WCAAP Trustee Meeting
April 28, 2017
Red Lion, SeaTac
6:00 – 9:00 PM
6:00 – 6:30 / Gather, get dinner visit
6:30 – 6:40 / Welcome, introductions & roll call / Rafton / In attendance: B. Tolby, K. Harthcock, T. Felt, R. Hilt, S. Morelli, A. Grant, B. Hood, J. Ayer, M. Lee, E. Meade, J. Polo, M. Thompson, F. Chalmers, M. Dudas, L. Rave,
On the phone: M. Barsotti
Staff: S. Rafton, V. Olson, M. Edmundson, J. Donahue, L. Lippold
6:40 – 6:45 / Approve minutes March (ad hoc) board meeting / Ayer / Minutes from March 29 telephone meeting provided for review.
Motion B. Hood to approve minutes as they stand; R. Hilt seconded. Motion passes all in favor/0 opposed.
6:45 – 7:15 / Chapter Finances:
· Cash management
· Financial dashboard
· Sustainability planning / Olson & Polo / V. Olson reviewed dashboard that shows first quarter of the year. Cash balance is up from a year ago, mainly due to P-TCPI. We expect cash balance to be at around $300k for the remainder of the year. Total membership vs paid membership – paid membership is up quite a bit over the same period last year. Budget vs. Actual by project reviewed. Surplus goes into reserves at the end of the year.
Cash management – we have been able to increase our reserves every year. Funds are in a no interest checking account and a very low rate money market. We’ve been earning very little in interest so we have looked at how we can increase that while preserving principle and maintaining liquidity. One option is Capital One, where we can open a savings account to earn a higher interest rate (1%). Propose moving $100,000 to Capital One, leaving $100,000 in savings and all of checking at Pacific Continental Bank. Executive Committee approves the proposal so we will move forward. Suggest moving all of savings over.
Sustainability plan – objectives last year were to maintain and strengthen our financial position. Goal to be able to sustain our core functions helps to define parameters that are used for the budget planning process. The sustainability process and timeline were reviewed. Planning committee formed: Ed Marcuse, Kim Hauff, Diane Liebe, Jim Polo, Sarah Rafton, Danette Glassy (as able), Bob Hilt, Beth Ebel have all volunteered to serve on the committee. Staff is having a mini retreat in late May to go over what we already have planned for the remainder of the year.
7:15 – 7:20 / Update from S&E / Meade / Wellness event tomorrow – 23 people registered. We have also been working on drafting our key messages to go out both to members and nonmembers. We are currently in the process of interviewing subspecialists across the state (both members and nonmembers) to ensure we are using messaging that resonates with them. M. Barsotti will give us names of people in Spokane that might be good to interview.
7:20 – 7:25 / Early Career Rep / Dudas / Brenna Lewis is very interested but needs to be sure she will be supported in that role by her organization (Confluence in Wenatchee). She will let us know. She is physician champion for north central for P-TCPI and would be a strong addition to the board. We will revisit during June phone meeting.
We also have a new Swedish rep, Sonal Avasare.
Listening sessions – we are overdue to hold a listening session. Suggestions: Olympia, Vancouver, Tri-Cities, South King County. Suggest circling back to Spokane, Yakima to talk about our legislative success on behavioral health. Suggest strategically mapping out future locations/dates. If we had 8 key locations and went quarterly, there would be continuity and be sure to get back to each location every 2 years. Good way for us to get a pulse on what is going on in the state as well as a good networking opportunity.
7:25 – 7:55 / 501c3 Status / Polo, Olson & Rafton / History: We are currently a 501c6; we were originally a c3 and changed to a c6 in order to be able to do more lobbying. This resulted in a problem doing projects/grants, which often require a c3 status. That led to the organization which is now BestStart Washington. BSW and the Chapter maintained a relationship and BSW acted as the charitable arm of the Chapter.
Grants are changing in that funders do not want to use a fiscal agent anymore. It is now hampering us that we are not a c3 and the lobbying rules have changed so that it would be ok for us to be a c3 and still do the advocacy work that we want to do. We have talked with BSW board and they are comfortable and supportive of us being a c3.
- 501c6 you can do unlimited lobbying and get involved in political campaign activities
- 501c3 you can do limited lobbying – direct to legislators and grassroots lobbying. We would have to track the amount of our expenses that go into lobbying as a proportion of total expenses. For expenditures up to $500K you can spend 20% on lobbying. The % goes down after that for higher expenditure levels.
- There are penalties if you go over and you can lose your status. We need a good process in place to track our lobbying activities. We are in safe shape (well below the threshold) and there a lot of advantages.
- Percentage of time spent educating is not the same as direct lobbying. Volunteers meeting with a legislator do not count. Also, if you are reacting to legislation that threatens your profession, that does not count as lobbying. Grassroots is trying to spur the public to action, not us activating our members. We need to be very clear and keep good track of what we are doing. We estimate we’d be between 12 and 20%.
- Need to get an estimate on how much it will cost to change over to be a 501c3. We were going to work with 501 Commons on the process but are exploring other options.
- We will actively work to avoid any conflict with BSW. BSW board is supportive but MOU will have to be revisited.
- Being a c3 also allows us to access discounts on things like software and training. Also makes it much easier to accept donations.
- Timeframe – if we begin the process we can start acting as a c3 immediately but it may take a year to complete the process.
- Any clear disadvantages? Cost, time involved in tracking lobbying activities.
- Motion R. Hilt that the chapter become a 501c3. E. Meade seconds. Motion passes with all in favor/0 opposed.
7:55 – 8:15 / Input for retreat / Dudas & all / - Retreat is July 21-23 in Leavenworth.
