December 18, 2012 Cook County Board Meeting

Telephones & Technology at the Court and the CTA

Commissioners absent:  Collins

Commissioner Daley was surprised by a resolution commemorating his 20 years as a Cook County commissioner.  (I believe there was cake!)

Forrest Claypool head of the CTA presented the FY 2013 Program and Budget and described some changes to the system made recently.  The senior fare will be raised 15 cents to be exactly half-fare.  The Red line reconstruction has awarded 30% of its contracts to disadvantaged south side businesses with 60% of those being black-owned.  There will be increased transit service to the Leighton Criminal Courts building and a re-opening of a stop at Loretta Hospital.  Disabled rider access will be made easier to use.

Lydia Murray,  Chief Information Officer, explained the changes negotiated with Securus telephone system used in the courts and jails.  The rates charged for collect calls made by defendants and detainees have been dramatically lowered with the goal of the County no longer making a profit on these phone calls  by the end of 2013.  This will give defendants and detainees more time to talk with their families, friends and attorneys without  paying high costs.

 Consolidation of Microsoft technology contracts among several departments has produced savings of $150,000.  The Landbank ordinance to be discussed next month is designed to turn foreclosed/abandoned land into productive property.  There has been a big drop recently in the use of electronic monitoring of adult defendants.  It appears there is miscommunication between the court, probation, sheriff, and judges regarding this issue.  Increased use should reduce costs for Cook County and better serve the defendants.

Future meetings  of the Cook County Board (in 2013) have been reduced to approximately every 3 weeks instead of every 2 weeks as is now the case.  Finance, Building & Zoning, and Roads & Bridges  committees will meet at 10:00am with the regular Board meeting beginning at 11:00am.

Forest Preserve of Cook County December 5 2012

At this meeting two newly purchased properties were added to the Forest Preserve holdings, in keeping with the budget and policies adopted in the recent past. These are in Sauk Village. 

There was also discussion of the budget and cash flow, with the pronouncement that the Forest Preserve administration remains confident of their 2013 forecasts.  Property Taxes are coming in on target, and licensing fees are increased due to more aggressive follow up on expired licenses than had been done in the past.  In addition, pool receipts were high due to a hot summer, better controls, and new programs instituted this year.

The Forest Preserve Board has put forth a new fee structure for services which is more transparent than in the past and is in line with market rates of similar services in the area.  Some fees are rising slightly while many remain substantially the same.

Cook County Board Meeting, December 4, 2012

The Meeting was called to order at 10:15 am by President Toni Preckwinkle.  All commissioners except Beavers and Tobolski were in attendance.  A delegation from Russia is in the United States to observe government meetings and was in attendance.  Commissioner Gainer commended these elected officials for several reasons including the fact that they do not collect a salary.

*Special Drivers License for Undocumented Immigrants:  Over the weekend, the League asked its members to call their Illinois legislators to urge support for allowing Illinois to provide temporary visitor driving licenses which would then allow drivers to obtain insurance.  On Thursday, The Cook County Board overwhelmingly passed a resolution in support.   It has the backing of a wide range of supporters including the Insurance and Health Care Industries and the Sheriffs and Police Chief Associations.  The Bill is expected to pass and be signed into law by the Governor.

* Implications of State Pension Reform:  Prior to the meeting, Commissioner Gainer held a Finance Subcommittee on Pension to discuss the possible implications of pension reform legislation that may be discussed by the Illinois General Assembly.  Over the past ten years the Cook County Pension Fund has dropped in its funded status from 88.8% to its 2010 valuation of 60.7%.

    

*The Finance Committee:  The controller gave a hopeful revenue report.  The County’s revenues are up $9.8 million over 2011 including sales tax which is up $8.8 million even with the reduction in the tax rate.  Recovery of patient costs at the Health and Hospitals System continues to be a major drag on the bottom line.

* Cost of Phone Service for Inmates:  The Reverend Jesse Jackson commended President Preckwinkle for working to reduce the very high cost of collect calls for inmates.  He asked for open hearings to learn more about what best practices are recommended.  Currently the cost per minute is over 40 cents.  The Administration has recommended reducing that to 23 cents per minute.  As a comparison, inmates in the Federal prisons pay 7 cents.  The jail holds a large number of women inmates, many with children.  Studies show that the ability to stay in touch lowers recidivism rates upon release.

