Metrics & Scoring Committee October 20, 2017 HEALTH POLICY - PowerPoint PPT Presentation

Metrics & Scoring Committee October 20, 2017 HEALTH POLICY & ANALYTICS Office of Health Analytics

Consent agenda  Review today’s agenda  Approve September minutes  Written updates (HPQMC next slide) Please note this meeting is being recorded. The recording will be made available on the Committee’s webpage: http://www.oregon.gov/OHA/HPA/ANALYTICS/Pages/Metrics-Scoring-Committee.aspx 2

Health Plan Quality Metrics Committee • Met October 12th and continued review of candidate measures, including hospital measures, maternal health measures, and measures related to asthma • Next meeting: November 9, 1.30-4.00 • Meeting information and materials are available online at: http://www.oregon.gov/oha/hpa/analytics/Pages/Quality- Metrics-Committee.aspx 3

Overview: Oregon Public Meetings & State Government Ethics for Public Officials • Purpose – Brief overview of Oregon Public Meetings Law – State Government Ethics for Oregon Public Officials – Information in these slides summarized from State of Oregon Overview of Boards, Commissions, & Small Entities (materials and references provided for further information) 4

Oregon Public Meetings Law Oregon’s Public Meetings Law serves two purposes: 1.To provide a means by which the public can be informed about the deliberations and decisions of state government; 2.To ensure governing bodies in Oregon have an open decision-making process The Public Meetings Law applies to state and local government “governing bodies” of “public bodies”

Oregon Public Meetings Law “Public body” includes the state, cities, counties, districts, boards, commissions, committees, subcommittees, advisory groups, and similar bodies. “Governing body” means the members of any public body consisting of two or more members (i.e., a board, commission, committee, subcommittee or council) with authority: • To make decision for a public body on policy or administration • To make recommendations to a public body on policy or administration

Oregon Public Meetings Law The Metrics & Scoring Committee is a public body and its meetings are subject to Public Meetings Law. A public meeting includes any deliberations that involve a quorum of Committee members. For M&S a quorum is 5 of the 9 members. Examples of activities that fall under Public Meetings Law include: • Information gathering sessions • Working lunches • Electronic meetings • Serial communications among a quorum of the Committee Likewise, any subcommittee or workgroup chartered by M&S is subject to Public Meetings Law.

Oregon Public Meetings Law Four basic requirements for conducting a public meeting • Advance notice must be provided to interested parties of meetings, location, and main subjects • Meetings must be open to public attendance • Meetings must be recorded or written minutes must be made • Votes must be cast publicly and recorded For specific limited purposes public bodies can meet in executive session to have confidential discussions. Executive sessions are closed to the public. Members of the media may attend but cannot report what was discussed. No decisions can be made in executive session.

Oregon Public Officials There are approximately 200,000 public officials in Oregon: • Individuals elected or appointed to an office or position with a state, county, city government, or special district • Employees of a state, county or city agency or special district • Unpaid volunteers for a state, county or city agency or special district • Anyone serving the State of Oregon or any of its political subdivisions Metrics & Scoring Committee members are public officials.

State Government Ethics for Public Officials Public officials are personally responsible for complying with the provisions in state ethics law. Public officials must make a personal judgment in deciding such matters as • Use of official position for financial gain • What gifts are appropriate to accept • When to disclose conflicts of interest

State Government Ethics for Public Officials Use of Position Ethics law prohibits using or attempting to use the position you hold as a public official to obtain a financial benefit, if the opportunity for the financial benefit would not otherwise be available but for the position you hold. Financial benefit can be either an opportunity for gain or to avoid an expense.

State Government Ethics for Public Officials Gifts • If the source of a gift has a legislative or administrative interest, any gift offered to you, your relative, or a member of your household, may only be offered and accepted under certain conditions. • If the source of a gift does not have a legislative or administrative interest, gifts are not restricted or prohibited. • ORS 244.020 defines “gift” and specifies a list of exceptions to this definition • ORS 244.025 establishes a $50 aggregate calendar year limit on gifts to public officials or household members from any single source that could reasonably be known to have a legislative or administrative interest

State Government Ethics for Public Officials Conflict of Interest • An actual conflict of interest occurs when you participate in an action that would affect the financial interest of yourself, your relatives, or a business with which you or your relative is associated. • A potential conflict of interest occurs when you participate in an action that could affect the financial interest of yourself, your relatives, or a business with which you or your relative is associated.

