1 DEPARTMENT OF PUBLIC HEALTH · RE: CT HEALTH INFORMATION TECHNOLOGY & EXCHANGE MAY 16, 2011 POST...

POST REPORTING SERVICE HAMDEN, CT (800) 262-4102

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VERBATIM PROCEEDINGS

DEPARTMENT OF PUBLIC HEALTH

CT HEALTH INFORMATION TECHNOLOGY AND EXCHANGE STRATEGIC PLAN

JEWEL MULLEN, CHAIRPERSON

MAY 16, 2011

101 EAST RIVER DRIVE EAST HARTFORD, CONNECTICUT

RE: CT HEALTH INFORMATION TECHNOLOGY & EXCHANGE MAY 16, 2011


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. . .Verbatim proceedings of a meeting in 1

the matter of CT Health Information Technology and 2

Exchange, held at 101 East River Drive, East Hartford, 3

Connecticut on May 16, 2011 at 4:36 P.M. . . . . 4

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CHAIRPERSON JEWEL MULLEN: Good afternoon 9

everyone. A lot of people wish the sun was shining, but 10

it's not. We might as well begin and start with the review 11

of last month's meeting minutes. 12

MALE VOICE: Move for approval? 13

FEMALE VOICE: Second. 14

CHAIRPERSON MULLEN: Any discussion? Okay, 15

all in favor? 16

VOICES: Aye. 17

MS. MARIANNE HORN: So we have some 18

reminders and updates. First of all, an update on the 19

Strategic and Operational Plan by Meg Hooper. 20

MS. MEG HOOPER: Good afternoon everyone. I 21

wanted to let you know that one of the attachments that was 22

sent out to you and also included in your package this 23

evening that we put in front of you, we wanted to let you 24



3

know that we're not doing folders anymore and we may not be 1

doing copies anymore. We've spoiled you for two meetings 2

or three with the folders, but just to let you know that 3

one of the items also included here and in your e-mail 4

distribution are the implementation requirements by the 5

Office of the National Coordinator for the Cooperative 6

Agreement with DPH. Many of these items are handled not 7

only by DPH but also certainly with the HITE/CT Board of 8

Directors. So we wanted you to take a look at this. 9

Many of the things that are due 60 days 10

after notice of the approval of the Cooperative Agreement 11

are being addressed, actually all of the items are being 12

addressed by DPH, and one of them is the final submission 13

of the Strategic and Operational Plan. If you recall, 14

Gartner prepared a supplement. We sent that out to you 15

all. What we're going to be doing at DPH is simply 16

incorporating that into one document straightening out some 17

of the formatting and the like but putting together 18

essentially one document. That we're going to do by the 19

end of this month and of course if it's not too large, I 20

will be sending it to you but certainly also posting it on 21

our web page. 22

The other items, ongoing requirements as you 23

go through this, these are all regarding governments and 24



4

this is all for the Board and for the new agency and the 1

staffing as you deem appropriate. We will be working 2

together with you on any of the fiscal reporting and 3

certainly alignment with the ARRA, which is the American 4

Reinvestment and Recovery Act. And those efforts, again, 5

are the responsibility of the Cooperative Agreement holder, 6

which is DPH. So we wanted to go through this with you. I 7

don't think that the agenda allows for the time but I'm 8

certainly available to answer any of the questions or 9

concerns. 10

We did share this with the Executive 11

Committee and they've raised some of the questions and we 12

are happy to provide detail or further explanation, and I 13

would leave it to the Board to advise me on how you would 14

like to proceed with knowing about this. Yes sir? 15

MR. JOHN LYNCH: Is this something that 16

should be divvied up between the various Committees such 17

that certain Committees should be tracking certain 18

components and making sure certain things get done? 19

MS. HOOPER: I think that's a great idea. 20

That's Mr. Lynch speaking that -- in fact I think later in 21

the agenda. You've all received what John put together for 22

Committee responsibilities and assignments. As those are 23

determined and finalized or at least agreed to perhaps 24



5

that's something that, with the Executive Committee, I 1

could put together a recommendation of who could be 2

assisting on each on these items if that would be 3

acceptable. Is that -- Commissioner, is that acceptable 4

for moving forward? 5

CHAIRPERSON MULLEN: I think so. We're also 6

still early in identifying the people and clarifying the 7

roles and responsibilities for a CEO and a Coordinator. 8

That will also, I think, play a role in determining what 9

belongs where and keeping people engaged, so. Anything you 10

want to add to that? 11

DR. THOMAS AGRESTA: I just think I want to 12

remind folks that a lot of these are just ongoing 13

responsibilities but a few of them have very discrete dates 14

that are relatively short-term deliverables. And I think 15

that we need to go from just sort of looking at what they 16

are to getting a little more detail about what does take to 17

actually answer that. 18

And so maybe that's one of the things that 19

we can try and address perhaps in a more robust fashion. I 20

mean, I'm not sure if we have the best venue to address 21

them. It may be -- John, I don't know, do you think that 22

that's best taken up by the Business and -- 23

MR. LYNCH: Well, I think it depends since, 24



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you know, like there's a Business Plan 831, Sustainability 1

Plan 831, so some of that yes. Some of it maybe, it's part 2

of Finance if it's kind of a Sustainability Plan. You 3

know, so that's why I was wondering whether we needed to 4

think through and see what's more appropriate. The 5

Sustainability, maybe that's something that Finance can -- 6

DR. AGRESTA: And my understanding of these 7

is that the majority of what they are is an update to the 8

Plan that was delivered. In other words, their 9

requirements are to define where you currently are, assess 10

-- you know, we're going to have the RFP kind of response. 11

So our Sustainability Plan, our Business Plan, are probably 12

going to look fairly different based on where we currently 13

are as opposed to what we planned on early on. And that's 14

what's going to be required and they probably are not huge 15

documents but they're going to have to be substantive. 16

MS. HOOPER: ONC has told us, again, based 17

on minutes, this is the formal notification of the 18

requirements. Our project officer has changed as you know 19

from Molly Smith to Lee Stevens and he has not required any 20

-- he has not stated any specifics as to format and the 21

like. Again, as we've said the Board has the opportunity 22

to revise the plan annually, in fact is asked to review the 23

plan annually. 24



7

And then at your discretion to either update 1

it -- and as part of that I think both the Sustainability 2

and the Financial Planning did submit to ONC a progress 3

report essentially from the Cooperative Agreement holder 4

being the Department of Public Health praising all of the 5

work that's been done by the Board and particularly on the 6

RFP issuance. Some of these things have been completed, 7

one being that the RFP was not only approved by 8

Commissioner Mullen, Lieutenant Governor Wyman and Governor 9

Malloy, but also approved by ONC. 10

So what I can do is provide a little more 11

detail on this. I'll bring it to the Executive Committee 12

with some ideas about what Committees could be supportive 13

of this and perhaps some ideas about how to meet some of 14

these deliverables in a timely fashion. 15

DR. AGRESTA: Yeah, I think that's a good 16

idea Meg. And the other thing that may be valuable is a 17

timeframe, when you're having your next communication with 18

Lee -- 19

MS. HOOPER: Yes. 20

DR. AGRESTA: -- maybe involving one or two 21

designated Board members -- 22

MS. HOOPER: That would be great. 23

DR. AGRESTA: -- that are going to be the 24



8

point person for trying to achieve the Board's response to 1

that. 2

MS. HOOPER: Yes, one of the things that -- 3

yes, terrific. Are there any questions that I can answer 4

on that or anything else on the Plan update? Thank you. 5

CHAIRPERSON MULLEN: Okay. 6

MS. HORN: The next item up is an update on 7

an item we talked about last time on Directors and Officer 8

insurance. But before I do that if I may, I'd like to 9

introduce two of these. Bernice from Shipman & Goodwin who 10

hopefully by the end of the meeting we will have signature 11

authorization for Dr. Agresta and we will be able to 12

officially welcome him aboard. 13

We have their engagement letters right here, 14

Bruce Chudwick (phonetic) and Scott Murphy. 15

MALE VOICE: Glad to be here. 16

MS. HORN: Delighted to have you. 17

CHAIRPERSON MULLEN: Which is Bruce and 18

which is Scott? 19

MS. HORN: And Updike, Kelly & Spellacy is 20

the other firm and they will be providing more the health 21

information technology privacy security part. And they are 22

here of their own good will to see how we work. 23

MS. HOOPER: Marianne, can I just -- this is 24



9

Meg at the HITE Board of Directors meeting. Who just 1

called in please? 2

MR. PETER COURTWAY: Peter Courtway. 3

MS. HOOPER: Hi Peter, are you on your way 4

or -- 5

MR. COURTWAY: I'm on my way and the traffic 6

-- it's fit and start but I'm still heading towards you. 7

MS. HOOPER: Oh I'm so grateful, thanks. 8

Anybody else call in other than Mark and Peter? Okay, 9

thank you. Go ahead Marianne. 10

MS. HORN: Just a quick update on the D&O 11

insurance. At last meeting the Executive Committee was 12

authorized to go out and investigate and obtain funds and 13

secure as soon as possible the Directors and Office of 14

Insurance Board. So I've done some research on what other 15

quasi-publics have done and spoken with them and I think 16

what I found is that it's a little more complicated than 17

just going out and ordering a Director's and Officer's 18

policy off the shelf. 19

It's a little more complicated in terms of 20

what we actually need and one of the quasi-publics 21

recommended that we use a risk assessment consultant who is 22

very knowledgeable in this area and has worked with a 23

couple of other quasi-publics and it saved them a great 24



10

deal of money because they're not paying for coverage they 1

don't need. So we, at the Executive Committee last week, 2

approved moving ahead with getting a consultant to do that 3

and to bring in several brokers who -- there are brokers 4

who compete in this area. It's a limited pool with this 5

kind of expertise and that the broker would bring in 6

several bids on the Directors and Officers insurance. 7

This would be for the first year while we 8

actually figure out what our risk is going to be, how the 9

HIE is going to be set up and designed and exactly what 10

kind of risk the Board is assuming and we can make a better 11

idea or decision in terms of what else -- what other kind 12

of coverage the Board would need. 13

MR. STEVE CASEY: Marianne, what was the 14

cost of the consultant? 15

MS. HORN: $5,000. That was half his usual 16

fee, so. And we have allocated and amended the legal 17

Memorandum of Understanding to accommodate this going 18

forward quickly rather than waiting for the larger MOA that 19

will be put together once we have a budget in place and we 20

can figure out what the deliverables will be. 21

So the total for that we've allocated is 22

$40,000. I think that is more than we're going to need for 23

this first year but it will be in there in case we need it. 24



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I don't think we're going to need $35,000 for the 1

Directors and Officers, but looking at the quasis, I got a 2

grid or a chart for all of the quasis and the premiums 3

range from $10,000 to $87,000 a year. So there's -- we're 4

going to sit down this week provided everything is approved 5

here and that -- and meet with the consultant to really 6

drill down to what kind of coverage are we going to need on 7

that. So I -- 8

MALE VOICE: Do you need a move -- 9

MS. HORN: Well what we do need, we're going 10

to need a couple of resolutions passed to give our Vice 11

Chair the authority to go ahead and one, to sign the legal 12

engagement letters with the two firms and two, to get the 13

risk assessment consultant onboard, and then three, to 14

actually enter into an agreement for the insurance, to 15

procure the insurance. 16

I believe that was consistent with the 17

direction we were given last time, that we go ahead and get 18

this as soon as possible. But certainly if the Board would 19

like us to bring it back for further input from the Board 20

we can do that. But we do need a resolution, which I have 21

drafted. 22

MR. DANIEL CARMODY: Marianne, question for 23

you. Is the fee that we're paying the consultant excluding 24



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commission that that individual will make on the policy 1

that is ultimately chosen or is it included? Meaning that 2

we're hiring somebody, you know, is that work separate and 3

then somebody else we're going to buy the insurance through 4

or is he recommending and then there's a subsequent payment 5

to him for commission on that? 6

MS. HORN: My understanding is he does not 7

get a subsequent commission, that he is not involved in 8

that area but he actually does the risk assessment and then 9

would recommend several -- or ask several brokers to give 10

us quotes. They would give us quotes and that premium 11

would be built into those quotes but not additional to him. 12

MR. CARMODY: Okay. 13

DR. AGRESTA: Marianne, can you describe 14

doing the risk assessment, will that require him coming and 15

meeting with the Executive Committee? What will it require 16

to actually happen so that he gets an accurate risk 17

assessment? 18

MS. HORN: I would welcome other members of 19

the Board to offer their expertise in this area. I think 20

our insurance people -- are there people who may have 21

expertise with -- 22

DR. AGRESTA: It's a different type of 23

assessment. 24



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MS. HORN: I know. It's not all the same, 1

