The Health and Hospitals Committee of the Cook County Board of Commissioners met on July 14 to discuss and approve the Cook County Health and Hospital Systems Board Strategic Plan that had been approved by their board in June. Commissioner Butler presided at the meeting which followed the Forest Preserve District meeting and he called the meeting to order at 12noon.
Mr. William Foley, CEO of the HHS presented a summary of the Strategic Plan. He stated that there were 5 key components of the plan and they are:
1. Enhancing access to the system for all persons wanting to use the services.
2. Ensuring quality service and cultural competency throughout the system.
3. Realigning resources and using service line planning within the system.
4. Staff development
5. Leadership development
He emphasized that the plan is a plan for growth with a goal of expanding the ability to treat outpatients by 50% over the next 5 years. The plan does anticipate health care reform although the effects of that are still uncertain. The focus is on primary care with a need to expand access to specialty care. The plan does call for realignment of services at Oak Forest and Provident Hospitals focusing more on outpatient care and access to specialty care at these facilities and a decrease in the inpatient services at both hospitals. He did not discuss specifics on cost but did say that the amount of money provided by the county to subsidize the system is not anticipated to change much over the next 5 years. It will remain at about $300M if they go forward with the changes as outlined. The amount provided for benefits, pension and debt service is an additional $172M for a total of $500M. Capital costs would be in addition and while some of those have already been budgeted (ie Fantus Clinic rebuilding) others would be additional. It was stressed that this is a strategic plan and that modifications can be made along the way and cost would be a determining factor in how the plan is executed.
Public Comments included groups such as the Civic Federation, Access to Care, and Dr. Q. Young speaking on behalf of the Health and Medicine Policy Research Group, and also several individuals who were in favor of the plan. There also were several speakers some representing unions, but also employees and patients who were opposed to the plan. Opposition was primarily focused on the closing of inpatient beds at Oak Forest and Provident with concern being focused on lack of access to county health services in the south suburbs.
After the public comment Comm. Beavers asked to hear from Dr. Mason who accompanied Mr. Foley to present the plan. Dr. Mason apparently had once worked at Provident Hospital. Comm. Beavers wanted to know how the city of Chicago could do "twice as much with half the resources" for the health of the persons in Chicago and also stated that closing Provident would leave a significant number of persons without access to emergency care since "95% of the persons that go to Provident are trauma cases." Dr. Mason stated that hard decisions needed to be made about how best to use the resources of the county. Comm. Beavers [corrected 10/9/10] then made a motion to defer the decision on the strategic plan.
Discussion then proceeded on both the motion to approve and the motion to defer.
Comm. Peraica pointed out the reality that many hospitals have been going out of business.
Comm. Gainer stated that the whole nature of health care is going to change and therefore the county also needs to change.
Comm. Schneider expressed concern about getting reimbursement from other counties or states when patients from outside Cook County use the system.
Comm. Claypool was pleased to see the primary care focus of the plan since that is what he sites as the key to better care and lower cost of health care. He stated that there will be radical change in the way hospitals function and cited an article in the current issue of Crain's.
Comm. Sims had reservations about the plan and was concerned that hospitals in the south suburbs would "cherry pick" patients and limit access to patients needing care in the south suburbs. She was not ready to vote and needed more time to consider the plan. Comm. Gorman commended the HHS Board for producing a plan within the time frame that they had established.
Comm. Murphy was happy with much of the plan but Oak Forest needed to have an emergency room and inpatient facilities included before she could support the plan. Comm. Butler stated that to delay is always costly and there is no perfect plan.
The motion to delay the decision was then taken by roll call with the following results:
Yes (3) - Beaver, Murphy, Sims No (9) - Claypool, Daley, Gainer, Gorman, Goslin, Peraica, Reyes, Schneider, Butler Absent (5) - Collins, Moreno, Silvestri, Steele, Suffredin
The motion to approve the 5 year CCHS Plan was then taken with the following results:
Yes (9) - Claypool, Daley, Gainer, Gorman, Goslin, Peraica, Reyes, Schneider, Butler No (3) - Beaver, Murphy, Sims Absent (5): Collins, Moreno, Silvestri, Steele, Suffredin
A motion to reconsider was taken immediately following with the reverse roll call being accepted. The Committee report now goes to the Board for approval.
The meeting was adjourned at 3:15pm.
--Submitted by Cynthia Schilsky
