Division of Health Policy and Analytics

MEDICAID ADVISORY COMMITTEE When: January 27, 2021, 9:00am-12:00pm Join on your computer or mobile app Click here to join the meeting Or call in (audio only) +1 971-277-2343,,924842358# , Portland Phone Conference ID: 924 842 358#

When What Who Welcome and introductions; review Leslee Huggins and Jeremiah Rigsby, 9:00 and approve December minutes MAC Co-Chairs Anna Lansky, Deputy Director, Office of 9:10 DHS Agency Update Developmental Disability Services (DHS) David Inbody, CCO Operations Manager 9:25 OHA Agency Update (OHA) Jeff Scroggin, Sr. Policy Advisor, OHA 9:40 Legislative Update Government Relations Advancing Consumer Experience 10:10 Lavinia Goto, Subcommittee Chair Subcommittee Update 10:30 Break Health-related Services Spending Anona Gund, Transformation Analyst, OHA 10:40 Trend for CCOs Transformation Center 11:10 OHPB Retreat - Discussion Jeremiah Rigsby and Leslee Huggins 11:20 Public Comment 11:30 Wrap up / adjourn

Next Meeting: February 24, 2021 9:00 am -12:00 TBD

OREGON ADVISORY COMMITTEE (MAC) December 2, 2020 9:00 AM – 12:00 PM

MEMBERS IN ATTENDANCE: Adrienne Daniels, Daniel Alrick, Dave Inbody, Jeremiah Rigsby, Karun Virtue, Lavinia Goto, Leslee Huggins, Tamara Bakewell, Brandy Charlan, Kevin Alfaro-Martinez MEMBERS ABSENT: Anna Lansky, Miguel Angel-Herrada ? Yes PRESENTERS: Sarah Dobra, Lisa Bui, Veronica Guerra, Joelle Archibald, Lauren Kustudick, Oceana Gonzales, Sarah Dobra, Joell Archibald, Dustin Zimmerman STAFF: Jackie Wetzel, Tom Cogswell, Margie Fernando

TOPIC Key Discussion Points Jeremiah Rigsby welcomed everyone to the meeting, and members introduced themselves. There was a motion to approve the minutes of 10/28/20; All votes were in favor of approval of the Welcome and Introductions 9/30/20 minutes.

Chris DeMars shared the results of the Accountable Health Communities Study that was conducted. It is a national CMS study seeking to understand if screening for social needs, provision of community resource information, and help from a patient navigator to access resources improves health and reduces the cost of care for Medicaid and Medicare beneficiaries.

The graphs show the health-related Social Needs of Medicaid and Medicare Beneficiaries before and during COVID-19. One big takeaway from this is that social needs increased amongst populations of color Accountable Health Communities and other communities because of COVID. Study Findings & Discussion: COVID-19 and Impact on Social In , $45 million of grants were awarded to address some of the unmet social needs. These grants Needs (Pages 5-8) went out both from Public Health Division and Office of Equity and Inclusion.

Sarah Dobra shared the links where we can find the list of grants awarded: COVID-19 Funding for Community-Based Organizations COVID-19 Health Equity Grants Jackie asked the MAC if they would like to include this topic as a regular feature. Jeremiah agreed that it will be very useful to ask if CCOs can share how they are addressing health-related needs.

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TOPIC Key Discussion Points

Lisa Bui, Director of Quality Improvement and Veronica Guerra, Quality Assurance and Contract Oversight Manager, OHA.

Lisa talked about the key areas of the Medicaid Quality Strategy: • CCO Transformation Quality Strategy (TQS) • Performance Improvement Projects • Network Adequacy • Complaints and Grievances

Here is the link to the TQS page: https://www.oregon.gov/oha/HPA/dsi-tc/Pages/Transformation-Quality- Strategy.aspx

MAC’s role in this Quality Strategy is to: • Inform the direction of the quality strategy updates Medicaid Quality Strategy • Inform the accountability methods for quality strategy implementation (Pages 9-46) Lisa also talked about Performance Improvement Projects (PIP). PIPs are a lever of quality to: • Improve quality of care • Improve in clinical and non-clinical areas • Follow quality improvement science

Veronica Guerra followed up with a report on the Provider Networks. All CCOs and DCOs must submit an Annual Delivery System Network (DSN) Provider Narrative Report on or before September 1, 2020. The Report includes five specific categories:

1. Description of the Delivery Network and Adequacy 2. Description of Enrollees (Members) 3. Additional Analysis of the MCO’s Provider Network to Meet Enrollee (Member) Needs 4. Coordination of Care (CCO only) 5. Performance on Metrics (CCO only)

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TOPIC Key Discussion Points In addition, Veronica added that all CCOs and DCOs are required to send out a notice to members for service denials. The review of these NOABDs started with the third quarter submission from CCOs and DCOs. Those were submitted September 2020.

Jackie would like to ask Lisa Bui and Veronica Guerra to come back to the January meeting of MAC to create time for questions and discussion.

These are the follow up topics that MAC can digest and have questions ready for the next meeting.

• Metrics reports; impacts on OHP members • Complaints and Grievance data and interventions to address problems • Delivery System Network that gets to access discussions • CCO Transformation Quality Strategy outcomes and policy directions

Tom Cogswell Project Coordinator, OHA Transformation Center presented on this topic. Tom introduced the panel who helped with the discussion. Tom gave a good overview of Community Advisory Councils. There are 36 CAC’s across the 16 CCOs.

Lauren Kustudick, Health Council CAC. Lauren covers the rural areas of Central Oregon. Lauren discovered that most of the services being offered were in Bend but did not cover areas outside of this area. She helps to connect people outside of this area.

CCO 2.0 and Community Oceana Gonzales, Eastern Oregon CCO Malheur LCAC. She and her children are OHP consumers. She has Engagement (Panel Discussion) been doing this for a year. She advocates for her community and brings her insight as an OHP member (Pages 5-8) and can reach out to her community.

