Chapter 720 Oregon Laws 2011

 

AN ACT

 

HB 2100

 

Relating to functions of the Oregon Health Authority; creating new provisions; amending ORS 3.408, 30.262, 87.533, 93.268, 106.045, 106.330, 113.085, 113.145, 114.305, 115.125, 115.195, 116.093, 130.370, 130.425, 179.505, 179.560, 179.570, 181.735, 185.140, 238.082, 243.061, 243.145, 243.862, 243.878, 279A.050, 292.051, 343.243, 343.507, 343.961, 408.370, 409.010, 409.161, 409.162, 410.040, 410.075, 410.080, 410.160, 410.230, 410.240, 410.300, 410.720, 411.010, 411.060, 411.070, 411.072, 411.081, 411.083, 411.087, 411.103, 411.300, 411.320, 411.400, 411.402, 411.404, 411.406, 411.408, 411.431, 411.432, 411.435, 411.439, 411.443, 411.459, 411.463, 411.593, 411.610, 411.620, 411.630, 411.632, 411.635, 411.640, 411.660, 411.670, 411.675, 411.690, 411.694, 411.703, 411.708, 413.011, 413.032, 413.033, 413.064, 414.025, 414.033, 414.041, 414.065, 414.211, 414.221, 414.227, 414.231, 414.312, 414.332, 414.334, 414.538, 414.705, 414.707, 414.708, 414.710, 414.712, 414.725, 414.730, 414.735, 414.736, 416.340, 416.350, 416.610, 417.349, 418.517, 418.975, 418.985, 419C.529, 426.005, 426.129, 426.250, 426.275, 426.495, 427.005, 430.021, 430.205, 430.210, 430.397, 430.610, 430.630, 430.632, 430.640, 430.670, 430.672, 430.695, 431.195, 431.962, 431.964, 431.966, 431.970, 431.974, 431.976, 431.978, 432.500, 433.055, 433.060, 433.095, 433.407, 441.021, 441.096, 442.011, 442.700, 443.410, 443.450, 443.465, 443.860, 443.861, 443.864, 443.869, 448.465, 475.495, 480.225, 497.162, 616.555, 616.560, 616.570, 616.575, 616.580, 676.150, 676.306, 676.350, 682.218, 708A.430, 723.466, 743.730, 743.736, 743A.010 and 743A.062 and section 1, chapter 426, Oregon Laws 2009, section 20, chapter 595, Oregon Laws 2009, and section 29, chapter 856, Oregon Laws 2009; repealing ORS 409.310, 409.330, 410.110, 414.338, 414.350, 414.355, 414.360, 414.365, 414.370, 414.375, 414.380, 414.385, 414.390, 414.395, 414.400, 414.410, 414.415, 414.715, 414.720, 414.741, 430.170, 431.190, 442.575, 442.580, 442.581, 442.583, 442.584, 442.588, 442.589 and 735.711 and section 57, chapter 9, Oregon Laws 2011 (Enrolled Senate Bill 353), and section 4, chapter 658, Oregon Laws 2011 (Enrolled House Bill 2600); appropriating money; and declaring an emergency.

 

Be It Enacted by the People of the State of Oregon:

 

PHARMACY AND THERAPEUTICS

COMMITTEE

 

          SECTION 1. As used in sections 1 to 12 of this 2011 Act:

          (1) “Compendia” means those resources widely accepted by the medical profession in the efficacious use of drugs, including the following sources:

          (a) The American Hospital Formulary Service drug information.

          (b) The United States Pharmacopeia drug information.

          (c) The American Medical Association drug evaluations.

          (d) Peer-reviewed medical literature.

          (e) Drug therapy information provided by manufacturers of drug products consistent with the federal Food and Drug Administration requirements.

          (2) “Criteria” means the predetermined and explicitly accepted elements based on compendia that are used to measure drug use on an ongoing basis to determine if the use is appropriate, medically necessary and not likely to result in adverse medical outcomes.

          (3) “Drug-disease contraindication” means the potential for, or the occurrence of, an undesirable alteration of the therapeutic effect of a given prescription because of the presence, in the patient for whom it is prescribed, of a disease condition or the potential for, or the occurrence of, a clinically significant adverse effect of the drug on the patient’s disease condition.

          (4) “Drug-drug interaction” means the pharmacological or clinical response to the administration of at least two drugs different from that response anticipated from the known effects of the two drugs when given alone, which may manifest clinically as antagonism, synergism or idiosyncrasy. Such interactions have the potential to have an adverse effect on the individual or lead to a clinically significant adverse reaction, or both, that:

          (a) Is characteristic of one or any of the drugs present; or

          (b) Leads to interference with the absorption, distribution, metabolism, excretion or therapeutic efficacy of one or any of the drugs.

          (5) “Drug use review” means the programs designed to measure and assess on a retrospective and a prospective basis, through an evaluation of claims data, the proper utilization, quantity, appropriateness as therapy and medical necessity of prescribed medication in the medical assistance program.

          (6) “Intervention” means an action taken by the Oregon Health Authority with a prescriber or pharmacist to inform about or to influence prescribing or dispensing practices or utilization of drugs.

          (7) “Overutilization” means the use of a drug in quantities or for durations that put the recipient at risk of an adverse medical result.

          (8) “Pharmacist” means an individual who is licensed as a pharmacist under ORS chapter 689.

          (9) “Prescriber” means any person authorized by law to prescribe drugs.

          (10) “Prospective program” means the prospective drug use review program described in section 7 of this 2011 Act.

          (11) “Retrospective program” means the retrospective drug use review program described in section 8 of this 2011 Act.

          (12) “Standards” means the acceptable prescribing and dispensing methods determined by compendia, in accordance with local standards of medical practice for health care providers.

          (13) “Therapeutic appropriateness” means drug prescribing based on scientifically based and clinically relevant drug therapy that is consistent with the criteria and standards developed under sections 1 to 12 of this 2011 Act.

          (14) “Therapeutic duplication” means the prescribing and dispensing of two or more drugs from the same therapeutic class such that the combined daily dose puts the recipient at risk of an adverse medical result or incurs additional program costs without additional therapeutic benefits.

          (15) “Underutilization” means that a drug is used by a recipient in insufficient quantity to achieve a desired therapeutic goal.

 

          SECTION 2. (1) There is created an 11-member Pharmacy and Therapeutics Committee responsible for advising the Oregon Health Authority on the implementation of the retrospective and prospective programs and on the Practitioner-Managed Prescription Drug Plan.

          (2) The Director of the Oregon Health Authority shall appoint the members of the committee, who shall serve at the pleasure of the director for a term of three years. An individual appointed to the committee may be reappointed upon completion of the individual’s term. The membership of the committee shall be composed of the following:

          (a) Five persons licensed as physicians and actively engaged in the practice of medicine or osteopathic medicine in Oregon, who may be from among persons recommended by organizations representing physicians;

          (b) Four persons licensed in and actively practicing pharmacy in Oregon who may be from among persons recommended by organizations representing pharmacists whether affiliated or unaffiliated with any association; and

          (c) Two persons who are not physicians or pharmacists.

          (3) If the committee determines that it lacks current clinical or treatment expertise with respect to a particular therapeutic class, or at the request of an interested outside party, the director shall appoint one or more medical experts otherwise qualified as described in subsection (2)(a) of this section who have such expertise. The medical experts shall have full voting rights with respect to recommendations made under section 4 (3) and (4) of this 2011 Act. The medical experts may participate but may not vote in any other activities of the committee.

          (4) The director shall fill a vacancy on the committee by appointing a new member to serve the remainder of the unexpired term.

 

          SECTION 3. Notwithstanding the term of office specified by section 2 of this 2011 Act, of the members first appointed to the Pharmacy and Therapeutics Committee:

          (1) Three shall serve for a term ending December 31, 2012.

          (2) Three shall serve for a term ending December 31, 2013.

          (3) Five shall serve for a term ending December 31, 2014.

 

          SECTION 4. (1) The Pharmacy and Therapeutics Committee shall advise the Oregon Health Authority on:

          (a) Adoption of rules to implement sections 1 to 12 of this 2011 Act in accordance with ORS chapter 183.

          (b) Implementation of the medical assistance program retrospective and prospective programs as described in sections 1 to 12 of this 2011 Act, including the type of software programs to be used by the pharmacist for prospective drug use review and the provisions of the contractual agreement between the state and any entity involved in the retrospective program.

          (c) Development of and application of the criteria and standards to be used in retrospective and prospective drug use review in a manner that ensures that such criteria and standards are based on compendia, relevant guidelines obtained from professional groups through consensus-driven processes, the experience of practitioners with expertise in drug therapy, data and experience obtained from drug utilization review program operations. The committee shall have an open professional consensus process for establishing and revising criteria and standards. Criteria and standards shall be available to the public. In developing recommendations for criteria and standards, the committee shall establish an explicit ongoing process for soliciting and considering input from interested parties. The committee shall make timely revisions to the criteria and standards based upon this input in addition to revisions based upon scheduled review of the criteria and standards. Further, the drug utilization review standards shall reflect the local practices of prescribers in order to monitor:

          (A) Therapeutic appropriateness.

          (B) Overutilization or underutilization.

          (C) Therapeutic duplication.

          (D) Drug-disease contraindications.

          (E) Drug-drug interactions.

          (F) Incorrect drug dosage or drug treatment duration.

          (G) Clinical abuse or misuse.

          (H) Drug allergies.

          (d) Development, selection and application of and assessment for interventions that are educational and not punitive in nature for medical assistance program prescribers, dispensers and patients.

          (2) In reviewing retrospective and prospective drug use, the committee may consider only drugs that have received final approval from the federal Food and Drug Administration.

          (3) The committee shall make recommendations to the authority, subject to approval by the Director of the Oregon Health Authority or the director’s designee, for drugs to be included on any preferred drug list adopted by the authority and on the Practitioner-Managed Prescription Drug Plan. The committee shall also recommend all utilization controls, prior authorization requirements or other conditions for the inclusion of a drug on a preferred drug list.

          (4) In making recommendations under subsection (3) of this section, the committee may use any information the committee deems appropriate. The recommendations must be based upon the following factors in order of priority:

          (a) Safety and efficacy of the drug.

          (b) The ability of Oregonians to access effective prescription drugs that are appropriate for their clinical conditions.

          (c) Substantial differences in the costs of drugs within the same therapeutic class.

          (5) The committee shall post a recommendation to the website of the authority no later than 30 days after the date the committee approves the recommendation. The director shall approve, disapprove or modify any recommendation of the committee as soon as practicable, shall publish the decision on the website and shall notify persons who have requested notification of the decision. A recommendation adopted by the director, in whole or in part, with respect to the inclusion of a drug on a preferred drug list or the Practitioner-Managed Prescription Drug Plan may not become effective less than 60 days after the date that the director’s decision is published.

          (6) The director shall reconsider any decision to adopt or modify a recommendation of the committee with respect to the inclusion of a particular drug on a preferred drug list or the Practitioner-Managed Prescription Drug Plan, upon the request of any interested person filed no later than 30 days after the director’s decision is published on the website. The decision on reconsideration shall be sent to the requester and posted to the website without undue delay.

 

          SECTION 5. In addition to the duties described in section 4 of this 2011 Act, the Pharmacy and Therapeutics Committee shall do the following subject to the approval of the Director of the Oregon Health Authority:

          (1) Publish an annual report, as described in section 12 of this 2011 Act.

          (2) Publish and disseminate educational information to prescribers and pharmacists regarding the committee and the drug use review programs, including information on the following:

          (a) Identifying and reducing the frequency of patterns of fraud, abuse or inappropriate or medically unnecessary care among prescribers, pharmacists and recipients.

          (b) Potential or actual severe or adverse reactions to drugs.

          (c) Therapeutic appropriateness.

          (d) Overutilization or underutilization.

          (e) Appropriate use of generic products.

          (f) Therapeutic duplication.

          (g) Drug-disease contraindications.

          (h) Drug-drug interactions.

          (i) Drug allergy interactions.

          (j) Clinical abuse and misuse.

          (3) Adopt and implement procedures designed to ensure the confidentiality of any information that identifies individual prescribers, pharmacists or recipients and that is collected, stored, retrieved, assessed or analyzed by the committee, staff of the committee, the Oregon Health Authority or contractors to the committee or the authority.

 

          SECTION 6. In appropriate instances, interventions developed under section 4 (1)(d) of this 2011 Act may include the following:

          (1) Information disseminated to prescribers and pharmacists to ensure that they are aware of the duties and powers of the Pharmacy and Therapeutics Committee.

          (2) Written, oral or electronic reminders of recipient-specific or drug-specific information that are designed to ensure recipient, prescriber and pharmacist confidentiality, and suggested changes in the prescribing or dispensing practices designed to improve the quality of care.

          (3) Face-to-face discussions between experts in drug therapy and the prescriber or pharmacist who has been targeted for educational intervention.

          (4) Intensified reviews or monitoring of selected prescribers or pharmacists.

          (5) Educational outreach through the retrospective program focusing on improvement of prescribing and dispensing practices.

          (6) The timely evaluation of interventions to determine if the interventions have improved the quality of care.

          (7) The review of case profiles before the conducting of an intervention.

 

          SECTION 7. The prospective drug use review program must use guidelines established by the Oregon Health Authority that are based on the recommendations of the Pharmacy and Therapeutics Committee. The program must ensure that prior to the prescription being filled or delivered a review will be conducted by the pharmacist at the point of sale to screen for potential drug therapy problems resulting from the following:

          (1) Therapeutic duplication.

          (2) Drug-drug interactions, including serious interactions with nonprescription or over-the-counter drugs.

          (3) Incorrect dosage and duration of treatment.

          (4) Drug-allergy interactions.

          (5) Clinical abuse and misuse.

          (6) Drug-disease contraindications.

 

          SECTION 8. The retrospective drug use review program must use:

          (1) Guidelines established by the Oregon Health Authority that are based on the recommendations of the Pharmacy and Therapeutics Committee; and

          (2) The mechanized drug claims processing and information retrieval system to analyze claims data on drug use against explicit predetermined standards that are based on compendia and other sources to monitor the following:

          (a) Therapeutic appropriateness.

          (b) Overutilization or underutilization.

          (c) Fraud and abuse.

          (d) Therapeutic duplication.

          (e) Drug-disease contraindications.

          (f) Drug-drug interactions.

          (g) Incorrect drug dosage or duration of drug treatment.

          (h) Clinical abuse and misuse.

 

          SECTION 9. (1) Information collected under sections 1 to 12 of this 2011 Act that identifies an individual is confidential and may not be disclosed by the Pharmacy and Therapeutics Committee, the retrospective program or the Oregon Health Authority to any person other than a health care provider appearing on a recipient’s medication profile.

          (2) The staff of the committee may have access to identifying information for purposes of carrying out intervention activities. The identifying information may not be released to anyone other than a staff member of the committee, the retrospective program, the authority or a health care provider appearing on a recipient’s medication profile or, for purposes of investigating potential fraud in programs administered by the authority, the Department of Justice.

          (3) The committee may release cumulative, nonidentifying information for the purposes of legitimate research and for educational purposes.

 

          SECTION 10. (1) Notwithstanding ORS 192.610 to 192.690, the Pharmacy and Therapeutics Committee shall meet in an executive session for purposes of:

          (a) Reviewing the prescribing or dispensing practices of individual physicians or pharmacists;

          (b) Discussing drug use review data pertaining to individual physicians or pharmacists;

          (c) Reviewing profiles of individual patients; or

          (d) Reviewing confidential drug pricing information, including substantial cost differences between drugs within the same therapeutic class, that is necessary for the committee to make final recommendations under section 4 of this 2011 Act or to comply with section 9 of this 2011 Act.

          (2) A meeting held in executive session is subject to the requirements of ORS 192.650 (2).

 

          SECTION 11. (1) Except as provided in section 10 of this 2011 Act, the Pharmacy and Therapeutics Committee shall operate in accordance with ORS chapter 192. The committee shall annually elect a chairperson from the members of the committee.

          (2) A committee member is not entitled to compensation but is entitled to reimbursement for actual and necessary travel expenses incurred in connection with the member’s duties, pursuant to ORS 292.495.

          (3) A quorum consists of six members of the committee.

          (4) The committee may establish advisory committees to assist in carrying out the committee’s duties under sections 1 to 12 of this 2011 Act, with the approval of the Director of the Oregon Health Authority.

          (5) The Oregon Health Authority shall provide staff and support services to the committee.

          (6) The committee shall meet no less than four times each year at a place, day and hour determined by the director. The committee also shall meet at other times and places specified by the call of the director or a majority of the members of the committee. No less than 30 days prior to a meeting the committee shall post to the authority website:

          (a) The agenda for the meeting;

          (b) A list of the drug classes to be considered at the meeting; and

          (c) Background materials and supporting documentation provided to committee members with respect to drugs and drug classes that are before the committee for review.

          (7) The committee shall provide appropriate opportunity for public testimony at each regularly scheduled committee meeting. Immediately prior to deliberating on any recommendations regarding a drug or a class of drugs, the committee shall accept testimony, in writing or in person, that is offered by a manufacturer of those drugs or another interested party.

          (8) The committee may consider more than 20 classes of drugs at a meeting only if:

          (a) There is no new clinical evidence for the additional class of drugs; and

          (b) The committee is considering only substantial cost differences between drugs within the same therapeutic class.

 

          SECTION 12. (1) The annual report required under section 5 (1) of this 2011 Act is subject to public comment prior to its submission to the Director of the Oregon Health Authority and must include the following:

          (a) An overview of the activities of the Pharmacy and Therapeutics Committee and the prospective and retrospective programs;

          (b) A summary of interventions made, including the number of cases brought before the committee and the number of interventions made;

          (c) An assessment of the impact of the interventions, criteria and standards used, including an overall assessment of the impact of the educational programs and interventions on prescribing and dispensing patterns;

          (d) An assessment of the impact of the criteria, standards and educational interventions on quality of care; and

          (e) An estimate of the cost savings generated as a result of the prospective and retrospective programs, including an overview of the fiscal impact of the programs to other areas of the medical assistance program such as hospitalization or long term care costs. This analysis should include a cost-benefit analysis of both the prospective and retrospective programs and should take into account the administrative costs of the drug utilization review program.

          (2) Copies of the annual report shall be submitted to the President of the Senate, the Speaker of the House of Representatives and other persons who request copies of the report.

 

DRUG USE REVIEW BOARD ABOLISHED

 

          SECTION 13. (1) The Drug Use Review Board is abolished. On the operative date of this section, the tenure of office of the members of the Drug Use Review Board ceases.

          (2) All the duties, functions and powers of the Drug Use Review Board are imposed upon, transferred to and vested in the Pharmacy and Therapeutics Committee.

 

          SECTION 14. (1) The Director of the Oregon Health Authority shall:

          (a) Deliver to the Pharmacy and Therapeutics Committee all records and property within the jurisdiction of the Drug Use Review Board that relate to the duties, functions and powers transferred by section 13 of this 2011 Act; and

          (b) Transfer to the committee those employees engaged primarily in the exercise of the duties, functions and powers transferred by section 13 of this 2011 Act.

          (2) The committee shall take possession of the records and property and shall take charge of the employees and employ them, in the exercise of the duties, functions and powers transferred by section 13 of this 2011 Act, without reduction of compensation but subject to change or termination of employment or compensation as provided by law.

          (3) The director shall resolve any dispute between the Drug Use Review Board and the Pharmacy and Therapeutics Committee relating to transfers of records, property and employees under this section, and the director’s decision is final.

 

          SECTION 15. (1) The unexpended balances of amounts authorized to be expended by the Drug Use Review Board for the biennium beginning July 1, 2011, from revenues dedicated, continuously appropriated, appropriated or otherwise made available for the purpose of administering and enforcing the duties, functions and powers transferred by section 13 of this 2011 Act are transferred to and are available for expenditure by the Pharmacy and Therapeutics Committee for the remainder of the biennium beginning July 1, 2011, for the purpose of administering and enforcing the duties, functions and powers transferred by section 13 of this 2011 Act.

          (2) The expenditure classifications, if any, established by Acts authorizing or limiting expenditures by the board remain applicable to expenditures by the committee under this section.

 

          SECTION 16. The transfer of duties, functions and powers to the Pharmacy and Therapeutics Committee by section 13 of this 2011 Act does not affect any action, proceeding or prosecution involving or with respect to such duties, functions and powers begun before and pending at the time of the transfer, except that the committee is substituted for the Drug Use Review Board in the action, proceeding or prosecution.

 

          SECTION 17. (1) Nothing in sections 1 to 16 of this 2011 Act or the repeal of ORS 414.350, 414.355, 414.360, 414.365, 414.370, 414.375, 414.380, 414.385, 414.390, 414.395, 414.400, 414.410 or 414.415 by section 228 of this 2011 Act relieves a person of a liability, duty or obligation accruing under or with respect to the duties, functions and powers transferred by section 13 of this 2011 Act. The Pharmacy and Therapeutics Committee may undertake the collection or enforcement of any such liability, duty or obligation.

          (2) The rights and obligations of the Drug Use Review Board legally incurred under contracts, leases and business transactions executed, entered into or begun before the operative date of section 13 of this 2011 Act are transferred to the Pharmacy and Therapeutics Committee. For the purpose of succession to these rights and obligations, the Pharmacy and Therapeutics Committee is a continuation of the Drug Use Review Board and is not a new authority.

 

          SECTION 18. Whenever, in any uncodified law or resolution of the Legislative Assembly or in any rule, document, record or proceeding authorized by the Legislative Assembly, reference is made to the Drug Use Review Board or an officer or employee of the Drug Use Review Board, the reference is considered to be a reference to the Pharmacy and Therapeutics Committee or an officer or employee of the Pharmacy and Therapeutics Committee.

 

          SECTION 19. For the purpose of harmonizing and clarifying statutory law, the Legislative Counsel may substitute for words designating the “Drug Use Review Board” or its officers, wherever they occur in statutory law, words designating the “Pharmacy and Therapeutics Committee” or its officers.

 

          SECTION 20. The Director of the Oregon Health Authority may take any action before the operative date specified in section 21 of this 2011 Act that is necessary to enable the Pharmacy and Therapeutics Committee to exercise, on and after the operative date of section 13 of this 2011 Act, the duties, functions and powers of the committee pursuant to section 13 of this 2011 Act.

 

          SECTION 21. Except as otherwise specifically provided in section 20 of this 2011 Act, sections 1 to 16 of this 2011 Act become operative 31 calendar days after the effective date of this 2011 Act.

 

HEALTH EVIDENCE REVIEW COMMISSION

 

          SECTION 22. (1) As used in this section:

          (a) “Practice of pharmacy” has the meaning given that term in ORS 689.005.

          (b) “Retail drug outlet” has the meaning given that term in ORS 689.005.

          (2) The Health Evidence Review Commission is established in the Oregon Health Authority, consisting of 13 members appointed by the Governor in consultation with professional and other interested organizations, and confirmed by the Senate, as follows:

          (a) Five members must be physicians licensed to practice medicine in this state who have clinical expertise in the areas of family medicine, internal medicine, obstetrics, perinatal health, pediatrics, disabilities, geriatrics or general surgery. One of the physicians must be a doctor of osteopathy, and one must be a hospital representative or a physician whose practice is significantly hospital-based.

          (b) One member must be a dentist licensed under ORS chapter 679 who has clinical expertise in general, pediatric or public health dentistry.

          (c) One member must be a public health nurse.

          (d) One member must be a behavioral health representative who may be a social services worker, alcohol and drug treatment provider, psychologist or psychiatrist.

          (e) Two members must be consumers of health care who are patient advocates or represent the areas of indigent services, labor, business, education or corrections.

          (f) One member must be a complementary or alternative medicine provider who is a chiropractic physician licensed under ORS chapter 684, a naturopathic physician licensed under ORS chapter 685 or an acupuncturist licensed under ORS chapter 677.

          (g) One member must be an insurance industry representative who may be a medical director or other administrator.

          (h) One member must be a pharmacy representative who engages in the practice of pharmacy at a retail drug outlet.

          (3) No more than six members of the commission may be physicians either in active practice or retired from practice.

          (4) Members of the commission serve for a term of four years at the pleasure of the Governor. A member is eligible for reappointment.

