July 21, 2017

Data show variations in amounts paid for procedures

Salem -- Reimbursement for the same procedures vary among hospitals operating in the same region and across the state, according to a new report from the Oregon Health Authority (OHA). The report details the median amounts paid by commercial insurers for the most common inpatient and outpatient procedures that were performed in Oregon hospitals in 2015.

The new 2015 report includes amounts patients paid for each procedure. (The 2014 edition only included amounts paid by insurers. Including patient contributions is more transparent and represents a complete picture of amounts paid.)

The report, "Oregon Hospital Payment Report 2015," (http://www.oregon.gov/oha/HPA/ANALYTICS/Pages/Hospital-Reporting.aspx) is mandated by ORS 442.466. The annual report draws on data collected in the All Payer All Claims (APAC) database. The goal is to provide a source of transparency to the public on hospital reimbursement. Inpatient care accounts for as much as 30 percent of health care spending in the state.

"This report is another step forward in our state's commitment to health care transparency and a look at the important services and procedures that hospitals across Oregon provide," said Lynne Saxton, Director of the Oregon Health Authority. "

Highlights of the report include:

--Most procedures show sizable variations in paid amounts, both within and between hospitals.
--Among common outpatient procedures, heart electrophysiology studies were reported to have the highest median paid amount at $36,900.
--Among common inpatient procedures, heart valve replacement surgeries were reported to have the highest median paid amount at $84,700.
--Among common diagnostic and imaging services, nuclear medicine evaluations of the cardiovascular system were reported to have the highest median paid amount at $2,200.
--The procedure with the largest increase in median paid amount from 2014 was coronary bypass surgeries, increasing by $8,700.
--The procedure with the largest percent increase in median paid amount from 2014 was guidance procedures for radiation therapy, increasing 80 percent.

This is the second year OHA has released this report and this year's report includes important updates and improvements.

Reimbursement for a procedure in a hospital depends on a number of factors. These factors should be taken into account when comparing charges between facilities. Here are some reasons that account for variations:

--Rate negotiation: Each hospital negotiates with each insurance provider they accept for the reimbursement rate for a procedure. This paid amount will vary depending on the hospital and the insurance company.
--Case complexity: An insurance company may reimburse a hospital within a range of amounts for a given procedure up to a predetermined maximum. This range is influenced by how sick the patient is, and how many extra services were required in order to perform the procedure.
--Geographic factors: A hospital's location influences paid amounts. Communities with higher costs of living have higher salary, lease, and utilities costs. These differences in hospital operating expenses should be considered when comparing paid amounts.
--Economies of scale: Hospital volume influences the paid amount. Hospitals that perform the procedure hundreds of times will often accept a lower paid amount for each case because they make the difference up in larger volumes.

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July 20, 2017

What: The regular monthly public meeting of the Medicaid Advisory Committee

When: Wednesday, July 26, 2017 from 9:00 a.m. to noon

Where: Oregon State Library, 250 Winter Street NE, Room 102, Salem. The meeting will also be available via webinar. A recording of the meeting will be posted at the Medicaid Advisory Committee's website http://www.oregon.gov/oha/HPA/HP-MAC/Pages/index.aspx

Members of the public can also call in to listen at:
Conference line: 1-888-398-2342 Access code: 3732275 Webinar: https://attendee.gotowebinar.com/register/4662689441953504004

Agenda: The MAC will hear a summary of the 2017 legislative session. Staff from the Department of Human Services and the Oregon Health Authority will update the committee on Integrated Eligibility efforts. The MAC will discuss and potentially finalize draft guiding principles for Oregon Medicaid (in response to federal Medicaid proposals). Carly Hood from the Oregon Primary Care Association will present an overview on social determinants of health.

The meeting site is accessible to people with disabilities. To request alternate formats, sign language interpreters, physical accessibility, or other reasonable accommodations, call the Oregon Health Authority at 1-800-282-8096 at least 48 hours before the meeting.

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July 19, 2017

What: The Tobacco Reduction Advisory Committee is holding a public meeting.

Agenda: Legislative session debrief; proposed TPEP budget overview; TPEP public comment

When: Thursday, July 27, 1-3 p.m.

Where: Portland State Office Building, 800 NE Oregon St., Room 1C, in Portland.

Background: The Tobacco Reduction Advisory Committee is a committee appointed by the Governor and comprised of both private organizations and state agencies dedicated to the reduction of the harmful impact of Oregonians' tobacco use.

Details: The meeting is open to the public. Please note that space is limited.

Individuals requiring accommodation may request alternate formats, sign language interpreters, physical accessibility, or other reasonable accommodations by calling the Oregon Health Authority at 1-800-282-8096 at least 48 hours before the meeting.

July 19, 2017

PORTLAND, Ore.--The Oregon Health Authority today announced the expansion of a youth marijuana use prevention campaign to a statewide audience.

That expansion will begin immediately. The goal of the Stay True to You campaign is to prevent or delay the initiation of marijuana use among Oregon's 12- to 20-year-old population.

