BOARD MEETING

VAAOM Annual Meeting

11/21/09

10:20AM

Attendance and Introductions

Shane Burras
Li Ming
Molly Beverage
Carol Cherich
Laura Cooley
David Ott- Treasurer
Kiki Colgan- President
Kerry Jenni- Secretary
Stewart Cohen- Director
Dale Walter
Jane Melrose- Director
Liz Fukushima
April Brumson
Molly Fleming

Candidate for VP: Shane Burras: verbal bio: Yo San grad, Beverly Hill relocation, hx of payor industry, movie sets, Kaiser employee, electronic medical records, 5 yr AAAOM board member treasurer, Dipl Orthopedic Acu training, advocacy for health insurance reimbursement, HR 646 education, advocate of business of acupuncture practice, chair of legislative committee this yr

Motion: Vote for Shane for VP of VAAOM seconded, 100% agreed, 0 opposed

Position of director of board of VAAOM, definition of “director”: no distinct on going responsibilities other than attendance of quarterly mtgs, knowledge of politics of acupuncture state and national, term is 3 yrs.

Li Ming announces interest in running for director position, currently rep for VAAOM on president’s council for AAAOM, motion to elect Li Ming by Molly F, seconded by Stewart, 100% agreed, 0 opposed

Stewart: access to old “egroup” of old files, Kiki and David working on hard copies of files for all to access

Kiki: review of 2009 work of board, David Ott joined board as treasurer, March CEU event with lonny jarret, well attended by national, thanks to Li for organizing speakers, April- AAAOM conference attended by Li and Shane, donated $650 by VAAOM to promote Sam as lobbyist in Washington, Friends of Acupuncture- recommended to donate non profit, Grand Rounds event in September hosted by Stewart along with picnic, Jane worked on website

Jane: Website: very close to have completion, Molly B on committee also, home page will be displayed later in mtg, member resource pg- downloads available for pts office forms, HR 646 letter to politicians, Molly- upkeep? Jane will be managing website, Jane and Kerry will work on newsletter quarterly, can subscribe to newsletter, member information will be sent to Jane she will update. Molly F- issues in past upkeep was slow for new members, Jane will work to upkeep more efficiently. Directory is up to date currently, announced to yahoo grp for paid members; yahoo grp is open to all. Stewart- questions finances for upkeep of website- will we pass responsibility to board member or hiring someone? Board will be responsible, update every few yrs for appx $50/hr, need to allocate in budget a few hrs per yr for maintenance, budget $100 for web hosting currently, $250 per yr is questioned to be allocated. Motion- allocate $250/yr for web maintenance (updating links to paypal, CEU events

Question Shane- advertising to support web site? Kiki- talked about developing tiers for herbal companies, Shane offers to connect Mayway, Kan, for advertising. Kiki- looking at WA state membership tiers of gold/jade levels for advertising costs, concern: will we edit corporate sponsorship, ex- Starbucks? Move to open floor to discussion- Shane- corporation must cover acupuncture to their employees, question: SEO- currently not tagged for google search. Jane- specific words for SEO? Molly- why open for advertising, currently we can afford it, use money toward legislation, Kiki- we would need finances to hire a lobbyist for VT, maybe look to in the future. Stewart- revenue stream currently based on CEU events not membership, national health care may be irrelevant not effect our day to day issues, will need a lobbyist eventually may need a corporate fund/advertising then. Our readership is so low currently, who would want to advertise? Mayway spent $10K on lobbyist funds, Li- would like to see a goal of dates expected, must finish something before moving on, should put discussion off for now. Hx- website contracted for with deposit for unacceptable work, time wasted, long delay, has been on agenda for years, Molly- corporate sponsors- Lhasa and Crane, no fee for advertising but discount to members? Ask Shane to join web committee, or sit in? WA state 3K platinum

David: Blogs: Shane answers big topics attract consumers, do we have capacity to post blogs? Yes, but newsletter is first, facebook? Facebook pg- easy, quick, may get lost in the shuffle

Yahoo gp public- concern about using grp to advertise? Stewart to post fee? Li- give VAAOM discount-

Newsletter- public or for patients? Quarterly update for anyone who uses website, no log in, patient or practitioner focused? Have not decided, talked about forming a committee. Website- discussion for tiered levels to be continued on egroup. Suggestions Laura- if we contract with SEO we could ask for general suggestions to increase traffic. Jane- 2 requests email for seminar in Plainfield- response must join the VAAOM to add to the group, members only to advertise, Molly F- not in favor to allow non acu to join the site, Molly B- must provide discount to members for us to post. Shane- policies and procedures regarding vendors? Previous experience of personality conflict accused- may need a policy and procedure. Request policy and procedures by web committee. Stewart- if it qualifies for continued ed for VT acus should be allowed if not should not be allowed, standard fee $25 for posting for something that qualifies to post group and newsletter, does not allow for membership just posting, keeps discussion private among members, should be professionally screened. Allow web master to apply screens. Dale- would like to screen for confidence, Shane- CA board publishes for consumers a brochure regarding consumer confidence. Could be member benefit. AAAOm also has a brochure.

