HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 (Coffee and Breakfast in S-207) Senator Dole Senator Hatch (check mark) Senator Heinz Senator Wilson (check mark) Senator Quayle Sheila Burke Dr. James H. Sammons (check mark) Executive Vice President American Medical Association 535 N. Dearborn Chicago, Illinois 60610 (312) 645-4302 Virgil S. Edwards (check mark, *) Administrator Redbud Community Hospital Redbud Hospital District Clearlake, California (707) 994-6486 Eunice Cole, President (check mark, *) American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 (816) 474-5720 Jerome A. Crest, President and Administrator (check mark, *) Emanuel St. Joseph's Hospital 325 Garden Boulevard Mankato, Minnesota 56001 James A. Vohs (check mark, *) Chairman, President and Chief Executive Officer Kaiser Foundation Health Plan The Ordway Building One Kaiser Plaza Oakland, California 94612 (415) 271-5910 Dr. William S. Hotchkiss (check mark) Chairman, Board of Trustees American Medical Association 2147 Old Greenbriar Road Chesapeake, Virginia 23320 Samuel H. Howard (check mark, *) Senior Vice President-Public Affairs Hospital Corporation of America 1 Park Plaza Nashville, Tennessee 37202 (615) 327-9551 Judith Ryan, Executive Director (check mark, *) American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 (816) 474-5720 Dr. Robert Heyssel (check mark, *) President Johns Hopkins Hospital 600 North Wolfe Baltimore, Maryland 21205 (301) 955-5667 entire page handwritten: Vohs Arg's sk- need some chqs- keep eye on himo- risk contracts- keep out bad guys- quality concerns- -costs are (illegible) under control- quality now the issue- -movement of pts into medicare risk contracts - problem fw Kaiser - heyssel we are not looking for federal govt to bail us out- need to give (illegible)- -people falling thru the cracks- BOB DOLE KANSAS UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC 20510 October 9, 1985 MEMORANDUM TO: SENATOR DOLE FROM: SHEILA BURKE SUBJECT: HEALTH BREAKFAST Attached is a list of confirmed attendees for tomorrow morning's scheduled breakfast. For this first health breakfast, I included representation from the key hospital groups, the American Hospital Association, the Federation of American Hospitals, the Public Hospital Association, and the Council of Teaching Hospitals. In addition, the two largest individual provider groups will be represented, the American Medical Association and the American Nurses Association. The hospital representatives that will be present represent a spectrum of institutions from very small to very large, both teaching and non-teaching and proprietary and non-profit or public. The Kaiser Health Maintenance Organization, which was also invited, is the largest HMO in the country and unlike many other HMOs, actually owns a number of hospitals in addition to operating HMOs throughout the country. The groups have been told that the purpose of the discussion is to review current problems that have resulted from recent changes in our payment systems for the Federal health programs. Also of interest are the questions being raised about the quality of care being provided and access and sources of payments for services provided to the indigent. Atts. (entire page handwritten) uncompensated - care -- howard f impact caid threshold risk poor sm business grants to specific hospitals to care for indigent short term unemployed continuity howard caps = (down arrow) quality 86 (illegible) = access 87 -rural good example -caid caps Edwards sm rurals don't need all - but some recc.- --> tax exempt finance for non profit hop's - - need access HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 (Coffee and Breakfast in S-207) Dr. James H. Sammons Executive Vice President American Medical Association, Chicago, Illinois - Chief Executive Officer for 10 1/2 years. - Previously practiced family medicine in Texas for approximately 20 years. Dr. William S. Hotchkiss Chairman, Board of Trustees American Medical Association, Chesapeake, Virginia - Presently a thoracic surgeon in Chesapeake, Virginia. - Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk. - Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978. Virgil S. Edwards Administrator Redbud Community Hospital, Clearlake, CA - Represents Public Hospital Association. - Has been in the health care field for about 9 years. - Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital. - Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services. - The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent. (entire page handwritten) - physicians refusing to take chronic pt's- - on theirs - they are losing millions - 3rd yr of drq's will be the worst --> --> drqs not reflective of real market - the one