This meeting was relatively uneventful with lots of time being taken by giving kudos and good-byes to the departing Superintendent Bylina and his Assistant Superintendent. There seems to be consensus that these two helped move the Forest Preserve district in the right direction of being responsive to the public interest and improving professionalism in the District.
President Preckwinkle ran a fairly efficient meeting, and started on time, which often did not happen under President Stroger.
The only noteworthy piece of business was when Commissioner Gorman moved emphatically to have an easement in Orland Park ok'd and then Commissioner Suffredin spoke during discussion to point out that a public hearing had never been held. In order to conform with the Land Management Policy adopted by the district, it is necessary to have a public hearing even if the Commissioners generally agree that the negotiation was a good one. It was a procedural question that has important precedent for how business will be conducted in this administration and President Preckwinkle supported the move to follow the Land Management Policy. When Commissioner Murphy offered to hold the hearing quickly but questions were raised about whether a quorum could be reached on the South Side in the near term (holiday season), the Board President stated that it is the job of Commissioners to attend these hearings and they need to show up. If all goes as planned, the Orland Park motion can come up again at the January meeting with no more questions.
After the meeting, President Preckwinkle hosted a press conference out in the hall and announced the appointment of the new CCFP Superintendent, Arnold Randall, and new Assistant Superintendent, Mary Laraia. They all took questions. Because Randall has a strong background in Park District administration, it was requested that President Preckwinkle speak to the fundamental differences between a Forest Preserve and a Park District. She cited her husband, a science teacher, in her response, saying that she and her administration understand that the Forest Preserve has part of its mission to be Conservation, as well as Recreation, and that she intends to honor both aspects of the mission. She and Randall intend to focus on improving public involvement and outreach in there future work.
Sunday, December 19, 2010
Saturday, December 18, 2010
Health and Hospital Systems Board Meeting
December 17, 2010
The meeting was called to order shortly after 7:30am by Chairman Batts. Only 1 public speaker before the Board got to the business of Committee Reports.
Finance Committee
A contract with Hektoen Institute of Medicine was included for approval. Hektoen oversees research grants within the system and the Board had determined that an agreement between Hektoen and HHS was needed to establish control over the grant monies involved. While it was reported that Hektoen was not satisfied with the contract Director Carvalho, Finance Committee Chair, asked for approval anyway stating that “change is hard.”
The Board had questions about the loss of medicaide revenue as reported in the Financial Statements for September and October – a total of $55m for the year to date. Mr. Ayres, the CFO, stated that he could do some analysis but he had no hypothesis as to why there was a decrease. Mr Foley, CEO for the system, stated that a major issue was the back log at the state in processing of medicaide applications for eligibility. He said they were trying to get an agreement wherein the County would provide funds for processing of eligibility that would presumably result in a net gain of funds if more applicants were found eligible. Further discussion revealed that this fall off in medicaide revenue is not being seen at other hospitals and that there may be other reasons for why the System is experiencing this decrease in medicaide revenue. There was also a reported decrease in patient hospital days which resulted in a discussion of whether the financial reports reflect actual patient days in the hospital or billed hospital days. There seemed to be confusion over the way that patient days are recorded in the financial reports and the confusion did not appear to be resolved.
Audit and Compliance Committee
It was reported that the committee is anxious to get started on the audit of Hektoen.
Chairman’s Report
Mr. Batts received a letter from the leadership of SEIU. They had done a budget analysis of the HHS proposed budget and sent their budget recommendations to the Board and also included suggestions for geographic representation of membership on the HHS Board, a labor/management partnership, and a Safety Net Summit. A response letter from the Chairman was presented seeking Board support. A discussion among the Board members ensued in which they discussed the new administration’s request that they spend only 21% of their 2011 budget request in the first quarter of the fiscal year. The CFO reported that the spending as of the end of 2010 was consistent with this request if they continued in the same pattern. Mr. Foley stated that reductions in spending may be less challenging as the year progresses when parts of Provident and Oak Forest are closed later in the year. It was also pointed out that more revenue is needed in the next few years to get the Strategic Plan moving forward and if that doesn’t happen this Independent Board will be perceived as doing the same old thing. Other directors pointed out that it was necessary to hear what different constituencies were saying and to get the community to work with them, although it was also pointed out that sometimes the community that claims they haven’t been heard is saying “you didn’t do what we wanted you to do”. Another opinion expressed was that you can do all the communicating you want but if you don’t deliver service it won’t make any difference.
