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Public Employees' Benefit Board Meeting Minutes, February 19, 2008
Public Employees’ Benefit Board
Tuesday, February 19, 2008, 10:30 a.m.-3:30 p.m. – Minutes
DAS/Basement Mt. Mazama Room
1225 Ferry St SE, Salem OR
Approved 3/18/08

Board Members Present
Diane Lovell, Chair
Sue Nelson, Vice Chair
Peter Callero
Rocky King
Paul McKenna
Rich Peppers
Bret West
PEBB Staff Present
Bobbie Barott
Adrienne Binam
Dena Comer
Wendy Edwards
Chelsea Hollingsworth
Isabel Joslen
Joan Kapowich
Lydia Lissman
Mona McMullen
Ingrid Norberg
Brian Olson
Margaret Smith-Isa
Rebecca Sweatman
Guests Present
Dotha Canning, Samaritan Health Systems
Sally Hill, Providence Health Plans
Gordon Hoberg, ODS
Diana Jones, Regence BCBSO
Julie Marshall, Cascade EAP
Megan Myrick, Willamette Dental
Jean Poling, Kaiser Permanente
Diane Skutack, BenefitHelp Solutions
Deborah Tremblay, Oregon Judicial Department
Consultants Present
James Foley, Mercer
Welcome and Approval of Minutes
Overview of Meeting
Board Priorities
Primary Care – Payment Reform
2009-2011 Budget Policy Option Packages
Annual Member Survey
Employee Assistance Program
Operational Issues
Report Discussion
General Public Comment
Future Agenda Items
Welcome and Approval of Minutes
Diane Lovell called the meeting to order.
Rocky King moved to approve the January 15, 2008 meeting minutes.
Bret West seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Overview of Meeting
Lydia Lissman provided an overview of the agenda items. The order of the agenda will change slightly to accommodate presenter schedules; the Employee Assistance Program presentation will be moved ahead of the presentation on the Annual Member Survey.
Board Priorities
Wendy Edwards referred to Bdattach.2 and reported that the Evidence Based Plan Design, Medical Home, Communications and Wellness work groups have been meeting based on the guidelines adopted by the Board at its January meeting. She provided an update on the progress and next steps for each work group, and explained that staff has been working with Mercer to identify viable options within each group for further discussion at the next Board meeting.
She referred to Bdattach.2a and explained that the Work Group Planning Guide is intended as a tool for determining the member impact, implementation, communication and resource impacts, sustainability needs, and measureable outcomes for each option. Staff requests Board approval to implement the Planning Guide. 
Rich Peppers moved to accept the PEBB Work Group Planning Guide.
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Evidence-Based Plan Design Work Group - Discussion
Rocky King suggested researching the efforts of Minnesota’s PEBB, which has implemented risk assessments, and lower co-pays and deductibles for those members who have completed the risk assessment process.
Wendy Edwards replied that staff could get information on this and provide it to the Board.
Diane Lovell stated that the Health Resources Commission has resources that PEBB might utilize as it creates baselines and identifies high-utilization areas.
Medical Home - Discussion
Bret West commented that a possible issue for consideration by the work group is the relatively low incidence of members who have selected a primary care provider (PCP). A challenge will be identifying and communicating the benefits of having a medical home.
Diane Lovell expressed the importance in having the medical home in place before emphasizing the benefits of having one.
Joan Kapowich reported that the at a recent Q-Corp board meeting, discussion focused on the problems relating to selecting a PCP, including fewer medical school graduates and fewer PCPs. This issue, along with the definition of medical home, needs to be addressed on a large scale.
Communications Work Group – Discussion/Action
Wendy Edwards introduced Chelsea Hollingsworth, PEBB’s part-time electronic Publishing Design Specialist working with Ingrid Norberg as staff to this work group.
The Communications work group requests Board approval to change the order of Board meeting agendas to incorporate public comment between 11:30 a.m. and 1 p.m. The work group seeks to enhance member communications and feedback to the Board; the lunch hour is convenient and does not require approved time off for PEBB members who may wish to attend and provide comment.
