The meeting was called to order by Chairman David Carvalho at 7:40 am. Michael Newman of AFSCME complained during the public comment period that the union was
not notified of the need for additional staff once the Medicaid waiver was
approved.
Board/Committee
Reports:
Quality and Patient Safety Committee chair Ed Michael congratulated
staff on the overall positive finding by Joint Commission on
Accreditation of Hospitals (JCAH). He also reported on the development of a Quality Dashboard to focus the entire
organization on “big dot” items needed in the coming year. Heather O’Donnell, finance committee chair,
reported that Automated Health Systems
will facilitate the Medicaid waiver, an
$8m contract. Human Resources
committee chair Quin Golden reported that hiring is moving forward, labor
contracts have been approved. Carvalho
said “all resources of the county system will be brought to bear” on hiring.
Action Items:
Dr. Raju said that hiring is moving forward quickly. The goal is to hire 500 FTEs into the system in the next 3
months, then 400 FTEs in the 4 months after that. With respect to revenue collection,
“Jumpstarting is so vital, we cannot fall back on our current collection
process.” Carvalho explained that the
3-year contracts with temp workers have a cancellation feature. The county does not
have to spend all the funds. If FTEs can come on earlier, the county can release
temps, but the key is BILLING. Carvalho pointed out that coders are not
certified and have low accuracy, and that skilled coders are critical now that Medicaid reimbursement is based on
accurate codes for services provided. The Medicaid reimbursement rate was
readjusted last July. System Chief
Financial Officer John Cookinham explained that reimbursement has focused on
inpatients and needs now to focus on outpatients. The county now has 120 days of revenue
outstanding and is far short of $42m goal in patient revenue as it continues to
serve 4,000 patients per day.
The board
recognized Dr. Michael Puisis, Chief Operating Officer of Cermak Clinic, for
his 30 years of service to the county and for providing “excellent quality to the
patient population.”
JCAH Consultant Roberta Fruth spoke
of JCAH history going back to 1910, and how the organization partners with Centers of Medicare/Medicaid
Services (CMS). JCAH was given “deeming”
status in 1965 when the US
government funded Medicare/Medicaid but did not have expertise to evaluate
services they were funding. The board’s role is to assure patient safety and
quality, and has ultimate oversight over licensed professionals.
Dr. Raju spoke of
the impact of caring for patients who
live outside the county, amounting to 7% of total system care/ The cost of this care is not
billable. He also mentioned the disproportionate amount of charity care provided by CCHHS as
a whole, emphasizing that this burden should be shared.
Susan Greene,
Interim Director of the Office of Managed Care and Clinical Tranformation,
spoke about the implementation of CountyCare,
which will provide services for the newly-eligible Medicaid recipients. To be eligible patients must live in Cook County,
be 19-64, have an income below 133% of poverty, not be eligible for state-plan
Medicaid or be on Medicare, have a Social Security number, be a legal immigrant
or US
citizen. The covered services mirror standard Medicaid and include hospital ER,
inpatient services, drugs, lab, x-ray, hospice services, and dental services
for 19-21 year olds. Patients will have
a “patient-centered medical home” at one of 13 selected Federally Qualified Health
Centers and be linked to a pharmacy.
--Submitted by Linda Christenson
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