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ACPM
Policy Committee Meeting
March 22, 2000
10:00 a.m. – 12:30 p.m.
Hilton Atlanta & Towers – Atlanta,
GA
MINUTES
Participants
Bob
Harmon (Chair); Christopher Armstrong;
Jacqueline Christman; Filip Dubovsky;
Halley Faust; Neal Kohatsu; Dorothy Lane;
Perrianne Lurie; Michael Parkinson; John
Poundstone; David Rabin; Nancy Sheenan;
Stephanie
Zaza
;
Jean Malecki; Douglas Lloyd; Steven Woolf;
Hugh Tilson; Mike Barry (Staff); Jessica
Cafarella (Staff);
Jud
Richland
(Executive Director).
Welcome
and Introductions
Dr.
Harmon welcomed Policy Committee members
and made several “housekeeping”
announcements.
Members approved the minutes of the
November 6, 1999 meeting.
Committee
Affairs
The
Policy Committee approved the Policy
Committee Charge, amended at the previous
Policy Committee meeting to reflect new
priority-setting criteria, with the
following minor revisions:
(1) indicate in the lead-in
sentence that policy goals and priorities
should be based on “a combination of the
following internal and external criteria;
(2) change the first external criteria to
“mortality and morbidity and economic
burden on the population”; and (3)
change the second external criteria to
“potential favorable impact of
prevention measures on the health and
quality of life of the population.”
Dr.
Harmon spoke on the need for a Vice Chair
of the Policy Committee.
He encouraged self nominations.
Dr. Harmon also discussed the
possibility of creating subcommittees
within the Policy Committee.
The
committee then discussed ideas for
convening an open policy session at
ACPM
’s
upcoming annual meeting, Preventive
Medicine 2001.
Several members suggested that
policy resolutions be presented to
ACPM
Fellows and to the Policy Committee in a
policy session that would be combined with
the business meeting.
Under the proposed approach, any
ACPM
member could present a resolution at the
session, but resolutions would have to go
through the Policy Committee before being
taken to the floor.
Some
members of the Policy Committee felt this
format would better embrace the base of
the membership.
Other members expressed concern
that such a format would make the process
of proposing or altering
ACPM
policy too structured.
They feared it would alienate and
intimidate younger or less experienced
participants.
After
discussion of several ideas and proposed
motions, the committee could not reach an
agreement on an approach.
Hence, the Committee passed a
motion that “there be a policy business
session at next year’s annual meeting,
the mechanics of which will be worked out
later.”
The
committee also discussed the Policy
Committee listserv.
One member expressed concern that
the listserv does not achieve closure.
The committee agreed the listserv
is useful for maintaining a list of issues
discussed by the committee, to be reviewed
periodically and presented to the Policy
Committee at meetings.
Action
Item:
The committee agreed that
ACPM
should maintain a list of policy listserv
issues, to be reviewed periodically and
presented to the committee.
Issue
Updates and Discussion
Residency
Funding
The
committee discussed the issue of eroding
support for preventive medicine training
programs.
Of particular concern was the issue
of the administration, in effect, zeroing
out Preventive Medicine Training in its FY
2001 budget proposal.
Policy Committee members suggested
working with the Office of Management and
Budget (OMB) prior to when the
administration’s budget is released to
achieve increased or level funding for
preventive medicine training from the HRSA
Title VII program.
The
committee agreed on the following action
items:
Action
Item:
Ask all
ACPM
members, not just residency directors, to
write letters to Congress on the Title
VII
issue.
Action
Item:
Develop a “key contact list” of
key legislators and constituents to key
legislators for use on the Title
VII
issue and all other policy issues.
Action
Item:
Attend the upcoming meeting of the
Council On Graduate Medical Education (COGME)
in a “show of force.”
ACPM
should stress the importance of conducting
a study on preventive medicine residency
funding and push for increased attention
on preventive medicine.
Members
of the Policy Committee also discussed
other means of obtaining residency program
funding, such as from foundations and
other private sector entities.
Committee members also raised the
idea of preparing an American Medical
Association (AMA) resolution on the topic,
as well as the possibility of enlisting a
luminary, such as Donna Shalala or David
Satcher, to promote preventive medicine
training.
Another
suggestion was to examine models of
tapping Medicaid funding for preventive
medicine training.
Members raised Michigan and
Massachusetts as examples of states that
had successfully used Medicaid money for
graduate medical education.
Action
Item:
Explore the issue of Medicaid
funding for preventive medicine residency
training programs.
Obtain copies of Medicaid funding
documentation in Michigan and
Massachusetts and provide drafts to
preventive medicine residency directors.
Tobacco
The
committee discussed some of the latest
policy issues surrounding tobacco
prevention and control, including the
issue of FDA authority to regulate tobacco
sales and marketing.
The day before the committee met,
the Supreme Court had ruled that the FDA
does not have authority to regulate
tobacco as a drug.
The committee discussed encouraging
states to implement legislation that would
consider tobacco a drug under state law.
Members suggested creating
boilerplate language/sample letters for
state advocacy.
Action
Item:
Draft a letter to Governor Michael
Leavitt (UT), President of the National
Governors Association, and copy John
Nelson, an
ACPM
member and personal friend of Governor
Leavitt, calling on NGA to urge states to
allocate their tobacco settlement dollars
toward tobacco prevention and control
efforts.
Action
Item:
Acknowledge in
ACPM
News
those states that were re-investing
tobacco settlement money into tobacco
prevention/education programs, as well as
those states that were not re-investing
their money this way.
Several
members recommended having governors of
the states that are re-investing tobacco
money speak at Preventive
Medicine 2001.
Medical Privacy
ACPM
had recently submitted comments to the
Secretary of Health and Human Services on
the
HHS
’s draft regulations providing
“Standards for Privacy of Individually
Identifiable Health Information.”
ACPM
’s comments stressed the research value
of retaining the ability to re-link
patients with certain information that is
not identifiable under the proposed
regulation.
Policy Committee members agreed
this could be an issue though which
ACPM
gains visibility.
Action
Item:
Develop an action plan on medical
privacy and prevention research.
The
plan should be aimed at educating
lawmakers on the potential negative side
effects of creating additional hurdles for
prevention research and at helping
researchers, from a methodological
standpoint, contend with stricter privacy
restrictions.
One idea to pursue is to bring
together preventive medicine and public
health organizations into one or more
workshops focusing on the effects of
privacy policy on clinical and
population-based prevention research.
The workshops might result in a
joint policy statement targeted at policy
makers and researchers.
Workforce
Development
The
American Association of Public Health
Physicians submitted a resolution for the
Policy Committee’s consideration
outlining a series of actions to
strengthen the job market for preventive
medicine physicians.
The committee agreed that the
concept being championed in the resolution
had merit, but that the resolution needed
more work and a better-defined focus.
Committee members expressed that
most medical jobs are never advertised,
and that one would not expect to find
preventive medicine jobs advertised in
journals such as those reviewed.
They also felt that a very
sophisticated marketing effort could be in
order.
Action
Item:
Refer the workforce development
issue to the Board for review and
appropriate follow-up action.
Patient
Safety
The
committee discussed the recent IOM report
on medical errors and the potential role
for preventive medicine.
The question was raised of whether
ACPM
should support mandatory reporting of
medical errors.
The committee expressed concern
that the data needed for the College to
weigh in on the issue was lacking.
Several committee members suggested
that perhaps
ACPM
should limit its involvement in this issue
to preventive medicine areas being
overlooked by other, larger organizations
(i.e., errors in screening, vaccines,
follow-up on preventive services).
Following
discussion of the patient safety issue,
the Committee was adjourned.
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