Probe
THE
Quarterly Newsletter of the Oregon Public Health Association
STOP WAR
M ost members of the American
Public Health Association oppose
war and the militarization of U.S. society.
At the 2002 annual meeting in Philadel-
phia, speakers voicing opposition to the
looming war were repeatedly interrupted
by the applause of thousands at the
opening plenary session. Later, the
Governing Council gave strong support
to two anti-war resolutions.
The first resolution, ”Opposing War
in Central Asia and the Persian Gulf,”
passed the council with an 82 percent
majority. The second resolution opposes
the militarization of public health and the
diversion of public health personnel and
resources to battling possible bio-
terrorism attacks at a time when we do
not have the resources to deal with actual
health crises in our communities. This
resolution had nearly unanimous support,
passing with 95 percent in favor.
These resolutions are now official
APHA positions. They reinforce our
definition of public health as social
justice and our commitment to human
(continued on page 6)
OPHA Mission
• Protect and promote the
health of all Oregon residents
• Educate and support public
health workers
• Advocate for just and
equitable health policies
System in disarray demands
government leadership
A new report by the Institute of Medicine on The Future of the
Public's Health in the 21st Century finds too many chiefs and
too little money fragmenting the U.S. public health system
A collaborative approach is necessary
to revitalize the nation’s languishing
public-health system, according to a new
report on the nation’s public-health
system by the Institute of Medicine
(IOM). Government action must involve
the community, the delivery system,
employers, the media and academia. But
government must provide the backbone.
We don’t expect you to do it all – you
can’t, the IOM committee is telling the
government; but we do want you to think
about it and lead us toward a health
system that works. Essential public
health services must monitor, diagnose,
educate, mobilize, plan and support,
enforce, coordinate, assure a competent
workforce, evaluate, and conduct re-
search. The committee follows an earlier
landmark IOM report that defined public
health as “What society does collectively
to assure the conditions for people to be
healthy.” The earlier report emphasized
government activities, while this report
emphasizes the critical roles of other
sectors of society.
Here is the central problem (p. 26):
“In 1988, the IOM found that the
governmental component of the nation’s
public health system was in disarray. The
Committee is seriously concerned that
despite subsequent efforts for im-
provement, government public health
agencies, the backbone of any public
December 2002
health system, still suffer from grave
underfunding, political neglect, and
continued exclusion from the very
forums in which their expertise and
leadership are most needed to assure an
effective public health system. The
governmental public health infra-
structure is built on a legal foundation
replete with obsolete and inconsistent
laws and regulations, and a great deal of
public health law is not coordinated
among states and territories. This state
of affairs sometimes complicates, rather
than facilitates, governmental contribu-
tions to the public health system. Similar
fragmentation and lack of coordination
is evident in the fact that responsibility
for health issues is dispersed across
several departments in the federal
government and across federal, state, and
local governments, with potentially dire
consequences for the public’s health.”
The top priority under these circum-
stances is communication. Government
must educate and coordinate the active
elements of the public health system, and
ensure communities are commited and
equipped to implement public-health
strategies.
Reposition Policy Perspective
The IOM committee believes too much
attention in public health is being devoted
(continued on page 2)
2 The Probe

Get web reports, performance standards, models

T he Institute of Medicine has published a number of
significant reports in the last two months. The Future of
the Public's Health in the 21st Century (Nov 11) was preceded
by a companion report titled, Who Will Keep the Public Healthy:
Educating Public Health Professionals for the 21st Century
(Nov 4). Before this, Leadership by Example: Coordinating
Government Roles in Improving Health Care Quality (Oct 30).
Most current, a great deal of enthusiasm is being generated by,
Fostering Rapid Advances in Health Care: Learning from
System Demonstrations (Nov 19).
Read and order these reports at www.iom.edu. Additional online
resources identified in The Future of the Public's Health in the
21st Century include the following.