          (5) Members are not entitled to compensation, but may be reimbursed for actual and necessary travel and other expenses incurred by them in the performance of their official duties in the manner and amounts provided for in ORS 292.495. Claims for expenses shall be paid out of funds available to the Oregon Health Authority for purposes of the commission.

 

          SECTION 23. (1) The Health Evidence Review Commission shall select one of its members as chairperson and another as vice chairperson, for terms and with duties and powers the commission determines necessary for the performance of the functions of the offices.

          (2) A majority of the members of the commission constitutes a quorum for the transaction of business.

          (3) The commission shall meet at least four times per year at a place, day and hour determined by the chairperson. The commission also shall meet at other times and places specified by the call of the chairperson or of a majority of the members of the commission.

          (4) The commission may use advisory committees or subcommittees whose members are appointed by the chairperson of the commission subject to approval by a majority of the members of the commission. The advisory committees or subcommittees may contain experts appointed by the chairperson and a majority of the members of the commission. The conditions of service of the experts will be determined by the chairperson and a majority of the members of the commission.

          (5) The Office for Oregon Health Policy and Research shall provide staff and support services to the commission.

 

          SECTION 24. (1) The Health Evidence Review Commission shall regularly solicit testimony and information from stakeholders representing consumers, advocates, providers, carriers and employers in conducting the work of the commission.

          (2) The commission shall actively solicit public involvement through a public meeting process to guide health resource allocation decisions.

          (3) The commission shall develop and maintain a list of health services ranked by priority, from the most important to the least important, representing the comparative benefits of each service to the population to be served. The list must be submitted by the commission pursuant to subsection (5) of this section and is not subject to alteration by any other state agency.

          (4) In order to encourage effective and efficient medical evaluation and treatment, the commission:

          (a) May include clinical practice guidelines in its prioritized list of services. The commission shall actively solicit testimony and information from the medical community and the public to build a consensus on clinical practice guidelines developed by the commission.

          (b) May include statements of intent in its prioritized list of services. Statements of intent should give direction on coverage decisions where medical codes and clinical practice guidelines cannot convey the intent of the commission.

          (c) Shall consider both the clinical effectiveness and cost-effectiveness of health services, including drug therapies, in determining their relative importance using peer-reviewed medical literature as defined in ORS 743A.060.

          (5) The commission shall report the prioritized list of services to the Oregon Health Authority for budget determinations by July 1 of each even-numbered year.

          (6) The commission shall make its report during each regular session of the Legislative Assembly and shall submit a copy of its report to the Governor, the Speaker of the House of Representatives and the President of the Senate.

          (7) The commission may alter the list during the interim only as follows:

          (a) To make technical changes to correct errors and omissions;

          (b) To accommodate changes due to advancements in medical technology or new data regarding health outcomes;

          (c) To accommodate changes to clinical practice guidelines; and

          (d) To add statements of intent that clarify the prioritized list.

          (8) If a service is deleted or added during an interim and no new funding is required, the commission shall report to the Speaker of the House of Representatives and the President of the Senate. However, if a service to be added requires increased funding to avoid discontinuing another service, the commission shall report to the Emergency Board to request the funding.

          (9) The prioritized list of services remains in effect for a two-year period beginning no earlier than October 1 of each odd-numbered year.

 

          SECTION 25. (1) As used in this section and section 26 of this 2011 Act:

          (a) “Medical technology” means medical equipment and devices, medical or surgical procedures and techniques used by health care providers in delivering medical care to individuals, and the organizational or supportive systems within which medical care is delivered.

          (b) “Medical technology assessment” means evaluation of the use, clinical effectiveness and cost of a technology in comparison with its alternatives.

          (2) The Health Evidence Review Commission shall develop a medical technology assessment process. The Oregon Health Authority shall direct the commission with regard to medical technologies to be assessed and the timing of the assessments.

          (3) The commission shall appoint and work with an advisory committee whose members have the appropriate expertise to conduct a medical technology assessment.

          (4) The commission shall present its preliminary findings at a public hearing and shall solicit testimony and information from health care consumers. The commission shall give strong consideration to the recommendations of the advisory committee and public testimony in developing its assessment.

          (5) To ensure that confidentiality is maintained, identification of a patient or a person licensed to provide health services may not be included with the data submitted under this section, and the commission shall release such data only in aggregate statistical form. All findings and conclusions, interviews, reports, studies, communications and statements procured by or furnished to the commission in connection with obtaining the data necessary to perform its functions is confidential pursuant to ORS 192.501 to 192.505.

 

          SECTION 26. (1) The Health Evidence Review Commission shall conduct comparative effectiveness research of medical technologies selected in accordance with section 25 of this 2011 Act. The commission may conduct the research by comprehensive review of the comparative effectiveness research undertaken by recognized state, national or international entities. The commission may consider evidence relating to prescription drugs that is relevant to a medical technology assessment but may not conduct a drug class evidence review or medical technology assessment solely of a prescription drug. The commission shall disseminate the research findings to health care consumers, providers and third-party payers and to other interested stakeholders.

          (2) The commission shall develop or identify and shall disseminate evidence-based health care guidelines for use by providers, consumers and purchasers of health care in Oregon.

          (3) The Oregon Health Authority shall vigorously pursue health care purchasing strategies that adopt the research findings described in subsection (1) of this section and the evidence-based health care guidelines described in subsection (2) of this section.

 

          SECTION 26a. The Health Evidence Review Commission,

in ranking health services or developing guidelines under section 24 of this 2011 Act or in assessing medical technologies under section 26 of this 2011 Act, and the Pharmacy and Therapeutics Committee, in considering a recommendation for a drug to be included on any preferred drug list or on the Practitioner-Managed Prescription Drug Plan, may not rely solely on the results of comparative effectiveness research.

 

HEALTH RESOURCES COMMISSION AND

HEALTH SERVICES COMMISSION

ABOLISHED

 

          SECTION 27. (1) The Health Resources Commission and the Health Services Commission are abolished. On the operative date of this section, the tenure of office of the members of the Health Resources Commission and the Health Services Commission ceases.

          (2) All the duties, functions and powers of the Health Resources Commission and the Health Services Commission are imposed upon, transferred to and vested in the Health Evidence Review Commission.

 

          SECTION 28. (1) The Director of the Oregon Health Authority shall:

          (a) Deliver to the Health Evidence Review Commission all records and property within the jurisdiction of the director that relate to the duties, functions and powers transferred by section 27 of this 2011 Act; and

          (b) Transfer to the commission those employees engaged primarily in the exercise of the duties, functions and powers transferred by section 27 of this 2011 Act.

          (2) The commission shall take possession of the records and property and shall take charge of the employees and employ them, in the exercise of the duties, functions and powers transferred by section 27 of this 2011 Act, without reduction of compensation but subject to change or termination of employment or compensation as provided by law.

          (3) The director shall resolve any dispute between the Health Resources Commission and the Health Services Commission and the Health Evidence Review Commission relating to transfers of records, property and employees under this section, and the director’s decision is final.

 

          SECTION 29. (1) The unexpended balances of amounts authorized to be expended by the Health Resources Commission and the Health Services Commission for the biennium beginning July 1, 2011, from revenues dedicated, continuously appropriated, appropriated or otherwise made available for the purpose of administering and enforcing the duties, functions and powers transferred by section 27 of this 2011 Act are transferred to and are available for expenditure by the Health Evidence Review Commission for the remainder of the biennium beginning July 1, 2011, for the purpose of administering and enforcing the duties, functions and powers transferred by section 27 of this 2011 Act.

          (2) The expenditure classifications, if any, established by Acts authorizing or limiting expenditures by the Health Resources Commission and the Health Services Commission remain applicable to expenditures by the Health Evidence Review Commission under this section.

 

          SECTION 30. The transfer of duties, functions and powers to the Health Evidence Review Commission by section 27 of this 2011 Act does not affect any action, proceeding or prosecution involving or with respect to such duties, functions and powers begun before and pending at the time of the transfer, except that the Health Evidence Review Commission is substituted for the Health Resources Commission or the Health Services Commission in the action, proceeding or prosecution.

 

          SECTION 31. (1) Nothing in sections 22 to 30 of this 2011 Act or the repeal of ORS 414.715, 414.720, 414.741, 442.575, 442.580, 442.581, 442.583, 442.584, 442.588 and 442.589 by section 228 of this 2011 Act relieves a person of a liability, duty or obligation accruing under or with respect to the duties, functions and powers transferred by section 27 of this 2011 Act. The Health Evidence Review Commission may undertake the collection or enforcement of any such liability, duty or obligation.

          (2) The rights and obligations of the Health Resources Commission and the Health Services Commission legally incurred under contracts, leases and business transactions executed, entered into or begun before the operative date of section 27 of this 2011 Act are transferred to the Health Evidence Review Commission. For the purpose of succession to these rights and obligations, the Health Evidence Review Commission is a continuation of the Health Resources Commission and the Health Services Commission and is not a new authority.

 

          SECTION 32. The Director of the Oregon Health Authority may take any action before the operative date of section 27 of this 2011 Act that is necessary to enable the Health Evidence Review Commission to exercise, on and after the operative date of section 27 of this 2011 Act, the duties, functions and powers of the commission pursuant to section 27 of this 2011 Act.

 

          SECTION 33. Whenever, in any uncodified law or resolution of the Legislative Assembly or in any rule, document, record or proceeding authorized by the Legislative Assembly, reference is made to the Health Resources Commission or the Health Services Commission or an officer or employee of the Health Resources Commission or the Health Services Commission, the reference is considered to be a reference to the Health Evidence Review Commission or an officer or employee of the Health Evidence Review Commission.

 

          SECTION 34. For the purpose of harmonizing and clarifying statutory law, the Legislative Counsel may substitute for words designating the “Health Resources Commission” or the “Health Services Commission” or the officers of the Health Resources Commission or the Health Services Commission, wherever they occur in statutory law, words designating the “Health Evidence Review Commission” or its officers.

 

          SECTION 35. Except as otherwise specifically provided in section 32 of this 2011 Act, sections 22 to 30 of this 2011 Act become operative on January 1, 2012.

 

OREGON HEALTH AUTHORITY

FINANCIAL ADMINISTRATION

 

          SECTION 36. Notwithstanding any other provision of law, federal laws shall govern the administration of federally granted funds. The Director of the Oregon Health Authority may request a waiver of any federal law in order to fully implement provisions of state law using federally granted funds.

 

          SECTION 37. (1) There is established an Oregon Health Authority Special Checking Account in the State Treasury. Upon the written request of the Director of the Oregon Health Authority, the Oregon Department of Administrative Services shall draw payments in favor of the authority to be charged against appropriations and other moneys available to the authority in the same manner as other claims against the state, as provided in ORS chapter 293. All such payments shall be deposited in the special checking account and may be disbursed by check or other means acceptable to the State Treasurer.

          (2) The special checking account may be used for the purpose of paying the administrative expenses of programs and services as assigned to the authority by law, including the payment of expenses to be reimbursed by the federal government.

          (3) In addition to funds authorized under ORS 293.180, the authority may establish petty cash funds out of the special checking account or any account established in the State Treasury for the authority. The authority may pay expenses using small cash disbursements from a petty cash fund. Periodically, the authority shall request reimbursement for disbursements made from a petty cash fund. Upon receipt of a reimbursement payment from an appropriate account, the authority shall use the payment to reimburse the petty cash fund.

 

          SECTION 38. Notwithstanding any other law, the Oregon Health Authority may, with the approval of the Oregon Department of Administrative Services and the State Treasurer, combine or eliminate any accounts that are established in statute and appropriated to the authority if economy and efficiency in operations can be obtained and the combination or elimination of accounts does not substantially alter the intent of the authorizing statutes. When accounts are combined, the Oregon Health Authority retains the authority granted by the statutes establishing the accounts.

 

          SECTION 39. The Oregon Department of Administrative Services shall draw warrants in favor of the Oregon Health Authority for the aggregate amounts of the authority’s expenses. The authority shall deposit the warrants in the State Treasury in a checking account in reimbursement of those expenses. The authority may draw its checks on the State Treasury in favor of the persons, firms, corporations, associations or counties entitled to payment under rules of the authority so as to include in single combined payments for specified periods all moneys allotted to particular payees from various sources for the period.

 

          SECTION 40. (1) On written request of the Oregon Health Authority, the Oregon Department of Administrative Services shall draw warrants on amounts appropriated to the authority for operating expenses for use by the authority as a revolving fund. The revolving fund may not exceed the aggregate sum of $100,000 including unreimbursed advances. The revolving fund shall be deposited with the State Treasurer to be held in a special account against which the authority may draw checks.

          (2) The revolving fund may be used by the authority:

          (a) To pay for or advance travel expenses for employees of the authority and for any consultants or advisers for whom payment of travel expenses is authorized by law;

          (b) For purchases required from time to time; or

          (c) For receipt or disbursement of federal funds available under federal law.

          (3) All claims for reimbursement of amounts paid from the revolving fund must be approved by the authority and by the department. When such claims are approved, the department shall draw a warrant covering them against the appropriate fund or account in favor of the authority. The authority shall use the moneys to reimburse the revolving fund.

 

ADMINISTRATION OF HUMAN SERVICES

 

          SECTION 41. (1) As used in this section:

          (a) “Adult foster home” has the meaning given that term in ORS 443.705.

          (b) “Health care facility” has the meaning given that term in ORS 442.015.

          (c) “Residential facility” has the meaning given that term in ORS 443.400.

          (2) Every adult foster home, health care facility and residential facility licensed or registered by the Oregon Health Authority shall:

          (a) Adopt a plan to provide for the safety of persons who are receiving care at or are residents of the home or facility in the event of an emergency that requires immediate action by the staff of the home or facility due to conditions of imminent danger that pose a threat to the life, health or safety of persons who are receiving care at or are residents of the home or facility; and

          (b) Provide training to all employees of the home or facility about the responsibilities of the employees to implement the plan required by this section.

          (3) The authority shall adopt by rule the requirements for the plan and training required by this section. The rules adopted shall include, but are not limited to, procedures for the evacuation of the persons who are receiving care at or are residents of the adult foster home, health care facility or residential facility to a place of safety when the conditions of imminent danger require relocation of those persons.

 

          SECTION 42. (1) As used in this section, “family member” means any individual related by blood, marriage or adoption to a person whose cremated remains are in the possession of the Oregon Health Authority.

          (2) Notwithstanding any other provision of law, the authority shall disclose to the general public the name and the dates of birth and death of a person whose cremated remains are in the possession of the authority for the purpose of:

          (a) Giving a family member of the person an opportunity to claim the cremated remains; or

          (b) Creating a memorial for those persons whose cremated remains are not claimed.

          (3) If an individual contacts the authority to determine whether the authority is in possession of the cremated remains of a family member of the individual and the authority determines that the authority is in possession of the cremated remains, the authority shall disclose to the individual that the authority is in possession of the cremated remains and offer the individual the opportunity to claim the remains.

 

          SECTION 43. Liquidated and delinquent debts owed to the Oregon Health Authority may be set off against amounts owed by the authority to the debtors.

 

          SECTION 44. (1) Notwithstanding ORS 8.690, 9.160, 9.320 or 203.145 or ORS chapter 180 or other law, in any contested case proceeding before the Oregon Health Authority, a corporation may be represented by an attorney or by any officer or authorized agent or employee of the corporation.

          (2) As used in this section, “corporation” includes a public or private corporation, whether or not organized for profit.

 

          SECTION 45. (1) The Oregon Health Authority may accept funds, money or other valuable things from relatives, corporations or interested persons or organizations for the care and support of needy persons and may expend the same for the care and support of the individual or individuals for whom the moneys were paid.

          (2) The authority may accept from individuals, corporations and organizations contributions or gifts in cash or otherwise that shall be disbursed in the same manner as moneys appropriated for public assistance purposes, unless the donor of a gift stipulates a different manner in which a gift must be expended. Moneys received under this section shall be deposited with the State Treasurer in an account separate and distinct from the General Fund. Interest earned by the account shall be credited to the account. Moneys in the account are continuously appropriated to the department for the purposes specified in this section.

 

          SECTION 46. All sums of money recovered by or paid to the Oregon Health Authority as reimbursement for funds expended for medical assistance shall be paid into the Oregon Health Authority Fund established by ORS 413.031 and may be used for the provision and administration of medical assistance. However, the United States Government is entitled to a share of any amount received as its interest may appear, which shall be promptly paid to the United States Government.

 

          SECTION 47. In addition to its other powers, the Oregon Health Authority may:

          (1) Enter into agreements with, join with or accept grants from the federal government for cooperative research and demonstration projects for health and health care purposes, including, but not limited to, any project that:

          (a) Improves the lifelong health of Oregonians.

          (b) Aids in effecting coordination of planning between private and public health and health care agencies of the state.

          (c) Improves the administration and effectiveness of programs carried on or assisted by the authority.

          (2) With the cooperation and the financial assistance of the federal government, train personnel employed or preparing for employment by the authority. The training may be carried out in any manner, including but not limited to:

          (a) Directly by the authority.

          (b) Indirectly through grants to public or other nonprofit institutions of learning or through grants of fellowships.

          (c) Any other manner for which federal aid in support of the training is available.

          (3) Subject to the allotment system provided for in ORS 291.234 to 291.260, expend the sums required to be expended for the programs and projects described in subsections (1) and (2) of this section.

 

          SECTION 48. (1) The Oregon Health Authority shall adopt and enforce rules governing the custody, use and preservation of the records, papers, files and communications of the authority in accordance with applicable privacy laws. The use of the records, papers, files and communications is limited to the purposes for which they are furnished and by the provisions of law under which they may be furnished.

          (2) The records, papers, files and communications of the authority may be maintained in a single or combined data system accessible to the authority and to the Department of Human Services for the administration of programs and the coordination of functions shared by the authority and the department.

 

          SECTION 49. (1) For the protection of applicants for and recipients of public assistance, except as otherwise provided in this section, the Oregon Health Authority may not disclose or use the contents of any public assistance records, files, papers or communications for purposes other than those directly connected with the administration of the public assistance programs or necessary to assist public assistance applicants and recipients in accessing and receiving other governmental or private nonprofit services, and these records, files, papers and communications are considered confidential subject to the rules of the authority. In any judicial or administrative proceeding, except proceedings directly connected with the administration of public assistance or child support enforcement, their contents are considered privileged communications.

          (2) Nothing in this section prohibits the disclosure or use of contents of records, files, papers or communications for purposes directly connected with the establishment and enforcement of support obligations pursuant to the Title IV-D of the Social Security Act.

          (3) Nothing in this section prohibits the disclosure of the address, Social Security number and photograph of any applicant or recipient to a law enforcement officer at the request of the officer. To receive information pursuant to this section, the officer must furnish the agency the name of the applicant or recipient and advise that the applicant or recipient:

          (a) Is fleeing to avoid prosecution, custody or confinement after conviction for a felony;

          (b) Is violating a condition of probation or parole; or

          (c) Has information that is necessary for the officer to conduct the official duties of the officer and the location or apprehension of the applicant or recipient is within such official duties.

          (4) Nothing in this section prohibits disclosure of information between the authority and the Department of Human Services for the purpose of administering public assistance programs that the authority and the department are responsible for administering.

 

          SECTION 50. (1) The Oregon Health Authority may serve a notice described in ORS 183.415 by regular mail or, if requested by the recipient of the notice, by electronic mail. The legal presumption described in ORS 40.135 (1)(q) does not apply to a notice that is served by regular mail under this section.

          (2) Except as provided in subsection (3) of this section, a contested case notice served in accordance with subsection (1) of this section that complies with ORS 183.415 but for service by regular or electronic mail becomes a final order against a party and is not subject to ORS 183.470 (2), upon the earlier of the following:

          (a) If the party fails to request a hearing, the day after the date prescribed in the notice as the deadline for requesting a hearing.

          (b) The date the authority or the Office of Administrative Hearings mails an order dismissing a hearing request because:

          (A) The party withdraws the request for hearing; or

          (B) Neither the party nor the party’s representative appears on the date and at the time set for hearing.

          (3) The authority shall prescribe by rule a period of not less than 60 days after a notice becomes a final order under subsection (2) of this section within which a party may request a hearing under this subsection. If a party requests a hearing within the period prescribed under this subsection, the authority shall do one of the following:

          (a) If the authority finds that the party did not receive the written notice and did not have actual knowledge of the notice, refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding on the merits of the authority’s intended action described in the notice.

          (b) Refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding to determine whether the party received the written notice or had actual knowledge of the notice. The authority must show that the party had actual knowledge of the notice or that the authority mailed the notice to the party’s correct address or sent an electronic notice to the party’s correct electronic mail address.

          (4) If a party informs the authority that the party did not receive a notice served by regular or electronic mail in accordance with subsection (1) of this section, the authority shall advise the party of the right to request a hearing under subsection (3) of this section.

 

          SECTION 50a. (1) As used in this section:

          (a) “Care” means treatment, education, training, instruction, placement services, recreational opportunities, support services or case management, or the supervision of such services, for clients of the Oregon Health Authority.

          (b) “Subject individual” means a person who is:

          (A) Employed or who seeks to be employed by the authority to provide care;

          (B) A volunteer or who seeks to be a volunteer to provide care on behalf of the authority; or

          (C) Providing care or who seeks to provide care on behalf of the authority.

          (2) The Oregon Health Authority may use abuse and neglect reports, as defined in ORS 409.025, for the purpose of providing protective services or screening subject individuals.

          (3) The authority shall adopt rules to carry out the provisions of subsection (2) of this section.

          (4) The rules adopted in subsection (3) of this section may include:

          (a) Notice and opportunity for due process for an employee of the authority who is found to be unfit; and

          (b) Notice and opportunity for hearing in accordance with ORS chapter 183 for a subject individual described in subsection (1)(b)(C) of this section.

          (5) Reports used by the authority under this section are confidential and may not be disclosed for any purpose other than in accordance with this section or any other provision of law.

 

AMENDMENTS TO STATUTES

 

          SECTION 51. ORS 3.408 is amended to read:

          3.408. (1) The presiding judge of the judicial district may assign to a family court department established under ORS 3.405 all of the following matters:

          (a) Proceedings under the provisions of ORS chapters 107, 108, 109 and 110;

          (b) Proceedings under the provisions of ORS chapter 25;

          (c) Guardianship proceedings for minors under the provisions of ORS chapter 125;

          (d) Juvenile court proceedings under ORS chapters 419A, 419B and 419C;

          (e) Proceedings to commit a person with a mental illness under the provisions of ORS chapter 426 [and ORS 430.397 to 430.401];

          (f) Probate proceedings under ORS chapters 111, 112, 113, 114, 115, 116 and 117; and

          (g) Any other proceeding in which a family is involved.

          (2) In addition to the matters specified in subsection (1) of this section, the presiding judge of the judicial district may assign to a family court department any criminal proceeding that involves domestic violence or other crime between family members.

 

          SECTION 52. ORS 30.262 is amended to read:

          30.262. (1) The following facilities and training homes are public bodies for the purposes of ORS 30.260 to 30.300:

          (a) A nonprofit residential training facility as defined in ORS 443.400, nonprofit residential training home as defined in ORS 443.400 or nonprofit facility as defined in ORS 427.005, organized and existing under ORS chapter 65, that receives more than 50 percent of its funding from the state or a political subdivision of the state for the purpose of providing residential or vocational services to individuals with [mental retardation or] developmental disabilities.

          (b) A nonprofit residential training facility as defined in ORS 443.400, nonprofit residential training home as defined in ORS 443.400 or nonprofit facility as defined in ORS 427.005, organized and existing under ORS chapter 65, that receives less than 50 percent of its funding from the state or a political subdivision of the state but that provides residential or vocational services to individuals with [mental retardation or] developmental disabilities, more than half of whom are eligible for funding for services by the Department of Human Services under criteria established by the department.

          (2) The provisions of this section apply only to a nonprofit residential training facility, nonprofit residential training home or nonprofit facility that provides services to individuals with [mental retardation or] developmental disabilities under a contract with:

          (a) The Department of Human Services; or

          (b) A community mental health [and] program or community developmental disabilities program established pursuant to ORS 430.620.