In 2016, the Oregon Legislature instructed OHA to evaluate the effectiveness of youth marijuana prevention messaging by conducting a geographically limited pilot. That campaign lasted from June 2016 to June 2017 and took place in the Portland metro area, and Jackson and Josephine counties. RMC Research, an independent evaluation firm, found that the pilot campaign successfully raised awareness of the legal consequences of underage marijuana use and contributed to a correct perception that only 1 in 5 Oregon teens use marijuana.

"Research shows that our audience was receptive to the Stay True to You campaign," said Kati Moseley, policy specialist at OHA's Public Health Division. "With this expansion, youth and young adults statewide will hear the message that marijuana use should be delayed until adulthood or avoided entirely."

OHA developed the Stay True to You campaign using extensive audience research and focus groups. Twenty-eight focus groups were conducted in Portland, Bend, Medford and Pendleton featuring 260 youth and young adults between 14 and 20 years old. Participants from the African American, Asian and Pacific Islander, white, American Indian/Alaskan native and Latino communities were included. DHM Research (Davis, Hibbitts, & Midghall Inc.), contracted by OHA to facilitate all focus groups, conducted groups in English and Spanish between October 2015 and March 2016.

"Our focus group research showed youth and young adults are eager for more information on the effects of marijuana use," Moseley said. "Though research into marijuana use isn't as extensive as that on alcohol or tobacco, there is sufficient evidence that using marijuana can have a significant effect on developing brains."

The facts cited in the campaign on brain development and marijuana's effects on learning are based on reviews of the current science by OHA's Retail Marijuana Scientific Advisory Committee.

OHA's role following the legalization of marijuana is to educate the public about the health issues related to marijuana use; prevent youth marijuana use; and monitor marijuana use, attitudes and health effects. OHA will publish final research results of the pilot campaign evaluation late this summer.

The statewide campaign will advertise across a variety of media, but the bulk of advertising will take place on digital and streaming video to most effectively reach the youth audience. Other campaign elements include a social media presence (#StayTrueOregon), a website (StayTrueToYou.org) and promotions and outreach to organizations where youth gather.

July 17, 2017

Reduced blue-green algae and toxin levels confirmed in areas except Perry South Cove, where continued caution recommended

The Oregon Health Authority has updated the health advisory issued June 30 for Lake Billy Chinook, located about 12 miles west of Madras in Jefferson County.
The update lifts the advisory on those areas of the Deschutes and Crooked River of Lake Billy Chinook arms affected by the advisory, and confines the advisory on the Metolius Arm to Perry South Cove.
Water monitoring has confirmed that the level of blue-green algae toxins are below guideline values for human exposure. However, OHA recommends that people remain cautious when using the lake, particularly with pets because toxins are still well above the very low exposure levels established for dogs.
Oregon health officials advise recreational visitors to always be alert to signs of algae blooms in all Oregon waters, because only a fraction of the many lakes and waterways in Oregon are sampled for blue-green algae by state, federal and local agencies. People and their pets should avoid areas where the water is foamy, scummy, thick like paint, pea-green, blue-green or brownish red in color, if a thick mat of blue-green algae is visible in the water, or bright green cells are suspended in the water column. If you observe these signs in the water you are encouraged to avoid activities that cause you to swallow water or inhale droplets, such as swimming or high-speed water activities.

For health information, to report human or pet illnesses due to blooms, or to ask questions about a news release, contact the Oregon Health Authority at 971-673-0400. For information about advisories issued or lifted for the season, contact the Oregon Public Health toll-free information line at 1-877-290-6767 or visit the Harmful Algae Blooms website at http://healthoregon.org/hab and select "Algae Bloom Advisories."
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July 17, 2017

What: OHA and the State Health Assessment Steering Committee will hold an informational webinar.

Agenda: Provide an overview of public health modernization; review findings from the 2016 public health modernization assessment; discuss how understanding of Oregon's public health system can be used to inform the state health assessment.

When: Monday, July 31, 2-4 p.m. The meeting is open to the public. A 10-minute public comment period is at 3:50 p.m.; comments are limited to three minutes.

Where: Join the webinar at: https://attendee.gotowebinar.com/register/762040006992861187 . For audio dial the conference call line: 1-877-848-7030, access code 2030826#.

Oregon's revised State Health Assessment is one of three prerequisites for public health accreditation. The assessment describes the health of the population and identifies areas for improvement, contributing factors that impact health outcomes, and assets and resources that can be mobilized to improve population health.

See the following reference documents:
--Public health modernization at http://www.healthoregon.org/modernization
--2016 public health modernization assessment at http://www.oregon.gov/oha/PH/ABOUT/TASKFORCE/Documents/PHModernizationFullDetailedReport.pdf
--State Health Assessment at http://www.oregon.gov/oha/PH/ABOUT/Pages/state-health-assessment.aspx

Program contact: Christy Hudson, 971-673-2284, Christy.j.hudson@state.or.us

July 14, 2017

What: The monthly public meeting of the Public Health Advisory Board (PHAB)

Agenda: Hear an update on AIMHI grant activities; adopt "Guiding Principles for Public Health and Health Care Collaboration"; discuss state health improvement plan priorities for oral health and suicide prevention; hear an update from PHAB Incentives and Funding Subcommittee; discuss public health modernization implementation in 2017-19.

