ORS 413.017
Public Health Benefit Purchasers Committee, Health Care Workforce Committee, Health Plan Quality Metrics Committee and Behavioral Health Committee


(1)

The Oregon Health Policy Board shall establish the committees described in subsections (2) to (5) of this section.

(2)

Intentionally left blank —Ed.

(a)

The Public Health Benefit Purchasers Committee shall include individuals who purchase health care for the following:

(A)

The Public Employees’ Benefit Board.

(B)

The Oregon Educators Benefit Board.

(C)

Trustees of the Public Employees Retirement System.

(D)

A city government.

(E)

A county government.

(F)

A special district.

(G)

Any private nonprofit organization that receives the majority of its funding from the state and requests to participate on the committee.

(b)

The Public Health Benefit Purchasers Committee shall:

(A)

Identify and make specific recommendations to achieve uniformity across all public health benefit plan designs based on the best available clinical evidence, recognized best practices for health promotion and disease management, demonstrated cost-effectiveness and shared demographics among the enrollees within the pools covered by the benefit plans.

(B)

Develop an action plan for ongoing collaboration to implement the benefit design alignment described in subparagraph (A) of this paragraph and shall leverage purchasing to achieve benefit uniformity if practicable.

(C)

Continuously review and report to the Oregon Health Policy Board on the committee’s progress in aligning benefits while minimizing the cost shift to individual purchasers of insurance without shifting costs to the private sector or the health insurance exchange.

(c)

The Oregon Health Policy Board shall work with the Public Health Benefit Purchasers Committee to identify uniform provisions for state and local public contracts for health benefit plans that achieve maximum quality and cost outcomes. The board shall collaborate with the committee to develop steps to implement joint contract provisions. The committee shall identify a schedule for the implementation of contract changes. The process for implementation of joint contract provisions must include a review process to protect against unintended cost shifts to enrollees or agencies.

(3)

Intentionally left blank —Ed.

(a)

The Health Care Workforce Committee shall include individuals who have the collective expertise, knowledge and experience in a broad range of health professions, health care education and health care workforce development initiatives.

(b)

The Health Care Workforce Committee shall coordinate efforts to recruit and educate health care professionals and retain a quality workforce to meet the demand that will be created by the expansion in health care coverage, system transformations and an increasingly diverse population.

(c)

The Health Care Workforce Committee shall conduct an inventory of all grants and other state resources available for addressing the need to expand the health care workforce to meet the needs of Oregonians for health care.

(4)

Intentionally left blank —Ed.

(a)

The Health Plan Quality Metrics Committee shall include the following members appointed by the Oregon Health Policy Board:

(A)

An individual representing the Oregon Health Authority;

(B)

An individual representing the Oregon Educators Benefit Board;

(C)

An individual representing the Public Employees’ Benefit Board;

(D)

An individual representing the Department of Consumer and Business Services;

(E)

Two health care providers;

(F)

One individual representing hospitals;

(G)

One individual representing insurers, large employers or multiple employer welfare arrangements;

(H)

Two individuals representing health care consumers;

(I)

Two individuals representing coordinated care organizations;

(J)

One individual with expertise in health care research;

(K)

One individual with expertise in health care quality measures; and

(L)

One individual with expertise in mental health and addiction services.

(b)

The committee shall work collaboratively with the Oregon Educators Benefit Board, the Public Employees’ Benefit Board, the authority and the department to adopt health outcome and quality measures that are focused on specific goals and provide value to the state, employers, insurers, health care providers and consumers. The committee shall be the single body to align health outcome and quality measures used in this state with the requirements of health care data reporting to ensure that the measures and requirements are coordinated, evidence-based and focused on a long term statewide vision.

(c)

The committee shall use a public process that includes an opportunity for public comment to identify health outcome and quality measures that may be applied to services provided by coordinated care organizations or paid for by health benefit plans sold through the health insurance exchange or offered by the Oregon Educators Benefit Board or the Public Employees’ Benefit Board. The authority, the department, the Oregon Educators Benefit Board and the Public Employees’ Benefit Board are not required to adopt all of the health outcome and quality measures identified by the committee but may not adopt any health outcome and quality measures that are different from the measures identified by the committee. The measures must take into account the recommendations of the metrics and scoring subcommittee created in ORS 414.638 (Metrics and scoring subcommittee) and the differences in the populations served by coordinated care organizations and by commercial insurers.

