Cook County Health Board
Finance and Human Resources Committee Meetings
January 18, 2024
The fiscal year for Cook County Government runs from December 1 to November 30 of the following year. On an accrual basis, interim financials show that CCH end November 2023 with a $362.1M favorable variance to budget. On a cash basis, it showed a $252M favorable balance primarily due to the timing difference in CountyCare’s reimbursements.
2023 Financials Actual Budget
Revenue $4,746 B $3,844 B
Expense 4,528 B 3,992 B
Stroger Hospital Actual Budget
Average daily hospital census 306 267
Emergency room visits 85,843 95,006
Surgeries 11,490 11,436
Average daily hospital census 20 26
Emergency room visits 26,180 29,994
Surgeries 3,442 3,248
ACHN Patient Activity
Primary Care Visits 237,076 281,649
Specialty Care Visits 378,305 274,000
COOK COUNTY HUMAN RESOURCES FISCAYEAR-END SNAPSHOT
Positions Filled 1,359
External Hires 853
TOTAL 562 *
* 9.8% against a national benchmark of 2023
Observer - Diane Edmundson
Cook County Health Board of Directors
Quality & Patient Safety Steering Committee
January 18, 2024 - No meeting this month - report based on dashboard slides
In 2023, data was reported in monthly increments. In 2024 the committee will look at most of the data on rolling 12-months increments to better quantify improvements. Not all data will have this format to start with.
In 2024 control charts have been added for performance monitoring data for many items. Control charts are visual depictions of quantitative data. They can be used for common variation monitoring or new process parameters (good/bad). The new areas of focus are listed below:
Improve % Top Box for Communication with Nursing Domain
Improve HCAHPS Survey Response Return percent
Reduce CLABSI,( central line-associated bloodstream infection ) and
CAUTI (Catheter-Associated Urinary Tract Infection) & CDIF Volume of occurrences
Reduce PSI - Patient Safety Indicator PSI12 Perioperative Pulmonary Embolism or Deep Vein Thrombosis volume of occurrences
Reduce House wide Readmissions all Payors-including patients admitted elsewhere
Reduce timeline of Inpatient Ordered to physician verified (Diagnostic Radiology Orders)
Improve GMLOS (geo-metric mean length of stay) variance
Increase Overall Medical & Surgical CMI
Improve % Top Box for Communication with Nursing Domain
Improve HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems)
Survey Return percent
Improve SEP-1 (Severe Sepsis and Septic Shock Management Bundle) Compliance Rate
Improve HH (hand hygiene) Compliance and coach clinicians where we are not meeting the
Improve LWBS ( left without being seen) Rate
Observer - Lisa Slankard
Cook County Health Board of Commissioners
Managed Care Committee
January 19, 2024
The MANAGED CARE COMMITTEE accepted an emphasis on the expansion of the telehealth service into urgent care by Quarters 3 and 4, 2024. There was no discussion and no details were provided to the committee at the meeting.
Report on CountyCare Health Plan Metrics (in power point slides) was presented and discussed:
ITEMS TO WATCH:
ITEMS OF INTEREST:
ITEMS PROMPTING THE MOST DISCUSSION
Observer - Victoria L Cerinich
Cook County Health (CCH) Board of Directors Meeting
January 18, 2024
Tom Nutter MD, CCH Chief Behavioral Health Officer, talked about the newly formed CCH Office of Behavioral Health (BH) and the upcoming Cook County (CC) Behavioral Health Summit on February 15, 2024. Invitations have been extended county-wide to mental health and addiction disorder colleagues to convene together. The emphasis will be listening sessions from all stakeholders to get feedback on issues such as inequities in BH care, the need for improved BH care and need for increased access to BH care. This summit will help to develop a CC Behavioral Health Strategic Plan. There will be upcoming community-based funding opportunities from CC government because of the American Rescue Plan. The Summit’s listening sessions will also help with guidance for awarding future Behavioral Health grants. March 6, 2024 will be the date to submit requests for grant funding proposals.
