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County Commission Minutes 05/09/01
COUNTY OF DUKES COUNTY                  COUNTY COMMISSIONERS

A regular meeting of the County of Dukes County Commissioners was held on Wednesday, May 9, 2001, at 7:30 p.m. in Courtroom of the Courthouse, notice of such meeting having been posted as required by law.

Commissioners Present:  Leslie H. Leland, Chairman
                                E. B. Collins
                                Roger Wey       
                                Leonard Jason, Jr.
                                Robert Sawyer
                                Daniel Flynn
                Absent: John Alley
                                
Also Present:  Carol Borer, County Manager      
                  Marsha Smolev, Executive Assistant
                  Sandra Lothrop, Associate Commissioner
                 Richard Combra, Selectman, Oak Bluffs
                  Cynthia Mitchell, DCHC, Chair
                  Pat Fairchild, Consultant, John Snow, Inc.
                  Murray Frank, DCHC
                  Tad Crawford, DCHC
                 Ned Robinson-Lynch, DCHC
                  Les Holcomb, DCHC
                  Sarah Isenberg, DCHC
                  Michele Lazerow, DCHC
                  Peter Strock, DCHC
                  Fred Rundlet, DCHC
                  Michael Carroll
                  Sarah Kuh, VHCAP

Chairman Leland called the meeting to order at 7:30 p.m.  Commissioner Jason Moved to Approve the Minutes of April 25, 2001. Commissioner Flynn Seconded the Motion. The Minutes were Accepted as written.

The County Manager reported the County has applied to the Edgartown Zoning Board of Appeals for a permit to rent a maximum of 20 parking spaces on Pine Street to a business.

The County Manager pointed out the Press Release about the groundbreaking for the Ropes Challenge Course.  Also included in the Commissioners’ packet was the RFP and draft contract the Emergency Medical Services.  



Mrs. Borer reported that construction is proceeding on the Administration Building Addition and the rough electric work is done.  There was discussion about the installation of the new flagpole at the Courthouse.  Commissioner Wey preferred moving the pole to the other side of the building, nearer the memorials.  It appeared that the other Commissioners preferred the present location, as it will be less costly and risky to keep it there.  

Mrs. Borer also reported on the Cape Light Compact’s presentation to the All-Island Selectmen the previous week.  Discussion followed about discounts and eligibility for reduced rates.  Commissioner Wey questioned the feasibility of continuing to fund the Compact.  Mrs. Borer explained that the funds are for paying a consultant.  Commissioner Wey suggested that if rates don’t go down, the cost may not be worthwhile.  Mrs. Borer reminded the Commissioners that Barnstable picks up a large portion of the costs.

Mrs. Borer explained that the County Fuel Bid is being prepared, and that it will be more inclusive.  She also mentioned upcoming Bids for centralized purchasing of Office Supplies, and Janitorial Supplies.

Chairman Leland did not have a report.  The only subcommittee report was  Commissioner Flynn’s on the New York Avenue property.  Commissioner Flynn reported that the Charrette was postponed due to complaints by abutters that they were not properly informed.  There was a meeting of the subcommittee with the Selectmen, abutters and organizers of the Charrette (Becca Rogers and John Abrams,) the previous Saturday.  Commissioner Flynn thought it best to put aside whatever happened the past two years and start anew.  The Saturday meeting was deemed successful, in that it helped sort out misunderstandings.

Commissioner Flynn resigned from the New York Avenue Subcommittee and asked that the Commissioners give the new Chair a strong mandate with which to move on.  Commissioner Sawyer said that besides the mandate already given about housing, the Commissioners had mandated that there remain a meeting place for the members of the community that presently use the space.  Commissioner Flynn agreed that keeping current users was to be part of the Charrette.  Commissioner Sawyer asked what the community wanted?  Commissioner Flynn said it was more what they didn’t want!  Commissioner Jason reviewed that at their meeting of April 26, 2000, the County Commissioners Moved to form a subcommittee for the New York Avenue property and to deal with the property in a way that would not displace anyone.  Commissioner Jason said there is no reason to reconsider.  He suggested being more inclusive, involving the town of Oak Bluffs, but he said he could not see backing off this prior commitment.



Chairman Leland agreed, stating there had been considerable input before that decision was made.  Commissioner Wey reiterated that there had been a lack of communication. He felt Saturday’s meeting was good, and that the town needed to be included, and the project started again.  He said the abutters should be notified of meetings by registered mail.  

Commissioner Jason nominated Commissioner Wey to take Commissioner Flynn’s place on the Subcommittee.  Commissioner Sawyer Seconded the Motion.   The Vote was Unanimous.  Commissioner Wey reminded the others that he will be going away, but he agreed to take the position.  He added that he wanted to bring the subject of the property up with his fellow Oak Bluffs Selectmen and see how they wished to proceed.  He suggested cleaning up the property, making it safe, then stepping back.

Oak Bluffs Selectman Combra said he thought the mandate was the problem.  He hoped the Committee would look at all possibilities and suggested the shacks on the property should not be the reason the Commissioners are looking to have housing on the property.  

Mrs. Borer said that after the Public Hearing, part of the mandate was to get an assessment of the property.  She added that the Commissioners decided to take a new look at the property when the Extension Service closed.  She reminded the group that the Martha’s Vineyard Commission purchased the buildings in 1993 and that the County owns the property, not the buildings.  The County Manager also reiterated that the mandate was housing, not 30 units as was suggested.  