When: Thursday, July 20, 2:30-5:30 p.m. A 15-minute public comment period is at 5:15 p.m.; comments are limited to three minutes.

Where: Portland State Office Building, Room 1A, 800 NE Oregon St., Portland. A conference call line is available at 877-873-8017, access code 767068. A live-stream is also available at: https://www.youtube.com/watch?v=QyDRFUS4JsU


Oregon's Public Health Advisory Board provides guidance for Oregon's governmental public health system and oversees the implementation of public health modernization and Oregon's State Health Improvement Plan.

Program contact: Cara Biddlecom, 971-673-2284, cara.m.biddlecom@state.or.us

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Public Health Advisory Board website: http://www.oregon.gov/oha/ph/About/Pages/ophab.aspx

July 14, 2017

What: The second public meeting of the Public Health Administrative Rules Workgroup on local public health authority, subcontracting of services

Agenda: Understand purpose and goals for administrative rules workgroup; discuss concepts for rules related to local public health authority, subcontracting of public health services and relinquishment.

When: Monday, July 31, 1-3 p.m. A 15-minute public comment period is at 2:45 p.m.; comments are limited to three minutes.

Where: Portland State Office Building, 800 NE Oregon St, Room 918; Portland. You can also join by webinar at https://attendee.gotowebinar.com/register/5083473647741392131. A conference call line is also provided at 877-873-8017, access code 767068#.

Background: The Public Health Administrative Rules Workgroup on local public health authority, subcontracting of services, and relinquishment is holding its second meeting to help inform the public health rules advisory committee to modernize the public health system. An agenda and updated materials will be posted one week before the meeting on the Public Health Division Public Health Modernization website at http://www.healthoregon.org/modernization/.

For more information, see the following reference documents:
-- Oregon Revised Statutes, Chapter 431 at https://www.oregonlegislature.gov/bills_laws/ors/ors431.html
-- HB 2310 Enrolled at https://olis.leg.state.or.us/liz/2017R1/Downloads/MeasureDocument/HB2310/Enrolled

Program contact: Danna Drum, 971-673-1223, danna.k.drum@state.or.us

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What: The monthly public conference meeting of the Conference of Local Health Officials

Agenda: CLHO subcommittee structure proposal; public health modernization funding and scope of work; public health modernization rulemaking update; update on public health modernization process measures work with CLHO subcommittees; OHA and local public health updates.

When: Thursday, July 20, 9:30 a.m. to noon. The meeting is open to the public. No conference call option is available for the public.

Where: Portland State Office Building, Room 1E, 800 NE Oregon Street, Portland

The Conference of Local Health Officials provides recommendations to the Oregon Health Authority on the foundational capabilities and programs and any other public health program or activity under ORS 431.147 (ORS 431.340)

Program contact: Danna Drum, 971-673-1223, danna.k.drum@state.or.us

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July 11, 2017

Oregon CCOs continue to advance health system transformation by focusing on better care and better health outcomes while controlling health care costs.

That's the takeaway from two reports on the performance and stability of Oregon's coordinated care organizations (CCOs) released today by the Oregon Health Authority (OHA): the Oregon Health System Transformation Quarterly Legislative report and the CCO Metrics report.

"Oregon's CCO model is continuing to lead the nation in providing Oregon Health Plan members with better health outcomes through patient-centered coordinated care while controlling costs with a 3.4 percent cost growth cap," said Jon Collins, health analytics director for the Oregon Health Authority. "These reports show that our focus on value and outcomes as well as our focus on accountability is continuing to advance health reforms that improve the lives of Oregonians."

*Oregon Health System Transformation Quarterly Legislative Report*

The 2016 fourth-quarter legislative report details the state's health system transformation efforts including an update on the Oregon Health Plan demographics, a report on efforts to reduce health disparity, CCO financial information, and an update on eligibility and enrollment efforts.

Key features of the report include:

-- A breakdown of the Medicaid expansion population that has been added to OHP through the Affordable Care Act including where they live, their employment status and the services they use.
-- A new CCO incentive measure beginning in 2018 that is aimed at addressing health disparities. Emergency department (ED) use has been declining in Oregon since 2011; however, CCO members with severe and persistent mental illness (SPMI) use the ED at more than double the rate of members overall. Therefore, in January 2017 the Metrics and Scoring Committee elected to add ED use among members with SPMI as an incentive measure to address this health disparity. This ties funding to CCO performance, creating more incentive for CCOs to improve outcomes.
-- Information about the Behavioral Health Collaborative recommendations and plans to begin transforming the behavioral health system in Oregon.
-- An update on the financial performance of Oregon's CCOs. On a statewide basis, CCO operating and total margins have been trending downward from their peak in 2014. This stabilization in margins is expected and while the margins are down since 2015, the overall financial health of Oregon's CCOs remains strong.

More information about the quarterly legislative report can be found on the OHA website at http://www.oregon.gov/oha/HPA/ANALYTICS/Documents/Legislative-Report-Q4-2016.pdf.

*2016 CCO Metrics Report*

The 2016 CCO Metrics Report details Oregon's pay-for-performance program in which OHA created a quality pool from a percentage of monthly CCO payments to reward performance. To earn their full incentive payment, CCOs have to meet benchmarks or improvement targets on at least 13 of the 18 measures and have at least 60 percent of their members enrolled in a patient-centered primary care home.

