SENATE COMMITTEE ON HUMAN SERVICES

 

 

February 04, 2005                                                                                                Hearing Room NEWPORT

1:00 P.M.                                                                                                                     Tapes  10 - 12

Corrected 10/03/2005

MEMBERS PRESENT:         Sen. Bill Morrisette, Chair

Sen. Jeff Kruse, Vice-Chair

Sen. Laurie Monnes Anderson

Sen. Charles Starr

Rep. Allen Brown

 

MEMBER EXCUSED:          Sen. Rick Metsger

 

STAFF PRESENT:                 Rick Berkobien, Committee Administrator

Brittany Kenison, Committee Assistant

 

MEASURES/ISSUES HEARD:

Coastal hospital and health care systems – Informational Meeting

Sustaining the Rural Health Safety Net – Informational Meeting

Social service issues in coastal Oregon – Informational Meeting

In home care for seniors – Informational Meeting

SB 98 - Public Hearing

Issues such as access to health care, long-term care, access to prescription drugs, oral health care, and services within the Oregon Department of Human Services - 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 Morrisette

Calls meeting to order at 1:07 p.m. Opens informational meeting on coastal hospital and health care systems.

COASTAL HOSPITAL AND HEALTH CARE SYSTEMS - INFORMATIONAL MEETING

005

David Bigalow

Chief Executive Officer, Samaritan Pacific Health Services.  Submits and presents written testimony (EXHIBIT A).  Submits graphs for record of write-off’s (EXHIBIT B).

001-099

 

**Recording error, no audio

100

Sen. Kruse

Asks for input regarding covered providers and also asks why he didn’t discuss issue of labor.

105

Bigalow

Discusses concern of proposed program to set a rate by hospitals.

110

Sen. Kruse

Refers to last page of (EXHIBIT A) and comments on the States that the rates that Bigalow compared, more received Medicaid reimbursement than Oregon and asks how it can compare to Oregon.  Speculates on possible problems.

120

Bigalow

Agrees with possible problems Oregon would face.

121

Chair Morrisette

Confirms that one of the five hospitals has a union contract.

125

Bigalow

Clarifies that four of the five hospitals has union contracts.

126

Chair Morrisette

Expresses concern for community college and medical program expenses.  Asks if the Newport college has the same problems.

130

Bigalow

Affirms high expenses.  Notes that they have an actively working partnership with the local colleges and will provide a lab and work space for students.

132

Chair Morrisette

Emphasizes need for nursing programs.

135

Chair Morrisette

Stands at ease to accommodate for more chairs.

140

Chair Morrisette

Expresses need to extend the tax credit to help practitioners.

145

John Zeier

Clinic Director for Yachats hospital.  Submits and presents written testimony (EXHIBIT C).  Expresses concern for clinics and how it is connected to the Rural Health Care Safety Net.

160

Zeier

Defines rural health care safety net clinics and what they provide.

195

Zeier

Discusses solutions to help fund the rural health care safety net clinics and the programs.

230

Chair Morrisette

Addresses solutions of being paid on time. Explains a bill being introduced to require this.

250

Sen. Monnes Anderson

Explains electronic billing and why the Oregon Medical Assistance Programs (OMAP) is behind issuing payments.  Explains another bill being introduced for incentive to set up for electronic billing.

265

Sen. Kruse

Asks if Zeiers clinic is a Federally Qualified Health Center (FQHC).

268

Zeier

Answers no.

270

Sen. Kruse

Asks what it would take for the clinic to become a FQHC.

271

Zeier

Comments that the clinic could not qualify and explains why.

275

Sen. Kruse

Addresses need to find a way to get rural health clinics qualified.

300

Karen Whitaker

Director of the Oregon Health and Science University (OHSU) center for rural health.  Introduces herself.

301

Scott Ekblad

Deputy Director of the OHSU center for rural health.  Introduces himself.

302

Whitaker

Discusses how the clinic in Yachats could not qualify, notes that qualifications might change.

327

Sen. Kruse

Expresses need to be aggressive to find funding for small clinics.

340

Ekblad

Comments on tax credit and would help in retaining and recruiting hospital officials.

355

Kruse

Asks what kind of impacts the tax credit bill will have.

360

Whitaker

Mentions that they are working with the Oregon Medical Association to get data on income to prepare an income differential report. Reports on a 2001 survey that found a $20,000 to $30,000 difference in income between rural and urban practice.

