MANAGEMENT STAFFING CONTINUES AT CCHHS

Board Meeting of Cook County Health and Hospitals System March 13, 2009

 

With a new CEO due to arrive in May, interviews continue for other positions, namely Compliance Officer, and senior Auditor.

There was considerable discussion of existing procurement policies under which the System must operate until the System adopts its own policies, anticipated in late May. In contracts, the System must currently abide by County ordinances which include specific minority/women certifications. It was noted that a tension will always exist between recognizing this requirement and the lowest bid. The Cook County Purchasing Agent addressed continuing problems with purchase orders coming from the System and the need for training. The relatively new System Procurement Director responded.

The Finance Committee had met but without a quorum was unable to approve a long list of contracts and procurements. The Board went over these, discussed and approved most.

An article in the Chicago Tribune regarding the care of heart attack patients at Stroger ER was addressed in detail by two staff Cardiologists.

The County Director of Capital Planning reported on needed repairs at two clinic sites owned by the City of Chicago. Discussion ensued regarding whether to continue at those sites or seek other locations.

Forest Preserve Commissioners Meeting March 5 2009

At the regular meeting of the Forest Preserve Commissioners of Cook County on March 5 2009 there was a legal report to start. Judge Anderson has entered a Supplemental Relief Order with no complaints, paving the way for the FP to have the earliest "out" of the Shakman Decree on June 2010. Judge Anderson complimented the District on keeping its costs down.

There was then an adjournment so the Finance Committee of the whole could meet. During this time many contacts and disbursements were ok'd without much discussion. One item discussed was the restoration of about 40 lakes which are in the Forest Preserve District and are being overrun with vegetation and becoming less usable for enjoyment by citizens. The restoration process and expense was discussed. Superintendent Bylina used this opportunity to explain that the District is one of the hosts of the IHSA State Championships for Fishing this year and they are very proud of this distinction and service.

Back to the regular meeting the Annual Watchman report was presented. It was reported that, in keeping with policy the number of homes has decreased with them being taken out of service when repair costs rise. There are now 47 homes in service as opposed to 57 in 2008. One is being repaired because it is worth it now so 9 have been taken permanently out of service. The rent for these homes is deducted from each watchman's salary so there is no one in arrears and there was a $50,000 profit to the FPDCC due to this program last year. Commissioner Peraica raised a concern about the in-house make-up of the committee which oversees this program, but there was no general discussion of that issue.

New items of business were:

Commissioner Suffredin moved to receive and file a report which is annually prepared by Kent Fuller, steward of the Miami Woods restoration efforts. Mr. Fuller reported phenomenol growth in the hours and efforts of volunteers. Since 2001 there have been more than 5194 volunteers working to help restore Miami Woods. They are recognized and thanked.

Commissioner Stroger and others honored Eileen Agnes O'Malley and sent condolences to her family upon her death. Mrs. O'Mally had donated 100 acres of open space to the Forest Preserve during her life.

Last issue was a big confused because the request was for approval to award an Auditing contract but the request had not been submitted early enough to warrant action under the Open Meetings Act. It could not be approved at this meeting, but there is some time pressure for the auditors to get started. The firm chosen gave the lowest bid and is a reputable firm, though they had also made one political contribution which made them suspect to Commissioner Peraica. In order to conform to the Open Meetings Act this request was discussed and deferred. A special meeting will be called for March 17 in the morning to vote on awarding this contract.

That's all.

COMMISSIONERS DEFER DECISION ON MOVING DPH OFFICE

Health and Hospitals Committee of the Board of Commissioners of Cook County
Meeting on March 5, 2009

Commissioners Silvestri and Collins had proposed a resolution to the Board of Commissioners in opposition to the relocation of the Cook County Department of Public Health to the Oak Forest Hospital of Cook County Campus. It was considered at this meeting. This Committee is a standing Committee of the whole and includes all 17 members. (Its origins predate the establishment of the Independent Board of the Health and Hospitals System. Jerry Butler, the Cook County Board representative on CCHHS, serves as chair.)

The Directors of DPH and Capital Planning gave arguments in favor of the move and noted that renovation of the Oak Forest facility were underway with a target finish date in 2011. They cited the need to consolidate emergency management functions in which DPH is involved at a site on the outskirts of the County for safety reasons. They stated that the current office in Oak Park provides only administrative functions that do not involve the public and that clinical services for west suburban residents are located in Maywood and Cicero. Vital statistics have been transferred to the Clerk's office. The current lease to 2011 is $600,000 and operating expenses about $50,000 annually. The build out in Oak Forest would cost about $5.1 million. Operating expenses would continue.

Arguments against the move were made by several Commissioners and the President of the Village of Oak Park and the current building leaser. These included the convenient central location and public transportation for employee access and the harm that would be done to the Village by removing (variously) 70 to 100 workers from the Downtown. The leaser offered to negotiate rent to retain the Department. Concerns were also raised about the construction cost in this tight economy.

