DUKES COUNTY HEALTH COUNCIL
Thursday, April 27, 2006 Meeting Minutes
West Tisbury Public Safety Building
CALL TO ORDER
Chairman Cindy Mitchell called the meeting to order at 7:40am. Chair determined that a quorum was present. Attendees included: Hans von Steiger, Tony Teixeira, Terry Appenzellar, Olga Church, Rhonda Cohen, Dr. S. Patrick Donegan, Janet Holladay, Jacque Cage, Michele Lazerow, Patsy McCornack, Dr. James Weiss, Matt Poole, Tom Bennett, Susan Wasserman, Nancy Gilfoy, and Valci Carvalho. Also present were E. Winn Davis, County Manager and Sarah Kuh, VHCAP as members ex officio, guest Dedie Wieler, 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 May 25, 2006.
MINUTES:
Susan Wasserman moved, seconded by Dr. Weiss to accept the minutes of the March 23, 2006 and SO VOTED unanimously with the following name changes:
- Patty Blakley to Patty Bagley (on page
- Anthony Teixeira to Tony Teixeira
- Hans Von Steiger to Hans von Steiger.
TREASURER’S REPORT: Terry Appenzellar distributed the April 2006 treasurer’s report. Terry Appenzellar noted the transfer of funds to the VHCAP as previously approved is complete leaving a balance of $1,108.07. She noted the $600 left in the forum account was based on Tad Crawford’s estimate of report fees plus a small amount in case of an error. She continued by noting that the backside of the report details the budget vs. actual expenses and shows the actual transfers made. Olga Church moved to accept the Treasurer’s Report, seconded by Dr. Weiss, and SO VOTED unanimously.
COORDINATING COMMITTEE:
Cindy Mitchell started with the nomination of officers and noted that Chris Knowles originally offered to be chairman. Cindy Mitchell noted that during his conversation with the committee, he stated his approach would be to operate the DCHC in a manner that would take a step down approach or less aggressive approach with the Coordinating Committee and its role. Mr. Knowles advised that his position was not relating to facilitating the work between the Coordinating Committee and the Health Council, but that he objected to the Coordinating Committee adopting an independent agenda of its own other than that of the whole DCHC, the setting of policy other than in consultation with the DCHC as a whole, and conducting advocacy activities not voted upon by the DCHC as a whole.) Ms. Mitchell reported that the Coordinating Committee decided that was not the kind of leadership that was needed and after some discussion, he withdrew his candidacy for chairman and offered to be vice chair.
Ultimately, Ms. Mitchell advised that the slate of candidates being presented for election are:
Chair: Cindy Mitchell
Vice Chair Chris Knowles
Treasurer Terry Appenzellar
Secretary Cathy Brennan
With no disagreement or nominations from the floor, Tom Bennett moved to accept the slate of candidates as presented, seconded by Susan Wasserman, and SO VOTED unanimously.
Multi-Cultural Health Care Task Force: Sarah Kuh reported they are sponsoring an event to celebrate the launch of the Island translation service, which focuses on helping improve access to medical care for people with limited English proficiency, on May 9th from 4 pm to 6 pm at the Mansion House. She noted this is in honor not only of the start of the service but to acknowledge the efforts of the many people who helped in the development of the program. She added that five years ago people with limited English were struggling to get accurate information because there were no translation services available or the services available were very limited.
She added that the original committee formed several years ago really didn’t go anywhere but in 2004 they applied to BC/BS for a planning grant to assess the state of the Brazilian community. One of the results of the grant, she continued, was the determination that a major barrier to health care was the language issue and this was an area they thought they could address through an interpreter program. With this information, she noted, they went back to BC/BS to get funding for the new program.
Ms. Kuh added they used the services of Cultural Smart, a consulting firm specializing in the development of interpreter programs, and eventually hired Miriyam Gerson to coordinate the program. Dedie Wieler noted that the hospital staff has wanted to have professional interpreters and the idea of having a service available 24/7 is great.