Systems Operational Plan Update
A presentation was given by Dr. Schrader from the Emergency Dept. and a representative from Price Waterhouse on Simulation Modeling that has been done in the Emergency Room. Monitoring of all processes in the ER from when a patient walks in to when they are discharged from the ER was done during a 2 week period in October. Analysis was done to determine where processes could be expedited and some changes have already been instituted to decrease wait times and to expedite the time for tests so the patients can be moved through the ER in a more efficient manner. The big obstacle continues to be bed availability for patients that need to be admitted. Mr. Foley said that issue was being addressed in a different way.
Employee Engagement Survey
A system wide Employee Engagement Survey will be done in January. Such a survey has not been done recently and it will provide a baseline for further evaluation of employee satisfaction. It is being conducted by the survey arm of Price Waterhouse Coopers. The computerized survey has 50 questions and will take 20-30 minutes to complete, and participation is not required but strongly encouraged. The survey process will begin on January 12 and run for 10 days, with the hope of presenting the aggregate data results to the Board by March. Training will also be provided to managers so that they can utilize data gleaned to develop departmental goals which are in line with the Strategic Plan 2015 Vision.
HHS System Compensation Review
Mr. Foley stated that there has been a heightened level of concern regarding compensation levels within the HHS. The CC Board approved an ordinance requesting the County Auditor do an audit of the appropriateness of compensation packages in HHS. The President’s office will outline the scope of the audit. They have requested that it include comparisons to other large public hospitals. The CC Board wants this completed by Jan. 19 so they will have the information prior to their consideration of the budget. It was pointed out that comparisons have been done based on similar positions in the Chicago area and not on similar hospitals in other locations. This is consistent with comparisons for other personnel salaries that are also based on location (Chicago) and not type of institution (public hospitals in other cities). The scope remains to be determined, and it is not clear what the President and the CC Board will do with the information once they have it.
Observer left at 9:15am and board was still meeting with 1 remaining item on agenda before going into closed session.
Cynthia Schilsky
LWVCC Observer
The meeting was called to order shortly after 7:30am by Chairman Batts. Only 1 public speaker before the Board got to the business of Committee Reports.
Finance Committee
A contract with Hektoen Institute of Medicine was included for approval. Hektoen oversees research grants within the system and the Board had determined that an agreement between Hektoen and HHS was needed to establish control over the grant monies involved. While it was reported that Hektoen was not satisfied with the contract Director Carvalho, Finance Committee Chair, asked for approval anyway stating that “change is hard.”
The Board had questions about the loss of medicaide revenue as reported in the Financial Statements for September and October – a total of $55m for the year to date. Mr. Ayres, the CFO, stated that he could do some analysis but he had no hypothesis as to why there was a decrease. Mr Foley, CEO for the system, stated that a major issue was the back log at the state in processing of medicaide applications for eligibility. He said they were trying to get an agreement wherein the County would provide funds for processing of eligibility that would presumably result in a net gain of funds if more applicants were found eligible. Further discussion revealed that this fall off in medicaide revenue is not being seen at other hospitals and that there may be other reasons for why the System is experiencing this decrease in medicaide revenue. There was also a reported decrease in patient hospital days which resulted in a discussion of whether the financial reports reflect actual patient days in the hospital or billed hospital days. There seemed to be confusion over the way that patient days are recorded in the financial reports and the confusion did not appear to be resolved.
Audit and Compliance Committee
It was reported that the committee is anxious to get started on the audit of Hektoen.
Chairman’s Report
Mr. Batts received a letter from the leadership of SEIU. They had done a budget analysis of the HHS proposed budget and sent their budget recommendations to the Board and also included suggestions for geographic representation of membership on the HHS Board, a labor/management partnership, and a Safety Net Summit. A response letter from the Chairman was presented seeking Board support. A discussion among the Board members ensued in which they discussed the new administration’s request that they spend only 21% of their 2011 budget request in the first quarter of the fiscal year. The CFO reported that the spending as of the end of 2010 was consistent with this request if they continued in the same pattern. Mr. Foley stated that reductions in spending may be less challenging as the year progresses when parts of Provident and Oak Forest are closed later in the year. It was also pointed out that more revenue is needed in the next few years to get the Strategic Plan moving forward and if that doesn’t happen this Independent Board will be perceived as doing the same old thing. Other directors pointed out that it was necessary to hear what different constituencies were saying and to get the community to work with them, although it was also pointed out that sometimes the community that claims they haven’t been heard is saying “you didn’t do what we wanted you to do”. Another opinion expressed was that you can do all the communicating you want but if you don’t deliver service it won’t make any difference.
