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