Karun Virtue, InterCommunity Health Network CCO CAC. Karun has been involved for the last 7 years. This group has been actively involved. Karun realized that although CCO2.0 has a long list of action goals; it does not really impact the members and the community. In addition, the Wildfires severely impacted housing and in the short term and there is a greater need for social determinants of health.

The Learning Collaborative of the CAC will provide a peer-to peer sharing space and discuss best practices. It will be a space for sharing and learning for all members.

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TOPIC Key Discussion Points How is the CAC trying to recruit new members? Tom explained that each local community tries to identify the needs of the local community. They have strategies and resources that are discussed at their monthly meetings. For rural communities, it is harder to access because of the lack of Wi-Fi connections.

Sarah Dobra, Manager of the Ombuds Program and Innovator Agents, Joell England Archibald, RN, and Dustin Zimmerman gave an update on the Innovator Agents in the CCO’s.

Joell Archibald gave a brief history of how the concept of the Innovator Agent program started.

Dustin Zimmerman introduced the 6 Innovator Agents working across the CCOs in Oregon and the service areas they cover.

Innovator Agents have been working since the beginning of the formation of CCOs over 8 years ago. They Innovator Agent Update (Pages have worked closely with the CCOs and have a tremendous wealth of community knowledge. Specifically, 47-57) they work to:

• Support and participate in CCO Community Advisory Councils to amplify OHP member voice • Gauge the impact of transformation on community health and OHP member needs • Inform OHA of opportunities and obstacles • Identify system and/or policy solutions to support CCOs, community partners and OHP members • Build, support and participate in learning collaboratives at the community and state level • Regular connection between all IAs to discuss/learn/share…help good ideas travel faster • Share innovative and successful practices with other CCOs, with OHA and with national audiences.

Dave Inbody gave a verbal update on OHA. The focus is on the planning and distribution of the COVID vaccine. The second is the Governor’s budget that was sent out. There will be challenges that will require ongoing work to address.

CCO Deliverables: At the end of this year, each CCO is required to submit a Health Equity Plan. This plan Agency Updates, OHA & DHS will allow visibility into progress., impacts, and future plans for continued work. OHA also received the first submission on Language Access reporting. There is Legislative Concept coming up on this area.

As we move into 2021, there will be additional contractual requirements placed on CCOs. One example is Intensive In-Home Behavioral Health Treatment (IIBHT program). OHA has met with CCOs to explain the

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TOPIC Key Discussion Points program and how to work through the associated requirements. Another example is related to the CCOs new responsibility for individuals placed on the waitlist for the State Hospital. OHA has scheduled meetings to discuss this new responsibility with CCOs, as well as CMHPs and other providers.

Anna Lansky was not available to present in person, but a written update was distributed prior to the meeting.

Public Comment There was no public comment. The next meeting is January 27, 2021 via Microsoft Teams Closing Comments

Next Meeting Wed Jan 27, 2021, 9am-noon Via Microsoft Teams

5 2021 Session Calendar

JANUARY FEBRUARY SMTWTFS SMTWTFS 1 New Years 2 123456 Day

3 4 5 6 7 8 9 7 8 9 10 11 12 13

11 15 15 19 12 13 14 10 Org. Days - LC Draft 16 14 President's 16 17 18 LC returns 20 Trainings Trainings Trainings Swearing in Request Day drafts 23 24 18 19 17 20 21 22 23 21 22 Measure Revenue 25 26 27 MLK Day Session begins Intro Deadline Forecast 24/ 31 25 26 27 28 29 30 28

MARCH APRIL SMTWTFS SMTWTFS

1 2 3 456 123

7 8 9 10 11 12 13 4 5 6 7 8 9 10

19 13 14 15 16 17 18 Post Work 20 11 12 1st Chamber 14 15 16 17 Session WS Deadline

21 22 23 24 25 26 27 18 19 20 21 22 23 24

28 29 30 31 25 26 27 28 29 30

MAY JUNE SMTWTFS SMTWTFS

1 12345

2 3 4 5 6 7 8 6 7 8 9 101112

14 18 9 10 11 12 13 Post work 15 13 14 15 16 17 19 Target Sine Die session 19 16 17 18 Revenue 20 21 22 20 21 22 23 24 25 26 Forecast

24/ 28 27 23/ 30 31 25 26 27 2nd Chamber 29 Constitutional 29 29 30 Memorial Day WS Deadline Sine Die

12/28/2020 Dates subject to the adoption of the 2021 Regular Session concurrent resolution. Organizational Day Member swearing in; first reading of pre-session filed bills. Training Days Member and staff virtual trainings. State Holiday Holiday Leg. Counsel Deadlines Deadlines for bills to be postedrequested, for workreturned sessions, by LC, then and voted introduced out of (after policy these committees deadlines, in the drafts/intros first and second count chambers.against per-legislator limits). Important Session Dates Does not apply to Rules, Revenue, or Joint Committees. Joint Transportation will adhere to the second chamber deadline only. Floor as Schedule Requires Senate and House floor sessions may be called as noted by chamber schedule(s). Regular Floor Sessions Senate and House floor sessions on all weekdays unless otherwise canceled. 2021 Legislative Committee Schedule

