Minutes, December 19, 1997
Membership: (Chapter 97-286, Laws of Florida, Section 27)
Others in Attendance:
I. Call to Order and Welcome: Dr. Jim Howell called the first meeting of the Florida Health Information Systems Council to order and welcomed the participants. In lieu of a roll call, Dr. Howell asked that each of the participants introduce themselves. After briefly reviewing the Councils objectives as set forth by statute, Dr. Howell discussed the legislative interest to "maximize and integrate" Floridas health information systems. He expressed his belief that this Council is charged with creating an efficient and effective system that will transform to meet future needs.
Ms. Judy Bentley provided an overview of CS/SB 940, the legislation from the 1997 Regular Session that created the Florida Health Information Systems Council. In response to a question from Dr. Howell, Ms. Vickie Smith explained that Senator Brown-Waite wrote a letter to Senator Kirkpatrick, chairman of the Legislative Information Technology Resources Committee, expressing concern that health data be shared, standardized and collected in the most efficient manner possible.
Ms. Bentley continued by reviewing the legislative requirements "to facilitate the identification, collection, standardization, sharing and coordination of health-related data, including fraud and abuse data and professional and facility licensing data, among federal, state, local and private entities." The Council must also meet at least quarterly, develop a mission statement, goals and an action plan, and develop a strategic plan by March 1, 1998. Ms. Bentley concluded by reviewing the guiding principles as set forth in Section 282.3032, Laws of Florida, also part of CS/SB 940.
III. Brainstorm Issues: Dr. Howell asked for general comments and encouraged participants to voice ideas in a brainstorming session. Mr. Buddy Croft commented that the Council has been cited with a "monumental task" which requires division into smaller elements.
Establish an Understanding of Data Needs. Mr. Croft suggested performing an inventory to determine which data are currently held. Ms. Liz Dudek agreed that AHCA also has a need to inventory current data. She added that a list of data desired by each agency would be helpful. Mr. John Burke suggested that basic information about each organizations systems, data capabilities, and other specifics would assist in the identification of shared needs and possible exchanges. Mr. Jim Wright agreed with the necessity to establish an understanding of each organizations data needs and added that consideration should be also given to the customers that access the data. Ms. Dudek suggested the Councils activities might also provide a vehicle to bring statutory changes regarding repeal of certain mandates for collection of data that have become extraneous. A general discussion followed regarding the inventory of current data to assist in the determination of needs and recommendations for the elimination of certain elements or the collection of new ones.
Mr. Edwin Lott suggested that duplication of collection across organizations could also be identified during the process. Dr. Howell requested that the inventory reflect the impetus for each collection, such as legislative mandates.
Inventory Workgroup: Next the Council focused on creating a workgroup to design an inventory survey. Ms. Dudek suggested that the functional analysis recently prepared for the Senate and House of Representatives might provide a good foundation for the survey. The Year 2000 projects report each agency will submit to the Year 2000 Task Force in the Governors Office is another potential source of information. Ms. Cheryll Lesneski expressed interest in using the inventory as a tool to identify potential linkages between organizations and data sets. Mr. Wright stated that he felt an inventory reflecting data currently being captured could have a multitude of uses to the Council.
Presentations by Organizations: In response to a request for basic functional information on the organizations involved in the Council from Ms. Linda Keen, Dr. Howell asked that each organization provide a short presentation beginning with AHCA, DCF and DOH, at the next meeting.
Strategic Plan Workgroup: Mr. Wright suggested that a workgroup also be assembled to create a strategic plan to meet the March 1, 1998, submission requirement. Mr. Robert Anderson pointed out that the legislation mandated that the entire committee prepares the strategic plan. Mr. Wright offered to contact each organization to obtain a delegate to serve on the strategic plan workgroup, which would then provide a draft to the Council as a whole, for its approval.
At this time, Ms. Cretta Johnson, Director of the Department of Health and Social Service in Hillsborough County introduced herself to the Council. Ms. Johnson serves on the Council as a representative of the Florida Association of Counties. Dr. Howell welcomed Ms. Johnson and thanked her for attending.