The CCH Board approved a Memorandum of Understanding to be a member of the new corporation, West Side United Not-For-Profit. Launched in 2018, West Side United is an organization initiated by West Side Health Care Institutions (including CCH), whose main goal is to close the life expectancy gap in the west side diverse neighborhoods of Chicago where there is a high level of poverty. People in these neighborhoods experience barriers to health and wellness because of education inequities, employment, access to healthy food, safe housing, violence, transportation issues and access to banking. The founding West Side Health Care Institutions determined that a not-for-profit corporation was needed.
The CCH’s Patient Bill of Rights & Responsibilities document includes the right to provide “interpreter services, free of charge, including sign language” and information written in other languages. Two contracts were extended by board approval for phone interpretation, document translation and interpreting services by video remote.
Observed by Michele Niccolai
Cook County Health Board of Directors Meeting
October 27, 2023 Virtual and in person meeting- observed virtually
Human Resources Committee Report
Carrie Pramuk-Volk, now the Interim Chief Human Resources Officer, reported on the continued positive hiring and retention metrics. For fiscal year 2023 there have been 1146 hires who have started. In 2022 there were 497 and in 2021 there were 562. Turnover rate continues to drop from a high of 11.4% in 2022 to the current rate of 8.4%, which is well under the national benchmark. The accelerated nursing hiring program has resulted in 195 job offers with 120 of them being accepted.
Cook County Department of Public Health Report
Amy O’Rourke and Dr Hasbrouk from Cook County Department of Public Health reported on the Good Food Purchasing Program (GFPP). The GFPP was started to address food disparity in health and wealth. Cook County is the third local government to sign on to this program. Los Angeles did in 2012, Chicago in 2017 and Cook County in 2018. Currently there are 57 institutions and 24 cities participating nationally. GFPP encourages County-run institutions to shift their food spend toward five core values: local, healthy, humane, sustainable, and equitably-produced food.
GFPP implementation is underway and initial investments have been made in local food producers. The 2023 Good Food Purchasing Initiative (GFPI) Community Fund awardees will be announced by the beginning of FY24.
The 19th Annual Chicago Food Justice Summit will be held in early FY24.
GFPP Program Update
Other Committee Reports:
The Audit and Compliance, Finance, Managed Care, QPC committees met in October and their minutes were approved with minimal discussion. The CEO reported on the strategic initiative results and the numerous awards won by employees.
The meeting went into closed session and reconvened on October 31 to give the news that CEO Rocha has resigned as of Dec 1, 2023.
Items to Watch for in the Future: New CEO search
Observed By: Lisa Slankard
Cook County Health Board of Director's Meeting
September 29, 2023 Virtual and In-person Meeting
CEO Israel Rocha, Chief Operating Officer, and staff presented departmental metrics and a third quarter update to Strategic Initiatives for the Cook County Department of Public Health. The Strategic Plan for 2023-2025 was introduced in April 2023 and critical ones were included in each area’s Metrics Review.
Highlighted in CEO Rocha’s presentation to the Board was an update by Dr. Urjeet Patel, Interim Medical Director of the CCH Cancer Center, on the Cancer Center Service Line. The presentation reflected incorporation of the Strategic Initiatives introduced earlier in the year. With a Mission to provide the highest quality, integrated care across the cancer care continuum for the community served; to create a comprehensive cancer institute through clinical and operational leadership alignment to serve as a fundamental pillar of the Change Institute of Cook County Health with health equity, state of the art care, patient safety, clinical excellence, and patient-centered experience. The six areas identified to incorporate the Cancer Care Continuum were:
Director Reiter talked of a future plan for a master RFP process where all 3 contracts will be consolidated into one contract. Ms. Amos expressed concern that without this plan, CCH Human Resources will be unable to maintain the recruiting activity needed for the Health System.
CEO Rocha also noted that CCH’s Stroger Hospital has been named the #1 most racially inclusive hospital in Illinois and #2 most racially inclusive hospital in the nation by the Lown Institute Hospitals Index. Cermak Health Services earned accreditation by the National Commission on Correctional Health Care (NCCHC).
What to Watch for in the Future:
A description of how the plan mentioned by Director Reiter for a master RFP process would work and whether it would address the issue of multiple contracts targeting one initiative.
Observers: Peg Moster and Susan Avila – Finance Report
Individual authors are credited at the end of each report.