DHFAC Meeting Minutes
March 17, 2000

Attending:

• Patricia Blevins
• Deborah Capano
• Joseph DiPinto
• Tom Grabowski
• Charles Reinhardt
• Dennis Rochford
• Gregg Sylvester
• Calvin Wilson.

Absent:

• Vivian Longo
• David McBride
• Joseph Leiberman
• Charles Simpson.

Welcome and Introductions

Gregg Sylvester welcomed the Committee members and the public. Introductions followed.

Review and Approval of Minutes

Minutes were reviewed. Charles Reinhardt asked that the minutes be corrected to indicate the goal of "preventing youth tobacco use." Minutes were approved as corrected.

Tobacco Issues - Update

Gregg Sylvester reported that he was notified that the next tobacco settlement payment is to be made on April 17 and that another reduction is expected. The $15.5 million projected is now expected to be $13 million. He also reported that a letter of intent was submitted on March 13 to the American Legacy Foundation to apply for grant funding.

Fred Breukelman reported that the Institute of Medicine recently published a paper in which IOM reviewed tobacco control efforts based upon Best Practice methodologies. Mr. Breukelman provided the Committee with the IOM's paper.

Old Business

HFAC Discussion: Funding Amounts, Criteria and Oversight

1. Recommendations Worksheet

   Secretary Sylvester introduced a worksheet to be used to develop and record HFAC recommendation and which outlined the initiatives discussed to date and the three areas in which the HFAC has agreed to make recommendations: administrative oversight, criteria and funding amount. The initiatives discussed to date were listed as: strategic reserve, Delaware Prescription Assistance Program, tobacco control and prevention, public access defibrillation, the uninsured and other Senate Bill 8 purposes (chronic diseases and testing regimens). Sen. Patricia Blevins asked that one time costs for substance abuse infrastructure be added to the list of initiatives to be discussed.

2. Strategic Reserve

   Regarding criteria, the Committee offered the following: Cash Management Policy Board would manage investment of the fund; HFAC maintains oversight of Fund, working with Cash Management Policy Board; the Fund be a separate account, not invested in tobacco companies. The amount for the strategic reserve would remain $20 million.

3. Delaware Prescription Assistance Program

   Regarding administrative oversight, Secretary Sylvester reminded the Committee that DHSS has oversight, through its Division of Social Services. Sen. Blevins and Rep. Joseph DiPinto commented that there were some changes that might be made to the law to improve the program and both suggested as a criterion reserving the right to make program suggestions and suggest amendments to the law as necessary. Charles Reinhardt also suggested evaluation as a criterion The amount for the "Pill Bill" will be left at $5 million.

4. Tobacco Prevention

   Sec. Sylvester reported that the Committee has received three requests - from the Sunset Committee, the Attorney General and the Secretary of the Department of Public Safety to have additional money dedicated to enforcement. These requests, distributed to the Committee, ranged from $100,000 to $500,000.

   Regarding administrative oversight, three options were discussed: DHSS, DoE and DPS. Regarding criteria, the following general criteria were offered: strong enforcement of tobacco laws; limiting the growth of government; and not using funds to replace funds already budgeted. Regarding the funding amount, the detailed budget requested from the Division of Public Health was distributed. Rep. Capano suggested that the HFAC have an opportunity to review the detailed plan more carefully and that a special meeting on the tobacco plan be convened and involve the HFAC, state agencies and representatives of community groups and organizations. HFAC asked that this meeting be held prior to the next HFAC meeting. The issues of the funding amount and final criteria were deferred until the next meeting.

5. Automatic External Defibrillators

   Sec. Sylvester reminded HFAC that the appropriate oversight agency for the public access defibrillation initiative would be DHSS/EMS. Clarifying questions about the initiative were raised and discussed and the criteria suggested were evidence-based placement of AEDs and a thorough evaluation of the program. Funding amount remained as proposed: $750,000.

6. Uninsured

   First year funding proposals for three initiatives suggested by Sen. Blevins were discussed:

   1. adult health insurance program;
   2. including dental coverage to DHCPenrolled children; and
   3. providing Medicaid benefits to disabled persons waiting to be eligible for Medicare.

   The Committee agreed that providing medical services to persons 100% disabled and waiting to become eligible for Medicare was an important initiative. More information was requested. Also discussed was the need to coordinate resources and to develop coalitions and coordination. Specifically mentioned as an example of such a project is a proposed study of services needs for disabled persons. The Delaware Health Care Commission was asked to prepare a proposed budget for these activities, for presentation at the next HFAC meeting.

7. Other Senate Bill 8 Initiatives

   To begin addressing other SB 8 initiatives, including chronic diseases and testing regimens, the Delaware Health Care Commission originally requested $750,000. Infrastructure/substance abuse issues were also included in this category and the category was deferred to the next HFAC meeting.

Summary of Old Business

Sec. Sylvester suggested that the next steps for the HFAC were to:

1. hold a separate meeting on Tobacco Prevention/Education/Enforcement and to revisit the issue at the next HFAC meeting;
2. receive more information from DHCC on coordination efforts related to serving the uninsured;
3. gather information on one-time substance abuse infrastructure costs; and
4. revise worksheets to reflect HFAC's support of
   1. Pill Bill
   2. AED initiative
   3. Expansion of health insurance for segment of disabled population

Public Comment

• Chris Manning, American Heart Association, commented on AED's and commended the committee on the public/private coordination on tobacco control.
• Deborah Brown, IMPACT Delaware and the American Lung Association presented a budget and a letter from the Kick Butts Generation.
• Denise McMullen-Powell, ADAPT, commented on the need for transitional services/attendant services
• Mark Morton and Lisa Lessner, Delaware Children's Museum, presented information on a permanent exhibit. Deborah Capano suggested that they come to the next meeting.

The meeting was adjourned at 2:00pm.

The next meeting will be on April 7, 2000, at Buena Vista Conference Center 12:30pm - 2:30pm