SENATE COMMITTEE ON HEALTH POLICY

 

 

March 14, 2005                                                                                                       Hearing Room B

1:00 P.M.                                                                                                                     Tapes  39 - 40

 

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:

SB 298 – Public Hearing and Work Session

SB 697 – Public Hearing and Work Session

SB 698 – Public Hearing

SCR 7 – Public Hearing and Work Session

SB 880 – 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 39, A

003

Chair Monnes Anderson

Calls the meeting to order at 1:01 p.m.  Opens a public hearing on SB 298.

SB 298 – PUBLIC HEARING

010

Chair Monnes Anderson

Seeing no witnesses, closes the public hearing and opens a work session on SB 298.

SB 298 – WORK SESSION

012

Chair Monnes Anderson

Introduces and explains the -1 amendments (EXHIBIT A).

020

Sen. Courtney

MOTION:  Moves to ADOPT SB 298A -1 amendments dated 3/14/05.

 

 

VOTE:  4-0-1

EXCUSED:  1 - Sen. Kruse

 

Chair Monnes Anderson

Hearing no objection, declares the motion CARRIED.

SEN. BROWN will lead discussion on the floor.

025

Chair Monnes Anderson

Closes the work session on SB 298 and opens a public hearing on SB 697.

SB 697 – PUBLIC HEARING

040

Rick Berkobien

Committee Administrator.  Submits -1 amendments (EXHIBIT B).

042

Marshall Coba

Oregon Society of Physician Assistants.  Submits and presents written testimony in support of SB 697 (EXHIBIT C).

050

Scott Byers

President, Oregon Society of Physician Assistants.  Testifies if support of SB 697.

070

Chair Monnes Anderson

Asks if there is any known opposition to SB 697.

072

Byers

Answers, no.

The following material is submitted for the record without public testimony:

 

Karen Whitaker

Vice-Provost, Oregon Health and Science University Center for Rural Health.  Submits written testimony in support of SB 697 (EXHIBIT D).

075

Chair Monnes Anderson

Closes the public hearing and opens a work session on SB 697.

SB 697 – WORK SESSION

080

Sen. Courtney

MOTION:  Moves to ADOPT SB 697A-1 amendments dated 3/10/05.

 

 

VOTE:  5-0-0

 

Chair Monnes Anderson

Hearing no objection, declares the motion CARRIED.

083

Sen. Courtney

MOTION:  Moves SB 697A to the floor with a DO PASS AS AMENDED recommendation.

087

Sen. George

States that he does not have the -1 amendments.

090

Chair Monnes Anderson

Explains the -1 amendments.

 

 

VOTE:  5-0-0

 

Chair Monnes Anderson

Hearing no objection, declares the motion CARRIED.

SEN. MORRISETTE will lead discussion on the floor.

100

Chair Monnes Anderson

Closes the work session on SB 697 and opens a public hearing on SB 698.

SB 698 – PUBLIC HEARING

105

Marshall Coba

Oregon Society of Physician Assistants.  Submits and presents written testimony in support of SB 698 (EXHIBIT E).

125

Scott Beyer

President, Oregon Society of Physician Assistants.  Testifies in support of SB 698.

140

Sen. Morrisette

Asks for clarification on having a physician involved in rural areas.

145

Beyer

Explains that they do not have to be physically present.

149

Sen. Morrisette

Comments on the chain of command the bill will create.  Asks witness to confirm statement regarding possible problems.

155

Beyer

Affirms.

158

Karen Whitaker

Vice Provost, Oregon Health and Science University (OHSU) center for Rural Health.  Submits and presents written testimony in support of SB 698 (EXHIBIT F).

170

Nan Hein

Oregon Ambulance Association.  Testifies in opposition to SB 698.

220

Dave Lapof

Oregon Ambulance Association.  Testifies in opposition to SB 698.

250

Sen. Morrisette

Clarifies that the medics have constant communication with physicians.

255

Lapof

Affirms. Elaborates.

275

Chair Monnes Anderson

Ask to clarify that medic would not have to follow the instructions of a physician assistant (PA).

285

Lapof

Answers, no and defers to Shawn Baird for further clarification.

295

Shawn Baird

Oregon Volunteers Firefighters Association.  Answers the Chair’s question.  Submits and presents written testimony in opposition to SB 698 (EXHIBIT G).

365

Sen. George

Asks if any daily routine would change if the bill became law.

385

Baird

Answers question.

388

Sen. George

Clarifies that carrier states are only authorized to receive instructions from a licensed physician.

390

Baird

Affirms.  Adds that he has to provide his insurance company with a copy of their state license.

393

Chair Monnes Anderson

Asks if that is the same for Nurse Practitioners.

395

Baird

Responds, no.

398

Sen. Morrisette

Clarifies response.

400

Baird

Answers and explains.

413

Sen. Morrisette

Asks if insurance companies are requiring medics to make contact with emergency room doctors only.

418

Baird

Answers and explains procedure.

430

John Praggastis

Vice President, Oregon State Paramedic Association.  Submits and presents written testimony in opposition to SB 698 (EXHIBIT H).

TAPE 40, A

020

Praggastis

Continues discussing opposition to SB 698.

040

Chair Monnes Anderson

Submits written testimony from Ritu Sahni, Physician, Lake Oswego, Oregon, in opposition to SB 698 (EXHIBIT I), and written testimony in opposition to SB 698 from Denise Giard, President, Oregon Fire Medical Administrators Association (OFMAA) (EXHIBIT J) for the record.  States that a work session will not be held. Closes the public hearing on SB 698 and opens a public hearing on SCR 7.