it's like law it's not all the same. Oh dear. So yes, I 2

think it would be very helpful if people have had 3

experience with Directors and Officers insurance or other 4

kinds of manager liability insurance that we may be needing 5

to look into, to sit down at the table because I have this 6

much experience with that. 7

The consultant is available any time we want 8

to meet and suggested that we meet as soon as we get things 9

finalized. 10

MR. KEVIN CARR: I would just throw it out 11

there that it seems like a reasonable fee and this is 12

extremely important to all of us. And also as you 13

mentioned, be sure that we choose the right coverage and 14

not overbuy just because we're afraid of what we don't 15

know. I think we're kind of locked up to that year after 16

year after year so it sounds like a great idea. 17

MR. LYNCH: I'm willing to help on that. I 18

believe you will have a lot of unanswered questions, the 19

difficult questions they'll be asking. Are we -- do we 20

have a database -- 21

MS. HORN: Ahum. 22

MR. LYNCH: -- are we storing stuff that 23

will be vulnerable, etc., and I'm not sure we've come to 24



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those conclusions yet and certainly not until after the RFP 1

responses. We're probably in a chicken and an egg on what 2

we can do immediately versus what he's going to want to 3

know what we're going do. 4

MS. HORN: Mark, do you have any experience 5

with D&O insurance? 6

MR. MARK MASSELLI: No, I haven't. 7

MS. HORN: Okay. 8

MR. MASSELLI: Sounds good. 9

MS. HORN: Okay, well if anybody else would 10

like to be part of that, please let me know. So we need -11

- we'll need a motion to authorize the Vice Chair to enter 12

into an agreement with the consult and to prepare the 13

insurance and secondarily enwrapped in that resolution is 14

to also enter into engagement letters with the legal firms. 15

MR. LYNCH: Move we approve that. 16

MALE VOICE: Second. 17

MS. HORN: Any further discussion? All in 18

favor? 19

VOICES: Aye. 20

MS. HORN: Okay, I do have a copy of the 21

resolution if anybody would like to see it. 22

MR. MASSELLI: You know, I believe that you 23

have a rider on your homeowner insurance for volunteer 24



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work. I don't know if somebody mentioned that earlier. 1

It's also helpful to have. So if you look at your home 2

insurance it's a good source for another umbrella of 3

protection. 4

MS. HORN: Oh, that's good. And I think 5

there's some federal laws that indemnify volunteers on 6

Boards, but we'd like to have something here. 7

CHAIRPERSON MULLEN: So do people have a 8

sense, enough of a sense of what the Board is buying and 9

what it means for you? I'm just wondering -- everybody 10

agreed it's a good idea but when you find out you have D&O 11

insurance are you going to feel any better and do you know 12

what you're going to feel better about if you are? 13

So if there are questions then we need to 14

make sure they get answered even if it means getting a 15

consultant to come and meet with us for a little bit -- 16

this is what it means, this is what it doesn't mean. You 17

know, we have other items on the agenda about conflict of 18

interest and just how we engage as a Board anyway so we are 19

building. So if it's not necessary it's -- 20

MR. CARR: No, I think it's a good idea just 21

know the parameters that it -- I think even if we had a 22

formal presentation, but at a minimum having just a summary 23

on certain items -- 24



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MS. BARBARA PARK-WOLF: Particularly what 2

you're not getting and you know what you're running with. 3

MR. MARK HEUSCHKEL: Yeah. 4

MR. STEVEN THORNQUIST: I mean, when you get 5

closer to actually having the policy, what the policy will 6

or will not cover -- 7

MS. HORN: Okay, so perhaps with next 8

meeting we should be ready to bring those quotes that he is 9

recommending to us back to this meeting? 10

MR. CASEY: And his assessment. I assume 11

you're going to get -- 12

MS. HORN: Yes, and the assessment yeah. 13

DR. AGRESTA: Yeah, that would make sense. 14

And maybe in the interim as a point of description my guess 15

is that he could put together a -- you know, what does it 16

typically cover, what does it not cover, what is negotiable 17

-- 18

MS. HORN: Ahum. 19

DR. AGRESTA: -- fact sheet that might be 20

capable of just being e-mailed as informational to the 21

Board. So it doesn't have to be part of a Board of 22

Director's meeting but it will allow us to kind of digest 23

and think about it and understand what kind of questions we 24



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might want to bring back at the next one. 1

MS. HORN: Okay. Now I was planning to meet 2

with him later this week so if anybody would like to be 3

part of that, either by phone or in person, that would be a 4

great way to get him started to do his assessment. And 5

then we can move this along so that we actually do have 6

something ready for you guys next month and then we can 7

just enter into the best policy. 8

CHAIRPERSON MULLEN: After you sign the 9

resolution. 10

DR. AGRESTA: After I sign the resolution. 11

MR. MASSELLI: I'm out of here but put down 12

my name after I leave. 13

MS. HORN: That's good, okay. I'm wondering 14

what the Commissioner's -- I can skip to D. 15


MS. HORN: Thank you. The ethic's liaison 17

volunteer needed -- we're reordering the agenda here. The 18

Office of State Ethics indicated that we really should have 19

an ethic's liaison, which I had known about and not sure if 20

we'd get staff onboard to do that. But it looks like we're 21

going to have somebody volunteer to do that, so. 22

MR. CASEY: I'll volunteer. 23

MS. HORN: Oh, excellent. Actually I think 24



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it would be interesting, so all conflict of interest 1