The quality pool model rewards CCOs for the quality of care provided to Medicaid members. This model increasingly rewards CCOs for outcomes, rather than use of services, and is one of several key health system transformation mechanisms for achieving Oregon's vision for better health, better care, and lower costs.

As CCOs made large strides on existing measures in the first few years of the program, the aspirational benchmarks, often based on the most exceptional national performance, require focused, sustained efforts to improve quality and be successful on the measures.

This report's results demonstrate that as the quality pool model continues, the targets and benchmarks become even harder to meet or exceed. This ensures that CCOs continue to focus on metrics and strive toward improvement and better health outcomes for members.

The quality pool amount increased to 4.25 percent of monthly payments in 2016, for a total of almost $179 million. While all CCOs showed improvement on a majority of measures, only seven earned 100 percent of their quality pool dollars.

The results from the quality pool model are demonstrating that this is not just another program to pay CCOs for service, but to accelerate CCOs' performance and improve the health outcomes of members.

For a detailed report of the CCO metrics and how much each CCO earned through the pay-for-performance program check out the full report at http://www.oregon.gov/oha/HPA/ANALYTICS-MTX/Documents/CCO-Metrics-2016-Final-Report.pdf.

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Links in this release
Quarterly legislative report: http://www.oregon.gov/oha/HPA/ANALYTICS/Documents/Legislative-Report-Q4-2016.pdf
CCO metrics report: http://www.oregon.gov/oha/HPA/ANALYTICS-MTX/Documents/CCO-Metrics-2016-Final-Report.pdf

July 7, 2017

What: A public meeting of the Public Health Administrative Rules Workgroup on local public health authority, subcontracting of services, and relinquishment

Agenda: Understand purpose and goals for administrative rules workgroup; discuss concepts for rules related to local public health authority, subcontracting of public health services and relinquishment.

When: Wednesday, July 12, 1-3 p.m. A 15-minute public comment period is at 2:45 p.m.; comments are limited to three minutes.

Where: Portland State Office Building, 800 NE Oregon St, Room 1D, Portland. You can also join by webinar at https://register.gotowebinar.com/register/36699882886878211. A conference call line is also provided at 877-873-8017, access code 767068#.

Background: The Public Health Administrative Rules Workgroup on local public health authority, subcontracting of services, and relinquishment is holding its first meeting to help inform the public health rules advisory committee to modernize the public health system. See the following reference documents:

-- Oregon Revised Statutes, Chapter 431 at https://www.oregonlegislature.gov/bills_laws/ors/ors431.html

-- HB 2310 B-Engrossed at https://olis.leg.state.or.us/liz/2017R1/Downloads/MeasureDocument/HB2310/B-Engrossed

Program contact: Danna Drum, 971-673-1223, danna.k.drum@state.or.us

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July 10, 2017

Today the Oregon Health Authority (OHA) released two reports related to the performance and stability of Oregon's hospitals. Oregon's hospitals are focusing on improving patient safety and the quality of care they provide, according to the third annual report of OHA's Hospital Transformation Performance Program (HTPP).

OHA also released the Q4 2016 Oregon hospital financial report, which highlights that while the fourth quarter of 2016 was a turbulent quarter with lower operating and total margins, the overall margins for 2016 continue to remain higher than typically observed before the implementation of the Affordable Care Act (ACA).

The hospital financial report demonstrates that Oregon hospitals continue to stabilize from the high levels seen in the aftermath of the ACA. However, net patient revenue continues to see steady increases and charity care remains low after a sharp drop from 2013 to 2014. Overall, Oregon hospitals remain financially strong heading into the future.

"The reports released today give OHA insights into how Oregon's hospitals are performing on key measures and their financial strength," said Lynne Saxton, OHA Director. "They are also an important element of our commitment to increased transparency and accountability as we continue to make progress toward better health, better care, and lower costs for all Oregonians."

*Hospital Transformation Performance Program*

The HTPP report covers the program's third year, October 2015 through September 2016. OHA requires hospitals to submit data on 11 measures or "metrics" that include goals such as reducing health care-associated infections, reducing readmissions of patients after discharge, improving medication safety, improving overall patient experience, and screening for alcohol and substance use.

The health authority's Hospital Metrics Advisory Committee developed the HTPP measures in coordination with the Centers for Medicare & Medicaid Services. The 11 measures cover six areas, including two that focus on collaboration between hospitals and coordinated care organizations (sharing information about emergency department visits with primary care providers, and behavioral health). Hospitals are scored on whether they meet benchmarks or make progress toward them as measured against baselines set in the latest performance year.

This year $87 million in "quality pool" dollars, funded by the Hospital Provider Assessment Program, is awarded to hospitals based on their performance on these measures.

The quality pool funds are paid in two phases. Each participating hospital can receive a lump sum of $500,000 by achieving at least 75 percent of the measures for which it is eligible. Thirteen hospitals achieved this, resulting in $6.5 million in payments to hospitals in phase one.

