MINUTES OF THE
DUKES COUNTY HEALTH COUNCIL
Regular Meeting of May 23, 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 May 23, 2002.
Meeting began at 8:10 a.m.
Members Present: Cynthia Mitchell, Chairman *Ex
Officio
Jane Cleare Michele Lazerow
Tad Crawford Murray Frank
Jacque Cage Charles Silberstein
Carol Borer* Sarah Isenberg
Chris Knowles Kathy Logue
Else Membreno Peter Strock
Sarah Kuh * Marni Lipke
Melinda Loberg Kathleen Fitzgibbon
Fred Rundlet William Elbow
Kathleen Rose Joyce Steward Ilene Klein
Also Present: Marsha Smolev, Nancy Kasen, Art Bingham, Dan Greenberg, Pamela Speir, Carole Cohen,
Absent:
Jo Ann Murphy Marguerite Bergstrom Dennis Hoak
Tim Walsh Michelliny Faust Sandra Lothrop
Ned Robinson-Lynch Robert Sawyer Patty Begley
Cathy Brennan Dan Seklecki Lorna Andrade
The next meeting will be held June 27th. This meeting began with the Treasurer’s Report. Tad Crawford reported that the County Commissioners adopted Grant Policies which will require a deeper level of accounting for every Health Council fund. Mr. Crawford reviewed budget funding requests that were submitted to the County: $167,000 for VHCAP; $55,000 for Island Health Plan; $5,000 operating expenses, noting the vital need for this funding. Several pledges to the Health Council were discussed: up to $100,000 from DMA for an insurance partnership; $25,000 raised by the Foundation for Island Health for rural health scholars; and $20,000 from Merck/Vagelos to be managed by the 501(c)(3).
County Manager, Carol Borer, reviewed the state of the FY 2003, noting that revenues were down and the Town assessments were still only 2 ½%. She said it would be difficult to fund more than salaries and benefits for the VHCAP. Ms. Mitchell asked how the State’s budget affected the County, especially the Sheriff’s Department and Registry of Deeds. Mrs. Borer said the County would provide greater support to the Sheriff’s Department should that budget be cut by the State.
Cynthia Mitchell reported on attending, with Tad Crawford and Sarah Kuh, the County Commissioners’ Meeting of May 22, to request funding. The Chairman explained the proposed State program where 50% of VHCAP’s expenses for Medicaid related activities could be reimbursed. Ms. Mitchell said this would mean the proposed $46,000 County Budget for VHCAP would be doubled to $92,000. She asked the County Manager for an update on this issue. Mrs. Borer said she needed a definite commitment for reimbursement and documentation or a reimbursement process. She added that she couldn’t make any guarantees, and would review the information with the County Treasurer. Murray Frank said that while the process might be new to the County, every school in the State had been doing it for the past 10
years. He added that for the County to act like this was difficult, was inappropriate. The County Manager reiterated that she needed to see the program in writing and have appropriate signatures. She said she couldn’t go to the Department of Revenue, or the County Advisory Board stating that the reimbursement would happen, without documentation. Murray Frank stated that the document, a contract with Carol Borer’s name on it, had already been given to her. Tad Crawford said the Council did not need the County’s appropriation in order to spend grant money. Cynthia Mitchell disagreed, saying it had to be spent from somewhere in order to be reimbursed. Fred Rundlet urged the County and Health Council to work together. Ilene Klein asked if the Council could look at the Budget and see where the money’s being spent. Carol Borer said it was a public process. Kathy Logue asked if the County would commit to where the
reimbursable funds would be spent. Mrs. Borer said it depended on the details of what the reimbursement would be used for. Ms. Logue reiterated that if the money was in the Budget because of the Health Council, then it should be spent b y the Health Council. Mrs. Borer said the documentation would detail that. Kathy Logue asked could the money be generated by the Health Council and spent elsewhere, and Carol Borer replied absolutely not, that the money would go into a reimbursable grant fund.
Kathy Logue Moved to Accept the Treasurer’s Report. Charles Silberstein Seconded the Motion. The Vote to Accept the Treasurer’s Report was Unanimous.
The Chronic Illness Network reported that it was searching for funding. Marni Lipke reported that between $70,000 - $80,000 was needed. A Robert Wood Johnson Grant would be for $35,000 for the first 18 months, but would prefer that the director be full time. The Network is looking for a $40,000 - $50,000 matching grant. Carol Cohen mentioned a grant that would require clergy participation. Marni Lipke was not sure if the Network wanted to move in that direction.
Murray Frank reviewed the reimbursement grant that was discussed earlier. He also mentioned a grant for $8,000 outreach for Elder Services and a Blue Cross/Blue Shield Grant for mental health services for kids ($25,000 planning year, $50,000 years 2 and 3.) Mr. Frank also mentioned a State coverage initiative for $1,000,000, by Robert Wood Johnson Foundation that was being administered in Washington at what was previously the Alpha Center.
Peter Strock discussed the problems with the Dental Clinic, namely the lack of chair time for patients.
Jacque Cage said that the Geriatric subcommittees would report in June.
Charlie Silberstein reported that there will be a Community Grand Rounds on June 20th.
He said the Wellness group is working on the Wellness Matrix as well as tobacco prevention.
Murray Frank reported that UMASS Medical Students were coming, thanks to Ilene Klein’s work.
Fred Rundlet expressed concern about the Emergency Room’s plan to do physicals for NSTAR employees. He said this would take patients from primary care physicians and would mean that the Hospital would be competing with the private sector.
Ilene Klein asked that a group be formed to look at how different programs would affect healthcare – Health Professionals Capacity Committee. Chris Knowles said this would be addressed on November 11, 2002 at 12:30 at a conference in Philadelphia. Murray Frank said he would be presenting the history of the Health Council at the New England Regional Rural Health Conference in October.
Sarah Kuh reported that the Medical interpreting services at the Hospital were terminated. Discussion followed about the importance of the service.
Carole Cohen said the Second Annual Foundation for Health Symposium would be held Sunday August 4th.
Cynthia Mitchell asked the Council to revisit its decision regarding the Island Health Plan and discussed the issues: if significant numbers enrolled who were above the 400% level, it could be costly to the Hospital; there was a problem with 100% reimbursement to physicians when it was proposed to the Neighborhood Health Plan; Peter Strock felt there was dissatisfaction and confusion with the decision.
Nancy Kasen said the discussion with Neighborhood Health Plan focused on the launch, target, and restriction. The rising cost of health care and the budget have affected how NHP was looking at the Health Plan. It would be difficult politically, for NHP to fund the Island Health Plan providers at a higher rate than providers elsewhere. Other options, like restricting the Plan initially to 400% and below. Nancy Kasen warned that if the door was opened to everyone but the target was 400% and below, enrollment couldn’t be controlled. Legally, enrollment could not be capped and that would cause crowd-out. Chris Knowles asked if small employers would still be the portal to subscribers, and Nancy Kasen replied yes. Murray Frank said the Council was close to advertising for someone to market
the Plan. He said the office would be in the Islander Building.
Ilene Klein said the NHP considered the Island as a virtual community health center, but community health centers (with salaried employees) have an immunity that the Island physicians do not have. Dr. Klein added that she believed January was a very aggressive launch date.
Art Bingham noted the Council’s approval was for 100% reimbursement rate for physicians. He noted that a prescription plan was not mentioned. Nancy Kasen said prescriptions would be covered. She discussed a blended rate of reimbursement and a 3 tiered reimbursement rate. Ms. Kasen added that there would be a 10% premium increase based on inflation.
The meeting adjourned at 10:05 AM.
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