questions -- so now I'm going to do the conflict of 2

interest piece. So if you have any questions go to our 3

ethics liaison, thank you Steve. 4

The conflict of interest, we did put 5

together a policy, I think it's a fairly conservative 6

approach to conflict of interest, for discussion. And it 7

basically says that if you do have an interest in one of 8

the venders who is going to be applying for the RFP and 9

that is identified as a conflict, that you not only be a 10

non-vote on that application coming before the Board but 11

you would not vote on any of the applications coming before 12

the Board. So it's a fairly conservative approach. I think 13

the language in the statute is probably -- lends itself to 14

a reading in either direction. 15

But when we discussed it, I think that's 16

where the fact that if the person -- or they render you 17

have an interest in is before you, then you're not voting 18

on that one. But then the next one comes up and your vote 19

then is somehow compromised because you have an interest at 20

the table. Is that very unclear? 21

MR. CARMODY: No. So you're saying that if 22

you don't have a direct interest in the -- that particular 23

vender that would preclude you from voting in any way even 24



19

if you had industry knowledge that --where you would want 1

to have the conversation or influence the direction based 2

upon your industry knowledge so you should recuse yourself? 3

MS. HORN: Correct. 4

DR. AGRESTA: That's not -- no, no, no. 5

MR. CARMODY: Well I mean, you're saying 6

that it's either all or nothing and then -- I mean, I've 7

been on Boards where -- I'll give you an example. I recuse 8

myself from when I voted on a Board voting for my employer 9

but that didn't preclude me from entering and engaging in a 10

conversation when I was using my industry knowledge around 11

how to approach that and then ultimately voting for what in 12

essence was a competitor. 13

MS. HORN: Ahum. 14

MR. CARMODY: So to say -- I can understand 15

why I couldn't vote in relationship to my employer but I 16

think that it might be too far reaching to say that you 17

couldn't vote to say -- hey wait a minute, let's say it was 18

between other competing venders that you had a particular 19

disposition on because you thought hey wait a minute, 20

because I saw what you had had you would preclude that 21

person from voting on another vender. 22

MR. MASSELLI: So you're saying when we 23

narrow it down here the venders -- you have no horse in the 24



20

race here -- 1

MR. CARMODY: Yeah -- 2

MR. MASSELLI: -- you've got the last two 3

candidates you should be able to -- 4

MR. CARMODY: -- you should be able to vote 5

as long as you didn't have a financial interest in it to 6

say geeze, I have an opinion or somebody had an opinion. I 7

mean, I'm not going to have an interest in any of these but 8

I'm just saying if anybody else had that would say why you 9

shouldn't be voting. 10

MS. HORN: So just to clarify, you're horse 11

is out of the race. 12

MR. CARMODY: What's that? 13

MS. HORN: Your horse is out of the race. 14

MR. CARMODY: Your horse is out of the race, 15

you should be able to continue to have a say. 16

MS. HOOPER: Does that differ from what's 17

here? 18

MS. HORN: Yes. I think the assumption 19

we're making here is that your horse is still in the race 20

and you're not going to vote on that or any of the other 21

ones that are still in the race. So that -- you're raising 22

a different issue. 23

MS. PARK-WOLF: Oh, I thought that it -- my 24



21

reading of it was that anything that happened afterwards 1

didn't matter, you're still out of the raise. That's the 2

way I read it. 3

MR. CARMODY: Once your horse is gone, then 4

you should be able to -- 5

DR. AGRESTA: I think that this is 6

particularly important because we have stages to what's 7

going to happen in our peer review. The stages will be 8

such hopefully that what comes back to the Executive 9

Committee and then the Board will be sort of much more 10

narrowed choices based on review. But that first review is 11

going to have all the RFP responses, you know, in it. 12

And at that stage the chance of having a 13

conflict is going to be greater and depending on whether 14

the conflict kind of proceeds then there may be more folks 15

available to vote and there may not be. And that part we 16

can't sort out and I recognize that. But I do think if 17

your interest is no longer participating and you have 18

knowledge that will help in discerning between the other 19

venders, then I think we should utilize that because we're 20

not thick on knowledge or skill. I mean, we're not -- I 21

mean, we have different capacity to kind of weigh in based 22

on our experience and our roles. 23

MS. HORN: Well I think that's good to 24



22

discuss, all of those issues. It really becomes not so 1

much of a legal issue at that point as one of appearance 2

and consistency. I think as long as people are not voting 3

on applications when the pool is such that they have some -4

- a horse in the race, then anything that happens after 5

that I think would be fine. 6

CHAIRPERSON MULLEN: That's not what No. 6 7

says, okay, so -- 8

MR. THORNQUIST: Yeah, I was just going to 9

say No. 6 contradicts that. 10

CHAIRPERSON MULLEN: -- so that's one 11

question is this your No. 6 or is this our -- the State's 12

No. 6? You know what I mean? 13

MS. HORN: Yes, yes. 14


MS. HORN: No, this is being offered to you 16

as a conflict of interest to bring up points of discussion 17

that was modeled on a stem cell -- the way we run the stem 18

cell. We have a much bigger pool and really two 19

institutionals in the running, so it's a little bit of a 20

different scenario. 21


MR. THORNQUIST: But these FAQs come from 23

you? 24



23

MS. HORN: Yes. 1

MR. THORNQUIST: Okay. 2

CHAIRPERSON MULLEN: So I think I understand 3

the interpretation. 4

MS. HORN: Yeah. 5

CHAIRPERSON MULLEN: And I think to answer 6

people's question, we could determine whether or not 7

there's a specific language related to this that we should 8

follow through our office, the State Ethics, and if not the 9

conversation about just what you brought up is one that we 10

can also pursue further. 11

I understand it becomes hard to predict when 12

somebody might feel they would suffer a loss once they're 13

moved from the possibility of experience in a game and that 14

might be subject to some kind of interpretation. I'm not a 15

lawyer as you know, but I get that. And sometimes it gets 16

hard to explain. So we can figure it out though, we can 17

find out the concrete answer and then go from there. And 18

if the concrete answer is it depends or no rather than yes, 19

is there a direction you want to go in? 20

DR. AGRESTA: Well -- and I think this is 21

important because I'm just looking at the timing of our 22

next Board meeting and I think it may actually come up at 23

the next Board meeting. So -- I mean, we're going to have 24



24

to -- Peter, can you -- I mean, our next Board meeting is 1

June 20th. Are we going to be voting at that point a 2

recommended vender? 3

MR. COURTWAY: I don't believe so, I think 4

it's after that. I don't -- I mean, I don't have a 5

calendar that I can easily take my hands off the wheel and 6

find. 7

DR. AGRESTA: Yeah, don't do that. I think 8

that's probably not a smart -- 9

MR. COURTWAY: So we can certainly take a 10

look at that. I mean, there's two phases to this. One 11

phase is to narrow down to only several venders, and that's 12

anticipated to be the Chairs of the domain. You know, so 13

that's all the Executive Committee narrowing to the short 14

list. And then after the short list comes the demos and 15

the usability of the project and then it comes to the final 16

of the top finalists, which one do we pick, and that's the 17

final vote. 18

But even the final vote, and it's safe to be 19

more by recommendation by the Selection Committee and I 20

don't see conflicts at the Executive Committee in this 21

regard. 22

DR. AGRESTA: Not the Executive Committee 23

but I think -- I mean well, we'll have to see if there's 24



25

any conflicts at the Executive Committee but coming back to 1

the scheduled meetings here, it still needs to get approved 2

-- the final thing needs to get approved here. And I'm 3

just looking at our timing and I think we had said 4

something like trying to do it in early July. 5

And we'll need to look at these dates and 6

see if they actually jive with when we need to vote on this 7

as a group too. 8

MR. CARR: Is there a resolution that we 9

could task giving for example you the authority to make the 10

edits to question No. 6 as appropriate given the guidance 11

that you receive that? This seems to be logical to make it 12

such that the Ethics Committee liaison -- 13

MS. HOOPER: You have -- 14

MR. CARR: -- to make that -- wouldn't that 15

make more sense? 16

DR. AGRESTA: You mean adjust it, the 17

language -- No. 6? 18

MS. HORN: And actually if I could explain 19

No. 6 now that I read this, this was really for when an 20

applicant -- a reviewer looked at an application and had a 21

conflict and then went to do the review and determine there 22

was no longer a conflict. So you still got that particular 23

application in the mix. It's not having that application 24



26

gone from the mix and then being able to vote on it. So we 1

could actually take No. 6 right out if that would be 2

helpful. 3

MR. THORNQUIST: I think clear language on 4

that sort of thing is important because again, we don't 5

want to run into guess work later about stuff we've done 6

now. 7

MS. HORN: Okay. And then I could 8

substitute what Dan was talking about where if you no 9

longer have a conflict in the running then you are able to 10

vote. And I think the other thing that would come up in 11

the stem cell meetings was that if you had a factual 12

question that you could respond to, that was certainly fine 13

for you to weigh in on that particular thing to clarify but 14

not to enter into discussion or any valuing or voting. 15

MR. LYNCH: Another question is what happens 16

if you have a quorum and then you've got, I don't know 17

three, four people who have a conflict and now you're less 18

than a quorum. Is it do you still need the same number of 19

votes or how many votes do you need? 20

MS. HORN: Well, we need a quorum. 21

MR. MASSELLI: They can stay but they can't 22

-- 23

MR. LYNCH: No, they have to recuse. 24



27

MR. MASSELLI: They recuse but not from the 1

quorum. 2

MS. HORN: No, you're still counted as part 3

of the quorum. 4

MR. MASSELLI: If you're a Board and people 5

are recusing themselves but we might be in the course of a 6

larger meeting which sets the quorum. 7

MS. HOOPER: Correct. 8

MS. HORN: Yes. 9

MR. MASSELLI: So they're not -- 10

MS. HOOPER: Recusing is a vote, is a count. 11

MR. LYNCH: Is it a count -- 12

MS. HOOPER: Right. 13

MR. LYNCH: -- against the quorum? 14

MS. HORN: No, it's not counted in the vote 15

but you're counted toward the total -- 16

MR. LYNCH: Okay. 17

MS. HORN: -- in the -- as a recused -- 18

MS. HOOPER: It's in the -- 19

MR. THORNQUIST: So you still have a 20

majority and a quorum if a large percent recuse themselves 21

I would assume. 22

MR. LYNCH: Okay, so if I'm the only non-23

recused member -- as long as you don't split your vote. 24



28

DR. AGRESTA: If you manage to do that, I'll 1

be impressed. 2

MS. HORN: Okay, so moving forward I'll 3

revise No. 6 and if people have any other comments -- 4

MR. CARR: I have one question on -- so 5

previously I've repeated myself verbally and so this states 6

that a letter was to be required. I was wondering if we 7

could just put another sentence that we would recognize 8

there could be verbal recusals? 9

MS. HORN: Sure. 10

MR. CARR: And going forward then there 11

would be a letter. 12

MS. HORN: Yes, I can make that -- 13

accommodate that because obviously at some point you might 14

come along and all of a sudden you have to recuse yourself 15

on the spot, so. It won't necessarily always be in 16

writing. Anything else? 17

MS. BRENDA KELLEY: Well with regard to this 18

upcoming RFP, I'm assuming then that we will get a list of 19

who has submitted so that we can identify the conflict if 20

you want it promptly. Because I'm assuming that what this 21

means is, is that if I knew today that I have a conflict 22

with one of or more than one of the applicants I need to 23

send you a letter. But how do I know that if I don't know 24



29

who has applied? 1

MS. HORN: Right, I think we'd wait till we 2

get the list of applicants, send those out, and sometimes 3

you have to look through the application before you 4

actually know that you have a conflict. 5

MS. KELLEY: Sure. 6

MS. HORN: We will have conflict of interest 7

forms that you will sign indicating that you don't have a 8

conflict or that you do and with which specific ones and 9

the non-disclosure form as well. 10

MS. KELLEY: So you don't need to just write 11

your letter at any point because you're going to give us 12

the form to fill out? 13

MS. HORN: Correct. 14

MS. KELLEY: Okay. 15

DR. AGRESTA: Right, because the vender may 16

actually have subcontractors -- 17

MS. KELLEY: Sure. 18

DR. AGRESTA: -- I mean, it can get 19

complicated. 20

MS. HORN: Yeah, and if you have any 21

questions we now have an ethics liaison who will answer all 22

your questions. 23

MS. HOOPER: Marianne, is there a vote 24



30

needed to include this conflict of interest summary as part 1

of our By-Laws? What do you need to -- with the 2

understanding of the corrections being made on timing of 3

the letter and/or No.6, do you need -- I'm sorry, does the 4

Board want this to be part of your By-Laws? I shouldn't 5

just be asking Marianne. Legally is it required? 6

DR. AGRESTA: I think we should wait and ask 7

our legal representation -- 8

MS. HORN: That would be excellent but -- 9

DR. AGRESTA: -- when I've signed the -- 10

MS. HORN: -- my guess is that we will have 11

to do a whole separate ethics policy. But in terms of for 12

the purposes that we need this for, if the Board would like 13

to make a motion to approve what we have with the changes 14

as suggested to No. 6 and No. 8, that would get us 15

something official to work with. 16

MR. CASEY: So moved. 17

MR. LYNCH: Second. 18

MS. HORN: Okay, Steve Casey and John Lynch. 19

All in favor? 20

VOICES: Aye. 21

MS. HORN: Okay. Okay, so now we are moving 22

on to the financial treasury update. 23

DR. AGRESTA: So alright, I'm passing around 24



31

the balance sheet as it stands right now for the Health 1

Information Technology, for HITE/CT. And there's not a lot 2

of current assets in the bank because we have not had too 3

much funds actually currently transferred but we have been 4

able to set up a bank account in Webster, set up and get 5

the State -- get all the federal numbers that we need to to 6

officially set up our HITE/CT as a recognized entity with 7

the federal government, with the state government. 8

Thank you Sarju for the work that you've 9

done in that regard, and Marianne. And we have actually 10

managed to transfer funds all the way through that system 11

into our bank account, so we now have some funds. And so 12

we have $11,500 as the initial funds to start built on a 13

Memorandum of Agreement that was executed back in January 14

or February that permitted the initial funds to flow for 15

seeking the legal counsel and initial funding for the legal 16

counsel. So there's one fund that is transferred over, 17

