Democrats pass key priorities DESPITE walkouts
The 82nd Legislative Assembly convened on January 22 and adjourned on June 30, six and a half hours ahead of the midnight constitutional deadline. Democrats held super majorities in the Senate (18-12) and in the House (38-22) but Senate Republican walkouts and the House practice of requiring all bills be read in their entirety, led to one of the most contentious sessions in decades. The first walkout, which lasted four days, was to protest HB 3427, the Student Success investment package and the $2 billion tax to pay for it. Gov. Kate Brown negotiated the return of the Republicans by trading away a hard-fought vaccine bill and an omnibus gun bill, a priority for Democrats.
Republican senators walked out the second time over HB 2020, a sweeping cap-and-trade bill. Over 140 bills, including the Oregon Health Authority (OHA) budget and the $2 per-pack tobac- co tax referral to voters, were left in limbo until the Rs returned nine days later — just two days before adjournment. The rhetoric was heated and one lawmaker faced a hearing before the Sen- ate Special Committee on Conduct for statements that appeared to threaten the state police who were charged by the governor to round up the missing legislators. Senate President Peter Court- ney, D-Salem, made an extraordinary statement midway through the walkout, that the Democrats didn’t have the votes to pass HB 2020. Environmental groups, thinking they had the votes, were outraged. The governor pledged to pursue action by executive order or by a special session, if necessary. Her staff is researching options.
The Democratic supermajorities still allowed them to pass a new corporate business tax of $2 billion to fund the education package, as well as bills on universally offered nurse home visiting for newborns, paid family medical leave, rent control, a tobacco tax referral to the ballot, and juvenile justice reform, which end automatic referral of juveniles to adult court.
However, if this was the most contentious session in decades, HB 3063, the bill to remove non- medical exemptions for school-entry requirements, was the most inflammatory issue. This bipartisan bill sponsored by Rep. Mitch Greenlick, D-Portland, Rep. Cheri Helt, R-Bend, and Sen. Chuck Thomsen, R-Hood River and others, was backed by a large health provider coalition that included the Oregon Chapter of the American College of Emergency Physicians. Despite this concerted effort by health advocates, opponents to the bill were able to rally thousands to the Capitol for protests, swamping legislators with calls and emails and showing up en-mass for hearings. Over 2,000 letters were submitted for the record at the two hearings. The policy argument by medical experts and advocates held sway, passing the House by 35-25. The bill reportedly had the votes to pass the Senate before the governor traded it to end the first Republican walkout.
OR ACEP Priority Bills
OR-ACEP advanced several priority bills and initiatives during the recent 2019 Legislative Session. This session, 2768 bills were introduced. OR-ACEP tracked 15 priority one bills and 38 priority two bills. To recap some of the highlights:
- HB 2014, lifts the cap on damages juries can award for “pain and suffering.” FAILED
- HB 2637, requires hospital EDs to become medical detoxification centers. FAILED
- HB 2701 Prohibits “surprise billing” and opens door for grandfathering in claims. FAILED SB 823 Workplace violence prevention. PASSED
- SB 1027 Needle stick injuries. PASSED
- HB 2257 Governor’s Opioid Epidemic Task Force bill. PASSED
- HB 2270, Referral to the 2020 November ballot to raise the tobacco tax by $2 per-pack and to create a new e-cigarette and a vaping product tax. This would raise $346 million with 90 percent allocated to fund the Oregon Health Plan and 10 percent for the tobacco prevention and education program. PASSED
In the loss column, SB 140 and SB 141 and HB 2624 and HB 2621, bills to fund emergency department boarding pilots and to pay for mental health crisis support, died in Ways and Means.
State economists project a $1.4 billion increase in revenue, the kicker is coming but OHP funding is not assured
The unprecedented increase — which exceeds 2 percent of the forecast — will trigger the state’s unique kicker law, returning a record $1.2 billion to taxpayers. The previous record was $1.1 bil- lion in 2007. For context, the state’s two-year budget is $22.5 billion. Corporate income tax will likely exceed forecasts by $616 million, which will be spent on K-12 education as a result of a measure voters approved in 2012. Economists say there’s $3.5 billion in a rainy day fund and other reserve accounts, which may be needed if a recession is on the horizon in 2020.
The governor’s plan to provide long-term (6-year) sustainable funding for the Oregon Health plan and to address the shortfall of $830 million, was partially successful. HB 2010, the bill to extend the hospital provider tax, passed early in session. The tobacco tax referral to the voters, to raise $346 million, passed in the waning hours. A bill to establish a “Walmart tax” on employers who rely for OHP for their employee health plans, failed.
OHA Key General Fund Investments (HB 5525) The highlights
- $31.6 million as part of the Behavioral Health investment package
- $13 million to increase behavioral health provider rates
- $10 million for Public Health Modernization
- $2.9 million, SB 526 Voluntary universal home visiting program
- Mental Health Clinical Advisory Group: $396 GF, $321 FF (SB 138)
Policy Option Package 802: As part of Package 802, $50 million General Fund behavioral health package, the budget recommendation includes $31.3 million to support investments related to recommendations from the Children and Youth with Specialized Needs workgroup, as well as other targeted behavioral health investments. This includes:
- CCO 2.0, including behavioral health portion: $1.8 General Fund, $907 Federal Funds
- Behavioral Health Funding shortfall: $9 million
- Behavioral health IT System Project $1.5 million. Initial stage only.
- Rental assistance — permanent supportive housing $4.5 million
- Project Nurture —SUD treatment and maternity care $2.5 million
- Project Echo — tele-mentoring for primary care providers $1 million
- Suicide prevention — $967,000 (Oregon State Hospital)
- OSH Nursing staff shift differentials $1.8 million.
HB 5050, the budget reconciliation (Christmas Tree) bill, also included the following investments:
- Children and youth with specialized behavioral health needs: $5.7 million.
- Community mental health: $6 million.
- Mental and behavioral health pilot programs $1.5 million
- Community Housing Trust Account/support facility improvements to help people with mental illness. $1.5 million.
- Sobering center competitive grants $1 million.
Oregon Medical Board fund sweep
HB 2377, the state financial administration and program change bill included a $5 million “sweep” of the ending balance for the Oregon Medical Board (OMB). The funds are dedicated licensure fees and charges and upon passage will go into the state general fund. This will likely result in an increase of up to 15 percent for the next biennium for OMB licensees unless the governor intervenes with a line-item veto.
Note: The fiscal impacts of the bill are included in HB 5050, the budget reconciliation bill.
OHA Budget Notes
Budget Note: Behavioral Health Caseload Forecast
The Oregon Health Authority, in consultation with the Chief Financial Office of the Department of Administrative Services, the Legislative Fiscal Office, and community mental health programs, shall make recommendations to the 2020 Legislative Assembly about how to update behavioral health caseload forecast methodologies, processes and related funding formulas. At a minimum, the agency shall consider if the price per case accurately captures the cost of community based behavioral health treatment and how caseload methodologies and use of funding incentivizes regionally and nationally recognized best practices, and outcome oriented strategies, to create a more effective system to meet the behavioral health needs of individuals in the community and to prevent higher levels of care when appropriate. The agency shall present recommendations to the Legislature by December 1, 2019.