DUKES COUNTY HEALTH COUNCIL MINUTES
Thursday, February 23, 2006 Meeting
West Tisbury Public Safety Building
CALL TO ORDER
Chairman Cindy Mitchell called the meeting to order at 7:50am. Chair determined that a quorum was present. Attendees included: Antonio Teixeira, Terry Appenzellar, Judie Flanders, Dr. James Weiss, Olga Church, Patsy McCornack, Dr. Ilene Klein, Ron MacLaren, Tad Crawford, Matt Poole, Jacque Cage, Susan Wasserman, Tom Bennett, Chris Knowles, Cathy Brennan, Jo Ann Murphy, Janet Holladay, Ardell Otten, Linda Swanson, Anna Markwica, Cindy Doyle, Bob Tonti, Nancy Gilfoy, Dr. S. Patrick Donegan, Valci Carvalho, Susan Wasserman and Nelson Smith. Also present were, Sarah Kuh, VHCAP and member ex officio, E. Winn Davis, Dukes County Manager and member ex-officio, and Deborah H. Potter, executive assistant to the county manager to record minutes. Due to several new attendees, the committee
introduced themselves to each other.
SWEARING IN: Mr. Sollitto swore in the following members of the DCHC: Terry Appenzellar, Valci Carvalho, Dr. S. Patrick Donegan, Anna Markwica, Jo Ann Murphy, Ardell Otten, Linda Swanson, Chris Knowles, Dr. Ilene Klein, and Matt Poole.
NOMINATING COMMITTEE: Cathy Brennan noted that the dilemma of the last meeting was to accommodate a student and a consumer so Olga Church was asked to switch from consumer to practioner to accommodate both positions. Also Ron MacLaren is the new Director of Tribal Health Care services and will be assuming the role of Donald Malonson.
New member Valci Carvalho noted that he arrived here 4 years ago and has been a pastor for 14 years. His ministry has churches throughout the world and he came here originally to help the previous pastor who eventually had to return to Brazil. Although there was no church here, Mr. Carvalho decided to stay here to organize a new church chapter to accommodate the needs of the community. He noted that his goal is to have the church work towards helping not just the Brazilian community but the whole Island community as well. He is grateful for the opportunity to help make a difference and is eager to find ways to work with the Council. He loves Martha's Vineyard and is very happy to be here.
New member Ardell Otten advised that she has been a resident for about 9 years and became a full time resident about 2 ½ years ago. She stated her background includes being an administrator in the Los Angels health care department and as an executive in the health research field. She is happy to get involved in Health Care in the community she is now living in and is looking forward to working with the Council.
Anna Markwica said she is a junior at the high school and is 17. She wants to learn about the council and help wherever she can. Janet Holladay noted that she had been a user of the systems for years due to a variety of illnesses but was now interested in other aspects of health care. Ron MacLaren stated he was in the Health Care industry for 20 years and is now the new Tribal Director for Health Care. Dr. Weiss noted that he was the Superintendent of the School system but has always been interested in Health Care and is eager to work with the group.
Cathy Brennan reported that the Coordinating Committee is up for re-election again and there is at least one anticipated opening. She added that if any one is interested to let her or Cindy Mitchell know. She also noted that there would be an orientation for new members to discuss the DCHC and the work that is being done to help ascertain what areas they may be interested in. Cindy Mitchell noted that they will take names for the Coordinating Committee up to the day of the election and that the election will be taken next month.
NEXT MEETING:
Cindy Mitchell advised the next meeting is March 23, 2006.
MINUTES:
The motion to accept the minutes of January 26, 2006 was made by Chris Knowles moved to accept the minutes and seconded by Patsy McCornack and the motion was SO VOTED unanimously with Dr. Weiss abstaining.
TREASURER’S REPORT:
Terry Appenzellar provided a copy of the February Treasurer’s report. She reported that all accounts balance to the Dukes County records. She noted that in the footnotes there is a small amount that will need to be covered by another account and that under the Health Council there is a pending warrant submitted to cover the cost of the health forums. Additionally she noted that the Coordinating Committee has recommended the approval of another $450 dollars for the Youth Task Force. She stated that other than that there are no outstanding expenses and the reports are reconciled.
Cindy Doyle moved to accept the Treasurer’s report and seconded by Bob Tonti with the motion being SO VOTED unanimously.
Terry Appenzellar continued with the recommendation to transfer funds. The Youth Task force requires an additional $450 dollars and the treasurer recommends transferring it from the Chronic Illness budget to the Youth Task Force.