$11,500, and then there's another one that will transfer 18

over shortly. So we have had no expenses out of that 19

account at the moment so that's what our fund balance is 20

and that will obviously change. 21

We have to go through the process of 22

actually setting up a Memorandum of Agreement both for the 23

transfer funds for the D&O insurance and also then for the 24



32

remainder of budget that we will discuss in much more 1

detail coming up, so. 2

MS. HORN: And moving into the budget. 3

MS. HOOPER: Dan, if you don't mind I'll 4

kick it off. 5

MR. CARMODY: Sure. 6

MS. HOOPER: What was sent out to you and is 7

also in your package is, we wanted to make sure you had the 8

full budget and budget justification that was submitted to 9

the ONC and approved by them for the full Cooperative 10

Agreement. This includes not only an estimate on what 11

HITE/CT would be contracted to receive but also be DPH's 12

responsibilities and costs are. That's the first piece. 13

The shorter one that was attached and 14

included in your package is a draft budget that DPH has 15

framed for you -- the Finance Committee, and Dan will be 16

speaking about that and his issues. We framed what some of 17

those items could or would be, estimated ranges, and this 18

was discussed at the Executive Committee meeting. But I 19

want him to speak first on the full Cooperative Budget 20

Agreement budget. This can be amended and redirected funds 21

and DPH is looking at with our own fiscal situation any 22

opportunity where we can cut some funding and requirements 23

but right now based on what is required from DPH and what 24



33

we estimate to be for the HITE/CT. 1

And then getting into the detail on the 2

HITE/CT is certainly including your staffing opportunities, 3

paying for the actual full service HIE. The requirements 4

for the budget are for stage one, meaningful use. The 5

requirement for the budget approval, not only by ONC but 6

secondarily by the Department, is that in fact stage one 7

meaning full use be met with these funds. That would be 8

the only threat to having those funds either challenged or 9

withdrawn. And so with that, I'll be happy to answer any 10

questions on the full Cooperative Agreement budget and 11

justification that was submitted to you. 12

And if I may, I'd like to introduce you all 13

for one of those items, my secretary. I want to introduce 14

Catherine Winkeller. Will you let everybody know -- 15

MS. CATHERINE WINKELLER: Hi. 16

MS. HOOPER: -- with the Department. She 17

serves with Marianne Horn as our IRB secretary also so she 18

will not be confused by your words, we hope. 19

MS. WINKELLER: It's a pleasure to be here. 20

MS. HOOPER: So you all may be seeing e-21

mails and/or see her at many of our meetings just so to 22

have a face put to some of the funding. The rest of us 23

here around the table from DPH are here because we really 24



34

want to be. Any questions from the Department or from the 1

Cooperative Agreement? Dan. 2

MR. CARMODY: So let me -- the split of the 3

grant is between the two, the Cooperative Agreement and 4

Connecticut HIE. And I would say that so we have discussed 5

this at the Executive Committee meeting. The Finance 6

Committee did review the actual budget. I think what was 7

sort of teased out in most of the conversations, it's a 8

reasonable budget. We looked through a lot of the line 9

items. 10

I think there was two items that the Finance 11

Committee sort of piloted as a -- probably a couple of 12

questions. One was the software cost. The software cost 13

that you see down here for about $565,000, that was the one 14

that drew a lot of attention because they thought it was 15

low. I think it was reaffirmed at the Executive Committee 16

meeting and talking -- and Peter was on there and he 17

reaffirmed that this is a low number. So a couple of the 18

issues that you'll find with this is that to the extent 19

that that number goes up as we define services, that will 20

then turn into how quickly or how many years we're going to 21

go. 22

MR. MASSELLI: What page are we on? 23

MR. CARMODY: This is on Item No. 3 of the 24



35

short -- so then we'll get quickly into how quickly we 1

actually start to burn through some of the funding because 2

again, the budget is based upon the grant money and the 3

grant money -- once the money goes because we don't have 4

any additional funds coming in yet, obviously we may be 5

backing this up from a four year budget to maybe not a four 6

year budget. 7

And so we're going to have to see what 8

services we are willing to provide. I was also asked I 9

think at the last meeting to -- I guess this sort of drops 10

into the sort of mini -- the foreshadowing of those, to 11

have an initial conversation with the e-Health Connecticut, 12

which is the State Rep. And I had a very robust 13

conversation with them specifically around would they be 14

willing to engage in a conversation on where we could 15

actually maximize expenses as far as trying to capitalize 16

on things that they're doing. They're very open to have 17

that dialogue so everything was on the table. You know, we 18

basically didn't go into too, too much detail other than to 19

try to get at least a sense around what we could start to 20

have that dialogue about. 21

But what was very -- what I thought was a 22

very good conversation was again, right from sharing space 23

they even brought into the conversation that there's other 24



36

folks that they're looking at like the Capital Community 1

College, where they've gotten some money to do some 2

training. You know, is there a way to try to capitalize on 3

some of that space? I mean, it was a very open and robust 4

dialogue so I do think that we have some opportunity to not 5

go alone. Even the 15 percent that you see here as 6

indirect, it's one line item which is where you're going to 7

get your office space and some of the other one, again, 8

could be taxed if you don't try to actually collaborate. 9

So it was a very good collaborative dialogue. 10

I think once we get through the RFP process 11

we can readjust the line item when it comes down to what 12

this actual cost was. There was another push on the legal 13

expenses of -- and I didn't really have a good -- I knew we 14

talked about it but I did not articulate it but you might 15

want to capture it in the notes so that I don't forget 16

because as soon as I walk out of here -- which was why do 17

we go on a per billing hour versus trying to get a retainer 18

and then I think -- and remember, some of the Finance 19

Committee members are from some of the other quasi-state 20

agencies and they said that they talked about thinking that 21

we may want to go to a retainer type system. 22

I know you talked about it and maybe even 23

investigated it with Lisa, I just didn't have a good, 24



37

clean, crisp answer that I know you're going to articulate 1

and we're going to capture in the notes. 2

MS. HOOPER: Well, what we did -- what we 3

were requested was a new meeting attendance to make sure if 4

they were going to attend the meetings could we get a no-5

fee or a flat fee rate for that. And what we were able to 6

negotiate was when they're on the clock, they will be on 7

the clock and when they're not, they're not charging. 8

MR. CARMODY: Okay. 9

MS. HOOPER: So if we specifically ask for a 10

proposal or a presentation, their input on something, the 11

meter goes on and otherwise they're just here. 12

MR. CARMODY: And was there a reason why you 13

didn't work from a retainer standpoint as the overall -- 14

what you think our budget was and what we'd get for 15

services? I think the push from the Committee was would we 16

be gun shy of trying to get legal opinion when we needed it 17

because we were looking at it on a per billing basis versus 18

thinking that we just need it for some kind of system where 19

there was a smaller retainer versus some billing and -- if 20

we don't have that as a clear answer then maybe you'd want 21

to be able to go back to them. 22

MS. HORN: Yes -- no, we did not go any 23

further than that and I think the first year we're just 24



38

going to have to feel our way a little bit in terms of how 1

much this is all going to cost us and certainly be very 2

careful in using them. But we'll need to have some good 3

sound legal advice, so we don't want to not use them for 4

the reason that you expressed. 5

MR. CARMODY: So those are the big items. I 6

think the other thing that we talked about at the Executive 7

Committee meeting was, again, I think maybe there was some 8

dialogue on use of a full-time accountant, thinking about 9

where this is at and was there opportunity there. And 10

these aren't relatively large numbers but they were still 11

more -- they were numbers nonetheless, so I think there was 12

a push there as well as at some point in time, even on the 13

administrative assistant is there a way to be able to 14

again, try collaboration around what we could actually 15

achieve between what you're asking for that individual to 16

do as well as what you might want to do depending on the 17

work load. 18

So I think for now I think one of the things 19

we want to explore further is one, get through the RFP 20

process, figure out what the implications are to this and 21

then maybe look to then make an adjustment to the budget 22

figures. 23

DR. AGRESTA: Dan, one of the things that 24



39

was brought up at the Executive Committee for folks to 1

understand is that -- and we did ask for clarification for 2

this, was that the budget that is outlined for us at four 3

years does not need to be -- it's not allocated dollar-wise 4

that way over those four years from ONC. We've actually 5

got the full amount of money released to us so that if we 6

need it to adjust what years we spent the money in we could 7

do so. 8

And we ought to do that wisely recognizing 9

that we might need to spend more of it early on and develop 10

a very clear robust Sustainability Plan as part of that. 11

CHAIRPERSON MULLEN: The other piece for the 12

Board to figure out over time is how much DPH continues to 13

step away and the Board actually is paying for someone else 14

to do some of this work. For example for responsibility to 15

the Feds for just the grant reporting and the account 16

payables and those -- as the Board comes into more of a 17

position for other issues that we can take on. 18

MS. ELLEN ANDREWS: Can I just ask a 19

question about the -- the front of this one table -- I 20

guess this is the long form. Are these -- these are DPH 21

employees -- 22

MS. HOOPER: Yes. 23

MS. ANDREWS: -- those positions? 24



40

MS. HOOPER: Yes, on the large one -- 1

MS. ANDREWS: Table one, federal report? 2

MS. HOOPER: -- yeah, the first document 3

that's larger than the rest that's, again, what was 4

submitted to ONC as part of the Cooperative Agreement. And 5

yes, the first part is personnel for the Department of 6

Public Health. And that was as determined -- the State 7

Health IT Coordinator was what we had proposed for, again, 8

serving out of either the Governor's office -- it was in 9

our recommendation in the Plan, again, to serve as overseer 10

and support for the REC, for the HIE, for DPH and for DSS. 11

That position the Commissioner is reviewing 12

how that can be so that wouldn't actually be a DPH position 13

necessarily. But for the State HIT Coordinator, yes, for 14

the informatic specialist because one of the requirements 15

in the ONC Cooperative Agreement and for HIE is for Public 16

Health information meaningful use by 2013. The accountants 17

are only for the funds that we've been not only receiving 18

and trying to receive and securing and the accountability 19

to ONC with monthly reports and quarterly fiscals. And 20

then the secretary is for the work that we're trying to do 21

through the Department in both the ONC grant management and 22

then also in the Public Health Information Network FIN and 23

the Health Information Exchange meaningful use for putting 24



41

out -- 1

MS. ANDREWS: And are these new positions or 2

are these -- is it federal funding for current positions? 3

MS. HOOPER: Well, it's federal funding for 4

positions and right now we have the accountant filled. And 5

Cate is here, we transferred her from another section. 6

CHAIRPERSON MULLEN: We didn't hire people. 7

MS. HOOPER: We didn't hire. Actually -- 8

CHAIRPERSON MULLEN: Did not. 9

MS. HOOPER: -- yeah, they were not new 10

positions they were just moved from other grants that they 11

were completing their projects on. 12

MS. ANDREWS: And about the short one, the 13

salaries, how were those developed? 14

MS. HOOPER: That was just some rough 15

estimates that we put -- again, it's a framework for all of 16

you to work from based on some of the other states and 17

their CEOs for their HITE/CTs -- or I'm sorry, for their 18

HIE agencies. 19

MR. CARMODY: I thought we had Gartner too -20

- I mean, didn't they -- 21

MS. HOOPER: Gartner is part of the plan, 22

they did a kind of financial overview in looking at other 23

states. But again, this was the framework for your 24



42

discussion about how much funding you want to allocate for 1

whether you want positions, contractual or however you want 2

to proceed. 3

MR. CARR: And the process for this budget 4

is that a Finance Committee edits and brings 5

recommendations back to the Board is that -- 6

MR. CARMODY: We had established that. I 7

think the way that we worked it is that the Department had 8

established this in a framework. The Finance Committee 9

looked at it for reasonableness. They poked and prodded, 10

they honestly they looked at it and said most of the line 11

items seem to be in proximity to what you would expect. 12

Again, one of the big glaring issues was what did we find 13

out on the RFP as to what we're going to provide for the 14

services. Everything seems to be a general proxy. 15

Peter has given me some additional 16

information on what he's seen. I have not been able to go 17

through it, I looked at it but I haven't lined it up to 18

what we saw here. I'm going to try and see if we can push 19

and pull it. I don't think it's unreasonable to what 20

you're looking at in here but I do think, again, the more 21

that we can do from a collaborative standpoint in working 22

with some other folks, whether it would be other places, 23

it's not a lot of money at the end of the day. Especially 24



43

if we haven't come up with a sustainability model. So the 1

more that we can collaborate and try to capitalize on this 2

process all the better. 3

MS. ANDREWS: I would just urge you to be 4

really careful and mindful of the fact that this is a 5

quasi-public agency and that these are tax dollars and that 6

there have been concerns around what State employees make 7

and various test reports and we don't want this quasi-8

public being one of those. 9

MS. HOOPER: Also these are ARA funds. I 10

mean, not only public funds but they are ARA with their 11

specific responsibilities and accountabilities. 12

MR. CARMODY: I think when we looked at it 13

with Gartner the intent was the fact that in order to keep 14

the group small and you wanted it to be effective, you 15

needed to bring (indiscernible) individuals. You're going 16

to draw them from public sector or draw them from private 17

sector, there was a certain level of talent in order to 18

keep that group small and the information you were bringing 19

