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Elizabeth "Liz" Bowyer's Files
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Withdrawal/Redaction Sheet
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001. fax
From: Megan Moloney, To: Liz, Re: Info on Lincoln Center, Floor
2/17/94
b(7)(E)
Plan (1 page)
002. list
Great Plains' Summitt - Citizen Participants [partial] (2 pages)
2/15/94
b(6)
003. list
Profiles of Discussion Participants [partial] (3 pages)
nd
b(6)
004. schedule
Schedule for Hillary Rodham Clinton, Draft #5 [partial] (3 pages)
2/18/94
b(7)(E)
005. schedule
Schedule for Hillary Rodham Clinton, Draft #6 [partial] (4 pages)
2/18/94
b(7)(E)
006. list
Citizen Participants [partial] (2 pages)
2/15/94
b(6)
007. schedule
Schedule for Hillary Rodham Clinton, Draft #2 [partial] (1 page)
2/18/94
b(7)(E)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)|
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information |(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute ((a)(3) of the PRA]
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information [(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy ((b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes [(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions |(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
FILE
Memorandum
TO:
Chris Jennings
FROM: Mike Brogioli, Senator Daschle's office
RE:
Great Plains Summit on Rural Health Care
DATE:
January 20, 1994
I. Format of the summit
The Great Plains Summit on Rural Health Care is scheduled to be held near Sioux Falls, SD on
February 18 at Lennox High School (approximately 30 minutes from the Sioux Falls airport in a
rural farming community). As in Boston, citizen participants and members of Congress will be
invited to join Mrs. Clinton to engage in dialogue on the need for reform and the various proposed
solutions. The focus in Sioux Falls will be on rural health concerns. Members of Congress,
citizen-participants and audience members will come from South Dakota, North Dakota, Iowa,
Nebraska and Minnesota. We anticipate an audience of approximately 1,500.
Suggested format for Great Plains Summit:
Roundtable discussion structured around rural health care issues--an opportunity
to tell Mrs. Clinton about the unique health care problems of rural America (i.e.
scarcity of providers, inadequacy of health insurance, problems small businesses
face, distances from sources of care, etc.)
Members of Congress will participate alongside citizen-participants; long-winded
speeches will be discouraged.
Mrs. Clinton will be asked to give brief (10 minutes max.) opening remarks
and engage in discussion with members and citizens over the course of the two
hour summit.
II. Citizen-participants
At a January 10 meeting of the region's congressional health staffers, we agreed that each office
would contribute a short list (4-6 names) of citizens who should be considered for inclusion at the
summit table. These citizen-participants will come from different walks of life and will play a
central role in the discussion on February 18.
The following categories are under consideration:
Small business people (employers and employees)
Providers (hospital/clinic administrators, doctors, nurses, physician-assistants
etc.)
Farmers/Ranchers
Students
Homemakers
Senior citizens
Disabled/chronically ill people
Native Americans, other minorities
Small town government leaders (i.e. town councilors, school board members)
Insurance reps (small company agents/large companies)
Veterans
Migrants/cyclically employed
III. Breakout Sessions
As in Boston, we would like to hold several breakout sessions following the roundtable
discussion. These sessions will be similar to the workshops conducted during "Health Care
University" and will give general audience participants as well as members of Congress and
citizen-participants a chance to voice their concerns and learn more about reform.
Ken Rynne at the DPC is coordinating this effort. If you have suggestions for breakout topics,
please contact Ken at 224-3232.
IV. Pre or Post Summit Events with Mrs. Clinton
As you can imagine, we are getting plenty of requests from South Dakotans for Mrs. Clinton to
visit clinics, hospitals, nursing homes, etc. We would love it if Mrs. Clinton could make at least
one site visit with Senator Daschle, perhaps to a health care clinic in Lennox. Please let me
know if this is possible, and if she would like to make a visit either before or
after the summit.
Another idea that has been raised is to have Mrs. Clinton visit the school's auditorium immediately
following the summit to greet students and take a few questions (they would watch the summit on
closed-circuit TV).
V. Next Steps
We should meet sometime next week to discuss plans for the summit. Also, as you suggested, we
should schedule a meeting with congressional staff representing the five-state region. Please let me
know what time/dates look good for these meetings.
I know that it is not possible for the White House to give a 100% firm
commitment that Mrs. Clinton will attend on February 18, but unless I hear
otherwise, it is my understanding that we can announce her plans to attend on the
18th. You indicated that she would probably fly to Sioux Falls that morning to
attend an early afternoon event. Is this still the case? We need to firm this up
right away in order to print invitations, alert the media, etc. Please let me know
as soon as possible. Thanks!
01/26/94
17:08
1 605 334 2591
SEN. TOM DASCHLE
DC
5.
002/004
To:
Mike B., et al
Fr.
Erp
RE:
Floor plans
Here are the floor plans for the two different sites: Lennox High gym and Augustana College's
Elmen Center.
The Elmen Center has three full-sized basketball courts and bleacher seating for 3,700. The floor
plans show two viewing areas and two large classrooms. We would easily be able to accomodate
the break-out sessions and a working press area.
The Lennox gym is roughly one-third the size, with less than one-third of the bleacher seating.
I hope this gives you an idea of the layout and differences between the two sites. Give me a call if
you have any questions.
26/94 17:09
01 605 331 2591
SEN TOM DASCHLE
DC
Music room ( Holding room for MB. Clinton
H
Bleachers 200 to
-Capacity 250
(Raised stage)
45'
Tt
1
1
BLEACHOAR rasneites 500
LENNOX
90'
GYM
BLEACHEDS- Capacity 500
PRESS RISERS
t
I
Bagging Track
Jopping Trace
Multi-Up Forms
LOBBY
Maid Or Feasus
Offices
Hell
Women's
A complete
of
Verwing
Viswing
Fame
Area
Area
Wrestling
Locker
Requelbal
Rooms
Recquethal
Doyris
Storege
Reduction
HPER
Ouprts
Suimming
Weight Training
Swimming
Paol
Pool
First
Second
Trainlay
Men's
000 4091
Floor
Locker
facility
Floor
Classistor
Classionm
Rooms
Team advantage when the Elmen
There will be a running track; swimming pool; a multi-purpose exer-
Center will provide a mulli-purpose
cise room for wrestling and dance; racquetball courts; practice and
ntion and recreation. It will include a
competition courts for basketball, volleyball, and tennis; weight room;
of William P. and Irene Hall, with sea-
training room; classrooms; kilchen; conference room; offices and
more.
THE WHITE HOUSE
WASHINGTON
MEMORANDUM TO FIRST LADY HILLARY RODHAM CLINTON
FROM:
John Hart
DATE:
February 18, 1994
SUBJECT: South Dakota and the Health Security Act
I.
Summary and Background
South Dakota is behind most states in respect to health
reform legislation. With over half of the state rural,
South Dakota is one of the least densely populated states in
the nation, with 28% of the population underserved.
Consequently, South Dakota's reform initiatives have focused
on rural health care and financing and delivery reform.
Governor George Michelson, a Republican, was one of the few
governors designated by the National Governor's Association
to represent the government on the Health Care Task Force.
He was a strong advocate for rural health care concerns. He
was killed in a plane crash in April 1993. Governor Walter
Miller, also a Republican, replaced Governor Michelson.
II. Health Care Reform Efforts
Reforms underway in South Dakota are similar to the goals of
the Health Security Act. Increasing access to care in rural
areas and improving rural health care infrastructure will be
bolstered by increased funding under the Health Security
Act. The Health Security Act develops strategies for
delivering and financing health care in rural areas that
will benefit South Dakota.
The legislature considered a bill to reform how insurance
can be sold to individuals and employer groups, but the bill
that was passed was a much weaker than the one Governor
Walter Miller had proposed, and he vetoed it.
The legislature did approve a resolution to support an
existing health care commission, created in 1992, and called
on it and other state agencies to study managed competition
among other strategies, systematically implement national
health reform measures as they are instituted and initiate
state-based measures to fill the gaps and impose reforms on
areas within its jurisdiction.
Reforms already underway include the formation of integrated
rural health care delivery systems, a consumer education
program to promote healthy lifestyles and cost conscious
health purchases, a centralized data system, and changes in
Medicaid and state employee health insurance programs. An
interagency workgroup with an advisory commission that
includes legislators, consumers, business, providers, and
insurers supports these activities.
Regulation of small group insurance includes guaranteed
renewal and rating bands that limit the difference between
the lowest and the highest premium rates charged to
different groups of employers with different risk
characteristics.
Rural Health Care Reform, Effective July 1, 1992
During the 1992, $250,000 was provided to improve rural
emergency medical services -- ambulances, emergency medical
equipment, and emergency communication equipment.
Municipalities and counties are authorized to guarantee
bonds issued to private nonprofit hospitals for the purpose
of raising money to help finance physical improvements and
equipment in facilities. The law is intended to help rural
hospitals especially. South Dakota is the first state in
the nation to implement this approach.
III. Demographics
703,000 -- Total Population 1991
13.3%
-- Population Below Poverty 1990
50.0%
-- Rural Population 1990
7.3%
-- Native American 1993
Health Insurance Coverage
10.2% -- Covered by Medicaid
16.5% -- Covered by Medicare
78.2% -- Covered by Private Payers
9.9%
-- Uninsured
Medicaid
64,000 -- Recipients in 1992
$231,000,000 -- Medicaid Payments 1992
$3,597 -- Medicaid Payments per Recipients 1992
23.6% -- Medicaid Expenditures as a Percent of State Budget
70.27% -- FMAP FY1993
Managed Care
1 -- HMO in 1992
2.9% -- Population enrolled in HMO in 1992
0 -- Operational PPO in 1990
Hospitals, 1991
64 -- Total in the State
6
-- PHS Indian Hospitals
1
-- Psychiatric Hospital
3 -- VA Hospitals
1 -- Hospital at Ellsworth Air Force Base
February 17, 1994
OFFICIAL PHOTOS WITH SUMMIT CO-SPONSORS
DATE:
Friday, February 18
TIME:
11:45 am
LOCATION:Lennox High School
FROM:
Liz Bowyer, Angela Buchanan
I
PURPOSE
To take official photos with the co-sponsors of the Great Plains Summit on Rural
Health Care.
II
BACKGROUND
The co-sponors of the Summit are:
The Argus Leader, the Sioux Falls paper and the largest paper in South Dakota
KSFY-TV, an ABC affiliate
Non-profit
III
PARTICIPANTS
HRC
IV
SEQUENCE OF EVENTS
HRC arrive in the holding room.
HRC takes photos with sponsors
HRC proceeds to Forum with Senator Daschle
V
PRESS PLAN
Closed Press
VI
REMARKS
Informal
FEB-17-1994 17:35 FROM MMRF EPI/BIO
TO ##11112812024562317 P.18
Attachment 5
SPECIAL
Committee, to do something positive to meet health
care problems. Mr. Laird contended that public
The Greater Marshfield
pressure was so great that Congress would be com-
pelled to cnact sweeping health reform measures,
Community Health Plan-
probably by 1972 but certainly no later than 1975.
Hc and we were concerned that background infor-
A Community Experiment
mation being utilized in Washington had been ac-
cumulated primarily from the Kaiscr, HIP, and
RUSSELL F. LEWIS, MD
other plans, the only sources of adequate statistical
Marshfield, Wisconsin
data. However, we felt that these groups were selec-
tive and not representative of the population area
they served. This and other factors caused us to
question whether the statistics were meaningful in
ON MARCH 1, 1971, the first group of participants
our context.
started receiving health care under the Greater
Marshfield Community Health Plan (GMCHP), a
Our interest led to meetings with two Wisconsin
prepaid medical care program jointly sponsored by
companies in our area, Employers Mutual Insurance
the Marshfield Clinic, St. Joseph's Hospital, and
Company of Wausau and Sentry Insurance Com-
Wisconsin Blue Cross and Surgical Care Blue Shield
pany of Stevens Point, to discuss proposals that
of Milwaukec. Approximately one year of negotia-
would provide the entire population of our area with
tion went into preparation of the plan.
an acceptable comprehensive plan. Later, Wisconsin
Physicians Service (WPS Blue Shield) joined the
Our initial interest was stimulated by a strong
discussions. Originally we involved the physicians
belief that public opinion was forcing the federal
from Marshfield, Wisconsin Rapids, Stevens Point,
government to establish new pathways for accessibil-
and Wausau. After a series of meetings and a trip
ity of care and to attempt control of the increasing
to Washington, the Department of Health, Educa-
cost of medical care. We believed that most prepaid
tion, and Welfare suggested a survey in our area,
programs, health maintenance organizations, and
and the Comprehensive Health Planning group was
other proposed solutions did not meet what the
selected. Meanwhile, the Office of Economic Oppor-
American public is demanding, namely, total com-
tunity (OEO) asked to be involved in the survey.
prehensive health care at reasonable cost to every
This was cleared with Washington and, in the sum-
citizen regardless of income, geographic location,
mer of 1968, OEO canvassed households in five
or state of health
SENT BY:
2-17-94 :12:14PM ;
OBEY'S OFFICE-
COMM/RESEARCH:# 1/1
MEMORANDUM
TO: LIZ BOYER
FROM: MARSHA BENEDETTO
DATE: 2/17/94
RE: CONGRESSMAN DAVE OBEY'S BETTER WAY CLUB
THE BETTER WAY CLUB WAS ESTABLISHED 20 YEARS AGO BY THE CITIZENS FOR DAVE OBEY
COMMITTEE TO BE THE CHIEF FUNDRAISING ARM OF HIS CAMPAIGNS. IT IS THE
PRINCIDAL METHOD TO BRINC SMALL CONTRIBUTORS INTO THE CAMPAIGN.
THE BETTER WAY CLUB DRINGS SPEAKERS TO THE 7TH CONGRESSIONAL DISTRICT TWICE A
YEAR. AFTER SHORT INTRODUCTORY STATEMENTS BY OBEY AND HIS GUEST, THEY ANSWER
QUESTIONS FOR AN HOUR. AFTER THE PROGRAM, PEOPLE ARE ABLE TO SHAKE HANDS WITH
THE GUEST.
PAST GUESTS HAVE INCLUDED JIMMY CARTER WHEN HE WAS PRESIDENT, HARRY BELEFONTE
(THE PERFORMER), CONG. DAVID BONIOR, SEN. GEORGE MITCHELL, CONG. DICK
GEBHARDT, FORMER SENATOR GAYLORD NELSON, SECRETARY MADELINE ALBRIGHT, CONG.
NANCY PELOSI, AND IN APRIL OF 1993 SECRETARY DONNA SHALALA.
THIS TIME WE ARE HAVING A PRIVATE RECEPTION AT THE WAUSAU CLUB (A PRIVATE
CLUB). WE EXPECT 450 PEOPLE TO BE THERE, WE HAVE THE BALLROOM RESERVED WHICH
HOLDS 500. THE RECEPTION WILL BE FROM 7:30 PM - 8:15 PM. PEOPLE PAID $100
EACH FOR THE RECEPTION. (THIS IS A HIGH AMOUNT FOR CENTRAL WISCONSIN!!!)
THE MAIN BETTER WAY CLUB EVENT IS AT THE GRAND THEATER, OUR RENOVATED "OPERA
HOUSE," ONE BLOCK FROM THE WAUSAU CLUB. IT HOLDS 1200, 800 ON THE MAIN
FLOOR. PEOPLE PAID $60 EACH FOR THE GRAND THEATER SEATS.
February 17, 1994
TOUR OF THE LENNOX AREA MEDICAL CENTER
DATE:
Friday, February 18
TIME:
10:30 am
LOCATION:Lennox, SD
FROM:
Liz Bowyer, Angela Buchanan
I.
PURPOSE
To tour the Lennox Medical Center with Senator Daschle, and have a brief discussion
on providing rural care with the staff of
II.
BACKGROUND
The Lennox Area Medical Center is a rural, store front clinic that provides basic
primary care for the residents of Lennox and the surrounding area. It is typical of
the primary health care facilities that serve this area. There is no hospital in this
area? closest one is 20 miles away in Sioux Falls.
The Center is staffed by a 2 part-time nurses, a physician's assistant and a one-day-a-
week doctor.
The Clinic Director, Dr. Larry Sittner will lead you and Senator Daschle on a tour of
the waiting room, patients' rooms, and clinical rooms of the Center. Will she see
anything else?
The Center opened in 1977, and until 1982 was owned and operated by the non-
profit Lennox Area Development Corporation, entitling it to federal rural health clinic
grant funds. Dr. Larry Sittner purchased the Center in 1982 and
Why did Daschle pick this?
Who are the patients? Profile?
The majority of patients they see is , young families
Dr. Sittner may have questions regarding the effect of health care reform on small
rural clinics like this one, and on family practice physicians, physicians' assistants
and nurse practioners.
S1138
CONGRESSIONAL RECORD-SENATE'
February 8, 1994
tant first step in addressing these prob-
In striking new postures for this nation
formed me of a problem with an overly
lems. Letting children pray will help
and its federal government, the Educate
strict interpretation of an environ-
reduce violence in our society more
America act clearly raises questions about
mental regulation. I did not respond
the balance between local control and initia-
than any gun control or antipoverty
tive, on the one hand, and federal powers on
that I could not help him until a ma-
program could ever do.
the other. Governors from both parties have
jority of cities face the same problem.
Mr. President, I ask unanimous con-
concluded that this legislation, while not
For the city of Hastings, there is a cri-
sent that I be added as a cosponsor to
perfect. is appropriate and workable. We are
sis now. II have heard from many No-
Senator HELMS' amendment.
committed to overseeing its implementation
braskans about health care problems.
The PRESIDING OFFICER. The Sen-
and will be quick to call for corrective ao-
For them, there is a crisis. It does not
ator from Nebraska is recognized.
tion if such proves necessary. I welcome your
matter to them whether there is a na-
support and assistance in establishing this
tionwide crisis. They need help now.
new national thrust and in furthering an ef-
GOALS 2000
fective partnership at all levels to make all
2. I AM FOR/AGAINST MANDATES TO PAY FOR
young Americans world-class learners.