372

Chair Morrisette

Closes informational meeting on coastal hospital and health care systems and opens an informational meeting on sustaining the Rural Healthcare Safety Net.

RURAL HEALTH SAFETY NET, SUSTAINING THE  – INFORMATIONAL MEETING

375

Ed Patterson

Executive Director, Rural Health Association.  Submits and presents written testimony (EXHIBIT D).  Discusses sustaining the Rural Health Safety Net.

420

Patterson

Continues discussing sustaining the Rural Health Safety Net.  Gives background on budgeting and how to create the safety net as a priority.

TAPE 11, A

020

Patterson

Continues discussing funding the rural Health Safety Net Program.

030

Chair Morrisette

Asks Patterson to explain Medicaid Upper Payment Limits (MUPL) funds.

035

Patterson

Clarifies that it stands for Medicaid Upper Payment Limits and explains its purpose.

060

Patterson

Explains bill introduced to build funds.

065

Chair Morrisette

Comments on field trip held in 2001 that toured the rural health clinics.  Explains how they are working on finding ways to attract money and find monies over time.

080

Sen. Kruse

Also comments on the impact of the tour.

095

Chair Morrisette

Closes informational meeting on sustaining the Rural Health Safety Net and opens an informational meeting on social service issues in coastal Oregon.

SOCIAL SERVICE ISSUES IN COASTAL OREGON – INFORMATIONAL MEETING

100

Jan Kaplan

Director, Lincoln County Health and Human Services department.  Submits and presents written testimony (EXHIBIT E).  Notes that they have applied twice to be a FQHC. Adds that second application is pending.

120

Sen. Kruse

Asks Whitaker if she was aware of the submitted application.

121

Whitaker

Affirms.

125

Kaplan

Begins to discuss the human services needs and challenges of the coastal region.  Explains how the service systems run east to west and reports on coastal demographics.

150

Chair Morrisette

Alleges that the projection is an increase in the population.

151

Kaplan

Affirms.  Addresses growing population of Hispanics.

155

Chair Morrisette

Asks Kaplan to explain what FQHC stands for.

156

Kaplan

Answers that it stands for a Federally Qualified Health Center.  Continues to report on coastal demographics.

185

Kaplan

Discusses importance of the Oregon Health Plan (OHP) to the coastal region.

225

Kaplan

Addresses current bills in Washington DC that could drastically change the Medicaid program and urges the committee to be come familiar with the bills and possible impacts.

245

Kaplan

Explains current outbreak of Pertussis.  Expresses need of funding because of outbreak and the current lack of funds.

275

Kaplan

Expresses the uniqueness of Oregon, and adds that it can cause issues when addressing concerns (from legislatures) because of different counties.

295

Kaplan

Provides list of agencies, staff and services for health and human services. Also addresses current issues with staffing and funding.

330

Chair Morrisette

Comment on helpfulness of information provided.

350

Chair Morrisette

Closes informational meeting on social service issues in coastal Oregon and opens an informational meeting on in home care for seniors.

IN HOME CARE FOR SENIORS – INFORMATIONAL MEETING

355

Joan Wesley

Client Employed Provider.  Submits and presents written testimony (EXHIBIT F).  Explains how in home health care saves money and how it is important in rural areas.

420

Wesley

Continues to discuss need for in home care workers and their needs because the lack of respect for the workers. Explains the lack of training, no ongoing training, no meetings for policy updates, and no structure.

TAPE 10, B

020

Wesley

Continues to discuss concerns for in home care workers.

050

Wesley

Summarizes and concludes.

060

Sen. Monnes Anderson

Comments on own mother having in home care and the importance of caregivers.

065

Chair Morrisette

Asks to confirm that there are 320 in Lincoln County and 13,000 total state wide of in home care workers.

066

Wesley

Affirms.

070

Chair Morrisette

Comments on Wesley’s dedication to work.

080

Chair Morrisette

Closes informational meeting on in home care for seniors and opens a public hearing on SB 98.

SB 98 – PUBLIC HEARING

080

Rick Berkobien

Committee Administrator.  Explains bill.

100

Cindy Hannum

Administrator, Seniors and People with Disabilities, Licensing and Quality of Care Oregon Department of Human Services.  Submits and presents written testimony in support of SB 98 (EXHIBIT G).  Adds that emergency clause is needed first.

140

Chair Morrisette

States that the committee will not hold a work session until they receive the amendments.  Closes public hearing on SB 98.  Opens public on hearing issues such as access to health care, long-term care, access to prescription drugs, oral health care, and services within the Oregon Department of Human Services.

