2007 Oregon Code - Chapter 442 :: Chapter 442 - Health Planning
Chapter 442 —
Health Planning
2007 EDITION
HEALTH PLANNING
PUBLIC HEALTH AND SAFETY
ADMINISTRATOR OF THE OFFICE FOR
442.011Â Â Â Â Office
for Oregon Health Policy and Research created; appointment of administrator
ADMINISTRATION
442.015Â Â Â Â Definitions
442.025Â Â Â Â Findings
and policy
442.035Â Â Â Â Oregon
Health Policy Commission; qualifications; terms; officers; meetings;
compensation and expenses
442.045Â Â Â Â Commission
duties
442.057Â Â Â Â Commission
subcommittees and advisory committees
442.120Â Â Â Â Ambulatory
surgery and inpatient discharge abstract records; alternative data; rules; fees
442.200Â Â Â Â Definitions
for ORS 442.205
442.205Â Â Â Â Community
benefit reporting; rules
CERTIFICATES OF NEED FOR HEALTH SERVICES
442.315Â Â Â Â Certificate
of need; rules; fees; enforcement; exceptions; letter of intent
442.325Â Â Â Â Certificate
for health care facility of health maintenance organization; exempt activities;
policy relating to health maintenance organizations
442.342Â Â Â Â Waiver
of requirements; rules; penalties
442.344Â Â Â Â Exemptions
from requirements
442.347Â Â Â Â Rural
hospital required to report certain actions
HEALTH CARE COST REVIEW
442.400    “Health
care facility” defined
442.405Â Â Â Â Legislative
findings and policy
442.420Â Â Â Â Application
for financial assistance; financial analysis and investigation authority; rules
442.425Â Â Â Â Authority
over reporting systems of facilities
442.430Â Â Â Â Investigations;
confidentiality of data
442.445Â Â Â Â Civil
penalty for failure to perform
442.450Â Â Â Â Exemption
from cost review regulations
442.460Â Â Â Â Information
about utilization and cost of health care services
442.463Â Â Â Â Annual
utilization report; contents; approval; rules
RURAL HEALTH
442.470Â Â Â Â Definitions
for ORS 442.470 to 442.507
442.475Â Â Â Â Office
of Rural Health
442.480Â Â Â Â Rural
Health Care Revolving Account
442.485Â Â Â Â Responsibilities
of Office of Rural Health
442.490Â Â Â Â Rural
Health Coordinating Council; membership; terms; officers; compensation and
expenses
442.495Â Â Â Â Responsibilities
of council
442.500Â Â Â Â Technical
and financial assistance to rural communities
442.502Â Â Â Â Determination
of size of rural hospital
442.503Â Â Â Â Eligibility
for economic development grants
442.505Â Â Â Â Technical
assistance to rural hospitals
442.507Â Â Â Â Assistance
to rural emergency medical service systems
442.515Â Â Â Â Rural
hospitals; findings
442.520Â Â Â Â Risk
assessment formula; relative risk of rural hospitals
NURSING SERVICES PROGRAM
442.535Â Â Â Â Definitions
for ORS 442.540 and 442.545
442.540Â Â Â Â Nursing
Services Program created; criteria for participation; rules
442.545Â Â Â Â Conditions
of participation in Nursing Services Program
RURAL HEALTH SERVICES PROGRAM
442.550Â Â Â Â Definitions
for ORS 442.550 to 442.570
442.555Â Â Â Â Rural
Health Services Program created; rules; criteria for participation
442.560Â Â Â Â Conditions
of participation in Rural Health Services Program; rules
442.561Â Â Â Â Certifying
individuals licensed under ORS chapter 679 for tax credit
442.562Â Â Â Â Certifying
podiatric physicians and surgeons for tax credit
442.563Â Â Â Â Certifying
certain individuals providing rural health care for tax credit; rules
442.564Â Â Â Â Certifying
optometrists for tax credit
442.566Â Â Â Â Certifying
emergency medical technicians for tax credit
442.568Â Â Â Â Oregon
Health and
442.570Â Â Â Â Rural
Health Services Fund; matching funds
HEALTH RESOURCES COMMISSION
442.575Â Â Â Â Definitions
for ORS 442.575 to 442.584
442.580Â Â Â Â Health
Resources Commission; membership; terms
442.581Â Â Â Â Officers;
quorum; meetings; staffing
442.583Â Â Â Â Medical
technology assessment program; content; advisory committee
442.584Â Â Â Â Application
for certificate of need
442.588Â Â Â Â Employees
MISCELLANEOUS
442.600Â Â Â Â Policy
on maternity care
442.625Â Â Â Â Emergency
Medical Services Enhancement Account; distribution of moneys in account
Note         Task
Force for Comprehensive Obesity Prevention Initiative--2007 c.904 §§1,2
COOPERATIVE PROGRAM ON HEART AND KIDNEY
TRANSPLANTS
442.700Â Â Â Â Definitions
for ORS 442.700 to 442.760
442.705Â Â Â Â Legislative
findings; goals
442.710Â Â Â Â Application
for approval of cooperative program; form; content; review; modification; order
442.715Â Â Â Â Authorized
practices under approved cooperative program
442.720Â Â Â Â Board
of governors for cooperative program
442.725Â Â Â Â Annual
report of board of governors
442.730Â Â Â Â Review
and evaluation of report; modification or revocation of order of approval
442.735Â Â Â Â Complaint
procedure
442.740Â Â Â Â Powers
of director over action under cooperative program
442.745Â Â Â Â Disclosure
of confidential information not waiver of right to protect information
442.750Â Â Â Â Status
of actions under cooperative program; effect on other liability
442.755Â Â Â Â Rules;
costs; fees
442.760Â Â Â Â Status
to contest order
ADVISORY COMMITTEE ON PHYSICIAN CREDENTIALING
INFORMATION
442.800Â Â Â Â Advisory
Committee on Physician Credentialing Information; membership; terms
442.805Â Â Â Â Committee
recommendations
442.807Â Â Â Â Implementation
of recommendations; rules
Note         Definitions--2003
c.686 §1
442.820Â Â Â Â
442.825Â Â Â Â Funds
received by commission
442.830Â Â Â Â
442.835Â Â Â Â Appointment
of administrator
(Temporary provisions relating to Oregon Patient Safety Reporting
Program are compiled as notes following ORS 442.835)
HEALTH CARE ACQUIRED INFECTIONS
(Temporary provisions relating to health care acquired infections are compiled
as notes following ORS 442.835)
     442.005 [1955 c.533 §2; 1973 c.754 §1; repealed by 1977 c.717 §23]
     442.010 [Amended by 1955 c.533 §3; 1971 c.650 §20;
repealed by 1977 c.717 §23]
ADMINISTRATOR
OF THE OFFICE FOR
     442.011
Office for
     (2) In carrying out the responsibilities
and duties of the administrator, the administrator shall consult with and be
advised by the Oregon Health Policy Commission and the Oregon Health Fund
Board. [1993 c.725 §33; 1997 c.683 §16; 2001 c.69 §1; 2003 c.784 §5; 2007 c.697
§14]
     Note: The amendments to 442.011 by section 15,
chapter 697, Oregon Laws 2007, become operative January 2, 2010. See section
28, chapter 697, Oregon Laws 2007. The text that is operative on and after
January 2, 2010, is set forth for the userÂ’s convenience.
     442.011. (1) There is created in the Department of
Human Services the Office for Oregon Health Policy and Research. The
Administrator of the Office for Oregon Health Policy and Research shall be
appointed by the Governor and the appointment shall be subject to Senate
confirmation in the manner prescribed in ORS 171.562 and 171.565. The
administrator shall be an individual with demonstrated proficiency in planning
and managing programs with complex public policy and fiscal aspects such as
those involved in the Oregon Health Plan. Before making the appointment, the
Governor must advise the President of the Senate and the Speaker of the House
of Representatives of the names of at least three finalists and shall consider
their recommendation in appointing the administrator.
     (2) In carrying out the responsibilities
and duties of the administrator, the administrator shall consult with and be
advised by the Oregon Health Policy Commission.
ADMINISTRATION
     442.015
Definitions. As used in ORS
chapter 441 and this chapter, unless the context requires otherwise:
     (1) “Acquire” or “acquisition” means
obtaining equipment, supplies, components or facilities by any means, including
purchase, capital or operating lease, rental or donation, with intention of
using such equipment, supplies, components or facilities to provide health
services in Oregon. When equipment or other materials are obtained outside of
this state, acquisition is considered to occur when the equipment or other
materials begin to be used in
     (2) “Adjusted admission” means the sum of
all inpatient admissions divided by the ratio of inpatient revenues to total
patient revenues.
     (3) “Affected persons” has the same
meaning as given to “party” in ORS 183.310.
     (4) “Ambulatory surgical center” means a
facility that performs outpatient surgery not routinely or customarily
performed in a physicianÂ’s or dentistÂ’s office, and is able to meet health
facility licensure requirements.
     (5) “Audited actual experience” means data
contained within financial statements examined by an independent, certified
public accountant in accordance with generally accepted auditing standards.
     (6) “Budget” means the projections by the
hospital for a specified future time period of expenditures and revenues with
supporting statistical indicators.
     (7) “Case mix” means a calculated index
for each hospital, based on financial accounting and case mix data collection
as set forth in ORS 442.425, reflecting the relative costliness of that
hospitalÂ’s mix of cases compared to a state or national mix of cases.
     (8) “Commission” means the Oregon Health
Policy Commission.
     (9) “Department” means the Department of
Human Services of the State of
     (10) “Develop” means to undertake those
activities that on their completion will result in the offer of a new
institutional health service or the incurring of a financial obligation, as
defined under applicable state law, in relation to the offering of such a
health service.
     (11) “Director” means the Director of
Human Services.
     (12) “Expenditure” or “capital expenditure”
means the actual expenditure, an obligation to an expenditure, lease or similar
arrangement in lieu of an expenditure, and the reasonable value of a donation
or grant in lieu of an expenditure but not including any interest thereon.
     (13) “Freestanding birthing center” means
a facility licensed for the primary purpose of performing low risk deliveries.
     (14) “Governmental unit” means the state,
or any county, municipality or other political subdivision, or any related
department, division, board or other agency.
     (15) “Gross revenue” means the sum of
daily hospital service charges, ambulatory service charges, ancillary service
charges and other operating revenue. “Gross revenue” does not include
contributions, donations, legacies or bequests made to a hospital without restriction
by the donors.
     (16)(a) “Health care facility” means a
hospital, a long term care facility, an ambulatory surgical center, a
freestanding birthing center or an outpatient renal dialysis facility.
     (b) “Health care facility” does not mean:
     (A) An establishment furnishing
residential care or treatment not meeting federal intermediate care standards,
not following a primarily medical model of treatment, prohibited from admitting
persons requiring 24-hour nursing care and licensed or approved under the rules
of the Department of Human Services or the Department of Corrections; or
     (B) An establishment furnishing primarily
domiciliary care.
     (17) “Health maintenance organization” or “HMO”
means a public organization or a private organization organized under the laws
of any state that:
     (a) Is a qualified HMO under section 1310
(d) of the U.S. Public Health Services Act; or
     (b)(A) Provides or otherwise makes
available to enrolled participants health care services, including at least the
following basic health care services:
     (i) Usual physician services;
     (ii) Hospitalization;
     (iii) Laboratory;
     (iv) X-ray;
     (v) Emergency and preventive services; and
     (vi) Out-of-area coverage;
     (B) Is compensated, except for copayments,
for the provision of the basic health care services listed in subparagraph (A)
of this paragraph to enrolled participants on a predetermined periodic rate
basis; and
     (C) Provides physicians’ services
primarily directly through physicians who are either employees or partners of
such organization, or through arrangements with individual physicians or one or
more groups of physicians organized on a group practice or individual practice
basis.
     (18) “Health services” means clinically
related diagnostic, treatment or rehabilitative services, and includes alcohol,
drug or controlled substance abuse and mental health services that may be
provided either directly or indirectly on an inpatient or ambulatory patient
basis.
     (19) “Hospital” means a facility with an
organized medical staff, with permanent facilities that include inpatient beds
and with medical services, including physician services and continuous nursing
services under the supervision of registered nurses, to provide diagnosis and
medical or surgical treatment primarily for but not limited to acutely ill
patients and accident victims, to provide treatment for patients with mental
illness or to provide treatment in special inpatient care facilities.
     (20) “Institutional health services” means
health services provided in or through health care facilities and includes the
entities in or through which such services are provided.
     (21) “Intermediate care facility” means a
facility that provides, on a regular basis, health-related care and services to
individuals who do not require the degree of care and treatment that a hospital
or skilled nursing facility is designed to provide, but who because of their
mental or physical condition require care and services above the level of room
and board that can be made available to them only through institutional
facilities.
     (22) “Long term care facility” means a
facility with permanent facilities that include inpatient beds, providing
medical services, including nursing services but excluding surgical procedures
except as may be permitted by the rules of the director, to provide treatment
for two or more unrelated patients. “Long term care facility” includes skilled
nursing facilities and intermediate care facilities but may not be construed to
include facilities licensed and operated pursuant to ORS 443.400 to 443.455.
     (23) “Major medical equipment” means
medical equipment that is used to provide medical and other health services and
that costs more than $1 million. “Major medical equipment” does not include
medical equipment acquired by or on behalf of a clinical laboratory to provide
clinical laboratory services, if the clinical laboratory is independent of a
physicianÂ’s office and a hospital and has been determined under Title XVIII of
the Social Security Act to meet the requirements of paragraphs (10) and (11) of
section 1861(s) of that Act.
     (24) “Net revenue” means gross revenue
minus deductions from revenue.
     (25) “New hospital” means a facility that
did not offer hospital services on a regular basis within its service area
within the prior 12-month period and is initiating or proposing to initiate
such services. “New hospital” also includes any replacement of an existing
hospital that involves a substantial increase or change in the services
offered.
     (26) “New skilled nursing or intermediate
care service or facility” means a service or facility that did not offer long
term care services on a regular basis by or through the facility within the
prior 12-month period and is initiating or proposing to initiate such services.
“New skilled nursing or intermediate care service or facility” also includes
the rebuilding of a long term care facility, the relocation of buildings that
are a part of a long term care facility, the relocation of long term care beds
from one facility to another or an increase in the number of beds of more than
10 or 10 percent of the bed capacity, whichever is the lesser, within a
two-year period.
     (27) “Offer” means that the health care
facility holds itself out as capable of providing, or as having the means for
the provision of, specified health services.
     (28) “Operating expenses” means the sum of
daily hospital service expenses, ambulatory service expenses, ancillary
expenses and other operating expenses, excluding income taxes.
     (29) “Outpatient renal dialysis facility”
means a facility that provides renal dialysis services directly to outpatients.
     (30) “Person” means an individual, a trust
or estate, a partnership, a corporation (including associations, joint stock
companies and insurance companies), a state, or a political subdivision or
instrumentality, including a municipal corporation, of a state.
     (31) “Skilled nursing facility” means a
facility or a distinct part of a facility, that is primarily engaged in
providing to inpatients skilled nursing care and related services for patients
who require medical or nursing care, or an institution that provides
rehabilitation services for the rehabilitation of individuals who are injured
or sick or who have disabilities.
     (32) “Special inpatient care facility”
means a facility with permanent inpatient beds and other facilities designed
and utilized for special health care purposes, including but not limited to a
rehabilitation center, a college infirmary, a chiropractic facility, a facility
for the treatment of alcoholism or drug abuse, an inpatient care facility
meeting the requirements of ORS 441.065, and any other establishment falling
within a classification established by the Department of Human Services, after
determination of the need for such classification and the level and kind of
health care appropriate for such classification.
     (33) “Total deductions from gross revenue”
or “deductions from revenue” means reductions from gross revenue resulting from
inability to collect payment of charges. Such reductions include bad debts,
contractual adjustments, uncompensated care, administrative, courtesy and
policy discounts and adjustments and other such revenue deductions. The
deduction shall be net of the offset of restricted donations and grants for
indigent care. [1977 c.751 §1; 1979 c.697 §2; 1979 c.744 §31; 1981 c.693 §1;
1983 c.482 §1; 1985 c.747 §16; 1987 c.320 §233; 1987 c.660 §4; 1987 c.753 §2;
1989 c.708 §5; 1989 c.1034 §5; 1991 c.470 §9; 2001 c.100 §1; 2001 c.104 §181a;
2001 c.900 §179; 2003 c.75 §91; 2003 c.784 §11; 2005 c.22 §300; 2007 c.70 §242]
     442.020 [Amended by 1955 c.533 §4; 1973 c.754 §2;
repealed by 1977 c.717 §23]
     442.025
Findings and policy. (1) The
Legislative Assembly finds that the achievement of reasonable access to quality
health care at a reasonable cost is a priority of the State of
     (2) Problems preventing the priority in
subsection (1) of this section from being attained include:
     (a) The inability of many citizens to pay
for necessary health care, being covered neither by private insurance nor by
publicly funded programs such as Medicare and Medicaid;
     (b) Rising costs of medical care which
exceed substantially the general rate of inflation;
     (c) Insufficient price competition in the
delivery of health care services that would provide a greater cost
consciousness among providers, payers and consumers;
     (d) Inadequate incentives for the use of
less costly and more appropriate alternative levels of health care;
     (e) Insufficient or inappropriate use of
existing capacity, duplicated services and failure to use less costly
alternatives in meeting significant health needs; and
     (f) Insufficient primary and emergency
medical care services in medically underserved areas of the state.
