The Oregon Medical Board has put forward legislation that would loosen state controls of the board and turn the medical board into a “semi-independent state agency,” less bound by the tight budget process that most state licensing agencies have to go through.
The authority is not unprecedented -- the Board of Optometry and the Board of Physical Therapy already enjoy this increased independence, which allows them to set an independent budget process and purchase office equipment and supplies without having to go through state vendors.
Kathleen Haley, the medical board’s executive director, said an independent purchasing process could have saved them $100 on each laptop computer purchased for board members, and that setting their own budget -- with a public process -- would shorten budget preparation time from 18 months to just six. The reduced administrative burden should also help the board limit any increase in licensing fees.
“This model offers us increased efficiency and a reduction in our expenses,” Haley told the Senate Health Committee last week. The board’s revenues are almost entirely drawn from licensing fees which are currently set at $486 for podiatrists and physicians, $447 for physician assistants and $322 for acupuncturists. A license is good for two years.
Haley’s assistant, Nicole Krishnaswami, told The Lund Report that the independent budgeting would provide more transparency at the medical board, not less, as critics have feared. Instead of tucked in with all the other state licensing hearings in the legislative Committee on Ways & Means, the medical board will post their proposed budget online and hold their own public hearings seeking approval.
Senate Bill 279, the medical board’s proposal, allows the legislative budget committee to hold its own hearings if it has any concerns.
Sen. Alan Bates, D-Ashland, said that continued oversight will be the check on the medical board’s power, not the Legislature’s Ways & Means process, which holds hearings but rarely asks for any amendments to the medical board’s proposed budgets. “I don’t want to spend any more time reviewing a budget which we rubber-stamp each time.”
Sen. Elizabeth Steiner Hayward, D-Portland, who, like Bates, is a family practice physician, said she had serious concerns about Haley’s proposal, but decided to support it. “This gives the Legislature significant oversight without tying them up in administrative hassles,” she said.
“As you might guess, I have at times had a very stormy relationship with the medical board,” said Bates. “Many times we feel the board has over-reached and been unfair to some physicians. But I believe they’ve turned a corner -- They had a little trouble last time with confirmations.”
Since the Senate had the opportunity to confirm Gov. Kitzhaber’s appointees to the board, Bates said he and Steiner Hayward were able to have their concerns taken more seriously by the standoffish board.
SB 279 has the support of the Oregon Medical Association, the chief physicians’ organization in the state, but will still face opposition -- Sen. Fred Girod, R-Stayton, a dentist, told The Lund Report he would oppose the bill, saying he did not feel it wise to increase the medical board’s authority.
Girod said that licensing boards can already get out of control, and he has been at odds with the Board of Dentistry, most significantly over the issue of penalties wagered on dentists who did not comply with a confusing set of tests for their autoclave machines, which sterilize equipment. The senator charged that the penalties were nothing more than “a money grab,” that impugned good dentists’ reputation.
The bill is still likely to pass out of the Senate Health Committee this month, although Steiner Hayward and Sen. Laurie Monnes Anderson, D-Gresham, the committee chairwoman, said they may amend the bill to require the medical board to provide a seat for a physician assistant.
Monnes Anderson compared the situation to the colonial cry of “taxation without representation.”