Committee Monday Tuesday Wednesday Thursday Friday Senate Committees 3:15PM – 5:00PM 3:15PM – 5:00PM Education Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Energy & Environment Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 3:15PM – 5:00PM 1:00PM – 2:45PM 3:15PM – 5:00PM Finance & Revenue Virtual Meeting Virtual Meeting Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Health Care Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Housing and Development Virtual Meeting Virtual Meeting Human Services, Mental Health and 3:15PM – 5:00PM 3:15PM – 5:00PM Recovery Virtual Meeting Virtual Meeting Judiciary and Ballot Measure 110 8:00AM – 9:45AM 8:00AM – 9:45AM 8:00AM – 9:45AM 8:00AM – 9:45AM Implementation Virtual Meeting Virtual Meeting Virtual Meeting Virtual Meeting 8:00AM – 9:45AM 8:00AM – 9:45AM Labor & Business Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Redistricting Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Rules Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Natural Resources and Wildfire Recovery Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Veterans & Emergency Preparedness Virtual Meeting Virtual Meeting House Committees 8:00AM – 9:45AM 8:00AM – 9:45AM Behavioral Health Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Business & Labor Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM General Government Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Early Childhood Virtual Meeting Virtual Meeting 8:00AM – 9:45AM 8:00AM – 9:45AM Economic Recovery & Prosperity Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Education Virtual Meeting Virtual Meeting House Committees, continued. Monday Tuesday Wednesday Thursday Friday 1:00PM – 2:45PM 1:00PM – 2:45PM Energy & Environment Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Health Care Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Health Care – COVID-19 Subcommittee* Virtual Meeting Virtual Meeting 8:00AM – 9:45AM 8:00AM – 9:45AM Housing Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Human Services Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Judiciary Virtual Meeting Virtual Meeting Judiciary – Equitable Policing 8:00AM – 9:45AM 8:00AM – 9:45AM Subcommittee Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Judiciary – Civil Law Subcommittee Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Agriculture & Natural Resources Virtual Meeting Virtual Meeting Special Committee – Modernizing the 5:30PM – 7:15PM People’s Legislature* Virtual Meeting 5:30PM – 7:15PM 5:30PM – 7:15PM Special Committee – Redistricting Virtual Meeting Virtual Meeting 5:30PM – 7:15PM Special Committee – Wildfire Recovery* Virtual Meeting 3:15PM – 5:00PM 1:00PM – 2:45PM 3:15PM – 5:00PM 1:00PM – 2:45PM Revenue Virtual Meeting Virtual Meeting Virtual Meeting Virtual Meeting 1:00PM – 2:45PM 1:00PM – 2:45PM Rules Virtual Meeting Virtual Meeting 3:15PM – 5:00PM 3:15PM – 5:00PM Veterans & Emergency Preparedness Virtual Meeting Virtual Meeting 8:00AM – 9:45AM 8:00AM – 9:45AM Water Virtual Meeting Virtual Meeting Joint Committees 3:15PM – 5:00PM 3:15PM – 5:00PM Joint Audits Virtual Meeting Virtual Meeting Joint Information Management & 8:00AM – 9:45AM 8:00AM – 9:45AM Technology Virtual Meeting Virtual Meeting Joint Transportation 8:00AM – 9:45AM 8:00AM – 9:45AM Virtual Meeting Virtual Meeting 8:00AM – 9:45AM Joint Ways and Means Virtual Meeting Joint Committees, continued. Monday Tuesday Wednesday Thursday Friday Joint Ways and Means – Capital 1:00PM – 2:45PM Construction Subcommittee Virtual Meeting Joint Ways and Means – Education 1:00PM – 2:45PM 1:00PM – 2:45PM Subcommittee Virtual Meeting Virtual Meeting Joint Ways and Means – General 1:00PM – 2:45PM 1:00PM – 2:45PM Government Subcommittee Virtual Meeting Virtual Meeting Joint Ways and Means – Human Services 1:00PM – 2:45PM 1:00PM – 2:45PM Subcommittee Virtual Meeting Virtual Meeting Joint Ways and Means – Natural 8:00AM – 9:45AM 8:00AM – 9:45AM Resources Subcommittee Virtual Meeting Virtual Meeting Joint Ways and Means – Public Safety 1:00PM – 2:45PM 1:00PM – 2:45PM Subcommittee Virtual Meeting Virtual Meeting Joint Ways and Means – Transportation 8:00AM – 9:45AM 8:00AM – 9:45AM & Economic Development Subcommittee Virtual Meeting Virtual Meeting

Joint Tax Expenditures**

Legislative Administration**

Legislative Counsel** Legislative Counsel – Public Records Subcommittee**

Legislative Policy and Research**

Interstate 5 Bridge**

Joint Conduct**

* These committees shall meet as needed. ** These committees shall be scheduled as needed.

Please contact Kristina Narayan in the House Speaker's office at [email protected] or Derek Sangston in the Senate President's office at [email protected] with any questions.

Tina Kotek 900 Court Street NE Speaker of the House Salem, OR 97301

Oregon House of Representatives

MEMORANDUM

TO: Timothy G. Sekerak, Chief Clerk of the House

FROM: , Speaker of the House

RE: Appointments – Committee Assignments for the 2021 Legislative Session

DATE: December 31, 2020

Effective immediately and pursuant to House Rule 8.05, I am making the following appointments:

2021 House Standing Committees

Agriculture and Natural Resources Committee Business and Labor Committee , Chair , Chair Vikki Breese-Iverson, Vice Chair , Vice Chair , Vice Chair , Vice Chair Vikki Breese-Iverson Susan McLain Jeff Reardon Paul Evans Anna Williams Bill Post Brad Witt

Behavioral Health Committee Early Childhood Committee , Chair , Chair Raquel Moore-Green, Vice Chair , Vice Chair , Vice Chair , Vice Chair Cedric Hayden John Lively John Lively Lisa Reynolds

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Economic Recovery and Prosperity Committee Health Care Committee John Lively, Chair , Chair Jami Cate, Vice Chair Cedric Hayden, Vice Chair , Vice Chair Andrea Salinas, Vice Chair Daniel Bonham Brian Clem Rachel Prusak Raquel Moore-Green Sheri Schouten

Education Committee Subcommittee on COVID-19 Teresa Alonso Leon, Chair Maxine Dexter, Chair Courtney Neron, Vice Chair Cedric Hayden, Vice Chair Suzanne Weber, Vice Chair Wlnsvey Campos Zach Hudson Raquel Moore-Green Mark Owens Andrea Salinas Jeff Reardon Ricki Ruiz David Brock Smith Boomer Wright

Energy and Environment Committee Housing Committee Pam Marsh, Chair Julie Fahey, Chair David Brock Smith, Vice Chair Wlnsvey Campos, Vice Chair Daniel Bonham Lily Morgan, Vice Chair Pam Marsh Diego Hernandez Raquel Moore-Green Courtney Neron Suzanne Weber Jack Zika

