The County of Dukes County
County Commission Minutes 05/08/02
COUNTY OF DUKES COUNTY                  COUNTY COMMISSIONERS

A regular meeting of the County of Dukes County Commissioners was held on Wednesday, May 8, 2002 at 7:30 p.m. in the Conference Room of the County Administration Building, notice of such meeting having been posted as required by law.

Commissioners Present:  Leslie H. Leland, Chairman
                                Daniel Flynn    
                                Robert Sawyer
                                E. B. Collins
                                John Alley (7:38PM)
                                Roger Wey
Absent:                 Leonard Jason, Jr.
Also Present:           Carol Borer, County Manager     
                                Marsha Smolev, Executive Assistant      
                                Sheriff McCormack
                                Sandra Lothrop, Associate Commissioner
                                Anson Krickl, Universal Access Committee
                                George Schiffer
                                Nelson Smith
                                Cynthia Mitchell, Health Council (7:55PM)
                                Murray Frank, Health Council (7:55PM)
                                Fred Rundlet, Health Council (7:55PM)   
Chairman Leland called the meeting to order at 7:32 p.m.
        
        Commissioner Collins Moved that the Commissioners defer
consideration of the Minutes of April 24, 2002, as he did not have
time to read them.  Commissioner Flynn seconded the Motion.  A
vote to approve the Minutes was deferred by consensus.

The County Manager began her report by thanking the Sheriff’s Department for building and installing the new County Administration Building sign.  
Mrs. Borer reported that Reynolds, Rappaport, and Kaplan donated a collection of law books to the County.  The County Manager expressed her gratitude for the gift.  Mrs. Borer noted that on May 15th there would be a County Commission meeting to review the Fiscal Year 2003 Budget.  It was mentioned that the Advisory Board Meeting scheduled for May 9th was canceled.

Mrs. Borer reviewed items in the Commissioners’ packets, including a letter of disclosure by Steamship Authority Representative Kathryn Roessel, prepared by Steven Sayres, about her position on the Tisbury Harbor Management Committee.  Mrs. Borer stated that a vote on the issue was not necessary at this time, but Ms. Roessel would come back to the Commissioners should there be changes.  

Chairman Leland appointed Commissioners Sawyer and Collins to join him on a Subcommittee to review wages not covered by the County’s Compensation Plan.  The Subcommittee will bring information back to the County Commissioners.
Associate Commissioner Lothrop introduced Anson Krickl who presented a report on the work of the Universal Access Committee. The Universal Access Committee had been working with the Town of Tisbury and the Oak Bluff’s Branch of the MV Cooperative Bank on accessibility issues.  The Committee’s report on the SSA was distributed.  Mr. Krickl reported that the report was already presented to the Operation Manager of the SSA and would be formally presented to the SSA Board on June 20th.  Mr. Krickl also noted that he had been working to eliminate sidewalks in Tisbury.  The Universal Access Committee would like to develop a brochure that would indicate accessible locations on the Island.  Mr. Krickl was planning to contact the Chamber of Commerce, as this would be a great service for tourists, as well as Islanders.

Mr. Krickl announced that the Massachusetts Office on Disabilities named him liaison on the Island for complaints about accessibility.  The Commissioners thanked Mr. Krickl for his work and his report.  

Mrs. Borer asked about the current status of CORD.  Mr. Krickl said it was still in operation.

The Chairman introduced members of the Health Council.  Ms. Mitchell began by stating that the Council had asked to be on the Agenda in order to bring the Commissioners up to date.  The three issues Ms. Mitchell wanted to discuss were: Phase III of the Island Health Plan; the need to file for 501(c)(3) non-profit structure; the future of the Vineyard Health Care Access Program (VHCAP).

Ms. Mitchell explained that the Health Council was negotiating for the Neighborhood Health Plan to partner with the Island Health Plan.  The target population would be 200 – 400% of the Federal poverty level (income of $35,000 - $70,000 for a family of four.)  Ms. Mitchell also explained that the Council was working with the Division of Medical Assistance to arrange the conversion of Mass Health members (Medicaid) to the Island Health Insurance Plan.  
Ms. Mitchell reported that the Health Council was given an award of recognition by the Commissioner of Medicaid for innovation for access to health insurance.  She added that the Health Council was noted in the State for developing innovative programs, and that the State would be applying for a million dollar grant from the Robert Wood Johnson Foundation for local communities.  Martha’s Vineyard would benefit should this application succeed.
Ms. Mitchell announced that a Martha’s Vineyard Coordinator of the Island Health Plan would soon be hired.  This position would evolve into Director of the regional effort that would include the Cape and Nantucket.