     (3) As a result of rising health care
costs and the concern expressed by health care providers, health care users,
third-party payers and the general public, there is an urgent need to abate
these rising costs so as to place the cost of health care within reach of all
Oregonians without affecting the quality of care.
     (4) To foster the cooperation of the
separate industry forces, there is a need to compile and disseminate accurate
and current data, including but not limited to price and utilization data, to
meet the needs of the people of
     (5) It is the purpose of this chapter to
establish area-wide and state planning for health services, staff and
facilities in light of the findings of subsection (1) of this section and in
furtherance of health planning policies of this state.
     (6) It is further declared that hospital
costs should be contained through improved competition between hospitals and
improved competition between insurers and through financial incentives on
behalf of providers, insurers and consumers to contain costs. As a safety net,
it is the intent of the Legislative Assembly to monitor hospital performance. [1977
c.751 §2; 1981 c.693 §2; 1983 c.482 §2; 1985 c.747 §1; 1987 c.660 §3]
     442.030 [Amended by 1955 c.533 §5; 1961 c.316 §8;
1967 c.89 §4; repealed by 1977 c.717 §23]
     442.035
     (2) The members of the commission shall be
residents of the State of
     (a) The commission shall have 10 public
members and shall include at least one member from each congressional district
of the state.
     (b) The membership of the commission shall
broadly represent the geographic, social, economic, occupational, linguistic
and racial population of the state and shall include individuals who represent
     (c) The commission shall have a majority
of members who are not direct providers of health care and shall include
individuals who represent
     (d) The commission shall have at least one
member who is a physician licensed to practice in this state. For the purposes
of this paragraph, “physician” has the meaning given that term in ORS 677.010.
     (e) Members shall be appointed to
three-year terms.
     (f) A member may not serve more than two
consecutive terms.
     (3) Voting members of the commission shall
serve at the GovernorÂ’s pleasure.
     (4) Voting members shall select a
chairperson and a vice chairperson from among themselves.
     (5) The commission shall meet at least
quarterly.
     (6) Members are entitled to compensation
and expenses as provided in ORS 292.495.
     (7) If a vacancy of a voting member is
created on the commission for any reason, the Governor shall fill the vacancy
by appointing a member to a three-year term.
     (8) In addition to the members appointed
to the commission under subsection (2) of this section:
     (a) The President of the Senate, in
consultation with leadership from the minority party, shall appoint two members
of the Senate to the commission, one from the majority party and one from the
minority party, who shall be nonvoting, advisory members; and
     (b) The Speaker of the House of
Representatives, in consultation with leadership from the minority party, shall
appoint two members of the House of Representatives to the commission, one from
the majority party and one from the minority party, who shall be nonvoting,
advisory members. [1977 c.751 §3; 1979 c.697 §3; 1981 c.693 §3; 1983 c.482 §3;
1985 c.747 §4; 1987 c.660 §1; 1995 c.727 §20; 1997 c.683 §17; 2001 c.280 §1;
2003 c.784 §1; 2005 c.771 §2]
     Note: Section 1, chapter 771, Oregon Laws 2005,
provides:
     Sec.
1. Notwithstanding ORS
442.035 (2)(e), the terms of office of the first three members appointed by the
Governor to the Oregon Health Policy Commission on or after the effective date
of this 2005 Act [August 23, 2005] shall be four years. [2005 c.771 §1]
     442.040 [Amended by 1955 c.533 §6; 1973 c.754 §3;
repealed by 1977 c.717 §23]
     442.045
Commission duties. The
Oregon Health Policy Commission shall perform the following functions:
     (1) Develop a plan for and monitor the
implementation of the state health policy.
     (2) Act as the policy-making body for a
statewide data clearinghouse established within the Department of Human Services
or among other state agencies as appropriate for the acquisition, compilation,
correlation and dissemination of data from health care providers, other state
and local agencies including the state Medicaid program, third-party payers and
other appropriate sources in furtherance of the purpose and intent of the
Legislative Assembly as expressed in ORS 442.025.
     (3) Review reports provided at least
biennially by the Administrator of the Office for Oregon Health Policy and
Research on the findings, trends and long-term implications arising from data
collected pursuant to ORS 442.120 and 442.400 to 442.463 and by the statewide
data clearinghouse authorized by subsection (2) of this section.
     (4) Provide a forum for discussion of
health policy and health care issues facing the citizens of the State of
     (5) Identify and analyze significant
health policy and health care issues affecting the state and make policy
recommendations to the Governor.
     (6) Prepare and submit to the Governor and
the Legislative Assembly resolutions relating to health policy and health care
reform.
     (7) Review State Medicaid Plan amendments,
modifications in Medicaid operational protocols, applications for waivers to
the Centers for Medicare and Medicaid Services proposed by the Department of
Human Services and administrative rules for the stateÂ’s medical assistance
program and other health care programs.
     (8) Act as the primary advisory committee
to the Office for Oregon Health Policy and Research, the Governor and the
Legislative Assembly.
     (9) Perform all other functions authorized
or required by state law. [1977 c.751 §4; 1981 c.693 §4; 1983 c.482 §4; 1985
c.187 §1; 1985 c.747 §5; 1987 c.660 §2; 1991 c.470 §17; 1995 c.727 §22; 1997
c.683 §18; 1999 c.581 §1; 2003 c.784 §3]
     442.050 [Amended by 1957 c.697 §3; 1969 c.535 §2;
1973 c.754 §4; 1977 c.284 §50; repealed by 1977 c.717 §23]
     442.053 [1955 c.533 §7; 1973 c.754 §5; repealed by
1977 c.717 §23]
     442.055 [1955 c.533 §8; repealed by 1973 c.754 §8]
     442.057
Commission subcommittees and advisory committees. The Oregon Health Policy Commission may
establish subcommittees and may appoint advisory committees to advise it in
carrying out its duties. Members of advisory committees shall not be eligible
for compensation but shall be entitled to receive actual and necessary travel
and other expenses incurred in the performance of their official duties. [1977
c.751 §15; 1981 c.693 §5; 2003 c.784 §4]
     442.060 [Amended by 1963 c.92 §1; repealed by 1977
c.717 §23]
     442.070 [Amended by 1961 c.316 §9; 1967 c.89 §5;
repealed by 1971 c.734 §21]
     442.075 [1971 c.734 §58; repealed by 1973 c.754 §6
(442.076 enacted in lieu of 442.075)]
     442.076 [1973 c.754 §7 (enacted in lieu of 442.075);
repealed by 1977 c.717 §23]
     442.080 [Repealed by 1977 c.717 §23]
     442.085 [1977 c.751 §5; 1981 c.693 §6; repealed by
1987 c.660 §40]
     442.090 [Repealed by 1955 c.533 §10]
     442.095 [1977 c.751 §6; 1981 c.693 §7; 1983 c.482 §5;
1985 c.747 §7; 1987 c.660 §5; 1993 c.754 §6; repealed by 1995 c.727 §48]
     442.100 [1977 c.751 §7; repealed by 1981 c.693 §31]
     442.105 [1977 c.751 §38; 1981 c.693 §8; 1983 c.482 §6;
repealed by 1987 c.660 §40]
     442.110 [Formerly 431.250 (3), (4); repealed by 1987
c.660 §40]
     442.120
Ambulatory surgery and inpatient discharge abstract records; alternative data;
rules; fees. In order to
provide data essential for health planning programs:
     (1) The Office for Oregon Health Policy
and Research may request, by July 1 of each year, each general hospital to file
with the office ambulatory surgery and inpatient discharge abstract records
covering all patients discharged during the preceding calendar year. The
ambulatory surgery and inpatient discharge abstract record for each patient
must include the following information, and may include other information
deemed necessary by the office for developing or evaluating statewide health
policy:
     (a) Date of birth;
     (b) Sex;
     (c) Zip code;
     (d) Inpatient admission date or outpatient
service date;
     (e) Inpatient discharge date;
     (f) Type of discharge;
     (g) Diagnostic related group or diagnosis;
     (h) Type of procedure performed;
     (i) Expected source of payment, if
available;
     (j) Hospital identification number; and
     (k) Total hospital charges.
     (2) By July 1 of each year, the office may
request from ambulatory surgical centers licensed under ORS 441.015 ambulatory
surgery discharge abstract records covering all patients admitted during the
preceding year. Ambulatory surgery discharge abstract records must include
information similar to that requested from general hospitals under subsection
(1) of this section.
     (3) In lieu of abstracting and compiling
the records itself, the office may solicit the voluntary submission of such
data from
     (4) Subject to prior approval of the
Oregon Department of Administrative Services and a report to the Emergency
Board, if the Legislative Assembly is not in session, prior to adopting the
fee, and within the budget authorized by the Legislative Assembly as the budget
may be modified by the Emergency Board, the fee established under subsection
(3) of this section may not exceed the cost of abstracting and compiling the
records.
     (5) The office may specify by rule the
form in which the records are to be submitted. If the form adopted by rule
requires conversion from the form regularly used by a hospital, reasonable
costs of such conversion shall be paid by the office.
     (6) Abstract records must include a
patient identifier that allows for the statistical matching of records over
time to permit public studies of issues related to clinical practices, health
service utilization and health outcomes. Provision of such a patient identifier
must not allow for identification of the individual patient.
     (7) In addition to the records required in
subsection (1) of this section, the office may obtain abstract records for each
patient that identify specific services, classified by International
Classification of Disease Code, for special studies on the incidence of
specific health problems or diagnostic practices. However, nothing in this
subsection shall authorize the publication of specific data in a form that
allows identification of individual patients or licensed health care
professionals.
     (8) The office may provide by rule for the
submission of records for enrollees in a health maintenance organization from a
hospital associated with such an organization in a form the office determines
appropriate to the officeÂ’s needs for such data and the organizationÂ’s record
keeping and reporting systems for charges and services. [Formerly 442.355; 1991
c.703 §7; 1993 c.754 §7; 1995 c.727 §23; 1997 c.683 §19; 1999 c.581 §2; 2007
c.71 §128]
     442.150 [1977 c.751 §10; repealed by 1987 c.660 §40]
     442.155 [1977 c.751 §11; 1983 c.482 §7; 1985 c.747 §6;
repealed by 1987 c.660 §40]
     442.160 [1977 c.751 §12; repealed by 1987 c.660 §40]
     442.165 [1977 c.751 §13; 1981 c.693 §9; repealed by
1983 c.482 §23]
     442.170 [1977 c.751 §14; repealed by 1983 c.482 §23]
     442.200
Definitions for ORS 442.205.
As used in this section and ORS 442.205:
     (1) “Charity care” means free or
discounted health services provided to persons who cannot afford to pay and
from whom a hospital has no expectation of payment. “Charity care” does not
include bad debt, contractual allowances or discounts for quick payment.
     (2) “Community benefit” means a program or
activity that provides treatment or promotes health and healing in response to
an identified community need. “Community benefit” includes:
     (a) Charity care;
     (b) Losses related to Medicaid, Medicare,
State ChildrenÂ’s Health Insurance Program or other publicly funded health care
program shortfalls;
     (c) Community health improvement services;
     (d) Research;
     (e) Financial and in-kind contributions to
the community; and
     (f) Community building activities
affecting health in the community. [2007 c.384 §2]
     Note: 442.200 and 442.205 were added to and made a
part of ORS chapter 442 by legislative action but were not added to any smaller
series therein. See Preface to Oregon Revised Statutes for further explanation.
     442.205
Community benefit reporting; rules. (1) The Administrator of the Office for Oregon Health Policy and
Research shall by rule adopt a cost-based community benefit reporting system
for hospitals operating in
     (2) Within 90 days of filing a Medicare
cost report, a hospital must submit a community benefit report to the Office
for Oregon Health Policy and Research of the community benefits provided by the
hospital, on a form prescribed by the administrator.
     (3) The administrator shall produce an
annual report of the information provided under subsections (1) and (2) of this
section. The report shall be submitted to the Governor, the President of the
Senate and the Speaker of the House of Representatives. The report shall be
presented to the Legislative Assembly during each regular session and shall be
made available to the public.
     (4) The administrator may adopt all rules
necessary to carry out the provisions of this section. [2007 c.384 §3]
     Note: See note under 442.200.
     442.300 [Formerly 441.010; repealed by 1981 c.693 §31]
CERTIFICATES
OF NEED FOR HEALTH SERVICES
     442.315
Certificate of need; rules; fees; enforcement; exceptions; letter of intent. (1) Any new hospital or new skilled nursing
or intermediate care service or facility not excluded pursuant to ORS 441.065
shall obtain a certificate of need from the Department of Human Services prior
to an offering or development.
     (2) The department shall adopt rules
specifying criteria and procedures for making decisions as to the need for the
new services or facilities.
     (3)(a) An applicant for a certificate of
need shall apply to the department on forms provided for this purpose by
department rule.
     (b) An applicant shall pay a fee
prescribed as provided in this section. Subject to the approval of the Oregon
Department of Administrative Services, the Department of Human Services shall
prescribe application fees, based on the complexity and scope of the proposed
project.
     (4) The Department of Human Services shall
be the decision-making authority for the purpose of certificates of need.
     (5)(a) An applicant or any affected person
who is dissatisfied with the proposed decision of the department is entitled to
an informal hearing in the course of review and before a final decision is
rendered.
     (b) Following a final decision being
rendered by the department, an applicant or any affected person may request a
reconsideration hearing pursuant to ORS chapter 183.
     (c) In any proceeding brought by an
affected person or an applicant challenging a department decision under this
subsection, the department shall follow procedures consistent with the
provisions of ORS chapter 183 relating to a contested case.
     (6) Once a certificate of need has been
issued, it may not be revoked or rescinded unless it was acquired by fraud or
deceit. However, if the department finds that a person is offering or
developing a project that is not within the scope of the certificate of need,
the department may limit the project as specified in the issued certificate of
need or reconsider the application. A certificate of need is not transferable.
     (7) Nothing in this section applies to any
hospital, skilled nursing or intermediate care service or facility that seeks
to replace equipment with equipment of similar basic technological function or
an upgrade that improves the quality or cost-effectiveness of the service
provided. Any person acquiring such replacement or upgrade shall file a letter
of intent for the project in accordance with the rules of the department if the
price of the replacement equipment or upgrade exceeds $1 million.
     (8) Except as required in subsection (1)
of this section for a new hospital or new skilled nursing or intermediate care
service or facility not operating as a Medicare swing bed program, nothing in
this section requires a rural hospital as defined in ORS 442.470 (5)(a)(A) and
(B) to obtain a certificate of need.
     (9) Nothing in this section applies to
basic health services, but basic health services do not include:
     (a) Magnetic resonance imaging scanners;
     (b) Positron emission tomography scanners;
     (c) Cardiac catheterization equipment;
     (d) Megavoltage radiation therapy
equipment;
     (e) Extracorporeal shock wave
lithotriptors;
     (f) Neonatal intensive care;
     (g) Burn care;
     (h) Trauma care;
     (i) Inpatient psychiatric services;
     (j) Inpatient chemical dependency
services;
     (k) Inpatient rehabilitation services;
     (L) Open heart surgery; or
     (m) Organ transplant services.
     (10) In addition to any other remedy
provided by law, whenever it appears that any person is engaged in, or is about
to engage in, any acts that constitute a violation of this section, or any rule
or order issued by the department under this section, the department may
institute proceedings in the circuit courts to enforce obedience to such
statute, rule or order by injunction or by other processes, mandatory or
otherwise.
     (11) As used in this section, “basic
health services” means health services offered in or through a hospital
licensed under ORS chapter 441, except skilled nursing or intermediate care
nursing facilities or services and those services specified in subsection (9)
of this section. [1989 c.1034 §2; 1993 c.722 §3; 1995 c.727 §39; 2001 c.875 §3;
2003 c.14 §258]
     442.320 [Formerly 441.090; 1979 c.697 §4; 1981 c.693
§10; 1983 c.482 §8; 1985 c.747 §31; 1987 c.660 §6; 1989 c.708 §6; repealed by
1989 c.1034 §11]
     442.325
Certificate for health care facility of health maintenance organization; exempt
activities; policy relating to health maintenance organizations. (1) A certificate of need shall be required
for the development or establishment of a health care facility of any new
health maintenance organization.