The second phase of the quality pool payments is in the form of proportional awards to hospitals for meeting the individual benchmarks or making progress toward them. All 28 participating hospitals received some payment, and Legacy Mount Hood became the first hospital to meet the target on all 11 measures.

The HTPP program covers the state's "DRG" hospitals. Those are hospitals that are paid per patient by the state Medicaid program based on a patient's diagnosis or diagnosis-related group (DRG) rather than for every service performed.

The full reports are available online:
-- Hospital Transformation Performance Program report: http://www.oregon.gov/oha/HPA/ANALYTICS-MTX/Documents/HTTP-Year-3-Report.pdf
-- Q4 2016 Hospital Financial report: http://www.oregon.gov/oha/HPA/ANALYTICS/HospitalReporting/Hospital-Quarterly-Report-2016-Q4.pdf

More information about the Hospital Transformation Performance Program is available on the OHA website at http://www.oregon.gov/oha/analytics/Pages/Hospital-Baseline-Data.aspx, or by contacting Jon Collins, PhD, director of the OHA Office of Health Analytics, at 503-945-6429 or jon.c.collins@state.or.us.

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July 6, 2017

Program contact: Jacee Vangestel, 503-945-2852, jacee.m.vangestel@state.or.us

What: Public meeting of the Oregon State Hospital Advisory Board

When: Thursday, July 13, 1-5 p.m.

Where: Oregon State Hospital, 2600 Center Street NE, Salem, in the Callen Conference Room. The public also can attend via toll-free conference line at 888-278-0296, participant code 4294893.

Agenda: Topics will include public comment, the grievance process, community integration, the Psychiatric Security Review Board and updates on the following: 2017-19 budget, continued operation of the Junction City campus, recruitment for the new superintendent, state legislation, the Peer Advisory Council, data reports, and the Aid and Assist population.

Details: The Oregon State Hospital Advisory Board advises the superintendent, Oregon Health Authority Director and legislators on issues related to the safety, security and care of patients. Members include consumers, providers, advocates, legislators, community members, consumer families and OSH union members.

The meeting site is accessible to people with disabilities. To request alternate formats, sign language interpreters, physical accessibility, or other reasonable accommodations, call Oregon State Hospital at 503-945-2852 at least 48 hours before the meeting.

For more information, see the board's website at http://www.oregon.gov/oha/osh/Pages/advisory-board.aspx.

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July 6, 2017

The Oregon Health Authority (OHA) announced today that CareOregon will build a care coordination model for American Indian/Alaska Native members in the Oregon Health Plan (OHP) fee-for-service program. It will do this in coordination with all nine federally recognized Native American tribes in Oregon and the Native American Rehabilitation Association of the Northwest, Inc. (NARA).

In 2016 all nine federally recognized tribes in Oregon asked OHA to coordinate with CareOregon to develop a culturally appropriate, statewide program of care coordination services for tribal members on OHP. This care coordination program would not only be specific to tribal member needs, but it would engage directly with each tribes' own health care clinics and systems of care.

Leaders from the nine tribes and NARA worked directly with OHA and CareOregon to develop a new care coordination contract. Starting August 1, American Indian/Alaska Native OHP members on fee-for-service will begin working with CareOregon for their care coordination needs.

"We feel very honored to have been chosen by the tribes to provide care coordination services, and we take seriously the responsibility of developing with members of the tribes a culturally responsive program that meets the unique needs of the Native American population in Oregon," said Eric C. Hunter, CareOregon's CEO and president.

Care coordination is hands-on member engagement that helps OHP members with chronic or acute illnesses access health care services and navigate health care options.

"Through care coordination, we bring individual members, their providers, specialists and community resources together into a unified whole to help them overcome the barriers to health," said Amit Shah, CareOregon's chief medical officer.

Culturally responsive care is a key element in Oregon's health system transformation to help provide OHP members with better care, better health and lower costs.

"This is an important step forward in providing quality health care that incorporates and respects the needs of Oregon's tribal members," said Julie Johnson, OHA Tribal Affairs director. "OHA was pleased to help make this partnership with CareOregon and the Oregon tribes a reality."

"All of Oregon's nine tribes and NARA have been working together to ensure all Native Americans in Oregon receive the highest quality health care. This helps in that effort," said Caroline Cruz, health and human services manager for the Confederated Tribes of Warm Springs.

"We appreciate the efforts of the state in recognizing and addressing the health care needs of Native Americans," said Sharon Stanphill, health operations officer, Cow Creek Band of Umpqua Tribe of Indians. "This will assist with continuity of care at our tribal facilities and help ensure access to health care for Native Americans in Oregon."

Even though CareOregon will soon provide care coordination services for American Indians/Alaska Natives on the OHP fee-for-service program, no one will have to change clinics or providers. CareOregon will work with tribal health leaders to help tribal members:
-- Get timely appointments with a doctor, specialist, or other providers
-- Find a specialty provider
-- Get the equipment, supplies, or services they need through the Oregon Health Plan
-- Coordinate care among patients, doctors, other providers, community support agencies, tribal health center and social service organizations
-- Connect users to other resources in their community.

For more information about care coordination or the services that CareOregon provides, call 503-416-4100 or 800-224-4840.

