 Good afternoon everyone and welcome to the Green Mountain Care Board meeting. My name is Kevin Mullin chair of the board and we'll start this afternoon's meeting with our executive director's report Susan Barrett. Good afternoon and hello everyone. I just have a couple of scheduling announcements first to let everyone know that we will not have a board meeting next week January 6th 2021 and also that our schedule for the month of January is on our website. If you go on to the Green Mountain Care Board website and look under board meetings and schedules you'll see that listing of all the meetings for the month of January that includes primary care advisory group meeting a couple of technical advisory group meetings on prescription drugs and other events so please check that out and that is all I have to report. Happy New Year everyone. Thank you Susan. Happy New Year to you. The next item are the minutes of Wednesday December 23rd. Is there a motion? So moved. It's been moved and seconded to approve the minutes of Wednesday December 23rd without any additions deletions or corrections. Is there any discussion? Hearing none all those in favor of the motion signify by saying aye. Aye. Aye. Any opposed signify by saying nay. Motion carries unanimously. Okay now for the purpose of today's meeting we're going to talk about the all-payer model future and present negotiations and I'm going to turn it over to Michael Barber. Mike. Thank you Mr. Chair. For the record my name is Michael Barber the board's general council and yeah I want to talk with you about a potential delegation of authority that I drafted for your review and consideration. As you all know we're going to have to start working with our state and federal partners in the coming weeks and months on either a potential successor agreement or a modification to the existing all-payer model agreement and I think you all can appreciate that that isn't necessarily realistic for a five-person public body to participate in a process like that. So the idea here with this delegation that I've drafted is to just allow the board to be more flexible and nimble and capable of you know effectively and efficiently doing that work that's going to be required in coordination with AHS and so the board's statutes allow for delegations of authority specifically 18 VSA 93 74 D states that accept for final decisions in regulatory matters over which the board has jurisdiction. A member of the board a board officer or board employee may perform any service that is within the board's jurisdiction and which the board delegates to the member officer or employee. The statute also requires the establishment of procedures to ensure that the board remains informed regarding delegated activities. So in accordance with this statute the delegation would give a fairly broad authority to negotiate on behalf of the board with respect to any amendments or modifications to the agreement or any subsequent agreement. That delegation of authority would not however extend to the final decision to sign an agreement. That authority would obviously remain with the full board kind of consistent with the statute. The delegation would also specify that the board would receive updates from time to time regarding the activities pursued under the delegation. Obviously there may be times when there's no update update to provide or when more frequent updates are called for but it would just set a kind of baseline expectation of periodic updates. And as you can appreciate some of these updates may need to occur in an executive session and the open meetings law as you know has a few provisions that would allow you to consider and discuss contractual matters in an executive session. Obviously two board members is not a quorum and I would suggest that the delegation named two board members here and my recommendation would be that Kevin as the chair be one of those and that the other be Robin just because I think her prior experience in these types of negotiations as well as her kind of legislative drafting background would be really helpful. So that's all I had. Happy to answer questions you guys may have about the draft. Questions for Mike? Would someone like to make a motion? Normally would but it seems odd for me to make the motion so I was thinking maybe I should not. Sure I will. I move that we vote a delegation authority to Kevin and Robin in the upcoming negotiations in the all payer model as outlined by the buyer. Is there a second? Second. Okay is there discussion from the board? My only discussion is that at the end of this first five years we've run into this virus which I think has you know really kind of thrown everything up in the air greatly and so I just you know think that we need to be very observant of that and careful as how you know we move from the first all payer agreement to this revised agreement but once things settle down in hopefully a virus free world that this second agreement be very specific about what defines success or failure my feeling is over the first four years or five years the infrastructure has been put in place to implement this and I agree with the concept that this is a test there's no guarantee of success but we are you know kind of the one of the leading states in the country trying to reform our healthcare system and put it on a more cost effective and health effective basis and this next agreement really clearly I think has to define what that means and provide very clear measures as to what what is success and and what isn't. Other members of the board hearing none before I go to a vote I'm going to call on the public for public comment. Does any member of the public wish to comment on this motion for a delegation of authority regarding negotiations? Susan Aronoff. Yeah Mr. Chair you might not have been here the last time the Green Mountain Care Board negotiated the all payer model agreement but I was I was in a different role at the time and the Green Mountain Care Board had a very different chair and some very different staff members some of whom you know just really actively brought people together to shape the the current agreement we're all operating under and it wasn't a very open and transparent process so whoever has the authority and however you know the board conducts itself with executive sessions and whatnot I would just implore you to be as open and transparent and let the stakeholders and not just those this was the quote that was given to me when I was a state employee at the time that the meetings were closed these were some of the Richards lost the meetings unless you had money on the table skin in the game that was the exact quote and I have it in an email so I would hope that with this round with different people and some lessons learned that there be more transparency in the negotiation process especially since the services that are not currently under financial perhaps those that only Medicaid pays for long-term long-term care services and supports for people with disabilities in the community since those services are now going to be on the table I would just implore you to let some sunshine in so people know how this agreement might impact them and people with disabilities their family members and their service providers with that thanks thank you and good luck thank you Susan is there other comment from the public other comment from the public if not is there any further discussion from the board hearing none all those in favor of the motion signify by saying aye aye those opposed signify by saying nay let the record show it was a unanimous vote thank you mike thank you is there any old business to come before the board hearing none is there any new business to come before the board hearing none is there a motion to adjourn so moved second second it's been moved and seconded to adjourn all those in favor signify by saying aye those opposed signify by saying nay so in closing I would just like to wish everybody a very happy new year and please be safe over the holiday Vermont has been very good up until today but we are very close to really having a significant portion of the population on schedule to get vaccinations and I know that healthcare workers have already been receiving those and I know that from talking with CEOs at hospitals that there has been a general sense of real happiness from members of the staff being able to be vaccinated looking forward to their second shot and that time period that would elapse that would then put them in the position that they are truly immunized so with that happy new year stay safe and see everyone in 2021