BOARD OF COMMISSIONERS'
REGULAR MEETING
July 27, 2010
Following HACSA
Harris Hall Main Floor
APPROVED 9-1-2010  

Commissioner Bill Fleenor presided with Commissioners Bill Dwyer, Rob Handy, Pete Sorenson and Faye Stewart present.  County Administrator Jeff Spartz, County Counsel Liane Richardson and Recording Secretary Melissa Zimmer were also present.

1. ADJUSTMENTS TO THE AGENDA

None.

2. PUBLIC COMMENTS

Bill Klupenger, Eugene, said he is now on Medicare and pays $25.00 per month for supplemental Part B with no prescription drugs.  He said health care in the community is fragmented and expensive.  He believes in providing medical services to other human beings. He wanted a home base clinic that provides a card with all the health care information on it.  He wanted to separate health care from insurance.  He commented that insurance adds to the expense without benefit.  He wanted the commissioners to do what they can do make this vision a reality and he is willing to help the Board do it.

Betty Shirley, Eugene , said she moved to Eugene 12 years ago.  She stated that she knows some of the issues that are wrong with health care delivery.  She wanted the Board to contact San Francisco to see what they have done with health care.  She thought Lane County could do the same.  She commented that people could benefit from local care.

John Deleau, Springfield, talked about San Franciscoís health plan.  He encouraged people to investigate the San Francisco Plan and come up with something that could be recommended for Lane County.

Marc Shapiro, Eugene, said he was a proponent of single payer.  He reported there were 60,000 uninsured citizens in Lane County last year and there are now 72,000 uninsured citizens in Lane County.  He noted the parallels between Lane County and San Francisco .  He commented the uniqueness of Lane County is public employment that could be seed money to generate a program.  He thought it might give Lane County the elements they need.  He urged the Board to contact San Francisco staff to make it happen.

Charlotte Maloney, Eugene , urged the Board to find out about the Healthy San Francisco Plan.  She said people are not getting information early enough to change their lifestyle.  She was not enthused about the federal health bills because things donít go into effect for many years.  She was not asking to replicate it, but to see what works for San Francisco and what would work in Lane County.

Cheryl Crumbly, Eugene , said there is need for access to health care.  She indicated that the United Way has been promoting the Family Wise Prescription Drug Program.  She said it is a point of purchase and they have saved residents over $150,000 in prescription drugs over the past year.  She wanted the Board to take advantage of what United Way has learned.  She said if the Board decides to move forward on this, to keep in mind the Oregon Drug Prescription Plan is a bulk buying program.  She said they were careful not to have the Family Wise plan as a competitor but as an augmentation.  She didnít know the discount amount the Board was considering but she asked the Board not to pose it as a competition to the Oregon Drug Prescription Plan.  She asked to consider the burden on the local pharmacies and the paperwork it takes.  She commented that the pharmacies want to do the right thing and they are losing profits.  She was concerned that if the Board passes this, the pharmacies wonít accept the card.  She wanted to collaborate in bringing prescription discounts to the citizens instead of having it as a competition.

3. COMMISSIONERS' RESPONSE TO PUBLIC COMMENTS AND/OR OTHER ISSUES AND REMONSTRANCE

Dwyer stated that he is a single payer advocate.  He announced the birth of his great-granddaughter.

Sorenson thought the idea they could do something with medical care (like San Francisco) was an optimistic thing.  He thought they could look at the innovations that are in other communities for a medical home for people, minimizing the transaction costs of the health care system.

Stewart recommended contacting Val Hoyle as she works at United Way .  He thought they should invite her to come speak on bringing in expertise to see how things could be done better.  He recalled this past weekend medical services were offered free to citizens in Coburg .  He stated on July 13 and 14 he told the Board he was going to be attending a Resources Advisory Committee meeting for the Umpqua Siskiyou RAC where they pick projects for Title II funding.  He indicated that Lane County had two requests: one for the Sheriff Inmate Work Crew funding for $40,000 that they received and for DYS to fund their request of $26,000.

Handy acknowledged the passing of former Lane County Commissioner Chuck Ivey.

4. EMERGENCY BUSINESS

None.

5. COMMISSIONERSí BUSINESS

a. RECOGNITION/Outstanding Lane County Citizen Alice Kaseberg.

6. COUNTY COUNSEL

a. Announcements

None.

b. REPORT BACK/National Association of Counties (NACo) Prescription Drug Program.

Richardson said NACo has a prescription drug plan that they have had for a few years.  She said if they sign up with NACo, they will provide the prescription drug card for the citizens.  She said it could say Lane County and it would allow the citizens to go to 60,000 participating pharmacies, getting reduced costs for most prescription drugs.  She said there is a 22 percent average discount off of the full price.  She noted counties across the country have been joining.  She said Lane County was asked to joint the NACo program. She discovered the United Way has a similar program with no cost.  She asked if the Board wants to go forward with NACo or another prescription drug program, what they need to do.