Legislative: See handout.

Kiki phone conversation with sam burneli, lobbyist, needs help from state level, need to contact peer welsh, bernie sanders to sponsor bill, make phone calls, web link provided on hand out, please provide to your patients.

Shane- hx of HR 646 has been on the table for 10yr, reason- our profession not represented in DC, other professions lobbying DC in accelerated, organized fashion, national health care discussion, Medicare is first step to national recognition, challenges- not all states have licensure, other professions have 120 hr requirements PT, DC< MD, dry needling as modality to scope of practice. Liz- acupuncture not recognized as a profession? Shane- b/c not listed as Medicare provider, PT go to school less time, but are listed in Medicare providers, in hospitals, global coverage in policies and experiencing growth. Acus- providing needed service and need to distinguish ourselves, HR 646 defines qualified acupuncturist covered by Medicare, difficult d/t Medicare budget. However- baby boomers challenges, medication combinations, we provide cost effective non-invasive non-drug management, will reduce Medicare costs. Challenge- not represented. Sam burnelli, lobbyist, AAAOM interview many, 60K/yr to Burnelli, whose wife has had excellent success with acupuncture, and has excellent contacts. Direct access to female legislatures in NM this yr, 38K spent on activism. Medicare fact book- will not be mandatory for everyone but is necessary for national health care for the first time n 25 yrs in profession. Rec- join facebook advocacy grp, need more then just professionals, need patients. Everyone must get pts to send in to politicians. Need many letters to gain attention. Concerns- will Medicare be mandatory- NO, changes to practices to see Medicare pts, need to send electronic claims, no training offered by Medicare, provides manuals, after bill passes, educational opportunities, must have computer, must take good notes, Medicare will come to your door and ask to see chart notes, if you can’t provide them they will require reimbursement for pass paid fees. Must come into mainstream, if you chose to take Medicare pts. Consequences if our profession does not do this- we will disappear. DC, PT, and MD will take over. Micheal Terramina- lawyer for AAAOM. Question- optin in/out Medicare? Must understand Medicare system, step one enrollment- fill out paper work to be credentialed/in system. Then chose to accept Medicare or not. If yes, fee schedule, example LA is $45, VT is probably $40 for CPT acupuncture, there are additional service (manual therapy, heat therapy, nutrition advice) additional not covered in bill. Only need to enroll if you will see Medicare eligible pts, mandatory submission electronically. Discounting services- rules apply must practices within these rules. Stewart clarifies, 100/service Medicare pays 40, you cannot bill 100, can only collect 40, cannot bill remainder to pt. Must charge same amt per service to all insurance/Medicare. Must have set fee schedule, posted and available. Copay with Medicare- 20% plus deductable. Shane distinction charge for services you decide, no on can tell you how much. Ins company/Medicare can set schedule for reimbursement. Can set two separate schedules for Medicare pts and non. Not recommended. Rec- set standard fee structure. Must charge same amt for all insurance co. Rec- have a bill service. If you do not accept Medicare, you can enroll but not accept, you will not abide by Medicare schedule but will not collect more then 120% of Medicare approved charge. Medicare supplement policy- get Medicare age 65, purchase policy that pays % of part B services, most beneficiaries opt in to this. Providers receive 100% reimbursement for these pts. Most professions agree and abide by Medicare rates are minimum wage. Will receive a fee schedule to decide if you want to apply based on CPT code adjusted by zip code. Once in to Medicare, CPT codes will be renegotiated, and may decrease every yr d/t budgets. Benefit- access to huge part of population. Will see more pts. April- EMR will be required for a certain reimbursement rate, less without. Shane- not at the beginning, no difference. Options for EMR that are cheaper. Upsides- can accept referrals electronically. MD can create referrals directly via electronics. Must chart electronically and document electronically. Unsure since acu is not part of stimulus, b/c we are not part of Medicare, if we become, can we receive part of the stimulus. Opting out- process to create private contract, signs form with individual pts to agree to not pay via Medicare. Not offered in 646, trying to add it. Should not be difficult to add on to bill. This is not opting out of Medicare system. If pt signs to not send electronic records, you are not required to so you don’t violate HIPAA. Student loan payback is not part of this bill, we want it to be. Provisions require primary care, not within our scope nationally. VT could be primary/direct entry since we don’t require referral, trying to add to bill. Scope of practice- trying to bring it up, WA pres. Recommend bringing scope unified, not separate, change massage therapy to manual therapy.

Membership 46 active licenses 130, ¼ have out of state. Recommended to send letter of invite to list of acupuncturist in state not just paid members.

