CC Board Health & Hospitals Committee, July 14, 2010 Meeting

The Health and Hospitals Committee of the Cook County Board of Commissioners met on July 14 to discuss and approve the Cook County Health and Hospital Systems Board Strategic Plan that had been approved by their board in June. Commissioner Butler presided at the meeting which followed the Forest Preserve District meeting and he called the meeting to order at 12noon.

Mr. William Foley, CEO of the HHS presented a summary of the Strategic Plan. He stated that there were 5 key components of the plan and they are:

1. Enhancing access to the system for all persons wanting to use the services.

2. Ensuring quality service and cultural competency throughout the system.

3. Realigning resources and using service line planning within the system.

4. Staff development

5. Leadership development

He emphasized that the plan is a plan for growth with a goal of expanding the ability to treat outpatients by 50% over the next 5 years. The plan does anticipate health care reform although the effects of that are still uncertain. The focus is on primary care with a need to expand access to specialty care. The plan does call for realignment of services at Oak Forest and Provident Hospitals focusing more on outpatient care and access to specialty care at these facilities and a decrease in the inpatient services at both hospitals. He did not discuss specifics on cost but did say that the amount of money provided by the county to subsidize the system is not anticipated to change much over the next 5 years. It will remain at about $300M if they go forward with the changes as outlined. The amount provided for benefits, pension and debt service is an additional $172M for a total of $500M. Capital costs would be in addition and while some of those have already been budgeted (ie Fantus Clinic rebuilding) others would be additional. It was stressed that this is a strategic plan and that modifications can be made along the way and cost would be a determining factor in how the plan is executed.

Public Comments included groups such as the Civic Federation, Access to Care, and Dr. Q. Young speaking on behalf of the Health and Medicine Policy Research Group, and also several individuals who were in favor of the plan. There also were several speakers some representing unions, but also employees and patients who were opposed to the plan. Opposition was primarily focused on the closing of inpatient beds at Oak Forest and Provident with concern being focused on lack of access to county health services in the south suburbs.

After the public comment Comm. Beavers asked to hear from Dr. Mason who accompanied Mr. Foley to present the plan. Dr. Mason apparently had once worked at Provident Hospital. Comm. Beavers wanted to know how the city of Chicago could do "twice as much with half the resources" for the health of the persons in Chicago and also stated that closing Provident would leave a significant number of persons without access to emergency care since "95% of the persons that go to Provident are trauma cases." Dr. Mason stated that hard decisions needed to be made about how best to use the resources of the county. Comm. Beavers [corrected 10/9/10] then made a motion to defer the decision on the strategic plan.

Discussion then proceeded on both the motion to approve and the motion to defer.

Comm. Peraica pointed out the reality that many hospitals have been going out of business.

Comm. Gainer stated that the whole nature of health care is going to change and therefore the county also needs to change.

Comm. Schneider expressed concern about getting reimbursement from other counties or states when patients from outside Cook County use the system.

Comm. Claypool was pleased to see the primary care focus of the plan since that is what he sites as the key to better care and lower cost of health care. He stated that there will be radical change in the way hospitals function and cited an article in the current issue of Crain's.

Comm. Sims had reservations about the plan and was concerned that hospitals in the south suburbs would "cherry pick" patients and limit access to patients needing care in the south suburbs. She was not ready to vote and needed more time to consider the plan. Comm. Gorman commended the HHS Board for producing a plan within the time frame that they had established.

Comm. Murphy was happy with much of the plan but Oak Forest needed to have an emergency room and inpatient facilities included before she could support the plan. Comm. Butler stated that to delay is always costly and there is no perfect plan.

The motion to delay the decision was then taken by roll call with the following results:

Yes (3) - Beaver, Murphy, Sims No (9) - Claypool, Daley, Gainer, Gorman, Goslin, Peraica, Reyes, Schneider, Butler Absent (5) - Collins, Moreno, Silvestri, Steele, Suffredin

The motion to approve the 5 year CCHS Plan was then taken with the following results:

Yes (9) - Claypool, Daley, Gainer, Gorman, Goslin, Peraica, Reyes, Schneider, Butler No (3) - Beaver, Murphy, Sims Absent (5): Collins, Moreno, Silvestri, Steele, Suffredin

A motion to reconsider was taken immediately following with the reverse roll call being accepted. The Committee report now goes to the Board for approval.

The meeting was adjourned at 3:15pm.

--Submitted by Cynthia Schilsky

Cook County Board Meeting July 13, 2010

The meeting was presided over by President Pro-tem Moreno as President Stroger was not present.

Ms. Eden Hurd was appointed to the Cook County Housing Authority to take the place of James Jones for a term to expire on 6/1/15.

The Cook County Dept. of Revenue received the 2010 National Association of Counties (NACo) Achievement Award for modernization of the collection process for Home Rule Taxes. The same award was given to Cook County Facilities Management for doing a good job of maintaining County Facilities. Several Unsung Heroine Awards were given to women who were recognized for altruistic activities in the county. Commissioner Silvestri received Oak Leyden Services President's Award for his efforts in assisting disabled adults to move to appropriate housing, thereby avoiding having to be institutionalized.

Commissioners Gorman, Moreno and Murphy submitted a proposal for the audio and video recording of the Cook County Health and Hospitals Board meetings. The proposal passed.

An amendment regarding the posting of the Cook County Board Meeting Agenda and the time lines pertaining to items being placed on the agenda was moved to the Rules Committee.

A proposal passed requiring the Cook County Health and Hospitals System to reward 35% of contracts to minority or women owned companies.

The Assessor's Office had a large printing bill for materials advising senior citizens that their tax exemptions would not be renewed automatically. The request was approved as the exemptions needed to be verified.

