Attendees (in person): Kathy Bennett, Mary Lou England, Mary DeGroot, Bob Keller, Debra Kinsey, Paul Kuehnert, Stephen Laker, Miriam Link-Mullison, Deborah Saunders, Ralph Schubert, Glendean Sisk, Myrtis Sullivan, Greg Wilson.
Attendees (phone): Karen Ayala, Pat Donald, Ernest Jenkins, Doris Lomax, Stephen Martin, Elizabeth Patton, David Remmert, Olivia Roanhorse, Jerry Wynn.
Welcome and Introductions
Dr. Sullivan opened the meeting with Welcome and Introductions.
Presentation on Federal Rule Changes
Greg Wilson from HFS gave a presentation on the Federal Rule changes. Talking points were as follows:
- Rule change that the federal centers for Medicaid/Medicare issued in December 4, 2007 regarding targeted case management.
- Federal matching rule effective March 3, 2008.
- Rule has big impact on administrative case management.
- CMS provided some clarification during a conference call and thru question/answers
- Will allow administrative claiming to continue (interagency agreement with another government agency)
- Primary Issue- fed. govt. can't like cost shifting (not doing it in FCM)
- County health departments cost incurred in excess of claim falls under administrative. Get .50 of every dollar incurred.
- Drafted version 3 letter to federal government explaining why we are on strong ground to continue claiming as we have been.
- CMS may want us to develop service explanation (involves a lot)
- If move to service, claiming may receive slightly higher reimbursement rate.
- School-based claiming will likely cease
- The Governor's office decided to use the letter from Director Miriam to Congressional delegation to submit to Covington and Barling (a law firm that we have contracted with) to file a lawsuit with four other states. The lawsuit has garnered national
attention and CMS is becoming more flexible. The person that created the new rules has resigned from CMS so this may help as well.
- When states submit claim, CMS has 60 days to dispute. Within 60 days we should have a good understanding if CMS will accept claims the way we claim now.
- HR5613 places a one year moratorium on this rule and others that have huge fiscal impact on states
- Claims submitted through March would not be affected by new rules. This message needs to be delivered to providers.
- Greg to distribute a copy of the letter from Covington and Barling to Board members.
- Need to find a way to distribute information to providers to let them know that the rule does not affect claims for Oct, Nov, Dec, or Jan, Feb, March.
- Need a 1 page plan in case something goes wrong.
- Ralph to share the question and answer page
- Greg will share the list of schedules of phone calls
- As Greg receives information from CMS he will share with group.
Candidates for Vacant Slots
- The Board still has vacancies that need to be filled.
- An e-mail was sent out to Board members requesting recommendations to fill the vacant spots.
- Dewayne Mitchell, Dr. Dennis Vickers, Dr. Eddie Swift, and Dr. Janine Arlette James have all submitted letters of interest.
- Need recommendations for a physician located in the central or southern region.
- Dr. Sullivan will inquire at SIU School of Medicine as well as Deb Saunders.
- Still need representatives from IDPH and Legislation. Deb Saunders mentioned that she may not be the official representative from HFS, still waiting on response from her Director.
- Deb mentioned that we need to solicit legislatures that have been involved in MCH such as Beth Coulson, Rep. Harmon, etc.
- Deb also mentioned that we need to invite organizations such as ISMS to attend mtgs. because they have been actively involved in MCH. The discussion focused on how to make them feel like members when the Board is convened by statue. The Board agreed
to invite them to attend and they will serve as an advisory group to the Board.
- Dr. Sullivan mentioned that Boards and committee's are part of audits so it is important that people attend the meetings and if they cannot make it to send a representative.
- The group was reminded that these meetings are "open" meetings and anyone can attend.
- Glendean mentioned that a nurse midwife that she met would like to become a part of the Board.
- Bob Keller mentioned going to the chair of organizations to get them to recommend someone from their agency.
