No Lack of Input at Second Public Hearing on Proposed Budget

2016 Budget Public Hearing:  Maybrook Court House, Maywood,  November 5, 2015,  6:30 PM.

The hearing began on time and had 12 commissioners present. The hearing was chaired by Comm. Boykin. 

Approximately 25 people spoke, some alone and some on behalf of groups with many people standing at the podium.
Many people spoke out against the e-cigarette tax, one even claiming that such a tax would increase the amount of people who smoked regular cigarettes. One speaker was the owner of a “Vape” shop and worried about the loss of business that might occur. Also noted were several speakers who wanted more money for Restorative Justice programs. A group called Peacekeepers handed out sheets of statistics to the commissioners about lowering recidivism rates. These folks were very polite and thanked the board for the $500,000 donation to their group. Conversations about budget balancing ensued. Finally, Reclaim Chicago spoke about the Responsible Business Act. It basically taxes employers who pay less than a fair wage.

   

Some other interesting speakers included the Mayor of Lyons who complained about the 3% Amusement Tax hurting seniors the most. The Commissioners thanked this mayor profusely for the recent regulations placed on the gun shop in Lyons. Other speakers complained about the same tax. Comm. Daley stated that this tax probably would not happen.

A doctor from Access to Care based at Loyola Medical Center in Maywood asked for more funding. Some discussion ensued about treating illegal immigrants. Comm. Suffredin said that he would work with this program to try to come up with a solution to this problem. Others complained about county taxes treating illegals. Comm. Garcia said CCHHS has a mission to treat everyone equally and doctors have an oath to treat the sick.

The SEIU (state unionized workers) speaker complained about cutting the grafitti removal team because it has been very successful. A speaker from Safer Foundation thanked the board for its support in the past. Several cancer patients thanked the board for County Care and the expansion of Medicaid. Many had had no health care at all until 2 years ago.
 

A huge group from TASC (Treatment Alternatives for Safe Communities) came to the podium. They explained their mission and looked forward to working with the State’s Attorney's Office and the Jail by expanding diversion programs. Another speaker asked for more county facilities to be compliant with the Americans with Disabilities Act. She complained about both downtown county buildings and the difficulties wheelchair bound people have negotiating some of the doors and elevators.

   

The most emotional part of the evening came when one speaker (calling himself “just a taxpayer") complained about the increasing sales tax which makes Cook County have the highest sales tax in the nation. Comm. Sims said that it was a fair tax because it hits everyone who shops in Cook County evenly. She became emotional when she told everyone how difficult it was to balance this budget when all groups are asking for more money.

--Submitted by Jan Goldberg

Commissioners question CEO for nearly 3 hours on proposed 2016 budget as CCHHS evolution remains front and center

2016 Cook County Budget Hearing: Health and Hospitals System, Oct. 22, 2015

Dr. Shannon, CEO for the Cook County Health and Hospitals System (CCHHS), appeared before the County Board to present the CCHHS budget for 2016. In his presentation he emphasized that the Affordable Care Act has been a “game changer” for the system, as, for the first time in history, a majority of the patients being served are now insured (70% have some type of coverage). The desire to maintain the mission of serving all in need while having increased competition for patients who now with insurance have choice of where they get their health care is the underlying concern. 

Dr. Shannon further described how health care is changing from an acute care model to an outpatient ambulatory care model. Also, Cook County medicaid patients are now required by the state to be a part of a managed care system. These changes have resulted in the CCHHS Board rethinking how their services are best rendered and how their facilities are most efficiently and effectively utilized to deliver services. 

The viability of CCHHS depends on its financial success and therefore they now use national benchmarks to gauge their progress as they move towards implementing an expanded ambulatory system that is located county wide rather than hospital centered as it has been in the past. Changes within the system still need to take into account limits imposed by existing staffing models and physical space constraints. 

Revenue concerns he noted: the general decrease in hospitalization of patients and how this impacts hospital income as well as the yearly redetermination requirement for medicaid recipients.

