74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 3909
Senate Bill 3
Sponsored by Senators MONNES ANDERSON, CARTER; Senators AVAKIAN,
BATES, BROWN, BURDICK, COURTNEY, DECKERT, DEVLIN, GORDLY,
JOHNSON, METSGER, MONROE, MORRISETTE, PROZANSKI, VERGER,
WALKER, WESTLUND
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Creates Oregon Healthy Kids Program, which includes private
health option to provide health care coverage to children.
Imposes duties on Department of Human Services and Office of
Private Health Partnerships to carry out program.
Creates grant program in Office of Private Health Partnerships
to fund outreach, enrollment and retention activities related to
Oregon Healthy Kids Program.
Establishes Private Health Option Program Account.
Continuously appropriates moneys in account to Office of Private
Health Partnerships for purposes of administering private health
option.
Establishes Oregon Healthy Kids Program Fund. Continuously
appropriates moneys in fund to Department of Human Services for
purposes of Oregon Healthy Kids Program.
Establishes Healthy Kids Safety Net Fund. Continuously
appropriates moneys in fund to Department of Human Services for
grants to community health centers and safety net clinics.
Allocates cigarette and other tobacco products taxes imposed by
Oregon Constitution.
Takes effect only if Senate Joint Resolution 4 (2007) is
approved by people. Takes effect on effective date of proposed
constitutional amendment.
A BILL FOR AN ACT
Relating to health; creating new provisions; amending ORS
323.455, 323.457, 323.505, 414.025, 414.725, 414.839, 442.507,
735.701, 735.710 and 735.754; appropriating money; and
prescribing an effective date.
Be It Enacted by the People of the State of Oregon:
{ +
OREGON HEALTHY KIDS PROGRAM + }
SECTION 1. { + Sections 2 and 3 of this 2007 Act are added to
and made a part of ORS chapter 414. + }
SECTION 2. { + (1) The Oregon Healthy Kids Program is created
to provide health care coverage for Oregon's children. The
program is composed of:
(a) Medical assistance administered by the Department of Human
Services provided to children under the state programs funded by
Title XIX of the Social Security Act, under the Children's Health
Insurance Program funded by Title XXI of the Social Security Act
and under state programs funded by the Legislative Assembly;
(b) A private health option administered by the Office of
Private Health Partnerships under sections 8 and 9 of this 2007
Act;
(c) A statewide Healthy Kids Advice Line; and
(d) A statewide Healthy Kids Healthcare Access Line.
(2) A child or a person authorized to act on behalf of a child
may apply to the Department of Human Services for a determination
of the child's eligibility for the Oregon Healthy Kids Program.
(3) When an application is received by the department under
subsection (2) of this section, the department shall determine
whether the child is eligible for medical assistance. The
department shall enroll an eligible child in an appropriate
medical assistance program referred to in subsection (1) of this
section.
(4) If the department determines that a child for whom
application has been made under subsection (2) of this section is
not eligible for medical assistance but is eligible for
enrollment in the private health option, the department shall
transfer the application to the Office of Private Health
Partnerships to complete the enrollment process.
(5) The Department of Human Services and the Office of Private
Health Partnerships shall streamline and simplify the application
process for the Oregon Healthy Kids Program, by means including
the development and implementation of an online application
process for the program.
(6) Notwithstanding subsection (5) of this section, the
department shall adopt verification requirements to ensure that
recipients of benefits in the Oregon Healthy Kids Program are
legal residents. + }
SECTION 3. { + (1)(a) Except as provided in subsection (2) of
this section, to be eligible for the private health option under
sections 8 and 9 of this 2007 Act or for the Children's Health
Insurance Program funded by Title XXI of the Social Security Act,
a child must be uninsured for a minimum of 60 consecutive days
immediately preceding enrollment.
(b) As used in this subsection, 'uninsured' means that a person
is not enrolled in an unsubsidized or privately funded health
benefit plan.
(2) The Department of Human Services may adopt rules specifying
exceptions to the requirement in subsection (1) of this section.
(3) A child is eligible for enrollment in the Children's Health
Insurance Program only if the household income of the child's
family is no more than 200 percent of the federal poverty
guidelines.
(4) The department shall adopt rules for annually renewing
enrollment in the Oregon Healthy Kids Program. + }
SECTION 4. ORS 414.025 is amended to read:
414.025. As used in this chapter, unless the context or a
specially applicable statutory definition requires otherwise:
(1) 'Category of aid' means assistance provided by the Oregon
Supplemental Income Program, temporary assistance for needy
families granted under ORS 418.035 to 418.125 or federal
Supplemental Security Income payments.
(2) 'Categorically needy' means, insofar as funds are available
for the category, a person who is a resident of this state and
who:
(a) Is receiving a category of aid.
(b) Would be eligible for, but is not receiving a category of
aid.
(c) Is in a medical facility and, if the person left such
facility, would be eligible for a category of aid.
(d) Is under the age of 21 years and would be a dependent child
under the program for temporary assistance for needy families
except for age and regular attendance in school or in a course of
professional or technical training.
(e)(A) Is a caretaker relative named in ORS 418.035 (2)(a)(C)
who cares for a dependent child who would be a dependent child
under the program for temporary assistance for needy families
except for age and regular attendance in school or in a course of
professional or technical training; or
(B) Is the spouse of such caretaker relative and fulfills the
requirements of ORS 418.035 (1).
(f) Is under the age of 21 years, is in a foster family home or
licensed child-caring agency or institution under a purchase of
care agreement and is one for whom a public agency of this state
is assuming financial responsibility, in whole or in part.
(g) Is a spouse of an individual receiving a category of aid
and who is living with the recipient of a category of aid, whose
needs and income are taken into account in determining the cash
needs of the recipient of a category of aid, and who is
determined by the Department of Human Services to be essential to
the well-being of the recipient of a category of aid.
