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Minutes: February 18, 2009

    3 p.m., Wednesday, February 18, 2009
    School of Medicine Administration, Board Room 103

PRESENT: Drs. Armstrong, Barker, Brayton, Chou, Chuck, Cooke, Goldstein, Green, Halushka, Herman, Ishii, Maragakis, McCarthy, McGrath-Morrow, Molinaro, Nussbaum, Pidcock, Pomerantz , Regan, Sargent, Schramm, Stivers, Wong, Mr. Pirruccello, Mss. Bruno, Fairman, Nguyen, and  Foy.
ABSENT: Drs. Allaf, Bennett, Bergles, Cromwell, DeLeon, Efron, Fine, Flynn, Huang, Leahy, Magaziner, Mooney, Reading, Resar, Robinson, Tompkins, Tufaro, Wong, Yaster, Yehia, Zhen,  Messrs. Chen and Feng, Ms. Oliver

GUESTS:  Drs. Baumgartner and Clements, Mr. Wilczek, Mss. Langley and Simon

I.  Minutes

The minutes of the January 21, 2009 meeting were approved. 

II. Chair’s Report – Dr. Armstrong

    The May meeting has been rescheduled from May 20th to May 6th to accommodate Dean Miller’s schedule.  Topics for Dr. Miller to discuss should be forwarded to Dr. Armstrong in advance of the May 6th meeting.

Dr. Armstrong encouraged MSC members to arrive on time so the meetings will not be extended beyond 5pm.

III. Faculty Financial Concerns- Dr. Janice Clements, Vice Dean for Faculty

    Dr. Clements updated the Medical School Council on the School of Medicine financial situation.  A recent letter from President Brody outlined the challenges the University faces in the current economic downturn.  The School of Medicine may be in a slightly better position than other University divisions due to the anticipated increases in NIH funding as part of the Stimulus Package.  A $10.4 billion increase in NIH funding is anticipated with an emphasis on infrastructure and instrumentation grants.  Faculty were advised to keep in close contact with their NIH program directors for current information and application deadlines.

    The School of Medicine finances show expenses exceeded projected revenue for this fiscal year.  Dean Miller has asked each department to review programs to determine where reductions may occur.  Going forward there could be a reduction in the indirect cost rate from 64% to 62% with an estimated reduction of $8 million for the School of Medicine.  Reduced Medicare reimbursement and flat or reduced endowment income will negatively impact the bottom line in FY10.

    Dr. Clements noted the importance of faculty having accurate and timely information on school finances.  To this end, Dr. Clements and Mr. Grossi are working on providing a monthly/bimonthly financial update on the School of Medicine website.

    In response to questions, it was noted that lab technicians and postdoc fellows can be hired if grant support is available.  There is no hiring freeze on grant supported positions.

    Dr. Armstrong encouraged continued email communication with faculty in addition to information on the website.  Dr. Armstrong thanked Dr. Clements for her presentation.

IV. Clinical Practice Association – Dr. William Baumgartner, Vice Dean for Clinical Affairs and Mr. Kenneth Wilczek, Associate Dean for Clinical Practice

    Dr. Baumgartner updated the council on finances of the clinical practice association and on the newly designed Community Health Initiative that begins in June 2009.

    The Clinical Practice Association encompasses some 1,600 practicing physicians in 20 clinical departments at Johns Hopkins Hospital, Johns Hopkins University, and Johns Hopkins Bayview Medical Center.  The current structure was established in 1997 and expanded in 2002 to encompass Johns Hopkins Bayview Medical Center  physicians. 

    A financial comparison between 2007 and 2008 was presented.  It was noted revenue increased, but expenses outpaced the increased revenue.  Operating costs that contributed to increased expenses included faculty salaries, staff positions, and malpractice costs.  The mix of business comparison between 2007 and 2008 showed an increase in Medicaid and managed care case mix.  There was a decrease in Blue Shield, commercial, self-pay, and international charges.

    The CPA governance structure consists of thirteen members including six elected department chairs and three members-at-large from the faculty.  All committees reporting to the Board of Governors are faculty driven.  A major initiative of the board is to make it easier for faculty to practice in the Hopkins environment.

    Dr. Baumgartner commented on efforts to increase efficiencies through automation.
    In response to questions, Dr. Baumgartner commented on carve-outs and the impact on faculty. 

    Dr. Armstrong thanked Dr. Baumgartner and Mr. Wilczek for their presentation.

    Community Health Initiative – Ms. Anne Langley

    The Community Health Initiative grew out of concern for the needs of the uninsured and underinsured in our East Baltimore Community.  The primary objectives are to facilitate access to community-based primary care by helping patients overcome barriers and to improve availability to specialty care.  Patients have had access to community-based primary care, but have had difficulty accessing outpatient specialty care when needed.  The pilot program will target uninsured and Medicaid patients in the emergency departments at Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center.  Such patients will receive support to help them establish a primary care home.  Patients living in two zip codes: 21213 and 21205, meeting the criteria for the pilot program will be screened for insurance eligibility and financial need.  Such patients must work with a referral coordinator at the East Baltimore Medical Clinic to coordinate their specialty care access.  The referral coordinator serves as a gate-keeper for specialty care for eligible EBMC patients, assists with setting up appointments, helps patients overcome barriers to ensure attendance, and maintain relationships with patients to monitor ongoing care.

    As this is a pilot program to begin in June 2009 it was recommended that another presentation would be beneficial after more concrete operational plans and some experience with the pilot program was available.  The Medical School Council was supportive of the program. 

Dr. Armstrong thanked Ms. Langley for her presentation.

V. Conflict of Commitment Policy- Dr. Cory Brayton

    Dr. Brayton updated the Medical School Council on recent Conflict of Commitment deliberations.  The January 2009 proposed policy eliminates the 26 day per year threshold and recommends no specific day limit; a replacement policy recommends time spent on outside activities must be compatible with fulfilling one’s responsibility to the University and one’s appropriate academic pursuit needs to be determined by the department director (or designee) after discussion with the faculty member.  Reportable activities and services, review and management of professional commitments, prohibited activities, sanctions for non-compliance, and reporting procedures have been addresses in the proposed policy.  A written summary of the committee’s recommendations was distributed.  Comments on the proposal should be forwarded to Drs. Brayton or Armstrong prior to March 3rd.

VI. Medical School Council Elections- Julie Simon, Administrative Coordinator
     Ms. Simon presented a proposal to modify the Medical School Council annual election process from a paper to an electronic system.  The efficiencies in going to an email ballot process were endorsed by the MSC.

VII. Other Business   

There being no further business this meeting was adjourned at 4:30 p.m.

                            Respectfully submitted,

                            Mary E. Foy

Future Medical School Council meetings:
All meetings will be held in the School of Medicine Board Room (SOM 103), 3:00 to 5:00 p.m.
March 18, 2009
April 15, 2009
May 6, 2009
June 17, 2009