State Government Ethics for Public Officials Conflict of Interest Public officials met with an actual or potential conflict of interest need to disclose it • When met with a potential conflict of interest, announce publicly the nature of the potential conflict prior to taking any action in the capacity of a public official • When met with an actual conflict of interest, announce publicly the nature of the actual conflict and refrain from participating as a public official in any discussion or debate on the issue out of which the actual conflict arises or from voting on the issue.

References • State of Oregon Overview of Boards, Commissions, & Small Entities • Quick Reference Guide to Oregon Public Meetings Law • Oregon Revised Statues

Public testimony HEALTH POLICY & ANALYTICS Office of Health Analytics 16

Measuring and Incentivizing Obesity Reduction Efforts in Oregon Metrics & Scoring Committee Meeting October 20, 2017 Katrina Hedberg, MD, MPH, State Public Health Officer Cat Livingston, MD, MPH, Associate Medical Director, Health Evidence Review Commission Sara Kleinschmit, MSc, Policy Advisor, Office of Health Analytics

Presentation Overview • Briefly review data on extent of obesity problem, focusing specifically on the Medicaid population. • Review evidence of effective obesity reduction interventions. • Discuss measure selected by Metrics & Scoring Committee, and concerns from partners, including the Health Plan Quality Metrics Committee. • Discuss proposal for glide path to evidence-based measure.

Obesity among Oregon adults, 1990-2015 Medicaid 35% 29% 30% Percent obese 25% 20% 15% 10% 11% 5% 0% 1990 1995 2000 2005 2010 2015 Source: Oregon Behavioral Risk Factor Surveillance System Note: Vertical dashed line (---) indicates change in survey methods (2010). Estimates are age-adjusted.

Percent of Medicaid members who are obese by CCO AllCare Health Plan 34.9% Cascade Health Alliance 37.8% Columbia Pacific 34.9% Eastern Oregon 40.8% FamilyCare 28.0% Health Share of Oregon 36.3% Intercommunitiy Health Network 38.8% Jackson Care Connect 34.2% PacficSource - Central 31.5% PacificSource - Gorge 32.4% PrimaryHealth of Josephine County 34.3% Trillium 42.3% Umpqua Health Alliance 40.1% Western Oregon Advanced Health 41.0% Willamette Valley Community… 38.8% Yamhill CCO 41.3% 0% 10% 20% 30% 40% 50% Source: 2014 Oregon Medicaid BRFSS

Obesity among Oregon adult Medicaid recipients by race and ethnicity Pacific Islander 46% 44% American Indian or Alaska Native Latino 40% African American 39% White 36% Asian 10% Source: 2014 Oregon Medicaid BRFSS Note: Race and ethnicity categories are mutually exclusive.

Obesity among Oregon youth, 2001-2015 16% 11th graders 13% 12% 11% 7% 8% Percent 8th graders 7% 4% 0% 2001 2003 2005 2007 2009 2011 2013 2015 Source: Oregon Healthy Teens Survey

Obesity among Oregon WIC Participants Aged 2-5, 2006-2016 Obesity rates peaked in 2010/2011 and have gradually declined 18% 16% 15% 15% 14% 0% 2006 2008 2010 2012 2014 2016 Source: Oregon WIC Program Administrative Data Note: Vertical dashed line (---) indicates change in reporting methods (2011) from CDC to state reporting.

Significant Decrease in Obesity among WIC Children Ages 2-4 in Oregon and Nationally (2010-2014) Source: Pan L, Freedman DS, Sharma AJ, Castellanos-Brown K, Park S, Smith RB, Blanck HM. Trends in Obesity Among Participants Aged 2-4 Years in the Special Supplemental Nutrition Program for Women, Infants, and Children—United States, 2000-2014. MMWR Morb Mortal Wkly Rep 2016; 65(45).