WVRHEP/AHEC
Restructuring Task Force
Initial
Meeting
John E. Jones
Conference Center Room B
Attendance: Members: Dan Brody, Bobby Brown, Patti Crawford,
Imogene Foster, Richard Meckstroth, Connie Simmons, Tom Hefner, Sara Jane
Gainor, Carla See, David Hughes, Norman Ferrari, Alvita Nathaniel, Jill
Cochran, Barry Linger, JoAnn Raines, Helen Baker, Chuck Conner. Guests:
Anna Reno, Robin Schimmel, Angie . Staff: Hilda Heady, April Vestal,
Jodie Jackson, Sandra Pope, Henry Taylor, and Alicia Tyler.
The meeting was called to order and facilitated by Hilda Heady. Introductions were made by members and guests. Heady reviewed the challenges and charge to the Task Force. In November 2003, the Panel passed a resolution to look for program cost savings measures through mergers and consolidations and other means. The Panel charged each consortium to come up with these changes by May 1 to be in effect by July 1. Because of the reauthorization being approved for one year, this process needs to be accelerated. We have roughly 90 days to meet this challenge. Heady asked for comments and questions.
Tom Hefner asked about the final budget and Heady stated that the cuts are the same as in Higher Education and roughly 7.5 to 8%. Margaret Novacich has developed budgets at these various percent levels and these were distributed. Bobby Brown suggested taking the overall budget of 2.7 million to 2.3 or 2 million across the board as one method.
Tom Hefner suggested a statewide merger with AHEC as an alternative that could improve both programs give better focus and better coordination. He told the group about the experience of the three RHEP consortia in forming the northern AHEC. He said that an option to consider and analyze the savings is to merger the RHEP consortia into 5 AHECs in the state, including the 4 now and the 5th in the center of the state.
Bobby Brown reported on his conversation with the Chancellor regarding this move. He said that the Chancellor said merger was the way to go. When asked about the number of consortia, the Chancellor said he did not care as long as there was a cost savings and that consolidation is the right direction. Bobby further stated that the Chancellor said three things: (1) we need to look at cost per student week, (2) that Capital purchases cease and (3) we must consolidate. He also reported that the Chancellor would be setting up a meeting with Senator Plymale to discuss this matter.
Hilda Heady reminded the group that Senator Plymale is the Chair of the Senate Education Committee and LOCEA to whom we area required to report annually as specified in the RHI Act, therefore his opinion is very important. She also said that there is too much speculation going on right now about what the one year reauthorization might mean. She informed the task force that she has set up an appointment with the PERD staff for April 16 to discuss this year's report. When she called PERD about this meeting, at that time, they were unaware that the Panel had been reauthorized for only one year. She stated that, while we are frustrated by the situation, we need to move forward in a proactive manner. She also reported on her meeting with Sen. Plymale on February 16. He called to set up the meeting to discuss the budget. He asked for us to develop budget scenarios with a 10%, 15%, and 20%. The Senator said he was glad that the Panel passed the merger resolution in November, but we need to accelerate this process. When asked about his sense of our expenses, he said we have "too many secretaries," and he disagrees with our use of these funds for capital purchases. Hilda stated that there are issues of accountability concerning state ownership of capital purchases and how these are deeded to lead agency acting as fiscal agent for consortia. This is an issue that PERD reviewed and language for changes to the RHI Act was submitted by the PERD staff, but the legislature did not act on this issue in the last session.
Hilda called a meeting of the finance committee to discuss the Senator's request. The budgets were e-mailed to Sen. Plymale's office, but he decided to go with the Governor's recommendations in the Higher Education Budget for the RHI funds.
In follow up to Tom
Hefner's comments about a possible merger with AHEC, Hilda made comments on
AHEC federal funding. We are in the last
year of the initial AHEC grant which ends
Unlike most federal grant programs, AHEC federal
grants are unusual in that these require a one to one match. For every federal grant dollar, a dollar has
to be matched or cost shared from another non-federal source. These cost share dollars do not have to be
put into a separate budget but they do have to be used for the same mission as
AHEC and support AHEC-related activities.
After the 12 years of AHEC grant funding, the expectation is that the
existing
Bobby Brown stated that the Finance Committee spent a lot of time looking at all ways to allocate funding, reduce expenditures. He expressed considerable frustration at both the time the committee has spent on this issue and it is not enough, and the fact that there is no legislative direction explaining the reasons why the program is only reauthorized for one y ear. He stated that the Finance Committee at their March 15th decided to
institute a freeze on fund balances as well as continue the moratorium on capital purchases. Also at the March 15th meeting, the Committee decided that the Task Force should consider the cost per student week as the most effective measure in their deliberations. According to the data the Committee had at that time, the cost per student week range was from $347.00 to $4,748. The staff has since discovered a data error rendering these figures inaccurate. The new figures were given to the Task Force. The statewide average is roughly $585.00. The Finance Committee on March 15th suggested that the Task Force use the benchmark of $650.00 per student week. At this level about ½ the consortia fall above this benchmark and ½ fall below this mark. Bobby further said that the Task Force needs to review the budgets statewide by category -(i.e. personnel, meeting costs, travel, etc.) Margaret stated that this information is available for the community side funding only.
