Cook County Health and Hospital Services Board Meeting June 26, 2015

Chairman Hill Hammock introduced a resolution honoring Susan Greene who died May 22.  Susan led the effort to found CountyCare, which has expanded to serve 179,000 patients, of whom 90,000 were previously uninsured.  CEO Dr. Jay Shannon characterized Susan as “the best bargain we ever had in a contractor.”  Trustees Mary Gugenheim, Carmen Velasquez, and Susan’s daughter Nicole spoke movingly of Susan’s enthusiasm and generous spirit.  Former CCHHS board chair David Carvalho was also present to honor Susan.

Public speaker George Blakemore complained of extended CCHHS contracts: “Waste, fraud, and abuse are in these contracts.  And it’s taxpayers’ money.”

CEO Shannon announced the 4^th leadership development graduation class; a Robert Wood Johnson Foundation grant to address social disparities in the system; and the CCHHS nominating committee having submitted four names to President Preckwinkle for the 11^th CCHHS board position.  Shannon and board member Emilie Junge spoke in support of the Supreme Court decision supporting the ACA: that thanks to the Affordable Care Act, CCHHS has reduced uncompensated care costs from about $500m annually to about $300m.

Meeting Reports

Quality and Patient Safety.  Chair Gugenheim spoke of interventions to prevent patient infections including hand hygiene and unit infection preventionists.  Joint Commission accreditation results are due before November. Shannon presented an explanation of the patient experience data prepared by an outside contractor securing a 15% return on patient surveys.  Stroger satisfaction ranks about “two stars out of five.”  Compared to other area hospitals, Stroger ranks 3^rd lowest, with only Mt. Sinai and Norwegian lower.  “We’re working on this,” Shannon said, through evidence-based interventions, data driven performance improvement, customer service training, leadership and accountability, and operational enhancements including the call center, improved parking access, and improvements in nurse communication.

Human Resources.  Chair Wiese introduced Gladys Lopez, Chief of Human Resources, who addressed vacancies filled and time to hire.  Lopez said her goal is to reduce vacancies to 600.  In 2015, 191 nurses have been hired, vs. 94 in 2014.  Currently hiring requires 139 days on average.  Packets are emailed to hiring managers.  Hiring time can’t be lowered below 90-100 days, Lopez said, though two weeks - one month is standard elsewhere.  Board member Wayne Lerner remarked, “Our people have options; we don’t want to lose good candidates.”

Finance. Deputy CEO Doug Elwell provided an explanation for the three no-bid contracts, that they provided services not available elsewhere.  CCHHS has 80 days’ cash on hand, plus an untapped line of credit, will continue to get fee for service Medicare and Medicaid payments.  Inpatient days dropped  from 9235 in 2013 to 8000 in 2015; outpatient visits also down from about 80,000 in 2013 to about 76,000 in 2015; ER visits down from about 14,000 in 2013 to about 12,000 in 2015. Obstetrics and pediatric visits have also diminished. Lerner pointed out, “These trends are not going to stop; how do you manage the enterprise under those conditions?” 

Managed Care. Steven Glass, Executive Director of Managed Care, said CountyCare membership is now at 179,000, on budget; 159,000 prescriptions were filled in May; readmission is flat.  In a presentation on Behavioral Health (a diagnosis encompassing mental health and substance abuse), Glass showed that these persons die 22 years earlier on average, and that 68% have additional physical disorders.   Behavioral Health has a volatile funding history, with a 5-year decrease in funding.   Psychiatry and chemical dependency are most costly to care for; the ER most frequent admission is for acute alcoholism.  BH represents 10% of CountyCare’s external costs.  To reduce costs, CountyCare is working to streamline intake and strengthen its contracted networks including the Community Counseling Centers of Chicago (C4) who provide 7 psychiatrists, 130 social workers, and a crisis team. There has been an increase in Behavioral Health (BH) patients since 2009; CCHHS has no dedicated BH unit, yet has 10,000 BH admissions; CCHHS has 37 psychiatry staff members.  The largest group of BH patients is at the Cermak Health Center, which currently has 1864 BH diagnoses; the goal is to reduce that number by 600.  State grants for BH to service organizations may terminate June 30.

Outgoing COO Peter Daniels reported on the central medical campus redevelopment. Proposals from three shortlisted developers were due June 26.  Fantus Clinic will be replaced, along with the administrative building; parking capacity will increase; and Stroger Hospital space will be optimized.  A separate proposal will address the highest and best use of the 1914 Cook County Hospital building.  Contract negotiation is due to take place in October/November 2015, budget approval in April/May 2016.

Chairman Hammock acknowledged the board for their consistent attendance and participation in the board and committee meetings, and for attending meetings of committees they are not even appointed to. 

  

The meeting adjourned to closed session at 12:25.

Submitted by Linda Christianson