Systems Operational Plan Update
A presentation was given by Dr. Schrader from the Emergency Dept. and a representative from Price Waterhouse on Simulation Modeling that has been done in the Emergency Room. Monitoring of all processes in the ER from when a patient walks in to when they are discharged from the ER was done during a 2 week period in October. Analysis was done to determine where processes could be expedited and some changes have already been instituted to decrease wait times and to expedite the time for tests so the patients can be moved through the ER in a more efficient manner. The big obstacle continues to be bed availability for patients that need to be admitted. Mr. Foley said that issue was being addressed in a different way.
Employee Engagement Survey
A system wide Employee Engagement Survey will be done in January. Such a survey has not been done recently and it will provide a baseline for further evaluation of employee satisfaction. It is being conducted by the survey arm of Price Waterhouse Coopers. The computerized survey has 50 questions and will take 20-30 minutes to complete, and participation is not required but strongly encouraged. The survey process will begin on January 12 and run for 10 days, with the hope of presenting the aggregate data results to the Board by March. Training will also be provided to managers so that they can utilize data gleaned to develop departmental goals which are in line with the Strategic Plan 2015 Vision.
HHS System Compensation Review
Mr. Foley stated that there has been a heightened level of concern regarding compensation levels within the HHS. The CC Board approved an ordinance requesting the County Auditor do an audit of the appropriateness of compensation packages in HHS. The President’s office will outline the scope of the audit. They have requested that it include comparisons to other large public hospitals. The CC Board wants this completed by Jan. 19 so they will have the information prior to their consideration of the budget. It was pointed out that comparisons have been done based on similar positions in the Chicago area and not on similar hospitals in other locations. This is consistent with comparisons for other personnel salaries that are also based on location (Chicago) and not type of institution (public hospitals in other cities). The scope remains to be determined, and it is not clear what the President and the CC Board will do with the information once they have it.
Observer left at 9:15am and board was still meeting with 1 remaining item on agenda before going into closed session.
Cynthia Schilsky
LWVCC Observer
Tuesday, December 14, 2010
Preckwinkle Runs First Board Meeting December 14, 2010
Today being the first board meeting of the new Preckwinkle administration, there were lots of changes: new calendar, new seating arrangements, new rules and procedures, new committee assignments, and a very speedy meeting. Done before noon! New commissioners Tobolski, Garcia, and Fritchey tried to keep up with the fast pace of approving resolutions, ordinances, contracts, expenses; audience members were madly flipping agenda pages to follow along.
Some major expenditures included more pass-through grant money from the federal government to Project Shield, which is part of Homeland Security. The Johnson Controls contract was extended for another year, which brings the total expenditures to $25, 884,644.00 since 2008. This controversial project is in the last of three stages--now concerning inter-operable mobile, video, and data network system for first responders throughout the county.
Concerns by Comm. Gainer, Beavers and others about pay raises and salary adjustments for administrators at the Health and Hospital System (HHS) delayed their approval. Human Resources Dept. head Sova was asked to provide a written rationale and Auditor Berman will do a review of salaries at HHS once she is given the scope and number of employees to be reviewed. This will be determined by Pres. Preckwinkle's office.
Numerous departments requested vehicle purchases. These were referred to committee where some type of centralization of fleet management can be considered. Pres. Preckwinkle and Comm. Gorman were both concerned that vehicles be purchased in or near Cook County and that purchases be consolidated. This is intended to reduce costs and unnecessary duplication.
There was some concern by Comm. Gainer and Collins regarding foreclosure legal aid and mediation help. They asked for a report on how many Cook County people were actually helped, and in which way, by the $241, 000.00 fund delegated for this purpose.
Pres. Preckwinkle declared a moratorium on Capital Improvements projects and expenditures (except for health and safety) until they can be evaluated.
Retiring Chief Administrative Officer Mark Kilgallen was praised for his 29 years with the county. He will be replaced by CAO Robin Kelly in the Preckwinkle administration.
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