This afternoon, the House and Senate both passed an increase in the state tobacco tax. The $1 increase was part of the larger tax bill, and the legislature decided to pull out this piece to pass it with a July 1, 2008 effective date. The House passed the bill on a 95-52 vote, and the Senate passed it 26-9. The $1 increase will generate approximately $174 million, all of which will go into the Commonwealth Care Trust Fund to help pay for health reform. This money replaces other revenues proposed in the Governor’s budget (such as casino licensing) and therefore does not decrease the funding shortfall for health reform.

Increasing the cigarette tax to $2.51 per pack will prevent 46,000 kids from lighting up and spur 26,000 smokers to quit. The bill also includes all of the inventory currently held by sellers. A key concern, language that would eliminate the state’s minimum pricing law, was also left out of the conference committee version. This means that the state will see the full public health and health economic benefits from the increase.

The ACT!! Coalition, working with Tobacco-Free Mass, strongly supported the measure. Increasing the tobacco tax raises needed funds and decreases the cost of the health programs funded by the revenue. The bill text is here.
Lindsey Tucker

A few good clicks:

1. “Money well spent” – that’s the conclusion of the Boston Globe editorial from Saturday on the outreach grant funding now before the budget conferees. The Globe drew this lesson from the delayed mailing of notices to some 16,000 CommCare members and applicants. The editorial stated that “The glitch does point up the need for the state to continue to fund the work of nonprofit community outreach groups that were instrumental in enrolling the uninsured. These 45 groups, many rooted in Spanish- or Portuguese-speaking communities, are still needed to help enrollees in the subsidized program, called Commonwealth Care, navigate the ins and outs of keeping, or losing, coverage.”

2. “given sufficient resources, more can be done” - The New England Journal of Medicine reviewed health reform implementation and called for increased federal support through the MassHealth waiver, still under negotiation. The report’s conclusions are important:

“Health care reform in Massachusetts is not a panacea for the many shortcomings of the health care system…. Having health insurance is not having health care. There are still many difficulties with access to primary care and other services. However, Massachusetts has made some strides, and given sufficient resources, more can be done. This includes identifying and reaching people who are still uninsured and helping them gain coverage, expanding employer-sponsored insurance, and improving the options for part-time employees, for low-paid workers who are offered insurance by their employers but who earn less than 300% of the federal poverty guideline and cannot afford it, and for others with hardship exemptions.

3. “The state made a great commitment, a heroic commitment” - Today’s USA Today pegs a story to the first anniversary of the start of the individual mandate. The lead features a 55-year old woman whose premium went from $422 to $615, which we frankly don’t understand (Commonwealth Choice rates have been erratic at times, but we haven’t seen this much of a jump for adult plans). This is counterbalanced with a woman whose life was saved when her thyroid cancer was treated with state-provided coverage. The story covers budget issues, and features Connector ED Jon Kingsdale making the coverage first, costs second pitch:

“The way to do this is to make the moral commitment to cover everybody,” Kingsdale says. That forces “the political leadership, doctors, hospitals and health insurers to grapple with how to make this affordable. I don’t know any other way to get America to confront this very tough problem.”

4. “we’re already seeing some impressive results” - Finally, DPH Commissioner John Auerbach writes on WBUR’s Commonhealth blog on the public health gains they are measuring as health coverage improves. Higher adult vaccination and colonoscopy rates, and less need for subsidized breast and cervical cancer screenings have been observed. DPH is monitoring health improvements, and expects to have more data later.

The Health Care Quality and Cost Council will hold 2 committee meetings Wednesday, July 2, at One Ashburton Place, 21st floor.  The End of Life Committee will meet from 11-12:30 and the Communications and Transparency Committee will meet from 3-5.  Agendas are below. Also, check back here later today for an update on the HCQC Council’s retreat.

