Bill Text: OR HB2859 | 2013 | Regular Session | Enrolled
Bill Title: Relating to medical assistance; and declaring an emergency.
Spectrum: Committee Bill
Status: (Passed) 2013-07-29 - Chapter 688, (2013 Laws): Effective date July 29, 2013. [HB2859 Detail]
Download: Oregon-2013-HB2859-Enrolled.html
77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session
Enrolled
House Bill 2859
Sponsored by COMMITTEE ON HEALTH CARE
CHAPTER ................
AN ACT
Relating to medical assistance; creating new provisions; amending
ORS 1.198, 18.784, 18.838, 18.847, 25.381, 30.800, 93.967,
93.969, 97.939, 108.725, 109.811, 113.085, 113.086, 114.305,
114.515, 114.517, 115.125, 115.195, 125.170, 130.425, 166.715,
179.505, 183.458, 192.588, 293.231, 314.860, 409.010, 410.150,
410.490, 411.010, 411.070, 411.081, 411.087, 411.095, 411.119,
411.141, 411.159, 411.400, 411.402, 411.404, 411.406, 411.408,
411.435, 411.439, 411.443, 411.610, 411.620, 411.630, 411.632,
411.635, 411.640, 411.660, 411.670, 411.675, 411.690, 411.694,
411.703, 411.795, 411.802, 411.965, 411.967, 411.969, 411.970,
413.109, 413.175, 414.025, 414.041, 414.065, 414.095, 414.115,
414.231, 414.428, 414.534, 414.536, 414.706, 414.709, 414.727,
414.736, 414.740, 414.841, 414.842, 414.848, 414.862, 416.340,
416.350, 419B.373, 419C.550, 426.300, 435.215, 689.778 and
735.625 and section 6, chapter 290, Oregon Laws 1987, section
9, chapter 736, Oregon Laws 2003, section 20, chapter 595,
Oregon Laws 2009, and section 1, chapter 867, Oregon Laws 2009;
repealing ORS 411.431, 411.432, 414.707, 414.708, 414.750,
414.866, 414.868, 414.870 and 414.872; and declaring an
emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + (1) All applicants for and recipients of
medical assistance, as defined in ORS 414.025, shall be treated
in a courteous, fair and dignified manner by Oregon Health
Authority employees.
(2) Any applicant or recipient who alleges discourteous, unfair
or undignified treatment by an authority employee or alleges that
an authority employee has provided incorrect or inadequate
information regarding medical assistance programs may file a
grievance with the authority. The authority shall publicize the
grievance system in each office of the authority that is open to
the public.
(3) The grievance shall be discussed first with the supervisor
of the employee against whom the grievance is filed. If the
grievance is not resolved, the applicant or recipient may discuss
the grievance with the manager of the office.
(4) The authority shall compile a monthly report that
summarizes each grievance filed against an authority employee and
the action taken. The report shall identify each grievance by
office and indicate the number of grievances filed against each
authority employee. The report shall protect the anonymity of
Enrolled House Bill 2859 (HB 2859-A) Page 1
authority employees. The report shall be provided to the Medicaid
Advisory Committee established under ORS 414.211. + }
{ + NOTE: + } Section 2 was deleted by amendment. Subsequent
sections were not renumbered.
SECTION 3. ORS 1.198 is amended to read:
1.198. (1) ORS 1.197 does not apply to liquidated and
delinquent accounts that are:
(a) Prohibited by state or federal law or regulation from
assignment or collection; or
(b) Subject to collection through an offset of federal tax
refunds pursuant to an agreement entered into under ORS 1.196.
(2) Notwithstanding ORS 1.197, a state court or a commission,
department or division in the judicial branch of state
government, acting in its sole discretion, may choose not to
offer a liquidated and delinquent account to a private collection
agency or to the Department of Revenue if the account:
(a) Is secured by a consensual security interest in real or
personal property;
(b) Is based on that part of a judgment that requires payment
of restitution or a payment to the Crime Victims' Assistance
section of the Criminal Justice Division of the Department of
Justice;
(c) Is in litigation, mediation or arbitration or is subject to
a stay in bankruptcy proceedings;
(d) Is owed by a local or state government or by the federal
government;
(e) Is owed by a debtor who is hospitalized in a state hospital
as defined in ORS 162.135 or who { - is on - } { +
receives + } public assistance as defined in ORS 411.010 { + or
medical assistance as defined in ORS 414.025 + };
(f) Consists of moneys for which a district attorney has
assumed collection responsibility under ORS 8.680;
(g) Consists of moneys owed by a person who is incarcerated;
(h) Is an account that was previously offered to a private
collection agency and was refused, or that was previously
assigned to a private collection agency and the agency thereafter
relinquished the account;
(i) Is less than $100, including penalties; or
(j) Would result in loss of federal funding if assigned.
SECTION 4. ORS 18.784 is amended to read:
18.784. (1) Except as provided in subsection (6) of this
section, if a writ of garnishment is delivered to a financial
institution that has an account of the debtor, the financial
institution shall conduct a garnishment account review of all
accounts in the name of the debtor before taking any other action
that may affect funds in those accounts. If the financial
institution determines from the garnishment account review that
one or more payments described in subsection (3) of this section
were deposited in an account of the debtor by direct deposit or
electronic payment during the lookback period described in
subsection (2) of this section, an amount equal to the lesser of
the sum of those payments or the total balance in the debtor's
account is not subject to garnishment.
(2) The provisions of this section apply only to payments
described in subsection (3) of this section that are deposited
during the lookback period that ends on the day before the day on
which the garnishment account review is conducted and begins on:
(a) The day in the second calendar month preceding the month in
which the garnishment account review is conducted, that has the
same number as the day on which the period ends; or
Enrolled House Bill 2859 (HB 2859-A) Page 2
(b) If there is no day as described in paragraph (a) of this
subsection, the last day of the second calendar month preceding
the month in which the garnishment account review is conducted.
(3) The provisions of this section apply only to:
(a) Federal benefit payments;
(b) Payments from a public or private retirement plan as
defined in ORS 18.358;
(c) Public assistance { + or medical assistance, as defined in
ORS 414.025, + }payments from the State of Oregon or an agency
of the State of Oregon;
(d) Unemployment compensation payments from the State of Oregon
or an agency of the State of Oregon;
(e) Black lung benefits payments from the United States
Department of Labor; and
(f) Workers' compensation payments from a workers' compensation
carrier.
(4) The provisions of this section apply only to a payment that
a financial institution can identify as being one of the types of
payments described in subsection (3) of this section from
information transmitted to the financial institution by the
payor.
(5) A financial institution shall perform a garnishment account
review only one time for a specific garnishment. If the same
garnishment is served on a financial institution more than once,
the financial institution may not perform a garnishment account
review or take any other action relating to the garnishment based
on the second and subsequent service of the garnishment.
(6) A financial institution may not conduct a garnishment
account review under this section if a Notice of Right to Garnish
Federal Benefits from the United States Government or from a
state child support enforcement agency is attached to or included
in the garnishment as provided in 31 C.F.R. part 212. If a Notice
of Right to Garnish Federal Benefits is attached to or included
in the garnishment, the financial institution shall proceed on
the garnishment as otherwise provided in ORS 18.600 to 18.850.
(7) The provisions of this section do not affect the ability of
a debtor to claim any exemption that otherwise may be available
to the debtor under law for any amounts in an account in a
financial institution.
SECTION 5. ORS 18.838 is amended to read:
18.838. Instructions to garnishees must be in substantially the
following form:
_________________________________________________________________
INSTRUCTIONS TO GARNISHEE
Except as specifically provided in these instructions, you must
complete and deliver the Garnishee Response within seven calendar
days after you receive the writ of garnishment. If the writ does
not comply with Oregon law, the writ is not effective to garnish
any property of the Debtor, but you still must complete and
deliver the Garnishee Response. You must complete and deliver the
response even though you cannot determine from the writ whether
you hold any property or owe any debt to the Debtor. If the
seventh calendar day is a Saturday, Sunday or legal holiday, you
must deliver your response on or before the next following day
that is not a Saturday, Sunday or legal holiday.
The writ is not effective, and you need not make a Garnishee
Response, if:
Enrolled House Bill 2859 (HB 2859-A) Page 3
o You do not receive the writ within 60 days after the date of
issuance shown on the face of the writ.
o You do not receive an original writ of garnishment or a copy
of the writ.
Statutes that may affect your rights and duties under the writ
can be found in ORS 18.600 to 18.850.
NOTE: The Garnishor may be the Creditor, the attorney for the
Creditor or some other person who is authorized by law to issue
the writ of garnishment. See the writ to determine who the
Garnishor is.
STEP 1. FILL OUT THE GARNISHEE RESPONSE.
All garnishees who are required to deliver a garnishee response
must fill in Part I of the Garnishee Response. Garnishees who
employ the Debtor must also fill in Part II of the response. You
should keep a copy of the response for your records.
Completing Part I of the Garnishee Response. If you discover
before you deliver your response that a bankruptcy petition has
been filed by or on behalf of the Debtor, and the bankruptcy
petition was filed after a judgment was entered against the
Debtor or after the debt otherwise became subject to garnishment
(see the date specified in the writ), you must put a check by the
appropriate statement in Part I. If a bankruptcy petition has
been filed, you should not make any payments to the Garnishor
unless the court orders otherwise. You need not complete any
other part of the response, but you still must sign the response
and deliver it in the manner described in Step 2 of these
instructions.
In all other cases you must list in Part I all money and
personal property of the Debtor that is in your possession,
control or custody at the time of delivery of the writ. You must
also list all debts that you owe to the Debtor, whether or not
those debts are currently due (e.g., money loaned to you by the
Debtor that is to be repaid at a later time).
If you are the employer of the Debtor at the time the writ is
delivered to you, you must put a check by the appropriate
statement in Part I. In addition, you must complete Part II of
the response.
If you believe that you may hold property of the Debtor or that
you owe a debt to the Debtor, but you are not sure, you must put
a check by the appropriate statement and provide an explanation.
When you find out what property you hold that belongs to the
Debtor, or you find out whether you owe money to the Debtor and
how much, you must prepare and deliver an amended response. You
must do this even if you find out that you have no property of
the Debtor or that you do not owe anything to the Debtor.
If you determine that the writ, on its face, does not comply
with Oregon laws governing writs of garnishment, or if you are
unable to determine the identity of the Debtor from the
information in the writ, then the writ is not effective to
garnish any property of the Debtor. You must put a check by the
appropriate statement in Part I and provide an explanation. You
still must complete the response and deliver the response in the
manner described in Step 2 of these instructions.
Enrolled House Bill 2859 (HB 2859-A) Page 4
If you have received an order to withhold income that applies
to the income of the Debtor and that order has priority over the
garnishment, and if compliance with the order will reduce or
eliminate the money or property that you would otherwise deliver
under the garnishment, you must put a check by the appropriate
statement in Part I. You still must fill out the remainder of the
response and deliver the response in the manner described in Step
2 of these instructions. If you employ the Debtor, you still must
complete Part II of the response.
If you receive notice of a challenge to the garnishment before
you send your response, you must complete and deliver your
response as otherwise required by these instructions. However,
see Step 3 of these instructions regarding payment of money or
delivery of property after receipt of notice of a challenge to
the garnishment.
If you owe a debt to the Debtor and the Debtor owes a debt to
the holder of an underlying lien on your property, you may be
able to offset the amount payable to the underlying lienholder.
See ORS 18.620. You must note that you have made the offset in
Part I of the response (under 'Other') and specify the amount
that was offset.
Completing Part II of the Garnishee Response (employers only).
You must fill in Part II of the response if you employ the Debtor
on the date the writ of garnishment is delivered to you, or if
you previously employed the Debtor and still owe wages to the
Debtor on the date the writ is delivered to you.
Wages affected. Except as provided below, the writ garnishes
all wages that you owe to the Debtor for work performed before
the date you received the writ, even though the wages will not be
paid until a later date. The writ also garnishes all wages that
are attributable to services performed during the 90-day period
following the date you received the writ, even though you would
not pay the Debtor for all or part of those services until after
the end of the 90-day period. Wages subject to garnishment under
the writ include all amounts paid by you as an employer, whether
on an hourly, weekly or monthly basis, and include commission
payments and bonuses.
Example 1: Debtor A is employed by you and is paid a monthly
salary on the first day of each month. You receive a writ of
garnishment on July 17. The writ garnishes all wages that
you owe to Debtor A for work performed on or before July 17.
If Debtor A was paid on July 1 for services performed in the
month of June, the writ garnishes Debtor A's salary for the
period beginning July 1 and ending October 15 (90 days after
receipt of the writ).
The writ does not garnish any wages you owe to a Debtor for a
specific pay period if:
(a) The writ is delivered to you within two business days
before the Debtor's normal payday for the pay period;
(b) When the writ is delivered to you, the Debtor's wages are
paid by direct deposit to a financial institution, or you use an
independent contractor as payroll administrator for your payroll;
and
(c) Before the writ was delivered to you, you issued
instructions to the financial institution or the payroll
administrator to pay the Debtor for the pay period.
Enrolled House Bill 2859 (HB 2859-A) Page 5
If any wages are not garnishable by reason of the issuance of
instructions to a financial institution or a payroll
administrator as described above, you must so note in the
Garnishee Response. Thereafter, you must pay to the Garnishor
all wages that are subject to garnishment that are attributable
to services performed by the Debtor during the 90-day period
following the date you received the writ.
Calculation of wages subject to garnishment. A Wage Exemption
Calculation form is attached to the writ of garnishment. You must
use this form to calculate the amount of the Debtor's wages that
is subject to garnishment. You should read the instructions
printed on the Wage Exemption Calculation form to determine the
normal wage exemption and the minimum wage exemption for each
payment you make under the writ.
A Wage Exemption Calculation form must be sent with the first
payment you make under the writ. For the 90-day period during
which the writ is effective, you must also fill out and return a
Wage Exemption Calculation form with a subsequent payment any
time the initial calculation changes. Finally, you must fill out
and return a Wage Exemption Calculation form with the final
payment that you make under the writ.
Payment of amount subject to garnishment. Payments under the
writ must be made at the following times, unless the amount owing
on the judgment or other debt is fully paid before the final
payment is made or the writ is released:
(a) You must make a payment to the Garnishor of all wages
subject to garnishment at the time you next pay wages to the
Debtor. Complete the wage exemption computation, using the Wage
Exemption Calculation form, to determine the portion of the
Debtor's wages that is subject to garnishment. Be sure to adjust
the minimum exemption amount for any payment that covers less
than a full pay period. You must include a copy of the Wage
Exemption Calculation form with this first payment.
Example 2: Using the facts given in Example 1, when you next
make any payment of wages to Debtor A after you receive the
writ on July 17, you must complete the Wage Exemption
Calculation form and send the form to the Garnishor along
with all amounts determined to be subject to garnishment
that are attributable to the period covered by the payment.
If you pay Debtor A on August 1, the payment will be for all
wages attributable to the period beginning July 1 and ending
July 31.
(b) Unless the writ of garnishment is satisfied or released,
during the 90-day period following the date you received the
writ, you must pay to the Garnishor all wages that are determined
to be subject to garnishment whenever you issue a paycheck to the
Debtor. If the Debtor is paid on a weekly basis, you must make
payment under the writ on a weekly basis. If the Debtor is paid
on a monthly basis, you must make payment under the writ on a
monthly basis. If the amount paid to the Debtor varies from
paycheck to paycheck, or changes at any time from the amount
being paid at the time the writ was delivered to you, you must
perform a new wage exemption computation to determine the amount
of wages subject to garnishment under the writ. You must send a
copy of the new Wage Exemption Calculation form with your payment
to the Garnishor.
Enrolled House Bill 2859 (HB 2859-A) Page 6
Example 3: Using the facts given above, as you make each
subsequent payment of wages to Debtor A you must make a
payment of that portion of the Debtor's wages that are
subject to garnishment. If you continue to pay Debtor A on
the first of each month, payments must be made on September
1 and October 1.
(c) Upon the expiration of the 90-day period, you must make a
final payment to the Garnishor for all wages that were owing to
the Debtor for the work performed by the Debtor through the 90th
day following your receipt of the writ. This payment may be made
at the time of the Debtor's next paycheck. You will need to
complete another Wage Exemption Calculation form to determine the
amount of the wages subject to garnishment.
Example 4: Using the facts given above, you must make a
final payment for the wages owing to Debtor A for the period
beginning October 1 and ending October 15. You may make this
payment at the time you issue Debtor A's paycheck on
November 1, but you must make the payment at any time you
issue a paycheck to Debtor A after October 15. Be sure that
in completing the wage exemption computation for the final
payment you adjust the minimum exemption amount to take into
account the fact that the period covered is only 15 days of
the full month (see instructions on Wage Exemption
Calculation form).
Processing fee. You may collect a $2 processing fee for each
week of wages, or fraction of a week of wages, for which a
payment is made under the writ. The fee must be collected after
you make the last payment under the writ. The fee must be
withheld from the wages of the debtor, and is in addition to the
amounts withheld for payment to the garnishor under the writ or
under any other writ you have received.
If you receive more than one writ of garnishment. If you
receive a second writ of garnishment for the same Debtor from
another Garnishor, the first writ will have priority for wages.
The priority of the first writ lasts for the 90-day period
following delivery of that writ to you, or until the first writ
is paid in full, whichever comes first. In your response to the
second writ, you must put a check by the appropriate statement in
Part II and indicate the date on which the first writ will expire
(90 days after the date you received the writ). You should make
no payments under the second writ until expiration of the first
writ. The expiration date of the second writ is 90 days after
the date you received the second writ; the expiration date is not
affected by any delay in payment attributable to the priority of
the first writ.
STEP 2. DELIVER THE GARNISHEE RESPONSE.
You must deliver your Garnishee Response and copies of the
response in the manner provided in this step. The response and
copies may be mailed or delivered personally.
You must complete and deliver the Garnishee Response within
seven calendar days after you receive the writ of garnishment. If
the seventh calendar day is a Saturday, Sunday or legal holiday,
Enrolled House Bill 2859 (HB 2859-A) Page 7
you must deliver your response on or before the next following
day that is not a Saturday, Sunday or legal holiday.
If you are required to hold any property under the writ or make
any payment under the writ, either at the time of making your
response or later, you must:
(a) Send the original of your Garnishee Response to the
Garnishor at the address indicated on the writ under Important
Addresses.
(b) Send a copy of your Garnishee Response to the court
administrator at the address indicated on the writ under
Important Addresses.
(c) Send a copy of your Garnishee Response to the Debtor if an
address is indicated on the writ under Important Addresses.
If you are not required to hold any property under the writ or
make any payment under the writ, either at the time of making
your response or later, you must:
(a) Send the original of your Garnishee Response to the
Garnishor at the address indicated on the writ under Important
Addresses.
(b) Send a copy of your Garnishee Response to the Debtor if an
address is indicated on the writ under Important Addresses.
STEP 3. DELIVER THE FUNDS OR OTHER PROPERTY.
As long as the writ is in effect, you may be liable to the
Creditor if you pay any debt or turn over any property to the
Debtor except as specifically allowed by law. If you have any
money or property of the Debtor in your possession, control or
custody at the time of delivery of the writ, or owe any debt to
the Debtor, you must pay the money or hold the property as
required by this step. Exceptions to this requirement are listed
below.
IF YOU ARE HOLDING MONEY FOR THE DEBTOR OR OWE A DEBT THAT IS
CURRENTLY DUE, you must pay the money to the Garnishor with your
response. You must send your payment to the Garnishor at the
address indicated on the writ under Important Addresses. Make
your check payable to the Garnishor.
IF YOU OWE A DEBT TO THE DEBTOR THAT WILL BECOME DUE WITHIN 45
DAYS AFTER THE DATE YOU RECEIVED THE WRIT, you must send your
payment directly to the Garnishor at the address provided in the
writ when the debt becomes due. Make your check payable to the
Garnishor.
IF YOU ARE HOLDING PROPERTY THAT BELONGS TO THE DEBTOR, OR OWE
A DEBT TO THE DEBTOR THAT WILL NOT BECOME DUE WITHIN 45 DAYS
AFTER THE DATE YOU RECEIVED THE WRIT, you must keep the property
or debt in your possession, control or custody until you receive
written notice from the Sheriff. The Sheriff's notice will tell
you what to do with the property or debt. If you have followed
all of the instructions in the writ and you receive no notice
from the Sheriff within 30 days after the date on which you
delivered your Garnishee Response, you may treat the writ as
being of no further force or effect.
EXCEPTIONS:
Enrolled House Bill 2859 (HB 2859-A) Page 8
1. Challenge to garnishment or specific directions from court.
If you are making any payments under the garnishment and before
making a payment you receive notice of a challenge to the
garnishment from the court, or receive a specific direction from
the court to make payments to the court, you must send or deliver
the payment directly to the court administrator. If the money is
currently due when you receive the notice, send the payment
promptly to the court. If the payment is for a debt that is
payable within 45 days after you receive the writ, make the
payment to the court promptly when it becomes due. If you make
payment by check, make the check payable to the State of Oregon.
Because you may be liable for any payment that does not reach the
court, it is better not to send cash by mail.
A challenge to the garnishment does not affect your duty to
follow the instructions you receive from the Sheriff for property
that belongs to the Debtor and debts that you owe to the Debtor
that do not become due within 45 days.
2. Previous writ of garnishment. If you receive a second writ
of garnishment for the same Debtor from another Garnishor, the
first writ will have priority and you need not make payments or
deliver property under the second writ to the extent that
compliance with the first writ will reduce or eliminate the
payment of money or delivery of property that you would otherwise
make under the garnishment. You must still deliver a Garnishee
Response to the second writ, and must commence payment under the
second writ as soon as the first writ is satisfied or expires.
3. Offset for payment of underlying lien. If you owe a debt to
the Debtor and the Debtor owes a debt to the holder of an
underlying lien on your property, you may be able to offset the
amount payable to the underlying lienholder. See ORS 18.620.
4. Subsequent events:
(a) Bankruptcy. If you make your response and then discover
that a voluntary or involuntary bankruptcy petition has been
filed by or on behalf of the Debtor after the judgment was
entered against the Debtor or after the debt otherwise became
subject to garnishment (see date in writ), you may not make any
further payments or delivery of property under the writ unless
the court orders otherwise. If you have not delivered all
property that is subject to garnishment under this writ when you
discover that a bankruptcy petition has been filed, you must mail
the following notice to the Garnishor and to the Debtor.
(b) Order to withhold income. If you make your response and
then receive an order to withhold income that has priority over
the writ, you may make payments or deliver property under the
writ only after payment of the amounts required under the order
to withhold income. If you have not delivered all property that
is subject to garnishment under this writ when you receive an
order to withhold income that has priority, you must mail the
following notice to the Garnishor and to the Debtor.
_________________________________________________________________
SUPPLEMENTAL GARNISHEE
RESPONSE
TO: The Garnishor and the Debtor
Enrolled House Bill 2859 (HB 2859-A) Page 9
RE: Writ of garnishment received ___, 2_ (date), in the case of
_____ (Plaintiff) vs. _____ (Defendant), Circuit Court of ____
County, Oregon, Case No. ___.
The undersigned Garnishee furnished a Garnishee Response to
this writ of garnishment on ___, 2_ (date). Since that time
(check appropriate statement):
_ I have discovered that a voluntary or involuntary bankruptcy
petition has been filed by or on behalf of the Debtor after
the judgment was entered against the Debtor or after the debt
otherwise became subject to garnishment.
