PRESENT: Chairman: Andrea Stewart-Cousins Members: Lois Bronz,

Sue Swanson, Ursula LaMotte Secretary: Lynne Creighton

Legislator Richard Wishnie

Commissioner Mary Glass, George Hosey, Jo Brill, May Aisen,

Harriet Goldberg, Rosemary Castiglia

The meeting was called to order at 2:10 PM by Mrs. Stewart-Cousins.

Commissioner Glass gave a presentation on Managed Care .

She said that each client received a package of information on the various health plans available and a booklet answering some of the most frequently asked questions. Mrs. Glass said that a toll-free number is also available to answer questions.

The Dept. of Social Services did an RFP (Request for Proposals) for Managed Care in 1995. Eleven organizations responded. This was the first mandatory Managed Care program in the state with competitive bidding A team was set up to evaluate each of those respondents--one from the Westchester County Medical Center, the State Health Department, the County Health Department, one from Mental Health and one from Social Services.

They were trained in the evaluation document by consultants and each one

reviewed the responses from the 11 organizations, eliminating one early, when, asked to describe the service area, they described New York City

The evaluation approach was 1)to describe their service plan to serve the clients . During this process four were eliminated, which left six plans.

They had to address questions such as how they were going to educate the clients, the kinds of benefits, would there be 24-hr. coverage, etc.

When the six plans are actually operating they have the capacity to cover

58,000 lives, which is more than the 36,000 needed but Social Services decided to go for more coverage rather than less.

All materials were submitted to both State and Federal government for approval, after which time the enrollment process started in January of 1996.

This information is being distributed in several ways:

1-A mailing to all cases being recertified in the district offices.

2-When people apply they are enrolled in Managed Care.

3-A team was set up, made up of 5 examiners plus a supervisor.

Three speak Spanish. This team mans an 800 line and go into

the district offices explaining to clients what Managed Care is.

There are also two health care coordinators who are nurses, whose role is

to make sure that the plan laid out by the various health care organizations is

in fact occurring. If the client cannot resolve a problem with their health care

provider they can call DSS, where medically qualified people will be on staff to respond to the issue. A part-time physician is also being hired.

A team is also sent out to each managed care organization to verify that what they stated on paper can actually be provided.

Mrs. Glass said that all 36,000 individuals are expected to be enrolled in this program by April or May

Mrs. LaMotte wanted to know if one provider is being used more than others and Mrs. Glass said that so far they are evenly spread, and that clients are encouraged to review the material carefully, focusing on where they live,

what hospitals are associated with each of the plans, etc.

Mr. Wishnie wanted to know how long the contracts are for and Mrs. Glass said each plan is for one year, they will be redone in the summer when a modified RFP will be sent out, and they hope to renew the contracts for two years.

Mrs. LaMotte wanted to know the breakdown of the clientele and Mrs. Glass said there are 12,000 cases and 36,000 individuals.

Mrs. Glass said that if a client doesn’t make a decision, they are auto-assigned by computer, keeping in mind their location, price, the capacity of the provider, etc.

There was a further discussion and answer period, after which Mrs. Stewart-Cousins thanked Mrs. Glass for her presentation.

Agenda Item 1A11. Proposed Act fixing and determining the charges for the care and maintenance of inpatients at the Westchester County Medical Center. On motion of Mrs. Bronz and seconded by Mrs. Swanson, this item was signed out of committee and submitted to the full Board at the 3.11 Board meeting.

Mrs. Stewart-Cousins would like to look at privatization of medical services at the County jail and would like to invite Acting Commissioner Luke Smith

in for the first quarter projection, possibly in April.

Mrs. Stewart-Cousins would also like to get a report from Mr. Smith on how the contractors are doing and Mrs. Swanson said that perhaps he could supply a fact sheet.

The minutes were passed on motion of Mrs. LaMotte, seconded by Mrs. Bronz.

The meeting was adjourned at 3:00 PM on motion of Mrs. Swanson, seconded by Mrs. LaMotte.