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:
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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.)
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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.)
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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
(http://cleanerair.oregon.gov), or at upcoming public
hearings.
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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:
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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.
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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.
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.
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