The CCHHS proposed budget for FY16 is $1.7B with an anticipated “subsidy” from Cook County of $125m (anticipated decrease of $34m from 2015). It includes staffing throughout the system of 6736 FTE’s (a decrease of 11 from 2015) and assumes that County Care will maintain a membership of about 170,000 members.

Concerns raised during commissioner questioning:

•    Correctional health in the jail and in JTDC continues to be a challenge. One development is Community Triage Centers that will be staffed 24/7 and located in the community to assess individual arrestees with minor offenses who can perhaps be treated at these sites and diverted from jail. A pilot is anticipated to open in early 2016 on the south side of Chicago.

•    The Access to Care program had a decrease in funding in this budget and Comm. Suffredin and Schneider both expressed concern over the cut. Dr. Shannon stated that Access to Care, a program that provides community based medical care for uninsured persons, has also been impacted by the ACA and thus that program is also undergoing changes.

•    Comm. Steele expressed concern that the cultural shift within the system was not being effectively communicated to the staff within the system. Dr. Shannon said that as the staffing model is changing, they are working with the unions to try to ensure that employees will be able to find positions within the system. He stated that 200 new nurses have been hired and many nurses have changed to different positions.

•    Comms. Steele, Sims, and Garcia expressed concern that a new Trauma Center that has been proposed for Holy Cross Hospital would introduce unwanted competition to Stroger’s Trauma Center. Comm. Sims wanted to know if Dr. Shannon would be opposed and he stated that there was a process in Illinois to determine the need for another Trauma Center. When he did not express opposition, she wanted to know if he had been involved in planning discussions and he stated he was not involved. When asked if he had concerns, he stated that whatever solution concerning another Trauma Center had to have staying power as opening a Trauma Center was a big deal and so was closing one.

•    Comm. Boykin wanted to know why they were giving people raises when taxes are being raised to cover such raises. Comm. Sims wanted to know who developed the salary schedules. Dr. Shannon stated that 90% of the employees are union and the salaries are determined during union negotiations. They have done salary comparisons with other hospitals and Comm. Sims asked to have that information shared with the commissioners. Comm. Moore wanted to know why Physical Therapists (who have doctoral degrees) made less than drivers. No explanation was provided.

•    When asked about the closing of the pediatric inpatient beds, Dr. Shannon reiterated that they are committed to investment in ambulatory care and primary care for pediatric patients as the demand is for ambulatory pediatric specialists not inpatient services.

•    They have also made investments in dental clinics and hope to expand this service. There are now 5 dental clinics operating.

•    Comm. Sims and Comm. Arroyo asked about minority hiring. Dr. Shannon stated they do make an effort to ensure a diverse work force but there is a lot of competition in this area for competent staff and the County salary schedule is not always competitive and people go elsewhere to work.

•    Comm. Morrison wanted to know what would happen if CCHHS did not meet their projected revenue from County Care. Dr. Shannon stated that they continuously monitor using metrics and would decrease cost if revenues were not as expected. Dr Shannon stated again that this is going to be a tumultuous time in health care as all medicaid clients are moved to managed care and the switch is made to a focus on ambulatory care but he is committed to their mission and doesn’t think they should close up shop.

•    Comm. Gainer asked what they spent on outside attorneys for litigation. Dr. Shannon stated that they turn any litigation over to the State’s Attorney and if outside attorneys are hired it is done by the SA’s office.

Dr. Shannon ended the nearly 3 hour questioning by stating again that CCHHS is trying to make the pivot from a single campus to a countywide full service system for patients.

 

Dr. Shannon’s slide presentation can be found by clicking on CCHHS Budget Presentation under Attachments.