 

          SECTION 53. ORS 87.533 is amended to read:

          87.533. A lien created by ORS 87.503 shall not be enforced so as to interfere with:

          (1) Any assets or income allowed to the community spouse or dependent family member under 42 U.S.C. 1396r-5(d) or any rule of the Department of Human Services or the Oregon Health Authority.

          (2) The priority given to the recovery of medical assistance payments under ORS 115.125 (1)(i) or (j) or other medical assistance claims under ORS 411.708, 411.795 and 416.350 [(2) and (3)].

          (3) The eligibility of a person for medical assistance or entitlement to Medicaid assistance payments.

          (4) The priority given to the recovery of cost of care payments under ORS 115.125 (1)(k), 179.620 or 179.740.

 

          SECTION 54. ORS 93.268 is amended to read:

          93.268. (1) As used in this section, “encumbrance” has the meaning given that term in ORS 411.692.

          [(1)] (2) A title insurance company or agent that discovers the presence of a request for notice of transfer or encumbrance pursuant to ORS 411.694 in the deed and mortgage records when performing a title search on real property shall:

          (a) Provide the [Department of Human Services] state agency that filed the request with a notice of transfer or encumbrance of the real property within 30 days of a transfer or encumbrance that results in the issuance of a certificate of title insurance; and

          (b) Disclose the presence of the request for notice of transfer or encumbrance in any report preliminary to, or any commitment to offer, a certificate of title insurance for the real property.

          [(2)] (3) If the Department of Human Services or the Oregon Health Authority has caused to be recorded a termination of request for notice of transfer or encumbrance in the deed and mortgage records, a title insurance company or agent is no longer required to provide the notice of transfer or encumbrance required by subsection [(1)(a)] (2)(a) of this section for the affected real property.

          [(3) The Department of Human Services shall adopt by rule a model form for notice of transfer or encumbrance required by subsection (1)(a) of this section. A title insurance company or agent shall use the model form or a form substantially similar to the model form when notifying the department under subsection (1)(a) of this section.]

          (4) A title insurance company or agent shall use the form adopted under ORS 411.694 or a form substantially similar to that form when providing the notice required by subsection (2)(a) of this section.

 

          SECTION 55. ORS 106.045 is amended to read:

          106.045. (1) In addition to any other fees provided by law, the county clerk shall collect a fee of $25 upon the application for a marriage license.

          (2) The county clerk shall regularly pay over to the [Oregon Health Authority] Department of Human Services all moneys collected under subsection (1) of this section to be credited to the Domestic Violence Fund pursuant to ORS 409.300.

 

          SECTION 56. ORS 106.330 is amended to read:

          106.330. (1) In addition to any other fees provided by law, the county clerk shall collect a fee of $25 for registering a Declaration of Domestic Partnership.

          (2) The county clerk shall regularly pay over to the [Oregon Health Authority] Department of Human Services all moneys collected under subsection (1) of this section to be credited to the Domestic Violence Fund pursuant to ORS 409.300.

 

          SECTION 57. ORS 113.085 is amended to read:

          113.085. (1) Except as provided in subsection (2) of this section, upon the filing of the petition, if there is no will or there is a will and it has been proved, the court shall appoint a qualified person it finds suitable as personal representative, giving preference in the following order:

          (a) The executor named in the will.

          (b) The surviving spouse of the decedent or the nominee of the surviving spouse of the decedent.

          (c) The nearest of kin of the decedent or the nominee of the nearest of kin of the decedent.

          (d) The Director of Human Services or the Director of the Oregon Health Authority, or an attorney approved [by the director] under ORS 113.086, if the decedent received public assistance [pursuant to ORS chapter 411 or received care at an institution described in ORS 179.321 (1),] as defined in ORS 411.010 or received care at an institution described in ORS 179.321 (1) or (2) and it appears that the assistance or the cost of care may be recovered from the estate of the decedent.

          [(e) The Director of the Oregon Health Authority, or an attorney approved by the director under ORS 113.086, if the decedent received public assistance pursuant to ORS chapter 414 or received care at an institution described in ORS 179.321 (2), and it appears that the assistance or the cost of care may be recovered from the estate of the decedent.]

          [(f)] (e) The Department of Veterans’ Affairs, if the decedent was a protected person under ORS 406.050 (8), and the department has joined in the petition for such appointment.

          [(g)] (f) Any other person.

          (2) Except as provided in subsection (3) of this section, the court shall appoint the Department of State Lands as personal representative if it appears that the decedent died wholly intestate and without known heirs. The Attorney General shall represent the Department of State Lands in the administration of the estate. Any funds received by the Department of State Lands in the capacity of personal representative may be deposited in accounts, separate and distinct from the General Fund, established with the State Treasurer. Interest earned by such account shall be credited to that account.

          (3) The court may appoint a person other than the Department of State Lands to administer the estate of a decedent who died wholly intestate and without known heirs if the person filing a petition under ORS 113.035 attaches written authorization from an estate administrator of the Department of State Lands appointed under ORS 113.235 approving the filing of the petition by the person. Except as provided by rule adopted by the Director of the Department of State Lands, an estate administrator may consent to the appointment of another person to act as personal representative only if it appears after investigation that the estate is insolvent.

 

          SECTION 58. ORS 113.145 is amended to read:

          113.145. (1) Upon appointment a personal representative shall deliver or mail to the devisees, heirs and the persons described in ORS 113.035 (8) and (9) who were required to be named in the petition for appointment of a personal representative, at the addresses therein shown, information that shall include:

          (a) The title of the court in which the estate proceeding is pending and the clerk’s file number;

          (b) The name of the decedent and the place and date of the death of the decedent;

          (c) Whether or not a will of the decedent has been admitted to probate;

          (d) The name and address of the personal representative and the attorney of the personal representative;

          (e) The date of the appointment of the personal representative;

          (f) A statement advising the devisee, heir or other interested person that the rights of the devisee, heir or other interested person may be affected by the proceeding and that additional information may be obtained from the records of the court, the personal representative or the attorney for the personal representative;

          (g) If information under this section is required to be delivered or mailed to a person described in ORS 113.035 (8), a statement that the rights of the person in the estate may be barred unless the person proceeds as provided in ORS 113.075 within four months of the delivery or mailing of the information; and

          (h) If information under this section is required to be delivered or mailed to a person described in ORS 113.035 (9), a statement that the rights of the person in the estate may be barred unless the person proceeds as provided in ORS 112.049 within four months of the delivery or mailing of the information.

          (2) If the personal representative is a devisee, heir or other interested person named in the petition the personal representative is not required to deliver or mail the information under this section to the personal representative.

          (3) The failure of the personal representative to give information under this section is a breach of duty to the persons concerned, but does not affect the validity of appointment, duties or powers or the exercise of duties or powers.

          (4) Within 30 days after the date of appointment a personal representative shall cause to be filed in the estate proceeding proof of the delivery or mailing required by this section or a waiver of notice as provided under ORS 111.225. The proof shall include a copy of the information delivered or mailed and the names of the persons to whom it was delivered or mailed.

          (5) If before the filing of the final account the personal representative has actual knowledge that the petition did not include the name and address of any person described in ORS 113.035 (4), (5), (7), (8) or (9), the personal representative shall:

          (a) Make reasonable efforts under the circumstances to ascertain each of those names and addresses;

          (b) Promptly deliver or mail information as described in subsection (1) of this section to each of those persons located after the filing of the petition and before the filing of the final account; and

          (c) File in the estate proceeding, on or before filing the final account under ORS 116.083, proof of compliance with this subsection or a waiver of notice as provided under ORS 111.225.

          (6) Within 30 days after the appointment of a personal representative, the personal representative must mail or deliver the information specified in subsection (1) of this section and a copy of the death certificate of the decedent to the Department of Human Services and the Oregon Health Authority or as otherwise provided by rule adopted by the authority.

 

          SECTION 59. ORS 114.305 is amended to read:

          114.305. Subject to the provisions of ORS 97.130 (2) and except as restricted or otherwise provided by the will of the decedent, a document of anatomical gift under ORS 97.965 or by court order, a personal representative, acting reasonably for the benefit of interested persons, is authorized to:

          (1) Direct and authorize disposition of the remains of the decedent pursuant to ORS 97.130 and incur expenses for the funeral, burial or other disposition of the remains in a manner suitable to the condition in life of the decedent. Only those funeral expenses necessary for a plain and decent funeral and disposition of the remains of the decedent may be paid from the estate if the assets are insufficient to pay the claims of the Department of Human Services and the Oregon Health Authority for the net amount of public assistance, as defined in ORS 411.010, paid to or for the decedent and for care and maintenance of any decedent who was at a state institution to the extent provided in ORS 179.610 to 179.770.

          (2) Retain assets owned by the decedent pending distribution or liquidation.

          (3) Receive assets from fiduciaries or other sources.

          (4) Complete, compromise or refuse performance of contracts of the decedent that continue as obligations of the estate, as the personal representative may determine under the circumstances. In performing enforceable contracts by the decedent to convey or lease real property, the personal representative, among other courses of action, may:

          (a) Execute and deliver a deed upon satisfaction of any sum remaining unpaid or upon receipt of the note of the purchaser adequately secured; or

          (b) Deliver a deed in escrow with directions that the proceeds, when paid in accordance with the escrow agreement, be paid to the successors of the decedent, as designated in the escrow agreement.

          (5) Satisfy written pledges of the decedent for contributions, whether or not the pledges constituted binding obligations of the decedent or were properly presented as claims.

          (6) Deposit funds not needed to meet currently payable debts and expenses, and not immediately distributable, in bank or savings and loan association accounts, or invest the funds in bank or savings and loan association certificates of deposit, or federally regulated money-market funds and short-term investment funds suitable for investment by trustees under ORS 130.750 to 130.775, or short-term United States Government obligations.

          (7) Abandon burdensome property when it is valueless, or is so encumbered or is in a condition that it is of no benefit to the estate.

          (8) Vote stocks or other securities in person or by general or limited proxy.

          (9) Pay calls, assessments and other sums chargeable or accruing against or on account of securities.

          (10) Sell or exercise stock subscription or conversion rights.

          (11) Consent, directly or through a committee or other agent, to the reorganization, consolidation, merger, dissolution or liquidation of a corporation or other business enterprise.

          (12) Hold a security in the name of a nominee or in other form without disclosure of the interest of the estate, but the personal representative is liable for any act of the nominee in connection with the security so held.

          (13) Insure the assets of the estate against damage and loss, and insure the personal representative against liability to third persons.

          (14) Advance or borrow money with or without security.

          (15) Compromise, extend, renew or otherwise modify an obligation owing to the estate. A personal representative who holds a mortgage, pledge, lien or other security interest may accept a conveyance or transfer of the encumbered asset in lieu of foreclosure in full or partial satisfaction of the indebtedness.

          (16) Accept other real property in part payment of the purchase price of real property sold by the personal representative.

          (17) Pay taxes, assessments and expenses incident to the administration of the estate.

          (18) Employ qualified persons, including attorneys, accountants and investment advisers, to advise and assist the personal representative and to perform acts of administration, whether or not discretionary, on behalf of the personal representative.

          (19) Prosecute or defend actions, claims or proceedings in any jurisdiction for the protection of the estate and of the personal representative in the performance of duties as personal representative.

          (20) Prosecute claims of the decedent including those for personal injury or wrongful death.

          (21) Continue any business or venture in which the decedent was engaged at the time of death to preserve the value of the business or venture.

          (22) Incorporate or otherwise change the business form of any business or venture in which the decedent was engaged at the time of death.

          (23) Discontinue and wind up any business or venture in which the decedent was engaged at the time of death.

          (24) Provide for exoneration of the personal representative from personal liability in any contract entered into on behalf of the estate.

          (25) Satisfy and settle claims and distribute the estate as provided in ORS chapters 111, 112, 113, 114, 115, 116 and 117.

          (26) Perform all other acts required or permitted by law or by the will of the decedent.

 

          SECTION 60. ORS 115.125 is amended to read:

          115.125. (1) If the applicable assets of the estate are insufficient to pay all expenses and claims in full, the personal representative shall make payment in the following order:

          (a) Support of spouse and children, subject to the limitations imposed by ORS 114.065.

          (b) Expenses of administration.

          (c) Expenses of a plain and decent funeral and disposition of the remains of the decedent.

          (d) Debts and taxes with preference under federal law.

          (e) Reasonable and necessary medical and hospital expenses of the last illness of the decedent, including compensation of persons attending the decedent.

          (f) Taxes with preference under the laws of this state that are due and payable while possession of the estate of the decedent is retained by the personal representative.

          (g) Debts owed employees of the decedent for labor performed within 90 days immediately preceding the date of death of the decedent.

          (h) Child support arrearages.

          (i) The claim of the Department of Human Services or the Oregon Health Authority for the amount of the state’s monthly contribution to the federal government to defray the costs of outpatient prescription drug coverage provided to a person who is eligible for Medicare Part D prescription drug coverage and who receives benefits under the state medical assistance program or Title XIX of the Social Security Act.

          (j) The claim of the Department of Human Services or the Oregon Health Authority for the net amount of assistance paid to or for the decedent, in the following order:

          (A) Public assistance, as defined in ORS 411.010, funded entirely by moneys from the General Fund; and

          (B) Public assistance, as defined in ORS 411.010, funded by a combination of state and federal funds.

          (k) The claim of the Department of Human Services or the Oregon Health Authority for the care and maintenance of the decedent at a state institution, as provided in ORS 179.610 to 179.770.

          (L) The claim of the Department of Corrections for care and maintenance of any decedent who was at a state institution to the extent provided in ORS 179.610 to 179.770.

          (m) All other claims against the estate.

          (2) If the applicable assets of the estate are insufficient to pay in full all expenses or claims of any one class specified in subsection (1) of this section, each expense or claim of that class shall be paid only in proportion to the amount thereof.

 

          SECTION 61. ORS 115.195 is amended to read:

          115.195. (1) A claim that has been disallowed by the personal representative may not be allowed by any court except upon some competent, satisfactory evidence other than the testimony of the claimant.

          (2) Notwithstanding subsection (1) of this section, claims for recovery of public assistance as defined by ORS 411.010 may be allowed based on evidence in the form of documents from the Department of Human Services or the Oregon Health Authority that contain information relating to that public assistance, such as the date that services were provided to the decedent, the classification of those services, the name of the provider or the provider’s identification number, and the amount of the public assistance payment made for the services. The documents may be prints obtained from microfilm or microfiche, or printouts from computer records or other electronic storage medium. Notwithstanding ORS 40.460 and 40.510, a document described in this subsection is prima facie evidence of the information contained in the document and is not excluded from introduction as hearsay, and extrinsic evidence of authenticity of the document as a condition precedent to admissibility is not required, if the document bears a seal that on its face is the seal of the Director of Human Services or the designee of the director, or the Director of the Oregon Health Authority or the designee of the director, and:

          (a) For a print obtained from microfilm or microfiche, also bears a statement indicating that the print is a true copy of the microfilm or microfiche record, signed by a person who purports to be an officer or employee of the department [of Human Services] or the authority; or

          (b) For a printout from computer records or other electronic storage medium, also bears a statement indicating that the printout accurately reflects the data retrieved, signed by a person who purports to be an officer or employee of the department [of Human Services] or the authority.

 

          SECTION 62. ORS 116.093 is amended to read:

          116.093. (1) Upon filing the final account and petition for a judgment of distribution, the personal representative shall fix a time for filing objections thereto in a notice thereof. Not less than 20 days before the time fixed in the notice, the personal representative shall cause a copy of the notice to be mailed to:

          (a) Each heir at the last-known address of the heir, if the decedent died intestate.

          (b) Each devisee at the last-known address of the devisee, if the decedent died testate.

          (c) Each creditor who has not received payment in full and whose claim has not otherwise been barred.

          (d) Any other person known to the personal representative to have or to claim an interest in the estate being distributed.

          (2) The notice need not be mailed to the personal representative.

          (3) Proof of the mailing to those persons entitled to notice shall be filed in the estate proceeding at or before approval of the final account.

          (4) If the Department of Human Services has presented a claim under ORS chapter 411 or ORS 416.310 to 416.340, 416.350 or 417.010 to 417.080, or the Oregon Health Authority has presented a claim under ORS chapter 414 or ORS 416.310 to 416.340, 416.350 or 416.510 to 416.990, or the Department of Corrections has presented a claim under ORS 179.620 (3), and the claim has not been settled or paid in full, the personal representative shall mail to the appropriate [department] agency a copy of the final account at the same time, and shall make proof of the mailing in the same manner, as the notice provided for in this section.

          (5) The Oregon Health Authority may adopt rules designating the Department of Human Services as the appropriate department to receive the final account for claims presented by the authority under subsection (4) of this section.

 

          SECTION 63. ORS 130.370 is amended to read:

          130.370. (1) Within three months after a petition is entered in the register of the court under ORS 130.355, or within such longer time as the court allows, a trustee must make reasonably diligent efforts to investigate the financial records and affairs of the settlor and to take such further actions as are reasonably necessary to ascertain the identity and address of each person who has or asserts a claim against the trust estate. The court shall allow the trustee as much time as requested by the trustee for the purpose of determining the claims against the trust estate. The trustee must thereafter cause to be delivered or mailed a notice containing the information required in subsection (2) of this section [to each person known by the trustee to have or to assert a claim against the trust estate and] to the Department of Human Services and the Oregon Health Authority, or as otherwise provided by rule adopted by the authority, and to each person known by the trustee to have or to assert a claim against the trust estate. Notice under this section is not required for any claim that has already been presented, accepted or paid in full or on account of a claim that is merely conjectural.

          (2) The notice required by this section must include:

          (a) The name of the settlor and the last four digits of the settlor’s Social Security number;

          (b) The name of the trustee and the address at which claims must be presented;

          (c) A statement that claims against the trust estate that are not presented to the trustee within 30 days after the date of the notice may be barred;

          (d) The date of the notice, which shall be the date on which the notice is delivered or mailed; and

          (e) A copy of the settlor’s death certificate.

 

          SECTION 64. ORS 130.425 is amended to read:

          130.425. (1) Claims allowed against the trust estate under ORS 130.350 to 130.450 must be paid by the trustee in the following order of priority:

          (a) Expenses of administering the trust estate.

          (b) Expenses of a plain and decent funeral and disposition of the remains of the settlor.

          (c) Debts and taxes with preference under federal law.

          (d) Reasonable and necessary medical and hospital expenses of the last illness of the settlor, including compensation of persons attending the settlor.

          (e) Taxes with preference under the laws of this state that are due and payable while possession of the trust estate of the settlor is retained by the trustee.

          (f) Debts owed employees of the settlor for labor performed within 90 days immediately preceding the date of death of the settlor.

          (g) Child support arrearages.

          (h) [A claim] Claims of the Department of Human Services and the Oregon Health Authority for the net amount of public assistance, as defined in ORS 411.010.

          (i) [A claim] Claims of the Department of Human Services [or] and the Oregon Health Authority for the care and maintenance of any settlor who was a patient at a state institution under ORS 179.610 to 179.770.

          (j) All other claims against the trust estate.

          (2) If the assets of the trust estate are insufficient to pay in full all expenses or claims of any one class specified in subsection (1) of this section, each expense or claim of that class shall be paid only in proportion to the amount thereof.

 

          SECTION 65. ORS 179.505 is amended to read:

          179.505. (1) As used in this section:

          (a) “Disclosure” means the release of, transfer of, provision of access to or divulgence in any other manner of information outside the health care services provider holding the information.

          (b) “Health care services provider” means:

          (A) Medical personnel or other staff employed by or under contract with a public provider to provide health care or maintain written accounts of health care provided to individuals; or

          (B) Units, programs or services designated, operated or maintained by a public provider to provide health care or maintain written accounts of health care provided to individuals.

          (c) “Individually identifiable health information” means any health information that is:

          (A) Created or received by a health care services provider; and

          (B) Identifiable to an individual, including demographic information that identifies the individual, or for which there is a reasonable basis to believe the information can be used to identify an individual, and that relates to:

          (i) The past, present or future physical or mental health or condition of an individual;

          (ii) The provision of health care to an individual; or

          (iii) The past, present or future payment for the provision of health care to an individual.

          (d) “Personal representative” includes but is not limited to:

          (A) A person appointed as a guardian under ORS 125.305, 419B.370, 419C.481 or 419C.555 with authority to make medical and health care decisions;

          (B) A person appointed as a health care representative under ORS 127.505 to 127.660 or a representative under ORS 127.700 to 127.737 to make health care decisions or mental health treatment decisions; and

          (C) A person appointed as a personal representative under ORS chapter 113.

          (e) “Psychotherapy notes” means notes recorded in any medium:

          (A) By a mental health professional, in the performance of the official duties of the mental health professional;

          (B) Documenting or analyzing the contents of conversation during a counseling session; and

          (C) That are maintained separately from the rest of the individual’s record.

          (f) “Psychotherapy notes” does not mean notes documenting:

          (A) Medication prescription and monitoring;

          (B) Counseling session start and stop times;

          (C) Modalities and frequencies of treatment furnished;

          (D) Results of clinical tests; or

          (E) Any summary of the following items:

          (i) Diagnosis;

          (ii) Functional status;

          (iii) Treatment plan;

          (iv) Symptoms;

          (v) Prognosis; or

          (vi) Progress to date.

          (g) “Public provider” means:

          (A) The Blue Mountain Recovery Center, the Eastern Oregon Training Center and the Oregon State Hospital campuses;

          (B) Department of Corrections institutions as defined in ORS 421.005;

          (C) A contractor of the Department of Corrections, the Department of Human Services or the Oregon Health Authority that provides health care to individuals residing in a state institution operated by the agencies;

          (D) A community mental health program or community developmental disabilities program as described in ORS 430.610 to 430.695 and the public and private entities with which it contracts to provide mental health or developmental disabilities programs or services;

          (E) A program or service provided under ORS 431.250, 431.375 to 431.385 or 431.416;

          (F) A program or service established or maintained under ORS 430.630 or section 174 of this 2011 Act;

          (G) A program or facility providing an organized full-day or part-day program of treatment that is licensed, approved, established, maintained or operated by or contracted with the Oregon Health Authority for alcoholism, drug addiction or mental or emotional disturbance;

          (H) A program or service providing treatment by appointment that is licensed, approved, established, maintained or operated by or contracted with the authority for alcoholism, drug addiction or mental or emotional disturbance; or

          (I) The impaired health professional program established under ORS 676.190.

          (h) “Written account” means records containing only individually identifiable health information.

          (2) Except as provided in subsections (3), (4), (6), (7), (8), (9), (11), (12), (14), (15), (16) and (17) of this section or unless otherwise permitted or required by state or federal law or by order of the court, written accounts of the individuals served by any health care services provider maintained in or by the health care services provider by the officers or employees thereof who are authorized to maintain written accounts within the official scope of their duties are not subject to access and may not be disclosed. This subsection applies to written accounts maintained in or by facilities of the Department of Corrections only to the extent that the written accounts concern the medical, dental or psychiatric treatment as patients of those under the jurisdiction of the Department of Corrections.

          (3) If the individual or a personal representative of the individual provides an authorization, the content of any written account referred to in subsection (2) of this section must be disclosed accordingly, if the authorization is in writing and is signed and dated by the individual or the personal representative of the individual and sets forth with specificity the following:

          (a) Name of the health care services provider authorized to make the disclosure, except when the authorization is provided by recipients of or applicants for public assistance to a governmental entity for purposes of determining eligibility for benefits or investigating for fraud;

          (b) Name or title of the persons or organizations to which the information is to be disclosed or that information may be disclosed to the public;

          (c) Name of the individual;

          (d) Extent or nature of the information to be disclosed; and

          (e) Statement that the authorization is subject to revocation at any time except to the extent that action has been taken in reliance thereon, and a specification of the date, event or condition upon which it expires without express revocation. However, a revocation of an authorization is not valid with respect to inspection or records necessary to validate expenditures by or on behalf of governmental entities.

          (4) The content of any written account referred to in subsection (2) of this section may be disclosed without an authorization:

          (a) To any person to the extent necessary to meet a medical emergency.

          (b) At the discretion of the responsible officer of the health care services provider, which in the case of any Oregon Health Authority facility or community mental health program is the Director of the Oregon Health Authority, to persons engaged in scientific research, program evaluation, peer review and fiscal audits. However, individual identities may not be disclosed to such persons, except when the disclosure is essential to the research, evaluation, review or audit and is consistent with state and federal law.