End of Life Care Committee and Chronic Care Management and Prevention Committee

I.   Approval of Minutes from May 7, 2008 meeting

II.  Items for Discussion

A.     Discussion of End of Life event to focus on Dartmouth Atlas findings

B.     Hospice Care Statistics; Diane Bergeron, Hospice Care, Inc.

C.     Physician Order for Life Sustaining Treatment (POLST); Ruth Palombo, Executive Office of Elder Affairs, Andy Epstein, Department of Public Health

Communications and Transparency Committee

I.   Approval of Minutes from May 7, 2008 meeting

II.   Items for Discussion

A.     Analysis and display of variation in quality measures across hospitals; John Freedman, M.D., Clinical Consultant to the Council

B.     Collection of patient race and ethnicity data

C.     Follow up from Council Retreat

The Third Annual E-Health Consumer Summit was a room-bursting success. Titled, “Are We There Yet? The Mass eHealth Collaborative Experience: Lessons Learned, Opportunities and Challenges for the Future,” the agenda balanced presentations – one weighing the policies and procedures of the MAeHC three-community pilots against national consumer principles, and the other offering an overview of the projects and how they fit into the larger context – and audience-panel questions and answers.

You can download Lisa Fenichel’s presentation, measuring how Massachusetts e-health pilots conform with consumer protection standards, here. More on HCFA’s active e-health project is here.

The panel, which included the executive staff of the MAeHC and others – clinicians, IT staff, and a Brockton MAeHC Community Consumer Council member – represented all three communities: Brockton, Newburyport, and North Adams.

The panelists were asked some difficult questions such as what unique challenges each community faced when switching to e-health records (EHRs), how to ensure quality reports, how to handle the reporting of mental health conditions in EHRs and what the challenges are when working with multiple vendors.

All of the speakers acknowledged that the process of moving from paper-based records to EHRs, and from there to interconnected records, was neither easy nor perfect, but the consensus was that things were moving in the right direction. Richard Mindess, a physician in Newburyport, had described the process as building a house. He said that “we have dug the hole and have our foundation, but we still do not have a house.” The panelists also recognized that there is no one model that fits every community.

Yet the overall message of the panel discussion remained positive. All panelists believed that the exchanging of health information electronically is the future. Mindess, in spite of the challenges he acknowledged with “going live” with the health information exchange, went so far as to say that the new system and the pilot programs have “the potential to redefine what is good, quality care.”

The $50 million funding from Blue Cross/Blue Shield for the MAeHC pilot projects will be spent by the end of 2008. Much of the future of the MAeHC rests on what happens with e-health funding (S. 2660, Cost Containment Bill) in the legislature. We are all watching this bill closely and keeping our fingers crossed . . .
Lisa Fenichel and Sarah Donohue-Rolfe

Kayla (pictured above with her mother and Re. Golden) is one of the lucky ones. Faced with a bipolar diagnosis and substance abuse issues as a high school student, she and her family were able to access treatment that effectively addressed her needs. Now 20, she recently got her driver’s license and bought her first car.

But Kayla will be the first to tell you that she is one of the lucky ones. There are thousands of young people in Massachusetts who are unable to get the care necessary to confront their mental illness. That’s why Kayla and her mother Irene came to the Lowell MSPCC offices this morning – to advocate for systems change that will help those kids who are not as lucky as she was.

The Greater Lowell Children’s Mental Health Forum was attended by more than 40 parents, service providers, and advocates. Representative Tom Golden spoke in support of S. 2518, An Act Relative To Children’s Mental Health and how Kayla and Irene’s story brought him into the world of mental health system reform. Aides to Representative Miceli and Senator Panagiotakos also participated.

S. 2518 would encourage early identification of mental illness in children, Provide schools new tools and resources to help their students, expand insurance protections for families of children living with mental illness, and restructure current state agency structures to break down silos of care.

Currently, the bill is pending action by the Senate Ways and Means Committee, but time is running out in the current legislative session.

