Childhood & Adult Obesity Task Force Regular Meeting
June 4, 2010
Meeting Minutes
Task Force Attendees: Lucy Nolan, Co-chair; Marlene Schwartz, Co-chair; Andrea Rynn; and Neil Vitale
Office of the Healthcare Advocate: Africka Hinds-Ayala
SustiNet Consultants: Linda Green
Excused: Christine Finck; Jennifer Smith-Turner;
Marlene Schwartz opened the meeting by welcoming Task Force members.
The April 23, 2010 meeting minutes were approved without correction or changes.
Marlene stated that the two co-chairs made the Childhood & Adult Obesity Task Force presentation at the June 1, 2010 SustiNet Board of Directors meeting. Lucy provided a briefing of the presentations stating that it was an opportunity for the eight groups to get together to share their work status to date and determine the intersecting factors among the groups based on the template provided. There were a number of questions and discussion points regarding eating habits, breastfeeding, body mass index (BMI), healthy eating behaviors, and charge a higher premium for those who are overweight / obese.
Marlene said it was clarified at this meeting that the taskforces are charged with developing a statewide plan to address specific healthcare issues: obesity, tobacco use / cessation, and healthcare workforce; whereas, the committees are charged with developing the SustiNet Health Insurance Plan that will incorporate the specific healthcare issues. The final Obesity Task Force report will distinguish which recommendations are about the SustiNet Health Plan design and which are about statewide health policy, which the task force was more focused on. All comments and feedback was incorporated into the template that was presented. The suggested outline for the final report will determine the structure and concerns to be addressed: description of the recommendation; identify opposition to the recommendation; determine the successful factors of the recommendation; expected outcomes; governance of the recommendations; cost; categorize the short-/long-term goals; and low-/ high-level of complexity of the recommendations.
Linda Green said there was discussion regarding fiscal impact of the recommendations and to determine the income and expenses at this point would be difficult. The work of the taskforce is to make recommendation about program components and not to design a health insurance program.
Lucy Nolan said that there are various obesity cost determining factors and impact websites available (United Health, CDC, etc.). Marlene said that there is the Connecticut obesity related medical expenditure that is provided annually; in addition, there is data from the Eric Finklestein’s 2004 report: Obesity Research that has state level medical expenditures attributed to obesity. Lucy stated that more recent data includes a February 2010 fact check broadcasted on CNN; the information stated in the media report was gathered from a 2009 White House / CDC report, which reported that annual obesity–related medical expenses topped $147B annually within the United States and that it cost 42% more to treat an obese individual versus the person of normal weight. Marlene feels that the data is incomplete to truly calculate costs. The cost categories will be excluded.
There are recommendations to add that are cognizant of pre-conception weight and the impact on the fetus (Marlene will research guidelines with the Mayo Clinic, March of Dimes and OB/GYN Physicians). There maybe a discriminatory factor with a physician suggesting a mother loose weight before conception, but it no different from the physician warning woman against tobacco and drug abuse before conception. The group agreed that the SustiNet Health Plan includes nutritional consultation for women who are planning to get pregnant and/or overweight as policy and program design. Africka Hinds-Ayala said that state-employee health insurance plans do support breast feeding and offers free breast pumps to the nursing mother. Marlene said this will be included as a recommendation.
Marlene discussed the possibility of a financial reward for healthy behavior, but obesity is not an actual behavior for every case because it can be genetically or medically related as opposed to self-inflicted. There are no studies substantiating paying individuals to loose weight and keep it off. The recommendation is to SustiNet continue track the research and strategies that work.
Marlene stated that the Health Disparities and Equity Advisory Committee have been very supportive of the task forces efforts. As the members continued to discuss the listed recommendations of toys removed from fast food meals for unhealthy choices, food bank point system (more money/points for purchase of fruits and vegetables), healthy foods in neighborhood “bodegas” that are competitively priced, bariatric surgery (gastric bypass, lap band, gastric sleeve) with covered services to include surgery, nutritional, psychological, and emotional counseling, and recording adolescent abnormal weight gain and loss (which is used with a special code to approve gastric bypass surgery)
Marlene mentioned the effects of medication on weight gain, specifically with ADHD. Linda said these are issues that should be watched to indicate that the taskforce is aware of them. Neil Vitale said ADHD is co-morbid with obesity; there maybe a causative or additive effect of the medications. Neil said Adderall was originally marketed as a weight loss drug for adults, but FDA removed the licensing.
The report will complete and finalized before June 21, 2010.
Meeting was adjourned.
