ADVISORY PANEL MEETING
MINUTES
NOVEMBER 26, 2001
at
Days Inn, Flatwoods
Members in Attendance: Steve Smith, Jane Horst, Elizabeth "Betsy" Degges, Imogene Foster (for E. Jane Martin), JoAnn Raines (for Robert Walker), Carla See (for George Spratto), Sandra Pope, James Welshonce, Billie Hall, Mike Lewis, Dennis McCutcheon, Hilda R. Heady, Michael Tierney, Sharon Hanna.
Others in Attendance: April Vestal, Penny Asbury, Chuck Connor, Alicia Tyler, Jennifer Plymale, Patricia Crawford, Lora Adkins, Jacquelynn Copenhaver, Ralph Utzman, Shannon Bell, Judy Thomas, Patsy Hughey, Shirley Neel, Elaine Mason, Jodie Jackson, Nancy Dunn, Marilyn Fox, Margaret Novacich, Parr Thacker, Melissa Marco, Robert Blake, Georgianna Tills, Malinda Turner, Carla Campbell, Kathryn Greenlief, Sonnie Strader, Judy Koehler, Aaron Brown, Kristian A. Robinson, Sandra Baker
Dennis called the meeting to order at 2:40 PM.
Introductions of all in attendance were made.
AHEC Development Update
Dr. Nottingham gave an update on AHEC Development as follows:
Internal: Jennifer Plymale of Marshall University and Bill Shires of West Virginia School of Osteopathic Medicine have agreed to be liaisons with the program office. They are to make sure that the three medical schools are cooperating and coordinating their efforts as set forth in the AHEC proposal. Jennifer and Bill will be individuals with whom you can communicate with assurance they will be communicating internally with their respective medical schools about issues that will be coming down the road in years to come. One issue will be the second year of the project, which starts September 1, at which time the two new AHECs will be developed and hopefully the Eastern AHEC will be up and running. Bill and Jennifer will have courtesy invitations to AHEC meetings in the eastern part of the state to see what they are going through in developing the first AHEC. When September comes, they will have a jump-start on the Southeastern and Southwestern Area Health Education Centers. This will be a liaison relationship coordinating and getting a jumpstart on the second year.
Our AHEC program faculty is in place. These consist of four faculty members from WVU who have agreed to fulfill the role of making sure that what is done in the four discipline areas are in accordance with the four schools they represent in AHEC. Dr. Mitch Jacques has agreed to be the Director of AHEC Medical Education; Dr. Cindy Persily, Director of AHEC Nursing Education; Dr. Jennifer Justice, Director of AHEC Pharmacy Education; and Dr. Jim Koelbl, Director of AHEC Dental Education. They will provide technical assistance to the communities as they develop. In the second year, we will be relying on faculty members from Marshall University and the School of Osteopathic Medicine to provide similar faculty guidance in developing AHECs in those parts of the state.
External: The most exciting event taking place,
in the terms of the community, is the development of the Eastern Area Health
Education Center which had previously been delayed, but is now moving very
smoothly. Dr. Mike Friedland, Dean of the Eastern Health Sciences
Center, has agreed to be the facilitator of a group of people, key individuals,
that will convene for a meeting to select an interim lead agency so funds
can begin to flow. Hopefully there will be a steering committee of
five to seven people that is responsible for developing a board of directors
in accordance with the memorandum agreement, which was approved by this
board. As outlined in the memorandum agreement, RHEP Consortia consented
to assist in the creation of these boards. Hopefully an interim director
will be selected to develop the AHEC as outlined in the proposal and hire
the appropriate staff to make sure committees are in place. The next step
will be the beginning of developing by-laws and articles of incorporation.
Hopefully, around July 1, the official Area Health Education Center will
be in place, dropping the interim and hopefully selecting a permanent executive
director, board, etc. By mid July or August 1, at the latest, a trial four-week
rotation of seven learners of the program will take place in accordance
of the plan. The learners include a resident of the Harpers Ferry program,
a fourth year medical student that has an interest in doing a residency
training at Harpers Ferry, a nursing, pharmacy, dentistry, allied health
and public health graduate students. By August 30th, end of the fiscal
year, all obligations will be fulfilled for the first year of the contract
of the federal government and therefore, will begin to jumpstart the second
year
.
Chuck Conner asked, "Is there any leeway in other counties being involved?"
Dr. Nottingham stated that the original six counties are exempt and cannot
be involved. However, seven, eight, nine or even ten years from now there
is another type of AHEC funding that will be available and we definitely
think that these six original counties can be brought up as part of the
Capitol Area Health Education Center. Chuck also asked, "If Roane
County did not receive any monies, is there any way to present this?"