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July 6, 2017

What: The first meeting of the State Health Assessment Steering Committee

Agenda: Complete phases 1 and 2 of the Mobilizing for Action through Planning and Partnerships (MAPP) process; familiarize committee members with MAPP process and purpose of the assessment; define core elements of the assessment's vision and values; form subcommittees and identify process for community involvement

When: Wednesday, July 12, 9 a.m. to 2 p.m. The meeting is open to the public. A 10-minute public comment period is at 1:45 p.m.; comments are limited to three minutes.

Where: Portland State Office Building, Room 918, 800 NE Oregon St., Portland. Join the webinar at https://attendee.gotowebinar.com/register/8429710842570583554

Background: Oregon's revised State Health Assessment is one of three prerequisites for public health accreditation. The assessment describes the health of the population, identifies areas for improvement, contributing factors that affect health outcomes, and assets and resources that can be mobilized to improve population health.

-- Health departments are required to participate in or lead an assessment process at least once every five years. This assessment will inform the next version of the State Health Improvement Plan (SHIP). Read more about the SHIP at http://www.oregon.gov/oha/PH/ABOUT/Pages/HealthImprovement.aspx.
-- The Public Health Division will use the Mobilizing for Action through Planning and Partnerships (MAPP) framework, widely used by coordinated care organizations (CCOs) and local health departments. The MAPP framework uses six phases. The SHA is developed over the first three phases, and the SHIP is implemented over the second three phases. Get more details: SHA Overview (pdf) at http://www.oregon.gov/oha/PH/ABOUT/Documents/sha/State-Health-Assessment-overview.pdf.
-- The previous State Health Assessment was completed in 2012. It consisted of the Public Health Division System Assessment (pdf), available at http://www.oregon.gov/oha/PH/ABOUT/Documents/ph-system-assessment-report.pdf, and the State Health Profile (pdf) available at http://www.oregon.gov/OHA/PH/ABOUT/Documents/oregon-state-health-profile.pdf.

Program contact: Christy Hudson, 971-673-2284, christy.j.hudson@state.or.us

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July 6, 2017

What: A public meeting of the Incentives and Funding Subcommittee of the Public Health Advisory Board (PHAB)

Agenda: Receive update on conclusion of 2017 legislative session; discuss whether changes are needed to PHAB recommendations for the allocation of public health modernization funding; prepare for August subcommittee meeting

When: Tuesday, June 11, 1-2 p.m. A five-minute public comment period is at 1:40 p.m.; comments are limited to two minutes.

Where: Join the webinar at https://attendee.gotowebinar.com/register/1017967828287751171. A conference call line is also provided at 877-873-8017, access code 767068#.

Background: Oregon's Public Health Advisory Board provides guidance for Oregon's governmental public health system and oversees the implementation of public health modernization and Oregon's State Health Improvement Plan. The Incentives and Funding Subcommittee develops recommendations for the board's consideration.

Program contact: Sara Beaudrault, 971-673-0432, sara.beaudrault@state.or.us

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Public Health Advisory Board website: http://www.oregon.gov/oha/ph/About/Pages/ophab.aspx

July 5, 2017

Contact: Jeff Scroggin, 541-999-6983, jeffrey.scroggin@state.or.us (meeting information or accommodations)

What: The monthly public meeting of the Oregon Health Policy Board

When: Tuesday, July 11, 8:30 a.m. to noon

Where: OHSU Center for Health & Healing, 3303 SW Bond Ave., third floor, room 4, Portland. The meeting will also be available via live web-stream. A link to the live-stream and a recording of the meeting will be posted on the board's meeting page at http://www.oregon.gov/OHA/OHPB/Pages/OHPB-Meetings.aspx. Members of the public can also listen to the meeting by calling 888-808-6929, participant code 915042#.

Agenda:
-- OHA Director's report
-- OHPB committee updates
-- Federal health policy update
-- 2017 legislative session update
-- Public testimony
-- Health System Transformation Metrics report
-- Hospital Transformation Metrics report
-- Health System Transformation Quarterly Legislative Report

For more information on the meeting, visit the board's meeting page at http://www.oregon.gov/OHA/OHPB/Pages/OHPB-Meetings.aspx.

The meeting site is accessible to people with disabilities. To request alternate formats, sign language interpreters, physical accessibility, or other reasonable accommodations, call the Oregon Health Authority at 800-282-8096 at least 48 hours before the meeting.

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June 30, 2017

*High toxin levels found in Lake County lake*

A health advisory was issued today for Drews Reservoir, located 15 miles west of the town of Lakeview in Lake County.

Water monitoring has confirmed the presence of blue-green algae and the toxins they produce in Drews Reservoir. These toxin concentrations can be harmful to humans and animals.

People should avoid swallowing water while swimming or inhaling water droplets as a result of high-speed water activities, such as water skiing or power boating, in areas where blooms are identified. Although toxins are not absorbed through the skin, people who have skin sensitivities may experience a puffy, red rash at the affected area.

Drinking water directly from Drews Reservoir at this time is especially dangerous. Oregon public health officials advise campers and other recreational visitors that toxins cannot be removed by boiling, filtering or treating water with camping-style filters.