After lengthy discussion and no evidence of consensus, a motion to defer the discussion was approved.

Submitted by Nancy Staunton

So how's that transparency idea going in Cook County?

Board Meeting, March 4th, 2009. Cook County Board of Commissioners

All board members and the president were present except Earlean Collins.  Congratulations were given to Commissioner Quigley on winning yesterday's Democratic primary election for the 5th  Congressional District.

  Some notes on transparency of government actions: at today's meeting some progress was made  (see below), and yet there is still confusion for observers and even commissioners in understanding what funds are actually available, amounts in issuing bonds, and contract bid vendors.  At times it is still difficult for observers to know what is being discussed and voted on, since we do not have access to all of the paperwork to be able to follow along.

To encourage more transparency in government, an ordinance was sponsored by Comm. Peraica to establish a monthly check register on the Cook County Web Page that can be accessed by anyone.  This is already being done in Du Page County and being promoted at the state and federal levels.

In Cook County, this would show all expenditures from the main checking account, which covers about 90% of expenses including vendors, contracts, and employees.  Advantages to citizens would be seeing where the county spends its money, who gets contracts, are there conflicts of interest or campaign contributions that influence contracts.  

Two commissioners voted against this saying it didn't go far enough; however, it was pointed out that it was much easier to start with the main account instead of delaying this until every part could be perfected.  Antonio Hylton, Chief Information Officer, said his office did not have the $10,000 to implement this because the capital bonds were not passed today.  Several commissioners did not accept this excuse since it was such a small amount out of tens of millions of dollars in the IT budget and it could be done with in-house employees.  Other commissioners volunteered to use office supply money to cover the cost since it was so important. According to Antonio Hylton, this will take 90-120 days to implement.  The ordinance passed 10 yes, 2 no, 4 absent.

 

The on-going debates about issuing the capital improvement bonds continued at this meeting.  At issue was using bonds to buy equipment like cars and computers which lose their value so quickly, yet will be paid for over long periods of time--with interest.  Also the amount of the bonds  was under discussion.  Is it $294,000,000?  $262,000,000? or the previously passed $740,000,000?  Clarity was lacking, so the selecting of the finance team to issue these bonds was delayed by not passing this item.

The new CEO of the  Health and Hospital Systems, William Foley, was presented to the board of commissioners.  His top three priorities are infrastructure, strategic planning, and financial turn-around.  

Near the end of the meeting, Pres. Stroger lambasted  "the 3 Democrats" for siding with the Republicans, who have not backed Stroger's plans (particularly the bond issues).    

Health Services Budget Cut Only 2%

Cook County Health and Hospitals Systems Board meeting February 26, 2009

The good news at the Health and Hospitals System (HHS) Board meeting was that in the County budget for 2009, the budget for HHS was cut only 2% (approximately $14.2 million) while other County departments were cut 4% to address the expected revenue shortfall. There is no planned reduction in staff or services beyond those contained in the earlier proposed budget. The cut will be absorbed in supply and support contracts. There are currently 700 vacancies in HHS; about half are currently in the hiring process.

Board business addressed on-going issues:

• Clarification of relationships with medical schools regarding resident training that addresses their numbers and purposes. A master affiliation agreement should also address costs and supervision responsibilities.
  
• The intra-governmental agreement with State of Illinois continues under review.
  
• The planned consolidation of all surgical services at Stroger Hospital is well underway with re-deployment of staff. The purpose is to reduce wait times to surgery.
  
• Similar integration of all systems across the various institutions is underway with meetings of Chairs and staffs of departments and is well received by professionals.
  
• Recruitment continues for CEO, CFO, Chief Legal Officer, Chief Compliance Officer, and a System's Press Relations Director.
  

Reports were given by consultants addressing information services (IT), billing (especially the impact of Medicaid rate changes) and the strategic planning process.

Adopting a general direction in strategic planning was recognized as urgent, with specifics to be added later. From data gathered on the hospitals and ambulatory care facilities, the system is an essential part of the safety net, with provision of 40% of the care for the uninsured in the County.

Partnerships with other providers must be forged. Surveys indicated it is not the provider of choice for most users; patient satisfaction is poor, location is not convenient and there are long waits. Town hall meeting should be held soon to involve the public in discussions. The Health Department should help set goals and desired health outcomes.

Data in the Performance Report point to inaccuracies due to errors in coding. Providers and coders must be educated; a strong case-management system would be useful.

Oak Forest Hospital is part of a national initiative, Hospital Consumer Assessment of Health Care Providers, which is surveying patients regarding their satisfaction with services, e.g., communications, pain care, and discharge. Results will be compared to national standards and a quarterly review will enable training of providers to improve customer service. Results are not yet available.

--Submitted by Observer Nancy Staunton