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Public Employee's Benefit Board Meeting Minutes, February 13, 2007
Public Employees’ Benefit Board
Tuesday, February 13, 2007 - 12:30 – 2:00 p.m. (Public Meeting)
PEBB Board Room
775 Court St NE, Salem OR
Approved 3/20/07
Board MembersPresent
Diane Lovell, Chair
Peter Callero
Rocky King
Sue Nelson
Paul McKenna
Rich Peppers
Jeanene Smith
PEBB Staff Present
Claire Kemmerer
Lisa Krois
Lydia Lissman
Ingrid Norberg
Brian Olson
Rebecca Sweatman
Jean Thorne
Consultants Present
Barbara Wall, Aon
Guests Present
Dotha Canning, Samaritan Health
Claudia Grimm, OMIP
Jennifer Hall, ODS
Kristina Herron, Providence
Diana Jones, Regence
Bill Lindekugel, Kaiser
Julie Marshall, Cascade (EAP)
Renee McDonald, Regence
Megan Myrick, Willamette Dental
Paul Pfinster, AFLAC
David Scearce, The Standard Ins. Co.
Diane Skutuck, BenefitHelp Solutions
Tamara Strauss, Samaritan Health
Deborah Trembley, OJD
Kim Waldroff, BenefitHelp Solutions
Welcome and Approval of Minutes
Overview of Agenda
Patient Safety Commission / Leapfrog
Results of 2006 PEBB Member Survey
Planning for March Meeting with COI
Draft Board Schedule for the Coming Months
General Public Comment
Other Business
Welcome and Approval of Minutes
Diane Lovell called the meeting to order.  Rocky King moved to approve the minutes from the December 19, 2006 meeting (Bdattach.1). Peter Callero seconded the motion.  The motion passed unanimously.
Jean Thorne:  PEBB Staff changes:  Lisa Krois’s replacement has decided to stay with her present employer, so Lisa has agreed to stay a while longer.  Mona McMullen started February 22 as the Fiscal Coordinator taking Scott Smyth’s place.  Brian Olson will start April 1 as PEBB’s contracts coordinator.  Brian is currently at the DHS Division of Medical Assistance Program as the pharmacy program manager and is a member of the Bar.    Rick Schoonover will continue part time for now. 
Legislative Issues
Diane Lovell:  In the packets are copies of the testimony Rocky and Diane gave last week in support of PEBB’s budget.  Questions were asked regarding the Oregon Educators’ Benefits Board (OEBB) and a hearing will take place later this week.  As OEBB moves forward with a shared administrator, she believes that PEBB should ask for a deputy administrator, program development position, and clerical staff to support the shared boards.  She noted that her belief that bringing up the new Board and its work would draw significantly from PEBB’s resources to undertake its own work.  Including these positions in PEBB may help PEBB offset that impact.
Rocky King moved that the Board request inclusion of a deputy administrator, program specialist, and clerical support for PEBB as part of the OEBB fiscal impact.  Rich Peppers seconded the motion.  The motion passed unanimously.
David Hartwig expressed concern that there is no recognition of the impact the implementation of OEBB will have upon PEBB.  With OEBB, there are multiple employers, unions, etc. and PEBB should not miss an opportunity to make these concerns known to the Governor.
Jean Thorne shared that some legislative members were asking PEBB to actually take over responsibilities for OEBB.  If this Board were to take on OEBB, the Vision would be set aside because all the Board’s time would be focused on implementation activities.
Group discussion brought forth the general concern that the Board be perceived as supporting the OEBB effort, that there is a definite need for two separate administrators (if not, then a deputy administrator for PEBB), and that PEBB staff not experience expectations that extend them beyond their current work loads.
Jean Thorne spoke to what is known:  by October 2008 OEBB would be in place and medical/dental/life & disability/long-term care plans would be in place and available to the first phase of school districts.   The bill promises that the school districts will have access to a comparable plan at less cost than they currently have.
Meeting Overview
Jean Thorne gave the meeting overview:  Lisa Krois will provide updates on the Patient Safety Commission and lead discussions on hospital participation in Leapfrog and the Council of Innovators March joint Board meeting.  Jean Thorne will review the Board work schedule for coming months.  Rural Subsidies was taken off the agenda and Diane Lovell will address this decision.  Following the Public Meeting, the Board will go into executive session to review information on 2007 renewals.
Patient Safety Commission / Leapfrog
Lisa Krois highlighted Bdattach2, stating that the Oregon Patient Safety Commission (OPSC) began the Adverse Event Reporting Program for hospitals in May, 2006.  Their mission, to improve patient safety by reducing the risk of serious adverse events occurring in Oregon's health care system and by encouraging a culture of patient safety, is to be accomplished by:
  • Establishing a confidential, voluntary serious adverse event reporting system in Oregon.