(h) Is a caretaker relative named in ORS 418.035 (2)(a)(C) who
cares for a dependent child receiving temporary assistance for
needy families or is the spouse of such caretaker relative and
fulfills the requirements of ORS 418.035 (1).
(i) Is under the age of 21 years, is in a youth care center and
is one for whom a public agency of this state is assuming
financial responsibility, in whole or in part.
(j) Is under the age of 21 years and is in an intermediate care
facility which includes institutions for the mentally retarded;
or is under the age of 22 years and is in a psychiatric hospital.
(k) Is under the age of 21 years and is in an independent
living situation with all or part of the maintenance cost paid by
the Department of Human Services.
(L) Is a member of a family that received temporary assistance
for needy families in at least three of the six months
immediately preceding the month in which such family became
ineligible for such assistance because of increased hours of or
increased income from employment. As long as the member of the
family is employed, such families will continue to be eligible
for medical assistance for a period of at least six calendar
months beginning with the month in which such family became
ineligible for assistance because of increased hours of
employment or increased earnings.
(m) Is an adopted person under 21 years of age for whom a
public agency is assuming financial responsibility in whole or in
part.
(n) Is an individual or is a member of a group who is required
by federal law to be included in the state's medical assistance
program in order for that program to qualify for federal funds.
(o) Is an individual or member of a group who, subject to the
rules of the department and within available funds, may
optionally be included in the state's medical assistance program
under federal law and regulations concerning the availability of
federal funds for the expenses of that individual or group.
(p) Is a pregnant woman who would be eligible for temporary
assistance for needy families including such aid based on the
unemployment of a parent, whether or not the woman is eligible
for cash assistance.
(q) Would be eligible for temporary assistance for needy
families pursuant to 42 U.S.C. 607 based upon the unemployment of
a parent, whether or not the state provides cash assistance.
(r) Except as otherwise provided in this section and to the
extent of available funds, is a pregnant woman or child for whom
federal financial participation is available under Title XIX
{ + or Title XXI + } of the federal Social Security Act.
(s) Is not otherwise categorically needy and is not eligible
for care under Title XVIII of the federal Social Security Act or
is not a full-time student in a post-secondary education program
as defined by the Department of Human Services by rule, but whose
family income is less than the federal poverty level and whose
family investments and savings equal less than the investments
and savings limit established by the department by rule.
{ + (3) 'Health benefit plan' has the meaning given that term
in ORS 735.720. + }
{ - (3) - } { + (4) + } 'Income' has the meaning given that
term in ORS 411.704.
{ - (4) - } { + (5) + } 'Investments and savings' means
cash, securities as defined in ORS 59.015, negotiable instruments
as defined in ORS 73.0104 and such similar investments or savings
as the Department of Human Services may establish by rule that
are available to the applicant or recipient to contribute toward
meeting the needs of the applicant or recipient.
{ - (5) - } { + (6) + } 'Medical assistance' means so much
of the following medical and remedial care and services as may be
prescribed by the Department of Human Services according to the
standards established pursuant to ORS 414.065, including payments
made for services provided under an insurance or other
contractual arrangement and money paid directly to the recipient
for the purchase of medical care:
(a) Inpatient hospital services, other than services in an
institution for mental diseases;
(b) Outpatient hospital services;
(c) Other laboratory and X-ray services;
(d) Skilled nursing facility services, other than services in
an institution for mental diseases;
(e) Physicians' services, whether furnished in the office, the
patient's home, a hospital, a skilled nursing facility or
elsewhere;
(f) Medical care, or any other type of remedial care recognized
under state law, furnished by licensed practitioners within the
scope of their practice as defined by state law;
(g) Home health care services;
(h) Private duty nursing services;
(i) Clinic services;
(j) Dental services;
(k) Physical therapy and related services;
(L) Prescribed drugs, including those dispensed and
administered as provided under ORS chapter 689;
(m) Dentures and prosthetic devices; and eyeglasses prescribed
by a physician skilled in diseases of the eye or by an
optometrist, whichever the individual may select;
(n) Other diagnostic, screening, preventive and rehabilitative
services;
(o) Inpatient hospital services, skilled nursing facility
services and intermediate care facility services for individuals
65 years of age or over in an institution for mental diseases;
(p) Any other medical care, and any other type of remedial care
recognized under state law;
(q) Periodic screening and diagnosis of individuals under the
age of 21 years to ascertain their physical or mental
impairments, and such health care, treatment and other measures
to correct or ameliorate impairments and chronic conditions
discovered thereby;
(r) Inpatient hospital services for individuals under 22 years
of age in an institution for mental diseases; and
(s) Hospice services.
{ - (6) - } { + (7) + } 'Medical assistance' includes any
care or services for any individual who is a patient in a medical
institution or any care or services for any individual who has
attained 65 years of age or is under 22 years of age, and who is
a patient in a private or public institution for mental diseases.
' Medical assistance' includes 'health services' as defined in
ORS 414.705. 'Medical assistance' does not include care or
services for an inmate in a nonmedical public institution.
{ - (7) - } { + (8) + } 'Medically needy' means a person
who is a resident of this state and who is considered eligible
under federal law for medically needy assistance.
{ - (8) - } { + (9) + } 'Resources' has the meaning given
that term in ORS 411.704. For eligibility purposes, 'resources'
does not include charitable contributions raised by a community
to assist with medical expenses.
SECTION 5. ORS 414.725 is amended to read:
414.725. (1)(a) Pursuant to rules adopted by the Department of
Human Services, the department shall execute prepaid managed care
health services contracts for health services funded by the
Legislative Assembly. The contract must require that all services
are provided to the extent and scope of the Health Services
Commission's report for each service provided under the contract.
The contracts are not subject to ORS chapters 279A and 279B,
except ORS 279A.250 to 279A.290 and 279B.235. Notwithstanding ORS
414.720 (8), the rules adopted by the department shall establish
timelines for executing the contracts described in this
paragraph.