          (c) To governmental agencies when necessary to secure compensation for services rendered in the treatment of the individual.

          (5) When an individual’s identity is disclosed under subsection (4) of this section, a health care services provider shall prepare, and include in the permanent records of the health care services provider, a written statement indicating the reasons for the disclosure, the written accounts disclosed and the recipients of the disclosure.

          (6) The content of any written account referred to in subsection (2) of this section and held by a health care services provider currently engaged in the treatment of an individual may be disclosed to officers or employees of that provider, its agents or cooperating health care services providers who are currently acting within the official scope of their duties to evaluate treatment programs, to diagnose or treat or to assist in diagnosing or treating an individual when the written account is to be used in the course of diagnosing or treating the individual. Nothing in this subsection prevents the transfer of written accounts referred to in subsection (2) of this section among health care services providers, the Department of Human Services, the Department of Corrections, the Oregon Health Authority or a local correctional facility when the transfer is necessary or beneficial to the treatment of an individual.

          (7) When an action, suit, claim, arbitration or proceeding is brought under ORS 34.105 to 34.240 or 34.310 to 34.730 and involves a claim of constitutionally inadequate medical care, diagnosis or treatment, or is brought under ORS 30.260 to 30.300 and involves the Department of Corrections or an institution operated by the department, nothing in this section prohibits the disclosure of any written account referred to in subsection (2) of this section to the Department of Justice, Oregon Department of Administrative Services, or their agents, upon request, or the subsequent disclosure to a court, administrative hearings officer, arbitrator or other administrative decision maker.

          (8)(a) When an action, suit, claim, arbitration or proceeding involves the Department of Human Services, the Oregon Health Authority or an institution operated by the department or authority, nothing in this section prohibits the disclosure of any written account referred to in subsection (2) of this section to the Department of Justice, Oregon Department of Administrative Services, or their agents.

          (b) Disclosure of information in an action, suit, claim, nonlabor arbitration or proceeding is limited by the relevancy restrictions of ORS 40.010 to 40.585, 183.710 to 183.725, 183.745 and 183.750 and ORS chapter 183. Only written accounts of a plaintiff, claimant or petitioner shall be disclosed under this paragraph.

          (c) Disclosure of information as part of a labor arbitration or proceeding to support a personnel action taken against staff is limited to written accounts directly relating to alleged action or inaction by staff for which the personnel action was imposed.

          (9)(a) The copy of any written account referred to in subsection (2) of this section, upon written request of the individual or a personal representative of the individual, shall be disclosed to the individual or the personal representative of the individual within a reasonable time not to exceed five working days. The individual or the personal representative of the individual shall have the right to timely access to any written accounts.

          (b) If the disclosure of psychiatric or psychological information contained in the written account would constitute an immediate and grave detriment to the treatment of the individual, disclosure may be denied, if medically contraindicated by the treating physician or a licensed health care professional in the written account of the individual.

          (c) The Department of Corrections may withhold psychiatric or psychological information if:

          (A) The information relates to an individual other than the individual seeking it.

          (B) Disclosure of the information would constitute a danger to another individual.

          (C) Disclosure of the information would compromise the privacy of a confidential source.

          (d) However, a written statement of the denial under paragraph (c) of this subsection and the reasons therefor must be entered in the written account.

          (10) A health care services provider may require a person requesting disclosure of the contents of a written account under this section to reimburse the provider for the reasonable costs incurred in searching files, abstracting if requested and copying if requested. However, an individual or a personal representative of the individual may not be denied access to written accounts concerning the individual because of inability to pay.

          (11) A written account referred to in subsection (2) of this section may not be used to initiate or substantiate any criminal, civil, administrative, legislative or other proceedings conducted by federal, state or local authorities against the individual or to conduct any investigations of the individual. If the individual, as a party to an action, suit or other judicial proceeding, voluntarily produces evidence regarding an issue to which a written account referred to in subsection (2) of this section would be relevant, the contents of that written account may be disclosed for use in the proceeding.

          (12) Information obtained in the course of diagnosis, evaluation or treatment of an individual that, in the professional judgment of the health care services provider, indicates a clear and immediate danger to others or to society may be reported to the appropriate authority. A decision not to disclose information under this subsection does not subject the provider to any civil liability. Nothing in this subsection may be construed to alter the provisions of ORS 146.750, 146.760, 419B.010, 419B.015, 419B.020, 419B.025, 419B.030, 419B.035, 419B.040 and 419B.045.

          (13) The prohibitions of this section apply to written accounts concerning any individual who has been treated by any health care services provider irrespective of whether or when the individual ceases to receive treatment.

          (14) Persons other than the individual or the personal representative of the individual who are granted access under this section to the contents of a written account referred to in subsection (2) of this section may not disclose the contents of the written account to any other person except in accordance with the provisions of this section.

          (15) Nothing in this section prevents the Department of Human Services or the Oregon Health Authority from disclosing the contents of written accounts in its possession to individuals or agencies with whom children in its custody are placed.

          (16) The system described in ORS 192.517 (1) shall have access to records, as defined in ORS 192.515, as provided in ORS 192.517.

          (17)(a) Except as provided in paragraph (b) of this subsection, a health care services provider must obtain an authorization from an individual or a personal representative of the individual to disclose psychotherapy notes.

          (b) A health care services provider may use or disclose psychotherapy notes without obtaining an authorization from the individual or a personal representative of the individual to carry out the following treatment, payment and health care operations:

          (A) Use by the originator of the psychotherapy notes for treatment;

          (B) Disclosure by the health care services provider for its own training program in which students, trainees or practitioners in mental health learn under supervision to practice or improve their skills in group, joint, family or individual counseling; or

          (C) Disclosure by the health care services provider to defend itself in a legal action or other proceeding brought by the individual or a personal representative of the individual.

          (c) An authorization for the disclosure of psychotherapy notes may not be combined with an authorization for a disclosure of any other individually identifiable health information, but may be combined with another authorization for a disclosure of psychotherapy notes.

 

          SECTION 66. ORS 179.560 is amended to read:

          179.560. (1) There is established in the [Department of Human Services] Oregon Health Authority the Oregon State Hospital Advisory Board, consisting of 16 members. Two nonvoting members shall be from the Legislative Assembly, one appointed by the President of the Senate and one appointed by the Speaker of the House of Representatives. Fourteen members shall be appointed by the Governor and be subject to confirmation by the Senate in the manner prescribed in ORS 171.562 and 171.565 and shall include the following:

          (a) Three voting members who are individuals who advocate for or provide representation to individuals with mental illness;

          (b) Three voting members who are health care professionals who have experience working with individuals with mental illness;

          (c) Two voting members who are or have been consumers of mental health services, at least one of whom is a former patient of the Oregon State Hospital located in Salem, Marion County;

          (d) One voting member who is a member of the family of a consumer of mental health services;

          (e) Two voting members who are members of the general public who live in the vicinity of the Oregon State Hospital located in Salem, Marion County; and

          (f) Three nonvoting members who are members of a public employee bargaining unit and who are employed by the Oregon State Hospital located in Salem, Marion County, as follows:

          (A) One individual to represent board-certified physicians;

          (B) One individual to represent board-certified nursing staff; and

          (C) One individual to represent direct care services staff.

          (2) Members appointed by the Governor shall serve four-year terms, but a member serves at the pleasure of the Governor. Before the expiration of the term of a member appointed by the Governor, the Governor shall appoint a successor whose term begins on July 1 next following. A member is eligible for reappointment.

          (3) Members of the board appointed by the President of the Senate and the Speaker of the House of Representatives shall serve two-year terms.

          (4) If there is a vacancy for any cause, the appointing authority shall make an appointment to become immediately effective for the unexpired term.

          (5) The Governor shall select one of the voting members of the Oregon State Hospital Advisory Board as chairperson and another as vice chairperson, for such terms and with duties and powers necessary for the performance of the functions of such offices as the Governor determines.

          (6) A majority of the voting members of the board constitutes a quorum for the transaction of business.

          (7) The board shall meet at times and places specified by the call of the chairperson or of a majority of the members of the board.

          (8) The [Department of Human Services] Oregon Health Authority shall provide staff support to the board.

          (9) A voting member of the board may not individually or in a fiduciary capacity have a financial interest in the Oregon State Hospital located in Salem, Marion County.

 

          SECTION 67. ORS 179.570 is amended to read:

          179.570. The Oregon State Hospital Advisory Board established by ORS 179.560:

          (1) Shall periodically conduct a comprehensive review of federal and state laws concerning, and administrative rules, policies, procedures and protocols of the Oregon State Hospital related to, the safety, security and care of patients;

          (2) May make recommendations directly to the superintendent of the Oregon State Hospital, the Director of [Human Services] the Oregon Health Authority, the Legislative Assembly or interim committees of the Legislative Assembly concerning:

          (a) Federal and state laws concerning, and administrative rules, policies, procedures and protocols of the hospital related to, the safety, security and care of patients;

          (b) Performance measures related to the safety, security and care of patients;

          (c) Goals for improvement in the safety, security and care of patients of the hospital and improvements that are under way; and

          (d) Potential legislative proposals or budget packages related to the hospital; and

          (3) Shall report annually to an appropriate committee of the Legislative Assembly regarding the activities of the board.

 

          SECTION 68. ORS 181.735 is amended to read:

          181.735. (1)(a) The Department of State Police shall create and maintain a medical health database within the Law Enforcement Data System in order to provide law enforcement agencies with information to help the agencies assist persons with a qualifying illness or condition in obtaining medical, mental health and social services.

          (b) The department shall provide each community mental health

program director and each community developmental disabilities program director with the ability to input and remove data from the medical health database.

          (c) The medical health database may not be accessible to any person who is not employed by a community mental health [and] program, community developmental disabilities program or a law enforcement agency as defined in ORS 181.010.

          (2) Not later than seven days after receiving a completed enrollment form described in subsection (6)(a) of this section, a [community mental health and developmental disabilities program] director shall enter an individual’s information into the medical health database if the director:

          (a) Has verified that the individual has a qualifying illness or condition; and

          (b) Has obtained the express written consent of:

          (A) The individual;

          (B) A person authorized to make medical decisions for the individual, if the individual is subject to a guardianship, advanced directive for health care, declaration for mental health treatment or power of attorney that authorizes the person to make medical decisions for the individual; or

          (C) A parent of the individual, if the individual is under 14 years of age.

          (3) To be valid, the express written consent described in subsection (2)(b) of this section must be witnessed by at least two adults as follows:

          (a) Each witness shall witness either the signing of the instrument by the individual or the person described in subsection (2)(b)(B) or (C) of this section, or the individual’s or person’s acknowledgment of the signature of the individual or person.

          (b) At least one witness shall be a person who is not:

          (A) A relative of the individual by blood, marriage or adoption; or

          (B) An owner, operator or employee of a health care facility in which the individual is a patient or resident.

          (c) The individual’s primary care physician or mental health service provider, or any relative of the physician or provider, may not be a witness.

          (4) [The community mental health and developmental disabilities program] A director shall destroy the completed enrollment form and remove an individual’s information from the medical health database:

          (a) If the director receives a completed revocation of consent form described in subsection (6)(b) of this section, signed by the individual or a person described in subsection (2)(b)(B) or (C) of this section;

          (b) If the individual or a person described in subsection (2)(b)(B) of this section provides the director with a court order or other document demonstrating that the person no longer has the authority to make medical decisions for the individual;

          (c) When an individual for whom consent was obtained under subsection (2)(b)(C) of this section becomes 14 years of age; or

          (d) Three years from the date on which the individual’s information was entered into the database.

          (5) Not less than 90 days prior to removing an individual from the medical health database under subsection (4)(c) or (d) of this section, [the] a director shall provide notice of the impending removal to the individual and the person described in subsection (2)(b)(B) or (C) of this section.

          (6) The [Department of Human Services] Oregon Health Authority shall develop:

          (a) An enrollment form that allows for the collection of information to be entered into the medical health database, and that clearly states that consent by the individual or a person described in subsection (2)(b)(B) or (C) of this section is voluntary, revocable and is not a precondition for receiving medical care or mental health treatment or for discharge from a facility or program.

          (b) A revocation of consent form that allows an individual or a person described in subsection (2)(b)(B) or (C) of this section to revoke the consent to include the individual’s information in the medical health database.

          (7) The medical health database must contain the following information:

          (a) The individual’s name, date of birth, last known address and physical description;

          (b) Any pertinent information related to the individual’s illness or condition, including related symptoms, that may assist law enforcement agencies in carrying out the purposes of this section;

          (c) The date on which the information was first entered into the medical health database and the date of any subsequent updates; and

          (d) Contact information for at least two of the following persons:

          (A) The individual’s primary care physician;

          (B) The individual’s case manager in the community mental health [and] program or the community developmental disabilities program;

          (C) A probation officer;

          (D) A family member; or

          (E) Any other person willing to serve as an emergency contact person for the individual.

          (8) Each [community mental health and developmental disabilities program] director shall provide the local public safety coordinating council described in ORS 423.560 with an annual report on the use of the medical health database. The report may not include personally identifiable information that is contained in the medical health database.

          (9) As used in this section:

          (a) “Community mental health program director” and “community developmental disabilities program director” [includes] include a designee of the director.

          (b) “Dementia” means the progressive deterioration of intellectual functioning and other cognitive skills, including but not limited to aphasia, apraxia, memory, agnosia and executive functioning, that leads to a significant impairment in social or occupational function and that represents a significant decline from a previous level of functioning.

          (c) “Developmental disability” has the meaning given that term in ORS 40.460 (18a)(d).

          (d) “Qualifying illness or condition” means:

          (A) Dementia;

          (B) A developmental disability;

          (C) An Axis I diagnosis that is described in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association; or

          (D) A physical or behavioral disorder that causes disorientation or otherwise may impede an individual’s ability to interact effectively with a law enforcement officer.

 

          SECTION 68a. ORS 185.140 is amended to read:

          185.140. (1) The Oregon Disabilities Commission shall:

          (a) Advise the Department of Human Services, the Oregon Health Authority, the Governor, the Legislative Assembly and appropriate state agency administrators on services and resources needed to serve individuals with disabilities and recommend action by the Governor, the Legislative Assembly, state agencies, other governmental entities and the private sector appropriate to meet such needs.

          (b) Advise the Governor, state and local elected officials and managers of public and private firms and agencies on issues related to achieving full economic, social, legal and political equity for individuals with disabilities.

          (2) The commission in no way shall impinge upon the authority or responsibilities of any other existing or duly appointed commissions, boards, councils or committees. The commission shall act as a coordinating link between and among public and private organizations serving individuals with disabilities.

 

          SECTION 69. ORS 238.082 is amended to read:

          238.082. (1) Subject to the limitations in this section, any public employer may employ any member who is retired for service if the administrative head of the public employer is satisfied that such employment is in the public interest.

          (2) Except as provided in this section, the period or periods of employment by one or more public employers of a retired member who is reemployed under this section may not total 1,040 hours or more in any calendar year.

          (3) A retired member who is receiving old-age, survivors or disability insurance benefits under the federal Social Security Act may be employed under this section for the number of hours permitted by subsection (2) of this section, or for the number of hours for which the salary equals the maximum allowed for receipt of the full amount of those benefits to which the person is entitled, whichever is greater.

          (4) Except as provided in subsection (9) of this section, the limitations on employment imposed by subsections (2) and (3) of this section do not apply to a retired member who is employed as a teacher or as an administrator, as those terms are defined in ORS 342.120, if the retired member is employed by a school district or community college district located within a county with a population of not more than 35,000 inhabitants according to the latest federal decennial census, or is employed by an education service district and the retired member’s primary work duties are performed in a county with a population of not more than 35,000 inhabitants according to the latest federal decennial census. A retired member who is employed under this subsection as a teacher, as defined in ORS 342.120, by the same public employer that employed the member at the time of retirement remains in the same collective bargaining unit that included the member before retirement.

          (5) Except as provided in subsection (9) of this section, the limitations on employment imposed by subsections (2) and (3) of this section do not apply to a retired member who is employed:

          (a) By the sheriff of a county with a population of fewer than 75,000 inhabitants, according to the latest federal decennial census;

          (b) By the municipal police department of a city with a population of fewer than 15,000 inhabitants, according to the latest federal decennial census;

          (c) By the state or a county for work in a correctional institution located in a county with a population of fewer than 75,000 inhabitants, according to the latest federal decennial census;

          (d) By the Black Butte Ranch Rural Fire Protection District, the Black Butte Ranch Service District or the Sunriver Service District;

          (e) By the Oregon State Police for work in a county with a population of fewer than 75,000 inhabitants, according to the latest federal decennial census; [or]

          (f) As a deputy director or assistant director of the Department of Human Services, if the Governor approves the exemption for the person from the limitations on employment imposed in subsections (2) and (3) of this section[.]; or

          (g) As a deputy director or assistant director of the Oregon Health Authority, if the Governor approves the exemption for the person from the limitations on employment imposed in subsections (2) and (3) of this section.

          (6) Except as provided in subsection (9) of this section, the limitations on employment imposed by subsections (2) and (3) of this section do not apply to a retired member who is employed to temporarily replace an employee who serves in the National Guard or in a reserve component of the Armed Forces of the United States and who is called to federal active duty.

          (7) Except as provided in subsection (9) of this section, the limitations on employment imposed by subsections (2) and (3) of this section do not apply to a retired member who is employed by a road assessment district organized under ORS 371.405 to 371.535.

          (8) Except as provided in subsection (9) of this section, the limitations on employment imposed by subsections (2) and (3) of this section do not apply to a retired member who is a nurse and is employed by a public employer as a nurse or for the purpose of teaching nursing during the period in which a nursing workforce shortage declared by the Legislative Assembly or the Governor is in effect.

          (9)(a) Except as provided in paragraph (b) of this subsection, subsections (4) to (8) of this section do not apply to any member who retires under the provisions of ORS 238.280 (1), (2) or (3).

          (b) Subsection (4) of this section applies to a person who retires under the provisions of ORS 238.280 (1), (2) or (3) as long as the person’s date of retirement is more than six months before the date the person is employed under subsection (4) of this section.

          (10) Employment under this section does not affect the status of a person as a retired member of the system and a recipient of retirement benefits under this chapter.

          (11) Hours worked by a person employed under subsections (4) to (8) of this section shall not be counted for the purpose of the limitations on employment imposed by subsections (2) and (3) of this section.

 

          SECTION 70. ORS 243.061 is amended to read:

          243.061. (1) There is created in the Oregon [Department of Administrative Services] Health Authority the Public Employees’ Benefit Board consisting of eight voting members and two members of the Legislative Assembly as nonvoting advisory members. Two of the voting members are ex officio members and six are appointed by the Governor. The voting members shall be:

          (a) Four members representing the state as an employer and management employees, who shall be as follows:

          (A) The Director of the Oregon [Department of Administrative Services] Health Authority or a designee of the director;

          (B) The Administrator of the Office for Oregon Health Policy and Research or a designee of the administrator; and

          (C) Two management employees appointed by the Governor from areas of state government other than the Oregon [Department of Administrative Services] Health Authority or the Office for Oregon Health Policy and Research; and

          (b) Four members appointed by the Governor and representing nonmanagement representable employees, who shall be as follows:

          (A) Two persons from the largest employee representative unit;

          (B) One person from the second largest employee representative unit; and

          (C) One person from representable employees not represented by employee representative units described in subparagraphs (A) and (B) of this paragraph.

          (2) One member of the Senate shall be appointed by the President of the Senate and one member of the House of Representatives shall be appointed by the Speaker of the House to serve as nonvoting advisory members.

          (3) The term of office of each appointed voting member is four years, but an appointed voting member serves at the pleasure of the Governor. Before the expiration of the term of a voting member appointed by the Governor, the Governor shall appoint a successor to take office upon the date of that expiration. A member is eligible for reappointment. If there is a vacancy for any cause, the Governor shall make an appointment to become immediately effective for the unexpired term.

          (4) The appointments by the Governor of voting members of the board are subject to confirmation by the Senate in the manner prescribed in ORS 171.562 and 171.565.

          (5) Members of the board who are not members of the Legislative Assembly shall receive no compensation for their services, but shall be paid for their necessary and actual expenses while on official business in accordance with ORS 292.495. Members of the board who are members of the Legislative Assembly shall be paid compensation and expense reimbursement as provided in ORS 171.072, payable from funds appropriated to the Legislative Assembly.

 

          SECTION 71. ORS 243.145 is amended to read:

          243.145. (1) The Public Employees’ Benefit Board shall have authority to employ whatever means are reasonably necessary to carry out the purposes of ORS 243.105 to 243.285 and 292.051. Such authority shall include but is not limited to authority to self-insure and to seek clarification, amendment, modification, suspension or termination of any agreement or contract that in the board’s judgment requires such action.

          (2) Upon providing specific notice in writing to the carrier, the affected employee organization or organizations, the Oregon [Department of Administrative Services] Health Authority and affected, eligible employees, and after affording opportunity for a public hearing upon the issues that may be involved, the board may enter an order withdrawing approval of any benefit plan. Thirty days after entry of the order, the board shall terminate all withholding authorizations of eligible employees and terminate all board-approved participation in the plan.

          (3) The board by order may terminate the participation of any state agency if within three months the state agency fails to perform any action required by ORS 243.105 to 243.285 and 292.051 or by board rule.

 

          SECTION 72. ORS 243.862 is amended to read:

          243.862. (1) There is established in the Oregon [Department of Administrative Services] Health Authority an Oregon Educators Benefit Board consisting of 10 members appointed by the Governor, including:

          (a) Two members representing district boards;

          (b) Two members representing district management;

          (c) Two members representing nonmanagement district employees from the largest labor organization representing district employees;

          (d) One member representing nonmanagement district employees from the second largest labor organization representing district employees;

          (e) One member representing nonmanagement district employees who are not represented by labor organizations described in paragraphs (c) and (d) of this subsection; and

          (f) Two members with expertise in health policy or risk management.

          (2) The term of office of each member is four years, but a member serves at the pleasure of the Governor. Before the expiration of the term of a member, the Governor shall appoint a successor to take office upon the date of that expiration. A member is eligible for reappointment. If there is a vacancy for any cause, the Governor shall make an appointment to become immediately effective for the unexpired term.

          (3) A member of the board is not entitled to compensation, but may be reimbursed from funds available to the board for actual and necessary travel and other expenses incurred by the member in the performance of the member’s official duties in the manner and amount provided in ORS 292.495.

          (4) The board shall select one of its members as chairperson and another as vice chairperson, for such terms and with duties and powers necessary for the performance of the functions of such offices as the board determines.

          (5) A majority of the members of the board constitutes a quorum for the transaction of business.

          (6) The board shall meet at times and places specified by the call of the chairperson or of a majority of the members of the board.

          (7) Appointments of members to the board by the Governor are subject to confirmation by the Senate in the manner prescribed in ORS 171.562 and 171.565.

 

          SECTION 73. ORS 243.878 is amended to read:

          243.878. (1) The Oregon Educators Benefit Board may employ whatever means are reasonably necessary to carry out the purposes of ORS 243.860 to 243.886. This authority includes, but is not limited to, authority to self-insure and to seek clarification, amendment, modification, suspension or termination of any agreement or contract.

          (2) Upon providing specific notice in writing to the carrier, the affected labor organization or organizations, the districts, the Oregon [Department of Administrative Services] Health Authority and the affected eligible employees, and after affording opportunity for a public hearing on the issues that may be involved, the board may enter an order withdrawing approval of a benefit plan. Thirty days after entry of the order, the board shall terminate all withholding authorizations of eligible employees and terminate all board-approved participation in the plan.

          (3) The board by order may terminate the participation of a district in a benefit plan if, within three months, the district fails to perform an action required by ORS 243.860 to 243.886 or by board rule.

 

          SECTION 73a. ORS 279A.050 is amended to read:

          279A.050. (1)(a) Except as otherwise provided in the Public Contracting Code, a contracting agency shall exercise all procurement authority in accordance with the provisions of the Public Contracting Code.