Sarah Kuh noted that the first class was sponsored by Lighthouse Health Alliance and the students went to Hyannis every Saturday for training. Cindy Mitchell added that the group is now having the classes here on the island and by the time the students are done they will have 48 hours of training. Valci Carvalho noted that he is attending the training and the Brazilian community is very excited with the idea. He added that some of the translators are very young and it is a big responsibility. He also suggested increasing awareness of the program because many members of the Brazilian community are still unaware of the program and are afraid to go to the hospital because of their lack of language skills. His feedback from users is that the service helps them feel comfortable
with going to the hospital and the more comfortable individuals are with the service the more they will use the hospital. Patsy McCornack asked how many translators are trained and available and Cindy Mitchell noted that there were 11 available translators currently active to cover two shifts a day. She added they are training more people to cover additional shifts especially during the day. The question was asked if the service was available to non-hospital providers and Cindy Mitchell noted that they were in negotiation with MVCS to cover this aspect of the service. She added that the current fee is 30 per hour with a minimum of 2 hours for smaller providers which is not cost effective for them. She noted that they are working on developing other means to provide this service more economically to the small service providers. Valci Carvalho offered to provide identification cards for interpreters in the program.
County Budget update: Winn Davis noted that the FY07 budget has been approved. Unfortunately, he added, right before the public hearing, the TTOR changed the revenue projection that resulted in a loss of $16,000. He stated that the final budget required a few cuts to bring the budget back into balance. He reported that the department with the largest cut was Emergency Management, then his office, and then $1,200 from the DCHC that was for a group that was no longer in existence. He noted that there was also a $250 cut in VHCAP and identified other departments that received cuts as well. He stated that due to two unfortunate deaths of participants in the County retirement system the cuts were not deeper. He added that as money comes available in FY07, as he
expects it will, he plans to re-fund the areas that were cut. Mr. Davis also reminded the group that they do still have the pledge for $20,000 from the MVH. Cindy Mitchell asked Mr. Davis if he could come to a coordinating committee meeting so that they could go over the VHCAP budget to make sure that everyone is up to speed on exactly what the department’s budget is.
Coordinating Committee Report: Cindy Mitchell noted the group discussed that the committees are trying to address the new member orientation through the regular meetings instead of through a separate meeting. She stated the idea is that at the May meeting, once the regular meeting is over, the new members will stay for an extra ½ hour to cover any other details that they may need.
Cindy Mitchell advised that the Coordinating Committee functions as a facilitating group not as an executive group. She noted they work the various chairs to see that the tasks are on track as expected in accordance with the work plan. She added they have also taken on a few extra goals in support of the DCHC. Some of these addition goals, she pointed out, included working on the sustainability of the VHCAP as well as supporting and facilitating the development of public health programs. She reported that there seems to be a lot of interest and leadership and the goals seem to be bearing fruit. This committee meets once a month, she noted, to accomplish these goals.
HEALTH COUNCIL COMMITTEE/PROGRAM REPORTS AND UPDATES:
Chronic Illness Redux: Patsy McCornack advised that they had a meeting in an attempt to reorganize. She is responsible for trying to get the group incorporated and get a 501c status. She stated they will not be seeking any major grants but will be looking for some small seed money to get going. She noted that the group is an offshoot of the DCHC and was established to try to be a service to help provide referral services to people with chronic illnesses. She noted the biggest stumbling block has always been money. She stated that after completing much of the preliminary work, they discovered that they really need insurance and in order to get insurance they need to be 501C. She noted that the group did find one insurance agent to cover them but they still
don’t have money to pay the premium that at the last time checked it was about $1,000. She stated she would love to have money from the DCHC to help support the effort but they realize that funding might not be available.
