Your turn to comment on Cleaner Air Oregon rules

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Issues and actions in Oregon health today

October 26, 2017

Your turn to comment on Cleaner Air Oregon rules

Three Rs

State air quality regulators and health experts want your comments on proposed new rules to reduce the impact industrial pollutants have on Oregonians. The proposed Cleaner Air Oregon rules would set health risk limits on pollutants that industrial facilities emit. These limits would protect neighbors and vulnerable people (such as children) from potentially harmful levels of exposure to air toxics.

The proposed rules would close gaps in the state’s existing air quality rules that can create health risks for families and communities. These gaps can allow industrial facilities to release potentially harmful amounts of air toxics, but still operate within legal requirements. Some of the ways Cleaner Air Oregon would close the gaps in current air toxics rules include:

  • Report air toxics: Cleaner Air Oregon requires companies to report use of 600 heavy metals, chemicals and other pollutants to state regulators. (Current rules do not require companies to report air toxics emissions to regulators.)
  • Risk assessments: The proposed rules would set risk limits for 260 industrial air toxics. New and existing industrial facilities would be required to calculate the risks their emissions pose to people who live nearby (e.g., cancer, birth defects, nerve damage, nausea, breathing problems, rashes) and report their results to state regulators. (Under current rules, health risks to neighbors are not considered in setting use limits for air toxics.)
  • Reduce risk: The new rules tie air quality permits and enforcement to the levels of potentially harmful air toxics a facility puts into the air and the impact they could have on neighbors. Companies would be required to act if the levels of air toxics they emit exceed health safety limits. (Current rules do not let regulators use health risks to neighbors to decide whether to grant permits to factories and other sources of air toxics.)

Governor Kate Brown launched the Cleaner Air Oregon rule-making in April 2016, after communities around the state raised concerns about heavy metals, chemicals and other pollutants from factories and other industrial sources. Members of the public have until Dec. 22 to submit comments. Oregonians can submit their input online at the Cleaner Air Oregon website (, or at upcoming public hearings.


CCO rates will receive independent review

This month OHA chief financial officer Laura Robison informed coordinated care organization (CCO) leaders that the state would seek outside independent reviewers to evaluate Oregon’s CCO rate methodology. OHA has worked closely with CCOs and its outside actuary to ensure that the rate development process is rigorous, equitable, and collaborative and that it complies with all Centers for Medicare & Medicaid Services (CMS) requirements. CMS has approved the actuarial soundness of Oregon’s CCO rates for the past three years. However, stakeholders have raised questions and concerns about certain elements of the methodology, and OHA believes it’s important to take steps to review these concerns.

To conduct the review, OHA will:

  • Contract for independent actuarial review of CCO rate development methodology: OHA will contract with an independent Medicaid-qualified actuary to review the current 2018 rate development methodology. If any material issues are identified in the current as-executed methodology, the independent actuary will recommend changes to the methodology.
  • Contract for independent regulatory review of the rate development methodology: Similarly, OHA will contract with an outside firm to review the rate development methodology against current federal regulations and Oregon’s 1115 Medicaid waiver. The independent firm will recommend changes, if needed.

OHA anticipates that these reviews will be complete by late November. Meanwhile, OHA will submit the current 2018 rates for CMS approval in the coming days to avoid losing progress toward approval of the 2018 rates, if no changes are warranted. If changes are warranted, OHA will work with CCOs and CMS to implement those changes.

CCOs coordinate and manage health, behavioral health and dental care for nine out of 10 members of the 1 million Oregonians enrolled in the Oregon Health Plan (OHP). CCOs have played a pivotal role in Oregon’s nationally recognized health reforms, which have improved the quality of care for OHP members and saved taxpayers more than $1.3 billion since 2012. The purpose of the independent reviews is to ensure that all stakeholders, policymakers, taxpayers and OHP members can be fully confident that Oregon’s CCO rate development process is methodologically sound, fiscally responsible and appropriately transparent.

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OHA, DHS prepare to implement Senate Bill 558 (Cover All Kids)

DHS and OHA have been collaborating with community partners to implement Senate Bill 558, or Cover All Kids, beginning on Jan. 1, 2018.

This new policy opens the doors to health coverage for Oregon children and teens younger than 19 who were previously ineligible due to their immigration status. The Legislature allocated $36.1 million in state general funds to make this expansion possible.

Preparing for the implementation involves standing up an enrollment outreach and marketing infrastructure, modifying our enrollment technology (MMIS), and ensuring our Coordinated Care Organizations have proper guidance on how to manage this new population.

DHS and OHA have been actively engaging stakeholders to ensure that communications materials are culturally and linguistically appropriate. This work includes examining how we should talk about the changes to Oregon Health Plan eligibility and what platforms to use, as well as identifying outreach best practices – all with the goal of encouraging enrollment.

DHS is also working on pivoting the focus of the current I’m healthy! / ¡Soy sano! program to implementation of Senate Bill 558.

Finally, the children and teens impacted by Senate Bill 558 will receive full OHP benefits, and the goal is to enroll them in CCOs. OHA will continue discussions with CCOs and provide more detailed guidance regarding the newly eligible population.