          (b) When a contracting agency has authority under this section to carry out functions described in this section, or has authority to make procurements under a provision of law other than the Public Contracting Code, the contracting agency is not required to exercise that authority in accordance with the provisions of the code if, under ORS 279A.025, the code does not apply to the contract or contracting authority.

          (2) Except as otherwise provided in the Public Contracting Code, for state agencies the Director of the Oregon Department of Administrative Services has all the authority to carry out the provisions of the Public Contracting Code.

          (3) Except as otherwise provided in the Public Contracting Code, the Director of Transportation has all the authority to:

          (a) Procure or supervise the procurement of all services and personal services to construct, acquire, plan, design, maintain and operate passenger terminal facilities and motor vehicle parking facilities in connection with any public transportation system in accordance with ORS 184.689 (5);

          (b) Procure or supervise the procurement of all goods, services, public improvements and personal services relating to the operation, maintenance or construction of highways, bridges and other transportation facilities that are subject to the authority of the Department of Transportation; and

          (c) Establish standards for, prescribe forms for and conduct the prequalification of prospective bidders on public improvement contracts related to the operation, maintenance or construction of highways, bridges and other transportation facilities that are subject to the authority of the Department of Transportation.

          (4) Except as otherwise provided in the Public Contracting Code, the Secretary of State has all the authority to procure or supervise the procurement of goods, services and personal services related to programs under the authority of the Secretary of State.

          (5) Except as otherwise provided in the Public Contracting Code, the State Treasurer has all the authority to procure or supervise the procurement of goods, services and personal services related to programs under the authority of the State Treasurer.

          (6) The state agencies listed in this subsection have all the authority to do the following in accordance with the Public Contracting Code:

          (a) The Department of Human Services to procure or supervise the procurement of goods, services and personal services under ORS 179.040 for the department’s institutions and the procurement of goods, services and personal services for the construction, demolition, exchange, maintenance, operation and equipping of housing for the purpose of providing care to individuals with mental retardation or other developmental disabilities, subject to applicable provisions of ORS 427.335;

          (b) The Oregon Health Authority to procure or supervise the procurement of goods, services and personal services under ORS 179.040 and construction materials, equipment and supplies for the authority’s institutions and the procurement of goods, services,[and] personal services, construction materials, equipment and supplies for the construction, demolition, exchange, maintenance, operation and equipping of housing for persons with chronic mental illness, subject to applicable provisions of ORS 426.504;

          (c) The State Department of Fish and Wildlife to procure or supervise the procurement of construction materials, equipment, supplies, services and personal services for public improvements, public works or ordinary construction described in ORS 279C.320 that is subject to the authority of the State Department of Fish and Wildlife;

          (d) The State Parks and Recreation Department to procure or supervise the procurement of all goods, services, public improvements and personal services relating to state parks;

          (e) The Oregon Department of Aviation to procure or supervise the procurement of construction materials, equipment, supplies, services and personal services for public improvements, public works or ordinary construction described in ORS 279C.320 that is subject to the authority of the Oregon Department of Aviation;

          (f) The Oregon Business Development Department to procure or supervise the procurement of all goods, services, personal services and public improvements related to its foreign trade offices operating outside the state;

          (g) The Housing and Community Services Department to procure or supervise the procurement of goods, services and personal services as provided in ORS 279A.025 (2)(o);

          (h) The Department of Corrections to procure or supervise the procurement of construction materials, equipment, supplies, services and personal services for public improvements, public works or ordinary construction described in ORS 279C.320 that is subject to the authority of the Department of Corrections;

          (i) The Department of Corrections, subject to any applicable provisions of ORS 279A.120, 279A.125, 279A.145 and 283.110 to 283.395, to procure or supervise the procurement of goods, services and personal services under ORS 179.040 for its institutions;

          (j) The Department of Veterans’ Affairs to procure or supervise the procurement of real estate broker and principal real estate broker services related to programs under the department’s authority;

          (k) The Oregon Military Department to procure or supervise the procurement of construction materials, equipment, supplies, services and personal services for public improvements, public works or ordinary construction described in ORS 279C.320 that is subject to the authority of the Oregon Military Department;

          (L) The Department of Education, subject to any applicable provisions of ORS 329.075, 329.085 and 329.485 and the federal No Child Left Behind Act of 2001 (P.L. 107-110, 115 Stat. 1425), to procure or supervise the procurement of goods, services, personal services and information technology relating to student assessment; and

          (m) Any state agency to conduct a procurement when the agency is specifically authorized by any provision of law other than the Public Contracting Code to enter into a contract.

          (7) Notwithstanding this section and ORS 279A.140 (1), the Director of the Oregon Department of Administrative Services has exclusive authority, unless the director delegates this authority, to procure or supervise the procurement of all price agreements on behalf of the state agencies identified in subsection (6)(a) to (k) of this section under which more than one state agency may order goods, services or personal services and, except for contracts procured by the Oregon Health Authority, all state agency information technology contracts. This subsection does not apply to contracts under which the contractor delivers to the state agency information technology products or services incidental to the performance of personal services contracts described in ORS chapter 279C or construction contracts described in ORS chapter 279C. A state agency identified in subsection (3) or (6)(a) to (k) of this section may not establish a price agreement or enter into a contract for goods, services, [or] personal services, construction materials, equipment or supplies without the approval of the director if the director has established a price agreement for the goods, services or personal services.

 

          SECTION 74. ORS 292.051 is amended to read:

          292.051. (1) Except as authority over contracts for health benefit plans described in ORS 243.135 is vested in the Public Employees’ Benefit Board, upon receipt of the request in writing of an officer or employee so to do, the state official authorized to disburse funds in payment of the salary or wages of the officer or employee may deduct from the salary or wages of the officer or employee an amount of money indicated in the request for payment of the applicable amount set forth in benefit plans selected by the officers or employees or in their behalf for:

          (a) Group life insurance, including life insurance for dependents of officers or employees.

          (b) Group dental and related services and supplies, or any other remedial care recognized by state law and related services and supplies, other than medical, surgical or hospital care, recognized under state law, including such insurance for dependents of state officers or employees.

          (c) Group indemnity insurance for accidental death and dismemberment and for loss of income due to accident, sickness or other disability, including such insurance for dependents of state officers or employees.

          (d) Automobile casualty insurance under a monthly payroll deduction program endorsed or offered by an employee organization representing 500 or more state employees. Membership in the employee organization is not a requirement for participation in this program.

          (e) Legal insurance under a monthly payroll deduction program endorsed or offered by an employee organization representing 500 or more state employees.

          (f) Self-insurance programs that are approved and provided by the Public Employees’ Benefit Board.

          (2) The Oregon [Department of Administrative Services] Health Authority may establish and collect a fee to cover costs of administering this section.

          (3) No state official authorized to disburse funds in payment of salaries or wages is required to make deductions as authorized by subsection (1) of this section for more than one benefit plan of the type referred to in each of the paragraphs in subsection (1) of this section per eligible employee.

          (4) Moneys deducted under subsection (1) of this section shall be paid over promptly:

          (a) To the insurance companies, agencies or hospital associations, or persons responsible for payment of premiums to the companies, agencies or associations, in accordance with the terms of the contracts made by the officers or employees or in their behalf; or

          (b) With respect to self-insurance benefits, in accordance with rules, procedures and directions of the Public Employees’ Benefit Board.

          (5) As used in this section, “officer or employee” means all persons who receive salaries or wages disbursed by any state official.

 

          SECTION 75. ORS 343.243 is amended to read:

          343.243. (1) Each school year, the Department of Education shall receive an amount, as calculated under this section, from the State School Fund to pay the costs of educating children in programs under ORS 343.261, 343.961 and 346.010.

          (2) To meet the requirements of ORS 343.261, the department shall receive from the State School Fund an amount that is equal to the product of the following:

          (a) The average net operating expenditure per student of all school districts during the preceding school year; and

          (b) The number of slots available for students in the hospital programs under ORS 343.261, as determined by the department for the school year.

          (3) To meet the requirements of ORS 343.961, the department shall receive from the State School Fund an amount that is equal to the product of the following:

          (a) The average net operating expenditure per student of all school districts during the preceding school year; and

          (b) The number of slots available for students in long-term care and treatment programs under ORS 343.961, as reported to the Department of Education by the Oregon Health Authority, the Department of Human Services and the Oregon Youth Authority for the school year.

          (4) To meet the requirements of ORS 346.010, the Department of Education shall receive from the State School Fund an amount that is equal to the product of the following:

          (a) The average net operating expenditure per student of all school districts during the preceding school year; and

          (b) The resident average daily membership of students enrolled in a program under ORS 346.010 for one-half of the school day or more, exclusive of preschool children covered by ORS 343.533.

          (5) The children covered by this section shall be enumerated in the average daily membership of the district providing the instruction but the district may not accrue credit for days’ attendance of such children for the purpose of distributing state school funds.

          (6) The liability of a district shall not exceed the amount established under this section even if the child is otherwise subject to ORS 336.575 and 336.580.

          (7) The department shall credit amounts received from the State School Fund under this section to the appropriate subaccount in the Special Education Account.

 

          SECTION 76. ORS 343.507 is amended to read:

          343.507. (1) Each contractor for early childhood special education and early intervention services shall assist in the development of a local early intervention interagency advisory council in every county within the contractor’s service area.

          (2) Each local early intervention interagency advisory council shall include as members at least 20 percent parents of preschool children with disabilities, 20 percent providers of early childhood special education and early intervention services or other services to preschool children with disabilities, a representative of the State Commission on Children and Families and representatives from public and private agencies that serve young children and their families, including but not limited to Head Start and Oregon prekindergartens, community child care, the Child Care Division of the Employment Department, local school districts, education service districts, Department of Education regional special education programs, community mental health [and] programs, community developmental disabilities programs, Department of Human Services health programs, child welfare programs and public assistance programs, Indian education agencies, migrant programs serving young children and community colleges.

          (3) Each local early intervention interagency advisory council shall select its own chairperson and vice chairperson and fix the duties of its officers.

          (4) The department shall establish procedures pursuant to rules of the State Board of Education for seeking and considering local council advice regarding the selection of contractors, coordination of services and procedures for local resolution of disputes.

 

          SECTION 77. ORS 343.961 is amended to read:

          343.961. (1) The Department of Education shall be responsible for payment of the cost of the education in programs with which the Oregon Health Authority, the Department of Human Services or the Oregon Youth Authority contracts for long-term care or treatment. Programs eligible for such education shall be in accordance with criteria adopted by rule by the State Board of Education.

          (2) The Department of Education shall be responsible for payment of the costs of such education by contract with the school district, excluding transportation, care, treatment and medical expenses. The resident district shall provide transportation to pupils enrolled in programs under ORS 430.715 who live at home but require day treatment. The payments may be made to the school district or, at the discretion of the school district, to the district providing the education, as set forth in subsection (3) of this section, from the funds appropriated for the purpose.

          (3) The school district in which the agency is located is responsible for providing the education directly or through an adjacent school district or through the education service district in which the program is located or one contiguous thereto. The instruction may be given in facilities of such districts or in facilities provided by such agency.

          (4) The school district may request the Department of Education to combine several private agency school programs into one contract with a school district, an adjacent school district or an education service district.

          (5) The Oregon Health Authority, the Department of Human Services or the Oregon Youth Authority shall give the school district providing the education at a treatment program 14 days’ notice, to the extent practicable, before a student is dismissed from the treatment program.

          (6) The Department of Education may make advances to such school district from funds appropriated therefor based on the estimated agreed cost of educating the pupils per school year. Advances equal to 25 percent of such estimated cost may be made on September 1, December 1 and March 1 of the current year. The balance may be paid whenever the full determination of cost is made.

          (7) School districts which provide the education described in this section on a year-round plan may apply for 25 percent of the funds appropriated therefor on July 1, October 1, January 1, and 15 percent on April 1. The balance may be paid whenever the full determination of cost is made.

          (8) In addition to the payment methods described in this section, the Department of Education may:

          (a) Negotiate interagency agreements to pay for the cost of education in treatment programs operated under the auspices of the State Board of Higher Education; and

          (b) Negotiate intergovernmental agreements to pay for the cost of education in treatment programs operated under the auspices of the Oregon Health and Science University Board of Directors.

 

          SECTION 78. ORS 408.370 is amended to read:

          408.370. (1) In addition to the other uses for the Oregon Housing Fund set forth in ORS 458.600 to 458.665, financial support for an Oregon Veterans’ Home is a permitted use of moneys from the Oregon Housing Fund.

          (2) Notwithstanding ORS 442.315, 442.325 and 442.584, an Oregon Veterans’ Home is not subject to any certificate of need requirement [but is otherwise subject to the authority of the Health Resources Commission].

 

          SECTION 79. ORS 409.010 is amended to read:

          409.010. (1) The Department of Human Services is created.

          (2) The department is responsible for the delivery and administration of programs and services relating to:

          (a) Children and families, including but not limited to child protective services, foster care, residential care for children and adoption services;

          (b) Elderly persons and persons with disabilities, including but not limited to social, health and protective services and promotion of hiring of otherwise qualified persons who are certifiably disabled;

          (c) Persons who, as a result of the person’s or the person’s family’s economic, social or health condition, require financial assistance or other social services;

          (d) Developmental disabilities;

          (e) Vocational rehabilitation for individuals with disabilities;

          (f) Licensing and regulation of individuals, facilities, institutions and programs providing health and human services and long term care services[,] delegated to the department by or in accordance with the provisions of state and federal law; [and]

          (g) Services provided in long term care facilities, home-based and community-based care settings and residential facilities to individuals with physical disabilities or developmental disabilities and to seniors who receive residential facility care; and

          [(g)] (h) All other human service programs and functions delegated to the department by or in accordance with the provisions of state and federal law.

          (3) The department shall be the recipient of all federal funds paid or to be paid to the state to enable the state to provide the programs and services assigned to the department except for Medicaid funds that are granted to the Oregon Health Authority.

          (4)(a) All personnel of the department, including those engaged in the administration of vocational rehabilitation programs, public assistance programs and services to families or children in compliance with the federal Social Security laws, shall be subject to the merit system prescribed in the State Personnel Relations Law. For purposes of the State Personnel Relations Law, the department is the appointing authority of all employees in the department.

          (b) The Director of Human Services, in conformity with the State Personnel Relations Law, may appoint and employ such personnel as may be necessary for the department, and may appoint and fix the compensation of all assistants and employees of the department.

          (c) The director may authorize reimbursement of such expenses as are approved by the department and incurred by assistants and employees of the department, and by volunteers or other persons not employed by the department, in carrying out duties assigned or authorized by the department.

          (5) The director may designate employees to be custodians of records within any of the organizational units of the department, and persons so designated shall have the duties and powers of custodians of public records as prescribed by law. Such designation shall be in writing and notice thereof shall be filed in the office of the Secretary of State, with the director and in the organizational unit to which the authorization applies.

 

          SECTION 80. ORS 409.161 is amended to read:

          409.161. (1) The Department of Human Services shall report to all relevant committees of the Legislative Assembly at each regular session with respect to department employees in the classified service who directly provide:

          (a) Child welfare services under ORS 418.005;

          (b) Temporary assistance for needy families under ORS 412.006;

          (c) Nutritional assistance under ORS 411.816;

          (d) Medical assistance eligibility determinations under ORS 411.404;

          (e) Services to elderly persons and to persons with disabilities under ORS 410.070 and 412.014; and

          (f) Vocational rehabilitation services under ORS 344.530.

          (2) The report of the department under this section shall address each of the following:

          (a) Workload increases or decreases over the current biennium.

          (b) Workload efficiencies achieved during the current biennium.

          (c) Notwithstanding ORS 291.371 (5), additional staffing needs or decreases in staffing needs that exist for the current biennium or that are projected for the next biennium, including a statement of the number of full-time equivalent positions that are vacant on the date the report is prepared or that can be double filled in order to meet any needs for additional staffing.

          (3) As used in this section, “double filled” means that the department is using one budgeted full-time equivalent position to employ more than one employee.

 

          SECTION 81. ORS 409.162 is amended to read:

          409.162. (1) The Department of Human Services shall collaborate with its existing advisory groups to identify and implement workload efficiencies in the state agencies that administer programs providing:

          (a) Child welfare services under ORS 418.005;

          (b) Temporary assistance for needy families under ORS 412.006;

          (c) Nutritional assistance under ORS 411.816;

          (d) Medical assistance eligibility determinations under ORS 411.404;

          (e) Services to elderly persons and to persons with disabilities under ORS 410.070 and 412.014; and

          (f) Vocational rehabilitation services under ORS 344.530.

          (2) The department shall collaborate with the following advisory groups and other groups designated by the department in identifying and implementing workload efficiencies:

          (a) The advisory committee created by ORS 418.005 (2).

          (b) The Family Services Review Commission established under ORS 411.075.

          (c) The State Independent Living Council established by Executive Order 94-12.

          (d) The advisory committee established under ORS 344.735.

          (e) Area agency advisory councils required under ORS 410.210.

          (f) The Governor’s Commission on Senior Services created by ORS 410.320.

 

          SECTION 82. ORS 410.040 is amended to read:

          410.040. As used in ORS 409.010, 410.040 to 410.300,410.320[,] and 411.159 [and 441.630]:

          (1) “Appropriate living arrangement” means any arrangement for an elderly person or a person with a disability in a residential setting which is appropriate for the person considering, in order of priority, the following criteria:

          (a) The desires and goals of the person;

          (b) The right of the person to live as independently as possible, in the least restrictive environment; and

          (c) The cost of the living arrangement compared to other types of living arrangements, based on the criteria in paragraphs (a) and (b) of this subsection.

          (2) “Area agency” means:

          (a) An established or proposed type A or type B Area Agency on Aging within a planning and service area designated under Section 305 of the Older Americans Act; or

          (b) Any public or nonprofit private agency which is designated as a type A or type B Area Agency on Aging under Section 305 of the Older Americans Act.

          (3) “Area agency board” means the local policy-making board which directs the actions of the area agency within state and federal laws and regulations.

          (4) “Department” means the Department of Human Services.

          (5) “Elderly person” means a person who is served by a type A area agency or type B area agency or by the department and who is 60 years of age or older.

          (6) “Local government” means a political subdivision of the state whose authority is general or a combination of units of general purpose local governments.

          (7) “Person with a disability” means a person with a physical or mental disability:

          (a) Who is eligible for Supplemental Security Income or for general assistance; and

          (b) Who meets one of the following criteria:

          (A) Has [mental retardation or] a developmental disability or is mentally or emotionally disturbed, and resides in or needs placement in a residential program administered by the department.

          (B) Is an alcohol or drug abuser and resides in or needs placement in a residential program administered by the department.

          (C) Has a physical or mental disability other than those described in subparagraphs (A) and (B) of this paragraph.

          (8) “Preadmission screening” means a professional program within the department or type B area agencies, with staff that includes registered nurses and social workers, that assesses the needs of clients and recommends appropriate placements in residential programs administered by the department or type B area agencies.

          (9) “Protective services” means a service to be provided by the department directly or through type B area agencies, in response to the need for protection from harm or neglect to elderly persons and persons with disabilities.

          (10) “Title XIX” means long term care and health services programs [in] funded by Title XIX of the Social Security Act available to elderly persons and persons with disabilities.

          (11) “Type A area agency” means an area agency:

          (a) For which either the local government or the area agency board does not agree to accept local administrative responsibility for Title XIX; and

          (b) That provides a service to elderly persons.

          (12) “Type B area agency” means an area agency:

          (a) For which the local government agrees to accept local administrative responsibility for Title XIX;

          (b) That provides a service to elderly persons or to elderly persons and persons with disabilities who require services similar to those required by elderly persons; and

          (c) That uses the term “disabled services” or “disability services” in its title to communicate the fact that it provides services to both populations described in paragraph (b) of this subsection.

 

          SECTION 83. ORS 410.075 is amended to read:

          410.075. The Department of Human Services or the Oregon Health Authority may take title to real and personal property in performing its duties under ORS 411.630, 411.708, 411.795, 416.310 and 416.350. Title shall be taken in the name of the department or the authority. The department or the authority may convey the property by deed or other appropriate conveyance under procedures adopted by rule of the department or the authority.

 

          SECTION 84. ORS 410.080 is amended to read:

          410.080. (1) The Department of Human Services is the designated single state agency for all federal programs under ORS 409.010[,] and 410.040 to [410.320, 411.159 and 441.630] 410.300 except that the Oregon Health Authority is the single state agency responsible for supervising the administration of all programs funded by Title XIX or Title XXI of the Social Security Act as provided in ORS 413.032 (1)(j).

          (2) Except as provided in ORS 410.070 (2)(d) and 410.100, the administration of services to clients under ORS [409.010,] 410.040 to [410.320, 411.159 and 441.630] 410.300 shall be through area agencies, and shall comply with all applicable federal regulations.

 

          SECTION 85. ORS 410.160 is amended to read:

          410.160. Nothing in ORS 409.010[,] and 410.040 to [410.320, 411.159 and 441.630] 410.300 extends estate claims requirements and procedures related to certain Title XIX services under current Oregon statutes and federal regulations to other services.

 

          SECTION 86. ORS 410.230 is amended to read:

          410.230. Nothing in ORS 409.010[,] and 410.040 to [410.320, 411.159 and 441.630] 410.300 requires an area agency or local governmental unit to expend local funds for the purpose of maintaining or expanding services to elderly persons and persons with disabilities.

 

          SECTION 87. ORS 410.240 is amended to read:

          410.240. On and after October 1, 1981, a type A area agency shall operate in the same manner as it operated with local administrative responsibility for Title III of the Older Americans Act and Oregon Project Independence before October 1, 1981. Nothing in ORS 409.010[,] and 410.040 to [410.320, 411.159 and 441.630] 410.300 requires a type A area agency to become a type B area agency.

 

          SECTION 88. ORS 410.300 is amended to read:

          410.300. (1) A type B area agency may contract with the Department of Human Services for services of state employees or have such employees transferred to employment by the area agency by transfer agreement.

          (2) State employees whose services have been contracted to a type B area agency shall be supervised for program purposes by the area agency.

          (3) If state employees are transferred to a type B area agency, the provisions of ORS 236.610 to 236.640 shall apply.

          (4) Prior to transfer of any state employee to any other public employer under ORS [409.010,] 410.040 to [410.320, 411.159 and 441.630] 410.300, at a date to be determined by the Director of Human Services, each type B area agency shall prepare a plan in coordination with local staff of the department for implementation of ORS [409.010,] 410.040 to [410.320, 411.159 and 441.630] 410.300. The plan shall show how statutory responsibilities are to be met and how all staff are to be utilized.

 

          SECTION 89. ORS 410.720 is amended to read:

          410.720. (1) It is the policy of this state to provide mental health and addiction services for all Oregon senior citizens and persons with disabilities through a comprehensive and coordinated statewide network of local mental health services and alcohol and drug abuse education and treatment. These services should involve family and friends and be provided in the least restrictive and most appropriate settings.

          (2) The Department of Human Services and the Oregon Health Authority shall facilitate the formation of local community partnerships between the senior, disability, mental health, alcohol and drug abuse and health care communities by supporting the development of program approaches including, but not limited to:

          (a) Mental health and addiction screenings and assessments in long term care settings;

          (b) Outreach services to seniors and persons with disabilities in their homes, including gatekeeper programs, neighborhood programs and programs designed for rural communities;

          (c) Multilingual and multicultural medical and psychiatric services for ethnic minorities with physical disabilities and hearing impairments;

          (d) Education and training for health care consumers, health care professionals and mental health and addiction services providers on mental health and addiction issues, programs and services for seniors and persons with disabilities; and

          (e) Education and consultation services for primary care physicians treating seniors and persons with disabilities.

          (3) In carrying out the provisions of subsections (1) and (2) of this section, the department and the authority shall:

          (a) Develop plans for service coordination within the department and the authority;

          (b) Recommend budget provisions for the delivery of needed services offered by the department and the authority; and

          (c) Develop plans for expanding mental health and addiction services for seniors and persons with disabilities to meet the increasing demand.

 

          SECTION 90. ORS 411.010 is amended to read:

          411.010. As used in this chapter and in other statutes providing for assistance and services to needy persons, unless the context or a specially applicable statutory definition requires otherwise:

          [(1) “Department” means the Department of Human Services.]