     (2) Any activity of a health maintenance
organization which does not involve the direct delivery of health services, as
distinguished from arrangements for indirect delivery of health services
through contracts with providers, shall be exempt from certificate of need
review.
     (3) Nothing in ORS 244.050, 431.250,
441.015 to 441.087, 442.015 to 442.420 and 442.450 applies to any decision of a
health maintenance organization involving its organizational structure, its
arrangements for financing health services, the terms of its contracts with
enrolled beneficiaries or its scope of benefits.
     (4) With the exception of certificate of
need requirements, when applicable, the licensing and regulation of health
maintenance organizations shall be controlled by ORS 750.005 to 750.095 and
statutes incorporated by reference therein.
     (5) It is the policy of ORS 244.050,
431.250, 441.015 to 441.087, 442.015 to 442.420 and 442.450 to encourage the
growth of health maintenance organizations as an alternative delivery system
and to provide the facilities for the provision of quality health care to the
present and future members who may enroll within their defined service area.
     (6)(a) It is also the policy of ORS
244.050, 431.250, 441.015 to 441.087, 442.015 to 442.420 and 442.450 to
consider the special needs and circumstances of health maintenance
organizations. Such needs and circumstances include the needs of and costs to
members and projected members of the health maintenance organization in
obtaining health services and the potential for a reduction in the use of inpatient
care in the community through an extension of preventive health services and
the provision of more systematic and comprehensive health services. The
consideration of a new health service proposed by a health maintenance
organization shall also address the availability and cost of obtaining the
proposed new health service from the existing providers in the area that are
not health maintenance organizations.
     (b) The Department of Human Services shall
issue a certificate of need for beds, services or equipment to meet the needs
or reasonably anticipated needs of members of health maintenance organizations
when beds, services or equipment are not available from nonplan providers. [1977
c.751 §56; 1981 c.693 §11; 1995 c.727 §40; 1999 c.581 §9]
     442.330 [Formerly 441.092; 1979 c.697 §5; repealed
by 1981 c.693 §31]
     442.335 [1977 c.751 §8; 1981 c.693 §12; 1983 c.482 §9;
1987 c.660 §7; repealed by 1989 c.1034 §11]
     442.340 [Formerly 441.095; 1979 c.174 §1; 1979 c.285
§2; 1979 c.697 §6; 1981 c.693 §13; 1983 c.482 §10; 1985 c.747 §33; 1987 c.660 §8;
repealed by 1989 c.1034 §11]
     442.342
Waiver of requirements; rules; penalties. (1) Notwithstanding any other provision of law, a hospital licensed
under ORS 441.025, in accordance with rules adopted by the Department of Human
Services, may apply for waiver from the provisions of ORS 442.325 and section
9, chapter 1034, Oregon Laws 1989, and the department shall grant such waiver
if, for the most recently completed hospital fiscal year preceding the date of
application for waiver and each succeeding fiscal year thereafter, the
percentage of qualified inpatient revenue is not less than that described in
subsection (2) of this section.
     (2)(a) The percentage of qualified
inpatient revenue for the first year in which a hospital is granted a waiver
under subsection (1) of this section shall not be less than 60 percent.
     (b) The percentage in paragraph (a) of
this subsection shall be increased by five percentage points in each succeeding
hospital fiscal year until the percentage of qualified inpatient revenue equals
or exceeds 75 percent.
     (3) As used in this section:
     (a) “Qualified inpatient revenue” means
revenue earned from public and private payers for inpatient hospital services
approved by the department pursuant to rules, including:
     (A) Revenue earned pursuant to Title
XVIII, United States Social Security Act, when such revenue is based on
diagnostic related group prices which include capital-related expenses or other
risk-based payment programs as approved by the department;
     (B) Revenue earned pursuant to Title XIX,
United States Social Security Act, when such revenue is based on diagnostic
related group prices which include capital-related expenses;
     (C) Revenue earned under negotiated
arrangements with public or private payers based on all-inclusive per diem
rates for one or more hospital service categories;
     (D) Revenue earned under negotiated
arrangements with public or private payers based on all-inclusive per discharge
or per admission rates related to diagnostic related groups or other service or
intensity-related measures;
     (E) Revenue earned under arrangements with
one or more health maintenance organizations; or
     (F) Other prospectively determined forms
of inpatient hospital reimbursement approved in advance by the department in
accordance with rules.
     (b) “Percentage of qualified inpatient
revenue” means qualified inpatient revenue divided by total gross inpatient
revenue as defined by administrative rule of the department.
     (4)(a) The department shall hold a hearing
to determine the cause if any hospital granted a waiver pursuant to subsection
(1) of this section fails to reach the applicable percentage of qualified
inpatient revenue in any subsequent fiscal year of the hospital.
     (b) If the department finds that the
failure was without just cause and that the hospital has undertaken projects
that, except for the provisions of this section would have been subject to ORS
442.325 or section 9, chapter 1034, Oregon Laws 1989, the department shall
impose one of the penalties outlined in paragraph (c) of this subsection.
     (c)(A) A one-time civil penalty of not
less than $25,000 or more than $250,000; or
     (B) An annual civil penalty equal to an
amount not to exceed 110 percent of the net profit derived from such project or
projects for a period not to exceed five years.
     (5) Nothing in this section shall be
construed to permit a hospital to develop a new inpatient hospital facility or
provide new services authorized by facilities defined as “long term care
facility” under ORS 442.015 under a waiver granted pursuant to subsection (1)
of this section. [1985 c.747 §35; 1987 c.660 §9; 1991 c.470 §18; 1995 c.727 §41]
     Note: 442.342 was enacted into law by the
Legislative Assembly and added to or made a part of ORS chapter 442 by
legislative action but not to any series therein. See Preface to Oregon Revised
Statutes for further explanation.
     442.344
Exemptions from requirements.
In furtherance of the purpose and intent of the Legislative Assembly as
expressed in ORS 442.025 to achieve reasonable access to quality health care at
a reasonable cost, the requirements of ORS 442.325 shall not apply to
ambulatory surgical centers performing only ophthalmic surgery. [1987 c.723 §1]
     Note: 442.344 was enacted into law by the Legislative
Assembly but was not added to or made a part of ORS chapter 442 or any series
therein by legislative action. See Preface to Oregon Revised Statutes for
further explanation.
     442.345 [1977 c.751 §33; 1981 c.693 §14; 1985 c.747 §36;
repealed by 1989 c.1034 §11]
     442.347
Rural hospital required to report certain actions. A rural hospital exempted from the
certificate of need requirement by ORS 442.315 (8) shall report any action
taken by the hospital that would have required a certificate of need if the
exemption did not exist. [1993 c.722 §4]
     Note: 442.347 was enacted into law by the
Legislative Assembly but was not added to or made a part of ORS chapter 442 or
any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
     442.350 [Formerly 441.140; repealed by 1989 c.1034 §11]
     442.355 [1983 c.482 §12; 1985 c.747 §14; renumbered
442.120]
     442.360 [1977 c.751 §9; 1979 c.697 §7; 1981 c.693 §25;
1985 c.747 §37; repealed by 1989 c.1034 §11]
HEALTH CARE COST
REVIEW
     442.400
“Health care facility” defined.
As used in ORS 442.400 to 442.463, unless the context requires otherwise, “health
care facility” or “facility” means such facility as defined by ORS 442.015,
exclusive of a long term care facility, and includes all publicly and privately
owned and operated health care facilities, but does not include facilities
described in ORS 441.065. [Formerly 441.415; 1979 c.697 §8; 1981 c.693 §15]
     442.405
Legislative findings and policy. The Legislative Assembly finds that rising costs and charges of health
care facilities are a matter of vital concern to the people of this state. The
Legislative Assembly finds and declares that it is the policy of this state:
     (1) To require health care facilities to
file for public disclosure reports that will enable both private and public
purchasers of services from such facilities to make informed decisions in
purchasing such services; and
     (2) To encourage development of programs
of research and innovation in the methods of delivery of institutional health
care services of high quality with costs and charges reasonably related to the
nature and quality of the services rendered. [Formerly 441.420; 1999 c.581 §3]
     442.410 [1977 c.751 §45; 1981 c.693 §16; 1983 c.482 §13;
1985 c.747 §38; 1995 c.727 §24; 1997 c.683 §20; repealed by 1999 c.581 §11]
     442.415 [1977 c.751 §46; 1983 c.482 §14; 1995 c.727 §25;
1997 c.683 §21; repealed by 1999 c.581 §11]
     442.420
Application for financial assistance; financial analysis and investigation authority;
rules. (1) The Office for
Oregon Health Policy and Research may apply for, receive and accept grants,
gifts, payments and other funds and advances, appropriations, properties and
services from the United States, the State of Oregon or any governmental body,
agency or agencies or from any other public or private corporation or person,
and enter into agreements with respect thereto, including the undertaking of
studies, plans, demonstrations or projects.
     (2) The Administrator of the Office for
Oregon Health Policy and Research shall conduct or cause to have conducted such
analyses and studies relating to costs of health care facilities as considered
desirable, including but not limited to methods of reducing such costs,
utilization review of services of health care facilities, peer review, quality
control, financial status of any facility subject to ORS 442.400 to 442.463 and
sources of public and private financing of financial requirements of such
facilities.
     (3) The administrator may also:
     (a) Hold public hearings, conduct
investigations and require the filing of information relating to any matter
affecting the costs of and charges for services in all health care facilities;
     (b) Subpoena witnesses, papers, records
and documents the administrator considers material or relevant in connection
with functions of the office subject to the provisions of ORS chapter 183;
     (c) Exercise, subject to the limitations
and restrictions imposed by ORS 442.400 to 442.463, all other powers which are
reasonably necessary or essential to carry out the express objectives and
purposes of ORS 442.400 to 442.463; and
     (d) Adopt rules in accordance with ORS
chapter 183 necessary in the administratorÂ’s judgment for carrying out the
functions of the office. [Formerly 441.435; 1981 c.693 §17; 1983 c.482 §15;
1985 c.747 §39; 1995 c.727 §26; 1997 c.683 §22; 1999 c.581 §4]
     442.425
Authority over reporting systems of facilities. (1) The Administrator of the Office for
Oregon Health Policy and Research by rule may specify one or more uniform
systems of financial reporting necessary to meet the requirements of ORS
442.400 to 442.463. Such systems shall include such cost allocation methods as
may be prescribed and such records and reports of revenues, expenses, other
income and other outlays, assets and liabilities, and units of service as may
be prescribed. Each facility under the administratorÂ’s jurisdiction shall adopt
such systems for its fiscal period starting on or after the effective date of
such system and shall make the required reports on such forms as may be
required by the administrator. The administrator may extend the period by which
compliance is required upon timely application and for good cause. Filings of
such records and reports shall be made at such times as may be reasonably
required by the administrator.
     (2) Existing systems of reporting used by
health care facilities shall be given due consideration by the administrator in
carrying out the duty of specifying the systems of reporting required by ORS
442.400 to 442.463. The administrator insofar as reasonably possible shall
adopt reporting systems and requirements that will not unreasonably increase
the administrative costs of the facility.
     (3) The administrator may allow and
provide for modifications in the reporting systems in order to correctly
reflect differences in the scope or type of services and financial structure
between the various categories, sizes or types of health care facilities and in
a manner consistent with the purposes of ORS 442.400 to 442.463.
     (4) The administrator may establish
specific annual reporting provisions for facilities that receive a
preponderance of their revenue from associated comprehensive group-practice
prepayment health care service plans. Notwithstanding any other provisions of
ORS 441.055 and 442.400 to 442.463, such facilities shall be authorized to
utilize established accounting systems and to report costs and revenues in a
manner consistent with the operating principles of such plans and with
generally accepted accounting principles. When such facilities are operated as
units of a coordinated group of health facilities under common ownership, the
facilities shall be authorized to report as a group rather than as individual
institutions, and as a group shall submit a consolidated balance sheet, income
and expense statement and statement of source and application of funds for such
group of health facilities. [Formerly 441.440; 1981 c.693 §18; 1995 c.727 §27;
1997 c.683 §23; 1999 c.581 §5]
     442.430
Investigations; confidentiality of data. (1) Whenever a further investigation is considered necessary or
desirable by the Office for Oregon Health Policy and Research to verify the
accuracy of the information in the reports made by health care facilities, the
office may make any necessary further examination of the facilityÂ’s records and
accounts. Such further examinations include, but are not limited to, requiring
a full or partial audit of all such records and accounts.
     (2) In carrying out the duties prescribed
by ORS 441.055 and 442.400 to 442.463, the office may utilize its own staff or
may contract with any appropriate, independent, qualified third party. No such
contractor shall release or publish or otherwise use any information made
available to it under its contractual responsibility unless such permission is
specifically granted by the office. [Formerly 441.445; 1995 c.727 §28; 1997
c.683 §24]
     442.435 [Formerly 441.460; 1983 c.482 §16; 1987
c.660 §27; 1995 c.727 §29; 1997 c.683 §25; repealed by 1999 c.581 §11]
     442.440 [Formerly 441.465; 1983 c.482 §17; 1983
c.740 §161; repealed by 1987 c.660 §40]
     442.442 [1979 c.697 §10; repealed by 1981 c.693 §31]
     442.445
Civil penalty for failure to perform. (1) Any health care facility that fails to perform as required in ORS
442.205 and 442.400 to 442.463 or section 3, chapter 838, Oregon Laws 2007, and
rules of the Office for Oregon Health Policy and Research may be subject to a
civil penalty.
     (2) The Administrator of the Office for
Oregon Health Policy and Research shall adopt a schedule of penalties not to
exceed $500 per day of violation, determined by the severity of the violation.
     (3) Civil penalties under this section
shall be imposed as provided in ORS 183.745.
     (4) Civil penalties imposed under this
section may be remitted or mitigated upon such terms and conditions as the
administrator considers proper and consistent with the public health and
safety.
     (5) Civil penalties incurred under any law
of this state are not allowable as costs for the purpose of rate determination
or for reimbursement by a third-party payer. [Formerly 441.480; 1981 c.693 §19;
1983 c.482 §18; 1983 c.696 §21; 1991 c.734 §24; 1993 c.18 §110; 1995 c.727 §30;
1997 c.683 §26; 1999 c.581 §6; 2007 c.384 §4; 2007 c.838 §7]
     Note: The amendments to 442.445 by section 8,
chapter 838,
     442.445. (1) Any health care facility that fails to
perform as required in ORS 442.205 and 442.400 to 442.463 and rules of the
Office for Oregon Health Policy and Research may be subject to a civil penalty.
     (2) The Administrator of the Office for
Oregon Health Policy and Research shall adopt a schedule of penalties not to
exceed $500 per day of violation, determined by the severity of the violation.
     (3) Civil penalties under this section
shall be imposed as provided in ORS 183.745.
     (4) Civil penalties imposed under this
section may be remitted or mitigated upon such terms and conditions as the
administrator considers proper and consistent with the public health and
safety.
     (5) Civil penalties incurred under any law
of this state are not allowable as costs for the purpose of rate determination
or for reimbursement by a third-party payer.
     442.450
Exemption from cost review regulations. The following are not subject to ORS 442.400 to 442.463:
     (1) Physicians in private practice, solo
or in a group or partnership, who are not employed by, or hold ownership or
part ownership in, a health care facility; or
     (2) Health care facilities described in
ORS 441.065. [1977 c.751 §55]
     442.460
Information about utilization and cost of health care services. In order to obtain regional or statewide data
about the utilization and cost of health care services, the Office for Oregon
Health Policy and Research may accept information relating to the utilization
and cost of health care services identified by the Administrator of the Office
for Oregon Health Policy and Research from physicians, insurers or other
third-party payers or employers or other purchasers of health care. [1985 c.747
§15; 1995 c.727 §31; 1997 c.683 §27; 1999 c.581 §7]
     442.463
Annual utilization report; contents; approval; rules. (1) Each licensed health facility shall file
with the Office for Oregon Health Policy and Research an annual report
containing such information related to the facilityÂ’s utilization as may be
required by the Administrator of the Office for Oregon Health Policy and
Research, in such form as the administrator prescribes by rule.
     (2) The annual report shall contain such
information as may be required by rule of the administrator and must be
approved by the administrator. [1985 c.747 §§18,19; 1995 c.727 §32; 1997 c.683 §28;
1999 c.581 §8]
     442.465 [1985 c.747 §22; 1987 c.660 §10; 1989 c.1034
§6; 1995 c.727 §33; 1997 c.683 §29; repealed by 1999 c.581 §11]
     442.467 [1985 c.747 §23; repealed by 1989 c.1034 §11]
     442.469 [1985 c.747 §24; 1987 c.660 §11; 1989 c.1034
§7; 1995 c.727 §34; 1997 c.683 §30; repealed by 1999 c.581 §11]
     Note: Sections 1, 2 and 3, chapter 665, Oregon
Laws 2007, provide:
     Sec.