• RWJ Foundation "Turning Point" project for model laws:
www.turningpointprogram.org/Pages/phsc_MSPH%20Act3.pdf
• Model State Emergency Health Powers Act (MSEHPA):
www.publichealthlaw.net
• Public Health Law Collaborative:
www.phppo.cdc.gov/PhLawNet
• Performance standards instruments:
www.phppo.cdc.gov/nphpsp
www.astho.org/phiip/performance.html
www.naccho.org/project48.cfm
www.nalboh.org/perfstds/perfstds.htm
Supporting IOM's focus, the Public Health Foundation
provides the following online information resources.
• Tools and resources for improving performance:
www.phf.org/PerformanceTools/NPHPSPtools-EPHS.pdf
• Survey on performance management in state health
agencies:
www.turningpointprogram.org/Pages/pmc_state_survey.pdf
• Council on Linkages, academia and practice general info:
www.phf.org/Link.htm
• Council on Linkages list of core competencies:
www.trainingfinder.org/competencies/list.htm
• Tools for helping to implement core competencies:
www.phf.org/Link/tools.htm#Competencies
• Developing a research and applications agenda:
www.phf.org/Link/vol13n1/devagend-ronbialek.htm

IOM report: Reduce the health risk for the whole population
(from page 1)
to personal health services, primarily as a
result of inadequate insurance coverage
and a stressed delivery system. Targeting
high-risk populations for acute care
weakens the population focus necessary
for public health. The idea of public health
is to shift the risk continuum of the whole
society to a lower level. Even a small risk
affecting everyone can influence overall
health dramatically. The physical environ-
ment, socioeconomic status, racial and
ethnic disparities, social connectedness
and health behaviors are some of the areas
where public health can make a difference.
Regarding the 450,000 salaried public-
health workers in the country, the IOM
committee found a CDC study showing
80 percent lack formal training. The
committee endorsed current efforts to
promote core competencies, including:
• Analysis and assessment
• Policy development, planning
• Communication
• Cultural competency
• Community dimensions of practice
• Basic public health sciences
• Financial planning and management
• Leadership and systems thinking.
The committee discusses perform-
ance standards and the possibility of
establishing a formal process of accred-
itation for public health agencies. This
process involves strengthening the
management capacity of the Department
of Health and Human Services.
The lack of a national strategy and
adequate funding is an undue burden on
the nation's public-health system, but
local management capacity is also
important. The committee suggests
another method for improving local
performance by clustering multiple
categorical grants from the feds into a
block grant to improve the state's
discretion over program spending. The
current funding support for safety-net
clinics, for example, is a great windfall
for a number of critical service centers
in the state, but the committee finds it
essential to coordinate the initiative with
state and local authorities and com-
munity resources. Arms-length social
engineering is a mistake.
Personal care provided by safety-net
clinics is not the business of public
health in the first place, according to this
report's definition. Nevertheless, the
committee heeds the conclusion of an
earlier IOM report called Coverage
Matters (2001), making a "compelling
case that the health of the American
people as a whole is compromised by the
absence of insurance coverage for so
many." Until some lasting solution is
developed, it becomes the responsibility
of public-health authorities to ensure the
continued viability of the safety net. The
committee recommends large-scale
demonstration projects to lead us toward
effective and efficient healthcare finance
and delivery systems.
Read or order a copy of the new IOM
report online at www.iom.edu under
"Recent Publications." The report covers
a broad array of topics and does an
excellent job balancing perspective with
evidence. As a policy document, its
recommendations are worth reviewing.
The 14-person IOM Committee on
Assuring the Health of the Public in the
21st Century, which authored the report,
was co-chaired by Dr. Christine Cassel,
dean of the School of Medicine at OHSU
(Oregon Health and Science University).