  • Establishing quality improvement techniques to reduce system errors.
  • Sharing evidence-based prevention practices to improve patient outcomes.
As of October 2006, fifty-two hospitals, out of fifty-seven total in Oregon, are enrolled in the OPSC’s voluntary and confidential reporting program for serious adverse events.  These hospitals provide 98% of inpatient care in Oregon.
Lisa went on to share the reports statistics on types of events reported in 2006, adverse events resulting in death, and a summary of contributing factors and conclusion
David Hartwig (a member of OPSC) shared how people came to discuss their personal experience and to work as a group to solve the problem. 
Rich Peppers asked about follow-up actions [by the commission] for hospitals that have adverse reports.  David Hartwig shared that there is staff assigned to follow-up and work with hospitals on issues that are identified. 
Leapfrog Reporting
Lisa Krois reviewed Bdattach3, stating that Leapfrog Group Hospital Quality and Safety Survey is the only national survey that provides a full assessment of a hospital’s quality and safety.  The Leapfrog website, updated on a monthly basis, displays each hospital’s results, which can be easily and freely accessed by the public at no charge.  Leapfrog data is also available on commercial sites, including Healthgrades.com.
Although Leapfrog reporting was initially a requirement of PEBB’s RFP, since 2005, only three more hospitals in Oregon have begun reporting in Leapfrog.  All Providence hospitals in PEBB’s service are now reporting.  All of Samaritan’s hospitals are either now reporting or are taking steps to reporting.  However, there are many hospitals with significant amounts of PEBB business (e.g., Salem Hospital, Sacred Heart, St. Charles) that are not reporting.
Diana Jones of Regence indicated that hospitals have identified issues about the amount of resources needed to report and the desire for flexibility to apply their resources where they think it would be most beneficial.
Group discussion lead to questions regarding the requirement of reporting and the difficulty the plans have with some of their hospitals.  Questions on the survey elements and staff time (one staff - 3-4 days) for reporting yielded a consensus that staff time was not a valid argument for hospitals to forego participating in Leapfrog.  The importance of Leapfrog is the comparability of the data and end-user ease in accessing information. 
Board member suggestions included posting Leapfrog information on the PEBB website and in the newsletter regarding which hospitals are reporting publiclyand which are not, developing an incentive program for those who report, and staff preparing recommendations on other steps PEBB could take in moving use of Leapfrog forward.
Board members indicated they supported the staff recommendation that Leapfrog should remain the preferred method for providing hospital quality and patient safety information to PEBB members.  PEBB should continue to support and report to its members which hospitals are reporting to Leapfrog and how they score.  However, when a health plan is unable to include this requirement in its contract with a hospital, the plan must include an acceptable alternative that provides, at minimum, publicly reported data on quality and patient safety that is written in consumer friendly language.
Results of 2006 PEBB Member Survey
Rebecca Sweatman reviewed Bdattach.4, 2006 Annual Member Survey Results Summary.
This year, PEBB replaced the annual Open Enrollment survey with the expanded Annual Member Survey that includes questions about benefits, customer services, member communications and electronic medical records.  The survey was distributed online.  20% of PEBB enrollees (about 9,000) responded to the survey and of that group, 84% felt the 2007 benefits to be either excellent or good.  Prescription drug coverage was the most cited reason for dissatisfaction with the benefit plan. 
PEBB will use the results from this survey to help plan for Open Enrollment in 2007, improve member services, and develop communication strategies.
Group discussion centered on the numbers of respondents [vs. total enrollees] not being representative of the membership and questions regarding how PEBB can get more input from members in the future. 
Planning for March Meeting with COI
Lisa Krois reviewed the March 20th draft agenda (Bdattach.5 ) and outlined the discussion and activities regarding the Prioritized List.  Dr. Som Saha, Dr. John Santa, and Darren Coffman will assist the group with a presentation and discussion points. 
Draft Board Schedule for the Coming Months
Jean Thorne discussed the segments of Bdattach.6 and asked the Board to review and be prepared for the discussion and decision making following executive sessions.
The May 8 meeting schedule has changed:  10:30-4:30. 
Diane Lovell spoke to determining member input and asked for volunteers between now and March to work with PEBB staff to look at possible ways to gather such input.  Diane also asked for strategy on behalf of the unions to reach out to their own folks.  Rich Peppers and Peter Callero agreed to assist. 
General Public Comment
Other Business
Rural Subsidies Issue:  Group agreed to defer information gathering and discussion(s) to later this year for consideration for the 2009 plan year.
Public Meeting Adjourned