1. The Legislative Assembly
finds that:
     (1) An efficient and effective health care
system is critical to quality of life in
     (2)
     (3) For all Oregonians to have access to
health care, the delivery system must be expanded; and
     (4) Clinical trials using health care
provider teams designed to take advantage of decision-supporting software and
utilizing lower cost frontline providers should be evaluated as part of
     Sec.
2. (1) The Department of
Human Services shall seek approval from the Centers for Medicare and Medicaid
Services to operate a demonstration project to test alternative health care
delivery systems through one or more pilot programs. Pilot programs may
include, but are not limited to, programs testing advanced information
technology applications, including decision supporting software that would
improve health assessment data collection and decision-making.
     (2) Technology or other methods tested
under subsection (1) of this section shall be evaluated for:
     (a) Demonstration of health outcomes that
are equal to or better than those the current delivery system provides;
     (b) Ease of use by patients and providers;
     (c) Extent of public acceptance; and
     (d) The cost of implementation and
administration.
     (3) The department may adopt rules
necessary to implement the provisions of this section. [2007 c.665 §2]
     Sec.
3. Sections 1 and 2 of this
2007 Act are repealed on January 2, 2012. [2007 c.665 §3]
RURAL HEALTH
     442.470
Definitions for ORS 442.470 to 442.507. As used in ORS 442.470 to 442.507:
     (1) “Acute inpatient care facility” means
a licensed hospital with an organized medical staff, with permanent facilities
that include inpatient beds, and with comprehensive medical services, including
physician services and continuous nursing services under the supervision of
registered nurses, to provide diagnosis and medical or surgical treatment
primarily for but not limited to acutely ill patients and accident victims.
     (2) “Council” means the Rural Health
Coordinating Council.
     (3) “Office” means the Office of Rural
Health.
     (4) “Primary care physician” means a
doctor licensed under ORS chapter 677 whose specialty is family practice,
general practice, internal medicine, pediatrics or obstetrics and gynecology.
     (5)(a) “Rural hospital” means a hospital
characterized as one of the following:
     (A) A type A hospital, which is a small
and remote hospital that has 50 or fewer beds and is more than 30 miles from
another acute inpatient care facility;
     (B) A type B hospital, which is a small
and rural hospital that has 50 or fewer beds and is 30 miles or less from
another acute inpatient care facility;
     (C) A type C hospital, which is considered
to be a rural hospital and has more than 50 beds, but is not a referral center;
or
     (D) A rural critical access hospital as
defined in ORS 315.613.
     (b) “Rural hospital” does not include a
hospital of any class that was designated by the federal government as a rural
referral hospital before January 1, 1989. [1979 c.513 §1; 1987 c.660 §12; 1987
c.918 §5; 1989 c.893 §8a; 1991 c.947 §1; 2001 c.875 §2]
     442.475
Office of Rural Health.
There is created the Office of Rural Health in the Oregon Health and
     442.480
Rural Health Care Revolving Account. (1) There is established the Rural Health Care Revolving Account in
the General Fund.
     (2) All moneys appropriated for the
purposes of ORS 442.470 to 442.507 and all moneys paid to the Office of Rural
Health by reason of loans, fees, gifts or grants for the purposes of ORS
442.470 to 442.507 shall be credited to the Rural Health Care Revolving
Account.
     (3) All moneys contained in the Rural
Health Care Revolving Account are continuously appropriated to the Oregon
Department of Administrative Services for the Office of Rural Health and shall
be used for the purposes of ORS 442.470 to 442.507. [1979 c.513 §3; 1987 c.660 §14;
1989 c.708 §1; 2005 c.755 §37]
     442.485
Responsibilities of Office of Rural Health. The responsibilities of the Office of Rural Health shall include but
not be limited to:
     (1) Coordinating statewide efforts for
providing health care in rural areas.
     (2) Accepting and processing applications
from communities interested in developing health care delivery systems.
Application forms shall be developed by the agency.
     (3) Through the agency, applying for
grants and accepting gifts and grants from other governmental or private
sources for the research and development of rural health care programs and
facilities.
     (4) Serving as a clearinghouse for
information on health care delivery systems in rural areas.
     (5) Helping local boards of health care
delivery systems develop ongoing funding sources.
     (6) Developing enabling legislation to
facilitate further development of rural health care delivery systems. [1979
c.513 §4; 1983 c.482 §19; 1987 c.660 §15]
     442.490
Rural Health Coordinating Council; membership; terms; officers; compensation
and expenses. (1) In
carrying out its responsibilities, the Office of Rural Health shall be advised
by the Rural Health Coordinating Council. All members of the Rural Health
Coordinating Council shall have knowledge, interest, expertise or experience in
rural areas and health care delivery. The membership of the Rural Health
Coordinating Council shall consist of:
     (a) One primary care physician who is
appointed by the Oregon Medical Association and one primary care physician
appointed by the Oregon Osteopathic Association;
     (b) One nurse practitioner who is
appointed by the Oregon Nursing Association;
     (c) One pharmacist who is appointed by the
State Board of Pharmacy;
     (d) Five consumers who are appointed by
the Governor as follows:
     (A) One consumer representative from each
of the three health service areas; and
     (B) Two consumer representatives at large
from communities of less than 3,500 people;
     (e) One representative appointed by the
Conference of Local Health Officials;
     (f) One volunteer emergency medical
technician from a community of less than 3,500 people appointed by the Oregon
State EMT Association;
     (g) One representative appointed by the
Oregon Association for Home Care;
     (h) One representative from the Oregon
Health and Science University, appointed by the president of the Oregon Health
and Science University;
     (i) One representative from the Oregon
Association of Hospitals, appointed by the Oregon Association of Hospitals;
     (j) One dentist appointed by the Oregon
Dental Association;
     (k) One optometrist appointed by the
Oregon Association of Optometry;
     (L) One physician assistant who is appointed
by the Oregon Society of Physician Assistants; and
     (m) One naturopathic physician appointed
by the Oregon Association of Naturopathic Physicians.
     (2) The Rural Health Coordinating Council
shall elect a chairperson and vice chairperson.
     (3) A member of the council is entitled to
compensation and expenses as provided in ORS 292.495.
     (4) The chairperson may appoint nonvoting,
advisory members of the Rural Health Coordinating Council. However, advisory
members without voting rights are not entitled to compensation or reimbursement
as provided in ORS 292.495.
     (5) Members shall serve for two-year
terms.
     (6) The Rural Health Coordinating Council
shall report its findings to the Office of Rural Health. [1979 c.513 §5; 1981
c.693 §20; 1983 c.482 §19a; 1989 c.708 §2]
     442.495
Responsibilities of council.
The responsibilities of the Rural Health Coordinating Council shall be to:
     (1) Advise the Office of Rural Health on
matters related to the health care services and needs of rural communities;
     (2) Develop general recommendations to
meet the identified needs of rural communities; and
     (3) View applications and recommend to the
office which communities should receive assistance, how much money should be
granted or loaned and the ability of the community to repay a loan. [1979 c.513
§6; 1981 c.693 §21; 1983 c.482 §20; 2007 c.71 §129]
     442.500
Technical and financial assistance to rural communities. (1) The Office of Rural Health shall provide
technical assistance to rural communities interested in developing health care
delivery systems.
     (2) Communities shall make application for
this technical assistance on forms developed by the office for this purpose.
     (3) The office shall make the final
decision concerning which communities receive the money and whether a loan is
made or a grant is given.
     (4) The office may make grants or loans to
rural communities for the purpose of establishing or maintaining medical care
services.
     (5) The office shall provide technical
assistance and coordination of rural health activities through staff services
which include monitoring, evaluation, community needs analysis, information
gathering and disseminating, guidance, linkages and research. [1979 c.513 §8;
1981 c.693 §22; 1983 c.482 §21]
     442.502
Determination of size of rural hospital. (1) For purposes of determining the size of a rural hospital, beds
certified by the Department of Human Services on the license of the hospital as
special inpatient care beds shall not be included.
     (2) As used in this section, “special
inpatient care beds” means beds that:
     (a) Are used for the treatment of patients
with mental illness or for the treatment of alcoholism or drug abuse, or are
located in a rehabilitation center, a college infirmary, a chiropractic
facility, a freestanding hospice facility, an infirmary for the homeless or an
inpatient care facility described in ORS 441.065;
     (b) Are physically separate from acute
inpatient care beds, at least by being located on separate floors or wings of
the same building;
     (c) Are never used for acute patient care;
     (d) Are staffed by dedicated direct care
personnel for whom separate employment records are maintained;
     (e) Have separate medical directors; and
     (f) Maintain separate admission, discharge
and patient records. [1993 c.765 §55; 2007 c.70 §243]
     442.503
Eligibility for economic development grants. In addition to any other authorized uses of funds for economic
development available from the Administrative Services Economic Development
Fund, economic development grants may be made for the purpose of constructing,
equipping, refurbishing, modernizing and making other capital improvements for
type A and B rural hospitals, as defined under ORS 442.470. [1989 c.893 §10]
     Note: 442.503 was enacted into law by the
Legislative Assembly but was not added to or made a part of ORS chapter 442 or
any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
     442.505
Technical assistance to rural hospitals. The Office of Rural Health shall institute a program to provide
technical assistance to hospitals defined by the office as rural. The Office of
Rural Health shall be primarily responsible for providing:
     (1) A recruitment and retention program
for physicians and other primary care providers in rural areas.
     (2) An informational link between rural
hospitals and state and federal policies regarding regulations and payment
sources.
     (3) A system for effectively networking
rural hospitals and providers so that they may compete or negotiate with urban
based health maintenance organizations.
     (4) Assistance to rural hospitals in
identifying strengths, weaknesses, opportunities and threats.
     (5) In conjunction with the Oregon
Association of Hospitals, a report that identifies models that will replace or
restructure inefficient health services in rural areas. [1987 c.918 §3; 2005
c.22 §301]
     442.507
Assistance to rural emergency medical service systems. (1) With the moneys transferred to the
Office of Rural Health by ORS 442.625, the office shall establish a dedicated
grant program for the purpose of providing assistance to rural communities to
enhance emergency medical service systems.
     (2) Communities, as well as nonprofit or
governmental agencies serving those communities, may apply to the office for
grants on forms developed by the office.
     (3) The office shall make the final
decision concerning which entities receive grants, but the office may seek
advice from the Rural Health Coordinating Council, the State Emergency Medical
Service Committee and other appropriate individuals experienced with emergency
medical services.
     (4) The office may make grants to entities
for the purchase of equipment, the establishment of new rural emergency medical
service systems or the improvement of existing rural emergency medical service
systems.
     (5) With the exception of printing and
mailing expenses associated with the grant program, the Office of Rural Health
shall pay for administrative costs of the program with funds other than those
transferred under ORS 442.625. [1999 c.1056 §5]
     442.515
Rural hospitals; findings.
The Legislative Assembly finds that
     442.520
Risk assessment formula; relative risk of rural hospitals. (1) Subject to the formula set out in
subsection (2) of this section, the Office of Rural Health, in consultation
with the Oregon Association of Hospitals, shall establish a risk assessment
formula to identify the relative risk of a rural hospital, as defined in ORS
442.470.
     (2) To assess the degree of risk faced by
each rural hospital, the risk assessment formula developed by the Office of
Rural Health, in consultation with the Oregon Association of Hospitals, shall
include the following categories:
     (a) Organizational risk: The financial
situation of each facility, as measured by a nationally accepted formula that
identifies the hospitalÂ’s current and future financial viability;
     (b) Population risk: The impact that a
hospital closure would have on the health care needs of the citizens of each
hospitalÂ’s respective service area, as measured by an index that includes
medically underserved, distance and target population components; and
     (c) Economic risk: The direct and indirect
economic contribution made to the communities of each hospitalÂ’s respective
service area, as measured by an index that measures the overall economic
benefit added to the service area community by the hospital. [1991 c.947 §20]
     Note: 442.520 was enacted into law by the
Legislative Assembly but was not added to or made a part of ORS chapter 442 by
legislative action. See Preface to Oregon Revised Statutes for further
explanation.
     442.525 [1989 c.893 §9; 1993 c.765 §50; repealed by
2005 c.806 §5]
NURSING
SERVICES PROGRAM
     442.535
Definitions for ORS 442.540 and 442.545. As used in ORS 442.540 and 442.545:
     (1) “Commission” means the Oregon Student
Assistance Commission.
     (2) “Nurse” means any person who is
licensed under ORS 678.010 to 678.410 as a registered nurse.
     (3) “Nursing critical shortage area” means
a locality or practice specialty identified as such by the Oregon State Board
of Nursing, in consultation with the Office of Rural Health, under ORS 442.540.
     (4) “Qualifying loan” means any loan made
to a nursing student under:
     (a) Programs under Title IV, parts B, D
and E, of the Higher Education Act of 1965, as amended; or
     (b) The Nursing Student Loan and Health
Education Assistance Loan programs administered by the United States Department
of Health and Human Services. [2001 c.599 §1]
     Note: 442.535 to 442.545 were enacted into law by
the Legislative Assembly but were not added to or made a part of ORS chapter
442 or any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
     442.540
Nursing Services Program created; criteria for participation; rules. (1) There is created the Nursing Services
Program, to be administered by the Oregon Student Assistance Commission
pursuant to rules adopted by the commission. The purpose of the program is to
provide loan repayments on behalf of nurses who agree to practice in nursing
critical shortage areas.
     (2) To be eligible to participate in the
program, a nurse or prospective nurse shall submit a letter of interest to the
commission. Applicants who are selected for participation according to criteria
adopted by the commission under subsection (3) of this section shall sign a
letter of agreement stipulating that the applicant agrees to abide by the terms
of the program described in ORS 442.545.
     (3) The commission shall by rule adopt, in
consultation with the Oregon State Board of Nursing and the Office of Rural
Health, criteria for participation in the program.
     (4) The Oregon State Board of Nursing by
rule shall annually identify, in consultation with the Office of Rural Health,
those areas that are considered nursing critical shortage areas.
     (5) Amounts paid to the commission as
penalties under ORS 442.545 shall be credited and deposited in the Nursing
Services Account created under ORS 348.570. The commission, in consultation
with the Oregon State Board of Nursing, by rule shall allow waiver of all or
part of any fees or penalties owed to the commission due to circumstances that
prevent a nurse from fulfilling a service obligation under ORS 442.545. [2001
c.599 §2]
     Note: See note under 442.535.
     442.545
Conditions of participation in Nursing Services Program. (1) A nurse or prospective nurse applicant
who is a graduate of an accredited nursing program with a baccalaureate or
associate degree and who wishes to participate in the Nursing Services Program
established under ORS 442.540 shall agree that:
     (a) For each year of nursing school, the
applicant designates an agreed amount, not to exceed $8,800 or the amount
determined under subsection (2) of this section, as a qualifying loan for the
program.
     (b) In the four years following the
execution of a Nursing Services Program agreement with the Oregon Student
Assistance Commission, a nurse agrees to practice for at least two full years
in a nursing critical shortage area in
     (c) For not less than two nor more than
four years that the nurse practices in a nursing critical shortage area, the
commission shall annually pay:
     (A) For full-time practice, an amount
equal to 25 percent of the total of all qualifying loans made to the nurse.
     (B) For half-time practice, an amount
equal to 12.5 percent of the total of all qualifying loans made to the nurse.
     (d) If the nurse does not complete the
full service obligation set forth in paragraphs (b) and (c) of this subsection,
the commission shall collect 100 percent of any payments made by the commission
to the nurse under the Nursing Services Program. In addition, the commission
shall assess against the nurse a penalty equal to 50 percent of the qualifying
loans and interest paid by the commission.
     (2)(a) On July 1 of each year, beginning
in 2002 and ending in 2007, the Oregon Student Assistance Commission shall
adjust the maximum dollar amount allowed under subsection (1)(a) of this
section as a qualifying loan by multiplying the amount by a cost-of-living
adjustment as specified in this subsection.
     (b) The cost-of-living adjustment applied
on July 1 each year by the commission shall be equal to the ratio of the
seasonally adjusted United States City Average Consumer Price Index for All
Urban Consumers as published by the Bureau of Labor Statistics of the United
States Department of Labor for April of the calendar year divided by the value
of the same index for April 2001.
     (c) Beginning on July 1, 2008, the
commission shall use the cost-of-living adjustment calculated for July 1, 2007.
     (d) If the value of the dollar amount
determined under paragraph (a) of this subsection is not a multiple of $100,
the commission shall round the dollar amount to the next lower multiple of
$100. [2001 c.599 §3]
     Note: See note under 442.535.
