1. The meeting was called to order by Steering Committee Chair Todd Hufnagel at 4:05pm. The minutes for the meeting of 25 November, 2007 were available online but unfortunately were not distributed at the meeting. It was decided to hold approval of those minutes over to the next meeting of the Faculty Assembly.

2. Professor Hufnagel introduced the first topic on the agenda concerning faculty and staff benefits. He introduced invited guests James McGill, Senior Vice President for Finance and Administration, Charlene Hayes, Vice President for Human Resources, and Heidi Conway, Senior Director for Benefits Services and Human Resources Shared Services.

Mr. McGill explained that the benefits rate allocates roughly 7% to government-mandated categories such as social security; 10% to retirement plans; 10% and growing to medical and dental; and the rest to tuition remission, vacation and sick leave for staff. The total package is roughly 33% of salary which is somewhat higher than our peer institutions and is projected to grow to 38% over the next five years if no changes are made. This growth increment would have to be covered either by general resources or grants.

Three years ago, President Brody asked that the benefits package be reconsidered. We cannot change the government mandated expenditures and we have not changed the retirement package. The principle variable was health-care related costs. A committee was formed to look into the issue. This committee included faculty and staff representatives.

So far we have taken several actions to reduce the overall benefits rate and curb the projected growth. Last year, benefits ran to 34%. We're holding that now to 32.5% with projected growth over five years to 35.5 or 36% instead of 38%.

Ms. Hayes noted that the decision to reconsider benefits was made 4 « years ago, just before she was hired. President Brody and Mr. McGill delivered a very clear message that we needed to be aggressively looking at health benefits. She formed an advisory committee in the spring of 2004 which had two faculty from Arts & Sciences and one from Engineering. The committee undertook a very extensive review of benefits — the first such review in 12 years. A survey of faculty and staff sought to establish which benefits were seen as most important.

The recommendations of this committee, submitted in August 2004, were wide-ranging. One of them was to eliminate benefit dollars altogether. The formula in use gave higher amounts to senior employees because it was closely tied to life insurance. Rather than eliminate benefit dollars, the Human Resources office decided to make them more equitable by giving everyone the same amount regardless of status.

Other recommendations concerned pharmaceutical costs which were rising at a faster rate than other medical costs. This prompted a switch to encouraging mail order and generic drugs purchases.

The committee also looked at cost sharing. Hopkins was carrying anywhere from 85-95% of costs, depending on the health plan, compared with an industry standard of closer to 75%. The committee recommended moving to 80%.

Given that the largest costs were related to health care, Human Resources developed the philosophy that we should be a leader on managing health care costs through promoting employee health. Programs to encourage prevention and wellness were established under the umbrella Healthy @ Hopkins.

The Health Risk Assessment (HRA) was part of this effort. The first year it was administered (2006) the response rate was only 15%. Given the conclusion that the best way to manage health care costs was to help employees manage their health, we felt we needed a higher response rate; this led us to the idea of providing an incentive to respond to the survey. It worked: this year the response rate was 60%.

The purpose of the HRA is first to provide a summary of the responses to the individual employee highlighting steps they could take to protect their own health. Second, the responses inform the Healthy @ Hopkins initiatives to support faculty and staff who are trying to improve their lifestyles and physical condition.

The university looks at data only in aggregate; we don't look at individual responses. The data is managed by EHP which has subcontracted the survey to a third party.

That is the history in a nutshell. It really came out of this committee's work.

Professor Hufnagel distributed a letter from the Medical School Council formally expressing medical school faculty concerns about the HRA and Ms. Hayes' response. The letter can be seen at http://www.hopkinsmedicine.org/medschoolcouncil/

3. A question and answer period followed:

Professor Galambos (History): What was the total amount of savings to the university when you went to $800 across the board?

Ms. Hayes: We implemented the reduction over three years, during which we have saved $4-5 million. If we had eliminated the benefits dollars altogether, we would have saved $7 million.

Professor Hufnagel: If you take benefits dollars and the university subsidy for health care together, is that total number still going up?

Ms. Hayes: Yes, absolutely, because the cost of health care is going up.

Professor Callison-Burch (Computer Science): You have put the emphasis on employee health to control costs, but isn't the main problem the rising cost of HMOs? Are you negotiating with them?

Mr. McGill: We have focused on our self-insured plans (EHP and CareFirst). The HMOs are a small share — less than 10%. The rising costs come from hospital and physician fees.

Professor Hendrickson (Chemistry): We're the largest employer in the state. It seems that we should have some influence over insurers to bring their costs down. Are we lobbying?