in, what seemed to be a pre-requisite as far as what you 20

would actually see in the marketplace for a person to come 21

in and fill those positions. 22

MR. CARR: Is your concern like the CEO? 23

MS. ANDREWS: Yeah, that's one of them. 24



44

That's a lot of money. 1

DR. AGRESTA: It's not a lot of money in 2

this particular -- 3

MS. ANDREWS: In my world, it's a lot of 4

money. And I'll tell you I can identify five or six 5

Senators who are going to go berserk if they see that. 6

DR. AGRESTA: I think we probably need to 7

create the justification of why it's a lot of money. But 8

it's out there and all the other states that are doing 9

this, what it costs -- you know, and that's actually a low 10

cost. It's not a high cost for that -- 11

MR. MASSELLI: I think that the point is 12

that we should be mindful -- 13

CHAIRPERSON MULLEN: Absolutely. 14

MR. MASSELLI: -- I think it's a point well 15

taken and we all -- yeah. 16

DR. AGRESTA: I think we need to lay out why 17

does it cost that much, what do you get with that kind of -18

- 19

MS. HOOPER: So to answer that question, the 20

Finance Committee, you're going to -- 21

MR. CARMODY: No, I wouldn't say that -- I 22

think the Board -- I would say, and this goes back to the 23

general issues as a volunteer Board. This is why we're 24



45

going to need to bring people in to manage this budget so 1

from an advisory capacity and a volunteer Board they can 2

look at it from reasonableness, policy changes, setting 3

direction. But then I'll work from the budget on a day in 4

and day out basis. 5

But the sooner we can get individuals in 6

place to help start managing this and spending more time 7

with it, is really what they're going to talk about because 8

the CEO is going to then actually manage the budget on in 9

and day out basis. And they're going to go back and 10

they're going to look at it and they're going to make 11

recommendations on line item transfers and whatnot. So I 12

think it's fair for the Finance Board to look at it for 13

reasonableness, make recommendations as we start to see 14

things coming in, look at other proxies, but that's what 15

you're going to get out of a volunteer Board. You're not 16

going to have them (indiscernible). That's the problem 17

we've had right from the beginning. 18

MS. KELLEY: Just -- I don't know that I 19

care -- I'm not as concerned about the CEO salary perhaps, 20

but I do agree with Ellen in the sense that the general 21

community -- and I don't think the Legislature approves 22

anything we do do they? No, so we don't have to worry 23

about that. Yeah, indirectly, but I do think that it's 24



46

reasonable that we have a market analysis of what people in 1

these positions are making. 2

And -- I mean, I work for AARP and we do 3

that for every job we have. And we also have a policy that 4

says we don't pay the maximums. You know, if you go out 5

into the market and this the max or this is the minimum, 6

AARP generally tries to aim for the middle. So to do a 7

market comparison and to say where are we on that salary 8

range, I think is something that's prudent even if the 9

Legislature doesn't do it so that I feel comfortable in 10

voting on it and everyone else does. And that we know that 11

we're scrutinizing. 12

Another question that I had, I'm just very 13

confused by both these documents because I'm assuming that 14

the State Health IT Coordinator and Chief Executive Officer 15

isn't the same thing, or is it? 16

MS. HOOPER: That's correct, it is not. One 17

is -- 18

MS. KELLEY: Okay, because this is a very 19

much lower salary. 20

MS. HOOPER: Yes, it is. Absolutely, that's 21

a State employee essentially. 22

MS. KELLEY: Yeah. 23

MS. HOOPER: That is the funds, again, 24



47

through DPH to work with the Commissioner as to how she and 1

the Governor feel appropriate for a State HIT Coordinator 2

to again, oversee and assist the HITE/CT Board, all of you, 3

your CEO, DSS, the REC and DPH. So it's kind of an 4

overseer to be the link between ONC and Connecticut. 5

So the ideal State HIT Coordinator is not a 6

part of any one of our individual agencies. So in fact the 7

State HIT Coordinator is an overseer, the CEO is reportable 8

to the Board of Directors, to all of you, as a distinct 9

employee as part of the agency that has been established. 10

MS. KELLEY: But the federal funds that are 11

-- this is where I'm confused. 12

MS. HOOPER: Yes. 13

MS. KELLEY: The federal funds that are 14

coming to Connecticut is paying for the CEO. Is it also 15

going to pay for the State IT Coordinator? 16

MS. HOOPER: Yes. All of this is those ONC 17

funds, correct. And again, they're paying for the HIE 18

agency and it's your determination as to the amount for the 19

CEO, but the Commissioner had a comment on that also. 20

CHAIRPERSON MULLEN: This is a draft budget 21

that we send to the ONC. I think your point about a salary 22

range is a good one. What I'm hearing is that what 23

informed the budget proposal is really an understanding of 24



48

the salary range and that usually -- I don't have the range 1

in front of me, we end up losing candidates because they 2

knew the market is going to pay them more in the private 3

sector. 4

MS. KELLEY: Sure, and I'm not making that 5

point. I just would like to know what the salary range is. 6

CHAIRPERSON MULLEN: Yeah. And for us to 7

budget and ensure that we've at least put in enough is 8

better right now than to under budget what we think. 9

MS. KELLEY: Oh sure. 10

CHAIRPERSON MULLEN: And then to work with 11

our project officers or the Board to do that for some 12

revisions. 13

MS. KELLEY: So one other question. I 14

probably have many but I won't take up the whole agenda, 15

but when I'm looking at the shorter one not the longer one 16

there is a five percent retirement. Obviously on the other 17

one it's built in, State retirement. When I looked at it, 18

it looks like the State retirement is built in. But when I 19

see five percent I'm assuming that that's a matching 20

contribution into a 401K. What is that retirement? 21

MS. HOOPER: That would be -- again, it's 22

our framework provided with Gartner in looking at other 23

HITE/CTs. It would be up to this Board to determine if you 24



49

were offering those kind of benefits to your staff. And 1

that's -- again, it was made available as a line item for 2

your consideration. You all might decide that your staff 3

don't -- 4

MR. MASSELLI: Place holder. 5

MS. HOOPER: -- yes, thank you Mark. 6

MS. KELLEY: But it obviously isn't enough 7

to do anything other than some sort of a matching 8

contribution, that's what I'm asking, yeah. Okay. 9

DR. AGRESTA: And I think it's really 10

important to note that a State HIT Coordinator is required 11

by ONC. The State has to name a State HIT Coordinator and 12

all of the grants that come into Connecticut require that 13

to be in place, whether it's the RAC funds or the funds for 14

the Capital Community College or for this, or for even DSS. 15

All of them require that the State have an HIT 16

Coordinator. 17

The HIE grant or the Cooperative Agreement 18

is the only one, I think is the only one, that provides for 19

the mechanism for which payment can occur to the -- for the 20

cost of the State HITE Coordinator salary. 21

MS. HOOPER: Well, we've -- 22

DR. AGRESTA: I may be incorrect but I think 23

that may be the case. 24



50

MS. HOOPER: ONC has said that certainly 1

funds could be combined for an HIE Coordinator but again, 2

we've already submitted to ONC and been approved that the 3

HIT Coordinator would come out of this Cooperative 4

Agreement. Again, we do have one until the end of this 5

month and that's Mr. Wollschlager. And again, the 6

Commissioner will be working with the Governor as to when 7

ONC is not strictly saying okay, who is it on June 1st 8

okay. They basically -- they know that the Commissioner is 9

in charge and that we've got this -- again, we can serve as 10

liaison for all that information. Did you like that? 11

MS. KELLEY: Loved it. 12

MS. HOOPER: So again, ONC is not saying 13

okay, we need a name right now. But it is a requirement 14

for the State of Connecticut. 15

CHAIRPERSON MULLEN: I feel obligated to be 16

in charge of the time. 17

MS. HORN: Yes, we are running severely 18

behind. 19

CHAIRPERSON MULLEN: We're way behind. 20

MS. KELLEY: Well, I just have one other 21

question if that's okay. But if other people have 22

questions I will hold my question. 23

Where is the money in this budget, and I'm 24



51

sure it's here but I am reading it for the first time, for 1

the RFP that we are issuing to pay for that? 2

MR. CARMODY: Well, that's the line item 3

that I was highlighting, which was the HA Software 4

Services. 5

MS. KELLEY: Okay, alright thank you. 6

MR. CARMODY: It's page 3. That was the one 7

that I think drew the most -- 8

MS. KELLEY: Okay. 9

MR. CARMODY: -- no matter what venue, that 10

was the one that we think had the largest volatility to it. 11

So I think the other ones are probably reasonable plus or 12

minus, whatever we settle on. 13

MS. KELLEY: Okay. 14

MR. CARMODY: That's the one I think we have 15

exposure to. 16

MS. KELLEY: Okay I missed that, thank you. 17

MS. HORN: Okay, anything further on the 18

budgets? We're moving to Item No. 5, work plan with 19

Committee assignments for 10 minutes. John. 20

MR. LYNCH: It will probably substantially 21

less than that. You've got a proposed work plan in front 22

of you. We are talking about three Subcommittees under the 23

Business and Operations Committee. One Subcommittee 24



52

provider relations, one on quality reporting and one on 1

public health. We'll need volunteers for all three of 2

those, so we encourage to submit names of people who might 3

very well represent that. 4

Also, the Special Populations Committee will 5

be taking on the patient component. I don't know if you're 6

full or you need -- 7

MR. MASSELLI: We need more, yes. 8

MR. LYNCH: -- names there as well to help 9

represent the patients on that Subcommittee. So one, send 10

names, etc., but two, really encourage people on the Board 11

themselves. I don't know if you've all gotten on any 12

Committee yet. If you're not, we really would love to have 13

you volunteer for one or more of the Subcommittees where 14

you think you might have a skill that could help. 15

The Provider Subcommittee as an example. We 16

believe initially we're going to need to make sure we deal 17

with physicians for the direct NHIN components as well as 18

the lab component the first year, but certainly beyond so 19

we make sure we address homecare and VNA and you name it. 20

MS. HOOPER: This was included in the 21

package we believe. It was tucked in at the end of what 22

was -- what's here on your table. 23

MR. LYNCH: Okay, thank you. So certainly 24



53

on the -- did we get that as well? I didn't get it. 1

MS. HOOPER: Yes, second to last page of 2

what was handed out today. But we will send all this 3

electronically again to make sure we have it. 4

MR. LYNCH: Alright, thank you. So we do 5

encourage you to participate on Committees. If you're not 6

on one please help. As I said providers in particular, we 7

need to represent homecare and VNA and long-term care 8

facilities that are long-term. But certainly first year, 9

we definitely need to talk about work flows with providers. 10

11

The quality improvement reporting, I 12

believe, was not scheduled for year one necessarily but 13

public health reporting is. So if you have someone who has 14

public health skills who can work with us to help with the 15

public health reporting to help get that flow working. 16

MR. HEUSCHKEL: Should we submit names to 17

you? 18

MR. LYNCH: Names to me would be fine. 19

MR. THORNQUIST: You don't have providers 20

for public health on this list. 21

MR. LYNCH: No, those would be under the 22

Business and Operations. 23

MR. THORNQUIST: Other Subcommittees. 24



54

MR. LYNCH: It would be three Subcommittees 1

under that, but we definitely need names to get those 2

going. And we need to have certainly the provider's 3

component flying very quickly because with the RFP coming 4

in we have to start working on how do we implement that, 5

how do we -- whatever we decide on. And in conjunction 6

with the Policy Committee, how do we take the policies and 7

the technical and then make it a viable workflow for the 8

providers. 9

MS. HOOPER: Would you like names sent to 10

you e-mail or a discussion -- 11

MR. CARMODY: Any away, snail mail, e-mail, 12

immediately, verbal, we'll take them all. 13

MS. HORN: And the By-Laws do require two 14

Board members on each Committee, so don't be shy. 15

MR. LYNCH: And we will need another one 16

definitely on the Business and Operation. I think at the 17

moment we only have one. 18

MS. HOOPER: And we also have the 19

requirement that Commissioner Mullen has to approve the 20

membership -- 21

MR. LYNCH: Right, correct. So I would put 22

forth the slate you recommend to me to Commissioner Mullen 23

for approval. 24



55

MS. HORN: Okay Peter, you are up with the 1

RFP HIT status update for 10 minutes. 2

MR. COURTWAY: For 10 minutes, so this will 3

take the place of my regular Committee reports -- 4

MS. HORN: Yes, I think we can shorten up on 5

the Committee reports. 6

MR. COURTWAY: We started to receive, or at 7

least we received, one update RFP already. Have we 8

received any others? 9

MR. CASEY: No, it's the only one so far. 10

MR. COURTWAY: Just the one, and we have 11

over 19 bidders that we're expecting to come in. So we 12

have -- so two representations and I think we'll have a lot 13

of work to do from the Committee. The main work that's 14

taking place right now with the Technical Committee itself 15

is to create the scoring templates, go through and give 16

each of the Domain Committee Chairs an idea of what the key 17

parts of the RFP that are in their domain to review until 18

suggested waiting factors for those groups to then take it 19

to the next step. 20

So we're finishing up that, we're finishing 21

up the process and one thing that we did find is that we 22

are -- we were missing a key tab which is the usability of 23

the product itself. We had all of the -- you know, whether 24



56

or not it was going to work for us or not but we are going 1

to form a position like a Committee to -- underneath the 2

Technical Committee to identify the usability of the 3

products. And we have some names and so we're interviewing 4

two different folks to sit on those Committees and also to 5

expand out the Technical Committee. 6

And again as John would say, any physicians 7

who have any experience in this area that you know of that 8

you would like to throw their hat in the ring, we're more 9

than happy to contact them. We are going to be keyed to 10

the demos to take place in the June timeframe so that we 11

can get the feedback of, you know, what products are going 12

to be acceptable from a workflow point of view. 13

CHAIRPERSON MULLEN: How many do you want? 14

MR. COURTWAY: Ideally I would like to see 15

up to six. 16

CHAIRPERSON MULLEN: Six. 17

MR. COURTWAY: I think we've identified so 18

far two or three, so three or four more would be good. 19

CHAIRPERSON MULLEN: You want some people 20

that you know just love technology and others who might be 21

the very slow adapters? 22

MR. COURTWAY: It's always good to have that 23

mix. I love the lowlights, you have to love the lowlights. 24



57

It's important to have all the reasons why it's not going 1

