State of Nevada WICHE Commission Meeting

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State of Nevada WICHE Commission Meeting

Tuesday, November 22, 2011

The State of Nevada WICHE

Commission Meeting

Minutes for November 22, 2011

Disc #2, File #24

Attendance: Executive Commissioner Carl Shaff, Commissioner Joseph Hardy, Commissioner Jane Nichols, Jeannine Sherrick, Dana Westre, Cameron Vandenberg(Deputy Attorney General), Vic Redding (NSHEFiscal).

1. Call to Order. Meeting was called to order by Commissioner Shaff at 3:03 p.m.

1. Public Comment. None.

1. Approval of the August 29, 2011,Minutes. Minutes were reviewed. Commissioner Nichols moved for approval. Commissioner Hardy seconded. Approved.

1. Certification of Annual Year 2011 Applications in the Fields of Nursing, Optometry, Pharmacy, Physical Therapy, Physician Assistant, and Veterinary Medicine. Ms. Sherrick stated the list is standard. There were no questions. Commissioner Nichols moved for approval. Commissioner Hardy seconded. Approved.

1. Veterinary Medicine Participant Mein’s Request for New Terms. Ms. Sherrick stated that the individual graduated in 1998and was in bankruptcy in 2001. She is now out of bankruptcy and WICHE has reinstated her student loan. The loan was called for payment in full, but the recipient is unable to do so. The balance is approximately $32,000 with $12,900 in interest. Ms. Mein proposed making a $5,000 lump sum payment now, freezing the interest, and reducing some interest to bring her balance to approximately $20,000. She would then like fixed payments over eight years of $200 per month. Ms. Westre added that the participant is close to retirement and there is no opportunity for her income to increase; therefore, she would not be able to make incremental increases. Commissioner Shaff stated that the account is old and there may not be a chance to collect payments. Ms. Westre stated that there is a commitment from the participant for these payment arrangements. Ms. Sherrick stated she recommends the participants terms, as it is a solid commitment. Commissioner Nichols moved for approval. Commissioner Hardy seconded. Approved.

1. Regional WICHE’s Implementation Plan for New Way to Apply Support Fees. Ms. Sherrick stated this is an informational item only. At the Regional WICHEcommission meeting in October 2011, a new method was discussed and approved to fund PSEP fields that will allow public institutionswhose differentials are not being met to credit the support fee against full nonresident tuition and have the student pay the balance. The new method will take effect forFiscal Year 2014 newly funded PSEP students. Continuing PSEP students enrolled in public institutions will be grandfathered through using the current method. Additionally, all physician assistant programs will now receive only two years of funding at the 12-month rate and nothing in year three. This method will take effect for all students, new and continuing, effective Fiscal Year 2014.

1. Financial Reporting. Agency financial reports were reviewed. Commissioner Shaff asked if there a need for the Collections Report; maybe just a verbal review of updates is all that is needed. Ms. Sherrick stated that if the Commission would like, the staff can condense or reduce the number of reports. She added that an update of accounts that may not be collectable will be provided at the January commission meeting. Commissioner Hardy stated that on the Collections Report, there are only two accounts that have payment dates and asked if the accounts are being worked. Ms. Westre answered that the last column on the report states the latest action on the accounts. WICHE has asked for a December 31st report stating which accounts will not be collected on and why. She added that progress can be seen on the files as noted on the report; however, it is not known if collection will occur. Commissioner Hardy stated that on the accounts that show “debtor refused to pay” status that the Commission will have to make a decision what they will do. Ms. Westre stated that in those instances the status may change to the POE (place of employment) status, which means General Revenue Corporation (GRC) will take whatever steps they can to collect. If that fails then the Commission would decide furtheraction, such as write-off, etc. Commissioner Nichols asked if the State of Nevada has some ability to go after them. Mr. Redding stated that most of the accounts are out of statute due to their age. Ms. Sherrickconfirmed this, adding that GRC is going after them on a moral level. Commissioner Nichols stated that GRC is the new collection agency, it is a new contract, and it is necessary to be mindful and take action to not let new accounts get to that point. Commissioner Hardy stated that with the new terms being made for some of the accounts,itwould be a renewal of the contract. In essence, it is a new contract and the statute of limitations would be effective as of the new contract date. This needs to be understood in a new contract, not just a verbal agreement. Ms. Westre stated that once the Commission’s decision is made,a new terms contract is written up, signed, and returned.