_ I have received an order to withhold income of the Debtor by
reason of a support obligation. Under ORS 25.375, the order
to withhold income has priority over any other legal process
under Oregon law against the same income. The withholding of
income pursuant to the order to withhold income might reduce
or eliminate subsequent payments under the garnishment.
(Provide details, including the name of the agency serving
the order to withhold, the date the order was served on you
and the amounts to be withheld.)
Dated ___, 2_
__________
Name of Garnishee
__________
Signature
__________
Address
_________________________________________________________________
SPECIAL INSTRUCTIONS FOR BANKS
AND OTHER FINANCIAL INSTITUTIONS
Unless a Notice of Right to Garnish Federal Benefits from the
United States Government or from a state child support
enforcement agency is attached to or included in the garnishment,
you must conduct a garnishment account review for each account
that you hold for the debtor. If a Notice of Right to Garnish
Federal Benefits from the United States Government or from a
state child support enforcement agency is attached to or included
in the garnishment, you should not conduct a garnishment account
review, and should proceed upon the garnishment in the normal
manner.
If you hold an account for the debtor, and any of the payments
listed below has been deposited in the account by direct deposit
or electronic payment during the lookback period described in ORS
18.784 (2) (the period that begins on the date preceding the date
of your garnishment account review and that ends on the
corresponding date of the month two months earlier, or on the
last day of the month two months earlier if the corresponding
date does not exist), an amount equal to the lesser of the sum of
those payments or the total balance in the debtor's account is
not subject to garnishment, and you may not deliver that amount
to the garnishor:
Enrolled House Bill 2859 (HB 2859-A) Page 10
(a) Federal benefit payments as defined in ORS 18.600 (payments
from the United States Social Security Administration, the United
States Department of Veterans Affairs, the United States Office
of Personnel Management or the Railroad Retirement Board);
(b) Payments from a public or private retirement plan as
defined in ORS 18.358;
(c) Public assistance { + or medical assistance, as defined in
ORS 414.025, + } payments from the State of Oregon or an agency
of the State of Oregon;
(d) Unemployment compensation payments from the State of Oregon
or an agency of the State of Oregon;
(e) Black lung benefits payments from the United States
Department of Labor; and
(f) Workers' compensation payments from a workers' compensation
carrier.
If the Garnishor fails to pay the search fee required by ORS
18.790 and you do not employ the Debtor, you are not required to
deliver a Garnishee Response and you may deal with any property
of the Debtor as though the garnishment had not been issued.
If the Debtor owes a debt to you that was due at the time you
received the writ of garnishment, you may be able to offset the
amount of that debt. See ORS 18.795. You must note that you have
made the offset in Part I of the Garnishee Response (under '
Other') and specify the amount that was offset.
Before making a payment under the writ, you may first deduct
any processing fee that you are allowed under ORS 18.790. If you
are required to conduct a garnishment account review, you may not
charge or collect a processing fee against any amount that is not
subject to garnishment, and may not charge or collect a
garnishment processing fee against any amounts in the account
after the date that you conduct the review.
You need not deliver any property contained in a safe deposit
box unless the Garnishor pays you in advance for the costs that
will be incurred in gaining entry to the box. See ORS 18.792.
If you are required to conduct a garnishment account review and
you determine from the review that one or more of the payments
listed in ORS 18.784 (3) have been deposited into the debtor's
account by direct deposit or electronic payment during the
lookback period described in ORS 18.784 (2), and that there is a
positive balance in the account, you must issue a notice to the
account holder in substantially the form set forth in ORS
18.847. The notice must be issued directly to the account holder
or to a fiduciary who administers the account and receives
communications on behalf of the account holder. The notice must
be sent separately to the account holder and may not be included
with other materials being provided to the account holder that do
not relate to the garnishment. You must send the notice to the
account holder within three business days after you complete the
garnishment account review. You may issue one notice with
information related to multiple accounts of a single account
holder.
_________________________________________________________________
SECTION 6. ORS 18.847 is amended to read:
Enrolled House Bill 2859 (HB 2859-A) Page 11
18.847. The notice given by a financial institution to a debtor
under ORS 18.785 (1) must be in substantially the following form:
_________________________________________________________________
_______________
_______________
_______________
(Name, address of financial institution)
IMPORTANT INFORMATION ABOUT
YOUR ACCOUNT
Date: ______
Notice to: ______
Account Number: ______
Why am I receiving this notice?
On ___ date on which garnishment order was served , ____ name
of financial institution received a garnishment order from a
court to garnish funds in your account. The amount of the
garnishment order was for $___ amount of garnishment order . We
are sending you this notice to let you know what we have done in
response to the garnishment order.
What is garnishment?
Garnishment is a legal process that allows a creditor to remove
funds from your bank/credit union account to satisfy a debt that
you have not paid. In other words, if you owe money to a person
or company, they can obtain a court order directing your
bank/credit union to take money out of your account to pay off
your debt. If this happens, you cannot use that money in your
account.
What has happened to my account?
On ______ date of account review , we researched your account
and identified that one or more payments identified by ORS 18.784
(1) have been deposited in the last two months (see below for a
list of qualifying payments). In most cases, these payments are
protected from garnishment. As required by state and federal
regulations, therefore, we have established a 'protected amount '
of funds that will remain available to you and that will not be
frozen or removed from your account in response to the
garnishment order.
(Conditional paragraph if funds have been frozen)
__ (check if applicable) Your account contained additional
money that may not be protected from garnishment. As required by
law, we have placed a hold on or removed these funds in the
amount of $____ amount frozen and may have to turn these funds
over to your creditor as directed by the garnishment order.
The chart below summarizes this information about your
account(s):
Enrolled House Bill 2859 (HB 2859-A) Page 12
ACCOUNT SUMMARY AS OF ____ DATE OF ACCOUNT REVIEW
____NOTE_TO_WEB_CUSTOMERS:__________________________________
THE FOLLOWING TABULAR TEXT MAY BE IRREGULAR.
FOR COMPLETE INFORMATION PLEASE SEE THE PRINTED MEASURE.
_______________________________________________________________
Amount
Accountin Amount
Number AccountProtected
___
___
___
___
___
___
____________________________________________________________
END OF POSSIBLE IRREGULAR TABULAR TEXT
____________________________________________________________
____NOTE_TO_WEB_CUSTOMERS:__________________________________
THE FOLLOWING TABULAR TEXT MAY BE IRREGULAR.
FOR COMPLETE INFORMATION PLEASE SEE THE PRINTED MEASURE.
_______________________________________________________________
Amount
Subject to
garnish-
ment (nowGarnish-
frozen/ment fee
removed)charged
___
___
___
___
____________________________________________________________
END OF POSSIBLE IRREGULAR TABULAR TEXT
____________________________________________________________
(If the account holder has multiple accounts, use a separate
row for each account)
Please note that these amount(s) may be affected by deposits or
withdrawals after the protected amount was calculated on
______ (date of garnishment account review).
Do I need to do anything to access my protected funds?
You may use the protected amount of money in your account as
you normally would.
There is nothing else you need to do to make sure that the
protected amount is safe.
Who garnished my account?
Enrolled House Bill 2859 (HB 2859-A) Page 13
The creditor who obtained a garnishment order against you
is ______ (name of creditor).
What types of benefit payments are protected from garnishment?
In most cases, you have protections from garnishment if the
funds in your account include one or more of the following
benefit payments:
o Social Security benefits
o Supplemental Security Income benefits
o Veterans' benefits
o Railroad retirement benefits
o Railroad Unemployment Insurance benefits
o Civil Service Retirement System benefits
o Federal Employees Retirement System benefits
o Payments from a public or private retirement plan as defined
in ORS 18.358
o Public assistance { + or medical assistance, as defined in
ORS 414.025, + } { - payments - } from the State of Oregon
or an agency of the State of Oregon
o Unemployment compensation payments from the State of Oregon
or an agency of the State of Oregon
o Black lung benefits payments from the United States
Department of Labor
o Workers' compensation payments from a workers' compensation
carrier
What should I do if I think that additional funds in my account
are from protected benefit payments?
If you believe that funds in your account(s) should not have
been frozen or removed, there are several things you can do:
You can fill out a Challenge to Garnishment form and submit it
to the court.
You may contact the creditor that garnished your account and
explain that funds are from protected benefit payments and should
be released to you. The creditor may be contacted at
______ (address of creditor).
You may consult an attorney to help you prove to the creditor
that garnished your account that additional funds are from
protected benefit payments and cannot be taken. For information
about how to find an attorney, contact the Oregon State Bar's
Lawyer Referral Service at (800) 452-7636 or go online to
www.oregonlawhelp.org.
This notice contains all the information that we have about the
garnishment order. However, if you have a question about your
account, you may contact us at ______ (telephone number of
financial institution).
_________________________________________________________________
SECTION 7. ORS 25.381 is amended to read:
25.381. (1) Whenever services are being provided under ORS
25.080, support rights are not and have not at any time during
the past five months been assigned to this or another state, and
no arrearages under a support order are so assigned, the
administrator shall provide, upon request of an obligor or
obligee, services sufficient to permit establishment of income
Enrolled House Bill 2859 (HB 2859-A) Page 14
withholding under ORS 25.378, including services necessary to
establish a support payment record under ORS 25.164 and 25.167.
(2) Regardless of whether services are being provided under ORS
25.080, the administrator shall provide, upon request of an
obligor or obligee, services sufficient to permit establishment
of income withholding under ORS 25.378:
(a) For the payment of child support without the necessity of
an application for support enforcement services under Title IV-D
of the Social Security Act (42 U.S.C. 651 et seq.); and
(b) For the payment of spousal support if the obligee is
receiving supplemental nutrition assistance or any other form of
public assistance, as defined in ORS 411.010, from the Department
of Human Services { + or medical assistance, as defined in ORS
414.025, from the department or the Oregon Health Authority + }.
SECTION 8. ORS 30.800 is amended to read:
30.800. (1) As used in this section { + and ORS 30.805 + }, '
emergency medical assistance' means:
(a) Medical or dental care not provided in a place where
emergency medical or dental care is regularly available,
including but not limited to a hospital, industrial first-aid
station or a physician's or dentist's office, given voluntarily
and without the expectation of compensation to an injured person
who is in need of immediate medical or dental care and under
emergency circumstances that suggest that the giving of
assistance is the only alternative to death or serious physical
aftereffects; or
(b) Medical care provided voluntarily in good faith and without
expectation of compensation by a physician licensed by the Oregon
Medical Board in the physician's professional capacity as a team
physician at a public or private school or college athletic event
or as a volunteer physician at other athletic events.
(2) No person may maintain an action for damages for injury,
death or loss that results from acts or omissions of a person
while rendering emergency medical assistance unless it is alleged
and proved by the complaining party that the person was grossly
negligent in rendering the emergency medical assistance.
(3) The giving of emergency medical assistance by a person does
not, of itself, establish the relationship of physician and
patient, dentist and patient or nurse and patient between the
person giving the assistance and the person receiving the
assistance insofar as the relationship carries with it any duty
to provide or arrange for further medical care for the injured
person after the giving of emergency medical assistance.
SECTION 9. ORS 93.967 is amended to read:
93.967. During a transferor's life, a transfer on death deed
does not:
(1) Affect an interest or right of the transferor or any other
owner, including the right to transfer or encumber the property;
(2) Affect an interest or right of a designated beneficiary,
even if the designated beneficiary has actual or constructive
notice of the deed;
(3) Affect an interest or right of a secured, unsecured or
future creditor of the transferor even if the creditor has actual
or constructive notice of the deed;
(4) Affect the eligibility of the transferor or a designated
beneficiary for any form of public assistance { + or medical
assistance, as defined in ORS 414.025 + };
(5) Create a legal or equitable interest in favor of the
designated beneficiary; or
Enrolled House Bill 2859 (HB 2859-A) Page 15
(6) Subject the property to claims or process of a secured,
unsecured or future creditor of the designated beneficiary.
SECTION 10. ORS 93.969 is amended to read:
93.969. (1) Except as provided otherwise in the transfer on
death deed and subject to ORS 107.115, 112.455 to 112.555 or
112.570 to 112.590 and ORS 93.981, 93.983 and 93.985, when a
transferor dies, the following rules apply to property that is
subject to a transfer on death deed and owned by the transferor
at death:
(a) A designated beneficiary's interest in the property:
(A) Is transferred to the designated beneficiary in accordance
with the deed if the designated beneficiary survives the
transferor; or
(B) Lapses if the designated beneficiary does not survive the
transferor.
(b) If the transferor has identified multiple designated
beneficiaries to receive concurrent interests in the property:
(A) Concurrent interests are transferred to the designated
beneficiaries in equal and undivided shares with no right of
survivorship; and
(B) The share of a designated beneficiary that lapses or fails
for any reason is transferred to the remaining designated
beneficiaries in proportion to the interest of each designated
beneficiary in the remaining part of the property held
concurrently.
(2) A beneficiary takes the property subject to all
conveyances, encumbrances, assignments, contracts, mortgages,
liens and other interests to which the property is subject at the
transferor's death, including a claim or lien by a state
authorized to seek { + reimbursement for + } public assistance
{ + or medical assistance, as defined in ORS 414.025, + }
{ - reimbursement - } if assets of the transferor's probate
estate are insufficient to pay the amount of the claim or lien.
(3) If a transferor is a joint owner and is:
(a) Survived by one or more joint owners, the property subject
to a transfer on death deed belongs to the surviving joint owners
with a right of survivorship.
(b) The last surviving joint owner, the transfer on death deed
is effective.
(4) A transfer on death deed transfers property without
covenant or warranty of title even if the deed contains a
contrary provision.
SECTION 11. ORS 97.939, as amended by section 7, chapter 7,
Oregon Laws 2012, is amended to read:
97.939. (1) Three copies of a written sales contract shall be
executed for each prearrangement sales contract or
preconstruction sales contract sold by a certified provider. The
certified provider shall retain one copy of the contract and a
copy of the completed contract shall be given to:
(a) The purchaser; and
(b) The depository or the master trustee, if applicable.
(2) Upon receiving trust funds under ORS 97.941, the master
trustee shall sign a copy of the contract received under
subsection (1) of this section, retain a copy for its files and
return the contract to the purchaser.
(3) Each completed contract shall:
(a) Comply with the plain language standards described in ORS
180.545 (1);
(b) Be consecutively numbered;
(c) Have a corresponding consecutively numbered receipt;
Enrolled House Bill 2859 (HB 2859-A) Page 16
(d) Be preprinted or, if the certified provider uses a master
trustee, be obtained from the master trustee;
(e) Identify the purchaser and certified provider who sold the
contract;
(f) Specify whether the contract is a guaranteed contract or a
nonguaranteed contract;
(g) Specify the specific funeral or cemetery merchandise or
services or undeveloped interment spaces included and not
included in the contract; and
(h) If a guaranteed contract, disclose that the certified
provider is entitled to receive 10 percent of the sales price.
(4)(a) Notwithstanding ORS 97.943 (8), in the case of a
prearrangement sales contract, if at the time of entering into
the contract, the beneficiary of the contract is a recipient of
public assistance { + or medical assistance, as defined in ORS
414.025, + }or reasonably anticipates becoming a recipient of
public assistance { + or medical assistance + }, the contract
may provide that the contract is irrevocable.
(b) The contract may provide for an election by the
beneficiary, or by the purchaser on behalf of the beneficiary, to
make the contract thereafter irrevocable if after the contract is
entered into, the beneficiary becomes eligible or seeks to become
eligible for public assistance { + or medical assistance + }.
SECTION 12. ORS 108.725 is amended to read:
108.725. (1) A premarital agreement is not enforceable if the
party against whom enforcement is sought proves that:
(a) That party did not execute the agreement voluntarily; or
(b) The agreement was unconscionable when it was executed and,
before execution of the agreement, that party:
(A) Was not provided a fair and reasonable disclosure of the
property or financial obligations of the other party;
(B) Did not voluntarily and expressly waive, in writing, any
right to disclosure of the property or financial obligations of
the other party beyond the disclosure provided; and
(C) Did not have, or reasonably could not have had, an adequate
knowledge of the property or financial obligations of the other
party.
(2) If a provision of a premarital agreement modifies or
eliminates spousal support and that modification or elimination
causes one party to the agreement to be eligible for support
under a program of public assistance { + or medical
assistance + } at the time of separation or marital dissolution,
a court, notwithstanding the terms of the agreement, may require
the other party to provide support to the extent necessary to
avoid that eligibility.
(3) An issue of whether a premarital agreement is
unconscionable shall be decided by the court as a matter of law.
SECTION 13. ORS 109.811 is amended to read:
109.811. (1) The court shall award the prevailing party,
including a state, necessary and reasonable expenses incurred by
or on behalf of the party, including costs, communication
expenses, attorney fees, investigative fees, expenses for
witnesses, travel expenses and child care expenses during the
course of the proceedings, unless the party from whom fees or
expenses are sought establishes that the award would be clearly
inappropriate. An award may be inappropriate if the award would
cause the parent or child to seek public assistance { + or
medical assistance, as defined in ORS 414.025 + }.
(2) The court may not assess fees, costs or expenses against a
state unless authorized by law other than ORS 109.701 to 109.834.
Enrolled House Bill 2859 (HB 2859-A) Page 17
SECTION 14. ORS 113.085 is amended to read:
113.085. (1) Except as provided in subsection (2) of this
section, upon the filing of the petition, if there is no will or
there is a will and it has been proved, the court shall appoint a
qualified person it finds suitable as personal representative,
giving preference in the following order:
(a) The executor named in the will.
(b) The surviving spouse of the decedent or the nominee of the
surviving spouse of the decedent.
(c) The nearest of kin of the decedent or the nominee of the
nearest of kin of the decedent.
(d) The Director of Human Services or the Director of the
Oregon Health Authority, or an attorney approved under ORS
113.086, if the decedent received public assistance as defined in
ORS 411.010 { + , received medical assistance as defined in ORS
414.025 + } or received care at an institution described in ORS
179.321 (1) or (2) and it appears that the assistance or the cost
of care may be recovered from the estate of the decedent.
(e) The Department of Veterans' Affairs, if the decedent was a
protected person under ORS 406.050 (8), and the department has
joined in the petition for such appointment.
(f) Any other person.
(2) Except as provided in subsection (3) of this section, the
court shall appoint the Department of State Lands as personal
representative if it appears that the decedent died wholly
intestate and without known heirs. The Attorney General shall
represent the Department of State Lands in the administration of
the estate. Any funds received by the Department of State Lands
in the capacity of personal representative may be deposited in
accounts, separate and distinct from the General Fund,
established with the State Treasurer. Interest earned by such
account shall be credited to that account.
(3) The court may appoint a person other than the Department of
State Lands to administer the estate of a decedent who died
wholly intestate and without known heirs if the person filing a
petition under ORS 113.035 attaches written authorization from an
estate administrator of the Department of State Lands appointed
under ORS 113.235 approving the filing of the petition by the
person. Except as provided by rule adopted by the Director of the
Department of State Lands, an estate administrator may consent to
the appointment of another person to act as personal
representative only if it appears after investigation that the
estate is insolvent.
SECTION 15. ORS 113.086 is amended to read:
113.086. The Director of Human Services, or the director's
designated representative, or the Director of the Oregon Health
Authority, or the director's designated representative, may
approve in writing attorneys who are eligible to be appointed as
personal representatives under ORS 113.085 if the decedent
received public assistance { - pursuant to ORS chapter 411 or
414 - } { + as defined in ORS 411.010, received medical
assistance as defined in ORS 414.025 + } or received care at an
institution as defined in ORS 179.010, and it appears that the
assistance or the cost of care may be recovered from the estate
of the decedent. An attorney approved under this section does not
represent the Director of Human Services or the Director of the
Oregon Health Authority when appointed as a personal
representative.
SECTION 16. ORS 114.305 is amended to read:
Enrolled House Bill 2859 (HB 2859-A) Page 18
114.305. Subject to the provisions of ORS 97.130 (2) and (10)
and except as restricted or otherwise provided by the will of the
decedent, a document of anatomical gift under ORS 97.965 or by
court order, a personal representative, acting reasonably for the
benefit of interested persons, is authorized to:
(1) Direct and authorize disposition of the remains of the
decedent pursuant to ORS 97.130 and incur expenses for the
funeral, burial or other disposition of the remains in a manner
suitable to the condition in life of the decedent. Only those
funeral expenses necessary for a plain and decent funeral and
disposition of the remains of the decedent may be paid from the
estate if the assets are insufficient to pay the claims of the
Department of Human Services and the Oregon Health Authority for
the net amount of public assistance, as defined in ORS
411.010, { + or medical assistance, as defined in ORS
414.025, + } paid to or for the decedent and for care and
maintenance of any decedent who was at a state institution to the
extent provided in ORS 179.610 to 179.770.
(2) Retain assets owned by the decedent pending distribution or
liquidation.
(3) Receive assets from fiduciaries or other sources.
(4) Complete, compromise or refuse performance of contracts of
the decedent that continue as obligations of the estate, as the
personal representative may determine under the circumstances. In
performing enforceable contracts by the decedent to convey or
lease real property, the personal representative, among other
courses of action, may:
(a) Execute and deliver a deed upon satisfaction of any sum
remaining unpaid or upon receipt of the note of the purchaser
adequately secured; or
(b) Deliver a deed in escrow with directions that the proceeds,
when paid in accordance with the escrow agreement, be paid to the
successors of the decedent, as designated in the escrow
agreement.
(5) Satisfy written pledges of the decedent for contributions,
whether or not the pledges constituted binding obligations of the
decedent or were properly presented as claims.
(6) Deposit funds not needed to meet currently payable debts
and expenses, and not immediately distributable, in bank or
savings and loan association accounts, or invest the funds in
bank or savings and loan association certificates of deposit, or
federally regulated money-market funds and short-term investment
funds suitable for investment by trustees under ORS 130.750 to
130.775, or short-term United States Government obligations.
(7) Abandon burdensome property when it is valueless, or is so
encumbered or is in a condition that it is of no benefit to the
estate.
(8) Vote stocks or other securities in person or by general or
limited proxy.
(9) Pay calls, assessments and other sums chargeable or
accruing against or on account of securities.
(10) Sell or exercise stock subscription or conversion rights.
(11) Consent, directly or through a committee or other agent,
to the reorganization, consolidation, merger, dissolution or
liquidation of a corporation or other business enterprise.
(12) Hold a security in the name of a nominee or in other form
without disclosure of the interest of the estate, but the
personal representative is liable for any act of the nominee in
connection with the security so held.
Enrolled House Bill 2859 (HB 2859-A) Page 19
(13) Insure the assets of the estate against damage and loss,
and insure the personal representative against liability to third
persons.
(14) Advance or borrow money with or without security.
(15) Compromise, extend, renew or otherwise modify an
obligation owing to the estate. A personal representative who
holds a mortgage, pledge, lien or other security interest may
accept a conveyance or transfer of the encumbered asset in lieu
of foreclosure in full or partial satisfaction of the
indebtedness.
(16) Accept other real property in part payment of the purchase
price of real property sold by the personal representative.
(17) Pay taxes, assessments and expenses incident to the
administration of the estate.
(18) Employ qualified persons, including attorneys, accountants
and investment advisers, to advise and assist the personal
representative and to perform acts of administration, whether or
not discretionary, on behalf of the personal representative.
(19) Prosecute or defend actions, claims or proceedings in any
jurisdiction for the protection of the estate and of the personal
representative in the performance of duties as personal
representative.
