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 Each month, Oregon Health Forum will post highlights from its latest 16-page issue to give you a taste of what's available. We encourage you to subscribe now to get the full month's serving of news, insight and statistics on health care in Oregon. November 2007 Oregon slips as long-term care leader For decades, states across the country have modeled their long-term care strategies after Oregon’s. Oregon had been successful, until about 2001, in giving a relatively high percentage of seniors alternatives to institutionalized care in nursing homes. According to the Department of Human Services, as of June 2006 there were 18,750 people aged 65 and over receiving state-funded assistance and living in their own homes, adult foster homes, residential care, assisted living or nursing facilities. Most were living in their own homes. Anchored by Oregon Project Independence, a state-funded program designed to keep seniors living in their own homes, and Medicaid-reimbursable services, including assisted living facilities, adult foster homes and home care, the state has been widely recognized for preserving the quality of life of thousands of seniors while also saving money. Oregon pioneered these alternatives in the mid-1970s through the 1990s. But today, with a growing number of baby boomers turning 65, the system is buckling under the weight of greater demands and has arguably failed a number of seniors already. While Oregon still leads the country, with 96.5 percent of seniors living outside of nursing homes, budget cuts and lack of long-term planning have tarnished the state’s reputation. Legacy plans to expand children services, ER by 2010 Pending its board’s approval, Legacy Health System has confirmed reports that it will expand its Legacy Emanuel campus in northeast Portland. Plans include a new pediatric-only emergency room and expansion of the adult emergency room facilities within the next two years. These proposed improvements would extend the types of specialty care children can receive at Emanuel. The Children’s Hospital currently occupies two floors of Emanuel. In addition to the new pediatric-only emergency department, the expansion includes new MRI and CT imaging services for pediatric patients, as well as an additional 21 pediatric and 46 adult beds. Legacy would not comment on the number of staff required to run these new services but said that patient volume would determine staffing. CMS and DHS don’t see eye to eye on OHP renewal Edge declined to cite specifics but acknowledged that part of the discussions revolve around State Children’s Health Insurance Program funding that the Family Health Insurance Assistance Program relies on to provide health care for some of its adult members. FHIAP enrolls more than 17,000 members and has a budget of about $22 million, according to Rocky King, its administrator. “This is especially complex because of the negotiations going on about federal reauthorization of the SCHIP program,” Edge said. A set of napkins hangs on the wall of Barney Speight’s new Salem office, just below a sign that reads, “Break glass, remove and use when in need of inspiration!” Although Speight admits that the story that Gov. John Kitzhaber and he jotted down the original plans for the Oregon Health Plan on a bar napkin is steeped in “a lot of mythology,” he also knows he may need to invoke some of that legend as he embarks on his current task. As executive director of the Oregon Health Fund Board, Speight is once again at the forefront of reform. And he’s got his work cut out for him. Senate Bill 329 lays out an ambitious timeline that calls for a progress report in February and development of a final plan by next fall. Oregon Health News editor-in-chief Tim Stumm recently caught up with Speight to see if he, the board and its subcommittees are on track. Speight shares his thoughts in the following excerpts from that interview. OHN: I think many in Oregon thought they had seen the last of you when you accepted a job in Washington state more than two years ago. Why did you decide to come back? BS: It was a tough decision. I really enjoyed the work I did for Washington Health Care Authority. I came back for two fundamental reasons. One, I was intrigued by the energy. The other, quite candidly, was a chance to work with a lot of people I had worked with before. Most hospitals leapfrog over quality reporting survey Most of Oregon’s 57 hospitals don’t feel like playing Leapfrog, it seems. Only 13 of the state’s hospitals have responded to the Leapfrog Group’s hospital quality and safety survey, according to Regina Gallwas of the Washington State Health Care Authority. She was in Portland recently to discuss the survey, which collects hospitals’ voluntary submissions on a range of safety and quality indicators. The information is posted online “to help patients make informed decisions about where to receive hospital care,” according to the Leapfrog Web site, leapfroggroup.org. The Leapfrog Group, based in Washington, D.C., works to reduce preventable medical mistakes that injure and kill thousands of patients annually. It was started in 2000 by a group of large employers that wanted to assess health care quality and compare providers. Both opponents and supporters of the group’s survey agree that two factors play a major role in Oregon’s low response rate: time, and the validity of the information produced.
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