--Submitted by Cynthia Schilsky

Cook County Health and Hospitals System Board of Directors Meeting May 29, 2015

        I.          Chairman Hammock called the meeting to order at 9:00am

      II.         Public Speakers: There were 6 speakers representing the public.  A representative from the Service Employees International Union (SEIU) Local 73 representing the Health Care Professionals, Hospital Technologists, Service Employees and Hospital Technicians of CCHHS complained that labor contracts had expired and the new negotiated wages and healthcare changes which had already been approved by the Cook County Board were being held up by the CCHHS Board.  Chair Hammock responded that the Board required comprehensive comparative metrics from other hospitals to determine the criteria for a decision.  This data was now available and a vote would be taken later in the meeting.

Nurses from Stroger Hospital and Cermak and SEIU representatives for the nurse’s union contract spoke.  They stated than there were insufficient nurses per patient leading to unsafe practices.  CCHHS had cut nursing overtime leading to a more severe shortage, there were over 200 nurse position vacancies and wages were inadequate.  One of the nurses from Stroger Hospital stated that “a strike vote by the nurses” had been taken and introduced a representative who served the Chair of CCHHS Board with a formal notice that the nurses will begin picketing. Chair Hammock responded that filling vacancies was a high priority for the CCHHS Board as reflected in the monthly metrics on vacancies.

A citizen spoke complaining that Oak Forest Hospital had been closed and the patients moved to nursing homes. “There is not enough money spent on real health care”,  “the CCHHS leadership don’t receive their  health care at CCHHS, and they should! Its good enough for the poor.”

    III.       Employee Recognition:  CEO Dr. Shannon recognized the CCHHS/Stroger physicians from the “internal medicine jeopardy team” who had progressed to the national semi-finals.  He acknowledged an ophthalmologist who was listed as one of the “40 under 40” by the Ophthalmology Association.

   IV.            Board and Committee Reports

A.  Minutes of the CCHHS BOD from 4-24-15 were approved

B.    Quality and Patient Safety Committee Meeting 5-12-15 

Dr. Das reviewed the metrics of quality measures and 12 month trending pointing out that on-time OR start was only 17% (target 80%) at Provident Hospital and the “patient experience and willingness to recommend the hospital” was 71% at Stroger and 67% at Provident Hospital (target: 85%). This represented a small improvement from the previous 60-70% for Stroger but little change for Provident Hospital. Director Dr. Marsh requested better trending to understand any improvement, not just monthly variations.   Director Weise asked whether a survey of CCHHS employees on whether they would recommend the hospital might be useful. Director Gugenheim reported that Provident Hospital had been granted full accreditation by JCAHO.

               C.  Audit and Compliance Committee

Director Velasquez reported that IlliniCare, Medical Director malfeasance (as reported in the press) was being addressed. Cathy Bodnar reviewed the CountyCare oversight structure (grievances, complaints, appeals etc.).  Fraud Waste and Abuse program training is on-going for staff.  Only 8 allegations of FWA were validated in the previous year.  Director Lerner requested a deeper evaluation of the metrics to include rate of 1) repeat allegation by type and 2) what was the outcome.  Cathy Bodnar noted that the prescription abuse program included restricting a member to a single pharmacy if there was a pattern of abuse and working with the member personally.

 D.  Managed Care Committee

Steve Glass reported that CountyCare membership in May 2015 was 183,415 exceeded the goal of 155,860 but that the “total member months was only at 97.6% of budget."  In the last 6 months (Dec. 2014—June 2015) CountyCare has doubled in size and is now the 2^nd largest Medicaid managed care organization in the area (2^nd to Family Health Network).  Director Junge asked what % of the of membership are due to auto enrollment versus actively choosing CountyCare.  Mr. Glass responded that he would follow-up with the State of IL who would have this information.  State of IL sent out new annual re-enrollment letters to members in February, 2015, with a 60 day deadline for member redetermination which at this time, is reported as 8,000 who had Medicaid cancellation.

                  Director Lerner asked for sources of Medicaid cancellation and the response was that        there were multiple reasons including 1) members not completing the process of                  redetermination and 2) members now employed and no longer meets Medicaid eligibility                   or another such change in status.  Member/provider surveys required by the CCHHS                   contract for Medicaid with the State of IL shows only 99 member responses with 44%                  worried about where they will stay tonight and 32% worried about food availability.