(b) It is the intent of ORS 414.705 to 414.750 that the state
use, to the greatest extent possible, prepaid managed care health
services organizations to provide physical health, dental, mental
health and chemical dependency services under ORS 414.705 to
414.750.
(c) The department shall solicit qualified providers or plans
to be reimbursed for providing the covered services. The
contracts may be with hospitals and medical organizations, health
maintenance organizations, managed health care plans and any
other qualified public or private prepaid managed care health
services organization. The department may not discriminate
against any contractors that offer services within their
providers' lawful scopes of practice.
(2) The department may institute a fee-for-service case
management system or a fee-for-service payment system for the
same physical health, dental, mental health or chemical
dependency services provided under the health services contracts
for persons eligible for health services under ORS 414.705 to
414.750 in designated areas of the state in which a prepaid
managed care health services organization is not able to assign
an enrollee to a person or entity that is primarily responsible
for coordinating the physical health, dental, mental health or
chemical dependency services provided to the enrollee. In
addition, the department may make other special arrangements as
necessary to increase the interest of providers in participation
in the state's managed care system, including but not limited to
the provision of stop-loss insurance for providers wishing to
limit the amount of risk they wish to underwrite.
(3) As provided in subsections (1) and (2) of this section, the
aggregate expenditures by the department for health services
provided pursuant to ORS 414.705 to 414.750 may not exceed the
total dollars appropriated for health services under ORS 414.705
to 414.750.
(4) Actions taken by providers, potential providers,
contractors and bidders in specific accordance with ORS 414.705
to 414.750 in forming consortiums or in otherwise entering into
contracts to provide health care services shall be performed
pursuant to state supervision and shall be considered to be
conducted at the direction of this state, shall be considered to
be lawful trade practices and may not be considered to be the
transaction of insurance for purposes of the Insurance Code.
(5) Health care providers contracting to provide services under
ORS 414.705 to 414.750 shall advise a patient of any service,
treatment or test that is medically necessary but not covered
under the contract if an ordinarily careful practitioner in the
same or similar community would do so under the same or similar
circumstances.
(6) A prepaid managed care health services organization shall
provide information on contacting available providers to an
enrollee in writing within 30 days of assignment to the health
services organization.
(7) Each prepaid managed care health services organization
shall provide upon the request of an enrollee or prospective
enrollee annual summaries of the organization's aggregate data
regarding:
(a) Grievances and appeals; and
(b) Availability and accessibility of services provided to
enrollees.
(8) A prepaid managed care health services organization may not
limit enrollment in a designated area based on the zip code of an
enrollee or prospective enrollee.
{ + (9)(a) Notwithstanding subsection (2) of this section, a
prepaid managed care health services organization shall reimburse
a qualified community health center or safety net clinic for a
contracted service provided by the center or clinic to an
enrollee of the organization participating in the Oregon Healthy
Kids Program. The department by rule shall adopt standards for
qualifying community health centers and safety net clinics for
reimbursement under this subsection.
(b) As used in this subsection, 'community health center or
safety net clinic' means a nonprofit medical clinic that provides
primary physical health, vision, dental or mental health services
to low-income patients without charge or using a sliding fee
scale based on the income of the patient. 'Community health
center or safety net clinic' includes a school-based clinic. + }
SECTION 6. ORS 414.839 is amended to read:
414.839. (1) Subject to funds available, the Department of
Human Services may provide public subsidies for the purchase of
health insurance coverage { - provided by public programs or
private insurance, including but not limited to - } { + in + }
the Family Health Insurance Assistance Program, for currently
uninsured individuals
{ - based on - } { + whose + } incomes { - up to - } { +
are not more than + } 200 percent of the federal poverty
{ - level - } { + guidelines + }. The objective is to create a
transition from dependence on public programs to privately
financed health insurance.
(2) Public subsidies shall apply only to health benefit plans
that meet or exceed the basic benchmark health benefit plan or
plans established under ORS 735.733.
(3) Cost-sharing shall be permitted and structured in such a
manner to encourage appropriate use of preventive care and
avoidance of unnecessary services.
(4) Cost-sharing shall be based on an individual's ability to
pay and may not exceed the cost of purchasing a plan.
(5) The state may pay a portion of the cost of the subsidy,
based on the individual's income and other resources.
SECTION 7. { + Sections 8 to 13 of this 2007 Act are added to
and made a part of ORS chapter 735. + }
SECTION 8. { + (1) The Office of Private Health Partnerships
shall administer a private health option to expand private health
care coverage for Oregon's children.
(2) The office shall contract with carriers to provide health
benefit plans approved under section 9 of this 2007 Act. The
office will manage the collection and payment of premiums for
children participating in the plans.
(3) The office shall provide a subsidy for a health benefit
plan provided pursuant to a contract entered into under this
section for a child whose family's household income is more than
200 percent but no more than 300 percent of the federal poverty
guidelines. The amount of the subsidy shall be determined in
accordance with subsection (4) of this section and is payable to
the carrier in the manner specified by the contract.
(4) The office shall adopt rules for determining the subsidies
to be paid under this section based upon the following factors:
(a) Household income;
(b) Family size; and
(c) Other factors established by the office.
(5) The office shall adopt rules under which families with
household incomes that are more than 300 percent of the federal
poverty guidelines may purchase health benefit plans offered
through the private health option.
(6) As used in this section and section 9 of this 2007 Act:
(a) 'Carrier' has the meaning given that term in ORS 735.700.
(b) 'Child' means a person under 19 years of age.
(c) 'Health benefit plan' has the meaning given that term in
ORS 735.720. + }
SECTION 9. { + (1) The Office of Private Health Partnerships
must approve health benefit plans offered through the private
health option described in section 8 of this 2007 Act. To be
approved, health benefit plans must offer benefit packages
comparable to those provided under section 2 (1)(a) of this 2007
Act and must cover mental health, vision and dental services.
(2) Approved health benefit plans may impose copayments or
co-insurance amounts that are based upon a family's ability to
pay as determined according to criteria adopted by the office by
rule.
