2023-25 Cook County Department of Public Health Strategic Plan Presented to Cook County Health Board
Cook County Health (CCH) Board of Directors Meeting
April 28, 2023
CEO Rocha, Chief Operating Officer, Dr. LaMar Hasbrouck and staff presented the Cook County Department of Public Health’s (CCDPH) product from a collaborative and participatory strategic planning effort begun in 2022. The resulting 2023-2025 strategic plan for CCDPH, “Putting the Public in Public Health,” defines CCDPH’s vision, mission, and values. Based on feedback from across a variety of assessments and many facilitated planning sessions and conversations with staff, community partners, and the Strategic Planning Advisory Group, CCDPH identified five strategic pillars where CCDPH must focus its attention to be successful at advancing its vision and mission over the next three years. The foundational pillars are:
CEO Rocha noted that effective Monday, May 15th masks will be strongly recommended but optional for many patients, visitors and staff. Masks will remain a requirement for staff providing direct patient care, entering an occupied patient room or in high-risk areas. Tests and vaccines for COVID will continue to be available at primary care medical homes.
The Community Murals Project unveiled three new murals at Provident Hospital, Blue Island Health Center and the Professional Building on central campus. Paint parties were held where patients, staff and visitors came together to paint sections of the murals.
Human Resources –
What to Watch for in the Future:
Observer - Peg Moster
Cook County Emergency Medicine Residency Program Accepts Top 17 of 1,300 Applicants This Year
Cook County Health Board Meeting
March 31, 2023 Virtual Meeting
Emergency Medicine at Cook County Health remains one of the most competitive physician residency programs nationwide drawing from the brightest graduating medical students. Minority and underrepresented groups account for 16% of the internal medicine residency slots beginning with the 2023 class.
Strengthening the multicultural diversity of primary care physicians (internal medicine, Family Practice) training at Stroger, Provident Hospitals and affiliated clinics is a priority of CCH’s DEI plan (diversity, equity & inclusion) Dr. Claudia Fegan, Chief Medical Officer, expounded.
Items to Watch for in the Future:
Redetermination for CountyCare managed Medicaid plan members is likely to eventuate in decreased plan membership in the June 2023 Managed Care data, noted Aaron Galeener, Chief Administrative Officer for CountyCare.
Observer - Susan Kern
Cook County Health (CCH) Board of Directors Meeting
February 24, 2023
CCH Human Resources’ goal toward maximizing efficiency and decreasing the time in recruitment and hiring receives continuing support from outside consultants.
Human Resources Committee
Managed Care Committee
Items of Interest
Observer - Michele Niccolai
Cook County Health Board Approves Contracts for Continued Reliance on Agency Staffing and Consultants
Cook County Health Board of Directors Meeting
January 27, 2023
New Cook County Health Board Members were approved by the Cook County Board of Commissioners at their meeting on 1/26/2023. The new members are Tanya Sorrell, PhD, PMHNP-BC and Mia Webster Cross, MSN, RN. These new board members have replaced Mike Koetting and Dr Heather Prendergast
CEO Rocha reported that CCH with support from the CCH Foundation has selected local artists to lead mural projects at three health system sites.
Observer: Michele Niccolai
Cook County Health Board Of Directors Meeting
December 9, 2022
Cook County vaccination rates, particularly the 3rd booster is extremely low. Board members stated that the system has an obligation to target communities most in need. Dr. Hasbrouck, Public Health, said that he is building an outreach team to work with providers and to also go into homes. He noted that people are “vaccine tired”. Financial incentives and a mobile vaccine clinic have been initiated. Directors noted that schools should also be targeted. A $700,000 grant was received to raise the vaccination rates.
Finance Committee [based on 9-30-22 reports]. CCH ended the 3rd quarter with a $15.8 M unfavorable balance to budget. On a cash basis, the variance was favorable by $201,000 due to timing of reimbursement rates. Managed Care expenses are higher than budget due to higher membership rates.
During procurement coverage, board members were concerned that the System is paying premium dollars to outside agencies to fill such jobs as janitors from the same local market as CCH is recruiting.
Also under procurement was a new contract for a new service to provide medically tailored meals to patients outside of the hospitals. The Greater Chicago Food Depository and local minority vendors will be used. Director Story asked for an evaluation tool by 2023.
