Negotiated rulemaking committee, Day 2

Lots of interesting, good-willed folks on the committee. The going has been slow to even agree on the issues to be discussed. [I should say it seems slow to me, one of the facilitators told me that it is just an average group in terms of getting started]. At this point, the meeting has felt a bit like running into a brick wall in preparation to visit the Dentist.

Update 4:40pm: we have agreed that the following topics will be next step priorities for us to discuss: (1) how to measure need; (2) whether there should be two designations (a la HPSA and MUA) versus one; (3) what are the definitions of two key concepts: underservice and access.

Update: 6:00pm. We ended with a plan for the next meeting in October, focus on the issues of whether there will be a single designation v. two (HPSA and MUA) with some input from HRSA about the range of programs that use the various designations. Further, we will discuss the concept of need moving into the related concepts of underservice (which I would define as the fit between the needs of a person and the health care available to that person; those obviously aggregate to population levels), and access. There is an interest in not moving directly to what can be measured as the first, even though data issues are an issue. Instead, I think we will try and decide what we would like to measure to designate areas as underserved and/or suffering from a provider shortage and then move to what we can measure. There are also several who rightly note that some things will be impossible to measure in any way other than via local efforts.