December 2002 3

I
OPHA
n 1979, my mother developed What causes health inequities is
what were to be terminal not race or ethnicity or even
complications due to diabetes. genetics. What causes health
As a poor immigrant, her health- inequities is the same thing that
care was spotty at best, and keeps communities barely sur-
consistently we ran into doctors viving in perpetual cycles of
and hospitals that would send poverty, violence and hopeless-
her home prematurely because PRESIDENTIAL PROBE ness. Dare I say it? It’s oppres-
her Medicaid did not reimburse sion, and racism and history that
A stirring call to Be willing,
as much as other patients’ goes unacknowledged or gets
private insurance. I spent the Build relationships, and Believe dismissed. Housing and educa-
better part of the next three years tion, opportunity and hope for
by 2003 OPHA President
in the waiting rooms of various the future give people what it
city hospital emergency rooms, Amalia Alarcon-Gaddie takes to safeguard their health.
helplessly watching her deteri- And until public health gets
orate. Renal and congestive more involved in righting these
heart failure took my mother’s life in when one is ill a part of everyday life in societal wrongs, we will continue to see
1982. She was 64 years old. Cange. Zanmi Lasante not only takes care these inequities take promising, too-
Flash forward to the present. This of the health of the people in this town; it young lives within our most vulnerable
morning, as I was driving to work, I heard also repairs their dwellings, provides communities.
a remarkable thing on the radio. A scholarships for their children’s edu- In a country whose government says
woman named Loune Viaud had been cation, works to improve literacy, and it would do more if it only had resources,
awarded the Robert Kennedy Foundation here comes Ms. Viaud, creating out of
Human Rights Award for founding a
clinic in rural Haiti built on the premise
Every activity we her vision and commitment a socio-
medical complex that has become the
that health care is a fundamental human entire country’s primary referral site for
right. undertake this year drug-resistant tuberculosis. That, my
Imagine that, I thought, health care as friends, is the power of ONE.
a fundamental human right. What would has the goal of What, you may ask, does all this have
Oregon look like if we embraced the to do with the Oregon Public Health
premise that health care was a fundamen-
tal human right? What would my life (and
inspiring the public Association? The OPHA board has
adopted “100 percent access, 0 dispari-
my mother’s) have been like if this ties” as its policy focus for 2002-03. As
country embraced the ideal of health care health community in a result, every activity we undertake this
as a fundamental human right? year has the goal of inspiring the public
Back to Haiti. Loune Viaud’s clinic, Oregon to eliminate health community in Oregon to eliminate
Zanmi Lasante (Partners in Health), is in health inequities and increase access to
Cange – identified as a squatter’s settle-
ment in Haiti’s central plateau. Now, a
health inequities and wellness education and quality health
care for all. Our 2002 annual meeting in
few facts about conditions in Haiti: there October was the kick-off event; our
are 8 doctors per 100,000 inhabitants; 6.1 increase access spring meeting in April will continue the
percent of the adult population is infected focus; and our 2003 annual meeting will
with HIV, which, along with tuberculo- provides safe drinking water. To Viaud, give us an opportunity to check in and
sis, is the number one cause of death removing non-health related socio- celebrate our progress, and brainstorm
among adults; the adult literacy rate is economic stressors is key to securing the solutions for the challenges registered
49 percent; 54 percent of Haitians don’t well being of Zanmi Lasante’s patients. along the way.
have access to clean water; and a third of “We don’t want them to be worried What have we learned so far? It’s very
the population suffers from chronic about their children not going to school, simple really. In order to eliminate health
malnutrition, with over half the popula- to be worried about their children not inequities, we must:
tion identified as undernourished. This having something to eat,” says Viaud. • Be willing to share power, to involve
is a place where people live in abject Now, I’m guessing that some of you community, consumers and front line
poverty. Where they routinely die of reading this are thinking, Well, what does health workers in every facet of program
preventable or treatable disease. fixing houses and offering scholarships development, evaluation, and decision-
What has this clinic done? It has made have to do with public health? It’s pretty making;
being healthy and going to the doctor revolutionary, when you think about it. (continued on page 5)
4 The Probe
Providence Benedictine using sheltered
instruction to train non-English speakers
F ounded in 1955 and incorporated
with Providence Health System in
1998, Providence Benedictine Nursing
Center (PBNC) in Mt. Angel, has provid-
ed nursing-assistant training throughout
its history. With Oregon facing severe
nursing shortages at all levels, PBNC
embarked on a new project last spring to
make its training program accessible to
English-language learners in a separate,
“sheltered” format with additional
bilingual assistance and resource mater-
ials. The third 150-hour sheltered training
session was completed in November.
