Meeting of the Finance Committee of the HHS Board February 21, 2014

Meeting called to order at 8:45 am.

CONTRACTS AND PROCUREMENT ITEMS

Gina Besenhofer, System Director of Supply Chain Management, provided a summary of requests for grant, intergovernmental agreement, and contract renewals and initial requests for funding.  The $219,000, one-year grant renewal for HIV/AIDS surveillance/prevention services was submitted to the Illinois Dept. of Public Health. The grant will provide funding to maintain surveillance in suburban Cook County and to provide services to reduce HIV/AIDS through linkages to sexually transmitted infection treatment, HIV care, case management services, behavioral interventions, and  partner notification services.  Board Chairman Carvalho stated that the Board needs to be advised on whether the grant-related services  are mandated or optional.  In the ensuing discussion, Cook County Dept. of Public Health COO Terry Mason, MD, sponsor of the grant renewal request, offered to provide a presentation that gives a broad overview of grants.  Chairman Carvalho reminded the Board of the need to assure grant compliance and management, which should be included in the future educational session.  

Other grants and service agreements and contracts were approved:    

• Great Lakes Hemophilia Foundation to conduct public health surveillance at CCHHS on congenital bleeding disorders and determine best practices for treatment ($13,031); 
• Inspection of Food Service Establishments and Retail Food Stores in 34 suburban Cook municipalities ($205,000);  
•  Rental of new/updated Blood Culture systems including  blood culture bottles and full service for 36 months ($841,068) and  
• Maintenance/Repair of Provident Hospital building controls for 24 months ($203,650) 

Board member Ada Gugenheim questioned the assertion by the vendor of Micro-fiber Mops/floor cleaning supplies ($311,688, 12-month contract) that it effectively eliminates 99.9% of microbes.
 

Besenhofer and Linda Shapiro, CCHHS Chief Strategy Officer, answered questions on the request for contract renewal and increased payment ($550,000 for 2014 vs $500,000 in 2013) for Prairie Group Consulting. The contractor provides outreach campaign services for promotional and educational events aimed at individuals who become eligible for the CountyCare program. 

Concerned Citizen George Blakemore mentioned during his comments that this consulting group provided events at shelters/churches etc. but was not responsible for registering individuals into CountyCare. He was concerned that there was no accountability on their effectiveness as recruiters for CCHHS. He asked, as an example, why individuals who were being registered were not asked how they became aware of CountyCare, so that there would be a mechanism to track the actual contribution of the consulting group’s efforts.

UPDATE ON SECTION 1115 MEDICAID WAIVER DEMONSTRATION PROJECT/COUNTYCARE

Steve Glass, Executive Director of Managed Care, stated that CountyCare continues to operate under a temporary 90 day extension of the 1115 Medicaid Waiver which expires on March 31, 2014.  The State of Illinois (holder of the 1115 Waiver) has been told that an additional 90 days may be requested, which would extend the Waiver to June 30. Illiniois has not yet heard if the second extension is approved.  Prior to the Waiver expiration, CCHHS must have entered into a contract with the State of Illinois to become a Managed Care Community Network (MCCN). The State provided CCHHS with a draft MCCN agreement. CCHHS is working through a request for proposal process to select a new third party administrator for this MCCN.  Glass stated that he hoped the contract would be finalized in a few weeks.

Glass stated that to date, 141,000 CountyCare applications have been initiated, with 113,000 submitted to the State of Illinois Dept. of Human Services. He predicts that  81,000 applicants will be approved by the State by the end of Feb. 2014.  Recruitment into CountyCare is going well with approximately 6800 applications to be submitted to the State this month for processing.  Thus far, the State has approved  83% of applications submitted by CCHHS (17% found not eligible).  Board members discussed the importance of continuing to recruit applicants for CountyCare as CCHHS budget is dependent on a constant number of enrolled.

REPORT FROM CHIEF FINANCIAL OFFICER

John Cookinham, CCHHS CFO, reported that year to date (Dec, 2013—Jan, 2014) cash collections were $139,683,958 which is slightly over $39.3MM in excess of the budget.  Most of this represents 1115 Waiver/CountyCare payments owed from 2013 ($33,960,380 of the total 1115 Waiver payments of $59,387,346) as well as regular Medicaid ($35,953,892), a large portion that was owed from 2013.  However, Medicare collections were also slightly above budget ($938,651) which is a good sign.  Disproportionate Hospital Share (supplemental payments for hospitals serving a large Medicaid population) payments were also increased ($27,056,372), due to the one year postponement of its expected reduction in 2014. 

The budget for 2014 planned on an average of 56,350 CountyCare members for a full year at $629/per member per month capitated payment.  Jan—Nov 2014 capitated payment will be paid 100% to CountyCare (100% federal payment starting 1-2014 via PPACA).  Dec 2013 will be paid 50% (under 1115 Waiver federal and State share payments 50/50)

The 2014 budget assumed that there would be $70,000,000 of 2013 budget paid in fiscal year 2014, delayed due to the State's processing backlog of about 18,000 applications. CCHHS will be paid retroactively to the date of submission of application. Of this $70MM, nearly ½ has already been collected and the rest is expected to be paid over the next 6 months from 2013 owed. 

Of note, only cash collections, no expenses, were reported in the CFO documents for the Board meeting.  Thus, it is not known what the actual financial condition of CCHHS is.  However, it appears to be far improved from previous years.

Meeting adjourned at 10 am

Submitted by Susan Kern