Advisory Sub Committee
Archived Minutes
Meeting Minutes - April 16, 2004
The meeting was held via Met Net (Miles City, Billings, Great Falls, Missoula, Helena) Members present: Helena- Mary Anne Guggenheim MD, Mo Leo, Barb Smith. Guests-Thom Danenhower, Mary Noel, Chuck Hunter; Billings- Marian Kummer MD, Cyndi Leaphart RN, Peggy Eggen, Teri Webb, Lori Byron MD; Missoula- Peggy Schlesinger MD, Anne Manktelow MD, Ellen Carey RN; Miles City- Slyvia Danforth Part C.
The meeting was called to order by Chair, Mary Anne Guggenheim at 12:30 pm. Minutes of meeting of October 24, 2003 were approved.
1. Tom Danenhower, Emergency Medical System (EMS) coordinator for the state, gave a presentation about his program as it relates to children. It partners with state wide ERs and output clinics to ensure adequate equipment and services for children. There is a national resource center (www.ems-c.org) charged with establishing standards of care and support for children with special health needs in the EMS systems. The state has a suicide hot line (for children trauma is # 1 and suicide #2 in deaths.) There was discussion from committee members. Mr. Danenhower can be reached at: 406-444-4126 or tdanenhower@state.mt.us
2. Chuck Hunter, the new appointed administrator of the Child and Adult Health Resources Division, introduced himself and described his division, which includes Children's Health Insurance Program (CHIP), Children's Special Health Services (CSHS), Children's Mental Health, and Medicaid primary and acute care. His goal is to better coordinate medical services for kids. They are working on Medicaid re-design, and ways to increase CHIP services, among others.
3. Reports from the two regional clinics:
Missoula (Ellen Carey RN): 9 specialty clinics. In 2001 saw 272 patients, in 2002 - 446 patients, and in 2003 562 patients. Endocrine and pulmonary clinics are in highest demand.
Billings: (Cyndi Leaphart RN) - currently have a new director (supervisor) from St. Vincent's and are in a transition period - some staff rearrangements, remodeling, etc. Currently have 15 specialty clinics. Will provide information regarding number of patients, etc at next meeting. Dr. Kummer reported that Dr. Laura Nicholson will be starting her practice (located at the Children's Clinic) in developmental and general pediatrics in August - and is interested in working with CSHS.
4. Report on the Family to Family Training program given by Barb Smith - focus is on training advocates. Teri Webb, Dr. Schlesinger, and Mo Leo offered to participate.
5. BJ Archambault reported on the status of the Health Coverage survey - draft in process. Due June 1. The draft will be available for committee review at the next meeting.
6. Michelle reported on the status of the Website - currently stymied at the state level as no resources available to put in on line in a coordinated way. Suggestion made as to whether Roger Holt at PLUK could be a helpful resource.
7. Financial report: overall budget designates 55% of total budget for clinical, contract and financial assistance; 45% for staff support in Helena. Funding from feds keeps decreasing. Need to look at additional resources (billing for clinics). Mary Anne Guggenheim noted that in FY99 the budget was $803K and FY04 had dropped to $768K.
8. CHIP report by Mary Noel: currently no waiting list with additional state $$ recently authorized by the governor. 10,860 children enrolled. Question raised by Mary Anne Guggenheim as to what would happen after 6-30-04 with new fiscal year as the additional dollars was a one-time authorization only for FY03. Mary Noel indicated that she had been verbally assured that the increased coverage would continue. Marian Kummer asked about pros and cons of having/not having a waiting list. Mary Anne Guggenheim asked about the donation program. $400 donated so far and the program would be - going public- in May during the -Cover the Uninsured Week-. The contract with BC/BS would come up for re-negotiation in the fall. Mo Leo asked about how CHIP is audited vis a vis the insurance carrier contract.
9. Update on the electronic interface project by MaryLynn Donnelly. Issues relate to programmatic info, sharing agreements and quality of data. Working with Montana Birth Outcome Monitoring System (MBOMS). (some funding via that program) and the MSDB registry. Goal is to link resources more effectively to provide better services to families.
10. Physician credentials regarding being a recognized specialty provider for CSHS was discussed. A specific request from Dr. Fred Gunville in Billings who sees many children with diabetes but is not a board certified specialty physician has again raised the issue. Our ARM indicates BC/BE requirement. In reality Dr. Gunville sees a large number of children with diabetes from eastern Montana and functions as a specialist in that area. After much discussion we decided to have a sub-committee review the issues related to specialty providers and their financial support by CSHS. Mary Anne Guggenheim will appoint the committee and ask for their recommendations for our next meeting.
The meeting was adjourned at 4:20 pm. Next meeting scheduled for October 8, 2004 Although there are some disadvantages, the committee members felt that the advantages of holding meetings via Met Net were considerable and urged that this be continued.