           E.    Human Resources Committee

Director Wiese and Gladys Lopez reported that they are focusing on filling vacancies particularly nursing ones which are reported in the monthly metrics. Lopez noted that compared to May, 2014 when 216 CCHHS vacancies were filled, in May, 2015, 448 were filled.

F.       Finance Committee

Mr.Elwell reviewed the contracts that required action and all were approved with the exception of  item #14, “First Transit,Inc” providing transportation benefit for the Managed Care System, contract $8,000,000  which required further fact checking prior to approval. He reported that CCHHS has YTD  ($23 million) income loss with a poor operating margin compared to other hospitals.  The “plant/buildings/equipment” are aging and now 17 years old and “going in the wrong direction”.  There has been inadequate funding for renewal of this capital equipment, most of which dates from the opening of the new Stroger Hospital. 

Overtime is very high at 8% of worked hours costing CCHHS $40 million. It should be less than 5%.  Monthly Inpatient days (9,225 vs 8,315), emergency room visits (14,261 vs 12,887) and outpatient registration (7,821 vs 7,543)  are all down significantly from 2014 but there is no decrease in the overtime!  

 Mr. Elwell stated that there needs to be realignment of CCHHS managers with the new business model of managed care.  All positions must be looked at to determine whether they are needed.  

Director Marsh inquired about wait time in ER.  Elwell responded that no one is left in the ER waiting room, they are placed in exam rooms waiting for the physician to see them.  

Director Lerner asked about metrics on nursing FTEs per occupied bed.  Elwell responded that they are working on an automated system for nursing documentation to derive the metrics from.

 

      V.             Board Education

     A comprehensive focus area power point presentation and overview of the  responsibilities of the Cook County Department of Public Health, a component of CCHHS, was given by COO of CCDPH Dr. Terry Mason.  It will be posted on-line on the CCHHS web site.

    VI.            Action Items

 The Board adjourned temporarily to Executive Session for 20 minutes to discuss the SEIU   union negotiated wages and healthcare changes for CCHHS employees including SEIU   Local 73 Health Care Professionals, Hospital Technologists, Service Employees and    Hospital Technicians.  The open BOD meeting was reconvened and it was announced that  the Board had approved the contracts.  These do not include the more comprehensive nurses'  contract.

  VII.            Report from the Chairman of the Board

Chair Hammock noted that the Board has invested tremendous efforts into recruiting nurses.

VIII.            Report from the CEO Dr. Shannon

Dr. Shannon rebutted the comments made by various nurses/union representatives public comments. He stated that there are appropriate nursing levels at CCHHS based on the acuity of the patient care derived from national standards and metrics.  Most hospitals no longer base nurse staffing on a specific ratio of nurse to patient, which is what the union wants, but on acuity of care. CCHHS has used “floater nurses” to cover periodic shortage rather than overtime. He disagrees with the nurses’ union demand for a wage increase of 5% for each of the next several years and the demand that seniority not performance serve as the criteria used for retention.  “We are far apart on the terms for the new nursing contract”. Dr. Shannon indicated that the Union must give CCHHS 5 days notice of a strike.  He feels that the BOD could obtain a legal stay of the strike action.  However the CCHHS BOD are creating contingency plans to maintain nurse staffing of CCHHS Hospitals and clinics.

The meeting adjourned at 1:15 pm.

Submitted by Susan Kern, MD,  observer for LWV Cook County, Health Issues Committee

Meeting of Cook County Health and Hospitals System Finance Committee February 20, 2015

The entire committee attended the meeting: Chair Lewis M. Collens and Directors Jerry Butler, Ric Estrada and Ada Mary Gugenheim in person; Board Chair M. Hill Hammock, Director Dorene P. Wiese and non-Director Committee member Steven Scheer by phone.