Commissioner Wey asked that a questionnaire be drafted and distributed to the 32 abutters.  Discussion followed about starting over with a new public hearing.  Commissioner Wey believed it was agreed to start over.  The County Manager, Commissioner Flynn, and Commissioner Jason were opposed to starting over.  Selectman Combra said he believed the agreement was to abandon the previous plan that wasn’t successful.  Commissioner Jason disagreed, questioning what was unsuccessful.  Commissioner Combra said, having 30 units!  Mrs. Borer said John Abrams’ idea for the Charrette was for 6 to 8 units, not 30.  Commissioner Jason asked Selectman Combra if he was aware of Marnie Edwards and Mike Carroll’s goal. He had not seen it.  Commissioner Jason said the Charrette exercise was to listen to all ideas.  Chairman Leland said the mandate was for public use, some housing and some other uses.  Discussion followed in which Commissioner Wey asked for another Public Hearing.  Commissioner Jason said the Commissioners stated, “This is what happens on the property.  How can we make it better?”  He agreed the shacks are deplorable, but so is the meeting room.  Get rid of the meeting room?

Mrs. Borer said if the Selectmen want another Public Hearing, then have it.  
Commissioner Flynn suggested revoking the mandate.  Commissioner Sawyer said wait for the Public Hearing, adding that he was not sure the mandate was limiting.  Chairman Leland believed it’s open.  Commissioner Flynn suggested involving the Oak Bluffs Planning Board.

Chairman Leland introduced the Dukes County Health Council.  Cynthia Mitchell, DCHC Chair, introduced Pat Fairchild.  Ms. Mitchell thanked the County Commissioners for the opportunity to present Phase II and congratulated them on the passage of the Intermunicipal Agreement.  Ms. Mitchell stated that unlike the Access Program that has a County Employee at its head, this will be a 501C3.  She said the DCHC is not looking to the County to fund this, but to support it.

Pat Fairchild, Consultant from JSI, reviewed the history of the project that started in July 1999.  There were two original parts included in developing an Island Health Plan: the insurance piece; how health services are organized (and what is available.) Work has focused on the insurance piece. Phase I was the feasibility phase.  Conclusions drawn from Phase I were: most uninsured people are employed (80+%); people who have insurance are not likely to switch providers.  It was decided to focus on the uninsured and their employers.

Phase II was the planning phase. Detailed actuarial studies were done to see what a Plan would cost.  The Plan that laid out these costs marked the end of Phase II.  Also researched during this phase was access to physicians.  

Phase III will focus on taking the plan to employers and seeing if they would buy it.

Chairman Leland thanked the members of the Health Council for their commitment and hard work.  He introduced several financial concerns that focused on financial solvency, sustainability, and the participation of physicians.  Commissioner Sawyer suggested that this Plan does not create a new company.  Ms. Fairchild explained that the Plan will not require financial reserves, that an insurance company, perhaps Blue Cross, will contract to be a third part administrator.  She also said that physicians will be paid at Medicare rates, which are generally considered to be good.  Discussion followed about the costs of office visits. It was mentioned that the number of people targeted for the Health Plan is about 1300.  Ms. Fairchild agreed that if the employers won’t join the Plan, it won’t be able to move forward.  However, employers seemed to value health insurance when questioned, they just couldn’t afford it.  

Ms. Mitchell stated that this is a beginning, and that an Island Health Plan would attract grant funding because it would be viewed as innovative.  Perhaps with additional funding, employer portions and physicians’ services could be subsidized.  Commissioner Collins questioned if a sustainable program could be built based on grant money.  Ms. Mitchell said it would evolve and mentioned the skyrocketing costs of health insurance now.  This would ask providers to be part of a community effort to improve health care.

Mrs. Borer asked how many people would sign onto the Plan.  Ms. Fairchild answered that it would relate to the number of employers who participate.
The family premium would cost between $379-$513 and the individual premium would be between $120-$160.  

Michele Lazerow mentioned the need to look at prevention too.  Dr. Strock said the original vision of the Health Council was to pull together those who need care, with those who provide it.  Using the Emergency Room for regular health care is the most expensive scenario.  Fred Rundlet spoke about managing health, not money, working on preventative care, as was discussed at the Healthy Communities Seminar.  

Commissioner Flynn asked how will employer participation be assured?  He suggested mandating that health insurance be provided when towns sign contracts, making it a requirement.

Commissioner Collins mentioned the increase in payroll costs for providing health insurance.  Commissioner Jason questioned which key aspects outlined in the Scope of Work are ready?  Ms. Fairchild said the benefit structure, provider and employer participation pieces are ready.  Ms. Fairchild said she is focusing on Blue Cross, because as a third party contractor, Blue Cross would give the Plan legitimacy.

Cynthia Mitchell asked that the County Commissioners vote to support and accept Phase II so they can move into Phase III.  There was some discussion about $32,500 that Ms. Mitchell mentioned, funds from the Alpha Center.  Mrs. Borer asked if these funds will be used for Phase III.  Ms. Mitchell said they are not part of Phase III.  

Commissioner Flynn Moved to Accept the Report of the Health Council and Pat Fairchild on Phase II and endorse movement into Phase III.  Commissioner Sawyer Seconded the Motion.  The Vote was Unanimous.  Mrs. Borer thanked the Health Council and Pat Fairchild for their presentation.  Murray Frank said he was impressed that he Commissioners had read the report so carefully and had asked such important question.  He said the Health Council appreciated the attention this has gotten.



Commissioner Jason Moved that the meeting adjourn.  Commissioner Collins Seconded the Motion. The meeting adjourned at 9:30 PM.

Complete text of meeting is available on tape at the County Commissioner’s office.




__________________________________                     
JOSEPH E. SOLLITTO, JR.
 CLERK OF THE COURTS   




 
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