Signed by Governor Tina Kotek

Vote Smart's Synopsis:

Vote to pass a bill that requires the Department of Human Services to measure and streamline the approval process for long-term care services provided through Medicaid in Oregon.

Highlights:

• Requires the Department of Human Services to create a dashboard to measure the time it takes to determine eligibility for long-term care services and supports provided through the medical assistance program (Sec. 1).

• Requires the Department of Human Services and the Oregon Health Authority to conduct an operational review to streamline eligibility determinations, in which they must do the following (Sec. 2):

• Conduct a baseline analysis - using data from the dashboard - of average processing times for functional and financial assessments;

• Develop benchmarks for improving processing times and identify a target date to meet these benchmarks;

• Explore technologies, including automation, to meet the benchmarks;

• Explore changes to staff assignments and workflows, including the creation of dedicated teams, to meet the benchmarks;

• Develop protocols for communication and case management for when delays occur in conducting assessments;

• Develop a decision tree to help hospital staff navigate the process of conducting eligibility determinations; and

• Explore payment model options for providing temporary coverage while an eligibility determination is pending.

• Requires the Department of Human Services and the Oregon Health Authority to study the regulatory framework for facilities that serve residents with complex medical or behavioral health conditions (Sec. 3).

• Requires the Department of Human Services and the Housing and Community Services Department to study opportunities to offset the cost of creating new adult foster homes (Sec. 4).

• Requires the Department of Human Services and the Oregon Health Authority to study options to expand medical respite programs statewide, and partner with coordinated care organizations and insurers that offer Medicare Advantage Plans to promote timely and appropriate hospital discharges (Sec. 5).

• Requires the Oregon Health Authority to establish a post-hospital extended care benefit to cover a medical assistance recipient’s stay in a skilled nursing facility for up to 100 days (Sec. 6).

Full Bill Text