56th PIHOA Board Meeting Minutes
11-15 August 2014
Honolulu, Hawaii
Meeting Objective: To convene senior and deputy health leadership from the Territory of American Samoa, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, the Territory of Guam, the Republic of the Marshall Islands and the Republic of Palau to discuss issues of regional significance, and by the end of the meeting, decide on critical priorities forward through official communiques, resolutions and recommendations.
Attendance Day 2: Executive and Associate Members: Minister Gregorio Ngirmang (Palau), Minister Phillip Muller (RMI), CEO Esther Muna (CNMI), Director Livinson Taulung (Kosrae, FSM and proxy for Secretary Vita Skilling), Dr. Suzanne Kaneshiro (Guam and proxy for Director Jim Gillan), Director Paulino Rosario (Pohnpei, FSM), Director James Gilmar (Yap, FSM), Jesse Tudela (CNMI), Warren Villagomez (CNMI). PIHOA Secretariat: Emi Chutaro, Cerina Mariano, Regie Tolentino, Billie Hiraishi, Mark Durand, Greg Dever and Alicia Sitan. Guest Speakers: Captain Randolph Daley (CDC Preparedness), Captain John Walmsley (Region IX HHS), Mark Burchess (Perry Point, via TC), Clarette Matlab (Palau, via TC), Dr. Jonathan Mermin (CDC NCHHSTP), Bill Gallo (CDC OSTLTS), Vicky Rayle (CDC OSTLTS), Liza Corso (CDC OSTLTS), Carol Moehrle (PHAB), and Dr. Kaye Bender (PHAB, via TC), Captain Cathy Wasem (Region IX HHS Hawaii), Mrs. Terry Ngirmang (PCC, Palau). General Attendees: Derrik Felix (CDC NCHHSTP) and Andy Heetderks (CDC NCHHSTP)- for Dr. Mermin part only, and Temengil Temengil (Palau MOH).
Attendance Day 3: Executive and Associate Members: Minister Gregorio Ngirmang (Palau), Francyne Wase-Jacklick (RMI, proxy for Minister Muller), Director Livinson Taulung (Kosrae, FSM and proxy for Secretary Vita Skilling), Dr. Suzanne Kaneshiro (Guam and proxy for Director Jim Gillan), Director Paulino Rosario (Pohnpei, FSM), Director James Gilmar (Yap, FSM), Jesse Tudela (CNMI), Warren Villagomez (CNMI, and proxy for CEO Muna). Affiliate Members: Dr. Lee Buencosejo-Lum (UH and CCPI), Dr. John Ray Taitano (CCPI), Louise Santos (PBDA), Arielle Buyum (PIPCA), and Clifford Chang (PIPCA). PIHOA Secretariat: Emi Chutaro, Cerina Mariano, Regie Tolentino, Billie Hiraishi, Mark Durand, Greg Dever, Angela Techur-Pedro, Vasiti Uluiviti, Dr. Kristine Qureshi, and Alicia Sitan. Guest Speakers: Vanessa Lee (HRSA, via TC), Dr. Louise Iwaishi (Hawaii), Duane Lopez (Hawaii DOH), John White (Shriners Hospital, Hawaii), Donald Zeke Schmus (Shriners Hospital, Hawaii), Susan Yamamoto (Shriners Hospital), Gregg Nakano (UH), Dr. Ian Rouse (FNU), Dr. Chris Whelen (Hawaii State Lab), Dr. Philip Dauterman (CNMI CHCC), Dr. Matthew Bankowski (Hawaii DLS). General Meeting Attendees: Colonel Jennifer Walker (?), Captain John Walmsley (Region IX HHS), Bill Gallo (CDC OSTLTS), Captain Cathy Wasem (Region IX HHS), Terry Ngirmang (PCC Palau), Dr. Rachel Novotny (UH), Katie Sellers (ASTHO), Karl Ensign (ASTHO), Lindsay Strack (ASTHO), Ed Hope (Hawaii DLS), Louis Yamada (Hawaii DLS), Janos Barkos (UH), Dr. EmaisRoberts (Palau MOH), anyone else?