David Ott Treasurer- Started January 09, budget for 2010, need to streamline treasure system so next treasurer will be able to take over with more ease. Last yr this time balance pay pal and checking acct

35932 combined

36045 this yr

Surplus this yr due to CEU event, thank you to LI

CEU event net 3379.42

Practitioner fee $275 for CEU event this yr

Korean and Chinese groups very successful, CEU events provided with membership fee ($60). Bring in high-ticket speakers who sell books. We offer grand rounds free of charge. No payment for grand rounds speakers. Paid this year, Stewart. If all 46 members renew- will not cover this yrs budget. Molly questions non-profit status, we are non-profit to date. SEE ATTACHED BUDGET

Legislation budget may not be enough.

Li CEUs 2010

2 types of cues- local events to benefit locals, and big name people to draw out of state acus. Now- focus

NCCAOM requires ethics and CPR for cert, NESA class in April, 2010 Micheal Terramina talk on ethics, Shane for update?, Helen Dermit requested Tibetan medicine CEU event, Betsy Smith from NNCAOM would speak about ethics, Dale- check local hospital for CPR free often frequently, Red Cross? Liz- should not be a high priority of this group. Li- combine CPR and ethics? Insurance billing CEU event? No interest. Pulse Diagnosis CEU event recommended by Molly F, contemporary pulse dx, trying to organize pulse seminar, Ross Rosen, small grp required- 15, may not be profitable. Emerson ecologics may want to sponsor. Bringing to VT saves members money to bring locally. Laura- NADA training requested last yr.

Liz OPR New database for OPR, renew licesenses in Jan, if licensed to practice herbs will have additional # on license, for “new” practitioners, can update if you become licensed, will be searchable on license. Herbs definition- unsure, what is the burden if you offer your services for herbal. If not acupuncturist can practice herbs unregulated, if licensed you can only practice if you have been trained to do. B/c we are licensed we are held to a higher standard, concern others are recommending who are unlicensed. Burden- state of VT reluctant to license new professions. Last issue of practicing without a license 1K fee. Def of acupuncture scope is strange and needs work. Designated two different scopes, this yr. Role of advisors- Glynn wrote incorrectly- acu advisors are not advisors from profession to the office. No profession is the advisor the link from OPR to profession. Advisors offer advise to OPR not link to profession. Cannot be an officer of this profession’s prof association. Inappropriate for Liz to invite Dan Sachs, is not the role of this position. Liz does not agree with email from Glynn, Stewart responds acupuncturists originally agreed/understanding that we would work together with the VAAOM community. Liz- some prof have boards, some have advisors, advisors serve as board. Stewart- why do they have to be acus? Liz- b/c you answer questions about acu. This organization does not rep all acus in state, just members. No public member. Molly F- same issues in NDs. If profession has issues that they want brought before OPR, need committee to bring to OPR, Chris Winters, head of OPR, always happy to hear from prof membership organizations. If we want VAAOM issues should elect another person, not the advisor. Stewart- does not make sense the advisor would have a deaf ear to the community. No communication does not make sense. Liz agrees, but the advisors may not have same opinion as VAAOM. Li- pt who’s OPR rep and board member of dieticians. Cannot be both roles. Molly B- needs to have impartiality, work on complaint cases. A personal agenda in direct contradiction to community is the problem. Molly F- avenues to change things are often difficult and do not represent the profession well.

Laura- NH organization- changed name d/t word Oriental, bill in DC was dropped d/t the word Oriental, changing to ASIAN. To avoid future discrimination concern. Shane- legal language changed from Oriental to Asian. Li- word Oriental not allowed in NY. Oriental is not allowed to describe people. Probably will be used for whole country. Stewart- no difference, Asian refers to location Asian Bodywork has been licensed in NH, acupuncturists not happy, but voted to allow them into association. Bodywork not licensed in VT at all. Asian and massage together connotation sexual. Subject in NH to initiate NH/ME/VT regional mtg, VT is interested.

Liz- asks Laura who in VT is NADA certified? Brattleboro retreat looking for supervisor, no qualifications for supervisors, just complete NADA training.

Stewart- inclusion, lots of issues through the yrs about issues, we will all benefit from max inclusion. Look for a way to include all. Send letter to all acupuncturists in state, mission to grow profession, uniqueness comes from being excellent.

Li- thank you more to Stewart, legacy of work of board should be continued and thanked. Learn from the past, important role.

Molly- Rachel sent email about doctoral level, ACAM topic at national level. AAAOM will be asked to provide stand, Shane does not have an opinion on topic at this time. Open to hearing everyone’s opinions. Molly F same goal for the PTs, some states have it. Most organized profession and engaged, marketed well. Targeting specific states, need to be aware and cautious of. Fine line btw dry needling and acupuncture.

Laura- NADA one page paper of different styles and education levels.