HEALTH CARE
Mr. KERREY Mr. President, I would
Sincerely:
This argument is also irrelevant. We
like to respond and will respond to the
E. BENJAMIN NELSON.
already have mandates in place to pay
Republican leader and to the distin-
Governor.
for health care today. The idea that
guished Senator from New Mexico, but
Mr. KERREY. Mr. President, all the
the American people are reading op-ed
before I do, I will just indicate that I
concerns that I had for a heavy-handed
pieces either for or against mandates
do intend, after a considerable amount
approach from the Federal Government
when I have an imposed 3 percent man-
of deliberation on the subject, to vote
have been resolved, I must say. I appre-
date on wages now is an indication of
for the Goals 2000 proposal of the Presi-
ciate very much the Labor Commit-
how politicians have been misleading
dent. I. have some significant reserva-
tee's hard work on this, and the admin-
the public. This mandate is called the
tions but I spoke to anumber of the co-
istration's hard work on this. I remain
part A FICA Medicare tax. Individuals
sponsors of the legisfation and I spoke
concerned about some of the aspects of
and employers each pay 1.45 percent of
with Secretary Riley.
the legislation but, in general. it seems
payroll to finance health care.
Mr. President, I ask unanimous con-
to me it does provide a very good
3. I AM AGAINST NATIONAL HEALTH INSURANCE
sent to print a letter in the RECORD
framework for us to reform education
We currently have national health
from the Governor of the State of Ne-
from the ground up.
insurance. And there is a payroll tax
braska in support of Goals 2000.
I make it clear, Mr. President, those
used to fund it as discussed in No. 2
There being no objection, the letter
who, like myself and others, the distin-
above. We call it Medicare, but it is na-
was ordered to be printed in the
guished Senator from Massachusetts,
tional health insurance. You have to be
RECORD, as follows:
have pushed this legislation because it
65 years of age to qualify. Understand.
STATE OF NEBRASKA,
requires we set higher standards, make
I am not advocating extending Medi-
EXECUTIVE SUITE,
it clear that we as individuals, as par-
care for everyone, but for politicians to
Lincoln, NE, January 8, 1994.
ents in particular, but we as individ-
stand up and say they are against na-
Hon. J. ROBERT KERREY,
U.S. Senate, Hart Office Building, Washington,
uals, as citizens, are going to have to
tional health insurance, while support-
DC.
work harder. Our standards will not be
ing Medicare, is a very misleading ar-
DEAR BOB: The reservations you shared
achieved simply as a consequence of
gument. It makes it difficult for us to
with me recently concerning S. 1150, the
enactment of legislation. After discuss-
reach the correct solution to the
Goals 2000/Educate America Act, prompted
ing this with the sponsors and with the
health care problem.
me to double-check the substance and trust
Secretary and the Governor of the
4. I AM AGAINST USING BROAD-BASED TAXES FOR
of this major piece of legislation.
State of Nebraska, I come to the con-
HEALTH CARE
The language clearly states that nothing
sequence of believing this will indeed
Although the authors of virtually all
in the legislation can be interpreted by "any
give us a framework for doing real
federal official to mandate, direct, or control
the health reform plans, including
the curriculum or program of a state, local
grassroots groundwork support and re-
President Clinton, have proclaimed
education agency [school district). or school,
form of education.
their opposition to using broad-based
or the allocation of State and local re-
taxes to pay for health care. The fact is
sources." It also provides financial support
we are already using broad-based taxes
for systemic school reform. a new form of as-
TOP 10 IRRELEVANT ARGUMENTS
to pay for health care. We need to tell
sistance that has been missing from the fed-
IN THE HEALTH CARE DEBATE
Americans, fully 30 percent of your in-
eral array of narrow and mostly top-down
categorical federal education programs. Fur-
Mr. KERREY. Mr. President, I would
come taxes are being used to finance
thermore, the act provides for waivers from
like to respond to some statements
Federal health care spending. Not only
existing federal regulations if such waivers
made earlier by the distinguished Re-
are individual income taxes being used.
are needed for advancing local reform ef-
publican leader and the distinguished
but corporate income tax, payroll
forts. Finally, it assigns coordination and
senior Senator from New Mexico. They
taxes, and property taxes finance
oversight responsibilities for national policy
commended the courage of Robert
health care today. By stating that we
to an intergovernmental body dominated by
Reischauer, the head of the Congres-
don't want to use broad-based taxes to
elected state officials (the National Edu-
sional Budget Office.
pay for health care, we are avoiding a
cation Goals Panel, which I had the privilege
very important question, How are we
of chairing) and an independent standards
As the health care debate heats up
certification body (the National Standards
during the next several months, we
going to pay the bills?
and Improvement Council), not to the federal
need to be honest with the American
5. I DO NOT PAY FOR HEALTH CARE TODAY
executive or legislative bureaucracies.
people. I have heard several arguments
Many individuals and companies be-
We Governors are champions of America's
lately that I believe are misleading and
lieve that they do not pay for health
unique system of locally-governed public
do not contribute to an honest debate
care today simply because they do not
schools. We have worked hard every step of
on health care. The arguments are ir-
purchase insurance. In reality, as I al-
the way to ensure that this legislation pro-
relevant and do not begin to solve the
ready discussed, because a great
vides. an energetic and yet appropriate na-
tional and federal framework to support
health care problems facing our coun-
amount of tax dollars are used to pay
state and local education improvement ef-
try. I have collected these into a top 10
for health care, everyone is paying for
forta. Given the size and scope of the edu-
list of irrelevant health care argu-
health care today. We need to have an
cational challenge facing the U.S. in this
ments.
honest discussion on how we should be
fast-paced and tension-filled global economy.
1. IS THERE A HEALTH CARE CRISIS?
paying for health care 80 that everyone
and given the fact that states and schools in
Whether or not there is a health care
understands how much and in what
Nebraska and across this great nation are al-
crisis is irrelevant. We do not wait
manner they are paying.
ready actively engaged in significant reform,
it is incumbent on the nation as a whole to
until the majority of Americans suffer
6. I AM AGAINST A GOVERNMENT TAKEOVER OF
join in the process of challenging and assist-
a crisis to act. If a constituent notifies
HEALTH CARE
ing all young learners to higher levels of
me of a problem, I act on their behalf.
As is made clear by argument No. 4,
achievement.
For example, the mayor of hastings in-
there is already substantial Govern-
February 8, 1994
CONGRESSIONAL RECORD-SENATE
S1139
ment involvement in health care. The
ity care is tied to ability to generate
So if you walk down on the floor here
Government pays $450 billion out of the
wealth, both individually and as a
and say you are against a mandate, if
$700 billion of non-out-of-pocket health
country. We all know that individuals
you walk to the floor and say you are
care expenditures in the United States
who are wealthy do not worry about
against national health insurance, it
in 1993. The question we should be de-
high quality care because they have
must inescapably follow that you are
bating is, What is the proper role for
the personal resources to pay for it.
against Medicare. That is not what is
the Government? That is the question
What is true for the individual is true
going on.
we need to address.
for the Nation. Our capacity as a na-
I hear people say, "I'm against a big
7. UNINSURED AMERICANS ARE CAUSING THE
tion to afford high quality care, will in
Government takeover of health care."
HEALTH CARE PROBLEM
the end, depend on our ability to gen-
And $450 billion this year will be col-
We should not be focusing on the
erate additional wealth. We must con-
lected in taxes and used to pay for
problem of the uninsured-the problem
tinue to focus on education and job cre-
health care-Government health care,
is that health care costs have risen to
ation which improve our country's
Mr. President. If you are against a big
a point where you have to be insured
wealth as we work to reform the health
Government takeover of health care,
for routine health services. The best
care system.
then for gosh sakes, identify what part
example for me is that in 1974 and in
In conclusion, I believe it is time to
of the Government you want to stop;
1976 when my children were born, I paid
tell the truth to all Americans. When
where do you want to get Government
for the costs out-of-pocket. I did not
everyone is operating in an open and
out?
have to be insured to have a baby. It
honest environment, we will be able to
I think there is an emerging consen-
now costs $6,500 for a 2-day normal de-
reform our health care system and
sus in this body that begins by saying
livery of a baby in Nebraska. The me-
begin to create a healthier America.
that there is a crisis; that this system
dian family income in Nebraska is
Mr. President, I essentially identify
is broken and it needs to be fixed. I be-
$18,000 per year-therefore it is a finan-
what I consider to be the top 10 irrele-
lieve that there is a bipartisan consen-
cial catastrophe to have a baby in Ne-
vant arguments on the issue of health
sus to do just that. The President of
braska without health insurance. The
care. The fact of the matter is that the
the United States has not polarized the
problem is that the cost of health care
American people say there is a crisis in
debate by indicating that he is unwill-
has grown to a point where people of
health care.
ing to compromise. Quite the opposite.
average means live tn constant terror
We recently heard-my latest irrele-
He has merely said that he wants to be
that they will have to encounter the
vant argument-is there not a crisis?
able to go to bed at night, as I do, se-
health system. It is not just preexist-
There is not a crisis for us who have
cure in the knowledge that every single
ing conditions, it is not just the lack of
our health care taken care of, but for
American is covered. We can do that,
portability; it is the overall costs of
an increasing number of Americans, in-
Mr. President I believe by focusing on
health care have become extreme.
deed a majority of Americans feel like
those things that are indeed broken
8. REFORMING THE HEALTH CARE SYSTEM WILL
they are on this thin ice where if al-
I would like to suggest four things we
CAUSE RATIONING
most anything happens in their life.
need to fix in a couple of minutes and
There is already rationing in today's
they will find themselves medically in-
then I will let the distinguished Sen-
health care system. The hardest thing
digent.
ator from Massachusetts jump in. He is
we have to deal with in health care is
The most courageous individual in
looking at his watch. I will try to give
that at some point we ration care.
the health care debate right now is the
him enough time to talk before the
There are very few Americans that can
President of the United States who has
vote.
afford the $175,000 that it costs, on av-
introduced a very specific piece of leg-
Mr. President, the four things to me
erage, to receive a bone marrow trans-
islation and has put himself at risk as
are, number one, the insurance system
plant for breast cancer. I heard earlier
a consequence and has indicated to
is broken. Indeed, the President needs
this week from clinical researchers and
all-there is only one indivisible prin-
to be given a great deal of credit for
oncologists that rationing already ex-
ciple that he has, only one principle he
bringing the insurance companies to
ists when it comes to patients receiv-
says that if it is not included in the
the table and saying they are willing to
ing the newest treatments. Both pa-
legislation, that he is going to veto it,
fix preexisting conditions, they are
tients and insurers have to face the re-
and that is health care legislation
willing to end the problem of port-
ality that certain procedures and treat-
must be 100 percent universal. That is
ability, they are willing to end the
ments are very expensive and cannot
to say every single American has to be
skimming going on today in the sys-
be given to everyone. What we need to
covered.
tem, a system that provides an incen-
debate is how to set up a system where
I am here to say that we have a lot of
tive only to Insure those who are
the resources are allocated in the fair-
work to do to enact a piece of legisla-
healthy. We need to fix what is wrong
est, most humane way.
tion. I think the CBO report is useful,
with the insurance system.
9. I SUPPORT A PURE COMPETITIVE HEALTH CARE
in fact. It does give us an indication of
Second, our Medicaid system is bro-
MARKET
what can be on- and off-budget. I share
ken, and I would identify that as the
Many today argue that the country's
those who say Mr. Reischauer was cou-
second most important thing we need
health care problems can be solved
rageous in stating his honest opinion of
to do.
solely through the market. However,
the impact of the President's legisla-
Third, if we really want to move from
there have been so many interventions
tion. But if we are going to get univer-
a
Government-controlled system.
that there is no longer a competitive
sal coverage, if we are going to enact a
which we have today. to a more mar-
health care market. For example, there
piece of legislation, then we are going
ket-oriented system where individuals
are licensing restrictions that limit the
to have to stop all the irrelevant argu-
are more in control of making deci-
number and types of providers. Patent
ments that I hear over and over and
sions about price and quality, then
laws protect new drugs. The tax system
over.
there are a number of things that we
subsidizes the purchase of health insur-
For example, one of the irrelevant ar-
are going to have to change in our tax
ance and many health care industries
guments is, should we or should we not
system.
are tax exempt. Although using the
have a mandate? Mr. President, we al-
Fourth, I believe there are a whole
market can help us solve the current
ready have a mandate in place. Every
series of things that I identify as com-
health care problems, we need to look
employer pays a tax of 1.45 percent of
ing under the heading of accountabil-
more deeply at current practices that
their payroll, every employee pays a
ity. Our system is unaccountable. We
hinder competition.
tax of 1.45 percent of their wages. It is
have an unaccountable system when we
10. ISSUING A HEALTH CARE CARD WILL
mandated and in place right now. It
collect money in Washington; we have
GUARANTEE HIGH QUALITY CARE FOR EVERYONE
goes for part A Medicare, and guess
an unaccountable system when an indi-
I support simplified eligibility for
what part A Medicare really is? It is
vidual goes into a hospital; we have an
health care, however, simply issuing a
national health insurance. The only
unaccountable system when an individ-
card will not guarantee high quality
catch is, you have to be 65 before you
ual finds themselves not able to get
care. The ability to receive high qual-
are eligible.
payment for something troubling
S1140
COI
them: we have a very unaccountable
and difficult system.
I came here to say that I appreciate
that the Republican leader and the dis-
tinguished senior Senator from New
Mexico recognize the courage of Mr.
Reischauer, but I hope they also recog-
nize the courage of the President of the
United States for pushing this issue to
a point wherein if we do the work and
stop the irrelevant arguments, we have
the potential of being able to reform
and enact legislation this year that
will indeed extend coverage to every
single American.
I thank the Chair and yield the floor.
Mr. KENNEDY. Mr. President, how
much time remains?
The PRESIDING OFFICER. Two
minutes eleven seconds.
Lennox
prepares
to meet
first lady
By RANDY HASCALL
Argus Leader Staff
LENNOX - First lady IIil-
lary Rodham Clinton won't be
the most famous person to ever
sel foot in town.
Theodore Roosevelt once
stopped here during a cam-
paign trip by train, said Verlyn
Hofer, president of the Lennox
Commercial Club.
Although Clinton might have
to settle for second place. she'll
receive a first-rate reception
and likely won't encounter any
protesters. Hofer said.
"We're a pretty strong Re-
publican community. but we're
too polite for that:" he said.
"We'll try to put our best foot
forward. be polite and consid-
erate."
Clinton will be in town Feb.
18 for a forum on rural health
care.
Mayor Floyd Beach was
busy Tuesday distributing new
welcome banners that arrived
in the mail. Business owners
will hang them in their win-
dows, and the American Legion
will display U.S. flags down-
town. Then. they'll all hope the
entourage arrives or departs
over main street.
As Clinton's trip nears, ru-
mors grow.
According to one story, Se-
cret Service agents have been
roaming the halls and class-
rooms at Lennox High School
- the site of the forum -
checking out the school and
students.
The wildest rumor is that the
Secret Service fastened down
all manhole covers on main
street so no one could pop up
with a gun to ambush Clinton's
caravan.
Despire WHIN people say. THE
Secret Service agents have
been to town as far as high
Lloyd B. Cunningham/ Argus Leader
school principal Alan Rops
Lennox Mayor Floyd Beach inspects his work after hanging a banner in the
knows. He said the strangers in
front window of his hardware store on Main Street on Tuesday. The town's
suits are members of Sen. Tom
Commercial Club bought 18 welcome banners to display during First Lady
Daschle's staff who have made
Hillary Rodham Clinton's visit next week.
three visits.
After classes Feb. 17, Rops
will turn the school over to the
Summit tickets available today
Secret Service.
Details of Clinton's visit are
Tickets for the Great Plains Summit on Feb 18 in the Lenhox High School gymna
sketchy, Rops said. She's
Rural Health Care with First Lady Hillary stum:
scheduled to arrive in Lennox
Rodham Clinton will be available today at the 110 get a tickel you must have photo
between 11 a.m. and noon,
Argus Leader
identification and your Social Security
wo hundred tickets will be handed out
number Use the south entrance. The licket
conduct a national news confer-
from 7 to 9 a.m. at the Argus, 200 S.
must be lot you, not someone else.
ence in the school library and
Lennox/See 2A
Minnesota Ave. The Summit will be at noon
Lennox: Town prepares for first lady
Continued from 1A
"It's nice` she's coming to a
sistant at the Lennox Area Med-
small town," said Marilyn Ren-
ical Center, said there's talk that
then give her presentation to
back, who lives in Harrisburg and
Clinton might stop at the clinic.
about 1,000 people in the gym.
works in Lennox.
"No one has officially notified
Ten or 11 classrooms will be
Jack Jacobson, a 16-year-old
us," he said. "I'm a Republican,
open to those without tickets, and
sophomore from rural Tea, said
but I hope she stops by. How often
they can watch the summit on
he'll be in Sioux Falls before 7
do you get a first lady in town?"
TVs.
a.m. today to try to get a ticket.
Hofer said a number of resi-
Rops said he expects to get a
Jacobson said he hopes to learn
dents are concerned that not
one-on-one session with Clinton
more about the Clinton adminis-
many local people will have an
and would like to put her in touch
tration's health plan so he can
opportunity to attend the event.
with students. Meeting the first
answer the questions of his grand-
lady could be J highlight for
"I'll go if I can get a ticket," he
parents, who need medical care.
said. "If not, I'll watch from the
many, particularly tcen-age girls
who look up to Clinton.
Scott Rogers, a physician's as-
outside."
To accommodate the crowd.
school and city workers will clear
snow to turn the practice football
field into a parking lot. Twenty
additional phone lines have been
installed for the media and White
House staff.
Rops said volunteers will direct
parking and help with coat checks
and other tasks.
The community's response Indi-
cates that Rops will have no
trouble finding volunteers.
"There's a lot of excitement,"
Mayor Beach said.
"Something like this doesn't
happen often, said Barb Scott of
Lennox."
February 17, 1994
GREAT PLAINS SUMMIT ON RURAL HEALTH CARE
home Pat 715-341-1
DATE:
Friday, February 18
TIME:
12:00 pm
LOCATION:Lennox High School Gymnasium
FROM:
Liz Bowyer, Angela Buchanan
I.
PURPOSE
715-346-
1415
To discuss rural health care and the Clinton approach in a roundtable discussion
with elected officals and citizens from the Great Plains states.
II.
BACKGROUND
The Great Plains Summit on Rural Health Care
General Information
Senator Daschle is the official host of the Summit, and the Sioux Falls Argus Leader,
KSFY-TV and the Foundation for Hospice and Home Care, a Washington-based
foundation and think tank, are the co-sponsors.
The states that will be represented are North Dakota, South Dakota, Minnesota,
Nebraska and Iowa, and members of Congress from all of those states except for
Iowa will participate. Citizens from Iowa will be in the audience, however.
