SENATE COMMITTEE ON HUMAN SERVICES

 

 

January 18, 2005†† Hearing Room D

3:00 P.M.†††† Tapes† 1 - 3

Corrected 10/25/2005

MEMBERS PRESENT:††††††††††† Sen. Bill Morrisette, Chair

Sen. Rick Metsger

Sen. Laurie Monnes Anderson

Sen. Charles Starr

 

MEMBER EXCUSED:††††††††††† Sen. Jeff Kruse, Vice-Chair

 

 

STAFF PRESENT:††††† ††††††††††† Rick Berkobien, Committee Administrator

Brittany Kenison, Committee Assistant

 

 

MEASURES/ISSUES HEARD & WITNESSES:†

Adoption of Committee Rules - Organizational Meeting

Introduction of Committee Members - Organizational Meeting

Discussion of Committee Work Plan - Organizational Meeting

Rural Health Care Issues, Overview of - Informational Meeting

††††††††††† Karen Whitaker, OHSU Center for Rural Health

††††††††††† Ed Patterson, Oregon Rural Health Association

††††††††††† Dr. Bruce Goldberg, Office of Oregon Health Policy & Research

 

These minutes are in compliance with Senate and House Rules.† Only text enclosed in quotation marks reports a speakerís exact words.† For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE 1, A

003

Chair Morrisette

Opens the committee to order at 3:07 PM. Opens an organizational meeting.

ADOPTION OF COMMITTEE RULES - ORGANIZATIONAL MEETING

005

Chair Morrisette

Asks for motion to adopt proposed Committee Rules (EXHIBIT A).

007

Sen. C. Starr

MOTION:† Moves to ADOPT the proposed Committee Rules dated 01/18/05.

010

 

VOTE:† 4-0- 1

EXCUSED:† 1 - Kruse

 

Chair Morrisette

Hearing no objection, declares the motion CARRIED.

INTRODUCTION OF COMMITTEE MEMBERS - ORGANIZATIONAL MEETING

012

Chair Morrisette

Introduces himself and background. Expresses interest in human services.

020

Sen. Monnes Anderson

Introduces herself and background.

030

Sen. Starr, C.

Introduces himself and background.

035

Sen. Metsger

Introduces himself and background.

DISCUSSION OF COMMITTEE WORK PLAN - ORGANIZATIONAL MEETING

045

Chair Morrisette

Goes over committee work plan:

         Rural health.

         Prescription drug plan.

         Long term care.

         Services of Children and Family

085

Chair Morrisette

Closes organizational meeting. Opens information meeting on rural health care. Invites Karen Whitaker, for testimony.

RURAL HEALTH CARE ISSUES, OVERVIEW OF - INFORMATIONAL MEETING

090

Karen Whitaker

Oregon Health and Science University Center for Rural Health (OHSU).† Introduces herself and gives background.

100

Chair Morrisette

Asks why she went to work at OHSU in 1989.

110

Whitaker

Explains history and reason.

115

Whitaker

Submits written PowerPoint presentation for testimony (EXHIBIT B)

         Reviews map of rural districts in Oregon.

         Reviews Oregon population by county.

145

Whitaker

Explains differences of health care in rural areas.

155

Whitaker

Reviews charts of population, unemployment, income, uninsured in rural counties.

180

Chair Morrisette

Makes comment on percentage of uninsured Oregonians and his interest in providing health care.

200

Whitaker

Comments on the ability to get an accurate percentage. Continues to review charts for unintentional injury (death) rates and tobacco-related deaths.

245

Whitaker

Summarizes rural health clinics and where they are in Oregon.

280

Rick Berkobien

Committee Administrator.† Asks if there is a significant turn over in health clinics in rural counties.

285

Whitaker

Confirms that there is a high rate but adds that it is getting better and that it varies clinic to clinic.

300

Chair Morrisette

Asks if clinics have a funding cycle and the longevity

305

Whitaker

Believes that grants are received and are renewable on yearly basis. Refers to Dr. Bruce Goldberg for clarification.

315

Chair Morrisette

Asks if grants will continue to be funded and federal will not close the grants.

320

Whitaker

Confirms that it will continue and adds that most clinics can not survive off of grant money alone..

335

Whitaker

Reviews chart for the 2004 Rural Health Care (RHC) report findings & top concerns.

385

Whitaker

Reviews Oregon map of location of rural hospitals.

415

Chair Morrisette

Comments that a public hearing will be held at the Newport Hospital on February 4, 2005.

TAPE 2, A

010

Whitaker

Presents photos of rural hospitals around Oregon.

025

Whitaker

Reviews chart for occupancy rate for Oregon hospitals by percentage.

040

Whitaker

Reports on rural physicians conducted by University of North Carolina.

050

Whitaker

Discusses issues with rural health.

060

Whitaker

Shares success stories in rural health.

085

Whitaker

Gives overview of duties of the State Office of Rural Health.

090

Whitaker

Explains map of Emergency Medical Services Grants in rural communities, however the program is no longer available.

110

Whitaker

Reviews area health education centers.

130

Whitaker

Goes over the issues that need to be addressed, outcomes and economic impacts.

180

Whitaker

Summarizes and concludes.

185

Chair Morrisette

Comments on correlation of long term care.

195

Whitaker

Adds that she is gathering information and believes that it is a related issue.