- Board members will e-mail recommendations to Dr. Sullivan and Brenda Letcher.
- After all names have been submitted, Brenda will prepare and send to Governor's office for approval.
Perinatal Depression Screening Rules/New workgroup
- Dr. Sullivan contacted Daniel Kelber and Larry Mclain of Professional Regulation about the new Perinatal Depression Act (095-0469) to assist the Board in creating rules.
- Dr. Sullivan would like to create a sub-committee to work on the rules and guidance.
- Pat Donald, Debra Kinsey, Glendean Sisk, Mary Lou England, Dr. Sullivan, and Daniel Kelber will be on the Perinatal Depression Rules Committee.
Glendean reported that the Clinical Sub-Committee met on 3/31/08.
- Completed revisions of the Risk Screening Tools
- Recommendations on how to pilot the tools were made
- Committee finishing up discussion on frequency of screening. There is a conference call on May 7, 2008 to discuss this.
- There was discussion of putting this process on hold because of the CMS rule changes. Deb Saunders suggested not putting this on hold because it is a long process.
- There was discussion on tools becoming more prescriptive than what they previously were. There was reminder that we want to make sure that tools aren't prescriptive
- Glendean will transmit concerns to sub-committee.
- Dr. Sullivan consulted with Dr. Rosenberg to look at tools to come up with the best way to pilot them
- Outcomes, systems and other variables must be considered
- Many agencies don't have TIPCM or Healthy Steps so need to design something for their own agencies.
Steve reported on the historical sub-committee.
- Ralph, Steve and Mary Lou England are on this sub-committee.
- Steve and Ralph had one conversation about the committee. Ralph has drafted some information and will get it to Steve and Mary Lou.
- Steve reported that the pilot needs to be defined and how it gets implemented i.e. paper or through Cornerstone.
- Steve also suggested that they are working on case managers being able to see services that were provided
- Deb suggested that we need an annual report card to see key MCH indicators and to compare nationally by state and then locally by county. The clinical sub-committee will work on this.
- Legislative Sub-committee will look at the Act to decide the scope of the Board.
- Dr. Sullivan has also applied for an MCH Fellow. It would be good for the Fellow to work on this as well.
- Mary Lou England would like to set up priority list of issues such as obesity, perinatal depression, infant mortality, etc. Dr. Sullivan suggested having a mechanism for emerging issues that come up. A workgroup may have to be created to address
those emerging issues.
- Mary Lou England would also like to take a look on how stress affects infant mortality.
- Dr. Sullivan will invite Robyn Gabel to next meeting for insight and report on the Infant Mortality Summit, which addressed stress issues.
- Steve will work on getting a newsletter to keep every one informed.
- Dr. Sullivan will work on contacting Robyn Gabel.
- Dr. Sullivan will get a sample of an annual report card and put on the agenda for the Legislative Sub-committee to discuss.
- Dr. Sullivan will get some models of the report card as well and distribute to entire Board.
- Dr. Sullivan will speak with Ralph to assist her in serving on this committee.
- Group will work on a way to market report card.
Debra Kinsey reported that DCFS:
- Has an interagency agreement for health data with HFS and IT from DHS, DCFS, and HFS are discussing increased data scoring.
- The DCFS data changes in an updated version of Cornerstone will be in place by next year.
- There is a conference call on Monday regarding potential agreement with DHS
- There is a conference tomorrow i.e. National Children's Study UIC, Northwestern of a 20 year longitudinal study of the concern for the shortage of Public Health Nurses. Currently working with academia to get the message out.
- Administrative Association talking to consultants about medical reimbursement. It is on hold because of FCM rules.
- Cornerstone is 20 years old; there is concern about further enhancing Cornerstone making it more reliable than it is now.
Next meeting will be held on July 23, 2008 at 1112 S. Wabash, 3rd Floor, in Chicago, IL from 11:30 to 2:30.
Meeting Adjourned at 3:45 p.m.