MINUTES OF THE
DUKES COUNTY HEALTH COUNCIL
Regular Meeting of November 1, 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
November 1, 2001.
Meeting called to order at 8:10 a.m.
Members Present:
*Ex Officio
Cynthia Mitchell, Chairman Jacque Cage
Murray Frank Patty Begley
Carol Borer* Kathy Logue
Jane Cleare Kathleen Rose
Arthur Wortzel Ned Robinson-Lynch
Sarah Kuh * Kevin Burchill
Sharon Clauss-Zanger Else Membreno
Lorna Andrade Fred Rundlet
Tad Crawford Cathy Brennan
Sandra Lothrop* Katharine Colon
Robert Sawyer
Also Present: Marsha Smolev, Nancy Kasen (JSI), Joyce Steward, Charles
Silberstein, Melinda Lobrig, Kathy Fitzgibbon
Absent:
Matt Poole Marguerite Bergstrom*
Elizabeth Norcross Karen Kukolich
Dennis Hoak Peter Strock
Maureen Kelly Michele Lazerow
Chris Knowles Sarah Isenberg
Chairman Mitchell announced that there will be two more meetings in November, and then one December 13th. Tad Crawford asked that the Council take a moment to reflect on the ongoing effects of the September 11 tragedies.
Tad Crawford distributed the Treasurer’s Report and noted that the County was still operating without a budget. He reported that the Access Program was being funded through cash reserves and issues with JSI invoices and County warrants had been resolved. The Treasurer said that the Health Council was still looking to the County for funding and hopeful that the County would fund $70,000 as part of the Supplemental Budget. Kathy Logue Moved that the Treasurer’s Report be approved as distributed. Arthur Wortzel Seconded the Motion. The Report was approved.
Nancy Kasen presented an update on key informant interviews with 9 employers offering health insurance. The purpose of the interviews was to ‘tease out factors’ that would make employers decide to offer insurance and find out more about decisions employers face. The three large employers were Martha’s Vineyard Hospital, Community Services, and Cronigs Market. There were 6 small employers. The large employers saw offering health insurance as part of the cost of business. There were many factors involved in health insurance issues with small employers, the main focus being the moral obligation to ensure that employees were healthy.
Small employers tended to have a fixed number of dollars with which to buy insurance. Fred Rundlet asked if there was any incentive offered to healthy employees. Nancy Kasen reported there was not. Discussion followed. (Charles Silberstein left at 8:45 AM.) Nancy Kasen explained that insurance is either experience rated or community rated. In reference to premium costs, members of the Council agreed that it would be necessary to educate the community on choices and differences of benefits/cost. There was some discussion about eligibility and levels of subsidies. Nancy Kasen reminded the Council that there were limited subsidy funds and more comprehensive funds would eventually be needed. Also, employers are currently paying more than the $100 maximum they said they could
afford in earlier focus groups. Nancy Kasen reiterated that 86% of people offered health insurance accepted it.
Cynthia Mitchell suggested that subsidy be used as an incentive for employers to take the Health Plan. Nancy Kasen said that the assumptions that made the Health Plan appear viable were: full use of subsidies and enrollment in the family assistance plan. Sarah Kuh said the future of funding for the family assistance plan was in jeopardy.
Nancy Kasen reported that employers would want to know sustainability and financial stability of the Plan. And there would have to be Champions – individuals willing to speak up and champion the plan in public.
Robert Sawyer asked whether consideration has been given to including the seasonal market. Nancy Kasen said discussion would have to follow. This would include high costs and greater risks, since seasonal employees leave.
Jane Cleare said she’d assumed the Plan was not a single-phase program, and many of these issues would be dealt with in another phase.
Nancy Kasen reviewed recommendations that included: setting up a team to deal with employers, developing tools to explain what’s been learned and continue to deal with the facts. The discussion about ‘picking fruit’ followed: people most likely to enroll, on the fence, not interested. The strategy would be ‘push-pull.’ ‘Push’ the employers and ‘pull’ the employees. (If an employer doesn’t offer the Plan, employees will ask how they can join.) Initial enrollment will be small, but Nancy Kasen said that was okay, since the initial subsidy is small. She said there would have to be a ‘shift in cultural norms…to include health and well being…for the community to be able to sustain the Plan.
Cynthia Mitchell discussed the Plan’s ‘kick-off,’ and said the Coordinating Committee felt January, 2002 was too soon. Cynthia Mitchell and Council members thanked Nancy Kasen for her report. Nancy Kasen explained the idea of the cultural shift, by saying the Plan needs to be ‘organic’ in structure. Cynthia Mitchell said that’s the reason the Council chose to focus on a Health Plan, because it would be a vehicle to affect change.
The meeting adjourned at 10:00 AM.
Respectfully submitted,
Marsha Smolev
Executive Assistant
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