Strategic Plan Status Update at CCHHS Board Meeting, January 29, 2010

Jeanene Johnson, Director of the Office of Performance Improvement, gave an overview of activities and progress. The staff of three, specializing in finance, operations, and IT, oversee consultants with a goal of improving all business functions and becoming unnecessary as the management team grows. They will store all records on a restricted access website for future use. Their target is $105 million in reduced expenses. Some focus areas are lab consolidation and pharmacy formularies.

Ten employees will be funded to participate in relief efforts in Haiti for 10 days each.

CEO Foley reported on system leadership goals. The Strategic Plan and 5 year financial plan should be completed by June for approval by the Board. It will include management restructuring to achieve the budget reduction of $105 million (400-500 positions). It will include attention to cultural diversity, patient satisfaction and staff morale. A Board member reminded him that productivity is basic to budget reduction; the director of the Ambulatory & Community Health Network (ACHN) provided data that showed some improvement, e.g., the increase in patients seen per primary care physician session. Concerns continue regarding referrals to specialists. Financial statements will be provided next month. Management is in preliminary discussions with University of Chicago to explore shared use of Provident Hospital.

The Finance Committee Report noted that the Graduate Medical Education study showed inadequate documentation to claim reimbursement due to poor record keeping. Payment systems are still challenging. Systemic issues still need attention.

The Board adjourned to closed session to discuss relevant issues. 
--Submitted by Observer Nancy Staunton

January 26 Cook County Board Meeting

At the Cook County Board meeting on January 26, 2010, Commissioner Butler offered his condolences to Haitian families who had lost loved ones in the recent disastrous earthquake.  Commissioner Suffredin reminded those in attendance that after New York City, Chicago has the largest Haitian population in the country.  Other commissioners also expressed sympathy and support for the people of Haiti.  Dr. Baptiste provided a brief history of Haiti, including its vulnerability to storms such as Hurricane John in 2004 and four hurricanes in 2008. Individual tributes were paid to Robert "Squirrel" Lester, reknown blues singer; Carlos Hernandez Gomez, passionate news reporter and recipient of the Edward R. Murrow award; as well as Michael E. Lavelle, Sr., election law scholar and chairman of the Chicago Election Board.


The Board debated a comprehensive immigration reform proposal, authored by President Stroger and Commissioners Gainer and Moreno. The resolution, which the commissioners discussed at length, urges passage of the Comprehensive Immigration Reform for America's Security and Prosperity Act of 2009 (H.R. 4321). A vote was taken on the motion, which carried with thirteen yays; Commissioners Goslin, Gorman, and Schneider opposed its passage.  Board members then questioned how much money the county was paying to Shakman compliance officers.  A county spokesperson promised to provide this information the Board requested regarding this issue. Commissioner Schneider called attention to the county's payment of $8000 to an employee who fell off of a chair.  The commissioners turned to the Comptroller Revenue Report, which revealed that the Health and Hospitals budget has suffered because this arm of Cook County government had to return $53.1 million.  Commissioner Collins asked whether the public is aware of Stroger Hospital's state-of-the-art medical facilities, implying more should be done to let others know.


Commissioner Peraica drew the Board's attention to the revenue report.  He stated that the county is losing money on its sale of cigarettes because of the county sales tax.  Commissioner Moreno expressed disagreement over this statement, suggesting that the reason cigarette sales have fallen is because fewer people are smoking and also because of the recession.  Commissioner Moreno argued that business is coming to Chicago, while Commissioner Peraica countered that conventions are no longer bringing their business to Chicago.  Commissioner Peraica continued to question the county budget, calling the Board's attention to the Public Safety Fund, which was $35 million over budget due to salaries and a high personnel turnover.  According to Cook County CFO Jaye WIlliams, the increase in salary payments are due to an increase in personal services.


Commissioner Gainer brought up an additional budget concern regarding Health and Hospital systems.  She questioned whether the county is paying a standard rate to hospitals, or a reduced rate, citing the county's recent payment of $35,000 to Christ Hospital, which contained no discount.  Finally, Commissioner Peraica proposed an amendment to repeal the entire county sales tax.  A suggestion was made to bring his proposal to the Finance Committee.  The motion to do so was passed with eleven yays and six nays.

--Submitted by Observer Stephanie Polito

Board of Commisioners Meeting - January 12, 2010

The Board Meeting was called to order at 10:20am by President Stroger and after an hour of reading tributes and honors to various persons and groups the Finance Committee meeting was convened.