People who draw in-home water directly from the affected area are advised to use an alternative water source because private treatment systems are not proven effective for removing algae toxins. However, public drinking water systems can reduce algae toxins through proper filtration and disinfection. If people connected to public water systems have questions about treatment and testing, they should contact their water supplier. If community members have questions about water available at nearby campgrounds, they should contact campground management.

Oregon health officials recommend that those who choose to eat fish from waters where algae blooms are present remove all fat, skin and organs before cooking, as toxins are more likely to collect in these tissues. Fillets should also be rinsed with clean water. Public health officials also advise people to not eat freshwater clams or mussels from Drews Reservoir and that Oregon Department of Fish and Wildlife regulations do not allow the harvest of these shellfish from freshwater sources. Crayfish muscle can be eaten, but internal organs and liquid fat should be discarded.

Exposure to toxins can produce a variety of symptoms including numbness, tingling and dizziness that can lead to difficulty breathing or heart problems, and require immediate medical attention. Symptoms of skin irritation, weakness, diarrhea, nausea, cramps and fainting should also receive medical attention if they persist or worsen. Children and pets are at increased risk for exposure because of their size and level of activity. People who bring their pets to Drews Reservoir for recreation activities should take special precautions to keep them from drinking from or swimming in the lake.

The advisory will be lifted when the concern no longer exists.

With proper precautions to avoid activities during which water can be ingested, people are encouraged to visit Drews Reservoir and enjoy activities such as canoeing, fishing, camping, hiking, biking, picnicking, and bird watching. Boating is safe as long as speeds do not create excessive water spray. Although inhalation risk is much lower than ingestion, it can present a risk.

For health information or to report an illness, contact the Oregon Health Authority (OHA) at 971-673-0400. For campground or lake information call the local management agency.

OHA maintains an updated list of all health advisories on its website. To learn if an advisory has been issued or lifted for a specific water body, visit the Harmful Algae Blooms website at http://www.healthoregon.org/hab and select "algae bloom advisories," or call the Oregon Public Health Division toll-free information line at 1-877-290-6767.

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LBC-Scum3.png

June 30, 2017

*High toxin levels found in Jefferson County lake*

A health advisory was issued today for Lake Billy Chinook, located about 12 miles west of Madras in Jefferson County. Advisory boundaries are different for each arm of the lake. The boundaries are as follows:

-- The Metolius River Arm--From Perry South Campground to the northern tip of Chinook Island.
-- The Deschutes River Arm--All areas in and around Cove Palisades State Park, the day use areas and boat docks.
-- The Crooked River Arm--All areas in and around the Jefferson County day use area past Cove Palisades Resort and Marina to the confluence of the Deschutes River Arm.

Water monitoring conducted by Jefferson County in several areas of Lake Billy Chinook managed by the county and state have confirmed the presence of blue-green algae and the toxins they produce. These toxin concentrations can be harmful to humans and animals. The portion of the advisory for Perry South Campground, owned and managed by the U. S. Forest Service, is based on visible scum identified by Forest Service staff; visible scum is considered a reason for issuing an advisory, pending toxin results, to protect public health.

People should avoid swallowing water while swimming or inhaling water droplets as a result of high-speed water activities, such as water skiing or power boating, in areas where blooms are identified. Although toxins are not absorbed through the skin, people who have skin sensitivities may experience a puffy, red rash at the affected area.

Drinking water directly from these areas of Lake Billy Chinook at this time is especially dangerous. Oregon public health officials advise campers and other recreational visitors that toxins cannot be removed by boiling, filtering or treating water with camping-style filters.

People who draw in-home water directly from the affected area are advised to use an alternative water source because private treatment systems are not proven effective for removing algae toxins. However, public drinking water systems can reduce algae toxins through proper filtration and disinfection. If people connected to public water systems have questions about treatment and testing, they should contact their water supplier. If community members have questions about water available at nearby campgrounds or day use areas, they should contact campground management.

Oregon health officials recommend that those who choose to eat fish from waters where algae blooms are present remove all fat, skin and organs before cooking, as toxins are more likely to collect in these tissues. Fillets should also be rinsed with clean water. Public health officials also advise people to not eat freshwater clams or mussels from Lake Billy Chinook and that Oregon Department of Fish and Wildlife regulations do not allow the harvest of these shellfish from freshwater sources. Crayfish muscle can be eaten, but internal organs and liquid fat should be discarded.

Exposure to toxins can produce a variety of symptoms including numbness, tingling and dizziness that can lead to difficulty breathing or heart problems, and require immediate medical attention. Symptoms of skin irritation, weakness, diarrhea, nausea, cramps and fainting should also receive medical attention if they persist or worsen. Children and pets are at increased risk for exposure because of their size and level of activity. People who bring their pets to these areas of Lake Billy Chinook for recreation activities should take special precautions to keep them from drinking from or swimming in these areas.

The advisory will be lifted when the concern no longer exists.

With proper precautions to avoid activities during which water can be ingested, people are encouraged to visit these areas of Lake Billy Chinook and enjoy activities such as canoeing, fishing, camping, hiking, biking, picnicking, and bird watching. Boating is safe as long as speeds do not create excessive water spray. Although inhalation risk is much lower than ingestion, it can present a risk.