(20) Prosecute claims of the decedent including those for
personal injury or wrongful death.
(21) Continue any business or venture in which the decedent was
engaged at the time of death to preserve the value of the
business or venture.
(22) Incorporate or otherwise change the business form of any
business or venture in which the decedent was engaged at the time
of death.
(23) Discontinue and wind up any business or venture in which
the decedent was engaged at the time of death.
(24) Provide for exoneration of the personal representative
from personal liability in any contract entered into on behalf of
the estate.
(25) Satisfy and settle claims and distribute the estate as
provided in ORS chapters 111, 112, 113, 114, 115, 116 and 117.
(26) Perform all other acts required or permitted by law or by
the will of the decedent.
SECTION 17. ORS 114.515 is amended to read:
114.515. (1) If the estate of a decedent meets the requirements
of subsection (2) of this section, any of the following persons
may file an affidavit with the clerk of the probate court in any
county where there is venue for a proceeding seeking the
appointment of a personal representative for the estate:
(a) One or more of the claiming successors of the decedent.
(b) If the decedent died testate, any person named as personal
representative in the decedent's will.
(c) The Director of Human Services, the Director of the Oregon
Health Authority or an attorney approved under ORS 114.517, if
the decedent received public assistance { - pursuant to ORS
chapter 411 or 414 - } { + as defined in ORS 411.010, received
medical assistance as defined in ORS 414.025 + } or received care
at an institution as defined in ORS 179.010, and it appears that
the assistance or the cost of care may be recovered from the
estate of the decedent.
(2) An affidavit under this section may be filed only if:
(a) The fair market value of the estate is $275,000 or less;
(b) Not more than $75,000 of the fair market value of the
estate is attributable to personal property; and
Enrolled House Bill 2859 (HB 2859-A) Page 20
(c) Not more than $200,000 of the fair market value of the
estate is attributable to real property.
(3) An affidavit under this section may not be filed until 30
days after the death of the decedent.
(4) An affidavit filed under the provisions of this section
must contain the information required in ORS 114.525 and shall be
made a part of the probate records. If the affiant is an attorney
approved by the Director of Human Services or the Director of the
Oregon Health Authority, a copy of the document approving the
attorney must be attached to the affidavit.
(5) In determining fair market value under this section, the
fair market value of the entire interest in the property included
in the estate shall be used without reduction for liens or other
debts.
(6) The clerk of the probate court shall charge and collect the
fee established under ORS 21.145 for the filing of any affidavit
under this section.
(7) Any error or omission in an affidavit filed under this
section may be corrected by filing an amended affidavit within
four months after the filing of the affidavit.
(8) One or more supplemental affidavits may be filed at any
time after the filing of an affidavit under this section for the
purpose of including property not described in the original
affidavit. Copies of all previously filed affidavits must be
attached to the supplemental affidavit and all information
required in ORS 114.525 must be reflected in the supplemental
affidavit. A supplemental affidavit may not be filed if by reason
of the additional property described in the supplemental
affidavit any limitation imposed by subsection (2) of this
section is exceeded.
SECTION 18. ORS 114.517 is amended to read:
114.517. The Director of Human Services, or the director's
designated representative, or the Director of the Oregon Health
Authority, or the director's designated representative, may
approve in writing attorneys who are eligible to file an
affidavit under ORS 114.515 if the decedent received public
assistance
{ - pursuant to ORS chapter 411 or 414 - } { + as defined in
ORS 411.010, received medical assistance as defined in ORS
414.025 + } or received care at an institution as defined in ORS
179.010, and it appears that the assistance or the cost of care
may be recovered from the estate of the decedent. An attorney
approved under this section does not represent the Director of
Human Services or the Director of the Oregon Health Authority
when the attorney files an affidavit under ORS 114.515.
SECTION 19. ORS 115.125 is amended to read:
115.125. (1) If the applicable assets of the estate are
insufficient to pay all expenses and claims in full, the personal
representative shall make payment in the following order:
(a) Support of spouse and children, subject to the limitations
imposed by ORS 114.065.
(b) Expenses of administration.
(c) Expenses of a plain and decent funeral and disposition of
the remains of the decedent.
(d) Debts and taxes with preference under federal law.
(e) Reasonable and necessary medical and hospital expenses of
the last illness of the decedent, including compensation of
persons attending the decedent.
Enrolled House Bill 2859 (HB 2859-A) Page 21
(f) Taxes with preference under the laws of this state that are
due and payable while possession of the estate of the decedent is
retained by the personal representative.
(g) Debts owed employees of the decedent for labor performed
within 90 days immediately preceding the date of death of the
decedent.
(h) Child support arrearages.
(i) The claim of the Department of Human Services or the Oregon
Health Authority for the amount of the state's monthly
contribution to the federal government to defray the costs of
outpatient prescription drug coverage provided to a person who is
eligible for Medicare Part D prescription drug coverage and who
receives benefits under the state medical assistance program or
Title XIX of the Social Security Act.
(j) The claim of the Department of Human Services or the Oregon
Health Authority for the net amount of assistance paid to or for
the decedent, in the following order:
(A) Public assistance, as defined in ORS 411.010, { + and
medical assistance, as defined in ORS 414.025, + } funded
entirely by moneys from the General Fund; and
(B) Public assistance, as defined in ORS 411.010, { + and
medical assistance, as defined in ORS 414.025, that may be
recovered from an estate under ORS 416.350, + } funded by a
combination of state and federal funds.
(k) The claim of the Department of Human Services or the Oregon
Health Authority for the care and maintenance of the decedent at
a state institution, as provided in ORS 179.610 to 179.770.
(L) The claim of the Department of Corrections for care and
maintenance of any decedent who was at a state institution to the
extent provided in ORS 179.610 to 179.770.
(m) All other claims against the estate.
(2) If the applicable assets of the estate are insufficient to
pay in full all expenses or claims of any one class specified in
subsection (1) of this section, each expense or claim of that
class shall be paid only in proportion to the amount thereof.
SECTION 20. ORS 115.195 is amended to read:
115.195. (1) A claim that has been disallowed by the personal
representative may not be allowed by any court except upon some
competent, satisfactory evidence other than the testimony of the
claimant.
(2) Notwithstanding subsection (1) of this section, claims for
recovery of public assistance as defined by ORS 411.010 { + or
medical assistance as defined in ORS 414.025 + } may be allowed
based on evidence in the form of documents from the Department of
Human Services or the Oregon Health Authority that contain
information relating to that public assistance { + or medical
assistance + }, such as the date that services were provided to
the decedent, the classification of those services, the name of
the provider or the provider's identification number, and the
amount of the public assistance { + or medical assistance + }
payment made for the services. The documents may be prints
obtained from microfilm or microfiche, or printouts from computer
records or other electronic storage medium. Notwithstanding ORS
40.460 and 40.510, a document described in this subsection is
prima facie evidence of the information contained in the document
and is not excluded from introduction as hearsay, and extrinsic
evidence of authenticity of the document as a condition precedent
to admissibility is not required, if the document bears a seal
that on its face is the seal of the Director of Human Services or
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the designee of the director, or the Director of the Oregon
Health Authority or the designee of the director, and:
(a) For a print obtained from microfilm or microfiche, also
bears a statement indicating that the print is a true copy of the
microfilm or microfiche record, signed by a person who purports
to be an officer or employee of the department or the authority;
or
(b) For a printout from computer records or other electronic
storage medium, also bears a statement indicating that the
printout accurately reflects the data retrieved, signed by a
person who purports to be an officer or employee of the
department or the authority.
SECTION 21. ORS 125.170 is amended to read:
125.170. (1) Not more than once each calendar year, the court
may charge a respondent or protected person for any visitor
services provided during the year. The court may order
reimbursement to the state from the assets of the respondent or
protected person for the cost of any interview or report unless
the court finds that the assessment would impose a hardship on
the respondent or protected person. If the respondent or
protected person is receiving public assistance { + or medical
assistance + }, { + as defined in ORS 414.025, + } there is a
rebuttable presumption that charging a respondent or protected
person for the services of a visitor would impose a hardship.
(2) The presiding judge by court order shall establish fees for
visitors conducting interviews and preparing reports.
(3) All amounts collected under this section in reimbursement
for visitor services shall be forwarded to the State Court
Administrator and are continuously appropriated to the State
Court Administrator. Funds appropriated to the State Court
Administrator under this section may be used by the State Court
Administrator for the purpose of funding visitor services
provided under ORS 125.150 and 125.155.
SECTION 22. ORS 130.425 is amended to read:
130.425. (1) Claims allowed against the trust estate under ORS
130.350 to 130.450 must be paid by the trustee in the following
order of priority:
(a) Expenses of administering the trust estate.
(b) Expenses of a plain and decent funeral and disposition of
the remains of the settlor.
(c) Debts and taxes with preference under federal law.
(d) Reasonable and necessary medical and hospital expenses of
the last illness of the settlor, including compensation of
persons attending the settlor.
(e) Taxes with preference under the laws of this state that are
due and payable while possession of the trust estate of the
settlor is retained by the trustee.
(f) Debts owed employees of the settlor for labor performed
within 90 days immediately preceding the date of death of the
settlor.
(g) Child support arrearages.
(h) Claims of the Department of Human Services and the Oregon
Health Authority for the net amount of public assistance, as
defined in ORS 411.010 { + , and for the net amount of medical
assistance that may be recovered from an estate under ORS
416.350 + }.
(i) Claims of the Department of Human Services and the Oregon
Health Authority for the care and maintenance of any settlor who
was a patient at a state institution under ORS 179.610 to
179.770.
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(j) All other claims against the trust estate.
(2) If the assets of the trust estate are insufficient to pay
in full all expenses or claims of any one class specified in
subsection (1) of this section, each expense or claim of that
class shall be paid only in proportion to the amount thereof.
SECTION 23. ORS 166.715 is amended to read:
166.715. As used in ORS 166.715 to 166.735, unless the context
requires otherwise:
(1) 'Documentary material' means any book, paper, document,
writing, drawing, graph, chart, photograph, phonograph record,
magnetic tape, computer printout, other data compilation from
which information can be obtained or from which information can
be translated into usable form, or other tangible item.
(2) 'Enterprise' includes any individual, sole proprietorship,
partnership, corporation, business trust or other profit or
nonprofit legal entity, and includes any union, association or
group of individuals associated in fact although not a legal
entity, and both illicit and licit enterprises and governmental
and nongovernmental entities.
(3) 'Investigative agency' means the Department of Justice or
any district attorney.
(4) 'Pattern of racketeering activity' means engaging in at
least two incidents of racketeering activity that have the same
or similar intents, results, accomplices, victims or methods of
commission or otherwise are interrelated by distinguishing
characteristics, including a nexus to the same enterprise, and
are not isolated incidents, provided at least one of such
incidents occurred after November 1, 1981, and that the last of
such incidents occurred within five years after a prior incident
of racketeering activity. Notwithstanding ORS 131.505 to 131.525
or 419A.190 or any other provision of law providing that a
previous prosecution is a bar to a subsequent prosecution,
conduct that constitutes an incident of racketeering activity may
be used to establish a pattern of racketeering activity without
regard to whether the conduct previously has been the subject of
a criminal prosecution or conviction or a juvenile court
adjudication, unless the prosecution resulted in an acquittal or
the adjudication resulted in entry of an order finding the youth
not to be within the jurisdiction of the juvenile court.
(5) 'Person' means any individual or entity capable of holding
a legal or beneficial interest in real or personal property.
(6) 'Racketeering activity' includes conduct of a person
committed both before and after the person attains the age of 18
years, and means to commit, to attempt to commit, to conspire to
commit, or to solicit, coerce or intimidate another person to
commit:
(a) Any conduct that constitutes a crime, as defined in ORS
161.515, under any of the following provisions of the Oregon
Revised Statutes:
(A) ORS 59.005 to 59.451, 59.710 to 59.830, 59.991 and 59.995,
relating to securities;
(B) ORS 162.015, 162.025 and 162.065 to 162.085, relating to
bribery and perjury;
(C) ORS 162.235, 162.265 to 162.305, 162.325, 162.335, 162.355
and 162.365, relating to obstructing governmental administration;
(D) ORS 162.405 to 162.425, relating to abuse of public office;
(E) ORS 162.455, relating to interference with legislative
operation;
(F) ORS 163.095 to 163.115, 163.118, 163.125 and 163.145,
relating to criminal homicide;
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(G) ORS 163.160 to 163.205, relating to assault and related
offenses;
(H) ORS 163.225 and 163.235, relating to kidnapping;
(I) ORS 163.275, relating to coercion;
(J) ORS 163.665 to 163.693, relating to sexual conduct of
children;
(K) ORS 164.015, 164.043, 164.045, 164.055, 164.057, 164.075 to
164.095, 164.098, 164.125, 164.135, 164.140, 164.215, 164.225 and
164.245 to 164.270, relating to theft, burglary, criminal
trespass and related offenses;
(L) ORS 164.315 to 164.335, relating to arson and related
offenses;
(M) ORS 164.345 to 164.365, relating to criminal mischief;
(N) ORS 164.395 to 164.415, relating to robbery;
(O) ORS 164.865, 164.875 and 164.868 to 164.872, relating to
unlawful recording or labeling of a recording;
(P) ORS 165.007 to 165.022, 165.032 to 165.042 and 165.055 to
165.070, relating to forgery and related offenses;
(Q) ORS 165.080 to 165.109, relating to business and commercial
offenses;
(R) ORS 165.540 and 165.555, relating to communication crimes;
(S) ORS 166.180, 166.190, 166.220, 166.250, 166.270, 166.275,
166.410, 166.450 and 166.470, relating to firearms and other
weapons;
(T) ORS 164.377 (2) to (4), as punishable under ORS 164.377
(5)(b), 167.007 to 167.017, 167.057, 167.062 to 167.080, 167.090,
167.122 to 167.137, 167.147, 167.164, 167.167, 167.212, 167.355,
167.365, 167.370, 167.428, 167.431 and 167.439, relating to
prostitution, obscenity, sexual conduct, gambling, computer
crimes involving the Oregon State Lottery, animal fighting,
forcible recovery of a fighting bird and related offenses;
(U) ORS 171.990, relating to legislative witnesses;
(V) ORS 260.575 and 260.665, relating to election offenses;
(W) ORS 314.075, relating to income tax;
(X) ORS 180.440 (2) and 180.486 (2) and ORS chapter 323,
relating to cigarette and tobacco products taxes and the
directories developed under ORS 180.425 and 180.477;
(Y) ORS 411.630, 411.675, 411.690 and 411.840, relating to
public assistance payments { + or medical assistance
benefits + }, and ORS 411.990 (2) and (3);
(Z) ORS 462.140, 462.415 and 462.420 to 462.520, relating to
racing;
(AA) ORS 463.995, relating to boxing, mixed martial arts and
entertainment wrestling, as defined in ORS 463.015;
(BB) ORS 471.305, 471.360, 471.392 to 471.400, 471.403,
471.404, 471.405, 471.425, 471.442, 471.445, 471.446, 471.485,
471.490 and 471.675, relating to alcoholic liquor, and any of the
provisions of ORS chapter 471 relating to licenses issued under
the Liquor Control Act;
(CC) ORS 475.005 to 475.285 and 475.752 to 475.980, relating to
controlled substances;
(DD) ORS 480.070, 480.210, 480.215, 480.235 and 480.265,
relating to explosives;
(EE) ORS 819.010, 819.040, 822.100, 822.135 and 822.150,
relating to motor vehicles;
(FF) ORS 658.452 or 658.991 (2) to (4), relating to farm labor
contractors;
(GG) ORS chapter 706, relating to banking law administration;
(HH) ORS chapter 714, relating to branch banking;
(II) ORS chapter 716, relating to mutual savings banks;
Enrolled House Bill 2859 (HB 2859-A) Page 25
(JJ) ORS chapter 723, relating to credit unions;
(KK) ORS chapter 726, relating to pawnbrokers;
(LL) ORS 166.382 and 166.384, relating to destructive devices;
(MM) ORS 165.074;
(NN) ORS 86A.095 to 86A.198, relating to mortgage bankers and
mortgage brokers;
(OO) ORS chapter 496, 497 or 498, relating to wildlife;
(PP) ORS 163.355 to 163.427, relating to sexual offenses;
(QQ) ORS 166.015, relating to riot;
(RR) ORS 166.155 and 166.165, relating to intimidation;
(SS) ORS chapter 696, relating to real estate and escrow;
(TT) ORS chapter 704, relating to outfitters and guides;
(UU) ORS 165.692, relating to making a false claim for health
care payment;
(VV) ORS 162.117, relating to public investment fraud;
(WW) ORS 164.170 or 164.172;
(XX) ORS 647.140, 647.145 or 647.150, relating to trademark
counterfeiting;
(YY) ORS 164.886;
(ZZ) ORS 167.312 and 167.388;
(AAA) ORS 164.889;
(BBB) ORS 165.800; or
(CCC) ORS 163.263, 163.264 or 163.266.
(b) Any conduct defined as 'racketeering activity' under 18
U.S.C. 1961 (1)(B), (C), (D) and (E).
(7) 'Unlawful debt' means any money or other thing of value
constituting principal or interest of a debt that is legally
unenforceable in the state in whole or in part because the debt
was incurred or contracted:
(a) In violation of any one of the following:
(A) ORS chapter 462, relating to racing;
(B) ORS 167.108 to 167.164, relating to gambling; or
(C) ORS 82.010 to 82.170, relating to interest and usury.
(b) In gambling activity in violation of federal law or in the
business of lending money at a rate usurious under federal or
state law.
(8) Notwithstanding contrary provisions in ORS 174.060, when
this section references a statute in the Oregon Revised Statutes
that is substantially different in the nature of its essential
provisions from what the statute was when this section was
enacted, the reference shall extend to and include amendments to
the statute.
SECTION 24. ORS 179.505 is amended to read:
179.505. (1) As used in this section:
(a) 'Disclosure' means the release of, transfer of, provision
of access to or divulgence in any other manner of information
outside the health care services provider holding the
information.
(b) 'Health care services provider' means:
(A) Medical personnel or other staff employed by or under
contract with a public provider to provide health care or
maintain written accounts of health care provided to individuals;
or
(B) Units, programs or services designated, operated or
maintained by a public provider to provide health care or
maintain written accounts of health care provided to individuals.
(c) 'Individually identifiable health information' means any
health information that is:
(A) Created or received by a health care services provider; and
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(B) Identifiable to an individual, including demographic
information that identifies the individual, or for which there is
a reasonable basis to believe the information can be used to
identify an individual, and that relates to:
(i) The past, present or future physical or mental health or
condition of an individual;
(ii) The provision of health care to an individual; or
(iii) The past, present or future payment for the provision of
health care to an individual.
(d) 'Personal representative' includes but is not limited to:
(A) A person appointed as a guardian under ORS 125.305,
419B.370, 419C.481 or 419C.555 with authority to make medical and
health care decisions;
(B) A person appointed as a health care representative under
ORS 127.505 to 127.660 or a representative under ORS 127.700 to
127.737 to make health care decisions or mental health treatment
decisions; and
(C) A person appointed as a personal representative under ORS
chapter 113.
(e) 'Psychotherapy notes' means notes recorded in any medium:
(A) By a mental health professional, in the performance of the
official duties of the mental health professional;
(B) Documenting or analyzing the contents of conversation
during a counseling session; and
(C) That are maintained separately from the rest of the
individual's record.
(f) 'Psychotherapy notes' does not mean notes documenting:
(A) Medication prescription and monitoring;
(B) Counseling session start and stop times;
(C) Modalities and frequencies of treatment furnished;
(D) Results of clinical tests; or
(E) Any summary of the following items:
(i) Diagnosis;
(ii) Functional status;
(iii) Treatment plan;
(iv) Symptoms;
(v) Prognosis; or
(vi) Progress to date.
(g) 'Public provider' means:
(A) The Blue Mountain Recovery Center { - , the Eastern Oregon
Training Center - } and the Oregon State Hospital campuses;
(B) Department of Corrections institutions as defined in ORS
421.005;
(C) A contractor of the Department of Corrections { - , the
Department of Human Services - } or the Oregon Health Authority
that provides health care to individuals residing in a state
institution operated by the agencies;
(D) A community mental health program or community
developmental disabilities program as described in ORS 430.610 to
430.695 and the public and private entities with which it
contracts to provide mental health or developmental disabilities
programs or services;
(E) A program or service provided under ORS 431.250, 431.375 to
431.385 or 431.416;
(F) A program or service established or maintained under ORS
430.630 or 430.664;
(G) A program or facility providing an organized full-day or
part-day program of treatment that is licensed, approved,
established, maintained or operated by or contracted with the
Enrolled House Bill 2859 (HB 2859-A) Page 27
Oregon Health Authority for alcoholism, drug addiction or mental
or emotional disturbance;
(H) A program or service providing treatment by appointment
that is licensed, approved, established, maintained or operated
by or contracted with the authority for alcoholism, drug
addiction or mental or emotional disturbance; or
(I) The impaired health professional program established under
ORS 676.190.
(h) 'Written account' means records containing only
individually identifiable health information.
(2) Except as provided in subsections (3), (4), (6), (7), (8),
(9), (11), (12), (14), (15), (16) and (17) of this section or
unless otherwise permitted or required by state or federal law or
by order of the court, written accounts of the individuals served
by any health care services provider maintained in or by the
health care services provider by the officers or employees
thereof who are authorized to maintain written accounts within
the official scope of their duties are not subject to access and
may not be disclosed. This subsection applies to written accounts
maintained in or by facilities of the Department of Corrections
only to the extent that the written accounts concern the medical,
dental or psychiatric treatment as patients of those under the
jurisdiction of the Department of Corrections.
(3) If the individual or a personal representative of the
individual provides an authorization, the content of any written
account referred to in subsection (2) of this section must be
disclosed accordingly, if the authorization is in writing and is
signed and dated by the individual or the personal representative
of the individual and sets forth with specificity the following:
(a) Name of the health care services provider authorized to
make the disclosure, except when the authorization is provided by
recipients of or applicants for public assistance { + or medical
assistance, as defined in ORS 414.025, + }to a governmental
entity for purposes of determining eligibility for benefits or
investigating for fraud;
(b) Name or title of the persons or organizations to which the
information is to be disclosed or that information may be
disclosed to the public;
(c) Name of the individual;
(d) Extent or nature of the information to be disclosed; and
(e) Statement that the authorization is subject to revocation
at any time except to the extent that action has been taken in
reliance thereon, and a specification of the date, event or
condition upon which it expires without express revocation.
However, a revocation of an authorization is not valid with
respect to inspection or records necessary to validate
expenditures by or on behalf of governmental entities.
(4) The content of any written account referred to in
subsection (2) of this section may be disclosed without an
authorization:
(a) To any person to the extent necessary to meet a medical
emergency.
(b) At the discretion of the responsible officer of the health
care services provider, which in the case of any Oregon Health
Authority facility or community mental health program is the
Director of the Oregon Health Authority, to persons engaged in
scientific research, program evaluation, peer review and fiscal
audits. However, individual identities may not be disclosed to
such persons, except when the disclosure is essential to the
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research, evaluation, review or audit and is consistent with
state and federal law.
(c) To governmental agencies when necessary to secure
compensation for services rendered in the treatment of the
individual.
(5) When an individual's identity is disclosed under subsection
(4) of this section, a health care services provider shall
prepare, and include in the permanent records of the health care
services provider, a written statement indicating the reasons for
the disclosure, the written accounts disclosed and the recipients
of the disclosure.