restraint on drq's = will be malpractice -- not pro's - Sammons 8.5M employed in health delivery system - risk in (up arrow) unemployment - particularly re: nurses = (down arrow) quality of care Edwards small rural hospitals (illegible) problems large (illegible) of medicare/caid - drq's built on coverages Crest contact made i hospitals i drqs tax exempt bonds - they need access so they can brag about changes needed in institutions to (up arrow) amb. services - pt's leaving sicker/quicker - - making arrangements to allow pt's to stay in empty beds and pay themselves - - may lose drq's/medicare because of this - Samuel H. Howard Senior Vice President - Public Affairs Hospital Corporation of America, Nashville, Tennessee - Represents Federation of American Hospitals. - Served as White House Fellow to Arthur Goldberg from 1966-1967. - Served as a member of the 1982 Advisory Council on Social Security which studied medicare program. - An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs. - HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states. Eunice Cole President American Nurses Association, Kansas City - Currently serving her second term as President of the American Nurses Association. - From 1974-1976 was President of the Washington State Nurses Association. Dr. Judith Ryan Executive Director American Nurses Association, Kansas City - From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota. - Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982. (entire page handwritten) 2 SNF/HH taking care of sicker pt's - increased demand for nsg. <--> services in these settings Sammons Hopkins/AMA (illegible) quality study Heyssel house/stall - under increasing pressure - frozen levels of pay - fewer admissions intra system changing - greater pressures (down arrow) quality Sammons don't force reductions in (illegible)/financing too soon - we need quality residents Ryan demand for home care in community - doing study on acuity - (up arrow) demand for nsg services and patient population shifts - concerns: VNA etc. being challenged by (illegible) service home health agencies - no coordination of care - Cole people falling through the cracks - particularly frail elderly - need to look at under(illegible) traditional agencies Vohs competition getting wild out there - surons quality concerns - uncompensated care becomes greater concern because of competition Howard 25% fewer pt's - mostly reductions in private patients - but now also have time for medicare Los stable now after dropping have laid off 6,500 personnel - bad debts 2-3% higher - rural hosp's - not likely to survive because of drq's -3- Jerome A. Crest President and Administrator Emanuel St. Joseph's Hospital, Mankato, Minnesota - Represents American Hospital Association. - Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984. - Recently completed 18 months service as chairman of the Minnesota Hospital Association. - Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services. Dr. Robert Heyssel President Johns Hopkins Hospital, Baltimore, Maryland - Represents American Association of Medical Colleges, Council of Teaching Hospitals - Named President in July 1983 after serving as Executive Vice President and Director since 1972. - Is professor of Medicine at Johns Hopkins School of Medicine. - Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services. - Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services. James A. Vohs Chairman, President and CEO Kaiser Foundation Health Plan - Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952. - Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states. - Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees. (entire page handwritten) hurig (illegible) recon waiver no fee freeze Quayle GME FMG's - maldrotib. of (illegible)'s primary care Wilson nsg. homes/qual. pps - quality/aged quality of care in military concurrent/prospective quality ck - not retrospective Hotchkiss fee freeze/congress breaking contract don't like pal/non-pal - old mix hatch/md's claiming they will request pt's Hotchkiss - not wide spread - competition growing Sammons not widespread - but real concern re: access/accountability drq's - counterproductive re: liability/quality - (up arrow) malpractice - cosponsor hatch Hatch malpractice = too much care as protection Hurig drq's create opportunity for malpractice Sammons we're sending them home sicker/quicker Heyssel - old don't like being sent home from ambulatory surgery - need to loosen up on amb surg rules - drq's don't measure what they are supposed to -- - people fall out of averages - higher costs of teaching hospitals 14% educational costs Ryan impact on nsg - drq's don't look @ nsg resource use - shorter length of stay reduces ability