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.