(6) The content of any written account referred to in
subsection (2) of this section and held by a health care services
provider currently engaged in the treatment of an individual may
be disclosed to officers or employees of that provider, its
agents or cooperating health care services providers who are
currently acting within the official scope of their duties to
evaluate treatment programs, to diagnose or treat or to assist in
diagnosing or treating an individual when the written account is
to be used in the course of diagnosing or treating the
individual. Nothing in this subsection prevents the transfer of
written accounts referred to in subsection (2) of this section
among health care services providers, { - the Department of
Human Services, - } the Department of Corrections, the Oregon
Health Authority or a local correctional facility when the
transfer is necessary or beneficial to the treatment of an
individual.
(7) When an action, suit, claim, arbitration or proceeding is
brought under ORS 34.105 to 34.240 or 34.310 to 34.730 and
involves a claim of constitutionally inadequate medical care,
diagnosis or treatment, or is brought under ORS 30.260 to 30.300
and involves the Department of Corrections or an institution
operated by the department, nothing in this section prohibits the
disclosure of any written account referred to in subsection (2)
of this section to the Department of Justice, Oregon Department
of Administrative Services, or their agents, upon request, or the
subsequent disclosure to a court, administrative hearings
officer, arbitrator or other administrative decision maker.
(8)(a) When an action, suit, claim, arbitration or proceeding
involves { - the Department of Human Services, - } the Oregon
Health Authority or an institution operated by the
{ - department or - } authority, nothing in this section
prohibits the disclosure of any written account referred to in
subsection (2) of this section to the Department of Justice,
Oregon Department of Administrative Services, or their agents.
(b) Disclosure of information in an action, suit, claim,
nonlabor arbitration or proceeding is limited by the relevancy
restrictions of ORS 40.010 to 40.585, 183.710 to 183.725, 183.745
and 183.750 and ORS chapter 183. Only written accounts of a
plaintiff, claimant or petitioner shall be disclosed under this
paragraph.
(c) Disclosure of information as part of a labor arbitration or
proceeding to support a personnel action taken against staff is
limited to written accounts directly relating to alleged action
or inaction by staff for which the personnel action was imposed.
(9)(a) The copy of any written account referred to in
subsection (2) of this section, upon written request of the
individual or a personal representative of the individual, shall
be disclosed to the individual or the personal representative of
the individual within a reasonable time not to exceed five
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working days. The individual or the personal representative of
the individual shall have the right to timely access to any
written accounts.
(b) If the disclosure of psychiatric or psychological
information contained in the written account would constitute an
immediate and grave detriment to the treatment of the individual,
disclosure may be denied, if medically contraindicated by the
treating physician or a licensed health care professional in the
written account of the individual.
(c) The Department of Corrections may withhold psychiatric or
psychological information if:
(A) The information relates to an individual other than the
individual seeking it.
(B) Disclosure of the information would constitute a danger to
another individual.
(C) Disclosure of the information would compromise the privacy
of a confidential source.
(d) However, a written statement of the denial under paragraph
(c) of this subsection and the reasons therefor must be entered
in the written account.
(10) A health care services provider may require a person
requesting disclosure of the contents of a written account under
this section to reimburse the provider for the reasonable costs
incurred in searching files, abstracting if requested and copying
if requested. However, an individual or a personal representative
of the individual may not be denied access to written accounts
concerning the individual because of inability to pay.
(11) A written account referred to in subsection (2) of this
section may not be used to initiate or substantiate any criminal,
civil, administrative, legislative or other proceedings conducted
by federal, state or local authorities against the individual or
to conduct any investigations of the individual. If the
individual, as a party to an action, suit or other judicial
proceeding, voluntarily produces evidence regarding an issue to
which a written account referred to in subsection (2) of this
section would be relevant, the contents of that written account
may be disclosed for use in the proceeding.
(12) Information obtained in the course of diagnosis,
evaluation or treatment of an individual that, in the
professional judgment of the health care services provider,
indicates a clear and immediate danger to others or to society
may be reported to the appropriate authority. A decision not to
disclose information under this subsection does not subject the
provider to any civil liability. Nothing in this subsection may
be construed to alter the provisions of ORS 146.750, 146.760,
419B.010, 419B.015, 419B.020, 419B.025, 419B.030, 419B.035,
419B.040 and 419B.045.
(13) The prohibitions of this section apply to written accounts
concerning any individual who has been treated by any health care
services provider irrespective of whether or when the individual
ceases to receive treatment.
(14) Persons other than the individual or the personal
representative of the individual who are granted access under
this section to the contents of a written account referred to in
subsection (2) of this section may not disclose the contents of
the written account to any other person except in accordance with
the provisions of this section.
(15) Nothing in this section prevents the Department of Human
Services or the Oregon Health Authority from disclosing the
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contents of written accounts in its possession to individuals or
agencies with whom children in its custody are placed.
(16) The system described in ORS 192.517 (1) shall have access
to records, as defined in ORS 192.515, as provided in ORS
192.517.
(17)(a) Except as provided in paragraph (b) of this subsection,
a health care services provider must obtain an authorization from
an individual or a personal representative of the individual to
disclose psychotherapy notes.
(b) A health care services provider may use or disclose
psychotherapy notes without obtaining an authorization from the
individual or a personal representative of the individual to
carry out the following treatment, payment and health care
operations:
(A) Use by the originator of the psychotherapy notes for
treatment;
(B) Disclosure by the health care services provider for its own
training program in which students, trainees or practitioners in
mental health learn under supervision to practice or improve
their skills in group, joint, family or individual counseling; or
(C) Disclosure by the health care services provider to defend
itself in a legal action or other proceeding brought by the
individual or a personal representative of the individual.
(c) An authorization for the disclosure of psychotherapy notes
may not be combined with an authorization for a disclosure of any
other individually identifiable health information, but may be
combined with another authorization for a disclosure of
psychotherapy notes.
SECTION 25. ORS 183.458 is amended to read:
183.458. (1) Notwithstanding any other provision of law, in any
contested case hearing before a state agency involving child
support, public assistance as defined in ORS 411.010 { + ,
medical assistance as defined in ORS 414.025 + } or the right to
be free from potentially unusual or hazardous treatment
procedures under ORS 426.385 (3), a party may be represented by
any of the following persons:
{ + (a) An attorney licensed to practice law in any state who
is an employee of or contracts with a nonprofit legal services
program that receives funding pursuant to ORS 9.572. + }
{ - (a) - } { + (b) + } An authorized representative who is
an employee of a nonprofit legal services program that receives
funding pursuant to ORS 9.572. The authorized representative must
be supervised by an attorney also employed by a legal services
program.
{ - (b) - } { + (c) + } An authorized representative who is
an employee of the system described in ORS 192.517 (1). The
authorized representative must be supervised by an attorney also
employed by the system.
(2) In any contested case hearing before a state agency
involving child support, a party may be represented by a law
student who is:
(a) Handling the child support matter as part of a law school
clinical program in which the student is enrolled; and
(b) Supervised by an attorney employed by the program.
{ + (3) In any contested case hearing before a state agency
involving an applicant for or recipient of medical assistance,
the claimant may be represented by a relative, friend or any
other person of the claimant's choosing. + }
{ - (3) - } { + (4) + } A person authorized to represent a
party under this section may present evidence in the proceeding,
Enrolled House Bill 2859 (HB 2859-A) Page 31
examine and cross-examine witnesses and present factual and legal
arguments in the proceeding.
SECTION 26. ORS 192.588 is amended to read:
192.588. (1) Upon the request of the Department of Human
Services { + or the Oregon Health Authority + } and the receipt
of the certification required under subsection (2) of this
section, a financial institution shall advise whether a person
has one or more accounts with the financial institution, and if
so, the balance on deposit in each such account on the date this
information is provided.
(2) In requesting information under subsection (1) of this
section, the department { + or authority + } shall specify the
name and Social Security number of the person upon whom the
account information is sought, and shall certify to the financial
institution in writing, signed by an agent of the department { +
or authority + }:
(a) That the person upon whom account information is sought is
an applicant for or recipient of public assistance, as
{ - described - } { + defined + } in ORS 411.010 { + , + }
{ - to 411.116 - } { + or medical assistance, as defined in
ORS 414.025 + }; and
(b) That the department { + or authority + } has authorization
from the person for release of the account information.
(3) Any financial institution supplying account information
under ORS 192.583 to 192.588 and 411.632 shall be reimbursed for
actual costs incurred.
(4) No financial institution that supplies account information
to the department { + or authority + } pursuant to this section
shall be liable to any person for any loss, damage or injury
arising out of or in any way pertaining to the disclosure of
account information under this section.
(5) Each financial institution that is requested to supply
account information under this section may specify to the
department { + or authority + } that requests for account
information and responses from the financial institution shall be
submitted in written, tape or electronic format. A reasonable
time shall be provided the financial institution for response.
(6) The department { + or authority + } shall seek account
information under this section only with respect to persons who
are applicants for or recipients of public assistance { + , + }
as
{ - described - } { + defined + } in ORS 411.010 { + , + }
{ - to 411.116 - } { + or medical assistance, as defined in
ORS 414.025 + }.
SECTION 27. ORS 293.231 is amended to read:
293.231. (1) Except as provided in subsections (4) to (9) of
this section, a state agency, unless otherwise prohibited by law,
shall offer for assignment every liquidated and delinquent
account to a private collection agency or to the Department of
Revenue as provided in ORS 293.250 not later than:
(a) Ninety days from the date the account was liquidated if no
payment has been received on the account within the 90-day
period; or
(b) Ninety days from the date of receipt of the most recent
payment on the account.
(2) Nothing in subsection (1) of this section prohibits a state
agency from offering for assignment a liquidated and delinquent
account to a private collection agency at any time within the
90-day period.
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(3) If, after a reasonable time, the private collection agency
is unable to collect the account, the private collection agency
shall notify the state agency that assigned the account that it
has been unable to collect the account and shall relinquish the
account to the state agency. A private collection agency that
collects an account under this section shall be held to the same
standard of confidentiality, service and courtesy imposed on the
state agency that assigned the account.
(4) If a state agency assigns a liquidated and delinquent
account to the Department of Revenue as provided in ORS 293.250,
the department shall have six months from the date of assignment
to collect a payment. If the department does not collect a
payment within that six-month period or if six months have
elapsed since the date of receipt of the most recent payment on
the account, the department shall notify the state agency. The
state agency shall then immediately offer for assignment the debt
to a private collection agency.
(5) The provisions of subsection (1) of this section do not
apply to a liquidated and delinquent account that is prohibited
by state or federal law or regulation from assignment or
collection.
(6) The Oregon Department of Administrative Services may adopt
rules exempting specified kinds of liquidated and delinquent
accounts from the time periods established in subsections (1),
(2) and (4) of this section.
(7) The Oregon Department of Administrative Services shall
adopt rules exempting liquidated and delinquent accounts that
originate in the Department of Revenue or the Employment
Department from the time periods established in subsections (1),
(2) and (4) of this section.
(8) A liquidated and delinquent account that is subject to
assignment under this section shall be assigned to a private
collection agency if more than one year has elapsed without a
payment on the account.
(9) Notwithstanding subsection (1) of this section, a state
agency may, at its discretion, choose not to offer for assignment
to a private collection agency a liquidated and delinquent
account that:
(a) Is secured by a consensual security interest in real or
personal property;
(b) Is a court-ordered judgment that includes restitution or a
payment to the Department of Justice Crime Victims' Assistance
Section;
(c) Is in litigation, including bankruptcy, arbitration and
mediation;
(d) Is a student loan owed by a student who is attending
school;
(e) Is owed to a state agency by a local or state government or
by the federal government;
(f) Is owed by a debtor who is hospitalized in a state hospital
as defined in ORS 162.135 { + , + } { - or who is on - } { +
who receives + } public assistance as defined in ORS 411.010 { +
or who receives medical assistance as defined in ORS 414.025 + };
(g) Is owed by a debtor who is imprisoned;
(h) Is less than $100, including penalties; or
(i) Would result in loss of federal funding if assigned.
(10) Nothing in this section prohibits a state agency from
collecting a tax offset after a liquidated and delinquent account
is assigned to a private collection agency.
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(11) For the purposes of this section, a state agency shall be
deemed to have offered for assignment an account if:
(a) The terms of the offer are of a type generally acceptable
within the collections industry for the type of account offered
for assignment; and
(b) The offer is made to a private collection agency that
engages in collecting on accounts of the type sought to be
assigned or is made generally available to private collection
agencies through a bid or request for proposal process.
(12) A state agency that retains a private collection agency
under this section may add a fee to the amount of the liquidated
and delinquent account as provided in ORS 697.105. A fee may not
be added under this subsection unless the state agency has
provided notice to the debtor:
(a) Of the existence of the debt;
(b) That the debt may be assigned to a private collection
agency for collection; and
(c) Of the amount of the fee that may be added to the debt
under this subsection.
(13) Except as provided by federal law, the state agency may
not add a fee under subsection (12) of this section that exceeds
the collection fee of the private collection agency.
SECTION 28. ORS 314.860 is amended to read:
314.860. (1) The Department of Revenue may disclose certain
information relative to applicants for elderly rental assistance
to the { - Director of Human Services or to employees of
the - } Department of Human Services { + or the Oregon Health
Authority + }. The information disclosed by the Department of
Revenue shall be confined to the names, addresses and Social
Security numbers of applicants under ORS 310.630 to 310.706 for
the current and preceding calendar year. The information
requested shall be confined to those names, addresses and Social
Security numbers which will assist in the collection of debts due
and owing to the State of Oregon arising from client-caused
overpayments of public assistance { + or medical assistance, as
defined in ORS 414.025, + }and shall be used solely for such
purpose and shall not be used or disclosed for any other purpose.
Any person who violates this prohibition against disclosure, upon
conviction, is punishable as provided in ORS 314.991 (2).
(2) Disclosure under this section shall be given only upon
written request of the Director of Human Services { + or the
Director of the Oregon Health Authority + }. The form for the
request shall be prescribed by the Director of Human Services
{ + or the Director of the Oregon Health Authority + } and
approved by the Director of the Department of Revenue.
(3) The Department of Revenue shall keep on file the requests
for disclosure made pursuant to this section. The requests
constitute a public record within the meaning of ORS 192.410 to
192.505.
SECTION 29. ORS 409.010 is amended to read:
409.010. (1) The Department of Human Services is created.
(2) The department is responsible for the delivery and
administration of programs and services relating to:
(a) Children and families, including but not limited to child
protective services, foster care, residential care for children
and adoption services;
(b) Elderly persons and persons with disabilities, including
but not limited to social, health and protective services and
promotion of hiring of otherwise qualified persons who are
certifiably disabled;
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(c) Persons who, as a result of the person's or the person's
family's economic, social or health condition, require financial
assistance or other social services;
(d) Developmental disabilities;
(e) Vocational rehabilitation for individuals with
disabilities;
(f) Licensing and regulation of individuals, facilities,
institutions and programs providing health and human services and
long term care services delegated to the department by or in
accordance with the provisions of state and federal law;
(g) Services provided in long term care facilities, home-based
and community-based care settings and residential facilities to
individuals with physical disabilities or developmental
disabilities and to seniors who receive residential facility
care; and
(h) All other human service programs and functions delegated to
the department by or in accordance with the provisions of state
and federal law.
(3) The department shall be the recipient of all federal funds
paid or to be paid to the state to enable the state to provide
the programs and services assigned to the department except for
Medicaid funds that are granted to the Oregon Health Authority.
(4)(a) All personnel of the department, including those engaged
in the administration of vocational rehabilitation programs,
public assistance programs { + , medical assistance programs + }
and services to families or children in compliance with the
federal Social Security laws, shall be subject to the merit
system prescribed in the State Personnel Relations Law. For
purposes of the State Personnel Relations Law, the department is
the appointing authority of all employees in the department.
(b) The Director of Human Services, in conformity with the
State Personnel Relations Law, may appoint and employ such
personnel as may be necessary for the department, and may appoint
and fix the compensation of all assistants and employees of the
department.
(c) The director may authorize reimbursement of such expenses
as are approved by the department and incurred by assistants and
employees of the department, and by volunteers or other persons
not employed by the department, in carrying out duties assigned
or authorized by the department.
(5) The director may designate employees to be custodians of
records within any of the organizational units of the department,
and persons so designated shall have the duties and powers of
custodians of public records as prescribed by law. Such
designation shall be in writing and notice thereof shall be filed
in the office of the Secretary of State, with the director and in
the organizational unit to which the authorization applies.
SECTION 30. ORS 410.150 is amended to read:
410.150. For the protection of applicants for and recipients of
services, the Department of Human Services shall not disclose or
use the contents of any records, files, papers or communications
for purposes other than those directly connected with the
administration of the laws of Oregon, and these records, files,
papers and communications are considered confidential subject to
the rules of the Department of Human Services, except as
otherwise provided in ORS 411.320. In any judicial proceedings,
except proceedings directly connected with the administration of
public assistance { + or medical assistance + } laws, their
contents are considered privileged communications.
SECTION 31. ORS 410.490 is amended to read:
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410.490. (1) To provide greater flexibility and availability of
services, the Department of Human Services shall apply for waiver
of federal statutory and regulatory requirements to make adult
day care services available under ORS chapter 414.
(2) The Department of Human Services shall adopt rules
consistent with the rules adopted under ORS 410.495, that include
a provision identifying adult day care as a service available for
recipients eligible for medical assistance { + as defined in ORS
414.025 + }.
(3) As used in ORS 410.485 and this section, 'adult day care'
means community-based group programs designed to meet the needs
of adults with functional or cognitive impairments through
individual plans of care that are structured, comprehensive and
provide a variety of health, social and related support services
in protective settings during part of the day but provide less
than 24-hour care.
SECTION 32. ORS 411.010 is amended to read:
411.010. As used in this chapter and in other statutes
providing for assistance and services to needy persons, unless
the context or a specially applicable statutory definition
requires otherwise:
(1) 'General assistance' means assistance or service of any
character provided to needy persons not otherwise provided for to
the extent of such need and the availability of funds, including
medical, surgical and hospital or other remedial care.
(2) 'Public assistance' means the following types of
assistance:
(a) Temporary assistance for needy families granted under ORS
412.001 to 412.069 and 418.647;
(b) General assistance granted under ORS 411.710 to 411.730;
{ - (c) Medical assistance; - }
{ - (d) - } { + (c) + } Assistance provided by the Oregon
Supplemental Income Program;
{ - (e) - } { + (d) + } General assistance other than
general assistance granted under ORS 411.710 to 411.730; and
{ - (f) - } { + (e) + } Any other functions, except the
administration of medical assistance by the Oregon Health
Authority, that may be delegated to the Director of Human
Services by or in accordance with federal and state laws.
{ + NOTE: + } Section 33 was deleted by amendment. Subsequent
sections were not renumbered.
SECTION 34. ORS 411.070 is amended to read:
411.070. (1) The { - Oregon Health Authority and the - }
Department of Human Services shall adopt by rule statewide
uniform standards for all public assistance programs and shall
effect uniform observance of the rules throughout the state.
(2) In establishing uniform statewide standards for public
assistance, the department { - and the authority - } , within
the limits of available funds, shall:
(a) Take into consideration all basic requirements for a
standard of living compatible with decency and health, including
food, shelter, clothing, fuel, public utilities,
telecommunications service, medical care and other essential
items and, upon the basis of investigations of the facts, shall
provide budgetary guides for determining minimum costs of meeting
such requirements.
(b) Develop standards for making payments and providing support
services in the job opportunity and basic skills program
described in ORS 412.006.
SECTION 35. ORS 411.081 is amended to read:
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411.081. (1) A person seeking public assistance shall file an
application for public assistance with the Department of Human
Services { - or the Oregon Health Authority - } . At the time
of application, the applicant shall declare to the department
{ - or the authority - } any circumstance that directly affects
the applicant's eligibility to receive assistance or the amount
of assistance available to the applicant. Upon the receipt of
property or income or upon any other change in circumstances that
directly affects the eligibility of the recipient to receive
assistance or the amount of assistance available to the
recipient, the applicant, recipient or other person in the
assistance household shall immediately notify the department
{ - or the authority - } of the receipt or possession of such
property or income, or other change in circumstances. The
department { - or the authority - } shall recover from the
recipient the amount of assistance improperly disbursed by reason
of failure to comply with the provision of this section.
(2) The department may recover any cash assistance granted for
general assistance under ORS 411.710 to 411.730, and the
recipient's portion of the aid described in ORS 412.014 (3), that
has been paid to any recipient 18 years of age or older when the
recipient is presently receiving or subsequently receives
Supplemental Security Income. The amount of recovery shall be
limited to the total amount of Supplemental Security Income that
was received for the same time period that the general assistance
or the aid received under ORS 412.014 was being paid.
(3) Nothing in subsection (1) or (2) of this section shall be
construed as to prevent the department { - or the authority - }
from entering into a compromise agreement for recovery of
assistance improperly disbursed, if the department { - or the
authority - } determines that the administration and collection
costs involved would exceed the amount that can reasonably be
expected to be recovered.
{ + NOTE: + } Section 36 was deleted by amendment. Subsequent
sections were not renumbered.
SECTION 37. ORS 411.087 is amended to read:
411.087. (1) Every person 18 years of age or over who applies
for or receives any type of general assistance or public
assistance, as defined in ORS 411.010, whether the general
assistance or public assistance is applied for or received for
the benefit of the person or of another individual, shall execute
to the Department of Human Services at the time of making the
application, and at such times as may be required by the
department { - or by the Oregon Health Authority by rule - } ,
written statements relating to each individual for whose benefit
the general assistance or public assistance is applied for or
received, and to any person who has a duty to support the
individual, or to whom the individual owes a duty of support. The
statements must include, but need not be limited to, as much of
the following information, relating to each individual or other
person, as may be specified or required by the department
{ - or the authority - } :
(a) The name of the individual, address, date and place of
birth, residence, family relationships, and the composition of
the household in which the individual lives;
(b) The financial circumstances of the individual and means of
and ability for support of the individual and other individuals,
including but not limited to information concerning:
(A) The employment of the individual and the nature and amount
of the income of the individual, from whatever source derived;
Enrolled House Bill 2859 (HB 2859-A) Page 37
(B) The tangible and intangible assets of the individual,
property and resources of any nature including, but not limited
to, money, real and personal property, rights and expectancies as
an heir, devisee, legatee, trustee or cestui que trust, and any
rights, benefits, claims or choses in action, whether arising in
tort or based upon statute, contract or judgment; and
(C) Other information as may be required by the department
{ - or the authority - } pursuant to state or federal laws
applicable to general assistance or public assistance.
(2) All applications for general assistance or public
assistance and all statements referred to in subsection (1) of
this section shall be upon forms prescribed and furnished by the
department { - or the authority - } . Each statement shall be
subscribed by each individual who executes or joins in the
execution of the statement.
(3) The spouse of any individual who applies for or receives
general assistance or public assistance may be required by the
department { - or the authority - } to join in the execution
of, or separately to execute, any statement referred to in
subsection (1) of this section, under oath or affirmation, except
during any period in which it appears to the department { - or
the authority - } that:
(a) The individual and the spouse of the individual are
estranged and are living apart;
(b) The spouse is absent from this state or the whereabouts of
the spouse is unknown; or
(c) The spouse is physically or mentally incapable of executing
the statement or of providing any information referred to in
subsection (1) of this section.
