Cook County Health and Hospital Systems Board Meeting October 30, 2015

Chairman Hill Hammock welcomed new board member Mary Richardson-Lowry.

Cook County Commissioner Robert Steele addressed the board as a public speaker. “Communication is HORRIBLE between this body and the Cook County board.  We are ONE!  I am the public face. I should be attuned; I am offering to be a communicator. It’s what I am here for as a public official.  It’s my responsibility to be your partner under chair Butler. I represent areas where clinics are slated to be redeveloped; I am here to help drive membership. Your culture, your staffing is NOT GOOD below here.  If we don’t get it right now, these buildings will be EMPTY.  I am your face in Washington, D.C.”

Committee Reports

Managed Care Executive Director Steven Glass reported that 99.7% of all CountyCare patients now had been assigned to a medical home; usage has increased; and ER admissions have decreased.  Claims reveal little change in use of services; 6 months are required to get a claim processed.   

Glass presented the results of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey, established by the US government in 1997 surveying patients on their experience with their healthcare plan and services, assessed primarily by mail in early 2015 with respondents about 50/50 male/female.  Of these, 2/3 rated their health good or excellent.  Of respondents, 75.2% reported that they received needed care; 79% reported getting care quickly; 89%, good doctor communication; 89%, good customer service; 76%, shared decision making; 83%, good coordination of care; 69% received needed information; 94% reported ease of filling out forms; 76% reported receiving health promotion and education.  

These outcomes compare favorably with other healthcare providers nationally, though Executive Director Dr. Jay Shannon cautioned that many of those surveyed may never have seen a specialist, and “the data are soft.”  CountyCare also compared favorably with other Illinois healthcare plans.

Finance. Deputy CEO Doug Elwell explained the 2 sole source contracts.  Clayco received a $946,410 contract to do the planning for the new $90m Fantus Clinic. CCHHS prepared the purchase order for this contract. The County will fund it, and it had joint approval. 

Elwell presented a summary of current CCHHS finances: it has 57 days of cash on hand vs. 96 days at the same point in 2014 due to slow state payments; overtime is slightly lower at 7% vs. 8% last year; bad debt has risen to $185,000 from $168,000 last year; inpatient days have decreased from 8700 in 2014 to 8400 this year; monthly ER visits have dropped from 12,800 last year to 12,420 this year.  The charity write-off has dropped from $279,000 last year to $217,300 this year.  He explained that a very low number of CCHHS employees use CCHHS because of their insurer.  “We’re going to fix that,” Elwell said.   

CountyCare has a $9.7m profit, and CCHHS as a whole is showing $14.7m in profit for the year.  Costs for Cermak Clinic and JTDC are due to rise from $62m to $85m to fill unfilled positions and raise psychiatry salaries. The CCHHS budget shows $125m received from the County, but it’s actually $164m including pension costs.   

Elwell discussed Capital Asset Management: CCHHS has not had a solid inventory of equipment, but a new document to be completed by June 2016 will detail the age and condition of equipment as a guide in upgrading and replacing dated equipment at the hospitals and clinics.

Human Resources.  Director Gladys Lopez showed a 55% increase in vacancies filled over the same period in 2014, 68% of which were clinical.  She is working with unions to move departing staff into existing positions, so there are fewer external candidates.  Filling an appointment now requires 122 days.  Lopez said there were 804 vacancies, but the budget shows 1100; Hammock asked her to clarify this discrepancy.  A concern is the high staff turnover at Cermak Clinic, Lopez explaining that staff there use Cermak as a gateway to the system.  She is preparing a customer satisfaction survey.

Board member Wayne Lerner praised Dr. Shannon for his presentation at the budget hearings, along with Communications Director Caryn Stancik.  Lerner expressed amazement at the challenges facing CCHHS.

Dr. Shannon said there would be a mid-November vote on the FY2016 budget, after the public hearings. He reported that CCHHS will begin a marketing campaign in multiple languages; in early 2016, a pilot community triage center will open; and there is now a 3-chair dental service at Prieto Clinic.

The meeting adjourned to closed session at 11:45.

Submitted by Linda Christianson