(3) Approved health benefit plans may not exclude coverage of
pre-existing conditions. + }
SECTION 10. { + (1) The Office of Private Health Partnerships
is responsible for marketing the Oregon Healthy Kids Program
statewide, as well as coordinating, with the Department of Human
Services, statewide enrollment training and outreach.
(2) In addition to the duties described in subsection (1) of
this section, to maximize the enrollment and retention of
eligible children in the Oregon Healthy Kids Program, the office
shall develop and administer a grant program to provide funding
to organizations and local groups for outreach and enrollment
activities. The department and the office shall collaborate in
developing and administering the grant program.
(3) The criteria for awarding grants under subsection (2) of
this section shall include, but are not limited to, the extent to
which a grantee offers:
(a) Information and assistance to a diverse geographic area or
a culturally diverse community in this state, including
communities that need the information and assistance provided in
alternative formats and in languages other than English;
(b) Assistance with the application process; and
(c) Assistance to individuals and families in enrolling and
maintaining enrollment in the Oregon Healthy Kids Program. + }
SECTION 11. { + Notwithstanding eligibility criteria and
subsidy amounts determined pursuant to section 8 of this 2007
Act, subsidies under the private health option shall be provided
to eligible children to the extent the Legislative Assembly
appropriates funds for that purpose or establishes expenditure
limitations to provide such subsidies. + }
SECTION 12. { + There is established in the State Treasury,
separate and distinct from the General Fund, the Private Health
Option Program Account, which shall consist of moneys
appropriated to the account by the Legislative Assembly and all
moneys transferred as reimbursements to the account by the
Department of Human Services under section 14 of this 2007 Act.
All moneys in the Private Health Option Program Account are
continuously appropriated to the Office of Private Health
Partnerships to carry out the provisions of sections 8, 9 and 10
of this 2007 Act. + }
SECTION 13. { + (1) Except as otherwise provided in this
section and ORS 735.710, the Office of Private Health
Partnerships and the Department of Human Services may not
disclose information provided as part of an application for
enrollment in the Oregon Healthy Kids Program except for purposes
directly connected with the administration of the program.
(2) The office and the department may exchange applicant
information with other state and federal agencies for the
purposes of determining eligibility for and administering the
Oregon Healthy Kids Program, identifying economic trends relevant
to administration of the program and providing the report
required by section 16 of this 2007 Act.
(3) In accordance with applicable state and federal law, the
office or the department may request that applicants provide
their Social Security numbers and may use those numbers in the
administration of the Oregon Healthy Kids Program. + }
SECTION 14. { + (1) The Department of Human Services shall
apply to the Centers for Medicare and Medicaid Services for the
waivers necessary to implement sections 2, 3, 8, 9 and 10 of this
2007 Act and to obtain federal financial participation for health
care coverage provided to children through the Oregon Healthy
Kids Program.
(2) The department shall adopt rules implementing sections 2
and 3 of this 2007 Act as soon as practicable after receipt of
the necessary waivers. The Office of Private Health Partnerships
shall adopt rules implementing sections 8, 9 and 10 of this 2007
Act as soon as practicable after receipt of the necessary
waivers.
(3) The office and the department shall work cooperatively to
obtain federal financial participation under subsection (1) of
this section.
(4) The office and the department shall develop a system for
reimbursement by the department to the office for costs
associated with administering the private health option. + }
SECTION 15. { + (1) The Oregon Healthy Kids Program Fund is
established in the State Treasury, separate and distinct from the
General Fund. Interest earned by the Oregon Healthy Kids Program
Fund shall be credited to the fund.
(2) Moneys in the Oregon Healthy Kids Program Fund are
continuously appropriated to the Department of Human Services for
purposes of the Oregon Healthy Kids Program created by section 2
of this 2007 Act.
(3) Notwithstanding subsection (2) of this section, if and to
the extent that the Legislative Assembly determines that the
Oregon Healthy Kids Program is fully funded, moneys in the Oregon
Healthy Kids Program Fund established by this section may be
used, in amounts determined by the Legislative Assembly, to fund
other health services provided by the department. + }
SECTION 16. { + The Office for Oregon Health Policy and
Research shall analyze and evaluate the implementation of the
Oregon Healthy Kids Program and report its findings to the
Legislative Assembly every two years in the manner provided by
ORS 192.245. The report shall include at least the following
information for the preceding two-year period:
(1) An estimate of the number of children who are eligible for
but not enrolled in the program;
(2) The number of children enrolled in the program;
(3) The number of children disenrolled from the program and the
reasons for disenrollment;
(4) A description of any identified barriers to enrolling or
maintaining enrollment of children in the program and a
description of the plans developed by the office and the
Department of Human Services to overcome the barriers; and
(5) An estimate of the number of families who have voluntarily
discontinued employer-sponsored dependent health coverage and
enrolled their children in the program. + }
SECTION 17. ORS 735.701 is amended to read:
735.701. (1) The Office of Private Health Partnerships is
established.
(2) The office shall carry out the duties described under ORS
414.831, 735.700 to 735.714 and 735.720 to 735.740 { + and
sections 2, 8, 9 and 10 of this 2007 Act + }.
SECTION 18. ORS 735.710 is amended to read:
735.710. (1) In carrying out its duties under ORS 735.700 to
735.714 and 735.720 to 735.740 { + and sections 2, 8, 9 and 10
of this 2007 Act + }, the Office of Private Health Partnerships
may:
(a) Enter into contracts for administration of ORS 735.700 to
735.714 and 735.720 to 735.740 { + and sections 2, 8, 9 and 10
of this 2007 Act + }, including collection of premiums and paying
carriers.
(b) Retain consultants and employ staff.
(c) Enter into contracts with carriers or health care providers
for health benefit plans.
(d) Set premium rates for eligible employees and small
employers.
(e) Perform other duties to provide low-cost health benefit
plans of types likely to be purchased by small employers.