General Government Committee Human Services Committee , Chair Anna Williams, Chair , Vice Chair Gary Leif, Vice Chair John Lively, Vice Chair Ricki Ruiz, Vice Chair Diego Hernandez Ron Noble Jack Zika Mark Owens Tawna Sanchez Sheri Schouten

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Judiciary Committee Rules Committee Janelle Bynum, Chair , Chair Ron Noble, Vice Chair Christine Drazan, Vice Chair Karin Power, Vice Chair Paul Holvey, Vice Chair Maxine Dexter Daniel Bonham Ken Helm Julie Fahey Jason Kropf Andrea Salinas Jack Zika Lily Morgan Kim Wallan Marty Wilde Veterans and Emergency Management Subcommittee on Civil Law Committee Karin Power, Chair Paul Evans, Chair Kim Wallan, Vice Chair Rick Lewis, Vice Chair Ken Helm Mark Meek, Vice Chair Jason Kropf Dacia Grayber Lily Morgan Kim Wallan Boomer Wright Subcommittee on Equitable Policing Janelle Bynum, Chair Ron Noble, Vice Chair Maxine Dexter Rick Lewis Marty Wilde

Revenue Committee Water Committee , Chair Ken Helm, Chair Khanh Pham, Vice Chair Mark Owens, Vice Chair E. Werner Reschke, Vice Chair Jeff Reardon, Vice Chair Diego Hernandez Vikki Breese-Iverson Gary Leif Pam Marsh Lisa Reynolds Greg Smith Marty Wilde Brad Witt

2021 Special Committees

Modernizing the People’s Legislature Committee Wildfire Recovery Committee Mark Meek, Co-Chair Brian Clem, Chair Kim Wallan, Co-Chair Rick Lewis, Vice Chair Vikki Breese-Iverson Pam Marsh, Vice Chair Janelle Bynum Jami Cate Paul Evans Redistricting Committee Andrea Salinas, Chair Dacia Grayber Shelly Boshart Davis, Vice Chair Mark Meek Daniel Bonham Lily Morgan Wlnsvey Campos Bill Post Khanh Pham

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2021 Joint Committees

Interstate 5 Bridge Ways and Means – Human Services Subcommittee Susan McLain, Co-Chair Rob Nosse, Co-Chair Shelly Boshart Davis Wlnsvey Campos Karin Power Cedric Hayden Greg Smith Anna Williams

Ways and Means Committee Ways and Means – Natural Resources Subcommittee , Co-Chair Jeff Reardon, Co-Chair David Gomberg, Co-Vice Chair Vikki Breese-Iverson Greg Smith, Co-Vice Chair Paul Holvey Janelle Bynum Khanh Pham Christine Drazan David Brock Smith Gary Leif Susan McLain Rob Nosse Tawna Sanchez Janeen Sollman Duane Stark

Ways and Means – Capital Construction Ways and Means – Public Safety Subcommittee Subcommittee Paul Holvey, Co-Chair Janeen Sollman, Co-Chair Christine Drazan Dacia Grayber Tina Kotek Jason Kropf Nancy Nathanson Gary Leif Greg Smith Duane Stark

Ways and Means – Education Subcommittee Ways and Means – Transportation and Economic Development Subcommittee Susan McLain, Co-Chair David Gomberg, Co-Chair Teresa Alonso Leon Paul Evans Bobby Levy Julie Fahey E. Werner Reschke Gary Leif Ricki Ruiz Jack Zika

Ways and Means – General Government Subcommittee Greg Smith, Co-Chair David Gomberg Zach Hudson Mike Nearman Marty Wilde

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2021 Joint Statutory Committees

Legislative Administration Committee Legislative Information Management and Technology Committee Tina Kotek, Co-Chair Nancy Nathanson, Co-Chair Christine Drazan Pam Marsh Paul Holvey Mike Nearman Greg Smith Barbara Smith Warner Nancy Nathanson, Alternate

Legislative Audit Committee Legislative Policy and Research Committee Dan Rayfield, Co-Chair Tina Kotek, Co-Chair Nancy Nathanson Teresa Alonso Leon Greg Smith David Gomberg Cedric Hayden Legislative Counsel Committee David Brock Smith Tina Kotek, Co-Chair Duane Stark Christine Drazan Karin Power Kim Wallan Marty Wilde

Legislative Counsel Committee – Public Transportation Committee Records Subcommittee Kim Wallan, Co-Chair Susan McLain, Vice Chair Karin Power Paul Evans, Vice Chair Ron Noble, Vice Chair Shelly Boshart Davis Rick Lewis Nancy Nathanson Karin Power

Please contact Kristina Narayan in the House Speaker’s office at (971) 209-5808 or [email protected] with any questions.

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Kate Brown, Governor

OHA 2021 Request Legislation

The 10-year strategic goal of Oregon Health Authority (OHA) is to eliminate health inequities. The 2021-2023 biennium offers OHA and partners an opportunity to advance this goal through legislation.

The OHA and Oregon Health Policy Board defined health equity: Oregon will have established a health system that creates health equity when all people can reach their full health potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances. Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments, to address: The equitable distribution or redistribution of resources and power; and Recognizing, reconciling and rectifying historical and contemporary injustices.

The package of legislation OHA has requested for 2021 presents opportunities to: (1) increase access to quality behavioral health services and reduce inequities in the behavioral health system; (2) address systemic racism and health inequities in the health care system; and (3) breakdown barriers to health in our communities.

OHA’s requests will continue to be shaped by community partner input and feedback. OHA will proactively partner with other stakeholders regarding proposals that will help reduce health inequities.

Below is a summary for each of OHA’s legislative requests.

Improve access and quality of behavioral health services and decrease behavioral health inequities

1. Increase Access and Quality of Behavioral Health Services (HB 2086)

Governor Brown issued an Executive Order in October 2019 to convene the Behavioral Health Advisory Council. The council developed recommendations aimed at improving access to effective behavioral health services and supports for all adults and transitional-aged youth with serious mental illness or co-occurring mental illness and substance use disorders. The Council recommended policies and funding to address behavioral health needed program and service capacity; a culturally and linguistically appropriate workforce; and housing and residential needs.