Mr. McGill: Maryland is the only state left that regulates hospital fees, so they aren't under our control. Physician's fees — that's an interesting dilemma, an interesting negotiation. Our physicians argue they are not paid very well. Drug costs: we are doing some things there, but it partly depends on how we and our doctors buy drugs. Generics are a big help.

Professor Dalrymple (Civil Engineering): The Medical School Council letter makes four requests. How do you respond to them? [Professor Dalrymple elaborated the points as below, with Ms. Hayes' responses in italics]

—Are you going to put the $100 back in to the regular benefits package?

No, it was an incentive program that worked.

—What about protecting privacy and confidentiality?

The privacy issue is a major concern for all of us. We have an agreement with EHP and EHP has an agreement with the contractor collecting the data. This was reviewed by the HIPAA Council. We are having it audited to ensure that we've done everything possible to secure the data. The data is fully encrypted. We are following the highest standards. The contractor has a legal and moral obligation to ensure that the data is protected.

—A breakdown of benefits rates was referenced in the Medical School document but not attached or available on the website.

[Ms. Hayes referenced pie charts that were not available for distribution at the meeting. They are attached as an addendum to these minutes. Follow these links to: Pie Chart 1: JHU FY2007 Benefits Program Costs and Pie Chart 2: FY2008 Budgeted Benefits Program Costs.]

—The Medical School Council requested prior information about proposed benefits changes and the ability to participate in the decision-making process.

Communication is a big issue for us. We do articles, we do meetings, we send out benefit news and broadcast emails. We're working with focus groups to help us improve our communications.

Ms. Hayes: No change. $800 plus the incentive.

Professor Principe: A gun in the hand of a mugger is also an incentive, but it's not a good idea. This is a bogus argument.

Professor Hendrickson: Most of the people I know didn't answer accurately. They just filled in bubbles. But they were surprised and frustrated that the benefit dollars were going down. We need to figure out a way to keep information private and retain the benefit dollars.

Ms. Hayes: I've heard that from others and it's unfortunate. There are also concerns that employers would use this information to make decisions about employment; for example, that we're no longer hiring smokers. We are not doing this. Over time, as people see how we actually use the data to enhance our wellness, and they see that we're not using it to get personal information on you, we believe the accuracy of the responses will increase. How much is accurate now? It does match our claims data quite well.

Professor Karlin (Chemistry): Regarding the comment about getting information out, the website is horrendous. It was hard to find and deceiving. I pointed out a mistake that was corrected. Wellsource employees may have access to your personal information. Hopkins may not see it, but it could still have impacts. It is not protected.

Ms. Hayes: Is it protected from any eyes? No. Someone has to take the data and send it to EHP. It's a remote possibility that it could affect your eligibility for insurance.

Professor Cone (Biophysics): It's a remote possibility, but why do we need to do it at all? It is coercive. An IRB would call this coercive.

Ms. Hayes: EHP handles our disease management program for EHP participants and for CareFirst. Each of them uses claims data to identify people with chronic diseases or health risks. They have the data; they have always had it; they have to have it to process your claims. They are now taking the claims data and the HRA data and using it to enhance the disease management program.

Professor Cone: How is this confidential?

Ms. Hayes: The university uses the information only in the aggregate.

Professor Ditz (History): I was not in principle so concerned about the survey and the privacy issue because Blue Cross/Blue Shield already knows everything about me and is already targeting me. But I did object to using the money as an incentive to fill out the survey. I saw that what I would be getting was so much more junk mail about Weight Watchers, etc. It is still targeting. It would be good to give people the opportunity to opt out. I would urge better communications on everything we do. Some of us drew wildly erroneous conclusions when we first heard about this. We thought it meant that our total benefits package was being reduced to $800. There is a misunderstanding about how the total benefits package is related to the benefits dollars. This is, of course, very upsetting. You need to be much clearer about what actually is happening. You're reading junk mail in your inbox and you don't know what it means.

Professor Vidal (Biomedical Engineering): There is a perception of coerciveness plus the report that many people lie plus the data is available from other sources. Why are you persisting in this? There is a big cost in morale.

Ms. Hayes: Part of the recommendations coming out of the committee was that we needed to do a better job of raising the awareness of employees about how they are contributing to health care costs and also about the dollars we spend. The total compensation statements that we issue came out of the committee — not just the benefit dollars or salary but all this other money going into benefits. Also putting the total cost of prescriptions so you would know that the medications cost more than your co-pay of $10. All of this is about increasing awareness.

