Healthcare (Hospitals)

HCR 202 is a concurrent resolution declaring Oregon's 2033 policy goal for its healthcare system to be more affordable and accessible for all residents. It does not create new laws or allocate funds but sets six specific targets, including ensuring timely primary care access, improving population health outcomes, stabilizing hospital finances, and reducing healthcare costs below national averages. The resolution directly affects Oregonians (especially those delaying care due to cost), healthcare providers, hospitals, insurers, and employers facing rising premiums. It acknowledges systemic issues like Medicaid funding losses and high hospital deficits but focuses on long-term vision rather than immediate policy changes.

Requires a vote to adopt a nurse staffing plan by a hospital nurse staffing committee to be documented in the staffing plan. Directs a hospital to implement a hospital-wide nurse staffing plan that has been developed and adopted by the hospital nurse staffing committee or, if the committee has not adopted a plan, a hospital-wide nurse staffing plan that meets the statutory requirements. Directs that the statutory direct care registered nurse-to-patient staffing ratios constitute the nurse staffing plan for a unit if the hospital nurse staffing committee has not adopted a nurse staffing plan for the unit. Changes from four to five the number of patients that a direct care registered nurse may be assigned for a medical-surgical unit under the statutory staffing ratios. Allows a type C hospital to vary from the statutory direct care registered nurse-to-patient staffing ratios. Requires a unit manager to notify the cochairs of the hospital nurse staffing committee after each deviation from a nurse staffing plan. Establishes a maximum amount in civil penalties that may be imposed for violations of the hospital staffing requirements. Directs that all civil penalties collected shall be distributed to the local public health authorities. Prohibits the impositions of civil penalties for violations that occur before July 1, 2027. Modifies what constitutes a single violation for purposes of failure to comply with certain staffing ratios.

Requires the Oregon Health Authority to adopt rules and procedures to allow a hospital to apply for a license as a rural emergency hospital. Takes effect on the 91st day following adjournment sine die.

Modifies the requirements for screening a hospital patient for presumptive eligibility for financial assistance. [ Prohibits the Oregon Health Authority from requiring certain home health agencies to comply with Medicare conditions of participation. ] [ Modifies the requirements for how the Department of Human Services must publish Residential Care Quality Measurement Program data. ] Removes the requirement that an applicant for a residential care facility administrator license hold a bachelor's degree in a health or social service related field. Allows a person residing in a correctional facility to receive prerelease medical assistance benefits under certain circumstances. [ Prohibits the authority or a coordinated care organization from requiring prior authorization for medical assistance coverage for repairing complex rehabilitation technology if the repair costs $1,500 or less. ] Modifies the requirements for meetings held by the Health Evidence Review Commission. Modifies the composition of the Medicaid Advisory Committee. Modifies the eligibility requirements for parent providers who are paid to provide attendant care services to their children. {See A-Eng Bill for omitted text.} Allows a full-time dentistry student enrolled in an out-of-state dental education program to practice dentistry without a license if the student is supervised by a faculty member of a dental education program accredited by the Commission on Dental Accreditation of the American Dental Association. Requires casualty or health insurance policies to provide coverage for medically necessary anesthesia services, regardless of duration, for any covered procedures. Requires dental insurers to follow certain rules for payment and denial of claims. Requires the Legislative Policy and Research Director to develop and propose to the [ Legislative Policy and Research Committee ] committees with jurisdiction over health care an insurance coverage mandate impact statement policy. Directs the [ committee ] committees to perform due diligence in considering the proposal and authorizes the [ committee ] committees to modify the proposal if the [ committee ] committees so [ determines ] determine , and then to adopt the policy. Repeals requirement that enrollees in individual or group policies or certificates of health insurance [ or members of coordinated care organizations ] be assigned by their insurer [ or organization ] to primary care providers under certain circumstances. Specifies exemptions from the requirement that pharmacy services administrative organizations must register with the Department of Consumer and Business Services as third party administrators. {See A-Eng Bill for omitted text.} Modifies requirements for the Prescription Drug Affordability Board's annual affordability determination for insulin products. Allows licensees of the Occupational Therapy Licensing Board and the Oregon Board of Physical Therapy to provide psilocybin services as licensed psilocybin service facilitators while providing occupational therapy or physical therapy services. {See A-Eng Bill for omitted text.} Lowers the age at which a naturopathic physician may request a retired license status from 70 years of age to [60] 65 years of age. Includes nurse practitioners and physician associates in the definition of "attending physician" for purposes of the treatment of workers’ compensable injuries. Declares an emergency, effective on passage.

] [ Authorizes ] Requires the State Treasurer to [ loan ] use up to [ 20 percent of ] $44 million from the Unclaimed Property and Estates Fund to guarantee a loan made to a rural [ hospitals ] hospital for financial stabilization. Declares an emergency, effective on passage.

Directs a hospital to implement a hospital-wide nurse staffing plan that has been developed and adopted by the hospital nurse staffing committee or, if the committee has not adopted a plan, a hospital-wide nurse staffing plan that meets the statutory requirements. Directs that the statutory direct care registered nurse-to-patient staffing ratios constitute the nurse staffing plan for a unit if the hospital nurse staffing committee has not adopted a nurse staffing plan for the unit. Changes from four to five the number of patients that a direct care registered nurse may be assigned for a medical-surgical unit under the statutory staffing ratios. Allows a type C hospital to vary from the statutory direct care registered nurse-to-patient staffing ratios. Modifies the definition of type C hospital. Requires a unit manager to notify the cochairs of the hospital nurse staffing committee after each deviation from a nurse staffing plan. Directs the Oregon Health Authority to determine whether a complaint is valid or not within 30 days after receiving the complaint. Requires the authority to accept an attestation from a hospital as sufficient documentation the hospital took certain actions. Establishes a maximum amount in civil penalties that may be imposed for violations of the hospital staffing requirements. Directs that all civil penalties collected shall be paid into the Hospital Quality Assurance Fund. Requires the authority to submit an annual report on the number and types of violations to the committees or interim committees of the Legislative Assembly related to health care. Prohibits the impositions of civil penalties for violations that occur before July 1, 2030.

Expands the definition of "debilitating medical condition" for the medical use of marijuana. Requires an organization or residential facility that is designated as an additional caregiver for a medical marijuana cardholder to create and maintain a written policy and provide educational training for certain staff regarding the medical use of marijuana. Exempts hospitals and hospital-affiliated clinics from the requirements. Requires that in order to engage in the medical use of marijuana, the patient or resident of the organization or residential facility must be a medical marijuana cardholder or have applied to be a medical marijuana cardholder. Protects an organization or residential facility [ and its employees and contractors ] from certain criminal liability related to the medical use of marijuana. Prohibits the Oregon State Board of Nursing from taking disciplinary action against a nurse for discussing the medical use of marijuana with a patient. Takes effect on the 91st day following adjournment sine die.