DHFAC Meeting Minutes
September 27, 1999
Attendees
- Patricia Blevins
- Thomas Grabowski
- Joseph Lieberman
- Dennis Rochford
- Gregg C. Sylvester
- Calvin Wilson
Welcome and Introductions
Governor Carper addressed the meeting and thanked the committee members for their service. He discussed Delaware’s involvement in the National Tobacco Settlement and his involvement with the American Legacy Foundation, created with $300 million of settlement funds. Governor Carper serves on the Board of the foundation, which will make grants to implement best practices for tobacco prevention. The initial focus is youth prevention, and states will be required to provide a 1/3 match four foundation funds. The foundation will also run a major media and grassroots anti-tobacco campaign aimed at youth.
Dr. Gregg Sylvester also welcomed the group. He noted that other states were using their tobacco funds to pave road and install streetlights, unlike Delaware, where we have the mandate to improve health, defined broadly to include physical, mental, emotional and environmental well-being of our citizens. Secretary Sylvester shared principles that the National Governor’s Association has put forth for tobacco funds. The principles are to create healthy citizens, to make sure program initiatives are flexible to meet changing needs, to try not to grow government bureaucracy, and to keep our eyes on the future.
Origins of the committee
The National Tobacco Settlement
Malcolm Cobin, Assistant State Solicitor
- The settlement was negotiated among State Attorneys General and the major tobacco manufacturers. It includes agreements that could not have been imposed by a judge, such as limits on advertising and creation of the foundation discussed earlier.
- Delaware’s share of the settlement is projected to be $775 million over 25 years. The settlement actually continues in perpetuity, but payment projections have been calculated through 2025.
- Settlement payments will be adjusted based on terms in the settlement. The most notable of these adjustments
are:
- An adjustment for reduction in tobacco sales. When tobacco sales go down, payments go down.
- An adjustment for any federal tax where the dollars go to the states. However, this adjustment is dollar for dollar, meaning that any money states get from the federal government will be offset by equal reductions in the settlement payments, with no net change.
- Delaware’s payments are due to begin no later than June 30, 2000. Funds for the first payment, approximately $9 million, are already in escrow, where they are earning interest. The timing of the first payments is dependent on states finalizing the settlement agreement. Eighty percent of the states, representing 80% of the tobacco market, must finalize the settlement for the funds to be disbursed before June 30. After that, payments will be made directly to the states in January and April through 2003, and in January only thereafter.
Senator Patricia Blevins and Representative Maier, two of the sponsors of The Delaware Health Act of 1999 (SB 8), shared their vision with the Advisory Committee. Sen. Blevins discussed her hope that the fund would improve health in Delaware and would address not only physical health, but also mental health and substance abuse. Representative Maier expressed her excitement that the committee was beginning its work.
Goals and Objectives of the Committee
Purposes of the fund
SB 8 outlines the following uses of the fund:
- Expanding access to health care
- Making long-term investments in state-owned health care infrastructure
- Promoting healthy lifestyles, including tobacco, alcohol, and other drug abuse prevention
- Promoting preventive care
- Detecting and identifying lessor-known but devastating and costly illnesses
- Promoting a payment assistance program for prescription drugs
- Promoting a payment assistance program for debilitating chronic illnesses
- Such other expenditures as are deemed necessary, provided they are made for health-related purposes.
Goal of the committee
Make recommendations, consistent with the purposes outlined in SB 8, to the Governor and the General Assembly for appropriating Delaware Health Fund monies.
Objectives
- To report to the Governor and the General Assembly by November 15th of each year. This year, we will submit an interim report with final recommendations to follow. The committee decided that firm recommendations were needed by the budget mark-up in May, with final ideas in place by March 1.
- To hold public hearings as necessary to provide an opportunity for public comment.
- To report to the Governor and the General Assembly on expenditures, savings and investment accounts under the Delaware Health Fund for the previous fiscal year and to what extent those expenditures accomplished their purpose on the second Tuesday in January. The Chair makes this presentation.
Decision-making process
Ground rules for committee discussion
The committee agreed to engage in active discussion and information seeking in order to decide how to invest the Delaware Health Fund. The committee agreed to the following ground rules, which can be amended or added to throughout the committee’s work:
- We will fully utilize the resources of all group members. This means that all members are expected to participate fully, during meetings and with between-meeting work.
- Every question is a good question.
- Every idea that is put forth will be listened to and considered.
- Those who are bound by the conflict of interest provision in the law will ensure that they abide by that rule. This applies to public members.
Decision making process
The group discussed various models, including consensus decision making or decisions by majority opinion. The group agreed to strive for consensus. This model will strengthen the group’s recommendations and set an important precedent for the coming years.
Public input process
The group decided that public hearings would be held from November or December of 1999 through January 2000. These hearings will be in addition to regular committee meetings. The meetings will be held throughout the state with at least 30 days notice to the public. Committee members will strive to attend the hearings whenever possible.
Information gathering
Secretary Sylvester noted that he would have a point person in his office to meet the committee’s information needs by doing research (with the help of DHCC and the Divisions), by providing background materials, and by arranging speakers. Members should feel free to contact anyone in the Secretary’s Office with questions or requests.
Secretary Sylvester suggested using the next several meetings to give committee members a common grounding in health-related information. This would require several presentations, with topics such as health status in Delaware, health care in Delaware, tobacco issues, disability issues, and substance abuse and mental health issues. The committee agreed to this approach.
How often do we meet? When, where, and how long? Who should attend?
It was decided that the committee should meet twice a month at least until the end of the year. Having the meetings at different locations throughout the state would give the public a chance to come to the meetings.
Public Comment
Q. Does the Federal lawsuit in Washington have an impact on the funding?
No, it is based on Medicare, and states do not share Medicare costs with the federal government.
Q. When and how can groups make formal proposals to the committee? Should these be presented at public hearings? Submitted to the committee?
The committee expressed their desire to get information any way possible. Proposals can be made at public hearings or in written form.
Members of the public made the following points:
- Public hearings should take into account the differences within counties. For example, there are several segments of New Castle County with different populations and different needs, and Sussex County has a similar situation.
- The committee should assure that Sussex County is represented. (It was noted that Vivian Longo works and now lives in Sussex County, but was unable to attend this meeting.)
