Cook County Health and Hospitals System Board Meeting November 19, 2009
Public comment included a citizen who accused the Board of undesirable relationships with private providers and failure to recognize the role "Chicago politics" will play in their acceptance. The Board responded by assuring him that any relationships that are developed are examined from the perspective of what benefits they bring to the County System. A Dietician from Oak Forest Hospital reported that employees there are demoralized over layoffs recommended in the Navigant Report [a report generated by consulting firm Navigant Consulting Inc.]. She enumerated 200 in non-clinical positions and also related the difficulties of providing efficient meal service in a physical plant spread out over three locations.
As part of on-going Board of Directors education, the coordinator of the Internal Medicine Residency gave an overview of that program which includes 144 positions. Those accepted were selected from about 5000 who apply yearly. The program has been accredited since 1955 and has high standing among 370 comparable programs in the U.S. These Residents participate in every patient encounter throughout the hospital, including the ICU and ER. About 50% go on to Fellowships.
CFO Foley reported that the Strategic Plan would not be adopted at this meeting. It needs further analysis after public and internal meetings. The emphasis will continue on improving access.
The Consultant led the Board through the goals in the Plan and some proposed changes in emphasis. With regard to inpatient facilities several additional data are necessary, particularly an evaluation of the need for services at those facilities and what other resources and alternatives exist. He emphasized that the County mission is fundamentally different from that of the private sector. With regard to out patient services, suitable resources at other Centers must be evaluated. The development of Service Lines such as Trauma, Women and Children, and Surgery also need further analysis. Initiatives will be prioritized with time lines of 3-5 years.
There was considerable discussion regarding how to proceed with the financial future in jeopardy. Enabled by improved revenues, the 2010 CCHHS budget was cut by $75 million. Interjected was the roll back of sales tax and what its impact would be on the 2011 budget. Rumors included another $75 million cut in Health which could translate into losing 1250 FTEs. It was noted that Health spending accounts for about 30% of the budget, but reimbursements for health services (which go into the General Fund) reduce the portion of the tax-generated revenues spent on Health to about 12%. Therefore, any cuts in Health should be proportionate. The challenge is how to maximize income other than tax revenue. Some possibilities are better billing and performance improvement. Other communities have added 501(c)3 status to garner voluntary contributions. Critical to any implementation is a Financial Plan. Its development was assigned to the Finance and Audit Committees.
The Director of Public Health reported on the status of H1N1 immunization and incidence. The program is moving as quickly as possible with distribution of doses. Acceptance has been high except among the African-American population. Efforts are underway to reach Ministers and others who could be influential in communicating the benefits of this immunization.
A report on Phase 1 of the Performance Improvement Assessment was detailed. The consultant gathered data from many sources. It addressed physician alignment, clinics, pharmacy, laboratories, hospitals and showed much "opportunity" for improvement. Implementing change would involve modifying the infrastructure and adding tools, including automation. Services have to be managed frequently and staff training is critical. CFO Foley responded with his intention to implement many of the recommendations using the existing management team.
The Board adjourned to Executive session.
--Submitted by Observer Nancy Staunton