Mt. Angel and the surrounding
communities have a rapidly increasing
Hispanic population. About one-fourth of
Mt. Angel’s 3,000 population is His-
panic. Those who speak English as a
second language often have difficulty
gaining entry to nursing jobs due to job
requirements, and speaking and writing
of medical terminology. Sheltered
instruction is a way to help students
overcome the language barrier. The first
year of the model program was funded
by the Northwest Health Foundation.
PBNC hopes to hire nearly all of the
graduate nursing assistants at its own
facilities.
Newborns give five little drops of blood
Legislation allows tests for 20 additional conditions for early alert
T he Oregon Department of Human
Resources (DHS) reported in Nov-
ember that newborn babies will be
screened for an additional 20 conditions
that may help to detect potentially fatal
disorders. Oregon has screened newborns
for six body chemistry disorders for the
past 40 years. All it takes is five drops of
the baby's blood.
"Legislation passed in 2001 enabled
the public health laboratory to adopt new
technology so that infants can now be
screened for fatty, amino and organic acid
disorders and congenital adrenal
hyperplasia (CAH)," DHS announced in
Director of the program, Sheryl Evers,
found reading remained a problem, even
though entry-level language skills were
tested. The first class, starting in May,
recruited 14 students, from which 9
finished. Evers changed books, changed
the pace and made other accommoda-
tions to improve reading comprehension,
since the tests – and the state board exam
– must be done in English. The second
class in July recruited 12 students, and 9
finished, showing a little better pass rate.
The third class in November recruited 19
students, and 17 finished, showing an
improved fit.
Evers has not yet heard how the students
have done on their state exams. She is
worried about the time pressure. English-
language learners need more time on a
test in English. The program goal is a 90-
a news release. Prompt medical manage-
ment following positive lab results is
crucial to the program's success. OHSU
is the partner for clinical intervention.
Oregon's public health laboratory
operates the Northwest Regional
Screening Program, serving Oregon,
Idaho, Nevada, Alaska and Hawaii. The
lab tests 230,000 samples per year. To
date, three million newborns have been
screened, with 1,300 identified with a
metabolic disorder.
For more information, check the DHS
website (www.hr.state.or.us/news) or call
503-229-5882.
percent pass rate.
During class sessions, involving half
classroom and half clinical instruction,
students volunteered to mentor those who
Because of the increasing
ethnic and cultural
diversity of Oregon, the
need for sheltered-learning
programs is growing
needed help. Additional assistance was
available from volunteer tutors from
Chemeketa Community College. First
prepared for Spanish speakers, the
sheltered-learning program also attracted
two Russian speakers, one Korean, one
Vietnamese and one South Pacific
islander, for whom no additional tutoring
was available. Evers was amused to find
classmates happily mentoring each other
across language and gender differences.
Because of the increasing ethnic and
cultural diversity of Oregon, the need for
sheltered-learning programs is growing.
PBNC intends to evaluate and dissemi-
nate the model program for other nursing
training sites in Oregon. Experienced
now with the primary population of
Spanish speakers, PBNC may pursue
sheltered training for the sizeable local
community of Russian speakers as well.
Currently the largest employer in Mt.
Angel, offering 275 jobs in the commun-
ity, Providence Benedictine furnishes a
skilled nursing center, assisted living,
adult foster are, and a home-health
agency serving over 1,000 elderly and
disabled persons. Both Providence and
the Benedictine sisters have a long history
of providing health care and educational
services to all who need them. Over half
of those served by PBNC are low-income
Medicaid recipients.
