The Human Services Coalition of Oregon (HSCO) is on record in support of health care expansion for children and low income individuals and families. Our support for these expansions was stated in the 2007 session, and in the 2009 session, HSCO joined with the SAFE Coalition in a statement that includes the following:
Sustainable: We must rein in the skyrocketing cost of health care to help ensure economic security for all Oregonians and Oregon businesses.
Available: We must create a healthy community by covering all people living in Oregon starting with expanding access to cover all children and more low income adults, as we reduce health disparities.
Funded: We must maximize the two-to-one match for Oregon's dollars from federal funds to expand our capacity to meet these goals.
Effective: We must ensure accountability and fairness, focus on treatments that are proven safe, effective and improve health outcomes, and cut waste in the current health care maze.
SAFE and HSCO support covering 80,000 more children, and 100,000 low income individuals and families.The negotiated funding mechanism for expansion now appears to be completed, and the funding, as well as the expansion populations, are contained in HB 2116. Meanwhile, a House Bill (HB 2009) and a Senate Bill (SB 856) that deal with structure and reform issues have moved out of committee to Ways and Means. As we understand it, HB 2009 will be the vehicle for the structural changes and reform efforts this session.
While HSCO fully supports expansion and the SAFE principles, we believe that the creation of the Oregon Health Authority (OHA), deserves greater discussion and scrutiny. OHA is a recommendation of the Oregon Health Fund Board, and advocates generally recognize the value that will be gained by greater efficiencies, as well as integrated health care planning, and program and policy coordination. However, we believe it is important to raise a number of issues that must be considered in moving major elements around, and eventually out of, the Department of Human Services (DHS.) These include, but are not limited to the following:
- First and foremost, the test of this innovation is to ensure that the creation of the OHA will improve services for DHS clients;
- Internal and external stakeholders, including HSCO, must be involved in planning for the creation of OHA and the form and content of the remainder of DHS;
- The investments necessary to create OHA must not come at the expense of the remainder of DHS;
- Assuming an independent OHA, the relationship with the remainder of DHS must be delineated on issues ranging from: the governance of DHS; consumer and advocacy access and involvement; budget processes, including rebalance and reshoot functions; partnerships with local government and the provider network; policy coordination; eligibility functions; Medicaid authority and the division of acute and long term care responsibilities and administration; information technology; transformation activities; and more. In fact planning activities, involving all stakeholders, should identify, flag, and work through all of these critical issues.
HSCO believes it is possible to make great progress this session in covering more Oregonians while working toward a comprehensive and affordable health care system. Broad involvement in the implementation of the changes enacted this session will help ensure that we accomplish the SAFE goals and protect the other important programs and services that serve low income and vulnerable Oregonians.
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