to prepare pt's for home HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 (Coffee and Breakfast in S-207) Dr. James H. Sammons Executive Vice President American Medical Association, Chicago, Illinois - Chief Executive Officer for 10 1/2 years. - Previously practiced family medicine in Texas for approximately 20 years. Dr. William S. Hotchkiss Chairman, Board of Trustees American Medical Association, Chesapeake, Virginia - Presently a thoracic surgeon in Chesapeake, Virginia. - Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk. - Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978. Virgil S. Edwards Administrator Redbud Community Hospital, Clearlake, CA - Represents Public Hospital Association. - Has been in the health care field for about 9 years. - Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital. - Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services. - The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent. -2- Samuel H. Howard Senior Vice President - Public Affairs Hospital Corporation of America, Nashville, Tennessee - Represents Federation of American Hospitals. - Served as White House Fellow to Arthur Goldberg from 1966-1967. - Served as a member of the 1982 Advisory Council on Social Security which studied medicare program. - An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs. - HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states. Eunice Cole President American Nurses Association, Kansas City - Currently serving her second term as President of the American Nurses Association. - From 1974-1976 was President of the Washington State Nurses Association. Dr. Judith Ryan Executive Director American Nurses Association, Kansas City - From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota. - Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982. -3- Jerome A. Crest President and Administrator Emanuel St. Joseph's Hospital, Mankato, Minnesota - Represents American Hospital Association. - Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984. - Recently completed 18 months service as chairman of the Minnesota Hospital Association. - Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services. Dr. Robert Heyssel President Johns Hopkins Hospital, Baltimore, Maryland - Represents American Association of Medical Colleges, Council of Teaching Hospitals - Named President in July 1983 after serving as Executive Vice President and Director since 1972. - Is professor of Medicine at Johns Hopkins School of Medicine. - Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services. - Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services. James A. Vohs Chairman, President and CEO Kaiser Foundation Health Plan - Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952. - Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states. - Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees. UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Mrs. Cole: Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch. I particularly appreciated your comments on the need to undergird our traditional home health agencies. These services have become increasingly important as we create incentives for beneficiaries to be discharged earlier, or simply remain at home, for the majority of their care. Clearly also of concern is the care of those who "fall through the cracks" of traditional financing mechanisms. We will continue to seek out ways to care for these individuals without further adding to our deficit problems. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) Bob Dole Mrs. Eunice Cole President American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Dr. Hotchkiss: Thank you for your willingness to attend the breakfast meeting last week. I am sorry I was delayed and unable to join you but understand that the discussion was very useful. I know you are particularly concerned with the continuation of the fee freeze and the participating physician program. Unfortunately, our continued battle to reduce the Federal deficit has again forced us to make a number of very difficult decisions. I can understand your frustration with what appears to be the breaking of an agreement with respect to the freeze, but you must also understand our dilemma with a projected deficit in excess of $170 billion. Over the long term, I agree that together we must begin to seriously examine payment reform. We have a responsibility to both the medicare beneficiary and to the physicians nationwide who care for these patients, to -2- create a reasonable and equitable payment system. