Health and Hospitals System Board Meeting May 29, 2012

The meeting was called to order at 7:40am by Chairman Batts when an adequate number of members arrived for a quorum and lasted only slightly over an hour before going into closed session to consider Human Resources concerns. The one action item of note was a change to their Rules of Organization and Procedure that will make it easier for the committees of the board to have a quorum present. The change will allow the committee chairperson to designate an elected director who is present at a committee meeting but not actually a member of that committee to serve as a substitute member of the committee for that meeting only in order to attain a quorum. This change was approved.

Dr. Bruce Siegel from the National Association of PublicHospitals and Health Systems (NAPH) was a guest speaker at the meeting. His association is based in Washington DC, has about 140 public health system members, and advocates for safety-net hospitals. He presented the following statistics to the board.

In the 10 largest cities in the US, Public Hospital Systems provide:

            1/3 of Outpatient Visits

            1/4 of Emergency Room Visits

            40% of trauma care

            63% of burn care

            1/5 of all uncompensated care

            1/4 of training of US physicians

He also provided the following comparative information on the payer mix for all US hospitals, all public hospital systems and CCHHS specifically. Mr Batts stated that while he knew that the payer mix was always reported to be unbalanced at CCHHS he had never seen statistics that showed it so starkly.

Payer	All Hospitals	Public Hospitals	Cook County HHS
Commercial	37%	19%	8%
Medicare	39%	24%	11%
Medicaide	16%	36%	32%
Uninsured	6%	18%	49%
Other	2%	3%	--

With 49% of patients at CCHHS being uninsured, the system will continue to have challenges going forward.  Under the Affordable Care Act the Disproportionate Share Hospital (DSH) subsidy for those hospitals that have been providing a disproportionate share of “charity care” is due to be ratcheted down.  The Board continues to await the Supreme Court ruling on the Affordable Care Act as the decision will impact future planning.

Don Howard, the HHS Chief Information Officer, gave a transition report on the status of the IT systems as he is leaving after serving for 10 years. He stated that the transformation of the system has been ongoing and will continue and there is a good team in place to carry on the plans that have been developed. Upgrades to Provident and Oak Forest will need to be developed in accordance with future plans for those sites.

Mr. Carvalho asked Dr Raju about state legislation that has been approved that will have an impact on the system. Dr. Raju stated that the state's Medicaide waiver, changes to the definition of charity care, and the cuts in Medicaide will need further analysis.  These issues will be more fully discussed at the next CCHHS Finance Committee meeting. At 8:45am the board went into closed session.

Cynthia Schilsky

LWVCC Observer