Cook County Health and Hospital Services Board Meeting August 29, 2014

Directors Jerry Butler, David Carvalho, and Carlos Ramirez were not in attendance (Calvin Morris has resigned).  Members of the public commended Stroger  Hospital for care in emergencies, pleaded for additional funding for mental health, affirmed care for incarcerated persons and for new mental and dental health services, and criticized the county for continuing to care for undocumented immigrants.  CEO Dr. Jay Shannon recognized several  outstanding employees.

COMMITTEE REPORTS: (1) Human Resources: Director Gladys Lopez will require more staff to maintain compliance with new regulations. (2) Quality/Patient Safety:  the Stroger Emergency Dept. wait time has diminished from 140 to 48 minutes.

ACTION ITEMS:  

A. Budget Review.  Dr. Shannon summarized that the budget is now twice as big as when CCHHS began in 2008, primarily because of the health plan allowing CCHHS to keep patients while decreasing the burden on county taxpayers.  CCHHS now serves a patient population that is primarily insured.  Because the patients will have a choice, the services must be of high quality in a clean, safe environment.  Investments are required in information technology and evaluation.   

Budget Director Aaron Galeener presented the budget's goals: to (1) maintain the mission (2) improve financial stability (3) expand CountyCare to new populations, (4) improve operational effectiveness, and (5) fulfill the Department of Justice requirements for the Cermak Clinic.   

Revenues and expenses are both higher and expected to break even at $1,536 million.  Specific goals include (1) improved access through a 24-hour call center; (2) centralized scheduling; (3) optimized staffing levels across the organization; (4) improved supply chain; (5) standardized data reporting,  a "single scorecard"; (6) maximized use of CCHHS mail order pharmacy; and (7) improved network utilization within CountyCare.  Capital investment will improve patient care.  CountyCare represents 67% of total revenue, with a decline in Medicaid patient fees.  CountyCare now serves 3 population groups: (1)  Affordable Care Act Adults, (2)  those covered by the Family Health Plan, and (3)  Seniors and Persons with Disabilities.

                                             ACA Adults            Fam. Health Plan                  Seniors/Disability

Membership                         79,500                              65,000                                     4,700

Projected revenue                $602 m                              $223 m                                     $88m

Projected expense                $306m                              $159m                                       $31m

Admin. expense                   $37m                                $17m                                         $7m

$348m reimbursement from CountyCare to CCHHS.

The budget increases by 9% due to (1) increase in membership in CountyCare (2) additional costs allocated to mail order pharmacy, and (3) pharmaceutical supply.   CountyCare members have 2 opportunities to be dropped from the system: (1) through redetermination of their eligibility, which occurs on the anniversary of their enrolling; and (2) during open enrollment when they may choose another provider.  Doreen Wiese emphasized the need to stay in communication with members and help them through the redetermination procedure.  The proposed preliminary budget was unanimously approved.

B. Contract Procurement.  1. IlliniCare Health Plan, Inc, contracted by CCHHS to provide managed care admin and clinical services for the CountyCare health Plan, will have the length of its contract reduced from five years to three years with the option to exercise two one-year extensions, and the requested total not-to-exceed amount will be reduced by $216,702,316 to $1,578,707,012.  The revised terms of the contract specify that IlliniCare will serve all Medicaid populations including seniors and persons with disabilities (SPDs) starting on September 1, 2014 and Family Health Plan (FHP) members starting on October 1, 2014. Lewis Collens pointed out that this contract can be terminated at any time. 2. A 3-year contract cost of $9,199,750 to provide operational services for Stroger and Provident Hospital parking garages as well as shuttle bus service between Stroger and JTDC.

CCHHS Chairman Hill Hammock reported that 3 members will be moving off the CCHHS board, and President Preckwinkle is now choosing new members (including a replacement for Calvin Morris), with the announcement due at the end of September.

Dr. Shannon reported that pending legislation, if approved, will allow jail detainees to be eligible for funded  mental health and substance abuse treatment.

The board adjourned to closed session at 10:15.

 
Submitted by Linda Christianson