2019-02-20 AVAP Council Meeting Page 1 of 86 c/o KidsVax.org® P.O. Box 1885 • Concord, NH 03302-1885 tel 1.855.KidsVax (543.7829) fax 1.855.KidsFax (543.7329) What: AVAP Council Meeting Date & Time: February 20, 2019; 11:00 a.m.-12:30 p.m., AKST Where: BP Energy Center, 900 E Benson Blvd, Anchorage, AK 99508 Public Access: Please register for the AVAP Council Meeting on February 20, 2019, 11:00 am to 12:30 pm EST at: https://attendee.gotowebinar.com/register/3084090928410617089, Webinar ID: 380-757-811 After registering, you will receive a confirmation email containing information about joining the webinar. Audio PIN: Shown after joining the webinar AVAP Agendas are subject to revision up to and including the time of the meeting. Approx. Time Topic/[Anticipated Action] Presented by: 11:00-11:05 a.m. 1. Welcome J. McLaughlin a. Notification of Recording b. Introductions/Finalization of Agenda 11:05-11:10 a.m. 2. Items for Council Consent J. McLaughlin * a. Approval of Sept. 20, 2018 Council Meeting Minutes 11:10- 11:25 a.m. 3. DHSS Updates M. Bobo a. Regulations b. CDC Vaccination Coverage Award c. 2019-2024 CDC Vaccine for Children Cooperative Agreement d. Enrolling Village Clinics into the Immunization Program e. DHSS Staffing 11:25-11:40 a.m. 4. Legislative Update M. Bobo a. SB 037 (review language of bill) i. Original Bill ii. February 13, 2019 Amendment b. Senate Health Committee Materials c. Senate Finance Committee Materials 11:40-11:50 a.m. 5. KidsVax Updates * a. Financial Update F. Potter/C. Roberge * b. Status (ED) Report F. Potter c. TRICARE F. Potter * i. Summary Memo * ii. Past Due Notice * iii. FLP email to Sharon Seelmeyer 11:50-11:55 a.m. 6. Other Items (if any) from Council Members 7. Public Comment Any 12:00 p.m. 8. Closing J. McLaughlin (Tentative) 9. Reference Materials * a. Proposed Form of Votes * b. 2019 Meeting Calendar * c. AVAP Contact Directory 2019 * d. BP Energy Center Map 2019-02-20 AVAP Council Meeting Page 2 of 86 1 Alaska Vaccine Assessment Program Council Meeting 2 September 20, 2018; 10:00 a.m.-12:30 p.m., AKDT 3 In-person Meeting 4 BP Energy Center, 900 E, Benson Rd., Anchorage, AK 99503 5 6 I. Participating in all or part of the meeting in person or by telephone (T) were the following individuals: Council Members Joe McLaughlin, MD, Chairman – Division of Epidemiology Sarah Bailey – Alaska Division of Insurance Fred Brown, Esq. – Health Care Cost Management Corporation of Alaska Jody Butto, MD – Anchorage Pediatric Group Kara King – Alaska Native Tribal Health Consortium (T) Rosalyn Singleton, MD, MPH – Alaska Native Medical Center Lydia Bartholomew, MD – Senior Medical Director, Aetna Mike Patton - Premera Blue Cross Department of Health and Social Services Jay Butler, MD –Chief Medical Officer/Director Matthew Bobo – Immunization Program Manager Kelsey Pistotnik – Deputy Program Manager Alicia Weber – Vaccine Depot Manager Absent Jill Lewis – Deputy Director, Juneau KidsVax® Fred L. Potter – Managing Member Nicole G. Price – Northeast Region, CEO (T) Claire Roberge, Controller (T) Heather Veen – Sr. Executive Assistant, Paralegal Norm Roberge, Assessment Monitoring/Internal Control (T) Matt Miller – Client Services Coordinator (T) Others Julia Zell (T) Katrina Anderson (T) Denyse Bayer (T) Amy Walker (T) 7 II. Summary of Actions Taken and/or Recommended 8 A. Actions Taken (votes adopted) 9 1. To approve the May 24, 2018, Council meeting minutes. 10 2. To pass a resolution to request the legislation to reauthorize AVAP with additional sunset periods. 11 3. To recommend 2019 Assessment Rates. 12 4. To approve AVAP’s 2019 Meeting Calendar. 13 1 2019-02-20 AVAP Council Meeting Page 3 of 86 1 III. Minutes 2 3 Welcome and Introductions 4 At approximately 10:00 a.m., a quorum having been established, Chairman Joe McLaughlin called the meeting to 5 order. Chairman McLaughlin announced that the meeting was being recorded for the benefit of the minute-taker 6 and the recording would be deleted following the final approval of the minutes. Following introductions, Chairman 7 McLaughlin proceeded to the Consent Calendar Items. 8 9 Consent Calendar Items 10 Chairman McLaughlin asked for comments and edits to the May 24, 2018, Council meeting minutes. 11 12 Upon motion duly made and seconded, it was unanimously 13 14 VOTED: To approve the May 24, 2018 Council meeting minutes as submitted. 15 16 DHSS Updates 17 18 Matt Bobo reported that the final AVAP regulations had gone through open notice, however, the senior regulation 19 reviewer noticed that a plan of operation had not been attached to the actual open notice post. Matt stated that a 20 supplemental open notice should be completed next week and is hoping regulations will be finalized by the end of 21 the month. 