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