(f) Establish contributions to be paid by small employers
toward the premiums incurred on behalf of covered eligible
employees.
(g) Establish procedures by rule for the publication or release
of aggregate data relating to:
(A) Applicants for enrollment and persons enrolled in the
Family Health Insurance Assistance Program;
(B) Health benefit plans for small employers offered by the
office; and
(C) Other programs operated by the office.
(2) Notwithstanding any other health benefit plan contracted
for and offered by the office, the office shall contract for a
health benefit plan or plans best designed to meet the needs and
provide for the welfare of eligible employees and small
employers.
(3) The office may approve more than one carrier for each type
of plan contracted for and offered, but the number of carriers
shall be held to a number consistent with adequate service to
eligible employees and family members.
(4) Where appropriate for a contracted and offered health
benefit plan, the office shall provide options under which an
eligible employee may arrange coverage for family members of the
employee.
(5) In developing any health benefit plan, the office may
provide an option of additional coverage for eligible employees
and family members at an additional cost or premium.
(6) Transfer of enrollment from one health benefit plan to
another shall be open to all eligible employees and family
members under rules adopted by the office.
(7) If the office requests less health care service or benefit
than is otherwise required by state law, a carrier is not
required to offer such service or benefit.
(8) The office may contract for and offer health benefit plans
for small employers that provide a sufficient level of benefits
to be eligible for a subsidy under ORS 735.724 as well as health
benefit plans for small employers that are not eligible for a
subsidy under ORS 735.724.
(9) The office may employ whatever means are reasonably
necessary to carry out the purposes of ORS 735.700 to 735.714 and
735.720 to 735.740 { + and sections 2, 8, 9 and 10 of this 2007
Act + }. Such authority includes but is not limited to authority
to seek clarification, amendment, modification, suspension or
termination of any agreement or contract that in the office's
judgment requires such action.
SECTION 19. ORS 735.710, as amended by section 8, chapter 742,
Oregon Laws 2003, section 4, chapter 238, Oregon Laws 2005,
section 4, chapter 262, Oregon Laws 2005, section 4, chapter 727,
Oregon Laws 2005, and section 20, chapter 744, Oregon Laws 2005,
is amended to read:
735.710. (1) In carrying out its duties under ORS 735.700 to
735.714 and 735.720 to 735.740 { + and sections 2, 8, 9 and 10
of this 2007 Act + }, the Office of Private Health Partnerships
shall:
(a) Enter into contracts for administration of ORS 735.700 to
735.714 and 735.720 to 735.740 { + and sections 2, 8, 9 and 10
of this 2007 Act + }, including collection of premiums and paying
carriers.
(b) Retain consultants and employ staff.
(c) Enter into contracts with carriers or health care providers
for health benefit plans, including contracts where final payment
may be reduced if usage is below a level fixed in the contract.
(d) Set premium rates for eligible employees and small
employers.
(e) Perform other duties to provide low-cost health benefit
plans of types likely to be purchased by small employers.
(f) Establish contributions to be paid by small employers
toward the premiums incurred on behalf of covered eligible
employees.
(g) Establish procedures by rule for the publication or release
of aggregate data relating to:
(A) Applicants for enrollment and persons enrolled in the
Family Health Insurance Assistance Program;
(B) Health benefit plans for small employers offered by the
office; and
(C) Other programs operated by the office.
(2) Notwithstanding any other health benefit plan contracted
for and offered by the office, the office shall contract for a
health benefit plan or plans best designed to meet the needs and
provide for the welfare of eligible employees and small
employers.
(3) The office may approve more than one carrier for each type
of plan contracted for and offered, but the number of carriers
shall be held to a number consistent with adequate service to
eligible employees and family members.
(4) Where appropriate for a contracted and offered health
benefit plan, the office shall provide options under which an
eligible employee may arrange coverage for family members of the
employee.
(5) In developing any health benefit plan, the office may
provide an option of additional coverage for eligible employees
and family members at an additional cost or premium.
(6) Transfer of enrollment from one health benefit plan to
another shall be open to all eligible employees and family
members under rules adopted by the office.
(7) If the office requests less health care service or benefit
than is otherwise required by state law, a carrier is not
required to offer such service or benefit.
(8) Health benefit plans for small employers contracted for and
offered by the office must provide a sufficient level of benefits
to be eligible for a subsidy under ORS 735.724.
(9) The office may employ whatever means are reasonably
necessary to carry out the purposes of ORS 735.700 to 735.714 and
735.720 to 735.740 { + and sections 2, 8, 9 and 10 of this 2007
Act + }. Such authority includes but is not limited to authority
to seek clarification, amendment, modification, suspension or
termination of any agreement or contract that in the office's
judgment requires such action.
SECTION 20. ORS 735.754 is amended to read:
735.754. (1) In order to increase public subsidies for the
purchase of health insurance coverage provided by public programs
or private insurance described by ORS 414.839 { + and sections
8, 9 and 10 of this 2007 Act + }, the Office of Private Health
Partnerships, the Oregon Medical Insurance Pool Board and the
Department of Human Services shall work cooperatively to obtain
federal matching dollars. The office, the Oregon Medical
Insurance Pool Board and the department shall develop a system
for payment or reimbursement of other costs and subsidies
provided to subsidized members.
(2) For each subsidized member, the Oregon Medical Insurance
Pool Board shall determine:
(a) The full cost of administering the benefits plan of the
subsidized member; and
(b) The amount of other costs.
(3) The Oregon Medical Insurance Pool Board shall bill the
Family Health Insurance Assistance Program for the total amount
of the premium received by the Oregon Medical Insurance Pool
Board and for the amount of other costs. The program shall
forward the bill to the department.
(4) The department shall pay the program an amount equal to the
portion of the premium that is a subsidy and for other costs.
The program shall forward the payment to the Oregon Medical
Insurance Pool Board.