SECTION 37a. ORS 411.095 is amended to read:
411.095. (1) Except as provided in subsection (2) of this
section, when the Department of Human Services { + or the Oregon
Health Authority + } changes a benefit standard that results in
the reduction, suspension or closure of a grant of
{ - general - } { + public + } assistance or a grant of
{ - public - } { + medical + } assistance, the department
{ + or the authority + } shall mail a notice of intended action
to each recipient affected by the change at least 30 days before
the effective date of the action.
(2) If the department { + or the authority + } has fewer than
60 days before the effective date to implement a proposed change
described in subsection (1) of this section, the department
{ + or the authority + } shall mail a notice of intended action
to each recipient affected by the change as soon as practicable
but at least 10 working days before the effective date of the
action.
(3) When the department { + or the authority + } conducts a
hearing pursuant to ORS 416.310 to 416.340 and 416.510 to 416.830
and 416.990 or when the department { + or the authority + }
proposes to deny, reduce, suspend or terminate a grant of
{ - general - } { + public + } assistance, a grant of
{ - public - } { + medical + } assistance or a support service
payment used to support participation in the job opportunity and
basic skills program, the department { + or the authority + }
shall provide an opportunity for a hearing under ORS chapter 183.
(4) When emergency assistance or the continuation of assistance
pending a hearing on the reduction, suspension or termination of
public assistance { + , medical assistance + } or a support
service payment used to support participation in the job
opportunity and basic skills program is denied, and the applicant
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for or recipient of public assistance { + , medical
assistance + } or a support service payment requests a hearing on
the denial, an expedited hearing on the denial shall be held
within five working days after the request. A written decision
shall be issued within three working days after the hearing is
held.
(5) For purposes of this section, a reduction or termination of
services resulting from an assessment for service eligibility as
defined in ORS 411.099 is a grant of public assistance.
(6) Adoption of rules, conduct of hearings and issuance of
orders and judicial review of rules and orders shall be in
accordance with ORS chapter 183.
SECTION 38. ORS 411.119 is amended to read:
411.119. (1) Except as provided in subsection (2) of this
section, a person who is otherwise eligible to receive public
assistance, including supplemental nutrition assistance, { + or
medical assistance + } may not be denied assistance because the
person has been convicted of a drug-related felony.
(2) The Department of Human Services may suspend a person's
supplemental nutrition assistance if:
(a) The person has been convicted of the manufacture or
delivery of a controlled substance under ORS 475.752 (1)(a) to
(c); and
(b) The person is on probation, parole or post-prison
supervision and the agency supervising the person makes a
recommendation to the department, pursuant to subsection (3) of
this section, that the department suspend the person's
supplemental nutrition assistance.
(3) When making a recommendation to the department regarding
the continuation or suspension of a person's supplemental
nutrition assistance, a supervising authority shall consider, at
a minimum, whether there is reason to believe:
(a) That the person traded the person's supplemental nutrition
assistance for controlled substances; and
(b) That, as a result of the trading, a member of the person's
household who is a dependent of the person did not receive the
supplemental nutrition assistance for which the member is
eligible.
(4) The department shall reinstate the supplemental nutrition
assistance of a person whose benefits were suspended under
subsection (2) of this section if the department receives a
recommendation from the supervising authority to reinstate the
benefits pursuant to subsection (5) of this section.
(5) When making a recommendation to the department regarding
the reinstatement of supplemental nutrition assistance, the
supervising authority shall consider, at a minimum, the
following:
(a) Whether members of the person's household are also
receiving supplemental nutrition assistance; and
(b) Whether the person is enrolled in and successfully
participating in a rehabilitation program.
SECTION 39. ORS 411.141 is amended to read:
411.141. The Department of Human Services may, subject to the
allotment system provided for in ORS 291.234 to 291.260, expend
such sums as are required to be expended in this state to provide
public assistance { - excluding medical assistance - } .
Expenditures for public assistance include, but are not limited
to, expenditures for the following purposes:
{ - (1) General assistance to needy persons and their
dependents. - }
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{ - (2) - } { + (1) + } Temporary assistance for needy
families granted under ORS 412.001 to 412.069 and 418.647,
including services to relatives with whom dependent children
applying for or receiving temporary assistance for needy families
are living in order to help such relatives attain the maximum
self-support or self-care consistent with the maintenance of
continuing parental care and protection or in order to maintain
and strengthen family life for such children.
{ - (3) - } { + (2) + } Assistance provided by the Oregon
Supplemental Income Program { + and medical assistance provided
to recipients of assistance under the Oregon Supplemental Income
Program + }.
{ - (4) - } { + (3) + } General assistance granted under
ORS 411.710 to 411.730.
{ - (5) - } { + (4) + } Carrying out the provisions of law
for child welfare purposes.
{ - (6) - } { + (5) + } Scholarships or grants for
qualified recipients to provide them education and professional,
technical or other helpful training, payable to a publicly
supported career school or educational institution on behalf of
the recipient.
{ - (7) - } { + (6) + } Other purposes for which the
department is authorized to expend funds, including the
administration expenses of the department.
{ - (8) - } { + (7) + } Carrying out the provisions of ORS
411.116.
SECTION 40. ORS 411.159 is amended to read:
411.159. A person who is hired as a housekeeper or homemaker,
or home care worker { - as defined in ORS 410.600 - } , and is
not otherwise employed by the Department of Human Services, an
area agency or other public agency, shall not for any purposes be
deemed to be an employee of the State of Oregon or an area agency
whether or not the department or agency selects the person for
employment or exercises any direction or control over the
person's employment. However, nothing in this section precludes
the state or an area agency from being considered the employer of
the person for purposes of ORS chapter 657.
SECTION 41. ORS 411.400 is amended to read:
411.400. (1) { + An + } application for any category of aid
shall also constitute { + an + } application for medical
assistance.
{ - (2) Except as otherwise provided in this section, a
person shall request medical assistance by filing an application
as provided in ORS 411.081. - }
{ - (3) The Department of Human Services shall determine
eligibility for and fix the date on which medical assistance may
begin, and shall obtain such other information required by the
rules of the department and the Oregon Health Authority under ORS
411.402. - }
{ - (4) If an applicant is unable to make application for
medical assistance, an application may be made by someone acting
responsibly for the applicant. - }
{ - (5) The department may modify the application
requirements in ORS 411.081 for a person whose basis of
eligibility for medical assistance changes from one category of
aid to another category of aid under ORS 414.025 (2). - }
{ + (2) Except as provided in subsection (6) of this section,
the Department of Human Services and the Oregon Health Authority
shall accept an application for medical assistance and any
required verification of eligibility from the applicant, an adult
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who is in the applicant's household or family, an authorized
representative of the applicant or, if the applicant is a minor
or incapacitated, someone acting on behalf of the applicant:
(a) Over the Internet;
(b) By telephone;
(c) By mail;
(d) In person; and
(e) Through other commonly available electronic means.
(3) The department and the authority may require an applicant
or person acting on behalf of an applicant to provide only the
information necessary for the purpose of making an eligibility
determination or for a purpose directly connected to the
administration of medical assistance or the health insurance
exchange.
(4) The department and the authority shall provide application
and recertification assistance to individuals with disabilities,
individuals with limited English proficiency, individuals facing
physical or geographic barriers and individuals seeking help with
the application for medical assistance or recertification of
eligibility for medical assistance:
(a) Over the Internet;
(b) By telephone; and
(c) In person.
(5)(a) The department and the authority shall promptly transfer
information received under this section to the Oregon Health
Insurance Exchange Corporation as necessary for the corporation
to determine eligibility for the exchange, premium tax credits or
cost-sharing reductions.
(b) The department shall promptly transfer information received
under this section to the authority for individuals who are
eligible for medical assistance because they qualify for public
assistance.
(6) The department and the authority shall accept from the
corporation an application and any verification that was
submitted to the corporation by an applicant or on behalf of an
applicant for the determination of eligibility for medical
assistance. + }
SECTION 42. ORS 411.402 is amended to read:
411.402. (1) The Department of Human Services and the Oregon
Health Authority shall adopt by rule { + , consistent with
federal requirements, the procedures for verifying eligibility
for medical assistance, including but not limited to all of the
following:
(a) The department and the authority shall access all relevant
state and federal electronic databases for any eligibility
information available through the databases.
(b) The department and the authority shall verify the following
factors through self-attestation:
(A) Pregnancy;
(B) Date of birth;
(C) Household composition; and
(D) Residency.
(c) The department and the authority may not use
self-attestation to verify citizenship and immigration status.
(d) The department and the authority may require the applicant
to provide verification in addition to the verification specified
in this subsection only if the department and the authority are
unable to obtain the information electronically or if the
information obtained electronically is not reasonably compatible
with information provided by or on behalf of the applicant.
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(e) The department and the authority shall use methods of
administration that are in the best interests of applicants and
recipients and that are necessary for the proper and efficient
operation of the medical assistance program. + } { - the
documentation required from each person applying for medical
assistance, including documentation of: - }
{ - (a) The identity of the person; - }
{ - (b) The category of aid that makes the person eligible
for medical assistance or the way in which the person qualifies
as categorically needy; - }
{ - (c) The status of the person as a resident of this state;
and - }
{ - (d) Information concerning the income and resources of
the person, which may include income tax return information and
Social Security number, as necessary to establish financial
eligibility for medical assistance, premium tax credits and
cost-sharing reductions. - }
(2) Information obtained by the department or the authority
under this section may be exchanged with { + the health
insurance exchange and with + } other state or federal agencies
for the purpose of:
(a) Verifying eligibility for medical assistance, participation
in the { - Oregon Health Insurance - } exchange or other
health benefit programs;
(b) Establishing the amount of any tax credit due to the
person, cost-sharing reduction or premium assistance;
(c) Improving the provision of services; and
(d) Administering health benefit programs.
SECTION 43. ORS 411.404 is amended to read:
411.404. (1) The Department of Human Services { + or the
Oregon Health Authority + } shall determine eligibility for
medical assistance according to criteria prescribed by rule { +
and in accordance with the requirements for securing federal
financial participation in the costs of administering Titles XIX
and XXI of the Social Security Act. + } { - in consultation
with the Oregon Health Authority that take into account: - }
{ - (a) The requirements and needs of the applicant and of
the spouse and dependents of the applicant; - }
{ - (b) The income, resources and maintenance available to
the applicant; and - }
{ - (c) The responsibility of the spouse of the applicant
and, with respect to an applicant who is blind or is permanently
and totally disabled or is under 21 years of age, the
responsibility of the parents. - }
{ - (2) Rules adopted by the department under subsection (1)
of this section: - }
{ - (a) Shall disregard resources for those who are eligible
for medical assistance only by reason of ORS 414.025 (3)(s),
except for the resources described in ORS 414.025 (3)(s). - }
{ - (b) May disregard income and resources within the limits
required or permitted by federal law, regulations or orders. - }
{ - (c) - } { + (2) Rules adopted under this section + }
may not require any needy person over 65 years of age, as a
condition of entering or remaining in a hospital, nursing home or
other congregate care facility, to sell any real property
normally used as the person's home.
{ - (3) Notwithstanding subsections (1) and (2) of this
section, the authority may adopt rules necessary to implement the
Health Care for All Oregon Children program established by ORS
414.231 or applicable provisions of federal law. - }
Enrolled House Bill 2859 (HB 2859-A) Page 42
SECTION 44. ORS 411.406 is amended to read:
411.406. { - Upon the receipt of property or income or upon
any other change in circumstances which directly affects the
eligibility of the recipient to receive medical assistance or the
amount of medical assistance available to the recipient, the
recipient - }
{ + (1) A medical assistance recipient + }shall immediately
notify the Department of Human Services or the Oregon Health
Authority, if required, of the receipt or possession of
{ - such - } property or income { - , - } or other change in
circumstances { + that directly affects the eligibility of the
recipient to receive medical assistance, or that directly affects
the amount of medical assistance for which the recipient is
eligible + }. Failure to give the notice shall entitle the
department or the authority to recover from the recipient the
amount of assistance improperly disbursed by reason thereof.
{ + (2)(a) The department or the authority shall redetermine
the eligibility of a medical assistance recipient at intervals
specified by federal law.
(b) The department and the authority shall redetermine
eligibility under this subsection on the basis of information
available to the department and the authority and may not require
the recipient to provide information if the department or the
authority is able to determine eligibility based on information
in the recipient's record or through other information that is
available to the department or the authority.
(3) Notwithstanding subsection (2) of this section, if the
department or the authority receives information about a change
in a medical assistance recipient's circumstances that may affect
eligibility for medical assistance, the department or the
authority shall promptly redetermine eligibility.
(4) If the department or the authority determines that a
medical assistance recipient no longer qualifies for the medical
assistance program in which the recipient is enrolled, the
department or the authority must determine eligibility for other
medical assistance programs, potential eligibility for the health
insurance exchange, premium tax credits and cost-sharing
reductions before terminating the recipient's medical
assistance. If the recipient appears to qualify for the exchange,
premium tax credits or cost-sharing reductions, the department or
the authority shall promptly transfer the recipient's record to
the exchange to process those benefits. + }
SECTION 45. ORS 411.408 is amended to read:
411.408. { + In addition to the requirements in ORS 414.635
(3) and 414.712 (5), + } if the Oregon Health Authority or the
Department of Human Services denies a claim for medical
assistance or fails to act with reasonable promptness on a claim
for medical assistance, the person making the claim may request a
contested case hearing. The hearing shall be held at a time and
place and shall be conducted in accordance with rules adopted by
the authority or the department, as appropriate.
SECTION 46. ORS 411.435 is amended to read:
411.435. The Oregon Health Authority and the Department of
Human Services shall endeavor to develop agreements with local
governments to facilitate the enrollment of medical assistance
program clients. Subject to the availability of funds therefor,
the agreement shall be structured to allow flexibility by the
state and local governments and may allow any of the following
options for enrolling clients in medical assistance programs:
Enrolled House Bill 2859 (HB 2859-A) Page 43
(1) Initial processing { - shall - } { + may + } be done at
the county health department by employees of the county, with
eligibility determination completed at the local office of the
Department of Human Services { + or by the authority + };
(2) Initial processing and eligibility determination
{ - shall - } { + may + } be done at the county health
department by employees of the local health department; or
(3) Application forms { - shall - } { + may + } be made
available at the county health department with initial processing
and eligibility determination { - shall be - } done at the
local office of the Department of Human Services { + or by the
authority + }.
SECTION 47. ORS 411.439 is amended to read:
411.439. (1) As used in this section:
(a) 'Person with a serious mental illness' means a person who
is diagnosed by a psychiatrist, a licensed clinical psychologist
or a certified nonmedical examiner as having dementia,
schizophrenia, bipolar disorder, major depression or other
affective disorder or psychotic mental disorder other than a
disorder caused primarily by substance abuse.
(b) 'Public institution' means:
(A) A state hospital as defined in ORS 162.135;
(B) A local correctional facility as defined in ORS 169.005;
(C) A Department of Corrections institution as defined in ORS
421.005; or
(D) A youth correction facility as defined in ORS 162.135.
(2) Except as provided in subsections (6) and (7) of this
section, the Department of Human Services or the Oregon Health
Authority shall suspend, instead of terminate, the medical
assistance of a person with a serious mental illness when:
(a) The person receives medical assistance because of a serious
mental illness; and
(b) The person becomes an inmate residing in a public
institution.
(3) The department or the authority shall continue to determine
the eligibility of the person { - as categorically needy - }
{ + for medical assistance + }.
(4) Upon notification that a person described in subsection (2)
of this section is no longer an inmate residing in a public
institution, the department or the authority shall reinstate the
person's medical assistance if the person is otherwise eligible
for medical assistance.
(5) This section does not extend eligibility to an otherwise
ineligible person or extend medical assistance to a person if
matching federal funds are not available to pay for medical
assistance.
(6) Subsection (2) of this section does not apply to a person
with a serious mental illness residing in a state hospital as
defined in ORS 162.135 who is under 22 years of age or who is 65
years of age or older.
(7) A person with a serious mental illness may apply for
medical assistance between 90 and 120 days prior to the expected
date of the person's release from a public institution. If the
person is found to be eligible, the effective date of the
person's medical assistance shall be the date of the person's
release from the institution.
SECTION 48. ORS 411.443 is amended to read:
411.443. (1) When a woman who is enrolled in medical assistance
as a pregnant woman becomes an inmate residing in a public
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institution, the Department of Human Services { + or the Oregon
Health Authority + } shall suspend medical assistance.
(2) The department { + or the authority + } shall continue to
determine the eligibility of the pregnant woman { - as
categorically needy - } { + for medical assistance + }.
(3) Upon notification that a pregnant woman described under
subsection (1) of this section is no longer an inmate residing in
a public institution, the department { + or the authority + }
shall reinstate medical assistance if the woman is otherwise
eligible for medical assistance.
SECTION 49. ORS 411.610 is amended to read:
411.610. Any check or warrant issued by the Department of Human
Services or the Oregon Health Authority to a recipient of public
assistance { + or medical assistance + } who subsequently dies
may be indorsed in the name of the deceased by the surviving
spouse or a next of kin in the order described in ORS 293.490
(3); and payment may be made and the proceeds used without any of
the restrictions enumerated in ORS 293.495 (1).
SECTION 50. ORS 411.620 is amended to read:
411.620. (1) The Department of Human Services or the Oregon
Health Authority may prosecute a civil suit or action against any
person who has obtained, for personal benefit or for the benefit
of any other person, any amount or type of { - general
assistance or - } public assistance { + or medical
assistance, + } or has aided any other person to obtain
{ - such general assistance or - } public assistance { + or
medical assistance + }, in violation of any provision of ORS
411.630 { - , - } or in violation of ORS 411.640. In such suit
or action { + , + } the department or the authority may recover
the amount or value of
{ - such general assistance or - } public assistance
{ - so - } { + or medical assistance + } obtained in violation
of ORS 411.630 { - , - } or in violation of ORS 411.640, with
interest { - thereon - } , together with costs and
disbursements incurred { - therein - } { + in recovering the
public assistance or medical assistance + }.
(2) { - Excepting as to - } { + Except with respect to + }
bona fide purchasers for value, the department, the authority,
the conservator for the recipient or the personal representative
of the estate of a deceased recipient may prosecute a civil suit
or action to set aside the transfer, gift or other disposition of
any money or property made in violation of any provisions of ORS
411.630, 411.708 and 416.350 and the department or the authority
may recover out of such money or property, or otherwise, the
amount or value of any { - general assistance or - } public
assistance { + or medical assistance + } obtained as a result
of { - such - } { + the + } violation, with interest
{ - thereon - } , together with costs and disbursements incurred
{ - therein - } { + in recovering the public assistance or
medical assistance + }.
SECTION 51. ORS 411.630 is amended to read:
411.630. (1) A person may not knowingly obtain or attempt to
obtain, for the benefit of the person or of another person, any
public assistance { + or medical assistance + } to which the
person or other person is not entitled under state law by means
of:
(a) Any false representation or fraudulent device, or
(b) Failure to immediately notify the Department of Human
Services or the Oregon Health Authority, if required, of the
receipt or possession of property or income, or of any other
Enrolled House Bill 2859 (HB 2859-A) Page 45
change of circumstances, which directly affects the eligibility
for, or the amount of, the assistance.
(2) A person may not transfer, conceal or dispose of any money
or property with the intent:
(a) To enable the person to meet or appear to meet any
requirement of eligibility prescribed by state law or by rule of
the department or the authority for any type of { - general
assistance or - } public assistance { + or medical
assistance + }; or
(b) Except as to a conveyance by the person to create a tenancy
by the entirety, to hinder or prevent the department or the
authority from recovering any part of any claim it may have
against the person or the estate of the person.
(3) A person may not knowingly aid or abet any person to
violate any provision of this section.
(4) A person may not receive, possess or conceal any money or
property of an applicant for or recipient of any type of
{ - general assistance or - } public assistance { + or medical
assistance + } with the intent to enable the applicant or
recipient to meet or appear to meet any requirement of
eligibility referred to in subsection (2)(a) of this section or,
except as to a conveyance by the applicant or recipient to create
a tenancy by the entirety, with the intent to hinder or prevent
the department or the authority from recovering any part of any
claim it may have against the applicant or recipient or the
estate of the applicant or recipient.
SECTION 52. ORS 411.632 is amended to read:
411.632. If it reasonably appears that a recipient of public
assistance { + or a recipient of medical assistance + } has
assets in excess of those allowed to a recipient of such
assistance under applicable federal and state statutes, rules and
regulations, and it reasonably appears that such assets may be
transferred, removed, secreted or otherwise disposed, then the
Department of Human Services or the Oregon Health Authority may
seek appropriate relief under ORCP 83 and 84 or any other
provision of law, but only to the extent of the liability. The
state shall not be required to post a bond in seeking the relief.
SECTION 52a. ORS 411.635 is amended to read:
411.635. (1) { + (a) + } { - Public assistance - } { +
Medical assistance + } improperly disbursed as a result of
recipient conduct that is not in violation of ORS 411.630 may be
recouped pursuant to ORS 293.250 by the Oregon Health Authority
or the Department of Human Services.
{ + (b) Public assistance improperly disbursed as a result of
recipient conduct that is not in violation of ORS 411.630 may be
recouped pursuant to ORS 293.250 by the department. + }
(2) The department { + and the authority + } may also recoup
public assistance { + and medical assistance + } improperly
disbursed from earnings that the state disregards pursuant to ORS
411.083 and 412.009 as follows:
(a) The department { + and the authority + } shall notify the
recipient that the recipient may elect to limit the recoupment
monthly to an amount equal to one-half the amount of disregarded
earnings by granting the department { + or the authority + } a
confession of judgment for the amount of the overpayment.
(b) If the recipient does not elect to grant the confession of
judgment within 30 days the department { + or the authority + }
may recoup the overpayment from the entire amount of disregarded
earnings. The recipient may at any time thereafter elect to limit
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the monthly recoupment to one-half the disregarded earnings by
entering into a confession of judgment.
(3) The department { + and the authority + } shall not execute
on a confession of judgment until the recipient is no longer
receiving public assistance { + or medical assistance + } and
has either refused to agree to or has defaulted on a reasonable
plan to satisfy the judgment.
(4) This section does not prohibit the department { + or the
authority + } from adopting rules to exempt from recoupment any
portion of disregarded earnings.
SECTION 53. ORS 411.640 is amended to read:
411.640. A person has received an overpayment of public
assistance { + or medical assistance + }, for purposes of ORS
411.703, if the person has:
(1) Received, either for the benefit of the person or for the
benefit of any other person, any amount or type of { - general
assistance or - } public assistance { + or medical
assistance + } to which the person or the other person is not
entitled under state law;
(2) Spent lawfully received public assistance { + or medical
assistance + } that was designated by the Department of Human
Services or the Oregon Health Authority for a specific purpose on
an expense not approved by the department or the authority and
not considered a basic requirement under ORS 411.070 (2)(a) { +
or a health service + };
(3) Misappropriated public assistance { + or medical
assistance + } by cashing and retaining the proceeds of a check
on which the person is not the payee and the check has not been
lawfully indorsed or assigned to the person; or
(4) Failed to reimburse the department or the authority, when
required by law, for public assistance { + or medical
assistance + } furnished for a need for which the person is
compensated by another source.
SECTION 54. ORS 411.660 is amended to read:
411.660. (1) If any person is convicted of a violation of any
provision of ORS 411.630, any grant of { - general assistance
or - } public assistance made wholly or partially to meet the
needs of such person shall be modified, canceled or suspended for
such time and under such terms and conditions as may be
prescribed by or pursuant to rules or regulations of the
Department of Human Services { - or the Oregon Health
Authority - } .