A group of twenty citizens will participate in the discussion (see attached profiles for
more information.) The group consists of health care providers and professionals,
senior citizens, small business owners, rural workers and a student. Three of the
participants are Native Americans. You will be seated between Cecilia Humphrey, a
senior citizen, and John Thompson, a young man whose arms were amputated after
a farm accident
The audience of approximately 1500 will represent a broad cross-section of the
general public and the health care community in the Great Plains states.
Format
The format of the roundtable discussion will be similar to the New England Health
Care Summit in Boston. Seated on stage with you will be elected officials from the
Great Plains states, Secretary Espy, twenty citizens, and the moderator, Lois Quam.
Following your remarks, Lois will open up the discussion to the citizen participants,
who will briefly share their experiences with the health care system. Each participant
will ask a question to be answered by you or one of the elected officials. Members
of Congress will be more involved in the actual discussion than they were in Boston,
and will not deliver prepared remarks at the end of the roundtable.
[Note: After your depart the Summit, a series of workshops will be held on the
following: Questions and Answers on the Clinton Plan, Health Care Providers, State
and Local Role in Reform, Small Business and a North Dakota Workshop.]
Discussion
The discussion will be structured around three main areas:
Small businesses
Rural providers
The elderly and long-term care
According to Lois Quam, the greatest concerns in this region are that business
(particularly small business) will be harmed by reform, and that the plan represents
too much government. Other concerns about health care are those typical of rural
areas -- security, access, the inability to receive specialty treatment, and especially,
the shortage of doctors and facilities.
Lois has a few suggestions in addressing these concerns :
The most persuasive arguments with Midwesterners concerning health care reform
are security and savings. Although rural areas in the Midwest have relatively few
uninsured compared to other parts of the country, those that are insured typically
have poor coverage, so security defined as bad insurance coverage is persuasive.
Because of the real emphasis on personal self-reliance in the Midwest, you might
want to point out the personal responsibility aspect of the plan, emphasizing that the
plan is not "free" or "government run".
As this region has a strong populist history, a rural populist theme in your remarks
and in the discussion would be warmly received. Taking on the special interests
opposing the plan is important. South Dakota in particular has a long history of anti -
East Coast fervor, so mentioning that those special interests are not from South
Dakota but represent big money elsewhere would be persuasive.
Basic problems with rural health care that will probably be raised:
Uninsured and underinsured population is proportionally higher in rural areas.
-People lack security of coverage and receive poor benefits
-Providers are not always paid for their work.
Small rural business and self-employed workers are adversely affected by the lack of
an organized insurance market.
current
-The current system allows insurance company abuses & discrimination
-Administrative costs are higher for individuals and small businesses
-Finding coverage and periodically refunding (?) is a hassle can be difficult and
insurance company paperwork burden some
The shortage of primary care providers
-Providing an insurance card is not enough -- the new system must build
provider capacity and improve access in rural area.
-Rural doctors see twenty percent more office visits
Competition for primary care providers is intense and is going to get worse as
will be in greater demand
?
managed care grows
have higher patient load
The existence of organized systems of care is erratic
-While much is being done in this area voluntarily and under state, federal
and
private sponsorship, many areas lack significant provider organization. This
makes areas vulnerable both now and in the future, and does little to
maximize the assurance of high quality care for rural people (?)
The attached materials describe how the Health Security Act addresses these
are to her come S 3 &
problems.
Info on the National Rural Health Association?
III.
PARTICIPANTS
arganized
HRC
Secretary Espy
Governor Miller (will make remarks and depart stage before HRC is on the dais. He
will remain in the audience)
Senator Thomas Daschle
Senator Presser
Senator Conrad
Senator Kerry
Senator Wellstone
Congressman Pomeroi
Congressman Minge
20 citizen-participants (see attached)
1500 audience attendees
15.373 1030
FEB-17-'94 THU 18:17 ID:
TEL NO:
#161 P01
To: Liz
From: Megan Molonay
Phone: 715/842-0711
FAX TO.' 202/456-2239
-INFO ON LINCOLN CENTER,
GRAND THEATRE,
WAUSAU CLUB
3461415
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001. fax
From: Megan Moloney, To: Liz, Re: Info on Lincoln Center, Floor
2/17/94
b(7)(E)
Plan (1 page)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act - [44 U.S.C. 2204(a)|
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information |(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRAJ
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRAJ
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information [(a)(4) of the PRAJ
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes [(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA|
RR. Document will be reviewed upon request.
FEB-17-'94 THU 18:18 ID:
TEL NO:
#161 P03
nosnom 51 woll
University of Wesconsin
WORK
Servens Point
Arlington Pl.
66
from 10
Downlown Slevens Point
a
from
Waupaca
111111111
10
PARK
RIDGE
STEVENS POINT
wisconsin Rapids
WATER
/
BUS
51
51
Lincoln Center
WHITING
Portage County Dept. On Aging
1519 Water Street
from Madison
from Wisconsin Rapids
54
B
54
Why join RSVP?
Volunteer Benefits
Retired
You've spent a lifetime developing
Supplemental personal accident,
your skills, refining your talents, and
liability, and excess automobile liabil-
building your knowledge and abilities.
ity insurance while volunteering.
Senior
You're a rich resource. Retirement
Mileage reimbursement or bus fare
offers a valuable opportunity to both
to and from volunteer sites.
you and your community.
Best of all, the feeling of personal
Volunteer
FEB-17-'94 THU 18:19 ID:
You're free to choose now, free to
accomplishment and satisfaction while
decide how to use your know-how and
helping someone else.
experience. NOW is the time to try
RSVP. Call or mail the form below
TODAY. You've learned a lot in your
Program
lifetime - don't keep it to yourself!
RSVP is a program of the Department on Aging
located at Lincoln Center.
Portage County RSVP
1519 Water Street
TEL NO:
Stevens Point, Wisconsin 54481
(715) 346-1401
Yes, I would like more information
about RSVP.
Name
Portage County provides employment and ser-
Street
vices to any eligible person without regard
to age, race, religion, sex, national origin,
#161 P04
City
sexual orientation, handicap, color, marital
status, physical condition, developmental
"A life can never be measured in
Zip Code
disability, or ability to pay.
years - only in what we learn and in
what we share "
Telephone
What is RSVP?
I 1 I 1
Housing
The RETIRED SENIOR VOLUN-
RSVP
Energy Assistance Program
Homestead Property Tax Refund
TEER PROGRAM offers people age 60
Program
and over the opportunity to share their
1
Expenses
Community Service
skills and talents with people of all
Adult Day Care Program
ages throughout Portage County. Vol-
Retired Senior Volunteer Program
Diiver/Escort Program
unteers can choose from over 100
1519 Water Street
Friendly Visitors/Peer Counselors
community services based upon their
Stevens Point, Wisconsin 54481
Humane Society
interests and abilities. Volunteer
(715) 346-1401
Loss of Spouse Support Group
schedules are flexible and training is
Nursing Homes
provided as needed, allowing volunteers
FEB-17-'94 THU 18:20 ID:
St. Michael's Hospital
the opportunity to learn new skills.
Through RSVP older adults discover
Volunteer Opportunities
Stevens Point Police Department
Telecare Program
outlets for their creativity, energy,
It is impossible to list all the
Warm Line Program
and expertise. By sharing what they
needs volunteers meet, but below are
have spent a lifetime learning, volun-
teers improve the quality of life for
examples of some of the non-profit
people of all ages in their community.
private and public community organi-
RSVP volunteer opportunities are as
zations they serve:
diverse as the volunteers themselves.
Health and Nutrition
American Cancer Society
American Red Cross
Blood Pressure Screening Clinics
Child Passenger Safety Association
Commodities Distribution Program
TEL NO:
Immunization Clinics
Meals on Wheels Program
Senior Citizen Meal Sites
Knowledge and Skills
Adult Literacy Program
Folk Art Fairs
Historical Society
Lincoln Center Class Instructors
Portage County Libraries
School Tutors/Teacher's Assistants
Special Olympics
UW-SP Learning Disabled Students
Program
#161 P05
Economic Development
Holly Shoppe
Merchants' Older Buddies Program
Operation Bootstrap
St. Vincent De Paul Thrift Store
United Way
Where is More
Information Available?
Possible Services
AN Alternative To Nursing
May Include:
Home Care
#161 P06
To get more information or to make
a referral, call or write to:
Service Coordination
Supportive Home Care
Office Address:
Attendent Care
Portage County
Human Services
Respite Care
817 Whiting Avenue
Home Modifications
Stevens Point, WI 54481
Nursing Care
Home-Delivered Meals
TEL NO:
Telephone:
Specialized Transportation
715-346-4311
and any other service required by the
program participant to remain in his/her
own home.
Community
Options
FEB-17-'94 THU 18:20 ID:
Program
Regular Working Hours:
Portage County
8:00 a.m. - 5:00 p.m.
Monday thru Friday
Community Human Services
817 Whiting Ave.
Stevens Point, WI
1
What is the Community
How is Eligibility
When are Costs
Options Program (COP
Determined?
Involved?
It is a service designed to assist elderly and
Assessments are provided through the Port-
Recipient's responsibility to share inthe cost
chronically disabled people to remain in their
age County Human Services Department for
will be made at the time of assessment based
own homes rather than entering nursing
those individuals residing in the community
on the following:
homes or other institutions.
or who are current residents of a Portage
FEB-17-'94 THU 18:21 ID:
County nursing home or state center for the
developmentally disabled.
SSI Eligibility
No <DSt to participant
Patients at St. Michael's hospital in Stevens
Point can receive an assessment from
Who is Eligible?
hospital social service department prior to
Current Income and Available Assets
discharge.
The population targeted in Portage County
includes:
Personal Interviews will be required by both
A cost sharing formula will be used to sel the
the potential COP recipient and family
amount owed by COP recipient, based on the
members or other interested persons.
level of income and assets
Developmentally Disabled
Necessary information will include:
There is no cost for the assessment and
development of a case plan.
Chronically Mentally III
Current Medical, Living, and Financial
Conditions.
Physically Disabled
:ON 731
Current use of Community Services
Chronic Substance Abusers
Available Natural Supports
(family, friends, neighbors)
Frail Elderly
Why Participate Now?
A review by a social worker and R.N. will
In addition to having a long term or
determine program eligibility, need for
irreversible illness or disability the potential
services, and shared costs.
Participation is voluntary. Persons eligible
COP recipient must meet the following
for nursing home care will not be denied
requirements:
admittance to a home. HOWEVER, if it is
anticipated that medical assistance will pay
Be at risk of entering a nursing home or
for the cost of a nursing hone, assessment
state center for developmentally disabled or
must occur prior to admittance.
are current residents of such facilities.
#161 P07
Require on going assistance to remain
living at home.
FEB-17-'94 THU 18:22 ID:
TEL NO:
#161 P08
PORTAGE COUNTY
DEPARTMENT ON AGING
INFORMATION AND
ASSISTANCE
1717
Escort Coordinator at Lincoln Center Monday through Friday
from 1:00 to 4:00 P.M.
Current Route Schedule
(As of December, 1993)
Stevens Point
Portage County
Rides to Lincoln Center for activities or lunch, Monday through
Friday.
Department On Aging
Grocery shopping rides, Fridays.
Town of Hull
Bus to Stevens Point, Tuesdays and Thursdays.
FEB-17-'94 THU 18:23 ID:
Ployer
Bus to Municipal Center for lunch, Tuesdays and Thursdays.
Transportation
Rosholt
Bus to lunch at Legion Hall, Mondays and Wednesdays.
Bus to Stevens Point, second and fourth Tuesdays of the month
Services
Amherst
Bus to Jensen Center for lunch, Mondays, Wednescays, fridays.
Bus to Stevens Point, second Thursday of the month.
Junction City
Bus to lunch at the Park Pavilion, Tuesdays and Thursdays.
Bus to Stevens Point, Wednesdays.
TEL NO:
For all transportation-related questions call 346-1401 or the
number in your area (listed inside).
Portage County Department On Aging
Lincoln Center
1519 Water Street
Stevens Foint, Wisconsin 54481
(715) 346-1401
Assuring that Portage County is 2 good place
in which to grow old.
#161 P10
Portuge County provides employment and services to uny eligible person without regard 8 #
race, relgton, sex, nacional origin, sexual orientation, hindcap, odor, markal status, physical
condition, developmental disability or ability to pay
The Department On Aging offers a variety of transportation
services throughout Portage County for people age 60 and over.
Bus Rides to Nutrition Program Meal Sites
The bus picks you up at your door and returns you home
General Information
after lunch. Call the number in your area for the schedule or
information or to make reservations.
#161 P11
For more information or reservations, please call these
numbers:
Stevens Point/Plover
346-1401
Wheelchair Transportation
Rosholt
577-4806
Point Transit provides rides for people in wheelchairs in
Amherst
824-5202
Stevens Point, Whiting and Park Ridge. Call 341-2000 for informa-
Almond/Bancroft
335-4613
tion or reservations. For other areas of the county. call the
Junction City
457-2518
Department On Aging at 346-1401.
All riders are asked to donate toward the cost of trans-
Lincoln Center Bus Service (Stevens Point)
portation services. The amount you donate is confidential.
For those who cannot drive or ride a city bus to Lincoln
Center the Department On Aging bus picks up at 11:00 A.M. and
TEL NO:
Ali rides must be reserved ahead of time: for bus rides, 24
returns people home around I:30 P.M. These times can some-
hours in advance; for escort rides, 48 hours in advance.
times be adjusted to fit your schedule of activities or appoint-
ments at Lincoln Center.
In addition to the services described here, we provide
transporation for special group events, transport RSVP volunteers
Grocery Shopping Bus Service (Stevens Point)
to work stations, and provide instruction on the use of city buses.
Each Friday Department On Aging buses take people
We'll work with individuals and families to help solve particular
grocery shopping. This service is for those who have no other way
transportation problems.
to obtain groceries and need help carrying their hags.
If you're age 60 or over and live within the Stevens Point
Volunteer Driver Escort Program
School District, you can ride school buses on their regular routes
Throughout Portage County volunteers drive people to
into Stevens Point free-of-charge.After authorization by the
medical and personal business appointments. In the Stevens Point
FEB-17-'94 THU 18:23 ID:
Department On Aging you'll be issued with a boarding pass and
telephone exchange area rides are requested from the Escort
may ride any time you wish.
Coordinator Monday through Friday from 1:00 to 4:00 P.M. at
346-1401. in rurai areas rides are requested by calling the num-
Rural Route Buses
bers listed to the left under General Information.
If you live in a rural village or in the countryside you can
come into Stevens Point weekly, twice monthly or monthly
Taxi Escort Service (Stevens Point)
depending on where you live. The bus picks you up around 9:00
People who have no other transportation are provided
A.M. and returns you home around 3:00 P.M. Use this service to
rides to medical appointments by the Checker Cab Company. The
shop. see your doctor, visit Lincoln Center or friends. People in
Department On Aging pays for the cost of the ride not covered
Stevens Point can ride the bus to rural areas.
by passenger donations. Each ride must be requested from the
Portage County
FOSTER
GRANDPARENT
PROGRAM
A PART OF ACTION
TOJ 20TH
ON
you -
FEB-17-'94 THU 18:25 ID:
TEL NO:
#162 P02
What is the Foster Grandparent Program?
What are the benefits?
Foster Grandparents-a remarkable idea.
STIPEND: Non-taxable, not includable in
If the world is full of special children, It also has
income calculations relating to receipt of any
millions of would-be grandmas and grandpas.
other benefits.
Begun in 1965, the Foster Grandparent
TRANSPORTATION: Transportation or
Program is a program of ACTION, the federal
reimbursement for transportation to and from
volunteer agency. and of the Portage County
assignments and other official program activities
Department On Aging. The program is funded by
when needed.
federal and state grants.
MEALS: A meal, or assistance with the cost of
Portage County Foster Grandparents
meals taken while on assignment.
assist in the Head Start Program, Madison View
Daycare, and in the county's school districts.
MEDICAL BENEFITS: Annual physical
examination.
The program seeks to match income-
eligible older adults with special needs children.
INSURANCE: Accident, personal liability and
The child's needs might be social, educational,
excess auto coverage (for volunteers driving their
emotional and/or physical. The Foster Grand-
own cars).
parents serve four hours per day, five days per
week. and receive a number of tangible benefits.
RECOGNITION: Each Foster Grandparent is
given recognition of his or her service to the
The intangible benefits are far greater,
community at least annually at a formal public
however. Foster Grandparents will tell you they
recognition event.
receive far more than they give-that's the
miracle of love given and love returned.
TRAINING: Before commencing service. each
volunteer receives at least 40 hours of training.
As well as providing a general introduction to the
What are the requirements?
Foster Grandparent Program and the particular
project and project staff, pre-service training
Foster Grandparents must:
prepares new volunteers to function effectively in
their specific assignments, understanding the
be age 60 or over
unique needs they are addressing and their special
meet income guidelines
place within the larger team of care providers.
be In good health
Subsequent In-service training sessions (four
accept. supervision as required
hours each month) build on and enhance skills
have a desire to assist special needs children
and knowledge relative to volunteers' assignments
and provide necessary support and advice.
For more Information please contact:
Foster Grandparent Program
Under the guidelines of the Americans With
Portage County Department On Aging
Disabilities Act, the Foster Grandparent Program is
Lincoln Center
accessible to people with disabilities.
Stevens Point, Wisconsin 54481
(715) 346-1401
How to get to The Holly Shoppe
#162 P03
Holly
FIRST
CONTAIN
NOISING
MALL
go
WATER
Shoppe
MAIN
IDC
CLARK
10
ELLIS
TEL NO:
river
WATER
Z-
N
BRAWLEY
53
Handcrafted
LINCOLN CENTER
THE HOLLY SHOPPE
Gifts
FEB-17-'94 THU 18:26 ID:
Lincon Center
1519 Water Street
Stevens Point
FEB-17-'94 THU 18:27 ID:
Welcome to The Holly
lst a sampling of our
If you're looking for
is added to a item's
Shoppe- unique merchan-
offerngs would include:
something and don't see
purchase price to help
dise and quality crafts-
it, ask us- we have a
defray our operating
manship are our
quite
Special Order Service
expenses.
traderrarks.
ceramics
dolhauses
Stop in and browse.
