Oregon Health Policy Board (OHPB) Approved Meeting Minutes June 1, 2021 Zoom Virtual Meeting - Oregon.gov

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Oregon Health Policy Board (OHPB) Approved Meeting Minutes June 1, 2021 Zoom Virtual Meeting - Oregon.gov
Oregon Health Policy Board (OHPB)
                        Approved Meeting Minutes
                              June 1, 2021
                          Zoom Virtual Meeting

1. Welcome, Roll Call and Minutes Approval – Chair David Bangsberg
   OHPB members present:
   Chair David Bangsberg, Vice Chair Oscar Arana, John Santa, Kirsten Isaacson,
   Brenda Johnson, Ebony Clarke, Jessica Gomez and Bill Kramer
   OHPB members absent: None
   Oregon Health Authority (OHA) staff present:
   Alissa Robbins, Amanda Peden, Amy Clary, Belle Shepherd, Chris DeMars, Craig
   Mosbaek, Daphne Peck, Dave Inbody, Deepti Shinde, Ellie Isenhart, Emily L. Wang,
   Estela Gomez, Holley Oglesby, Jackie Leung, Jeannette Taylor, Jeff Scroggin,
   Jeremy Vandehey, Jill Gray, Joell Archibald, Jon Collins, Karen Hale, Laura Sisulak,
   Leela Richman, Liz Walker, Lori Coyner, Mackenzie Carroll, Marc Overbeck, Megan
   Auclair, Michelle Hatfield, Neelam Gupta, Kate Lonborg, Stacey Schubert, Leann
   Johnson, Maria E. Castro, Philip Schmidt, Sara Kleinschmit, Sarah Bartelmann,
   Steph Jarem, Summer Boslaugh, Tara Chetock, Thomas Cogswell, Tim Sweeney,
   Tom Wunderbro, Trang Weitemier, Trilby de Jung, Vanessa Wilson

   Quorum was present. The Board voted unanimously to approve the May meeting

   New members Jessica Gomez and Bill Kramer each gave a brief introduction.

2. Liaison Updates
   Board members gave updates about committees of the Board.

   Brenda Johnson gave an update of the Healthcare Workforce Committee, saying
   they are in listening sessions that will continue through June. The committee is
   readying itself for potentially new behavioral health resources and funding
   depending on how things turn out through the legislative session.

   John Santa gave an update of the Metrics and Scoring Committee saying they have
   had a productive discussion of the kindergarten social-emotional metric that was
   discussed at the last OHPB meeting. Measures will continue to be added in June.
   Chair Bangsberg said he was able to attend the last meeting and he was impressed
   with the innovated kindergarten readiness measure.

   David Bangsberg said he attended the Health Equity Committee in May where the
   Medicaid waiver was reviewed.

3. OHA Legislative Update
   Belle Shepherd and Jeff Scroggin gave a legislative presentation.
Belle and Jeff discussed several bills including:
      • Expand and Sustain Tribal Traditional Health Workers (HB 2088, POP 404:
      • Race, Ethnicity, Language and Disability (REALD) and Sexual Orientation
          and Gender Identify (SOGI) Data Collection (HB 3159)
      • Create a Cover All People Pilot (HB 2164, Racial Justice Council request,
          $10M GF, and HB 3352)
      • Expand Regional Health Equity Coalitions (SB 70)
      • Improve Language Access and Health Care Interpreters (HB 2087 not
          moving, 2359 is related)
      • Create Statewide Value Based Payment System (HB 2082 not moving)
      • Reduce Pharmacy Costs (HB 2080 not moving, SB 848 is similar, POP 436:
      • Public Option (HB 2010)
      • COFA Dental (SB 557)
      • Operate Fee for Service Like a CCO (POP 407, $11.1M GF)

4. Cost Growth Target Program Updates
   Sarah Bartelmann and Jeremy Vandehey gave a presentation.

   Accountability legislation (HB 2081) passed the Senate May 10th and was signed by
   the Governor May 21st. HB 2081 authorizes accountability mechanisms for payers
   and provider organizations who exceed the cost growth target in calendar year (CY)
   2022 or beyond, including Performance Improvement Plans and financial penalties.