The Health Care Quality and Cost Council will be holding a day-long retreat on Monday, June 30 at Worcester State College’s Student Center – Blue Lounge, 486 Chandler Street in Worcester (directions and campus map link -look for building 10).

The sessions will go from 9 am to 3 pm.

The agenda includes discussions of a theoretical framework linking cost reduction and quality improvements, evaluation of the Council’s success so far and opportunities and challenges for future efforts, a discussion of website and communications opportunities with outside experts, and establishing priorities and and agenda for the coming year.

The coming year will be critical for the Council, as it moves from its planning to its operational stages. The cost control legislation pending in the House may put more responsibilities on the Council as they work on their current priorities. Information on the Council is available on their website.

Some exciting news for consumers in the e-health world today: at a press conference this afternoon, Connecting for Health/Markle Foundation released its long-awaited Common Framework for Networked Personal Health Information. Endorsed by many organizations, including AARP, Consumers Union, The National Partnership for Women and Families, The Center for Democracy and Technology, Dossia, Google, and Health Care For All (our own E-Health Consumer Advocate, Lisa Fenichel, participated in this 18-month project and is quoted in the press release), this framework tackles the difficult policy and technological issues that arise when personal health information is on the internet as happens when using PHR — personal health record — services. Its primary focus is the creation of practices and policies that promote privacy, personal control, ease of use, accessibility of information, and accountability.

Simultaneous with today’s Framework release, Markle released a survey that “indicates that an overwhelming majority of U.S. adults see the value of online personal health records . . . At the same time, the vast majority of respondents said having key privacy practices in place would be a factor in their decision to use such services. Nearly half called specific privacy practices ‘critical’ in their decision to try one out,” said David Lansky, chair of the work group that developed the new framework.

This ambivalence is no surprise. What is a surprise, however, is how well the framework faces the dueling needs of privacy and information flow and comes out with policies and practices that balance them both without seeming to sacrifice either.
Lisa Fenichel

The pharmaceutical gift ban is garnering more support from health care providers across the state. Four prominent Massachusetts physicians wrote to Governor Patrick, Speaker DiMasi and Senate President Murray in support of legislation that would prohibit pharmaceutical companies from giving gifts to health care providers, as did the National Physician’s Alliance and the Boston University and Tufts University chapters of the American Medical Student Association, which together represent 970 practicing and future Massachusetts physicians. (you can read the letters here)

Two former editors-in-chief of the New England Journal of Medicine (Dr. Marcia Angell, now of Harvard Medical School, Dr. Jerome Kassirer, now of Tufts Medical School) joined with Dr. David Coleman, Chief of Medicine at Boston Medical Center, and Dr. Stephen Tosi, Chief Medical Officer of UMass Memorial Medical Center, to call on the state’s leaders to put an end to the use gifts to market prescription drugs, a practice that undermines patient care, diminishes confidence in the medical profession and increases health care costs. The physicians stressed that “the intellectual aptitude and education required to become a physician do not make physicians any less susceptible to the persuasive power of marketing.”

The National Physician’s Alliance and Boston University and Tufts University chapters of the American Medical Student Association also expressed strong support the pharmaceutical gift ban and academic detailing provisions in the Senate President’s cost control bill. Recognizing the need to eliminate conflicts of interest in patient care, the medical students and national physician group stated that “prescribing decisions must be based on independent scientific evidence, free of inappropriate influences.”
Claribel Vargas

Great back-and-forth dialogue in the comments section of our blog last week on the delay in the Quality and Cost Council’s website. At issue is the planned public posting of hospital cost data. The discussion is between Paul Levy, President of Beth Israel Deaconess Medical Center, and Charlie Baker, CEO of Harvard Pilgrim Health Care. These are the two Boston health care CEOs with their own blogs (Paul’s here, and Charlie’s here); we’re happy to provide a neutral forum for their exchange.