An item was passed prohibiting towns and villages other than Ford Heights from using Cook County Sheriffs Police in lieu of their own police departments. The Sheriff will police Ford Heights as the town has no funding for police services, but the cost of same for other villages will not be paid by the County in order to discourage this practice.

--Submitted by Beverly Graham

Cook County Board Meeting June 15, 2010

The Finance Committee meeting began at 11:50 and started with a discussion of Shackman oversight by the Duty of Compliance Administrator, overseen by Judge Wayne Anderson. The amount allotted ($1,923,000) was questioned by Commissioner Collins. C. Daley responded that the funds go to the administrators. He explained that there are 15 monitors who ensure compliance with the decree. The item was unanimously approved. All bills and claims were approved and passed. C. Peraica questioned the tax bills sent by certified mail. C. Daley explained that they were delinquent notices.

All Workman's Comp. claims were approved, as were all subrogation claims.

Revenue Report: The Comptroller reported a negative $10.6 million. County sales tax increased slightly. Alcohol tax was negative $1 million. Reports were given from Provident Hospital revealing a loss of Medicaid revenue. Their CFO said that payments were 86% below expected level. Oak Forest Hospital reported a loss of 56%. It is expected that the percentage of decline will continue for the rest of the year. New rates begin July 1, 2010. The cause of underpayments is a drop in the number of Medicaid patients. It was also reported that Med Assets would be replaced by Price Waterhouse, and that the scope of their oversight would be broadened. Forty percent of patients are undocumented; that is, they do not provide sufficient information; and as a result, $48 million is lost.

Red Light Violation Contracts: Less money was collected than anticipated. (A further discussion of this item took place as an item on the Board of Commissioners agenda.)

All Highway bills were approved, as were Zoning and Building, and Roads and Bridges.

Cook County Board of Commissioners Agenda - Proposed Ordinance Amendments, and other items:

The meeting was chaired by C. Moreno, President pro-temp. President Stroger returned towards the end of the meeting.

The meeting began with the reading of a long list of clerical mistakes on the items submitted for the agenda. There was an equally lengthy discussion about the number of mistakes. C. Beavers suggested that everyone responsible for the mistakes should be fired. C. Murphy suggested that if an item has a mistake, they should vote no. Item 2 was withdrawn, and Item 4, requiring all personnel activity (hires, resignations, reclassifications, transfers), be reported to the Board of Commissioners, passed.

Item 5, establishment of an automated red light traffic safety system, was discussed at length. The amendment allows municipalities to "opt out" of the installation and maintenance of the cameras. Apparently, the Commissioners had been contacted by numerous town and village presidents and mayors who were not if favor of the monitors. Rupert Graham (Highways), stated that the top 30 intersections for serious accidents were identified and thus selected to have the cameras installed. C. Murphy said that she does not believe that the municipalities are aware of this, and she requested that Mr. Graham provide statistics of traffic fatalities. C. Daley said that there had been "communication problems" between the county and the towns. The issue was further politicised by the fact that the contract was with a company from Arizona. At the end of the discussion, the amendment was passed, so that towns will be able to opt out.

Items 6 and 7 passed regarding additional filing fees and the installation of blue hospitality signs along the county highways.

Item 8, regarding a committee of two, (C. Sims, Chairman, and C. Goslin) be established to oversee the use of federal funds in suburban Cook County for Homeland Security. C. Sims stated that the committee would oversee the use of federal funds, and nothing more. There was some discussion about the small size of the committee, and C. Sims responded that they would report back to the board. The amendment was passed.

Item 9 , consent calendar, and Item 11, regarding the use of credit cards for bail, were passed. The cost to the county is nil. Items 13 - 15 passed, 16 and 17 were moved to Environmental Control, 26 - 31 were moved to Construction. Three items were withdrawn, and the rest were passed without discussion.

There was a discussion at the end of the meeting regarding the federal employee who is currently in charge of the Juvenile Detention Center, Mr. Delaney. C. Beavers was unreserved and outspoken regarding his disdain for this individual, and said he had asked Judge Evans to "get rid of him". Mr. D., defended himself by saying that all the people he had hired were minorities, although no one had accused him of racism. Mr. Stroger admonished Mr. D. for speaking, saying that this was his turf, and that Mr. D. could not speak. C. Murphy said that the conditions at the detention center had improved vastly under his supervision. The motion passed, and the meeting was adjourned.

Cook County Board Meeting June 1--Two Big Issues

First on the agenda was deciding whether to make the Health and Hospital System (HHS) independent board a permanent one. Although the nurses and SEICU unions spoke against making the board permanently independent, and many commissioners had concerns about the large raises given to administrators of the HHS, this was passed. The vote was 13 in favor, 3 against (Commissioners Beavers, Murphy and Sims) and 1 absent (Comm. Steele).

The next hour of the meeting was taken up by memorials, recognitions, etc. After 12:00 pm, the business portion of the meeting was addressed again.

A resolution to boycott Arizona and its businesses was proposed by Comms. Reyes, Moreno, and Murphy. This was intended as a protest to the new immigration law in Arizona to go into effect later this summer. The discussion among the commissioners was quite heated, with some mentioning that Arizona businesses who employ minorities would be hurt; others mentioned racial profiling; and some that the federal government should be addressing this issue. The boycott resolution passed 10 to 6 with Commissioners Daley, Gorman, Goslin, Peraica, Schneider and Silvestri voting against. Comm. Steele was absent.It should be noted that the resolution as stated in the agenda was not the resolution voted on. A last-minute set of major changes was made and this observer and the others in the audience did not have access to the new wording.

Sometime after this vote, the Board voted to award a red-light camera contract to Arizona-based American Traffic Solutions.

Although the Board meeting continued for a very long time, this observer left at 1:15.