Chairman Hammock called the meeting
to order at 9:00 am.
Present were Directors Velasquez, Collens, Gugenheim, Lerner, Estrada, Marsh, Junge, Wiese
and Commissioner Butler.
Public Speakers: Mr. Blakemore complained that the CCHHS Board Finance Committee for Sept. 2015 was cancelled. He stated that he learns from this financial information which is supposed to be open to the public. How could he, as a citizen, know how the money was being spent when the meeting is not held. He asserted that leadership were political appointees, working with the unions.
Board and Committee Reports
Finance Committee: Doug Elwell indicated that the committee did not meet this month due to “timing issues”.
Contracts totaling close
to $12 million were reviewed and
approved. All were by competitive
selection method except for a $205,000 contract for micro catheters used in
neuro-interventional cases and one for $187,605 for immunology testing which
were sole source due to lack of comparable acceptable vendor.
A $7.5 million, 3-year, contract for
marketing & advertising services to support CCHHS ($3.75 million) and
CountyCare ($3.75 million) was awarded by RFP/competitive selection to Res
Publica Group,LLC, Chicago. Director Estrada was concerned about the lack of
minority representation on the Board and mid-management of this company. Director Junge said that this company should
reach out to the Labor Union leadership to support the ad campaign. Director Wiese mentioned poor CountyCare
advertising on the North Side. Mr. Elwell
responded that they use zip codes with the highest Medicaid populations as
marketing priority areas.
Mr. Elwell reported that
due to the budget deadlock in Springfield, the State of IL has not paid CCHHS in 3 months with
$250,000,000 owed (primarily Medicaid).
In response, CCHHS is withholding
payments to IL (permissible per contract with the State).
Days of cash on hand have dropped due to this situation. The contract with the State requires CCHHS to pay Vendors for the 1st 3 months of suspended payments from the State and employees but not Vendors after 3 months.
Bad debt/charity write-offs have dropped from over $300,000 in 2013 to around $152,000 in 2015.
Other Metrics: ER visits continued to slowly drop; fewer inpatient
days; steady to slightly decreased outpatient visits. CountyCare total membership continues to drop
slowly (trending for the last 5 months) but is leveling off at 168,968 and
remains above Budget. CountyCare’s goal
is to capture $263,000,000 of Medicaid payments but is at $126,000,000 due to
the use of non-CCHHS facilities by CountyCare members (CCHHS must pay these
other hospitals/ERs/Clinics from the Medicaid payments). Mr. Elwell noted that the FQHCs (Federally
Qualified Health Centers) have outpaced CCHHS clinics in cleanliness, updated
facilities, and front desk demeanor.
Cermak Health Services and the Dept. of
Public Health show cost overruns due to salary & benefit expenses; CCHHS
shows significant excess overtime use which is costly.
The Minutes of the Board of Directors Meeting 8-28-15 approved
Human Resources Committee Meeting: Gladys Lopez reported a 6.2% employee turnover rate, which she said was within the industry standard.
Audit and Compliance Committee: Cathy Bodnar reported a program which includes better oversight of Vendor compliance including CountyCare vendors.
Managed Care Committee: Mr. Elwell reported on CountyCare metrics:
HIV patients: 34% use CCHHS pharmacy (goal 80%). However, there is better utilization of CCHHS pharmacy by HIV patients on maintenance prescriptions with extended supply of 84 days: 56% (goal 85%). 100% of patients have been assigned a “medical home”. Readmission within 30 days of discharge is 22% (benchmark is 10%), mainly due to patients with substance abuse issues. Director Lerner commented that the Metrics for CountyCare should have higher goals with tighter control going forward. Director Marsh asked the proportion of patients admitted via the ED vs directed admissions from a physician/medical home. Mr. Elwell and Dr. Shannon responded that close to 90% were admitted from the ED.
IlliniCare (the third
party administrator for CountyCare) is now in competition for the same
population as CountyCare. They have
143,461 members vs CountyCare 165,848.
This is why the RFP for a new 3rd party administrator
restricts IlliniCare from bidding.
Quality and
Patient Safety Committee: Director Gugenheim reported that the Press
Ganey survey questions (Center for Medicare and Medicaid Services instrument to
measure patient perceptions of care and used to publicly report hospital
performance) always cite cleanliness as
a problem area for CCHHS. Dr. Das noted
that they are embarking on a customer service training intervention in response to low rates of
patients recommending CCHHS.
An operating room performance project
is underway with the goal of increasing on-time OR starts (goal 80%) and decreasing the time to turn an OR room
over for the next case (goal 30 min). The
main OR does 11,350 cases/year, of which, 20% are trauma related and are therefore
a large component of the 28% of urgent cases (which complicates OR room
scheduling). Timed studies starting with
patient arrival to patient being wheeled out of the OR have identified staffing opportunities to reduce delays, as well
as facility and equipment issues that are being addressed.
Identifying the
surgeon/anesthesiologist etc. who may be tardy, are being posted to encourage
timeliness.
Action Items
CCHHS submittal of documentation to the Illinois Health Facilities and
Services Review Board for:
- Provident Hospital to reduce ICU beds from 11 to 6
- Provident Hospital to not re-open the Obstetrics Unit
Report from the Chairman of the Board:
Chair Hammock asked the Board to re-evaluate the metrics that are being
used by their Committees to insure that they are still relevant, and identify
new ones to add. In particular,
ambulatory care metrics should be included.
Report from Chief Executive Officer: Dr. Shannon reiterated a pivot by CCHHS to focus on ambulatory care. He mentioned a partnership with The Greater Chicago Food Depository (GDFD) with their screening of children and families for “food insecurity” and working collaboratively to connect them with safety net organizations such as SNAP and WIC (food stamps). GCFD fresh produce trucks will be stopping at CCHHS clinics to support nutrition/diet interventions.
Meeting adjourned to Closed Session at 11:55 am
Submitted by Susan Kern, MD
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