Of course, we’re not so neutral in this discussion. Paul’s worried about accuracy and validity. Charlie’s view is let’s get this started, and make improvements along the way. Our concern, which we wrote about two days earlier (with two interesting comments added), is whether this is really worth it. Our point, that price transparency may not be too useful, and could lead to price increases, was picked up by this week’s lead Modern Healthcare article (link, registration required).

All over the country, state governments, health plans and hospital associations are making hospital prices public. The article raises a flag of caution:

On the face of it, healthcare’s newest grail—pricing transparency—seems like a noble mission, but under the microscope all sorts of pesky problems begin to come into focus, caused in large part by healthcare’s notoriously inscrutable pricing system. And although it seems to be a no-brainer as a necessary way for engaging patients into making informed healthcare decisions, it may not be the panacea for consumerism that it is made out to be.

Paul Ginsburg, president of the Center for Studying Health System Change, says he has been trying to convince policymakers of that for some time.

“The potential of price transparency is being oversold,” Ginsburg says. “Its potential to make a difference in the near term in consumers’ decisions is fairly limited, and by the way, if it’s done in a clumsy fashion, it could even raise prices.”

Thanks Paul and Charlie for the discussion, and keep on blogging on.
Brian Rosman

On Friday, the Children’s Mental Health Campaign held its eighth regional legislative forum on reform of the children’s mental health system. Several parents shared stories about their personal struggles to get help for their children. These parents are often frustrated by lack of resources and understanding on the part of schools, state agencies, and insurance companies. Following these testimonials about the need for reform, Representative Geraldine Creedon and Senator Robert Creedon had their names added to the list of 120 members of the legislature supporting reform legislation.

A Brockton Enterprise article provides a summary of the event.

Legislation that is supported by the Children’s Mental Health Campaign is still pending action by the Senate. S. 2518, An Act Relative To Children’s Mental Health, was sent to the Senate Ways and Means Committee in February and has yet to be reported out. The bill would mandate early screenings for mental illness by pediatricians, provide resources to schools to help students living with mental illness, strengthen insurance protections for children and their families, and restructure state agencies to make the children’s mental health system easier to navigate. Senators need to hear from their constituents about the importance of this legislation and the need for it to be passed this session (click here to find contact information for your State Senator).

This coming Friday, June 27, the Children’s Mental Health Campaign will be holding another forum in Lowell from 8:30 -10 am at the MSPCC offices at 126 Phoenix Avenue. For more information or to RSVP, contact Matt Noyes, Children’s Health Coordinator with Health Care For All, at 617-275-2939 or mnoyes@hcfama.org.
Matt Noyes

The proposed ban on gifts to doctors from pharmaceutical companies in the Senate health care cost and quality bill (S. 2660) has been grabbing headlines and op-ed space since it was first introduced in March, and now a new survey (download pdf) has found that the majority of Americans disapprove of many of the gifts that pharmaceutical companies give to doctors.

The survey, conducted earlier this month, polled more than 1000 people across the country about pharmaceutical company relations with doctors. Here are some results that pertain to the pharmaceutical section of the Massachusetts bill:

Gifts:

• 86% of those surveyed believe free dinners (from pharmaceutical companies) should not be allowed
• 80% believe speaking fees should not be allowed
• 78% believe free lunches at the office should not be allowed
• 70% believe free note pads and pens should not be allowed
• 62% believe free attendance at mandatory continue medical education classes should not be allowed.

Disclosing payments to doctors from drug companies: 68 percent would support legislation requiring pharmaceutical companies to publicly disclose any gifts or payments given to physicians.

Academic detailing: 71 percent would support legislation that enables clinical experts to provide unbiased non-commercial information about drugs to physicians in their offices.

While the proposed gift ban has been hotly contested by industry leaders, who have the ear of many in the press and legislature, this survey suggests the ban and academic detailing elements of the bill reflect a growing clamor for clearer lines about just what’s allowed and what’s not. Clearly, the line between gifts and inducements in medicine right now is too blurry for many patients.