Revenue projections were for 2013 through 2016 as preliminary information for the January meeting. The projections provided do not include payoffs that may occur in the future. Regional WICHE has asked for the number of veterinary medicine slots Nevada will fund next year, which needs to be providedafter the January 2012 meeting. Commissioner Nichols asked if there is a plan for the current year’s shortage projection. Ms. Sherrick answered that the total shortage amount reflects funding all program slots, and that the agency is looking at first ensuring funding the PSEP program. Currently, there is a $3,000.00 to $5,000.00 projected shortage to fund PSEP. The potential transfer of $7,883in administrationfunds can cover that, with any extra applied to the HCAP program. Commissioner Nichols asked ifthe issue in January is planning for next year. Ms. Sherrick answered yes, as well as future PSEP obligations.

Ms. Sherrick stated that Regional WICHE has decided not to increase its dues in this biennium, which leaves a $3,000.00 credit in the administration account for this fiscal year and next. Mr. Redding stated that dues are a category in which the specific amount was asked for a specific purpose. Historically,the funds need to be utilized for the purpose intended or reverted, so the amount will probably be a reversion. It was determined that the funds cannot be paid towards next year and carried as a credit. Ms. Sherrick asked if a one-time usage could be used for another situation, for example thecost for an updated impact report from Dr. Packham’s office. She spoke with his office and, although it has not been necessary in the past,it is likely that a subcontract with the UNR EconomicsDepartment might be needed. She asked if Interim Finance Committee (IFC) could approve the funds to be used in this manner. Commissioner Shaff stated that the question might arise about the value of the report. The Commission thinks it is valuable; however, people do not read it. Ms. Sherrick stated that their reports havebeen condensed, and it could be available for distribution at the next legislative session. Commissioner Nichols asked, what if IFC asked what the purpose of the report is and why should money be spent on it. Ms. Sherrick answered to show the value and impact of the agency, that for every dollar the state puts in how much the state is receiving by our professionals providing services. Commissioner Hardy expressed concern that the report may be interpreted asa self-serving document; Commissioner Shaff agreed. Ms. Sherrick stated that WICHE does not produce the report,we just provide the numbers, that it is produced by the Economics Department and Dr. Packham’s office.Commissioner Hardy stated that if something is brought up at IFC, it puts the agency above the level of the radar. Commissioner Nichols stated it would be best to find the funds for the report elsewhere in the administration budget. It was agreed that the excess regionaldues are to be reverted back. Commissioner Hardy moved to approve the financial reports. Commissioner Nichols seconded. Approved.

1. Commitment of Veterinary Medicine (PSEP) Slots for Fiscal Years 2013-2016. Item postponed until the January Commission meeting.

Collaboration with the Federal Emergency System for Advanced Registration of Volunteer Health Professionals (ESAR-VHP) Program. An informational sheet was reviewed. Ms. Sherrick stated that back in 2007 the Commission looked at and approved its health care professionals to be called for service during an emergency. Since time has passed, she wanted to bring it back to the Commission’s attention. WICHE is looking at having its healthcare professionals on the State’s emergency call registry, which requires a minimum of 20 health care fields and all of WICHE’s fields qualify. Commissioner Nichols asked who is running the program. Ms. Sherrick answered it was run through the Division of Health and Human Services [Nevada State Health Division] andis now under a new director, Wendy Luck.

Commissioner Nichols asked what is being asked of WICHE. There would be minimal work on WICHE’s part. The procedures are already in place to make a request of our professionals to see if they want to volunteer for this program. What this can do for WICHE is demonstrate its collaboration with other agencies, expand use of WICHE professionals, and because it is on a federal level it could help qualify for potential federal funding opportunities. There is no requirement to participate at this time. Participation in the program can be easily tracked in the WICHE database. If, in the future, a requirement is decided upon it can be discussed then. She added that she and Commissioner Shaff, in their interviews, ask this service question and no one has said they would not volunteer. Commissioner Shaff added that all have said they would be more than willing to volunteer services if there is a disaster. Ms. Sherrick stated they cannot volunteer unless they are registered under this State program.

Commissioner Nichols asked who is being considered in the realm of WICHE professionals; does it include participants who owe money? Ms. Sherrick answered yes, it includes current practitioners who are actively licensed and currently obligated to WICHE. Commissioner Shaff asked would they receive a reduction in money owed to WICHE. Ms. Sherrick answered she has thought about an incentive, and at this time would like to send out the request annually with the practice questionnaire and explain the program.Commissioner Hardy stated he would want to know if they volunteer for the disaster and leave their practice for any amount of time, for example one month, would WICHE forgive the payment for that month they were volunteering - something along those lines.

Commissioner Shaff stated additional information is required for further discussion. Commissioner Nichols asked Ms. Sherrick to contact the regional office to see if they have any knowledge of other states inquiring about the ESAR-VHP. Regional can ask if any of the other states have alliances with their state’s emergency call registry, and if there isany loan forgiveness or service forgiveness based upon their service in times of crisis. Let’s see if more information can be gathered. If every state has this we do not have to reinvent the wheel. Ms. Sherrick stated for WICHE purposes the form is sent out to participants, the information then forwarded to ESAR-VHP, and they do the rest. She will check with Regional WICHE to see if other states participate on the regional level.