*Other News of Interest:  The Board gave the Department of Risk Management the authority to resolve Workers Compensation Cases not to exceed $25,000. Commission Simms in particular but also Commissioners Murphy and Collins expressed concern with previously granted approval to give increased procurement authority to the Purchasing Department.  Two resolutions were referred back to committee.  This subject will likely come up again as the two resolutions were for rather routine purchasing authority.  The Cook County Board will meet on a 3 week schedule instead of a two-week schedule beginning "soon."  The number of meetings will be reduced from 24 to 17.

The meeting was adjourned at 12:40 p.m.  Submitted by:  Diane Edmundson

Health and Hospitals Systems Board Meeting November 29, 2012

The meeting was called to order by Chairman David Carvalho at 7:40 am.  Michael Newman of AFSCME complained during the public comment period that the union was not notified of the need for additional staff once the Medicaid waiver was approved.

Board/Committee Reports: 

Quality and Patient Safety Committee chair Ed Michael congratulated staff on the overall positive finding by Joint Commission on Accreditation of Hospitals (JCAH). He also reported on the development of a Quality Dashboard to focus the entire organization on “big dot” items needed in the coming year.  Heather O’Donnell, finance committee chair, reported that Automated Health Systems will facilitate the Medicaid waiver, an $8m contract.  Human Resources committee chair Quin Golden reported that hiring is moving forward, labor contracts have been approved.  Carvalho said “all resources of the county system will be brought to bear” on hiring.

Action Items:  

Dr. Raju said that hiring is moving forward quickly. The goal is to hire 500 FTEs into the system in the next 3 months, then 400 FTEs in the 4 months after that.  With respect to revenue collection, “Jumpstarting is so vital, we cannot fall back on our current collection process.”  Carvalho explained that the 3-year contracts with temp workers have a cancellation feature.  The county does not have to spend all the funds. If FTEs can come on earlier, the county can release temps, but the key is BILLING.  Carvalho pointed out that coders are not certified and have low accuracy, and that skilled coders are critical now that Medicaid reimbursement is based on accurate codes for services provided. The Medicaid reimbursement rate was readjusted last July.  System Chief Financial Officer John Cookinham explained that reimbursement has focused on inpatients and needs now to focus on outpatients.  The county now has 120 days of revenue outstanding and is far short of $42m goal in patient revenue as it continues to serve 4,000 patients per day.  

The board recognized Dr. Michael Puisis, Chief Operating Officer of Cermak Clinic, for his 30 years of service to the county and for providing “excellent quality to the patient population.”

JCAH Consultant Roberta Fruth spoke of JCAH history going back to 1910, and how the organization partners with Centers of Medicare/Medicaid Services (CMS).  JCAH was given “deeming” status in 1965 when the US government funded Medicare/Medicaid but did not have expertise to evaluate services they were funding. The board’s role is to assure patient safety and quality, and has ultimate oversight over licensed professionals.

Dr. Raju spoke of the impact of caring for patients who live outside the county, amounting to 7% of total system care/  The cost of this care is not billable.  He also mentioned the disproportionate amount of charity care provided by CCHHS as a whole, emphasizing that this burden should be shared.

Susan Greene, Interim Director of the Office of Managed Care and Clinical Tranformation, spoke about the implementation of CountyCare, which will provide services for the newly-eligible Medicaid recipients.  To be eligible patients must live in Cook County, be 19-64, have an income below 133% of poverty, not be eligible for state-plan Medicaid or be on Medicare, have a Social Security number, be a legal immigrant or US citizen.  The covered services mirror standard Medicaid and include hospital ER, inpatient services, drugs, lab, x-ray, hospice services, and dental services for 19-21 year olds.  Patients will have a “patient-centered medical home” at one of 13 selected Federally Qualified Health Centers and be linked to a pharmacy.

--Submitted by Linda Christenson