MINUTES
DUKES COUNTY HEALTH COUNCIL
Thursday, March 23, 2006 Meeting
West Tisbury Public Safety Building
CALL TO ORDER
Chairman Cindy Mitchell called the meeting to order at 7:42am. Chair determined that a quorum was present. Attendees included: Chris Knowles, Dr. James Weiss, Cindy Doyle, Dr. Ilene Klein, Judies Flanders, Jo Ann Murphy, Anna Markwica, Jane Cleare, Linda Swanson, Janet Holladay, Patsy McCornack, Jacque Cage, Hans Von Steiger, Olga Church, Anthony Teixeira, Julia Burgess, Susan Wasserman, Tad Crawford, and Matt Poole. Also present were Sarah Kuh, VHCAP and member ex officio, Mary Leddy, VHCAP, guests Dedie Wieler and Trudy Carty, and Deborah H. Potter, executive assistant to the county manager to record minutes.
NEXT MEETING:
Cindy Mitchell reminded everyone that the next meeting is set for April 27, 2006.
MINUTES:
Chris Knowles moved, seconded by Dr. Weiss to adopt the minutes of February 23, 2006 and SO VOTED unanimously with the following changes:
- Add Susan Wasserman to the members being sworn in
- Change references on page 2 from Nominating Committee to Coordinating Committee
Due to several new attendees, the members introduced themselves.
TREASURER’S REPORT: Cindy Mitchell provided the Treasurer’s report in Terry Appenzellar’s absence and added that the coordinating committee has accepted the report. Ms. Mitchell noted the Coordinating Committee has discussed the fact that the VHCAP is losing grant money on May 1st and the Coordinating Committee is working with VHCAP regarding sustainability. She stated that one idea from the DCHC is that if the balance of $4,000 in the DCHC budget is not needed for the next three months, perhaps some of those funds could be transferred to the VHCAP to help off set the loss of the grant. She stated the amount would be around $2,500 to $3,000.
Susan Wasserman moved, seconded by Olga Church, to approve the recommendation of the Coordinating Committee to transfer all available funds from the DCHC to VHCAP. Matt Poole asked what the $2,500 would cover and Sarah advised that most of it would offset the office manager’s salary pending additional grant revenue. Cindy Mitchell asked for a vote on the motion and it was SO VOTED unanimously. Tad Crawford noted that at last nights Dukes County Commissioners meeting, Mr. Davis mentioned that he and the hospital had worked out a deal to help offset the additional lost revenue from the grant money. Cindy Mitchell added that there has been an effort to increase the involvement of the hospital in the support of the VHCAP.
Cindy Mitchell asked for a motion to adopt the treasurer’s report as presented which was made by Chris Knowles, seconded by ?? and SO VOTED unanimously.
Nominating Report: Chris Knowles advised the DCHC that the coordinating committee met with the Nominating Committee to propose a slate of candidates to serve on the Coordinating Committee. The following individuals are being presented as the nominees for the Coordinating Committee for the next year: Terry Appenzellar, Cathy Brennan, Chris Knowles, Cindy Mitchell, Jane Cleare, Olga Church, and Rhonda Cohen.
Cindy Mitchell explained that the Coordinating Committee meets once a month and prepares agendas, monitors progress, etc. She also asked if there were any nominations from the floor and there were none. Chris Knowles moved to unanimously elect the slate of individuals presented, seconded by Dr. James Weiss, and the motion was SO VOTED unanimously.
Cindy Mitchell noted that at the next meeting, the Coordinating Committee would present a slate of officers for election. She continued that the new member orientation will be done slightly differently this year and noted that they will be conducted as part of the regular DCHC meetings wherein each committee chair will present an update that will include a detailed brief for new members
Cindy Mitchell distributed the work plan used by the council to guide the direction and monitor the progress of the DCHC in various areas for the new members. She stated she will email the new members the summary sheet defining the DCHC goal this week.
HEALTH COUNCIL COMMITTEE/PROGRAM REPORTS AND UPDATES:
Jacque Cage: Jacque Cage reported that various surveys had previously been done and the group decided they wanted their survey to cover the local area.
Their survey was very simple and sent over 200 out to various individuals, such as pharmacists, public safety organizations, physicians, alternative medicine providers, institutions like the MVH and Windemere.
She noted the survey included questions regarding services provided and also asked questions regarding existing available services. Ms. Cage advised that the survey discovered that there were only a handful of groups providing the proper referrals to elders. The committee took this group of reliable information providers and created an informational referral card that could be distributed to seniors and other individuals as needed.
