Health and Hospitals System Board Meeting January 24, 2014

Chair David Carvalho announced that Dr. Raju is likely to be confirmed as the new head of the New York City Health and Hospital System, so an interim CEO will be needed for CCHHS, as well as a permanent CEO.  "There is no process beyond this board for selecting a new CEO," Carvalho said. After a closed session Jay Shannon, current Chief of Clinical Integration, was chosen by the CCHHS board as Interim CEO.

During discussion of a NuCare Service contract for $5,435,854, Carvalho explained that because Oak Forest no longer provides long term care, an RFP was issued and NuCare was selected to provide custodial care for 45-50 patients. The quality of their care is to be monitored by scheduled and unscheduled visits. Lerner cautioned that there should be clear performance criteria, penalties for noncompliance, and good linkage between CCHHS and NuCare staff to coordinate services. Recipients of these services will be patients ineligible for Medicare or Medicaid (primarily undocumented residents); "We don't apologize for that," Carvalho said.

An intergovernmental agreement with the Forest Preserve District will allow for an ADA-compliant, accessible, paved walking trail on the former Oak Forest Hospital property, as well as a facility to explain the history of the property as a former poor farm.

Former CCHHS chair Warren Batts now heads the new CCHHS Foundation. Batts is currently filling board positions and developing strategy for the new Foundation.

Dr. Raju reported:

1. There will be a 90-day extension of CountyCare so patients can receive care during the rollout of ACA; 
2. 72,716 patients were approved for CountyCare as of January 22, a total of 103,000 applications filed (state backlog of nearly 30,000)
3. 80 people are now hired each month, up from 30
4. A contract monitoring team has been added.  A joint planning team of the Illinois Medical District will coordinate the redesign and reconstruction of the Fantus Clinic to become an ambulatory care clinic linked to Stroger Hospital.  Dr Raju recognized Dr. DuMont, who heads palliative care, for her excellence.  Dr. Raju also commended CCHHS board member Carmen Velasquez, retiring as CEO of Alivio Medical Center at the end of January.

Linda Diamond Shapiro, new Chief Strategy Officer, explained her priorities are to find opportunities to improve the system, build leadership, and improve patient experience.  She plans to pull together communications, media, intergovernmental affairs, community relations, policy decision support, and marketing.  Her team will be active in recommending that the County, through CCHHS, hold an HMO license, and by so doing become Provider, Plan, Payer and monitor of Population Health.

Carvalho explained that though there will be new leadership at CCHHS, the plan is in place, and no changes in strategy are anticipated: "The board is committed to the direction we've been on."

Meeting adjourned to closed session at 9:40.    

 Submitted by Linda Christianson

Health and Hospital Systems Board Meeting, August 9, 2012

The meeting was called to order by Acting Chairman Jorge Ramirez.  A vote of the membership chose David Carvalho as Chairman and Ramirez as Vice-Chairman, each a one-year term.  Carvalho, a deputy director for the Illinois Department of Public Health, then chaired the meeting. The four new board members introduced themselves: (1) Carmen Velasquez, executive director of Alivio Medical Center; (2) Rev. Calvin Morris, retired executive director of the Community Renewal Society; (3) Dr. Doreen Wiese, president of the American Indian Association of Illinois; and (4) Ed Michael, retired executive vice president of diagnostics at Abbott Laboratories.  Carvalho asked that new members identify their committee preferences, and reminded them that “we are serving ALL residents without respect to their ability to pay.”  The audit was approved, noting that there had been major improvements since 4 years ago.

Gina Besenhofer, system director, supply chain, presented contracts for approval, including contracts to procure (1) Stryker knee systems; (2) HIV genotyping by Siemens Healthcare; (3) temporary admin staffing; (4) translation of remittance notices into format useful to hospital system; (5) maintenance and repairs at CCHHS; (6) PET/CT imaging; (7) radiopharmaceuticals to nuclear medicine departments; (8) maintenance of AIX mainframe by IBM; (9) courier services to pick up patient fluid samples; (10) professional services for 2 clinical pharmacists; (11) physical, occupational and speech therapy; (12) maintenance of Pysix drug dispensing equipment; (13) maintenance of HVAC system; (14) orthopedic surgery services from residents at Midwestern University.   The board members posed questions concerning competitive bidding process, costs, reasons for needing the services, duration of contracts, compliance with Minority and Women-Owned Business Ordinance requiring that providers must comply directly or indirectly with provision that they be 25% minority-owned and 10% women-owned.  Carvalho explained CCHHS participation in GPO, a Group Purchasing Organization, with other hospitals nationally to secure better pricing.  Dr. Raju said CCHHS now has a new computerized monitoring system for contracts.  All contracts were approved by the board.

