Oregon House health committee hears wide-ranging LC 241 omnibus bill; parent-paid caregiver proposal draws intense scrutiny
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Summary
Committee introduced LC 241 as a committee bill and held an informational hearing on about 20 health-related provisions, from PDN reporting and wheelchair repair prior authorization to dentist-network rules and a disputed proposal to allow parents of children on the CEN waiver to be paid as personal support workers.
The House Interim Committee on Health Care on Jan. 14 introduced three legislative concepts as committee bills and spent the afternoon hearing testimony on LC 241, a broad omnibus health-care measure that staffs and advocates said includes roughly 20 discrete provisions affecting long-term care, Medicaid policy and insurance administration.
Committee members formally moved to introduce LC 188 (dated 12/15/2025), LC 194 (01/08/2026) and LC 241 (01/06/2026) as committee bills; the chair called the roll and the committee adopted the concepts to be introduced as committee bills. The motion and adoption make the concepts eligible for formal amendment and debate during the 2026 legislative session but do not bind members to their final votes on the measures.
Testimony on LC 241 covered multiple sections. Sean Comer of the Hospital Association of Oregon described Section 1 as a targeted fix to unintended implementation challenges from Oregon’s presumptive eligibility and hospital financial assistance policies; he said the section would prioritize staff screening but would not change who is eligible for assistance or Medicaid presumptive eligibility. Catherine Morrison of the Oregon Association for Home Care urged removing Medicare Conditions of Participation (COPs) requirements from private-duty nursing (PDN) providers, arguing COPs impose reporting burdens designed for older Medicare home-health patients and are inappropriate for largely pediatric, Medicaid-funded PDN services.
Advocates for long-term care transparency asked the Oregon Department of Human Services to publish residential care quality measurement data through existing consumer-facing tools, and the Oregon Healthcare Association supported a change to licensing language that would require only a bachelor’s degree in any field for residential-care administrators rather than a field-specific degree, a change proponents said would expand the applicant pool.
On Medicaid policy, the Oregon Health Authority described a statutory change to ORS 411.447 to allow enrollment of eligible justice-involved youth in limited pre-release Medicaid services (screenings, diagnostic services and targeted case management) in alignment with federal guidance; OHA staff said implementation could begin no earlier than Jan. 1, 2027 and that failing to change statute would risk noncompliance with federal law.
Consumer advocates and suppliers backed a proposed $1,500 cap on prior authorizations for wheelchair repair parts to enable quicker repairs for common, low-cost components. The Health Evidence Review Commission and provider stakeholders requested clearer posting dates and public access to materials and comments to improve transparency for coverage guidance affecting Medicaid recipients.
Several insurance and provider stakeholders urged administrative changes elsewhere in LC 241: the measure would direct LPRO to pilot mandate-review templates for insurance coverage mandates; prompt-pay and retroactive-denial protections were proposed to bring dental plans in line with medical prompt-pay practices; and a provision affecting primary-care auto-assignment (from SB 1529) prompted debate, with insurers and some plans citing implementation issues and provider groups warning of lost outreach and preventive-care coordination.
A contested policy debate centered on a provision allowing parents of children on the Children with Extraordinary Needs (CEN) waiver (about 155 children currently) to be employed and paid as personal support workers (PSWs) rather than only as agency-employed direct support professionals (DSPs). Callie Ross, a parent and policy director who supports the change, said it preserves family choice, can reduce costs and offers continuity for medically fragile children who already receive close oversight through higher-intensity case management and training requirements. Opponents, including Matthew Sears of the Oregon Developmental Disabilities Coalition, warned that paying parents changes their role, could remove agency oversight and checks-and-balances that agencies provide (continuous supervision, corrective action, incident response) and may shift incentives over time. Committee members asked detailed questions about oversight, swap mechanisms for extra hours, pandemic-era pilot experience, and the tradeoffs between family-led care and independent third-party oversight.
Stakeholders also sought a technical fix for Pharmacy Services Administrative Organizations (PSAOs) to avoid inadvertently sweeping small, support-focused PSAOs into broader PBM licensing; consumer- and transparency-focused commenters flagged risks if exemptions are too broad. Multiple witnesses urged clearer drafting and further stakeholder engagement.
Throughout the hearing, committee members and vice chairs urged continued negotiation and directed staff and members to flag sections they would not support so cleanup amendments could be prepared before session. The chair closed the LC 241 informational hearing and invited further vice-chair-level conversations on controversial items.
The informational hearing did not produce final votes on individual sections; committee members will decide during session whether to move provisions forward. The committee also noted there will be an opportunity to refine fiscal language and remove or amend items that produce unanticipated fiscal impacts before the bill advances.
Ending: The committee concluded the informational meeting after extensive testimony and directed vice chairs to consult members to identify sections they would oppose, setting the stage for amendment drafting before the regular session.