1 1/2/20 Improve Treatment of Co-occurring Disorders (SB 67)

The behavioral health workforce is not consistently trained to screen, assess, or treat co- occurring disorders (such as mental health and substance use, or problem gambling or intellectual and a developmental disabilities (I/DD) diagnosis). Additionally, Oregon facilities are credentialed or licensed as either substance use or mental health facilities, creating barriers to care for individuals seeking treatment. There is not a billing code for co-occurring disorders and there are separate funding sources for substance use and mental health. This results in lack of data for co-occurring disorders. Lastly, providers are required to complete separate assessment screenings and tools for mental health and substance use disorder (the American Society of Addiction Medicine (ASAM)). This placeholder request will be used to address barriers to having a comprehensive system that treats the behavioral health needs of the individual holistically.

2. Expand Recovery Housing for Harm Reduction (SB 69)

Current statute only allows for funding of recovery housing that is Alcohol and Drug Free, whereas a full range of options are necessary to ensure a continuum of care that embraces harm reduction as well as abstinence-based recovery. The proposed solution changes statutory language to allow for multiples treatment models in housing.

3. Fill gaps in system of care (SB 68)

The System of Care (SOC) Advisory Council is directed under SB 1 (2019) to improve the effectiveness and efficacy of child serving state agencies and the continuum of care that provides services to youth ages 0-25 by providing centralized and impartial forum for statewide policy development, funding strategy recommendations and planning. The recommendations to the legislature and agency directors are highly likely to include the need for new legislation and changes or updates to existing statutes in order to address continuum of care gaps and needs and develop and more functional SOC for Oregon.

4. Improve Suicide Data Reporting and Uniform Postvention Response (SB 66)

ORS 418.735 does not require medical examiners or law enforcement to report a suspected suicide death to the local mental health authorities (LMHAs), which creates inconsistent and unreliable suicide postvention responses. Currently, postvention response varies widely across the state – and in some counties there is no postvention response from the local mental health authority. This proposal changes the Oregon Revised Statute (ORS) 418.735 to address these concerns.

5. Ban Flavored Tobacco Sales (HB 2148)

The proposal will ban the sale of all flavored tobacco products and Inhalant Delivery Systems (IDS) such as e-cigarettes or vape products. The flavor ban includes mint and menthol, as well as “concept flavors” such as “jazz” and “red”. The proposal also will ban online and telephonic sales of all tobacco products to Oregon addresses, which would create parity with cigarettes and smokeless tobacco. Federal regulations prohibited flavored cigarettes, except for menthol flavored cigarettes, in 2009, but since then, a multitude of new flavored tobacco products designed to get around that prohibition have entered the market. These include e-cigarettes and vaping products, flavored little cigars, and novel alternative tobacco products.

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6. Create Tobacco Retail Licensure (HB 2071)

In Oregon, even as tobacco use remains the top preventable cause of death and disability in the state, no state license is required to sell tobacco products or inhalant delivery systems (IDS). In 2019, 16% of Oregon tobacco retailers illegally sold a tobacco product to a person under the age of 21. Without a state license, there is limited capacity to effectively enforce tobacco sales laws such as the minimum legal sales age. Statewide Tobacco Retailer Licensure will ensure retail store owners are held accountable for illegally selling tobacco to underage persons and for following other state and local tobacco regulations. Fees from licensing allow for sustainable administration and enforcement of the program, including regular inspection. Enforcement action is taken on the retailers, not on the youth buyer. Other states with tobacco retail licenses show that it can reduce youth access to tobacco products.

7. Maintain Prescription Drugs Monitoring Program (HB 2074)

The Prescription Drug Monitoring Program (PDMP) allows prescribers to be fully informed of the prescription history of their patients when prescribing controlled substances. The PDMP was created by statute in 2009 and since then has expanded substantially in both function and size. New enhancements include interstate data sharing, health information technology (HIT) integration, improved user interface, and collection of additional drugs and fields for clinical use and research purposes, all of which keep the PDMP in line with legislative mandates and with emerging best practices. However, this growth has increased the cost of operation so that is no longer covered by the $25 annual fee paid by Oregon healthcare licensees. This proposal increases that fee to $35, to maintain sufficient capacity for program operations and database functions.

8. Oregon State Hospital (OSH) Technical Corrections (SB 72)

OHA proposes three statutory changes to ensure appropriate and efficient procedures at the state hospital. 1) OHA is seeking a technical fix to ORS 127.720 to include ORS 426.701 to the list of types of commitments cited in the statute. ORS 426.701 took effect after ORS 127.720 was last amended and therefore was inadvertently excluded. 2) OSH is currently unable to include outpatient services in the cost of care to a patient while at the state hospital. While OSH has a medical and dental clinic, patients at OSH come to the hospital with a variety of medical needs. Some needs, including terminal illnesses and surgeries, require sending patients to receive care at a facility outside OSH. OHA proposes amending ORS 179.701 to remove the language excluding outpatient services in the cost of care, which will allow OSH to include these costs of care in compliance with Medicare requirements.

9. Access to Criminal Justice Data for Behavioral Health Outcomes (SB 73)

OHA does not currently have access to Oregon criminal justice information that would allow the agency to track outcomes for consumers. OHA proposes changes to state statute to authorize the agency to access this information with appropriate parameters for the use and handling of the information.

10. Aid and Assist Placeholder (SB 71)

OHA maintains a placeholder to address unforeseen issues with ORS 161.370 that may arise during the legislative session.

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Reduce barriers to health and health inequities in our communities

11. Expand and Sustain Tribal Traditional Health Workers (HB 2088)

OHA proposes to create a sixth traditional health worker (THW) category in statute. The services, training, qualifications, and certification of the Tribal Traditional Health Worker would be defined in administrative rule. Tribes are providing critical health services to tribal members, but many of these providers and practices do not fit within the five existing Traditional Health Worker categories. Creating a sixth, separate THW category for tribes would allow the tribes and urban Indian health program to receive reimbursement using tribal based practices and curricula developed by the tribes themselves.