22 23 Mr. Bobo discussed the transition of the vaccine depot. He reported DHSS will be out of the current vaccine depot 24 by the end of October. The vaccine depot will now be in the Frontier Building near the section of epidemiology on 25 the fifth floor. McKesson is a third-party distributor and can’t ship to some of the more rural locations, so going 26 forward the DHSS epidemiology section will maintain a “mini depot” and ship to those more rural areas. 27 28 Mr. Bobo went on to discuss the reauthorization of AVAP. When the Senate Bill passed there was a clause saying 29 the bill sunsets January 1, 2021. Mr. Bobo reported there is a 90-day legislative session starting in January usually 30 after Martin Luther King Day and continuing through April. DHSS is now gathering data and getting everything 31 together for the legislative session. Chairman McLaughlin informed the Council that they are seeking 32 reauthorization at the commencement of the legislature’s two-year cycle due to inevitable uncertainty inherent in 33 any legislative process. He then opened the floor for comment. 34 35 Mr. Potter praised the Council for their diligent work which had fully implemented best practices and brought 36 AVAP to a remarkably stable operating condition. Fred Brown made a motion to recommend to the legislature the 37 reauthorization of AVAP, with a three-year sunset. There was no second to that motion. At that point, another 38 motion was made and seconded to recommend to the legislature the reauthorization of AVAP without a sunset. 39 After much discussion, the matter was put to vote. 40 41 Upon motion duly made and seconded, 42 43 VOTED: To recommend to the legislature reauthorization of AVAP without a sunset. 44 45 There was only one vote in opposition; that was Mr. Brown’s. Mr. Brown confirmed that he is favorable toward the 46 reauthorization of AVAP, that his vote in opposition was not in opposition to AVAP’s reauthorization, but was 47 based upon his general view that every government agency is best subject to periodic sunset reviews. 48 49 Rate Setting Workshop 50 51 Mr. Potter thanked Mr. Bobo and his team for pulling the numbers together. The Council engaged in extensive 52 discussion of the Annual Assessment Setting Workbook and examination of each of the applicable control points. 53 Mr. Potter noted it was KidsVax®’s recommendation to release approximately one-third of excess reserves. It was 2 2019-02-20 AVAP Council Meeting Page 4 of 86 1 the sense of the Council that that approach seemed appropriately measured and equitable to all payers. Chairman 2 McLaughlin opened the phones for public comment. There was none. 3 4 Upon motion duly made and seconded, it was unanimously 5 6 VOTED: To adopt recommend 2019 assessment rates of $7.44 per month per child and $.53 per month per 7 adult. 8 9 KidsVax® Updates 10 Mr. Potter informed the Council that Julia Zell is now living in Boise, Idaho and has moved on to full-time work for 11 the Washington Vaccine Association. Mr. Potter thanked Ms. Zell for her work with AVAP. Chairman 12 McLaughlin added his personal commendation of Julia’s work for AVAP as well. 13 14 Mr. Potter gave a brief overview of his ED report. He updated the Council regarding TRICARE stating AVAP has a 15 seven percent reduction in rates due to TRICARE’s commitment of regular quarterly payments in August. He noted 16 with the $1.5 million TRICARE arrearages collected to date, together with its commencement of regular quarterly 17 payments, KidsVax® is aware of no payer in this market that is not paying its equitable share as determined by the 18 Council. Mr. Potter again thanked the Council members for their diligent work. Chairman McLaughlin thanked Mr. 19 Potter and Ms. Zell for their tremendous work and dedication in obtaining such a positive outcome with regard to 20 TRICARE arrearages. Dr. Singleton echoed Chairman McLaughlin’s thanks and inquired about Medicare and 21 Medicaid. Mr. Bobo stated DHSS has begun talks with Medicare and Medicaid and is hoping to have answers in 22 that regard in the fall. Further discussion ensued. 23 24 Mr. Potter gave a further TRICARE update and summary of TRICARE 2018 collections. He reported that he and 25 Ms. Zell met with DHA in Colorado and have been able to resolve numerous remaining issues, all in favor of the 26 state vaccine programs. Mr. Potter informed the Council he recently received a memo from DHA stating they were 27 willing to pay monies toward the assessment rate and allow the balance to be recovered over future months through 28 a supplemental TRICARE assessment.