Rich Peppers moved to implement a change to the schedule of Board meetings to incorporate public comment between 11:30 a.m. and 1 p.m.
Bret West seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Wellness Work Group - Discussion
Rocky King reported that Claudia Black of the Governor’s Office, Bruce Goldberg of the Department of Human Services (DHS), and other agencies are looking at large initiatives around wellness. He suggested that the Board might want to invite Claudia or Bruce to a future meeting to share the Governor’s interest and DHS’s philosophy on wellness.
Joan Kapowich reported that DHS has collaborated with PEBB to sponsor a StayWell Annual Training, titled “Building a Culture of Wellness with Management Support”. All agencies have been invited, and Bruce Goldberg is included as a presenter on the agenda. The training is scheduled for February 26, 9 a.m. to 4 p.m., at Willamette University. To date, approximately 27 agencies have registered to participate. Adrienne Binam will provide a conference agenda to Board members today.
Lydia Lissman reminded the Board that PEBB plays a key leadership role with Staywell and the Healthy Worksites Initiative. PEBB staff coordinate plan efforts with worksite initiatives to incorporate wellness.
Rich Peppers commented that self-awareness is a first step to improvement, and suggested posting the results of the employee health survey to highlight problem health areas and methods to address them.
Primary Care – Payment Reform
Margaret Smith-Isa referred to Bdattach.3 and provided an update on the activities related to PEBB’s involvement in ongoing collaborative efforts to address the Medical Home model in the broader community. Following its presentation to the Board in September 2007, CareOregon hosted a meeting in October 2007 to engage a variety of stakeholders in a discussion of opportunities to pilot the Medical Home across health plans and purchasers. Kaiser Permanente hosted a follow-up meeting in January 2008. The two major challenges include researching a consensus definition of “Medical Home” among stakeholders (there are a variety of definitions for the term), and payment reform, which must be addressed in order for Medical Home to be sustainable.
PEBB will be hosting the next meeting, anticipated for March 2008, when discussion will be focused on specific opportunities to reform primary care payment. Options that may be further explored in this forum include reimbursement for e-visits with primary care providers, expanding payment to primary care for services that might be provided by non-physician providers, and examining how funding might be made available to support the technology and infrastructure investment necessary to successfully implement the Medical Home in practice
Rich Peppers commented that payment reform must include outcomes.
Margaret Smith-Isa replied that the meetings have included this discussion, and the long road to establishing the infrastructure and possible intermediate payment options toward the ultimate goal of paying based on outcomes.
2009-2011 Budget Policy Option Packages
Lydia Lissman provided a general overview of potential concepts for inclusion in one or more policy option packages (POPs) for the 2009-2011 budget. A draft of the proposed POPs is due to the Department of Administrative Services (DAS) on April 1. DAS will then make the decision on which POPs will be included in the Agency Request Budget.
The Board discussed the details of each POP and whether they would approve them for submission to the DAS Director’s Office.
Rich Peppers moved to approve Policy Option Packages 1, 2, 4, and 5 for submission to DAS, as follows:
  • Package 1: Ensure that PEBB has adequate infrastructure to manage key business functions.  PEBB is requesting permanent positions authority for two limited duration positions (procurement and contract specialist 2, research analyst 4) and permanent position authority for two new positions (compliance specialist 2 and public affairs specialist 2).
  • Package 2: Provide the essential funding to develop and implement changes to the pebb.benefits system based on:
    • recommendation from the PEBB Advisory Committee
    • federal or state requirements; and
    • Board changes to benefits.
  • Package 4: Increase the limitation of the PEBB operational budget to include the broker/consultant commission fee.
  • Package 5: Include funding for the actuarial valuation of OPEB as required by the Government Accounting and Standards Board (GASB).
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Rocky King moved to table Policy Option Package 3 until the March meeting, to allow sufficient time to develop the request.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Employee Assistance Program
Dr. Julie Marshall, Clinical Director of Cascade Centers, Inc. referred to Bdattach.5, and distributed additional documentation which summarized services available to PEBB members. Cascade presents every client with a customer satisfaction survey, and has received very high ratings from PEBB members.