Two public commenters pointed out that contracts slated for extension as part of the committee agenda were exceptionally expensive–for instance, the McKesson company is paid $13 million to collect $32 million in accounts receivable, a rake-off of nearly 40%, while the industry standard is between 4% and 7.5%. Procurement Chief Doug Elwell explained that these interim contracts would last only until May 31 while the System prepared to bring their functions in-house; Chair Collens added that the contracts were arranged four years ago, before there was an independent Hospitals board, and would not be approved today.

Several directors pressed Elwell about whether it would be possible to do the necessary hiring before the end of May, given that filling single vacancies takes nearly six months. Elwell acknowledged that the timetable was ambitious but noted it’s easier to fill 50 identical new positions (which can all be posted at once) than to refill 50 vacancies. He also acknowledged that bringing accounts receivable and other functions in-house might not save any money but stressed that it would improve the quality and consistency of coding, which is essential for collecting reimbursements.

The new supply chain management contract, by contrast, is expected to save $2-3 million per year, though it will be expensive in the short term because the old and new systems have to be run simultaneously. A third contract to provide necessary software support to an existing system was roundly criticized: why wasn’t such support included in the original 2011 contract? To which the answer was, “We blew it,” apparently because hardware is in the System’s capital budget and software in its operations budget. The committee instructed Elwell to supply information about both in the future.

As if to emphasize the improved contracting procedures, Elwell recused himself from presenting a contract with HMA, for which he previously worked, though he’d had no part in negotiating the agreement. CEO Dr. Jay Shannon presented instead, noting that under Procurement’s scoring system for quality, HMA had 20% more points than its closest competitor, and that the scoring system was proctored by Procurement officers not involved in awarding the initial score. All standard business practice, but revolutionary at CCHHS.

The Committee then reviewed balance sheets, noting that the system “has a small profit once the County subsidy is figured in,” though at $9.7 million in a multi-billion dollar budget the profit is little more than “a rounding error.” The meeting’s financials appear at www.cookcountyhhs.org/wp-content/uploads/2014/11/02-20-15-Finance-scan-Minutes.pdf.

Highlighted financial data, though the year doesn’t close til March 1:

• Collections take an average of 37 days vs. 58 days in 2011.
• Very briefly the System had 93 days’ worth of cash on hand, versus a recommended 100 days; it’s since slipped back into the 80s but is still better than in 2012 or 2013.
• The Unrestricted Fund Balance (cash, versus assets in Restricted Fund Balance) is starting to rebound: it went from $168 million in 2011 down to $95 million in 2012 and $36 million in 2013, but improved to $88 million last year.
• Procurement goals for the year are less outside staffing (adding 130-200 jobs and resolving conflicts with labor), remote hosting of hospital data to improve quality, and lab automation, a possible source of earned revenue from other hospitals. The System will also consider how to improve patient transport and whether to provide on-site dialysis instead of referring those patients to other facilities.
• Overall strategic issues: the size and design of clinics, the central campus redevelopment for which five proposals have been received, and the possibility of risk-sharing with existing managed care groups. One possible partner could bring the System 90,000 patients if the System is willing to assume some of the partner’s risks.

The metrics presented were not, as directors noted, as clear as those presented to the Human Resources Committee, which saw a detailed step-by-step account of the hiring process and progress in reducing how long it takes. (HR attributes much of the delay to the Shakman decree.)

But a few items came through:

• The System gets 40% of the primary care provided under County Care but only 7.6% of the specialty care, when specialty care is where hospitalizations come from. This may be because CCHHS doesn’t provide adequate support services for specialists, e.g. scheduling. Ellwood proposes making specialists available at the System’s Federally Qualified Health Centers (clinics) to connect patients long-term to those specialists.
• The System’s fixed costs are high enough that extra patients cost very little.
• Because the proposed Rauner Medicaid cuts are to special payments the System rarely receives, those cuts won’t hurt the System directly; but the cuts to the County’s revenue from the state could be devastating.