RURAL HEALTH
SERVICES PROGRAM
     442.550
Definitions for ORS 442.550 to 442.570.
As used in
ORS 442.550 to 442.570:
     (1) “Commission” means the Oregon Student
Assistance Commission.
     (2) “Dentist” means any person licensed to
practice dentistry under ORS chapter 679.
     (3) “Nurse practitioner” means any person
licensed under ORS 678.375.
     (4) “Pharmacist” means any person licensed
as a pharmacist under ORS chapter 689.
     (5) “Physician” means any person licensed
to practice medicine under ORS chapter 677.
     (6) “Physician assistant” means any person
licensed under ORS 677.495 and 677.505 to 677.525.
     (7) “Qualifying loan” means any loan made
to a medical student, physician assistant student, dental student, pharmacy
student or nursing student under:
     (a) Common School Fund loan program under
ORS 348.040 to 348.090;
     (b) Programs under Title IV parts B, D and
E, of the Higher Education Act of 1965, as amended; and
     (c) The Health Professions Student Loan,
Nursing Student Loan, Health Education Assistance Loan and Primary Care Loan
programs administered by the United States Department of Health and Human
Services.
     (8) “Qualifying practice site” means:
     (a) A rural hospital as defined in ORS
442.470;
     (b) A rural health clinic;
     (c) A pharmacy that is located in a
medically underserved rural community in Oregon or a federally designated
health professional shortage area and that is not part of a group of six or
more pharmacies under common ownership; or
     (d) Another practice site in a medically
underserved rural community in
     Note: 442.550 to 442.570 were enacted into law by
the Legislative Assembly but were not added to or made a part of ORS chapter
442 or any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
     442.555
Rural Health Services Program created; rules; criteria for participation. (1) There is created the Rural Health
Services Program, to be administered by the Oregon Student Assistance
Commission, pursuant to rules adopted by the commission. The purpose of the
program is to provide loan repayments on behalf of physicians, physician
assistants, dentists, pharmacists and nurse practitioners who agree to practice
in a qualifying practice site.
     (2) To be eligible to participate in the
program, a prospective physician, physician assistant, dentist, pharmacist or
nurse practitioner shall submit a letter of interest to the commission. Applicants
who are selected for participation according to criteria adopted by the
commission in consultation with the Office of Rural Health shall sign a letter
of agreement stipulating that the applicant agrees to abide by the terms stated
in ORS 442.560.
     (3) Subject to available resources, the
commission may enter into agreements with not to exceed 10 prospective
physicians, 10 prospective physician assistants, 10 prospective dentists, 10
prospective pharmacists and 10 prospective nurse practitioners each year. The
commission may give preference to prospective physicians, physician assistants,
dentists, pharmacists and nurse practitioners who agree to practice in a
community that has contributed funds to the Rural Health Services Fund.
     (4) The Office of Rural Health shall adopt
criteria to be applied to determine medically underserved communities and
qualifying practice sites for purposes of ORS 442.550 to 442.570 and for the
purposes of compliance with federal Public Law 95-210, establishing rural
health clinics.
     (5) A qualifying practice site shall
submit an application to the Office of Rural Health to participate in the
program. The office shall make a list of qualifying practice sites available to
prospective physicians, physician assistants, dentists, pharmacists and nurse
practitioners. [1989 c.893 §17; 1991 c.877 §20; 1991 c.947 §6; 1993 c.765 §52;
1999 c.291 §32; 1999 c.704 §24; 2005 c.357 §1; 2007 c.485 §2]
     Note: See note under 442.550.
     442.560
Conditions of participation in Rural Health Services Program; rules. (1) Prospective physicians, physician
assistants, dentists, pharmacists and nurse practitioners who wish to
participate in the Rural Health Services Program shall agree that:
     (a) For each year of medical, physician
assistant, dental, pharmacy or graduate school, the applicant designates an
agreed amount, not to exceed $25,000, as a qualifying loan subject to ORS
442.550 to 442.570.
     (b) In the time period immediately
following the completion of all residency requirements or the time period immediately
following the execution of a Rural Health Services agreement with the Oregon
Student Assistance Commission, whichever comes later, a physician or dentist
agrees to practice for at least three full years in a rural hospital as defined
in ORS 442.470, in a rural health clinic or in a medically underserved rural
community in Oregon.
     (c) For not less than three nor more than
five years that a physician or dentist serves in a rural hospital as defined in
ORS 442.470, in a rural health clinic or in a medically underserved rural
community, the commission shall annually pay an amount that is a percentage of
the total of all qualifying loans made to the physician or dentist through the
programs described in ORS 442.550.
     (d) In the time period immediately following
the completion of physician assistant or graduate school or the time period
immediately following the execution of a Rural Health Services agreement with
the commission, whichever comes later, a physician assistant or nurse
practitioner agrees to practice for at least two years in a rural hospital as
defined in ORS 442.470, in a rural health clinic or in a medically underserved
rural community in Oregon.
     (e) For not less than two nor more than
four years that a physician assistant or nurse practitioner practices in a
rural hospital as defined in ORS 442.470, in a rural health clinic or in a
medically underserved rural community, the commission shall annually pay an
amount that is a percentage of the total of all qualifying loans made to the
physician assistant or nurse practitioner through the programs described in ORS
442.550.
     (f) In the time period immediately
following the completion of all pharmacy residency requirements or the time
period immediately following the execution of a Rural Health Services agreement
with the commission, whichever comes later, a pharmacist agrees to practice for
at least three full years in a rural hospital as defined in ORS 442.470, in a
rural health clinic, in a medically underserved rural community in Oregon or in
a pharmacy that is located in a medically underserved rural community in Oregon
or a federally designated health professional shortage area and that is not
part of a group of six or more pharmacies under common ownership.
     (g) For not less than three nor more than
five years that a pharmacist serves in a rural hospital as defined in ORS
442.470, in a rural health clinic, in a medically underserved rural community
or in a pharmacy that is located in a medically underserved rural community or
a federally designated health professional shortage area and that is not part
of a group of six or more pharmacies under common ownership, the commission
shall annually pay an amount that is a percentage of the total of all
qualifying loans made to the pharmacist through the programs described in ORS
442.550.
     (2) If the participant does not complete
the full service obligation set forth in subsection (1)(b), (d) or (f) of this
section, the commission shall collect 100 percent of any payments made by the
commission to the participant under this program. In addition, a penalty equal
to 50 percent of the qualifying loans and interest paid by the commission shall
be assessed by the commission, to be credited to and deposited in the Rural
Health Services Fund established under ORS 442.570.
     (3) The Oregon Student Assistance
Commission, in consultation with the Office of Rural Health, shall establish
rules to allow waiver of all or part of the fees and penalties owed to the
commission due to circumstances that prevent the participant from fulfilling
the service obligation. [1989 c.893 §18; 1991 c.877 §21; 1991 c.947 §3; 1993
c.765 §53; 1993 c.813 §13; 2005 c.357 §2; 2007 c.485 §3]
     Note: See note under 442.550.
     442.561
Certifying individuals licensed under ORS chapter 679 for tax credit. The Office of Rural Health shall establish
criteria for certifying individuals who are licensed under ORS chapter 679 as
eligible for the tax credit authorized by ORS 315.616. Upon application
therefor and upon a finding that the applicant is or will be providing dental
services to one or more rural communities and otherwise meets the eligibility
criteria established by the office, the office shall certify individuals
eligible for the tax credit authorized by ORS 315.616. [1995 c.746 §40; 1999 c.291
§33; 1999 c.459 §2]
     Note: See note under 442.550.
     442.562
Certifying podiatric physicians and surgeons for tax credit. The Office of Rural Health shall establish
criteria for certifying individuals who are licensed as podiatric physicians
and surgeons under ORS chapter 677 as eligible for the tax credit authorized by
ORS 315.616. Upon application therefor and upon a finding that the applicant is
or will be providing podiatric services to one or more rural communities and
otherwise meets the eligibility criteria established by the office, the office
shall certify individuals eligible for the tax credit authorized by ORS
315.616. [1995 c.746 §41; 1999 c.291 §34; 1999 c.459 §3]
     Note: See note under 442.550.
     442.563
Certifying certain individuals providing rural health care for tax credit;
rules. (1) Subject to ORS
442.560, the Office of Rural Health shall establish criteria for certifying
individuals eligible for the tax credit authorized by ORS 315.613, 315.616 or
315.619. Upon application therefor, the office shall certify individuals
eligible for the tax credit authorized by ORS 315.613.
     (2) The classification of rural hospitals
for purposes of determining eligibility under this section shall be the
classification of the hospital in effect on January 1, 1991. [1989 c.893 §7;
1991 c.877 §19; 1995 c.746 §35; 1999 c.291 §35; 1999 c.459 §4]
     Note: See note under 442.550.
     442.564
Certifying optometrists for tax credit. The Office of Rural Health shall establish criteria for certifying
individuals who are licensed as optometrists under ORS 683.010 to 683.335 as
eligible for the tax credit authorized by ORS 315.616. Upon application
therefor and upon a finding that the applicant is or will be providing
optometry services to one or more rural communities and otherwise meets the
eligibility criteria established by the office, the office shall certify
individuals eligible for the tax credit authorized by ORS 315.616. [1997 c.787 §2;
1999 c.291 §36; 1999 c.459 §5]
     Note: See note under 442.550.
     442.565 [1989 c.893 §19; renumbered 442.568 in 2005]
     442.566
Certifying emergency medical technicians for tax credit. The Office of Rural Health shall establish
criteria for certifying individuals who are certified as emergency medical
technicians under ORS chapter 682 as eligible for the tax credit authorized by
ORS 315.622. Upon application for the credit and upon a finding that the
applicant will be providing emergency medical technician services in one or
more rural areas and otherwise meets the eligibility criteria established by
the office, the office shall certify the individual as eligible for the tax
credit authorized by ORS 315.622. [2005 c.832 §65]
     Note: See note under 442.550.
     442.568
     (2) The university shall reserve a number
of admissions to each class at the medical school for qualified students who
agree to participate in the Rural Health Services Program. The number of
admissions under this section is not required to exceed 15 percent of each
class, but that figure is a goal consistent with the long term intention of the
Legislative Assembly to encourage the availability of medical services in rural
areas.
     (3) In the event that the university is
unable to recruit the number of qualified students required under subsection
(2) of this section, after having made a reasonable effort to do so, the
university is authorized to fill the remaining positions with other eligible
candidates. [Formerly 442.565]
     Note: See note under 442.550.
     442.570
Rural Health Services Fund; matching funds. (1) There is established in the State Treasury a fund, separate and
distinct from the General Fund, to be known as the Rural Health Services Fund,
for investments as provided by ORS 293.701 to 293.820, for the payment of
expenses of the Oregon Student Assistance Commission in carrying out the
purposes of ORS 315.613, 315.616, 315.619, 353.450, 442.470, 442.503 and
442.550 to 442.570. Interest earned by the account shall be credited to the
account.
     (2) The Office of Rural Health shall seek
matching funds from communities that benefit from placement of practitioners
under ORS 442.550 to 442.570. The office shall establish a program to enroll
interested communities in this program and deposit money proceeds from this
effort in the Rural Health Services Fund. In addition, the office shall explore
other funding sources including federal grant programs. [1989 c.893 §21; 1991
c.877 §22; 1991 c.947 §4]
     Note: See note under 442.550.
HEALTH
RESOURCES COMMISSION
     442.575
Definitions for ORS 442.575 to 442.584. As used in ORS 442.575 to 442.584:
     (1) “Commission” means the Health
Resources Commission established pursuant to ORS 442.580.
     (2) “Established medical technology” means
a medical technology that is in widespread use and considered by practitioners
as accepted or standard practice for addressing a specific clinical condition.
     (3) “Medical technology” means drugs,
medical equipment and devices, and medical or surgical procedures and
techniques used by health care providers in delivering medical care to
individuals, and the organizational or supportive systems within which such
care is delivered.
     (4) “Medical technology assessment” means
evaluation of indicators for use, clinical effectiveness and cost of a
technology in comparison with its alternatives.
     (5) “New and emerging medical technology”
means a medical technology that is not in widespread use or does not constitute
standard practice for a particular clinical condition. [1993 c.754 §3]
     442.580
Health Resources Commission; membership; terms. (1) There is created the Health Resources
Commission, consisting of eleven members appointed by the Governor.
     (2) The commission shall include:
     (a) Four physicians, one of whom engages
in family practice, and each of whom shall be licensed to practice in this
state and experienced in health research and the evaluation of medical
technologies and clinical outcomes;
     (b) One representative of hospitals;
     (c) One insurance industry representative;
     (d) One business representative;
     (e) One representative of labor
organizations;
     (f) One consumer representative; and
     (g) Two pharmacists engaged in the
practice of pharmacy, one of whom engages in the practice of pharmacy at a
retail drug outlet. For the purposes of this paragraph:
     (A) “Pharmacist” has the meaning given
that term in ORS 689.005;
     (B) “Practice of pharmacy” has the meaning
given that term in ORS 689.015; and
     (C) “Retail drug outlet” has the meaning
given that term in ORS 689.005.
     (3) The term of office of each member of
the commission is three years. Each member serves at the pleasure of the
Governor. Before the expiration of the term of a member, the Governor shall
appoint a successor whose term begins on July 1 next following. A member is
eligible for reappointment. If there is a vacancy for any cause, the Governor
shall make an appointment to become immediately effective for the unexpired
term.
     (4) The consumer representative on the
commission shall be entitled to compensation and expenses as provided in ORS
292.495. The other members shall not be entitled to compensation or expenses. [1991
c.470 §2; 2001 c.238 §1]
     442.581
Officers; quorum; meetings; staffing. (1) The Health Resources Commission shall select one of its members as
chairperson and another as vice chairperson, for such terms and with duties and
powers as the commission determines necessary for the performance of the
functions of such offices.
     (2) A majority of the members of the
commission constitutes a quorum for the transaction of business.
     (3) The commission shall meet at least
once every two months at a place, day and hour determined by the chairperson.
The commission also shall meet at other times and places specified by the call
of the chairperson or of a majority of the members of the commission.
     (4) The commission may use advisory
committees or subcommittees, the members to be appointed by the chairperson of
the commission subject to approval by a majority of the members of the
commission.
     (5) The Office for Oregon Health Policy
and Research shall provide the commission such staff and support services as it
requires. [1991 c.470 §4; 1995 c.727 §37; 1997 c.683 §31]
     442.582 [1991 c.470 §5; repealed by 1993 c.754 §4
(442.583 enacted in lieu of 442.582)]
     442.583
Medical technology assessment program; content; advisory committee. (1)(a) The Health Resources Commission shall
develop a medical technology assessment program that addresses the
introduction, diffusion and utilization of medical technologies and their
associated services and shall make recommendations regarding the programÂ’s
implementation.
     (b) The assessment program developed
pursuant to paragraph (a) of this subsection shall include the results of at
least two medical technology assessments to be selected by the commission. The
commission shall select one new and emerging medical technology and one
established medical technology to be assessed.
     (c) The program shall include criteria for
selection of the medical technologies to be assessed.
     (d) The commission shall appoint and work
with an advisory committee whose members shall have the appropriate expertise
to develop a medical technology assessment program. The advisory committee
shall present its recommendations to the commission at a public hearing. The
commission shall conduct public hearings to solicit testimony and information
from health care consumers prior to making the report described in subsection
(2) of this section. The commission shall give strong consideration to the
recommendations of the advisory committee and public testimony in developing its
report.
     (2)(a) The commission shall present its
findings and recommendations in a report to the Governor and the appropriate
interim legislative committees on or before April 1, 1994. The report shall
include, in addition to at least two medical technology assessments, a
determination of the supply and distribution of medical technology and
associated services that are required to meet the need for medical technology
in the five years following the completion of the assessment.
     (b) The report also shall identify
strategies and contain recommendations:
     (A) Regarding the program’s
implementation, including which agency should implement the program;
     (B) To promote compliance with the program
regarding the introduction, diffusion and utilization of those medical
technologies assessed;
     (C) Regarding whether the state should
have a regulatory function and, if so, which agency should carry out that
function; and
     (D) Regarding the collection, storage and
dissemination of data required for a technology assessment program.
     (3) To insure that confidentiality is
maintained, no identification of a patient or a person licensed to provide
health services shall be included with the data submitted under this section,
and the commission shall release such data only in aggregate statistical form.
All findings and conclusions, interviews, reports, studies, communications and
statements procured by or furnished to the commission in connection with
obtaining the data necessary to perform its functions shall be confidential pursuant
to ORS 192.501 to 192.505.
     (4) All data and information collected,
analyzed and summarized by professional and trade associations conducting
quality assurance and improvement programs shall be considered confidential and
shall not be admissible in any legal proceeding or used to create a legal
standard of care. However, such data and information may be submitted to the
commission on request and shall remain confidential and inadmissible. [1993
c.754 §5 (enacted in lieu of 442.582)]
     442.584
Application for certificate of need. (1) All applicants for a certificate of need for any of the
technologies or services under study by the Health Resources Commission shall
provide the information specified in paragraphs (a) to (f) of this subsection.
