SENATE COMMITTEE ON HUMAN SERVICES

 

January 20, 2005                                                                                                     Hearing Room D

3:00 PM                                                                                                                           Tapes  4 - 5

Corrected 10/25/2005

MEMBERS PRESENT:         Sen. Bill Morrisette, Chair

Sen. Rick Metsger

Sen. Laurie Monnes Anderson

 

MEMBER EXCUSED:          Sen. Jeff Kruse, Vice-Chair

Sen. Charles Starr

 

STAFF PRESENT:                 Rick Berkobien, Committee Administrator

Brittany Kenison, Committee Assistant

 

 

MEASURES/ISSUES HEARD & WITNESSES:      

Federally Qualified Health Centers and Other Community Health Centers - Informational Meeting

     Craig Hostetler, Executive Director, Oregon Primary Care Association

     Doug Riggs, Legislative Affairs Coordinator, Oregon Primary Care Association

 

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 4, A

003

Chair Morrisette

Calls committee meeting to order at 3:05 PM. Opens an informational meeting.

FEDERALLY QUALIFIED HEALTH CENTERS, INFORMATIONAL MEETING

020

Craig Hostetler

Executive Director, Oregon Primary Care Association (OPCA).  Introduces himself and submits written testimony (EXHIBIT A).

030

Hostetler

Gives background of OPCA.

045

Hostetler

Explains characteristics of a Community Health Center (CHC). Adds that CHC also is referred to as Federally Qualified Health Center (FQHC).

070

Hostetler

Gives overview and statistics of health centers nationally.

085

Hostetler

Presents overview and statistics of health centers in Oregon.

095

Chair Morrisette

Asks if OPCA accepts patients who have lost Oregon Health Plan (OHP) coverage.

100

Hostetler

Affirms.

101

Hostetler

Presents overview of the FQHC budget.

120

Rick Berkobien

Committee Administrator.  Asks if people with commercial insurance are able to get care.

125

Hostetler

Answers that it ranges by community.

130

Hostetler

Continues discussing FQHC budget.

140

Chair Morrisette

Requests examples of private funding.

141

Hostetler

Gives examples of operations (short-term), fundraisers, federal foundations and adds other foundations like the Myer Memorial trust, North West health foundation, and the Ford foundation.

155

Chair Morrisette

Asks which foundations are involved currently and which could be involved and requests lists.

165

Steve Manela

Community Health Centers of Lane County.  There FQHC has partnerships locally with hospitals, schools, government and foundations.

180

Chair Morrisette

Refers information to go to Rick and expresses his interest to get involved.

195

Hostetler

Comments on new Director for Development for OPCA and his ideas for funding.

205

Chair Morrisette

Would like to get in touch with the new Director.

210

Hostetler

Discusses FQHC Encounters.

220

Hostetler

Remarks on CHC benefits.  Discusses also how the CHC’s are cost effective.

255

Chair Morrisette

Wonders what the pharmaceutical savings are.

260

Hostetler

Answers that savings are 41 percent.

275

Chair Morrisette

Verifies that OPCA is not receiving savings from programs but that they are finding the savings through other methods.

278

Hostetler

Affirms

285

Berkobien

Asks what are the general cost for pharmacy is under the B43 program.

295

Hostetler

Defers to Steve Manela, CareOregon, Inc.

300

Manela

Confirms that there is a 40-60% savings for medications. Federal has contract that determines cost on quarterly basis to service FQHC patients.

315

Berkobien

Clarifies that the cost under the B43 program is below what Medicaid and the OHP pays.

318

Manela

Believes that Medicaid pays wholesale plus 15 percent and the B43 program saves 40-60% off of the wholesale price.

322

Chair Morrisette

Asks how patients obtain savings.

325

Manela

Answers that it varies by center. Adds that it can be an in-house dispensary, or have contracts with a pharmacy.

330

Chair Morrisette

Clarifies that a contract can be with an individual pharmacy.

335

Manela

Specifies that only one pharmacy contract can be made per center.

340

Chair Morrisette

Asks if patients have to go to pharmacy for that discount.

341

Manela

Affirms. Adds that a contract with same pharmacy at multiple locations can be made.

345

Hostetler

Points out correlation with health centers and decrease in percentage of emergency room (ER) visits.

355

Hostetler

Reviews how CHC’s provide high quality care. Remarks that JCAHO stands for Joint Commission on Accreditation for Health Care Organization.  Presents background on this type of certification.

385

Chair Morrisette

Requests studies for correlation of Diabetes patients in the ER.

390

Hostetler

Offers to return information to the committee.

400

Hostetler

Reviews community benefits of health centers.

410

Hostetler

Emphasizes need for state and local support.

TAPE 5, A

003

Chair Morrisette

Asks when the last time organization had line items from the state.

005

Hostetler

Believes three sessions ago, defers to Joyce Soares, CareOregon, Inc.

007

Joyce Soares

CareOregon, Inc.  Reports that the last time was in the 2001-2003 biennium.  Adds that after the five special sessions (2003-2005), the money was not allocated.

010

Chair Morrisette

Asks what the percentage of the funds was that the organization was depending on.

012

Hostetler

Reports between $12,000 to $14,000.

015

Chair Morrisette

Asks what changed from when they had enough money to fund the organization.