to be used and it's not going to work so that we can at 2

least know what hurtles we have out there. 3

MR. THORNQUIST: Those shouldn't be that 4

hard to find. 5

DR. AGRESTA: One of the things that Peter 6

and I have talked about is trying to get folks on that 7

Usability Committee that are also non-physician, either a 8

pharmacists or others who may have to engage in the Health 9

Information Exchange. And this -- again, the usability 10

testing that you know that would include about six or eight 11

people, you can actually find most usability gaps. 12

MR. COURTWAY: And the only other thing 13

since we have had some people who are connected to other 14

states, you know, to reach out to other states who have 15

selected the technology to see if there's folks that we 16

would be able to bring in to go through and help us with 17

our selection with stuff that they've learned from their 18

selection -- you know, to inform us also. 19

MS. HOOPER: DSS does a lot of that too. 20

MR. COURTWAY: Is there any questions for me 21

then through the Tech Committee? Thank you. 22

MS. HORN: Thank you. Okay Committee 23

reports, and I think we can go a little more quickly and 24



58

pick up some time here. The Executive Committee. 1

DR. AGRESTA: I think -- I mean the 2

Executive Committee met, I think we met only once -- have 3

we met twice? We met twice. 4

MS. HOOPER: Yes, twice. 5

DR. AGRESTA: We met twice, once in person 6

and once by phone. But I think you have seen sort of all 7

of the work that's come out of that presented in terms of 8

the treasurer report, the review of the initial budget, the 9

review and approval of the framework that John has 10

presented in terms of content to move forward. I think 11

there were several -- there may be several things that were 12

covered that are not represented here, one of which was -- 13

and there was a discussion about how to kind of move 14

forward after our discussion at the last Board meeting 15

around consent and the Executive Committee meeting prior to 16

that. 17

There was an agreement to kind of move 18

forward with taking that Consent Policy and actually having 19

a patient bill of rights and things like that. But having 20

that move into specifically under Mark's Committee and 21

having that group tasked with actually developing an 22

education framework and a patient bill of rights. Actually 23

I'm going to restate that. The education framework was 24



59

going to go under some of the stuff that John Lynch was 1

responsible for and the bill of rights, etc. -- 2

MR. LYNCH: No, I think you were right the 3

first time. All the patient stuff was going to be moved to 4

the Populations Committee. They would have patient portal, 5

patient bill of rights, all the patient related components. 6

DR. AGRESTA: Okay. So I think that was 7

probably the only thing that we covered in that Executive 8

Committee that hasn't sort of already been presented in 9

some format. 10

CHAIRPERSON MULLEN: The only other thing 11

that I would cite from last week's conversation is the 12

Executive Committee's acknowledgement for how much work, 13

physical and emotional work and personal investment, it 14

takes to be a part of this and that we appreciate it in 15

ways that might not show. 16

But I just remember a conversation early on 17

with people who serve on one of our Medical Boards who 18

remind us at the Department that they go at it for the rest 19

of their lives and their professional domains and people 20

remember that they're part of a Board. And within that 21

sometimes they then have to answer things that people have 22

heard about, the work of a Committee that they volunteered 23

to be a part of. And it can sometimes drive people away or 24



60

make them feel very proud of indifferent about their 1

participation. 2

Nevertheless, we acknowledge that it's a lot 3

of work and sometimes can feel like you have to ask 4

yourself why you volunteered. Thank you for volunteering 5

today. You, to be our ethics legal liaison for example, 6

but in all seriousness we just wanted to acknowledge that 7

because it's not always easy. This work is not always easy 8

and we appreciate it. 9

MS. HORN: Mr. Carmody. 10

MR. CARMODY: I think I said most of the 11

things that have taken place on the Finance Committee. I 12

laid out at least a framework to start, which I think is 13

the start of a conversation around the -- when we start 14

talking about sustainability and we talk about what may be 15

the next steps. There really is a need to talk about how 16

we can incorporate the thought process of making the HIE 17

sort of the enablement piece to what is a broader business 18

conversation. 19

People have heard me talk about this over 20

the last few months around how do you put this in the 21

context of what it's going to drive. And we can even -- in 22

the outline that we put together in that framework, it was 23

to drive -- what we haven't really done yet is we really 24



61

haven't talked about how we're going to come up with those 1

metrics. Now, there's public health metrics but then there 2

is a broader context of metrics of how do we get hospitals 3

and the physicians and the people who are delivering care 4

to agree to a set of metrics that we think are going to be 5

-- that they need to achieve in order to drive down those 6

cost savings. 7

And then use the HIE as an enablement to be 8

able to help try to measure those cost savings, otherwise 9

it becomes a technology for technology sake. And I know we 10

didn't -- we specifically stayed away from the stern the 11

finance needed but it becomes more relevant as I've seen 12

some other markets in the U.S. talk about and bring those 13

quality metrics that you want to achieve and then start to 14

measure them and then use the cost savings and come up with 15

some type of cost sharing, I'll say formula or algorithm, 16

and then use that as a way to pay for the HIE. 17

And then you get changing the conversation 18

from a sustainability conversation to really a cash flow 19

conversation. People will underrate -- if you think you 20

have a good cash flow to say we're going to achieve these 21

metrics, we're going to drive these savings, we're going to 22

achieve these metrics. Then you can get institutions, and 23

I think there's a variety of different ones out there, to 24



62

potentially subsidize the cash flow because a lot of these 1

savings are going to accrue over time and now it's not a 2

conversation on sustainability but really just how do I 3

enable that cash flow. And then what you do is you peel 4

off a piece of the cash flow to be able to repay the people 5

that have seeded you that capital money. 6

Now granted, the Feds have provided us a 7

portion of that which is good. But if you want it to be 8

done over a longer term we're going to need to get more 9

people to the table to talk about how we're going to 10

measure and what those metrics are. I can assure you that 11

you don't want the finance people doing it. I think the 12

people that actually deliver the care are the ones, now we 13

can account for it, we can talk about it and maybe push and 14

pull on what you think. But it's the physicians and the 15

hospitals that have to come up with whatever those metrics 16

are going to be because they are going to be the ones that 17

are not only going to talk about cost savings but they're 18

going to talk about quality because I think it's a 19

combination of both. 20

It's not one or the other. I think if you 21

actually start with quality and then you put the cost 22

savings piece and then you agree to how you're going to 23

measure it and use it, I believe at this point you have 24



63

places where you can run towards (indiscernible) or 1

wherever else to say this is what measure. I think we can 2

start down that road. So there is going to have to be 3

somewhat of a dialogue with the finance people working in 4

those other places that we want to measure in order to see 5

if we can bring more people to the table. And I think that 6

even includes a greater representation from employers who 7

eventually, as they currently stand in this current 8

environment, pay quite a bit in terms of what they're 9

providing as benefits to the people that they employ. 10

And you're going to want them at the table 11

in order to help understand one, what is really actually 12

driving -- you know, some of the drivers to the health care 13

cost. Because what you're hearing, and I will just take it 14

from my own venue, it keeps saying that we can't sustain 15

this cost structure. And the cost structure is when you 16

look at all of the dollars that go into it, they're saying 17

that this product that we're a part of is not sustainable 18

and how do we actually get there. So I think that there's 19

a framework there for that conversation that we want to 20

really investigate at some point in time. 21

MS. HORN: John. 22

MR. LYNCH: I thank Dan for introducing the 23

Quality Committee. As you remember, we just talked about 24



64

having three Subcommittees, one being called a reporting. 1

It seems like the Quality Reporting Committee, we're going 2

to need someone let's say maybe has a cross share with the 3

Finance Committee just to kind of represent that. But it 4

seems like from what you've said we would need not only 5

physicians, etc., to measure it from the health care 6

quality but we would need employers for example and maybe 7

someone from the Legislature. What type of quality 8

reporting from the legislative prospective would be 9

expected or whatever, so we need to beef up that quality 10

reporting Subcommittee. 11

Let's try to get some cross-fertilized with 12

the Finance, but also names of Legislators or employers 13

that would have different perspectives on what kind of 14

quality metrics they'd be willing to see funded because 15

they believe in those quality metrics like you said would 16

drive the purpose for this, as one component. 17

CHAIRPERSON MULLEN: I just wanted to 18

propose that we refer to it as a Safety and Quality 19

Committee. 20

MR. LYNCH: Yeah, sounds good. 21

CHAIRPERSON MULLEN: Great, let's all keep 22

proposing. 23

MR. CARMODY: If we knew somebody that had a 24



65

keen medical background that sits on the Finance Committee 1

it would be -- somebody who might be interested. 2

MR. LYNCH: Oh, whatever that would mean. 3

CHAIRPERSON MULLEN: And I, as you introduce 4

this, see this as if it's not obvious to those outside of 5

this HIT domain, why this is important. I think Safety and 6

Quality is a way to start to really recruit everybody else 7

who's working on a portion of transformation of care, cost 8

containment, health reform or even trying to preserve the 9

status quo, which is not sustainable. 10

So I think I'll speak as the Commissioner, 11

this is a way for us to really also go back and say we 12

should be really clear in this discipline that we don't 13

just become another group addressing that because this is 14

from the public reporting standpoint and the cost 15

containment standpoint, a place that I know the State and 16

the country really needs to go fast, so. 17

DR. AGRESTA: Actually another thought to 18

get your thoughts on, Health Insurance Exchange going on 19

activity -- 20

CHAIRPERSON MULLEN: Yes. 21

DR. AGRESTA: -- is this maybe where it 22

overlaps? 23

CHAIRPERSON MULLEN: Yes. 24



66

MR. LYNCH: Is this -- you know, is it maybe 1

this Subcommittee on Safety and Quality where that would 2

overlap in terms of what kind of data really should be 3

coming through the HIE that might help support something 4

like that? 5

CHAIRPERSON MULLEN: And health homes and 6

patient-centered medical homes, and you can just list, 7

list, so. 8

MR. LYNCH: The other components then is the 9

Public Health Subcommittee. Again, that's a year one 10

target. We need both sides of the equation and it's not 11

just -- actually the name of this at the moment was kind of 12

Public Health because it was year one but the reality is 13

that Subcommittee has to be kind of multiple inter-agency 14

Committee. 15

So that -- for example relationships with 16

DSS, I mean, what kinds of exchanges do we need to happen 17

with DSS or with Consumer Protection relative to 18

pharmacists and that kind of thing. I think those would 19

potentially fit in here as a Subcommittee that's really 20

inter-agency relations kind of, not just Public Health but 21

Public Health certainly being year one. 22

DR. AGRESTA: Well I think John, the other 23

thing to be cognitive of that Public Health Committee, that 24



67

piece needs to think about what are the public health 1

exchange requirements with clinicians and hospitals too. So 2

I think you need to think about how do you get folks that 3

are facile on understanding those -- I mean, those are real 4

informatics issues too. I think you're not just talking 5

about what are you exchanging but how are you exchanging 6

it. 7

MR. LYNCH: Right. 8

DR. AGRESTA: You know, the functional 9

aspects of it. 10

MR. LYNCH: Examples of that are things like 11

the W-10 form that goes from doctors to home care and back 12

and forth, etc., multiple times that have always been 13

problematic from a workflow issue. 14

DR. AGRESTA: Yeah, those are longer term 15

examples. I think the short-term example is we've got to 16

exchange -- you know, we've got to do surveillance and 17

we've got to do exchange of immunizations. In other words 18

they're sort of like very early exchange things that need 19

to happen, and I'll argue that require very specific work 20

groups to actually make happen otherwise they won't happen. 21

You know, they're not going to happen automatically. 22

MR. LYNCH: Yeah. 23

MS. HOOPER: We even have within the agency 24



68

and started working on, the immunization registry to get it 1

compliant by 2013. But also I think that your comment 2

about the other agencies in public health that as we've 3

clarified that again, there are a number of agencies in 4

public health that the true perspective of public health 5

includes for example DOIT and how its relationship with 6

DCF, with DSS, with Mental Health and Addiction Services, 7

which has much of the information that we're looking to not 8

only protect but also to provide. 9

So I think public health doesn't just mean 10

DPH. 11

MR. LYNCH: Right. And expecting that you 12

will be adding some names to the table here as well from 13

the agency side, etc., as well as once you get the public 14

health informatics specialist onboard I would expect that 15

that would a natural person to help figure out how would we 16

interoperate. 17

MS. HOOPER: Yes. 18

MR. CARMODY: John, what do you think that 19

the safety and quality was going to -- did you say those 20

were things you want to do? 21

MR. LYNCH: Technically, that's not in the 22

Strategic Plan for year one. Year one is kind of public 23

health and providers, but I think it really still needs to 24



69

be -- because from the financial and the ROI kinds of 1

perspective, we need to be getting that going at least even 2

though we're not necessarily -- and we also need to be 3

proposing -- you know, at the moment we haven't really 4

talked about what kind of repository if there will be a 5

repository. 6

We kind of talked about there's going to be 7

exchange and exchange, that doesn't necessarily mean 8

there's a repository or what would go into a repository, 9

what kind of information. So there's a whole area of work 10

