MINUTES OF THE
DUKES COUNTY HEALTH COUNCIL
Regular Meeting of April 25, 2002
I certify, that to the best of my ability to record and recall, these are the Minutes of the Regular Meeting of the Dukes County Health Council held on April 25, 2002.
Meeting began at 8:10 a.m.
Members Present: Cynthia Mitchell, Chairman *Ex
Officio
Jane Cleare Michele Lazerow
Murray Frank Tad Crawford
Jacque Cage Charles Silberstein
Tim Walsh Dennis Hoak
Lorna Andrade Chris Knowles
Cathy Brennan Sarah Isenberg
Patty Begley Kathy Logue
Else Membreno Peter Strock
Sarah Kuh * Marni Lipke
Melinda Loberg Kathleen Fitzgibbon
Fred Rundlet Sandra Lothrop
Kathleen Rose Dan Seklecki Ilene Klein Joyce Steward
William Elbow
Also Present: Marsha Smolev, Nancy Kasen, Art Bingham, Dan Greenberg, Pamela Speir, John McCarthy
Absent:
Jo Ann Murphy Marguerite Bergstrom Carol Borer* Michelliny Faust
Ned Robinson-Lynch Robert Sawyer
Cynthia Mitchell began the meeting by explaining that as she was no longer a Selectmen, there would need to be a vote to allow her to continue as Interim Chairman of the Health Council until a Chair was formally chosen. Tad Crawford Moved that Cynthia Mitchell continue as Interim Chair until a formal chairman was chosen. Peter Strock Seconded the Motion. The Vote to Pass the Motion was Unanimous. Cynthia Mitchell introduced Dan Greenberg from the High School, and John McCarthy from the Chronic Illness Network. The next meeting was scheduled for May 23rd.
Tad Crawford reported on the Draft Audit Report from Chris Rogers of Powers and Sullivan. It was recommended in the Audit Report, that grants be accounted for individually, rather than grouped. He said there was language about communication between the County and Health Council, and balance responsibility, including easy access for those needing records. Murray Frank added that the Auditors commended Tad Crawford’s accuracy and recording.
Tad Crawford reported that the Budget was submitted to the County, including $5000 operating funds and $55,000 for Phase III of the Island Health Plan. In total, with Sarah Kuh’s request for the Access Program, the request was for $167,500. Sarah Kuh said that the startup money for the Access Program had been used, and it was her belief that the as the program was called a County program, the County should fund more of it. Discussion followed about how to help the County Commissioners understand the need for the funding. Tad Crawford suggested meeting individually with Commissioners and perhaps bring the clients of the VHCAP to the County Commissioners’ meeting, as the Veterans did when they sought funding. Sarah Isenberg agreed that “powers that be” didn’t understand Sarah
Kuh’s program, or what happened when clients came in to that office. She suggested education and exposure. Murray Frank added that the decision was unilaterally Carol Borer’s, and not the County Commissioners’. Murray Frank also suggested Health Council members meet with County Advisory Board members as well as County Commissioners.
Fred Rundlet added that he thought the State should pick up more of the funding. Cynthia Mitchell said the Health Council was viewed as being at “the cutting edge” with the State. In fact, the Council was receiving an award from the Commissioner of Medicaid that evening for innovations for access to health insurance. Murray Frank asked for input for his description of the Health Council’s work, to be presented at the Award ceremony. Marni Lipke noted strong leadership. Murray Frank said the Health Council found it intolerable that people didn’t have affordable access to good healthcare, and that kept the Health Council going.
Cynthia Mitchell agreed with the Treasurer’s report, that the County needed to find funds for VHCAP.
Peter Strock asked for a progress report on the Intermunicipal Agreement. Cynthia Mitchell said the towns couldn’t agree on direction, so nothing was happening.
Cynthia Mitchell asked that Coordinating Committee elections be deferred. Peter Strock Moved that the Coordinating Committee elections be deferred. Kathy Logue Seconded the Motion. The Vote to Pass the Motion was Unanimous.
Nancy Kasen presented two decisions that needed to be made. One was philosophical and about partnering with the Neighborhood Health Plan. The other was about moving forward on the 501(c)(3). She described the difference between an “affordable” plan, one in which the targeted population was 200-400% of the poverty level. In this case, physicians would receive 68.5% of Medicare reimbursement. The other case is the “commercial product,” in which there would be no provider subsidy and a higher income. Nancy Kasen reviewed the choices and noted that the consultants recommended the “commercial product” which would be affordable, but would compensate physicians at market rate. To use this plan, subsidies would have to be found. Charlie Silberstein asked where they
would come from. Cynthia Mitchell stated she didn’t know. Tim Walsh said the Hospital would have to negotiate rates for a commercial plan, that the rates the Hospital had considered were for the other, affordable, plan. Discussion followed. Cynthia Mitchell said it was important to realized costs would have to be controlled through other than traditional ways, such as local providers, consumers, State, Federal, Robert Wood Johnson funds, perhaps. Michele Lazerow asked how to provide services with a better cost of care? Cynthia Mitchell replied that if the Plan was successful, the cost of care would go down.
Charlie Silberstein suggested that the Council would miss an opportunity if it didn’t start out with an affordable Plan. Cynthia Mitchell agreed, saying JSI recommended starting there, but targeting low income. Charlie Silberstein was concerned with how mental health providers would be affected. Nancy Kasen said that was still a dilemma.
The complication of “crowd out” was discussed, the idea of an employer changing insurance to get in on a better premium.
Cynthia Mitchell asked for a Motion to accept the recommendation of the consultants and begin with 100% Medicare reimbursement rate to providers and include that it was implicit that a mental health reimbursement package be quickly added as a resource. The target group would be up to 400% income. Jane Cleare made the Motion. Michele Lazerow Seconded the Motion. All but one member voted “aye.” Tim Walsh asked for clarification and noted that there was still a need for providers.
The 501(c)(3) was discussed. Murray Frank explained that it would provide tax exempt status so the group could receive funds. The application opened the door for funds while the application was pending. The Health Council Bylaws were “melded” with other Bylaws to describe an organization created to develop an integrated healthcare system on the Island. There needed to be incorporation first. Terms of the members was mentioned. Originally set at 3 years, it was suggested by Tad Crawford that that would cause confusion, as Health Council appointments were for 2 years. The legalities of the parallel structure, free of County oversight, was being handled by Reynolds, Rappaport Law Firm. Chris Knowles asked if there would continue to be a Health Council that was a
“creature of the County.” It was explained that the Board would be Council Members, but members were free to not be on it. Michele Lazerow Moved to accept the endeavor to create a 501(c)(3). Jane Cleare Seconded the Motion. Marsha Smolev suggested that the Health Council members explain this to the County Commissioners.
Dennis Hoak asked if the Board would then be able to hire employees, doctors, for example. Cynthia Mitchell said if they wanted to. Cathy Brennan was concerned about liability issues of the Board members being Health Council members.
The Vote to continue the endeavor to create the 501(c)(3) Passed. Charles Silberstein abstained.
The meeting adjourned at 10:05 AM.
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