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) BOB DOLE Majority Leader Dr. William S. Hotchkiss Chairman, Board of Trustees American Medical Association 2147 Old Greenbriar Road Chesapeake, Virginia 23320 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Dr. Ryan: Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch. I was particularly interested to learn of your ongoing survey of home health agencies and your intention of learning more about the acuity of the patient mix and the resulting nursing service needs. It has been clear to me for some time, particularly since the implementation of the Prospective Payment System, that attention needed to be given to both home health care service providers and nursing home service providers. It may well be time to reexamine the design and financing of these benefits. Patient care needs seemed to have changed as has our capacity to care for people in non-institutional settings. As we continue to urge reductions in the use -2- of inpatient services, we must make an effort to assure that quality, alternative services are readily available. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) BOB DOLE Majority Leader Dr. Judith Ryan Executive Director American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Jim: Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch. I particularly appreciated your comments regarding the need to keep a close eye on the quality of the health care services provided to the elderly. As you point out, this is especially true with respect to certain prepaid health plans. We cannot afford a repeat of the problems documented in California in the 1970's. Of course, on the non-HMO side, we must be equally as vigilant. The Prospective Payment System has achieved a great deal in bringing about reductions in cost and lengths of stay, but neither of these -2- achievements can overcome serious quality of care issues should they occur. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) BOB DOLE Majority Leader James A. Vohs Chairman, President, and Chief Executive Officer Kaiser Foundation Health Plan The Ordway Building One Kaiser Plaza Oakland, California 94612 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Mr. Edwards: Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch. I particularly appreciated hearing your concerns about the survival of small rural hospitals and the need of certain institutions for continued access to tax exempt bonds. With respect to rural hospitals, it was clear from the outset of the Prospective Payment System that we might well need to make adjustments. As you know, the Department was directed to prepare a study on the need to make adjustments for small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them. With respect to tax exempt bonds, as I indicated in our discussion, it appears unlikely that the tax reform bill will see -2- action in the Senate this year. However, in anticipation of these discussions, I will review carefully the current use of this authority and its value to non-profit institutions like your own. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) BOB DOLE Majority Leader Virgil S. Edwards Administrator Redbud Community Hospital Redbud Hospital District Clearlake, California 95422 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Mr. Crest: Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch. I particularly appreciated hearing your concerns about the survival of small rural hospitals. It was clear from the outset of the Prospective Payment System that we might well need to make a limited number of adjustments to meet certain specific needs. To assist us, as you know, the Department was directed to prepare a study on the needs of small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) BOB DOLE Majority Leader Jerome A. Crest President and Administrator Emanuel St. Joseph's Hospital 325 Garden Boulevard Mankato, Minnesota 56001 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Dr. Heyssel: Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch. I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) BOB DOLE Majority Leader Dr. Robert Heyssel President Johns Hopkins Hospital 600 North Wolfe Baltimore, Maryland 21205 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Jim: Thanks for taking the time to attend last week's breakfast meeting. Unfortunately, I was unavoidably delayed and missed getting the chance to talk with you, however, I understand the discussion went quite well. Like you, I am concerned that as we continue to try to bring health care costs under control, we keep a close eye on the quality of care being provided to medicare beneficiaries nationwide. I urge you to let me know if you have any particular concerns that we should address at this time and look forward to seeing you in the near future. Sincerely yours, (signature) BOB DOLE Majority Leader Dr. James H. Sammons Executive Vice