She added that part of the work plan is to distribute the cards until they are out of them and to keep these areas updated especially with regards to adding internet/web resources. Consequently, she stated, these are the “getting the information out” efforts that the group is pursuing. She added that most of the respondents were interested in receiving geriatric education and noted that Judie Flanders now represents the DCHC on the Geriatric Education Center advisory board. Judie Flanders noted that the RI funding was lost and the Cape and Islands group is looking for additional resources enable them to take over those educational responsibilities and services. She stated that when they know more they will be happy to come over to brief the council. Jacque Cage
noted that on the list there were several state groups that were rarely used.
She added that the holes tended to be in the areas of pharmacists, ministers, and public agency groups. She stated the group decided to try to find a common area to get the groups together and decided on an accident prevention campaign to help with this effort. They have engaged the Triad program along with the Councils on Aging to discuss and participate in the efforts that will be the main focus of the group for the upcoming year. Tad Crawford volunteered the County website as a resource for the survey and information distribution.
Dr. Klein on the PLHS: Dr. Klein noted the public forum for the Tick Borne Disease conference sponsored by Dukes County and the MVH will be held on April 29 at 11:00 am at the Katherine Cornell Theater and the night before they will have a special session by invitation for clinicians. She added it will be videotaped and translated into Portuguese with the idea of broadcasting it at a later date.
She also noted that the website is offering a health issue of the month with the idea of getting other members of the community involved in writing the different articles. She added that the website also has the survey feature available and that can now be used to try to get statistical information.
Dr. Klein noted that she and Chuck Cotnoir met with the local BOH agents at their meeting to give a brief of the LPHS and she also gave a brief overview for new members of the DCHC. She noted the LPHS is a survey being used by various communities for several years to evaluate services that are available and then develop and forge partnerships to bridge the gaps.
She added that the survey respects and acknowledges various different methods of providing care including both traditional and non-traditional services with the goal being not to give all the answers but to get an idea of where the community stands on certain issues and where it can improve. She advised that the standards within the survey were set very high and comprehensive and the PHC decided they wanted a broad assortment of individuals to participate in the survey to provide a good cross section of community participants. Suzanne Cashman helped with a train the trainer session and the facilitators seem to be very interested and motivated in participating in the survey.
She reported that the goal is to have the survey done by the end of May. Then, she stated, the report goes to the CDC where our data is evaluated and technical support is provided for free by the Government. She advised that the report comes back over the summer and in the fall it will be presented back to the participants for their information. After that, she noted, the DCHC will also receive the report for evaluation on areas where improvement can be taken.
Cindy Mitchell added, for the benefit of the new members, that the PHC is not a subcommittee of the DCHC but is a County Committee; however, the DCHC is well represented on the committee by DCHC members Dr. Klein, Chris Knowles, Susan Wasserman, and Matt Poole.
Matt Poole added that for the past few months the BOH agents have been meeting once a month, which is unusual for the island, and he suggested that in the future someone from the DCHC could come and give a briefing on the activities of the DCHC to update the BOH agents.
Oral Health Working Group: Sarah Kuh distributed the work plan of the Oral Health Working group plan along with a descriptive summary of the program.
She noted that there have been different groups over the years convened to address different dental needs of island residents. This group was established three years ago despite having a dental center at the hospital to deal with several crisises to the availability of dental services on the island. She added that access the dental care for low-income people is a pervasive problem throughout the county as well as throughout many rural areas. She gave an overview of the previous dental clinic program that eventually was closed; consequently, she stated that part of the current efforts of the group are efforts to get the dental center re-opened and the MVH has agreed to take over that part of the program. She reported that the group has also been working on a reduced fee program plan
where a number of local dentists agree to see some emergency cases as needed at a discounted rate. She also noted the education and prevention aspects of the Tooth Tutoring program that goes into the schools to provide dental information to young students in preschool, kindergarten, and first grade. She reported that a sub committee of the group is the Children’s group is the Children’s Oral Health Promotion committee that focuses primarily on educational aspects but will probably expand into treatment of children in school.
