DHFAC Meeting Minutes
February 11, 2000
Attending:
- Patricia Blevins
- Deborah Capano
- Joseph DiPinto
- Thomas Grabowski
- Joseph Lieberman
- Vivian Longo
- David McBride
- Charles Simpson
- Dennis Rochford
- Gregg Sylvester
Absent:
- Charles Reinhardt
- Calvin Wilson
Welcome and Introductions
Gregg Sylvester welcomed the committee members and the public. The committee members introduced themselves.
Review and Approval of Minutes
Joseph Lieberman corrected the minutes from the January 24, 2000 meeting adding, "the Commission recommends that investments be envisioned as a "strategic reserve," rather than as an endowment." The minutes were approved as corrected.
Old Business
Anti-Tobacco Conferences
HFAC was briefed by Deborah Brown, Tobacco Free Delaware, on the two anti-tobacco conferences held in early February - "Mission Possible: Achieving a Tobacco Free Delaware" and The Governor's Conference on Youth and Tobacco Prevention. Ms. Brown provided the Committee with recommendations from the youth conference for
- structuring Delaware's movement against tobacco;
- best messages to convince Delaware teens not to start smoking; and
- best ways to reach Delaware teens with anti-smoking messages.
HFAC also viewed one television advertisement from Florida's "Truth" campaign and one television advertisement that marked the kick-off of the American Legacy Foundation's anti-tobacco media campaign. Both had been viewed at the Youth Conference and were viewed by the HFAC as examples of counter-marketing campaigns.
The Committee also discussed the American Legacy Foundation's RFP. More information needs to be gathered regarding potential matching funds as well as what type of programming can be funded.
Reports from the Delaware Health Care Commission and Division of Public Health
Paula K. Roy, Executive Director Delaware Health Care Commission reviewed the Delaware Health Fund Advisory Committee recommendations to date and reminded the HFAC of the charge given to the DHCC on 2/11: the development of more specific criteria for programs to be funded this year. The DHCC reported that to do so they met with the Impact Coalition and the Division of Public Health on the issues of tobacco prevention and AED's.
Tobacco Control: Program and Budget Recommendations
Paul Silverman, Ph.D., Chief, Health Monitoring and Program Consultation Section, Division of Public Health, proposed spending $8.6 million over three years to expand Delaware's tobacco prevention and control program to a comprehensive program. Dr. Silverman recommended that the HFAC spend $2.5 million in the first year on tobacco control and increase spending in the following two year years to $6.5 million. This spending, along with an estimated current spending of $1.4 - $2.0 million would bring Delaware, in three years, to the CDC's recommended minimum spending on tobacco control. The Committee discussed aspects of the tobacco control program proposed. Deborah Capano raised questions about the specificity of the progress of school programs, suggesting that without good data on what is currently being done in schools it is difficult to gauge an appropriate increase for such funding. Dennis Rochford and Joseph DiPinto also suggested that a primary focus of tobacco spending should be on smoking cessation and prevention. Rep. Capano also suggested the benefit of having additional stakeholders provide their perspective on how to best structure and fund a comprehensive tobacco control plan.
AED Initiative and Budget Recommendations
Bill Stevenson, Director of Emergency Medical Services, presented information about the need for automatic external defibrillators (AED's) and a program to improve the "chain of survival" in Delaware. To do so, Mr. Stevenson recommended a program to enhance early defibrillation by increasing public access AED's in a multitude of targeted initial sites. Moreover, Mr. Stevenson recommended that to properly implement the program, a program budget of $753,600 is needed. During discussion about this initiative points raised included liability for persons using AED's (to be dealt with via Good Samaritan legislation); staff training, and the ease/difficulty of improperly using AED devices.
Delaware Health Care Commission: Additional Recommendations
Ms. Roy advised the Committee that given Public Health's spending recommendations, and other HFAC commitments (strategic reserve; prescription assistance), the total recommended expenditure is $28.25 million, of the total expected revenue of $30 million. Given this spending plan, $1.75 million unaccounted for funds would remain.
