Commissioner questions focused on revenue concerns - why the system continues to be unable to collect patient fees in a timely and efficient manner. There continue to be issues with multiple contractors doing billing for different types of fees and coordinating the efforts has been an ongoing challenge. Physicians have not billed for their services until recently so this is a cultural change within the system and providing the software and training to facilitate this process is now underway. State reimbursement for Medicaide continues to be problematic. Dr. Raju expressed his commitment to ensuring that the revenue collection system will be optimized and that fees will be collected from those patients who have an ability to pay. He also stated that he is committed to reviewing all contracts with outside vendors to ensure that they are necessary. He would like to have as many of the system functions be internal as possible.
Another area of concern for the commissioners was HR with questions focused on vacant positions, hiring, and layoffs. There was also discussion of how personnel within the system were deemed essential so that they were not required to take the unpaid furlough days. Dr. Raju said that they needed to work out a system of sharing more equitably if furlough days were going to be required but most of the employees within the system belonged to unions that had not agreed to the furlough days. There was discussion of the President's offer to the unions to take 6 unpaid holidays to mitigate the number of layoffs - but it was uncertain if the unions would agree to this. Andrea Gibson, CC Budget Director, was asked how much money could be saved if no raises were given in 2012 and she stated that it was about $50m. Hiring within the system continues to be challenging and Deborah Tate, head of HR for the system, reported that over the last year 235 persons had been hired - but as she explained the number it included 163 medical students, 44 physicians, 61 people at Cermak, and 40 nurses who had been "processed" including 23 internal candidates - so the numbers did not seem to add up. There are union regulations about filling vacancies, displacement, bumping and layoffs that need to be considered in hiring. Ms. Tate stated that the displacement process involved with the changes in personnel needs as a result of the strategic plan should be completed by November 30.
Other issues raised were:
- need to reinstate rape crisis counselors in Stroger ER ($275,000)
- ensuring that clinics throughout the county are not being closed - according to Dr. Martinez they are not
- phasing in the change of MH2 positions to licensed MH3 positions at Cermak so as not to be disruptive to the patients - and providing training for MH2s who want to become licensed MH3s
- need to increase funding for Access to Care, a suburban program that provides access to primary care physicians for the uninsured
Dr. Raju and has staff provided answers to the commissioners on the issues that they raised. Dr. Raju, who has only been in his position of CEO for 1 month, assured the committee that he is dedicated to improving the revenue stream of CCHHS and he will be vigilant in monitoring contracts in the coming year. He also stated that the system will need to tweak its financial model as health care reform continues towards 2014. Since very little specific information relating to numbers was discussed in this three hour session it was unclear to the observer whether amendments to this part of the budget would be forthcoming.
Cynthia Schilsky
LWVCC Observer
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