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Legislative updates for OHA employees

May 30, 2023

What is happening in the legislature?

As has happened several times in recent years, disagreements among legislators have led to the Senate being unable to reach a quorum necessary to pass legislation.

How is OHA responding to the situation? 

OHA continues to do its work to prepare the 2023-25 OHA budget for passage. Additionally, OHA is staying in close communication with legislative leadership and the Governor’s Office to answer any questions about the policy and budget impacts of stalled legislation. OHA continues to support the Governor’s agenda, including her priority bills.  

What end-of-session scenarios is OHA preparing for? 

Like all state agencies, OHA is preparing for a scenario where priority bills may not all pass this legislative session. OHA is also preparing for a scenario where a continuing resolution carries the agency budget forward at current service level. If OHA’s budget bill (SB 5525) does not pass by June 30, OHA will maintain current service level funding due to the earlier passage of a continuing resolution bill (SB 5046) until a budget can be passed in a special session. 

What OHA priority bills are potentially affected? 

In addition to OHA’s main budget bill (SB 5525), there are a variety of additional stalled bills that would impact the health of Oregonians and the work of OHA.  

Bills on the senate floor

• HB 2446: In the absence of this legislation, OHA would need to conduct an extensive, two-year procurement process starting in Fall 2023 with a release in early 2024. During this same period, OHA is preparing for and implementing a new 1115 waiver, conducting redetermination efforts for all OHP members because of the public health emergency ending, and establishing a new Basic Health Program. 

Considering the number of significant projects OHA is responsible for during this same period, HB 2446 calls for the current contracts with CCOs be extended for two years to December 31, 2026. As a result, the contract procurement period would be delayed for two years to 2025-2026, enabling OHA and CCOs to focus on implementing the new 1115 waiver, completing the redetermination process, and working together to establish the Basic Health Program – all of which will benefit CCO members or people needing coverage after redeterminations.  

• HB 2278: Childhood influenza immunization rates have declined since the beginning of the of the COVID-19 pandemic, including the two most recent flu seasons of 2021-22 and 2022-23.Part of the decline in childhood influenza immunizations is due to issues of access to shots at usual providers. Adding more providers, such as pharmacists, to the slate of those who can immunize young children will help relieve access issues. 
• HB 2286: HB 2286 establishes a statutory basis for an existing Medicaid program – the 100% Federal Medical Assistance Percentage (FMAP) Tribal Savings and Reinvestment Program.Participating Tribes can use the funding made available from this program to reinvest and strengthen the American Indian/Alaska Native health care system.  
• HB 2279: On October 27, 1997, Oregon enacted the Death with Dignity Act, which allows terminally ill individuals to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. The act currently provides that only Oregon residents may be prescribed medication by Oregon physicians for the purposes of ending their life under the act. By removing the residency requirement, individuals no longer will need to be Oregon residents to participate in the Death with Dignity Act.
• HB 2395: This bill ensures that test strips are not considered drug paraphernalia, and ensures OHA has authority to prescribe naloxone through standing orders which increases access for many partners working on the front lines of the opioid epidemic. It also provides authority for EMS providers to dispense naloxone. 

Bills in the Joint Ways and Means Committee  

• SB 972: SB 972 directs OHA to transition Oregon to a state-based marketplace (SBM) through which people in Oregon will enroll in health plans for the 2027 plan year. 

The current Federally Facilitated Marketplace (FFM) is a one-size fits all solution, designed for use by many states, and cannot be customized according to Oregon’s needs, preferences, or requirements. In contrast, a SBM would be more nimble and able to drive state innovation. SBMs have access to real-time data and offers a more agile platform for supporting Oregon’s already robust consumer outreach efforts.  

• SB 1044: This bill Includes over $70 million in new behavioral health investments:
  • $10 million for Community Mental Health programs 
  • $8.3 million to support the expansion of behavioral rehabilitation
  • $6 million for transition case management for individuals discharged from the Oregon State Hospital who are at risk of homelessness
  • $4.9 million to Community Mental Health Programs to expand jail diversion services to all Oregon counties
  • $2.3 million for additional children’s psychiatric residential treatment capacity
  • $4 million to the Oregon Department of Human Services for long term care facility behavioral health specialty care
  • $20 million for the Health Care Provider Incentive Program, with a priority to increase Oregon’s behavioral health workforce
  • $15 million for substance use disorder facilities and recovery centers
  • $7.7 million to expand the child and adult suicide prevention, intervention and postvention program to reduce suicide in Oregon
• SB 966: Requires OHA to work with community members whose health is affected by OHA and health system representatives to study the CCO Quality Incentive Program and propose structural changes to ensure that the program focuses on addressing health inequities. The bill also allows CCOs to gradually integrate Health Related Social Needs services into their budgets. These services are a core part of the waiver's work to drive towards health equity. They are services like housing, nutrition and support during climate emergencies.  
• HB 2397: HB 2397 is the funding vehicle for the clearinghouse to ensure access to naloxone throughout Oregon.

There are many other bills held up that also could significantly affect the health of people in Oregon and the work of OHA. Other topics under consideration include hospital workforce, prescription drug monitoring, Measure 110, transportation for people leaving Oregon State Hospital, and more.

What is the legislature expected to do next?

That is not clear. Senate Republicans who have not attended floor session recently have said they would return on June 25 to pass a budget and a limited number of bills. Democrats, who hold a majority in both the House and Senate, have suggested they will finish as much business as they can in the next week or so, then adjourn and come back later in the summer for a special session.

What should we do now?    

We continue to do the same important work we already do. There will likely be continued requests for OHA to review proposed amendments for their policy and fiscal impacts, as is typical at this point in every session. Because legislators may act on those amendments quickly, it is essential that we complete our analysis right away.

If we get closer to the end of the biennium without passage of a state budget, agency leadership will share more information about any impacts to our work. As noted above, a continuing resolution passed earlier would maintain OHA’s budget at current services level through September 15.

The uncertainty around legislative bills, budgets, and their impacts on programs and the health of people in Oregon is unsettling. Please talk with your manager about any concerns you feel, and please continue to uphold OHA’s commitment to serve the needs of everyone in Oregon.

If you have questions or suggestions for the 5 Minute Update, or if you would like to request this document in an accessible alternate format or language please contact Matthew Green.