12. Expand Regional Health Equity Coalitions (RHEC) (SB 70)

OHA is proposing a statewide expansion of the RHEC program, as well as defining RHECs and the RHEC model in statute to ensure fidelity. The RHECs have the expertise based in lived experience to identify most critical and regionally specific health equity issues, while crafting policy, system, and environmental solutions. Meaningfully impacting these issues and health inequities in general requires sustained, long-term efforts with dedicated fiscal investment. Specific benefits of sustained/expanded funding include: increased opportunities for coordinated care organizations (CCOs) to partner with RHECs, offer technical assistance and training to build CCO’s capacity around health equity and the social determinants of health; providing coalitions the level of autonomy needed to improve health equity in meaningful and appropriate ways that ensures anti-racist priorities are not compromised; growing the necessary capacity of Oregon to address health equity issues in culturally specific and effective ways; creating additional opportunities to sustainably address issues related to avoidable policy and system barriers which may help lower costs to health and other related systems.

13. Modernize Public Health (HB 2073)

For the past two biennia, the state Legislature has invested in modernizing state, local, and Tribal public health to more nimbly respond to emerging health issues. This bill is a placeholder for statutory fixes to be determined, to help streamline delivery of public health services. It is tied to an agency budget request of $30 million.

14. Improve Home Health Care Oversight (HB 2072)

Home Health Agencies (HHAs) provide skilled medical nursing services and other therapeutic services to patients in their homes. OHA is responsible for ensuring the quality of client care, complaint investigations and triennial surveys. OHA proposes raising fees to support the necessary regulation of home health licensees and in doing so to protect their clients. Current fee levels no longer support the cost of the regular surveys and complaint investigations.

15. Sustain Radiation Protection Services (HB 2075)

Radiation Protection Services (RPS) is charged to be the state radiation control program protecting Oregonians from unnecessary or harmful exposure and to promote beneficial uses of radiation. The program regulates over 4,200 registrants and licensees who provide services to patients and the public using 14,000 radiation devices and sources for medical, industrial, academic and research applications. Without additional funding to meet increasing demand, RPS will not be able to complete facility inspections of all registrants to ensure radiation devices/sources are being used safely and within manufacturer specifications. This proposal 4 would raise several fees paid by registrants and licensees, which will also better align Oregon’s fee structure with the Washington and tube-based fee models, and better ensure that Registrants are paying a registration fee based upon RPS staff’s inspection time required to ensure safe machine operation.

16. Modernize Emergency Medical Services (HB 2076)

Oregon does not currently have a comprehensive Emergency Medical Services (EMS) & Trauma system. There is no unifying individual, agency, or plan for the provision of emergency medical services throughout state government, no system for regionalization of emergency medical services to treat time-sensitive emergencies, and no plan that will allow for surge capability in the event of a medium or large size disaster. This proposal provides for an integrated Emergency Healthcare System that recognizes problems, determines which services needed and then delivers the patient to those resources. Such a system can provide for better coordination of emergency care, regionalization to allow smaller agencies to benefit from economies of scale, improved targeted transport of patients to regional specialty centers, and improved assessment, triage and transfer from small general hospital to regional referral centers.

17. Remediate Lead-Based Paint Hazards (HB 2077)

Lead-based paint is a source of neurotoxin exposure that continues to be a critical environmental health risk, particularly among young children. However, despite delegated authority to enforce federal regulations on lead-based paint, OHA does not have the authority to require property owners or contractors to properly assess and decontaminate a residence or facility. OHA can issue civil penalties if work was performed by uncertified firms or if lead-safe work practices were not followed but cannot mandate cleanup or issue stop-work orders in case of ongoing unsafe work. This proposal would add statutory authority for OHA to compel cleanup of a lead- contaminated site when OHA has determined a property owner has violated lead-based paint requirements, and to issue a stop-work order if necessary.

18. Technical Fixes for Public Health (SB 64)

This proposal contains several minor fixes to ease implementation of public health laws, tentatively including: bringing state law into alignment with federal regulations on lead-based paint remediation; clarifying the definitions of "health officer" and "local public health administrator”; allowing School Health Services Planning Grant Sites to pursue either a School- Based Health Center (SBHC) or an alternative model (school nursing) as best fits their community needs.

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Reduce health inequities in the healthcare system and realize better care, better health, and lower costs

19. Provide a Cover All People Pilot (LC 681; bill number TBD)

To expand affordable healthcare access in Oregon and ensure all people have coverage, this proposal is for a pilot program of a Medicaid-like product. The goal is build on the success of the Oregon’s CCO model. The proposal would build a state-funded subsidy structure to provide health care services to individuals who are typically the most underserved and marginalized. These subsidy structures will be based on 1) the Affordable Care Act (ACA) affordability framework for individuals whose income is under 400% of the federal poverty level (FPL) and 2) ACA expansion population experience for individuals whose income is under 138% of FPL.

Note that Cover All People is a Governor’s Office bill based on a recommendation from the Governor’s Racial Justice Council. OHA supports the bill, but it is not our request.

20. Improve Language Access and Health Care Interpreters (HCI) Workforce (HB 2087)

OHA is proposing to expand and support quality language access services for improved health outcomes for limited English proficient (LEP) and sign language patients. The proposal is built to benefit both urban and rural communities in Oregon and will allow linguistically competent services to be utilized throughout the state. By strengthening existing requirements to work with trained HCIs, the proposal will ensure that Coordinated Care Organizations (CCOs), provider networks and interpreting agencies, work with Qualified and Certified HCIs. To that end, this is a needed step to professionalize Oregon’s HCI workforce and ensure that a stable supply of quality trained interpreters is available across the state, especially in rural communities experiencing growth in LEP populations.

21. Enforce Cost Growth of Health Care (HB 2081)

OHA is seeking legislative authority to implement mechanisms to hold insures and providers accountable for containing health care costs and meeting the annual cost growth target established by Senate Bill 889 (2019) and adopted by the Oregon Health Policy Board. SB 889, which passed with broad bipartisan support, directed the OHA to work with stakeholders and consumers to set a Sustainable Health Care Cost Growth Target that would apply to insurance companies, hospitals and healthcare providers, so that healthcare costs do not outpace wages or the state’s economy.