Dr. Nottingham stated that rules are rules at this time, but there are
probably ways around it and we will have to explore ways to get around
the exclusion.
The panel agreed that there should be an AHEC update at every Advisory Panel Meeting. The board agreed to have the Eastern AHEC representatives attend the Panel Meeting in March and present a report.
A motion to approve the consent agenda was made and approved. (Welshonce/Foster - unanimous).
Comments from Vice Chancellor
Medical Malpractice
Dr. Lewis reported that there is a medical malpractice crisis.
He stated that Governor Wise called a special legislative session
on October 21, 2002, to deal with the medical malpractice crisis in the
state. Dr. Lewis read an article that a very knowledgeable lobbyist
had put on the web entitled, "The Good, The Bad and The Ugly". This
was referring to the House going one way on the malpractice issue and the
Senate going the other. During this special session, the Governor
presented a draft of a bill that the legislators should address.
Wise recommended setting up a malpractice program under BRIM (Board of
Risk Insurance Management) but not a part of BRIM as is relates to medical
schools. All other educators and employees of state funded programs
are covered under BRIM (i.e. state police, state property liability, etc.).
Gov. Wise was proposing that another board be set up under BRIM doing the
underwriting of doctors' according to their specialty and claims history.
Those with bad claims history would be charged more.
Dr. Lewis stated that many states have a panel that must review every potential malpractice suit before it is brought forward. The findings of the panel does not necessarily keep the suit out of courts but recommends whether or not to settle out of court or will defer suits that are too frivolous to go to court. Doctors do not want to settle cases in this manor as the outcome is reported to a national data bank and as a result, if you apply for licensure to an HMO or managed care program, the HMO or managed care program may refuse to let the doctor(s) see patients or the doctor(s) may lose their hospital privileges, resulting in a no win situation. Last year, physicians won 82% of their malpractice suits brought against them. One of the issues being looked at now is forming a physician-run insurance company. Dr. Lewis stated that if a physician-run insurance company is formed, there has to be a cap on the amount paid out per case. The legislature has until the end of the month (November) to come up with a some type of legislation or we will be in a real crisis in terms of health care. If a physician does not renew malpractice insurance, the physician has to purchase tail coverage, which amounts to thousands of dollars, driving physicians out of state.
Dr. Lewis encouraged the panel and those in attendance to work with their legislators and encourage them to do something soon.
LOCEA (Legislative Oversight Committee on Education)
Dr. Lewis stated that each year RHEP gives a report to the LOCEA.
Two reports came out this year:
1) PERD (Performance Evaluation Research Division of the Legislature)
- which is an overall RHEP report. A concern of this report is the
evaluation and tracking of students. A funding request has been submitted
asking legislature to support the funding to meet the need of evaluating
and tracking students. Over the past four or five years, medical
schools, nursing schools, dental schools, health sciences, etc. received
3.25% increase each year and RHEP has not received anything. RHEP has built
this increase into a budgetary request.
2) Evaluation by Doak, Cuppett & Poling (DCP) - which is concerned with financial oversight of funds; how they were being distributed, spent and accounted for. A sub-committed was appointed and addressed some of the issues. Dr. Lewis asked Dennis McCutcheon to put together another sub-committee and address the two or three issues not previously addressed. Dr. Lewis suggested putting together a package that would make an impact on the Legislature. Each lead agency administrator will be getting a letter asking for copies of contracts and agreements, etc. in order to have a more concise and efficient oversight process on agreements, contracts, and flow of money. Please send this information to Margaret's office and send copies to site coordinators to help get information put together quickly. RHEP needs to have crisp and concise answers for the LOCEA concerns!
Partnership between WVRHEP, WVU and the Catholic University in Central
Mozambique
Dr. Elizabeth "Betsy Walker", Associate Professor, WVU Department of
Anatomy, was awarded the "Rotary International Grant for Teachers in Developing
Countries". She gave a slide presentation on rural health care and education
in Mozambique during her January 2000, visit. She hoped to entice
others to join the adventure. Dr. Walker's husband, David Walker, set up
a web site for the medical school in Mozambique. To look at this
web site go to www.walkerconsult.com. She reported that within the
last five years, agriculture school, economic and management, education,
law and medical schools have been set up in different cities. There is
a great need and desire for education in Mozambique. While staying there
for three months, and seeing that there was no health education system,
she wrote a grant. This was very rural area in Mozambique. There
is no health care or health education system because they have been at
war to gain freedom from Portugal and also through a civil war took place
and destroyed what health care system they had.
At the rural health clinic in Mozambique, 40% of those seen are under five years of age and young mothers. Only 30% of the population has access to health care and 40% of the staff is not properly trained.