Holy Shoppe clerks,
Located at Lincoln
toys
We're proud of our
cashiers, and registrars
Center, The Hally Shoppe
baby clothes
friendy. relaxed
are volunteers.
sells handcra: items
staffed animals
atmosphere. While
made by Portage County
sik flowers
you're here, tour
Any Portage County
residents age 60 and
plant stands
Lincoln Center, view the
resident age 60 or over
TEL NO:
over. AI merchandise n
dots and doll cothes
works in our art gallery,
may sell crafts through
The Holly Shoppe is
afghans
or take time for
The Holly Shappe. New
The Holly Shoppe is
made by hand and each
jewelry
refreshments at the
participants are always
open Monday
item shows the time,
funiture
Coffee Stop.
welcome. Registration
through
care, and love which went
novelties
of merchandise is held
Friday from 10am
into its creation
needlecrafts
The Holly Shoppe is a
on Fridays at Lincoln
knitted caps, mittens,
program of the Portage
Center from 9 am to
to 4:30 pm, and
The Holly Shoppe has
and scarves
Country Department On
2 pm
on Saturday from
something for everyone-
wreaths
Aging and is supported
11 am to 3 pm
whether you're buying
linens
by the United Way.
Our phone number is
Our hours are
for yourself a looking
holiday decorations of
Proceeds from sales are
346-1401; ask for
United Way
for that special gift. for
all kinds
returned to our crafts-
The Holly Shoppe
#162 PD4
extended during the
k brings out the best
someone, you find it
people as an income
Manager.
Christmas season.
in all of us.
here.
supplement. A percentage
02/15/94
11:49
1 605 334 2591
SEN. TOM DASCHLE
004
Great Plains' Summit - Citizen Participants
Roger Andal, Brandon, South Dakota
Disabled Veteran
Age: 45
Mr. Andal has been self-employed, worked for the federal government, and
now receives his health care through the V.A. system. He is satisfied with
the health care he receives, but wonders what will happen to the V.A.
system under health care reform.
He is married and has 4 children.
Native of South Dakota.
Carla Anderson, Center, North Dakota
Administrator, Square Butte Health Center
Age: 34
Center is a town of 1,000 people that had no medical services until 12
years ago. At that time, the community sought and received federal funds
to build a clinic. The clinic enjoys wide community support and provides a
wide range of health services. The town is now served by a nurse
practioner, physicians, a dentist, and opthamologist. Ms. Anderson has
been with the clinic from the start and is knowledgeable and articulate on
the delivery of health care in small communities.
The Square Butte Health Center merged with Med Center One this past
year. They are happy with the managed care system and believe that it is
headed in the right direction.
She is married and has two sons, ages15 and 3.
Native of North Dakota.
02/15/94
11:50
81 605 334 2591
SEN. TOM DASCHLE
005
John Blackhawk, Winnebago, Nebraska.
Chairman of the Winnebago Tribe and Aberdeen Tribal Chairman's Health
Board serving Nebraska, lowa, South and North Dakota Native Americans.
Age: 40
As chairman of the Health Board, John has followed the issue of health
reform with the interests of the Native American community in mind. He
will address the health care needs of the population and the problems and
advantages of the Indian Health Services that serve his community.
He is married with 2 children.
Native of Nebraska.
Gregg Bourland, Eagle Butte, South Dakota.
Tribal Chair of the Cheyenne-River Sioux and Chair of the Aberdeen Tribal
Chairman's Health Care Reform Task Force.
Age: 38
Gregg like, John Blackhawk, has been active in health reform and
represents tribes in Nebraska, South and North Dakota, and lowa. He is
familiar with the health reform plans proposed, and will be able to talk
about the reform ideas and needs of the Native American population.
He is married with 2 children, a son -12 and a daughter - 6.
Born in Utah.
02/15/94
11:50
1 605 334 2591
SEN. TOM DASCHLE
1
006
Dr. Ray Christenson, Mooselake, Minnesota
Rural Family Physician
Age: 50
Mr. Christenson grew up in rural Wisconsin and practices in rural
Minnesota. He is active with rural physicians on recruitment and
retention issues and with the Minnesota Department of Health on
improving access to care in rural Minnesota. His current practice was
started in 1972, and currently has with 6 physicians and 2200 charts.
He is married and has 2 daughters.
Native of North Dakota.
John Dean, Willmar, Minnesota
Principal of Affiliated Insurance Service
Age: 51
Mr. Dean is currently associated with National Travelers Life Insuranceand
is a principal in Affiliated Insurance Services in Willmar. As an insurance
broker, he understands the needs to be a player in the health care reform
debate. While he sees many of his colleagues fighting to stall health care
reform, John has become a leader in his industry. He believes that there
should be universal coverage and reform in pre-existing conditions and
portability problems. He does have some questions on the mandatory
health alliances. He Is also involved in long-term care issues in his
community as a volunteer.
He is married and has 4 children, and 3 grandchildren.
Native of Minnesota.
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
002. list
Great Plains' Summitt . Citizen Participants [partial] (2 pages)
2/15/94
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA|
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRAJ
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information [(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
DEN. 10m DASCHLE
5.
007
Cecelia Firethunders, Martin, South Dakota
Nurse, South Dakota Department of Health
Age: 48
Cecilia joins her colleagues in discussing the Indian Health Service's
ability to provide adequate health care for the Native American
community. She is very concerned about the uninsured
(b) (6)
(b)(6)
002
uninsured). She has a particular interest in wellness and prevention
programs, and the urban Indian population.
She is single, has 2 sons ages 27 and 25.
Native of South Dakota.
Beth Furlong, Omaha, Nebraska
Nurse, Coordinator for Community Health Nursing
at Creighton University, School of Nursing
Age: 52
Ms. Furlong has been teaching public health nursing for 22 years and just
recently completed her PhD in political science. She has been active in
community activities and is a strong believer in universal access and
preventative care. She serves on the Board of Directors of the Wellness
Council of the Midlands for health promotion.
She is single.
Native of lowa.
02/15/94 11:52
1 605 334 2591
SEN. TOM DASCHLE
008
Marilyn Harms, Sioux Falls, South Dakota
Physician Assistant
Age: 54
Ms. Harms has been a physician assistant for 15 years. She is the
President-elect of the South Dakota Academy of Physician Assistants and
serves on the nominating committee of the American Academy of
Physician Assistants. She is concerned by the number of patients she sees
that are receiving false information from the insurance companies about
the effects of health care reform. She believes everyone must be covered
in order to get our health system back on track.
She is divorced, has 3 children.
Native of South Dakota.
Cecilia Humphrey, Sioux Falls, South Dakota
Senior Citizen
Age: 85
Mrs. Humphrey currently lives in the Good Samaritan Village in Sioux
Falls. She has been in the long-term care facility for the last 5 years.
having decided herself that she needed assistance. She is very active in
the Village and is well read on current issues. She participated in a
seminar about health care last year. The points that she wants to make is
that reform is good but she is worried that she won't be able to choose
the doctor of her choice, which she has gone to be the last 30 years. She
also pays over $200 a month for her prescriptions. She is on Medicare,
Social Security, and receives her husband's small veterans pension.
She has been widowed for the last 31 years, and has no children.
Native of South Dakota
02/15/94
11:52
1 805 334 2591
SEN. TOM DASCHLE
009
Dr. Clayton Jensen, Grand Forks, North Dakota
Interim Dean of the University of North Dakota School of Medicine and is
Professor and Chairman of the Dept. of Family Medicine.
Age: 66
Dr. Jensen has been a family physician and currently teaches and promotes
family medicine at the University of North Dakota. He has spent his entire
life in North Dakota working in this field. He is articulate and can ask
questions and express points of view from the unique perspective of
family doctors in rural America.
He is married with 2 sons and 3 grandchiidren.
Native of North Dakota.
Larry Juhi, New London, Minnesota
Owner and Administrator of the GlenOaks Long Term Care Campus
Age: 43
Mr. Juhl runs the GlenOaks Adult Day Services, an adult day care center
opened in 1991. GlenOaks goal is to keep the seniors in the least
restrictive setting as long as possible, avoiding or delaying
institutionalization. GlenOaks has received state and national recognition
for its comprehensive long term care campus. New London is a town of
1,000 people, and currently there are 4-5 people per a day enrolled in the
adult day care program. Larry is also the mayor of New London.
He is married and has 2 children.
Native of Minnesota.
02/15/94
11:53
1 605 334 2591
SEN. TOM DASCHLE
010
Carol Kobberman, Hancock, Minnesota
Dairy Farmer
Age: 55
Mrs. Kobberman and her husband run a dairy farm of 360 acres, and a herd
of 80 cows. She receives her insurance through the group dairy
association, and has fairly good coverage. However, she says that the
group association had to change insurers this year to keep costs down, and
worries about the changing nature of insurance.
She is married with 9 children and 14 grandchildren.
Native of Minnesota.
Joe Lathrop, Valley. Nebraska
Owner and Pharmacist of Valley Pharmacy
Age: 40
Valley, Nebraska is a town of 1,716 people. Mr. Lathrop has run the
pharmacy for 12 years and is a graduate of the University of Nebraska
Pharmacy School. His pharmacy fills about 150 prescriptions a day,
handles prescriptions for the local nursing home, as well as the Medicare
population of the area. He will speak to the high cost of drugs for seniors
and the hard choices he sees many of his customers making everyday. He
is also a small businessman and can address the issue of providing
Insurance as a business owner. He currently provides insurance for his
one full time employee, another pharmacist.
He is married with two small children, ages I and 3.
Native of Nebraska.
02/15/94
11:53
T1 605 334 2591
SEN. TOM DASCHLE
4
011
Anne Nation, Friend, Nebraska
Consultant and free lance writer
Member of the Board of Directors, Nebraska of Comprehensive Health
Insurance Pool
Age: 42
002
Ms. Nation has experienced the health care system
(b)(6)
and
as a member of the state board that provides insurance for high risk
individuals. Anne served on the Governors' Blue Ribbon Coalition to Study
Health Care in Nebraska.
(b)(6)
(b)(6)
002
Interestingly, Anne and her husband lived in Canada for a year in 1975 and
experienced first-hand the Canadian single-payer system. This gives Anne
an unique advantage to comment first hand on both systems.
She is married, has no children.
Native of Nebraska.
Kathleen Piper, Yankton, South Dakota
Owner of Pied Piper Flower shop, and County Commissioner
Age: 43
Ms. Piper is the owner-operator of a small business in Yankton. She
carried health insurance for her 8 employees until the cost became too
high and she had to drop the coverage. She waited until all her employees
could receive coverage elsewhere before dropping her insurance. She
would like to provide coverage but can't afford it today. She, herself,
receives insurance through her position as county commissioner. She can
speak as a small business person and from the perspective of a county
commissioner.
She is married with two children.
Native of lowa.
THE WHITE HOUSE
WASHINGTON
December 2, 1993
VISIT TO THE EL PUEBLO HEALTH SERVICES CLINIC TO
DISCUSS RURAL HEALTH CARE ISSUES
Rog
DATE:
December 3, 1993
LOCATION: El Pueblo Health Services Clinic, Bernalillo, NM
TIME:
3:00 pm MST
FROM:
Julia Moffett
L
PURPOSE
This event gives you the opportunity to tour a rural health care facility, to hear from a doctor
on the front lines of rural health care, to have a discussion with both patients and providers
regarding their problems and concerns and to further educate them about how the Health
Security Act of 1993 addresses rural health care problems.
The patients and providers who have come togther for this event are, for the most part, not
experts in rural health care. They come to this discussion with their own problems and
circumstances--security, access, shortage of doctors and facilities, inability to get specialty
treatment--which are representative of many of the typical health care problems experienced
in rural areas. The doctors and other rural health care administrators in the audience bring
many more personal stories with them in addition to a more macro-understanding of the
problems these areas are facing.
II.
BACKGROUND
Message
This event is essentially a regional event due to its time and subject matter. However, no
regional health care event which will resonate more than one which focuses on rural health
care issues. The Health Security Act of 1993 does a lot to address the needs of rural
communities: By providing universal coverage, the plan creates affordable insurance even if
you farm, own a small business or work in a small business; the plan encourages more
doctors and nurses to serve rural America; the plan guarantees access to the services rural
Americans need with funding for additional transportation services as an example; the single-
claim form will dramatically reduce red tape, both for doctors and consumers; choice will be
improved; and networks of rural doctors and leading medical centers will improve the quality
of rural medical care.
The El Pueblo Health Services Clinic, Bernalillo and the state of rural health care services
The El Pueblo Health Services Clinic has been in operation for 17 years. The staff includes
Dr. Alan Firestone and Dr. Carmen Rodriguez, 1 full-time medical assistant, 1 office manager,
1 full-time billing clerk, and 1 full-time insurance billing person. This staff has grown from 1
front desk receptionist when the clinic opened. Additionally, the administrative space at the
clinic has grown by 500%. The clinic sees 35-45 patients per day. Approximately 15-20% of
the patients are Medicaid recipients, 30-35% are uninsured. Atypical for rural areas, this
clinic serves a small Native American and Migrant population.
Bernalillo is in Sandoval County, one of 30 of the 33 New Mexico counties considered
underserved by federal standards. Although it is a low to middle-income, rural area,
agriculture is not as predominant as it is in many other counties. It is, however, plagued with
many of the problems indicative to New Mexico as a whole: more than 25% of the New
Mexico population is uninsured, more than one-third of the uninsured are children, nearly
40% of them are under 100% of the federal poverty level, one-third of them are employees of
businesses with under 25 employees, and nearly two-thirds are not working. New Mexico
ranks 47th in the country for lack of access to primary care--21% of the New Mexico
population does not have access to primary care.
Dr. Alan Firestone
Born in Youngstown, Ohio, Dr. Firestone came to Bernalillo as a National Health Service
Corps member after earning his medical degree from UCLA. After spending 11 years in the
Corps, the federal government attempted to reduce the size of the Corps and Dr. Firestone
was told to shut down his clinic. Instead, Dr. Firestone chose to leave the Corps but to keep
the El Pueblo Health Services Clinic open.
III.
PARTICIPANTS
Tour
The President
Dr. Alan Firestone, Director, El Pueblo Health Services Clinic
Discussion
There are twelve people whom you will have the primary discussion with. In addition to Dr.
Firestone, they are patients from the area as well as other rural health care providers. Their
biographies are attached.
The larger audience of 50 people is comprised of additional patients and providers ranging
from Bernalillo to Albuquerque to other surrounding rural towns and counties. You may wish
to include these people if you choose to expand the discussion as they are all involved with
rural health care in some fashion. A list of these people is attached.
VIPs
The VIPS attending the event will be seated in a special section of the audience and are not
expecting to participate in the primary conversation. You may choose to ask them to say a
few words if you open the discussion up to the larger group. They are:
Mayor Ernie Aguilar and Mrs. Mary Kay Aguilar
Senator Jeff Bingaman and Mrs. Anne Bingaman
Senator Pete Domenici
Governor Bruce King and Mrs. Alice King
Congressman Bill Richardson and Mrs. Barbara Richardson
Congressman Steven Schiff
Congressman Joe Skeen
*Chris and Donna Key and Jimmy Kidd have been invited.
IV.
PRESS PLAN
The press will be prepositioned during the clinic tour both inside and outside. The discussion
outside is open press. Several local television stations may go live during the outside
discussion.
V.
SEQUENCE OF EVENTS
You will arrive at the El Pueblo Health Services Clinic and will be met by Dr. Alan
Firestone.
You and Dr. Firestone will proceed into the clinic for a brief tour of the facility.
(The elected officials traveling with you will proceed directly to the tent.)
You will first walk through the waiting room to greet patients on your way to
Examination Room #1.
In Examination Room #1, you will meet Dr. Carmen Rodriguez and the patient she is
examining.
You will then proceed to the Children's Examination Room as well as Examination
Room #2. You may have an opportunity to greet patients in both areas.
You then proceed to Dr. Firestone's office to hold while the press positions for the
discussion outside.
Once the press is positioned, you and Dr. Firestone proceed to the tent area. You will
be greeted by Mayor Ernie Aguilar and his wife, Mary Kay.
Once in the tent, you may greet the 12 participants in the discussion.
Dr. Firestone will then introduce you.
You will then make brief opening remarks.
Dr. Firestone will then briefly introduce each of the twelve participants and they will
tell you a little about their history and experiences with rural health care.
You may follow up with the participants with individual questions or further
information about the plan.
You may also choose to open the discussion up to the wider audience or to initiate a
Q & A period.
When the conversation is through, you should make brief closing remarks.
Dr. Firestone will then thank everyone for joining you today.
You may meet and greet with the audience upon departure.
VL
REMARKS
Cards are enclosed which include brief opening and closing remarks as well as an outline to
use when leading the discussion on rural health care and how the Health Security Act of 1993
addresses rural health care issues.
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Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
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AND TYPE
003. list
Profiles of Discussion Participants [partial] (3 pages)
nd
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
PI National Security Classified Information [(a)(1) of the PRAJ
b(1) National security classified information |(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA|
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRAJ
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information [(a)(4) of the PRA
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors |a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes [(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
PROFILES OF DISCUSSION PARTICIPANTS
$
Harriett Pacheco Brandstetter
Ms. Brandstetter is the Executive Director of La Clinica de Familia, a privately and federally
funded community/migrant health center. She has 27 years of community health experience.
Her clinic is part of a 17 year old clinic system which includes four medical clinics and one
dental clinic. Her patients primarily consist of the underserved populations of New Mexicans
and Central American border residents. Her clinics are operating at full capacity with long,
active waiting lists.
Christina Campos
Ms. Campos is a trained community encourager for Guadalupe County. Her role is to
activate the community to design a healthcare system which is affordable and acceptable to
the citizens of this county. The community is a single-provider town of 2,100 residents.
There are other part-time providers in the County of 4,200 citizens, but not enough to meet
the healthcare needs of the County. Ms. Campos also serves as the financial officer of a
small hospital in Santa Rosa, and is able to articulate the problems of this ranching
community from many different perspectives.
Blanche Ekdahl
Ms. Ekdahl is 86 years old and lives in a trailer park in Abiquiu. She has severe arthritis and
walks with a cane. Her doctor has told her she must have surgery to replace her knee and he
has scheduled it to occur in the next few months. Since Abiquiu is a tiny, remote village far
from nursing care, Ms. Ekdahl will be forced to move to either Los Alamos or Sante Fe
where she will have access to consistent care.
Dr. Alan Mark Firestone
003
(b)(6)
Dr. Firestone came to Bernalillo as a National Health Service
Corps member after receiving his medical degree from UCLA. After spending 11 years in the
Corps, measures were taken to decrease the Corps numbers and he was told to close down his
clinic. Instead, Dr. Firestone chose to leave the Corps but to keep the El Pueblo Health
Services Clinic open. It is currently in its 17th year of operation.
