December 3, 2010 MERC Advisory Committee Meeting Minutes - Minnesota Dept. of Health

December 3, 2010
MERC Committee Meeting:

Committee Members Present: Michael Belzer, Jim Davis, Dan Foley, Louis Ling, Dawn Ludwig*, Kathleen Meyerle*, Carl Patow, John Rodewald, and Marilyn Speedie,

Alternates: Deb Mayland-Poyzer for Mary Edwards

Interested Parties Present: Gina Danyluk*, Rena Garni, David Godfrey, Cindy Hafferty*, David Knowlan, Tom Larson, Margo Marko, Janet McCarthy, Chris Milbrath, Merri Moody, Jay Ness*, Scott Nigon*, Rick Roberts, Joe Schindler, Trisha Schirmers, Patrick Sexton, and Troy Taubenheim.

MDH Staff Present: Diane Reger and Diane Rydrych – Minnesota Department of Health

*Indicates Attendance via Conference Call

I. Introductory Remarks – Louis Ling, Committee Chair

Dr. Ling opened the meeting by thanking members and interested parties for joining the meeting. He briefed the committee on the agenda and a roll call was then taken. There were some members and interested parties that joined the meeting via conference call.

II. Update on 2010 MERC/PMAP Distributions – Diane Reger, MDH

As part of the American Recovery and Reinvestment Act of 2009, MERC funds are eligible for an enhanced match again in 2010. Between the enhanced match and returns from the prior year, this brings funding to $63.5 million before direct payments to the University of MN AHC, UM Dental School, and Fairview. The remaining funds available for the distribution are just over $58.2 million. Please reference the handout for details.

MDH anticipates that funds will be released within a few weeks. All data has been sent to finance and should be finalized shortly. Once sponsoring institutions receive funds, they will have 60-days to forward payments to their clinical training sites. The Grant Verification Report (GVR) will direct them as to what the payments are and to whom they are payable.

A report was provided showing what each sponsoring institution will be receiving along with a summary of the amounts that will be forwarded to the clinical training sites. The committee discussed the various amounts and how under the current formula FTEs do not impact the grant amounts. Since funding is based on relative PMAP revenue amounts among the training sites, there are some sites that have grant amounts under $1. In the past, the committee had discussed the impact these small amounts have from both an administrative standpoint and a negative impact on showing appreciation to those sites. Current statute does not allow withholding these small amounts. The committee agrees this should be an area that is considered if changes to the State Plan Amendment and MERC statute are made in the future.

Ms. Reger pointed out that Northwestern College of Chiropractic did not apply for funding in 2010 or 2011 based on the impact of the formula. Last year, they received just over $5,000 for the 526 FTEs at 96 training sites included in their 2009 application. A large number of sites received extremely small grant amounts. Also, Duluth GME is no longer listed as a sponsoring institution; the program is now included under the University of MN AHC.

Of the 635 distinct training sites that were included on the 2010 application, over 84% of the FTEs came from twenty-two distinct sites which received over 70% of the distribution. There are 31 distinct sites (100 actual checks) that are receiving under $100, 18 distinct sites (approx 34 checks) receiving under $25, and 11 distinct sites that will not receive a grant at all due to lack of PMAP revenue. More information will be noted in the Legislative Report due to the Legislative Library in February. Ms. Meyerle would like to see the FTE verses grant size comparison included in this report.

The 2011 applications are all in and MERC staff will begin reviewing information once the 2010 distribution and reporting is completed. The current enhanced match will not be available for the 2011 distribution as the enhanced match process ends in June 2011 and funding for MERC/PMAP will not be finalized before that time.

III. Dental Innovations Grant Update – Diane Rydrych, MDH

Ms. Rydrych updated the committee on the dental innovations grant program, which is now administered out of MDH’s Office of Rural Health and Primary Care. The program received 10 grant applications and voted to fund eight of the 10 for a total of just over $1.1 million. In previous years, not all funds allocated to this program have been awarded; this year, the awarded grants used nearly all available funds.

IV. MDH Legislative Update – Diane Rydrych, MDH

The committee discussed the pending legislative session, which will likely be largely focused on the projected $6.2B deficit in SFY12-13. Ms. Rydrych reminded the committee that MDH is also in a time of transition, with Commissioner Sanne Magnan almost certain to depart when her term expires on 1/3/11. A new Commissioner may be appointed as soon as January, or it could be several months.

Ms. Rydrych discussed the fact that, given the large deficit, there is likely risk to MERC in the coming session. The new legislature and Governor will be looking for savings across the board, and small or large cuts to MERC are certainly possible, as are proposals to change the distribution in order to meet health reform or other statewide goals. MDH legislative staff will be meeting with new legislators to brief them on MDH priorities, including MERC, but we will not know how much risk MERC faces until the new Governor releases his budget proposal in early 2011.

The committee discussed the need to present a united front with legislators on MERC, highlighting the importance of this funding stream and the need to preserve it as-is. With MDH unable to take a lead role in lobbying for MERC, several interested parties indicated that they would pull together a group to develop common educational materials and messages for legislators. David Godfrey (HCMC) and Troy Taubenheim (Metro MN Council on GME) will take the lead on organizing this group. They will make sure to seek the involvement and input of all provider types currently included in the MERC application. Jim Davis (St. Cloud Hospital/Centracare) will attempt to work with Representative Gottwalt from St. Cloud, who will be chairing a House Healthcare/Human Services Committee.

The committee agreed that the goal should be to preserve MERC funding to the greatest extent possible, rather than lobbying for any changes to the formula to address issues that the committee has previously discussed (small sites, great variation in grant/fte, etc). If MERC suffers significant cuts, though, the committee agreed that there would be a need to have a discussion at its June meeting about whether the existing formula is still the right one to use with a smaller pool of funds, or whether MDH should seek state/federal approval to make changes.

Ms. Rydrych will work with legislative staff at MDH to see if MERC factsheets/briefing materials for new legislators and/or for the new Commissioner can be shared with the committee, to assist in their messaging.

V. Other Issues / Comments

Kathleen Meyerle informed the committee that Frank Iossi will be retiring from Mayo in a few weeks. Frank has been involved with MERC since its inception. MDH would like to thank him for his contributions. We wish him well.

V. Upcoming Meeting Dates

The next regularly scheduled MERC meetings will be held from 1 – 3 p.m. in the Red River Room at Snelling Office Park on Friday, June 17, 2011. For directions and further information, please visit:





Wednesday, December 15, 2010 at 10:49AM