(2) Subsection (1) of this section does not { - prohibit - }
{ + apply to + } a grant of { - general assistance or - }
public assistance to meet the needs of a child under the age of
18 years.
SECTION 55. ORS 411.670 is amended to read:
411.670. As used in this section and ORS 411.640, 411.675 and
411.690:
(1) 'Claims for payment' includes bills, invoices, electronic
transmissions and any other document requesting money in
compensation for or reimbursement of needs which have been
furnished to any public assistance { + or medical assistance + }
recipient.
(2) 'Need' means any type of care, service, commodity, shelter
or living requirement.
(3) 'Person' includes individuals, corporations, associations,
firms, partnerships, governmental subdivisions and agencies and
public and private organizations of any character.
SECTION 56. ORS 411.675 is amended to read:
Enrolled House Bill 2859 (HB 2859-A) Page 47
411.675. A person may not obtain or attempt to obtain, for
personal benefit or the benefit of another person, a payment for
furnishing any need to or for the benefit of a public assistance
{ + or medical assistance + } recipient by knowingly:
(1) Submitting or causing to be submitted to the Department of
Human Services or the Oregon Health Authority a false claim for
payment;
(2) Submitting or causing to be submitted to the department or
the authority a claim for payment that already has been submitted
for payment unless the claim is clearly labeled as a duplicate;
(3) Submitting or causing to be submitted to the department or
the authority a claim for payment that is a claim that already
has been paid by any source unless clearly labeled as already
paid; or
(4) Accepting a payment from the department or the authority
for the costs of items or services that have not been provided to
or for the benefit of a public assistance { + or medical
assistance + } recipient.
SECTION 57. ORS 411.690 is amended to read:
411.690. (1) A person who accepts from the Department of Human
Services or the Oregon Health Authority a payment for furnishing
any need to or for the benefit of a public assistance { + or
medical assistance + } recipient is liable to refund or credit
the amount of the payment to the department or the authority if
the person has obtained or subsequently obtains from the
recipient or from any source any additional payment for
furnishing the same need. However, the liability of the person is
limited to the lesser of the following amounts:
(a) The amount of the payment accepted from the department or
the authority; or
(b) The amount by which the aggregate sum of all payments
accepted or received by the person exceeds the maximum amount
payable for the need under rules adopted by the department or the
authority.
(2) Notwithstanding subsection (1) of this section, a person
who, after having been afforded an opportunity for a contested
case hearing pursuant to ORS chapter 183, is found to have
violated ORS 411.675 is liable to the department or the authority
for treble the amount of the payment received as a result of the
violation.
(3) The department and the authority may prosecute civil
actions to recover moneys claimed due under this section and for
costs and disbursements incurred in such actions.
SECTION 58. ORS 411.694 is amended to read:
411.694. (1) When an individual receives public assistance as
defined in ORS 411.010 { + or medical assistance as defined in
ORS 414.025 + } and the individual is the holder of record title
to real property or the purchaser under a land sale contract, the
Department of Human Services or the Oregon Health Authority may
present to the county clerk for recordation in the deed and
mortgage records of a county a request for notice of transfer or
encumbrance of the real property.
(2) A title insurance company or agent shall provide the state
agency that filed the request with a notice of transfer or
encumbrance as required by ORS 93.268.
(3) If the department or the authority has filed a request for
notice of transfer or encumbrance for recording in the deed and
mortgage records, the department or the authority shall file with
the county clerk a termination of request for notice of transfer
Enrolled House Bill 2859 (HB 2859-A) Page 48
or encumbrance when it is no longer necessary or appropriate to
monitor transfers or encumbrances related to the real property.
(4) The department shall adopt by rule a form of the request
for notice of transfer or encumbrance, the notice of transfer or
encumbrance and the termination of request for notice of transfer
or encumbrance that, at a minimum:
(a) Contains the name of the public assistance { + or medical
assistance + } recipient, a case identifier or other appropriate
information that links the individual who is the holder of record
title to real property or the purchaser under a land sale
contract to the individual's public assistance { + or medical
assistance + } records;
(b) Contains the legal description of the real property;
(c) Contains a mailing address for the department or the
authority to receive the notice of transfer or encumbrance; and
(d) Complies with the requirements for recordation in ORS
205.232 and 205.234 for those forms intended to be recorded.
(5) The authority shall use the forms adopted by the department
under subsection (4) of this section and may designate the
department to receive, on behalf of the authority, a notice of
transfer or encumbrance provided in accordance with subsection
(2) of this section.
(6) The department or the authority shall pay the recordation
fee required by the county clerk under ORS 205.320.
(7) The request for notice of transfer or encumbrance described
in this section does not affect title to real property and is not
a lien on, encumbrance of or other interest in the real property.
SECTION 59. ORS 411.703 is amended to read:
411.703. (1) If an overpayment of public assistance, including
supplemental nutrition assistance issued under ORS 411.806 to
411.845, { + or medical assistance + } is not repaid within 30
days of the payment due date, after an individual has been
afforded an opportunity for a contested case hearing under ORS
chapter 183 relating to the overpayment, the Department of Human
Services or the Oregon Health Authority may:
(a) Issue a warrant that meets the requirements of ORS 205.125
for the overpayment; and
(b) Present a warrant issued under this section for recordation
in the County Clerk Lien Record of the county clerk of any county
in the state.
(2) The warrant must include the principal amount of the
overpayment, interest accumulated pursuant to ORS 82.010 or other
applicable law, costs associated with recording, indexing and
serving the warrant and costs associated with an instrument
evidencing satisfaction or release of the warrant.
(3) The department or the authority shall mail a copy of the
warrant to the debtor at the last known address of the debtor.
(4) Upon receipt of the warrant for recordation, the county
clerk shall record the warrant in the manner provided in ORS
205.125.
(5) Upon issuance of the warrant, the department or the
authority may issue a notice of garnishment in accordance with
ORS 18.854.
(6) Upon recording, the warrant:
(a) Has the effect described in ORS 205.125 and 205.126; and
(b) May be enforced as provided in ORS 18.854 and 205.126.
SECTION 60. ORS 411.795 is amended to read:
411.795. (1) The amount of any general assistance paid under
ORS chapter 411 is a claim against the property or any interest
therein belonging to and a part of the estate of any deceased
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recipient or if there be no estate or the estate does not have
sufficient assets to satisfy the claim, the estate of the
surviving spouse shall be charged for such aid paid to either or
both; provided, however, that there shall be no adjustment or
recovery of any general assistance correctly paid to or on behalf
of any individual under ORS chapter 411 except after the death of
such individual and the surviving spouse of the individual, if
any, and only at a time when the individual has no surviving
child who is under 21 years of age or is blind or permanently and
totally disabled.
(2) Except where there is a surviving spouse, or a surviving
child who is under 21 years of age or is blind or permanently and
totally disabled, the amount of any general assistance paid under
ORS chapter 411 is a claim against the estate in any
conservatorship proceedings and may be paid pursuant to ORS
125.495.
(3) Nothing in this section authorizes the recovery of the
amount of any aid from the estate or the surviving spouse of a
recipient to the extent that the need for aid resulted from a
crime committed against the recipient.
{ - (4) As used in this section, 'general assistance'
includes the state's monthly contribution to the federal
government to defray the costs of outpatient prescription drug
coverage provided to a person who is eligible for Medicare Part D
prescription drug coverage and who receives benefits under the
state medical assistance program or Title XIX of the Social
Security Act. - }
SECTION 61. ORS 411.802 is amended to read:
411.802. If an approved provider { + who is compensated by the
Department of Human Services for + } providing in-home care to a
recipient of public assistance { - for compensation - } { +
or medical assistance + } marries the recipient, the department
{ - of Human Services - } shall consider the care provided as
compensable even though provided by a spouse. The standard of
compensation under this section shall be the same as the standard
applied for in-home care provided by an approved provider not
residing in the home of the recipient.
SECTION 62. ORS 411.965 is amended to read:
411.965. The Legislative Assembly finds:
(1) That many persons eligible for public assistance { + or
medical assistance + } programs, especially those with the lowest
incomes and the greatest need for assistance, are precluded from
receiving benefits because of program inaccessibility;
(2) That program inaccessibility stems from barriers that arise
in learning of the availability of benefits, in applying for
benefits and in maintaining eligibility once eligibility is
established;
(3) That a gap often exists between the reading and literacy
skills possessed by potential applicants to programs and the
skills demanded for completion of agency application forms and
procedures. Most persons eligible for public assistance { + and
medical assistance + } programs read at below the eighth-grade
level and most public assistance { + and medical assistance + }
forms require more than an eighth-grade reading level;
(4) That simplifying program rules and rewriting forms and
brochures to close the 'literacy gap' would contribute to
decreasing the program error rate and saving program costs; and
(5) That the Department of Human Services { + and the Oregon
Health Authority + } would better serve the people of the State
of Oregon by making public assistance { + and medical
Enrolled House Bill 2859 (HB 2859-A) Page 50
assistance + } programs accessible to those low-income persons
legally entitled to assistance.
SECTION 63. ORS 411.967 is amended to read:
411.967. Every form, notice, brochure or other written material
of the Department of Human Services { + or the Oregon Health
Authority + } intended for use by persons inquiring about,
applicants for or recipients of public assistance { + or medical
assistance + } shall be written in plain language. A form,
notice, or brochure is written in plain language if it
substantially complies with all of the following tests:
(1) Uses short sentences and paragraphs;
(2) Uses everyday words readable at an eighth-grade level of
reading ability;
(3) Uses simple and active verb forms;
(4) Uses type of readable size;
(5) Uses uppercase and lowercase letters;
(6) Heads sections and other subdivisions with captions which
fairly reflect the content of the section or subdivision and
which are in boldfaced type or otherwise stand out significantly
from the text;
(7) Uses layout and spacing which separate the paragraphs and
sections of the document from each other and from the borders of
the paper;
(8) Is written and organized in a clear and coherent manner;
(9) Is designed to facilitate ease of reading and
comprehension; and
(10) Is readable at the sixth-grade level of reading ability
except for vocabulary referred to in subsection (2) of this
section.
SECTION 64. ORS 411.969 is amended to read:
411.969. (1) The Department of Human Services { + and the
Oregon Health Authority + } shall publish, make available and
publicize to all persons inquiring about, applicants for and
recipients of public assistance { + or medical assistance + }
the following informational materials:
(a) Brochures enumerating and explaining the public assistance
{ + and medical assistance + } programs administered by the
department { + and the authority + }; and
(b) Publications explaining how public assistance { + and
medical assistance + } programs function, including but not
limited to how grants are calculated, how overpayments are
calculated, how child support is handled, the effect of earnings
on grants { + and benefits + }, hearing rights and the right of
the recipient to see the recipient's file.
(2) All notices of overpayments shall show the calculation of
the overpayment and contain an explanation of the calculation.
SECTION 65. ORS 411.970 is amended to read:
411.970. { + (1) As used in this section:
(a) 'Non-English-speaking household' means a household that
does not have an adult member who is fluent in English.
(b) 'Written materials' includes all forms, notices and other
documents that the Department of Human Services or the Oregon
Health Authority provides to any English-speaking client for the
establishment, maintenance and explanation of eligibility for
public assistance or medical assistance. + }
{ - (1) - } { + (2) + } { - When the caseload of - }
{ + If + } a Department of Human Services local office { + has
a caseload that + } consists of 35 or more non-English-speaking
households { - which - } { + that + } share the same
language, the department shall provide at { - that - } { +
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the + } local office written materials in that language and
access to a bilingual assistance worker or caseworker { + who
is + } fluent in both that language and English.
{ - (2) As used in this section: - }
{ - (a) A 'non-English-speaking household' is a household
that does not have an adult member who is fluent in English. - }
{ - (b) 'Written materials' includes all forms, notices and
other documents which the department of Human Services provides
to any English-speaking client for the establishment, maintenance
and explanation of eligibility for public assistance. - }
(3) The Personnel Division of the Oregon Department of
Administrative Services shall recruit qualified individuals and
shall maintain lists of such individuals for purposes of meeting
the requirements of this section.
SECTION 66. ORS 413.109 is amended to read:
413.109. (1) The Oregon Health Authority may accept funds,
money or other valuable things from relatives, corporations or
interested persons or organizations for the care and support of
needy persons and may expend the same for the care and support of
the individual or individuals for whom the moneys were paid.
(2) The authority may accept from individuals, corporations and
organizations contributions or gifts in cash or otherwise that
shall be disbursed in the same manner as moneys appropriated for
{ - public - } { + medical + } assistance purposes, unless
the donor of a gift stipulates a different manner in which a gift
must be expended. Moneys received under this section shall be
deposited with the State Treasurer in an account separate and
distinct from the General Fund. Interest earned by the account
shall be credited to the account. Moneys in the account are
continuously appropriated to the department for the purposes
specified in this section.
SECTION 67. ORS 413.175 is amended to read:
413.175. (1) For the protection of applicants for and
recipients of public assistance { + and medical assistance, as
defined in ORS 414.025 + }, except as otherwise provided in this
section, the Oregon Health Authority may not disclose or use the
contents of any public assistance { + or medical assistance + }
records, files, papers or communications for purposes other than
those directly connected with the administration of the public
assistance { + and medical assistance + } programs or necessary
to assist public assistance { + or medical assistance + }
applicants and recipients in accessing and receiving other
governmental or private nonprofit services, and these records,
files, papers and communications are considered confidential
subject to the rules of the authority. In any judicial or
administrative proceeding, except proceedings directly connected
with the administration of public assistance { + , medical
assistance + } or child support enforcement, their contents are
considered privileged communications.
(2) Nothing in this section prohibits the disclosure or use of
contents of records, files, papers or communications for purposes
directly connected with the establishment and enforcement of
support obligations pursuant to { - the - } Title IV-D of the
Social Security Act.
(3) Nothing in this section prohibits the disclosure of the
address, Social Security number and photograph of any applicant
or recipient to a law enforcement officer at the request of the
officer. To receive information pursuant to this section, the
officer must furnish the agency the name of the applicant or
recipient and advise that the applicant or recipient:
Enrolled House Bill 2859 (HB 2859-A) Page 52
(a) Is fleeing to avoid prosecution, custody or confinement
after conviction for a felony;
(b) Is violating a condition of probation or parole; or
(c) Has information that is necessary for the officer to
conduct the official duties of the officer and the location or
apprehension of the applicant or recipient is within such
official duties.
(4) Nothing in this section prohibits disclosure of information
between the authority and the Department of Human Services for
the purpose of administering public assistance { + and medical
assistance + } programs that the authority and the department are
responsible for administering.
SECTION 68. ORS 414.025 is amended to read:
414.025. As used in this chapter and ORS chapters 411 and 413,
unless the context or a specially applicable statutory definition
requires otherwise:
(1)(a) 'Alternative payment methodology' means a payment other
than a fee-for-services payment, used by coordinated care
organizations as compensation for the provision of integrated and
coordinated health care and services.
(b) 'Alternative payment methodology' includes, but is not
limited to:
(A) Shared savings arrangements;
(B) Bundled payments; and
(C) Payments based on episodes.
(2) 'Category of aid' means assistance provided by the Oregon
Supplemental Income Program, aid granted under ORS 412.001 to
412.069 and 418.647 or federal Supplemental Security Income
payments.
{ - (3) '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 a category of aid 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 as defined in ORS 412.001 except for age and regular
attendance in school or in a course of professional or technical
training. - }
{ - (e)(A) Is a caretaker relative, as defined in ORS
412.001, who cares for a child who would be a dependent child
except for age and regular attendance in school or in a course of
professional or technical training; or - }
{ - (B) Is the spouse of the caretaker relative. - }
{ - (f) Is under the age of 21 years and: - }
{ - (A) Is in a foster family home or licensed child-caring
agency or institution and is one for whom a public agency of this
state is assuming financial responsibility, in whole or in part;
or - }
{ - (B) Is 18 years of age or older, is one for whom federal
financial participation is available under Title XIX or XXI of
the federal Social Security Act and who met the criteria in
subparagraph (A) of this paragraph immediately prior to the
person's 18th birthday. - }
{ - (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
Enrolled House Bill 2859 (HB 2859-A) Page 53
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 as defined in ORS 412.001 who
cares for a dependent child receiving aid granted under ORS
412.001 to 412.069 and 418.647 or is the spouse of the caretaker
relative. - }
{ - (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
persons with developmental disabilities. - }
{ - (k) Is under the age of 22 years and is in a psychiatric
hospital. - }
{ - (L) 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. - }
{ - (m) Is a member of a family that received aid in the
preceding month under ORS 412.006 or 412.014 and became
ineligible for aid due to 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 due
to increased hours of employment or increased earnings. - }
{ - (n) Is an adopted person under 21 years of age for whom a
public agency is assuming financial responsibility in whole or in
part. - }
{ - (o) 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. - }
{ - (p) Is an individual or member of a group who, subject to
the rules of the department or the Oregon Health Authority, 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. - }
{ - (q) Is a pregnant woman who would be eligible for aid
granted under ORS 412.001 to 412.069 and 418.647, whether or not
the woman is eligible for cash assistance. - }
{ - (r) Except as otherwise provided in this section, is a
pregnant woman or child for whom federal financial participation
is available under Title XIX or 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 or the authority
by rule, but whose family income is at or below the federal
poverty level and whose family investments and savings equal less
than the investments and savings limit established by the
department or the authority by rule. - }
{ - (t) Would be eligible for a category of aid but for the
receipt of qualified long term care insurance benefits under a
policy or certificate issued on or after January 1, 2008. As used
in this paragraph, 'qualified long term care insurance' means a
policy or certificate of insurance as defined in ORS 743.652
(7). - }
{ - (u) Is eligible for the Health Care for All Oregon
Children program established in ORS 414.231. - }
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{ - (v) Is dually eligible for Medicare and Medicaid and
receiving care through a coordinated care organization. - }
{ - (4) - } { + (3) + } 'Community health worker' means an
individual who:
(a) Has expertise or experience in public health;
(b) Works in an urban or rural community, either for pay or as
a volunteer in association with a local health care system;
(c) To the extent practicable, shares ethnicity, language,
socioeconomic status and life experiences with the residents of
the community where the worker serves;
(d) Assists members of the community to improve their health
and increases the capacity of the community to meet the health
care needs of its residents and achieve wellness;
(e) Provides health education and information that is
culturally appropriate to the individuals being served;
(f) Assists community residents in receiving the care they
need;
(g) May give peer counseling and guidance on health behaviors;
and
(h) May provide direct services such as first aid or blood
pressure screening.
{ - (5) - } { + (4) + } 'Coordinated care organization'
means an organization meeting criteria adopted by the Oregon
Health Authority under ORS 414.625.
{ - (6) - } { + (5) + } 'Dually eligible for Medicare and
Medicaid ' means, with respect to eligibility for enrollment in a
coordinated care organization, that an individual is eligible for
health services funded by Title XIX of the Social Security Act
and is:
(a) Eligible for or enrolled in Part A of Title XVIII of the
Social Security Act; or
(b) Enrolled in Part B of Title XVIII of the Social Security
Act.
{ - (7) - } { + (6) + } 'Global budget' means a total
amount established prospectively by the Oregon Health Authority
to be paid to a coordinated care organization for the delivery
of, management of, access to and quality of the health care
delivered to members of the coordinated care organization.
{ - (8) - } { + (7) + } 'Health services' means at least so
much of each of the following as are funded by the Legislative
Assembly based upon the prioritized list of health services
compiled by the Health Evidence Review Commission under ORS
414.690:
(a) Services required by federal law to be included in the
state's medical assistance program in order for the program to
qualify for federal funds;
(b) Services provided by a physician as defined in ORS 677.010,
a nurse practitioner certified under ORS 678.375 or other
licensed practitioner within the scope of the practitioner's
practice as defined by state law, and ambulance services;
(c) Prescription drugs;
(d) Laboratory and X-ray services;
(e) Medical equipment and supplies;
(f) Mental health services;
(g) Chemical dependency services;
(h) Emergency dental services;
(i) Nonemergency dental services;
(j) Provider services, other than services described in
paragraphs (a) to (i), (k), (L) and (m) of this subsection,
Enrolled House Bill 2859 (HB 2859-A) Page 55
defined by federal law that may be included in the state's
medical assistance program;
(k) Emergency hospital services;
(L) Outpatient hospital services; and
(m) Inpatient hospital services.
{ - (9) - } { + (8) + } 'Income' has the meaning given that
term in ORS 411.704.
{ - (10) - } { + (9) + } '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 or the authority may establish by rule that are
available to the applicant or recipient to contribute toward
meeting the needs of the applicant or recipient.
{ - (11) - } { + (10) + } 'Medical assistance' means so
much of the medical, mental health, preventive, supportive,
palliative and remedial care and services as may be prescribed by
the authority according to the standards established pursuant to
ORS 414.065, including premium assistance and payments made for
services provided under an insurance or other contractual
arrangement and money paid directly to the recipient for the
purchase of health services and for services described in ORS
414.710.
{ - (12) - } { + (11) + } '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' does not include care or services for an
inmate in a nonmedical public institution.
{ - (13) - } { + (12) + } 'Patient centered primary care
home' means a health care team or clinic that is organized in
accordance with the standards established by the Oregon Health
Authority under ORS 414.655 and that incorporates the following
core attributes:
(a) Access to care;
(b) Accountability to consumers and to the community;
(c) Comprehensive whole person care;
(d) Continuity of care;
(e) Coordination and integration of care; and
(f) Person and family centered care.
{ - (14) - } { + (13) + } 'Peer wellness specialist' means
an individual who is responsible for assessing mental health
service and support needs of the individual's peers through
community outreach, assisting individuals with access to
available services and resources, addressing barriers to services
and providing education and information about available resources
and mental health issues in order to reduce stigmas and
discrimination toward consumers of mental health services and to
provide direct services to assist individuals in creating and
maintaining recovery, health and wellness.
{ - (15) - } { + (14) + } 'Person centered care' means care
that:
(a) Reflects the individual patient's strengths and
preferences;
(b) Reflects the clinical needs of the patient as identified
through an individualized assessment; and
(c) Is based upon the patient's goals and will assist the
patient in achieving the goals.
{ - (16) - } { + (15) + } 'Personal health navigator' means
an individual who provides information, assistance, tools and
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support to enable a patient to make the best health care
decisions in the patient's particular circumstances and in light
of the patient's needs, lifestyle, combination of conditions and
desired outcomes.
{ - (17) - } { + (16) + } 'Quality measure' means the
measures and benchmarks identified by the authority in accordance
with ORS 414.638.
{ - (18) - } { + (17) + } '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 69. ORS 414.041 is amended to read:
414.041. (1) The Oregon Health Authority, under the direction
of the Oregon Health Policy Board and in collaboration with the
Department of Human Services, shall implement a streamlined and
simple application process for the medical assistance and premium
assistance programs administered by the Oregon Health Authority
and the Office of Private Health Partnerships. The process { +
must meet the requirements of ORS 411.400, 411.402, 411.404,
411.406, 411.408 and 411.967. + } { - shall include, but not be
limited to: - }
{ - (a) An online application that may be submitted via the
Internet; - }
{ - (b) Application forms that are readable at a sixth grade
level and that request the minimum amount of information
necessary to begin processing the application; and - }
{ - (c) Application assistance from qualified staff to aid
individuals who have language, cognitive, physical or geographic
barriers to applying for medical assistance or premium
assistance. - }
(2) In developing the simplified application { - forms, the
department - } { + process, the authority + } shall consult
with persons not employed by the { - department - } { +
authority + } who have experience in serving vulnerable and
hard-to-reach populations.