Celestin "Cel" Gachupin
Cel Gachupin, the former Governor of the Zia Pueblo (40 miles north of Albuquerque), had a
(b)(6)
003
(b)(6)
3
(b)(6)
003
(b)(6)
is a patient of the El Pueblo Health Services Clinic. Though currently uninsured,
she was insured until her premiums doubled following surgery six years ago. She, like so
many rural residents, has to drive a long distance for care. Additionally, her grown children
face many health care problems, with her son and daughter-in-law most recently being told to
quit one of their jobs in order for the couple to qualify for children's health care assistance for
their young child.
(b)(6)
003
(b)(6)
has had diabetes for 40 years and has high-blood pressure. He was born in
Estancia 75 years ago. He is a success story in that his care is currently very good (his
doctor, Linda Stogner is in the audience) but, without it, his situation would be disastrous.
He lives 54 miles from Albuquerque. In the past,
(b)(6)
has had a gall-bladder attack
and had to travel to Albuquerque for treatment.
(b)(6)
003
(b)(6)
is a patient at the El Pueblo Health Services Clinic. She is an uninsured, single
mother with three grown children. Her employment history has consisted of many short-lived
rural jobs which typically have no infrastructure, no insurance and no security. Following an
accident at the stable where she was working,
(b)(6)
has incurred tremendous bills
which remain unpaid and has been unable to hold a permanent job. She currently finds
herself bartering jewelry for the therapy care her injury requires. Due to her limited budget,
she can only afford to pay each of her doctors $5 per month.
(b)(6)
003
(b)(6)
is a patient at the El Pueblo Health Services Clinic. He has been uninsured, but
has recently obtained a job at a paint and body shop which may offer insurance at some
point. Previously, he has been out of work with an infection he contracted from working with
cattle. He has two children and piles of unpaid medical bills.
(b)(6)
003
(b)(6)
live 2 miles west of the doctor. Her mother was living with them for 12
years. She had Parkinsons disease and was totally blind. The closest home care that they
knew about was in Albuquerque. In order to get someone to their home, they would have to
pay their transportation plus $7 an hour--which has taken a toll on their limited budget. Once
their mother became bed-ridden, Dr. Firestone would make housecalls, but when he could not
or when they felt as if they were burdening him by calling, their mother went without care.
(b)(6)
003
(b)(6)
will talk about the story of her mother who died of a brain tumor at 62 years old.
At 62, she was ineligible for Medicare.
(b)(6)
mother's case was one of many in which
people have little documentable income from their various rural jobs and, therefore, do not
qualify for Medicaid.
(b)(6)
belives her mother's condition could have been exacerbated
by her lack of access to doctors and her mother's difficulty in understanding the complexity of
the system.
Jack Vick, M.D.
Dr. Vick is a resident physician at the Department of Family and Community Medicine at the
University of New Mexico University Hospital. He intends to pursue a rural health care
practice upon completion of his residency. In the past, he served as the sole provider for a
small rural hospital and clinic when the only physician abondoned the center.
AUDIENCE MEMBERS
(This list includes audience members with direct relationships to rural health care issues only)
Francisco Crespin, Jr., M.D., New Mexico Department of Health District Health Officer
(b)(6)
003
Pamela Galbraith, Administrator, Medical Services, University Hospital, UNM
George Stephen Goldstein, Director, New Mexico Health Care Initiative
(b)(6)
003
Kay Elene Handleigh, nurse who witnesses lack of quality rural health care services
(b)(6)
003
Arthur Kaufman, M.D., Chairman, Department of Family and Community Medicine, UNM
James Kolb, Administrator, Catron County Medical Clinic
(b)(6).
003
Eugenio Lujan, County Extension Agent, Guadalupe County, organized county to provide care
(b)(6)
003
Linda Stogner, M.D., Director of Hope Medical Center; former National Health Service Corps
((b)(6)
003
Chris Urbina, M.D., Department of Family and Community Medicine, UNM
10:27AM
TO
12024562464
P.02
CASEY LUNA FORD MERCURY
September 10, 1993
President Bill Clinton
The White House
1600 Pennsylvania Avenue, North West
Washington, DC 20550
Dear Mr. President:
I want to offer to you my comments on your health care proposal
from my perspective as the owner of a small business. Though I owe
several different companies the core of those enterprises is an
automobile dealership which employees some seventy workers.
The early press reports on the program were of SOME concern to me.
It certainly pounded like small companies would be effected very
much by the changes. The more I looked into the matter I found that
the affects were not nearly as extreme as I originally anticipated.
When I looked carefully at your proposal and I then looked back
over my company's experience under the current arrangements I came
to the conclusion that changing the crazy quilt way we do things
was absolutely critical. An initial increase in costs is worthwhile
to get spiraling costs under control.
My company has always sought to provide the best possible health
coverage. To keep that coverage at a reasonably steady our expenses
have skyrocketed, threatening our ability offer other benefits and
even pay raises. Each year coverage was erded a little to keep
those costs from growing too precipitously. This is a situation
that cannot continue. Those small annual changes in coverage now
represent a significant cut in the quality and scope of coverage.
Your bold action was absolutely critical. Yes, it will cost more,
but I truly believe that you can bring some sanity to this system,
and, therefore, in the long run my company, my employees, and their
families will be better served and have access to better health
care.
I praise you for your effort and would like to help in anyway I can
to insure that this package is enacted by Congress in essentially
the form that you outlined.
Albuquerque (Dtrect Line) 505/865-9626 Belen Office 505/864-4414 Los Lunas Office 505/865-4333
Highway 85 North of Belen P.O. Drawer 1279 Belen. NM 87002-1279
OUTLINE FOR DISCUSSION
Acknowledgments:
Before we begin, I would like to acknowledge some people who are here. First,
Mayor Aguilar and his wife, Mary Kay, were nice enough to be with us today. I
am also delighted to recognize Governor King and his wife, Alice. Senator
Bingaman and his wife, Anne, Senator Domenici, Congressman Bill Richardson
and his wife, Barbara, and Congressmen Schiff and Skeen.
Introduction:
I'm happy to be here today to talk with you about the challenges rural areas
face in trying to access high quality, affordable health care. Having been born
and raised in a rural state, I've experienced first hand the problems of
communities with too few doctors, and no hospital for miles.
I've visited communities filled with self-employed farmers who struggle to
scrape together enough to buy health insurance in a market stacked against
the little guy.
And I've talked to doctors and nurses (like yourselves) who feel that making a
commitment to rural practice is an impossible proposition lower reimburse-
ment, little or no peer support, and a high number of patients with no
insurance and no ability to pay doctor's bills.
The promise of health care security for all Americans must mean access to high
quality care for all America-- our cities and suburbs, but also our rural towns
and farm communities.
Rural Communities and Universal Coverage
The biggest problem rural areas face is insecurity-- there are too many people with
out coverage. And too many that are with coverage find that insurance means
little because there are no doctors or hospitals available.
Twenty-one million rural residents are without access to consistent primary
care providers, and new, younger physicians setting up rural practices have
not kept pace with those who retire-- leaving many communities with no
doctor at all. Rural communities worry that the current shortage of
physicians will continue, and limit their access to care even further.
Americans living in rural areas also have a harder time getting to the
services they need. More than half of the rural poor do not own a car, and
nearly 60 percent of the older Americans in rural areas have no driver's
license.
Rural Communities
Page 2
The Health Security Act:
The Health Security Act guarantees you comprehensive health benefits, no
matter you live. Since rural areas have more than their share of uninsured,
underinsured and Medicaid recipients, providing universal coverage will
channel new resources into rural health care systems.
14 million Americans in rural areas will receive improved health care
services, since the Health Security plan targets rural areas in which more
than half of all residents earning low incomes.
As we phase-in health reform, current grants will continue to pay for
clinical services for the uninsured, as well as to supplement services for low-
income individuals.
After universal coverage is achieved, money that in the past was used for
health services to the uninsured will be redirected and combined with new
grants to pay for support services that improve access to care. These
services include outreach, follow-up, home visits, transportation, and child
care during office visits.
Rural Health Care and Access to Providers
I also know the promise of security presents different challenges in rural areas-- a
health security card means little to the person with no doctor that can see him, no
hospital for a hundred miles. Right now, two-thirds of rural counties do not have
enough doctors.
Rural doctors provide more charity care than any doctors in the country, and
when doctors and hospitals do get paid, they often get paid late. In the most
extreme cases, rural doctors are so strapped, there is one doctor trying to fulfill
the needs of 2,000 people.
The Health Security Act:
We have new ways to increase doctors and nurses in rural areas: tax
incentives, increased reimbursement, retraining, scholarships, and loan
forgiveness programs.
The Health Security Act expands the National Health Service Corps,
placing more than 3,000 primary care providers in rural areas by the year
Rural Communities
Page 3
2004.
Under the Health Security Act, technical and financial assistance will be
provided to help rural communities establish links with larger referral
centers and academic health centers.
The Health Security plan includes grants to support the development of
telecommunications links between rural providers and other providers,
health care centers, and institutions. This will help facilitate "group
practices without walls," allowing easier consultation and coordination
among rural providers and with urban providers.
Rural health care centers will receive special protection. These "essential
providers" will be offered contracts with plans, or receive reimbursement on
a fee-for-service basis to ensure access to care and continuity of care for
rural residents.
The Health Security Plan
RURAL COMMUNITIES
America's rural communities pose special challenges in health care-- both for
those who need services and those who provide them. A total of 34 million people--
half of them with incomes under 200 percent of poverty--live in rural areas with
inadequate health care.
The fragile economies of rural areas often mean that many residents have little
or no insurance, making it difficult for rural communities to attract and keep doctors
and maintain local hospitals. Twenty-one million rural residents are without
consistent access to primary care providers, and the population of younger rural
physicians has not expanded to replace those who retire. Rural communities worry
that the current shortage of physicians will continue, and limit their access to care
even further.
Americans living in rural areas also have a harder time getting to the services
they need. More than half of the rural poor do not own a car, and nearly 60 percent
of the rural elderly are not licensed to drive.
The Health Security plan will create a system that meets the unique needs of
rural communities. The plan will develop strategies for delivering and financing
health care in rural areas, making care more easily available, and attracting doctors
and nurses to and keeping them in rural areas.
Guarantees Universal Coverage
The Health Security plan will guarantee comprehensive health benefits for
all Americans, no matter who they are or where they live. Since rural areas
have a disproportionate number of uninsured, underinsured and Medicaid
recipients, providing universal coverage will help channel significant new
resources into rural health care systems.
The plan will encourage cooperative relationships among rural and urban
providers such as developing information sharing capabilities and referral
mechanisms to link academic health centers and rural health providers.
Under the plan, regional alliances may provide incentives to urban health
plans to serve rural areas in their region. They may also be required to serve
underserved rural areas as a condition of participation.
Rural Communities
Page 2
Increases Access to Providers
The Health Security plan will develop an infrastructure and provide support
for primary care capacity to help serve rural citizens and providers. An
additional 14 million Americans will receive improved health care services as
the Health Security plan targets rural areas in which more than half of all
residents earn incomes 200 percent or less of the poverty level.
New workforce initiatives, including tax incentives, increased
reimbursement, retraining, scholarships, and loan forgiveness programs, will
encourage health care providers to practice in rural underserved areas.
The Health Security plan will expand the National Health Service Corps,
placing at least 3,000 primary care practitioners in rural areas by the year
2000.
Encourages Health Networks
Under the Health Security plan, technical and financial assistance will be
provided to develop networks. This will help the rural communities that need
outside expertise to establish links with larger referral centers and academic
health centers.
The Health Security plan includes grants to support the development of
telecommunications links between underserved providers and other
providers, health care centers, and institutions. This will help facilitate
"group practices without walls," allowing easier consultation and
coordination among rural providers and with urban providers.
New grants will be provided to academic health centers to help build
information and referral infrastructure needed to support rural health
networks.
Investment in currently successful programs, such as community and
migrant health centers, will be increased to help them establish and enhance
contacts with other providers.
Assures Participation of Essential Community Providers
For the first five years after implementation, the Health Security plan will
designate as "essential providers" qualified practitioners and facilities in
underserved areas.
Rural Communities
Page 3
These providers will either be offered contracts with plans, or receive
reimbursement on a fee-for-service basis to ensure access to care and
continuity of care for rural and other vulnerable populations.
Federal grants and loans will help essential providers establish links with
local practitioners, community hospitals, and academic centers, and form
integrated practice networks or community-based plans.
Coordination of Programs
During the phase-in of health reform, current block grants will continue to
pay for clinical services for the uninsured as well as supplemental services for
all low-income individuals.
After universal coverage is achieved, funds which had been used to provide
health services to the uninsured will be redirected and combined with new
grants to pay for support services to ensure access to care. These services
include outreach, follow-up, home visits, transportation, and child care
during office visits.
December 2, 1993
THE WHITE HOUSE
WASHINGTON
MEMORANDUM FOR THE PRESIDENT
FROM:
John Hart, Deputy Assistant to the President for
Intergovernmental Affairs.
DATE:
December 3, 1993
SUBJECT: New Mexico and the Health Security Act
I.
Summary and Background
New Mexico is a largely rural state with a significant
uninsured population. New Mexico has the highest percent of
uninsured population in the country -- over 25%... The
combination of a large number of small businesses, low
wages, the lack of affordable coverage for the unemployed
and self-employed, and the lack of insurance in the hispanic
community has contributed to the high rate of uninsured.
The state's ability to address its health care needs has
been crippled by lack of funds. Consequently, New Mexico
commits less money to the low-income population than all
other states except three.
Access in rural New Mexico is a major problem.
A third of the population lives in Albuquerque, a third
along the Rio Grande corridor, and the remaining third
spread out in an area twice the size of New York state. All
or a portion of 30 of the 33 counties are medically
underserved.
Although New Mexico faces considerable barriers, the state
has been creative in delivering its limited resources to its
residents. New Mexico was the first state to have a
statewide Medicaid Primary Care Network, as well as peer
review of physicians. The three large cities have strong
HMO penetration. Large purchasing groups exist for public
employees and public school employees.
II. Health Care Reform in New Mexico
A.
Current Health Reform Climate
While there are many legislative proposals that have
been reviewed by the Health Care Task Force, it is
unlikely that any comprehensive reform package will
pass the legislature before national reform has been
solidified.
In the 50 mile radius around Albuquerque, HMO
penetration is quite high: 75% in the area are handled
by an HMO or other kind of managed care system. HMOs
have helped doctors to practice more cost-effective
medicine. However, premiums have still increased
faster than medical costs, and some believe that
successful HMOs have learned to disenroll groups that
are too costly.
In the last legislative session, the Governor, did not
appropriate the full amount of money to the Rural
Primary Health Care Act, which has upset many concerned
with rural health.
B.
Key Figures in Reform
The major impetus for reform in New Mexico is the New
Mexico Health Care Initiative, a body formed by the
Governor's Health Policy Commission, and directed by
Dr. Charles Goldstein. Although the Governor has not
been a major player in health care reform, it is highly
likely that he will be behind the legislation proposed
by the New Mexico Health Care Initiative. The
Democratic leadership has been an active participant in
reform, as well, including House Speaker Raymond
Sanchez, Rep. Manuel Olguin, Rep. Max Coll, Rep. Lucky
Varella, Sen. Manny Aragon, and Sen. Paster.
In attendance at the arrival will be the Mayor of
Albuquerque, Mayor Chavez; ten Pueblo Governors have
been invited.
Lieutenant Governor Casey Luna will be flying on Air
Force One to Albuquerque. The Lieutenant Governor is
the owner of a small business (a car dealership). In
September, he wrote a letter to President expressing
his enthusiastic support for the Health Security Act --
as a small business owner and a government official.
C.
Native American Health Care
1.
Background
In New Mexico, Indian Health Services (IHS) provide
care to about 148,000 Native Americans. Utilization of
the Indian Health Services system has been steadily
decreasing because of the distance of many of the
clinics that participate, and the fact that many Native
Americans are eligible for Medicaid, and utilize
alternative services.
Most Native Americans live in rural communities and
receive their care through primary care clinics. Any
form of specialized care must be attained by
contracting with outside providers, which drains IHS's
limited resources. Consequently, transportation is a
major impediment in the availability of comprehensive
care.
Native Americans have different health problems than
other populations. Native Americans are four times
more likely than other populations to have fatal
injuries. Most are the result of motor vehicle deaths,
many of which are associated with alcohol abuse.
Illness, hospitalization, and death from diabetes is
also more prevalent among Native Americans.
2. Native American Health Care Concerns
Health care delivery for Native Americans in New Mexico
is a complex issue, because 1) the Indian Health
Services system cannot sufficiently respond to the
community's needs, and 2) there is considerable Native
American skepticism on state and federal partnerships.
Today, funds for Indian Health Services in New Mexico
are capped at about $40 million. Under the Reagan
years, health care funding was changed to the block
grant system, and only states were eligible for the
grants. Consequently, Native Americans were forced to
negotiate with the state for funds, which goes against
their strong desire to uphold the trust responsibility
of the federal government.
The Health Security Act allows for Native Americans to
participate in the new system like all other citizens.
However, Native Americans have the option of receiving
a comprehensive benefits package through either IHS or
a private health plan. The Act requires IHS to provide
the same level of benefits as other health programs by
1998. Supplemental funding to bring IHS up to this
level will be made available. Indian Health Services
have not been able to become full providers in the past
30 years, and the requirement that they do so under the
Health Security Act appears unattainable to Native
American groups.
This fiscal year, the IHS budget will be reduced 3%,
another 3% next year, and 5% the following year. If
IHS does not receive the supplemental funds before
these cuts, parts of the community will be at risk.
Under the Health Security Act, if Native Americans are
attracted to the regional alliances, the IHS system
will see a decline. From the Native American
perspective, the fall of IHS will threaten the concept
of Tribal sovereignty and the Government to Government
relationship that currently exists. Native Americans
would like to see a levelled playing field among
providers.
D.
Migrant and Undocumented Workers
A Farm Worker Health Coalition of members of various
state agencies has been formed to coordinate outreach
to migrant workers. Migrants have greater health
problems, with chronic diseases, lack of child
immunization, exposure to pesticides, and lack of
dental care. The problem is most acute in the southern
region of the state, where there is only one public
rural health clinic to serve the area with the most
need. Limited resources have forced clinics to form
waiting lists for care.
Another issue is the fact that field and farm labor are
not covered under workers compensation. There is a law
suit that is currently seeking to remove this
exemption.
III. Key Elements of Reform
A.