Put it this way: If three-fifths (60 percent) of the U.S. Senate is considered a supermajority, then these numbers show that there is public super-support for legislation like S. 2660. And when it comes to public backing of a cost-containment bill, we think that’s uncommonly good news.
Kate Petersen, The Prescription Project

Disclosure: The survey was underwritten by the Prescription Project, a member of the Massachusetts Prescription Reform Coalition that works to eliminate conflicts of interest in prescribing. You can read more about the survey, including complete results, here.

Friday’s “productive” meeting between Governor Patrick and federal HHS Secretary Leavitt resulted in an agreement to extend the current waiver for 2 weeks beyond the June 30 deadline. Because of July 4, it’s not certain that the negotiations can wrap up by then. If needed, a further 2 weeks would be added. The Commonwealth will be sending a formal extension request on Monday.

The music around the negotiations continues to be positive. Secretary Bigby is quoted in the Telegram saying that Leavitt “repeated his commitment to make this work for us and indicated that he wanted to make sure that we continued our good discussions.” She told the State House News Service that she is “very optimistic.” WBUR also carried a report.

Congressman Ed Markey and staff from Senator Kennedy and Senator Kerry’s office attended. Senator Kennedy had called Leavitt on Thursday. Leavitt described the conversation in his blog: “He was forward looking, crisp and as passionate as always. There wasn’t a single hint of negativity or worry. I’m sure he has moments when both creep in, but the call was an unexpected lift to my spirits.”

Last week, we received updates from the Office of Medicaid on the outreach grantees who are doing critical work in helping people sign up and stay on health care coverage under funding through EOHHS. Beginning in November 2007, 45 non-profit organizations across the state were awarded grants ranging from $26,000 to $55,000 to conduct outreach and direct enrollment assistance into health programs. In April 2008, seven other organizations (including HCFA) were awarded larger grants ranging from $126,5000 to $170,000 to coordinate outreach efforts statewide and increase the number of the insured in hard-to-reach populations.

Here are some stats on the work of the 45 traditional outreach grantees for the period of December 2007 to April 2008:

93,135 Total individual encounters between outreach grantees and Massachusetts residents

77,919 Total individuals served by grantees (number does not include individuals with duplicate encounters)

39,189 Total individuals approved eligible for MassHealth, Commonwealth Care, Commonwealth Choice, and the Health Safety Net

35,806 Total number of individuals returning for additional assistance

21,921 Total number of individuals assisted with accessing a health care provider

58,229 Total number of individuals assisted with information on health care reform and/or the individual mandate

23,452 Total number of individuals assisted with information on wellness/preventive care

As you can see, the efforts by outreach workers across the state who are working tirelessly to enroll and retain coverage for individuals and families plays a critical role in health reform. And it doesn’t just end once an application is complete, or a redetermination form is submitted. Outreach workers are helping to change the way in which previously uninsured folks access the health care system and get necessary preventive services, reducing costs and improving efficiency.

The Conference Committee on the state budget is now deciding whether to continue these grants. Outreach grantees now deal with more complex cases of individuals who have wrongfully lost coverage. The numerous gains of health care reform would be lost if the many people who we successfully enrolled do not have continuity in care. Additionally, as we look on the horizon of implementation, Minimum Creditable Coverage becomes effective January 1, 2009. Even more efforts will be necessary to convey to residents that only certain types of coverage will be considered adequate to meet the requirements of the individual mandate. We urge policymakers to continue funding the outreach and enrollment line item at $3.5 million for fiscal year 2009 (half of that cost is federally reimbursed). Let’s keep up the great outreach and enrollment work that we’ve made over the past two years.
Jennifer Chow

Friday morning at 11:30, Governor Patrick, EOHHS Secretary Bigby and state officials will meet with federal HHS Secretary Michael Leavitt to discuss “the waiver.” Also at the meeting will be representatives from Senator Kerry and Senator Kennedy’s office, and possibly state legislative Health Care Financing Committee cochairs Richard Moore and Patricia Walrath.