ACCESS TO HEALTH CARE, LONG-TERM CARE, ACCESS TO PRESCRIPTION DRUGS, ORAL HEALTH CARE, AND SERVICES WITHIN THE OREGON DEPARTMENT OF HUMAN SERVICES - PUBLIC HEARING

160

Marjorie Waley

Citizen.  Expresses need for better vision service.  Explains family history of eye problems, including herself and her daughters.

195

Kruparao Kancharg

Citizen, Astoria, OR.  Discusses concern for the increase in liability insurance, and how the price can vary.

220

Chair Morrisette

Notes that he is aware of issue that it is being addressed.

225

Fred Albert

Citizen, Salem, OR.  Explains that he has seven foster care homes and expresses concern for rising costs in liability insurance. 

255

Albert

Explains that he found a company in California, but it will only cover Medicaid patients.  Discusses importance for lower insurance.

275

Suzanne Edmiston

Citizen, McMinnville, OR.  States that she currently has four foster care homes.  Expresses concern of increase of liability insurance.  States that her insurance rose from $4,500 to $15,000 four years ago.  Adds that she doesn’t currently have liability insurance.

310

Edmiston

Comments that she is anticipating increase of Medicaid to match Medicaid patients.  Expresses disappointed that they do not have support for issues.

320-480

 

**Recording error, no audio.

TAPE 11, B

005

Cindy Hannum

Administrator, Seniors and People with Disabilities, Licensing and Quality of Care Oregon Department of Human Services.  Discusses that Sparta did come to Oregon, and further explains the miscommunication and why Sparta withdrew from the market. 

030

Hannum

Explains bills to be introduced addressing homeowners insurance.

040

Chair Morrisette

Clarifies that if people use their homeowners insurance for a business, they are immediately cancelled.

045

Hannum

Affirms, adds that insurance agencies discover this if claims are filed.

050

Velma Hartwig

Addresses issue of extreme high health insurance cost to the first responders unit.  Provides district that the responders cover.

060

Chair Morrisette

Asks where her location is.

062

Hartwig

Answers that she is in Harlan.  Explains the danger zones in county.  Also comments that the volunteers that make up the first responders have to raise their own money to cover health care costs, equipment, and gas, in addition to their other duties.

090

Chair Morrisette

Comments on other areas of Oregon and how they fund their ambulances.

095

Karen Whitaker

Director, Oregon Health and Science University center for rural health.  Comments that funds use to be distributed to the Quick Response Team.  Stresses that reinstating funds would be important.

115

Russell Faria

Private physician, Newport, OR.  Addresses concern for increase of liability insurance. Also addresses concern from the failure of measure 35.  Addresses need for increase tax credit, but notes that the money will be used to pay malpractice insurance.  Also mentions programs created to help pay to recruit physicians and interns and concern that the program will cease to exist.

160

Sen. Kruse

Explains that program was a pilot program.  Adds that if it is successful, it could be extended.

170

Faria

Continues to address concerns for lack of funding.

200

Ray Burleigh

Executive Director for a non profit psychiatric center for children.   Addresses concern for budget note.  Explains the psychiatric day treatment center and the types of mental illnesses treated. 

240

Burleigh

Explains that they began only serving children on the Oregon Health Plan (OHP).  Notes staff cuts and cut back in patient care in February of 2003.  Remarks that many children are not being served.  Notes rumor of a 25 percent budget cut back, but doesn’t know when or where.

275

Sen. Kruse

Notes that he is not familiar with the budget note.  Asks to clarify that the budget note will have a 25 percent budget cut.

276

Burleigh

Answers no.  Explains the budget note created incentive for the State mental health and other possible impacts.

280

Sen. Kruse

Asks if the budget note was reflected in the Governor’s budget.

283

Burleigh

States that he in unaware. Offers to return information to the members.

285

Burleigh

Defines goals for the day treatment center.

310

Burleigh

Discusses issues for the center and in mental health.

325

Chair Morrisette

Comments on issues addressed.

340

Sen. Monnes Anderson

Comments on billion dollar short fall.  Also comments on the effectiveness of testimony.

370

Melody Clemens

Citizen, In-home caregiver for son.  Points out that in home care saves the state $41,000 per year versus nursing care. Notes that son’s progress has been from staying at home.

415

Chair Morrisette

Comments on sacrifices people make for caring for others.

425

Clemens

Expresses that if funding is cut, son will have to go into a nursing home and that will take away from her choice to stay home with him.