Comm. Peraica raised a concern about payment for private attorneys related to a Shakman case. Mr. Driscoll of the State's Attorneys office explained that a particular witness needed their own representation in this case and therefore county attorneys could not be used. This led to discussion of county compliance with the Shakman Decree. Comm. Peraica and Collins asked once again why it is taking so long, and costing so much for the county to come into compliance. Mr. Driscoll explained that the county continues to work towards compliance and that all the claims have been adjudicated. Comm. Daley stated that it is the Judge who will determine compliance. Comm. Sims and Murphy also got into the discussion stating that money should not be spent on Compliance Officers but go towards fixing the Human Resources Dept. so that hiring could be done the right way. They again requested that a desk audit of all positions in the County be done. Comm. Silvestri stated that the debate centers around those persons who occupy policy making positions since those are the positions that are "Shakman exempt", but these still seem to be undefined. The commissioners also sited the inability to comply with the orders of the Duran Decree (deals with Cook County Jail) due to the complexity of the issues involved. Mr. Driscoll stated that he thought Duran was an easier fix than Shakman.

Comm. Peraica also raised questions about the monitoring of contract minority participation. The office of Contract Compliance stated that they do monitor all contracts for minority participation and verify that the contract is carried out as outlined in the bid for the contract. Comm. Peraica wanted to know if contracts are also monitored if they are increased mid-contract. He also questioned why and how often contracts are being increased mid-contract, being particularly concerned with contracts at the JTDC. Comm. Murphy stated that she did not like the allegations that were being made at the meeting. Comm. Collins expressed concern with food contracts. Comm. Daley stated that if anyone had information about contracts that were not being carried out properly, they should turn that information over to the IIG.

The remainder of the agenda was dealt with in a routine fashion.

The following New Items on the agenda were referred to committees:

• an ordinance concerning social networking during meetings
• establishing a Diversion Program for mentally ill inmates at the jail
• conducting a feasibility study for a Bond Loan Fund for qualified arrestees
• establishing an Independent Civil Service type Board for hiring Shakman exempt employees
• an ordinance concerning cannabis possession

The meeting went into Executive Session at 12:50pm to discuss issues concerning Homeland Security, and the observer left at that time.

Cynthia Schilsky - Observer

Cook County Health and Hospitals System Board Meeting—December 18, 2009

Public comment: A representative of Nursing reiterated complaints about morale and staffing; a citizen reminded the Board, at length, of the "political atmosphere" in which they operate.

CEO Foley introduced Salim Al-Nurridin from the Health Care Consortium who was very involved in organizing the Town Meetings. In his review, he rated them generally positive in process and was complimentary to the Board on progress that has been made. The consultant's contract was extended with a projected end to the Strategic Planning process by June.

The new Chief Medical Officer, Dr. Terry Mason, was introduced. He comes from the Chicago Board of Health.

Discussion of a Settlement Agreement with the Health Facilities Planning Board continues.

Discussions have begun with the State on providing mental health services to replace closure of the Tinley Park facility. Oak Forest site is a possibility.

Dr. John Raba, who has been the interim Chief Medical Officer for the past 15 months, reviewed accomplishments during his tenure: service integration across facilities, partnering with FQHCs in Pediatrics, a Quality/Safety committee, improved clinical leadership, adjustments to salary inequities, increased accountability and productivity, all facilities accredited, with Cermak developing the "best team in the country".

Responding to a Board member inquiry, the H1N1 immunization rate for employees overall is reported as 51% (which includes persons declining for medical reasons). March 1 is the deadline for 100% implementation. More education is needed. Some delay was due to problems with supply.

In the process of adopting December minutes from the Finance Committee, a discussion of the proposed redevelopment of the historic Cook County Main Building for System administrative offices revealed confusion among Board members on the issue. Member Butler, who is a Cook County Commissioner, took a strong position that the cost involved in rehabbing the building versus new construction was wasteful, and the Board initially was swayed to agree. When further explanation was provided, that the building has National Historic recognition and cannot therefore be demolished and when they found that failing to accept the proposed site would mean their offices would be moved off campus, a subsequent motion passed saying they would move into any facility on campus. Staff must be relocated from their present location at 1900 W. Polk because the building is considered unsafe.

The Cook County Contract Compliance Officer reviewed the progress on implementing ordinances that relate to Women and Minority businesses. Workshops have been conducted to explain to these owners General Purpose contracts and how to participate in them.

Resolutions were adopted honoring Valerie L. Webb who has been elected President of the Illinois Public Health Association and Dr. Linda Rae Murray who is President-elect of the American Public Health Assn.