(d)

In identifying health outcome and quality measures, the committee shall prioritize measures that:

(A)

Utilize existing state and national health outcome and quality measures, including measures adopted by the Centers for Medicare and Medicaid Services, that have been adopted or endorsed by other state or national organizations and have a relevant state or national benchmark;

(B)

Given the context in which each measure is applied, are not prone to random variations based on the size of the denominator;

(C)

Utilize existing data systems, to the extent practicable, for reporting the measures to minimize redundant reporting and undue burden on the state, health benefit plans and health care providers;

(D)

Can be meaningfully adopted for a minimum of three years;

(E)

Use a common format in the collection of the data and facilitate the public reporting of the data; and

(F)

Can be reported in a timely manner and without significant delay so that the most current and actionable data is available.

(e)

The committee shall evaluate on a regular and ongoing basis the health outcome and quality measures adopted under this section.

(f)

The committee may convene subcommittees to focus on gaining expertise in particular areas such as data collection, health care research and mental health and substance use disorders in order to aid the committee in the development of health outcome and quality measures. A subcommittee may include stakeholders and staff from the authority, the Department of Human Services, the Department of Consumer and Business Services, the Early Learning Council or any other agency staff with the appropriate expertise in the issues addressed by the subcommittee.

(g)

This subsection does not prevent the authority, the Department of Consumer and Business Services, commercial insurers, the Public Employees’ Benefit Board or the Oregon Educators Benefit Board from establishing programs that provide financial incentives to providers for meeting specific health outcome and quality measures adopted by the committee.

(5)

Intentionally left blank —Ed.

(a)

The Behavioral Health Committee shall include the following members appointed by the Director of the Oregon Health Authority:

(A)

The chairperson of the Health Plan Quality Metrics Committee;

(B)

The chairperson of the committee appointed by the board to address health equity, if any;

(C)

A behavioral health director for a coordinated care organization;

(D)

A representative of a community mental health program;

(E)

An individual with expertise in data analysis;

(F)

A member of the Consumer Advisory Council, established under ORS 430.073 (Consumer Advisory Council), that represents adults with mental illness;

(G)

A representative of the System of Care Advisory Council established in ORS 418.978 (System of Care Advisory Council);

(H)

A member of the Oversight and Accountability Council, described in ORS 430.389 (Council to oversee and approve grants and funding to Behavioral Health Resource Networks and other entities to increase access to treatment and services), who represents adults with addictions or co-occurring conditions;

(I)

One member representing a system of care, as defined in ORS 418.976 (Definitions for ORS 418.976 to 418.981);

(J)

One consumer representative;

(K)

One representative of a tribal government;

(L)

One representative of an organization that advocates on behalf of individuals with intellectual or developmental disabilities;

(M)

One representative of providers of behavioral health services;

(N)

The director of the division of the authority responsible for behavioral health services, as a nonvoting member;

(O)

The Director of the Alcohol and Drug Policy Commission appointed under ORS 430.220 (Director), as a nonvoting member;

(P)

The authority’s Medicaid director, as a nonvoting member;

(Q)

A representative of the Department of Human Services, as a nonvoting member; and

(R)

Any other member that the director deems appropriate.

(b)

The board may modify the membership of the committee as needed.

(c)

The division of the authority responsible for behavioral health services and the director of the division shall staff the committee.

(d)

The committee, in collaboration with the Health Plan Quality Metrics Committee, as needed, shall:

(A)

Establish quality metrics for behavioral health services provided by coordinated care organizations, health care providers, counties and other government entities; and

(B)

Establish incentives to improve the quality of behavioral health services.

(e)

The quality metrics and incentives shall be designed to:

(A)

Improve timely access to behavioral health care;

(B)

Reduce hospitalizations;

(C)

Reduce overdoses;

(D)

Improve the integration of physical and behavioral health care; and

(E)

Ensure individuals are supported in the least restrictive environment that meets their behavioral health needs.

(6)

Members of the committees described in subsections (2) to (5) of this section who are not members of the Oregon Health Policy Board are not entitled to compensation but shall be reimbursed from funds available to the board for actual and necessary travel and other expenses incurred by them by their attendance at committee meetings, in the manner and amount provided in ORS 292.495 (Compensation and expenses of members of state boards and commissions). [2009 c.595 §7; 2015 c.3 §43; 2015 c.389 §2; 2019 c.3 §1; 2021 c.667 §16]

Source: Section 413.017 — Public Health Benefit Purchasers Committee, Health Care Workforce Committee, Health Plan Quality Metrics Committee and Behavioral Health Committee, https://www.­oregonlegislature.­gov/bills_laws/ors/ors413.­html.

