Hubert H. Humphrey Building
Washington, D.C.
The NCVHS Executive Subcommittee met for a half-day to do planning and evaluation, following the meeting of the full Committee. The following people attended the meeting, which was open to the public:
Committee members
Ex Officio Members:
Staff and liaisons
In a brief discussion, members endorsed the direction of the full Committee’s earlier discussion of responsibility for security topics, as noted below.
DECISION:
Discussion of this topic covered conceptual, structural, and process issues. Members reviewed different ways of framing quality issues, particularly those emphasizing healthcare and individual health status and those emphasizing population health, and they discussed how the Committee’s approach can integrate the two.
Structurally, the chief question was whether to keep the Workgroup as part of the Subcommittee on Populations. Mr. Hungate pointed out the overarching nature of quality issues and the small size of the Quality Workgroup, and said he was comfortable with the Workgroup’s current location within the Subcommittee on Populations. A decision to retain the current structure led to process questions on coordinating the work and purviews of the Quality Workgroup and the Subcommittee on Populations. One facet of this discussion concerned how to replace or institutionalize former Workgroup Chair Kathy Coltin’s role in integrating quality and population health issues. Mr. Scanlon suggested having HHS and VA agencies brief the full Subcommittee on Populations on these agencies’ quality research and data initiatives.
Looking ahead to the Workgroup’s future workplan, members were receptive to Mr. Hungate’s interest in looking at risk-adjusted outcomes, while noting the need to balance that activity with advising AHRQ on the National Healthcare Quality Report. It was noted that the respective roles of NCVHS and the AHRQ Advisory Committee (NAC) need to be worked out.
DECISIONS:
Members fine-tuned the procedures for ensuring that NCVHS members have opportunities for input into the evolving recommendations of other Subcommittees or Workgroups well in advance of the meeting at which they will be asked to act on those recommendations.
DECISIONS:
DECISION:
The question here was how, if at all, the subject of bioterrorism and public health should be on the NCVHS agenda. Members expressed some concern about the lack of compatibility between the national security approach and the traditional public health emergency approach. They also noted the significant financial infusion into the information infrastructure in the name of security, as well as the potential threats to privacy through the accumulation of information for counter-bioterrorism purposes.
DECISIONS:
The Subcommittee was receptive to Dr. Mays’ suggestion that the Committee’s attention be refocused on the models in the NCVHS 21st century health statistics report. In particular, the goal is to make sure everyone understands the implications of the models for the ongoing work of all facets of the Committee. Dr. Mays also encouraged that the Committee routinely discuss the potential population health impacts of whatever recommendations it is considering.
DECISIONS:
Mr. Scanlon explained that the best indications of Departmental objectives are the HHS Strategic Plan and the 10 Secretarial priorities. He suggested an update on these. Dr. Mays said that while in ways the objectives of NCVHS and the Department seem well aligned, there is concern that this is not the case regarding health disparities and the population health perspective. Members agreed to monitor this question over the next year or so.
Mr. Scanlon described the activities of the HHS Research Coordination Council, one of several Councils coordinating the activities of the Department. It has four workgroups on various areas of research, corresponding to the Secretary’s priorities. He suggested a briefing on the Council’s activities, as well as on a new NIH review of the conduct of clinical research.
DECISION:
Ms. Greenberg outlined the thinking of John Condray, the HHS ethics officer, on the acceptability of travel expense reimbursement for NCVHS members by an outside organization, when those members are speaking about NCVHS at meetings to which they are not directly sent by the Committee. She noted that the Committee covers the travel expenses of people sent as official representatives, but funds for this purpose are limited. Executive Subcommittee members engaged in a long discussion to clarify this issue, the principles involved, and the various applications.
DECISIONS:
Ms. Greenberg stressed the importance of getting Subcommittee and Workgroup agendas out in a timely fashion. She noted that this is the responsibility of the lead staff, in consultation with the Chair. If all the speakers have not yet been lined up when it is time to publish the agenda, a skeleton agenda stating the purpose of the meeting and general topics should be released, and then updated.
Ms. Greenberg also urged Subcommittee and Workgroup Chairs and lead staff to re- view and approve their meeting minutes more promptly, so they can be posted on the Web. She stressed the importance of minutes, both for maintaining the historical record and for communicating the activities of the Committee to the many who are interested, as required by the Federal Advisory Committee Act.
This led to a lengthy discussion of the need to improve the usefulness of the minutes, and particularly the need to keep them to a reasonable length. There was not perfect agreement on what is a reasonable length; but there was agreement that for testimony, the minutes can be supplemented by any materials submitted by presenters (e.g., PowerPoint slides and written text) that can be posted on the Web site along with the minutes and transcript. In such cases, the minutes need only briefly describe the presentation and presenter, with the main attention given to summarizing the discussion period. It was noted, however, that supplementary materials, including transcripts, are not kept in the files or on the web indefinitely, so the minutes must be self-contained as to the essence of the meeting. Also, some presenters do not provide electronic copies of their materials, and researchers who have not yet published their subject matter may not be willing to have their slides posted.
The review and approval process, as explained by Ms. Greenberg, is that minutes are submitted by the contractor, reviewed and corrected by lead staff, sent out to all speakers for review, corrected again (as appropriate and determined by the lead staff), and then signed by the Chair. These steps require someone with content expertise, hence the reliance on the lead staff and the Chair.
DECISION:
Dr. Mays commented on the Subcommittee on Populations’ desire for a Web site on population health. She also proposed finding a mechanism whereby members could stay abreast of and comment on the evolving reports and letters of their own and other NCVHS subcommittees and workgroups.
DECISIONS:
Dr. Lumpkin raised a request from the Chairs to try and lighten the load on Subcommittee and Workgroup staff members by raising the awareness of their supervisors in their “real jobs” about their NCVHS-related work. The Committee also wants to acknowledge the service of these individuals.
DECISIONS:
Mr. Rothstein raised a question about when, or whether, the Privacy Subcommittee should hold hearings on the enforcement rule. Executive Subcommittee members agreed that the Committee’s proper role is to look at the substantive rule in terms of any policy issues embodied in the rule that need consideration. They also agreed that no hearings should be held during the NPRM comment period.
DECISIONS:
DECISION:
Dr. Lumpkin then adjourned the meeting.
I hereby certify that, to the best of my knowledge, the foregoing summary of minutes is accurate and complete.
/s/ John R. Lumpkin 9/12/2003
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Chair Date