Attendance Day 4: Executive and Associate Members: Minister Gregorio Ngirmang (Palau), Minister Phillip Muller (RMI), Director Livinson Taulung (Kosrae, FSM and proxy for Secretary Vita Skilling), Dr. Suzanne Kaneshiro (Guam and proxy for Director Jim Gillan), Director Paulino Rosario (Pohnpei, FSM), Director James Gilmar (Yap, FSM), Jesse Tudela (CNMI), Warren Villagomez (CNMI, and proxy for CEO Muna). PIHOA Secretariat: Emi Chutaro, Cerina Mariano, Regie Tolentino, Billie Hiraishi, Mark Durand, Angela Techur-Pedro, and Alicia Sitan. Guest Speakers: Temengil Temengil (Palau MOH), Clifford Chang (Executive Director, PIPCA) and Dr. Lee Buencosejo-Lum (UH and CCPI). Affiliate Members (for HLC session) – Louise Santos (PBDA), Christine Deeley (PIPCA), Arielle Buyum (PIPCA), and Dr. John Ray Taitano (CCPI).
SUMMARY OF BOARD DECISIONS
Organizational
Item / DecisionNominations and Election of Board Secretary / Treasurer / CNMI (CEO Esther Muna) was unanimously elected as Secretary / Treasurer
55th PIHOA Meeting Minutes / Approved
56th PIHOA Meeting Agenda / Approved
Review and revision of the PIHOA By-Laws, as amended 2004 / Emi will make revisions, send an updated version, and if time permits on Thursday, the Board can review it on Thursday
Next PIIHOA Meetings / Board unanimously approved Palau as the venue for the next PIHOA meeting to coincide with the NCD Summit, targeting the first two weeks of March 2015. The next PIHOA jurisdiction meeting will be hosted by the RMI (early 2016).
Programmatic
Item / DecisionWebIZ Data-Sharing Agreement for Immunization / Board unanimously approved proceeding with the WebIZ Data Sharing Agreement, with the condition that all concerns are addressed by CDC
Regional Pharmaceuticals Formulary / Board unanimously approved continuing to address this as a priority issue
NPHII/Public Health Accreditation – Opportunities for the USAPIs / Board unanimously approved to have a formal communique to PHAB, program managers, and staff on the Board’s continued support of this matter, with support to the PIMs for them to work with PHAB on reviewing the Domains, Standards and Measures for relevance and appropriateness to the USAPIs.
Update on the Pacific Island Network of Nursing Education Directors (PINNED) / PINNED will come back to the Board for a more formal request for the support they need. Emi will work with the Board to call a meeting to discuss the request.
USAPI NCD Law and Policy Summit and Logistics / Emi will draft the communiques per Board discussion and decisions.
Health Leadership Council / HLC matter tabled pending further review and update of the Terms of Reference and that all Board concerns are addressed.
ASTHO Senior Leadership Competencies / Board approved use of the ACHE Healthcare Executive Competencies Assessment Tool for completion by Board members and senior health department staff
ASTHO Strategic Resource Management / Board approved:
- To give Secretariat staff access to health department grant expenditure data. Emi will prepare Concept Paper that will be given to finance offices as advance notice on this project and detailing the specific data requested.
- Use of the USAPI Resource Management Capacity Questionnaire and conducting the survey with health department staff.