This is a big, big deal. According to the Herald, former Bush White House chief of staff Andrew Card, a former Massachusetts state rep, has been involved in helping state officials get in touch with officials from the White House and the Office of Management and Budget. Senator Kennedy has been working the phones while getting treatments; the Globe has the story here.

“The waiver” is health-reform speak for the authority Massachusetts has had since 1997 to receive federal Medicaid reimbursements for its expanded MassHealth program, and, since 2006, for the health reform programs set up in Chapter 58.

The current waiver expires June 30, and negotiations over its renewal have been ongoing since the first of the year. The details can be mind-numbingly complicated. But the big picture is not. In order to keep health reform on track, the state needs expanded federal matching funds. For the past 3 years, federal funding under the waiver has been static. For the new waiver, growth in funds must match the increased enrollment and ever-increasing cost of health care.

The best explanations of the waiver are available in two papers written by the Mass Medicaid Policy Institute. A 2005 paper and a slide presentation, available here, explains what exactly is being “waived,” and how the state has used the waiver to cover more people while not increasing federal expenditures. An update from fall 2006 goes over the amendments that were approved after the passage of chapter 58.

The state’s extension request was originally filed in June 2007, with more financial details submitted in December 2007. You can read all of the documents here.

It’s unclear how much information will be made public following the meeting. Because they are not yet at the deadline, we don’t expect the meeting to wrap everything up, but to deal with a number of financial issues under discussion. Stay tuned.
Brian Rosman


Study: Most Children Strongly Opposed To Children�s Healthcare

The Cost and Quality Council’s website launch has now been delayed until late July or early August due to problems with cost data. The Council members will be testing the site ahead of the launch. Kudos to Jim Conway, Council member, who requested that members of the Council’s Advisory Committee, 30+ individuals representing a broad range of interests, including consumers, also be able to look over the site to determine its accessibility and user-friendliness.

Staff from DPH and Division of Health Care Finance and Policy (DHCFP) gave updates on some of their patient safety work that falls within the patient safety goals of the Council. DPH Commissioner John Auerbach updated the Council on DPH’s work on infection prevention and reporting. He told the Council that DPH will be able to meet the Council’s request that the first public report be issued in March of 2009. He also said that DPH has started looking at infections that may be reported beyond those on the original list of reportable infections. Secretary Bigby asked if DPH will be reporting infections beyond the hospital setting, and Commissioner Auerbach replied that they aren’t currently doing that but that they will.

Paul Dreyer, director of the quality division at DPH, and Stancel Riley, director of the Patient Care Assessment division at the Board of Registration in Medicine, gave an update on Serious Reportable Events. See this blog entry about today’s announcement regarding the state’s decision to stop paying for these events. DPH and BORIM will be working together to publicly report Serious Reportable Events.

Kate Nordahl from the DHCFP updated the Council on its work regarding hospital mortality rates. The Council wants to be able to publicly report mortality rates for MA hospitals by 2010. DHCFP will work to determine the best measure and have data to the Council by then. At the same time, the National Quality Forum is investigating mortality measures and hopes to move toward endorsing a measure over the next year. Much of the movement around this is thanks to HCFA’s Consumer Health Quality Council and its request to DPH and BORIM for public reporting of hospital mortality rates.

The Quality and Cost Council will be holding a retreat on June 30, 9am-3pm, at a location to be decided, somewhere near Worcester most likely. Once we have updated info, we will post it.
Deborah Wachenheim

Would you pay more for car that’s defective than you would for one that’s works well? Of course not, but that’s pretty much how the health care payment system works.

But change is afoot. EOHHS Secretary Bigby announced today that the state, as both an insurer and a purchaser of health care, will no longer provide payment to hospitals for costs associated with Serious Reportable Events (often referred to as Never Events). In addition, patients cannot be billed for the Never Events. Click here for the state’s press release, issued in the framework of its Healthy Mass initiative, and the list of events.