(3) The { - Oregon Health - } authority { + and the
department + } shall facilitate outreach and enrollment efforts
to connect eligible individuals with all available publicly
funded health programs, including but not limited to the Family
Health Insurance Assistance Program.
SECTION 70. ORS 414.065, as amended by section 19, chapter 8,
Oregon Laws 2012, is amended to read:
414.065. (1)(a) With respect to health care and services to be
provided in medical assistance during any period, the Oregon
Health Authority shall determine, subject to such revisions as it
may make from time to time and subject to legislative funding and
paragraph (b) of this subsection:
(A) The types and extent of health care and services to be
provided to each eligible group of recipients of medical
assistance.
(B) Standards, including outcome and quality measures, to be
observed in the provision of health care and services.
(C) The number of days of health care and services toward the
cost of which { - public - } { + medical + } assistance funds
will be expended in the care of any person.
(D) Reasonable fees, charges, daily rates and global payments
for meeting the costs of providing health services to an
applicant or recipient.
Enrolled House Bill 2859 (HB 2859-A) Page 57
(E) Reasonable fees for professional medical and dental
services which may be based on usual and customary fees in the
locality for similar services.
(F) The amount and application of any copayment or other
similar cost-sharing payment that the authority may require a
recipient to pay toward the cost of health care or services.
(b) The authority shall adopt rules establishing timelines for
payment of health services under paragraph (a) of this
subsection.
(2) The types and extent of health care and services and the
amounts to be paid in meeting the costs thereof, as determined
and fixed by the authority and within the limits of funds
available therefor, shall be the total available for medical
assistance and payments for such medical assistance shall be the
total amounts from { - public - } { + medical + } assistance
funds available to providers of health care and services in
meeting the costs thereof.
(3) Except for payments under a cost-sharing plan, payments
made by the authority for medical assistance shall constitute
payment in full for all health care and services for which such
payments of medical assistance were made.
(4) Notwithstanding subsections (1) and (2) of this section,
the Department of Human Services shall be responsible for
determining the payment for Medicaid-funded long term care
services and for contracting with the providers of long term care
services.
(5) In determining a global budget for a coordinated care
organization:
(a) The allocation of the payment, the risk and any cost
savings shall be determined by the governing body of the
organization; and
(b) The authority shall consider the community health
assessment conducted by the organization and reviewed annually,
and the organization's health care costs.
(6) Under the supervision of the Governor, the authority may
work with the Centers for Medicare and Medicaid Services to
develop, in addition to global budgets, payment streams:
(a) To support improved delivery of health care to recipients
of medical assistance; and
(b) That are funded by coordinated care organizations, counties
or other entities other than the state whose contributions
qualify for federal matching funds under Title XIX or XXI of the
Social Security Act.
SECTION 71. ORS 414.095 is amended to read:
414.095. Neither medical assistance nor amounts payable to
vendors out of { - public - } { + medical + } assistance
funds are transferable or assignable at law or in equity and none
of the money paid or payable under the provisions of this chapter
is subject to execution, levy, attachment, garnishment or other
legal process.
SECTION 72. ORS 414.115 is amended to read:
414.115. (1) In lieu of providing one or more of the health
care and services available under medical assistance by direct
payments to providers thereof and in lieu of providing such
health care and services made available pursuant to ORS 414.065,
the Oregon Health Authority { - shall - } { + may + } use
available medical assistance funds to purchase and pay premiums
on policies of insurance, or enter into and pay the expenses on
health care service contracts, or medical or hospital service
contracts that provide one or more of the health care and
Enrolled House Bill 2859 (HB 2859-A) Page 58
services available under medical assistance { - for the benefit
of the categorically needy - } . Notwithstanding other specific
provisions, the use of available medical assistance funds to
purchase health care and services may provide the following
insurance or contract options:
(a) Differing services or levels of service among groups of
eligibles as defined by rules of the authority; and
(b) Services and reimbursement for these services may vary
among contracts and need not be uniform.
(2) The policy of insurance or the contract by its terms, or
the insurer or contractor by written acknowledgment to the
authority must guarantee:
(a) To provide health care and services of the type, within the
extent and according to standards prescribed under ORS 414.065;
(b) To pay providers of health care and services the amount
due, based on the number of days of care and the fees, charges
and costs established under ORS 414.065, except as to medical or
hospital service contracts which employ a method of accounting or
payment on other than a fee-for-service basis;
(c) To provide health care and services under policies of
insurance or contracts in compliance with all laws, rules and
regulations applicable thereto; and
(d) To provide such statistical data, records and reports
relating to the provision, administration and costs of providing
health care and services to the authority as may be required by
the authority for its records, reports and audits.
{ + (3) The authority may purchase insurance under this
section through the health insurance exchange. + }
SECTION 73. ORS 414.231 is amended to read:
414.231. (1) As used in this section, 'child' means a person
under 19 years of age.
(2) The Health Care for All Oregon Children program is
established to make affordable, accessible health care available
to all of Oregon's children. The program is composed of:
(a) Medical assistance funded in whole or in part by Title XIX
of the Social Security Act, by the State Children's Health
Insurance Program under Title XXI of the Social Security Act and
by moneys appropriated or allocated for that purpose by the
Legislative Assembly; and
(b) A private health option administered by the Office of
Private Health Partnerships under ORS 414.826.
(3) A child is eligible for the program if the child is
lawfully present in this state and the income of the child's
family is at or below 300 percent of the federal poverty
guidelines. There is no asset limit to qualify for the program.
(4)(a) A child receiving medical assistance under the program
is continuously eligible for a minimum period of 12 months.
(b) The Department of Human Services { + and the Oregon Health
Authority + } shall reenroll a child for successive 12-month
periods of enrollment as long as the child is eligible for
medical assistance on the date of reenrollment.
(c) The department { + and the authority + } may not require a
new application as a condition of reenrollment under paragraph
(b) of this subsection and must determine the child's eligibility
for medical assistance using information and sources available to
the department { + and the authority + } or documentation
readily available.
{ - (5) Except for medical assistance funded by Title XIX of
the Social Security Act, the department or the Oregon Health
Enrolled House Bill 2859 (HB 2859-A) Page 59
Authority may prescribe by rule a period of uninsurance prior to
enrollment in the program. - }
SECTION 74. ORS 414.428 is amended to read:
414.428. (1) An individual { - described in ORS 414.025
(3)(s) - } who is eligible for or receiving medical
assistance { + , as defined in ORS 414.025, pursuant to a
demonstration project under section 1115 of the Social Security
Act + } and who is an American Indian and Alaskan Native
beneficiary shall receive the { - benefit - } { + same + }
package of health services { + as individuals + } described in
ORS
{ - 414.707 (1) - } { + 414.706 (1), (2) and (3) + } if:
(a) The Oregon Health Authority receives 100 percent federal
medical assistance percentage for payments made by the authority
for the { + package of + } health services provided { - as
part of the benefit package described in ORS 414.707 (1) - } ; or
(b) The authority receives funding from the Indian tribes for
which federal financial participation is available.
(2) As used in this section, 'American Indian and Alaskan
Native beneficiary' has the meaning given that term in ORS
414.631.
SECTION 75. ORS 414.534 is amended to read:
414.534. (1) The Oregon Health Authority shall provide medical
assistance { + , as defined in ORS 414.025, + } to a woman who:
(a) Is found by a provider to be in need of treatment for
breast or cervical cancer;
(b) Meets the eligibility criteria for the Oregon Breast and
Cervical Cancer Program prescribed by rule by the authority;
(c) Does not otherwise have creditable coverage, as defined in
42 U.S.C. 300gg(c); and
(d) Is 64 years of age or younger.
(2) The period of time a woman can receive medical assistance
based on the eligibility criteria of subsection (1) of this
section:
(a) Begins:
(A) On the date the Department of Human Services or the Oregon
Health Authority makes a formal determination that the woman is
eligible for medical assistance in accordance with subsection (1)
of this section; or
(B) Up to three months prior to the month in which the woman
applied for medical assistance if on the earlier date the woman
met the eligibility criteria of subsection (1) of this section.
(b) Ends when:
(A) The woman is no longer in need of treatment; or
(B) The department { + or the authority + } determines the
woman no longer meets the eligibility criteria of subsection (1)
of this section.
SECTION 76. ORS 414.536 is amended to read:
414.536. (1) If the Department of Human Services { + or the
Oregon Health Authority + } determines that a woman likely is
eligible for medical assistance under ORS 414.534, the department
{ + or the authority + } shall determine her to be presumptively
eligible for medical assistance until a formal determination on
eligibility is made.
(2) The period of time a woman may receive medical assistance
based on presumptive eligibility is limited. The period of time:
(a) Begins on the date that the department { + or the
authority + } determines the woman likely meets the eligibility
criteria under ORS 414.534; and
(b) Ends on the earlier of the following dates:
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(A) If the woman applies for medical assistance following the
determination by the department { + or the authority + } that
the woman is presumptively eligible for medical assistance, the
date on which a formal determination on eligibility is made by
the department { + or the authority + } in accordance with ORS
414.534; or
(B) If the woman does not apply for medical assistance
following the determination by the department { + or the
authority + } that the woman is presumptively eligible for
medical assistance, the last day of the month following the month
in which presumptive eligibility begins.
SECTION 77. ORS 414.706 is amended to read:
414.706. { - The Legislative Assembly shall approve and fund
health services to the following persons: - }
{ - (1) Persons who are categorically needy as described in
ORS 414.025 (3)(o) and (p); - }
{ - (2) Pregnant women with incomes no more than 185 percent
of the federal poverty guidelines; - }
{ - (3) Persons under 19 years of age with incomes no more
than 200 percent of the federal poverty guidelines; - }
{ - (4) Persons described in ORS 414.708; and - }
{ - (5) Persons 19 years of age or older with incomes no more
than 100 percent of the federal poverty guidelines who do not
have federal Medicare coverage. - } { + Within available funds
and subject to the rules of the Oregon Health Authority, medical
assistance shall be provided to an individual who is a resident
of this state and who:
(1) Is receiving a category of aid;
(2) Would be eligible for a category of aid but is not
receiving a category of aid;
(3) 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; and
(4) Is not described in subsection (3) of this section but for
whom federal funding is available under Title XIX or XXI of the
Social Security Act. + }
SECTION 78. ORS 414.709 is amended to read:
414.709. { - (1) Except as provided in subsection (2) of this
section, - } If insufficient resources are available during a
biennium, the population of eligible persons receiving health
services may not be reduced below the population of eligible
persons approved and funded in the legislatively adopted budget
for the Oregon Health Authority for the biennium.
{ - (2) The Oregon Health Authority may periodically limit
enrollment of persons described in ORS 414.708 in order to stay
within the legislatively adopted budget for the authority. - }
SECTION 79. ORS 414.727 is amended to read:
414.727. (1) A prepaid managed care health services
organization, as defined in ORS 414.736, that contracts with the
Oregon Health Authority { - under ORS 414.651 (1) - } to
provide prepaid managed care health services, including hospital
services, shall reimburse Type A and Type B hospitals and rural
critical access hospitals, as described in ORS 442.470 and
identified by the Office of Rural Health as rural hospitals,
fully for the cost of covered services based on the
cost-to-charge ratio used for each hospital in setting the
capitation rates paid to the prepaid managed care health services
organization for the contract period.
(2) The authority shall base the capitation rates described in
subsection (1) of this section on the most recent audited
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Medicare cost report for Oregon hospitals adjusted to reflect the
Medicaid mix of services.
(3) This section may not be construed to prohibit a prepaid
managed care health services organization and a hospital from
mutually agreeing to reimbursement other than the reimbursement
specified in subsection (1) of this section.
(4) Hospitals reimbursed under subsection (1) of this section
are not entitled to any additional reimbursement for services
provided.
SECTION 80. ORS 414.736 is amended to read:
414.736. As used in ORS 192.493, this chapter, ORS chapter 416
and section 9, chapter 867, Oregon Laws 2009:
(1) 'Designated area' means a geographic area of the state
defined by the Oregon Health Authority by rule that is served by
a prepaid managed care health services organization.
(2) 'Fully capitated health plan' means an organization that
contracts with the authority on a prepaid capitated basis under
ORS 414.618.
(3) 'Physician care organization' means an organization that
contracts with the authority on a prepaid capitated basis under
ORS 414.618 to provide the health services described in ORS
414.025 { - (8)(b) - } { + (7)(b) + }, (c), (d), (e), (f),
(g) and (j). A physician care organization may also contract with
the authority on a prepaid capitated basis to provide the health
services described in ORS 414.025 { - (8)(k) - } { +
(7)(k) + } and (L).
(4) 'Prepaid managed care health services organization ' means
a managed physical health, dental, mental health or chemical
dependency organization that contracts with the authority on a
prepaid capitated basis under ORS 414.618. A prepaid managed care
health services organization may be a dental care organization,
fully capitated health plan, physician care organization, mental
health organization or chemical dependency organization.
SECTION 81. ORS 414.740, as amended by section 26, chapter 8,
Oregon Laws 2012, is amended to read:
414.740. (1) Notwithstanding ORS 414.738 (1), the Oregon Health
Authority shall contract under ORS 414.651 with a prepaid group
practice health plan that serves at least 200,000 members in this
state and that has been issued a certificate of authority by the
Department of Consumer and Business Services as a health care
service contractor to provide health services as described in ORS
414.025 { - (8)(b) - } { + (7)(b) + }, (c), (d), (e), (g) and
(j). A health plan may also contract with the authority on a
prepaid capitated basis to provide the health services described
in ORS 414.025 { - (8)(k) - } { + (7)(k) + } and (L). The
authority may accept financial contributions from any public or
private entity to help implement and administer the contract. The
authority shall seek federal matching funds for any financial
contributions received under this section.
(2) In a designated area, in addition to the contract described
in subsection (1) of this section, the authority shall contract
with prepaid managed care health services organizations to
provide health services under ORS 414.631, 414.651 and 414.688 to
414.750.
SECTION 82. ORS 414.841 is amended to read:
414.841. For purposes of ORS 414.841 to 414.864:
(1) 'Carrier' has the meaning given that term in ORS 735.700.
(2) 'Dental plan' means a policy or certificate of group or
individual health insurance, as defined in ORS 731.162, providing
payment or reimbursement only for the expenses of dental care.
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(3) 'Eligible individual' means an individual who:
(a) Is a resident of the State of Oregon;
(b) Is not eligible for Medicare;
{ - (c) Is either: - }
{ - (A) For health benefit plan coverage other than dental
plans, a person who has been without health benefit plan coverage
for a period of time established by the Office of Private Health
Partnerships or meets exception criteria established by the
office; or - }
{ - (B) For dental plan coverage, an individual under 19
years of age who is uninsured or underinsured with respect to
dental plan coverage; - }
{ - (d) - } { + (c) + } Except as otherwise provided by the
office, has family income that is at or below 200 percent of the
federal poverty level; and
{ - (e) - } { + (d) + } Meets other eligibility criteria
established by the office.
(4) 'Family' means an eligible individual and all other related
individuals, as prescribed by the office by rule.
(5)(a) 'Health benefit plan' means a policy or certificate of
group or individual health insurance, as defined in ORS 731.162,
{ - providing payment or reimbursement for hospital, medical and
surgical expenses or for dental care expenses - } { + that
provides benchmark coverage as described in 42 U.S.C.
1396u-7(b) + }. 'Health benefit plan' includes a health care
service contractor or health maintenance organization subscriber
contract { - , the Oregon Medical Insurance Pool - } and any
plan provided by a less than fully insured multiple employer
welfare arrangement or by another benefit arrangement defined in
the federal Employee Retirement Income Security Act of 1974, as
amended.
(b) 'Health benefit plan' does not include coverage for
accident only, specific disease or condition only, credit,
disability income, coverage of Medicare services pursuant to
contracts with the federal government, Medicare supplement
insurance, student accident and health insurance, long term care
insurance, hospital indemnity only, vision only, coverage issued
as a supplement to liability insurance, insurance arising out of
a workers' compensation or similar law, automobile medical
payment insurance, insurance under which the benefits are payable
with or without regard to fault and that is legally required to
be contained in any liability insurance policy or equivalent
self-insurance or coverage obtained or provided in another state
but not available in Oregon.
(6) 'Income' means gross income in cash or kind available to
the applicant or the applicant's family. Income does not include
earned income of the applicant's children or income earned by a
spouse if there is a legal separation.
(7) 'Resident' means an individual who meets the residency
requirements established by rule by the office.
(8) 'Subsidy' means payment or reimbursement to an eligible
individual toward the purchase of a health benefit plan, and may
include a net billing arrangement with carriers or a prospective
or retrospective payment for health benefit plan premiums and
eligible copayments or deductible expenses directly related to
the eligible individual.
(9) 'Third party administrator' means any insurance company or
other entity licensed under the Insurance Code to administer
health benefit plans.
SECTION 83. ORS 414.842 is amended to read:
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414.842. (1) There is established the Family Health Insurance
Assistance Program in the Office of Private Health Partnerships.
The purpose of the program is to remove economic barriers to
health insurance coverage for residents of the State of Oregon
with family income that is at or below 200 percent of the federal
poverty level while encouraging individual responsibility,
promoting health benefit plan coverage of children, building on
the private sector health benefit plan system and encouraging
employer and employee participation in employer-sponsored health
benefit plan coverage.
(2) The Office of Private Health Partnerships shall be
responsible for the implementation and operation of the Family
Health Insurance Assistance Program. The Administrator of the
Office for Oregon Health Policy and Research, in consultation
with the Oregon Health Policy Board, shall make recommendations
to the Office of Private Health Partnerships regarding program
policy, including but not limited to eligibility requirements,
assistance levels, benefit criteria and carrier participation.
(3) The Office of Private Health Partnerships may contract with
one or more third party administrators to administer one or more
components of the Family Health Insurance Assistance Program.
Duties of a third party administrator may include but are not
limited to:
{ - (a) Eligibility determination; - }
{ - (b) - } { + (a) + } Data collection;
{ - (c) - } { + (b) + } Assistance payments;
{ - (d) - } { + (c) + } Financial tracking and reporting;
and
{ - (e) - } { + (d) + } Such other services as the office
may deem necessary for the administration of the program.
(4) If the office decides to enter into a contract with a third
party administrator pursuant to subsection (3) of this section,
the office shall engage in competitive bidding. The office shall
evaluate bids according to criteria established by the office,
including but not limited to:
(a) The bidder's proven ability to administer a program of the
size of the Family Health Insurance Assistance Program;
(b) The efficiency of the bidder's payment procedures;
(c) The estimate provided of the total charges necessary to
administer the program; and
(d) The bidder's ability to operate the program in a
cost-effective manner.
SECTION 84. ORS 414.848 is amended to read:
414.848. (1) Notwithstanding eligibility criteria and subsidy
amounts established pursuant to ORS 414.841 to 414.864, subsidies
shall be provided only to the extent the Legislative Assembly
specifically appropriates funds to provide such assistance.
(2) The Office of Private Health Partnerships shall prohibit or
limit enrollment in the Family Health Insurance Assistance
Program to ensure that program expenditures are within
legislatively appropriated amounts. Prohibitions or limitations
allowed under this section may include but are not limited to:
(a) Lowering the allowable income level necessary to qualify as
an eligible individual { + unless the individual is younger than
19 years of age + }; and
(b) Establishing a waiting list of eligible individuals
{ + with incomes above 138 percent of the federal poverty
level + } who shall receive subsidies only when sufficient funds
are available.
SECTION 85. ORS 414.862 is amended to read:
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414.862. The Administrator of the Office for Oregon Health
Policy and Research shall report biennially to the appropriate
interim { - human resources - } { + health care + } committee
and to the Legislative Assembly on the effectiveness and
efficiency of the Family Health Insurance Assistance Program,
including services and benefits covered under the purchased
health insurance plans, consumer satisfaction and other program
operational issues.
SECTION 86. ORS 416.340 is amended to read:
416.340. (1) With respect to any claim against the estate of a
deceased person, the Department of Human Services and the Oregon
Health Authority may:
(a) Secure payment of the claim in whole or in part by the
acceptance of assignments, conveyances, notes, mortgages and
other transfers of property or interests therein.
(b) Waive the claim to the extent that the department or the
authority finds that enforcement would tend to defeat the purpose
of the public assistance { + or medical assistance + } laws.
(2) To the extent that the need for aid resulted from a crime
committed against the recipient, a claim for recovery of the
amount of such aid defeats the purpose of the public assistance
{ + or medical assistance + } laws.
SECTION 87. ORS 416.350 is amended to read:
416.350. (1) The Department of Human Services or the Oregon
Health Authority may recover from any person the amounts of
medical assistance the department or the authority incorrectly
paid to or on behalf of the person.
(2) Medical assistance pursuant to ORS chapter 414 paid to or
on behalf of an individual who was 55 years of age or older when
the individual received the assistance, or paid to or on behalf
of a person of any age who was a permanently institutionalized
inpatient in a nursing facility, intermediate care facility for
persons with { - mental retardation - } { + intellectual
disabilities + } or other medical institution, may be recovered
from the estate of the individual or from any recipient of
property or other assets held by the individual at the time of
death including the estate of the surviving spouse. Claim for
such medical assistance correctly paid to or on behalf of the
individual may be established against the estate, but the claim
may not be adjusted or recovered until after the death of the
surviving spouse, if any, and only at a time when the individual
has no surviving child who is under 21 years of age or who is
blind or permanently and totally disabled. Transfers of real or
personal property by recipients of such aid without adequate
consideration are voidable and may be set aside under ORS 411.620
(2).
(3) Nothing in this section authorizes the recovery of the
amount of any aid from the estate or surviving spouse of a
recipient to the extent that the need for aid resulted from a
crime committed against the recipient.
(4) In any action or proceeding under this section to recover
medical assistance paid, it is the legal burden of the person who
receives the property or other assets from a medical assistance
recipient to establish the extent and value of the recipient's
legal title or interest in the property or assets in accordance
with rules established by the authority.
(5) Amounts recovered under this section do not include the
value of benefits paid to or on behalf of a beneficiary under a
{ + policy or certificate of + } qualified long term care
insurance
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{ - policy or certificate, described in ORS 414.025 (3)(t) - }
{ + as defined in ORS 743.652 + }, that were disregarded in
determining eligibility for or the amount of medical assistance
provided to the beneficiary.
(6) As used in this section { - , - } { + :
(a) + } 'Estate' includes all real and personal property and
other assets in which the deceased individual had any legal title
or interest at the time of death including assets conveyed to a
survivor, heir or assign of the deceased individual through joint
tenancy, tenancy in common, survivorship, life estate, living
trust or other similar arrangement.
{ + (b) 'Medical assistance' includes the state's monthly
contribution to the federal government to defray the costs of
outpatient prescription drug coverage provided to a person who is
eligible for Medicare Part D prescription drug coverage and who
receives medical assistance. + }
SECTION 88. ORS 419B.373 is amended to read:
419B.373. A person, agency or institution having legal custody
of a ward has the following duties and authority:
(1) To have physical custody and control of the ward.
(2) To supply the ward with food, clothing, shelter and
incidental necessaries.
(3) To provide the ward with care, education and discipline.