Health Policy Commission
The New Mexico Health Policy Commission was created by
the 1991 New Mexico Legislature to develop a feasible
universal access health care plan. In March, the
Commission proposed the Cooperative Health Care plan, a
multi-payer system, which has been folded into the
Health Care Authority Proposal (see Section C). The
Commission created the New Mexico Health Care
Initiative to complete this project.
B.
New Mexico Health Care Initiative, NMHCI
NMHCI, a special state agency that reports to the NM
Health Policy Commission, was funded by a grant of
almost $1 million from the Robert Wood Johnson
Foundation. NMHCI evaluates the feasibility of
different health-care reform proposals, including a
primary-payer model. The director of NMHCI, Dr.
Charles Goldstein, is also a member of the Legislative
Task Force.
The Initiative has recommended for 1994:
Expanding capacity of primary care clinics
Insurance reform: modified community ratings,
guaranteed renewability, and portability
Creating a pilot study for voluntary insurance
pools
Funding for needs analysis of health information
system architecture
Medicaid expansion
Set-asides for academic, chronic and long-term
levels of health care
The Initiative has recommended for 1995:
Creation of New Mexico Health Care Authority
Set up regional councils
Pass fiscal incentives for investing in existing
and current resources (tax incentives)
Pass malpractice reform
Mandate business contributions
C.
Proposed Health Care Authority
The New Mexico Health Authority, proposed by NMHCI, is
a public not-for-profit corporation with a: board of
seven paid members appointed by the governor with the
consent of the Senate that handles all regulatory tasks
and ensures that all rules and regulations are
equitable.
The Health Authority responsibilities include:
Ensuring access to all residents
Set maximum premium caps
Establish a statewide minimum benefits package for
all health plans
Review and approve cost-sharing levels
Set quality standards
Certify plans
Publish report cards of services
Oversee centralized claim system
Make policy for health care delivery and assist
with budget and resources
The Authority establishes five Regional Health Councils
with locally elected members around the state. Each
council selects the Health Plans to be offered in its
region. The Council's role is to advocate and
negotiate for its members. This proposal has been
written in light of the Health Security Act, however it
has not been submitted to the legislature.
D.
New Mexicare
The most ambitious proposal, New Mexicare, was
introduced and tabled within the 1993 legislative
session. The plan would have prohibited all private
health insurance for services covered under New
Mexicare. Private insurance would offer coverage for
services not in the state plan. The plan was funded by
a 8% income tax surcharge and a 3 1/2% payroll tax.
Premiums were set on a sliding scale, between $1,000
and $5,000 a year for all above the poverty line. It
is likely that a more detailed version of the bill will
be reintroduced in the next legislative session,
although support is still lacking.
E.
Joint Health Care Task Force
Over the summer, the legislature set up a task force to
review health reform after the single-payer bill was
tabled. The Task Force includes 12 legislators, four
members of the public, and four representatives from
executive agencies. The Task Force is investigating at
least two health care delivery and payment proposals --
single and multi payer plans.
Reforms being considered include:
standardization of forms
increased use of computers for claims
restricting malpractice awards
providing coverage to residents who leave the
state
increasing funds for training medical
practitioners
ensuring all residents are covered and costs are
equitable
NMHCI has been working with the Task Force -- supplying
data and analysis of different types of reforms.
F.
1991 Small Group Insurance Reform
Reform for small group insurance includes guaranteed
renewal and rating bands. Once a company is covered,
an insurer may not cancel coverage because of insurance
claims or changes in health status. The difference
between the lowest and highest premium rates charged to
different groups of employers with different risk
characteristics such as medical conditions, claims
experience, and duration of coverage are limited.
Insurers are still free to set different rates for
different "case characteristics", such as age, gender,
industry, and location.
Under the Health Security Act, there will be no rate
difference for "case characteristics" such as age,
gender, or industry. Community rating ensures that
risk will be spread across the entire population.
Premiums for the comprehensive benefits package will be
adjusted only for geographic location and family
status.
G.
Minimal Coverage Plans
Basic plans are available to small business. These
basic, no-frills policies are more affordable because
they are stripped of some or all of the more costly
state benefit and provider mandates.
H.
Uninsurable Population Program
A comprehensive insurance policy is available for those
who are unable to obtain health insurance at a standard
rate due to pre-existing or chronic medical conditions.
I.
Rural Health Care Reform
1. Rural Primary Health Care Act
The Rural Primary Health Care Act has expanded from
about $300,000 in 1988 to $1.2 million in 1993. [As
mentioned above, the Governor line-item vetoed $800,000
for the program.] This program will completely fund
three clinics and help fund another 24. These
subsidies will maintain a minimum level of primary care
services in underserved areas by supplementing the
salary of practitioners.
2. Rural Health Care for Women
La Clinica de Familia in southern New Mexico has
started one of the first mobile health education
services for rural women in the country. With a grant
from the State Maternal Child and Health Bureau,
members of the community, picked by the clinic, fan out
to help their fellow community members. By teaching
preventive medicine, health officials believe the
program will cut Medicaid and indigent care costs.
3. Addressing the Shortage of Providers
The roles of physician assistants and nurse
practitioners been expanded to allow independent
practice. As well, the curriculum at the University of
New Mexico Medical school has been changed to reflect
the need for more rural general practitioners.
Residency is now spent two years in rural underserved
areas and one year in a hospital. This program also
helps to temporarily alleviate the shortage of rural
doctors.
J.
Medicaid Reform
The 1992 and 1993 legislation redirected funds raised
by county gross receipts taxes to new rural health
centers in underserved areas and to expand Medicaid
eligibility.
Access for Medicaid recipients has been a problem --
from primary care providers and dentists, especially in
the northwest, southwest and southeast corners of the
state.
IV. Waivers
A. 0161.90
On November 20, 1992, New Mexico has asked for a
renewal to provide case management, homemaker/personal
care and private duty nursing to patients with AIDS or
ARC. The state stopped the 90 day clock on January 21,
1993 to resubmit information.
B. 0173.90.02
On September 30, 1993, New Mexico submitted a request
for waiver modification to provide services to
individuals who would otherwise require ICF/MR level of
care. The waiver is pending in HCFA and the 90th day
is December 29, 1993.
C. 01.R01
On August 2, 1993, New Mexico asked for a renewal
waiver to provide a primary care case management
system. The waiver was approved October 27, 1993.
V.
Relevant Health Care Statistics
Rank of New Mexico
1st -- Percent of state uninsured -- 25.6%
5th -- Percent of population covered by Medicaid -- 13.7%
6th -- Percent of population underserved -- 32.7%
10th -- Percent of health payments in average
family income -- 15.2%
16th -- Percent of population enrolled in HMOs -- 15.7%
32nd -- Infant mortality rate per 1000 live births -- 8.1
35th -- Medicaid expenditures as a percent of total state
expenditures -- 11.6%
38th -- Per capita health expenditures -- $3,425
45th -- Medicaid payments per recipient -- $2,259
46th -- Per capita income
46th -- Population above the poverty limit
Demographics
1,548,000 -- Total population (1991)
20.9% -- Population below poverty (1990)
27.0% -- Rural population (1990)
40.0% -- Hispanic (1993)
11.0% -- Native American
9,255 -- Migrant and seasonal farm workers (1991)
Total Health Payments per Family
1980 -- $1,989
1993 -- $7,274
2000 -- $13,774
266% -- Increase in costs from 1980 to 1993
592% -- Increase in costs from 1980 to 2000
Health Insurance Coverage, 1991
13.7% -- Covered by Medicaid
11.4% -- Covered by Medicare
60.4% -- Covered by private payers
21.5% -- Uninsured, 1991
25.6% -- Uninsured, 1993
Nonelderly Population with Selected Sources of Health
Insurance
52.9% -- With employer coverage
8.2% -- With other private insurance
60.9% -- Total with private insurance
Public Health System
$108,800,000 -- PHS public health expenditures (FY1992)
$49,034,000 -- State public health expenditures (FY1989)
$1,150,000 -- Local public expenditures (FY1989)
8 -- Community and migrant health centers
32.7% -- Population underserved
21.0% -- Lack access to Primary Care
Health Indicators
8.1 -- Infant mortality rate per 1000 live births (1991)
65.4% -- Two year olds appropriately immunized (1989)
45% -- Pregnant women who receive prenatal care (1993)
Medicaid
212,000 -- Medicaid recipients (1992)
$478,000,000 -- Medicaid payments (1992)
$2,259 -- Medicaid payments per recipients (1992)
11.6% -- Medicaid expenditures as a percent of state
expenditures (1992)
73.85 -- FMAP (FY 1993)
Managed Care
5 -- HMOs (1992)
15.7% -- Percent of population enrolled in HMOs (1992)
75.0% -- Percent of population around Albuquerque
in HMOs (1993)
5 -- Operational PPOs (1990)
VI. Sources
ASPE, HHS, New Mexico Overview, 11/93.
"Congressmen Look at N.M.'s Managed Care", AP, September 27,
1993.
Families USA Foundation, Skyrocketing Health Inflation, November
1993.
Governor King's Office
Lt. Governor Casey Luna, Letter to President Clinton, September
10, 1993.
New Mexico Department of Insurance
Joy Waldron, David Ricks, and Barbara Russell, State of New
Mexico, Health Care Initiative Office
Larry Salazar, Migrant Farm Workers Coalition Office
Sam Cata, Office of Indian Affairs
National Association of Communal Health Centers, "Medicaid and
Migrant Farmworkers Families", August 1991.
Health Care Task Force, "Bill Drafts, Proposals, and Issues",
November 18-19, 1993.
Julia Watson, "Rural Health Program Breaks New Ground", Sun-News.
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
004. schedule
Schedule for Hillary Rodham Clinton, Draft #5 [partial] (3 pages)
2/18/94
b(7)(E)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIA|
P2 Relating to the appointment to Federal office |(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRA]
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information |(a)(4) of the PRA|
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy |(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
Falls
Sout
SCHEDULE FOR HILLARY RODHAM CLINTON
5:30 6:00
DATE: FRIDAY, FEBRUARY 18, 1994
DRAFT: #5
WASHINGTON, DC/SIOUX FALLS, SD/WAUSUA, WI/MILWAUKEE, WI
Traveling Party:
HRC
Craighead
1-800SKYPAGE #207-4653
202-365-7717
CELLULAR
Caputo
1-800SKYPAGE #883-5733
Verveer
Alswang
Sec. Mike Espy
Steve Kinsella, Espy staffer
(b)(7)e
004
Congressional Delegation:
Lead Advance:
Sioux Falls, SD
Pat Halley
Holiday Inn
100 W. 8th Street
605-339-2000
RM 536
605-339-3724
fax
1-800SKYPAGE
#537-3335
Lead Advance:
Waussau, WI
Steve Graham
Waussau Inn & Conference Center
2001 N. Mountain Road
715-842-0711
RM 226
715-842-1838
fax
1-800SKYPAGE
# ?
Scheduling Desk:
Sara Grote
202-456-2922
office
202-456-2317
fax
202-483-7312
home
1-800-528-7528
WHCA #4363
PREV RON
The White House
NEW HAMPSHIRE DAY!
7:30 am
DEPART White House
EN ROUTE Andrews Air Force Base
Traveling w/ HRC:
-Craighead
-Caputo
-Verveer
-Alswang
-Sec. Mike Espy
-Steve Kinsella, Espy staffer
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 2
7:55 am
ARRIVE Andrews Air Force Base
8:00 am
WHEELS UP Andrews Air Force Base
Flight Time: 2 HRS. 45 MIN. [+1]
Manifest: HRC, CRAIGHEAD, CAPUTO, VERVEER, ALSWANG, ESPY,
KINSELLA,
(b)(7)e
004
Food: BREAKFAST
9:45 am
WHEELS DOWN Sioux Falls
FBO: Air National Guard Terminal
Phone: 605-333-5754
Fax: 605-333-5897
CLOSED PRESS ARRIVAL
Contact: John Carlson
605-333-5754
Greeter: Sen. Thomas Daschle [D]
9:55 am
DEPART Airport
EN ROUTE Lennox Area Medical Center
[drive time: 30 min.]
MOTORCADE MANIFEST:
HRC's Van: HRC, VERVEER, ESPY, SEN. THOMAS DASCHLE, ROGERS
Staff Van: CRAIDHEAD, CAPUTO, ALSWANG, KINSELLA
10:25 am
ARRIVE Lennox Area Medical Center
OPEN PRESS ARRIVAL
Greeter: Dr. Larry Sittner, Clinic Director
10:30 am-
11:00 am
TOUR OF Lennox Area Medical Center [w/ Sen.
Thomas Daschle]
Waiting Room, Patients Rooms, Clinical Rooms
Lennox Area Medical Center
108 South Main Street
Phone: 605-647-2841
TIGHT POOL PRESS
Format: Dr. Sittner to conduct tour. HRC &
Sen. Thomas Daschle to tour medical center
and visit with patients.
Participants: Approx. 12 people to attend.
[see briefing for more info.]
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 3
Contact: Mike Brogioli, Sen. Daschle's
Office
202-224-2321
605-334-9596 [o]
605-361-2345 [hotel]
Scott Rogers, Physician's Assistant
11:00 am
DEPART Lennox Area Medical Center
EN ROUTE Lennox High School
[drive time: 05 min.]
11:05 am
ARRIVE Lennox High School
Greeters: Alan Rops, Lennox High School Principal
Dr. Robert Mayer, School superintendent
11:10 am-
11:35 am
ADDRESS TO Students and Faculty
Study Hall
Lennox High School
CLOSED PRESS
Format: Sen. Thomas Daschle to speak and
intro. HRC. HRC to deliver brief remarks.
Work ropeline with Sen. Thoms Daschle.
Participants: Approx. 120 people to attend.
Contact: Mike Brogioli, Sen. Daschle's
Office
202-224-2321
605-334-9596 [o]
605-361-2345 [hotel]
11:35 am-
11:55 am
HOLD/LUNCH
Holding Room: Staff Work Room
Phone: 605-647-2030
Fax: 605-647-2031
Staff Hold: Room 101
CLOSED PRESS
11:58 am
PROCEED TO Forum W/Sen. Thomas Daschle
12:00 pm-
2:00 pm
NORTHERN GREAT PLAINS SUMMIT ON RURAL HEALTH
CARE
Gymnasium
Lennox High School
208 West 5th Avenue
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 4
OPEN PRESS
Seated at table with HRC:
-Sen. Thomas Daschle [D-SD]
-Sen. Larry Pressler [R-SD]
-Sen. Kent Conrad [D-ND]
-Sen. Robert Kerrey [D-NE]
-Sen. Paul Wellstone [D-MN]
-Cong. Earl Pomeroy [D-ND]
-Cong. David Minge [D-MN]
-Sec. Mike Espy
-20 citizens
Program:
-Sen. Thomas Daschle to delvier welcoming
remarks & intro. HRC
-HRC to deliver remarks-20 min.
-Lois Quan to act as moderator and open up
roundtable discussion on health care
-HRC to take questions and listen to
statements made by citizen participants
Participants: Approx. 1500 people to attend.
[See briefing for more info.]
Contact: Mike Brogioli, Sen. Daschle's
Office
202-224-2321
605-334-9596 [o]
605-361-2345 [hotel]
Rick Weiland
605-334-9596
2:05 pm-
2:10 pm
OFFICIAL PHOTOS W/20 Citizen Program
Participants
Band Room
CLOSED PRESS
2:10 pm-
2:20 pm
INTERVIEW W/
of Argus Leader
Holding Room
2:20 pm-
2:40 pm
TV INTERVIEWS
2:45 pm-
3:05 pm
MEET AND GREET/OFFICIAL PHOTO
Study Hall
Lennox High School
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 5
CLOSED PRESS
Format: Informal meet and greet/photo line.
Participants: Approx. 75 people to attend.
[See briefing for more info.]
Contact: Joe Trayhern
456-6257
3:10 pm
DEPART Lennox High School
EN ROUTE Airport
[drive time: 30 min.]
3:40 pm
ARRIVE Airport
3:45 pm
WHEELS UP Sioux Falls
Flight Time: 1 HR. 05 MIN.
Manifest:
Food:
4:50 pm
WHEELS DOWN Wausau, WI
Wisconsin Central
FBO:
Phone:
Fax:
CLOSED PRESS ARRIVAL
Greeters:
4:55 pm
DEPART Airport
EN ROUTE Lincoln Center at Stevens Point
[drive time: 20 min]
5:15 pm
ARRIVE Lincoln Center at Stevens Point
Greeters:
5:20 pm-
5:50 pm
DISCUSSION W/Seniors [w/Sen. Russell
Feingold, Sen. Herb Kohl & Cong. David Obey
Room:
Lincoln Center at Stevens Point
OPEN PRESS
Format:
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 6
Participants:
Contact: Joe Crappa, Cong. Obey's Office
@ TouR
225-3365
Jerry Madison, district rep.
715-842-5606
open discussion
discussion
Ruth Laroque, Sen. Feingold's
Office
0
224-5323
Moira Harrington, district office
608-828-1200
6:10 pm-
6:35 pm
PRIVATE MEETING W/Hospital Administrators
Room: TBA
Lincoln Center at Stevens Point
CLOSED PRESS
Format: Informal meeting
Participants: Approx. 12 people to attend.
[See briefing for more info.]
Contact:
6:40 pm
DEPART Lincoln Center at Stevens Point
EN ROUTE Grand Theater
[drive time: 40 min.]
7:20 pm
ARRIVE Wausau Supper Club
7:25 pm-
7:45 pm
HOLD
Greeters:
7:45 pm-
8:20 pm
VIP RECEPTION
Ballroom
Wausau Supper Club
CLOSED PRESS
Format: Cong. David Obey to intro. HRC. HRC
to deliver very brief remarks. Work
ropeline.
Participants: Approx. 350 people to attend.
[See briefing for more info.]
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 7
Contact: Joe Crappa, Cong. Obey's Office
225-3365
Jerry Madison, district rep.
715-842-5606
8:20 pm
DEPART Wausau Supper Club
EN ROUTE Grand Theater
[drive time: 5 min.]
8:25 pm
ARRIVE Grand Theater
Greeters:
8:30 pm-
10:00 pm
FUNDRAISER FOR CONG. DAVID OBEY
Grand Theater
Holding Room
Phone:
Fax:
OPEN PRESS
ON STAGE:
-HRC
OBEY
-Cong. David Obey
-Sen. Russell Feingold
-Sen. Herbert Kohl
Program:
-Cong. David Obey to act as MC, & intro. Sen.