          [(2)] (1) “General assistance” means assistance or service of any character provided to needy persons not otherwise provided for to the extent of such need and the availability of funds, including medical, surgical and hospital or other remedial care.

          [(3)] (2) “Public assistance” means the following types of assistance:

          (a) Temporary assistance for needy families granted under ORS 412.001 to 412.069 and 418.647;

          (b) General assistance granted under ORS 411.710 to 411.730;

          (c) Medical assistance;

          (d) Assistance provided by the Oregon Supplemental Income Program;

          (e) General assistance other than general assistance granted under ORS 411.710 to 411.730; and

          (f) Any other functions, except the administration of medical assistance by the Oregon Health Authority, that may be delegated to the Director of Human Services by or in accordance with federal and state laws.

 

          SECTION 91. ORS 411.060 is amended to read:

          411.060. Subject to ORS 417.300 and 417.305, the Department of Human Services shall[:]

          [(1) Administer and supervise all public assistance programs;]

          [(2) Determine eligibility for all public assistance programs; and]

          [(3)] adopt and enforce rules necessary to ensure full compliance with federal and state laws relating to public assistance programs and functions administered by the department.

 

          SECTION 92. ORS 411.070 is amended to read:

          411.070. (1) The Oregon Health Authority and the Department of Human Services shall adopt by rule [fix] statewide uniform standards for all public assistance programs and shall effect uniform observance [thereof] of the rules throughout the state.

          (2) In establishing uniform statewide standards for public assistance, the department and the authority, within the limits of available funds, shall:

          [(1)] (a) Take into consideration all basic requirements for a standard of living compatible with decency and health, including food, shelter, clothing, fuel, public utilities, telecommunications service, medical care and other essential items and, upon the basis of investigations of the facts, shall provide budgetary guides for determining minimum costs of meeting such requirements.

          [(2)] (b) Develop standards for making payments and providing support services in the job opportunity and basic skills program described in ORS 412.006.

 

          SECTION 93. ORS 411.072 is amended to read:

          411.072. (1) As used in this section “policy change” includes any change in the operation of public assistance programs that affects recipients adversely in any substantial manner, including but not limited to the denial, reduction, modification or delay of benefits. “Policy change” does not include any procedural change that affects internal management but does not adversely and substantially affect the interest of public assistance recipients.

          (2) The Department of Human Services may submit applications for waiver of federal statutory or regulatory requirements to the federal government or any agency thereof. [Following] Prior to the submission of any application for waiver that involves a policy change, and prior to implementation, the department shall do the following:

          (a) Conduct a [hearing in accordance with ORS chapter 183] public process regarding the waiver application or application for waiver renewals [and the proposed rules];

          (b) Prepare a complete summary of the testimony and written comments received [at the hearing] during the public process;

          (c) Submit the application for waiver or application for waiver renewals involving a policy change to the legislative review agency, as [defined] described in ORS 291.375, and present the summary of testimony and comments described in this section; and

          (d) Give notice of the date of its appearance before the Emergency Board or the Joint Committee on Ways and Means in accordance with ORS 183.335, and before the Family Services Review Commission.

 

          SECTION 94. (1) As used in this section, “policy change” includes any change in the operation of medical assistance programs that affects recipients adversely in any substantial manner, including but not limited to the denial, reduction, modification or delay of benefits. “Policy change” does not include any procedural change that affects internal management but does not adversely and substantially affect the interest of medical assistance recipients.

          (2) The Oregon Health Authority may submit applications for waiver of federal statutory or regulatory requirements to the federal government or any agency of the federal government. Prior to the submission of any application for waiver that involves a policy change, and prior to implementation, the authority shall do the following:

          (a) Conduct a public process regarding the application for waiver or application for waiver renewals;

          (b) Prepare a complete summary of the testimony and written comments received during the public process;

          (c) Submit the application for waiver or application for waiver renewals involving a policy change to the legislative review agency, as described in ORS 291.375, and present the summary of testimony and comments described in this section; and

          (d) Give notice of the date of the authority’s appearance before the Emergency Board or the Joint Committee on Ways and Means in accordance with ORS 183.335, and before the Medicaid Advisory Committee.

 

          SECTION 95. ORS 411.081 is amended to read:

          411.081. (1) A person seeking public assistance shall file an application for public assistance with the Department of Human Services or the Oregon Health Authority. At the time of application, the applicant shall declare to the department or the authority any circumstance that directly affects the applicant’s eligibility to receive assistance or the amount of assistance available to the applicant. Upon the receipt of property or income or upon any other change in circumstances that directly affects the eligibility of the recipient to receive assistance or the amount of assistance available to the recipient, the applicant, recipient or other person in the assistance household shall immediately notify the department or the authority of the receipt or possession of such property or income, or other change in circumstances. The department or the authority shall recover from the recipient the amount of assistance improperly disbursed by reason of failure to comply with the provision of this section.

          (2) The department may recover any cash assistance granted for general assistance under ORS 411.710 to 411.730 and the recipient’s portion of the aid described in ORS 412.014 (3) that has been paid to any recipient 18 years of age or older, and for the costs incurred by the department to provide representation to the recipient under ORS 412.014 (2), when the recipient is presently receiving or subsequently receives Supplemental Security Income. The amount of recovery shall be limited to the total amount of Supplemental Security Income that was received for the same time period that the general assistance or the aid received under ORS 412.014 was being paid.

          (3) Nothing in subsection (1) or (2) of this section shall be construed as to prevent the department or the authority from entering into a compromise agreement for recovery of assistance improperly disbursed, if the department or the authority determines that the administration and collection costs involved would exceed the amount that can reasonably be expected to be recovered.

 

          SECTION 96. ORS 411.083 is amended to read:

          411.083. (1) The Department of Human Services, in consultation with the Oregon Health Authority, may prescribe by rule that income and resources may be disregarded in the determination of eligibility and the amount of need with respect to a recipient of or applicant [of] for public assistance under ORS 411.706 and ORS chapter 414, [the Department of Human Services may disregard such amounts of income and resources as are] if required by federal law or rules adopted pursuant thereto or [as are] if authorized by the Legislative Assembly, including the following:

          (a) Any elderly rental assistance payments provided by ORS 310.635 or refunds in lieu of such relief shall be disregarded in determining eligibility and need.

          (b) Any increase in the amount of assistance that is authorized by section 4, Public Law 93-233 (87 Stat. 953) and which is also being paid on March 5, 1974, shall be disregarded in determining eligibility and need.

          (2) The department, in consultation with the authority, shall prescribe by rule that in the determination of eligibility and the amount of need with respect to a recipient of or applicant for public assistance under ORS 411.706 and ORS chapter 414:

          [(2)] (a) Any increase in the amount of assistance provided under Title XVI of the Social Security Act to meet changes in the cost of living that is an increase over that amount being paid on January 1, 1977, pursuant to an Act of Congress and which will first be paid after January 1, 1977, shall be disregarded [in determining eligibility and need].

          [(3)] (b) [When considering an application for public assistance, the department shall exempt from consideration as a resource] Up to $10,000 equity value of any licensed and unlicensed vehicles owned by the applicant or recipient is exempt from consideration as a resource.

          [(4)] (3) The department shall implement subsection [(3)] (2)(b) of this section statewide to the extent possible that is consistent with federal regulation to maintain state eligibility for federal participation in public assistance programs. In the event the department determines that this policy has a net fiscal cost to the state, the department shall present the fiscal analysis to the Emergency Board for additional funding or direction to modify or suspend the policy.

 

          SECTION 97. ORS 411.087 is amended to read:

          411.087. (1) Every person 18 years of age or over who applies for or receives any type of general assistance or public assistance, as defined in ORS 411.010, whether the general assistance or public assistance is applied for or received for the benefit of the person or of another individual, shall execute to the Department of Human Services at the time of making the application, and at such times as may be required by the department [in any case] or by the Oregon Health Authority by rule, written statements relating to each individual for whose benefit the general assistance or public assistance is applied for or received, and to any person who has a duty to support the individual, or to whom the individual owes a duty of support. The statements must include, but need not be limited to, as much of the following information, relating to each individual or other person, as may be specified or required by the department or the authority:

          (a) The name of the individual, address, date and place of birth, residence, family relationships, and the composition of the household in which the individual lives;

          (b) The financial circumstances of the individual and means of and ability for support of the individual and other individuals, including but not limited to information concerning:

          (A) The employment of the individual and the nature and amount of the income of the individual, from whatever source derived;

          (B) The tangible and intangible assets of the individual, property and resources of any nature including, but not limited to, money, real and personal property, rights and expectancies as an heir, devisee, legatee, trustee or cestui que trust, and any rights, benefits, claims or choses in action, whether arising in tort or based upon statute, contract or judgment; and

          (C) Other information as may be required by the department or the authority pursuant to state or federal laws applicable to general assistance or public assistance.

          (2) All applications for general assistance or public assistance and all statements referred to in subsection (1) of this section shall be upon forms prescribed and furnished by the department or the authority. Each statement shall be subscribed by each individual who executes or joins in the execution of the statement.

          (3) The spouse of any individual who applies for or receives general assistance or public assistance may be required by the department or the authority to join in the execution of, or separately to execute, any statement referred to in subsection (1) of this section, under oath or affirmation, except during any period in which it appears to the department or the authority that:

          (a) The individual and the spouse of the individual are estranged and are living apart;

          (b) The spouse is absent from this state or the whereabouts of the spouse is unknown; or

          (c) The spouse is physically or mentally incapable of executing the statement or of providing any information referred to in subsection (1) of this section.

 

          SECTION 98. ORS 411.103 is amended to read:

          411.103. (1) The Department of Human Services may serve a notice described in ORS 183.415 by regular mail or, if requested by the recipient of the notice, by electronic mail. The legal presumption described in ORS 40.135 (1)(q) does not apply to a notice that is served by regular mail under this section.

          (2) Except as provided in subsection (3) of this section, a contested case notice served in accordance with subsection (1) of this section that complies with ORS 183.415 but for service by regular or electronic mail becomes a final order against a party and is not subject to ORS 183.470 (2), upon the earlier of the following:

          (a) If the party fails to request a hearing, the day after the date prescribed in the notice as the deadline for requesting a hearing.

          (b) The date the department or the Office of Administrative Hearings mails an order dismissing a hearing request because:

          (A) The party withdraws the request for hearing; or

          (B) Neither the party nor the party’s representative appears on the date and at the time set for hearing.

          (3) The department shall prescribe by rule a period of not less than 60 days after a notice becomes a final order under subsection (2) of this section within which a party may request a hearing under this subsection. If a party requests a hearing within the period prescribed under this subsection, the department shall do one of the following:

          (a) If the department finds that the party did not receive the written notice and did not have actual knowledge of the notice, refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding on the merits of the department’s intended action described in the notice.

          (b) Refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding to determine whether the party received the written notice or had actual knowledge of the notice. The department must show that the party had actual knowledge of the notice or that the department mailed the notice to the party’s correct address or sent an electronic notice to the party’s correct electronic mail address.

          (4) If a party informs the department that the party did not receive a notice served by regular or electronic mail in accordance with subsection (1) of this section, the department shall advise the party of the right to request a hearing under subsection (3) of this section.

 

          SECTION 99. ORS 411.300 is amended to read:

          411.300. (1) The Department of Human Services shall [make] adopt and enforce [reasonable rules and regulations] rules governing the custody, use and preservation of the records, papers, files and communications of the department in accordance with applicable privacy laws. The use of [such] the records, papers, files and communications [by any other agency or department of government or person to which they may be furnished shall be] is limited to the purposes for which they are furnished and by the provisions of the law under which they may be furnished.

          [(2) No rules or regulations shall be made or administrative practice followed by the Department of Human Services pursuant to subsection (1) of this section that would interfere with the purposes of ORS 411.060, 411.078, 411.320 and 411.335.]

          (2) The records, papers, files and communications of the department may be maintained in a single or combined data system accessible to the department and to the Oregon Health Authority for the administration of programs and the coordination of functions shared by the department and the authority.

 

          SECTION 100. ORS 411.320 is amended to read:

          411.320. (1) For the protection of applicants for and recipients of public assistance, except as otherwise provided in this section, the Department of Human Services [shall] may not disclose or use the contents of any public assistance records, files, papers or communications for purposes other than those directly connected with the administration of the public assistance [laws of Oregon] programs or [as] necessary to assist public assistance applicants and recipients in accessing and receiving other governmental or private nonprofit services, and these records, files, papers and communications are considered confidential subject to the rules [and regulations] of the department [of Human Services]. In any judicial or administrative proceeding, except proceedings directly connected with the administration of public assistance or child support enforcement laws, their contents are considered privileged communications.

          (2) Nothing in this section prohibits the disclosure or use of contents of records, files, papers or communications for purposes directly connected with the establishment and enforcement of support obligations pursuant to the Title IV-D program.

          (3) Nothing in this section prohibits the disclosure of the address, Social Security number and photograph of any applicant or recipient to a law enforcement [official] officer at the request of [such official] the officer. To receive information pursuant to this section, the officer must furnish the agency the name of the applicant or recipient and advise that the applicant or recipient:

          (a) Is fleeing to avoid prosecution, custody or confinement after conviction for a felony;

          (b) Is violating a condition of probation or parole; or

          (c) Has information that is necessary for the officer to conduct the official duties of the officer and the location or apprehension of the applicant or recipient is within such official duties.

          (4) Nothing in this section prohibits disclosure of information between the department and the Oregon Health Authority for the purpose of administering public assistance programs.

 

          SECTION 101. ORS 411.400, as amended by section 3, chapter 73, Oregon Laws 2010, is amended to read:

          411.400. (1) Application for any category of aid shall also constitute application for medical assistance.

          (2) Except as otherwise provided in this section, a person shall request medical assistance by filing an application as provided in ORS 411.081.

          (3) The Department of Human Services shall determine eligibility for and fix the date on which medical assistance may begin, and shall obtain such other information required by the rules of the department and the Oregon Health Authority under ORS 411.402.

          (4) If an applicant is unable to make application for medical assistance, an application may be made by someone acting responsibly for the applicant.

          (5) The department may modify the application requirements in ORS 411.081 for a person whose basis of eligibility for medical assistance changes from one category of aid to another category of aid under ORS 414.025 (2).

 

          SECTION 102. ORS 411.402, as amended by section 4, chapter 73, Oregon Laws 2010, is amended to read:

          411.402. [For each person applying for medical assistance, the Department of Human Services shall fully document:]

          (1) The Department of Human Services and the Oregon Health Authority shall adopt by rule the documentation required from each person applying for medical assistance, including documentation of:

          (a) The identity of the person;

          [(1)] (b) The category of aid [as defined in ORS 414.025] that makes the person eligible for medical assistance or the way in which the person qualifies as categorically needy [as defined in ORS 414.025];

          [(2)] (c) The status of the person as a resident of this state; and

          [(3)] (d) Information concerning the income and resources of the person, which may include income tax return information and Social Security number, as necessary to establish financial eligibility[.] for medical assistance, premium tax credits and cost-sharing reductions.

          (2) Information obtained by the department or the authority under this section may be exchanged with other state or federal agencies for the purpose of:

          (a) Verifying eligibility for medical assistance, participation in the Oregon Health Insurance Exchange or other health benefit programs;

          (b) Establishing the amount of any tax credit due to the person, cost-sharing reduction or premium assistance;

          (c) Improving the provision of services; and

          (d) Administering health benefit programs.

 

          SECTION 103. ORS 411.404 is amended to read:

          411.404. (1) The Department of Human Services shall determine eligibility for medical assistance according to criteria prescribed by rule[, taking into account] in consultation with the Oregon Health Authority that take into account:

          (a) The requirements and needs of the applicant and of the spouse and dependents of the applicant;

          (b) The income, resources and maintenance available to the applicant; and

          (c) The responsibility of the spouse of the applicant and, with respect to an applicant who is blind or is permanently and totally disabled or is under 21 years of age, the responsibility of the parents.

          (2) Rules adopted by the department under subsection (1) of this section:

          (a) Shall disregard resources for those who are eligible for medical assistance only by reason of ORS 414.025 (2)(s), except for the resources described in ORS 414.025 (2)(s).

          (b) May disregard income and resources within the limits required or permitted by federal law, regulations or orders.

          [(3)] (c) [The department] May not require any needy person over 65 years of age, as a condition of entering or remaining in a hospital, nursing home or other congregate care facility, to sell any real property normally used as [such] the person’s home. [Any rule of the department inconsistent with this section is to that extent invalid.]

          (3) Notwithstanding subsections (1) and (2) of this section, the authority may adopt rules necessary to implement the Health Care for All Oregon Children program established by ORS 414.231 or applicable provisions of federal law.

 

          SECTION 104. ORS 411.406 is amended to read:

          411.406. Upon the receipt of property or income or upon any other change in circumstances which directly affects the eligibility of the recipient to receive medical assistance or the amount of medical assistance available to the recipient, the recipient shall immediately notify the Department of Human Services or the Oregon Health Authority, if required, of the receipt or possession of such property or income, or other change in circumstances. Failure to give the notice shall entitle the department [of Human Services] or the authority to recover from the recipient the amount of assistance improperly disbursed by reason thereof.

 

          SECTION 105. ORS 411.408 is amended to read:

          411.408. [Any individual whose claim for medical assistance is denied or is not acted upon with reasonable promptness may petition the Department of Human Services for a fair hearing.] If the Oregon Health Authority or the Department of Human Services denies a claim for medical assistance or fails to act with reasonable promptness on a claim for medical assistance, the person making the claim may request a contested case hearing. The hearing shall be held at a time and place and shall be conducted in accordance with [the] rules [of] adopted by the authority or the department, as appropriate.

 

          SECTION 106. ORS 411.431 is amended to read:

          411.431. (1) The Department of Human Services shall adopt rules in consultation with the Oregon Health Authority:

          (a) Requiring recipients of medical assistance who are not otherwise exempt to pay monthly premium payments while receiving medical assistance; and

          (b) Granting recipients of medical assistance under ORS 414.706 (5) who are required to pay monthly premium payments a grace period of up to six months for payment of overdue premiums.

          (2) [The department may not disenroll] A recipient may continue enrollment in medical assistance during the grace period described in subsection (1)(b) of this section.

          (3) A recipient or former recipient of medical assistance under ORS 414.706 (5) who did not pay one or more monthly premium payments while receiving medical assistance is not eligible [to reapply] for medical assistance under ORS 414.706 (5) until the recipient or former recipient has paid the amount of overdue premiums in full.

 

          SECTION 107. ORS 411.432 is amended to read:

          411.432. (1) As used in this section, “federal poverty guidelines” means the most recent poverty guidelines as published annually in the Federal Register by the United States Department of Health and Human Services.

          (2) Notwithstanding ORS [414.065] 411.431, the Department of Human Services shall adopt rules in collaboration with the Oregon Health Authority exempting recipients of medical assistance under ORS 414.706 (5) whose family income is no more than 10 percent of the federal poverty guidelines from the requirement to pay monthly premium payments.

 

          SECTION 108. ORS 411.435 is amended to read:

          411.435. The Oregon Health Authority and the Department of Human Services shall endeavor to develop agreements with local governments to facilitate the enrollment of [poverty level] medical assistance program clients. Subject to the availability of funds therefor, the agreement shall be structured to allow flexibility by the state and local governments and may allow any of the following options for enrolling clients in [poverty level] medical assistance programs:

          (1) Initial processing shall be done at the county health department by employees of the county, with eligibility determination completed at the local office of the [authority] Department of Human Services;

          (2) Initial processing and eligibility determination shall be done at the county health department by employees of the local health department; or

          (3) Application forms shall be made available at the county health department with initial processing and eligibility determination shall be done at the local office of the [authority] Department of Human Services.

 

          SECTION 109. ORS 411.439 is amended to read:

          411.439. (1) As used in this section:

          (a) “Person with a serious mental illness” means a person who is diagnosed by a psychiatrist, a licensed clinical psychologist or a certified nonmedical examiner as having dementia, schizophrenia, bipolar disorder, major depression or other affective disorder or psychotic mental disorder other than a disorder caused primarily by substance abuse.

          (b) “Public institution” means:

          (A) A state hospital as defined in ORS 162.135;

          (B) A local correctional facility as defined in ORS 169.005;

          (C) A Department of Corrections institution as defined in ORS 421.005; or

          (D) A youth correction facility as defined in ORS 162.135.

          (2) Except as provided in subsections (6) and (7) of this section, the Department of Human Services shall suspend the medical assistance of a person with a serious mental illness when:

          (a) The person receives medical assistance because of a serious mental illness; and

          (b) The person becomes an inmate residing in a public institution.

          (3) The department shall continue to determine the eligibility of the person as categorically needy [as defined in ORS 414.025].

          (4) Upon notification that a person described in subsection (2) of this section is no longer an inmate residing in a public institution, the department shall reinstate the person’s medical assistance if the person is otherwise eligible for medical assistance.

          (5) This section does not extend eligibility to an otherwise ineligible person or extend medical assistance to a person if matching federal funds are not available to pay for medical assistance.

          (6) Subsection (2) of this section does not apply to a person with a serious mental illness residing in a state hospital as defined in ORS 162.135 who is under 22 years of age or who is 65 years of age or older.

          (7) A person with a serious mental illness may apply for medical assistance between 90 and 120 days prior to the expected date of the person’s release from a public institution. If the person is found to be eligible, the effective date of the person’s medical assistance shall be the date of the person’s release from the institution.

 

          SECTION 110. ORS 411.443 is amended to read:

          411.443. (1) When a woman who is enrolled in medical assistance as a pregnant woman becomes an inmate residing in a public institution, the Department of Human Services shall suspend medical assistance.

          (2) The department shall continue to determine the eligibility of the pregnant woman as categorically needy [as defined in ORS 414.025].

          (3) Upon notification that a pregnant woman described under subsection (1) of this section is no longer an inmate residing in a public institution, the department shall reinstate medical assistance if the woman is otherwise eligible for medical assistance.

 

          SECTION 111. ORS 411.459 is amended to read:

          411.459. The Oregon Health Authority and the Department of Human Services shall approve or deny prior authorization requests for dental services not later than 30 days after submission thereof by the provider, and shall make payments to providers of prior authorized dental services not later than 30 days after receipt of the invoice of the provider.

 

          SECTION 112. ORS 411.463 is amended to read:

          411.463. When giving information concerning medical assistance, the Oregon Health Authority and the Department of Human Services shall make available to applicants or recipients materials which include at least a listing of all the healing arts licensed in this state.

 

          SECTION 113. ORS 411.593 is amended to read:

          411.593. (1) In connection with any public assistance investigation or hearing, the Director of Human Services, the Director of the Oregon Health Authority or any examiner, referee or other officer duly appointed to conduct the investigation or hearing may by subpoena compel the attendance and testimony of witnesses and the production of books, accounts, documents and other papers, and may administer oaths, take depositions and fix the fees and mileage of witnesses.

          (2) The Department of Human Services and the Oregon Health Authority shall provide for defraying the expenses of such investigations or hearings, which may be held in any part of the state.

 

          SECTION 114. ORS 411.610 is amended to read:

          411.610. Any check or warrant issued by the Department of Human Services or the Oregon Health Authority to a recipient of public assistance who subsequently dies may be indorsed in the name of the deceased by the surviving spouse or a next of kin in the order described in ORS 293.490 (3); and payment may be made and the proceeds used without any of the restrictions enumerated in ORS 293.495 (1).

 

          SECTION 115. ORS 411.620 is amended to read:

          411.620. (1) The Department of Human Services or the Oregon Health Authority may prosecute a civil suit or action against any person who has obtained, for personal benefit or for the benefit of any other person, any amount or type of general assistance or public assistance[, as defined in ORS 411.010,] or has aided any other person to obtain such general assistance or public assistance, in violation of any provision of ORS 411.630, or in violation of ORS 411.640. In such suit or action the department or the authority may recover the amount or value of such general assistance or public assistance so obtained in violation of ORS 411.630, or in violation of ORS 411.640, with interest thereon, together with costs and disbursements incurred therein.

          (2) Excepting as to bona fide purchasers for value, the department, the [Oregon Health] authority, the conservator for the recipient or the personal representative of the estate of a deceased recipient may prosecute a civil suit or action to set aside the transfer, gift or other disposition of any money or property made in violation of any provisions of ORS 411.630, 411.708 and 416.350 and the department or the authority may recover out of such money or property, or otherwise, the amount or value of any general assistance or public assistance obtained as a result of such violation, with interest thereon, together with costs and disbursements incurred therein.