Steven Glass, the director of Managed Care, then explained the complicated process of redetermining whether individuals qualify for Medicaid. 50% of Medicaid patients must be in coordinated care under the Affordable Care Act, so it’s essential to make sure they still qualify. They’re automatically re-enrolled every year but on a different timetable they must demonstrate that they’re still poor, and the whole thing is a 4-month process. Of the patients the System loses, 60% of them fail to go through the necessary I’m-still-poor process, despite assists from the Illinois Medicaid Redetermination Project and new cooperative efforts with the state’s Department of Children and Family Services and the city’s Department of Human Services. The System informs people about the Medicaid requirements, putting messages on every prescription and discharge notice and giving Primary Care docs data on who hasn’t re-upped so they can follow up with their own patients. Unfortunately, CCHHS isn’t allow to sign up uninsured people in the Emergency Room and then get paid for those emergency services.

To reduce the System’s dependence on Medicaid patients subject to these complex requirements, Glass talked about the important of risk-sharing with Primary Care Physician networks: if we share risk with them, they make us their designated provider of, e.g., liver scans. The System has the city’s most advanced scanner which makes it possible to avoid biopsies–“every hospital should be referring cases to us for scanning.”

Patient metrics:

• Membership increased 11% in January, to 96,000, less than budgeted because signup started late; Glass says he expects to catch up to budget later.
• “We were down in capitation [number of members] but captured most available Medicaid fee-for-service.”
• CCHHS is the third-largest health plan in the county.
• It’s not clear the System is getting its fair share of new ACA enrollees: 275,000 at one point of which we got zero? Are they all in the suburbs?
• The System’s membership growth is among the older population which is more expensive to care for–we keep those patients and lose the younger ones.

Submitted by Kelly Kleiman

Cook County Health and Hospitals System Board of Directors Meeting February 27, 2015

Chairman Hill Hammock called the meeting to order at 9am

Board and Committee Reports minutes were approved

A)     Board of Directors meeting minutes 1-30-15 approved

B)     Quality and Patient Safety Committee meeting 2-17-15

i.                 Metrics:    Director Gugenheim provided a lengthy overview of the QPS Committee organizational structure using a powerpoint [powerpoints presented at BoD meetings are now posted on-line on the CCHHS website under Governance section,click on BoD meetings—this is new and extremely valuable to BoD observers ]   A list of future presentations to the BoD (quarterly) and annually to the QPS Committee were provided.

ii.                  Focus Area Presentation:    A 5 year Accreditation Timetable listing all agencies that accredit any component of CCHHS,  and scheduled upcoming/past inspections listed.   In 2015: the following inspections are expected:   Stroger Hospital (JCAHO); ACHN (Primary Care Medical Home certification); Provident Hospital lab  (College of American Pathologists); Stroger blood bank ( FDA);  Stroger Hospital medical training programs (Graduate Medical Education).   

One of the Directors asked why GME accreditation, which is partially funded by Medicare, should be an issue at CCHHS which sees relatively few Medicare patients. Dr. Krishna Das, Chief Quality Officer, noted that despite few Medicare patients, the CMS licenses payments which applies to the entire Hospital.  Dr. Shannon indicated that JCAHO’s inspection will be unannounced and they will be bringing 5 surveyors for 4 days of inspections and over 1000 questions on the checklist.  JCAHO has deemed status for CMS conditions of participation.  Dr. Das displayed the table of teams that have been organized by discipline/category to prepare for the JCAHO inspection.  A Director asked whether the BoD would be involved in the Leadership Standards component of the JCAHO.  Yes, the Board members may be interviewed and were also invited to the Leadership Team meetings.

The PCMH inspection allows CCHHS to choose the clinic (from ACHN) that is inspected (Dr. Das said they would choose the Prieto Clinic which is the best run with staunch loyalty of patients to the Clinic).  Director Gugenheim questioned that approach “why shouldn’t we try to improve the quality of all of the Clinics?”  (see powerpoint posted on CCHHS web site for detailed information)

Director Gugenheim reported a recent unannounced IDPH survey triggered by a patient complaint for which CCHHS had to provide the Metrics: how do we reach certification goals 1)patient and staff education 2) patient self-management 3) access to care  4) referral management 5)quality performance improvement team approach at the Clinic level.