SCR 7 – PUBLIC HEARING

055

Jo Bell

Director, Oregon Association of Hospitals and Health Systems.  Submits and presents written testimony in support of SCR 7 (EXHIBIT K).

080

Chair Monnes Anderson

Closes the public hearing and opens a work session on SCR 7.

SCR 7 – WORK SESSION

082

Sen. Courtney

MOTION:  Moves SCR 7 be sent to the floor with a BE ADOPTED recommendation.

 

 

VOTE:  5-0-0

 

Chair Monnes Anderson

Hearing no objection, declares the motion CARRIED.

SEN. MONNES ANDERSON will lead discussion on the floor.

083

Chair Monnes Anderson

Closes the work session on SCR 7 and opens a public hearing on SB 880.

SB 880 – PUBLIC HEARING

100

Martin Taylor

Oregon Nurses Association.  Submits and presents written testimony in support of SB 880 (EXHIBIT L).

125

Elizabeth Ladu

Immediate Past Chair, Nurse Practitioners of Oregon.  Explains the bill and testifies in support of SB 880.

175

Ladu

Continues to explain the bill.

190

Anne Barry-Leaver

Nurse Practitioner, Salem, Oregon.  Submits written testimony explaining the bill and testifying in support of SB 880.

230

Sen. Kruse

Asks about communicable disease and how it relates with institutions.

245

Taylor

Answers that there are three (3) sections in the bill that relate to the communicable disease center.  Elaborates.

265

Sen. Kruse

Comments on making sure that the new authority is connected.

275

Ladu

Clarifies the intent of the bill.

275

Sen. Kruse

Re-clarifies statement on the new authority in the bill.

277

Taylor

Comments that the bill adds Nurse Practitioner after the word physician.

280

Chair Monnes Anderson

Comments on section six (6) of the bill.  Elaborates.

290

Ladu

Comments that a Nurse Practitioner has an equal level of responsibility to physicians in reporting communicable disease.

300

Barry-Leaver

States that patients need to know that Nurse Practitioners have authority.

320

Chair Monnes Anderson

Refers to section thirteen (13) of the bill and asks if there is a disagreement as well.

325

Taylor

Comments that there are different goals in mind.

327

Ladu

Comments on section thirteen (13) of SB 880.

350

Chair Monnes Anderson

Asks for a specific example of a pregnant woman that needed to have a transfer.

355

Ladu

States that she cannot think of specific example.  Provides another example.

390

Sen. Kruse

Refers to section thirteen (13) relating to SB 698.

397

Taylor

Explains the job of the Nurse Practitioner and how they work with medics.

415

Sen. Kruse

States that the issue is with the relationship with medics.

425

Sen. Morrisette

Asks to provide other examples of conflicts with medics and Nurse Practitioners.

437

Ladu

Answers that scenarios like that are rare and explains.

TAPE 39, B

003

Sen. Morrisette

Comments on arguments to SB 698 (2005)

006

Sen. Kruse

Comments on section thirteen (13) of the bill and dealing with emergency situations.

020

Andi Easton

Oregon Medical Association (OMA).  Testifies in opposition to SB 880.

033

Sen. Morrisette

Clarifies that she was not notified about this bill.

035

Easton

Affirms.

037

John Praggastis

Vice President, Oregon State Paramedic Association.  Submits and presents written testimony in opposition to SB 880 (EXHIBIT N).

065

Chair Monnes Anderson

States that the ultimate goal and focus should be on taking care of the patient.

068

Sen. George

Comments on Nurse Practitioners being the third supervisor for medics.  States that would compounding a problem.

070

Praggastis

Confirms statement.  Provides further concerns on SB 880.

090

Sen. George

Comments on possible concerns of the bill.

095

Praggastis

Affirms that the bill will cause problems.  Further comments on regular chain of command.

103

Sen. George

Asks who would have the ultimate authority and if that needs to be defined by law if the bill was passed.

105

Praggastis

Explains how the chain of command is in statute and how the bill would disrupt that.

125

Sen. Morrisette

Comments on shortage of physicians in rural areas.  Comments on personal experience with a Nurse Practitioner.

150

Praggastis

States that there are almost 200 certified physicians in Oregon that operate within the ambulance arena.  Comments on rural areas.

165

Shawn Baird

Oregon Volunteers Firefighters Association.  Testifies in opposition to SB 880.  Comments on previous testimony by the Nurse Practitioners.

190

Chair Monnes Anderson

Asks for parties to work together to solve conflicts.  Closes public hearing on SB 880 and adjourns meeting at 2:15 p.m.

 

EXHIBIT SUMMARY

 

A.     SB 298, -1 amendments, staff, 3 pp

B.     SB 697, -1 amendments, staff, 1 p

C.     SB 697, written testimony, Marshall Coba, 2 pp

D.    SB 697, written testimony, Karen Whitaker, 1 p

E.     SB 698, written testimony, Marshall Coba, 1 p

F.      SB 698, written testimony, Karen Whitaker, 1 p

G.    SB 698, written testimony, Shawn Baird, 1 p

H.    SB 698, written testimony, John Praggastis, 2 pp

I.       SB 698, written testimony, Ritu Sahni, 1 p

J.      SB 698, written testimony, Denise Giard, 1 p

K.    SCR 7, written testimony, Jo Bell, 6 pp

L.     SB 880, written testimony, Martin Taylor, 2 pp

M.  SB 880, written testimony, Ann Barry Leaver, 3 pp

N.    SB 880, written testimony John Praggastis, 2 pp