December 2002
Governor Kitzhaber summarizes
Conference on Prescription Drugs:
GLOBALIZE
EVIDENCE
LOCALIZE
DECISIONS
IDEAS
ARE
POWER
Power of one advances all
(from page 3)
• Build key collaborative relationships
across every sector of our community.
Engage communities, consumers, busi-
nesses, schools, private providers, public
health agencies, and more. You never
know where an interesting and effective
partnership can be found; and finally,
• Believe that eliminating disparities
and providing 100 percent access can
happen now.
Be willing, build relationships, and
believe! As Ms. Viaud’s example shows,
it is possible for one person’s passion and
Access Model offers primary
care in failing healthcare system
T he Access Committee of the Oregon
Health Council, a healthcare policy
body appointed by the governor, devel-
oped a model this summer to improve
access to health care for the uninsured to
complement the Oregon Health Plan
(OHP). A similar model was developed
by the Health Care Safety Net Coalition,
a statewide group of healthcare safety-
net providers and others concerned about
the health of low-income Oregonians.
Tri-County Communities Charge, a
project funded by the Robert Wood
Johnson Foundation, focusing on the
uninsured in Clackamas, Multnomah and
Washington counties, designed and
priced another similar model. Together,
these groups shared ideas and infor-
mation to create the “Access Model."
The Access Model offers a reduced
set of benefits at a cost of about $50 per
month, one-fifth of the average cost per
person per month for adults in OHP who
are not aged or disabled. The plan will
not provide catastrophic coverage, and
will therefore not protect individuals
from major medical expenses, but will
allow regular primary and preventive
care, limited prescription drugs and
specialty care, and outpatient mental
health and chemical dependency ser-
vices. Some durable medical equipment
might also be included. Hospital care
commitment to make even the most
seemingly unattainable dream a reality.
I want to take this opportunity to ask
you to join us on this journey. Join the
Oregon Public Health Association,
participate in a section or committee, help
plan and promote, explore our website
(www.oregonpublichealth.org) and see
the results of our annual meeting, get
contact information for our speakers,
access our reading list, inform yourself.
Let this be your New Year’s reso-
lution. Exercise your power of one and
join us to help Oregon embrace health
care as a fundamental human right.
5
would not be covered.
The fiscal crisis in Oregon makes the
case for the Access Model more compel-
ling. Benefits and services are being cut;
workers are being trimmed from good
jobs; insurance coverage is declining
even among the employed; OHP2 is
facing substantial cuts that threaten its
existence. The latest economic forecasts
indicate things are not expected to
improve soon, and the possibility exists
that voters will defeat the January 2003
ballot initiative to temporarily increase
state income taxes and avoid additional
cuts. A greater number of Oregonians are
likely to need financial assistance in order
to obtain needed health care at exactly
the time the revenue to fund that assist-
ance is eroding. Although inadequate, the
Access Model could help moderate the
number of personal bankruptcies, disabil-
ities and deaths due to uninsurance and
lack of access to health care.
Regional pilot programs would be a
reasonable way to test the Access Model
in areas of the state where need is greatest
and the safety net system has the neces-
sary clinical and administrative capacity.
Regional implementation would also
limit the state's funding responsibility
until the economy improves. Federal and
local matching funds could possibly
augment the capacity of the program.
MPH graduates eligible
for residency program
Oregon Health & Science University
offers a one-year practicum for students
with a Master of Public Health degree,
making them eligible for board certifica-
tion in general preventive medicine.
Career information is available at the
American Board of Preventive Medicine
website (www.abprevmed.org).
Residents rotate at selected sites,
including OHSU, state and county
agencies, community clinics, and more.
Applications for Fall 2003 are due by
January 17, 2003. For more information,
check the OHSU website (www.ohsu.edu).
