CCHHS Board Presented with Options in Delivery of Care

Cook County Health and Hospitals System Board Meeting

April 30, 2010 7:30 am to 4:00 pm

This was an all day meeting which covered regular Board agenda matters and a review of the Strategic Plan. The regular meeting spilled over its projected two hour time frame because of lengthy public comments, a protracted discussion of a contract for laundry linen services and a closed session regarding personnel matters. The current provider of laundry services was underbid by the GPO (Group Purchasing), a mechanism which had been approved several months ago to seek the lowest bidder for all services. Proponents of the current provider and losing bidder spoke of jobs lost by local residents to an out-of-state company. But Board members responded with arguments that the $2 million saving over 3 years of the contract could not be ignored. They recognized that use of GPOs represents change that may be hard on previous vendors and asked for a report on the efforts of the GPO to mentor small vendors to encourage their participation. The contract was approved with one negative vote.

The meeting resumed with a presentation of the current state of the Strategic Plan and the challenges inherent in it. Integrated Clinical Solutions, Inc., the consultant team, provided an in-depth assessment of community needs and related access factors, an overall evaluation of the System's current state, and key issues and a framework for the System to reach its goals. Four staff physicians then reported the progress of certain service lines whose development they are responsible for shepherding.

A few key issues drove the discussion: (1) There are significant unmet healthcare needs in Cook County. The community areas with the lowest health rankings – near south side, southland, east southland – have the least health resource coverage. Access to health care is a major issue in these communities. (2) System access points are not aligned geographically with patient populations having the greatest healthcare needs. There has been a significant geographic redistribution of the vulnerable population over the past 20+ years. (3) The current system configuration does not support a population/patient-centered approach to healthcare delivery. CCHHS is disproportionately skewed toward the provision of acute inpatient services, while evolving healthcare models are placing increased emphasis on primary care/prevention and comprehensive case management/care coordination. A greater proportion of CCHHS' traditional patients will have a choice in selecting their providers as national health care reforms. (4) CCHHS' current cost structure is not sustainable. Its cost per inpatient day is high, its losses are projected to increase; there is a significant opportunity to modify these by reallocating dollars.

Proposed scenarios would develop Regional Outpatient Centers that provide specialty services and are accessible to geographic areas with greatest needs – South, DT/West, and North, formalize partnerships with existing FQHCs (Federally Qualified health Centers) and other providers. The options include considerable detail regarding existing inpatient facilities, emergency services and long term care.

The final hour or so was devoted to four Service Lines which are considered critical to the Plan; Outpatient, Emergency, Maternal/Child Health and Surgical Services were scrutinized. The status and needs of each was detailed by the lead Physician especially as to how each fits into a long term plan.

The Board had many questions and will continue to peruse the mass of information that was provided. They hope to come to closure on a direction by their June meeting.

--Submitted by Observer Nancy Staunton