Progress in the Fight Against NCDs in the USAPI: 2000-2013; publication drafted by Dr. Durand / Board agreed to release this document, with a mandate for Secretariat staff to update the report annually
Financial
Item / DecisionHRSA Primary Care Office (PCO) Grant / Board voted to hire the PCO Director as a full-time staff position
DETAILED MINUTES
Day 1 – Monday, August 11: ASTHO Territorial Health/Insular Area Health Officials Meeting (Invited Guests)University of Hawaii John A. Burns School of Medicine, Cancer Center
Sullivan Conference Room
Day 2 – Tuesday, August 12 (Closed PIHOA Board Member Meeting and Invited Guests)
AlaMoana Hotel
Anthurium Conference Room
Time / Agenda Item / Discussion / Decisions Made / Action Needed
Morning Coffee and Fruits / PIHOA Board Member Registration
Opening Prayer: Director Paulino Rosario, Pohnpei State Health Services
Welcome and Acknowledgements: Emi Chutaro, Executive Director, PIHOA Secretariat / Emi welcomed RMI Minister Philip Muller, the newest member to PIHOA. Emi announced that Director Nua is unable to attend the meeting due to the Chikungunya outbreak in American Samoa; and that Secretary Skilling and Chuuk Director Marar are not able to attend due to priorities in the FSM. Dr. Livingston Taulung is Secretary Skilling’s proxy. Emi announced that CEO Muna accepted Secretary Skilling’s request to preside over today’s meeting, but another member will need to preside over the rest of the meeting as she will be returning to the CNMI tomorrow. As there are no officers in attendance, Emi has asked CEO Muna that we jump ahead in the agenda to the election of the Secretary/Treasurer, so there will be an officer in attendance for most of the meeting.
Nominations and Election of Board Secretary/Treasurer: Emi Chutaro / Nominations were opened by Emi. Minister Ngirmang nominated CEO Muna. He explained that she has been on the board longer than others and he believes in seniority. CEO Muna shared that she has been the Secretary before; she accepts the nomination, but welcomes anyone else who may be interested in serving in that position. Dr. Taulung seconded the nomination; and votes were unanimous. Emi promised CEO Muna that she would have the support of Secretariat staff. CEO Muna acknowledged the help provided by Secretariat Staff in the past. / CEO Muna was unanimously elected as Secretary/Treasurer.
Review and adoption of the 55th PIHOA Meeting Minutes: Esther Muna, CEO, CNMI CHCC, presiding on behalf of the PIHOA Board President / CEO Muna called the meeting called to order at 9:10am.
Emi advised that in keeping with the Board’s decision earlier this year to Go Green, minutes were sent via email; but offered to print minutes for review if preferred. CEO Muna asked members to review the minutes and suggest changes as needed. Emi reviewed the minutes, providing a synopsis of the agenda items and decisions made. Minister Ngirmang moved to approve the minutes; seconded by Dr.Tualung. / Minutes adopted.
Review and adoption of the 56th Meeting Agenda: Esther Muna / Minister Ngirmang moved to adopt the agenda; seconded by Dr. Suzanne Kaneshiro. / Agenda adopted.
Review and revision of the PIHOA By-Laws, as amended 2004: Emi Chutaro / This was tabled at the 55th PIHOA Meeting, with the plan for Board members to work with Emi on reviewing the Bylaws and proposing amendments. Emi reviewed the Bylaws with the Board and proposed suggested amendments; however, the following items were discussed in greater detail:
- Associate membership: Emi shared that the lack of payments from most associates result in PIHOA having outstanding invoices, some for long periods of time (i.e. years in arrears). How should this be better managed? Jesse Tudelamoved for the Secretariat to develop a process to safeguard PIHOA from having outstanding payments due to this issue. Members suggested that associate membership be reviewed annually.
- Membership dues: Emi reported that the current policy is that all past due membership dues are considered outstanding. Dues are a very important source of income for the organization. Board members asked if PIHOA members are obligated to pay past due membership dues. Also, what if a member decides that they can retain membership, then comes back and requests to be active? Guidelines must bedeveloped to address delinquent payments. Dr. Taulung commented that members need to support each other by paying dues timely. Minister Muller asked what membership dues cost. Emi advised that starting in fiscal year 2015, executive member dues will increase to $15,000 annually and associate members will remain status quo at $500 annually.
- CNMI CHCC: CEO Muna asked Emi to clarify who are PIHOA associates now that CHCC is a corporation. It is clear that the executive member is the CEO. CEO Muna asked if both the Director of Public Health and Hospital Administrator could be associate members. Emi advised that the CHCC could be handled the same as Palau, which has the Minister of Health as the Executive Board member and the Directors of Public Health and Hospital as Associate members.