(4) To authorize ordinary medical, dental, psychiatric,
psychological, hygienic or other remedial care and treatment for
the ward, and, in an emergency where the ward's safety appears
urgently to require it, to authorize surgery or other
extraordinary care.
(5) To make such reports and to supply such information to the
court as the court may from time to time require.
(6) To apply for any Social Security benefits { + , + }
{ - or - } public assistance { + or medical assistance, as
defined in ORS 414.025, + } to which the ward is otherwise
entitled and to use the benefits or assistance to { - pay - }
{ + provide + } for the care of the ward.
SECTION 89. ORS 419C.550 is amended to read:
419C.550. A person, agency or institution having legal custody
of a youth or youth offender has the following duties and
authority:
(1) To have physical custody and control of the youth or youth
offender.
(2) To supply the youth or youth offender with food, clothing,
shelter and incidental necessaries.
(3) To provide the youth or youth offender with care, education
and discipline.
(4) To authorize ordinary medical, dental, psychiatric,
psychological, hygienic or other remedial care and treatment for
the youth or youth offender, and, in an emergency when the youth
or youth offender's safety appears urgently to require it, to
authorize surgery or other extraordinary care.
(5) To make such reports and to supply such information to the
court as the court may from time to time require.
(6) To apply for any Social Security benefits { + , + }
{ - or - } public assistance { + or medical assistance, as
defined in ORS 414.025, + } to which the youth or youth offender
is otherwise entitled and to use the benefits or assistance to
{ - pay - } { + provide + } for the care of the youth or youth
offender.
SECTION 90. ORS 426.300 is amended to read:
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426.300. (1) The Oregon Health Authority shall, by filing a
written certificate with the last committing court and the court
of residence, discharge any patient from court commitment, except
one held upon an order of a court or judge having criminal
jurisdiction in an action or proceeding arising out of criminal
offense when in its opinion the individual is no longer a
mentally ill person or when in its opinion the transfer of the
individual to a voluntary status is in the best interest of the
treatment of the patient.
(2) The authority may sign applications for public assistance
{ + or medical assistance, as defined in ORS 414.025, + } on
behalf of those patients who may be eligible for public
assistance { + or medical assistance + }.
SECTION 91. ORS 435.215 is amended to read:
435.215. The refusal of any person to accept family planning
and birth control services shall in no way affect the right of
such person to receive public assistance { + , medical
assistance, as defined in ORS 414.025, + } or any other public
benefit and every person to whom such services are offered shall
be so advised initially both orally and in writing. Employees
engaged in the administration of ORS 435.205 to 435.235 shall
recognize that the right to make decisions concerning family
planning and birth control is a fundamental personal right of the
individual and nothing in ORS 435.205 to 435.235 shall in any way
abridge such individual right, nor shall any individual be
required to state the reason for refusing the offer of family
planning and birth control services.
SECTION 92. ORS 689.778 is amended to read:
689.778. An individual is eligible to obtain donated
prescription drugs through the Charitable Prescription Drug
Program created in ORS 689.772 if the individual:
(1) Is a resident of this state; and
(2)(a) Does not have health insurance coverage for the
prescription drug requested;
(b) Is enrolled in a program of public assistance, as defined
in ORS 411.010 { + , or medical assistance, as defined in ORS
414.025 + }; or
(c) Meets other requirements adopted by rule by the State Board
of Pharmacy that identify needy individuals with barriers to
accessing prescription drugs.
SECTION 93. ORS 735.625 is amended to read:
735.625. (1) Except as provided in subsection (3)(c) of this
section, the Oregon Medical Insurance Pool Board shall offer
major medical expense coverage to every eligible person.
(2) The coverage to be issued by the board, its schedule of
benefits, exclusions and other limitations, shall be established
through rules adopted by the board, taking into consideration the
advice and recommendations of the pool members. In the absence of
such rules, the pool shall adopt by rule the minimum benefits
prescribed by section 6 (Alternative 1) of the Model Health
Insurance Pooling Mechanism Act of the National Association of
Insurance Commissioners (1984).
(3)(a) In establishing portability coverage under the pool, the
board shall consider the levels of medical insurance provided in
this state and medical economic factors identified by the board.
The board may adopt rules to establish benefit levels,
deductibles, coinsurance factors, exclusions and limitations that
the board determines are equivalent to the portability health
benefit plans established under ORS 743.760.
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(b) In establishing medical insurance coverage under the pool,
the board shall consider the levels of medical insurance provided
in this state and medical economic factors identified by the
board. The board may adopt rules to establish benefit levels,
deductibles, coinsurance factors, exclusions and limitations that
the board determines are equivalent to those found in the
commercial group or employer-based medical insurance market.
(c) The board may provide a separate Medicare supplement policy
for individuals under the age of 65 who are receiving Medicare
disability benefits. The board shall adopt rules to establish
benefits, deductibles, coinsurance, exclusions and limitations,
premiums and eligibility requirements for the Medicare supplement
policy.
(d) In establishing medical insurance coverage for persons
eligible for coverage under ORS 735.615 (1)(d), the board shall
consider the levels of medical insurance provided in this state
and medical economic factors identified by the board. The board
may adopt rules to establish benefit levels, deductibles,
coinsurance factors, exclusions and limitations to create benefit
plans that qualify the person for the credit for health insurance
costs under section 35 of the federal Internal Revenue Code, as
amended and in effect on December 31, 2004.
(4)(a) Premiums charged for coverages issued by the board may
not be unreasonable in relation to the benefits provided, the
risk experience and the reasonable expenses of providing the
coverage.
(b) Separate schedules of premium rates based on age and
geographical location may apply for individual risks.
(c) The board shall determine the applicable medical and
portability risk rates either by calculating the average rate
charged by insurers offering coverages in the state comparable to
the pool coverage or by using reasonable actuarial techniques.
The risk rates shall reflect anticipated experience and expenses
for such coverage. Rates for pool coverage may not be more than
125 percent of rates established as applicable for medically
eligible individuals or for persons eligible for pool coverage
under ORS 735.615 (1)(d), or 100 percent of rates established as
applicable for portability eligible individuals.
(d) The board shall annually determine adjusted benefits and
premiums. The adjustments shall be in keeping with the purposes
of ORS 735.600 to 735.650, subject to a limitation of keeping
pool losses under one percent of the total of all medical
insurance premiums, subscriber contract charges and 110 percent
of all benefits paid by member self-insurance arrangements. The
board may determine the total number of persons that may be
enrolled for coverage at any time and may permit and prohibit
enrollment in order to maintain the number authorized. Nothing in
this paragraph authorizes the board to prohibit enrollment for
any reason other than to control the number of persons in the
pool.
(5)(a) The board may apply:
(A) A waiting period of not more than 90 days during which the
person has no available coverage; or
(B) Except as provided in paragraph (c) of this subsection, a
preexisting conditions provision of not more than six months from
the effective date of coverage under the pool.
(b) In determining whether a preexisting conditions provision
applies to an eligible enrollee, except as provided in this
subsection, the board shall credit the time the eligible enrollee
was covered under a previous health benefit plan if the previous
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health benefit plan was continuous to a date not more than 63
days prior to the effective date of the new coverage under the
Oregon Medical Insurance Pool, exclusive of any applicable
waiting period. The Oregon Medical Insurance Pool Board need not
credit the time for previous coverage to which the insured or
dependent is otherwise entitled under this subsection with
respect to benefits and services covered in the pool coverage
that were not covered in the previous coverage.
(c) The board may adopt rules applying a preexisting conditions
provision to a person who is eligible for coverage under ORS
735.615 (1)(d).
(d) For purposes of this subsection, a 'preexisting conditions
provision' means a provision that excludes coverage for services,
charges or expenses incurred during a specified period not to
exceed six months following the insured's effective date of
coverage, for a condition for which medical advice, diagnosis,
care or treatment was recommended or received during the
six-month period immediately preceding the insured's effective
date of coverage.
(6)(a) Benefits otherwise payable under pool coverage shall be
reduced by all amounts paid or payable through any other health
insurance, or self-insurance arrangement, and by all hospital and
medical expense benefits paid or payable under any workers'
compensation coverage, automobile medical payment or liability
insurance whether provided on the basis of fault or nonfault, and
by any hospital or medical benefits paid or payable under or
provided pursuant to any state or federal law or program except
the Medicaid portion of the medical assistance program
{ - offering a level of health services described in ORS
414.707 - } .
(b) The board shall have a cause of action against an eligible
person for the recovery of the amount of benefits paid which are
not for covered expenses. Benefits due from the pool may be
reduced or refused as a setoff against any amount recoverable
under this paragraph.
(7) Except as provided in ORS 735.616, no mandated benefit
statutes apply to pool coverage under ORS 735.600 to 735.650.
(8) Pool coverage may be furnished through a health care
service contractor or such alternative delivery system as will
contain costs while maintaining quality of care.
SECTION 94. Section 6, chapter 290, Oregon Laws 1987, as
amended by section 1, chapter 622, Oregon Laws 1991, section 1,
chapter 29, Oregon Laws 2007, section 25, chapter 599, Oregon
Laws 2009, and section 1, chapter 77, Oregon Laws 2011, is
amended to read:
{ + Sec. 6. + } (1) In carrying out the provisions of section
2, chapter 290, Oregon Laws 1987, the Public Utility Commission
shall establish a plan to provide assistance to low income
customers through differential rates or otherwise. The plan of
assistance shall be designed to use, to the maximum extent
possible, the available funding offered by the Federal
Communications Commission, and may provide different levels of
assistance to low income customers based upon differences in
local exchange rates. The plan established by the commission
shall prescribe the amount of assistance to be provided and the
time and manner of payment.
(2) For the purpose of establishing a plan to provide
assistance to low income customers under this section, the
commission shall require all public utilities, cooperative
corporations and unincorporated associations providing local
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exchange telecommunication service to participate in the plan,
except as provided in subsection (3) of this section.
(3) In lieu of participation in the commission's plan to assist
low income customers, a public utility, cooperative corporation
or unincorporated association providing local exchange
telecommunication service may apply to the commission to
establish an alternative plan for the purpose of carrying out the
provisions of section 2, chapter 290, Oregon Laws 1987, for its
own customers. The commission shall adopt standards for
determining the adequacy of alternative plans.
(4) The commission may contract with any governmental agency to
assist the commission in the administration of any assistance
plan adopted pursuant to this section.
(5)(a) As used in sections 2 to 6, chapter 290, Oregon Laws
1987, 'low income customer' means an individual determined by the
commission:
(A) To be receiving benefits from the Supplemental Nutrition
Assistance Program or from another low income public
assistance { + or medical assistance + } program for which
eligibility requirements limit participation to individuals with
income that does not exceed { - 135 - } { + 138 + } percent
of federal poverty guidelines; or
(B) To be a resident of a long term care facility, as defined
in ORS 442.015, or a residential care facility, as defined in ORS
443.400, who receives medical assistance under ORS chapter 414.
(b) The commission must be able to verify the continuing
participation of a low income customer in a program described in
paragraph (a) of this subsection.
SECTION 95. Section 9, chapter 736, Oregon Laws 2003, as
amended by section 2, chapter 757, Oregon Laws 2005, section 2,
chapter 780, Oregon Laws 2007, section 53, chapter 828, Oregon
Laws 2009, section 19, chapter 867, Oregon Laws 2009, and section
59, chapter 602, Oregon Laws 2011, is amended to read:
{ + Sec. 9. + } (1) The Hospital Quality Assurance Fund is
established in the State Treasury, separate and distinct from the
General Fund. Interest earned by the Hospital Quality Assurance
Fund shall be credited to the Hospital Quality Assurance Fund.
(2) Amounts in the Hospital Quality Assurance Fund are
continuously appropriated to the Oregon Health Authority for the
purpose of paying refunds due under section 6, chapter 736,
Oregon Laws 2003, and funding services under ORS { - 414.705 to
414.750 - } { + 414.631, 414.651 and 414.688 to 414.750 + },
including but not limited to:
(a) Increasing reimbursement rates for inpatient and outpatient
hospital services under ORS { - 414.705 to 414.750 - } { +
414.631, 414.651 and 414.688 to 414.750 + };
(b) Maintaining, expanding or modifying services for persons
described in ORS { - 414.025 (3)(s) - } { + 414.706 + };
(c) Maintaining or increasing the number of persons described
in ORS { - 414.025 (3)(s) - } { + 414.706 + } who are
enrolled in the medical assistance program; and
(d) Paying administrative costs incurred by the authority to
administer the assessments imposed under section 2, chapter 736,
Oregon Laws 2003.
(3) Except for assessments imposed pursuant to section 2
(3)(b), chapter 736, Oregon Laws 2003, the authority may not use
moneys from the Hospital Quality Assurance Fund to supplant,
directly or indirectly, other moneys made available to fund
services described in subsection (2) of this section.
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SECTION 96. Section 20, chapter 595, Oregon Laws 2009, as
amended by section 224, chapter 720, Oregon Laws 2011, is amended
to read:
{ + Sec. 20. + } { - On or before January 2, 2014, the
Department - } { + The + } { + Director + }of Human
Services { + , the executive director of the Oregon Health
Insurance Exchange Corporation + } and the { + Director of
the + } Oregon Health Authority may delegate to each other
{ + by interagency agreement + }any duties, functions or powers
{ - transferred by section 19, chapter 595, Oregon Laws 2009,
that the department or the authority deems - } { + granted to
the Department of Human Services, the corporation or the Oregon
Health Authority by law, as the directors deem + }necessary for
the efficient and effective operation of { - their respective
functions - } { + the respective functions of the department,
the corporation and the authority + }.
SECTION 97. Section 1, chapter 867, Oregon Laws 2009, as
amended by section 46, chapter 828, Oregon Laws 2009, section 2,
chapter 73, Oregon Laws 2010, and section 31, chapter 602, Oregon
Laws 2011, is amended to read:
{ + Sec. 1. + } (1) The Health System Fund is established in
the State Treasury, separate and distinct from the General Fund.
Interest earned by the Health System Fund shall be credited to
the fund.
(2) Amounts in the Health System Fund are continuously
appropriated to the Oregon Health Authority for the purpose of
funding the Health Care for All Oregon Children program
established in ORS 414.231, health services described in ORS
414.025 { - (8)(a) - } { + (7)(a) + } to (j) and other health
services. Moneys in the fund may also be used by the authority
to:
(a) Provide grants to community health centers and safety net
clinics under ORS 413.225.
(b) Pay refunds due under section 41, chapter 736, Oregon Laws
2003, and under section 11, chapter 867, Oregon Laws 2009.
(c) Pay administrative costs incurred by the authority to
administer the assessment in section 9, chapter 867, Oregon Laws
2009.
(d) Provide health services described in ORS 414.025
{ - (8) - } { + (7) + } to individuals { + : + }
{ - described in ORS 414.025 (3)(f)(B) - }
{ + (A) Who are 18 years of age or older and for whom federal
financial participation is available under Title XIX or XXI of
the Social Security Act;
(B) Who, immediately prior to their 18th birthday, were in
foster family homes or licensed child-caring agencies or
institutions; and
(C) For whom a public agency of this state was assuming
financial responsibility, in whole or in part + }.
(3) The authority shall develop a system for reimbursement by
the authority to the Office of Private Health Partnerships out of
the Health System Fund for costs associated with administering
the private health option pursuant to ORS 414.826.
SECTION 98. { + ORS 411.431, 411.432, 414.707, 414.708,
414.750, 414.866, 414.868, 414.870 and 414.872 are repealed. + }
SECTION 99. { + ORS 411.159 is added to and made a part of ORS
410.595 to 410.625. + }
SECTION 100. { + (1) The Oregon Health Authority shall
establish a program to provide grants to coordinated care
organizations to fund pilot projects designed to improve patient
Enrolled House Bill 2859 (HB 2859-A) Page 71
engagement in and patient accountability for a patient's own
health, disease prevention and wellness activities. To receive a
grant through the program, a coordinated care organization must
submit an application to the authority, no later than January 1,
2014, that includes:
(a) A proposal detailing the pilot project;
(b) An explanation of how the organization intends to promote
patient responsibility and improve health care outcomes for
patients through the pilot project;
(c) The incentives or penalties that the organization will
utilize in the pilot project; and
(d) The goals of the pilot project and how the success of the
pilot project will be measured.
(2) The Governor shall petition the federal government for
waivers of any federal laws that prevent the implementation of
the pilot projects. + }
SECTION 101. { + (1) The Task Force on Individual
Responsibility and Health Engagement is established, consisting
of 11 members appointed as follows:
(a) The President of the Senate shall appoint two members of
the Senate, one of whom is a Democrat and one of whom is a
Republican.
(b) The Speaker of the House of Representatives shall appoint
two members of the House of Representatives, one of whom is a
Democrat and one of whom is a Republican.
(c) The Governor shall appoint seven persons, at least two of
whom are receiving medical assistance.
(2) Under the direction of the Governor, the task force shall
develop recommendations for legislation that will establish
mechanisms to meaningfully engage medical assistance recipients
in their own health, disease prevention and wellness activities,
in addition to the pilot projects authorized by section 100 of
this 2013 Act. The task force shall prioritize recommendations
that:
(a) Use incentives or disincentives;
(b) Encourage partnerships between medical assistance
recipients and their health care providers;
(c) Are appropriate to the cultural and economic circumstances
of medical assistance recipients;
(d) Can be implemented rapidly upon receipt of any necessary
federal approval; and
(e) Represent best practices and are evidence-based with
respect to medical assistance recipients.
(3) The task force may receive testimony or reports from
persons or agencies that are nationally recognized experts in the
field, as appropriate.
(4) A majority of the members of the task force constitutes a
quorum for the transaction of business.
(5) Official action by the task force requires the approval of
a majority of the members of the task force.
(6) The task force shall elect one of its members to serve as
chairperson.
(7) If there is a vacancy for any cause, the appointing
authority shall make an appointment to become immediately
effective.
(8) The task force shall meet at times and places specified by
the call of the chairperson or of a majority of the members of
the task force.
(9) The task force may adopt rules necessary for the operation
of the task force.
Enrolled House Bill 2859 (HB 2859-A) Page 72
(10) The task force shall submit its recommendations, in the
manner provided in ORS 192.245, to the appropriate interim
committees of the Legislative Assembly no later than November 1,
2013.
(11) The Oregon Health Authority shall provide staff support to
the task force.
(12) Members of the task force who are not members of the
Legislative Assembly are not entitled to compensation, but may be
reimbursed for actual and necessary travel and other expenses
incurred by them in the performance of their official duties in
the manner and amounts provided for in ORS 292.495.
(13) All agencies of state government, as defined in ORS
174.111, are directed to assist the task force in the performance
of its duties and, to the extent permitted by laws relating to
confidentiality, to furnish such information and advice as the
members of the task force consider necessary to perform their
duties. + }
SECTION 102. { + The costs of the pilot projects described in
section 100 of this 2013 Act shall be paid from funds in the
legislatively adopted budget that are allocated to the Oregon
Health Authority to provide innovation grants to coordinated care
organizations. + }
SECTION 103. { + Section 101 of this 2013 Act is repealed on
the date of the convening of the 2014 regular session of the
Legislative Assembly as specified in ORS 171.010. + }
SECTION 104. { + The Oregon Health Authority, the Department
of Human Services and the Oregon Health Insurance Exchange
Corporation may take any action prior to January 1, 2014,
necessary to carry out sections 1 and 99 of this 2013 Act, the
amendments to ORS 1.198, 18.784, 18.838, 18.847, 25.381, 30.800,
93.967, 93.969, 97.939, 108.725, 109.811, 113.085, 113.086,
114.305, 114.515, 114.517, 115.125, 115.195, 125.170, 130.425,
166.715, 179.505, 183.458, 192.588, 293.231, 314.860, 409.010,
410.150, 410.490, 411.010, 411.070, 411.081, 411.087, 411.095,
411.119, 411.141, 411.159, 411.400, 411.402, 411.404, 411.406,
411.408, 411.435, 411.439, 411.443, 411.610, 411.620, 411.630,
411.632, 411.635, 411.640, 411.660, 411.670, 411.675, 411.690,
411.694, 411.703, 411.795, 411.802, 411.965, 411.967, 411.969,
411.970, 413.109, 413.175, 414.025, 414.041, 414.065, 414.095,
414.115, 414.231, 414.428, 414.534, 414.536, 414.706, 414.709,
414.727, 414.736, 414.740, 414.841, 414.842, 414.848, 414.862,
416.340, 416.350, 419B.373, 419C.550, 426.300, 435.215, 689.778
and 735.625 and section 6, chapter 290, Oregon Laws 1987, section
9, chapter 736, Oregon Laws 2003, section 20, chapter 595, Oregon
Laws 2009, and section 1, chapter 867, Oregon Laws 2009, by
sections 3 to 97 of this 2013 Act and the repeal of ORS 411.431,
411.432, 414.707, 414.708, 414.750, 414.866, 414.868, 414.870 and
414.872 by section 98 of this 2013 Act on and after January 1,
2014. + }
SECTION 105. { + Sections 1 and 99 of this 2013 Act, the
amendments to ORS 1.198, 18.784, 18.838, 18.847, 25.381, 30.800,
93.967, 93.969, 97.939, 108.725, 109.811, 113.085, 113.086,
114.305, 114.515, 114.517, 115.125, 115.195, 125.170, 130.425,
166.715, 179.505, 183.458, 192.588, 293.231, 314.860, 409.010,
410.150, 410.490, 411.010, 411.070, 411.081, 411.087, 411.095,
411.119, 411.141, 411.159, 411.400, 411.402, 411.404, 411.406,
411.408, 411.435, 411.439, 411.443, 411.610, 411.620, 411.630,
411.632, 411.635, 411.640, 411.660, 411.670, 411.675, 411.690,
411.694, 411.703, 411.795, 411.802, 411.965, 411.967, 411.969,
411.970, 413.109, 413.175, 414.025, 414.041, 414.065, 414.095,
Enrolled House Bill 2859 (HB 2859-A) Page 73
414.115, 414.231, 414.428, 414.534, 414.536, 414.706, 414.709,
414.727, 414.736, 414.740, 414.841, 414.842, 414.848, 414.862,
416.340, 416.350, 419B.373, 419C.550, 426.300, 435.215, 689.778
and 735.625 and section 6, chapter 290, Oregon Laws 1987, section
9, chapter 736, Oregon Laws 2003, section 20, chapter 595, Oregon
Laws 2009, and section 1, chapter 867, Oregon Laws 2009, by
sections 3 to 97 of this 2013 Act and the repeal of ORS 411.431,
411.432, 414.707, 414.708, 414.750, 414.866, 414.868, 414.870 and
414.872 by section 98 of this 2013 Act become operative January
1, 2014. + }
SECTION 106. { + This 2013 Act being necessary for the
immediate preservation of the public peace, health and safety, an
emergency is declared to exist, and this 2013 Act takes effect on
its passage. + }
----------
Passed by House May 28, 2013
.............................................................
Ramona J. Line, Chief Clerk of House
.............................................................
Tina Kotek, Speaker of House
Passed by Senate June 20, 2013
.............................................................
Peter Courtney, President of Senate
Enrolled House Bill 2859 (HB 2859-A) Page 74
Received by Governor:
......M.,............., 2013
Approved:
......M.,............., 2013
.............................................................
John Kitzhaber, Governor
Filed in Office of Secretary of State:
......M.,............., 2013
.............................................................
Kate Brown, Secretary of State
Enrolled House Bill 2859 (HB 2859-A) Page 75