SECTION 21. { + (1) The Healthy Kids Safety Net Fund is
established in the State Treasury, separate and distinct from the
General Fund. Interest earned by the Healthy Kids Safety Net Fund
shall be credited to the fund. The Healthy Kids Safety Net Fund
shall consist of moneys transferred to the fund under section 23
of this 2007 Act and moneys received by the Department of Human
Services in the form of gifts, grants, bequests, endowments or
donations.
(2) Moneys in the Healthy Kids Safety Net Fund are continuously
appropriated to the Department of Human Services for the purpose
of carrying out the provisions of section 22 of this 2007
Act. + }
SECTION 22. { + (1) The Department of Human Services shall
award grants to community health centers and safety net clinics
to ensure the capacity of each grantee to provide health care
services to underserved or vulnerable populations.
(2) The department shall by rule adopt criteria for awarding
grants under this section.
(3) As used in this section, 'community health centers and
safety net clinics' means nonprofit medical clinics that provide
primary physical health, vision, dental or mental health services
to low-income patients without charge or using a sliding fee
scale based on the income of the patient. 'Community health
centers and safety net clinics' includes school-based
clinics. + }
SECTION 23. { + (1) All moneys received by the Department of
Revenue from the taxes imposed under section 15, Article IX of
the Oregon Constitution, shall be paid over to the State
Treasurer to be held in a suspense account established under ORS
293.445. After the payment of refunds:
(a) 6.5 percent of the moneys in the account shall be
transferred to the suspense account created pursuant to ORS
323.455 (1) and credited in the same manner as moneys received
from the tax imposed by ORS 323.030 (1); and
(b) 13 percent of the moneys in the account shall be
transferred to the suspense account created pursuant to ORS
323.457 (1) and credited in the same manner as moneys received
from the tax imposed by ORS 323.031.
(2) After the amounts described in subsection (1) of this
section are transferred, the balance of the moneys in the account
shall be credited as follows:
(a) 4.918 percent shall be credited to the Tobacco Use
Reduction Account established under ORS 431.832 to fund cigarette
and tobacco use prevention and education programs recommended in
the Best Practices for Comprehensive Tobacco Control Programs
published by the United States Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion,
Office on Smoking and Health, August 1999; and
(b) 95.082 percent shall be credited to the Oregon Healthy Kids
Program Fund established by section 15 of this 2007 Act.
(3) Of the amounts credited to the Oregon Healthy Kids Program
Fund under subsection (2)(b) of this section:
(a) 3.97 percent shall be transferred to the Healthy Kids
Safety Net Fund established by section 21 of this 2007 Act; and
(b) 1.52 percent shall be transferred to the Rural Health Care
Revolving Account established by ORS 442.480 for the purposes
described in section 34 of this 2007 Act. + }
SECTION 24. Section 23 of this 2007 Act is amended to read:
{ + Sec. 23. + }(1) All moneys received by the Department of
Revenue from the taxes imposed under section 15, Article IX of
the Oregon Constitution, shall be paid over to the State
Treasurer to be held in a suspense account established under ORS
293.445. After the payment of refunds:
(a) 6.5 percent of the moneys in the account shall be
transferred to the suspense account created pursuant to ORS
323.455 (1) and credited in the same manner as moneys received
from the tax imposed by ORS 323.030 (1); and
(b) 13 percent of the moneys in the account shall be
transferred to the suspense account created pursuant to ORS
323.457 (1) and credited in the same manner as moneys received
from the tax imposed by ORS 323.031.
(2) After the amounts described in subsection (1) of this
section are transferred, the balance of the moneys in the account
shall be credited as follows:
(a) { - 4.918 - } { + Ten + } percent shall be credited to
the Tobacco Use Reduction Account established under ORS 431.832
to fund cigarette and tobacco use prevention and education
programs recommended in the Best Practices for Comprehensive
Tobacco Control Programs published by the United States
Department of Health and Human Services, Centers for Disease
Control and Prevention, National Center for Chronic Disease
Prevention and Health Promotion, Office on Smoking and Health,
August 1999; and
(b) { - 95.082 - } { + 90 + } percent shall be credited to
the Oregon Healthy Kids Program Fund established by section 15 of
this 2007.
(3) Of the amounts credited to the Oregon Healthy Kids Program
Fund under subsection (2)(b) of this section:
(a) 3.97 percent shall be transferred to the Healthy Kids
Safety Net Fund established by section 21 of this 2007 Act; and
(b) 1.52 percent shall be transferred to the Rural Health Care
Revolving Account established by ORS 442.480 for the purposes
described in section 34 of this 2007 Act.
SECTION 25. { + The amendments to section 23 of this 2007 Act
by section 24 of this 2007 Act become operative on July 1,
2009. + }
SECTION 26. { + Section 23 of this 2007 Act applies to tobacco
products distributions occurring on or after the first day of the
calendar month following the effective date of this 2007 Act. + }
SECTION 27. ORS 323.455 is amended to read:
323.455. (1) All moneys received by the Department of Revenue
from the tax imposed by ORS 323.030 (1) shall be paid over to the
State Treasurer to be held in a suspense account established
under ORS 293.445. Amounts necessary to pay the expenses incurred
by the Department of Revenue and to reimburse the Oregon State
Police and the Department of Justice for the administration and
enforcement of ORS 323.005 to 323.482 are continuously
appropriated to the Department of Revenue from the suspense
account. After the payment of administrative and enforcement
expenses and refunds { - , 89.65 - } { + :
(a) 37.931 + } percent shall be credited to the General Fund
{ - , - } { + ;
(b) + } 3.45 percent is appropriated to the cities of this
state { - , - } { + ;
(c) + } 3.45 percent is appropriated to the counties of this
state { - and - } { + ;
(d) + } 3.45 percent is continuously appropriated to the
Department of Transportation for the purpose of financing and
improving transportation services for elderly and disabled
individuals as provided in ORS 391.800 to 391.830 { - . - }
{ + ;
(e) 46.546 percent shall be dedicated to funding the
maintenance and expansion of the number of persons eligible for
medical assistance under the Oregon Health Plan, or to funding
the maintenance of the benefits available under the Oregon Health
Plan, or both; and
(f) 5.173 percent shall be credited to the Tobacco Use
Reduction Account established under ORS 431.832. + }
(2) The moneys so appropriated to cities and counties shall be
paid on a monthly basis within 35 days after the end of the month
for which a distribution is made. Each city shall receive such
share of the money appropriated to all cities as its population,
as determined under ORS 190.510 to 190.590 last preceding such
apportionment, bears to the total population of the cities of the
state, and each county shall receive such share of the money as
its population, determined under ORS 190.510 to 190.590 last
preceding such apportionment, bears to the total population of
the state.