SB 889 directed OHA to begin data collection and public reporting on the cost growth target. However, additional legislative authority is needed before any insurers or providers can be held accountable for meeting the annul health care cost growth target. Specific recommendations for accountability and enforcement (such as requiring performance improvement plans for payers or providers who exceed the cost growth target) will be made by the Implementation Committee by December 2020 and introduced as legislation for the 2021 session. COVID-19 and its economic impact highlighted the continued need for the state to develop policies and programs that ensure affordable healthcare for all Oregonians.

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22. Create Statewide Value-Based Payment System (HB 2082)

OHA is proposing to work with a multi-stakeholder Advisory Committee under the direction of the Oregon Health Policy Board to develop a roadmap to increase utilization of payments that are based on health outcomes. Currently payments based on the number of services provided is still the predominant form of payment for health care in Oregon. The committee’s work could include consideration and alignment of new payment methodologies so that providers are not faced with cascading and different payment structures for patients and consider health equity as a component of value-based payment arrangements. The committee would also be charged with identifying potential infrastructure needs as well as possible roadmap components like milestones and benchmarks.

23. Leverage State’s Purchasing Power to Reduce Pharmacy Costs (HB 2080)

OHA is proposing legislation to address three issues to increase its bargaining power in negotiations with prescription drug manufacturers. First, OHA will clarify its authority to require that providers receive authorization from the state prior to prescribing drugs whose manufacturers have not negotiated satisfactory terms with state purchasers. Second, OHA is requesting the legislature direct the Agency and CCOs to collaboratively develop a drug- purchasing plan that will improve member and provider experience while containing costs. Third, OHA seeks legislative authority to create a multi-agency pharmacy purchasing collaborative.

24. Leverage Purchasing Power of the Marketplace (SB 65)

Currently, the Marketplace for purchasing health plan coverage under the ACA is administered by the Oregon’s Department of Consumer and Business Services (DCBS). OHA and DCBS are proposing to move responsibility for running the Marketplace to OHA. This would allow OHA to coordinate improving quality and reducing cost in health care coverage across Medicaid, public employee plans and ACA plans sold through the Marketplace. This move would significantly enhance OHA’s ability to align new payment methodologies and expand on models for better coordinating patient care and health equity.

25. Review Health Care Mergers and Acquisitions for Health Equity (HB 2079)

In order to ensure Oregon’s private market health care system transformation aligns with our core priority health care principles of better care, better health, and lower costs along with our health equity goals, OHA is seeking enhanced regulatory authority over certain proposed mergers and acquisitions involving major health systems in Oregon. The proposal mirrors the Oregon Health Policy Board (OHPB) approved framework OHA uses when reviewing and approving mergers and acquisitions involving Coordinated Care Organizations and also uses the OHPB-approved definition of health equity. The process will guarantee transparency and provide an opportunity for public input when consideration of a proposed merger and acquisition is warranted. The proposal will be amended to reflect a two-step process in which the Agency will develop an implementation plan which requires legislative approval for before implementation.

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26. Align Purchasing Power Across PEBB/OEBB and Other Public Purchasers (HB 2083)

OHA proposes to expand the Public Employees Benefit (PEBB) and Oregon Educators Benefit Board (OEBB) enrollment footprint and procurement capability. The proposal will provide additional special procurement authority for joint purchasing initiatives by PEBB and OEBB to allow new models of care that improve value of health plans offered by the boards. It also adds resources to offer affordable health plan options to local governments and enroll interested entities.

27. Technical Fixes for Health Policy and Analytics (HB 2078)

OHA’s Health Policy and Analytics Division needs to make minor technical corrections to implement existing statutes as intended. The changes include: removing Common Credentialing; eliminating requirement for the Pain Management Commission to perform curriculum reviews; revising requirements for licensed professionals to periodically complete a pain management education program; discontinuing the Palliative Care and Quality of Life Interdisciplinary Advisory Council or reducing the annual meeting requirements from two to one; and amending PEBB’s statute so it aligns with the Affordable Care Act regarding the coverage of temporary employees.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters • Written materials in other languages • Braille • Large print • Audio and other formats

If you need help or have questions, please contact Matthew Green at 503-983- 8257, 711 TTY, [email protected].

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Office of the Senate President

MEMORANDUM

TO: Lori Brocker, Secretary of the Senate

FROM: , Senate President

DATE: December 23, 2020

RE: Standing Committee Appointments for the 2021 Legislative Session

Pursuant to Senate Rule 8.05, I am making the following appointments for the 2021 legislative session:

SENATE COMMITTEES

Education Sen. , Chair Sen. , Vice Chair Sen. Sen. Sen.

Energy and Environment Sen. , Chair Sen. , Vice Chair Sen. Kathleen Taylor Sen. Art Robinson Sen. Michael Dembrow

Finance and Revenue Sen. , Chair Sen. , Vice Chair Sen. Sen. Lynn Findley Sen.

Health Care Sen. Deb Patterson, Chair Sen. , Vice Chair Sen. James Manning, Jr. Sen. Heard Sen. Lee Beyer

900 Court St NE S-201, Salem, Oregon, 97301 (503) 986-1600 [email protected]

Housing and Development To be appointed, the Senator from Senate District 24, To be announced, Chair Sen. , Vice Chair Sen. Deb Patterson Sen. Dick Anderson Sen.