This information may be utilized by the commission in performing its functions
under ORS 442.583. The information shall include:
     (a) The estimated number of patients
needing the service or procedure who are not currently being served and who
cannot be served by existing programs in the service area.
     (b) The anticipated number of procedures
to be performed per year for a five-year period commencing on the date the
service is started or the technology is acquired.
     (c) The anticipated number of patients to
be served by the applicant, based on the incidence in the population to be
served or the conditions for which the technology or service will be used.
     (d) Clinical indications for ordering use
of the technology or service, with appropriate references to relevant literature.
     (e) An estimate of the treatment decisions
likely to result from use of the technology or service.
     (f) A proposed method for collecting data
on the patients served, costs engendered directly or indirectly and the health
outcomes resulting from use of the technology or service.
     (2) An application shall be decided in
accordance with the statutes and rules in effect at the time of filing of a
completed letter of intent for that application. [1991 c.470 §§7,22]
     442.586 [1991 c.470 §8; repealed by 1995 c.727 §48]
     442.588
Employees. Nothing in ORS
414.720, 431.120, 442.120, 442.575, 442.583 and 442.588 is intended to limit
the authority of the Health Resources Commission and Health Services Commission
to appoint their own employees. [1993 c.754 §10; 1995 c.727 §47]
     Note: 442.588 was enacted into law by the
Legislative Assembly but was not added to or made a part of ORS chapter 442 or
any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
MISCELLANEOUS
     442.600
Policy on maternity care.
The Legislative Assembly finds and declares that:
     (1) Maternity care is the cornerstone of
health care delivery in the state. It provides a proven, cost-effective
foundation for improving the health of all Oregonians, and a healthy start in
life allows our future citizens to achieve their full potential.
     (2) Although great strides have been made
to improve maternity care, barriers continue to exist as indicated by high
rates of inadequate prenatal care and lack of coordination between prenatal and
delivery services.
     (3) Individual communities have unique
combinations of barriers and resources. Therefore, planning and solutions must
be developed at the local level whenever possible, with the state providing
guidelines, standards and support.
     (4) Local resources are strained and
communities need a structure and technical assistance to assure development of
access to a coordinated system of maternity care.
     (5) There is a need for a system to assure
coordination of all maternity service providers to develop a comprehensive
service system for
     (6)(a) Therefore, it is the intent of this
state that there shall be a comprehensive system of maternity care based on the
plan that includes prenatal, delivery and postpartum care and that meets the
unique needs of the individual pregnant woman, available to all pregnant women
in this state.
     (b) As used in this subsection, “plan”
means the Maternity Care Access Planning CommissionÂ’s comprehensive statewide
plan for a maternity care system dated March 1993 and titled “Comprehensive
Perinatal Health Services: A Strategy Toward Universal Access to Care in
Oregon.” [1991 c.760 §1; 1993 c.514 §1]
     Note: 442.600 was enacted into law by the
Legislative Assembly but was not added to or made a part of ORS chapter 442 by
legislative action. See Preface to Oregon Revised Statutes for further
explanation.
     442.625
Emergency Medical Services Enhancement Account; distribution of moneys in
account. (1) The Emergency
Medical Services Enhancement Account is established separate and distinct from
the General Fund. Interest earned on moneys in the account shall accrue to the
account. All moneys deposited in the account are continuously appropriated to
the Department of Revenue for the purposes of this section.
     (2) The Department of Revenue shall
distribute moneys in the Emergency Medical Services Enhancement Account in the
following manner:
     (a) 35 percent of the moneys in the
account shall be transferred to the Office of Rural Health established under
ORS 442.475 for the purpose of enhancing emergency medical services in rural
areas as specified in ORS 442.507.
     (b) 25 percent of the moneys in the
account shall be transferred to the Emergency Medical Services and Trauma
Systems Program established under ORS 431.623.
     (c) 35 percent of the moneys in the
account shall be transferred to the
     (d) 5 percent of the moneys in the account
shall be transferred to the
     Note: 442.625 was enacted into law by the
Legislative Assembly but was not added to or made a part of ORS chapter 442 or
any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
     Note: Sections 1 and 2, chapter 904, Oregon Laws
2007, provide:
     Sec.
1. Task Force for Comprehensive Obesity Prevention Initiative. (1) There is created the Task Force for a
Comprehensive Obesity Prevention Initiative, consisting of 13 members appointed
as follows:
     (a) The President of the Senate shall
appoint:
     (A) Two members of the Senate Committee on
Health Policy and Public Affairs.
     (B) Two members who are on the faculty of
the Center for the Study of Weight Regulation and Associated Disorders at the
Oregon Health and
     (b) The Speaker of the House of
Representatives shall appoint:
     (A) Two members of the House of
Representatives Committee on Health Care.
     (B) Two members who are on the faculty of
the Department of Public Health at the
     (c) The Director of Human Services shall
appoint:
     (A) Two representatives from the Office of
Family Health Nutrition and Physical Activity; and
     (B) Three representatives from
universities within
     (i) Preventing obesity and associated
disorders;
     (ii) Promoting good nutrition and physical
fitness;
     (iii) The built or physical environment;
or
     (iv) Addressing health issues in minority
populations.
     (2) The task force shall:
     (a) Study obesity prevention and treatment
and ways to decrease the number of cases of obesity in this state; and
     (b) Utilize current research to develop a
plan to implement and fund initiatives that will result in decreasing obesity
and obesity-related diseases within the state.
     (3) A majority of the members of the task
force constitutes a quorum for the transaction of business.
     (4) Official action by the task force
requires the approval of a majority of the members of the task force.
     (5) The director, or the director’s
designee, shall serve as chairperson.
     (6) If there is a vacancy for any cause,
the appointing authority shall make an appointment to become immediately
effective.
     (7) 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.
     (8) The task force may adopt rules
necessary for the operation of the task force.
     (9) The task force shall submit a report,
and may include recommendations for legislation, to the interim committees
related to health care and health policy as appropriate no later than October
1, 2008.
     (10) The Department of Human Services
shall provide staff support to the task force.
     (11) 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. Claims for expenses incurred in performing
functions of the task force shall be paid out of funds appropriated to the
Department of Human Services for that purpose.
     (12) 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. [2007 c.904 §1]
     Sec.
2. Section 1 of this 2007
Act is repealed on the date of the convening of the next regular biennial
legislative session [January 12, 2009]. [2007 c.904 §2]
COOPERATIVE
PROGRAM ON HEART AND KIDNEY TRANSPLANTS
     442.700
Definitions for ORS 442.700 to 442.760. As used in ORS 442.700 to 442.760:
     (1) “Board of governors” means the
governors of a cooperative program as described in ORS 442.720.
     (2) “Cooperative program” means a program
among two or more health care providers for the purpose of providing heart and
kidney transplant services including, but not limited to, the sharing,
allocation and referral of physicians, patients, personnel, instructional
programs, support services, facilities, medical, diagnostic, laboratory or
therapeutic services, equipment, devices or supplies, and other services
traditionally offered by health care providers.
     (3) “Director” means the Director of Human
Services.
     (4) “Health care provider” means a
hospital, physician or entity, a significant part of whose activities consist
of providing hospital or physician services in this state. For purposes of the
immunities provided by ORS 442.700 to 442.760 and 646.740, “health care
provider” includes any officer, director, trustee, employee, or agent of, or
any entity under common ownership and control with, a health care provider.
     (5) “Hospital” means a hospital, as
defined in ORS 442.015 (19), or a long term care facility or an ambulatory
surgical center, as those terms are defined in ORS 442.015, that is licensed
under ORS 441.015 to 441.089. “Hospital” includes community health programs
established under ORS 430.610 to 430.695.
     (6) “Order” means a decision issued by the
director under ORS 442.710 either approving or denying an application for a
cooperative program and includes modifications of an original order under ORS
442.730 (3)(b) and ORS 442.740 (1) and (4).
     (7) “Party to a cooperative program
agreement” or “party” means an entity that enters into the principal agreement
to establish a cooperative program and applies for approval under ORS 442.700
to 442.760 and 646.740 and any other entity that, with the approval of the
director, becomes a member of a cooperative program.
     (8) “Physician” means a physician defined
in ORS 677.010 (13) and licensed under ORS chapter 677. [1993 c.769 §3; 2001
c.104 §182; 2007 c.70 §244]
     442.705
Legislative findings; goals.
(1) The Legislative Assembly finds that direct competition among health care
providers in the field of heart and kidney transplant services may not result
in the most cost efficient and least expensive transplant services for the
citizens of this state and that it is in the public interest to allow
cooperative programs among health care providers providing heart and kidney
transplant services.
     (2) The Legislative Assembly declares
that, to the extent provided in ORS 442.700 to 442.760, it is the policy and
intent of this state to displace competition among health care providers
providing heart and kidney transplant services by allowing health care
providers to enter into cooperative programs governing the provision of heart
and kidney transplant services in order to achieve in each instance the
following goals:
     (a) Reduction of, or protection against,
rising costs of heart and kidney transplant services;
     (b) Reduction of, or protection against,
rising prices for heart and kidney transplant services;
     (c) Improvement or maintenance of the
quality of heart and kidney transplant services provided in this state;
     (d) Reduction of, or protection against,
duplication of resources including, without limitation, expensive medical
specialists, medical equipment and sites of service;
     (e) Improvement or maintenance of
efficiency in the delivery of heart and kidney transplant services;
     (f) Improvement or maintenance of public
access to heart and kidney transplant services;
     (g) Increase in donations of organs for
transplantation; and
     (h) Improvement in the continuity of
patient care.
     (3) The Legislative Assembly further
declares that the goals identified in subsection (2) of this section represent
the policies of this state.
     (4) The Legislative Assembly further
declares that once a cooperative program is approved under ORS 442.700 to
442.760, there is an interest in insuring stability in the provision of health
care services by a cooperative program, to the extent stability is consistent
with achieving the goals identified in subsection (2) of this section.
     (5) The Director of Human Services shall
actively supervise the cooperative program in accordance with authority under
ORS 442.700 to 442.760 and 646.740. [1993 c.769 §1]
     442.710
Application for approval of cooperative program; form; content; review;
modification; order. (1) The
Oregon Health and Science University and one or more entities, each of which
operates at least three hospitals in a single urban area in this state, may
apply to the Director of Human Services for approval of a cooperative program.
The application shall include an executed written copy of all agreements for
the cooperative program.
     (2) An application for approval of a
cooperative program shall be made in the form and manner and shall set forth
any information regarding the proposed cooperative program that the director
may prescribe. The information shall include, but not be limited to:
     (a) A list of the names of all health care
providers who propose to provide heart and kidney transplant services under the
cooperative program, together with appropriate evidence of compliance with any
licensing or certification requirements for those health care providers to
practice in this state. In the case of employed physicians, the list and the
information to be submitted may be limited to the employer or organizational
unit of the employer;
     (b) A description of the activities to be
conducted by the cooperative program;
     (c) A description of proposed
anticompetitive practices listed in ORS 442.715, any practices that the parties
anticipate will have significant anticompetitive effects and a description of
practices of the cooperative program affecting costs, prices, personnel
positions, capital expenditures and allocation of resources;
     (d) A list of the goals identified in ORS
442.705 (2) that the cooperative program expects to achieve;
     (e) A description of the proposed places
and manner of providing heart and kidney transplant services and services
related to heart and kidney transplants under the cooperative program;
     (f) A proposed budget for operating the
cooperative program;
     (g) Satisfactory evidence of financial
ability to deliver heart and kidney transplant services in accordance with the
cooperative program;
     (h) The agreement that establishes the
cooperative program and policies that shall govern it; and
     (i) Other information the director
believes will assist in determining whether the cooperative program will likely
achieve the goals listed in ORS 442.705 (2).
     (3) The director shall review the
application in accordance with the provisions of this section and shall grant,
deny or request modification of the application within 90 days of the date the
application is filed. The director shall hold one or more public hearings on
the application, which shall conclude no later than 80 days after the date the
application is filed. The decision of the director on an application shall be
considered an order in a contested case for the purposes of ORS chapter 183.
     (4) The director shall approve an
application made under subsection (2) of this section after:
     (a) The applicants have demonstrated they
will achieve at least six of the goals of ORS 442.700 to 442.760 and 646.740,
including at least the goals identified in ORS 442.705 (2)(a) to (d); and
     (b) The director has reviewed and approved
the specifics of the anticompetitive activity expected to be conducted by the
cooperative program.
     (5) In evaluating the application, the
director shall consider whether a cooperative program will contribute to or
detract from achieving the goals listed in ORS 442.705 (2). The director may
weigh goals relating to circumstances that are likely to occur without the
cooperative program, and relating to existing circumstances. The director may
also consider whether any alternative arrangements would be less restrictive of
competition while achieving the same goals.
     (6) An order approving a cooperative
program shall identify and define the limits of the permitted activities for
purposes of granting antitrust immunity under ORS 442.700 to 442.760.
     (7) An order approving a cooperative
program shall include:
     (a) Approval of specific activities listed
in ORS 442.715;
     (b) Approval of activities the director
anticipates will have substantial anticompetitive effects;
     (c) Approval of the proposed budget of the
cooperative program;
     (d) The goals listed in ORS 442.705 (2)
that the cooperative program is expected to achieve; and
     (e) Approval of the cooperative program as
described in the application and a finding that the cooperative program is in
the public interest.
     (8) An order denying the application for a
cooperative program shall identify the findings of fact and reasons supporting
denial.
     (9) Either the director or all the parties
to the cooperative program may request a modification of an application made
under this section. A request for a modification shall result in one extension
of 30 days after submission of the modified application. The director shall
issue an order under this section within 30 days after submission of the
modified application. [1993 c.769 §14]
     442.715
Authorized practices under approved cooperative program. (1) To the extent permitted by an order
issued under ORS 442.710, health care providers providing heart and kidney
transplant services through a cooperative program approved under ORS 442.700 to
442.760 may engage in the following practices in order to achieve the goals
described in ORS 442.705 (2):
     (a) Set prices for heart and kidney
transplants and all services directly related to heart and kidney transplants;
     (b) Refuse to deal with competitors in the
heart and kidney transplant market;
     (c) Allocate product, service, geographic
and patient markets directly relating to heart and kidney transplants;
     (d) Acquire and maintain a monopoly in
heart and kidney transplant services; and
     (e) Engage in other activities that might
give rise to liability under ORS 646.705 to 646.836 or federal antitrust laws.
     (2) To the extent permitted by an order
issued under ORS 442.710 and in addition to the provisions of subsection (1) of
this section, physicians participating in a cooperative program may agree among
themselves on referrals of nontransplant cardiac surgeries to the extent
necessary to achieve redistribution of the cardiac surgery cases among
participating surgeons.
     (3) The Legislative Assembly intends that
all persons arranging or participating in a cooperative program approved and
conducted in accordance with an order issued under ORS 442.710 and all persons
participating in good faith negotiations conducted pursuant to ORS 442.750
shall:
     (a) Not be subject to the provisions of
ORS 646.705 to 646.836 so long as the activities of the cooperative program are
regulated, lawful and approved in accordance with ORS 442.700 to 442.760 and
646.740; and
     (b) Receive the full benefit of state
action immunity under federal antitrust laws. [1993 c.769 §2]
     442.720
Board of governors for cooperative program. (1) If the Director of Human Services issues an order approving an
application for a cooperative program under ORS 442.710, the director shall
establish a board of governors to govern the cooperative program. The board of
governors shall not constitute, for any purpose, a governmental agency.
     (2) The board of governors shall consist
of the president or other chief executive officer of each health care provider
that is a party to the cooperative program agreement and the director or a
designee of the director. The designee shall serve at the pleasure of the
director. The designee shall not have any economic or other interest in any of
the health care providers associated with the cooperative program.
     (3) In governing the cooperative program,
the board of governors shall develop policy and approve budgets for the
implementation of the cooperative program.
     (4) The director or designee of the
director may reject any operating or capital budget of the cooperative program
upon a finding by the director that the budget is not consistent with the goals
listed in ORS 442.705 (2) that the cooperative program is expected to achieve. [1993
c.769 §5]
     442.725
Annual report of board of governors. Not later than 60 days following each anniversary date of the approval
of a cooperative program by the Director of Human Services, the board of
governors of the cooperative program shall deliver an annual report to the
director. The report shall specifically describe:
     (1) How heart and kidney transplant
services and related services of the cooperative program are being provided in
accordance with the order;
     (2) Which of the goals identified in the
order are being achieved and to what extent; and
     (3) Any substantial changes in the
cooperative program. [1993 c.769 §6]
     442.730
Review and evaluation of report; modification or revocation of order of
approval. (1) The Director
of Human Services shall review and evaluate the annual report delivered under
ORS 442.725. The director shall:
     (a) Determine the extent to which the
cooperative program is achieving the goals identified in the order;
     (b) Review the activities being conducted
to achieve the goals; and
     (c) Determine whether each of the
activities is still necessary and appropriate to achieve the goals.