(3) The moneys appropriated to the Department of Transportation
under subsection (1) of this section shall be distributed and
transferred to the Elderly and Disabled Special Transportation
Fund established by ORS 391.800 at the same time as the cigarette
tax moneys are distributed to cities and counties under this
section.
{ - (4) Of the moneys credited to the General Fund under this
section 51.92 percent shall be dedicated to funding the
maintenance and expansion of the number of persons eligible for
medical assistance under the Oregon Health Plan, or to funding
the maintenance of the benefits available under the Oregon Health
Plan, or both, and 5.77 percent shall be credited to the Tobacco
Use Reduction Account established under ORS 431.832. - }
SECTION 28. ORS 323.455, as amended by section 27b, chapter
804, Oregon Laws 2003, is amended to read:
323.455. (1) All moneys received by the Department of Revenue
from the tax imposed by ORS 323.030 (1) shall be paid over to the
State Treasurer to be held in a suspense account established
under ORS 293.445. After the payment of refunds { - , 89.65 - }
{ + :
(a) 37.931 + } percent shall be credited to the General Fund
{ - , - } { + ; + }
{ + (b) + } 3.45 percent is appropriated to the cities of
this state { - , - } { + ;
(c) + } 3.45 percent is appropriated to the counties of this
state { - and - } { + ;
(d) + } 3.45 percent is continuously appropriated to the
Department of Transportation for the purpose of financing and
improving transportation services for elderly and disabled
individuals as provided in ORS 391.800 to 391.830 { - . - }
{ + ;
(e) 46.546 percent shall be dedicated to funding the
maintenance and expansion of the number of persons eligible for
medical assistance under the Oregon Health Plan, or to funding
the maintenance of the benefits available under the Oregon Health
Plan, or both; and
(f) 5.173 percent shall be credited to the Tobacco Use
Reduction Account established under ORS 431.832. + }
(2) The moneys so appropriated to cities and counties shall be
paid on a monthly basis within 35 days after the end of the month
for which a distribution is made. Each city shall receive such
share of the money appropriated to all cities as its population,
as determined under ORS 190.510 to 190.590 last preceding such
apportionment, bears to the total population of the cities of the
state, and each county shall receive such share of the money as
its population, determined under ORS 190.510 to 190.590 last
preceding such apportionment, bears to the total population of
the state.
(3) The moneys appropriated to the Department of Transportation
under subsection (1) of this section shall be distributed and
transferred to the Elderly and Disabled Special Transportation
Fund established by ORS 391.800 at the same time as the cigarette
tax moneys are distributed to cities and counties under this
section.
{ - (4) Of the moneys credited to the General Fund under this
section 51.92 percent shall be dedicated to funding the
maintenance and expansion of the number of persons eligible for
medical assistance under the Oregon Health Plan, or to funding
the maintenance of the benefits available under the Oregon Health
Plan, or both, and 5.77 percent shall be credited to the Tobacco
Use Reduction Account established under ORS 431.832. - }
SECTION 29. ORS 323.457 is amended to read:
323.457. (1) Moneys received under ORS 323.031 shall be paid
over to the State Treasurer to be held in a suspense account
established under ORS 293.445. Amounts necessary to pay the
expenses incurred by the Department of Revenue and to reimburse
the Oregon State Police and the Department of Justice for the
administration and enforcement of this section and ORS 323.031
are continuously appropriated to the Department of Revenue from
the suspense account. After the payment of administrative and
enforcement expenses and refunds { - : - } { + , + }
{ - (a) 29.37/30 - } { + 94 percent + } of the moneys shall
be credited to the Oregon Health Plan Fund established under ORS
414.109 { - ; - } { + . + }
{ - (b) 0.14/30 of the moneys are continuously appropriated
to - }
{ + (2) After payment of administrative and enforcement
expenses and refunds and amounts credited to the Oregon Health
Plan Fund under subsection (1) of this section, the balance of
the moneys in the suspense account are continuously appropriated
to:
(a) + }The Oregon Department of Administrative Services for
distribution to the cities of this state;
{ - (c) - } { + (b) + } { - 0.14/30 of the moneys are
continuously appropriated to - } The Oregon Department of
Administrative Services for distribution to the counties of this
state; { + and + }
{ - (d) - } { + (c) + } { - 0.14/30 of the moneys are
continuously appropriated to - } The Department of
Transportation to be distributed and transferred to the Elderly
and Disabled Special Transportation Fund established under ORS
391.800 { - ; and - } { + . + }
{ - (e) 0.21/30 of the moneys shall be credited to the
Tobacco Use Reduction Account established under ORS 431.832. - }
{ - (2)(a) - } { + (3)(a) + } Moneys distributed to cities
and counties under this section shall be distributed to each city
or county using the proportions used for distributions made under
ORS 323.455.
(b) Moneys shall be distributed to cities, counties and the
Elderly and Disabled Special Transportation Fund at the same time
moneys are distributed to cities, counties and the Elderly and
Disabled Special Transportation Fund under ORS 323.455.
