Cook County Health (CCH) Board of Directors Meeting
July 31, 2020
Meeting was held remotely with audio only available for observer
Human Resources Committee reported that it took 90 days on average to hire, from the time of initial job posting to hiring. CCH's Employment Plan brought CCH into compliance with the Shakman decrees, Federal court orders, which prohibit political influence into the employment process, but adds steps to the hiring process. It was suggested that hiring steps be broken down to see if there could be improvement in hiring time and to compare the hiring time of CCH to other Chicago hospital systems. A request for the diversity breakdown of nurses was requested. Almost half of nurses are African American; Asian and White each make up about
one-fifth of nurses. HR actively recruits bilingual staff and reaches out to local groups and universities.
Managed Care Committee reported that as of July 2, 2020 CountyCare membership was 364,973 with 10.5% of these members using CCH clinics. July 2, 2020 numbers are an increase over June 3, 2020 numbers. August membership numbers are projected to be around 369,000 due to increased Medicaid members and IL Healthcare and Family Services (HFS) temporarily stopping the redetermination process during the Covid-19 crisis. HFS's May data showed CountyCare had a 31.9% share of the Cook County Medicaid market. At some future point HFS will startup the redetermination process again and Medicaid numbers will decline. During Covid-19 pandemic, CountyCare patients are getting care along with food, transportation, specialty care. James Kiamos, CEO Health Plan Services, is leaving CCH and this is his last report.
Quality and Patient Safety Committee presented a new Quality Dashboard, specific graphs with reference targets for data collection and monitoring. This dashboard now contains categories at CCH that need to be improved in the CMS Star Rating reports. These CMS reports let consumers compare hospitals based on quality ratings. An important area for CCH is clinical documentation to accurately record a patient's problems such as homelessness and other insecurities/illness/case complexity so as to get properly reimbursed for that patient's care. In the LOWN Institute Hospital Index, Stroger Hospital rated very high in Civic Leadership, Value of Care, and Patient Safety.
Report from Debra Carey, Interim CEO:
Items to Watch For in the Future:
Observed by: Michele Niccolai Meeting Length: 3 hour
*Link to the CCH Statement on Health Equity approved by the Board of Directors
Cook County Health (CCH) Board of Directors Meeting - June 26,2020
This meeting was held remotely with audio only available to observer.
Items to Watch For in the Future
Observed by: Michele Niccolai Meeting Length: 3 hours
Cook County Health (CCH) Board of Directors Meeting - May 29, 2020
Virtual Audio Meeting due to COVID-19 shut down
Items to Watch for in the Future:
Observed by: Susan Kern, MD Meeting Length: 3 hours and 15 minutes
Cook County Health (CCH) Board Meeting - February 28, 2020
Board Reports and Discussion:
West Side United presented an overview of their plans. Six hospitals on the west side have joined together to address social determinants of health. The life expectancy on the west side is 16 years shorter than in the Loop that is just a couple miles away. They hope to halve the difference by 2030. They just completed a 1000-day plan and will be starting the next 1000-day strategic plan. They are convening with the community on March 5, 2020.
Dr. Sharon Welbel, epidemiologist at Stroger and Dr. Kiran Joshi of CC department of public health presented a COVID-19 update. Cook County has testing capabilities and does not need to use CDC kits. CCH has been actively preparing for an influx of cases and have implemented a rapid identification plan and set aside 2 ER rooms for suspected COVID-19 cases that are not in proximity to other rooms. Over 1000 healthcare workers have already been trained.
Board President Hammock report:
Items to Watch for in the Future:
Observer- Lisa Slankard Meeting Length: 2 hours 40 minutes then meeting went to closed session
Cook County Health (CCH) Board Meeting
January 31, 2020
Reports to the Board:
The Cook County Department of Public Health (CCDPH) - is at the command center for Chicago's coronavirus case, along with the Illinois State Department of Public Health and the Centers for Disease Control. The CCDPH website has links for coronavirus and flu information. Cook County Health has been screening for coronavirus. CCDPH also presented their 2019 Quality Improvement Projects. These projects result from Planning, Testing, Study, Implementation. The goal of planning is to understand and analyze a problem, potential solutions are pilot tested, afterward studied/evaluated, then the new process is implemented.
The 2019 CCDPH Quality Projects are:
Human Resources - starting out 2020 with approximately 526 vacant positions with 308 positions in the hiring process. They have a Position Control Committee that receives requests to hire. These requests must meet patient safety and quality standards, regulatory requirements, need to generate revenue and reduce expenses. If a position is approved by this committee, it goes for budget approval and then is posted on Taleo (the county's on line application site).
CountyCare - as of 1/2/2020 has 318,000 members, 10.6% of members using CCH clinics. Next Level Health, a Managed Care Organization (MCO) only available in Cook County, was recently purchased by Molina Healthcare. Molina is increasing its presence in the county. Over the past year, CountyCare membership has held steady with its 31.5% of total CC Medicaid members. In 2019 there has been an overall drop in total Medicaid members, and CountyCare membership has followed this trend. Auto-assignment of Medicaid enrollees into MCO health plans happens when a member does not choose a health plan/primary physician within the specified time. CountyCare auto-assignment has been increased from 35% to 50% starting April 1, 2020 and is open-ended. This increase is a result of CountyCare's innovations, quality and housing program. The 2020 projected enrollment is 326,000 members.
Quality and Patient Safety Committee - reports good results at the end of 2019 for decreased hospital acquired pressure injuries due to a focused nursing campaign. The aim is to sustain this decreased number with continuing preventive measures.
Observed by Michele Niccolai Meeting Length: 2 hours and 30 minutes
Cook County Health Board Meeting - December 20, 2019
Following up on the 2020 budget deliberations and the very real issue of the increased cost for charity care, Dr. Shannon, presiding at his final board meeting before leaving the system, led a discussion on “self-pay” and how other major public hospitals across the country handle it.
For purposes of discussion, self-pay is used in place of charity care. There was a 17% increase in year-over-year charges from FY 2018 to 2019 from $158 million to $185 million. The percentage of self-pay was 1.2% in 2018 but dropped to .4% in 2019. The largest service increases are: Radiation Therapy [75%], Family Practice [50%], Gynecology [33%] and Surgery [29%].
Comparisons of NY Health & Hospitals; Jackson Memorial [N. Texas & Oklahoma]; Parkland [Dallas]; and Grady [Atlanta]; self-pay plans were passed to the Board and include:
2. Kiosks with payment options
3. Training staff to collect/swipe cash or credit/debit cards
This would be a major change in policy for CCH as well as culture. Several board members questioned whether the County Commissioners and President would accept this concept. President Hammock responded that the System should provide an analysis and recommendations so that both it and the County elected officials have a base to work from including possibly deciding to provide more revenue to CCH to handle charity care.
Laurence Msall, President of the Civic Federation stated in public comments “The Civic Federation remains adamant in our support of this [volunteer] board…..” He also recommended that the System steer clear of initiatives that do not fit with its core strategy, but did not state what they might be.
Observer - Diane Edmundson Meeting Length: 2 ½ Hrs.
Individual authors are credited at the end of each report.