   Jeremy said last month we announced that we've had about 45 organizations across
   payers and providers, state payer and state organizations sign on to the compact on
   the on the payer side that represents 71% of the entire population of the state.
   There's a new workgroup that's being stood up that we're hosting in partnership with
   the Oregon Health Leadership Council, that will really help with implementing and be
   a centralized forum for addressing challenges as we're moving through value-based

   Sarah discussed the timeline for data submissions. She said they have been
   working with the new Technical Advisory Committee and have had a number of
   meetings already and have been working on all the details that need to go into that
   data submission template and specifications. All of the data submitters who have
   data due on October 1 this year were notified last week. Sarah said they will be
   releasing the specifications and template at the end of June and then doing training
   and technical assistance for data submitters throughout the summer leading up to
   that October 1 date.

                       June 1, 2021 | draft meeting minutes                       Pg. 2
One of those recommendations that came out of the implementation committee is to
have a standard set of quality measures or a subset that we would report on
annually. Some of those measures are:
   • Well child visits in the first 30 months of life
   • Child and adolescent well care visits
   • Statin therapy for patients with diabetes
   • Emergency Department utilization
   • Mental health treatment population reach (homegrown measure)
   • Plan all cause readmissions

Sarah discussed the negative impacts of the cost growth target. She said this is
conversation that we are having with the health equity committee and presented the
overall framework and how we're thinking about the conversation. One of the points
was we were originally framing this conversation as wanting to make sure that the
cost growth target and work and efforts to meet the cost growth target did no harm.
We want to think about where there might be harm in the system, what should we be
measuring? How can we avoid those negative impacts? The health equity
committee really encouraged us that that do no harm frame is a neutral place on this
spectrum. They encouraged us to really think beyond this neutral space and to think
more proactive, where are some opportunities where the customers target program,
and these levers can actually drive proactive improvement in the healthcare system
and not just looking to avoid harm.

Sarah discussed the annual cycle and the process of this program.

She asked how do we decide which strategies are the worthiest or should be
prioritized? We know that the state, the board, the payers and provider all have a
limited capacity and resources to make all of the changes. How do we decide which
ones should be focused on and which ones have been the most likely to have an

                    June 1, 2021 | draft meeting minutes                      Pg. 3
impact in addressing cost growth and the cost growth drivers that we've been able to
identify? As we're reviewing data and going through this cycle of measuring,
analyzing and reporting, we anticipate lots of potential strategies being identified.

She said 54% of the increase in medical spending in Rhode Island was driven by
pharmacy prices. Connecticut, Massachusetts and Rhode Island are working
together now on a similar policy that will cap the cost of prescription drugs in these
states. Last week, the Implementation Committee adopted a process and criteria to
guide these decisions.

   •   Identify strategies
          o Data analysis
          o Stakeholder considerations
   •   Assess strategies
          o Analysis of spending data indicates a significant opportunity for
               reduced spending or spending growth.
          o Successfully addressing the opportunity would have a substantive
               impact on cost growth target attainment.
          o Published evidence supports the strategy, or if not, there is a
               compelling logic model that supports the strategy.
          o There is capability and capacity to effectively implement the strategy in
               a timely manner. Required resource investment would not detract from
               previously prioritized strategy design and implementation.
   •   Committee consideration
          o Committee chair, vice chair and staff score the strategy against criteria
               using 1-3 scale
          o The assessment is presented to the Committee for discussion
          o The Committee considers whether to recommend pursuing the
                   ▪ Recommend proceeding
                   ▪ Request additional research
                   ▪ Request modification
                   ▪ Defer until later
                   ▪ Reject

Kristen Isaacson asked, for the equity layer, how do we, as a board, add more layers
to it? Sarah said the Board fits in many layers including helping to identify what to

Ebony Sloan-Clarke added a comment about undoing harm and how to effectively
measure that. How do we know that we're undoing harm?

John Santa said there is always significant variation wherever you look in the health
system. Bill asked how the tremendous variation between programs, Medicare,
Medicaid and commercial area will be handled.

                     June 1, 2021 | draft meeting minutes                        Pg. 4
Sarah said one is that what when we talk about measuring performance relative to
the cost growth target, we're measuring the trend, we're measuring the percent
change year over year, at a broad level, so statewide for each of the markets,
Medicare, Medicaid and commercial for the payers in the state and for the large
provider organization.

