Exodus of the House Committee Chairs
“Balancing our work, multiple day jobs, families and our service has become
unsustainable.”
Three key committee chairs announced during the last week of session that they would
not be running for re-election because of the low pay and high job demands. This
surprise announcement came after the failure of a bill to increase legislator pay. Rachel
Prusak, D-Tualatin, chair of the House Health Care Committee, Rep. Karin Power, D-
Milwaukie, and Rep. Anna Williams, D-Hood River, all said they can’t make their budgets work on their part-time pay of $33,000 per year, especially since the job is more than full-time between legislative sessions with special sessions to address emergencies, workgroups, interim legislative days and pandemic-related responsibilities.
The 2023 Legislative Session is expected to have a large cast of new legislators as many people leave or retire from legislative service. There have been 10 vacancies since the 2020 elections and at least 20 are retiring or running for other offices. The deadline for filing for the 2022 election is March 8.
2022 Budget
Once again, the projected revenue forecast has exceeded expectations by over $900
million. The increase is $1.7 billion more than at the adjournment of the 2021 Legislative
Session. Funds were invested in housing, community safety, workforce development,
OHSU workforce development, behavioral health recruitment and retention, health care
coverage, one-time relief payments to low income workers, and climate resilience.
Highlights from the budget include:
- A $400 million package to tackle housing and homelessness, including $165 million for homelessness services, $215 million to build and preserve affordable housing and $20 million to improve access to homeownership. This includes $100 million to increase behavioral health housing.
- Smart investments in community safety, including $15 million to support Community-Based Organizations working to prevent violence, $5 million to expand hospital-based community violence prevention programs, $13 million to help local communities around the state clean up trash and provide sanitation services, $14 million to support services for crime victims, and $10 million for the Oregon Domestic & Sexual Violence Services Fund.
- A $200 million investment in workforce development will help ensure workers hav access to the skills and training they will need to succeed, including $200 million for Future Ready Oregon (Senate Bill 1545). A nearly $300 million cost-of-living relief package, including direct, one-time relief payments of $600 that will help more than 240,000 low-wage workers cover their essential needs (House Bill 4157), $100 million to address the shortage of affordable childcare across the state (House Bill 4005), and increased outreach to help working families access tax relief (House Bill 4117).
- Over $300 million for health care needs, including a plan to protect health coverage for low-income Oregonians (House Bill 4035), $150 million to support behavioral health workers and providers (House Bill 4004), $45 million to address the crisis in Oregon’s health care workforce at OHSU, and new support for Oregon nurses who are experiencing burnout from the extreme stress of the pandemic (House Bill 4003).
- A $100 million climate resilience budget aims to tackle drought, extreme weather, and infrastructure needs.
- $100 million for child care for Oregon, including direct payments of $500 to childcare workers.
- Ending balance: Oregon will still maintain more than $2.7 billion in reserve. That includes projected balances of $760 million in General Funds, $1.3 billion in the Rainy Day Fund, and nearly $700 million in the Education Stability Fund.
Budget Notes: These are instructions from the Legislative branch to state agencies as they implement the budget appropriations. While they don’t have the force of law, the expectation is that they will be followed.
Oregon Health Authority $42.5 million to increase provider payments
The $42.5 million special purpose appropriation is intended to increase provider payment rates an average of 30 percent for behavioral health services under the medical assistance program for the purpose of improving access, maintaining provider networks, increasing wages, and retaining workers. Except to the extent delayed while waiting for approval from the Centers for Medicare and Medicaid Services, OHA shall increase fee-for-service payment rate increases effective no later than July 1, 2022, and all other payment rate increases no later than January 1, 2023.
OHA shall propose strategies to measure the extent to which coordinated care organizations
(CCOs) pass the rate increases through to behavioral health providers and strategies by which CCOs and OHA will measure the impact of the rate increase on behavioral health
provider stability and capacity. OHA shall report these proposed strategies, in addition to an update on rate implementation, at the next meeting of the Emergency Board.