Feingold
-Sen. Russell Feingold to deliver brief
remarks
-Cong. David Obey to intro. Sen. Herbert Kohl
-Sen. Herbert Kohl to deliver brief remarks
-Cong. David Obey to intro. HRC
-HRC to deliver 10 min. remarks
-HRC to take Q&A [40 min.]
-Cong. David Obey to act as moderator
Participants: Approx. 1000 people to attend.
Better Way Club-providing funding to Obey
Contact: Joe Crappa, Cong. Obey's Office
202-225-3365
Jerry Madison, district rep.
715-842-5606
Nelda Madison, funding
715-842-5606
10:05 pm
DEPART Grand Theater
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 8
EN ROUTE Airport
[drive time: 20 min.]
10:25 pm
ARRIVE Airport
10:30 pm
WHEELS UP Wausau, WI
Flight Time: 45 MIN.
Manifest: HRC, CRAIGHEAD, CAPUTO, VERVEER, MICHAEL VERVEER,
ALSWANG, SEN. RUSSELL FEINGOLD,
(b)(7)e
004
Food:
11:15 pm
WHEELS DOWN Milwaukee, WI
RON
Hyatt Hotel
Milwaukee, WI
Phone:
Fax:
02/17/94
14:54
202 401 7321
HHS ASPE/HP
1
002/014
Notes for the First Lady's Rural Health talk in South Dakota
Background: The National Rural Health Association is a diverse, multi-disciplinary organization.
Members include rural providers, Community and Migrant Health Centers, hospitals, state offices
of rural health, university types, etc. I was executive director for 9 years. Denise Denton, from
Colorado, is the President, and she worked with the task forces on health care reform this
summer.
Tom Dean, M.D., an NRHA former president, is an avid supporter of the President and the
Health Security Act. Tom is a family doctor in a small Community Health Center in Wessington
Springs, SD. He is very tight with Sen. Daschle, so there is a good chance you will meet him.
He is a model physician and great guy. His wife Kathy is a Certified Nurse Midwife.
Intro:
It may be useful to set the stage by acknowledging how different rural South Dakota is from rural
Arkansas. South Dakota is a "frontier" state (less than 6 people per square mile).
There is no specific rural section of the Act, but taken all together, all the rural picces in the Act
provide a comprehensive package of improvements to address rural health problems.
What are the problems?
1.
Uninsured and underinsured population proportionally higher in rural
people lack security of coverage and poor benefits
providers don't get paid for their work
2.
Small rural business and self-employed people adversely affected by the lack of an
organized insurance market
allows insurance company abuses
administrative costs higher for individuals and small business
finding coverage and periodically refinding is a hassle
3.
Shortage of primary care providers - docs, PAs and NPs
providing an insurance card is not enough - must build provider capacity
rural docs see 20 percent more office visits
competition for primary care providers is intense and going to get worse as
managed care grows
4.
Existence of organized systems of care is spotty
while a lot is being done in this area voluntarily and under state, federal and
private sponsorship, lots of areas lack much significant provider organization
this makes areas vulnerable both now and in the future, and does little to
maximize the assurance of high quality care for rural folks
The attached materials are cleared briefing slides that describe the benefits available to rural and
frontier area residents in the Health Security Act.
02/17/94
14:54
202 401 7321
HHS ASPE/HP
$
001/014
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ASSISTANT SECRETARY FOR PLANNING AND EVALUATION
OFFICE OF HEALTH POLICY
HUMAN SERVICES. USA
&
HEALTH
OF
PHONE: (202) 690-6870 FAX: (202) 401-7321
7866
Date:
From: BoB VAN Hook
To:
Liz BOYER
Phone: (202) 690- 7866
Phone: 456-2239
(202) 690-6870
FAX: (202) 401-7321
Fax: Es
Number of Pages (Including Cover): 147
Comments:
LIZ- How 'Bont INDIAN HEALTH? NeeD ANYTHINT?
of
02/15/1994 19:49
99999
QUAM AND ENTENZA
PAGE 02
To: Liz Boyer
From: Lois Quam
Re: First Lady's Midwestern trip
The most persuasive arguments with Midwesterners are the fundamental ones of security
and savings. Rural areas in the Midwest have relatively few uninsured compared to other
parts of the country. However, the insured people typically have poor coverage: high
deductibles, limited benefits including exclusions for preventive care, pre-existing condition
limitations,and lifetime limits. Security defined as bad insurance coverage is persuasive.
The greatest concern about the plan focuses on two points. First, there is concern that
business, particularly small business will be harmed. Second. there is concern that the
program represents too much government.
On the small business argument, I have found that the most persuasive approach is to
present the health care problems we face as the problems of small business. For example,
I talk about the fact that rural areas are hurt by the very structure of the health care system
because more rural Americans own their own business, farm, or work for a small company.
I close with the argument that we need a country where Americans can start their own
business and not have to put their families health security at risk.
An emphasis on the personal responsibility in the plan helps address the second concern.
There is a real emphasis on personal self-reliance in the Midwest. It is important to express
that the plan is not "free", or "government run".
This region has a strong populist history - particularly the Dakotas. South Dakota has a
long history of local pride and anti-East Coast fervor.
Talking about the special interests opposing the plan is important. Mentioning that those
interests are not from South Dakota but represent big money elsewhere would be very
persuasive. Perhaps, the First Lady could reference that coming from Arkansas she
understands how rural states often get taken for granted by the monied folks who want to
run the country. A rural populist theme would be warmly received.
The most prevalent rural issue is whether the plan will help get and keep doctors in rural
areas. This is one of the major thrusts of the plan. It is also a difficult task because the
average age of rural physicians is climbing. T answer that the plan does four things. First,
the plan trains more primary care physicians and nurse practitioners to go to rural areas.
Second, the plan provides rural training sites to provide medical residents and nursing
students a chance to appreciate rural practice. Third, the plan provides incentives through
loan forgiveness and tax deductions to get practitioners to go to rural areas. Finally, the
plan addresses the problems that cause doctors and nurse practitioners to leave rural areas
by making sure they get paid for their work through universal coverage and initiatives to
02/15/1994 19:49
99999
QUAM AND ENTENZA
PAGE 03
break the isolation. These initiatives also provide loans and grants to help improve and
convert rural clinics and hospitals.
The other materials provide a wide range of questions and answers.
Below are my updates on members.
Wellstone - I saw him Sunday night. He was supportive of the President and First Lady.
He called for support but said that it was important that the single payer groups made it
clear that they would not support compromises that lengthened the transition, cut benefits,
or made the coverage unaffordable. He is urging grassroots organizing in support of
universal coverage (as opposed to Cooper). He is derisive about Cooper.
Minge - I talked to him last week. He still sees himself as learning about health care. I
have offered to spend time with him. I am also organizing him a fundraiser this spring. He
is undecided but says he intends to support a bill like the President's.
Pomeroy - I was a co-sponsor of a Minnesota fundraiser for him recently but could not
attend. He has been particularly interested given his background in the insurance and
workers compensation sections.
Gunderson - He and I talked frequently in D.C. He was impressed with the plan and in
particular with the rural provisions. He was very supportive of Shalala when she was a the
University of Wisconsin and still feels an attachment to her. He will feel pressure from
Tommy Thompson and may feel squeezed between Thompson and the President.
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
005. schedule
Schedule for Hillary Rodham Clinton, Draft #6 [partial] (4 pages)
2/18/94
b(7)(E)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act - 144 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRAJ
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRAJ
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRA]
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information |(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy ((b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA
b(7) Release would disclose information compiled for law enforcement
purposes [(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
SCHEDULE FOR HILLARY RODHAM CLINTON
DATE: FRIDAY, FEBRUARY 18, 1994
DRAFT: #6
WASHINGTON, DC/SIOUX FALLS, SD/WAUSUA, WI/MILWAUKEE, WI
Traveling Party:
HRC
Craighead
1-800SKYPAGE #207-4653
202-365-7717
CELLULAR
Caputo
1-800SKYPAGE #883-5733
Verveer
Alswang
Sec. Mike Espy
Steve Kinsella, Espy staffer
(b)(7)e
005
Lead Advance:
Sioux Falls, SD
Pat Halley
Holiday Inn
100 W. 8th Street
605-339-2000
RM 536
605-339-3724
fax
1-800SKYPAGE
#537-3335
Lead Advance:
Wausau, WI
Steve Graham
Waussau Inn & Conference Center
2001 N. Mountain Road
715-842-0711
RM 226
715-842-1838
fax
715-573-1030
cellular
Scheduling Desk:
Sara Grote
202-456-2922
office
202-456-2317
fax
202-483-7312
home
1-800-528-7528
WHCA #4363
PREV RON
The White House
NEW HAMPSHIRE DAY!
7:30 am
DEPART White House
EN ROUTE Andrews Air Force Base
Traveling w/ HRC:
-Craighead
-Caputo
-Verveer
-Alswang
-Sec. Mike Espy
-Steve Kinsella, Espy staffer
7:55 am
ARRIVE Andrews Air Force Base
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 2
8:00 am
WHEELS UP Andrews Air Force Base
Flight Time: 2 HRS. 45 MIN. [+1]
Manifest: HRC, CRAIGHEAD, CAPUTO, VERVEER, ALSWANG, ESPY,
KINSELLA,
(b)(7)e
005
Food: BREAKFAST
9:45 am
WHEELS DOWN Sioux Falls
FBO: SD National Guard Terminal
Phone: 605-333-5754
Fax: 605-333-5897
CLOSED PRESS ARRIVAL
Contact: John Carlson
605-333-5754
NOTE: Pat Halley will meet HRC at the airport.
Greeter: Sen. Thomas Daschle [D]
Gov. Walter Dean Miller [R]
Pat Miller [Gov. Miller's wife]
9:55 am
DEPART Airport
EN ROUTE Lennox Area Medical Center
[drive time: 30 min.]
MOTORCADE MANIFEST:
HRC's Van: HRC, VERVEER, ESPY, SEN. THOMAS DASCHLE, ROGERS
Staff Van: CRAIGHEAD, CAPUTO, ALSWANG, KINSELLA, BROGIOLI,
WEILAND
10:25 am
ARRIVE Lennox Area Medical Center
OPEN PRESS ARRIVAL
Greeter: Dr. Larry Sittner, Clinic Director
10:30 am-
11:00 am
TOUR OF Lennox Area Medical Center [w/ Sen.
Thomas Daschle]
Waiting Room, Patients Rooms, Clinical Rooms
Lennox Area Medical Center
108 South Main Street
Phone: 605-647-2841
Fax:
TIGHT POOL PRESS
Format: Dr. Sittner to conduct tour. HRC &
Sen. Thomas Daschle to tour medical center
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 3
and visit with patients. NOTE: Sec. Mike Espy
will participate on tour.
Participants: Approx. 12 people to attend.
[see briefing for more info.]
Contact: Scott Rogers, Physician's Assistant
605-647-2841
11:00 am
DEPART Lennox Area Medical Center
EN ROUTE Lennox High School
[drive time: 05 min.]
MOTORCADE MANIFEST:
HRC's Van: HRC, VERVEER, ESPY, SEN. THOMAS DASCHLE, GOV. WALTER
DEAN MILLER ?, ROGERS
Staff Van: CRAIGHEAD, CAPUTO, ALSWANG, KINSELLA, BROGIOLI,
WEILAND
11:05 am
ARRIVE Lennox High School
Greeters: Alan Rops, Lennox High School Principal
Dr. Robert Mayer, School Superintendent
Mayor
?
11:10 am-
11:35 am
ADDRESS TO Students and Faculty
Study Hall
Lennox High School
CLOSED PRESS
Format: Sen. Thomas Daschle to speak and
intro. HRC. HRC to deliver brief remarks.
Work ropeline with Sen. Thomas Daschle.
Participants: Approx. 120 people to attend.
Contact: Mike Brogioli, Sen. Daschle's
Office
202-224-2321
605-334-9596 [o]
605-361-2345 [hotel]
11:35 am-
11:55 am
HOLD/LUNCH
Holding Room: Staff Work Room
Phone: 605-647-2030
Fax: 605-647-2031
Staff Hold: Room 101
CLOSED PRESS
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 4
11:58 am
PROCEED TO Forum W/Sen. Thomas Daschle
12:00 pm-
2:00 pm
NORTHERN GREAT PLAINS SUMMIT ON RURAL HEALTH
CARE
Gymnasium
Lennox High School
208 West 5th Avenue
OPEN PRESS
Seated at table with HRC:
-Sen. Thomas Daschle [D-SD]
-Sen. Larry Pressler [R-SD]
-Sen. Kent Conrad [D-ND]
-Sen. Robert Kerrey [D-NE]
-Sen. Paul Wellstone [D-MN]
-Cong. Earl Pomeroy [D-ND]
-Cong. David Minge [D-MN]
-Cong. Rod Grams [R-MN]
-Sec. Mike Espy
-20 citizens
Program:
-Gov. Walter Dean Miller to deliver welcoming
remarks
-Sen. Thomas Daschle & HRC to proceed to seat
at table
-Sen. Thomas Daschle to deliver welcoming
remarks & intro. HRC
-HRC to deliver remarks-20 min.
-Lois Quan to act as moderator and open up
roundtable discussion on health care
-HRC & members of Congress to take questions
and listen to statements made by citizen
participants
Participants: Approx. 1500 people to attend.
[See briefing for more info.]
Contact: Mike Brogioli, Sen. Daschle's
Office
202-224-2321
605-334-9596 [o]
605-361-2345 [hotel]
Rick Weiland
605-334-9596
2:05 pm-
2:10 pm
OFFICIAL PHOTOS W/20 Citizen Program
Participants
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 5
Band Room
CLOSED PRESS
2:10 pm-
2:20 pm
INTERVIEW W/
of Argus Leader
Holding Room
2:20 pm-
2:40 pm
TV INTERVIEWS
2:45 pm-
3:05 pm
MEET AND GREET/OFFICIAL PHOTO
Study Hall
Lennox High School
CLOSED PRESS
Format: Informal meet and greet/photo line.
Participants: Approx. 75 people to attend.
[See briefing for more info.]
Contact: Joe Trayhern
456-6257
3:10 pm
DEPART Lennox High School
EN ROUTE Airport
[drive time: 30 min.]
MOTORCADE MANIFEST:
HRC's Van: HRC, VERVEER, ROGERS, CRAIGHEAD, CAPUTO, ALSWANG
3:40 pm
ARRIVE Airport
3:45 pm
WHEELS UP Sioux Falls
FBO: SD National Guard Terminal
Phone: 605-333-5754
Fax: 605-333-5897
CLOSED PRESS DEPARTURE
Contact: John Carlson
605-333-5754
Flight Time: 1 HR. 05 MIN.
Manifest: HRC, CRAIGHEAD, CAPUTO, VERVEER, ALSWANG,
(b)(7)e
Food: LUNCH
005
4:50 pm
WHEELS DOWN Wausau, WI [Mosinee, WI]
Central Wisconsin Airport
FBO: Central Wisconsin Aviation
Phone: 715-693-6111
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 6
Fax: 715-693-4888
CLOSED PRESS ARRIVAL
NOTE: Steve Graham will meet HRC at the airport.
Greeters: Cong. David Obey
Sen. Russell Feingold
Mary Feingold [Sen. Russell Feingold's wife]
Sen. Herbert Kohl
Gov. ?
Mayor?
4:55 pm
DEPART Airport
EN ROUTE Lincoln Center at Stevens Point
[drive time: 20 min]
HRC's Van:
HRC, VERVEER, CONG. DAVID OBEY, SEN. RUSSELL
FEINGOLD, MARY FEINGOLD, SEN. HERBERT KOHL?,
ROGERS
Staff Van: CRAIGHEAD, CAPUTO, ALSWANG, MICHAEL VERVEER?
5:15 pm
ARRIVE Lincoln Center at Stevens Point
Phone: 715-346-1405
Fax: 715-346-1486
Greeters: Mayor Scott Schultz
5:20 pm-
5:35 pm
TOUR OF Lincoln Center at Stevens Point
Day-care Room
Crafts Room
POOL PRESS
Format: HRC to meet and greet with seniors
and observe activities.
Participants: Approx.
people to attend.
[See briefing for more info.]
Contact: Joe Crappa, Cong. Obey's Office
202-225-3365
Jerry Madison, district rep.
715-842-5606
Ruth Laroque, Sen. Feingold's
Office
202-224-5323
Moira Harrington, district office
608-828-1200
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 7
5:35 pm-
5:55 pm
DISCUSSION W/Seniors [w/Sen. Russell
Feingold, Sen. Herb Kohl & Cong. David Obey
Room:
Lincoln Center at Stevens Point
OPEN PRESS
Format:
to open up discussion. HRC to
participate in open discussion with seniors.
Participants: 8 seniors to attend. [See
briefing for more info.]
Contact: Joe Crappa, Cong. Obey's Office
202-225-3365
Jerry Madison, district rep.
715-842-5606
Ruth Laroque, Sen. Feingold's
Office
202-224-5323
Moira Harrington, district office
608-828-1200
6:00 pm
DEPART Lincoln Center at Stevens Point
EN ROUTE Grand Theater
[drive time: 40 min.]
MOTORCADE MANIFEST:
HRC's Van:
HRC, VERVEER, CONG. DAVID OBEY, SEN. RUSSELL
FEINGOLD, MARY FEINGOLD, SEN. HERBERT KOHL?,
ROGERS
Staff Van: CRAIGHEAD, CAPUTO, ALSWANG, MICHAEL VERVEER?
6:40 pm
ARRIVE Wausau Supper Club
6:45 pm-
7:45 pm
HOLD
Holding Room:
Phone:
Fax:
CLOSED PRESS
Greeters:
7:45 pm-
8:20 pm
VIP RECEPTION
Ballroom
Wausau Supper Club
CLOSED PRESS
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 8
Format: Cong. David Obey to intro. HRC. HRC
to deliver very brief remarks. Work
ropeline.
Participants: Approx. 350 people to attend.
[See briefing for more info.]
Contact: Joe Crappa, Cong. Obey's Office
202-225-3365
Jerry Madison, district rep.
715-842-5606
8:20 pm
DEPART Wausau Supper Club
EN ROUTE Grand Theater
[drive time: 5 min.]
MOTORCADE MANIFEST:
HRC's Van:
HRC, VERVEER, CONG. DAVID OBEY, SEN. RUSSELL
FEINGOLD, MARY FEINGOLD, SEN. HERBERT KOHL?,
ROGERS
Staff Van: CRAIGHEAD, CAPUTO, ALSWANG, MICHAEL VERVEER?