Oscar Arana said there should be an equity lens being attached to each of the four

Sarah discussed the Oregon Health Insurance survey data. She said the goals are
to provide additional data on consumer cost impacts from the Oregon Health
Insurance Survey (OHIS) and Inform continued development of the Framework for

2019 OHIS Question Topics:
   • Insurance Status
   • Health Status
   • Why Remain Uninsured
   • Program Eligibility
   • Coverage Changes
   • Mental Health Access
   • Dental Care
   • Utilization
   • Demographics
   • Costs
   • Underinsurance

15.7% of Oregonians reported they delayed care because of costs in 2019.
   • Younger adults were more likely to report delaying care because of costs than
      other age groups.
   • Uninsured Oregonians were more likely to report delaying care because of
      costs. 1 in 4 Native Hawaiian or Pacific Islander Oregonians & those reporting
      other race reported delaying care due to cost.
   • Oregonians were mostly like to report delaying dental care due to cost.

Paying Medical Bills
   • 7.7% of Oregonians were unable to pay medical bills in the past year.
   • Uninsured Oregonians were most likely to report inability to pay medical bills
      in the past year
   • 10% of Oregonians report trouble paying off medical bills over time.
   • 10.2% of Oregonians report using up all or most of their savings because of
      medical bills.
   • Uninsured Oregonians were most likely to report using up their savings on
      medical bills.

                    June 1, 2021 | draft meeting minutes                      Pg. 5
•   Native Hawaiian or Pacific Islander Oregonians were 3x as likely to report
         using up their savings on medical bills.

  Sarah encouraged the OHPB members to explore the live data in the dashboard.

5. Public Comment

  Rick Blackwell gave verbal comment. “I'm the director of Oregon government
  relations for Pacific source. Thank you for the opportunity to accept public comment.
  I just want to note our appreciation to have Oregon Health authorities work around
  drumming up public engagement and working with CEOs on the on this next 1115
  demonstration waiver. The I was a public I did some policy work in the past life and I
  know how difficult it is to do this kind of public engagement and to do this and as we
  come out of a pandemic is commendable. So just want to thank them for that. You're
  going to hear some from our colleagues about some specific ideas that CEOs have
  been considering advocating for and in the next few comments. I wanted to focus
  instead on how the waiver might be considered to drive community spending
  decisions. In today's presentation, you may hear more about how that how the
  waiver proposal will actually take steps to do that. I just wanted to make sure that the
  Policy Board understood that from our position we're already doing that work making
  trying to involve the community in spending decisions. Now if you've met one CCO,
  you've met one CCO but in pacific source. As experience we carry out our
  responsibilities under the CCO model by standing up health councils. Each is
  different that they try to improve the health of the community overall. pacific source
  does not govern these health councils instead, they're really a community driven
  effort. And they make spending decisions based on their on the work, which has real
  results. In Central Oregon Health councils invested about $35 million since 2013 on
  projects. So, as we continue to work on in communities in Oregon, we also want to
  see if there's a way to infuse data within the waiver. So, for instance, provider
  electronic health records are going well, but more support for interoperability and
  reporting is still needed. You know, we're working together, I guess I'll close really
  quickly to savor working together to identify and bring ideas forward. And as we
  serve unique communities, individual CEOs will have ideas that reflect on the unique
  needs of the communities we serve. So, with that, I think I'd beat the timer. Thank
  you for your consideration. And I'll, if there's any questions subsequently, please feel
  free to reach out.”

  Josh Balloch gave verbal public comment. “I'm the Vice President government affairs
  for AllCare Health. We're a Southern Oregon CCO. Um, so in 20, and 2012, Oregon
  was able to get an 1115 waiver to create coordinated care organizations to pitch to
  the feds was relatively simple. Oregon wanted to fully integrate mental physical
  behavioral health service Medicaid services under one community-based
  organization that would take full financial risk with a global budget to stay at 3.4%
  rate of growth. The feds believed in the model enough to invest $1.9 billion in
  Oregon to help us make it happen. But there was one thing that was not included
  inside of that waiver, a true global budget CCO budgets are still based year to year

                       June 1, 2021 | draft meeting minutes                         Pg. 6
only on medical spend. Investments and community don't count toward based
budget paying behavioral health providers what above what is usual-and-customary
is not included in the CCS based budget. As a result, CCS are negatively
incentivized to make upstream social determinants of health investments, CCS still
make these investments anyway, but they are forced to do so with short term or one
time grants, the current funding structure does not allow for the sustained changes
that were originally envisioned in the first CCO waiver in 2012. fixing this critical
issue, this critical funding issue is vitally important to achieving this goal, the goal of
the board's goals of health achieving health equity and investing in the social
determinants of health. And I will just also say I'm very concerned about some ideas
that have been kind of floated around of this idea around siloing out social
determinants of health funding on you know, this is an idea that, that would really
kind of create a another silo that will make things unsustainable, it will create more
fractures inside of it, it will it will undermine a lot of the good work that's being done
by our community advisory council. So, I would just very much caution around going
that direction. So, with that, thank you so much, and good luck.”