017

Soares

Believes that it started when safety net groups formed and asked for money on behalf of all the safety net clinics.  Comments on the amounts the group received.

020

Chair Morrisette

Comments on amount received and the competition involved between the groups. Ask what are the compelling needs of the organization for state funding and if they can get along without state funding.

025

Hostetler

Expresses that here have been clinic closures and cut back in services because of the cuts in the OHP.

032

Chair Morrisette

Asks if foundations require state matching funds.

033

Hostetler

Affirms.

035

Soares

Comments on the safety net clinics’ dependency on OHP.

037

Chair Morrisette

Comments that if money is put into the OHP, that it would filter down to their organization.

040

Hostetler

Continues discussing how state and local support is needed.

050

Hostetler

Discusses solutions.

060

Chair Morrisette

Comments on bill to a start tobacco tax. Asks if there is awareness of the bill and if there is a dedication attached to it.

065

Hostetler

Notes that not currently, but adds that a group is coming together.

075

Chair Morrisette

Comments on alcohol recovery fee bill and determining allocations of the money. Comments on whether groups are trying to pass the bill.

080

Doug Riggs

Oregon Primary Care Association.  Comments on trying to get a coalition together to support the purposed bill.

085

Chair Morrisette

Notes that he supports the effort from the organization.

090

Riggs

Remarks on trying to take advantage of drawing the maximum federal match.

095

Chair Morrisette

Clarifies that the money would go into the OPH to get the match and the state would have more money to disperse.

100

Manela

Remarks that the way people have been cut from the OHP doesn’t match their health needs and that a partnership with the safety net clinics could be a good alternative.

115

Hostetler

Continues discussing and identifying solutions.

130

Riggs

Adds that they met with Senator Ben Westland in Prineville a month ago and many members from around the community were on the list of board members.  Stresses the importance of community involvement to bring everyone together for the program.

140

Chair Morrisette

Comments on correlation with the Ford Family Foundation and getting people involved. Comments also on attracting new businesses with good medical care.

150

Berkobien

Asks if Medicare cost-based reimbursement is true.

155

Hostetler

Answers that it is a little less than cost-based. Explains how it changes each year and how it can fluctuate.

160

Berkobien

Asks how CHC’s claim money.

165

Hostetler

Answers that centers have to be registered by the state as a FQHC.  Comments on procedures with different patients.

168

Berkobien

Asks how long it takes to receive wrap around payments.

170

Hostetler

Explains that it can take nine to twelve months to receive payment and adds that it causes cash flow issues.

175

Sen. Monnes Anderson

Asks if all FQHC have electronic billing.

180

Hostetler

Answers almost. Adds that they are still working on it.

185

Sen. Monnes Anderson

Comments on the difference of receiving payments in six days compared to several weeks or months.

190

Hostetler

Comments on the delay and the procedure of sending requests in “batches.” Adds that the organization is working for a timelier solution.

200

Sen. Monnes Anderson

Clarifies that there will be no dual eligibility after the new Medicare bill.

205

Hostetler

Believes that there still will be some patients that are.

207

Chair Morrisette

Confirms that pharmaceuticals will not be dual eligible.

209

Hostetler

Affirms.

210

Berkobien

Asks what will become of dual eligible centers.

215

Hostetler

Alleges that there will be options available to the patients.  They have been looking at ways to maximize options.

220

Chair Morrisette

Asks Steve Manela to give specifics on a wrap around payment procedure.

225

Manela

Summarizes wrap around payment process.

240

Chair Morrisette

Comments on wrap around procedure and wants to know if wrap around issues have been resolved.

245

Manela

Remarks that issues have not been resolved.

250

Manela

Continues discussing the wrap around procedure.

255

Chair Morrisette

Asks if they have started process to change this procedure.

260

Manela

Notes that negotiations have started.

270

Chair Morrisette

Comments on unacceptability of receiving payment months later

275

Hostetler

Summarizes and concludes.

280

Chair Morrisette

Asks if issue with wrap around payment issue is with a certain company.

283

Manela

Answers that is an issue through the Office of Medical Assistance Programs (OMAP).

284

Chair Morrisette

Asks if OMAP pays half.

285

Manela

Explains billing procedure.

295

Ruby Haughton

Director, Legislative and Public Affairs, Care Oregon.  Comment that the organization has been seeking prompter payment. Comments on creating a bill and working with everyone involved to address the wrap around payment issue.

310

Chair Morrisette

Clarifies that bill would address state portion of funds only.

312

Haughton

Remarks that they cannot impact federal monies, however believes that state amount received is larger.

325

Sen. Monnes Anderson

Comments on health center she worked for and how it became a FQHC and should encourage more centers to be formed in communities in need.

340

Hostetler

Comments on national statistics compared to Oregon.

360

Chair Morrisette

Comments that communities in Oregon do qualify because of demographics.

375

Gil Munoz

Executive Director, Virginia Garcia Memorial Health Center. Reaffirms issue of needing prompter payments, remarks that they have opened new centers and have problems with cash flow.

395

Chair Monnes Anderson

Summarizes and concludes. Closes informational meeting. Adjourns meeting at 4:05 PM.

 

 

EXHIBIT SUMMARY

 

A.     Federally Qualified Health Centers, slide presentation, Craig Hostetler and Doug Riggs, 16 pp