MINUTES OF THE
DUKES COUNTY HEALTH COUNCIL
Regular Meeting of September 26, 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 September 26, 2002.
Meeting began at 8:03 a.m.
Members Present:
*Ex Officio
Jo Ann Murphy Jacque Cage
Tad Crawford Sandra Lothrop
Marni Lipke Charles Silberstein
Sarah Isenberg Ned Robinson-Lynch
Chris Knowles Kathy Logue
Else Membreno Peter Strock
Sarah Kuh * Cathy Brennan Lorna Andrade Tim Walsh
Kathleen Fitzgibbon Dennis Hoak
Fred Rundlet Dan Seklecki
Kathleen Rose William Elbow
Jane Cleare Michele Lazerow
Robert Sawyer
Also Present: Marsha Smolev, Art Bingham, Sarah Davis, Dan Greenberg
Absent: Melinda Loberg Ilene Klein Marguerite Bergstrom Carol Borer*
Michelliny Faust Joyce Steward
The next meeting will be held on October 24, 2002. Tad Crawford noted that anyone who hadn’t resigned from the Health Council to be on the Island Health Plan, was still a full voting member of the Health Council. Scheduling and posting procedures were mentioned, with Tad Crawford asking committee chairs to advise him of monthly meetings schedules. He went on to ask that the Minutes of the meeting of 9/12/02 be approved. Marsha Smolev voiced confusion about this Board approving those Minutes since that meeting was convened as an Island Health Plan meeting. Tad Crawford explained that while it might not have been posted correctly, it was a joint meeting and it was important to approve the Minutes. Ned Robinson-Lynch asked that the Minutes reflect this discussion. Jacque Cage would
bring amendments to those Minutes to Pam Speir, who wrote them. Commissioner Sawyer Moved that the Minutes of September 12, 2002 be Approved. Peter Strock Seconded the Motion. The Vote to Approve the Minutes was Unanimous.
There was not an official Treasurer’s Report, since, Tad Crawford reported, he was still waiting for County Treasurer Flanders to make requested changes to June’s records. Tad Crawford noted that VHCAP had spent $8000 so far, and Blue Cross Blue Shield monies needed to be ‘spent down,’ as did Rural Scholars Grant funds. Concern was voiced over the fact that VHCAP funding would run dry by the end of November or early December.
Sarah Kuh reported that it was the third anniversary of the VHCAP. She said that State funds were due to be cut again. That further cuts would happen at the same time that the VHCAP was running out of money and also having to move out of its offices, meant that the Program would be stressed to serve the additional individuals who would find themselves at risk. Commissioner Sawyer asked if Ms. Kuh had spoken to the County Manager about possible space in the County Administration Building. Tad Crawford said he wasn’t sure there was space there, but if space were found, it would probably not meet the needs of the VHCAP’s population for several reasons, including location and privacy. Fred Rundlet suggested possibly finding interim space. He also asked if the further cuts would
jeopardize the Island Health Plan which was built on particular funding levels per person. Sarah Kuh continued that the Globe article gave timely recognition to the idea of public/private partnerships and employer subsidies. Charles Silberstein added that the Island Foundation for Health and the Island Health Plan were both also looking for office space, so perhaps the programs should meet and find creative solutions to their needs.
Tad Crawford reviewed the list of Board members of the VHCAP: Kathy Rose, Sarah Isenberg, Dennis Hoak, Patty Begley, Else Membreno. He pointed out that some of these members belong to the Health Council, and others have chosen to be on the Island Health Plan. He stressed the need for the Health Council and Island Health Plan to work together to maintain ‘synergy,’ since it would be hard to draw a line between the two Boards.
Tad Crawford and Kathy Logue reviewed the results of the questionnaire that Health Council members filled out regarding the future of the Health Council, Island Health Plan, and Coordinating Committee membership. Several members are still undecided. Ned Robinson-Lynch called for a date by which all decisions would be made, but Tad Crawford stressed the need for people to take the time they need to become educated about the choices.
Tad Crawford asked Commissioner Bob Sawyer to discuss the special legislation he had suggested. He said that he spoke with an attorney at Ropes and Gray after the attorney had given the County Commissioners his opinion that the Health Council and Board of the Island Health Plan needed to be separate to avoid potential liability. Commissioner Sawyer said he asked the attorney how the two could stay together then and the answer was by special legislation that would eliminate liability. He then spoke with Representative Eric Turkington who told him there was a similar situation in Falmouth (where there was quasi public/private cross membership) and that he would have to know by November if the Vineyard groups were interested in pursuing this course. Tad Crawford reported that the Coordinating
Committee had decided it was premature to make that decision at this point.
Commissioner Sawyer left at 8:53 AM).
Kathy Logue explained how she read the questionnaire carefully, and respecting confidentiality, had tried to summarize the main topics she saw. Discussion followed. It appeared that there was confusion about the mission of the Island Health Plan. Some, apparently Health Council members, believed the Plan was an insurance plan that might eventually broaden. It seemed that Island Health Plan members saw the Plan as broader from the start. Sarah Isenberg voiced her confusion over this. Peter Strock thought the fundamental question was whether the Health Council set policy and stopped after developing programs or whether it ran programs. He thought dental programs should be part of the Island Health Plan.
Jane Cleare said she didn’t think the Health Plan and Health Council’s future work could be identified at this point. Furthermore, it appeared she couldn’t be on the Island Health Plan, since she would probably received insurance payments from it eventually.
