Legislative Update 3/19/2007

MONDAY UPDATE

Prepared for Oregon Academy of Family Physicians

March 19, 2007

SB 562 - Medical home pilot projects approved at first hearing
The Senate Committee on Health Policy and Public Affairs had plenty of questions for Elizabeth Steiner when she testified in support of medical homes. Sen. Peter Courtney (D-Salem) said he didn't really understand what a medical home was or how it would work until he heard Elizabeth's testimony.

SB 562, proposed by the Oregon Primary Care Association (OPCA), would fund pilot projects in 10 to 15 settings this biennium at an estimated cost of $7.5 million.

While OPCA members serve primarily uninsured and Medicaid patients through community health centers, rural health clinics, school based health centers and Indian Health Services clinics, they said medical homes should not be limited to their patients. Everyone should have a medical home.

Elizabeth told the committee that family physicians are on the front lines of primary care and have provided de facto medical homes for decades. She said SB 562 should test different models of medical homes, ranging from basic to comprehensive.

OPCA agreed that language in the bill needs to be changed. But committee chair Sen. Laurie Monnes Anderson (D-Gresham) was anxious to move the bill. So after some brief discussion, the committee moved the bill to Ways and Means without recommendation.

OAFP will work with OPCA on amendments for the Ways and Means Committee. The biggest challenge will be finding $7.5 million that's not in the Governor's budget.

HB 2946 - "Medical team" pilot project would evaluate decision-support software
A "Computer Health Access Medical Practice" pilot project is the brainchild of Dr. Peter Kohler, former President of OHSU. Kohler seeks to fund clinical trials of "provider teams" aided by decision-support technology. Medical assistants would be Tier 1 of the proposed team, backed up the RNs (Tier 2), PAs/NPs (Tier 3) and MDs (Tier 4). The pilot would determine the optimal composition of a team and compare this model to standard practice.

HB 2700 -- House passes birth control bill
The Access to Birth Control Act -- House Bill 2700 -- passed the House on Thursday. The Senate is expected to endorse insurance coverage for prescription contraceptives and Gov. Ted Kulongoski has indicated he'll sign the bill into law.

A 2005 survey by state health officials estimates 196,000 couples in Oregon rely on the pill for birth control. An additional 25,000 couples use Depo-Provera shots received by the woman, and 20,000 women wear the hormone patch.

The bill also contains a requirement that hospitals provide emergency contraception to victims of sexual assault.

HB 2372 - House Committee passes breastfeeding bill
The House Committee on Human Services and Women's Wellness approved a bill requiring employers to grant unpaid breaks for nursing mothers to express breast milk and make reasonable efforts to provide a private location for breast milk pumping.

Workgroup members were overwhelmed with requests for industry-specific carve-outs. Amendments were approved to allow the Bureau of Labor and Industries (BOLI) to convene industry-specific ad-hoc advisory committees, with an equal number of management and worker representatives, to solve concerns in specific industries.
BOLI testified that it will focus on educating businesses and will not fine employers for first offenses.

SB 37 - Tobacco tax for rural health may be added to Healthy Kids
The Rural Health Association and Office of Rural Health thought their bill would raise $8.2 million each year for rural hospitals, health clinics and emergency medical services. Instead, Legislative Revenue says the way the bill is drafted, it would raise only $3.4 million per year, not enough to meet the needs that have been identified.

The Senate Revenue Committee voiced support for the general idea but said funding for rural health care may be added to HB 2201, the Healthy Kids Plan, so they are waiting before taking any action on SB 37. In the meantime, the Rural Health Association needs to figure out how to get the $8 million they say they need.

HB 2650 - House Health Subcommittee considers junk food ban in schools
The House Subcommittee on Health Policy on Tuesday briefly considered HB 2650, which would specify minimum standards for food and beverages sold in K-12 schools.

Two amendments were considered:

• Eliminating specific mineral and vitamin standards for 100 percent fruit juice. Some Oregon apple juice does not meet the standards specified in the bill.
• The bill contains different calorie requirements for grades K-5, 6-8, and 9-12. Committee members questioned which standards blended schools - such as schools serving grades K-8 or 6-12- would be required to meet. The committee conceptually agreed that the school would be required to meet the calorie targets that correspond to the highest grade the school serves.

Committee Chair Rep. Tina Kotek (D-Portland) told committee members she planned to move the bill forward next week.

SB 109 - Bill could raise registration fees on charities
Charities could see their registration fees nearly double under a plan by the Department of Justice. Current registration fees are based on two elements that are set in statute. SB 109 would allow the Department to set the fee schedule in rule, subject to the following conditions:

• The first element of the fee would be $10-$400 based on the organization's current year receipts and income; and
• The second element of the fee would be a percentage of the year-end fund balance maintained by the organization, subject to a cap of .02 percent or $2,000, whichever is less.

The Senate Judiciary Committee seems inclined to pass SB 109, but asked for an amendment that would limit the fees to funding only the Charitable Activities section of the Department of Justice. The bill will be considered at an upcoming hearing.

SB 110, also sponsored by the Department of Justice, would crack down on charities that spend a large percentage of income on fundraising or executive salaries. The Charitable Activities section is working behind the scenes to try to resolve concerns expressed by legitimate charities. The bill will not be set for hearing until concerns are resolved.

HB 2189 - Bill would change "mandatory reporter law"
Sponsored by Oregon's Child Welfare Branch, HB 2189 originally sought to make broad changes to Oregon's mandatory reporter law. The Child Welfare Branch argued this bill would help in training its employees.

After a great deal of discussion, the House Committee on Human Services and Women's Wellness approved the bill with amendments that narrow the bill dramatically. The amended bill adds "circumstances that create a substantial threat that a child will experience or be subject to" the types of abuse already outlined in statute.

Rainy day fund established, most corporate kicker checks cancelled
On Friday, Gov. Ted Kulongoski signed into law a bipartisan plan to cancel nearly $300 million in corporate tax rebates to create a "rainy day" fund.

The plan also requires the Legislature to put 1 percent of all future state budgets into the new savings account.

The plan was approved by the Senate with only one vote to spare. Two Republicans -- Senators Frank Morse of Albany and David Nelson of Pendleton -- joined all Senate Democrats to vote for the plan.

Most of the $315 million in scheduled corporate kicker rebates will be canceled, though corporations that sell less than $5 million in Oregon in 2007 will still receive kicker rebate checks.

OAFP bill tracking Website: http://www.capitolonramp.com/cor/guests/1437310/

For more information contact Doug Barber at dbarber@ulum.com or 541-434-7023.