SECTION 30. ORS 323.457, as amended by section 5e, chapter 804,
Oregon Laws 2003, and section 110, chapter 94, Oregon Laws 2005,
is amended to read:
323.457. (1) Moneys received under ORS 323.031 shall be paid
over to the State Treasurer to be held in a suspense account
established under ORS 293.445. After the payment of refunds
{ - : - } { + , + }
{ - (a) 29.37/30 - } { + 94 percent + } of the moneys shall
be credited to the Oregon Health Plan Fund established under ORS
414.109 { - ; - } { + . + }
{ - (b) 0.14/30 of the moneys are continuously appropriated
to - }
{ + (2) After the amounts described in subsection (1) of this
section are credited to the Oregon Health Plan Fund, the balance
of the moneys in the suspense account are continuously
appropriated to:
(a) + }The Oregon Department of Administrative Services for
distribution to the cities of this state;
{ - (c) - } { + (b) + } { - 0.14/30 of the moneys are
continuously appropriated to - } The Oregon Department of
Administrative Services for distribution to the counties of this
state; { + and + }
{ - (d) - } { + (c) + } { - 0.14/30 of the moneys are
continuously appropriated to - } The Department of
Transportation to be distributed and transferred to the Elderly
and Disabled Special Transportation Fund established under ORS
391.800 { - ; and - } { + . + }
{ - (e) 0.21/30 of the moneys shall be credited to the
Tobacco Use Reduction Account established under ORS 431.832. - }
{ - (2)(a) - } { + (3)(a) + } Moneys distributed to cities
and counties under this section shall be distributed to each city
or county using the proportions used for distributions made under
ORS 323.455.
(b) Moneys shall be distributed to cities, counties and the
Elderly and Disabled Special Transportation Fund at the same time
moneys are distributed to cities, counties and the Elderly and
Disabled Special Transportation Fund under ORS 323.455.
SECTION 31. ORS 323.505 is amended to read:
323.505. (1) { + (a) + } A tax is hereby imposed upon the
distribution of all tobacco products in this state.
{ + (b) In addition, for purposes of administration and
collection, the taxes imposed under section 15, Article IX of the
Oregon Constitution, are hereby combined with the tax imposed
under paragraph (a) of this subsection. The combined statutory
and constitutional tax + } { - The tax imposed by this
section - } is intended to be a direct tax on the consumer, for
which payment upon distribution is required to achieve
convenience and facility in the collection and administration of
the tax. The tax shall be imposed on a distributor at the time
the distributor distributes tobacco products.
(2) The { + combined statutory and constitutional + } tax
{ - imposed under this section - } shall be imposed at the rate
of:
(a) { - Sixty-five - } { + Ninety-five + } percent of the
wholesale sales price of cigars, but not to exceed 50 cents per
cigar; or
(b) { - Sixty-five - } { + Ninety-five + } percent of the
wholesale sales price of all tobacco products that are not
cigars.
(3) If the { + combined statutory and constitutional + } tax
{ - imposed under this section - } does not equal an amount
calculable to a whole cent, the tax shall be equal to the next
higher whole cent. However, the amount remitted to the
Department of Revenue by the taxpayer for each quarter shall be
equal only to 98.5 percent of the total taxes due and payable by
the taxpayer for the quarter.
(4) No tobacco product shall be subject to the tax if the base
product or other intermediate form thereof has previously been
taxed under this section.
{ + (5) Solely for purposes of administration and collection,
the taxes imposed under section 15, Article IX of the Oregon
Constitution, shall be considered taxes imposed under ORS 323.500
to 323.645. + }
SECTION 32. { + The amendments to ORS 323.505 by section 31 of
this 2007 Act apply to tobacco products tax reporting periods
beginning on or after the first day of the calendar month
following the effective date of this 2007 Act. + }
SECTION 33. { + Section 34 of this 2007 Act is added to and
made a part of ORS 442.470 to 442.507. + }
SECTION 34. { + The Office of Rural Health may award to rural
health care providers grants that promote any of the following
goals:
(1) Replacement or renovation of aging rural hospitals.
(2) Modernization of capital equipment.
(3) Preservation of access to local health services in rural
areas through short-term support of vulnerable rural health care
providers.
(4) Expansion of community health educational opportunities.
(5) Providing incentives for the development of long-term,
sustainable approaches to providing improved health care services
and increased access to quality health care in rural areas.
(6) Development of collaborative approaches that sustain access
to quality rural health care.
(7) Expanding or sustaining health care for financially and
physically vulnerable rural populations.
(8) Providing operational support for rural health centers that
are not federally qualified health centers. + }
SECTION 35. ORS 442.507 is amended to read:
442.507. (1) { - With the moneys transferred to the Office of
Rural Health by ORS 442.625, - } The Office { + of Rural
Health + } shall establish a dedicated grant program for the
purpose of providing assistance to rural communities to enhance
emergency medical service systems.
(2) Communities, as well as nonprofit or governmental agencies
serving those communities, may apply to the office for grants on
forms developed by the office.
(3) The office shall make the final decision concerning which
entities receive grants, but the office may seek advice from the
Rural Health Coordinating Council, the State Emergency Medical
Service Committee and other appropriate individuals experienced
with emergency medical services.
(4) The office may make grants to entities for the purchase of
equipment, the establishment of new rural emergency medical
service systems or the improvement of existing rural emergency
medical service systems.
(5) With the exception of printing and mailing expenses
associated with the grant program, the Office of Rural Health
shall pay for administrative costs of the program with funds
other than those transferred under ORS 442.625.
{ +
CAPTIONS + }
SECTION 36. { + The unit captions used in this 2007 Act are
provided only for the convenience of the reader and do not become
part of the statutory law of this state or express any
legislative intent in the enactment of this 2007 Act. + }
{ +
EFFECTIVE DATE + }
SECTION 37. { + This 2007 Act does not take effect unless the
amendment to the Oregon Constitution proposed by Senate Joint
Resolution 4 (2007) is approved by the people. This 2007 Act
takes effect on the effective date of that constitutional
amendment. + }
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