Cook County Health & Hospitals System Board Meeting October 28, 2010

Stroger Hospital, 5^th floor Conference Room, 7:30 am

Board and Committee Reports

Finance Committee reported on the operating budget submitted to the County for public hearings. It requests appropriations of $817 million (a reduction from 2010 of about $48 million). Based on the revenue and expense projections, the required subsidy from Cook County would be approximately $217 million (almost 30% less than in 2010). The Board position has been to seek a cut in subsidy rather than across the total appropriation. The reduction will result in a loss of services of approximately 1000 Full Time Equivalent (FTE) positions. The budget process is anticipated to last until February.

Meanwhile, the CCHHS intends to proceed with implementation of its Strategic Plan.

Audit and Compliance Committee noted several policy revisions in process, notably the gift policy. Many departments are involved. Resolution is expected by December.

Quality and Patient Safety Committee reported on several services. With no in-patient psychiatric services at Stroger, the ER is inundated with cases. Obstetrics (OB) services at Provident have been suspended. Other improvements were noted with recognition that quality depends on staffing.

Resolutions were passed celebrating the 100^th anniversary of Oak Forest Hospital and the 50^th anniversary of Provident Hospital's Women's Auxiliary Board.

CEO Foley reported on progress on Leadership Goals. Under performance improvements, the Knowledge Web on the Internet has established a webpage for each department for internal use. Among operational improvements, lab consolidation has occurred, bringing testing from the clinics to Stroger, with anticipated savings of $5 million over 3 years, as well as more efficiency. Nursing professional development has streamlined 20 affiliation agreements to 10 at all levels, with better schedule monitoring and ability to assess competency.

The Strategic Plan proceeds with 14 teams addressing 350 tasks. The Cook County Ambulatory and Community Health Network (ACHN) team will address computer needs, regional outpatient services at Oak Forest and Provident, and potential expansion of Cicero and Palatine clinics. The consultant, Fantus, is involved in program planning for a new facility which involves County Capital Planning and Requests For Proposals with a target of Certificate Of Need (CON) approval in 2012 and construction in 2014.

The Oak Forest team has a March deadline for CON approval of a closure of inpatient beds in May, with inherent marketing and communications needs. They will also address an expansion of Building E to regional outpatient and specialty services, the development of ER to Urgent Care, and meetings with local hospitals.

The Provident team will address the downsizing of inpatient beds and suspended OB services, along with inherent communications needs, ER transition, the relationship with University of Chicago and collaboration with Federally Qualified Health Centers (FQHC) for primary care.

Overall goals continue: Access (which addresses barriers regarding phone, referral, and staff development), Quality, Service Excellence, and Cultural Competency. Specialized areas will continue to be examined, including ER/Trauma, Urgent Care, Maternal/child, Perioperative, Stroger capacity/length of stay, Staff development and training, and Staff satisfaction.

The meeting adjourned at 9:45 am. The next meeting will be on November 19 at 7:30 am.

--Submitted by Nancy Staunton, Observer

Cook County Board Meeting --November 3, 2010

BUDGET REPORTS BEGIN

Starting the meeting were budget reports from the three transit agencies that receive some funding from Cook County or have board members appointed by Cook County Board. The audience did not have access to the actual budget numbers.

Terry Peterson, chair of the CTA Board stated there would be no fare increases and no service reductions for 2011 and that the budget was lower than in 2008. His concern was that the state of Illinois is late on payments to the CTA. The inspector general office of the CTA costs about $2 million per year, but is considered a good example for transportation oversight. In the future, the CTA and other transportation agencies would like to get away from fare cards and instead have customers use credit or debit cards.

Jim Dodge of the Metra Board presented a $1 billion balanced budget. They will need to move money from capital funds to operating funds this year. There was a concern that lower sales taxes and late funding from the state would impact the operations. There will be no fare increases in 2011 and there will be electric line improvements this year. Dodge stated the Metra Board is "resetting" after the scandals of administration payment irregularities. There is some concern over the type of inspector general office needed for Metra. Commissioner

Suffredin questioned Metra's plans regarding the replacement of 22 bridges and the ensuing disruption for North Shore riders. Dodge indicated the project will be re-planned to possibly cost less and cause less disruption.

PACE also indicated no fare increases or service reductions , but services cannot be expanded at this time. Ridership is down, probably due to higher unemployment. New buses will be hybrids and be smaller, since many buses are now half-empty. ADA (Americans with Disabilities Act) compliance is a large portion of the budget.

The RTA, which is the overriding agency of CTA, METRA, and PACE had concerns about the $300 million that the state of Illinois is behind in paying these agencies. All boards are having to dip into capital funds for operations. Commissioner Peraica expressed concern that the agencies have an alternate budget ready in case the state doesn't come through with the money. He also stated that employee pensions, salary, etc. will doom these transportation agencies.

During the Finance meeting, the revenue report for the last 10 months was presented by the Comptroller, Connie Kravitz. Revenues are currently ahead of budget projections by $4.7 million. However, by the end of the fiscal year it will come out even. Concern was shown about the reduction in sales tax rate, which began July 1st, and that the Health System is still behind in its collections. The county is also receiving more money due to increased foreclosures (fees) and late property tax payment penalties. The next (late) property tax bill will be mailed the week of Nov. 13th and will be due Dec. 15th.

The Board then went into executive session to discuss a lawsuit and this League member left. I missed the discussion on unemployment benefits for recently arrested staff member, Carla Oglesby.