MINUTES
DUKES COUNTY HEALTH COUNCIL
January 29, 2004 Meeting
West Tisbury Public Safety Building
CALL TO ORDER
Chairman Tad Crawford called the meeting to order at 7:43 a.m. There was a quorum with the following members attending: Tad Crawford, Cathy Brennan, Jacque Cage, Sarah Kuh, Jane Cleare, Kathy Logue, Paddy Moore, Marni Lipke, Patsy McCornack, Rev. Mary Jane
O’Connor-Ropp, Jo Ann Murphy, Kathleen Rose, Frederick Rundlet, Anson W. Krickl Jr. and Dr. Charles Silberstein. Ex-officio member E. Winn Davis, Dukes County Manager, also was present. Brian S. Kinal, Dukes County Executive Secretary, served as recording secretary and took these minutes.
INTRODUCTIONS
Tad Crawford introduced Brian Kinal, the new recording secretary; and new Council member Anson W. Krickl Jr., the recently appointed Dukes County Associate Commissioner for Affairs Concerning Handicapped Persons.
APPROVAL OF MINUTES
The minutes of the December 19, 2003 meeting were approved unanimously without reading.
CHAIRMAN’S REPORT
Tad Crawford expressed optimism for the Health Council in 2004, referring to the significant progress that would be reported later in the meeting by many of the Council’s committees and working groups. Though we are in the dead of winter, like buds on the bare winter branches, many of the Council’s ideas and initiatives will be blossoming, he said. He also noted a much-improved working relationship between the Council and Dukes County government.
Tad Crawford reminded Council members that, as long as the Council is an all-volunteer organization, its mission is not to fund and run programs, but to identify gaps in health care service, and to initiate and foster programs that can fills those gaps, by turning them over, wherever possible, to existing community health and human service organizations to run them. Instead, he said, the Council’s mission is to improve the integration of health and human services and to promote wellness, not illness, as an approach to public health. He noted that the Vineyard Health Care Access Program is an exception to the Council’s non-funding principle.
Recalling an earlier meeting retreat, Tad said another retreat could be a good idea because Council meetings don’t allow sufficient time for a thorough airing of ideas and opinions. Support was expressed for this suggestion. He also mentioned there would be a new-member orientation in March.
Tad also spoke of the importance of “honoring dissent” within the Council. The Council needs to avoid situations in which only the majority point of view is heard and respected and where the view of the majority is represented as the view of the whole. He cited, as an example, the way he has handled his communication of the Council’s recent “endorsement of the Island Health plan.” He reported that the Island Health Plan is at the critical stage in the state legislative process, with key provisions that will be critical to its implementation. Tad had a telephone conversation with state Rep. Eric Turkington recently, and encouraged Turkington to support those provisions, while communicating very candidly that there are dissenting
points of view within the Council about the plan.
Jane Cleare concurred, saying that best problem solving occurs when opposing ideas are discussed.
TREASURER’S REPORT
Outgoing Treasurer Kathy Logue presented the Treasurer’s report, which showed a bottom-line balance of $54,756.28. That included $39,942.51 for the Access Program and $18,813.77 for the Council’s other programs.
Kathy said personal commitments prevent her from continuing as Treasurer. She said she will continue to be involved for a brief transition period, but said it is important that the Council finds another Treasurer as soon as possible.
The Treasurer said an item of immediate importance is submission of budget requests for fiscal year 2005.
Paddy Moore moved to thank Kathy for her service, and Marni and Tad both seconded the motion. Council members gave Kathy a hearty ovation. Sarah Kuh, in particular, thanked Kathy for helping the Health Care Access Program become self-sufficient in its accounting functions.
DUKES COUNTY MANAGER’S REPORT
County Manager E. Winn Davis said the vacant position of Dukes County Associate Commissioner for Elder Affairs might soon be filled because there is an interested candidate who is currently becoming acquainted with the elder affairs network.
Regarding the county budget for FY-05, Mr. Davis said he has asked department heads to evaluate their budgets programmatically as there are likely to be zero increases over FY-04. The reason, he said, is that next year’s revenue from assessments to the towns will result in a growth of only four-tenths of one percent in the overall budget. And that small increase, he added, will be consumed by mandatory pay increases.
Tad Crawford explained that the County has a very tight deadline of February 15. He requested from Winn Davis that the Council’s submission be viewed as preliminary, until it is approved at the next full Council Meeting at the end of February. Winn concurred.
The County Manager informed members that the next meeting of the Dukes County Commissioners, on Feb. 4, would deal with a Nantucket-based movement for that island to break away from the Steamship Authority. He said the issue is one of “keeping a big family together.”
NOMINATING COMMITTEE REPORT
Cathy Brennan gave the report of the Nominating Committee for new Council members. Cathy explained that the deadline for letters of interest was extended to Feb. 9. The committee will approve a final list of candidates on Feb. 12, present the list to the Dukes County Commissioners on Feb. 25, and present it to the Health Council at its Feb. 26 meeting. Tad Crawford assured Council members that the Nominating Committee’s proposed appointments would be reviewed by the Coordinating Committee and communicated to all Council members beforehand.
