Monday, April 6, 2015

Cook County Health and Hospitals System Board of Directors Meeting March 27, 2015



Meeting called to order by Chair H Hammock at 9am

Public Speakers   There were 2 public speakers. A man commented about high cost contracts being approved without apparent dissent by the Board, implying that they are being rubber-stamped. Second speaker was a woman whose son died at Stroger Hospital after being shot. She donated his organs.  She was distraught when her son’s personal belongings were not released in time for the service by the hospital due to a problem with the paperwork which the staff left in charge could not fix.  She was crying and stated that staff left in charge should have the ability to make decisions that are important to the public. Chair Hammock and CEO Dr. Shannon expressed their regret to Ms. Lewis and intention to enact corrective action to address this issue.

Board and Committee Reports

BoD meeting minutes from the 2-27-15 meeting were approved.

Quality and Patient Safety Committee, met on 3-17-15
Director Gugenheim and Dr. Das presented the  Quality Metrics reported for full year 2014 as variances from a stated target:

Stroger: Venous thromboembolism prophalaxis, variance of -14.8% below target (99%);  on-time start of surgical cases -45% (target 80%);  overall rating of hospital by patients -10% (target 85%) 

Provident Hospital: VTE prophalaxis -4.9% (target 99%); ACHN:  diabetes in control 78% (target 78%); Patient experience moving through visit -8% (target 75%); patient experience telephone experience  -13% (target 75%)   

Chair H Hammock said “good summary”.  He wants the Board to be very familiar with the metrics so that discussion will only be on remedial action. 
   
Dir. Gugenheim reported that the Primary Care Medical Home inspection of ACHN was passed with flying colors.

Dr. Das reported on the report “Overview of Linguistically Appropriate Care Presentation” including patient preferred languages (English #1, Spanish #2), and number of  interpreters (in-person vs phone 50/50%).  Dir. Junge requested metrics on language for the Cermak Clinic. Dr. Das said it would be forthcoming.

Audit and Compliance Committee 3-19-15   
Dir. Velasquez and Kathy Bodnar reported on Corporate Compliance issues by category with HIPPA 44% and  Human Resources 18% the top 2 issues for 2015 Quarter 1. CountyCare Health Plan issues were not included (separate report on fraud, waste, abuse etc. for CountyCare to come).

Managed Care Committee 3-19-15   
Dir. Lerner and Steven Glass explained powerpoint of metrics. CountyCare members by age 2015 Q 1 little change (25-44y/o= 29%; 55 + 29%); trending of extended supply of prescriptions (90 d supply vs 30 d) decreasing 10% in 12/14 and 8.6% 2/15.  Mr. Glass stated that the goal is to increase the % of 90 d PX because there is potentially a $2,000,000 annual savings in the labor costs when the total number of Px are decreased by giving patients a 3 month supply. The plan is to make this mandatory and require the patient to pay for any lost portions of the Px.  Dir. Butler was concerned that this would penalize patients unfairly. Mr. Glass reported potential 5,000,000 savings if all HIV Px are filled at CCHHS.  

Membership total (including ACA, FHP and SPD, home community waiver) for 2/15 now 152,995 up from 86,562 (12/14).  Goal based on budget is 156,943 (they are at 97,5% of goal for Feb.’15).
 
CountyCare is the 3rd largest managed care program in Chicago after Family Health Network and Harmony Health Plan.  Most of utilization is primary care and the goal is to spread utilization more evenly over the services which are being funded even if not utilized. Claims payment data shows metrics reaching goal of 30 days. Brief discussion of hard to reach population efforts by CountyCare. Mr. Glass noted that they work with the Salvation Army. Dir. Velasquez suggested that Catholic Charities be contacted.

Human Resources Committee 3-20-15 
Dir. Wiese and Gladys Lopez, Chief HR, reported that the vacancies on 2-26-15 were 989 with goal of 600 and days to fill a position 195 days with goal of 94 days. G. Lopez commented that “it is hard to compete with Northwestern and Rush Medical Centers at job Fairs because of the CCHHS union contract which requires posting jobs for 2 weeks and other bureaucratic requirements that  prevents on-spot hires”.  

 HR offers a CCHHS Leadership Development Program for employees that are at supervisor or director level (600 eligible) which teach performance management tools. 35 graduates thus far with 50% from the nursing dept.   

Dir. Velasquez asked “who evaluates the supervisors?”  Mr. Elwell responded that they are developing formal processes for evaluating supervisors.

Finance Committee 3-20-15   
Director Collens and Mr. Elwell reported on metrics. He indicated that CCHHS was experiencing difficulty in finding psychiatrists required by federal agencies for Cermak.  There were a decrease in in-patient days over the last 5 months below budget but this has been reported by all hospitals.  A positive is the decrease in uncompensated care from 50% to 24% of patients taken care of.   

Survey of the breakdown of physician work efforts at CCHHS shows time spent:  clinical 57%,  teaching 21%,  administration 20% and research 1%.  Overall financials show a slightly positive income for the 1st Q.

Report from Chair of the Board       
Chair H. Hammock indicated that attendance at committees of the Board and Board meetings, including Directors and non-Director attendees would be tracked by quarter going forward.  CCHHS fundraiser recently raised $100,000 to be used by the ER.

Report from CEO   
Dr. Shannon provided a legislative update as relevant to CCHHS (CC, State, Federal) including potential funding cuts by the State for the 2016 budget year.  He presented an overview of the Strategic Plan which is required to be for at least 3 years, 2016-2018 by the 2008 Cook County Ordinance.  It may be a 5 year plan.  It covers a wide range of elements.  A more definitive version of the Plan will be forthcoming.

Meeting adjourned to Closed Meeting Items at 11:45am

Submitted by Susan Kerns

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