DHFAC Meeting Minutes
January 10, 2000
Attending:
- Patricia Blevins
- Deborah Capano
- Joseph DiPinto
- Thomas Grabowski
- Joseph Lieberman
- Vivian Longo
- David McBride
- Charles Reinhardt
- Dennis Rochford
- Charles Simpson
- Gregg Sylvester.
Absent:
- Calvin Wilson
Welcome and Introductions
Gregg C. Sylvester welcomed the committee members and the public.
Review and Approval of Minutes & Agenda
Minutes from the last meeting and the agenda for today's meeting were reviewed and approved.
Tobacco Issues Update
Gregg Sylvester noted that members have received
- notice of Tobacco Free Delaware's conference on Friday, February 4 and
- an invitation from the Kick Butts Generation to attend their youth empowerment conference on Saturday, February 5.
HFAC members have been invited to attend the day-long youth conference, but in particular, to attend presentations of a youth plan to curb youth tobacco use. These presentations will be given from 4-5pm on February 5.
Gregg Sylvester reported that the January 2000 payment did arrive in the state treasury ahead of schedule, as suggested in the last meeting. On December 29, the payment of $8.5 million was received, reflecting an expected 13% volume adjustment. The next payment is due on April 15, 2000.
Joseph DiPinto asked about the adjustments in future payments and was informed that additional adjustments - increase or decrease - may be made in the April payment.
New Business
Gregg Sylvester suggested that the committee start to categorize funding priorities with percentages. Beginning with the percentage of the funds to put into an endowment, Dr. Sylvester reported that the Health Fund Investment Work Group had met once, and while they had not yet reached formal recommendations to the HFAC, it was likely that the group would recommend an endowment to be managed by the state's cash management policy board, and that the endowment be invested to yield a higher rate of return than other state endowments. The group is also still reviewing the option of securitization and will make recommendations about that at a later time.
In lieu of recommendations, the work group did provide the HFAC with preliminary spreadsheets modeling different expenditure scenarios and rates of return. The committee reviewed the spreadsheets but noted that additional expenditure scenarios were necessary as was a model using a 5% inflation rate. The Committee requested that these spreadsheets be available at the next meeting. Joseph DiPinto also requested that the spreadsheets be displayed graphically.
Committee deliberated also the categories of priorities and the possible percentages of funding for each. Charles Reinhardt reminded the committee of the original categories of priorities set out in December:
- Prevention/education
- uninsured/underinsured
- services
- infrastructure
- endowment
Prior to attaching funding amounts for these categories, the committee debated the best way to approach doing so. Setting out broad percentages, attaching dollar amounts, and gathering additional information were discussed. Committee discussed also what has already been committed and what portion of the fund might be put into an endowment. Also discussed was whether or not these recommendations were being made for the immediate term (fiscal year 2000) or for the longer-term (fiscal years 2001 and beyond). Joseph DiPinto argued that there were expenditures that could be made in FY00 and that the committee make recommendations for both the immediate and long terms.
From there, the Committee began to examine recommendations for FY00, recognizing that $2.7 million has already been set aside in FY00 for the Delaware Prescription Assistance Program. Regarding an endowment, Charles Reinhardt suggested that 15% go into an endowment whereas Rep. DiPinto recommended two-thirds of the payments go into an endowment. Patricia Blevins agreed with Rep. DiPinto, stating that programs funded by the Health Fund should "begin small," with room for future growth. The Committee concluded its discussion on this topic with a rough estimate of 66% of FY00 funds going into an endowment and $2.7 million going to provide prescription assistance services to the uninsured and underinsured. More information was requested about prevention services. The Delaware Health Care Commission reported that they are pulling together information about this and will provide the Committee with a report. The suggestion was also made to hire a research assistant for the Health Care Commission, to keep up with research needs.
Finally, the Committee discussed the need for a process to solicit and review proposals for funding. The Committee asked Dr. Sylvester and staff propose a process, including forms and applications. David McBride reminded the Committee that the legislature will put much scrutiny on any funded entity and encouraged the Committee not to lose sight of that in developing an RFP process. There was a discussion of how recommendations for spending should be sent to the legislators.
Dr. Sylvester reminded the Committee that a revenue, expenditure and investment report was due to the Governor and General Assembly January 11, 2000. It was agreed that the report would incorporate information related to each and the discussions in today's meeting.
Next Meeting/Future Meetings Dates
The meeting dates scheduled for Mondays in February and early March, will be changed due to the Joint Finance Committee's meetings on Mondays in February and March. A revised list of dates, times and locations will be available at the next meeting, scheduled for Monday, January 24, 2000, noon - 2pm at Del Tech, Terry Campus.
Public Comment
Rob Simmons, American Heart Association, commented that whereas AED's are a priority of the American Heart Association, the organizations top priority is the prevention of tobacco use.
Phillip Polner, MD, commented on the lack of data on the use of AED's in public facilities and questioned the decision to purchase AED's without supporting data of their efficacy. He encouraged the committee to use funds for the uninsured. Joseph DiPinto responded that while there has been discussion of purchasing AED's for use in public facilities, their placement with "first-responders" is also a top priority.
Judy Zahnow, Impact Delaware Tobacco Coalition, commented on her perception that some proposals have been made, whereas others have been put off, constituting an "end run" or sorts. Specifically, Ms. Zahnow stated that the AED initiative has taken prominence with the Committee, to the point of near decision-making, while other organizations have been asked to wait to present initiatives until a formal proposal process has been developed. Gregg Sylvester responded that the Committee requested information about the costs associated with AED's, however no proposals have been entertained. Rep. DiPinto responded that two prominent legislators made this initiative known well-prior to this process. Deborah Capano also added that the committee has been requesting hard data. Data should be made available to the Committee as soon as possible.
Amos McLuney, Coalition of De. Volunteers for Health Care Reform, commented that the problems of the uninsured are great in Delaware and are growing, due to an increase of working poor who have transitioned off welfare and into the workforce. Moreover, Mr. McLuney urged the Committee to take the opportunity its been given by the tobacco settlement to address this problem. Dr. Sylvester noted that individuals transitioning off welfare do maintain their Medicaid coverage.
Lloyd Mills presented handouts to the Committee on the cost of insurance for working families. Mr. Mills urged the Committee to address the issue of the uninsured.
The meeting was adjourned.