Bill Bouska gave verbal public comment. “…Director of government relations for
inner Community Health Network Coordinated Care Organization. Since 2012,
agency co has managed Oregon Health Plan benefit and Linn Benton and Lincoln
counties. Today we have an enrollment of over 71,000 individuals, I want to focus
my comments on the importance of making sure that eligibility enrollment process is
as simple and as an effective pot as possible. And also, about maintaining CCO
enrollment as people transition through the system of services and support. A couple
of key concepts that I want to highlight. It would be good to consider expansion of
postpartum coverage to at least 12 months post-delivery. We know that around half
of the babies born in Oregon are covered by the Oregon Health Plan. Currently OHP
coverage is expanded for individuals who are pregnant, but that expanded coverage
and 60 days after birth. There are three other states that have recently had their
1115 waivers approved with a 12 month postpartum coverage those states are
Georgia, Illinois, and Missouri. We feel like that extending that coverage to really
lead to healthier parents, Mom and the babies of course and families. The other
large group that I want to talk about is continued coverage and CCO enrollment for
Oregonians who are in jails, detention, incarceration, or the mental health system
that surrounds the Oregon State Hospital. Today, individuals involved in these
systems are disenrolled from OHP and lose connection with Medicaid reimburse
health care services and care coordination connections in their home communities,
these members frequently have complex health and social service needs. So, a
couple ideas under this bucket maintain CCO enrollment during pre-adjudication
phase for those in jail or detention. Another is to extend OHP coverage when the
length of stay in corrections facility or Oregon State Hospital is less than one year, or
allows CCO enrollment two months prior to release or discharge when these
facilities and last idea would be to create a care curtain care coordination only plan
or enrollment category for Oregon Health Plan individuals and settings for Oregon
Health Plan coverage is currently not allowed. So, we actively support the direction
of the waiver renewal as we understand it today. There are many steps ahead to get

                      June 1, 2021 | draft meeting minutes                           Pg. 7
us to the details. And we hope these ideas will help you think about the populations
   and settings that can be positively impacted in the next five-year waiver program.
   And we're excited to work with the Policy Board and the Oregon Health Authority
   and other stakeholders as we move forward this year. Thank you.”

   There was written comment received as well.

6. Waiver Updates: Deep Dive & Policy Concept Papers
   Lori Coyner and Jeremy Vandehey gave a presentation.

   Our waiver will advance health equity by:
     • Ensuring access to coverage for all people in Oregon
     • Creating an equity centered system of health
     • Encouraging smart, flexible spending
     • Reinvesting savings in communities

   People identify the racism in our system which prevents them from being healthy.

   What is an equity centered system of health? A system providing health services in
   an environment where all people can reach their full health potential and well-being
   and are not disadvantaged by their race, ethnicity, language, disability, gender,
   gender identity, sexual orientation, age, social class, intersections among these
   communities or identities, or other socially determined circumstances.
   It requires:
        • The equitable distribution or redistributing of resources and power
        • Recognizing, reconciling and rectifying historical and contemporary injustices

   To create an equity centered system of health we must:
      • Ensure the health system works for communities of color in Oregon.
      • Address the needs resulting from inequities and barriers which lead to health
      • Understand the lived experiences of members and fix what is not working.
      • Change the Oregon Health Plan to help members with complex needs
         stemming from systemic racism.

   Our goal:
     • OHP members experience coordinated, and integrated care across health
         and social systems.
     • There are no language, cultural, or economic barriers to receiving health care
     • OHP enrollment is preserved as patients transition between systems.

   Scope of current waiver, which we will build upon
      • Our current waiver provides a framework for promising strategies to truly
         move the needle on creating an equity centered system of health through:

                       June 1, 2021 | draft meeting minutes                        Pg. 8
•   Care Coordination, including ICC, which compels CCOs to address
       healthcare on a holistic level for those with qualifying "triggers" by
       coordinating healthcare as well as addressing social needs and
       complimentary care strategies
   •   Robust evidence-based benefits for those already covered by the OHP
   •   The potential to utilize in lieu of services to provide care that is better suited to
       those who may need something outside of traditional benefits or benefit
       providers to thrive

Better serve populations in transition between settings: How do we use OHP
eligibility and CCO enrollment to support populations who move across settings and
system and lose coverage and access to benefits?