- Opportunity to work in committees and plan for the year. Also could use some of the time for education.
- Feedback on last year: Committee planning could use more time.
- Time could be better spent working together and talking about our own issues. Look at our goals and invite someone in who can do education that can further our goals.
- Good opportunity to tighten up our policies on different topics.
- Need to continue to connect the dots for people on how the work we are doing will impact pediatricians.
- Suggest inviting Mary Ann Lindeblad come back to talk about implementation of children’s mental health legislation and what impact it will have.
- Elevator speech on how our policy priorities connect to people’s lives. We will be able to help with that when we present the messaging work we’ve done with Team Soapbox.
- Also some training on how to have a 5 minute conversation with your legislator.
- Helping colleagues understand what the WCAAP is doing for them has to be personalized.
- Leadership training could include advocacy training – ensures that board members can mentor new advocates.
- Team Soapbox contract is to educate us. Could invite them to come to the retreat, (or video conference) and then do in person training in October.
- Advocacy training – suggest pre meet at the beginning of the retreat for those who really want it. Lelach would be happy to put something together.
8:15 – 8:30 / Discuss education on Value Based Payment, ACH’s, MCO Workgroup / Chalmers, Dudas & Rafton / Map of work health care transformation team has been doing over the past year.
State level: We have made headway with all 5 MCOs this year. First question was about the data they are providing and what providers need to help them improve practice. Goal was for all MCOs to provide all the same data in the same way, in one report. MCOs remain engaged but we may need to lower our aspirations. They did agree that if we select the measures they will present the data in a uniform way. Asking how they can help us improve on the quality measures. How can they help us better understand value based payment?
Next meetings scheduled for June and August. If anyone wants to join at those meetings let Mike or Francie know.
Regional level: ACH involvement – Sarah Rafton has joined board for King County; Francie Chalmers has been working closely with North Sound; behavioral health champ in North Central is on integration committee (Blake); Beth Harvey and Phyllis Cavens are tracking Cascade Pacific closely. ACHs are going to design system reforms and we can benefit from that reform if we have people at the table talking about kids. Collaborative care model adaptations needed to help with behavioral health issues for kids. See that as an ACH project. Sarah talked with all of the ACHs and they do have an interest in child health topics. Now we need to get pediatricians in to collaborate with them.
8:30 – 8:55 / Legislative update and reflections / Lippold / Legislature adjourned last Sunday and special session started this week. There has been no sense that they are negotiating on the budget but there are informal discussions. Testimony this week on revenue package in Senate Ways and Means. It is unlikely to come out of committee, if it does, it may be without recommendation. Stalemate at this time. Issue is for us is that the bills we’ve had pass need funding in the budget.
- 3 mental health bills passed: paperwork reduction, broader children’s mental health bill and Thatcher’s bill about integration into primary care. They are being reviewed by Office of Financial Mgmt. There does not seem to be any problem with any of the 3. We expect governor to take action on them in the next week. He has until May 9 to sign bills into law.
- If money is in budget and the governor signs then we need to stay on top of them and make sure there is effective implementation by the HCA.
- Distracted driving bill passed, with delayed implementation (January 2019). Beth Ebel did an incredible job advocating for this. Rep. Farrell and Sen. Rivers also deserve a ton of thanks, they really partnered well and were champions for the legislation.
- There are still possibilities for tobacco 21 and family leave to move. There is a proviso in house budget to expand community work on safe firearm storage.
- Budget items: ROR and Medicaid rate – we have to continue to send the message. For Medicaid it’s a steep climb because it was not included in any of the proposed budgets. We have to keep talking about it so they understand the impact on kids. Stay vocal! ROR saw highest level in the Governor’s budget, lowest level in the Senate budget. From the state’s perspective the Senate budget would keep status quo in ROR but from program perspective it would be an effective cut because they are losing other sources of funding.
- Keep in touch with legislators during the interim! Most legislators will be in their districts, so go talk to them about what’s happening in your district and thank them for their work. Meet with them starting now!
- There will be a debrief on children’s mental health progress/work group. May result in recommendations for legislation to pursue next session.
- Legislative committee will continue to meet – let committee know what is on your mind so that we can consider before we propose priorities at the retreat.
- Could be a substantial part of our June board meeting agenda.
o Difficulty with kids getting ABA – waiting list is now 2 years long..
o Loss of medical home for kids and return to ER care
o How ACHs actually do behavioral health – Massachusetts has a referral assistance benefit program
o Medicaid – S. King county will have thousands of kids with no medical home soon.
o Autism, implementation for all the screening measures, reaching limited English proficiency families
o Implementation of distracted driving and behavioral health
o Medicaid rate
o Access to care, seeing 20% more volume, not sustainable
o Behavioral health – 1) workforce and 2) between community services and higher level acute services
o Streamlining process of next steps that arise from screening – there may be conflicts in the legislation that if you diagnose you can’t treat
o Access and Medicaid rates. Maybe we need to be more creative about what we are asking for.
- HCA is thinking about having a mtg in June to educate legislators and staff about what’s happening with the ACHs.
- Thanks from Laurie for being so amazing; she will be sorely missed!
8:55 – 9:00 / Closing / Dudas / Meeting adjourned
Mark Your Calendars:
Saturday April 29, Taking Back Your Life as a Physician: from Burnout to Balance, daytime SeaTac
Thursday June 8, Telephone evening Board Meeting
Monday July 10, Celebration of Service for Laurie Lippold, Seattle
Friday July 21 – Sunday July 23, Annual WCAAP Retreat, Leavenworth
Agenda WCAAP Trustee Meeting