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83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session
SENATE AMENDMENTS TO
SENATE BILL 529
By COMMITTEE ON HEALTH CARE
March 31
On page 1 of the printed bill, delete lines 5 through 26 and delete pages 2 through 4 and insert:
“SECTION 1. ORS 414.667 is amended to read:
“414.667. As used in ORS [414.667, 414.668 and 414.669,] 414.665 to 414.669:
“(1) ‘Community-based organization’ means a community-based organization that pro-
vides health care services through traditional health workers or community health regis-
terednurses.
“(2) ‘Community health registered nurse’ means a registered nurse licensed under ORS
678.010 to 678.410 who engages in the practice of nursing, as that term is defined in ORS
678.010, to provide patient care outside of a health care facility and in a setting that combines
primary care and public health.
“(3) ‘Doula’ means an individual who meets criteria for a doula adopted by the Oregon Health
Authority in accordance with ORS 414.665.
“(4) ‘Traditional health worker’ includes any of the following:
“(a) A community health worker.
“(b) A personal health navigator.
“(c) A peer wellness specialist.
“(d) A peer support specialist.
“(e) A doula.
“(f) A tribal traditional health worker.
“SECTION 2. ORS 414.665 is amended to read:
“414.665. [(1) As used in this section, ‘traditional health worker’ includes any of the following:]
“[(a) A community health worker.]
“[(b) A personal health navigator.]
“[(c) A peer wellness specialist.]
“[(d) A peer support specialist.]
“[(e) A doula.]
“[(f) A tribal traditional health worker.]
“[(2)] (1) In consultation with the Traditional Health Workers Commission established under
ORS 413.600, the Oregon Health Authority, for purposes related to the regulation of traditional
health workers, shall adopt by rule:
“(a) The qualification criteria, including education and training requirements, for the traditional
health workers utilized by coordinated care organizations;
“(b) Appropriate professional designations for supervisors of the traditional health workers; and
“[(c) Processes by which other occupational classifications may be approved to supervise the tra-
ditional health workers.]
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“(c) Requirements for the supervision of traditional health workers.
“(2) The requirements for the supervision of traditional health workers under this sec-
tionmust:
“(a) Create processes to allow other occupational classifications to be approved by the
authority to supervise traditional health workers;
“(b) Allow individuals who are not licensed but who have sufficient professional experi-
ence, as determined by the authority, to supervise traditional health workers; and
“(c) Establish a level and frequency of supervision of traditional health workers that will
allow for group supervision and remote supervision.
“(3) The criteria and requirements established under [subsection (2) of] this section:
“(a) Must be broad enough to encompass the potential unique needs of any coordinated care
organization;
“(b) Must meet requirements of the Centers for Medicare and Medicaid Services to qualify for
federal financial participation; and
“(c) May not require certification by the Home Care Commission.
“SECTION 3. Sections 4 and 5 of this 2025 Act are added to and made a part of ORS
414.665 to 414.669.
“SECTION 4.(1) The Oregon Health Authority shall adopt rules related to the regulation
of community health registered nurses. The rules adopted under this section must include
qualification criteria, including training and education requirements, for community health
registered nurses utilized by coordinated care organizations.
“(2) The criteria and requirements established under subsection (1) of this section:
“(a) Must be broad enough to encompass the potential unique needs of any coordinated
careorganization;
“(b) Must meet requirements of the Centers for Medicare and Medicaid Services to
qualify for federal financial participation; and
“(c) May not require supervision of community health registered nurses.
“SECTION 5. The Oregon Health Authority shall contract directly with community health
registered nurses and community-based organizations to provide services to medical assist-
ancerecipients.
“SECTION 6. ORS 414.668 is amended to read:
“414.668. (1) A coordinated care organization may provide reimbursement on a fee-for-
service basis or using alternative payment methodologies to:
“(a) Traditional health workers;
“(b) Community health registered nurses; and
“(c) Community-based organizations.
“(2) A coordinated care organization shall provide information to community health reg-
istered nurses and community-based organizations about the process for requesting to con-
tract with the coordinated care organization as an in-network provider. A coordinated care
organization shall approve or deny a request to contract submitted by a community health
registered nurse or community-based organization within 90 days.
“(3) A coordinated care organization shall make information about how to access [doula] ser-
vices from traditional health workers and community health registered nurses available on a
website operated by or on behalf of the coordinated care organization and shall provide the infor-
mation in print whenever a printed explanation of benefits is available.
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“SECTION 7. ORS 414.669 is amended to read:
“414.669. (1) The Oregon Health Authority shall establish comprehensive billing codes to
include reimbursement for the costs of a wide range of preventive and social support services
provided by traditional health workers and community health registered nurses to medical
assistance recipients. To be eligible for reimbursement, services provided by a traditional
health worker or community health registered nurse must be medically necessary and med-
ically appropriate, as determined by the authority.
“(2) [The Oregon Health authority, in coordination with the Traditional Health Workers Commis-
sion, shall in each even-numbered year review, and revise if necessary, any rates of reimbursement for
doulas.] In each even-numbered year the authority shall:
“(a) In coordination with the Traditional Health Workers Commission, review and revise
if necessary any rates of reimbursement for traditional health workers.
“(b) Review and revise if necessary any rates of reimbursement for community health
registerednurses.
“(3) When reviewing and revising rates of reimbursement under this section, the authority
shall consider factors including retention of [doulas] traditional health workers and community
health registered nurses, administrative costs to support traditional health workers and
community health registered nurses , access to culturally specific [doulas] traditional health
workers and community health registered nurses and evidence-based factors and empirical
studies related to the cost-effectiveness of services provided by [doulas] traditional health workers
and community health registered nurses.
“(4) The authority may not require a medical diagnosis as a condition of reimbursing the
cost of a service provided by a traditional health worker or a community health registered
nurse to a medical assistance recipient when the service is provided outside of a health care
facility.
“SECTION 8. Sections 4 and 5 of this 2025 Act and the amendments to ORS 414.665,
414.667, 414.668 and 414.669 by sections 1, 2, 6 and 7 of this 2025 Act become operative on
January 1, 2026.
“SECTION 9.The Oregon Health Authority may take any action before the operative date
specified in section 8 of this 2025 Act that is necessary to enable the authority to exercise,
on and after the operative date specified in section 8 of this 2025 Act, all of the duties,
functions and powers conferred on the authority by sections 4 and 5 of this 2025 Act and the
amendments to ORS 414.665, 414.667, 414.668 and 414.669 by sections 1, 2, 6 and 7 of this 2025
Act.
“SECTION 10. The amendments to ORS 414.668 by section 6 of this 2025 Act apply to new,
amended or renewed contracts between a coordinated care organization and the Oregon
Health Authority that take effect on or after the operative date specified in section 8 of this
2025 Act.
“SECTION 11.This 2025 Act being necessary for the immediate preservation of the public
peace, health and safety, an emergency is declared to exist, and this 2025 Act takes effect
on its passage.”.
SA to SB 529 Page 3