Oregon Health Authority Behavioral health reporting requirements
The Oregon Health Authority (OHA) shall continue exploring ways to streamline
behavioral health provider reporting requirements and remove those that are
unnecessary.
The agency shall present on the outcome of this work during the 2023 legislative session, including the identification of existing reporting requirements; the reporting requirements the agency has reduced, eliminated, or otherwise changed to streamline reporting processes; and the reporting requirements the agency plans to maintain and how these reports are being used.
OHA shall also review and present similar information and recommendations on the number of behavioral health advisory workgroups, task forces, or similar temporary or permanent bodies that require behavioral health provider and stakeholder involvement. OHA shall include in its recommendations for both the provider reporting requirements and advisory groups any changes to state law that are necessary to remove unnecessary burdens on behavioral health providers.
Health Care Legislation Spotlight
HOUSE BILLS
HB 4142 Preventing violence against health care workers FAILED
This bill co-sponsored by Rep. Shelly Boshart, R-Albany, and Rep. Shari Schouten, D- Beaverton, would increase the penalties for assaulting health care workers in hospitals on par with penalties for EMS providers, public transit drivers, taxi drivers, flaggers and corrections officers. The bill passed the House 53-7 in the last few days of session but landed in the Senate just as the final committee closed. This was a priority bill for the Oregon Chapter of the American College of Emergency Physicians and for the Oregon Emergency Nurses Association.
HB 4003 Nursing workforce PASSED
House Bill 4003, sponsored by Rep. Rachel Prusak, D-West Linn, would support the
Oregon Wellness Program, providing counseling, education, and telemedicine services
for Oregon health care professionals. The bill also extends the duration nonresident nurses can practice in the state on an assignment and establishes a nurse internship license through the Oregon State Board of Nursing.
HB 4004 Behavioral health workforce PASSED
This bill, sponsored by Rep. Rob Nosse, D-Portland, would create a $132 million flexible grant program to allow providers to increase wages for behavioral health professionals, offer retention bonuses, and recruit and hire new behavioral health staff. The funds must be used no later than May 31, 2022. Additional funding will be set aside for an ongoing increase in Medicaid rates for behavioral health services to support the increased cost of providing care, with the goal of increasing access to behavioral health services throughout Oregon. This bill was a priority for the Oregon Psychiatric Physicians Association.
HB 4005 Child care PASSED
This is part of a $100 million package of strategic investments to stabilize and begin
expanding the child care and early learning workforce. This will expand child care access across the state to serve more families, and provides professional learning opportunities and higher compensation to develop and retain childcare providers. This bill was a priority for the Oregon Pediatric Society. Rep. Karin Power, D-Milwaukie, is the champion.
HB 4006 Pay parity for naturopathic physicians FAILED
Requires individual and group health insurance policies to reimburse services provided by naturopathic physicians within scope of their practice if services are reimbursed when provided by licensed physicians. Sponsored by Rep. Rob Nosse, D-Portland.
HB 4109 Newborn bloodspot screening advisory board FAILED
This bill, opposed by the Oregon Pediatric Society and March of Dimes, would remove professional organization designations from the committee requirements and it would
bypass the national process for determining which conditions are considered to be screened. This bill has a fiscal for OHA to hire three positions because of the changes in the determination of bloodspot screening panels. It was sponsored by Rep. Susan
McClain, D-Hillsboro
HB 4010 Kratom regulation PASSED
This bill, sponsored by Rep. Stark, R-Grants Pass, requires processors of kratom products to register with the Department of Revenue (DOR) to distribute, sell, or offer for sale wholesale kratom products in the state beginning on or after July 1, 2023. DOR must adopt rules that establish procedures for a processor to register annually; certify that the products sold by a processor are tested by a third-party to satisfy industry standards; and is authorized to collect registration fees to support administration and enforcement of the measure. DOR may also impose civil penalties. Prohibits sale or distribution of kratom products to individuals under 21.