President American Medical Association 535 N. Dearborn Chicago, Illinois 60610 UNITED STATES SENATE OFFICE OF THE MAJORITY LEADER WASHINGTON, DC BOB DOLE KANSAS October 15, 1985 Dear Sam: Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch. I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all. I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance. Sincerely yours, (signature) BOB DOLE Majority Leader Samuel H. Howard Senior Vice President - Public Affairs Hospital Corporation of America 1 Park Plaza Nashville, Tennessee 37202 HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 (handwritten: Hotchkiss) (Coffee and Breakfast in S-207) handwritten in top margins: Chall, (illegible), Dole, Vohs, Wils, Edward, Heinz, Cole, Hatch, Heyssel, Quayle Senator Dole Senator Hatch Senator Heinz Senator Wilson (check mark) Senator Quayle (check mark) Sheila Burke Dr. James H. Sammons Executive Vice President American Medical Association 535 N. Dearborn Chicago, Illinois 60610 (312) 645-4302 Virgil S. Edwards Administrator Redbud Community Hospital Redbud Hospital District Clearlake, California (707) 994-6486 Eunice Cole, President American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 (816) 474-5720 Jerome A. Crest, President and Administrator Emanuel St. Joseph's Hospital 325 Garden Boulevard Mankato, Minnesota 56001 James A. Vohs Chairman, President and Chief Executive Officer Kaiser Foundation Health Plan The Ordway Building One Kaiser Plaza Oakland, California 94612 (415) 271-5910 Dr. William S. Hotchkiss Chairman, Board of Trustees American Medical Association 2147 Old Greenbriar Road Chesapeake, Virginia 23320 Samuel H. Howard Senior Vice President - Public Affairs Hospital Corporation of America 1 Park Plaza Nashville, Tennessee 37202 (615) 327-9551 Judith Ryan, Executive Director American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 (816) 474-5720 Dr. Robert Heyssel President Johns Hopkins Hospital 600 North Wolfe Baltimore, Maryland 21205 (301) 955-5667 only note on page (handwritten): Thursday; 3; dole TENTATIVE HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 (Coffee and Breakfast in S-207) handwritten at top of page: Packwood, Chafee Senator Dole (handwritten: confirmed) Senator Durenberger (handwritten: ?) Senator Hatch (handwritten: Cindy - 135 Russell) Senator Heinz (handwritten: confirmed) Senator Chafee (crossed out) Senator Wilson (handwritten: Dottie w/c/b) Senator Quayle (handwritten: Cynthia w/c/b - SH - 524) Sheila Burke (handwritten: confirmed) Dr. James H. Sammons (handwritten: MD, confirmed) Executive Vice President American Medical Association 535 N. Dearborn Chicago, Illinois 60610 (312) 645-4302 Virgil S. Edwards (handwritten: confirmed) Administrator Redbud Community Hospital Redbud Hospital District Clearlake, California (707) 994-6486 Eunice Cole, President (handwritten: conf.) American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 (816) 474-5720 Jerome A. Crest, Administrator (handwritten: conf.) Emanuel St. Joseph's Hospital 325 Garden Boulevard Mankato, Minnesota 56001 James A. Vohs (handwritten: conf.) Chairman, President and Chief Executive Officer Kaiser Foundation Health Plan The Ordway Building One Kaiser Plaza Oakland, California 94612 (415) 271-5910 handwritten note: 1:15-9:15 tonight, Sheraton Grand William H. Hotchkiss, MD (handwritten: confirmed) Chairman, Board of Trustees American Medical Association 2147 Old Greenbriar Road Chesapeake, Virginia 23320 Samuel H. Howard (handwritten: conf.) Senior Vice President - Public Affairs Hospital Corporation of America 1 Park Plaza Nashville, Tennessee 37202 (615) 327-9551 Judith Ryan, Executive Director (handwritten: conf.) American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 (816) 474-5720 Dr. Robert Heyssel (handwritten: conf.) President Johns Hopkins Hospital 600 North Wolfe Baltimore, Maryland 21205 (301) 955-5667 TENTATIVE (outlined) HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 Senator Dole (check mark) Senator Durenberger (check mark) Senator Hatch (check mark, handwritten: confirmed) Senator Heinz - confirmed (check mark, handwritten: confirmed) Senator Chafee - confirmed (check mark) Senator Wilson (check mark), handwritten: confirmed Senator Quayle (check mark), handwritten: confirmed Sheila Burke (check mark) Dr. James H. Sammons (check mark) Executive Vice President American Medical Association 535 N. Dearborn Chicago, Illinois 60610 (312) 645-4302 Virgil S. Edwards (handwritten: confirmed), (check mark) Administrator Redbud Community Hospital Redbud Hospital District Clearlake, California (707) 994-6486 (Contact: Larry Gage 293-8960) Eunice Cole, President (check mark) Judith Ryan, Executive Director (check