Cook County Health and Hospitals System Board Meeting - August 26, 2011

The Cook County HHS Board Meeting was called to order at 7:40am by Chairman Warren Batts. Public speakers presented concerns with inadequate nursing staffing, need for restoration of dental services, concern over the termination of 34 Mental Health Specialist 3 positions at Cermak Hospital, and concern over the closing of Oak Forest Hospital.

Mr. Carvalho, Chairman of the Finance Committee, indicated the proposed 2012 HHS budget that the board needs to present to President Preckwinkle for her Executive Budget is not yet complete, and therefore not ready for approval by the board at this meeting. He also stated that Mr. Ayres, the CFO for HHS, has resigned effective the end of August. A contract for Mr. Ayres services on a part time basis for 3 months to facilitate the transition to a new CFO was presented for approval. After some discussion of the reasons for offering this contract, the vote on the contract was deferred until further discussion in closed session.

Mr. Batts stated that he had attended the Certificate of Need hearings concerning the closing of Oak Forest Hospital and praised President Preckwinkle for her commitment to facilitating the process for finally getting approval for the closing. The opening of the Specialty Care Clinics at Oak Forest is scheduled for Sept. 1 and he stated the board would need to follow up on how the change in operation of Oak Forest impacts health care in the southern suburbs.

Dr. Mason, interim CEO, distributed copies of the STAR Report that was submitted to the President's office. He explained that it was part of the President's push for performance management and they will be held accountable by the President's office. HHS will also need internal meetings on how to meet the metrics that have been established. The report includes 95 measures which the Boston Consulting Group helped to define. Mr. Carvalho raised concerns about the measures used which led to a discussion among the board members on what should be measured and how to go about doing that. This also included discussion of how to use consultants, what is involved in standards for patient safety and quality control, and what is the future of health care in Cook County and how is it planned for.

Dr. Mason also announced that a RAMA (Random Area Medical Access) Event was held at Malcolm X College on Aug. 19-21. This was a free medical clinic sponsored by an outside group with assistance from Cook County. About 2000 people were seen and provided with optometry services and glasses, dental services, primary care and women's health services.

Mr. Ayres presented his report on the difficulties in presenting a balanced budget for HHS. There are supply chain problems that include an inability to fill open positions. Operations problems include the challenge of managing overtime due to inadequate staffing and the silo reporting structure within the system results in inefficiency. The fundamental problem as he sees it is the payor mix. If you take care of people who are unable to pay, the money has to come from somewhere. Again there was discussion of the use of contractors and how they are used, instead of having Cook County employees do the work that the contractors are doing. Dr. Ansell suggested that they need to spend more time discussing this issue.

At 9:50 the board went into closed session for discussion of human resources issues and returned to open session at 11:05am. Upon returning to open session they voted on Mr. Ayres contract which was approved. The meeting adjourned at 11:12am.

Cynthia Schilsky, Observer