Mental Health: Tom Bennett noted that last year they had the benefit of the UMASS students and they were asked to do an assessment of the community for mental health and substance abuse as part of their time here. He noted that one of the results of their survey was the idea of improving the assessment of mental health and substance abuse problems. Therefore, he noted, the committee followed up with the idea of developing some tools of use to the community and to start, they had Tim Warren from the Cape come over to provide some information. As a result, he added, they are trying to develop a depression assessment tool as a means to evaluate individuals. Cindy Mitchell noted it was a simple tool used at admission that appears to be reliable in determining
depression and is being used by a variety of health organizations.
Cindy Mitchell noted that 50% of the patients who took the survey were registering some form of depression. She added that one consideration was that we don’t want to distribute the survey for depression without having the system in place to deal with the results. Tom Bennett noted that his staff also found the alcohol assessment tool to be quite helpful. Olga Church advised that the audit was developed through the WHO but the tool may need to be refined for a particular population. She added it was specifically designed for alcoholism but could be used to address other addictions.
Tom Bennett also noted that there is a conference coming up for a variety of issues including substance abuse, mental health, domestic violence, etc. on October 27 and 28.
He also updated the council on the emergency services program. He noted they had a meeting with Gloria Mazza, the regional director, and as a result of that meeting they asked MVCS to draw up a model that they think would work for the island. He noted that MVCS has developed the new plan and another meeting is in the works. Cindy Mitchell asked if this was a different model than the firehouse model and Tom Bennett replied yes because the State thought that was to big of a plan. Susan Wasserman noted that the firehouse model requires staffing 24/7 coverage and during the attempts to craft a new plan they are discovering that they are having problems staffing the program and finding the funds to adequately pay the staff.
Sarah Kuh asked in the non-firehouse model if someone needs service off hours is it available. Tom Bennett noted that an answering service would be available. Susan Wasserman noted that they are attempting to make sure that services are available but they are trying to figure out the best way to provide them. Additionally, she noted,
MVCS does their best to adequately train everyone but there are some people that are better suited for the service than others. Tom Bennett noted that it also means that the senior staff gets pulled in regularly to help as needed.
MVH Community Benefits: Cindy Mitchell advised on the Community Benefit funding associated with the MVH DoN regarding the new MVH. Chris Knowles is now predicting that within the next two weeks the RFP will go out. She stated it will be a tight turnaround due back within 30 days. She noted that the proposal can come back from anywhere from a one to a five years. Sarah Kuh asked how was it going to be distributing the RFP. Cindy Mitchell stated that Chris Knowles is exploring all options to get the widest dissemination including using the County’s website. Following on the heels of that, she noted, will be an RFP for emerging needs. Furthermore, she added, another feature of things is that the clock starting running on the money on Jan 19, 2006 so any
proposal can seek to recapture spending back to that date. Dedie Wieler noted that the reason why the MVH has been slow on this is because it is inter-related to a variety of other factors including the DoN, MVC, fund raising, etc.
Terry Appenzellar noted that Chris Knowles wanted to make sure that everyone was looking for it soon. Sarah Kuh asked if any terms of community input or oversight/involvement were being provided for. Cindy Mitchell noted those questions are best directed to Tim Walsh or Chris Knowles and she added she is planning on making this an agenda item at the next meeting.
Updates:
Lyme Disease: Winn Davis reminded the DCHC of the Public Lyme Disease Forum being conducted on Saturday. Valci Carvalho noted that his son would be available for translation if needed.
Mass Health Access: Cindy Mitchell deferred this item due to the loss of a quorum but there was a short discussion on the topic. Patsy McCornack asked if the Island Health plan was incorporated into this and Cindy Mitchell advised not specifically but that four options are going to be available.
Cindy Mitchell noted that Island Health Plan needs to be modified to fit the state plan and they are just waiting for the details to come out such as how much will it cost, what is affordable, etc. Sarah reported that she is excited about restoring some of the MASS Health benefits that would be extremely beneficial to many of the island residents and that the increase to 300% for children will help cover a whole new group. Cindy Mitchell noted she would add this to the agenda for the next meeting.
ADJOURNMENT
Cindy Mitchell adjourned the meeting at 9:05 a.m.
Respectfully submitted,
Deborah Holtzer Potter
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