8:25 pm
ARRIVE Grand Theater
Greeters:
8:30 pm-
10:00 pm
FUNDRAISER FOR CONG. DAVID OBEY
Grand Theater
415 4th Street
Holding Room
Phone: 715-842-0988
Fax:
Attire: Business
OPEN PRESS
ON STAGE:
-HRC
-Cong. David Obey
-Sen. Russell Feingold
-Sen. Herbert Kohl
Program:
-Cong. David Obey to act as MC, & intro. Sen.
Feingold
-Sen. Russell Feingold to deliver brief
remarks
-Cong. David Obey to intro. Sen. Herbert Kohl
-Sen. Herbert Kohl to deliver brief remarks
-Cong. David Obey to intro. HRC
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 9
-HRC to deliver 10 min. remarks
-HRC to take Q&A [40 min.]
-Cong. David Obey to act as moderator
Participants: Approx. 1000 people to attend.
Better Way Club-providing funding to Obey
Contact: Joe Crappa, Cong. Obey's Office
202-225-3365
Jerry Madison, district rep.
715-842-5606
Nelda Madison, funding
715-842-5606
10:05 pm
DEPART Grand Theater
EN ROUTE Airport
[drive time: 20 min.]
MOTORCADE MANIFEST:
HRC's Van:
HRC, VERVEER, SEN. RUSSELL FEINGOLD, MARY
FEINGOLD, ROGERS
Staff Van: CRAIGHEAD, CAPUTO, ALSWANG, MICHAEL VERVEER?
10:25 pm
ARRIVE Airport
10:30 pm
WHEELS UP Wausau, WI [Mosinee, WI]
Central Wisconsin Airport
FBO: Central Wisconsin Aviation
Phone: 715-693-6111
Fax: 715-693-4888
CLOSED PRESS DEPARTURE
Flight Time: 45 MIN.
Manifest: HRC, CRAIGHEAD, CAPUTO, VERVEER, MICHAEL VERVEER,
ALSWANG, SEN. RUSSELL FEINGOLD, MARY FEINGOLD,
(b)(7)e
005
in
Food:
11:15 pm
WHEELS DOWN Milwaukee, WI
General Mitchell International Airport
FBO: AF Reserve Ramp
Phone: 414-747-5325
Fax: 414-747-4956
CLOSED PRESS ARRIVAL
NOTE: Roshane Paris will meet HRC at the airport.
RON
Hyatt Hotel
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 10
Milwaukee, WI
FORECAST FOR SIOUX FALLS, SD:
-47. Chance of showers
FORECAST FOR WAUSAU, WI:
-
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
006. list
Citizen Participants [partial] (2 pages)
2/15/94
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act - (44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information [(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRA]
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information [(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors (a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy |(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
004 2081
SEN. TOM DASCHLE
4
012
(b)(6)
006
(b)(6)
is known throughout the Great Plains area as a farm hero,
having survived a farm accident in January of 1992. Both of
(b)(6)
arms
were amputated in a ghastly accident (he was caught In a farm machinery
shaft.) He was alone on the farm when the accident happened, struggled to
get to the house to use a pencil to dial the phone, and then waited for help
in the bathtub to avoid bleeding on the carpet.
He continues to have physical therapy and will need future surgery. But,
the operation to save his arms has been deemed a success.
006
(b)(6)
is articulate about the problems that farmers face in emergency care
needs and the problems of receiving physical therapy.
Single.
Native of North Dakota.
Dr. Allen Van Beek, Edina, Minnesota
Surgeon, North Memorial Medical Center
Age: 51
Dr. Van Beek is the surgeon who provided the emergency care for
(b)(6)
006
(b)(6)
He is active in educating farm families on the need for
emergency care and will comment on how important the need for quick
service is in cases like
(b)(6)
006
V 013
Marvin Wangen, Albert Lea, Minnesota
Mayor of Albert Lea, and small businessman
Age: 63
Mayor Wangen has viewed the health care crisis both as a patient and as an
employer trying to provide health insurance for his employees. As a small
businessman, Marvin has experienced incredible premium increases in his
4-person group policy
(b)(6)
00
He has
had a similar experience with the city's insurance plan when 2 or the 150
employees had to undergo heart transplants.
Married with 4 children.
Native of Minnesota.
Dan Wogsland, Hannaford, North Dakota
Family farmer
Age: 38
Mr. Wogsland has run his family farm full time since 1977. He also is
serving his third term as state senator and majority leader for the North
Dakota State Legislature. Mr. Wogsland farms small grains and row crops,
no livestock, While he is able to get his insurance through the state, he
has witnessed many of his neighbors' troubles in obtaining insurance or
being priced out of the market.
Married with 3 children.
Native of North Dakota.
02/17/94
15:47
202 401 7321
HHS ASPE/HP
001/015
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ASSISTANT SECRETARY FOR PLANNING AND EVALUATION
OFFICE OF HEALTH POLICY
bhuman SERVICES USA
&
HEALTH
OF
PHONE: (202) 690-6870 FAX: (202) 401-7321
Date:
From: BOB VAN Hook
To:
Liz BOYER
Phone: (202) 690- 7866
Phone: 456-2239
(202) 690-6870
FAX: (202) 401-7321
Fax: Cs
Number of Pages (Including Cover): 14?
The FIRST PAGE 15 A HEADS-UP! !
Comments:
LIZ- 1100 INDIAN Hensens 7
of
02/17/94
14:23
1 605 334 2591
SEN. TOM DASCHLE
5.
001
THOMAS DASCHLE
615 South MAIN STREET
P.O. Box 1636
SOUTH DAKOTA
ABERDEEN, SD 57401
(605) 225-8623
COMMITTEES
818 6TH STREET
AGRICULTURE
ETHICS
Hnited States Senate
P.O. Box 8168
Rame CITY, so 67709
FINANCE
(905) 380-7551
INDIAN AFFAIRS
WASHINGTON, DC 20510-4103
VETERANS' AFFAIRS
810 SOUTH MINNESUTA AVENUE
P.O. Box 1274
(202) 224-2321
SIGUX FALLS. so 57101
TOLL FREE 1-800-424-5094
(605) 334-9596
TOO (605) 334-4632
TELECOPY COVER SHEET
DATE:
2/17
TO:
Lrz
Bonyer
FAX NO.: (502) 456-2234
FROM: Rich
Office of Senator Thomas A. Daschle
810 South Minnesota Avenue
Sioux Falls, SD 57104
Telephone: (605) 334-9596
FAX Number: (605) 334-2591
MESSAGE:
5
No. of Pages (Including Cover Sheet):
PRINTED ON RECYCLED PAPER
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
007. schedule
Schedule for Hillary Rodham Clinton, Draft #2 [partial] (1 page)
2/18/94
b(7)(E)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Liz Bowyer
OA/Box Number: 3983
FOLDER TITLE:
[HRC Background File] Friday, February 18 [1994] [1]
2014-0483-S
sb393
RESTRICTION CODES
Presidential Records Act 144 U.S.C. 2204(a)]
Freedom of Information Act - [5 U.S.C. 552(b)]
PI National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office [(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRA
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information [(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors |a)(5) of the PRA
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes [(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions |(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
SCHEDULE FOR HILLARY RODHAM CLINTON
DATE: FRIDAY, FEBRUARY 18, 1994
DRAFT: #2
WASHINGTON, DC/SIOUX FALLS, SD/WAUSUA, WI/MILWAUKEE, WI
Traveling Party:
HRC
Craighead
1-800SKYPAGE
#207-4653
202-365-7717
CELLULAR
Caputo
1-800SKYPAGE
#883-5733
Verveer
1090
WH Photographer
(b)(7)e
007
Congressional Delegation:
Lead Advance:
Sioux Falls, SD
Pat Halley
Holiday Inn
100 W. 8th Street
Lead Advance:
Waussau, WI
Steve Graham
Waussau Inn & Conference Center
2001 N. Mountain Road
715-842-0711
RM
715-842-1838
fax
Scheduling Desk:
Sara Grote
202-456-2922
office
202-456-2317
fax
202-483-7312
home
1-800-528-7528
WHCA #4363
PREV RON
The White House
NEW HAMPSHIRE DAY!
7:25 am
DEPART White House
EN ROUTE Andrews Air Force Base
7:50 am
ARRIVE Andrews Air Force Base
8:00 am
WHEELS UP Andrews Air Force Base
Flight Time: 2 HRS. 45 MIN. [+1]
Manifest: HRC, CRAIGHEAD, CAPUTO, VERVEER, WH PHOTOG,
MEMBERS OF CONGRESS,
(b)(7)e
007
Food: BREAKFAST
9:45 am
WHEELS DOWN Sioux Falls
FBO:
Phone:
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 2
Fax:
CLOSED PRESS ARRIVAL
Contact: Mike Marmach
605-336-0762
nohasp no
Greeters:
9:55 am
DEPART Airport
EN ROUTE Site: TBA
T Center fout
dinie
XXX
ARRIVE Site: TBA facily will
Lennofical
Greeters:
10:30 am-
Gob
11:00 am
Sawahan CBARL
long term 10e or mual
x
rural small store he Provider. Honcal "wal busic cae vesich, for
cen
tie
TOUR OF HC CLINIC [w/ Cong. Thomas Daschle]
Site: TBA
aff. m/ affal
PRESS?
the thereis
Format:
Participants:
Contact: Mike Brogioli ?
11:00 am
DEPART Site: TBA
EN ROUTE Lennox High School
11:10 am
ARRIVE Lennox High School
Greeters:
11:15 am-
Approl 100 students pfainly
11:40 am
ADDRESS TO Students and Faculty
D into HRC
1/2hr outside of
Study Hall?
HRC remarks
Sout Falls -
Lennox High School
PRESS ?
Q A
Lennot High School
Format: Sen. Thomas Daschle to speak and
intro. HRC. HRC to deliver brief remarks.
Alan Rops
Participants: Approx. 100 people to attend.
Brejolly
primipal
Contact: Mike Brogioli, Sen. Daschle's
Office
224-2321
605-334-9596 [o]
Renit
605-361-2345 [hotel]
Host:
SPOUSONS
1 Argus sp leader, Signafalls 1 $ paper
mimp in state
1 \ 7h on 3 - Found. ABC for affil. Has in picet SI $ Home
Care - DC bused foundertor
& think tank
invitid
each Cong. given
office inclus
region Crossection S.Daketa of states
.500 good publicy in
VIPs
mostly
provint int graps imp.
structylzussion. the
1
2
sh rural elderly (long term care
SCHEDULE FOR HILLARY RODHAM CLINTON
3
FRIDAY, FEBRUARY 18, 1994
concern of providers
PAGE 3
11:45 am-
11:55 am
OFFICIAL PHOTOS W/Summit Co-sponsors
Rooms: TBA
quest;
CLOSED PRESS
Rema - briefing for Lois
11:58 am
PROCEED TO Forum
12:00 pm-
T66P Summit on Rural HC
Lois Quam
2:00 pm
N.Q&A
RURAL HEALTH CARE FORUM
Lennox High School
208 West 5th Avenue
Holding Room
Conceuns Questions
Phone:
Fax:
invitation
OPEN PRESS
Audience
Lenot School High
Seated at table with HRC:
-Sen. Daschle
-Sen. Pressler
states represented
Format
-Sen. Conrad
-Sen. Kerry
NS Dakote
Lois will ask
-Sen. Wellstone
Neb
-Cong. Pomeroi
opening question:
-Cong. Minge
Minn
-20 citizens
Iowa
no mem of
congress or citizens
bios of citizens
Format:
IA3 in andrence
all imited were invited pot fit
and
Participants: Approx. 1500 people to attend.
[See briefing for more info. gen
Contact: Mike Brogioli, Sen. Daschle's
Office
all govsinto
224-2321
605-334-9596 [o]
Format
Millas
605-361-2345 [hotel]
2:00
PRESS INTERVIEWS
Dintro HRC 10. min.
VIP SD, box in
DEPART Lennox High School
Dintro LQuam
EN ROUTE Airport
f from rural hecember
it
ARRIVE Airport
3:00
pm
WHEELS UP Sioux Falls
Flight Time: 1 HR. 05 MIN.
Manifest:
Food:
ARC ARC rem rem
small bus.
Rep. of
short remarks claing
sec'y
Insurance reform gettleep
hc prov, small empts
consumers
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 4
4:05 pm
WHEELS DOWN Waussau, WI
XXX
DEPART Airport
EN ROUTE Grand Theater
XXX
ARRIVE Grand Theater
Greeters:
5:00 pm
HC EVENT W/Sen. Russell Feingold, Sen. Herb
Kohl & Cong. David Obey
Room:
Marshfield Family Health Center
PRESS?
Format:
Participants: Cathy Sykes - Task Force - health are
Contact: Joe Crappa, Cong. Obey's Office
225-3365
pason
Ruth Laroque, Sen. Feingold's
Office
Now Chair of Appropriations
224-5323
7:30 pm
OBEY FUNDRAISER
Grand Theater
stage - 2 milies chains on
high and donor
Holding Room
Phone:
Fax:
CLOSED PRESS
low down
Obey HIBC introduces HRC
Format:
Participants:
Goype
Questions
Contact: Joe Crappa, Cong. Obey's Office
225-3365
Jerry Madison, district rep.
715-842-5606
10:00 pm
WHEELS UP Waussau, WI
Flight Time: 45 MIN.
Manifest:
Food:
SCHEDULE FOR HILLARY RODHAM CLINTON
FRIDAY, FEBRUARY 18, 1994
PAGE 5
10:45 pm
WHEELS DOWN Milwaukee, WI
RON
Milwaukee, WI
State Party Fundrase
Sr. nl klecza
Town Mtg. w/ Barea
/
#159 P08
Obey considered top contender
to lead vital House committee
Appropriations
but another House Democrat,
of the underdog. Unlike some
chairman's health
speaking on condition of ano-
other Appropriations members,
nymity, said: "If the vote were
Obey has not been accused of
could open position
held today, Dave would win it.
using his committee assignment
It's looking good."
to bring pork barrel projects to
If Obey ascends to the chair-
his home district.
By PATRICK JASPERSE
manship, it would be a boost for
Obey represents the 7th Con-
Journal Washington bureau
Wisconsin, which in recent years
gressional District, which covers
has lost several of its most expe-
DAVE OBEY
TEL NO:
one-third of Wisconsin, stretch-
Washington, D.C. Sources
rienced legislators to retirement,
ing from Stevens Point and
say that Rep. Dave Obey (D-
cabinet appointment or election
Wausau up to Rhinelander and
The battle to replace Natcher
Wis.) is on the verge of becoming
defeat. Five of the state's 11 fed-
Superior.
began earlier this month, al-
chairman of the House Appro-
eral lawmakers have been in
The current chairman of the
though no one is campaigning
priations Committee, one of the
Congress for less than six years.
committee, Rep. William Natch-
openly out of respect for Natch-
most powerful positions in Con-
During his career, Obey has
er (D-Ky.), is in Bethesda Naval
er, 84, who has served in the
gress.
earned a reputation as a hard-
Hospital with what is reportedly
Obey isn't talking about it,
working, plainspoken defender
a serious heart condition.
Please see Obey page 4
FEB-17-'94 THU 10:32 ID:
HEAR FIRST LADY
HILLARY RODIAM
CLINTON
First Lady Hillary Rodham Clinton will
speak at Congressman Dave Obey's Better
Way Club and will answer questions from
the audience.
Friday, February 18
8:30 p.m.
Grand Theater
415 S. Fourth St.
###*/##
3A
Wausau Daily Herald
Tuesday, February 15, 1994
titles
Wausau
Those who want to attend can do SO by
joining the Better Way Club for $60. Better
Way membership includes a reserved ticket
to this Friday's event and another program
later this year. Tickets are going fast and
can still be purchased at the Performing
Arts Foundation box office, 407 Scott
Street from 10 a.m. to 2 p.m., Wednesday,
Thursday and Friday.
Any questions can be directed to
(715) 845-4595.
Please make checks payable to Chizana for Dave Obsy. Paid for by Citizens for Dave Obey, John
Spencer, Treasurer. Contributions are not tax deductive.
90d 6ST#
:ON 731
:01 10:31 ПНД
SENT BY:
2-17-94 ;12:14PM ;
OBEY'S OFFICE-
COMM/RESEARCH:# 1/ 1
MEMORANDUM
TO: LIZ BOYER
FROM: MARSHA BENEDETTO
DATE: 2/17/94
RE: CONGRESSMAN DAVE OBEY'S BETTER WAY CLUB
THE BETTER WAY CLUB WAS ESTABLISHED 20 YEARS AGO BY THE CITIZENS FOR DAVE OBEY
COMMITTEE TO BE THE CHIEF FUNDRAISING ARM OF HIS CAMPAIGNS. IT IS THE
PRINCIDAL METHOD TO BRING SMALL CONTRIBUTORS INTO THE CAMPAIGN.
THE BETTER WAY CLUB DRINGS SPEAKERS TO THE 7TH CONGRESSIONAL DISTRICT TWICE A
YEAR. AFTER SHORT INTRODUCTORY STATEMENTS BY OBEY AND HIS GUEST, THEY ANSWER
QUESTIONS FOR AN HOUR. AFTER THE PROGRAM, PEOPLE ARE ABLE TO SHAKE HANDS WITH
THE GUEST.
PAST GUESTS HAVE INCLUDED JIMMY CARTER WHEN HE WAS PRESIDENT, HARRY BELEFONTE
(THE PERFORMER), CONG. DAVID BONIOR, SEN. GEORGE MITCHELL, CONG. DICK
GEBHARDT, FORMER SENATOR GAYLORD NELSON, SECRETARY MADELINE ALBRIGHT, CONG.
NANCY PELOSI, AND IN APRIL OF 1993 SECRETARY DONNA SHALALA.
THIS TIME WE ARE HAVING A PRIVATE RECEPTION AT THE WAUSAU CLUB (A PRIVATE
CLUB). WE EXPECT 450 PEOPLE TO BE THERE, WE HAVE THE BALLROOM-RESERVED WHICH
HOLDS 500. THE RECEPTION WILL BE FROM 7:30 PM - 8:15 PM. PEOPLE PAID $100
EACH FOR THE RECEPTION. (THIS IS A HIGH AMOUNT FOR CENTRAL WISCONSIN!!!)
THE MAIN BETTER WAY CLUB EVENT IS AT THE GRAND THEATER, OUR RENOVATED "OPERA
HOUSE," ONE BLOCK FROM THE WAUSAU CLUB. IT HOLDS 1200, 800 ON THE MAIN
FLOOR. PEOPLE PAID $60 EACH FOR THE GRAND THEATER SEATS.