     (2) If the director determines that
additional information is needed for the review described in subsection (1) of
this section, the director may order the board of governors to provide the
information within a specified time.
     (3) Within 60 days after receiving the
annual report or any additional information ordered under subsection (2) of
this section, the director shall:
     (a) Approve the report if the director
determines that the cooperative program is operating in accordance with the
order and that the goals identified in the order are being adequately achieved
by the cooperative program;
     (b) Modify the order as appropriate to
adjust to changes in the cooperative program approved by the director and
approve the report as provided in paragraph (a) of this subsection;
     (c) Order the board of governors to make
remedial changes in anticompetitive activities not in compliance with the order
and request the board of governors to report on progress not later than a deadline
specified by the director;
     (d) Revoke approval of the cooperative
program; or
     (e) Take any of the actions set forth in
ORS 442.740. [1993 c.769 §7]
     442.735
Complaint procedure. (1) Any
person may file a complaint with the Director of Human Services requesting that
a specific decision or action of a cooperative program supervised by the
director be reversed or modified, or that approval for all or part of the
activities permitted by the order be suspended or terminated. The complaint
shall allege the reasons for the requested action and shall include any
evidence relating to the complaint.
     (2) The director on the director’s own
initiative may at any time request information from the board of governors
concerning the activities of the cooperative program to determine whether the
cooperative program is in compliance with the order. [1993 c.769 §8]
     442.740
Powers of director over action under cooperative program. (1) During the review of the annual report
described in ORS 442.730, after receiving a complaint under ORS 442.735, or on
the directorÂ’s own initiative, the Director of Human Services may take one or
more of the following actions:
     (a) If the director determines that a
particular decision or action is not in accordance with the order, or that the
parties are engaging in anticompetitive activity not permitted by the order,
the director may direct the board of governors to identify and implement
corrective action to insure compliance with the order or may modify the order.
     (b) If the director determines that the
cooperative program is engaging in unlawful activity not permitted by the order
or is not complying with the directive given under paragraph (a) of this
subsection, the director may serve on the cooperative program a proposed order
directing the cooperative program to:
     (A) Conform with the directive under
paragraph (a) of this subsection; or
     (B) Cease and desist from engaging in the
activity.
     (2) The cooperative program shall have up
to 30 days to comply with a proposed order under subsection (1)(b) of this
section unless the board of governors demonstrates additional time is needed
for compliance.
     (3) If the director determines that the
participants in the cooperative program are in substantial noncompliance with
the cease and desist directive, the director may seek an appropriate injunction
in the circuit courts of
     (4) If the director determines that a
sufficient number of the goals set forth in ORS 442.705 (2) are not being
achieved or that the cooperative program is engaging in activity not permitted
by the order, the director may suspend or terminate approval for all or part of
the activities approved and permitted by the order.
     (5) A proposed order to be entered under
subsection (1)(b) or (4) of this section may be served upon the cooperative
program without prior notice. The cooperative program may contest the proposed
order by filing a written request for a contested case hearing with the
director not later than 20 days following the date of the proposed order. The
proposed order shall become final if no request for a hearing is received.
Unless inconsistent with this subsection, the provisions of ORS chapter 183, as
applicable, shall govern the hearing procedure and any judicial review.
     (6) The only effect of an order suspending
or terminating approval under ORS 442.700 to 442.760 shall be to withdraw the
immunities granted under ORS 442.715 (3) for anticompetitive activity permitted
by the order and taken after the effective date of the order. [1993 c.769 §9]
     442.745
Disclosure of confidential information not waiver of right to protect
information. If parties to a
cooperative program agreement provide the Director of Human Services with
written or oral information that is confidential or otherwise protected from
disclosure under
     442.750
Status of actions under cooperative program; effect on other liability. (1) Notwithstanding the provisions of ORS
646.705 to 646.836:
     (a) A cooperative program for which
approval has been granted under ORS 442.700 to 442.760 and 646.740 is a lawful
program to the extent it engages in activities permitted by the order and
supervised by the Director of Human Services and is in compliance with the
order; and
     (b) If the parties to a cooperative
program apply to the director as provided in ORS 442.710, the conduct of the
parties and all other participants in negotiating or entering into a
cooperative program is lawful conduct.
     (2) Subsection (1)(b) of this section does
not apply to persons negotiating a cooperative program if it can be
demonstrated, by a preponderance of the evidence, that the persons do not or
did not intend to enter into a cooperative agreement.
     (3) Nothing in ORS 442.700 to 442.760 and
646.740 shall be construed to immunize any person from liability or impose
liability where none would otherwise exist under federal or state antitrust
laws for conduct in negotiating and entering into a cooperative program for
which no application was filed with the director. [1993 c.769 §11]
     442.755
Rules; costs; fees. (1) The
Director of Human Services shall adopt rules as may be necessary to carry out
the provisions of ORS 442.700 to 442.760.
     (2) The costs of program approval and
supervision shall be paid by the parties to a cooperative program agreement and
the director shall set fees for application, annual review and supervision as
necessary to fund the director’s supervision of the program. [1993 c.769 §12]
     442.760
Status to contest order.
Notwithstanding the provisions of ORS 183.310 (7) and 183.480, only a party to
a cooperative program agreement or the Director of Human Services shall be
entitled to a contested case hearing or judicial review of an order issued
pursuant to ORS 442.700 to 442.760 and 646.740. [1993 c.769 §13; 2003 c.75 §92]
ADVISORY
COMMITTEE ON PHYSICIAN CREDENTIALING INFORMATION
     442.800
Advisory Committee on Physician Credentialing Information; membership; terms. (1) The Advisory Committee on Physician
Credentialing Information is established within the Office for Oregon Health
Policy and Research. The committee consists of nine members appointed by the
Administrator of the Office for Oregon Health Policy and Research as follows:
     (a) Three members who are physicians
licensed by the Oregon Medical Board or representatives of physician
organizations doing business within the State of
     (b) Three representatives of hospitals
licensed by the Department of Human Services; and
     (c) Three representatives of health care
service contractors that have been issued a certificate of authority to
transact health insurance in this state by the Department of Consumer and
Business Services.
     (2) All members appointed pursuant to
subsection (1) of this section shall be knowledgeable about national standards
relating to physician credentialing.
     (3) The term of appointment for each
member of the committee is three years. If, during a memberÂ’s term of
appointment, the member no longer qualifies to serve as designated by the
criteria of subsection (1) of this section, the member must resign. If there is
a vacancy for any cause, the administrator shall make an appointment to become
immediately effective for the unexpired term.
     (4) Members of the committee are not
entitled to compensation or reimbursement of expenses. [1999 c.494 §1]
     Note: 442.800 to 442.807 were enacted into law by
the Legislative Assembly but were not added to or made a part of ORS chapter
442 or any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
     442.805
Committee recommendations.
(1) The Advisory Committee on Physician Credentialing Information shall develop
and submit recommendations to the Administrator of the Office for Oregon Health
Policy and Research for the collection of uniform information necessary for
hospitals and health plans to credential physicians seeking membership on a
hospital medical staff or designation as a participating provider for a health
plan. The recommendations must specify:
     (a) The content and format of a
credentialing application form; and
     (b) The content and format of a
recredentialing application form.
     (2) The committee shall meet at least once
every calendar year to review the uniform credentialing information and to
assure the administrator that the information complies with credentialing
standards developed by national accreditation organizations and applicable
regulations of the federal government.
     (3) The Office for Oregon Health Policy
and Research shall provide the support staff necessary for the committee to
accomplish its duties. [1999 c.494 §3]
     Note: See note under 442.800.
     442.807
Implementation of recommendations; rules. (1) Within 30 days of receiving the recommendations of the Advisory
Committee on Physician Credentialing Information, the Administrator of the
Office for Oregon Health Policy and Research shall forward the recommendations
to the Director of the Department of Consumer and Business Services and to the
Director of Human Services. The administrator shall request that the Department
of Consumer and Business Services and the Department of Human Services adopt
rules to carry out the efficient implementation and enforcement of the
recommendations of the committee.
     (2) The Department of Consumer and
Business Services and the Department of Human Services shall:
     (a) Adopt administrative rules in a timely
manner, as required by the Administrative Procedures Act, for the purpose of
effectuating the provisions of ORS 442.800 to 442.807; and
     (b) Consult with each other and with the
administrator to ensure that the rules adopted by the Department of Consumer
and Business Services and the Department of Human Services are identical and
are consistent with the recommendations developed pursuant to ORS 442.805 for
affected hospitals and health care service contractors.
     (3) The uniform credentialing information
required pursuant to the administrative rules of the Department of Consumer and
Business Services and the Department of Human Services represent the minimum
uniform credentialing information required by the affected hospitals and health
care service contractors. Nothing in ORS 442.800 to 442.807 shall be
interpreted to prevent an affected hospital or health care service contractor
from requesting additional credentialing information from a licensed physician
for the purpose of completing physician credentialing procedures used by the
affected hospital or health care service contractor. [1999 c.494 §4; 2001 c.900
§180]
     Note: See note under 442.800.
     Note: Section 1, chapter 686, Oregon Laws 2003,
provides:
     Sec.
1. Definitions. As used in
sections 1 to 12 of this 2003 Act [442.820 to 442.835 and sections 1, 4 to 6, 8
to 10 and 12, chapter 686, Oregon Laws 2003]:
     (1) “Participant” means an entity that
reports patient safety data to a patient safety reporting program, and any
agent, employee, consultant, representative, volunteer or medical staff member
of the entity.
     (2) “Patient safety activities” includes
but is not limited to:
     (a) The collection and analysis of patient
safety data by a participant;
     (b) The collection and analysis of patient
safety data by the Oregon Patient Safety Commission established in section 2 of
this 2003 Act [442.820];
     (c) The utilization of patient safety data
by participants;
     (d) The utilization of patient safety data
by the Oregon Patient Safety Commission to improve the quality of care with
respect to patient safety and to provide assistance to health care providers to
minimize patient risk; and
     (e) Oral and written communication
regarding patient safety data among two or more participants with the intent of
making a disclosure to or preparing a report to be submitted to a patient
safety reporting program.
     (3) “Patient safety data” means oral
communication or written reports, data, records, memoranda, analyses,
deliberative work, statements, root cause analyses or action plans that are
collected or developed to improve patient safety or health care quality that:
     (a) Are prepared by a participant for the
purpose of reporting patient safety data voluntarily to a patient safety
reporting program, or that are communicated among two or more participants with
the intent of making a disclosure to or preparing a report to be submitted to a
patient safety reporting program; or
     (b) Are created by or at the direction of
the patient safety reporting program, including communication, reports, notes
or records created in the course of an investigation undertaken at the
direction of the Oregon Patient Safety Commission.
     (4) “Patient safety reporting program”
includes but is not limited to the Oregon Patient Safety Reporting Program
created in section 4 of this 2003 Act and any other patient safety reporting
program established to improve the safety and quality of patient care.
     (5) “Serious adverse event” means an
objective and definable negative consequence of patient care, or the risk
thereof, that is unanticipated, usually preventable and results in, or presents
a significant risk of, patient death or serious physical injury. [2003 c.686 §1]
     442.820
     (2) The mission of the commission is to
improve patient safety by reducing the risk of serious adverse events occurring
in
     (a) Establish a confidential, voluntary
serious adverse event reporting system to identify serious adverse events;
     (b) Establish quality improvement
techniques to reduce systemsÂ’ errors contributing to serious adverse events;
and
     (c) Disseminate evidence-based prevention
practices to improve patient outcomes.
     (3) ORS 192.410 to 192.505 do not apply to
public records created or maintained by the commission that contain patient
safety data or to reports obtained by the program.
     (4) ORS 192.610 to 192.690 do not apply to
portions of a meeting of the Oregon Patient Safety Commission Board of
Directors, or subcommittees or advisory committees established by the board, to
consider information that identifies a participant or patient and the written
minutes of that portion of the meeting. [2003 c.686 §2]
     Note: 442.820 to 442.835 were enacted into law by
the Legislative Assembly but were not added to or made a part of ORS chapter
442 or any series therein by legislative action. See Preface to Oregon Revised
Statutes for further explanation.
     442.825
Funds received by commission.
The Oregon Patient Safety Commission may accept contributions of funds and
assistance from the United States Government or its agencies or from any other
source, public or private, and agree to conditions not inconsistent with the
purposes of the commission. All funds received by the commission shall be
deposited in the account established pursuant to ORS 182.470. The commission
may apply for grants and foundation support and may compete for contracts
consistent with the mission and goals of the commission. [2003 c.686 §3]
     Note: See note under 442.820.
     442.830
     (2) Membership on the board shall reflect
the diversity of facilities, providers, insurers, purchasers and consumers that
are involved in patient safety. Directors shall demonstrate interest, knowledge
or experience in the area of patient safety.
     (3) The membership of the board shall be
as follows:
     (a) The Public Health Officer or the officer’s
designee;
     (b) One faculty member, who is not
involved in the direct delivery of health care, of the Oregon University System
or a private
     (c) Two representatives of group
purchasers of health care, one of whom shall be employed by a state or other
governmental entity and neither of whom may provide direct health care services
or have an immediate family member who is involved in the delivery of health
care;
     (d) Two representatives of health care
consumers, neither of whom may provide direct health care services or have an
immediate family member who is involved in the delivery of health care;
     (e) Two representatives of health
insurers, including a representative of a domestic not-for-profit health care
service contractor, a representative of a domestic insurance company licensed
to transact health insurance or a representative of a health maintenance
organization;
     (f) One representative of a statewide or
national labor organization;
     (g) Two physicians licensed under ORS
chapter 677 who are in active practice;
     (h) Two hospital administrators or their
designees;
     (i) One pharmacist licensed under ORS
chapter 689;
     (j) One representative of an ambulatory
surgical center or an outpatient renal dialysis facility;
     (k) One nurse licensed under ORS chapter
678 who is in active clinical practice; and
     (L) One nursing home administrator
licensed under ORS chapter 678 or one nursing home director of nursing
services.
     (4) The term of office of each director
appointed by the Governor is four years. Before the expiration of the term of a
director, the Governor shall appoint a successor whose term begins on October 1
next following. A director is eligible for reappointment for an additional
term. If there is a vacancy for any cause, the Governor shall make an
appointment to become effective immediately for the unexpired term. The board
shall nominate a slate of candidates whenever a vacancy occurs or is announced
and shall forward the recommended candidates to the Governor for consideration.
     (5) The board shall select one of its
members as chairperson and another as vice chairperson for the terms and with
the duties and powers as the board considers necessary for performance of the
functions of those offices. The board shall adopt bylaws as necessary for the
efficient and effective operation of the commission.
     (6) The Governor may remove any member of
the board at any time at the pleasure of the Governor, but not more than eight
directors shall be removed within a period of four years, unless it is for
corrupt conduct in office. The board may remove a director as specified in the
commission bylaws.
     (7) The board may appoint subcommittees
and advisory groups as needed to assist the board, including but not limited to
one or more consumer advisory groups and technical advisory groups. The
technical advisory groups shall include physicians, nurses and other licensed
or certified professionals with specialty knowledge and experience as necessary
to assist the board.
     (8) No voting member of the board may be
an employee of the commission. [2003 c.686 §7; 2007 c.71 §130; 2007 c.476 §5]
     Note: See note under 442.820.
     442.835
Appointment of administrator.
The Oregon Patient Safety Commission Board of Directors shall appoint an
administrator of the Oregon Patient Safety Commission. Subject to the
supervision of the board, the administrator has authority to direct the affairs
of the commission. The administrator may not be a voting member of the board. [2003
c.686 §11]
     Note: See note under 442.820.
     Note: Sections 4 to 6, 9, 12 and 16, chapter 686,
Oregon Laws 2003, provide:
     Sec.
4.
     (a) Reporting by participants, in a timely
manner and in the form determined by the Oregon Patient Safety Commission Board
of Directors established in section 7 of this 2003 Act [442.830], of the
following:
     (A) Serious adverse events;
     (B) Root cause analyses of serious adverse
events;
     (C) Action plans established to prevent
similar serious adverse events; and
     (D) Patient safety plans establishing
procedures and protocols.
     (b) Analyzing reported serious adverse
events, root cause analyses and action plans to develop and disseminate
information to improve the quality of care with respect to patient safety. This
information shall be made available to participants and shall include but is
not limited to:
     (A) Statistical analyses;
     (B) Recommendations regarding quality
improvement techniques;
     (C) Recommendations regarding standard
protocols; and
     (D) Recommendations regarding best patient
safety practices.