MV HEALTH REPORT
Tad made preliminary remarks to a presentation by Charles Silberstein on the Martha’s Vineyard Health Report. Tad said the Council, for the first time, has an opportunity to become genuinely data driven. Charles said the Council would examine salient issues from the Health Report, see what other communities have done to address those health issues, and come up with a “Blueprint for Action.”
He said Volume I of the report is due out in February, and a Volume II will follow in the future.
PRIMARY CARE COMMITTEE
Committee Chair Ilene Klein was called away from the meeting for an emergency. The committee report was presented by co-chair Paddy Moore. Paddy said the committee has produced both a draft definition of “primary care” and a set of principles to emphasize the belief that the consumer is central to all health care. The working group has circulated these documents to all members of the committee and to the council, and is seeking engaged comments and approval from the constituencies that members represent. Tad encouraged the council members to focus on core concepts and principles, and not wordsmithing, in their responses.
HEALTH CARE ACCESS PROGRAM
Program Director Sarah Kuh talked about “Real Benefits” training, which is web-based training for determining eligibility for state health benefits. Sarah said training programs have been conducted off island, and the committee would like to see a training session held on Martha’s Vineyard. It would require about 12 sign-ups and the use of a facility with a sufficient number of computer terminals.
She also told the Council about a community service referral software program that facilitates referrals among agencies, and allows for tracking of referrals.
Council member Jacque Cage said such a system would be beneficial since referrals now are commonly made by simply telling the client to refer him/herself to an agency, and there is no follow-up to determine whether the client did take the referral.
On another matter, Sarah said the Dental Access Project took a step forward on Jan. 28 when a dentist agreed to see five clients. Although the number is small, Sarah said these are five people who will be taken off the Dental Center waiting list and given treatment.
She also said the Dental Center will receive additional staffing (a receptionist), and possibly add a third day to its weekly schedule.
Sarah also reported that the Rotary Club-funded Voucher Program has encountered a high demand. The program provides prescription vouchers to people who have applied for but not yet received benefits under MassHealth. Sarah gave five examples of clients who would have been in desperate straits without the program.
The Referral Satisfaction Survey was very successful, Sarah reported. The survey showed that people who were referred to specialists followed up on those referrals, that they were happy with the care they received, and that they liked the Health Care Access Program. Many of those referred were Brazilians, who have their own cultural expectations of health care.
Finally, Sarah asked whether the Health Council can be involved in political lobbying. She said lobbying is needed to reverse recent cuts in the Children’s Medical Security Plan. The cuts mean that 13,000 children in Massachusetts will be uninsured, she explained. Virtually unanimous support was expressed for that suggestion.
CHRONIC ILLNESS NETWORK
Marni Lipke made the following motion, which was seconded by Jane Cleare: “Pending final acceptance by all responsible boards and committees, the Dukes County Health Council supports the Chronic Illness Advisory Board collaboration with Island Health Inc. -- to implement the goals of the Chronic Illness Network and to help with outreach for primary care access.”
A lengthy discussion ensued.
Fred Rundlet expressed opposition to the motion. He said he had never heard of Island Health Inc. until the previous Monday at a meeting of the Island Health Plan. Fred said he was familiar with the organization called Island Health Plan, not Island Health Inc.
Marni replied that Island Health Inc. is the umbrella organization for Island Health Plan, and that Island Health Inc. will also oversee the Rural Health Clinic.
Tad noted that Island Health Plan is a spin-off of the Health Council, but that since spinning off, it has greatly expanded its role. He did note that a Health Council vote might not be necessary for the Chronic Illness Network to collaborate with Island Health Inc., but that the CIN Advisory Board was exercising “due diligence” by doing asking for a supportive vote, since the CIN Advisory Board is a committee of the Council and was formally appointed by the County Commissioners.
He also argued that the needs identified by CIN have existed for years, and that to date no one else, including the Council, has stepped forward to fund and staff CIN’s recommendations. “It’s good that somebody is willing to do it,” he said.
Patsy McCornack said, “The motion to have the DCHC support the collaboration between the CIN and the RHC for the purpose of primary care outreach was not brought before the council with any agenda other than that stated; there was no hidden agenda and it was not devious in any way. In fact, we felt that had we not brought the motion to the board and gone ahead, we would have been perceived as being devious and not proceeding in a collaborative manner.”
County Manager Davis added his voice to those abstaining, saying he did not know the structure of Island Health Inc.
A vote was taken on an amended motion, which read: “Dukes County Health Council supports the Chronic Illness Advisory Board collaboration with Island Health Inc. – to implement the goals of the Chronic Illness Network and to help with outreach for any primary care access.”
The motion passed, with eight votes in favor and five abstentions. Winn, an ex-officio member, was a sixth abstention.
With insufficient time remaining in the meeting, the balance of the agenda was continued to the next Council meeting.
ADJOURNMENT
The meeting was adjourned at 9:35 a.m.
Respectfully submitted,
Brian S. Kinal
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