HB 4013 Grants for homeless children programs PASSED
This bill, sponsored by Rep. Anna Williams, D-Hood River, expands access to services for current and former homeless youth with an appropriation for $1.2 million. This bill was a priority for the Oregon Pediatric Society.
HB 4034 Omnibus health care technical fix bill PASSED
Technical provisions include the deletion of the requirement that coordinated care organization collect REALD data from members and submit data to Oregon Health Authority. Includes technical fixes for telemedicine law.
HB 4035 Continuity of health care coverage for low-income Oregonians PASSED
House Bill 4035 would allow the Oregon Health Authority to delay redeterminations for OHP members most likely to lose their coverage until closer to the end of the 12-month period. The bill creates a bridge health insurance plan that, if approved by the federal government, would provide coverage to an estimated 300,000 individuals likely to lose their OHP coverage due to income fluctuations. Rep. Rachel Prusak, D-West Linn, was the champion.
HB 4045 Community violence prevention programs PASSED
This bill put forward by former House Speaker Tina Kotek, D-Portland, will fund grant programs for community safety and violence prevention and intervention services, alleviating risk factors that can lead to violence. This bill was a priority for the Oregon Chapter of the American College of Emergency Physicians and the Oregon Pediatric Society.
HB 4052 Racism as a public health crisis/mobile training units PASSED
This bill sponsored by Rep. Andrea Salinas, D-Lake Oswego, follows up the Declaration of Racism as a Public Health Crisis which passed in the 2022 legislative session. The bill provides initial funding and directs OHA to establish a Mobile Health Unit Pilot Program for underserved communities and establishes a new advocacy commission to ensure the ideas to end institutional racism and strategies for building health equity are directed, informed, and endorsed by BIPOC community members.
HB 4081 Requires pharmacists to offer naloxone with certain Rx FAILED
This bill from Rep. Rachel Prusak, D-West Linn, requires pharmacists who dispense opioid prescription to offer prescription for naloxone, or similar drug, and information about naloxone under specified circumstances.
HB 4085 Minor consent for behavioral health or SUD treatment FAILED
House Bill 4085 allows in-patient residential behavioral health facilities to admit minors under 18 if certain conditions, including commitment from parents, are met. Oregon law already has provisions in place to allow this. Rep. Boomer Wright, R-Coos Bay, met with behavioral health advocates to talk about ways to protect minors at risk of suicide.
HB 4117 Grant program for earned income tax credits PASSED
Earned-Income Tax Credit Outreach: The EITC helps low-income workers and families receive a tax break to reduce their overall tax burden. The budget will strengthen the resources available to help low-income families navigate the tax system and access this credit, with a focus on outreach by culturally responsive organizations, tribal governments, and under-resourced rural community service organizations.
HB 4134 Bans balance billing for out-of-network labor and delivery PASSED
House Bill 4134, introduced by Rep. Duane Stark, R-Grants Pass, specifies insurer reimbursement of out-of-network labor and delivery services if the services were provided out-of-network solely due to the diversion of the patient for a reason related to a public health emergency declaration.
HB 4157 One-time payments to low-income workers PASSED
This legislation directs Oregon Department of Revenue to establish and administer a program to address the negative economic impacts of the COVID-19 public health emergency. The Department of Revenue will provide $600 one-time assistance payments to low-income households with members who worked during the first year of the COVID-19 public health emergency. Only taxpayers who qualified for and claimed the earned income tax credit on their 2020 personal income tax returns are eligible to receive these payments, which must be made by July 31, 2022. The Oregon Department of Revenue estimates that 245,000 taxpayers will be eligible, and payments are limited to one per household. Funding for these payments comes from the State Fiscal Recovery Fund program, a part of the American Rescue Plan Act. Rep. Ricki Ruiz, D-Gresham, and a number of other legislators, acted as chief sponsors.