mark) American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 816-474-5720 Jerome A. Crest, Administrator (check mark) Emanuel St. Joseph's Hospital 325 Garden Boulevard Mankato, Minnesota 56001 (Contact: Jack Owen (AHA 638-1100) James A. Vohs (check mark) Chairman, President and Chief Executive Officer Kaiser Foundation Health Plan The Ordway Building One Kaiser Plaza Oakland, California 94612 (415) 271-5910 Senator Packwood not coming William S. Hotchkiss, M.D. (check mark) Chairman, Board of Trustees American Medical Association 2147 Old Greenbriar Road Chesapeake, Virginia 23320 handwritten notes: Sam (illegible) Howard Senior VP Public Affairs Hospital Corp of America 1 Park Plaza Nashville, Tennessee 37202 615-327-9551 Pres Elect of Federation Pres Cmte on SS. S-2017 17 -2- (Contact: Richard Froh 296-1314) Dr. Robert Heyssel President Johns Hopkins Hospital 600 North Wolfe Baltimore, Maryland 21205 (301) 955-5667 TENTATIVE HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 Senator Dole (handwritten: OK) Senator Durenberger Senator Hatch Senator Packwood (handwritten: no) Senator Heinz (handwritten: OK) Senator Chafee (handwritten: OK) Senator Wilson Senator Quayle Sheila Burke Dr. James H. Sammons Executive Vice President American Medical Association 535 N. Dearborn Chicago, Illinois 60610 (312) 645-4302 Mike Bromberg's person (833-3090) (David Jones, Humana?) (handwritten: not invited) Virgil S. Edwards Administrator Redbud Community Hospital Redbud Hospital District Clearlake, California (707) 994-6486 (Contact: Larry Gage 293-8960 Eunice Cole, President Judith Ryan, Executive Director American Nurses Association 2420 Pershing Road Kansas City, Missouri 64108 816-474-5720 American Hospital Association (Contact: Jack Owen 638-1100) (crossed out and replaced with Jerome A. Crest Administrator) James A. Vohs Chairman, President and Chief Executive Officer Kaiser Foundation Health Plan The Ordway Building One Kaiser Plaza Oakland, California 94612 handwritten note on page: Wm S. Hotchkiss MD Chairman AMA Bd. of Trustees 2147 Old Greenbriar Rd Chesapeake VA 23320 -2- (415) 271-5910 (Contact: Richard Froh 296-1314) Dr. Robert Heyssel President Johns Hopkins Hospital 600 North Wolfe Baltimore, Maryland 21205 (301) 955-5667 MEMORANDUM OF CALL TO: (handwritten) Joyce YOU WERE CALLED BY (checked) YOU WERE VISITED BY (handwritten: Jim Doherty OF (Organization) 6381100 PLEASE CALL (checked) --> PHONE NO. CODE/EXT. WILL CALL AGAIN RETURNED YOUR CALL IS WAITING TO SEE YOU WISHES AN APPOINTMENT MESSAGE (handwritten) Am Hosp. Assoc. H: breakfast Thurs. RECEIVED BY (handwritten) KMR DATE (handwritten) 10/3 TIME (handwritten) 4:00 MEMORANDUM OF CALL TO: (handwritten) S. Burke YOU WERE CALLED BY YOU WERE VISITED BY (handwritten) Deborah Knight OF (organization) (handwritten) Dr. Heyssel PLEASE CALL --> PHONE NO. CODE/EXT. WILL CALL AGAIN RETURNED YOUR CALL IS WAITING TO SEE YOU WISHES AN APPOINTMENT MESSAGE (handwritten) 301-555-5667 re: breakfast oct. 10 RECEIVED BY (handwritten) P DATE (handwritten) 10-4 TIME (handwritten) 9:15 handwritten: tentative HEALTH BREAKFAST ATTENDEES Thursday, October 10, 8:00 a.m., Room S-230 Dr. James H. Sammons (handwritten: bringing someone) Executive Vice President American Medical Association 535 N. Dearborn Chicago, Illinois 60610 (312) 645-4302 Mike Bromberg's person (833-3090) (David Jones, Humana?) Virgil S. Edwards Administrator Redbud Community Hospital Redbud Hospital District Clearlake, California (707) 994-6486 (Contact: Larry Gage 293-8960) Eunice Cole (handwritten: and Ryan) President American Nurses Association (Contact: Judith Ryan, Executive Director 816-474-5720) American Hospital Association (Contact: Jack Owen 638-1100) (handwritten: (illegible) Doherty) James A. Vohs Chairman, President and Chief Executive Officer Kaiser Foundation Health Plan The Ordway Building One Kaiser Plaza Oakland, California 94612 (415) 271-5910 (Contact: Richard Froh 296-1314) Dr. Robert Heyssel President Johns Hopkins Hospital 600 North Wolfe Baltimore, Maryland 21205 (301) 955-5667 handwritten: Debra Knight handwritten notes: Dole Durenberger Hatch ? Sheila Burke Jerry Crest Administrator Emanual St. Joseph's Hosp in Minn. 325 Garden Blv Mankato, Minn Jerome A. Crest 56001 Entire next page handwritten ARMSTRONG tony coppolino Thursday 8:00 am Oct 10, 1985 HEALTH BREAKFAST - Jim Sammon MD (312) 645-4302 - AMA Board Member Dr. James H. Sammons Exec V.P. AMA 5335 N. Dearborn Chic. IL 60610 - David Jones (alex) - Humana (CONTACT MIKE BROMBERG 833-3090) Virgil S. Edwards RH District - Administrator Redbud Hosp (community) Redbud, Cal. Clearlake CA 707-994-6486 contact/Larry Gage 293-8960 - American nurses drsn. Judith Ryan Executive Director (816) 474-5720 Eunice Cole - president - American Hospital Assn. - CONTACT Jack Owen 638-1100 - Kaiser Foundation Health Plan James A. Vohs Chairman, President CEO contact: Richard Froh Kaiser Fdtn Health Plan The Ordway Bldg. One Kaiser Plaza Oakland, CA 94612 415 271-5910 - AAMC Heyssel contact Dick Knapp 828-0490 (handwritten notes at top of page) - Judith Ryan Executive Director American Nurses Association - Pam Maraldo Executive Director National League for Nursing - NSQ - Public - Teaching OCT 8 8 am (illegible) home health Cigna? Petrocelle Robert Van Tuyle (labeled 2, nsg hornes Chairman Beverly Enterprises 873 So. Fairoaks Avenue Pasadena, California 91005 213-684-1100 Karl Bays (labeled 4) Chairman & CEO American Hospital Supply Corp. One American Plaza Evanston, Illinois 60201 312-866-4000 (bought by Baxter-Travenol not sure what his title will be) Thomas Frist, Jr. M.D. (crossed out) President & CEO Hospital Corporation of America P.O. Box 550 Nashville, Tennessee 37203 615-327-9551 Walter Weisman (crossed out) President & Chief Operating Officer American Medical International 414 No. Camden Drive Beverly Hills, California 90210 213-278-6200 Charles Ewell, Ph. D. (crossed out) President American Health Care Systems 1205 Prospect, Suite 520 La Jolla, California 92073 Richard Knapp Assoc. of American Medical Colleges One Dupont Circle, N.W. Washington, D.C. 20035 828-0400 Don L. Arnwine President Volunteer Hospitals of America P.O. Box 160 Erving, Texas 75016 214-830-0000 Lewis W. Lehr (labeled 5) Chairman & CEO 3 M Co. 3 M Center St. Paul, Minnesota 55144 David A. Jones (labeled 1) Chairman & CEO Humana Inc. P.O. Box 1438 Louisville, KY 40201 502-580-1000 Richard K. Eamer (crossed out) Chairman & CEO National Medical Enterprises 11620 Wilshire Blvd. Los Angeles, California 90025 213-479-5526 Michael D. Bromberg Executive Director Federal of American Hospitals 1111 19th Street, N.W. Washington, D.C. 20036 Robert A. Schoellhorn (labeled 3) Chairman & CEO Abbott Laboratories Abbott Park North Chicago, Illinois 60064 312-937-6100 notes on bottom of page: non prof chain Wagmeller MD's pharm (circled) next page handwritten: ABBOTT LABS 659-8524 American Hospital Supply Corporation 1090 Vermont Avenue N.W. Suite 210 Washington DC 20005 Telephone 202 842-3445 September 25, 1985 Ms. Sheila P. Burke Deputy Chief of Staff Office of the Majority Leader of the Senate S-230 Capitol Building Washington, D.C. 20510 Dear Sheila: It was good talking to you last week. Karl Bays is very interested in meeting with the Majority Leader on health issues. Mr. Bays will be out of the country for part of the week of October 7th. He will be in Washington for an Institute of Medicine meeting on October 17th and is expected to arrive in the evening on the 16th. He is also addressing the Health Industry Manufacturers' Association on October 3rd at noon. If that date is conceivable, I could ask him to leave Chicago at 4:30 a.m. to make a breakfast meeting with the Senator. October 17th in the morning looks like the optimal date for Mr. Bays. I know the Senator's schedule is incredibly intense and that day may not be appropriate. I do not know who the other prospective invitees are, but the Institute of Medicine meeting on the 17th draws a number of health industry leaders. I will try any other date but these look like the best so far. On the other matter that we discussed, I would like to ask you for a few minutes of your time with Karl and me. Please give me a call on either matter at your convenience. Best regards, (signature) David J. Aho, Esq. Director Government Relations BOB DOLE KANSAS United States Senate OFFICE OF MAJORITY LEADER S-230 THE CAPITOL (entire page handwritten) son rural sole comm. son rural admin. of redbud Rn Anderson Parkland Hosp. Texas entire page handwritten: HEALTH BREAKFAST #1 - Hospital Industry - Physicians - Nurses - HMO's HEALTH BREAKFAST #2 - Pharmaceuticals - Nursing homes - Hospital supply/manufacturing handwritten letter: Sheila Dick Knapp said that Bob Heyssel may be in Philadelphia (crossed out and replaced with Princeton) the morning of Oct 10th - if date of breakfast changes - Heyssel would like to be there. Back up names if 10th is firm J Robert Buchanon MD (illegible) Mass Gen (617) 726-2100 C. Thomas Smith President Yale New Haven Hospital (203) 785-2611 entire page handwritten: HEALTH MEETING #1 HOSPITALS -- DAVID JONES/HUMANA MD's -- Jim Sammons, one other Nurses HEALTH MTG. #2 - PHARM -- ABBOTT - Hosp supply -- DM Hosp Supply, SM - NSG Homes -- Robert Van Tuyle - Home Health - HMO's -- CIGNA, Kaisser entire page handwritten: HOSPITALS - AHA A Pub Hosp -- Redbud, Parkland AAMC --> Hopkins --> Heyssel OOT10 Press 301-955-5667 Johns Hopkins Hosp. FAH -- David Jones, Humana Nurses Physicians