Meeting of the Cook County Board of Commissioners, December 17, 2014

The meeting was rescheduled to the afternoon to allow Commissioners to attend the memorial service for Illinois Comptroller Judy Baar Topinka. Committee meetings began at 1:00 p.m. and included the Rules, Government & Legislation, Finance, Zoning & Building, and Roads and Bridges.  Of particular interest:

• Dr. Erica E. Marsh’s appointment to the Health and Hospital Systems independent board was enthusiastically received and approved in Committee and by the full Board.
• An approved appointee to the Weller Creek Drainage District, Thomas Munz, is an advocate for rethinking if this District is still needed. Commissioner Suffredin agreed and expanded  the concept to include all small drainage and sanitary districts. This is important because Illinois has over 8,000 taxing bodies, many of them very small and with little oversight.
• There was public testimony and lengthy discussion about a residential zoning variance in unincorporated Northfield. It is mentioned here because there is increasing effort on the part of the County to encourage annexation or consolidation  with established municipalities.  There is a new study out by the CivicFederation on this topic which would result in both cost and time savings for the County [but not for the unincorporated areas]

The Board of Commissioners meeting began at 2:30 p.m. presided by President, Pro Tem, Richard Steele. Absent from the meeting were President, Tony Preckwinkle and Commissioners Gorman and Tobolski. Newly elected Commissioners Luis Arroyo, Jr (8^th District) and Richard Boykin (1^st District) were welcomed.   

Public testimony included George Blakemoor, Karen Hobbs of the Natural Resources Defense Fund, and Sue Warwick of NAMI in support of a Resolution to be introduced by Commissioner Boykin to increase mental health funding. The Consent Calendar was approved in total, but several individual resolutions were pulled for reading into the minutes, comments, and picture taking. This Observer was struck by how much time was allocated to these resolutions considering the hour.

Agenda Item 15-0659: The Annual  Board Meeting Calendar was approved as presented with Commissioner Schneider stating that he would approve but will continue to advocate for increasing the number of meetings. The League agrees.

15-0708:  Boykin introduced and all in attendance signed on to urging the Governor and State Legislature to support additional mental health funding in Illinois pursuant to the successful Cook County Ballot Referendum. Resolution Approved.

15-0709:  Boykin introduced a Predatory Lending Resolution and asked the Board to waive the 24- hour notice to allow for acceptance of an amendment to change the language in several sections to be inclusive of all races and ethnicities affected by predatory lending. Fritchey recommended that it be sent to Committee, but Boykin asked leave to table the resolution until the end of the meeting so that he could meet with Commissioners and work out the language changes.  Leave was granted and the resolution was re-introduced at the end of the Board Meeting and approved by those commissioners remaining in the room. Banks will now be barred from doing business with the County if they are found guilty and/or settle a predatory lending lawsuit or an investigation.

15-0703, Introduced by Fritchey, this Zero-Based Budgeting Ordinance was referred to the Finance Committee without discussion.  [The League of Women Voters of Cook County will monitor.]

15-0712, Introduced by Fritchey, this Sweat-Shop Free Procurement Ordinance referred to the Finance Committee without discussion.

15-0675, introduced by Suffredin, this Presidential Appointments to Cook County Departments or Agencies Ordinance appears to reduce the number of Presidential appointees requiring Board approval. Referred to the Legislation Committee without discussion.

15-0012, Extends and increases contract with vendor for licenses, maintenance, hosting and support of equipment manager, and the on-line training website for election judges.  Approved.

15-0013, Extends and increases Circuit Court contract with Presence Behavioral Health for mental health counseling and aftercare referral services.  Approved.

15-0014, Extends and increases Circuit Court Contract with TASC for “client care management services” while a new RPF is completed. Approved.

15-006, Extends and increases s State’s Attorney contract with TASC for “first time offender drug diversion programs”.  Approved.

15-0587 Renewal of grant from the Illinois Criminal Justice Authority to the State’s Attorney’s Office to provide the salaries and fringe benefits for staff at the West Side Community Justice Center and the Central Community Justice Center.

There is a new section on the Agenda "Committee Items Requiring Board Action" which lists what actions were taken in the various committee meetings so that Commissioners and the public have the information before them when voting to accept, reject, or defer actions taken by the Committee.  [CC League of Women Voters is pleased that the Board heard its suggestions and responded].

Three New Items were added to Agenda during the Board Meeting:

1)     Resolution introduced by Commissioner Boykin urging President Obama to establish a national commission to examine the criminal justice system and the impact of race.  The rule requiring Committee review was suspended by a voice vote and the resolution was approved by the 7 or 8 commissioners left in attendance.

2)     Resolution introduced by President Preckwinkle urging the Illinois General Assembly to convene and pass House Bill 4733, raising the minimum wage from $8.25 per hour to $10.00 per hour state-wide beginning on January 1, 2015.  This bill was passed in the Senate on Dec. 3, 2014.  Approved.

3)     Resolution #150789 introduced by Suffredin and immediately referred to the Environmental Control Committee is a statement in support of efforts to strengthen and restore certain provisions of the U.S. Clean Water Act.  When the Committee next meets, it will consider two opposing resolutions–the 1^st introduced by Murphy is against the changes; the 2^nd introduced by Suffredin is in support of the changes. The State and County LWVs are in support of the changes and have been lobbying the commissioners.

