Advisory Sub Committee
Archived Minutes
Meeting Minutes - October 25, 2002
Members present: Mary Anne Guggenheim, Chairperson, Sylvia Danforth, Dr. Annette Grefe, Dr. John Johnson, Cyndi Leaphart RN, Dr. John O'Connor,
Members excused: Debbie Christian, Dr. Jack Haling, Dr. Marian Kummer, Diane Jeanotte, Michelle Thibodeaux, Dr. Mark Wilgus
State staff present: Mary Noel, Maggie Bullock, Jo Ann Dotson, BJ Archambault RN, MaryLynn Donnelly RN, Corliss Scott.
The meeting was called to order by Chairperson Guggenheim at 10:05 AM. The minutes of the 2 previous meetings were approved.
Mary Noel reported on the following aspects of the program:
* Sharon Wagner resigned her position several months ago. Initially this position was -frozen- due to budget constraints but it is in the process of being opened (no state match money required) and when that occurs a position as Director of CSHS will be advertised. In the interim Mary Noel has been directing the program.
* The state budget crisis has limited staff travel, both in and out of state.
* A Memorandum of Understanding (MOU) has been established with the MBOMs program, mostly related to sharing data and information. (That program formally was located within CSHS but now, along with the NBS coordinator, is in the MCH bureau supervised by Jo Ann Dotson.)
* the revision of rules that the council has been involved with over the past year is currently in legal services. Mary has been encouraging them to process the proposed rules changes expeditiously so they can be out for the required public comment and take effect ASAP, hopefully by the end of the year.
* A summary of financial expenditures for the CSHS program for (federal) FY2002 (10-1-01 to 9-30-02) was distributed. This is the first time that this kind of information has been available to the advisory council. It is hoped that by following this kind of budget data for several years the council may have useful guidance re optimal use of these Title V funds to best serve children with special health care needs (CSHCN).
* Staff has been looking at ways to bill 3rd party providers for children seen at CSHS clinics. It is not simple! Work on this will continue.
* CHIP currently has a waiting list of 389. Mary pointed out that there is always a fluctuation in the waiting list number as new openings are filled at the first of the month, and then the list grows as the month progresses.
MaryLynn Donnelly reported that a MOU with the Disability Determination Bureau (SSI) has been established. In the past SSI sent some information about children applying for SSI to CSHS to enable us to identify children who were eligible for CSHS and refer for local services if appropriate. This was done by SSI sending copies of parts of charts to CSHS. Now a representative of CSHS will directly review charts at the SSI office. This should allow better understanding of the needs of the children applying as the entire chart will be available. There was some discussion re how this information was used and whether ascertainment of information needed to be done by nursing staff or could be sorted by non-nursing personnel (contracted out) if guidelines could be identified. The council appears to have limited understanding of how these two programs interact. This would be a useful topic for a future meeting.
The council addressed in detail the proposed charter for the CSHS Advisory Council. Previously, the structure, goals, and responsibilities of this group has been informally determined. The council has agreed that establishing a formal structure (who is on the council, how they are selected, terms, leadership, responsibilities, etc) may help this group be more effective on a long term basis. Mary Noel had put together a draft charter that was made available at the last meeting. At this meeting the group worked through each section in a detailed fashion. The consensus draft is attached to these minutes. Further comments and suggestions for change should be submitted. It is anticipated that the charter will be formally adopted at the next council meeting.
Maggie Bullock joined the group at lunch and reported on the current financial challenges that face DPHHS. In addition to the budget cuts instituted over the past 18 months, the governor's office is asking for substantial reductions in the budget to be submitted to the next legislature. Although initially the CHIP program appeared to be vulnerable this no longer seems to be the case. Most of the substantial reductions being considered will directly affect adult Medicaid programs (reduction in provider fees, services covered, nursing home eligibility for seniors, etc.) The council members are obviously concerned re all of these programs, recognizing that most programs are already functioning in a restrictive environment. The major projected impact on children's services is the potential elimination of the Part C program. During the legislative session there may be opportunities for CSHS to identify families who can offer effective testimony to legislative committees. We offered to help in this and other aspects of the legislative budget process to help preserve necessary services for CSHCN.
The last item on the agenda (ways to improve access to specialty care providers) was not addressed, as considerably more time than projected was required to work on the council charter. A draft of the revised list of specialty clinics and providers was handed out for review. Any corrections or additions should be submitted in the next few weeks so that a final list can be established. The plan is to send this to 700 health care providers.
The meeting was adjourned at 2:45.
Next meeting is scheduled for Friday May 2, 2003 in Helena.