Housing and other social needs:
  • Utilize screening for Homelessness, Transitions of care, and other social
      needs to qualify OHP Members for a suite of benefits that address Health
      Related Social Needs.
  • Create a suite of benefits that address health related social needs.

Behavioral health access:
  • Capacity and workforce are being approached by working on investments of
      state dollars to strengthen those issues.
  • But what Medicaid system changes would allow those investments to truly

Tribal specific strategies - Through monthly meetings, tribes have begun to identify
priorities the 1115 waiver renewal. Examples include:
    • Including definitions and additional coverage for tribal specific practices
    • Reduce administrative burden around billing and reimbursement
    • Continue existing programs that work well

Reinvesting savings in communities

People want investment in the programs that support their health and healthy

Social issues that cause health inequities often extend beyond the scope of the
health care system. Our waiver renewal will seek to reinvest savings to combat
health inequities at the community level.

  • Savings generated through health reform are reinvested in communities to
       improve the social, economic and physical environment.
  • Community leaders partner on strategies to eliminate health inequities.

                      June 1, 2021 | draft meeting minutes                           Pg. 9
Successful implementation of Oregon’s statewide Sustainable Health Care Cost
Growth Target will result in substantial savings to the federal government by slowing
the rate of growth in health care expenditures.

Invest the savings in new “health equity zones”

A Health Equity Zone is a geographic area in which community-based partnerships
identify investments aligned with community needs to improve physical and
behavioral health outcomes at the intersection of equity and health.

Examples of investments:
   • Culturally responsive health care workforce
   • Outdoor opportunities and green spaces
   • Affordable, high quality childcare
   • Housing and housing related services

Collaborate with community partners to identify where statewide investments could
significantly reduce health inequities on a larger scale.

Ebony asked about the housing element of the proposal and specific strategies. She
also wanted more clarity around the behavioral health piece. Lori said the concept
papers get a little more into details about those topics but what they are looking at is
pretty similar to the last waiver. She said they are not going to ask to build housing
as CMS has been steadfast about not investing in the building of housing that they
don't see themselves as a housing organization. However, we will be asking for a
suite of housing services. That can include things like pre-tenancy services, helping
people fill out housing applications, helping people get paid for first and last month's
rent, paying for furniture to get started post and tenancy services to help members
maintain their housing. On the behavioral health front, we are taking another look at
peer support and traditional health workers.

Chair Bangsberg asked is there a mechanism for us to make upfront investments in
social determinants of health? Lori said there is legislation right now that's being
proposed, (House Bill 3353), that requires CCOs to invest 3% of their global budget
in health through health-related services that address social needs. There are quite
a few barriers to making those investments; we're hoping to reduce those barriers as
much as possible.

Draft concept papers

Draft papers lay out the vision, goals, steps and possible policy strategies to share
    • Stakeholders
    • Community Partners
    • OHP Members
    • CMS

                    June 1, 2021 | draft meeting minutes                         Pg. 10
Are we on the right track? Are there major gaps that must be addressed before CMS
sees these? Are there barriers to equitable health that are not addressed?

   • June 1st: Release Concept Papers for public comment
   • Month of June: gather input and feedback/revise papers
   • July 1st: Release 2nd draft of Concept Papers
   • July 6th: OHPB meeting to discuss
   • Mid-July: Submit drafts to CMS

Waiver Development Approach (high level)

The public can stay involved about the progress and review the concept paper drafts
at the website. Questions can be submitted to:

Our waiver will advance health equity by:
  • Ensuring access to coverage for all people in Oregon
  • Creating an equity centered system of health
  • Encouraging smart, flexible spending
  • Reinvesting government savings across systems

Vision: Oregon has a low uninsured rate with no racial or ethnic inequities in

  • Stabilized coverage for those at risk of becoming uninsured
  • Flexible, streamlined eligibility processes that preserve coverage across
  • Eligible people get enrolled and stay enrolled


                   June 1, 2021 | draft meeting minutes                          Pg. 11
•   Ensure people who are newly enrolled in OHP due to the COVID-19
       pandemic stay in the appropriate coverage (OHP or Marketplace) without
   •   Ensure that people who are eligible for OHP get and stay enrolled.
   •   Adjust eligibility to preserve continuity.

Creating an equity centered system of health
Vision: Oregon establishes an equity centered system of health that ensures people
have access to the services and supports they need (health care or otherwise) to
achieve optimal health and well-being, especially through times of transition.

