MINUTES OF THE
DUKES COUNTY HEALTH COUNCIL
Regular Meeting of September 28, 2000
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 28, 2000.
Meeting called to order at 8:04 a.m.
Members Present:
Cynthia Mitchell, Chairman Fred Rundlet
Arthur Wortzel Patty Begley
Sandra Lothrop* Else Membrezo
Carol Borer* Kathy Logue
Sharon Clauss-Zanger Sarah Isenberg
Murray Frank Dennis Hoak
Sarah Kuh * Ned Robinson-Lynch
Tad Crawford Maureen Kelly
Peter Strock Lorna Andrade
Bob Sawyer Bud Macy
Karen Kukolich Les Holcomb
Kevin Burchill Patty Blakesley
Jane Cleare Chris Knowles
Marsha Smolev, Executive Assistant *Ex Officio
Dawn Ahberg, MV Times
Pat Fairchild
Nancy Turnbull
Absent:
Matt Poole Michelle Lazerow Tina McMichael
Elizabeth Norcross Joan Creato Jacque Cage
Cathy Brennan Marguerite Bergstrom*
Sherrill Butterfield Katherine Colon
Cynthia Mitchell began the meeting by announcing that the next meeting of the DCHC will be October 26, 2000. Arthur Wortzel Moved that the Minutes of July 27, 2000 be Accepted. Peter Strock Seconded the Motion. Tad Crawford reviewed the Amendments he wanted included. Discussion followed about amending Minutes. Marsha Smolev asked that members realize that their statements at meetings will be included in Minutes. Amendments will be considered and made at posted meetings. Tad Crawford stated that he believes the County Commissioners hold the DCHC to the words of the Minutes, so it is important to be sure the Minutes are correct. Marsha Smolev will start taping DCHC meetings to avoid future confusion. Cynthia Mitchell asked that the Minutes be accepted with Amendments.
Arthur Wortzel Seconded the Motion that passed Unanimously.
Sarah Kuh distributed the VHCAP Report. She reported that there’s been difficulty with the reduced fee plan, since two primary care physicians left. She voiced her concern about elderly people who have no access to medical care and reiterated that she will continue to attempt to reach this population. Also, flyers about non-group insurance are ready for distribution. Kathy Logue suggested informing the newspapers about the non-group insurance policy. Chairman Mitchell will ask the press to cover the issue. Peter Strock suggested asking local access TV to cover the story in Portuguese.
Fred Rundlet mentioned the Pequot Pharmacy Program and asked that the DCHC get written information on sliding scales to local providers.
Cynthia Mitchell announced that as of September 1, 2000, Sarah Kuh is a County Employee with paid benefits. The Chairman thanked County Manager, Carol Borer, and County Commissioner Robert Sawyer, for moving this along and for their support.
Murray Frank asked about assignment to physicians when people are enrolled by the Access Program. Sarah Kuh said every child is seen by Dr. Goldfein regardless of how busy he is. Murray Frank added that the more successful we are in outreach, the more pressure we put on the system.
Murray Frank reported that Mass Medical Society awarded the DCHC $16,000 (1/2 of what was requested, but $1,000 more than projected.) These funds are earmarked for expanding the Access Program. Murray Frank proposed that the funds be used to hire a Portuguese speaking outreach person and to pay for ½ time Administrative Assistant. Sarah Kuh reported that the Access Board approved a ten month budget to become a County Departmental Budget, and that the DCHC needed to vote on it. Peter Strock Moved that the Coordinating Council review the Budget and approve it on behalf of the DCHC. Arthur Wortzel Seconded the Motion that passed Unanimously.
Cynthia Mitchell noted that Katherine Colon will be taking a leave. Murray Frank was designated to be temporary Chairman of the PR Committee in her absence.
Fred Rundlet reported that the Dental Program for the Wampanoag Tribe has expanded. He asked that a human interest story be done to present this successful program to the community.