6 The Probe
APHA ANNUAL MEETING
Report by Mitch Haas
Affiliate Representative to the Governing Council (ARGC)
O ver 12,000 members of the public
health community attended the
American Puclic Health Association
Annual Meeting in Philadelphia this
October. This year's theme was “Putting
the Public Back into Public Health.”
Members were able to select from over
900 scientific sessions, programs, poster
sessions, workshops and meetings.
Highlights included speeches by
Governor Howard Dean of Vermont, and
Richard Carmona, M.D., MPH, the 17 th
Surgeon General. Dr. Carmona gave a
moving keynote address about his
perspective of public health, based on his
own experiences growing up in poverty
in New York, serving in the Armed
Forces abroad, and working with com-
munities on the Mexican border. He
demonstrated a clear understanding of
and sympathy for the public health
agenda of APHA. Governor Dean gave
a stirring speech on how Vermont has
been able to insure virtually all children
in the state. Expect to see a socially
active, fiscally responsible democratic
candidate for president in 2004.
OPHA members were quite visible at
the meeting. Our own Jan Wallinder,
R.N., MSN, ran for APHA President-
elect. Although she lost to Virginia Caine,
M.D., of Indianapolis, I am sure that Jan
will continue to make outstanding
contributions to the national association.
Laura Brennan, OPHA immediate past
president, was featured at a town-hall
meeting sponsored by the APHA Task
Force on Universal Health Care. Laura
spoke on Measure 23 and the Oregon
Health Plan, then led a lively debate on
future endeavors to assure universal
access to comprehensive, quality health
care in this country.
The Governing Council held a break-
out session this year to review the
association's strategic priorities and to
select a focus for the coming year. The
three top priorities were access to health
care, ending racial and ethnic disparities,
and public health infrastructure. Action
plans for the implementation of this
year’s APHA policy statements will be
structured to address these three priorities
by the APHA Action Board.
The Governing Council passed 19
policy statements this year. Many of these
are particularly pertinent to state and local
public health efforts. Perhaps the most
important policy statement was entitled,
“Sustaining the Independence and
Effectiveness of Public Health While
Responding to Terrorism.” This resolu-
tion calls for government to ensure the
independence of public health practice,
for the protection of grants to state and
local health departments, and for an
increase in public health infrastructure
beyond programs devoted to terrorism
response. Other resolutions called for
efforts to reduce sodium consumption,
promotion of evidence-based smoking-
cessation interventions for women to
protect unborn children, creation of data
capacity for maternity and child health,
and monitoring of tobacco settlement
funds.
For further information, please visit
the APHA website (http://apha.org).
Join movement to promote peace
(from page 1)
and civil rights. These resolutions must
be publicized and promulgated quickly
in order to support and promote the anti-
war efforts of APHA members and their
colleagues in communities across the
country.
A group is now forming to communi-
cate and work directly with the APHA
Action Board to follow through with our
responsibility as public health leaders to
oppose war on Iraq. Our collective voice
needs to reach everyone in America.
If you support this effort, please join
us. There are e-mails and letters to write.
Phone calls to be made. We need to
publicize the APHA resolutions through
letters to local newspapers, through
forums at universities, and through
State plans for
West Nile virus
O regon is one of only five states
in the continental USA without a
reported case of West Nile Virus, which
has killed 218 persons as well as animals
across the country since arriving in 1999.
Already reported in California and
Washington, the virus is expected to
arrive here by spring or summer 2003,
according to a news release from the
Oregon Department of Human Services.
Mosquitos are the carrier. (Why Noah
let them on the Ark is a mystery.) The
state of Texas developed the so-called
four D's to diminish the risk of exposure:
Dusk to dawn, stay indoors. Dress in long
sleeves and pants. Use mosquito repellant
with DEET. Drain standing water.
activities that mobilize other professional
associations and unions.
To participate in a collective effort,
or to get more information, please feel
free to contact us.