TAPE 12, A

020

Sandy Post

Director, Shangri-La Corporation.  Expresses concerns for rural area for medical services and costs that are needed.  Notes that a cost of living adjustment has not been made for five years for caregivers. Urges committee to make a cost of living adjustment.

050

Cleo Circle

Citizen, Depot Bay, Oregon.  Expresses concern that money will be cut for in home care.  Explains that she has always cared for daughter at her home.

075

Rachel Elliot

Citizen, Florence, Oregon.  Discusses concern for increase of liability insurance and decrease in foster care homes. States that they have never filed an insurance claim in 19 years but ever year, the insurance company sends a cancellation notice before the first renewal date.

125

Elliot

Comments that she has asked to be in the medical health pool of funding, but doesn’t qualify.

160

Gary Lang

President, Adult Care Providers of Oregon.  States that he runs a foster care home for mental health only covered by Medicaid.  States that he has been without liability insurance for eight years due to cost.

175

Chair Morrisette

Clarifies that patients are all mentally ill.

177

Lang

Affirms.

178

Chair Morrisette

Comments on the greater workload required with an all mentally ill facility.

185

Lang

States that patients either diagnosed with a mental or physical disorder can be difficult.  Discusses difficultly of getting liability insurance with mentally ill patients.

200

Lang

Discusses concern that even if policies are being paid, they mostly likely will not be paid out.

220

Joel Gallob

Journalist, News-Times, Newport, Oregon.  Comments on insurance cap for doctors and possible solution for the committee to consider.

240

Sen. Kruse

Points out that Oregon used to have an insurance cap until the supreme court voted that it was unconstitutional.  Notes that they only way the cap could be put on was through the community voting on the issue.

250

Gallob

Suggests other solution with incentives.

255

Sen. Kruse

Explains that the bill favored most everyone.

255

Karen Bondly

Outreach Worker, Area Health Educations Centers Program (AHEC) of Oregon.  Submits informational packet on the school based health centers (EXHIBIT H) and on AHEC (EXHIBIT I).  Thanks the committee for its support for the organizations. Notes that will combined funding they are able to see 5,000 patients.

275

Chair Morrisette

Asks Karen Whitaker and Scott Ekblad to comment on issues brought up during the hearing.

280

Karen Whitaker

Director, Oregon Health and Science University (OHSU) center for rural health.  Comments on the effectiveness of meeting in the environments where the issues take place.  Comments that she was not aware of the liability insurance issue.  States that committee needs to investigate about rate setting to fix the issue.

330

Scott Ekblad

Deputy Director, OHSU center for rural health.  Comments about the issues and what the center for rural health needs to address

345

Chair Morrisette

Comments on budget cutting and the difficulty for the rural center.

355

Sen. Kruse

Discusses difference in cutting of programs from urban and rural counties.  Refers to the effects of the Douglas county malpractice lawsuit.

380

Whitaker

Reiterates that she wants to find how to set rates to make a better decision for the insurance company and the people paying insurance.

390

Sen. Kruse

States that there is a significant difference between states with caps and states without. 

410

Rep. Brown

States that most foster care experience has been personal.  Notes increase in insurance for contractors also.  Expresses concern for all areas.

455

Lang

Comments on deceiving message with gambling and lawsuits.

465

Chair Morrisette

Closes public hearing on issues such as access to health care, long-term care, access to prescription drugs, oral health care, and services within the Oregon Department of Human Services and adjourns meeting at 3:33 p.m.

 

 

 

EXHIBIT SUMMARY

 

A.     Coastal Hospitals and  Healthcare Systems, written testimony, David Bigalow, 3pp

B.     Coastal Hospitals and  Healthcare Systems, graph of write-offs, David Bigalow, 1 p

C.     Coastal Hospitals and  Healthcare Systems, written testimony, John Zeier, 2 pp

D.    Rural Health Safety Net, Sustaining The, written testimony, Ed Patterson, 1 p

E.     Coastal Oregon, Social Services Issues In, written testimony, Jan Kaplan, 9 pp

F.      In Homecare For Seniors, written testimony, Joan Wesley, 2 pp

G.    SB 98, written testimony, Cindy Hannum, 1 p

H.    Services Within Oregon Dept. of Human Services, informational packet on school based health centers in Lincoln County, Karen Bondly, 14 pp

I.       Services WithinOregon Dept. of Human Services, informational packet on Oregon Pacific Area Health Education Center, Karen Bondly, 10 pp