MINUTES 

MAINE HEALTH DATA ORGANIZATION
BOARD OF DIRECTORS MEETING
151 CAPITOL STREET, AUGUSTA, MAINE
THURSDAY, MARCH 13, 2003

Upon establishing a quorum, the meeting of the Maine Health Data Organization (MHDO) Board of Directors began at 9:15 a.m.  The following Board members were present: Richard Bruns, Chair, Dana Kempton, Vice-Chair, Vaikko Allen, Warren Bartlett, Theresa Bellmore, Robin Bickford, Michael Brannigan, David Johnson, Doug Libby, John Portela, and Sydney Sewall.  Absent members were Lynn Davey, Cathy Gavin, Peter Gore, Mark Granzier, Rebecca Martins, Dick Lowd, Diane Moongrove, and Vicki Purgavie.

The February 13, 2003, MHDO Board minutes were approved as written.

Executive Director Report
Financial Report:  Director Alan Prysunka informed the Board that funds have been transferred to the General Fund for two of the three shutdown days recently taken by MHDO employees.  He also informed the Board that the MHDO’s Capital Expenditure line category has been approved which will allow for the purchase of a storage unit needed to accommodate the large amount of health claims data being collected.  The Board also discussed a change in technology expenditures, as anticipated, as a result of savings derived from the new hospital in-house editing system.

Adoption of Chapter 125:  Health Care Information That Directly Identifies an Individual: Mr. Prysunka stated that no comments were received on Chapter 125 and recommended that the Board adopt the rule.  There was a motion and a second that the Board adopt Chapter 125.  Motion passed unanimously.

Adoption of Chapter 120:  Release of Data to the Public:  There was a discussion  regarding two organizations having submitted comments after the comment period ended and it was explained that, due to legal constraints the comments were not accepted by the MHDO.  A lengthy discussion ensued regarding the protection of proprietary interests by preventing the release of paid and charge data and payer and provider information simultaneously.  Mr. Prysunka also explained other changes made to Chapter 120 and there was a motion and a second that the Board adopt Chapter 120 as amended by Mr. Prysunka and the Board.  Motion passed unanimously.  Paul Gauvreau, Legal Counsel stated that the changes made would be within what was proposed at the hearing and no additional comment period would be needed. 

Initiate Rule-making Process - Chapter 10:  Determination of Assessments:  After a discussion about the rulemaking timeline for Chapter 10, Mr. Prysunka gave the Board an overview of the proposed changes to the rule and provided a handout showing comparative tables of FY 03 and proposed FY 04 assessments.  He also stated that
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there were two typographical changes that needed to be made to Chapter 10.  There was some discussion regarding modifications of certain assessments and it was stated that pharmacies’ assessments were reduced as previously agreed upon by the Board. There was a motion and a second that staff initiate the rule-making process with clerical changes to Chapter 10 as specified by Mr. Prysunka.  Motion carried unanimously.  

Legislative Update:  Al Prysunka stated that there will be a hearing of the Health & Human Services (H&HS) Committee on March 27 to discuss the LD’s which relate to the MHDO.  Mr. Prysunka stated that he will be present to give an overview of the MHDO and the Data Processing Center.  Mr. Prysunka also informed the Board that LD 497 and LD 857 have been referred to the Insurance and Financial Services Committee and that he has talked to sponsors of LD’s 112, 432, 497, 535 and 857 about possibly combining them, or at least discussing them together.  Also, after explaining to the sponsor of LD 112 what a large undertaking this bill would require from the MHDO, Representative Woodbury stated he will probably suggest removing Section 5 which would eliminate the MHDO from being referenced in LD 112.  Regarding LD 1121, the Board agreed that Mr. Prysunka should testify in opposition to this bill which proposes to exclude health care practitioners and freestanding ambulatory care facilities from the reporting requirements of the MHDO.

Mr. Prysunka gave the Board an overview on LD 857 and they agreed that Mr. Prysunka should write points regarding the bill stating the MHDO is neither for nor against LD 857 and that he will be available to answer questions.  Mr. Prysunka stated he has been appointed as a representative of the Health Action Team and he summarized discussions the committee has had to date.  There was a recommendation to have Trish Riley meet with the Board to outline what is expected of the MHDO. 

Mr. Prysunka also informed the Board that there is a competing bill to LD132 (LD 254) which would have the Maine Department of Human Services collect pharmacy information.

Mr. Prysunka stated that Bill Perry, formerly of Cigna Healthcare is now employed at the Maine Health Information Center (MHIC) and has resigned from Maine Health Data Processing Center Board (MHDPC).  Charlotte Pease, of Aetna, was recommended as his replacement by the Maine Association of Health Plans.  He also stated that the MHIC Board has accepted this nomination and the MHDO Board is required to vote on the nomination as well.  There was a motion to accept the nomination of Charlotte Pease to the MHDPC Board. Motion was seconded and passed unanimously.

Measuring Health Care Quality Presentation - Sydney Sewall, MD:  In Dr. Sewall’s presentation he explained how difficult it is to measure health care quality and what needs to be considered in measuring quality care.  He also explained various types of
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data used to measure quality care, where it can be found, and what information can be gathered by each type of data i.e.: administrative data, chart reviews, and patient surveys. He stated that one needs to weight circumstances when measuring quality and that outcomes are difficult to determine or define.  He also pointed out that quality outcomes are not available in MHDO data.  MHDO should be able to collect data regarding chronic care management.  There was some discussion about what determines quality measurements.  It was stated that MHDO data has some quality indicators but at issue was whether the MHDO should be a part of measuring quality using those indicators. This led to a discussion regarding the expected role of the MHDO in proposed legislation (LD 497 and LD 857) which would have the MHDO provide Maine consumers with information about the cost and quality of health care services in Maine.  The Board discussed taking on a significantly expanded role and it was stated that this could be done per MHDO’s statute except for the identification of physicians.  Concerns were raised regarding the MHDO being given an unfunded mandate.  However, it was the consensus of the Board that the MHDO would be willing to serve but that it does not have the capability, expertise or funds to perform these tasks.  There was a motion and a second that Al Prysunka make certain to elucidate to the H&HS Committee what has to happen if the MHDO is to be the repository of quality information to do quality reporting and that Mr. Prysunka impress upon the legislators that it would require more expertise, additional funds, and the identification of physicians. The motion passed unanimously.

Dennis Norton, a  business representative of United Food and Commercial Workers, was recommended to the Board a as consumer representative.  There were concerns of not having low income representation on the Board.  Many ideas were discussed and it was decided that Mr. Prysunka would wait until April to go to the Governor with recommendations while additional nominees are sought.

Public Comment
Richard Baldwin,  Downeast Rehabilitation Center stated that, although he agrees with the need for the MHDO and it’s charge, he has concerns with how assessments were implemented.  Mr. Baldwin disseminated copies of an assessment comparison he had prepared and restated his concerns from the previous Board meeting of unfair assessments.  In response to Mr. Baldwin’s concerns regarding some entities being excluded, the Board reiterated the process they followed and explained that they assessed entities who would benefit from not having to submit data themselves and, in an effort to keep the process manageable, only assessed licensed entities.

No additional comments were received.

The meeting adjourned at  12:20 p.m.