Annual Member Survey
Rebecca Sweatman referred to Bdattach.4 and explained that PEBB conducted its second Annual Member Survey in fall 2007. The Web-based, electronic survey was distributed via e-mail to approximately 46,000 PEBB members, and was posted on the PEBB Web site, as well. She outlined the questions within the categories and summarized the results.
Ingrid Norberg provided a brief report on the highlights from approximately 2,000 responses to the open-ended section, which was offered at the end of the survey.
Joan Kapowich announced that Rebecca Sweatman has resigned her position with PEBB effective February 29, and has accepted a position as a health management consultant with Providence Health Plans. She expressed her appreciation for Rebecca’s extensive body of work and contribution to PEBB, adding that she will be missed.
Operational Issues
ODS Fund Transfer
Wendy Edwards referred to Bdattach.6 and explained that the actual fund amount transferred on January 4 did not include interest past September 2007. ODS applied an interest rate of the Federal Treasury, which has been yielding roughly 2% less than the State Treasury rate. The contract with ODS did not specify that the Treasury rate was the federal or state rate.
Joan Kapowich explained that a meeting with ODS has been scheduled and will provide an opportunity for PEBB to express its concerns regarding this issue.
Rich Peppers moved to accept the staff recommendation that ODS transfer the following money to PEBB on April 1, 2008:
  • $3,274,568.70 (September 2007) plus any interest owed to PEBB through February 29, 2008, and
  • Interest for the period October 2007-January 4, 2008 on the original $4,758,781.73.
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Mercer Health Online
Wendy Edwards referred to Bdattach.7 and explained that Mercer Health Online is a third party data warehouse program that will allow PEBB staff and Mercer to analyze utilization and cost data, as well as share files, prepare automated reports, track progress for projects, compare plans and measure outcomes. PEBB currently relies on the work of contracted consultants for all analyses regarding member utilization, cost measures, trend and cross carrier comparisons.  The recent change of consultants from Aon to Mercer has highlighted the opportunity for PEBB staff to improve processes and redefine its role as a health care purchaser. Mercer Health Online, coupled with the high level research analyst PEBB is in the midst of recruiting for, will provide the tools necessary to set up analyses and outcome measures appropriate for the PEBB membership. PEBB staff reviewed a demonstration of the Mercer Health Online system in early February 2008. Additionally, because the tool is a stand-alone application, it can be branded with the PEBB look and feel.
Rocky King moved to approve funding for a PEBB-branded Mercer Online system for 2007-2009 out of Policy Option Package 303 funds, with Regence data to be implemented on 10/1/08, and Samaritan and Providence coming on 1/1/09.
Paul McKenna seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Report Discussion
Wendy Edwards referred to Bdattach.8 and explained that on the Board’s recommendation, staff implemented pebb.connect@state.or.us in September 2007 as a new way for members to communicate with the Board. In October 2007, the Board approved a process for responding, and staff established internal procedures. From September through December 2007, PEBB’s newsletters, statewide e-mails and Web site promoted pebb.connect.
During the third quarter of 2007, pebb.connect received more than 200 e-mails from members. This quarter covered Open Enrollment for 2008 benefits and a new process for members to certify eligibility of adult dependents. It was not surprising that most member e-mails to pebb.connect (more than 90%) were questions about these two topics. The PEBB member services team responded to these e-mails directly.
Nine messages received during this quarter required Board response. The two Board delegates reviewed and approved the responses, and the resulting response time averaged five to seven working days.
OregonHealth Fund Board
Diane Lovell referred to Bdattach.9 and explained that the newsletter is provided in lieu of a presentation by Jeanene Smith, who could not be present for today’s meeting.
Health Resources Commission
Diane Lovell reported that the Health Resources Commission Autism Work Group held its first meeting and focused primarily on how to weigh and examine evidence. The work group is now waiting on the Evidence-Based Research Center for best practices for autism, and she will share this information with the Board when it becomes available.
General Public Comment
Future Agendas
Lydia Lissman will send future agenda items electronically for review by the Board.