County Commissioner Robert Sawyer reported that the Emergency Medical Services Committee is currently editing a draft RFP. The benchmark consideration is that the community wants the same service to which it is accustomed. The vendor will be required to have a financial counselor mandated to review non-insured and uninsured patients to see what other coverage is possible.
Kathy Logue reported that she stood in for Tad Crawford at the first two meetings of the County Ad Hoc Committee. The Committee now has a Mission statement but is still in a formative state. A goal is to figure out who provides which services and how the providers’ services overlap.
Jane Cleare reported that the final packet of the Chronic Illness Survey is ready for distribution. She expects surveys to be returned by mid December, and results presented by January 1, 2001.
Cynthia Mitchell reported that the Coordinating Committee met 5 times over 2 weeks. One issue discussed was the negative tone of the July DCHC meeting. The Chairman apologized on behalf of the Coordinating Committee and said an effort will be made to keep the tone civil. Tad Crawford has completed the chart of accounts and is pleased to report the DCHC has a complete history of DCHC transactions. Also discussed: the County support of the Access Coordinator position; renewing and strengthening the relationship between the DCHC and the Chamber of Commerce; the CAP Grant. Cynthia Mitchell said CAP Grant was funded because our project is mature, not a start-up project. Chairman Mitchell also reported that individual members of the DCHC met with the Emergency Medical Services Committee, but the DCHC did not
put forth a position as a whole, because one had not been approved by a full vote of the Council.
Pat Fairchild and Nancy Turnbull arrived to report on the CAP Grant. Strategies of the Grant were explained by Pat Fairchild.
Aggressive outreach to get small employers to get insurance
Identify the hidden uninsured
Develop an affordable Island Health Plan
The Budget of the Grant is reduced to 90% of the original because there was an additional community included.
The Grant award was announced September 7, 2000. Ours was the only Grant awarded in New England. There will be a full-time Coordinator ($70,500 including benefits) and a full-time Enrollment Assistant. The Vineyard will receive money to hire the first Director of the Island Health Plan. Murray Frank, Cynthia Mitchell, Kevin Burchill and Ned Robinson-Lynch are on the Steering Committee.
Pat Fairchild said the award of this Federal Grant gives the DCHC legitimacy and will help in future funding efforts. Kathy Logue asked the DCHC to applaud Pat Fairchild’s success in this endeavor. Discussion followed.
Pat Fairchild discussed the target population of small employers. Charts of survey results were distributed by Nancy Turnbull. Some findings: Uninsured use the hospital and physicians less and the emergency room more (Ned Robinson-Lynch asked if Nancy Turnbull thought the “Intermunicipal Agreement” would encourage ER visits. Nancy Turnbull replied that if money is put into the ER, people will go there.); people buying coverage pay a lot of money for their policies, so there’s a “willingness gap” of people willing to pay premiums; people are disappointed that they have to go off island for care, but not necessarily dissatisfied with care received once they’re there; the Island Health Plan needs to be sensitive to people’s need to get care here.
The Employer Survey was reviewed. 550 surveys were sent out, 155 returned (34%.) Of the 155 returned, 39 employers offer insurance, 61 don’t. In companies without insurance, 77% covered the head of the firm. 65% of employers are not willing to contribute anything towards insurance. There appears to be a high receptivity to an Island Health Plan, but there is concern over its stability.
Nancy Turnbull said it will be important to see if providers will accept less payment from people with lower incomes. She suggested speaking with Blue Cross and arranging an Exclusive Provider Organization. Discussion followed.
Pat Fairchild presented the next steps:
Finish the Business Plan
Look at EPO or Municipal Approach
Cynthia Mitchell suggested the DCHC may need to change its thinking and see the Island Health Plan as, perhaps, not one plan, but a network of plans.
The meeting adjourned at 10:23 a.m.
Respectfully submitted,
Marsha Smolev
Executive Assistant
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