Volunteers are able to assist at the regional level, not just statewide, and Commissioner Hardy stated they can also go out of region. He stated he thinks it is a good idea to allow the network of WICHE providers to have everything ready to go so when and if they volunteer they would be accepted wherever they go. It would be a good concept, and if it does not take any major resources on Nevada WICHE’s part, even better. It will get WICHE involved in the world and region more, and then the Commission can figure out how to incentivize that kind of altruistic behavior if we want to do something along these lines. He added the Commission can say, yes, it would be happy to provide its participants the opportunity to do this, but the question if incentive should be provided. Ms. Sherrick stated that participants do get credit for the time they are serving. Perhaps their service credit could be doubled. Commissioner Hardy stated that makes sense. If two years are owed and they provide service in a disaster for a year, then they are done with their WICHE obligation.

Commissioner Nichols stated that some participants owe money and some time. She agrees that the Commission could authorize the forms go out with their annual practice questionnaires without any endorsement from WICHE, Ms. Sherrick can contact Regional WICHE and let the Commission think more carefully about this, and she can work with the director of the program. WICHE would have to verify that participants went and that they served. She asked when the annual questionnaire is done. Ms. Sherrick answered next quarter. The forms would be returned to her and she forwards the information. Commissioner Hardy moved to go ahead and send the forms to let participants know the program exists, with minimal participation on WICHE’s part, so they can participate and do something good in the world. Commissioner Nichols seconded. Ms. Sherrick stated that they provided information sheets and an application and shecan bring it back to the Commission in January. Commissioner Nichols asked how the annual questionnaires go out. Ms. Sherrick answered the practice questionnaires go out in the mail because original signatures are required.

1. Healthy Communities Coalition’s Request for WICHE Health Care Professionals to Participate inRural Two-Day Clinic. Ms. Sherrick stated that a letter was received from the Coalition requesting some assistance with a health fair that will be held in April 2012. The letter was reviewed. It is an opportunity for collaboration and this nonprofit is a grant writing group as well,so there could be a funding opportunity in the future. They are asking if we can send a notice out about the health fair askingif any of our practitionerswould be willing to volunteer their services at the two-day event. If WICHE offers some incentive to our participants to participate, it might be a good idea.

Commissioner Nichols stated the letter specifically asks for a reduction in loan repayment and that she is opposed to that. She does not know what other incentives we have, an extra day or two, but that is nothing major. WICHE has a responsibility to provide that service to the state, a responsibility to get the loan repayment from participants. If WICHE does this it will get beseeched with organizations wanting the same, so it is best a road not gone down.WICHE can publicize it for them, send out the information. Ms. Sherrick stated she thinks that all they are asking for is to notify WICHE practitioners, and if the Commission wants to provide some kind of incentive to get them out there that it is the Commission’s decision. Commissioner Nichols stated that a loan reduction request is specifically stated in the letter and the answer would be no. She recommends if there is a way to advertise without spending money for postage and so forth, then that would be fine.

Commissioner Hardy stated WICHE’s name could be added to the sponsoring group, perhaps something stating WICHE is partners with the Healthy Communities Coalition. He asked if WICHE a member. Ms. Sherrick stated WICHE has no official membership, but she is happy to participate further. She can provide additional information about the coalition at a future meeting. Commissioner Hardy stated that maybe the presenceof WICHE attheir meetings would give credence to the concept without the buy-in involved. Ms. Sherrick stated she was not at the last meeting but she spoke with the Coalition’sdirector, who had announced that WICHE has been approached about obtaining practitioners. WICHE’s name is out there with the seventy plus agencies that are working together, so there is that minor recognition. She added if there is something at the fair she can provide on WICHE’s behalf to get name recognition,she is happy to attend.

Commissioner Nichols stated it is a two-day event to provide services to the underinsured serving 3 counties: Lyon, Storey and Mineral. The intent is to begin to do this throughout rural Nevada, so this fair would be the first of many. She thinks at this time WICHE cannot require our practitioners to do it and there is not a system in place to begin to pare down their loan or service time. Commissioner Shaff stated that there is a struggle with funds as it is. Ms. Sherrick stated she would not recommend that the Commission reduce the financial obligation but maybe the service obligation for consideration. Commissioner Hardy stated the Commission is not ready to provide their request in the letter; however, that does not mean WICHE can’t participate with them. The Commission wants its people who get a WICHE educational loan or grant to think about rural Nevada. It works for WICHE to just be there, listen, and suggest a place for our participants to serve. Commissioner Hardy stated no motion is required.