For health information or to report an illness, contact the Oregon Health Authority (OHA) at 971-673-0400. For campground or lake information call the local management agency.

OHA maintains an updated list of all health advisories on its website. To learn if an advisory has been issued or lifted for a specific water body, visit the Harmful Algae Blooms website at http://www.healthoregon.org/hab and select "algae bloom advisories," or call the Oregon Public Health Division toll-free information line at 1-877-290-6767.

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June 28, 2017

For immediate release

Salem, OR -- The proposal from leadership in the U.S. Senate to repeal the Affordable Care Act (ACA) would cause nearly 440,000 Oregonians to lose health coverage as early as 2021, according to a new analysis from state health policy experts and insurance regulators. As a result, Oregon's uninsured rate would triple from its current level of 5 percent.

In addition, the Senate plan could shift more than $6.2 billion in costs to Oregon taxpayers and the state budget, due to steep cuts in federal Medicaid funding.

While younger Oregonians would likely pay lower premiums for health coverage on the individual commercial market, older people would pay more. On average, consumers would face higher deductibles and copays than they currently pay under the ACA.

Although it is similar to the ACA repeal that passed the U.S. House in May, state analysts found key elements of the Senate's Better Care Reconciliation Act (BCRA) were even harsher on Oregon and other states than the House bill, largely due to steeper Medicaid cuts.

Medicaid is the federal-state program that provides safety net health coverage for low-income and disabled children and adults, as well as working individuals and families close to the poverty line. Today Medicaid covers one in four Oregonians through the Oregon Health Plan (OHP).

Overall, the Senate plan would have far-reaching effects on Oregon:

-- Oregon's uninsured rate could triple by as early as 2021: Like the AHCA, more than 440,000 Oregonians would be at risk to lose health coverage as a result of BCRA. Dramatic reductions in coverage would occur over a longer time period than the House bill, due to a slower phase-out of Medicaid expansion if the state cannot make up for the loss of federal funds.

-- Oregon's budget would face a total $6.2 billion cost shift from 2020 to 2026: By enacting potentially steeper Medicaid reductions than the House bill and phasing out Medicaid expansion, the Senate plan would expose the state to annual costs that would reach a high of $1.8 billion in 2026. To avoid these costs, Oregon would be forced to cut coverage and benefits for individuals and families on OHP (though some cost shifts would be unavoidable).

-- Oregon's economy would lose approximately 23,000 jobs: The Senate plan would eliminate approximately 23,000 health care jobs by 2026 due to its Medicaid funding reductions, Medicaid expansion phase-out and reduced federal provider tax reimbursement.

*Impact on premiums and out-of-pocket health care costs for Oregonians*

Although the Senate plan's approach to premium subsidies differs from the House bill, the net effect will be similar: lower costs for young adults and increasing costs for older adults and low-income enrollees. The Senate plan funds cost-sharing subsidies through 2019 but eliminates them after that time.

*Impact on state budget for the 2017-2019 biennium*

The Senate plan would not have a significant impact on Oregon during the 2017-2019 biennium, because Medicaid cuts, the phase-out of Medicaid expansion and reduced federal reimbursement for provider taxes would begin to take effect in 2020.

However, the Senate bill would eliminate the Prevention and Public Health Fund, effective in 2018. This fund helps Oregon counties address unexpected health emergencies (like the Zika virus), provides immunization to children, prevents teen suicide, and helps prevent chronic diseases.

Oregon Health Authority Director Lynne Saxton said, "The Senate and House bills go far beyond repealing the Affordable Care Act. They fundamentally alter Medicaid, leaving the state exposed to billions of dollars in cost shifts. We encourage our federal partners to work with states like Oregon to maintain coverage, provide better health care and hold down costs through cost-effective innovations like Oregon's coordinated care system."

Department of Consumer and Business Services Director Patrick Allen said, "The Oregon health insurance market has had challenges, and although we have taken steps to stabilize it, there still is much work to do. We are committed to providing Oregonians with access to high-quality, affordable insurance options."

The report was prepared by the Oregon Department of Consumer and Business Services and the Oregon Health Authority. The full report is available at http://www.95percentoregon.com/uploads/9/9/2/6/99265876/bcra-report.pdf.

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June 28, 2017

For immediate release

Who: Director Lynne Saxton, Oregon Health Authority; Insurance Commissioner Laura Cali Robison, Division of Financial Regulation; and Leslie Clement, director, OHA Health Policy and Analytics Division.

What: The Department of Consumer and Business Services and the Oregon Health Authority will issue a report Wednesday detailing the impact of the U.S. Senate's Better Care Reconciliation Act on Oregon. This report will be available to download at http://www.95percentoregon.com/news-and-updates.html.

Leaders from both agencies will be available to answer questions about the law and how it will affect Oregonians, the health insurance market, the Oregon Health Plan, and the state budget.

When: Wednesday, June 28, 2-2:30 p.m.

Where: Via teleconference line. To join, dial 877-336-1828, access code 4001487

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The Division of Financial Regulation is part of the Department of Consumer and Business Services, Oregon's largest business regulatory and consumer protection agency. Visit http://www.dcbs.oregon.gov/ and http://www.insurance.oregon.gov/.