The Mozambique University Hospital has set up an outreach department this fall and this is where they will be working with us. The grant was written to the US Agency of International Development for people to travel back and forth to Mozambique only, not for equipment or supplies. The Brothers' Brothers Foundation sends books and medical supplies to Mozambique. The ultimate hope is for fourth year students to do rural rotations in Mozambique and for them (Mozambique students) to come here. Two people from Mozambique will be visiting the Winding Roads Consortium to see how RHEP is set up. One visitor will be the Dean of the Mozambique Medical School. The medical school was being set up and the first class started while Dr. Walker was visiting there.
The floor was open for comments and questions. Dennis McCutcheon asked about being church related and using (WVU) taxpayers dollars. Dr. Walker stated this was a US Agency of International Development Grant with no taxpayers dollars being involved. However, there is a conflict in Mozambique regarding church money and government money.
Finance/SubCommittee
Chuck Conner stated that they had a very good meeting. Dr. John
Corkrean, a field faculty member at Winding Roads Consortium provided a
community pharmacy perspective, talking about the new role of the PharmD
students and how his facility is involved in addressing the students' needs.
Through his discussion, the committee started looking at and thinking about
new models as curriculum changes. What are the standards for the
schools and are we looking at funding changes as the program changes?
The sub finance committee charges the school committee to review curriculum,
curriculum costs and how location and costs may be related also.
Another presentation was from Bob Harman and Malinda Turner from the eastern
panhandle. They talked about funding models for RHEP. The committee
is looking at how to allocate the money that we do have over the next couple
of years. Bob agreed to work with the Little Kanawha Area Consortium
on the other end of the spectrum in funding and gave an extremely good
presentation. The outcome of Mr. Harman's report charged the Site Coordinators
to look at the eastern model and overlay that information at the sites
to see what may or may not work for them. These results will be sent
to a subcommittee of the subcommittee, which will result in a proposal.
The question, "What will we do about the stagnant funding and how are we
going to use our money in a much better and more economical method?" came
about.
A field faculty survey and an agency survey was sent out to find out
what active pay was, if they were getting paid actively, and whether or
not they would stay in the program, etc. Fifty-four people responded
to the survey, and out of those 54 people, 63% said they would stay in
the program whether they were paid or not. The committee feels that
RHEP is on the right track and is trying to come up with a plan that is
workable for everyone.
Chuck thanked everyone for their input.
Evaluation Committee
Jodie Jackson stated Malinda Turner received good feedback on evaluations
from 12 of the 17 site coordinators. The School Committee will discuss
the evaluations at their March meeting. The School Committee will
have to look at some issues brought up by the site coordinators and then
send their feedback back to the Evaluation Committee. Jodie introduced
Sheryll Tennant and stated that she redesigned the report. Everyone welcomed
her.
Faculty Development
April announced that the Faculty Development Conference will be held
at the Embassy Suites in Charleston on September 6-8, 2002.
Student Advisory Committee
Billie Hall conveyed that the student panel and community members met
as a group. Ms. Hall announced that RHEP is redesigning the web site
and giving it a facelift. She said that the community members and students
went over things they would like to see incorporated or changed within
the web sites. She stated that the joint committee would like to
have a joint two-day retreat in mid-April, instead of a one-day retreat
in January due to the weather. They are looking at a tentative agenda.
Executive Directors Report
Hilda reminded everyone of the Annual Awards Dinner to be held at the
Embassy Suites in Charleston on February 11, 2002. She passed out
nomination forms and let everyone know that these forms are available on
the web also. She conveyed that the Vice Chancellor award is for
an outstanding campus based faculty member who exhibits the full mission
of the program. Dr. Lewis will choose the recipient. If anyone has
a nomination for the Judy Kandzari Award, please send it to Dr. Lewis with
a copy to April or Hilda. Hilda asked for any suggestions or new
ideas on the dinner agenda/program.
Hilda encouraged efforts to work with Field Faculty to talk with their legislators on what RHEP means to them, especially what it means to retain them in the local community and in their terms of leadership to the community. She stated that the CCPH Annual Board asked us to help them learn more about policy in West Virginia and particularly our relationship with Legislature. Six legislators met with the CCPH board, thus providing an outstanding session. Hilda conveyed that Senator Jackson stated that RHEP had at least another ten years to see the results that we need to see at the grassroots level in these communities. He firmly believes that this program will be successful when he can see that someone he recognizes as a student in his community, coaching a football team or in the role as a leader and is a health professional in that community. This is the ultimate test of the true indication of success. Please let your legislators know that these are the role models that students are being exposed to. Hilda will send out talking points relative to the HEPC (Higher Education Policy Commission) budget request with the annual fact sheet. She strongly urged that the legislators be invited to holiday events, etc.
Motion to adjourn. (Welshonce/Smith - Unanimous)