Professor Scheinerman (Applied Mathematics and Statistics): If the responses match the claims data, it doesn't seem the program is worth the cost or the ill will it generated. Many of the suggestions that came out of the HRA were not exactly news — e.g., exercise more, eat less fat.

Ms. Hayes: We focus on the negative, but a lot of employees came to us to say they really appreciated the survey. It was information they could take to their doctor to start conversations they hadn't had before.

Professor Hufnagel: No one objects to having the HRA available. The problem is linking it to the benefit dollars.

Professor Feldman (Physics and Astronomy): Your letter says you hired Wellsource to administer the survey. How much are you paying them — or are they paying us for the data?

Ms. Hayes: EHP contracts with Wellsource. It's actually very cost efficient — $2/person, less than $15,000 in all.

Professor Karlin: The mission of the university is research and education. The administration's function is to facilitate accomplishing this mission. The administration serves at the pleasure of the faculty. The staff and faculty are very upset. The staff are generally underpaid; some of them are shamefully underpaid. They're unhappy about the new job classifications. They're unhappy about the benefits. We're all worse off than we were before. Compensation has gone down. Our contracts have essentially been reneged upon because the amount of benefits people came in with has been drastically changed. How are we going to hire good people? The job of the administration is to keep the faculty and staff happy so we can carry out the mission. Hopkins One has been a disaster. There's tremendous pressure on faculty and staff. Faculty haven't gotten information about grants for 12-16 months. We can't order anything. Is there corruption? We'rre talking about $250 million — can there not be corruption? The faculty is underpaid relative to other institutions. The Medical School Council pointed this out. Do you think President Brody is really leading us toward the mission of the university?

Mr. McGill: President Brody is fully committed to the mission of the university. I agree with your characterization of the role of the administration. What we are trying to do here — perhaps it should be done in a different way — is balance some competing objectives: salaries, benefits, being competitive on grants. We can improve on how we do it and how we communicate about it.

Professor Leslie (History of Science and Technology): The incentive plan did not come out of the advisory committee. Who made that decision? Why $100 rather than $10 or $500?

Ms. Hayes: The $100 was pretty arbitrary. We talk to our peers all the time, and that's about what other people are doing. $100 is a sum that catches your attention. From an industry perspective, it is an effective incentive.

Professor Lattman (Biophysics and Associate Dean): Here's a practical suggestion. I don't see any reason for the data to be accumulated at all. The HRA response on the individual's health status is automated. There is no reason for the data to live on beyond the session.

Professor Cone: The whole privacy issue would disappear if was set up that way.

Professor Vidal: No one on the faculty participated in the decision about the incentive. Everyone is angry about it. Why not reverse it?

Ms. Hayes: The committee made general recommendations. We had to develop specific strategies to meet the recommendations. I'll take your advice on these things, but we can't ask faculty opinion about everything.

Professor Schoenberger: Have we established mechanisms to bring staff into these discussions? I imagine they have strong feelings as well.

Mr. McGill: That's a good idea. We need to look at focus groups, a general invitation.

Professor Callison-Burch: Could you explain the rationale for reducing employee benefits rather than increasing the fringe rate on grants over time?

Mr. McGill: It's a balancing act. Do we want to let our fringe rate rise on grants or take it out of general funds? We need to bring grant fringe rates to a level competitive with our peers. Ours is well above peer institutions.

Where do we lead our peers? We have a 12% contribution for retirement for faculty and senior staff; most of our peers run at 10%. The second is on health insurance because the university has been paying 85-95% depending on the plan rather than the 80% of our peers.

Professor Vidal: Has there not been a reduction in tuition benefits? We are only able to take classes at night now.

Dean Falk: That is a longstanding but inconsistently enforced policy. We have begun to enforce it consistently.

At Professor Hufnagel's suggestion, it was agreed we should end discussion of this issue at present and take it up again at a future closed session for more discussion amongst ourselves.

4. Provost Johnson spoke about strategic planning and the reorganization of the provost's office. She has been meeting with people all over the university and talking with the deans and the trustees. She seeks faculty involvement in setting the intellectual direction of the university. It is time for a new strategic plan. We need to articulate a common sense of mission and vision, test the assumptions we make about Hopkins — who we are, what we are about — in the context of general changes in the environment such as globalization, recession and so on. We need to remain preeminent in higher education in the world. We have to figure out what's going to keep us ahead of the competition, how to keep us on the cutting edge. How do we retain the best people given that they have now other places to go?

