CCHHS Board Special Meeting September 18, 2009
At a Special Meeting following a regular Board meeting, the Board members of CCHHS spent 3+ hours reviewing the data assembled by their consultant and feedback from the seven Town Hall meetings held in the summer. Their goal is to flesh out a Strategic Plan: what to be, what to do and how to do it. Among the findings were that Chicago has the lowest percentage of uninsured in the country; men, Latinos and 19-24 year olds lack services; infant mortality is highest in the southern part of the County; a large number of Federally Qualified Heath Centers (FQHC) provide services in areas of need; about 4% of Stroger ER services are provided to non-County residents; one-fourth of the budget goes to Provident and Oak Forest hospitals which doesn't coincide with usage. Medicaid usage is low and patients include very few Hispanics.
The reported major concerns raised at the public meetings attended by 400+ individuals were access and services. Regarding access, they noted geographic changes of the past decade have made the locations of facilities inappropriate, wait times are unacceptable and there are both language and physical barriers like parking and ingress. They felt the system is fragmented, has no continuity of care and lacks follow-up.
Observations by the Board regarding the physical plants: Fantus Clinic is deficient and needs to be replaced and its (re)location should be considered. Provident and Oak Forest hospitals are not configured for their current use; long term care and rehab may be more appropriate uses for Oak Forest hospital. Obstetric services are very low at Stroger and Provident hospitals. What should be the long term direction?
With much discussion from all members, some themes surfaced: planning should be patient-need focused, not facilities focused, keeping in mind geographic distribution and vulnerable populations. There is a potential for partnerships with FQHCs, VA services and medical schools. Volume thresholds and more programs of screening and early detection should be explored. Should the County be the provider of care or assure its delivery? Can County Primary Care services be coordinated and/or regionalized? Where should specialty care be located? Other issues: coordination of public health services, more emphasis on prevention/nutrition, role of school clinics, coordination with collar Counties. Is the best use a focus on areas of excellence, i.e., Trauma, Burn, AIDs, and development of others e.g., Diabetes, Asthma, Obesity? Nurse training? Education and research should be continued only as they serve the patient. Any planning must include financial forecasts that compare the current cost structure with a) planned productivity and supply changes and b) any additional changes.
--Submitted by Observer Nancy Staunton