413.006
Establishment of Oregon Health Policy Board
413.007
Composition of board
413.008
Chairperson
413.011
Duties of board
413.014
Rules
413.016
Authority of board to establish advisory and technical committees
413.017
Public Health Benefit Purchasers Committee, Health Care Workforce Committee, Health Plan Quality Metrics Committee and Behavioral Health Committee
413.032
Establishment of Oregon Health Authority
413.033
Oregon Health Authority director
413.034
Oregon Health Authority officers and employees
413.036
Use of abuse and neglect reports for screening subject individuals
413.037
Administering oaths
413.038
Service of notice by regular mail
413.041
Persons authorized to represent parties in contested cases
413.042
Rules
413.046
Right to courteous, fair and dignified treatment
413.071
Authorization to request federal waivers
413.072
Public process required if waiver of federal requirement involves policy change
413.083
Dental director
413.084
State School Nursing Consultant
413.085
Cross-delegation by directors of Department of Human Services, Department of Consumer and Business Services and Oregon Health Authority
413.101
Oregon Health Authority Fund
413.105
Deposit of reimbursements received for medical assistance expenditures
413.109
Acceptance and expenditures of funds received from private sources
413.121
Oregon Health Authority Special Checking Account
413.125
Revolving fund
413.129
Aggregation of warrants and payments
413.135
Combining and eliminating accounts
413.151
Setoff of liquidated and delinquent debts
413.161
Collection of data on race, ethnicity, language, disability status, sexual orientation and gender identity
413.162
Reports to Legislative Assembly on collection of data under ORS 413.161
413.163
System for collecting data on race, ethnicity, language, disability, sexual orientation and gender identity
413.164
Collection and reporting of data by health care providers and insurers
413.166
Grants for data collection
413.167
Reports to Legislative Assembly
413.171
Sharing of data with Department of Human Services
413.175
Prohibition on disclosure of information
413.181
Disclosure of insurer information by Department of Consumer and Business Services for purpose of administering Oregon Integrated and Coordinated Care Delivery System
413.195
Disclosure of information about cremated or reduced remains
413.196
Confidentiality and inadmissibility of information obtained in connection with epidemiologic morbidity and mortality studies
413.201
Targeted outreach for Cover All People program
413.223
School-based health centers
413.225
Grants to safety net providers
413.227
Oregon Health Authority reimbursement of coordinated care organization’s costs to provide services related to improving student access to school-based oral health services
413.231
Recruitment of primary care providers
413.234
Supplemental payments to emergency services providers
413.235
Emergency services intergovernmental transfer program
413.236
Coordinated care organization reimbursement of emergency medical services providers
413.246
Information provided to retired physicians and health care providers
413.248
Physician Visa Waiver Program
413.250
Statewide Health Improvement Program
413.255
Cooperative research and demonstration projects for health and health care purposes
413.256
Regional health equity coalitions
413.257
Experimental, prototype health care of tomorrow
413.259
Patient centered primary care home program and behavioral health home program
413.260
Patient centered primary care and behavioral health home delivery models
413.270
Advisory council
413.271
Palliative care information and resources
413.273
Palliative care for patients and residents of hospitals, long term care facilities and residential care facilities
413.300
Definitions for ORS 413.300 to 413.308, 413.310 and ORS chapter 414
413.301
Health Information Technology Oversight Council
413.303
Council chairperson
413.308
Duties of council
413.310
Oregon Health Information Technology program
413.430
Functions of Director of Oregon Health Authority regarding health professionals
413.435
Administrative requirements for students in clinical training
413.450
Continuing education in cultural competency
413.500
Women, Infants and Children Program
413.520
Gambling addiction programs in Oregon Health Authority
413.522
Problem Gambling Treatment Fund
413.550
Definitions for ORS 413.550 to 413.559
413.552
Legislative findings and policy on health care interpreters
413.554
Oregon Council on Health Care Interpreters
413.556
Testing, qualification and certification standards for health care interpreters
413.558
Procedures for testing, qualifications and certification of health care interpreters
413.559
Requirement for provider to work with health care interpreter from registry
413.560
Moneys received credited to account in Oregon Health Authority Fund
413.561
Agencies or boards with enforcement authority
413.562
State of Oregon as employer of health care interpreters for purposes of collective bargaining only
413.563
Requirement for interpretation service company to use health care interpreters from registry
413.570
Pain Management Commission
413.572
Additional duties of commission
413.574
Membership of commission
413.576
Selection of chairperson and vice chairperson
413.580
Pain Management Fund
413.582
Acceptance of contributions
413.590
Pain management education required of certain licensed health care professionals
413.599
Rules
413.600
Traditional Health Workers Commission
413.610
Purpose of Compact of Free Association Premium Assistance Program
413.611
Definitions
413.612
Eligibility for program
413.613
COFA Premium Assistance Program Fund
413.800
Emergency planning
Green check means up to date. Up to date