She is forming a Provost's Steering Committee with four working groups.

1. Strategic initiatives: these are the core departmental and school programs that speak to the heart of what is best about Hopkins;
2. Making people better, more productive — faculty, staff and students;
3. Infrastructure: finance and facilities;
4. Globalism: putting points 1-3 in context.

5. A question and answer period followed:

Professor Karlin: We did a ten-year plan four or five years ago. Most of the recommendations haven't beencarried out. The deans changed. Hopkins doesn't have enough money to implement any plan.

Provost Johnson: The last time a university-wide plan was done was in the mid-1990s — C21. When I went to Duke in 1999 there were no funds either, but we did a compelling plan and we ran a campaign which raised significant resources. I do understand the issue of resources, and we're working on it.

Professor Feldman: Is this university-wide or Homewood? There is an 800 pound gorilla in East Baltimore that weighs down everything we do here. Our cultures are very different.

Provost Johnson: An 800 pound gorilla can also be an asset. We need both cultures. There is a joke about two vultures. One of them says to the other, "I'm tired of waiting for something to die. Let's go kill something." Do we kill something or do we wait until something dies? We don't move quickly as universities. We think about things and move carefully. I want to get the best of both. There are such great people here.

Professor Cone: I'm troubled by the phrase "making people better, more productive." As a teacher, I want to help people, not make them better. It's a very top-down way of thinking. We want to enable people in the institution to participate and work better. This seemed to be dominating, manipulating.

Provost Johnson: Yes, but I want to be sure I have the tools and resources to help grad students work better so they can help us, and so on. That's what I mean. That's where my heart is. Listen to my heart.

Professor Cone: Even what your heart is saying sounds controlling.

Provost Johnson: I do want you to be happier and more creative. Why else are we here?

Professor Arrighi (Sociology): I'm happy to hear about the interest in globalization. About resources — there used to be a thriving Institute of Global Studies which was then starved of resources and effectively disappeared. So things don't happen.

Provost Johnson: The plan needs to drive the resource acquisition and allocation, not the other way around.

Professor Vinson (History): What exactly is your vision in terms of bringing us into this globalized world? What is the rationale for restructuring the provost's office?

Provost Johnson: Globalization is not an issue for study in this context; it is about how we organize ourselves to go forward in this new world order. How do we stay in the vanguard. What's the new new thing? I don't have predetermined ideas about what those will be. There were no vice provosts who were tenured faculty. So how do you connect to the faculty? I'm your advocate to the President and to the Board. I've met with all the chairs and center directors, and it's been fascinating. My philosophy was to find three very outstanding people who have been there, done that, walked in your shoes, so they really understand you.By design, they are two-thirds time in the provost's office. I've read Machiavelli. The Prince or Princess should live in the principality. I think it's important that we are all connected.

Professor Leslie: I'm trying to imagine President Gilman with a strategic plan. The fact that everyone else does them may suggest that it's not what we should do. If we think about people who really made a difference — an Eliot, a Gilman — it was not by plan or committee. Strategic plan sounds like Jack Welch and I don't want us to be GE.

Provost Johnson: A strong leader should run a process that is consultative. My ideas need some work — I hear what you're saying. But I've seen successful plans take institutions to the next level. We should be driving the next campaign. Development wants that. We have outstanding deans right now. We have outstanding faculty. I'm worried about losing faculty. I know our graduate stipends are low. What about financial aid?

Professor Guyer (Anthropology): This sounds very positive to me. I have a pragmatic question with a philosophical basis: how big will the working groups be? I'm thinking about the different needs and standards of different disciplines. The microecologies of areas of intellectual growth for the future can be in surprising places.

Provost Johnson: Size, I'm not sure. The strategic initiatives group will probably be larger. At Duke we had seven working groups with 8-10 faculty. We ended up involving about three-fourths of the faculty. Integrating was a challenge.

Professor Kingsland (History of Science and Technology): I'm on a committee looking at the status of women in the Krieger School. Questions of equity really fit all four of your categories. So where do we go to express our concerns? How do we know that our committee and its concerns stay on the radar and don't get submerged in these other issues?

Provost Johnson: Yes, there are many ongoing committees that overlap with the working groups. I will ask for committee representatives to the working groups.

Professor Hufnagel adjourned the meeting at 5:32.

Appendix
Pie Chart 1: JHU FY2007 Benefits Program Costs
Pie Chart 2: FY2008 Budgeted Benefits Program Costs

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Last updated 19Feb08 by dgips@jhu.edu