Charity Care reporting now expanded
2021 Actual 2022 Budget 2022 Actual/Projected
Traditional Charity Care $162,626 $152,827 $134,772
Other Uncompensated Care 100,894 109,162 164,595
Cermak & JTDC Health Services 104,465 106,405 106,405
Public Health 16,908 17,763 17,763
Other Public Programs and Services 68,750 66,321 66,321
TOTALS $453,643 $452,478 $489,856
% of Costs 27.9% 36.3% 34.5%
% of Revenues 38.6% 36.3% 41.1%
Managed Care: Membership is at 443,470 which is 32.5% of the total management care population in Cook County. 40,940 or 9.2% use CCH services at Stroger, Provident, or ambulatory clinics. Vaccination rates among managed care members is in line with overall county rates. Seniors lead the numbers at 52%; Adults 26-65 at 26%; Adults 19-25 at 17%; Adolescents 12-18 at 16%, Children 1-11 at 4% [23% for 2nd dose].
Human Resources: Filling nursing positions continues to be a huge challenge. The use of temporary hires was discussed, and Director Koetting noted that over 20% of total employees are out on FMLA at any one time.
Observer: Diane Edmundson Absent Board Members: Deer, Kim, Reiter
Cook County Health (CCH) Board Of Directors Meeting
October 28, 2022
Approximately 4,000 asylum seekers have arrived to date with the majority coming from Venezuela and the balance from other Central American countries. They are residing at 23 locations across Cook County in 12 shelters and 11 hotels. At the peak, there were 109 arriving per day but that is now trending down due to changes in policy at the border. Most of the health screening is routine and outpatient with most common complaints a cough or headache. A telephone triage center staffed by nurses has been established for after hours. A total of 183 Cook County Health staff have provided refugee health care to date. The center is establishing medical homes for the refugees and tracking expenses. A Resolution was introduced and approved to accept donations from individuals who have contacted CCH wishing to contribute a monetary amount in support of the services being rendered by Belmont Cragin to the migrant population.
CEO Israel Rocha, announced a Cook County Health/U. S. Navy Training Partnership centered on the Resuscitative Surgical System (ERSS) which began in October. Navy personnel will train at Stroger Hospital with staff knowledgeable in ERSS. When complete they will return to their assignments and possible deployment.
Due to an outbreak of Ebola in the Sudan, County Health is closely monitoring the situation and clients. Covid-related calls both inbound and outbound have declined as the numbers of Covid patients has decreased. CountyCare is providing rewards to its patients who are getting their Covid shots and boosters.
Provident Hospital is now providing hemodialysis services to serve the population in need of that service.
Dr. Sam Robinson’s appointment to the Board which was deferred at the September meeting has since been approved.
Human Resources: Chief of Human Resources Valerie Amos provided metrics on recruiting indicating 647 positions filled year-to-date at an average of 65 per month. The turnover rate is steady at 9.9%. There have been month over month increases in new hires. Resignations continue to outpace other types of separation i.e. retirements or discharges. Multiple hiring fairs have been conducted and the on-line presence improved for internal and external use.
Audit and Compliance Committee: The schedule of meetings for 2023 was not firm yet. The Committee’s focus is on CountyCare, Community Education and the metrics for CCH and CountyCare. There were no action items.
Quality and Patient Safety Committee: In an update on future directions for Stroger and Provident Hospitals the following initiatives are being pursued: Building Stroger’s Neuro ICU to a Level 1 Neurosciences ICU; Establishing Stroger as a Thrombectomy Capable Stroke Center; and Provident as a Stroke ready or Primary Stroke Center.
Managed Care: CountyCare continues at 32.7% of the Cook Market Share and has increased 7% over the past 12 months -– ahead of the Cook County increase of 4%. Enrollment continues to exceed budget projections. HEDIS rates remain stable.
Finance Committee: On an accrual basis, interim financials show that CCH ended August with a $6.7M positive variance to budget. On a cash basis, the County’s preliminary cash report on revenues and expenses shows a $204.4M positive variance primarily due to the timing difference of CountyCare PMPM payments impacting the revenue and claims payments impacting expenses. Year to date revenues better than Budget due to catch up payments from the State and higher than budgeted CountyCare membership. Other Non-operating Revenue negative variance due to fluctuations in County property tax collection. CountyCare membership remains over 400,000 which is greater than the 381,000 budgeted.
Contracts in excess of $1M were submitted and approved as follows:
Observer: Peg Moster
Individual authors are credited at the end of each report.