Cathy Brennan moved to approve the motion as recommended by Terry Appenzellar and seconded by Olga Church with the motion being SO VOTED unanimously.
SPECIAL REPORTS:
Public Health Update/Local Health Survey: Cindy Mitchell noted that Dr. Klein would be meeting with the Coordinating Committee before giving the council a report. Matt Poole advised that the Train the Trainer session would be conducted on March 18 with those individuals overseeing the 10 sub-groups covering the ten essential public health services. Cindy Mitchell asked him to provide a brief overview of the survey. Matt Poole advised that the survey assesses public health activities occurring in communities in the ten areas of:
- Monitor health status to identify community health problems
- Diagnose and investigate health problems and health hazards in the community
- Inform, educate, and empower people about health issues
- Mobilize community partnerships to identify and solve health problems
- Develop policies and plans that support individual and community health efforts
- Enforce laws and regulations that protect health and ensure safety
- Link people to needed personal health services and assure the provision of health care when otherwise unavailable
- Assure a competent public and personal health care workforce
- Evaluate effectiveness, accessibility, and quality of personal and population based health services.
- Research for new insights and innovative solutions to health problems
He noted that the survey on paper is thick; however, as applied to Martha's Vineyard there are several areas that would require little effort. He stated their goal is to bring in as diverse a group as possible, especially trying to bring in some new people, to the table with the idea that it is a limited commitment. He noted that the goal of the survey is to identify what services are available and what are not available. The info is sent to the CDC to be evaluated and they will return the results of our information for review.
Cindy Mitchell took a moment to express her gratitude for the work of the Nominating Committee, as this year was particularly tough in that there were more applicants than available positions.
Update VHCAP sustainability: Sarah Kuh advised that the VHCAP is a program established in 1999 by the DCHC with the goal of enrolling individuals eligible for Mass Health or Medicaid. Sarah noted she was hired in 1999 as the result of a $20,000 grant and has grown to employ 5 people year round. She added that the VHCAP is now a County program and following the loss of grant money for the VHCAP, the County has agreed to assume a greater financial role in the support of the program.
She noted the program enrolls about 200 people per month and also helps in a variety of situations including enrollment in Mass Health, Children’s Benefits, Healthy Start, disability applications, and other services. She noted that program is tri-lingual with about 1/3 of her clients are limited or non-English speaking members coming from the Portuguese community. Her program also performs follow up services as needed to help ensure people get what they are eligible for. She noted that they also have tried to establish a reduced fee plan program that provides a limited number of primary care services at a reduced cost and eventually they added several other programs such as Vision services, prescription assistance, and others. She noted they are also actively involved with
dental health as this is something needed by many people.
Overall 1/3 of funding comes from the County and their offices are housed in a County building rent-free. The remaining 2/3 of the budget comes from grant funding; however, grants eventually do go away, so sustainability is always an issue. One of her larger grants is from the Rural Health Outreach grant which ends in April and that is approximately 20% of her budget. She noted that they recently received a mini-grant to address sustainability issues and some of the recommendations of the consultant included breaking down what services are provided to identify what they do that is unique and what may be a duplication of efforts. Sarah Kuh advised that the consultant is preparing a report that will be shared with the DCHC when it is done. Ms. Kuh also noted that she
would be meeting with the treasurer to discuss what options are available when the grant funds run out. Sarah is extremely heartened by the increasing support from the County and noted they had also approached the Hospital under their DoN grant but that has been denied.
Cindy asked E. Winn Davis to provide an update on the county budget status. He advised that the county has managed to honor the VHCAP increase and the budget was actually balanced as of 4:30 pm yesterday. He stated that they are focusing on increasing fees. He noted that he did discuss with Sarah about a voluntary donation from users of $1 to help offset any potential cuts. Everyone is still in favor of keeping the requested VHCAP budget intact. Nelson Smith added that the VHCAP enjoyed broad based support from the commissioners. Mr. Crawford noted he was there for the meeting and he stated that it was quite clear they were in support of the program and would consider implementing the voluntary fee after hearing Sarah was in agreement. Tad recommended that she get
the approval of her board, as that would be helpful.