Assistant County Counsel Trina Laidlaw explained the issue of joining NACo and the prescription drug plan has come up over the years.  She said there are two components about signing up.  She said a question is have they addressed the competitive selection issue they need to because they are a government in Oregon .  The second issue is signing a contract with Caremark.  She recalled that NACo completed a competitive process in 2001 and that was when they first invited a pool of companies to compete.  She said they chose Caremark.  She added in a recent conversation with NACo,  they had someone call some of the competitors, to try to get information related to the main components of the program.  She said they wanted to see if they can try to get the numbers to do a comparison to see if Caremark was the best company.  She indicated that it wasnít a process where they invited the company to submit a proposal.  She said in terms of competitive selection, they look at NACo doing something in 2001, and this informal process last year.  She stated the issue for Lane County is whether the process done nine years ago is sufficient to meet the competitive selection obligations in Oregon.  She said in Lane County they typically review competitive selection every three years. She indicated the time frame for NACo is long and it is hard for Lane County to justify as an Oregon entity to piggy back onto their process and Lane County doesnít have to do their own process.

Laidlaw stated that Lane County could publish an ad in its interest in sponsoring a prescription drug discount program for Lane County residents, outlining the main components and indicate they are considering the NACo program and that NACo offers administrative assistance to Lane County in  managing the program and Lane County would be involved in a national market share.  She said they can then ask companies who wish to compete to send in a letter of interest addressing some of the main issues: how many pharmacies participating, average discount price or any other fees they charge, ease of use to consumers and  if  they can make a decision to do a more formal process.  She said if the Board decided Caremark was the appropriate plan to go with, then the Board could sign the contract through NACo and get the benefits they have gotten through the process.  She said the second component is signing the contract with Caremark.  She noted one issue is that it states any contract executed is a confidential document.  She said they are asking Lane County to agree the entire contract is confidential. She said they have to give notice and opportunity to object before they make the document public.  She said they have to explain to the public what type of services they are getting and not keep it in secrecy. 

Dwyer thought the best bang for the buck was not the NACo card but going through the FQHC.  He thought that was the direction they needed to go.

Rob Rockstroh, Health and Human Services,  said not everyone can be a member of the Federally Qualified Health Center.  He said Family Wise at United Way is a 20 percent or higher discount and the State of Oregon also has a plan.  He said the problem with the FQHC is the size and the clients they can take.  He said anyone can use a drug card but to get access to the 340 B program, they would have to be a member of the FQHC.  He said they want the whole community to have access to primary care.  He said if they want the Lane County logo, it would be good to have a card. He noted for Family Wise or other cards, it would be the same for individuals.

Sorenson thought the larger issue is whether the County provides it as another option for the citizens.  He said without the program in existence in the County, people are finding ways to get access.  He asked if this provides additional access.  He asked what the cost would be to Lane County in providing the service.

Laidlaw responded that there are no costs, but there would be costs with cards with the County logo on it.  She spoke with Health and Human Services and with other counties.  She said there are no hidden costs and there was ease of use.

Sorenson wanted to move ahead with the promotion of their own clinic and with this as well.  He didnít see a drawback advantages and the ability to have bulk purchasing.

Fleenor asked if the Board wants to move forward, they should have a proposal to bring back a board order with the stipulation of the caveats with advertising and open records law.

Richardson said they didnít need an official board order, but if the Board wants to proceed with the advertisement and conversations with NACo as described by Laidlaw, they could have a motion.

MOTION: to move to proceed with the advertisement and conversations with NACo as described by Trina Laidlaw.

Dwyer MOVED, Stewart SECONDED.

Stewart said he would support a larger conversation of health care options to save employees costs.

Fleenor asked to bring this back and include a report to be put in the motion.

Richardson indicated they could do a report back depending on how long it takes to do the advertising.  She said if they look into September, they could have recommendations made.

Dwyer amended the motion to have a report back on September 15.  Stewart SECONDED.

VOTE: 5-0.

7. PERFORMANCE AUDITOR  

a. Announcements

Stewart Bolinger, Performance Auditor, indicated that he made a list of recommendation collection actions for Justice Courts.  He is working on clearing the list.  He said he is drafting a list of risk conditions and background on those conditions so a new auditor will have his assessment on where they stand on the critical issues to consider if they adopt a new Risk Assessment Plan with a new auditor.  He was offered an opportunity to be Auditor Director for Save the Children in Haiti .  He said he will finish the Justice Court project and report to Haiti for two years.

8. EXECUTIVE SESSION as per ORS 192.660

None.

There being no further business, Commissioner Fleenor recessed the meeting at 12:00 p.m. 

Melissa Zimmer
Recording Secretary