Define Council Focus: Turning attention to another aspect of the legislation, Mr. Croft commented that the term "health-related data" covered a wide scope. He suggested that perhaps the Council could begin by narrowing and defining the focus. Some discussion followed concerning various areas that might fall under the umbrella of "health-related data."
Data Sharing Barriers: Next, the group discussed "barriers" to sharing data. The Council discussed the consequences of not fully utilizing otherwise easily obtainable information in various situations, especially with regard to domestic violence, where information sharing might be restricted legally. Mr. Anderson suggested that this Council could provide a statement to the legislature regarding instances of sharing restrictions based in statute. Another barrier to information sharing has been the variety of programs/software utilized to collect and manipulate the data. Mr. Wright suggested that the identification of all barriers from statutory to technical restrictions, such as the lack of standard formats and definitions, should be an aspect of the Councils project.
Legislative Initiatives and Data Needs: Discussion then turned to current and anticipated initiatives that might affect the collection and sharing of data. Mr. Croft mentioned the possible coordination of efforts between the Council and the workgroup currently considering the "integrated child information system." Ms. Bentley added that the House Committee on Children and Family Empowerment is preparing a bill to create a Council that encourages sharing of social services and education data. Among organizations involved in this effort are DCF, AHCA, the Department of Juvenile Justice, DOH, and the Department of Education. Ms. Smith noted that at this time there is no matching interim project or proposed bill in the Senate, but agreed that the Florida Health Information Systems Council and the proposed council could "dovetail."
Ms. Lesneski inquired as to the collection of Medicaid provider data. Mr. Lott stated that AHCA does not currently keep that information, although that data capture is under consideration. Ms. Lesneski pointed out that private insurance companies have developed systems for the efficient use of data, especially for the identification of fraud. She expressed interest in pursuing the possible sharing of privately collected data. Mr. Lott noted that a large portion of the private data exists within AHCA because many of the services captured privately are provided through a state agency.
Welfare Reform & Title XXI: Next, Ms. Anita Hakes discussed the data needed to properly implement federal legislation, its impact and critical issues currently facing Florida. Among the most critical issues are welfare reform and the implementation of Title XXI. For example, Ms. Hakes stated a vital need exists to follow women who are moving from welfare to employment. Data will also be needed to analyze teen pregnancy linkages to family planning. Further, through the Title XXI effort, $28 million will be spent annually to insure Floridas Children. A great deal of information will be needed to monitor the effects of these new expansive and significant programs.
Ms. Johnson agreed that the perspective of the Counties is also focused on the fiscal impacts of these legislative initiatives on the counties and the provision of health care to those removed from welfare. She identified a need for counties to link with Medicaid data to assist in the provision of services and make eligibility determinations. In Hillsborough County, temporary services are provided until eligibility is determined and then reimbursement is requested as appropriate. Dr. Howell also stressed the need for Counties to have increased access to information.
Ms. Hakes noted there is a need to determine the number of uninsured children in Florida. In response, Mr. Russ Mardon suggested that representation by the Department of Insurance could be helpful to the Council. Mr. Croft inquired as to whether a system has been designed to capture WAGES data. Ms. Hakes noted that the WAGES committee is working to identify linkages. Ms. Lesneski added that WIC would provide a certain amount of that data. Ms. Johnson suggested that no single organization is fully tracking these effects due to varying interests. Mr. Burke noted that several bills coming before the next session address the collection of items such as those mentioned.
Dr. Howell suggested the Council consider appointing a workgroup to examine the "gray area" between health and social services data. He requested that the legislative planning directors of the member organizations provide feedback regarding new legislation affecting the collection of health-related data.
IV. Action Items: Dr. Howell and Mr. Wright concluded with a review of the action items generated by the meeting.
There being no further business, Dr. Howell adjourned the meeting at 11:20 a.m.
The next meeting of the Florida Health Information Systems Council will be held on February 25, 1998, from 1:00 3:00 p.m.