DICK DAVID
(rdavid@uic.edu or 312-633-6686)
JOAN KENNELLY
(jfk3722@aol.com or 312-996-5752)
Submitted by:
DR. B. CECILIA ZAPATA
Office of Multicultural Affairs
Southern Oregon University
1250 Siskiyou Blvd
Ashland, OR 97520
Phone: (541) 552-8163
Fax: (541) 552-6715
December 2002
HEALTH POLICY
HEALTH
Hospital association proposes
ambitious 2003 legislative goals
A mong the lobbyist organizations in
Salem, the Oregon Association of
Hospitals and Health Systems (OAHHS)
is one of the top players. From 1987 to
1997, OAHHS spent an average of
$175,000 in the years the legislature was
in session, making it one of the top five
spenders along with the Western States
Petroleum Association, the Oregon
Medical Association (OMA), the Oregon
Education Association (OEA), and the
Association of Oregon Industries (AOI).
In 2001, OAHHS spent $296,603, well
behind the highest lobbying expenditures
of AOI at $444,591, and the Oregon
Restaurant Association at $424,500; a bit
below the expenditures of Oregon Health
& Science University at $332,709, OEA
at $303,217; and a bit above the expendi-
tures of the Association of Oregon
Counties at $287,436, the League of
Oregon Cities at $259,918, OMA at
$254,847, and Chevron at $246,784.
This gives an idea of the interests
represented each session in Salem.
Healthcare organizations are clearly
among the leaders. OAHHS identifies
the following legislative goals for 2003:
Budget
• Supports the vital stabilizing influence
of the Oregon Health Plan (OHP).
• Opposes any reduction in DRG rates
or outlier payments.
• Supports the practitioner-managed
drug plan from the 2001 session.
• Supports the continuation of the
tobacco tax to fund OHP.
• Opposes "securitization" of Tobacco
Settlement Fund Account. (Since 1999,
investment bankers have been lobbying
states to secure uncertain future tobacco-
settlement money with a bond issue
guaranteeing a set present value, giving
investment lawyers a large profit.
• Supports maximizing federal match-
ing funds via Medicaid, CHIP and OMIP.
• Supports integration of mental health
into current healthcare delivery system.
• Supports expanded insurance cover-
age to keep services for trauma patients,
who are often uninsured.
• Supports revision of medical liability
(tort reform) to arrive at an equitable
solution to the crisis of spiraling costs.
Human Resources
• Supports expansion of educational
capacity for healthcare workforce.
• Supports flexible duties; opposes
restrictions on scope of practice that
limits ability to cross-train staff.
• Opposes mandatory staffing ratios as
a system that fails to promote quality.
• Opposes additional licensing boards
for healthcare professional as an undue
administrative burden; supports consoli-
dation of licensing. (This idea would
apparently support standardization of
network insurers, who require indepen-
dent certification of physicians.)
Patient Safety and Quality
• Supports a no-fault environment for
practitioners to encourage reporting of
Ballot Measure 28 restores services
T he Oregon Center for Public Policy
and the Human Services Coalition of
Oregon have provided information to
support Measure 28, an income-tax
surcharge of .5 percent appearing for
voter approval in a January special
election. The measure temporarily
increases both personal and corporate
income tax rates for three years. The
typical Oregon taxpayer will pay about
$70 additional income tax per year if this
measure is enacted. The measure is
expected to raise $313 million in the
current biennium and another $411
million in 2003-2005.
If Measure 28 passes, basic services
7
errors (see tort reform above); also sup-
ports voluntary data sharing among
hospitals, but opposes mandatory report-
ing as counterproductive.
• Supports stronger protection of peer
review.
• Opposes ambulatory surgical centers
operating without safety requirements
like those imposed on hospitals.
Insurance Reform
• Opposes "body-part" legislation
mandating insurance coverage for
specific conditions.
• Supports evaluation of prompt-pay
requirement for insurers, passed in 2001.
Regulatory Issues
• Opposes administrative fee increases
that do not directly support essential
related services.
• Opposes unfunded mandates burden-
ing hospitals with obligations properly
belonging to the state.
