Oregon Health Authority officials plan to ask the Legislature to pass bills to implement a state-based insurance marketplace, give Medicaid recipients more influence over the program, reduce the impasse at the state hospital and more.
The agency has drafted two dozen “legislative concepts,” which are the first drafts of bills that will be submitted to lawmakers when they meet in Salem in January. He also prepared $4.2 billion in additional funding requests, including $286 million to modernize Oregon’s public health system and $269 million to expand behavioral health services in the state.
Jeff Scroggin, the health authority’s acting director of government relations, gave the Oregon Health Policy Board an overview of the agency’s legislative priorities Tuesday morning.
Scroggin noted that Governor-elect Tina Kotek will be sworn in next month and said the health authority has not yet received information on its health care priorities. But Scroggin pointed to Kotek’s goals listed on his campaign website to end racism in the healthcare system and improve behavioral health.
“I think our program is in pretty good shape for governor-elect,” Scroggin said. “I think a lot of the priorities I just shared are aligned with the priorities of the agency.”
Oregon Health Insurance Market
Among the Oregon Health Authority’s most sweeping proposals is legislation creating the state’s own health insurance marketplace where Oregonians can purchase federally subsidized plans. Oregon is currently one of 33 states that rely on the federal market, with 18 states and the District of Columbia using their own insurance exchanges.
Oregon officials had been reluctant to push for a state-based exchange after Cover Oregon failed after its launch in 2014, despite costing $300 million. Since then, Cover Oregon’s shadow has faded and technology has improved.
The state agency now says a state-based exchange would give it better data and control over its market, allowing it to extend enrollment periods or customize efforts to enroll uninsured populations. disproportionately. Oregon could tap the market used by about 320,000 residents for about $10 million a year, half of what it pays to connect to the federal market, according to a health authority document.
“It’s a good idea; we have to do it,” State Rep. Rob Nosse, a Portland Democrat who chairs the House Health Care Committee, told the Lund report.
Nosse said he’s confident the state can overcome any technological hurdles, adding that if it doesn’t, “at least when IT goes bad with the government, you’ll know about it.”
The Oregon Health Authority is pursuing legislative changes in response to recommendations from a court-appointed expert on how to streamline treatment for patients at Oregon State Hospital. Salem Psychiatric Hospital is the subject of ongoing litigation over delays in admitting felony patients who have been stuck in county jails awaiting treatment.
The legislation would require Oregon State Hospital to more frequently submit assessments of treated patients to the courts so they can aid and assist in their own defense. It also sets a time frame for the hospital to restore patients’ competence based on the severity of their offence, ranging from 90 days for a misdemeanor to one year for a violent crime.
The proposal will improve the timely transfer of patients to the state hospital, Emily Cooper, legal director for Disability Rights Oregon, told the Lund Report in an email. She said the increased assessments will identify patients ready for discharge and that the timelines “are rooted in solid clinical data and will ensure that limited hospital beds are only reserved for patients who need them.”
The health authority is also asking for $50 million to support the hospital’s staffing plan.
More changes to Medicaid
The Oregon Health Authority will ask lawmakers to approve its plans for a new committee that will guide the priorities of the state’s managed care organizations, which are responsible for serving Oregonians enrolled in Oregon’s Medicaid-funded health plan. . Oregon’s unique Medicaid system operates a recently reauthorized federal waiver that gives managed care organizations financial incentives for measurable improvements in enrollees’ health.
Legislation sought by the agency would create a new health equity quality measurement committee to oversee the incentive structure. Two-thirds of the members of the new committee would be Medicaid recipients, community members and health equity experts. The remaining seats would come from organizations and managed care providers.
Plans for the new committee were discussed at length inside the agency and at public meetings. The Lund report contacted CCO Oregon, the association of managed care organizations, for comment.
Among its other bills, the health authority seeks to prevent the publication of data on race, ethnicity, sexual orientation, gender identity and other sensitive information through requests for records. public. The authority said in a document that the legislative change is necessary to prevent people who answer its questionnaires from being exposed to “racism, disability, linguistic discrimination, transphobia, homophobia and anti-socialism”. ‘heterosexism’.
Protecting information from disclosure will mean better data because individuals will feel more comfortable providing information, according to documents from health authorities. The legislative proposal would still allow the publication of data in an aggregated form that does not identify individuals.
Under another legislative proposal, the agency would be allowed to compensate Oregonians who serve on volunteer advisory boards that help the agency write policies. The authority is concerned that Oregonians may be reluctant to sit on these committees if they have to take time off work or pay transportation or childcare costs to participate. This could mean the authority is less likely to hear from the disadvantaged groups it is trying to help.
Pharmacy Vaccines, dental pilots and others
Other legislation sought by the health authority would allow children as young as 6 months old to receive flu shots at pharmacies, ban the sale of flavored tobacco products and require insurers to pay for behavioral health crisis services. Another bill would remove the residency requirement from Oregon’s Death With Dignity law in response to a lawsuit settled earlier this year.
The agency is also seeking to remove the end date from its Dental Pilot Projects program that allows communities to complete monitored projects to expand training for oral health positions. The agency points to how an earlier pilot led to the creation of dental therapists, a new position authorized to fill minor cavities and perform simple extractions but is not a licensed dentist.
Nosse said the shortage of healthcare workers in Oregon will be a major focus of the session and that the development of dental therapists has contributed to the shortage of dentists.
You can reach Jake at [email protected] or through Twitter @jakethomas2009.
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