COMMISSION ON HEALTH CARE REFORM
MINUTES
Tuesday, September 20, 2005
Members Present: Representatives John Tracy, Co-chair; Steve Maier; Janet Ancel; Francis “Topper” McFaun; Senators Jim Leddy,
Co-chair; Ann Cummings; Jane Kitchel; Kevin Mullin; John Bloomer, Jr.
Members Absent: Walter Freed
Also Present: Legislative and Joint Fiscal staff, members of the Administration, the press, and the public
Meeting Recorded:CD 2005 – 8, 9, 10
1. Convene Review and Approve 8/3/05 and 8/9/05 Meeting Minutes
Senator Leddy and Representative Tracy convened the meeting at 1:00 p.m. in Room 11 at the State House, Montpelier, Vermont. Senator Leddy asked for a motion to accept the 8/3/05 and 8/9/05 meeting minutes as presented. Representative Tracy made a motion, and Senator Kitchel seconded the motion, to approve the 8/3/05 and 8/9/05 meeting minutes as presented. The motion passed unanimously on a voice vote.
2. Commission Process Update
Documents distributed:
Senator Leddy reviewed the process the Commission had gone through to solicit applicants for and interview possible Commission Directors. He said the two individuals the Commission had made offers to both declined. He said there was a discussion about reconsidering how to move forward without a director, recognizing that additional expertise was still needed to work on health care reform in Vermont.
Senator Leddy asked staff to distribute the resume of Dr. Kenneth Thorpe, the Robert W. Woodruff Professor and Chair, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia, whose works Senator Leddy had read. He said after legislators and staff met with Dr. Thorpe, he had their unanimous support to enlist Dr. Thorpe’s expertise in the area of health care. Senator Leddy invited Catherine Benham, Joint Fiscal Office, to present a different staffing model for the Commission to move forward.
Catherine Benham distributed the above documents. She said Dr. Thorpe had expert knowledge to assist the Commission with policy guidance on health care. She then reviewed Steve Klein’s memo which suggested she be the Commission’s staff director and to encourage the Commission to retain Dr. Thorpe for the period from now until January 20, 2006. Catherine Benham said Steve Klein suggested the studies’ work plan be carried out in a two-step process: first working with Dr. Thorpe to develop the initial findings and recommendations consistent with the study requirements by January 15, 2006. At the same time, the Commission and its staff and consultants would work to develop a longer term RFP.
Catherine Benham reviewed her memo, addressing the staff director position, the studies, office space, and preliminary budget estimates.
Commission members questioned Catherine Benham about her time split between the Commission and the Joint Fiscal Office and how she would prioritize her work, especially during the legislative session. Senator Bloomer asked about the staff structure and whether it was permissible under the statute. Bill Russell, Legislative Counsel, said there appeared to be no conflict. Act 71, Sections 277c and 277d were distributed and briefly reviewed.
Representative Tracy made a motion and Senator Kitchel seconded the motion, to hire Catherine Benham as Staff Director for the Commission, contract with Dr. Thorpe, and have Dr. Thorpe available at the next Commission meeting.
The Commission discussed the motion. Senator Mullin offered a friendly amendment to condition Catherine Benham’s hiring on 100% of her time for the Commission. Senator Leddy said he would prefer not to put conditions on Catherine Benham’s hiring without future discussion with Steve Klein, Joint Fiscal Office.
Representative Ancel restated the motion to clarify Catherine Benham would serve the House and Senate Health Care Committees as well as the Commission; that she would act as staff director, allocating time to the health care committees and Commission’s work on health care; that the co-chair contract with Dr. Thorpe now through January 20, 2006; that the scope of work would be discussed and reviewed by the Commission at the next meeting; and that Dr. Thorpe’s draft contract would be circulated to Commission members for review well prior to the date the contract is signed. The motion passed unanimously on a voice vote.
Senator Leddy and Catherine Benham discussed with the Commission Dr. Thorpe’s availability. They suggested the Commission meet October 10 and tentatively November 15, and they would try to have Dr. Thorpe available on October 10 and 11 and November 14 and 15. For the October 10 meeting, they would try to prepare a draft work plan.
3. Joint Health Committee Public Engagement Process Update
Senator Leddy discussed the six meetings of the Joint Health Committee, comprised of the House Health Care and the Senate Health and Welfare Committees. He announced the dates and places of the six evening public meetings and said each would begin at 6:30 p.m.: October 5, Springfield; October 11, Rutland; October 18, Lyndonville; October 20, Burlington; October 25, Bennington; and November 1, Barre.
Senator Leddy also said staff had received a call from Charles Smith, Secretary of Administration, inviting Commission members to a health care summit in Killington on October 17. He said he would be following up with Secretary Smith to find out the details.
4. Administration’s Health Resource Allocation Plan Presentation
Documents distributed:
Paulette Thabault, Deputy Commissioner for Health Care Administration, Department of Banking, Insurance Securities and Health Care Administration, distributed the two documents described above, one a power point presentation.
She reviewed the slides in her presentation which included defining that the Health Resource Allocation Plan was a four-year plan that identifies Vermont’s needs in health care services, programs, and facilities. It also identifies the resources available to meet those needs, as well as the priorities for addressing those needs on a statewide basis. She said Act 53 specifies that the plan must include hospitals, nursing homes, other inpatient services, and home health and mental health services, as well as other health care providers.
Deputy Commissioner Thabalut said the plan can be used as an information resource for policymakers’ deliberations about investment, divestment, and allocation in the Vermont health care system; and as a resource for health planners and providers who are evaluating health care programs and services. She also said the plan provides standards for the review of certificate of need applications.
5. Medicaid Global Commitment Update
Steve Kappel, Joint Fiscal Office, presented the Commission with the following update. He said:
1) Final paperwork received 9/13. This includes a list of which sections of statute are to be waived and the “special terms and conditions” of the waiver. We now know the budget neutrality cap and the broad outline of how Medicaid is proposed to change.
2) The same paperwork is working its way through the final sign-off process at the federal Department of Health and Human Services and Office of Management and Budget.
3) The Vermont legislature has engaged an independent consulting firm, Health Management Associates, to review the proposal. They will be providing a report to the Health Access Oversight Committee on September 27 and to the Joint Fiscal Committee on September 28.
4) The Joint Fiscal Office has established a Q&A protocol with the Office of Vermont Health Access. Forty-two questions were sent to OVHA last Friday, and answers were posted on OVHA’s web site on Tuesday.
5) HAOC and JFC have established a tentative meeting schedule. HAOC will meet September 27, and JFC will meet September 28. If HAOC is prepared to make a recommendation to JFC on the 28th, JFC will vote. If not, HAOC may meet on the morning of September 30 and JFC that afternoon.
The Commission agreed to meet Monday, October 10 in Room 11, State House Montpelier. Senator Leddy said the time of the meeting will depend on Dr. Thorpe’s availability.
The meeting adjourned at 4:05 p.m.
Respectfully submitted,
/s/ Rachel Levin, Legislative Council