210

Chair Morrisette

Recognizes issue and advises it will be addressed later.

215

Berkobien

Asks for data on the impact on physicians from HB 3603 (2003).

220

Whitaker

Says that it is too early to tell, but believes that it has had some impact.

240

Ed Patterson

Executive Director for Oregon Rural Health Association (ORHA).† Introduces himself. Submits written testimony (EXHIBIT C).Begins review for rural health disparities and the rural health care safety net

290

Patterson

Reports on data and contributing factors regarding rural health disparities.

295

Patterson

Gives history and background on the ORHA.

325

Patterson

Begins overview of Sustaining the Rural Health Safety Net, submits written testimony (EXHIBIT D).

         Fewer volunteers in rural communities and getting harder for the Area Health Education Center (AHEC) to recruit.

         Not enough staff in clinics, but no funding available.

         Shortage of physicians willing to practice in rural areas due to funding.

380

Patterson

Describes the Type A and Type B rural hospitals.

410

Chair Morrisette

Explains that all issues will be looked at under during this session.

TAPE 1, B

015

Patterson

Reviews cost trends of Median Operating Margins of Oregon Diagnostic Related Groups (DRG) hospitals.

030

Patterson

Reviews median operating margin trends for Type A and B rural hospitals

055

Patterson

Reviews statistics and charts for Legacy Emanuel Hospital.

080

Patterson

Reviews statistics and charts for OHSU Hospital.

090

Patterson

Reviews statistics and charts for Good Samaritan Regional Medical Center, in Corvallis.

100

Patterson

Reviews statistics and charts for:

         Samaritan North Lincoln hospital

         Samaritan Lebanon Community Hospital and

         Samaritan Pacific Communities Hospital, in Newport

Expresses concerns for each of the hospitals.

145

Sen. Monnes Anderson

Asks about comparisons of provider rate versus hospital rates and if any surveys have been conducted for rates comparing Type A, Type B, and DRG hospitals.

150

Patterson

Defers to Dr Bruce Goldberg.

160

Patterson

Discusses cost of procedures for smaller versus larger hospitals.

185

Chair Morrisette

Asks about medical technology being overused to defray costs of health equipment.

195

Patterson

Answers that newer equipment is more cost effective.

205

Chair Morrisette

Asks how are they paid for.

210

Patterson

Defers to Hospital Financial Management Association for precise answer.

230

Bruce Bishop

Oregon Association of Hospitals & Health Systems.† Introduces himself.

245

Bishop

Gives overview of letter from Barney Speight. Submits as written testimony (EXHIBIT E).

290

Bishop

Summarizes and concludes.

295

Chair Morrisette

Invites Dr. Bruce Goldberg, Office of Oregon Health Policy & Research

for testimony.

300

Bruce Goldberg

Introduces himself and submits written testimony. (EXHIBIT F).

320

Goldberg

Begins discussion of the Health Care Safety Net.

340

Goldberg

Refers to Notebook, submits for testimony (EXHIBIT G).

350

Goldberg

Continues discussing Health Care Safety Net (EXHIBIT F):

         Access and Capacity

TAPE 2, B

005

Goldberg

Continues discussing Health Care Safety Net:

         Access and Demand

         Health Care Safety Net-Definition

         Health Care Safety Net Patients

050

Goldberg

Continues discussing Health Care Safety Net:

         Health Care Safety Net Providers

         Health Care Safety Net Core

         Health Care Safety Net Typical Services

         Health Care Safety Net Funding Sources

105

Goldberg

Continues discussing Health Care Safety Net:

         Federally Qualified Health Centers

160

Goldberg

Continues discussing Health Care Safety Net:

         Rural Health Clinics

         School Based Health Centers

         Indian and Tribal Clinics

185

Berkobien

Asks if tribal clinics serve patients other then tribal members.

195

Goldberg

Affirms.

200

Goldberg

Continues discussing Health Care Safety Net:

         Community clinics

         Workforce Programs

270

Goldberg

Continues discussing Health Care Safety Net:

Gov. Health Care Safety Net Policy Team Recommendations.

400

Goldberg

Continues Discussing Governorís Recommendations

475

Goldberg

Summarizes and Concludes

TAPE 3, A

005

Chair Morrisette

Asks how to document success for prevention.

010

Goldberg

Explains the need to gather data to support policy choices to properly fund policies instead of measuring the effects later.

020

Chair Morrisette

Emphases importance of anecdotal documentation.

030

Chair Morrisette

Closes informational meeting. Adjourns committee meeting at 5:05 p.m.

 

 

EXHIBIT SUMMARY

 

A.     Rules, committee, staff, 3 pp

B.     Rural Health Care Issues, overview of, Karen Whitaker, 12 pp

C.     Rural Health Care Issues, overview of, Ed Patterson, 2 pp

D.    Rural Health Care Issues, overview of, written testimony, Ed Patterson, 9 pp

E.     Rural Health Care Issues, overview of, letter from Barney Speight, Bruce Bishop, 6 pp

F.      Rural Health Care Issues, overview of, Slide Presentation ďOregonís Health Care Safety Net,Ē Bruce Goldberg, 33 pp

G.    Rural Health Care Issues, overview of, Report on Governorís Health Care Safety Net Policy Team, Bruce Goldberg, 129 pp