• Supports continued cost-based Medi-
caid financing for rural hospitals.
• Supports continuation of the rural-
practitioner tax credit to encourage
workforce recruitment.
Community Health
• Supports funding of public health
disaster preparedness programs, but
opposes preemption by national agencies
or imposition of inappropriate state
emergency powers.
could be resurrected from this year's cuts:
• $136 million for education,
• $45 million for public safety,
• $88 million for seniors and disabled
citizens, health care assistance, alcohol
and drug treatment, and services for
children and families.
The increases apply to tax years
beginning from January 1, 2002. The
measure restores existing tax rates on
January 1, 2005.
Opponents to the measure, appearing
with arguments in the Voters Pamphlet,
include Don McIntire’s Taxpayer Assoc-
iation of Oregon, Citizens for a Sound
Economy and 17 Republican legislators.
8 The Probe
Coming in March: Public health event lets
Cover the Uninsured Week students explore field

C over the Uninsured Week is

scheduled for March 10-16, 2003.
The event includes a week-long series
of national and local activities designed
to raise public awareness for the millions
of families without health insurance. The
Oregon Health Action Campaign and
other organizations are working in the
Portland area to organize local events
as part of this national effort. Please
spread the word to others who might be
interested in attending or participating.
Cover the Uninsured Week is spon-
sored by two health foundations, the
Robert Wood Johnson Foundation and
the California Endowment, along with
a variety of national organizations.
Before Cover the Uninsured Week
is launched, additional foundations,
national and local sponsors and support-
ers are expected to join the effort.
Organizers of Cover the Uninsured
Week will work to involve national
leaders, including elected officials and
celebrities, whose support will focus the
ship Council, American Medical Asso-
ciation, American Nurses Association,
Health Insurance Association of Amer-
ica, Families USA, Blue Cross and Blue
Shield Association, American Hospital
Association, Federation of American
Hospitals, Catholic Health Association
of the United States, AARP and United
Way of America.
Contact information:
ELLEN PINNEY
Oregon Health Action Campaign
503-581-6830 (Salem office)
503-695-2806 (Portland office)
503-380-3288 (cell)
503-370-7630 (office fax)
BARBARA SMITH WARNER
CTUW Portland Field Organizer
ctuwportland2003@yahoo.com
503-490-4592
ONLINE:
http://coveringtheuninsured.org/
C oming February 28, 2003, about 70
Benson High School students will
participate in a Public Health Exploration
Day, to be held in the State Office
Building in Salem. The event is like a
career fair, and school organizers are
calling on public health professionals to
participate, provide informational staff
and materials, and possibly help with
planning. The session is scheduled from
10 a.m. to 2 p.m.
This exploration day is devoted to
sophomores enrolled in Benson High's
Health Occupations Program. Exploring
options helps them choose major reports,
activities and clinical experiences for
their junior and senior years.
An early response is appreciated. To
participate, or for more information
contact:
JIM PETTYJOHN
DHS Office of Multicultural Health
503-731-4002 x310
(Jim.Pettyjohn@state.or.us)
or GENNY OPLANSKY
Multnomah County Health Dept

Probe
nation on the urgency of this problem. THE 503-988-3674
Former Presidents Gerald Ford and (genevieve.a.oplansky@co.multnomah.or.us)
Jimmy Carter have already agreed to
serve as Honorary Co-chairs of this
unique nonpartisan project.
Give us your news!
TERRY HAMMOND Editor
Organizations already commited to The next issue of The Probe
the event include the U.S.Chamber of LAURA BRENNAN Editorial support appears in March. Send items to:
Commerce, AFL-CIO, the Business SHELLEY BANFE Webmaster TERRY (hammont@mail.pdx.edu)
Roundtable, the Service Employees 503-282-1242 – or to: OPHA
DANA KAYE Communication chair
International Union, Healthcare Leader- 818 SW 3rd Ave #1201, Ptd 97204

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