Human Services, Mental Health and Recovery Sen. Sara Gelser, Chair Sen. Dick Anderson, Vice Chair Sen. Sen. Art Robinson Sen. Kathleen Taylor

Judiciary and Ballot Measure 110 Implementation Sen. , Chair Sen. , Vice Chair Sen. Sara Gelser Sen. Dennis Linthicum Sen. James Manning, Jr. Sen. Sen. Michael Dembrow

Labor and Business Sen. Chuck Riley, Chair Sen. , Vice Chair Sen. Kate Lieber Sen. Alan Olsen To be appointed, the Senator from Senate District 24

Natural Resources and Wildfire Recovery Sen. Jeff Golden, Chair Sen. Dallas Heard, Vice Chair Sen. Floyd Prozanski Sen. Alan Olsen Sen. Deb Patterson

Redistricting Sen. Kathleen Taylor, Chair Sen. Tim Knopp, Vice Chair Sen. Sen. Bill Hansell Sen. Lee Beyer

Rules Sen. Rob Wagner, Chair Sen. , Vice Chair Sen. Ginny Burdick Sen. Kim Thatcher Sen. James Manning, Jr. 900 Court St NE S-201, Salem, Oregon, 97301 (503) 986-1600 [email protected]

Veterans and Emergency Preparedness Sen. James Manning, Jr., Chair Sen. Alan Olsen, Vice Chair Sen. Deb Patterson Sen. Dennis Linthicum

JOINT COMMITTEES

Joint Committee on Ways and Means Sen. Betsy Johnson, Co-Chair Sen. Elizabeth Steiner Hayward, Co-Chair Sen. Fred Girod, Co-Vice Chair Sen. Lew Frederick Sen. Chuck Thomsen Sen. Kathleen Taylor Sen. Tim Knopp Sen. Kate Lieber Sen. Bill Hansell Sen. Chris Gorsek Sen. Dick Anderson Sen. Jeff Golden

Capital Construction Subcommittee Sen. Fred Girod, Co-Chair Sen. Peter Courtney Sen. Elizabeth Steiner Hayward Sen. Chuck Thomsen Sen. Betsy Johnson

Education Subcommittee Sen. Lew Frederick, Co-Chair Sen. Chuck Thomsen Sen. Michael Dembrow

General Government Subcommittee Sen. Jeff Golden, Co-Chair Sen. Dick Anderson Sen. Kate Lieber

Human Services Subcommittee Sen. Kate Lieber, Co-Chair Sen. Tim Knopp Sen. Sara Gelser

Natural Resources Subcommittee Sen. Kathleen Taylor, Co-Chair Sen. Dick Anderson Sen. Lew Frederick

900 Court St NE S-201, Salem, Oregon, 97301 (503) 986-1600 [email protected]

Public Safety Subcommittee Sen. Chris Gorsek, Co-Chair Sen. Bill Hansell Sen. Floyd Prozanski

Transportation and Economic Development Subcommittee Sen. Lee Beyer, Co-Chair Sen. Bill Hansell To be appointed, the Senator from Senate District 24

Joint Committee on Tax Expenditures Sen. Ginny Burdick, Co-Chair Sen. Brian Boquist, Co-Vice Chair Sen. Chuck Riley Sen. Lynn Findley Sen. Rob Wagner

Joint Committee on Transportation Sen. Lee Beyer, Co-Chair Sen. Brian Boquist, Co-Vice Chair Sen. Lew Frederick Sen. Lynn Findley Sen. Chris Gorsek

Joint Committee on the Interstate 5 Bridge Sen. Lee Beyer, Co-Chair Sen. Lynn Findley Sen. Lew Frederick Sen. Brian Boquist

Joint Legislative Committee on Information Management and Technology Sen. Chuck Riley, Co-Chair Sen. Brian Boquist Sen. Betsy Johnson

Joint Committee on Legislative Audits Sen. Betsy Johnson, Co-Chair Sen. Kim Thatcher Sen. Elizabeth Steiner Hayward

If you have any questions, please contact Derek Sangston in my office at (503) 986-1603.

cc: Secretary of the Senate’s Office Chief Clerk’s Office Capitol Club

900 Court St NE S-201, Salem, Oregon, 97301 (503) 986-1600 [email protected]

ODHS 2021 Legislative Concepts/Bills

Bill # Office/ Title Bill Overview ODDS: Statute Alignment for Settings Supporting SB 86 will give ODDS authority to consider the performance of a Individuals with provider or provider agency operating a program or setting in another SB 86 Developmental Disabilities state outside of Oregon by aligning the statutory language for and Licensing Consideration residential training homes and facilities to be consistent with the of Provider Performance in statute for adult foster homes. Other States Senate Bill 20 was passed during the 2019 legislative session. The legislation moved certain Community Developmental Disability Programs SB 88 ODDS: Housekeeping (CDDP) functions from ORS 430.664 to ORS 430.662. This move made references to 430.664 elsewhere in statute inaccurate. SB 88 corrects these references. During the 2017 session, Senate Bill 243 expanded the definition of “Child in Care” to include children residing in a certified foster home or developmental disabilities residential facility. This legislation defined “developmental disabilities residential facility” as a residential SB 89 ODDS: Child in Care facility or foster home for children who are 18 years of age or younger and receiving developmental disability services. SB 89 clarifies that developmental disability residential facilities refers to children who are 17 years of age or under. SB 90 would protect client privacy by adding residential names and addresses of adults with intellectual and developmental disabilities (I/DD) ODDS: Client Privacy for SB 90 who reside in adult foster homes, residential training facilities and Vulnerable Population residential training homes to the “public records exempt from disclosure list” in ORS 192.355. Bill # Office/ Title Bill Overview HB 2151 proposes strategies to raise awareness of the Model ODDS: State as Model Employer Program, an existing resource for state hiring managers. This Employer Program for Concept would provide recognition of the program, allow the HB 2151 Employment of People with legislature to facilitate dialogue, demonstrate support of this Intellectual and important equity initiative, and recognize the benefits of employing Developmental Disabilities people with disabilities in the workplace. HB 2105 updates Oregon law to require consideration of Supported ODDS and APD: Supported Decision Making as an alternative to the appointment of a fiduciary for a Decision-Making: Promoting person with a disability. This would ensure that supported decision- HB 2105 Greater Self-Determination making agreements are considered as a less restrictive alternative to in the Area of Decision- protective proceedings under ORS chapter 125 for a person with a Making Supports disability who needs assistance with life decisions.

Updated 11/20/20