there that we need to get done, built up even before you 11

get downstream. 12

MR. CARMODY: I can give you some examples 13

from some other places that I've seen. I'll let you know, 14

that way you can start to stimulate with the others that 15

have started. 16

MR. LYNCH: Alright. 17

MS. HORN: Thank you. Legal and Policy, 18

Lisa is not available today and we have a couple of other 19

Committee members here today, so. 20

MS. ANDREWS: I remember that we recommended 21

D&O insurance. 22

MS. HORN: We recommended that, we did talk 23

about conflicts of interest and needing to develop some 24



70

guidance on that. 1

MR. LYNCH: I missed the last meeting but I 2

know that risk analysis is one of the things that's being 3

teed-up by Laurie. There's a whole document on risk 4

analysis that becomes very important to us from the D&O 5

insurance perspective as well but what kind of risks -- and 6

I think it would be very important from the perspective of 7

the hospitals and other participants in terms of who's 8

assuming what risks, etc. 9

These are all, I'll call it some governance 10

types of issues, that need to be addressed early rather 11

than later before people even start coming in, etc. So we 12

do need to be moving forward from the policy perspective on 13

things like the risk analysis and what kind of risks. 14

MS. HORN: Wednesday at 3:30 we're meeting, 15

a smaller group of us, to do the risk assessment, look at 16

that document and try to make some -- develop and tailor it 17

to DPH so -- or to the HIE. So if anybody would like to 18

participate in that, we're just doing a go-to meeting, a 19

smaller workgroup to begin to drill down some of these 20

policies. 21

But, we did collect some policies from other 22

collaboratives in the State so that we're not reinventing 23

the wheel in terms of business associate agreements and 24



71

DURSA's and what are the right questions that we need to be 1

asking. But right now we're going to get the policies 2

developed that we need to to really get this HIE ready to 3

be up and operational. 4

MR. COURTWAY: At the Committee meeting are 5

you also planning on ranking the risks or just -- you know, 6

in other words teeing it up from the practical safeguards 7

that are necessary to protect against the risks. But will 8

there be -- 9

MR. LYNCH: It's a good suggestion; I don't 10

think we've talked about that yet. It's a good suggestion. 11

MR. COURTWAY: -- but perhaps you could do 12

that. That really did help inform the RFP process because 13

if you do the ranking that would imply a rating to apply 14

that each one of those key risks will have something on the 15

chart to say how is this vender A versus vender B, 16

addressing the technical safeguard for high level risks. 17

MR. LYNCH: Good suggestion. 18

MS. ANDREWS: Do you want that ranking by 19

like how much it scares us or how much it's likely? 20

MR. COURTWAY: Well, I think that we're 21

going to do -- do these it's like the combination of the 22

two, how much it scares you and how likely it is to happen. 23

I think that in this particular case I think we should 24



72

just assume that they're all going to happen. So from here 1

it would be the scariness index and then go from there. 2

DR. AGRESTA: Well no, I think that that's a 3

valid question because, you know, is it exposure of a small 4

amount of data or small -- you know, or is it exposure of 5

the whole thing. And those are different, you know, levels 6

of risk. Those are -- that's data risk analysis. I think 7

there are kinds of risks, so those are -- I don't know what 8

you're covering in your risk analysis. Are you just 9

talking about risk assessment -- 10

MS. HOOPER: I think we might be talking 11

about two different things. 12

DR. AGRESTA: They may be very different 13

things. There are -- you know, when people get into 14

technical risk analysis, you know, privacy and security 15

risk analysis are very, very specific kind of in detail 16

types of things. You might be talking about something very 17

different from -- 18

MS. HOOPER: Well I think Peter, are you 19

talking about the risk assessment that we agreed to with 20

the legal services taking a look at risk assessment for the 21

Board? The risk analysis that you're looking at or that 22

I'm hearing you talking about is more on the HIE system. 23

MS. HORN: No, we're talking about the same 24



73

thing. 1

MS. HOOPER: Alright, good. So -- 2

MR. COURTWAY: Which of those same things 3

are we talking about? 4

MS. HORN: We're talking about the risk 5

assessment for the HIE. 6

MR. LYNCH: This is stuff that Laurie 7

Fourquette (phonetic) has been working on, so it's much 8

more that than was the insurance -- 9

MR. COURTWAY: -- have the stuff teed-up, so 10

-- 11

MS. HORN: Yes, this is the document we're 12

going to be working through so, it's looks thrilling. 13

Anybody that would like to join us Wednesday at 3:30? 14

MS. ANDREWS: It's actually very scary 15

though. 16

MS. HORN: Yes, it's very scary. 17

MR. COURTWAY: Four pages. 18

MS. HORN: Yes, so we'll take it -- 19

MS. KELLEY: Marianne, could you send me 20

that document? I know I saw an e-mail on this -- 21

MS. HORN: Yes. 22

MS. KELLEY: -- and you said the document -23

- if we don't decide to participate? 24



74

MS. HORN: That's right. Okay, Personnel 1

Search Committee. 2

MR. LYNCH: Yes, I'll take that for Mark. 3

We had a Personnel Search Committee meeting. We have 4

reviewed the draft CEO description as well as other job 5

descriptions that were being proposed. We adopted the 6

comments that we had received from others up until that 7

point in time -- were on the table from others. 8

We recommended this to go through the 9

Executive Committee, which it did last week. The Executive 10

Committee approved it to then go to the full Board here 11

today. If and when we approve that today then it can 12

immediately go out to the public tomorrow as soon as we can 13

get that out. We've got some -- we thank DPH for some 14

staff support in that process. It was very helpful to help 15

-- you know, your personnel Committee person -- your 16

personnel Guru was very helpful in coming up with some 17

better language and different things to do. 18

So we have this one for approval to go out 19

ASAP. We have a relatively short timeframe, we're hoping 20

to get people back in an ongoing process beginning mid-21

June. Not necessarily the final, final. We want to keep 22

it open until we have actually accepted someone so we don't 23

have an end date on it, but we have kind of a -- I call it 24



75

an early date where we will start reviewing applicants mid-1

June, at that point what's gotten in and try to narrow them 2

down. We have an accepted process of how we're going to 3

review and score those components. 4

And then we also have the other two 5

positions, we have the Chief Technology Officer and what 6

we're going to call Administrative Project Manager -- I 7

mean, it's kind of a job where we realize it was more than 8

-- you know, it was kind of project management. The person 9

would need to know a broad thing. So we have two job 10

descriptions developed at this point for that. Those are 11

also being reviewed and we hope in a similar type of 12

timeframe that we can be moving on all three positions 13

because we can't wait. We need people onboard. Now that 14

brings up the next issue, so we have teed-up and we want to 15

vote on that. 16

We also had the discussion then of Interim. 17

We basically recommended that we ought to be looking as an 18

interim solution because it might be three, four, five, six 19

months by the time we get a CEO onboard. And we can't be 20

waiting to -- you know, with the RFP coming in, etc., that 21

we basically recommended -- you know, we asked if we could 22

find some mechanism for Interim. And we started running 23

into some issues, do we need to the have State kind of 24



76

process and everything else, would that slow us down, etc. 1

I don't know, maybe you could fill us in on the latest on 2

what can we do or can't we do relative to an Interim? 3

You know, do we get a consultant, do we only 4

hire from existing like we did with the Gartner group, that 5

we can only do types of consultants? 6

MS. HOOPER: It's your money. 7

DR. AGRESTA: Yeah. 8

MR. LYNCH: Okay. 9

MS. HORN: It is a slightly different 10

process than we have to go through with the State but 11

still, it's public money and there are a certain amount of 12

competitive bidding that needs to happen but not 13

necessarily the full formal RFP process. My understanding 14

is that if we advertised for an Interim position, and that 15

was one way we could go, just less extensively than we 16

would be doing for the larger full-time positions. 17

If there were some names of people that you 18

had in mind, have the group put the offer out to them and 19

that would be a Plan B. But you do need to make sure that 20

people have an opportunity to avail themselves of this. 21

MR. LYNCH: Really, input from others about 22

thoughts on what we would like or not like relative to 23

Interim, do you think it's a good idea or -- 24



77

MR. CARR: I think it's a good idea to 1

explore. Just from my own experience in my day job hiring 2

professionals with health IT experience is very competitive 3

right now. You may end up -- I'm sorry, I just got 4

something in my eye. You may end up making offers to three 5

or four people before you actually get one to accept, even 6

though they started the process wanting that particular 7

position. 8

The market is so hot right now that many are 9

recruited out of the process while you're interviewing 10

them. So I think that having a backup plan is a really 11

good idea. 12

MR. LYNCH: So you really -- that basically 13

says you really need think Interim because it may be quite 14

awhile before we get the CEO onboard. 15

MR. CARR: I think it's -- yes. 16

DR. AGRESTA: And you need to recognize that 17

your Interim solution could lead to a permanent position. 18

MR. CARR: Yup. 19

DR. AGRESTA: And this is -- 20

MR. LYNCH: Yes. 21

DR. AGRESTA: -- this is really the reality 22

of the market at the moment. 23

MS. KELLEY: Can the Interim position be a 24



78

campaign for -- I'm in agreement with an Interim too. 1

DR. AGRESTA: I don't know, is there any 2

ethics -- I mean, that's a good question. Is there any -- 3

we'd have to kind of think through, is there any ethics -- 4

MS. HOOPER: Well, is this an Interim staff 5

person that you're -- again, it wouldn't be as difficult 6

but if it's a contracted service or -- you know, a service 7

that can be made available right away without going through 8

a hiring process as strict as or for as qualified because 9

you don't want to have the same process -- 10

MR. LYNCH: Correct. 11

MS. HOOPER: -- right. You would want 12

something -- 13

MR. CARR: You can have two different 14

processes -- 15

MR. LYNCH: Two different processes. 16

MS. HORN: I think you could make it clear 17

whether you wanted this person to be -- 18

MS. HOOPER: Eligible -- 19

MS. HORN: -- eligible for full-time or not, 20

make that very clear, but if that was okay to have them in 21

the running then we would have to go through that separate 22

application process as well and be part of that pool. 23

MR. LYNCH: Right. 24



79

MS. HORN: But I don't think Interim 1

necessarily conflicts them out of applying for a full-time 2

position. 3

DR. AGRESTA: As long as they don't have any 4

decision-making in that process. 5

MS. HORN: No, absolutely. 6

DR. AGRESTA: Right. 7

MR. COURTWAY: There are some firms that do 8

specialize in the space. You know, I can give you the 9

names of firms if you're interested in contacting firms -- 10

MR. CARR: Yup. 11

MR. COURTWAY: -- that specialize in space. 12

But one of the interesting things as we go forward is we 13

narrow down to the key venders that are here, depending on 14

how fast you feel the need for speed. You know, you may 15

want to tailor that into the particular venders selected 16

and if somebody has experience in that to get a leg up in 17

moving forward faster. 18

I think that we also ought to be open to 19

other collaborations in terms of how we buy the resources. 20

I think there's some very talented people at the State 21

level, I don't know if there's opportunities to buy from 22

the State. I don't know if any of those talented people in 23

other HIEs around the nation who are well established and 24



80

aren't in their learning stages that could be reached to 1

see whether or not they would have an interest of earning 2

some funding and bringing those folks onboard to try to 3

give us a leg-up. So I think there's other opportunities 4

that we could really avail ourselves of. 5

MR. CARR: Well with that in mind I wonder 6

if the State IT Coordinator may be able to serve that 7

interim role of the two or if that's not allowed. 8

MS. HOOPER: Again, I think that's worthy of 9

discussion but ONC envisions that person to be overseeing 10

the HITE/CT Agency Board, DPH, DSS and the REC. So 11

actually, it would preclude them from being overseer and 12

doer. 13

MR. COURTWAY: Well let's go with -- John, 14

you mentioned Chief Technology Officer. I would like to be 15

sure that we actually have a role, whether it's not any 16

multiple named role, for the Chief Security Officer. 17

MR. LYNCH: Good point. 18

MR. COURTWAY: You know, I think that the -19

- I believe that the latest guide says that HIEs are 20

something to HIPPA, so if the HIPPA requires -- I thought 21

so. They do require a named Chief -- a Privacy Officer and 22

a named Chief Security Officer they can be the same. 23

MR. LYNCH: We need to add those to that job 24



81

description. 1

MS. KELLEY: So you're saying that the IT 2

Director would also be IT Security Officer? 3

MR. COURTWAY: I don't know how it would 4

actually breakout. I haven't seen the other job 5

descriptions. 6

MR. LYNCH: Well, we've got basically three 7

positions. We have a CEO who we're expecting to be able to 8

talk at all levels relative to, you know, talking with 9

hospitals, talking with doctors, talking with the 10

legislature, etc. So we want a CEO broad level to really 11

run, manage the business, all those things. Don't 12

necessarily expect that that CEO have 100 percent of all of 13

the technology skills. We want that CEO to have some level 14

of that but we expect that there needs to be someone who 15

can really roll up their sleeves and work in detail with 16

the venders, with the hospitals to make sure the exchanges 17

and stuff happen from that perspective. 18

And then we have an Administrative Support 19

person Project Manager type, to really help us with 20

scheduling meetings and keeping things flowing, etc. So it 21

probably makes most sense that the Privacy and Security 22

Officer probably have to be in that second person, the 23

technology, privacy and security component. 24



82

MS. HOOPER: Unless this group feels that 1

you want more staffing and taking the funds away from 2

something else. 3

MR. LYNCH: Right. 4

DR. AGRESTA: Well, at this point I think 5

you can name that in the job description. And then if we 6

can re-look at the staffing costs, I don't think you're 7

going to get -- I don't think it's yet a full-time job to 8

do that, for one. And most people who are capable of being 9

the Chief Technology Officer are -- this is something 10

they're familiar with. If they're not familiar then it's a 11

problem. 12

MR. CARMODY: It's probably -- security and 13