     (c) Providing technical assistance to
participants, including but not limited to recommendations and advice regarding
methodology, communication, dissemination of information, data collection,
security and confidentiality.
     (d) Auditing participant reporting to assess
the level of reporting of serious adverse events, root cause analyses and
action plans.
     (e) Overseeing action plans to assess
whether participants are taking sufficient steps to prevent the occurrence of
serious adverse events.
     (f) Creating incentives to improve and
reward participation, including but not limited to providing:
     (A) Feedback to participants; and
     (B) Rewards and recognition to
participants.
     (g) Distributing written reports using
aggregate, de-identified data from the program to describe statewide serious
adverse event patterns and maintaining a website to facilitate public access to
reports, as well as a list of names of participants. The reports shall include
but are not limited to:
     (A) The types and frequencies of serious
adverse events;
     (B) Yearly serious adverse event totals
and trends;
     (C) Clusters of serious adverse events;
     (D) Demographics of patients involved in
serious adverse events, including the frequency and types of serious adverse
events associated with language barriers or ethnicity;
     (E) Systems’ factors associated with
particular serious adverse events;
     (F) Interventions to prevent frequent or
high severity serious adverse events; and
     (G) Appropriate consumer information
regarding prevention of serious adverse events.
     (2) Participation in the program is
voluntary. The following entities are eligible to participate:
     (a) Hospitals as defined in ORS 442.015;
     (b) Long term care facilities as defined
in ORS 442.015;
     (c) Pharmacies licensed under ORS chapter
689;
     (d) Ambulatory surgical centers as defined
in ORS 442.015;
     (e) Outpatient renal dialysis facilities
as defined in ORS 442.015;
     (f) Freestanding birthing centers as
defined in ORS 442.015; and
     (g) Independent professional health care
societies or associations.
     (3) Reports or other information developed
and disseminated by the program may not contain or reveal the name of or other
identifiable information with respect to a particular participant providing
information to the commission for the purposes of sections 1 to 12 of this 2003
Act [442.820 to 442.835 and sections 1, 4 to 6, 8 to 10 and 12, chapter 686,
Oregon Laws 2003], or to any individual identified in the report or
information, and upon whose patient safety data, patient safety activities and
reports the commission has relied in developing and disseminating information
pursuant to this section.
     (4) After a serious adverse event occurs,
a participant must provide written notification in a timely manner to each
patient served by the participant who is affected by the event. Notice provided
under this subsection may not be construed as an admission of liability in a
civil action. [2003 c.686 §4]
     Sec.
5. Patient safety data; use; disclosure. (1) Patient safety data reported to the Oregon Patient Safety
Commission and information developed pursuant to the auditing and oversight
described in section 4 (1) of this 2003 Act may not be disclosed to, subject to
subpoena by or used by any state agency for purposes of any enforcement or
regulatory action in relation to a participant.
     (2) Nothing in sections 1 to 12 of this
2003 Act [442.820 to 442.835 and sections 1, 4 to 6, 8 to 10 and 12, chapter
686, Oregon Laws 2003] may be construed to limit the regulatory or enforcement
authority of any state agency and, except for patient safety data, state
agencies have the same authority to access participant records or other
information in the same manner and to the same extent as if sections 1 to 12 of
this 2003 Act were not enacted.
     (3) As used in this section, “state agency”
has the meaning given that term in ORS 183.750. [2003 c.686 §5]
     Sec.
6. Fees. The Oregon Patient
Safety Commission may assess fees on the entities described in section 4 (2)(a)
to (f), chapter 686, Oregon Laws 2003, as determined by the Oregon Patient
Safety Commission Board of Directors to fund the operating costs of the Oregon
Patient Safety Reporting Program. [2003 c.686 §6; 2007 c.476 §2]
     Sec.
9. Powers of board relating to
     (a) Developing a list of objective and
definable serious adverse events to be reported by participants. In developing
this list, the board shall consider similar lists developed in other states and
nationally. The board may change the list from time to time. The first list
developed by the board shall focus on serious adverse events that caused death
or serious physical injury. Later lists may include, in the discretion of the
board, serious adverse events that did not cause death or serious physical
injury but posed a significant risk of death or a risk of significant physical
injury.
     (b) Developing a budget.
     (c) Establishing a process to seek grants
and other funding from federal and other sources.
     (d) Establishing a method to determine
participant fees, if necessary.
     (e) Establishing auditing and oversight
procedures, including a process to:
     (A) Assess completeness of reports from
participants;
     (B) Assess credibility and thoroughness of
root cause analyses submitted to the program;
     (C) Assess the acceptability of action
plans and participant follow-up on the action plan; and
     (D) Obtain certification by the Public
Health Officer on the completeness, credibility, thoroughness and acceptability
of participant reports, root cause analyses and action plans.
     (f) Establishing criteria for terminating
a participant from the program. Incomplete reporting, failure to comply with
section 4 (4) of this 2003 Act or failure to adequately implement an action
plan are grounds for termination from the program.
     (2) The board may not use or disclose
patient safety data reported, collected or developed pursuant to sections 1 to
12 of this 2003 Act for purposes of any enforcement or regulatory action in
relation to a participant.
     (3) The board shall maintain the
confidentiality of all patient safety data that identifies or could be
reasonably used to identify a participant or an individual who is receiving or
has received health care from the participant. [2003 c.686 §9]
     Sec.
12. Patient safety data not admissible in civil actions. (1) Patient safety data and reports obtained
by a patient safety reporting program from participants are confidential and
privileged and are not admissible in evidence in any civil action, including
but not limited to a judicial, administrative, arbitration or mediation
proceeding. Patient safety data, patient safety activities and reports are not
subject to:
     (a) Civil or administrative subpoena;
     (b) Discovery in connection with a civil
action, including but not limited to a judicial, administrative, arbitration or
mediation proceeding; or
     (c) Disclosure under state public records
law pursuant to section 2 (3) of this 2003 Act [442.820 (3)] and, if
permissible, federal public records laws.
     (2) The privilege established under this
section does not apply to records of a patientÂ’s medical diagnosis and
treatment and to records of a participant created in the ordinary course of
business.
     (3) Patient safety data, collected or
developed for the purpose of and with the intent to communicate with or to make
a disclosure or report to the patient safety reporting program, that are
contained in the business records of the participant are confidential and not
subject to civil or administrative subpoena or to discovery in a civil action,
including but not limited to a judicial, administrative, arbitration or
mediation proceeding.
     (4) The following persons are not subject
to an action for civil damages for affirmative actions taken, acts of omission
or statements made in good faith:
     (a) A person serving on the Oregon Patient
Safety Commission Board of Directors;
     (b) A person serving on a committee
established by the board;
     (c) A person communicating information to
the Oregon Patient Safety Reporting Program; or
     (d) A person conducting a study or
investigation on behalf of the program.
     (5) A participant or a representative of
the Oregon Patient Safety Reporting Program may not be examined in any civil
action, including but not limited to a judicial, administrative, arbitration or
mediation proceeding, as to whether a communication of any kind, including oral
and written communication, has been made or shared with another participant or
with the program regarding patient safety data, patient safety activities,
reports, records, memoranda, analyses, deliberative work, statements or root
cause analyses, provided the communication was made with the intent of making a
disclosure to or preparing a report to be submitted to the Oregon Patient
Safety Commission.
     (6) Nothing in this section may be
construed to:
     (a) Limit or discourage patient safety
activities of or among participants or the voluntary reporting of patient
safety data by one or more participants, individually or jointly, to a patient
safety reporting program;
     (b) Affect other privileges that are
available under federal or state laws that provide greater peer review or
confidentiality protections than do the protections afforded under sections 1
to 12 of this 2003 Act [442.820 to 442.835 and sections 1, 4 to 6, 8 to 10 and
12, chapter 686, Oregon Laws 2003];
     (c) Preempt or otherwise affect mandatory
reporting requirements under
     (d) Diminish obligations of participants
to comply with state and federal laws pertaining to quality assurance,
personnel management and infection control requirements.
     (7) Reporting or sharing of patient safety
data by a participant is not a waiver of any privilege or protection
established under sections 1 to 12 of this 2003 Act or other
     Sec.
16. Sections 1, 4, 5, 6, 9,
10 and 12, chapter 686, Oregon Laws 2003, and section 3 of this 2007 Act
[section 3, chapter 476, Oregon Laws 2007,] are repealed on January 2, 2010. [2003
c.686 §16; 2007 c.476 §4]
     Note: Section 3, chapter 476, Oregon Laws 2007,
provides:
     Sec.
3. Limit on amounts collected to fund
     (2) The dollar amount specified in
subsection (1) of this section shall be adjusted annually by the commission
based upon the change in the Consumer Price Index as defined in ORS 327.006 for
every fiscal year beginning on or after July 1, 2008. [2007 c.476 §3]
HEALTH CARE
ACQUIRED INFECTIONS
     Note: Sections 1 to 6 and 12, chapter 838, Oregon
Laws 2007, provide:
     Sec.
1. The Legislative Assembly
finds that Oregonians should be free from infections acquired during the
delivery of health care. Action taken in this state to prevent health care
acquired infections should be trustworthy, effective, transparent and reliable.
[2007 c.838 §1]
     Sec.
2. As used in sections 1 to
6 of this 2007 Act:
     (1) “Health care facility” has the meaning
given that term in ORS 442.015.
     (2) “Health care acquired infection” means
a localized or systemic condition that:
     (a) Results from an adverse reaction to
the presence of an infectious agent or its toxin; and
     (b) Was not present or incubating at the
time of admission to the health care facility.
     (3) “Risk-adjusted methodology” means a
standardized method used to ensure that intrinsic and extrinsic risk factors
for a health care acquired infection are considered in the calculation of
health care acquired infection rates. [2007 c.838 §2]
     Sec.
3. (1) There is established
in the Office for Oregon Health Policy and Research the Oregon Health Care Acquired
Infection Reporting Program. The program shall:
     (a) Provide useful and credible infection
measures, specific to each health care facility, to consumers;
     (b) Promote quality improvement in health
care facilities; and
     (c) Utilize existing quality improvement
efforts to the extent practicable.
     (2) The office shall adopt rules to:
     (a) Require health care facilities to
report to the office health care acquired infection measures, including but not
limited to health care acquired infection rates;
     (b) Specify the health care acquired
infection measures that health care facilities must report; and
     (c) Prescribe the form, manner and
frequency of reports of health care acquired infection measures by health care
facilities.
     (3) In prescribing the form, manner and
frequency of reports of health care acquired infection measures by health care
facilities, to the extent practicable and appropriate to avoid unnecessary
duplication of reporting by facilities, the office shall align the requirements
with the requirements for health care facilities to report similar data to the
Department of Human Services and to the Centers for Medicare and Medicaid
Services.
     (4) The office shall utilize, to the
extent practicable and appropriate, a credible and reliable risk-adjusted
methodology in analyzing the health care acquired infection measures reported
by health care facilities.
     (5) The office shall provide health care
acquired infection measures and related information to health care facilities
in a manner that promotes quality improvement in the health care facilities.
     (6) The office shall adopt rules
prescribing the form, manner and frequency for public disclosure of reported
health care acquired infection measures. The office shall disclose updated
information to the public no less frequently than every six months beginning
January 1, 2010, and no less frequently than every calendar quarter beginning
January 1, 2011.
     (7) Individually identifiable health
information submitted to the office by health care facilities pursuant to this
section may not be disclosed to, made subject to subpoena by or used by any
state agency for purposes of any enforcement or regulatory action in relation
to a participating health care facility. [2007 c.838 §3]
     Sec.
4. (1) There is established
the Health Care Acquired Infection Advisory Committee to advise the
Administrator of the Office for Oregon Health Policy and Research regarding the
Oregon Health Care Acquired Infection Reporting Program. The advisory committee
shall consist of 16 members appointed by the administrator as follows:
     (a) Seven of the members shall be health
care providers or their designees, including:
     (A) A hospital administrator who has
expertise in infection control and who represents a hospital that contains
fewer than 100 beds;
     (B) A hospital administrator who has
expertise in infection control and who represents a hospital that contains 100
or more beds;
     (C) A long term care administrator;
     (D) A hospital quality director;
     (E) A physician with expertise in infectious
disease;
     (F) A registered nurse with interest and
involvement in infection control; and
     (G) A physician who practices in an
ambulatory surgical center and who has interest and involvement in infection
control.
     (b) Nine of the members shall be individuals
who do not represent health care providers, including:
     (A) A consumer representative;
     (B) A labor representative;
     (C) An academic researcher;
     (D) A health care purchasing
representative;
     (E) A representative of the Department of
Human Services;
     (F) A representative of the business
community;
     (G) A representative of the Oregon Patient
Safety Commission who does not represent a health care provider on the
commission;
     (H) The state epidemiologist; and
     (I) A health insurer representative.
     (2) The Administrator of the Office for
Oregon Health Policy and Research and the advisory committee shall evaluate on
a regular basis the quality and accuracy of the data collected and reported by
health care facilities under section 3 of this 2007 Act and the methodologies
of the Office for Oregon Health Policy and Research for data collection,
analysis and public disclosure.
     (3) Members of the advisory committee are
not entitled to compensation and shall serve as volunteers on the advisory
committee.
     (4) Each member of the advisory committee
shall serve a term of two years.
     (5) The advisory committee shall make
recommendations to the administrator regarding:
     (a) The health care acquired infection
measures that health care facilities must report, which may include but are not
limited to:
     (A) Surgical site infections;
     (B) Central line related bloodstream
infections;
     (C) Urinary tract infections; and
     (D) Health care facility process measures
designed to ensure quality and to reduce health care acquired infections;
     (b) Methods for evaluating and quantifying
health care acquired infection measures that align with other data collection
and reporting methodologies of health care facilities and that support
participation in other quality interventions;
     (c) Requiring different reportable health
care acquired infection measures for differently situated health care
facilities as appropriate;
     (d) A method to ensure that infections
present upon admission to the health care facility are excluded from the rates
of health care acquired infection disclosed to the public for the health care
facility under sections 3 and 6 of this 2007 Act;
     (e) Establishing a process for evaluating
the health care acquired infection measures reported under section 3 of this
2007 Act and for modifying the reporting requirements over time as appropriate;
     (f) Establishing a timetable to phase in
the reporting and public disclosure of health care acquired infection measures;
and
     (g) Procedures to protect the
confidentiality of patients, health care professionals and health care facility
employees.
     (6) The Office for Oregon Health Policy
and Research shall adopt rules implementing the Oregon Health Care Acquired
Infection Reporting Program no later than July 1, 2008. Health care facilities shall
begin reporting health care acquired infection measures under section 3 of this
2007 Act no later than January 1, 2009. [2007 c.838 §4]
     Sec.
5. Notwithstanding the term
of office specified by section 4 of this 2007 Act, of the members first
appointed to the Health Care Acquired Infection Advisory Committee:
     (1) Five shall serve for terms ending
January 1, 2010.
     (2) Five shall serve for terms ending
January 1, 2011.
     (3) The remaining members shall serve for
a term ending January 1, 2012. [2007 c.838 §5]
     Sec.
6. (1) In addition to any
report required pursuant to section 3 of this 2007 Act, on or before April 30
of each year, the Administrator of the Office for Oregon Health Policy and
Research shall prepare an annual report summarizing the health care facility
reports submitted pursuant to section 3 of this 2007 Act. The Office for Oregon
Health Policy and Research shall make the reports available to the public in
the manner provided in ORS 192.243 and to the Legislative Assembly in the
manner provided in ORS 192.245. The first report shall be made available no
later than January 1, 2010.
     (2) The annual report shall, for each
health care facility in the state, compare the health care acquired infection
measures reported under section 3 of this 2007 Act. The office, in consultation
with the Health Care Acquired Infection Advisory Committee, shall provide the
information in the report in a format that is as easily comprehensible as
possible.
     (3) The annual report may include
findings, conclusions and trends concerning the health care acquired infection
measures reported under section 3 of this 2007 Act, a comparison to the health
care acquired infection measures reported in prior years and any policy
recommendations.
     (4) The office shall publicize the annual
report and its availability to interested persons, including providers, media
organizations, health insurers, health maintenance organizations, purchasers of
health insurance, organized labor, consumer and patient advocacy groups and
individual consumers.
     (5) The annual report and quarterly
reports under this section and section 3 of this 2007 Act may not contain
information that identifies a patient, a licensed health care professional or
an employee of a health care facility in connection with a specific infection
incident. [2007 c.838 §6]
     Sec.
12. Sections 1 to 6 of this
2007 Act are repealed on January 2, 2018. [2007 c.838 §12]
     442.990 [Amended by 1955 c.533 §9; repealed by 1977
c.717 §23]
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