Submitted by Diane Edmundson

Health and Hospitals System Board Meeting December 12, 2014

Recognition
CEO Dr. Jay Shannon recognized Stroger Hospital's Burn Unit for its 3 year certification by the American Burn Association, accorded to only 3 area hospitals, lost to Stroger for more than ten years.  Stroger serves more than 350 burn patients annually.  Shannon announced the licensing of new linear accelerators in oncology, and $280,000 in federal grant funds to Trauma Services to assist people with PTSD.

Committee Reports 

Finance: chair Lewis Collens reported 18 contracts approved, subject to review by the compliance officer. CCHHS cash position is strong, with significant capital issues related to IT and clinics.  Discussion of lags in CountyCare performance.
   

Quality/Patient Safety: chair Ada Mary Gugenheim reported  the Joint Commission evaluated Provident on 46 accountability measures of evidence-based care processes, found small issues, with corrective actions in place to address the issues cited. The committee formally approved quality improvement plans for both Stroger and Provident.

Contracts

Deputy CEO Douglas Elwell discussed a contract not to exceed $3,953,118 to Automated Health System from 1/1/15 to 4/30/15 to increase the current contract and allow the vendor and subcontractor to maintain the call center.  Since 2012 this firm has received more than $194,773,000 for this service, as well as to provide contract management and claims review and payment.  The contract allows the vendor and its subcontractor to maintain the Medicaid eligibility processing and the redetermination call center which will handle inbound and outbound calls for redetermination reminders, assistance, and to facilitate communication with the Illinois Medicaid Redetermination Project and CCHHS. 

In response to questions, Elwell said, "We're looking at the ability to bring this in house - we have the ability to do this job internally."  Board member Wayne Lerner commented, "There can't be anything too much more important than managing our call center.  I have much more concern about performance with respect to patient/ retention."  Board chair Hill Hammock said, "It's not going to be an easy fiscal year and next year will probably be tougher.  If vendors think we'll bring it in house they won't respond, so make a decision on this soon.  Contact reliable vendors to assure that we've got the best response price on this."   

Elwell clarified that the call center is not responsible for the determination of eligibility, only calling as reminders.  Board member Doreen Wiese commented, "I'm not aware of anyone who has gotten one of these calls.  We've lost thousands of people."  Elwell said there are 30 callers, as well as a robocalling system.  A problem with bringing the call center in house is that historically it was not possible to get rid of incompetent people, and the labor union has said supervisors may not listen in on the calls - so if labor won't change on this policy it will be outsourced again!  Shannon pointed out that "we'll have to be flexible around the hours of the calls - Saturday mornings and evenings are good times to reach people - and we currently run on bankers' hours."  Lerner asked that the committee be told the response of the labor unions to the demand for more oversight and flexible hours. Elwell said the in-house call center would require about 80 people.  The contract was approved.   

Hammock pointed out that these issues apply to all our large contracts, to get out and solicit bids to get costs down. Elwell responded that some vendors don't want to deal with CCHHS, and the perception is that contracts only go to incumbents, a process changing now.

Chairman Hammock's Report  

Rule Change: Hammock proposed a new standing Managed Care Committee to oversee the performance of CountyCare with respect to compliance, operations, and strategic initiatives.  It was approved.   

He also announced new committee assignments: Collens to chair finance, Wiese Human Resources, Velasquez Audit, and Lerner, the new Managed Care.  Hammock encouraged committee chairs to guide the committee in robust discussions on issues.  New metrics for each committee will be put in place in January.  Deputy CEO Doug Elwell was chosen to assist the new Gov. Rauner on his health team.  Hammock praised the Foundation dinner at the Culture Center  honoring Jerry Butler and raising funds for special CCHHS programs.

CEO Dr. Shannon's Report  

Dr. Shannon noted the swearing in of new County Commissioners Boykin and Arroyo, and announced that Dr. Erica E. Marsh, Assistant Professor of Obstetrics and Gynecology at Northwestern University's Feinberg School of Medicine, is being considered for the CCHHS board subject to approval at the next county board meeting.   

There will be a federal review of the 340B drug pricing program requiring pharmaceutical manufacturers to provide rebates for medication purchases based on sales to Medicaid beneficiaries as a condition of having their products covered by Medicaid. 

Donna Hart, currently on staff, was named new Chief Information Officer for the system, including telecommunications and Biomed.   

There was a discussion of the federal review of the ACA, particularly the Disproportional Share (DISH) funding re-evaluation.   DISH dollars plug major holes in the CCHHS budget: $250,000,000 currently comes to CCHHS in two forms, to supplement Medicaid and Medicare.  Lerner encouraged board members to weigh in with legislators on this, to assure the continuation of these funds.  

In response to a question from board member Emilie Junge, Shannon responded that it is currently unknown how the lack of a state healthcare marketplace will affect Illinois; the Supreme Court must rule on this.

The meeting adjourned to closed session at 9:30.

submitted by Linda Christianson