 

          SECTION 116. ORS 411.630 is amended to read:

          411.630. (1) [No] A person [shall] may not knowingly obtain or attempt to obtain, for the benefit of the person or of [any other] another person, any public assistance[, as defined in ORS 411.010,] to which the person or [such] other person is not entitled under state law by means of:

          (a) Any false representation or fraudulent device, or

          (b) Failure to immediately notify the Department of Human Services or the Oregon Health Authority, if required, of the receipt or possession of property or income, or of any other change of circumstances, which directly affects the eligibility for, or the amount of, [such] the assistance.

          (2) [No] A person [shall] may not transfer, conceal or dispose of any money or property with the intent:

          (a) To enable the person to meet or appear to meet any requirement of eligibility prescribed by state law or by rule [or regulation promulgated by] of the department [for a grant or an increase in a grant of] or the authority for any type of general assistance or public assistance[, as defined in ORS 411.010]; or

          (b) Except as to a conveyance by [such] the person to create a tenancy by the entirety, to hinder or prevent the department or the authority from recovering any part of any claim [which] it may have against the person or the estate of the person.

          (3) [No] A person [shall] may not knowingly aid or abet any person to violate any provision of this section.

          (4) [No] A person [shall] may not receive, possess or conceal any money or property of an applicant for or recipient of any type of general assistance or public assistance[, as defined in ORS 411.010,] with the intent to enable [such] the applicant or recipient to meet or appear to meet any requirement of eligibility referred to in subsection (2)(a) of this section or, except as to a conveyance by [such] the applicant or recipient to create a tenancy by the entirety, with the intent to hinder or prevent the department or the authority from recovering any part of any claim [which] it may have against [such] the applicant or recipient or the estate of the applicant or recipient.

 

          SECTION 117. ORS 411.632 is amended to read:

          411.632. If it reasonably appears that a [customer who is a] recipient of public assistance has assets in excess of those allowed to a recipient of such assistance under applicable federal and state statutes, rules and regulations, and it reasonably appears that such assets may be transferred, removed, secreted or otherwise disposed, then the Department of Human Services or the Oregon Health Authority may seek appropriate relief under ORCP 83 and 84[,] or any other provision of law, but only to the extent of the liability. The state shall not be required to post a bond in seeking the relief.

 

          SECTION 118. ORS 411.635 is amended to read:

          411.635. (1) Public assistance improperly disbursed as a result of recipient conduct that is not in violation of ORS 411.630 may be recouped pursuant to ORS 293.250 by the Oregon Health Authority or the Department of Human Services.

          (2) [or] The department may also recoup public assistance improperly disbursed from earnings that the state disregards pursuant to ORS 411.083 and 412.009 as follows:

          [(1)] (a) The department [of Human Services] shall notify the recipient that the recipient may elect to limit the recoupment monthly to an amount equal to one-half the amount of disregarded earnings by granting the department a confession of judgment for the amount of the overpayment.

          [(2)] (b) If the recipient does not elect to grant the confession of judgment within 30 days the department may recoup the overpayment from the entire amount of disregarded earnings. The recipient may at any time thereafter elect to limit the monthly recoupment to one-half the disregarded earnings by [granting the department] entering into a confession of judgment.

          (3) The department shall not execute on a confession of judgment until the recipient is no longer receiving public assistance and has either refused to agree to or has defaulted on a reasonable plan to satisfy the judgment.

          (4) [Nothing in this section limits the authority of the department by rule to exempt] This section does not prohibit the department from adopting rules to exempt from recoupment any portion of disregarded earnings.

 

          SECTION 119. ORS 411.640 is amended to read:

          411.640. A person has received an overpayment of public assistance, for purposes of ORS 411.703, if the person has:

          (1) Received, either for the benefit of the person or for the benefit of any other person, any amount or type of general assistance or public assistance[, as defined in ORS 411.010,] to which the person or [such] the other person is not entitled under state law;

          (2) Spent lawfully received public assistance that was designated by the Department of Human Services or the Oregon Health Authority for a specific purpose on an expense not approved by the department or the authority and not considered a basic requirement under [standards adopted by the department pursuant to] ORS 411.070 (2)(a);

          (3) Misappropriated public assistance by cashing and retaining the proceeds of a check on which the person is not the payee and the check has not been lawfully [endorsed] indorsed or assigned to the person; or

          (4) Failed to reimburse the department or the authority, when required by law, for public assistance furnished for a need for which the person is compensated by another source.

 

          SECTION 119a. ORS 411.660 is amended to read:

          411.660. (1) If any person is convicted of a violation of any provision of ORS 411.630, any grant of general assistance or public assistance made wholly or partially to meet the needs of such person shall be modified, canceled or suspended for such time and under such terms and conditions as may be prescribed by or pursuant to rules or regulations of the Department of Human Services or the Oregon Health Authority.

          (2) Subsection (1) of this section does not prohibit a grant of general assistance or public assistance to meet the needs of a child under the age of 18 years.

 

          SECTION 120. ORS 411.670 is amended to read:

          411.670. As used in this section and ORS 411.640, 411.675 and 411.690:

          (1) “Claims for payment” includes bills, invoices, electronic transmissions and any other document requesting money in compensation for or reimbursement of needs which have been furnished to any public assistance recipient.

          (2) “Need” means any type of care, service, commodity, shelter or living requirement.

          (3) “Person” includes individuals, corporations, associations, firms, partnerships, governmental subdivisions and agencies and public and private organizations of any character.

 

          SECTION 121. ORS 411.675 is amended to read:

          411.675. [No] A person [shall] may not obtain or attempt to obtain, for personal benefit or the benefit of [any other] another person, [any] a payment for furnishing any need to or for the benefit of [any] a public assistance recipient by knowingly:

          (1) Submitting or causing to be submitted to the Department of Human Services or the Oregon Health Authority a [any] false claim for payment;

          (2) Submitting or causing to be submitted to the department or the authority a [any] claim for payment [which] that already has been submitted for payment [already unless such] unless the claim is clearly labeled as a duplicate;

          (3) Submitting or causing to be submitted to the department or the authority a [any] claim for payment [which] that is a claim [upon which payment has been made by the department or any other] that already has been paid by any source unless clearly labeled as [such] already paid; or

          (4) Accepting [any] a payment from the department [for furnishing any need if the need upon which the payment is based has] or the authority for the costs of items or services that have not been provided to or for the benefit of a public assistance recipient.

 

          SECTION 122. ORS 411.690 is amended to read:

          411.690. (1) [Any] A person who accepts from the Department of Human Services [any payment made to such person] or the Oregon Health Authority a payment for furnishing any need to or for the benefit of a public assistance recipient [shall be] is liable to refund or credit the amount of [such] the payment to the department or the authority if [such] the person has obtained or subsequently obtains from the recipient or from any source any additional payment [received] for furnishing the same need [to or for the benefit of such recipient]. However, the liability of [such] the person [shall be] is limited to the lesser of the following amounts:

          (a) The amount of the payment [so] accepted from the department or the authority; or

          (b) The amount by which the aggregate sum of all payments [so] accepted or received by [such] the person exceeds the maximum amount payable for [such] the need [from public assistance funds] under rules adopted by the department or the authority.

          (2) Notwithstanding subsection (1) of this section, [any] a person who, after having been afforded an opportunity for a [hearing pursuant to the portions of ORS chapter 183 relating to a contested case] contested case hearing pursuant to ORS chapter 183, is found to [violate] have violated ORS 411.675 [shall be] is liable to the department or the authority for treble the amount of the payment received as a result of [such] the violation.

          (3) The department and the authority may prosecute civil actions to recover moneys claimed due under this section and for costs and disbursements incurred in such actions.

 

          SECTION 123. ORS 411.694 is amended to read:

          411.694. (1) When an individual receives public assistance as defined in ORS 411.010 and the individual is the holder of record title to real property or the purchaser under a land sale contract, the Department of Human Services or the Oregon Health Authority may present to the county clerk for recordation in the deed and mortgage records of a county a request for notice of transfer or encumbrance of the real property.

          (2) A title insurance company or agent shall provide the [department] state agency that filed the request with a notice of transfer or encumbrance as required by ORS 93.268.

          (3) If the department [has caused] or the authority has filed a request for notice of transfer or encumbrance [to be recorded] for recording in the deed and mortgage records, the department or the authority shall [present to the county clerk for recordation] file with the county clerk a termination of request for notice of transfer or encumbrance when[, in the judgment of the department,] it is no longer necessary or appropriate [for the department] to monitor transfers or encumbrances related to the real property.

          (4) The department shall adopt by rule a form of the request for notice of transfer or encumbrance, the notice of transfer or encumbrance and the termination of request for notice of transfer or encumbrance that, at a minimum:

          (a) Contains the name of the public assistance recipient, a [departmental] case identifier or other appropriate information that links the individual who is the holder of record title to real property or the purchaser under a land sale contract to the individual’s public assistance records;

          (b) Contains the legal description of the real property;

          (c) Contains a mailing address for the department or the authority to receive the notice of transfer or encumbrance; and

          (d) Complies with the requirements for recordation in ORS 205.232 and 205.234 for those forms intended to be recorded.

          (5) The authority shall use the forms adopted by the department under subsection (4) of this section and may designate the department to receive, on behalf of the authority, a notice of transfer or encumbrance provided in accordance with subsection (2) of this section.

          [(5)] (6) The department or the authority shall pay the recordation fee required by the county clerk under ORS 205.320.

          [(6)] (7) The request for notice of transfer or encumbrance described in this section does not affect title to real property and is not a lien on, encumbrance of or other interest in the real property.

 

          SECTION 124. ORS 411.703 is amended to read:

          411.703. (1) If an overpayment of public assistance, including supplemental nutrition assistance issued under ORS 411.806 to 411.845, is not repaid within 30 days of the payment due date, after an individual has been afforded an opportunity for a contested case hearing under ORS chapter 183 relating to the overpayment, [of public assistance, including supplemental nutrition assistance issued under ORS 411.806 to 411.845,] the Department of Human Services or the Oregon Health Authority may:

          (a) Issue a warrant that meets the requirements of ORS 205.125 for the overpayment; and

          (b) Present a warrant issued under this section for recordation in the County Clerk Lien Record of the county clerk of any county in the state.

          (2) The warrant must include the principal amount of the overpayment, interest accumulated pursuant to ORS 82.010 or other applicable law, costs associated with recording, indexing and serving the warrant and costs associated with an instrument evidencing satisfaction or release of the warrant.

          (3) The department or the authority shall mail a copy of the warrant to the debtor at the last known address of the debtor.

          (4) Upon receipt of the warrant for recordation, the county clerk shall record the warrant in the manner provided in ORS 205.125.

          (5) Upon issuance of the warrant, the department or the authority may issue a notice of garnishment in accordance with ORS 18.854.

          (6) Upon recording, the warrant:

          (a) Has the effect described in ORS 205.125 and 205.126; and

          (b) May be enforced as provided in ORS 18.854 and 205.126.

 

          SECTION 124a. ORS 411.708 is amended to read:

          411.708. (1) The amount of any assistance paid under ORS 411.706 is a claim against the property or interest in the property belonging to and a part of the estate of any deceased recipient. If the deceased recipient has no estate, the estate of the surviving spouse of the deceased recipient, if any, shall be charged for assistance granted under ORS 411.706 to the deceased recipient or the surviving spouse. There shall be no adjustment or recovery of assistance correctly paid on behalf of any deceased recipient under ORS 411.706 except after the death of the surviving spouse of the deceased recipient, if any, and only at a time when the deceased recipient has no surviving child who is under 21 years of age or who is blind or has a disability. Transfers of real or personal property by recipients of assistance without adequate consideration are voidable and may be set aside under ORS 411.620 (2).

          (2) Except when there is a surviving spouse, or a surviving child who is under 21 years of age or who is blind or has a disability, the amount of any assistance paid under ORS 411.706 is a claim against the estate in any conservatorship proceedings and may be paid pursuant to ORS 125.495.

          [(3) A claim under this section shall exclude benefits paid to or on behalf of a beneficiary under a policy of qualified long term care insurance, as defined in ORS 414.025 (2)(t).]

          [(4)] (3) Nothing in this section authorizes the recovery of the amount of any assistance from the estate or surviving spouse of a recipient to the extent that the need for assistance resulted from a crime committed against the recipient.

 

          SECTION 125. ORS 413.011 is amended to read:

          413.011. (1) The duties of the Oregon Health Policy Board are to:

          (a) Be the policy-making and oversight body for the Oregon Health Authority established in ORS 413.032 and all of the authority’s departmental divisions, including the Oregon Health Insurance Exchange described in section 17, chapter 595, Oregon Laws 2009.

          (b) Develop and submit a plan to the Legislative Assembly by December 31, 2010, to provide and fund access to affordable, quality health care for all Oregonians by 2015.

          (c) Develop a program to provide health insurance premium assistance to all low and moderate income individuals who are legal residents of Oregon.

          (d) Establish and continuously refine uniform, statewide health care quality standards for use by all purchasers of health care, third-party payers and health care providers as quality performance benchmarks.

          (e) Establish evidence-based clinical standards and practice guidelines that may be used by providers.

          (f) Approve and monitor community-centered health initiatives described in ORS 413.032 [(1)(g)] (1)(i) that are consistent with public health goals, strategies, programs and performance standards adopted by the Oregon Health Policy Board to improve the health of all Oregonians, and shall regularly report to the Legislative Assembly on the accomplishments and needed changes to the initiatives.

          (g) Establish cost containment mechanisms to reduce health care costs.

          (h) Ensure that Oregon’s health care workforce is sufficient in numbers and training to meet the demand that will be created by the expansion in health coverage, health care system transformations, an increasingly diverse population and an aging workforce.

          (i) Work with the Oregon congressional delegation to advance the adoption of changes in federal law or policy to promote Oregon’s comprehensive health reform plan.

          (j) Establish a health benefit package in accordance with ORS 413.064 to be used as the baseline for all health benefit plans offered through the Oregon Health Insurance Exchange.

          (k) Develop and submit a plan to the Legislative Assembly by December 31, 2010, with recommended policies and procedures for the Oregon Health Insurance Exchange developed in accordance with section 17, chapter 595, Oregon Laws 2009.

          (L) Develop and submit a plan to the Legislative Assembly by December 31, 2010, with recommendations for the development of a publicly owned health benefit plan that operates in the exchange under the same rules and regulations as all health insurance plans offered through the exchange, including fully allocated fixed and variable operating and capital costs.

          (m) By December 31, 2010, investigate and report to the Legislative Assembly, and annually thereafter, on the feasibility and advisability of future changes to the health insurance market in Oregon, including but not limited to the following:

          (A) A requirement for every resident to have health insurance coverage.

          (B) A payroll tax as a means to encourage employers to continue providing health insurance to their employees.

          (C) Expansion of the exchange to include a program of premium assistance and to advance reforms of the insurance market.

          (D) The implementation of a system of interoperable electronic health records utilized by all health care providers in this state.

          (n) Meet cost-containment goals by structuring reimbursement rates to reward comprehensive management of diseases, quality outcomes and the efficient use of resources by promoting cost-effective procedures, services and programs including, without limitation, preventive health, dental and primary care services, web-based office visits, telephone consultations and telemedicine consultations.

          (o) Oversee the expenditure of moneys from the Health Care Workforce Strategic Fund to support grants to primary care providers and rural health practitioners, to increase the number of primary care educators and to support efforts to create and develop career ladder opportunities.

          (p) Work with the Public Health Benefit Purchasers Committee, administrators of the medical assistance program and the Department of Corrections to identify uniform contracting standards for health benefit plans that achieve maximum quality and cost outcomes and align the contracting standards for all state programs to the greatest extent practicable.

          (2) The Oregon Health Policy Board is authorized to:

          (a) Subject to the approval of the Governor, organize and reorganize the authority as the board considers necessary to properly conduct the work of the authority.

          (b) Submit directly to the Legislative Counsel, no later than October 1 of each even-numbered year, requests for measures necessary to provide statutory authorization to carry out any of the board’s duties or to implement any of the board’s recommendations. The measures may be filed prior to the beginning of the legislative session in accordance with the rules of the House of Representatives and the Senate.

          (3) If the board or the authority is unable to perform, in whole or in part, any of the duties described in ORS 413.006 to 413.064 without federal approval, the [board] authority is authorized to request, in accordance with section 94 of this 2011 Act, waivers or other approval necessary to perform those duties. The [board] authority shall implement any portions of those duties not requiring legislative authority or federal approval, to the extent practicable.

          (4) The enumeration of duties, functions and powers in this section is not intended to be exclusive nor to limit the duties, functions and powers imposed on the board by ORS 413.006 to 413.064 and by other statutes.

          (5) The board shall consult with the Department of Consumer and Business Services in completing the tasks set forth in subsection (1)(j), (k) and (m)(A) and (C) of this section.

 

          SECTION 126. ORS 413.032 is amended to read:

          413.032. (1) The Oregon Health Authority is established. The authority shall:

          (a) Carry out policies adopted by the Oregon Health Policy Board;

          (b) Develop a plan for the Oregon Health Insurance Exchange in accordance with section 17, chapter 595, Oregon Laws 2009;

          (c) Administer the Oregon Prescription Drug Program;

          (d) Administer the Family Health Insurance Assistance Program;

          (e) Develop the policies for and the provision of publicly funded medical care and medical assistance in this state;

          (f) Develop the policies for and the provision of mental health treatment and treatment of addictions;

          (g) Assess, promote and protect the health of the public as specified by state and federal law;

          [(e)] (h) Provide regular reports to the board with respect to the performance of health services contractors serving recipients of medical assistance, including reports of trends in health services and enrollee satisfaction;

          [(f)] (i) Guide and support, with the authorization of the board, community-centered health initiatives designed to address critical risk factors, especially those that contribute to chronic disease;

          [(g)] (j) Be the state Medicaid agency for the administration of funds from Titles XIX and XXI of the Social Security Act and administer medical assistance under ORS chapter 414;

          [(h)] (k) In consultation with the Director of the Department of Consumer and Business Services, periodically review and recommend standards and methodologies to the Legislative Assembly for:

          (A) Review of administrative expenses of health insurers;

          (B) Approval of rates; and

          (C) Enforcement of rating rules adopted by the Department of Consumer and Business Services;

          [(i)] (L) Structure reimbursement rates for providers that serve recipients of medical assistance to reward comprehensive management of diseases, quality outcomes and the efficient use of resources and to promote cost-effective procedures, services and programs including, without limitation, preventive health, dental and primary care services, web-based office visits, telephone consultations and telemedicine consultations;

          [(j)] (m) Guide and support community three-share agreements in which an employer, state or local government and an individual all contribute a portion of a premium for a community-centered health initiative or for insurance coverage; and

          [(k)] (n) Develop, in consultation with the Department of Consumer and Business Services and the Health Insurance Reform Advisory Committee, one or more products designed to provide more affordable options for the small group market.

          (2) The Oregon Health Authority is authorized to:

          (a) Create an all-claims, all-payer database to collect health care data and monitor and evaluate health care reform in Oregon and to provide comparative cost and quality information to consumers, providers and purchasers of health care about Oregon’s health care systems and health plan networks in order to provide comparative information to consumers.

          (b) Develop uniform contracting standards for the purchase of health care, including the following:

          (A) Uniform quality standards and performance measures;

          (B) Evidence-based guidelines for major chronic disease management and health care services with unexplained variations in frequency or cost;

          (C) Evidence-based effectiveness guidelines for select new technologies and medical equipment; and

          (D) A statewide drug formulary that may be used by publicly funded health benefit plans.

          (c) Submit directly to the Legislative Counsel, no later than October 1 of each even-numbered year, requests for measures necessary to provide statutory authorization to carry out any of the authority’s duties or to implement any of the board’s recommendations. The measures may be filed prior to the beginning of the legislative session in accordance with the rules of the House of Representatives and the Senate.

          (3) The enumeration of duties, functions and powers in this section is not intended to be exclusive nor to limit the duties, functions and powers imposed on or vested in the Oregon Health Authority by ORS 413.006 to 413.064 or by other statutes.

 

          SECTION 126a. ORS 413.033 is amended to read:

          413.033. (1) The Oregon Health Authority is under the supervision and control of a director, who is responsible for the performance of the duties, functions and powers of the authority.

          (2) The Governor shall appoint the Director of the Oregon Health Authority, who holds office at the pleasure of the Governor. The appointment of the director shall be subject to confirmation by the Senate in the manner provided by ORS 171.562 and 171.565.

          (3)(a) In addition to the procurement authority granted by ORS 179.040 and 279A.050, the director shall have [the power to:] all powers necessary to effectively and expeditiously carry out the duties, functions and powers vested in the authority by ORS 413.032 and section 19, chapter 595, Oregon Laws 2009, and the duties, functions and powers that are shared by or delegated to the authority with respect to the following agencies:

          (A) The Oregon Department of Administrative Services;

          (B) The Department of Consumer and Business Services; and

          (C) The Department of Human Services.

          [(a) Contract for and procure, on a fee or part-time basis, or both, such actuarial, technical or other professional services as may be required for the discharge of duties.]

          (b) With respect to procurements and contracts that the authority is authorized to conduct or manage, the director may make procurements on behalf of, and supervise the procurement, establishment and administration of contracts entered into by, the departments described in paragraph (a) of this subsection.

          (c) Notwithstanding ORS 279B.085, the director may approve a special procurement under paragraph (b) of this subsection that:

          (A) Describes the proposed contracting procedure and the goods or services, or the class of goods or services, to be acquired through the special procurement;

          (B) Is unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts; and

          (C) Is reasonably expected to result in substantial cost savings to the authority or to the public.

          (d) The director shall give public notice of the approval of a proposed special procurement as provided by the authority by rule. The requirements applicable to the Director of the Oregon Department of Administrative Services under ORS 279B.400 apply to the Director of the Oregon Health Authority with respect to special procurements under this subsection.

          (e) Notwithstanding ORS 279C.335, the director may exempt a public improvement contract or a class of public improvement contracts that the authority is authorized to conduct or manage from the competitive bidding requirements of ORS 279C.335 (1) if the director makes the findings described in ORS 279C.335 (2). The provisions in ORS 279C.335 (3) to (8) with respect to the Director of the Oregon Department of Administrative Services apply to the Director of the Oregon Health Authority for exemptions granted by the director under this subsection.

          [(b)] (4) The director shall have the power to obtain such other services as the director considers necessary or desirable, including participation in organizations of state insurance supervisory officials and appointment of advisory committees. A member of an advisory committee so appointed shall receive no compensation for services as a member, but, subject to any other applicable law regulating travel and other expenses of state officers, shall receive actual and necessary travel and other expenses incurred in the performance of official duties.

          [(4)] (5) The director may apply for, receive and accept grants, gifts or other payments, including property or services from any governmental or other public or private person and may make arrangement for the use of the receipts, including the undertaking of special studies and other projects relating to the costs of health care, access to health care, public health and health care reform.

 

          SECTION 127. ORS 413.064 is amended to read:

          413.064. The Oregon Health Authority, in developing and offering the health benefit package required by ORS 413.011 (1)(j), may not establish policies or procedures that discourage insurers from offering more comprehensive health benefit plans that provide greater consumer choice at a higher cost. The health benefit package approved by the Oregon Health Policy Board shall:

          (1) Promote the provision of services through an integrated health home model that reduces unnecessary hospitalizations and emergency department visits.

          (2) Require little or no cost sharing for evidence-based preventive care and services, such as care and services that have been shown to prevent acute exacerbations of disease symptoms in individuals with chronic illnesses.

          (3) Create incentives for individuals to actively participate in their own health care and to maintain or improve their health status.

          (4) Require a greater contribution by an enrollee to the cost of elective or discretionary health services.

          (5) Include a defined set of health care services that are affordable, financially sustainable and based upon the prioritized list of health services developed and updated by the Health [Services] Evidence Review Commission under [ORS 414.720] section 24 of this 2011 Act.