C)    Audit and Compliance Committee Meeting 2-19-15

Director  Velasquez and Chief Compliance Officer, Cathy Bodnar reported that the CCHHS Internal Audit Charter was audited by the Firm Mcgladrey and Board Rules were reviewed.  A lengthy powerpoint of the  CCHHS Compliance Program Operations Plan was presented including graphs of the number of corporate compliance issues investigated/determined violations which are increasing in number.  A Director asked what the most common violations were and it was reported that HIPPA breaches (determined to be unintentional, not malicious) associated with electronic transmission of patient data. Corrective action includes encryption of all e-mails.

CountyCare Compliance Plan presented including monitoring of Fraud,Waste and Abuse.   Metrics provided included incidence of 1) upcoding 2) boilerplate coding  3) allegation that individual ineligible for CountyCare.  Director Marsh suggested that there should be random routine audits of charts for all health care providers (not to blame but to educate on coding issues etc.)

D)   Managed Care Committee meeting 2-19-15

Director Lerner and Exec. Dir. of Managed Care, Steven Glass presented an update of CountyCare. Goal of enrolled members is 124,318, at the end of Jan. 2015 it was 96,508 which is an improvement from Dec.2014 : 86,562.  Issues discussed included the CountyCare redetermination process, IL State funding of Medicaid, and prescription utilization by CountyCare members.  It was noted that members do not tend to use CCHHS pharmacies.  Dir. Wiese reported an incident of poor customer service in the redetermination process and wondered if this type of issue was responsible for lagging redetermination for eligibility in CountyCare.

E)     Human Resources Committee Meeting, 2-20-15

Director Wiese and HR Director Ms. Lopez reported that the goal was to reduce the Jan. 2015 vacancies of 1018  to 600 by year end with a decrease in the time to hire to 94 days.  One of the Directors wondered if there were excess  positions which may not need to be filled.  Brief discussion on the cost of replacing vacancy (HR time etc.)

F)     Finance Committee Meeting 2-20-15

Doug Elwell Deputy CEO Finance & Strategy noted that the financial metrics reviewed by the committee revealed a small operating surplus at the end of the Quarter with 93 days of cash on hand (good).  Dir. Collens responded that “We [CCHHS] are nowhere close to showing a profit”; and that the timing of reporting of various figures may not reflect the full picture. 

 

National Metrics are planned to be accessed to compare CCHHS financial data to similar hospitals nationally (County/Academic hospitals of comparable size) and to set up goals/measures /targets and benchmarking.  The Committee in the future will look for benchmarking of CCHHS to all hospitals (not just County ones) because Chicago is a town with numerous hospitals that CCHHS must compete with.   

Dir. Collens stated that it would be interesting to know what FTEs unit/work are at CCHHS vs other hospitals.  “Maybe we could decrease FTEs because they are in excess already.”

It was reported that they were looking at services that could be brought in house which would save money. Collective bargaining negotiations with the CCHHS unions ran into a sticking point with a “work rule issue of monitoring phone calls made  for quality purposes”. This has been resolved and the Union dropped their objection when it was documented that monitoring calls was a national standard.

Action Items  BoD approved all contracts except one which had not yet been reviewed by the Finance Committee.

Report of Chair of the Board Chair Hammock referred all to his written report.

Report of CEO Dr. Shannon noted that there were 5 responses to the RFP for the Central Campus redevelopment project.  These will be reviewed and eliminated to 3 in the next few months which will undergo further assessment. 

 

Dr. Shannon reported on legislative issues at the State level including the Governor’s budget calling for cuts to Medicaid which will adversely affect CCHHS.  He mentioned that a continued conversation with State and Federal Legislators on Medicaid funding would be important to advocate against cuts to the Medicaid funding.

Meeting adjourned to Closed Session at 12:15 pm

Submitted by Susan Kern