Dr. Raju addressed the $152m budget gap.  Some of the deficit will be offset by the Medicaid waiver (still pending); improved physician billing and collection; IT changes; and consolidation of billing. When will the CCHHS budget be ready for approval by the full Cook County board?  The finance committee will meet soon, then submit its budget for approval by the full CCHHS board.  Carvalho pointed out the importance of having the CCHHS board involved in negotiations with the full Cook County board, not cut out of the process and informed at the end.

Anna Ashcraft, Director of Real Estate Management for Cook County, explained that the ground floor of Oak Forest Hospital will be renovated by December as a regional health center. Additionally, 176 acres of Oak Forest property were conveyed to the forest preserve district, now to become Oak Forest Heritage Preserve, opening this fall, to be entered through the Oak Forest Hospital entrance where parking will be available.

The board adjourned to closed session at 10 a.m.

Submitted by Linda Christianson, League Observer

Cook County HHS Board Meeting - March 29, 2012

The meeting was called to order at 7:30am by Vice-chairman Ramirez in the absence of Chairman Batts.

Highlights of Committee Reports included:

Quality and Patient Safety Committee - Director Ansell stated that there were nurse retirements in December that resulted in bed closures at the hospital (I presumed Stroger Hospital although he didn't state which hospital). He also said that some of the beds had been reopened but that nurse recruitment was progressing slowly.

Finance Committee - Director Carvalho singled out one of the contracts being presented for approval. It was for up to $9m to contract out the care of long term ventilator patients if they were "self pay". He stated that an analysis had been done and it was cheaper to contract out services for these patients than it was to keep them in-house. Many of these patients are undocumented he said. All the contracts presented for approval were approved.

A request to execute a Data Sharing Agreement between IDHS and CCHHS was proposed. Dr. Raju, CEO of CCHHS, stated that this would facilitate the process of getting medicaide approval for those patients seeking to be qualified. Dr. Raju said that he has been meeting with the state every 2 weeks regarding the medicaide qualification process and it continues to be slow resulting in cash flow issues for the county. The request for the agreement was approved.

An update was given on the Oak Forest Health Center Capital Renovation Project by those working on this project. This is the first phase ($3m) of a $19m renovation planned for this building that is converting Oak Forest to a primary care and specialty care center. The plan is to have diagnostic imaging, central registration, laboratory and care link on the first floor of Bldg New E with a schedule for destruction bids to come in April and the project to be completed by October. Dr. Mason, chief medical officer, stated that at the present time services continue to be offered but they are spread out throughout the Oak Forest Campus and the intent is to consolidate most services into the New E Building. He also stated that they are looking ahead to establishing a relationship with U of I Extension for doing some gardening on the grounds at Oak Forest so that chronic disease treatment and nutrition will be integrated into future treatment at the center. There was also talk of going back to the CCHHS Strategic Plan that was developed a few years ago to assess progress and to see how the plan needs to proceed or be revised.

Dr. Raju in his report stated that while medicaid revenue has improved slightly in February he predicts they will still not end the year with a balanced budget. He continues to lobby legislators to expand medicaide and indicated that CCHHS is in for a very tough time if the ACA is overturned. He also thanked the Price Waterhouse Coopers team whose contact is not being renewed. They have been transitioning their functions over the last 3 months to Cook County employees and the services they provided will now be done in-house.

Dr. Ansell pressed for more information on the revenue shortfall with medicaide. Dr. Raju stated he thinks the system has a $100m functional deficit because there are a certain number of patients that cannot pay for their care, therfore the system will never run in the black. How to make up the difference is the question.

At 9:00am the meeting went into closed session and the observer left.

Cynthia Schilsky

LWVCC Observer