She noted that another piece they are working on is the Watch your Mouth campaign that is part of a National program geared at engaging people of the community to understand that oral health is much more than just getting your teeth cleaned. She also stated that the biggest project the group is working on at the moment is Vineyard Smiles which is a program funded by a grant to Island Health Inc. to look at oral health issues on the island. She advised that the first part covered a planning phase including an evaluation to determine needs of the community especially children. She added that the planning year will lead into an implementation grant to provide some services to a target population, in this case children, with the model being a portable dentistry model that would provide
services at local sites to provide dental services to children on island. She expects that the funding should be forthcoming. Cindy Mitchell noted that it is a significant amount of funds, approximately $400,000 over three years. Sarah stated the letter of intent was approved but now they need to submit a final proposal.
Dr. Klein asked about the sustainability of the program beyond the initial grant period. Sarah Kuh noted that the sustainability comes primarily through the billing to Mass Health for the reimbursement of services provided. She noted that currently none of the island’s dentists accepts Mass Health. She continued by noting the community piece does not have the same sustainability options and that will be a challenge at some point.
Sarah Kuh noted that the portable program will not meet all the demands and she is hoping the MVH clinic can pick up some of the additional need. There was some discussion about the various options regarding the opportunities for various dental services at the hospital.
Primary Care Working Group: Chris Knowles started by reporting on the history of the group to brief new members on what the direction and goals of the group were. He noted that back in 1992 when the Clinton Health reform was being proposed, Patty Blakely worked to get the various health groups to meet to discuss the possibility of forming a single group in response to the proposed changes. After two years, the group dissolved and Chris Knowles brought forth to the County Commissioners the idea of establishing a group similar to the successful Barnstable County Health and Human Services Advisory Council that ultimately led to the creation of the DCHC. He added that one of the work groups that resulted was the Primary Care Working Group who spent a substantial amount of time
determining what an acceptable definition of primary care was. He added that the next item was how to put together a continuum of providers and care that would eliminate trust and turf issues to maximize the benefit to consumers. He noted the first step they decided to take was to apply for a RHNDP grant that helps the groups plan and explore options together for providing rural health services before applying for the full grant to implement the actual plan. He noted this grant for $85,000 was for one year.
Dr. Klein then reported that everyone is working well together and everyone is advocating what they think is important for the community. She advised the new members that several of the organizations participating in the group included the MVH, MVCS, Hospice, Island Health Inc, the Wampanoag Tribe, FIH, as well as a few others. She noted that in this interest of the community, the group and the consultants have been moving the process forward. She stated that one of the primary goals was to come to a consensus for the goals of the network and they are at the point now where they are determining the shared values of the group that are important in building an integrated health care system.
Tad Crawford asked if the group would be in a position by July to continue the process by submitting for a full grant. Dr. Klein noted that the group is still working on it and she hopes that by July the group will determine if they are mature enough and ready to apply for the three year grant. Matt Poole asked how would the consumer benefit from this group. Dr. Klein noted that is an issue the group is working on. Cindy Doyle asked about the grant funds. Dr. Klein noted that most of the current grant was for the consultants.
Lighthouse Alliance: Cindy Mitchell noted that the DCHC has participated in this program since 2000. She noted it is a community action program grant and one of 23 originally awarded nationally. She stated the Cape, Vineyard, and Nantucket joined together to obtain the grant and each region came with a prime concern. She noted the Vineyard’s prime concern was the need for an affordable health care system. She stated that another goal was outreach and advocacy with the heart of the grant being to improve access for the uninsured. One result of the grant, she advised, was the Island Health Inc. and it also helped provide funding for VHCAP as well as a few other programs. She stated that the funding has now expired but the program continues. She
added the group is trying to figure out what its new purpose could be and how to go forward especially in the area of promoting regional collaboration. She also added that the group would continue meeting every other month and discuss a relevant access issue to include representatives from each region working in these access issue areas.
VHCAP: Sustainability Issues:
Cindy Mitchell asked to record in the minutes that in terms of the gap that needs to be filled in the VHCAP is not just the amount from the County, which has been generous in trying to replace some of the income, but VHCAP needs at least an additional $40,000 per year need to fund the program. Tad Crawford also noted that the county put forth additional funding to VHCAP before funding COLA’s for their employees and despite being under great scrutiny. Sarah Kuh added that during the contingency planning meetings the $40,000 loss would require a cut of 150 staff hours that would reduce program hours and increase delays for services provided. She said she was pleased to see some things moving forward with the hospital because she felt it was a good fit.
Adjournment:
With a motion to adjourn the meeting made by Chris Knowles, Cindy Mitchell adjourned the meeting at 9:35 a.m.
Respectfully submitted,
Deborah Holtzer Potter
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