposition to SB 407. Expresses concern of directors within different counties and conveys responses.

310

Kimble

Summarizes and concludes.

315

John McCulley

Oregon Psychiatric Association. Submits and presents testimony in opposition to SB 407 (EXHIBIT N).

365

McCulley

Refers to chart in testimony of training.

375

Sen. Morrisette

Asks who can presently prescribe medications and what kind of training they have

380

McCulley

Clarifies who can prescribe medications and what medical training is involved.

410

Sen. Morrisette

Asks if McCulley’s answer was from chart in testimony.

415

McCulley

Answers that it was not and defers to Teresa Shelby to clarify answer.

420

Teresa Shelby

Representative, Oregon Psychiatric Association. Clarifies medical training for physicians.

TAPE 13, B

010

McCulley

Discusses the issue of access.

030

McCulley

Summarizes and concludes.

040

Sen. Morrisette

Notes concern that doctors don’t take time to concur with psychologist before prescribing medications.

050

Shelby

Testifies in opposition to SB 407 and expresses concern.

100

Shelby

Continues to provide reasons for opposition.

115

Robert McKelvey

MD, Oregon Psychiatric Association. Testifies in opposition to SB 407.

165

McKelvey

Continues to discuss reasons of opposition.

195

McKelvey

Summarizes and concludes. 

210

Sen. Morrisette

Asks about continuing education for primary care physicians.

213

McKelvey

Answers common problems that he addresses in conferences around the state.  Also adds comment on psychologists’ lack of training.

235

Sen. Morrisette

Comments on the need to draft a bill to make certain schooling mandatory.

240

Tom Dodson

MD, private practice.  Testifies in opposition to SB 407. 

290

Dodson

Continues to give reason for opposition to SB 407.

330

Chair Monnes Anderson

Comments that other witnesses will have another opportunity to testify.  Addresses need for clarity in the bill.

360

Sen. Morrisette

Comments on continual medical training.

The following was submitted without public testimony:

 

Kathleen Haley

Executive Director, Board of Medical Examiners.  Submits testimony in opposition to SB 407 (EXHIBIT O).

365

Chair Monnes Anderson

Closes public hearing on SB 407.  Adjourns meeting at 2:50 p.m.

 

EXHIBIT SUMMARY

 

A.     Introductions, LC 1154, staff, 1 p

B.     Introductions, LC 1156, staff, 2 pp

C.     Introductions, LC 1157, staff, 1 p

D.    Introductions, LC 1807, staff, 8 pp

E.     Introductions, LC 2335, staff, 7 pp

F.      SB 450, informational packet, Martin Taylor, 4 pp

G.    SB 450, written testimony, Jo Bell, 2 pp

H.    SB 450, written testimony, Scott Gallant, 1 p

I.       SB 407, written testimony, David Wade, 2 pp

J.      SB 407, report David Wade, 6 pp

K.    SB 407, article, David Wade, 4 pp

L.     SB 407, report David Wade, 11 pp

M.  SB 407, written testimony, Robert Julien, 2 pp

N.    SB 407, written testimony, John McCulley, 12 pp

O.    SB 407, written testimony, Kathleen Haley, 2 pp