Budget Implications for OHP Challenge Transformation Team
Legislative leaders who sit on that team are determined to come up with those tough answers by March 23
February 10, 2011— When legislators grapple with the Oregon Health Plan budget in April, those in leadership positions may already have come up with the answers.
Senator Alan Bates (D-Ashland) made that quite clear when talking to The Lund Report following a Health Systems Transformation Team meeting Wednesday night.
“This committee (the transformation team) is where the budget is going to come from,” said Bates, who co-chairs the Ways and Means Subcommittee on Human Services.
““I’m hearing people starting to talk about, what can we do right now?” said Bates. “We’ve got to cut a budget here; we’ve got to do it in 2-3 months. If we don’t do that, we’re going to have a real problem.”
A March 23 deadline -- earlier than expected -- looms over the team, which is weighted heavily with legislators who hold strategic positions. They include Rep. Tina Kotek (D-Portland) and Rep. Tim Freeman (R-Roseburg), who also co-chair the Ways and Means Subcommittee. Originally the team was slated to meet until April 6, however its timeline has been moved up, according to state officials.
Other legislative leaders on the team include Rep. Mitch Greenlick (D-Portland), Rep. Val Hoyle (D-Eugene), Rep. Bill Kennemer (R-Oregon City), Sen. Jeff Kruse (R-Roseburg), Rep. Sen. Laurie Monnes Anderson (D-Gresham), Sen. Frank Morse (R-Albany), Rep, Chip Shields (D-Portland) and Rep. Jim Thompson (R-Dallas).
During the meeting, Kotek asked several provocative questions of Mike Bonetto, the governor’s health policy advisor who co-chairs the team.
“I think we’re missing the very first conversation,” Kotek told him. “What is the population we’re trying to impact? I think we’re jumping ahead if we move on and haven’t had that conversation.”
Bonetto responded with: “The vision is, it’s going to be the community that you live in.”
His answer didn’t satisfy Kotek, who kept pummeling him with questions, and called his response “incredibly broad.”
Isn’t the initial charge of this team to focus on the target population – the dual eligibles? she asked.
Bates, who concurred, said, “the things we learn and do … will be transferred to the entire population as we move forward,” implying that the transformation of the delivery system would eventually impact the entire Oregon Health Plan population, public employees (the Public Employees’ Benefit Board) and teachers and other school district employees (Oregon Educators Benefit Board) – 850,000 Oregonians.
The Transformation Team faces a monumental task: restructuring the state’s entire healthcare delivery system in the next eight weeks.
At the group’s first meeting, Governor John Kitzhaber reminded the team of the state’s “triple aim objectives” – better, health, better care, lower cost – and urged those present to “get out of stakeholder silos. …We’re all Oregonians. We share a common state, and we share a common destiny.”
Kitzhaber also reiterated relevant facts from his 2011-13 budget, released Tuesday, including the Oregon Health Authority’s impending 39% reduction in revenue due to the expiration of one-time federal stimulus funds on July 1.
Bonetto revealed that the state had submitted an application to the Center for Medicaid and Medicare Services’ Innovation Center last week for a planning grant to design an improved integrated healthcare system for dual eligible individuals: people who receive Medicare and Medicaid services.
The goal, Bonetto added, is for the selected states to create a model for integrated patient care that can quickly and easily be replicated in other states – a goal that mirrors the Medicaid system redesign mentioned in the Transformation Team’s charter
TO LEARN MORE
Health Systems Transformation Team Feb. 9 meeting packet:
Prior coverage at The Lund Report
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Finding funding for in-home care for disabled children. Dominic who is 3 years old, Native American and on the tribal rolls, I am the maternal grandmother who has guardianship of my grandson Dominic granted by the Multnomah County Circuit Court. This is our story and the struggles we face. My grandson Dominic suffers from a serve anoxic brain injury which has left him with no motor skills (unable to eat by mouth, walk, talk, sit or stand on his own) Dominic also suffers from seizures associated with the brain injury. Dominic requires 24/7 care which I have been providing for him for the passed 2 years. Unfortunately I am in need of help providing the care as I know have to work outside of the home to survive as a family unit.
My grandson is on SSI and does have Medicaid coverage. I have found a local nursing in-home care company to provide the services Dominic requires who also coordinates billing Medicaid. Despite having Medicaid we have been told by the local County Developmental Disability Services and the local DHS Seniors & People with Disabilities there are no funds to provide the in-home care Dominic requires. It is my understanding there are no funds for children age 0-4 years old. We have also been informed that due to budget cuts the State has to scrutinize each case regardless of the extensive medical documentation which speaks for Dominic's disabilities. I have been trying for over 2 years to get the services I believe Dominic is entitled to with no success. We are now forced into a corner having to make a decision to place Dominic into a nursing facility because I can not get help with the cost of in-home services that would allow Dominic to remain in the comfort of his own home with family.
I do not understand why the state would be willing to cover the enormous cost of a nursing care facility instead of helping the families with the cost of in-home care which is by far a lot less costly then a nursing care facility. Rather then scrutinize disabled children the State should scrutinize drug and alcohol users who seem to have free rain over State funds, these people are in their position by choice, the State should require the drug and alcohol users to provide a clean UA monthly in order to get free medical coverage which in turn would cut the cost of medical coverage and free up funds to be used for disabled children.
Sincerely,
Patricia Ramirez