2011-06 OR Issue

Helping communities find the federal funding they need.

OR State EditionThe FundBook

June 2011

www.fundbook.orgp.� ~ The Fundbook - OR | June �011

Health Care Reform in Oregon

With all the drama and intrigue around Federal health care reform, it’s easy to think of it both as political theater in D.C., and some-thing happening in the future -- or not at all. It was passed in 2009 and signed into law in March 2010, with a four year phase-in. Then Congress changed, and the House voted to re-peal it in January 2011, but the Senate voted against the repeal in February. It’s already be-coming an issue, along with Medicare, for the next year’s presidential election.

But, the Patient Protection and Affordable Care Act of 2010 is driving change in Oregon today, as the state and federal agencies pre-pare for its implementation over the next few years. Governor Kitzhaber, who designed the Oregon Health Plan (Medicaid) in 1994 as State Senate president, is encouraging agencies and the legislature to make cost savings through changing practices.

The Affordable Care Act will make numer-ous changes through 2014, as shown by this chart: http://goo.gl/jPUvZ

• Many changes will affect private health insurance and patients ’ rights, but the big three affecting states are: • Accountable Care Organizations,

which take effect in 2012 and will encourage integration of prima-ry, dental and behavioral (mental health and substance abuse treat-ment) care.

• Electronic Health Records, which will start being required in 2012.

• Health Care Exchanges, which will function as group insurance plans for individuals beginning in 2014.

Oregon began addressing the same issues in 2009 with the passage of H.B. 2009, which

created the Oregon Health Authority (OHA), which is consolidating all of state govern-ment’s health-related functions under one roof. It will take over the Oregon Health Plan, Public Health Division, Addictions and Men-tal Health Division, Prescription Program and smaller entities from the Department of Human Services. It will also absorb separate agencies like the Public Employees Benefit Board and Office of Private Health Partner-ships. This transition is well underway and is supposed to be complete by July 2011.

The Oregon legislature is addressing, or considering addressing, two major changes that will be affected by both OHA and the Af-fordable Care Act: Care Organizations and Exchanges.

H.B. 3650, Health System Transformation, would restructure the Oregon Health Author-ity to make the Oregon Health Plan work through Coordinated Care Organizations like HMO’s in serving Medicaid and dual Medicaid/Medicare patients. It is also intended to increase federal Medicaid reimbursement to Oregon, which would offset reduced payments to Med-icaid doctors and reduce. A bipartisan legisla-tive Transformation Committee designed the plan with approval of the leadership, and it is before the joint Ways & Means committee for a cost estimate. It is considered likely to pass as part of the budget. A copy of the bill is available here http://goo.gl/YTZEH and you can track it on this site http://goo.gl/U45li

S.B. 99 would establish a state Health Care Exchange, a semi-public body similar to SAIF, the workman’s compensation board. SB 99 passed the Senate on April 24th, but stalled in the House on May 12th over the issue of whether the exchange could negotiate with insurers for lower prices. It is in the House

The View from Oregon State

Grants Northwest has provided grants services to more than 100 organizations over 20 years, including all types of non-profits, local governments and educational institutions.

Grant Writing: Grants Northwest will help your organization win grants to support your programs and launch new projects. We do this by working with you to develop strong, fundable programs, not just by “writing grants”. The grant development process has five major elements and ideally is a one or two month process.

Teaching and Training: We offer in-depth, hands-on training for nonprofit staff, boards, grantwriters and others interested in learning the information and skills needed for successful grant proposal development. Participants learn practical skills they can use immediately. Workshops, presentations and classes are presented in a variety of formats.

Books: The Grantwriting Beyond the Basics books grew out of my experiences during 20 years as a grants consultant and over 30 years of working with nonprofits. I saw a need for more advanced information for grant professionals—information that goes “beyond the basics.”

Contact UsGrants Northwest1020 SW Taylor, Suite 545Portland, Oregon 97205Phone 503-294-2147Fax [email protected]

www.grantsnorthwest.com

Publisher of the Grantwriting: Beyond the Basics book series

Due to the high degree of principle-client interaction, we specialize in serving only

Oregon-based clients.

www.fundbook.org June �011 | The Fundbook - OR ~ p.�

Grants Northwest has provided grants services to more than 100 organizations over 20 years, including all types of non-profits, local governments and educational institutions.

Grant Writing: Grants Northwest will help your organization win grants to support your programs and launch new projects. We do this by working with you to develop strong, fundable programs, not just by “writing grants”. The grant development process has five major elements and ideally is a one or two month process.

Teaching and Training: We offer in-depth, hands-on training for nonprofit staff, boards, grantwriters and others interested in learning the information and skills needed for successful grant proposal development. Participants learn practical skills they can use immediately. Workshops, presentations and classes are presented in a variety of formats.

Books: The Grantwriting Beyond the Basics books grew out of my experiences during 20 years as a grants consultant and over 30 years of working with nonprofits. I saw a need for more advanced information for grant professionals—information that goes “beyond the basics.”

Contact UsGrants Northwest1020 SW Taylor, Suite 545Portland, Oregon 97205Phone 503-294-2147Fax [email protected]

www.grantsnorthwest.com

Publisher of the Grantwriting: Beyond the Basics book series

Due to the high degree of principle-client interaction, we specialize in serving only

Oregon-based clients.

www.fundbook.orgp.� ~ The Fundbook - OR | June �011

Health Committee and its fate is uncertain. If Oregon does not get an exchange going by early next year, the state could fail to meet deadlines set by the federal Affordable Care Act. The federal government would then im-pose a national health insurance exchange on the state.

So what does it all mean?

• County Governments, which have been responsible for mental health, will be able to negotiate with the Coordinated Care Organizations on mental health coverage. Since many low- income mental health patients aren’t covered by the Oregon Health Plan, there was a concern about their access to services. However, some mental health advocates were disap-pointed, feeling that some counties were not providing adequate care.

• The number of Coordinated Care Or-ganizations will be reduced from the current forty-plus Medicaid managed care plans in Oregon. The state wants to consolidate them, but how many there will be, and whether they will incorporate most of the managed care plans is uncertain.

• H.B. 3650 mandates a move integrat-ed care, which would coordinate pri-mary, dental and behavioral (mental health and substance abuse treatment) health care. While Federally Quali-fied Health Centers (safety net clin-ics) are now required to provide all of these services, they often do so through referrals . It requires coor-dinated care organizations to use a “patient centered primary care home” where a patient’s primary care pro-vider co-ordinates all care, “to the ex-tent practicable” but it ’s unclear how

integrated care would work between what are currently totally separate systems.

• Governor Kitzhaber and the budget office are hoping for $200 million in general fund savings from Transfor-mation, but it depends on several fac-tors including getting federal Medic-aid waivers for some changes.

All of this is part of a larger systemic change brought about by not only the federal Afford-able Care Act, but technology like electronic health records and the rising costs of health care.

For ongoing information and updates on Oregon health care, check out The Lund Re-port: http://www.thelundreport.org/ §

This article was contributed by Michael Wells of Grants Northwest. Grants Northwest is very knowledgable of the grants and funding territory in OR and works with local governments and non-profits on grants-related services there.

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