- Guam Behavioral Health & Wellness Center: Dr. Kaneshiro clarified that this is the same organization as the Department of Mental Health & Substance Abuse – they recently changed their name. Like the Guam Memorial Hospital, it is a separate entity from the Guam DPHSS. Emi noted that this organization was in severe arrears in their payment of dues.
- Affiliate, Honorary and Advisory members: Emi reviewed the definitions for each category and asked if there a need for all three categories.
- Emi shared that affiliate members are regional professional health organizations; most members of these organizations are staff of health departments; most regional organizations are independent of health departments and are funded from other sources. Their purpose as content area experts in their fields are to provide advice and support to the Board. Given this fact, should affiliate and advisory members be the same?
- Emi pointed out that Advisory members seem to be funders, which could pose some conflicts. Dr. Taulung suggested that “Advisory Members” be revised to “Support/Partner Agency Members.” Jesse Tudela suggested that this be stated as “Donor/Partner Agency Member.”
- Honorary members: Emi shared that the original bylaws define honorary membership to be by invitation. There are only two honorary members. The length of honorary membership is unclear – is it in perpetuity or an annual basis?
- CEO Muna suggested that a term should be specified. Also, the Bylaws seem to recognize organizations as honorary members, versus individuals. There also is some overlap between Associate and Honorary members.
- Minister Muller stated that usually honorary members refers to individuals and not organizations.
- Removal of Board Officer from office: Board members discussed the provision on how Neglect of Office is the responsibility by the Board of Directors. Members asked for an example of this issue. Emi explained that there are extreme cases where a Board member is just not communicating/engaging; or in some cases, are simply not paying dues.
- Minister Ngirmang asked if there are any examples of how the President can work against PIHOA. CEO Muna explained that there are cases where the President is very new and would really need Secretariat staff support to guide them.
- Emi mentioned that the New Board Orientation Packet is a tool to help guide members and engage those who may take on new positions. As Executive Director, she would also provide support to new members. Emi apologized that due to funding challenges, she has not been able to meet in person with new members such as Minister Muller.
- Further adjustments were made to the by-laws and tabled for Thursday afternoon for further finalization. Emi would then submit to the Board to review one last time and vote to adopt.
Note to PIHOA Secretariat Staff – please update New Board Member Orientation Packet with new By-Laws once finalized and approved by the Board.
CDC Preparedness – Regional Career Epidemiology Field Officer (CEFO) placement: Captain Dr. Randolph Daley, Branch Chief, Field Services, CDC Office of State and Local Readiness / Capt. Daley provided a presentation on Supporting Epidemiology Preparedness in the Pacific Islands, with a focus on placement of a CEFO in the USAPI. Board member questions/comments:
- If a needs assessment is conducted and it’s decided that additional CEFOs are needed, will CDC fund the additional CEFOs? Capt. Daley could not guarantee additional CEFOs, explaining that in the short term, that’s probably unlikely; however,he assured the Board that there is interest in placing other assignees that may augment the CEFO’s work, such as the Chronic Disease Epidemiologist. HHS would want to do this in a way that will maximize resources, with epidemiologists working collaboratively.
- How long is the assignment? Typically, CDC insists the jurisdiction commits for a two-year period. Capt. Daley has told his leaders that CDC needs to commit to this for five years. This is mostly supported, but there are no guarantees; however his leadership has committed to funding this effort for five years.
- How will the work be prioritized? This work will be collaborative. CDC needs someone embedded with PIHOA as a Supervisor/Technical Advisor to work with CEFO and the Board, to ensure the Board is supportive of the CEFO’s work priorities.
- Is there any idea of what funding is needed from local jurisdictions? Mainly just support/collaboration by allowing staff to work with the CEFO. The goal is to totally fund CEFO through CDC. There may be a need for travel funding in the future which can’t be paid with federal grant funds, but right now, there would be no expectation of funding support from PIJs.
- The timeline seems very close. Have candidates been identified? Yes, there are a couple that CDC is looking at, but Capt. Daley can’t share that information. One person meets CDC’s criteria for a CEFO. A key point is that the CEFO is not supposed to replace current CDC support in the PIJs; the CEFO is supposed to add support.