  • Enhance care coordination and non-clinical supports for members
       transitioning across systems to improve outcomes, including flexibility around
       eligibility and coverage.
  • Remove barriers to accessing critical, culturally, and linguistically appropriate
       health services for OHP members.
  • Prioritize groups of people who are currently experiencing inequities so that
       Oregon’s Medicaid program achieves equity in its system of health.

   • Identify the destabilizing transitions that could be most improved by
     temporary, enhanced care coordination and case management.
   • Define the Coordinated Transition Support package of services and supports
     for each of the identified transitions.
   • Improve the behavioral health system to better support members, especially
     at times of transition.

   •   Ensure that providers and partners in non-clinical settings have the
       infrastructure, training and support necessary to participate as a care partner
       for members
   •   Improve the screening processes to ensure that people who are engaged with
       multiple systems are identified for these enhanced coordination supports and
       get the care they need.

Encouraging smart, flexible spending
Vision: Oregon’s global budgets have the flexibility, incentives, and accountability to
community that is necessary to address medical and social needs of members,
invest in community health and well-being, and eliminate health inequities in Oregon.

  • Oregon creates savings that can address health inequities in the state, by
       maintaining a sustainable rate of growth in the CCO program
  • CCOs focus spending on health equity, prevention, care coordination, and
       quality because these are smart investments that will help them maintain
       sustainable cost growth

                   June 1, 2021 | draft meeting minutes                        Pg. 12
•   Communities have significantly more say in the spending decisions that
       impact them, especially when it comes to health inequities
   •   People, especially those experiencing health inequities, get the care and
       supports they need to stay healthy, including services to address health
       related social needs

   • Hold the CCO program to a sustainable cost growth target, in line with
     statewide efforts to contain health care costs.
   • Use innovative rate methods to set global budgets that encourage efficiency
     and upstream investment.
   • Increase CCO accountability to delivering care and supports members need
   • Enhance community voice in the CCO model to ensure community priorities
     and needs are driving spending decisions, and that community partners are
     participating in or leading decision making around spending
   • Revamp Oregon’s metrics program so that equity is the primary organizing
   • Ensure Oregon’s approach to evidence-based benefits enhances access to
     innovative and high value care, including health related social needs.

Reinvesting government savings across systems
Vision: Reinvest Oregon generated federal savings into communities to reduce
health inequities.

  • Reinvest savings generated through health reform toward communities to
       improve the social, economic and physical environment.
  • Focus on large scale investments that are targeted towards eliminating health
  • Partner with community leaders to identify and operationalize strategies to
       eliminate health inequities

   • Implement the Sustainable Health Care Cost Growth Target Program
   • Retain the savings achieved through slowing the rate of health care cost
     growth for Medicaid and Medicare Advantage
   • Invest those dollars in innovative models that extend across populations
     experiencing inequities

Jessica Gomez talked about eligibility adjustments and how something as simple as
overtime can affect someone’s OHP eligibility; she asked if that is something being
addressed by the waiver. Jeremy said there are conversations taking place to try to
smooth out that process for clients.

Brenda Johnson said she would like to explore the option of a small copay as an
option for people who pop out of that eligibility bracket, that there's an option for

                    June 1, 2021 | draft meeting minutes                          Pg. 13
them to also pay for a small percentage to remain eligible. Further, Brenda asked
  how exactly we can set guidance for the committee to deliberate areas of feedback
  that we think are really actionable, and reframe the concept papers or add to it
  things that fundamentally shift your thinking from what you've already drafted, and
  how the committee feels the right level of guidance from the board in order to do so.
  Jeremy said one of the things that the Medical Advisory Committee brings that's
  really, important is actually specific member stories. It's one thing to talk about that
  policy and talk about a change of rule but what we have heard from them last week
  was a lot of really specific examples of challenges people have tried to navigate the
  system, and how a policy can improve that.

  Ebony Sloan-Clarke said she is concerned about sustained funding for long-term
  Medicaid efforts. She also expressed concern for the workforce shortage in
  behavioral healthcare.

  Kirsten Isaacson asked what role, if any, the Regional Health Equity committees
  played in voicing, and giving feedback on the draft concept papers? Lori said they
  sponsored and had a hand in developing HB 3553; she said they have been in
  conversations about how to amplify those messages and policies.

7. Meeting Adjourn

  Chair Bangsberg thanked OHA staff, board members and public commentors for the
  meeting today.

                      June 1, 2021 | draft meeting minutes                         Pg. 14
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