COOK COUNTY Health and Hospital System Finance Committee Meeting August 24, 2012

The meeting was called to order by Chairwoman Heather O’Donnell at 9 a.m. George Blakemore for Clean Government, spoke on the need for transparency in government contracts.  Lionel Saffold, SEIU (Service Employees International Union) Local 1, spoke on the need to hire responsible contractors who pay workers according to the contracts.

Four contracts were brought up for approval: 1) an increase to the budget for hiring extra nurses through a nursing agency, 2) a contract to GE Medical Systems for bedside monitors, 3) a contract to Simplex-Grinnell for hospital emergency fire equipment which would result in 18% savings over the previous contract, and 4) a contract with Health Record Solutions.  Board members posed questions on the need for using a nursing agency.  All contracts were approved by the board.  

The Financial Reports through July 31^st were presented by Dorothy Loving, Executive Director of Finance.  It was noted that the number of days of outstanding revenue had decreased since the winter months.  Budget deficits have also decreased compared to the same month in 2011 due to Retroactive Payments moving faster.  After listening to questions and answers, Chairwoman O’Donnell suggested that a training program giving a broad overview of the budget would be helpful for new board members.   The Financial reports were unanimously approved.

Dr. Raju presented the preliminary 2013 CCHHS Budget.  Discussion would be held immediately and the vote deferred to September 5 at a meeting of the entire board.  Dr. Raju said during past years, quality of care was separated from patient satisfaction, but now they plan to work on equating these two factors.  2013 revenue is based on payer mix by surgical procedure.  He said the new budget does not project a higher volume, and that HHSSC has been proactive on the 1115 Waiver for early enrollment by already enrolling 60,000 patients of the 115,000 they expect to enroll and follow through 2014.  As CCHHS does not currently have the ability to track and document  individual costs per patient, Chairman O’Donnell noted the 1115 Waiver gives the County the incentive to do so.

Continuing with the 2013 Budget overview Dr. Raju noted that expenses associated with Oak Forest were moved to Stroger Hospital, and the revenue from Oak Forest Hospital is now credited to Stroger Hospital and ACHN (clinics).  Supply chain savings are expected to be $25 million.  Vacant positions in the system continue to be a problem.  Currently there are 382 positions in the pipeline.  The 2013 budget also allocates an additional $8 million for more information systems.  Chairman O’Donnell asked for monthly reports on the supply chain purchases, waiver implementation with early enrollment, and meaningful use.

2013 Budget hearings will be held on August 28, August 30, and September 4.  The board meeting was adjourned at 10:20 a.m..

 
--Submitted by Eleanor Prince, League Observer     

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

Forest Preserve Commission Mtg July 11 2012

The meeting started at 10:15 and after the invocation, 16 Environmental interns were introduced.  They were chosen in a competitive process from 169 applicants and have been working on a wide variety of projects, including media relations, trail linkage planning, program development and financial projections. 

It was noted that taxes are coming in as expected.  This is noteworthy given that is is different from past years where real estate bills were delayed and thus were revenues delayed. 

A resolution was passed to make an application for an OSLAD grant (Open Space Land Acqusition and Development, a state-financed program).  The purpose would be to acquire the 28 acre Powderhorn Lake in the Calumet region.  This is consistent with the proposed strategies in the current budget - and would require matching funds from the Forest Preserve if  it is awarded.

The Oak Forest Preserve Master Plan was submitted --  for 175 acres of land, which was acquired in 2010 by the FPDCC and which is adjacent to current Forest Preserve land.  This is again consistent with strategies outlined by President Preckwinkle to enhance the mission of the FPCC though thoughtful development of underutilized land.  Oak Forest has a long history including Native American Settlement and other amenities which are acknowledged and embraced in this plan.

An intergovernmental agreement (IGA) with IDNR was also discussed.  It allows for the removal of 5 dams on the Des Plaines river and 2 on the North Branch.  These dams are old, unneeded and hinder the free movement of fish.

The meeting ended about 11:20.

Health and Hospitals System Board Meeting June 29, 2012

The meeting was called to order at 7:40 a.m. by Chairman Batts and lasted two hours, until 9:40 a.m. before going into closed session to consider Human Resources concerns.  The main focus of the meeting was to acknowledge the contributions of the outgoing board members and to welcome the incoming members.

Cook County Board President Toni Preckwinkle expressed thanks to those leaving, particularly to Chairman Warren Batts for bringing in Dr. Ram Raju; Ruth Rothstein, Sister Sheila Lyne, Dr. David Ansell, and Benn Greenspan.  Dr. Raju spoke of the committee’s beginning in June 2008 with early meetings, evenings, town hall meetings, working with no “playbook”, laying the foundation for healthcare in Cook County, and commended all members for their hard, successful work. 

Additional commendations and thanks were presented by Kevin Scanlon, president of the Metropolitan Chicago Healthcare Council; Dr. David Goldberg, president of the medical staff at Stroger Hospital; Dr. Larry Goodman of Rush/Pres. St. Lukes; commissioner Jerry Butler; former CCHHS chairman William Foley; acting chairman Jorge Ramirez; committee members Munoz, Goldman, O’Donnell, and Carvalho; outgoing Chairman Warren Batts; and nominating committee member Lawrence Msall, President of the Civic Federation. Resolutions honoring Warren Batts, Dr. David Ansell, Benn Greenspan PhD, Sister Sheila Lyne, and Ruth Rothstein were approved.

New members Edward Michael, executive vice president of diagnostics at Abbott Laboratories (one-year term); Doreen Wiese, president of the American Indian Association of Illinois; and Carmen Valasquez, executive director of Alivio Medical Center, were introduced.  New member Rev. Calvin Morris, executive director of the Community Renewal Society, was not in attendance.

Two mental health workers from Cermak Clinic expressed concern that applications for continuing education have yet to be accepted.  They proposed that continuing education for current mental health workers be optional.  Drs. Ramirez and Munoz will meet to consider this request.

Quinn Golden will serve as interim Chair of the Human Resources Committee, Jerry Butler as interim chair of Patient Quality and Safety.  Attorney Helen Hayes proposed that cost items of $150k or more go to the board in a package to present early in the fiscal year, so the board may have an overview of providers and approximate costs.

John Morales, CFO of Stroger Hospital, proposed that Cook County/CCHHS lease property at 600 S. Hoyne to accommodate 38 staff to register and process new Medicaid recipients. Randall Mark, CCHHS Director of Intergovernmental Affairs and Policy, clarified that the county, not the state, will bear any cost for implementing the Medicaid waiver program.

Warren Batts cautioned that though the news of the Healthcare bill is good, we must bring costs under control: “Greece is in better shape than we are.”

Linda Christianson

LWVCC Observer