Lorna Andrade stressed looking at the original mission of the Health Council. Has that been completed? She wanted to keep going with it and not change now. Follow through.
Chris Knowles reported that he, Tad Crawford, and Kathy Logue had attended the County Commissioners’ meeting of September 11. He said he was struck by the level of antagonism and antipathy between the Commissioners and the Council members. He thought it was important to decide where the Access Program stood. Should the Health Plan raise funds or was it appropriate to ask County Commissioners for funds for it? Sarah Kuh said there was joint custody.
Tad Crawford added that at the Commissioners’ meeting there was a plea to treat each other with mutual respect. Kathy Logue thought the problem was communication. It wasn’t that people didn’t like what they heard, but that they hadn’t heard at all. Commissioners needed to communicate with the Health Council and the Council with Commissioners.
Tad Crawford asked for a Motion to make the questionnaire documents public. For the record, Charlie Silberstein made the Motion and Peter Strock Seconded it. The Vote was Unanimous. The documents, having been distributed at a public meeting, were already public.
Fred Rundlet reviewed the Council’s interest in having a retreat. Ned Robinson-Lynch and Fred reported on possible topics: the questionnaire document, review of bylaws and mission, future plans of providers and community groups, issues for different organizations, County Commissioners’ input about the future of the Health Council.
Discussion followed about how many retreats to have. Charlie Silberstein thought retreats would be essential. He suggested a Health Council retreat, and another island-wide health retreat. Jane Cleare thought there needed to be a retreat about the relationship between the Health Council and Island Health Plan. Sarah Isenberg said she thought the group was moving backwards and agreed with Jane Cleare. She said people were separating into two Boards before they were even informed about what the Island Health Plan was.
Marni Lipke said she thought there would be a questionnaire to determine the topics of the retreat. Dennis Hoak said the debate indicated transition. He said the Council was formed to be advisory to the County. Now it was rolling and there were operational pieces. At a retreat, the members should create a chart that would show how the Council worked, who was the CFO, how to pull in the Hospital and Windemere, etc., how to include a health system for the Island.
Ned Robinson-Lynch asked that everyone have the chance to speak. Kathy Logue thought the retreat should focus on the Health Council, but everyone would be welcome.
Kathy Rose agreed that it was time ‘to look at ourselves.’ Ned Robinson-Lynch agreed it was necessary to focus on the future of the Health Council. Jane Cleare said she didn’t know how they could talk about the direction of the Health Council if they didn’t know the overlapping areas. She added it wouldn’t feel complete without an underlying relationship with the Island Health Plan. Tad Crawford said it was necessary to determine where the Health Council was before it entered into relationships with others.
Charlie Silberstein suggested appointing a subcommittee for the purpose of moving the retreat forward, but Tad Crawford said Fred Rundlet and Ned Robinson-Lynch were already assigned to that. Peter Strock Moved that at the earliest possible date, the Health Council members in the subcommittee that exists, develop an agenda that could be provided to the Council (prior to a meeting) for comment. Lorna Andrade Seconded the Motion.
Dennis Hoak left 9:35 AM.
Marni amended the Motion to say that all would be welcome. Michele Lazerow Seconded the Motion to Amend. The Vote to pass the Motion including the Amendment Passed Unanimously.
Tad Crawford explained the concept of an Interim Coordinating Committee that would serve as volunteers until January 1, 2003. Kathy Logue Moved that the people who had presented themselves as interested in the Interim Coordinating Committee be appointed to serve as volunteers until January 1, 2003. Marni Lipke seconded the Motion. The names of volunteers included: Lorna Andrade, Tad Crawford, Kathy Logue, Jacque Cage, Fred Rundlet, Bob Sawyer (understanding there would be an election and he wouldn’t serve if enough others wanted to), Jane Cleare, Ilene Klein, Charlie Silberstein (maybe), Ned Robinson-Lynch (maybe) Kathy Rose, and Tim Walsh. The Vote to Approve was Unanimous.
Tad Crawford mentioned that there were vacancies on the Board. He thought it unfair to recruit while ‘we don’t know who we are’ and asked that the topic be postponed until after the retreat. Kathy Fitzgibbon asked if there should be a place on the Health Council for an Island Health Plan member. Jane Cleare Moved that they wait to discuss vacancies. Charles Silberstein Seconded the Motion that passed Unanimously.
Ned Robinson-Lynch left at 9:44 AM.
Jacque Cage asked to whom chairs should send their reports. Tad Crawford said he would take them for the time being.
Fred Rundlet and Charles Silberstein presented the prospect of an Island-wide Health Needs Analysis. Dr. Becker of Johns Hopkins University donated $1,000,000 of free service to the Island Foundation for Health to survey the health needs of the Vineyard. The project is slated to move ahead rapidly. The survey has to be designed. There has to be data collection, compilation, and results. Dr. Russell Hoxie and Fred Rundlet are co-chairing the committee that includes, Dr. Barbara Stelle, Kathy Fitzgibbons, and Kerry Binder. Discussion followed. Charles Silberstein said hopefully they’d get enough data to enable them to go to large funding sources like the Robert Wood Johnson Foundation and then develop a model for healthcare. Peter Strock Moved that the Health Council partner ‘hand in glove’ with the Foundation for Island Health to support this endeavor. Kathy Logue Seconded the Motion that Passed Unanimously.
Peter Strock Moved to adjourn. Kathy Logue Seconded the Motion.
The meeting adjourned at 10:00 AM.
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