 

          SECTION 128. ORS 414.025, as amended by section 1, chapter 73, Oregon Laws 2010, is amended to read:

          414.025. As used in ORS chapter 411 and this chapter, unless the context or a specially applicable statutory definition requires otherwise:

          (1) “Category of aid” means assistance provided by the Oregon Supplemental Income Program, aid granted under ORS 412.001 to 412.069 and 418.647 or federal Supplemental Security Income payments.

          (2) “Categorically needy” means, insofar as funds are available for the category, a person who is a resident of this state and who:

          (a) Is receiving a category of aid.

          (b) Would be eligible for a category of aid but is not receiving a category of aid.

          (c) Is in a medical facility and, if the person left such facility, would be eligible for a category of aid.

          (d) Is under the age of 21 years and would be a dependent child as defined in ORS 412.001 except for age and regular attendance in school or in a course of professional or technical training.

          (e)(A) Is a caretaker relative, as defined in ORS 412.001, who cares for a child who would be a dependent child except for age and regular attendance in school or in a course of professional or technical training; or

          (B) Is the spouse of the caretaker relative.

          (f) Is under the age of 21 years and:

          (A) Is in a foster family home or licensed child-caring agency or institution and is one for whom a public agency of this state is assuming financial responsibility, in whole or in part; or

          (B) Is 18 years of age or older, is one for whom federal financial participation is available under Title XIX or XXI of the federal Social Security Act and who met the criteria in subparagraph (A) of this paragraph immediately prior to the person’s 18th birthday.

          (g) Is a spouse of an individual receiving a category of aid and who is living with the recipient of a category of aid, whose needs and income are taken into account in determining the cash needs of the recipient of a category of aid, and who is determined by the Department of Human Services to be essential to the well-being of the recipient of a category of aid.

          (h) Is a caretaker relative as defined in ORS 412.001 who cares for a dependent child receiving aid granted under ORS 412.001 to 412.069 and 418.647 or is the spouse of the caretaker relative.

          (i) Is under the age of 21 years, is in a youth care center and is one for whom a public agency of this state is assuming financial responsibility, in whole or in part.

          (j) Is under the age of 21 years and is in an intermediate care facility which includes institutions for persons with [mental retardation] developmental disabilities.

          (k) Is under the age of 22 years and is in a psychiatric hospital.

          (L) Is under the age of 21 years and is in an independent living situation with all or part of the maintenance cost paid by the Department of Human Services.

          (m) Is a member of a family that received aid in the preceding month under ORS 412.006 or 412.014 and became ineligible for aid due to increased hours of or increased income from employment. As long as the member of the family is employed, such families will continue to be eligible for medical assistance for a period of at least six calendar months beginning with the month in which such family became ineligible for assistance due to increased hours of employment or increased earnings.

          (n) Is an adopted person under 21 years of age for whom a public agency is assuming financial responsibility in whole or in part.

          (o) Is an individual or is a member of a group who is required by federal law to be included in the state’s medical assistance program in order for that program to qualify for federal funds.

          (p) Is an individual or member of a group who, subject to the rules of the department or the Oregon Health Authority, may optionally be included in the state’s medical assistance program under federal law and regulations concerning the availability of federal funds for the expenses of that individual or group.

          (q) Is a pregnant woman who would be eligible for aid granted under ORS 412.001 to 412.069 and 418.647, whether or not the woman is eligible for cash assistance.

          (r) Except as otherwise provided in this section, is a pregnant woman or child for whom federal financial participation is available under Title XIX or XXI of the federal Social Security Act.

          (s) Is not otherwise categorically needy and is not eligible for care under Title XVIII of the federal Social Security Act or is not a full-time student in a post-secondary education program as defined by the department [of Human Services] or the authority by rule, but whose family income is less than the federal poverty level and whose family investments and savings equal less than the investments and savings limit established by the department or the authority by rule.

          (t) Would be eligible for a category of aid but for the receipt of qualified long term care insurance benefits under a policy or certificate issued on or after January 1, 2008. As used in this paragraph, “qualified long term care insurance” means a policy or certificate of insurance as defined in ORS 743.652 (6).

          (u) Is eligible for the Health Care for All Oregon Children program established in ORS 414.231.

          (3) “Income” has the meaning given that term in ORS 411.704.

          (4) “Investments and savings” means cash, securities as defined in ORS 59.015, negotiable instruments as defined in ORS 73.0104 and such similar investments or savings as the department [of Human Services] or the authority may establish by rule that are available to the applicant or recipient to contribute toward meeting the needs of the applicant or recipient.

          (5) “Medical assistance” means so much of the following medical and remedial care and services as may be prescribed by the [Oregon Health] authority according to the standards established pursuant to ORS [413.032] 414.065, including payments made for services provided under an insurance or other contractual arrangement and money paid directly to the recipient for the purchase of medical care:

          (a) Inpatient hospital services, other than services in an institution for mental diseases;

          (b) Outpatient hospital services;

          (c) Other laboratory and X-ray services;

          (d) Skilled nursing facility services, other than services in an institution for mental diseases;

          (e) Physicians’ services, whether furnished in the office, the patient’s home, a hospital, a skilled nursing facility or elsewhere;

          (f) Medical care, or any other type of remedial care recognized under state law, furnished by licensed practitioners within the scope of their practice as defined by state law;

          (g) Home health care services;

          (h) Private duty nursing services;

          (i) Clinic services;

          (j) Dental services;

          (k) Physical therapy and related services;

          (L) Prescribed drugs, including those dispensed and administered as provided under ORS chapter 689;

          (m) Dentures and prosthetic devices; and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist, whichever the individual may select;

          (n) Other diagnostic, screening, preventive and rehabilitative services;

          (o) Inpatient hospital services, skilled nursing facility services and intermediate care facility services for individuals 65 years of age or over in an institution for mental diseases;

          (p) Any other medical care, and any other type of remedial care recognized under state law;

          (q) Periodic screening and diagnosis of individuals under the age of 21 years to ascertain their physical or mental impairments, and such health care, treatment and other measures to correct or ameliorate impairments and chronic conditions discovered thereby;

          (r) Inpatient hospital services for individuals under 22 years of age in an institution for mental diseases; and

          (s) Hospice services.

          (6) “Medical assistance” includes any care or services for any individual who is a patient in a medical institution or any care or services for any individual who has attained 65 years of age or is under 22 years of age, and who is a patient in a private or public institution for mental diseases. “Medical assistance” includes “health services” as defined in ORS 414.705. “Medical assistance” does not include care or services for an inmate in a nonmedical public institution.

          [(7) “Medically needy” means a person who is a resident of this state and who is considered eligible under federal law for medically needy assistance.]

          [(8)] (7) “Resources” has the meaning given that term in ORS 411.704. For eligibility purposes, “resources” does not include charitable contributions raised by a community to assist with medical expenses.

 

          SECTION 129. ORS 414.033 is amended to read:

          414.033. The Oregon Health Authority may:

          (1) Subject to the allotment system provided for in ORS 291.234 to 291.260, expend such sums as are required to be expended in this state to provide medical assistance. Expenditures for medical assistance include, but are not limited to, expenditures for deductions, cost sharing, enrollment fees, premiums or similar charges imposed with respect to hospital insurance benefits or supplementary health insurance benefits, as established by federal law.

          (2) Enter into agreements with, join with or accept grants from, the federal government for cooperative research and demonstration projects for public welfare purposes, including, but not limited to, any project which determines the cost of providing medical assistance [to the medically needy] and evaluates service delivery systems.

 

          SECTION 130. ORS 414.041 is amended to read:

          414.041. (1) The [Department of Human Services] Oregon Health Authority, under the direction of the Oregon Health Policy Board and in collaboration with the [Oregon Health Authority] Department of Human Services, shall implement a streamlined and simple application process for the medical assistance and premium assistance programs administered by the Oregon Health Authority and the Office of Private Health Partnerships. The process shall include, but not be limited to:

          (a) An online application that may be submitted via the Internet;

          (b) Application forms that are readable at a sixth grade level and that request the minimum amount of information necessary to begin processing the application; and

          (c) Application assistance from qualified staff to aid individuals who have language, cognitive, physical or geographic barriers to applying for medical assistance or premium assistance.

          (2) In developing the simplified application forms, the department shall consult with persons not employed by the department who have experience in serving vulnerable and hard-to-reach populations.

          (3) The Oregon Health Authority shall facilitate outreach and enrollment efforts to connect eligible individuals with all available publicly funded health programs, including but not limited to the Family Health Insurance Assistance Program.

 

          SECTION 131. ORS 414.065 is amended to read:

          414.065. (1)(a) With respect to medical and remedial care and services to be provided in medical assistance during any period, and within the limits of funds available therefor, the Oregon Health Authority shall determine, subject to such revisions as it may make from time to time and with respect to the “health services” defined in ORS 414.705, subject to legislative funding in response to the report of the Health [Services] Evidence Review Commission and paragraph (b) of this subsection:

          (A) The types and extent of medical and remedial care and services to be provided to each eligible group of recipients of medical assistance.

          (B) Standards to be observed in the provision of medical and remedial care and services.

          (C) The number of days of medical and remedial care and services toward the cost of which public assistance funds will be expended in the care of any person.

          (D) Reasonable fees, charges and daily rates to which public assistance funds will be applied toward meeting the costs of providing medical and remedial care and services to an applicant or recipient.

          (E) Reasonable fees for professional medical and dental services which may be based on usual and customary fees in the locality for similar services.

          (F) The amount and application of any copayment or other similar cost-sharing payment that the authority may require a recipient to pay toward the cost of medical and remedial care or services.

          (b) [Notwithstanding ORS 414.720 (8),] The authority shall adopt rules establishing timelines for payment of health services under paragraph (a) of this subsection.

          (2) The types and extent of medical and remedial care and services and the amounts to be paid in meeting the costs thereof, as determined and fixed by the authority and within the limits of funds available therefor, shall be the total available for medical assistance and payments for such medical assistance shall be the total amounts from public assistance funds available to providers of medical and remedial care and services in meeting the costs thereof.

          (3) Except for payments under a cost-sharing plan, payments made by the authority for medical assistance shall constitute payment in full for all medical and remedial care and services for which such payments of medical assistance were made.

          [(4) Medical benefits, standards and limits established pursuant to subsection (1)(a)(A), (B) and (C) of this section for the eligible medically needy, except for persons receiving assistance under ORS 411.706, may be less than but may not exceed medical benefits, standards and limits established for the eligible categorically needy, except that, in the case of a research and demonstration project entered into under ORS 411.135, medical benefits, standards and limits for the eligible medically needy may exceed those established for specific eligible groups of the categorically needy.]

 

          SECTION 132. ORS 414.211 is amended to read:

          414.211. (1) There is established a Medicaid Advisory Committee consisting of not more than 15 members appointed by the Governor.

          (2) The committee shall be composed of:

          (a) A physician licensed under ORS chapter 677;

          (b) Two members of health care consumer groups that include Medicaid recipients;

          (c) Two Medicaid recipients, one of whom shall be a person with a disability;

          (d) The Director of the Oregon Health Authority or designee;

          (e) The Director of Human Services or designee;

          [(e)] (f) Health care providers;

          [(f)] (g) Persons associated with health care organizations, including but not limited to managed care plans under contract to the Medicaid program; and

          [(g)] (h) Members of the general public.

          (3) In making appointments, the Governor shall consult with appropriate professional and other interested organizations. All members appointed to the committee shall be familiar with the medical needs of low income persons.

          (4) The term of office for each member shall be two years, but each member shall serve at the pleasure of the Governor.

          (5) Members of the committee shall receive no compensation for their services but, subject to any applicable state law, shall be allowed actual and necessary travel expenses incurred in the performance of their duties from the Oregon Health Authority Fund.

 

          SECTION 133. ORS 414.221 is amended to read:

          414.221. The Medicaid Advisory Committee shall advise [the Administrator of the Office for Oregon Health Policy and Research and] the Director of the Oregon Health Authority and the Director of Human Services on:

          (1) Medical care, including mental health and alcohol and drug treatment and remedial care to be provided under ORS chapter 414; and

          (2) The operation and administration of programs provided under ORS chapter 414.

 

          SECTION 134. ORS 414.227 is amended to read:

          414.227. (1) ORS 192.610 to 192.690 apply to any meeting of an advisory committee with the authority to make decisions for, conduct policy research for or make recommendations to the Oregon Health Authority, [or] the Oregon Health Policy Board or the Department of Human Services on administration or policy related to the medical assistance program operated under this chapter.

          (2) Subsection (1) of this section applies only to advisory committee meetings attended by two or more advisory committee members who are not employed by a public body.

 

          SECTION 135. ORS 414.231 is amended to read:

          414.231. (1) As used in this section:

          (a) “Child” means a person under 19 years of age.

          (b) “Health benefit plan” has the meaning given that term in ORS 414.841.

          (2) The Health Care for All Oregon Children program is established to make affordable, accessible health care available to all of Oregon’s children. The program is composed of:

          (a) Medical assistance funded in whole or in part by Title XIX of the Social Security Act, by the State Children’s Health Insurance Program under Title XXI of the Social Security Act and by moneys appropriated or allocated for that purpose by the Legislative Assembly; and

          (b) A private health option administered by the Office of Private Health Partnerships under ORS 414.826.

          (3) A child is eligible for the program if the child is lawfully present in this state and the income of the child’s family is at or below 300 percent of the federal poverty guidelines. There is no asset limit to qualify for the program.

          (4)(a) A child receiving medical assistance under the program is continuously eligible for a minimum period of 12 months.

          (b) The Department of Human Services shall reenroll a child for successive 12-month periods of enrollment as long as the child is eligible for medical assistance on the date of reenrollment.

          (c) The department may not require a new application as a condition of reenrollment under paragraph (b) of this subsection and must determine the person’s eligibility for medical assistance using information and sources available to the department or documentation readily available to the person.

          (5) Except for medical assistance funded by Title XIX of the Social Security Act, the department or the Oregon Health Authority may prescribe by rule a period of uninsurance prior to enrollment in the program.

 

          SECTION 136. ORS 414.312 is amended to read:

          414.312. (1) As used in ORS 414.312 to 414.318:

          (a) “Pharmacy benefit manager” means an entity that negotiates and executes contracts with pharmacies, manages preferred drug lists, negotiates rebates with prescription drug manufacturers and serves as an intermediary between the Oregon Prescription Drug Program, prescription drug manufacturers and pharmacies.

          (b) “Prescription drug claims processor” means an entity that processes and pays prescription drug claims, adjudicates pharmacy claims, transmits prescription drug prices and claims data between pharmacies and the Oregon Prescription Drug Program and processes related payments to pharmacies.

          (c) “Program price” means the reimbursement rates and prescription drug prices established by the administrator of the Oregon Prescription Drug Program.

          (2) The Oregon Prescription Drug Program is established in the Oregon Health Authority. The purpose of the program is to:

          (a) Purchase prescription drugs, replenish prescription drugs dispensed or reimburse pharmacies for prescription drugs in order to receive discounted prices and rebates;

          (b) Make prescription drugs available at the lowest possible cost to participants in the program as a means to promote health;

          (c) Maintain a list of prescription drugs recommended as the most effective prescription drugs available at the best possible prices; and

          (d) Promote health through the purchase and provision of discount prescription drugs and coordination of comprehensive prescription benefit services for eligible entities and members.

          (3) The Director of the Oregon Health Authority shall appoint an administrator of the Oregon Prescription Drug Program. The administrator may:

          (a) Negotiate price discounts and rebates on prescription drugs with prescription drug manufacturers or group purchasing organizations;

          (b) Purchase prescription drugs on behalf of individuals and entities that participate in the program;

          (c) Contract with a prescription drug claims processor to adjudicate pharmacy claims and transmit program prices to pharmacies;

          (d) Determine program prices and reimburse or replenish pharmacies for prescription drugs dispensed or transferred;

          (e) Adopt and implement a preferred drug list for the program;

          (f) Develop a system for allocating and distributing the operational costs of the program and any rebates obtained to participants of the program; and

          (g) Cooperate with other states or regional consortia in the bulk purchase of prescription drugs.

          (4) The following individuals or entities may participate in the program:

          (a) Public Employees’ Benefit Board, Oregon Educators Benefit Board and Public Employees Retirement System;

          (b) Local governments as defined in ORS 174.116 and special government bodies as defined in ORS 174.117 that directly or indirectly purchase prescription drugs;

          (c) Oregon Health and Science University established under ORS 353.020;

          (d) State agencies that directly or indirectly purchase prescription drugs, including agencies that dispense prescription drugs directly to persons in state-operated facilities;

          (e) Residents of this state who lack or are underinsured for prescription drug coverage;

          (f) Private entities; and

          (g) Labor organizations.

          (5) The state agency that receives federal Medicaid funds and is responsible for implementing the state’s medical assistance program may not participate in the program.

          (6) The administrator may establish different program prices for pharmacies in rural areas to maintain statewide access to the program.

          (7) The administrator may establish the terms and conditions for a pharmacy to enroll in the program. A licensed pharmacy that is willing to accept the terms and conditions established by the administrator may apply to enroll in the program.

          (8) Except as provided in subsection [(10)] (9) of this section, the administrator may not:

          (a) Contract with a pharmacy benefit manager;

          (b) Establish a state-managed wholesale or retail drug distribution or dispensing system; or

          (c) Require pharmacies to maintain or allocate separate inventories for prescription drugs dispensed through the program.

          (9) The administrator shall contract with one or more entities to perform any of the functions of the program, including but not limited to:

          (a) Contracting with a pharmacy benefit manager and directly or indirectly with such pharmacy networks as the administrator considers necessary to maintain statewide access to the program.

          (b) Negotiating with prescription drug manufacturers on behalf of the administrator.

          (10) Notwithstanding subsection (4)(e) of this section, individuals who are eligible for Medicare Part D prescription drug coverage may participate in the program.

          (11) The program may contract with vendors as necessary to utilize discount purchasing programs, including but not limited to group purchasing organizations established to meet the criteria of the Nonprofit Institutions Act, 15 U.S.C. 13c, or that are exempt under the Robinson-Patman Act, 15 U.S.C. 13.

 

          SECTION 137. ORS 414.332 is amended to read:

          414.332. It is the policy of the State of Oregon that a Practitioner-Managed Prescription Drug Plan will ensure that:

          (1) Oregonians have access to the most effective prescription drugs appropriate for their clinical conditions;

          (2) Decisions concerning the clinical effectiveness of prescription drugs are made by licensed health practitioners, are informed by the latest peer-reviewed research and consider the health condition of a patient or characteristics of a patient, including the patient’s gender, race or ethnicity; and

          (3) The cost of prescription drugs in the medical assistance program is managed through market competition among pharmaceutical manufacturers by [publicly] considering, first, the effectiveness and safety of a given drug and, second, [its relative cost] any substantial cost differences between drugs within the same therapeutic class.

 

          SECTION 138. ORS 414.334 is amended to read:

          414.334. (1) The Oregon Health Authority shall adopt a Practitioner-Managed Prescription Drug Plan for the medical assistance program. The purpose of the plan is to ensure that enrollees [of] in the medical assistance program receive the most effective prescription drug available at the best possible price.

          [(2) Before adopting the plan, the authority shall conduct public meetings and consult with the Health Resources Commission.]

          (2) In adopting the plan, the authority shall consider recommendations of the Pharmacy and Therapeutics Committee.

          (3) The authority shall consult with representatives of the regulatory boards and associations representing practitioners who are prescribers under the medical assistance program and ensure that practitioners receive educational materials and have access to training on the Practitioner-Managed Prescription Drug Plan.

          (4) An enrollee may appeal to the authority a decision of a practitioner or the authority to not provide a prescription drug requested by the enrollee.

          (5) This section does not limit the decision of a practitioner as to the scope and duration of treatment of chronic conditions, including but not limited to arthritis, diabetes and asthma.

 

          SECTION 139. ORS 414.334, as amended by section 10, chapter 827, Oregon Laws 2009, is amended to read:

          414.334. (1) The Oregon Health Authority shall adopt a Practitioner-Managed Prescription Drug Plan for the medical assistance program. The purpose of the plan is to ensure that enrollees [of] in the medical assistance program receive the most effective prescription drug available at the best possible price.

          [(2) Before adopting the plan, the authority shall conduct public meetings and consult with the Health Resources Commission.]

          (2) In adopting the plan, the authority shall consider recommendations of the Pharmacy and Therapeutics Committee.

          (3) The authority shall consult with representatives of the regulatory boards and associations representing practitioners who are prescribers under the medical assistance program and ensure that practitioners receive educational materials and have access to training on the Practitioner-Managed Prescription Drug Plan.

          (4) Notwithstanding the Practitioner-Managed Prescription Drug Plan adopted by the authority, a practitioner may prescribe any drug that the practitioner indicates is medically necessary for an enrollee as being the most effective available.

          (5) An enrollee may appeal to the authority a decision of a practitioner or the authority to not provide a prescription drug requested by the enrollee.

          (6) This section does not limit the decision of a practitioner as to the scope and duration of treatment of chronic conditions, including but not limited to arthritis, diabetes and asthma.

          NOTE: Section 140 was deleted by amendment. Subsequent sections were not renumbered.

 

          SECTION 141. ORS 414.538 is amended to read:

          414.538. (1) The Department of Human Services and the Oregon Health Authority may not impose income or resource limitations or a prior period of uninsurance on a woman who otherwise qualifies for medical assistance under ORS 414.534 or 414.536.

          (2) [In determining eligibility for] In establishing eligibility requirements for medical assistance under ORS 414.534 [or 414.536], the department and the authority shall give priority to low-income women.

 

          SECTION 142. ORS 414.705 is amended to read:

          414.705. (1) As used in ORS 414.705 to 414.750, “health services” means at least so much of each of the following as are approved and funded by the Legislative Assembly:

          (a) Services required by federal law to be included in the state’s medical assistance program in order for the program to qualify for federal funds;

          (b) Services provided by a physician as defined in ORS 677.010, a nurse practitioner certified under ORS 678.375 or other licensed practitioner within the scope of the practitioner’s practice as defined by state law, and ambulance services;

          (c) Prescription drugs;

          (d) Laboratory and X-ray services;

          (e) Medical supplies;

          (f) Mental health services;

          (g) Chemical dependency services;

          (h) Emergency dental services;

          (i) Nonemergency dental services;

          (j) Provider services, other than services described in paragraphs (a) to (i), (k), (L) and (m) of this subsection, defined by federal law that may be included in the state’s medical assistance program;

          (k) Emergency hospital services;

          (L) Outpatient hospital services; and

          (m) Inpatient hospital services.

          (2) Health services approved and funded under subsection (1) of this section are subject to the prioritized list of health services required in [ORS 414.720] in section 24 of this 2011 Act.

 

          SECTION 143. ORS 414.707 is amended to read:

          414.707. (1) Persons described in ORS 414.706 (1), (2)[,] and(3) [and (5)] are eligible to receive all the health services approved and funded by the Legislative Assembly.

          (2) Persons described in ORS 414.706 (5) are eligible to receive all the health services approved and funded by the Legislative Assembly distinct from the services approved and funded for persons described in ORS 414.706 (1), (2) and (3).

          [(2)] (3) Persons described in ORS 414.708 are eligible to receive the health services described in ORS 414.705 (1)(c), (f) and (g).

 

          SECTION 144. ORS 414.708 is amended to read:

          414.708. (1) A person is eligible to receive the health services described in ORS 414.707 [(2)] (3) when the person is a resident of this state who:

          (a) Is 65 years of age or older, or is blind or has a disability as those terms are defined in ORS 411.704;

          (b) Has a gross annual income that does not exceed the standard established by the Oregon Health [Policy Board] Authority or the Department of Human Services; and

          (c) Is not covered under any public or private prescription drug benefit program.

          (2) A person receiving prescription drug services under ORS 414.707 [(2)] (3) shall pay up to a percentage of the Medicaid price of the prescription drug established by the authority by rule and the dispensing fee.

 

          SECTION 145. ORS 414.710 is amended to read:

          414.710. The following services are not subject to [ORS 414.720] section 24 of this 2011 Act:

          (1) Nursing facilities, institutional and home- and community-based waivered services funded through the Department of Human Services; and

          (2) Services to children who are wards of the Department of Human Services by order of the juvenile court and services to children and families for health care or mental health care through the department.