MINUTES OF THE
DUKES COUNTY HEALTH COUNCIL
Regular Meeting of January 25, 2001
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 January 25, 2001.
Meeting called to order at 8:15 a.m.
Members Present: *Ex Officio
Cynthia Mitchell, Chairman Les Holcomb
Arthur Wortzel
Else Membreno
Sarah Kuh * Dennis Hoak
Jacque Cage Bud Macy
Murray Frank Lorna Andrade
Fred Rundlet Ned Robinson-Lynch
Tad Crawford Maureen Kelly
Michele Lazerow Jane Cleare
Eric Butler Cathy Brennan
Tom Dresser
Also Present: Marsha Smolev Alan Hirshberg Nancy Kasen (JSI)
Teresa Rodrigues Chris Zadeh Nancy Turnbull (JSI)
Liz DiCarlo Pat Fairchild (JSI)
Absent: Bob Sawyer Sharon Clauss-Zanger
Matt Poole Marguerite Bergstrom*
Elizabeth Norcross Karen Kukolich
Sarah Isenberg Carol Borer*
Katherine Colon Sandra Lothrop*
Chris Knowles Peter Strock
Kathy Logue Kevin Burchill
Patty Begley
Cynthia Mitchell introduced Eric Butler, the new DCHC member representing the school system; Tom Dresser, the new member representing Windemere; Teresa Rodriguez, Program Assistant for the new Lighthouse Alliance Grant; Chris Zadeh, the MV Coordinator of the Lighthouse Grant and Director of the Island Health Plan; Liz DiCarlo, Project Coordinator for the Lighthouse Alliance Grant and Cape Coordinator for the Grant; and Nancy Kasen, Nancy Turnbull and Pat Fairchild from JDI. The next meeting of the DCHC was scheduled for February 22, 2001.
Lorna Andrade Moved to Accept the Minutes of December 21, 2000. Arthur Wortzel Seconded the Motion. The Minutes were Approved with Cathy Brennan abstaining.
Tad Crawford distributed and reviewed the Treasurer’s Report. The DCHC records reconcile to the penny with the County’s. Michelle Lazerow Moved to Accept the Treasurer’s Report. Arthur Wortzel Seconded the Motion. The Report was Accepted. Chairman Mitchell thanked Tad Crawford for his report.
Tad Crawford stated his disappointment that the County Commissioners, at their meeting of the previous night, had not endorsed his plan to stagger the DCHC terms. He explained that the present appointments need to run their course and new ads be placed before the terms can be staggered (next year.)
Murray Frank gave the Data and Funding Report. He that Dr. Goldfein and Dr. Miller wrote a grant that was awarded $7000 by the American Academy of Pediatrics. The goal of the grant is to plan a program to focus on healthcare needs of island school children. Sarah Kuh worked with the Pediatricians on the grant application and program design. Mr. Frank added that Kriner Cash, Superintendent of Schools, is committed to helping develop a way to track immunization needs of island students.
Cynthia Mitchell reported that the Coordinating Committee has been nominated for a leadership award for its “leadership for a changing world,” a grant funded by the Advocacy Institute in Washington, D.C.
Sarah Kuh reported on the Access Program, and expressed delight at having Teresa Rodriguez join her office. Sarah Kuh reported on her efforts to develop a pharmacy program similar to that of the Falmouth Free Clinic.
Jane Cleare reported on the Chronic Illness Committee. The survey looked at the incidence of people with chronic illness, what services are available and what services are needed. The survey was distributed to 40 – 50 locations. The final number of surveys tallied was 106. 42 of those are from people under age 65. There were significant differences in the populations responding over age 65 and under, mostly in the kinds of illness, and the kinds of services needed. Fear of losing services is a common response under age 65, but not over. Jane Cleare believes the survey provides enough of a sample to move forward. Cynthia Mitchell congratulated the Chronic Illness Committee on the successful collection of so many surveys.
Liz DiCarlo presented the five objectives of the Lighthouse Alliance:
Make access to healthcare reachable
Develop an affordable insurance product
Education
Develop a continuum of substance abuse services
Improve coordination of care with providers on the Cape and Islands and develop a shared Integrated Information System
(Pat Fairchild arrived 9:09)
Chris Zadeh said he is working to develop and roll out a new Vineyard Health Plan.
Alan Hirshberg mentioned a 2 wheeled vehicle study, and the draft to designate the Island as a HPSA location.
Pat Fairchild distributed a handout about the Island Health Plan. The final data is not yet available. Nancy Turnbull reviewed the handout:
The major reason people are not insured, is cost. There is a considerable gap between what policies cost, and the amount that would be available to cover costs.
State subsidies require employers to pay at least 50%. Local employers are not willing to do that. Ways to make healthcare affordable were discussed. An Actuary has been retained to model what the effects of different techniques would be. The information will be available at the next meeting. Nancy Turnbull stressed that there will have to be hard choices made in order to get a low premium. Discussion followed about target groups and affordability. The benefit design was presented with three options, high, medium, and low. Complimentary therapies are not included. The benefits include preventative state mandated screenings.
Different plans were discussed, low being catastrophic coverage, high being best for the consumer. The plan will be targeted to 250% of the poverty level, but not limited to that. There was discussion about whether co-pay is before or after insurance. Nancy Turnbull agreed that needs to be clear.
Fred Rundlet mentioned the financial benefits of being well, of rewarding smoking cessation, weight loss, wearing seatbelts.
Nancy Turnbull suggested that the objective is to get a price for an insurance plan, then ask people, “Are you willing to pay for this?”
There was discussion about Medicaid and Medicare payments and whether doctors would sign on if they receive only Medicaid. Ned Robinson-Lynch questioned whether there could be enrollments in a preferred provider network. Nancy Turnbull said they will look at that data. She agreed partnering would provide less risk.
Eligibility was discussed, as was verifying income. Murray Frank asked about a sliding scale. Nancy Turnbull answered a sliding scale makes it more affordable, but doesn’t help reduce the cost of the plan.
Tad Crawford mentioned that to lower the demand for services there needs to be an attractive selling point, something innovative. He added that coverage at Mass General needs to be included. He thought there would be greater stability in the work force, if employers offered insurance. Nancy Turnbull said she found that workers preferred higher wages to insurance.
Pat Fairchild said it is hard to convince employers to participate. Dr. Hoak said he felt it would be a hard sell to physicians in the hospital.
The meeting adjourned at 10:19 a.m.
Respectfully submitted,
Marsha Smolev
Executive Assistant
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