the privacy piece you can always -- 14

DR. AGRESTA: The privacy piece could be a 15

different -- 16

MR. COURTWAY: I'll say, we've rolled all of 17

these roles into a Chief Information Protection Officer. I 18

can send you our job description on that because that's the 19

blending of all of these and see if that helps you at all. 20

MR. LYNCH: Yes it would, thank you. So we 21

will add that to that job description, both privacy and 22

security. Those are the three we're looking for. Let's 23

see if we can take this up -- first, approval to send CEO 24



83

job description out tomorrow. 1

MS. KELLEY: To where? I mean I -- 2

MR. LYNCH: We have the full list of -- I 3

don't have it in front of me. We had -- 4

CHAIRPERSON MULLEN: Well may I just ask, if 5

we approve sending it out can where is it going become a 6

part of the discussion so we can at least deal with the 7

motion? 8

MS. HORN: Yes, good idea. 9

CHAIRPERSON MULLEN: So we can keep 10

ourselves -- okay. 11

MR. COURTWAY: So moved. 12

MS. HORN: Okay, so we have -- Peter is 13

moving. Is there a second? 14

MR. CASEY: Second. 15

MS. HORN: Steve seconded. 16

CHAIRPERSON MULLEN: Where -- 17

MR. LYNCH: Question. Where we had -- I 18

don't remember off the top of my head the list we had 19

developed. 20

MS. HORN: Sarju must have that. 21

MS. SARJU SHAH: It's New York Times, the 22

American Health Information Management Association, New 23

York Health Information Management Association -- 24



84

MR. LYNCH: Other HIEs. 1

MS. SHAH: -- other HIEs, ONC -- 2

MR. LYNCH: What about AMIA -- 3

MS. SHAH: I'm sorry? 4

DR. AGRESTA: The American Medical 5

Informatics Association? 6

MS. SHAH: Yeah. 7

MR. LYNCH: So those are where we would send 8

that and begin that process. 9

MR. COURTWAY: Will we also post it on the 10

website? 11

MS. SHAH: So what will happen as well is 12

that we have our HR personnel who will be posting it on the 13

State website, the State DAS website. And it will be sent 14

out to all the Board members so that you will be able to 15

post it in your own networks as well. 16

MR. LYNCH: Yeah, we would encourage it to 17

send it as widely -- your friends and family and everybody 18

else who might be possibly interested. 19

MS. HORN: Any further discussion? If not, 20

all in favor? 21

VOICES: Aye. 22

MS. HORN: Opposed? 23

MS. ANDREWS: Yes, I oppose. 24



85

MS. HORN: You're opposed? 1

MS. ANDREWS: Yes. 2

MS. HORN: Okay, one opposed. 3

MR. LYNCH: Anything that could be helpful 4

the reason why, because of the salary? 5

MS. ANDREWS: Yeah, the salary. I mean, 6

we're near the end of the conversation and everybody's 7

voted for it but I have concerns about the way it's that 8

big and the focus of the position. I believe in more 9

public trust, more discussion around engaging the public in 10

the job description. 11

MR. LYNCH: Input on that would useful as we 12

go to review the candidates. We don't even have to stop 13

there, we'd love to make sure we put that kind of stuff in 14

the review for the position. Then there's the question of 15

Interim. I get the consensus that Interim sounds okay. 16

Okay if we could find the rights of process for doing that, 17

again, CEO might take six months. And I'm assuming that 18

with the RFP stuff coming in this month we really need more 19

than just the volunteers to really start honing and working 20

with the vender, whatever vender gets selected right? 21

MR. COURTWAY: Well again, a lot of people -22

- I'm not sure being an Interim and the time and speed that 23

this thing is moving at -- I correct myself in regard to 24



86

the timing of this. The RFPs are due Thursday and May 31st 1

we have to get the short-list to the selection team. So 2

we're going to be moving pretty fast so we may be ready for 3

the June 20th Board meeting. I don't think we've moved the 4

final data but I think we have it set right around that 5

time. 6

MR. LYNCH: Well, once we approve or not in 7

June then we need to be rolling. Who's going to do the 8

work of interfacing -- 9

MR. COURTWAY: From our perspective it would 10

be -- you know, as an individual I think it would be very 11

helpful to have an Interim lined up so that somebody can 12

take some ownership of this and move it forward. 13

DR. AGRESTA: So is your perspective that an 14

Interim lined up by our next meeting -- we sort of get into 15

again, a sequencing of timing. You know, our next Board 16

meeting is June 20th, which we're voting on. And then 17

having to go into negotiations around a contract with a 18

vender at that timeframe, you know, the Interim being in 19

place would be of great value in the negotiations I would 20

assume. 21

But, that's a really short timeframe to get 22

an Interim in place. I mean, we're all moving so I don't 23

know how they do that that easily but is it your 24



87

recommendation that an Interim needs to be in place or 1

begin the negotiation with the vender or really when we 2

start to kind of get into the actual process of trying to 3

implement something because even the negotiation of the 4

vender, you're starting to do the Implementation Plan. 5

I mean, in many ways you have to have in 6

front of you the process by which you're going to complete 7

work so you almost need somebody whose full-time job at 8

that point is working on that. I mean, you've been -- I've 9

watched you put in huge amounts of time. 10

MR. COURTWAY: I do not want to be the 11

Interim. 12

DR. AGRESTA: Right, but I get that that 13

might -- huge amount of time but I think that might pale in 14

comparison to what it's going to take then to kind of now 15

move this through very quickly. 16

MR. COURTWAY: I guess what I would do is 17

encourage John to identify what it would cost, what 18

resources are available out there so at least we have 19

something to go by. We're not going to be able to get a 20

decision on this today. You know frankly, I think as we 21

take a look at the openness of the RFP and we take a look 22

at what the bids actually are, there may very well be 23

sufficient project management in the bids from a particular 24



88

set of venders that would move this a lot faster. 1

So it may be more cookie cutter than it is 2

development. So I think that we still have a long ways to 3

go but I'd love to have some people lined up that would be 4

able to say here's the type of people that are available 5

and this is the relative cost. What I wouldn't want to do 6

is to blow the bank on consultants in the first six months 7

and chew up our -- and that's real easy to do in projects 8

of this size moving at this speed. 9

MR. LYNCH: So if you can, send me names of 10

individuals or firms or whatever you feel might be valid in 11

the space for Interim. 12

MR. COURTWAY: Okay. 13

DR. AGRESTA: But I think we still need a 14

proposal for how we move forward so the proposal can be to 15

explore Interims and come back with costs and possible 16

types of options or the proposal can be to explore and take 17

action on some level. I don't know that we're -- without 18

kind having a next step review process I don't think we're 19

ready to do that. 20

Whether that goes to the Executive Committee 21

or back to the Search Committee, I mean what do -- 22

MS. HOOPER: Well you asked that they put 23

together, you're going to send John something. John, 24



89

obviously you're going to talk with Mark Masselli as the 1

Chair. 2

MR. LYNCH: Yup. 3

MS. HOOPER: Try and put together maybe 4

where some resources are on estimated costs. 5

MR. LYNCH: That's our next -- our next 6

Search Committee meeting that was meant to the subject, to 7

talk about that. 8

MS. HOOPER: And then if that was brought 9

before the Board on June 20th, would that be helpful for a 10

decision on moving forward or could that be sent out as a 11

request? Do you need a motion today on any of this moving 12

forward or can it just move forward? 13

MR. LYNCH: I assume it can just move 14

forward -- 15

MS. HORN: No, I think we're fine yeah. 16

MR. CARMODY: I think it needs to keep 17

moving forward on that. I mean, I think we have to be able 18

to explore that and get the cost and understand the timing 19

of it. I don't think I would hold anything up. 20

MS. ANDREWS: But, you were talking about 21

getting a list of this position that you would then choose 22

from based on names given by this group right? I think 23

that's the process you were talking about for hiring 24



90

someone for the Interim. There would be a public process 1

right? 2

MS. HORN: Yes. 3

MS. ANDREWS: Okay. I mean, if it's just 4

like this group puts in a list of friend that's a problem. 5

CHAIRPERSON MULLEN: We're exploring how to 6

get the work done until there's somebody onboard. I don't 7

think we've agreed to anything more specific than that as 8

action items at this point. 9

MS. HORN: So I think if we collect the 10

names of people from other -- and the firms that specialize 11

in this and the sources of people who might be able to do 12

this work and bring it back for the next meeting, and then 13

we can decide which is the best way to go from there. 14

MS. KELLEY: For someone that has no -- I'm 15

sorry Mark, go ahead. 16

MR. HEUSCHKEL: I was just going to say, 17

what is the process for this -- for hiring the Interim? 18

MR. LYNCH: If you were raising a question 19

this is all new -- 20

MR. HEUSCHKEL: Right, but what I'm saying 21

is, is part of this research suggesting the mechanism 22

because I'm not clear what the mechanism is exactly. 23

MS. HOOPER: Contracting with somebody -- 24



91

simply because this is short-term, hurry up, got to do the 1

RFP, need a quick skill set, don't know how long you're 2

going to be working but here's what we need? 3

MR. HEUSCHKEL: Yes, exactly. 4

MS. HOOPER: Particularly on the RFP 5

contract neg -- I mean, that's what at least has been 6

presented so far. But obviously as you're putting together 7

what those responsibilities would be essentially it can't 8

be a hiring process because they're not necessarily being 9

hired as staff. 10

MR. HEUSCHKEL: Right, as employees that's 11

right. 12

MS. HORN: Right. 13


MR. HEUSCHKEL: It's more like a procurement 15

and what can you do very rapidly. 16


MS. KELLEY: As someone that knows little 18

about how to do this in this arena it would seem to me from 19

listening to the conversation that what we're saying needs 20

to happen between now and the next meeting, is we need to 21

build a list not necessarily of people but of places that 22

we could secure an interim. 23

And I'm hearing that because of the 24



92

competitiveness of the whole field, that we might actually 1

be better going with a place that if something happened to 2

the person that they gave us they would have some 3

obligation to continue to provide a support until we had a 4

CEO. So it's right now a research process that we're 5

looking for between now and the next meeting. Who are 6

those places or people that might be able to do an Interim 7

and how much would it cost -- 8

MS. HOOPER: Right. 9

MS. KELLEY: -- and then we can -- if that 10

work gets done between now and the next meeting, then we 11

could vote on how do we go about -- do we post it, do we -12

-- you know, what do we do. And can we even afford it 13

because if the research shows that it's way too expensive 14

then we may have to reassess our plan. I don't see any 15

reason not to do that and if you need a motion to say that 16

between now and the next meeting we're going to do that 17

research piece, I'll make it. 18

But I think it would be way premature to try 19

to do more than that because of all the issues that Ellen 20

raised. I mean, we certainly do not want to just get a 21

bunch of people we know and be accused of hiring somebody 22

that's a friend of ours for something this important. But 23

I support the interim concept totally. I mean, I think -- 24



93

and I think an Interim can serve a very valuable function 1

because they can raise issues that need to be raised but 2

they do not have to deal with all the issues -- you know, 3

the problems. 4

So therefore, there's times that an Interim 5

can do a really good job of helping you get your head 6

together as to what you should do and it's worth probably 7

the expenditure of funds to do that because I think we are 8

going to struggle. Now my other question is, we're not 9

planning on hiring the other two people are we, until we've 10

hired the CEO? 11

MR. LYNCH: We had discussion that the 12

administrative support person is probably someone we can be 13

moving on -- the Chief Technology, Privacy, Security 14

person, you'd probably want to wait until the CEO is 15

onboard and selected. But if the CEO is not on for six 16

months we've got a lot of meetings for organizational and 17

things to happen to just getting policies and procedures in 18

place and getting insurance and all that stuff. 19

MS. KELLEY: My preference would be to 20

either buy it from whoever is going to help us do the 21

Interim or buy it from DPH rather than choosing because you 22

only have a staff of three. I would want some -- you know, 23

if I was going to be the person who was going to be the 24



94

CEO, some ability to choose the two people. 1

And I think my priority right now is to get 2

the CEO search under way and get the Interim search under 3

way and figure out if we can somehow take care of those 4

administrative things on a temporary solution. 5

MR. LYNCH: That kind of fits right in to 6

the Interim component as well -- 7

MS. KELLEY: Right -- 8

MR. LYNCH: -- and not only the CEO but -- 9

MS. KELLEY: -- what we need that DPH can't 10

provide him -- 11

MR. LYNCH: -- whatever we need to be done 12

in the next six months let's say, the contract portion, 13

whatever. 14

MS. KELLEY: Right. 15

MS. HORN: Okay good, and I think we have 16

pretty much been through the Technical Infrastructure 17

Committee and special thoughts that that Committee was 18

discussing as well. Mark is heading that up and has 19

laughed but that's the one that will have all the patient 20

and bill of rights being dealt with. 21

MR. CARMODY: Just to go back to -- I mean 22

the other places I looked besides just DPH, is there 23

anybody from the Department of Information Technologies -- 24



95

MS. HORN: Sure. 1

MR. CARMODY: -- then I just think that 2

based upon that skill set you could get somebody there. 3

MS. HORN: Good. I'm sorry, I didn't mean 4

to cut that conversation off but public comment, is there 5

any public comment? Do we have some public -- 6

DR. AGRESTA: No words of wisdom? 7

MS. HORN: Sarju. 8

MS. SHAH: I'm sorry, since Mark isn't here 9

I just want to put a little plug in for the special 10

population. I will most likely be the person who's 11

assisting -- just assisting with that Committee but I know 12

one of the things that Mark did discuss was that he'd like 13

to have Board members tell him or both of us who they think 14

would be a good person to have on that Committee. We're 15

looking -- especially because of the patient bill of rights 16

and the educational piece, we would like people who have 17

that knowledge base to also participate. 18

So if you could send him or both of us names 19

or volunteers that would be appreciated. That's it. 20

MS. HORN: Okay, a motion to adjourn. 21

MR. LYNCH: So moved. 22

MR. CARR: Second. 23

MS. HORN: All in favor? 24



96

VOICES: Aye. 1

MS. HORN: We are adjourned. 2

(Whereupon, the meeting was adjourned at 3

6:32 p.m.) 4

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