Dan Brody said that we should not overreact to this task. He stated that the reality is that all programs need to be cut. He stated that we are just being asked to do what other higher education programs are being asked to do. Task force should prepare for a 10% cut. Consolidation may or may not be the answer to cost savings, and one of the problems we have with perception is that purchasing vehicles is not a cost saving.
The Task Force then reviewed a large amount of data concerning the numbers of student weeks, cost per student week, HPSAs, etc. by county. There were questions concerning variable costs. There were also a number of questions about the information and its accuracy. The problems that were noted will be corrected by the next meeting of the Executive Council.
The members then spent considerable time discussing the issue of distribution of medical student rotations and the numbers in certain training sites. Ferrari- Student Cap
Hilda stated that as long as there are more sites than students at any given time, there will remain a distribution issue. Students are given three choices for each rotation. Dr. Ferrari brought up the idea of capping the number of rotations at certain sites.
The Task Force next discussed and approved a number of principles to guide their work. These include:
1. Overall program needs will take precedent over any individual consortia
2. Special consideration must be given to most needy areas of the state
3. Our goal is to provide health care to the whole state as well as the areas most in need
4. Our work should consider the changes over the past 12 years such as the development of a clinical campus in the Eastern Panhandle.
5. Listen for understanding instead of looking for judgment.
6. Act on data not innuendo
7. We must remember that students are active and adult learners and need to be respected.
8. Respect each other and respect all persons organizational perspective
9. Focus on all of WV
10. Operate within the values of RHEP
11. A consensus model will be used
Imogene consider all counties as needy
David uncompensated dental care-valuing community service provided through RHEP great resource people served and value of this
The Task Force then broke out into three groups and were to list issues and data needs without coming up with specific solutions. These are the findings of the groups:
Group 1
1. Numbers and cost per student for students not in RHI act
2. What are the fund balances and how are these budgeted?
3. Date in changes in health outcomes compared to the service learning projects.
4. Dollar figures on service learning?
5. Number of medical recruits-still involved in service-learning?
6. Numbers from out of state students and costs to host these rotations?
7. Data needs to be more accurate
8. Summarized data by HPSA
Group
2
1. Summary of wide swing in payments to on-site clinical directors and honoraria. Do we need all these variable expenses?
2. Open positions in 1990 as compared to today?
3. Can we look HPSA designation 1991 to now?
Group
3
1.
Strengthen goals of rotations and schools ownership of
these goals.
2.
Lottery for placement of students. (DON'T WORK)
3.
Consolidating RHEP & AHEC
4.
Consider eliminating honoraria due to variation of
costs
5.
Discussion to measure community service translated
into health care dollars.
6.
Due month rotation is a wild and wonderful
7.
Cost of annual dinner and large (mega meetings) over 3
years by year (pay for award winners)
8.
Cap rotations in popular sites by discipline.
9.
Workforce Investment Boards: do they have to $?
After the groups
reported, Hilda asked the Task Force if they wanted to set their meeting
schedule. It was the consensus of the
group to have the Executive Council meet and then let the whole Task Force know
if the whole group needed to meet again.
Information that the Council develops will be shared with the Task Force
via e-mail.
Hilda the reviewed the time frame for the Task Force's work:
May 17- Presentation to Panel of Plans for approval if ready for comments and changes from the floor;
June 7- Plans finalized changes incorporated
June 14-Final vote via conference
June 30- Implementation of plans and affiliation agreements
The meeting adjourned at
The following list outlines the central administrative staff responsibilities in developing information for the Executive Council
Central Administration
Staff Assignments
Hilda- Develop minimum structure and content of local consortia board agenda
April- Site Coordinator position description with focus on communications process for required content
April- Policy on payment of honoraria and FF
Margaret- Get honoraria payment methods from SC
Hilda- Board training-
1. What is a good Community service project?
2. What are recruitment needs?
3. Roles of Board Members in general?
4. Roles of RHEP Board members?
Alicia- Summary of HPSA data on one sheet and HPSA map.
Hilda- Schools
Is there a way for schools to help RHEP assess students' interests in:
1. Type of community service
2. Learning needs interaction in public health
3. Interest in primary care
Margaret - Get cost per student week from school
side of funding, for rural rotations
Elaine- How cab we help S.C.'s stay in
touch with residents who have completed RHEP rotations in their areas.