03/24/2017 Legislative Update March 27
"We need to get to work. February is a short session. The clock is ticking.”Senate President Peter Courtney in response to minimum wage negotiations
Interim Legislative Days November 16-19
An increase to the minimum wage, controversy over Coordinated Care Organization (CCO) rates, and a report on the Unity Behavioral Health Center set to open next year, were some of the issues heard during when legislators convened in Salem for interim legislative days.
Committees also previewed selected legislative concepts expected to be introduced during the 35-day session which begins February 1, 2016. OCEP Board member Dr. Sharon Meieran testified in front of the Senate Health Care Committee in support of a proposal to link the Prescription Drug Monitoring Program to the Emergency Department Information Exchange system. She was joined by Dr. Amit Shah, the clinical informatics medical director for Care Oregon. The proposal is supported by the Oregon Medical Association. Other partners include the Multnomah County Health Department and the Oregon Health Authority.
The deadline for legislators to submit concepts for drafting is November 24, 2015.
The Big Question: Will the legislature raise the statewide minimum wage?
Increasing the minimum wage will be the marquee issue for the Oregon Legislature during the short session. Lawmakers were unable to reach an agreement on this issue during the 2015 session but it’s front and center now as House and Senate leadership work to reconcile differences between their chambers, advocates and the business community.
A Senate committee on workforce issues heard three hours of testimony on this issue. Oregon’s minimum wage is $9.25 per hour. Advocates for change differ between $13.50 and $15 per hour. Some want a statewide increase, while others seek to lift the pre-emption that prohibits cities in Oregon from raising their own minimum wages. Some business owners say a higher minimum will make Oregon companies less competitive, and would lead to job cuts.
The Senate Interim Committee on Workforce and General Government is chaired by Sen. Michael Dembrow, D-Portland. Dembrow said he intends to introduce at least one bill revolving around the minimum wage. He also promised a public hearing on the topic in January.
House and Senate Health Care Committee hearings
CCO rate-setting and federal waivers
Oregon Heath Authority (OHA) Director Lynne Saxton reported to the House Health Care Committee and also to the Joint Ways and Means Human Services budget committee on negotiations over the CCO rate-setting process for 2015 and 2016. Earlier this year, the OHA announced it would be retrospectively setting the 2015 rates for CCOs in response to concerns from the Centers for Medicaid Services (CMS) over the process. To date, 15 of the 16 CCOs have signed amended contracts with the 2015 revised rates. Family Care, a Portland-based CCO, is in mediated talks with OHA over their rates which would require a $55 million-dollar clawback for 2015. A lawsuit is also pending.
Lawmakers questioned the department about the process, reserves for CCOs and impact to patients if a CCO disbands. Director Saxton said the issues are complex and discussions have been intense, but are ongoing. Sen. Alan Bates D-Ashland, co-Chair of the Ways and Means Committee expressed strong concerns about the viability of health transformation going forward if the foundational principle of the global budget (guaranteed by contract) isn’t honored. Other members of the committee also echoed that position.
Work on the 2016 CCO rates has begun. Contracts were delivered to the 16 CCOs for a 60-day review on November 9. The department is also working on renewing the federal waivers which created the framework for CCOs and health transformation. The waivers expire in 2017. A link to the report can be found here: https://olis.leg.state.or.us/liz/2015I1/Downloads/CommitteeMeetingDocument/81676
Improving Oregon’s Mental Health System
Director Saxton reported the OHA has been working for the last several months on an action plan to improve behavioral health outcomes. At the core is the integration of behavioral health into primary care. Next week the department will convene the 16 behavioral health directors from the CCOs to discuss what’s working and what’s not. The OHA also is wrapping up a state-wide behavioral health tour with Sen. Sara Gelser to hear from communities about the state’s mental health system.
Unity Center for Behavioral Health
Hospital officials from Legacy Health, Oregon Health & Sciences University (OHSU), Kaiser Permanente and Adventist Health presented on the Unity Center for Behavioral Health, a joint venture based on a model from Alameda County, California. The new facility slated to open in late 2016 will feature a 24/7 psychiatric emergency services department along with coordinated support services for patients in mental health crisis. It also will consolidate the current inpatient units for the four hospitals. The new model will improve patient care, decriminalize mental illness (get police out of the business of transporting people with mental illness to jail or an emergency department) and provide intentional design for transitions of care for adults, adolescents and culturally specific groups. Space also will be available for community providers to navigate ‘warm’ handoffs from Unity to community resources.
Legislative Concept Preview
Committees also received a preview of upcoming legislative concepts for the 2016 session. Each member may submit two drafting requests and each committee has three drafting requests that can be submitted to legislative counsel. Here are some of the proposals:
Linkage between the Prescription Drug Monitoring Program (PDMP) and the Emergency Department Information Exchange (EDIE): A concept would enable the state to link the PDMP to EDIE to allow providers to maximize use of both systems. Secure ‘push’ notifications from the PDMP would feed into EDIE to provide efficiencies in treating patients.
Basic Health Program: The Affordable Care Act allows states to waive specific provisions in order to implement innovative state solutions to health care issues such as the Basic Health Plan. This concept would grant the state the ability to apply for a a waiver in 2017. It also establishes a stakeholder group to advise and assist in identifying ACA provisions that, if waived, would improve the state’s health care system.
Licensing tobacco retailers: Multnomah County Chair Deborah Kafoury testified about the recent county ordinance to license retailers that was enacted to address illegal sales to minors and emerging e-cigarette use by youth. Rule-making will commence in 2016 with licenses issued in July of 2016. Enforcement will begin January 2017. State lawmakers may postpone action on vetting a state-wide program until 2017 to allow for more vetting time.
Tobacco 21: raise the minimum age for the sale of tobacco to age 21. Sen. Elizabeth Steiner Hayward is teaming up with Rep. Alissa Keny Guyer to reduce youth access to tobacco.
For more information about the legislative process, please contact Katy King.