The Health Care Commission's recommendation is to the use this revenue to begin work immediately on SB 8 purposes originally recommended for next year: the uninsured, chronic diseases and testing regimens. Regarding the uninsured, the Health Care Commission recommends investing resources to begin filling the gaps between existing programs and to improve existing programs. Specifically, funds would help the Commission to coordinate current activities that provide opportunities to move ahead, perform actuarial analyses, identify additional needed components and to improve existing services. Regarding chronic diseases, the Commission recommends that funds be directed towards the implementation of the Diabetes Task Force report. And regarding testing regimens, the Commission recommends using revenue to identify research to be conducted this year.
In sum, the Commission's spending proposal is:
- $20.0 Investment - Strategic Reserve
- $5.0 Prescription assistance for elderly
- $2.5 Tobacco Control
- $1.0 Uninsured
- $.750 Automatic External Defibrillators
- $.750 Other SB 8 purposes; with emphasis on testing regimens and diabetes
HFAC Discussion: Recommendations and Action Steps
In reaction to this plan, Patricia Blevins suggested that while $1.0 million towards the uninsured is reasonable, more specificity around its use would be helpful and that in lieu of it, the issue might best be dealt with next year. In addition, Sen. Blevins asked that the Committee receive information on program costs to expand the Delaware Healthy Children Program to adults. Also regarding the uninsured, Mr. Rochford expressed the concern that allocating $1.0 million for the uninsured at this time may build false hopes of brand new services.
Regarding tobacco control, Rep. Capano suggested also that prior to committing $2.5 million for tobacco control, the Committee receive more specific information regarding the proposed tobacco control plan, especially its school program component, and that the Committee hear additional perspectives on tobacco control spending. Mr. Rochford and Rep. DiPinto also commented that the real focus of this year's spending - and of the settlement money - should be smoking cessation and prevention of smoking by youth.
The Committee agreed that more specific information is needed prior to making recommendations and that every other week meetings would be held until they have the necessary information. In addition, it was agreed that the HFAC would not make a presentation before or present a report to the Joint Finance Committee until the recommendations were nearly finalized. David McBride suggested that the Committee draft its recommendations and then receive public input prior to reporting back to the Governor and General Assembly. No decisions were made at this time, however, about the precise manner in which the HFAC will proceed once it finalizes its recommendations.
Public Comment
John Baker, AIDS Delaware, stated that it is very important to advocate general prevention and informed the HFAC that AIDS Delaware will be involved in the process as it moves forward.
Leonard Young, Stand for Children, stated that Delaware should further explore accepting tobacco settlement monies "up front." In addition, Mr. Young argued that there are existing programs for the uninsured that can and should be invested in now. An example of this program is the Delaware Healthy Children Program.
Rita Moraco, DELARF, argued that funds should not be put aside when considerable needs currently exist.
Stephen Moores, Governor's Advisory Council for DADAMH, submitted a statement for HFAC, urging the Committee to use funds for inpatient and outpatient mental health and addictive disorders. Further, he urges the Committee to request that the Director of DADAMH submit a proposal for funding to provide services that are currently lacking or failing.
Alan Williams, AMID, argued that the great need for inpatient and outpatient mental health services presents a considerable "rainy day" in Delaware and urged that funds to be directed towards a strategic reserve instead be directed towards these services. Amos McLu+ney, Coalition of Volunteers for Health Care Reform, spoke in favor of services for the uninsured and urged the HFAC not to dismiss proposals to address the uninsured in this spending cycle.
William C. Gordon, retired Family Court judge, introduced Rev. Tyrone Johnson. Rev. Johnson urged the committee to keep smoking prevention and cessation a priority and discussed an existing program, Churches Take a Corner, that can be an effective partner in the prevention of substance abuse.
Lisa Prutsov discussed the need to direct attention towards those young people incarcerated in Delaware and providing substance abuse prevention and services in Delaware's prisons.
Meeting was adjourned at 2:20pm.