The list of 28 Serious Reportable Events (SREs) comes from the National Quality Forum, a national organization with a broad range of members, including consumer groups.

The policy was adopted by MassHealth, GIC, the Connector, and the Department of Correction. Together, they cover 1.6 million Massachusetts residents. Although other states have recently implemented similar policies in their Medicaid programs, the Commonwealth claims to be the first to establish a uniform policy across state government.

A presentation at today’s Quality and Cost Council meeting pointed out that there were 214 SREs reported by MA hospitals to the Board of Registration in Medicine in 2007. They believe the events are under-reported and that the actual numbers are higher. Falls that resulted in death or serious injury comprised 55% of those reported, and 22% of the reported events were wrong site surgery/wrong patient surgery/wrong surgical procedure. While there are no firm cost figures attached to these events, clearly they add to time spent in a hospital and the amount and intensity of care provided.

Health Care For All and our Consumer Health Quality Council have been advocating for fundamental payment reforms, including ending payment for a broad range of preventable complications, including never events, preventable infections and readmissions, and others. The Secretary’s announcement stated that they will be pursuing this next, and EOHHS is already making progress on cutting payments for preventable readmissions. For both quality and cost control reasons, we hope the House version of the Senate President’s cost control bill (out in maybe 2 weeks) will move further in this direction.

UPDATE: Blue Cross will join the state in not paying for “never events.” Globe story here.
UPDATED UPDATE: You can download DPH’s presentation on hospital reporting of SREs here.
Deborah Wachenheim

The Health Care Quality and Cost Council is putting the finishing touches on its first key deliverable, a website with detailed, comparable information on quality and the actual price providers charge for common medical procedures. The quality data will undoubtedly be helpful to consumers and should spur providers to improve their performance. But a new study questions the value of publicizing cost information, and warns that this may lead to higher, not lower costs. Click here for the rest of the story . . .

The Council on Racial and Ethnic Health Disparities convened its monthly meeting today. Chaired by Senator Dianne Wilkerson and EOHHS Secretary Bigby, the Council built on its earlier meetings, beginning to outline a plan of action for the diverse group of disparities experts. Council members voiced support for a comprehensive approach to fulfilling the Council’s mission, noting the importance of addressing the social determinants of health inequality. Additional concerns were raised regarding the need to address data gaps for Asian and Native American populations, and investigate disparities in health screening behaviors.

At the meeting’s close, Senator Wilkerson updated the Council on the budget process currently in process at the State House, noting the success of the provision creating an EOHHS Office of Health Equity in both the House and Senate budget bills. The Senator was optimistic that the Office will pass the Conference Committee process. EOHHS staff also announced that the Secretary has begun talking to the heads of all EOHHS agencies to determine the scope of programs/projects related to health disparities within the Secretariat.

The next Disparities Council Meeting is scheduled for Monday July 21st at 10am
Camille Watson

The Health Care Quality and Cost Council will be meeting on Wednesday, 1:00-4:00 pm at 1 Ashburton Place, 21st floor.

The agenda includes:

A. Update on Health Claims Data Issues: Suanne Singer, Maine Health Information Center

B. Update on Website Development

· Web Application Development: Afsana Akhter, Medullan

· Quality and cost ratings: John Freedman, M.D., Clinical Consultant

C. MAHP Proposal for Collecting Race and Ethnicity Data

D. Report from Advisory Committee

E. Reports on Progress toward Meeting the Council’s Recommendations

· Hospital-Acquired Infections: John Auerbach, Department of Public Health;
Paul Dreyer, Department of Public Health

· Serious Reportable Events: John Auerbach, Department of Public Health;
Paul Dreyer, Department of Public Health; Stancel Riley, Board of Registration in Medicine

· Mortality Measure: Kate Nordahl, Div. of Health Care Finance and Policy

· Physician Order for Life Sustaining Treatment (POLST):Ruth Palombo, Executive Office of Elder Affairs   Andy Epstein, Department of Public Health