The Commissioners received in their packets, the Bylaws for the Island Health Plan.  Ms. Mitchell announced that legal advice was being received from Reynolds, Rappaport, and Kaplan.  Murray Frank added that there was a Boston attorney as well.  Ms. Mitchell stressed the need for the public accountability and said that could be achieved by having the Health Council members make up the Board of the Island Health Plan.

Fred Rundlet added that this was the product of years of hard work by Roger Wey, now a County Commissioner, and others, and this was the Council’s best effort.  He suggested the Plan would be a model in the Nation and urged the Commissioners to support it.

Murray Frank reported that there were 1400 Medicaid members on the Island and that these would be “flipped” to the Neighborhood Health Plan for inclusion in the Island Health Plan.  This would bring substantial funds to the Island that otherwise would go to the State.  Discussion followed.  

Chairman Leland stated that he thought the 501(c)(3) would mean the end of the Health Council.  Cynthia Mitchell disagreed.  She added that people who were accountable to the County could oversee the Plan. Mrs. Borer questioned how.  Commissioner Sawyer said the Board would be separate, and the Health Council would continue to grow. He added that it was critical to have the public link.  Mrs. Borer asked if the funding for Phase III would go to the Health Council or the Island Health Plan?  Cynthia Mitchell said it would not matter.  

Chairman Leland asked about the provider network, since the Council had said that it was necessary for the Island Health Plan to work, and the Hospital had voiced concerns about reimbursement.  Ms. Mitchell explained that as long as the target group was between 200 and 400%, the Hospital had no problem.  Providers, she added, were supportive.  Chairman Leland asked about the “crowd out issue.”  Ms. Mitchell said the tiered co-pay design would take care of that.  She continued that mental health and complimentary and alternative care providers had concerns but that representatives of these providers would be included on the advisory panel.

Commissioner Flynn suggested the Commissioners support and recognize the importance of having the public component as part of the Island Health Plan.  He added that he thought the only way there would be health insurance for everyone on the Island was to fund and recognize this effort.  He asked that the County Manager put as much as possible into the Health Council’s budget. Commissioner Sawyer agreed.  Commissioner Sawyer disagreed with Ms. Mitchell’s comment that the County Commissioners weren’t interested in being partners in, or sponsors of, a health plan.  He asked for elaboration of Ms. Mitchell’s idea about a public/private subcommittee.  Ms. Mitchell said Commissioner Sawyer had misunderstood and explained that the Health Plan could not wait for the ‘municipal timeline.’  Commissioner Sawyer said he would fight for money for the Health Council, but his loyalty was to the financial stability of the County.  Commissioner Sawyer also voiced concern about the Health Council’s engagement of legal counsel.  

Cynthia Mitchell asked the Commissioners for a sense of their feelings about the 501(c)(3).  Commissioner Sawyer said he hoped the subcommittee would help define the role of the 501(c)(3).  Ms. Mitchell said it would not.  Commissioner Sawyer said he wanted the County to play a key role.  Ms. Mitchell said the County created the Health Council that will be the Board.  

        Commissioner Flynn Moved that the County Commissioners support
        the concept of the 501(c)(3).  Commissioner Sawyer suggested deferring
        the vote until everyone had a chance to read the Bylaws.  There was no
Second.  Movement on this was deferred.

Commissioner Wey said he had always supported the Health Council and he still did.  Ms. Mitchell said the Health Council would come to the Budget meeting and fight for funds.  Fred Rundlet asked that the Commissioners see this as an opportunity for the County to advocate for its citizens.  

Representatives of the Health Council left at 9:00 PM.

Commissioner Sawyer referred to documents in the Commissioners’ packets sent by SSA Representative Kathryn Roessel and said she had asked for the County Commissioners to sponsor a Forum in which SSA issues impacting Vineyard lives could be addressed.  

        Commissioner Flynn Moved that the Commissioners sponsor the Forum.
        Commissioner Alley Seconded the Motion.  The Vote to sponsor the Forum
was Unanimous.

Discussion about details of the sponsorship followed.  Commissioner Flynn suggested that the County Commissioners let Ms. Roessel run the Forum.  
Commissioner Sawyer distributed a list of four items (budget matter, advisory board matter, legal matters, new County enterprises) he wished to see included in the County’s Administrative codes (attached.)  Commissioner Alley said he thought three of these were already included.  Mrs. Borer said she would check the Laws on the first two.

Commissioner Alley Moved that the meeting adjourn. Commissioner Wey
Seconded the Motion.  

The Sheriff informed the Commissioners that there had been an escape at the County Jail.  Since the event was under investigation, he did not go into detail, but offered to supply more information on a one to one basis.
Commissioner Sawyer introduced Nelson Smith who had taken out papers to run for County Commissioner in Edgartown, as Commissioner Collins would not be running again.

The meeting adjourned at 9:14 PM.  

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



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