Cindy Mitchell noted that the enrollment services Sarah’s program provides leads to dramatically increased revenue for the larger providers such as the hospital. She stated that this value could be in the $100,000’s in enhanced revenue; therefore, one idea is that some of the larger entities might be capable of helping to sustain the program with regular funding in lieu of grants as it does provide a service to them as well. Mr. Knowles and Mr. Davis noted they were trying to get a meeting with Mr. Walsh to discuss this possibility. Valci Carvalho noted that many Brazilians use the service and he would like to know how they can help raise money in support of the program. Cathy Brennan asked if Community Services benefits as well and could they be asked to help
contribute? Susan Wasserman noted that MVCS already provides some of those enrollment services themselves and she noted she is not opposed to supporting the program but the answer isn’t as simple as shifting the burden of cost from one group to another. Tad Crawford noted that if there was some awareness of the situation, we could be able to find a cost effective way to address needs without pointing to the larger providers exclusively. Susan Wasserman also reiterated that the hospital DoN is still just a 5-year grant so sustainability would still be an issue. Olga Church asked if there was any support from the pharmacies on the island as they also benefit from the enrollment of the individuals on the plans and Cindy Mitchell explained how they currently participate.
Sarah added that on another note every other outreach program in the State has the support of the hospital they work with except this one. Sarah also asked that for the Network grant, the VHCAP services could be included. Cindy Mitchell noted that the Network planning is another grant process that is being worked on for integrated health service and is composed of eight major organizations including the MVH, the Tribe, MVCS, Island Health Care and Rural Health clinic, the County, the Foundation for Island Health, the Whole Health Alliance, and the Vineyard Physician’s Group. Antonio Teixeira asked if Stop and Shop, a major employer on the island, had made any contributions or funding for various programs and their foundation may be worth looking into for grants.
Report on Health Forum Presentations: Tad Crawford provided a one-page report on the status of the forums. He noted that the DCHC has always wanted to find a means to communicate with the public and the community at large. He added that through the help of several participants, including the League of Women Voters, the Hospital, MVCS, Island Health Inc, The Foundation for Island Health, and other members of the council helped bring these forums to fruition. He stated that the basic notion was to get people together and instead of a typical lecture format, they chose to engage the community in a round table discussion of various health topics moderated by Charlie Silberstein. There were six forums in all including Our Hospital, Primary Care, Mental Health, Health Care
Funding, Public Health, and the National Public Health Policy.
He stated that the idea now is to have the Health Council report and act on this information in a manner that the public could see that their ideas were heard and being acted upon. He noted that for a fee of $50, MVTV will provide a camera crew to record 4 events of that group throughout one year for non-profit organizations. Our intention, he said, is to take advantage of the MVTV service and return to the Hebrew Center community room and have a meeting to discuss the information gained during the forums, to acknowledge the community and tell then that they have been heard, and then identify that this is the work that will be undertaken by certain groups within the council to accomplish these goals. Cindy Mitchell noted that the idea is also to have the DCHC in attendance so that
everyone can participate in the process. Tad Crawford advised that Paddy Moore and Charlie Silberstein have both indicated that they are willing to help. Tad Crawford asked for a motion to support the efforts to promote the televising of a special meeting to discuss the forums. Terry Appenzellar moved to support the televised meeting as recommend by Tad Crawford and seconded by Nelson Smith with the motion being SO VOTED unanimously.
Tad Crawford did ask for a general idea of availability of individuals for an afternoon event and Tuesday seemed to be acceptable day to most of the group. Ardell Otten suggested that it be emphasized that this is not another forum or regular meeting but a discussion of the results and actions of the DCHC in response to the forums. Patsy McCornack suggested inviting the reporters so that they can do a piece on the program.
Other Reports:
Sarah Kuh reported that they are preparing to implement a program called Vineyard Smiles. She stated they were working with the Oral Health Foundation whose interest is in supporting a portable dentistry group designed to meet the needs of children in the underserved area of the community within the school system.
Cindy Doyle noted that the Youth Task force has had two meetings with the Heller school and they have set up 5 working groups to work on the various results of the Youth Survey. She noted the following groups were created: Resource mapping, Parent education and awareness, after school and out of school activities, and mentoring. She noted that if anyone wanted to help to let her know.
Cindy Mitchell read an email from Mr. Robert Sawyer describing the county’s newly formed Prescription Drug Task Force describing the new collaborative effort between the community and the Tribe to possibly provide prescription medications to both at a significant savings and based on the highly successful Penobscot Tribe efforts in Maine.
Tony Teixeira asked about funding for the program. Cindy Mitchell noted there is no funding at this time but if the partnership could be approved some funding, especially federal funding, could be sought.
Adjournment: Chairman Cindy Mitchell adjourned the meeting at 9:25 am.
Respectfully submitted,
Deborah Potter
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