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Cook County Department of Public Health Receives $40.8 Million Grant for Contact Tracing

6/30/2020

Cook County Health (CCH) Board of Directors Meeting - June 26,2020
This meeting was held remotely with audio only available to observer.

Public Comments

An employee stated they did feel they received adequate pay during their course of coronavirus infection.
Other employees said they needed to have more PPE, better staffing and more testing.

Annual Business

Annually a Chair and Vice Chair of the CCH Board of Directors is elected. At this meeting, Hill Hammock was elected as Chair and David Munar was elected as Vice Chair.

Committee Reports

Human Resources reported that hiring has slowed down in 2020 and the time to hire has been slowly decreasing over the past several years and is very close to meeting this goal in 2020.
Managed Care reported that current membership as of June 3, 2020 is 342,196, of which 10.5% are enrolled in CCH clinics. The IL Dept of Health and Family Services' April 2020 data showed that CountyCare had a 31.9% market share of the Managed Medicaid Organizations in Cook County (CC). It was predicted the number of members will increase in July due to the economic downturn, loss of jobs, and CountyCare outreach. People are enrolling in Medicaid in increasing numbers. Medical claims payments have continued to improve with priority payments to safety net hospitals, Federally Qualified Health Centers, and nursing homes. A recently passed Illinois law offers Medicaid to noncitizen seniors (over 65) with income at or under federal poverty level beginning July 1, 2020 when the Illinois FY2021 begins.
With Coronavirus overshadowing healthcare systems over the previous months, routine healthcare visits, elective surgeries are slowly starting to increase. Telehealth visits have played an important role in patient care. The Board approved an extended contract to Res Publica Group, LLC for continued marketing and advertising for CountyCare. Priorities for CountyCare are retaining current membership, recruiting new members and increasing brand awareness for those applying for Medicaid because of job loss.
Quality and Patient Safety is aware of the need to improve patients' willingness to recommend CCH OP clinics, Provident and Stroger hospitals to family members and friends. As a result a Patient Experience Steering Committee was created to improve Patient Satisfaction Scores. It is known that staff communication with patients, frequent rounding/checking in with patients and quiet surroundings rate high.
Finance A grant from the IL Dept of Human Services was approved by the Board to purchase NARCAN, medication for emergency treatment of narcotic overdose, for CCH OP health centers.
Also approved by Board was the $40.8 million Grant given to Cook County Dept Public Health (CCDPH) for Contact Tracing from the IL Dept Public Health. CCDPH provides public health services for suburban Cook County (CC). There was Board discussion on the Contract for the Hektoen Institute for Medical Research as related to the $40.8 Contact Tracing Grant. The contract as presented stated Hektoen would provide services for the Contact Tracing Grant: management, financial duties, hire staff, fill contact tracer positions, and give work to community based organizations outreach efforts. Board discussion of the Hektoen Contract as presented centered on defining Hektoen's role as to the hiring plan, management/staffing, payroll and financial details. It was felt the hiring process needed to hire from communities and minority groups most impacted by Covid-19 and there was a need to have input from CCH and CC human resources and unions regarding hiring. The Board suggested that the Finance Committee call a special meeting to meet with pertinent parties without delay to iron out and finalize the Hektoen Contract and report back to the July Board meeting.

Debra Carey, Interim CEO Report

CCH has adjusted to living with the Coronavirus, "The New Normal".
There is an emphasis on health care at CCH's Cermak Hospital.
Employee guidelines for returning to work are in place for those who worked remotely during the pandemic.
CCDPH has contact tracing plans.
CCH has preparedness plans for a potential resurgence of Covid-19.
Patient income generating visits have dropped off and surgery volumes are down for 2020. Telehealth visits have increased in 2020.
Community in-person events since March have been canceled.

Board Chair Hammock Report

Chair Hammock proposed that the CCH Board of Directors work together to issue a Board Resolution affirming CCH's commitment and work for Health Equity. There was also a suggestion for a new position in the FY2021 budget for a Chief Equity Officer as the health equity gap needed to be closed.
Chair Hammock also felt now was the time for the Board to begin planning and forecasting for the FY2021 budget. Discussions regarding finances included decline in patient revenues and cost saving measures such as renegotiating/putting on hold vendor contracts, reducing overtime and expenses, and decreasing non-union positions.
The growth of CountyCare is a priority for CCH's FY2021 budget. As CountyCare members get rehired into jobs as the economy picks up, membership loss will follow.
Chair Hammock referred to the June 26, 2020 CC FY2021 Preliminary Budget Forecast. President Preckwinkle stated that the projected shortfall in health funds was projected to rise to approximately $187 million. The Board felt that this number did not include the cost saving efforts of CCH.

Items to Watch For in the Future

The Finance Committee's revised contract for Hektoen Institute for Medical Research.
The Board Resolution affirming CCH's work for Health Equity

Observed by: Michele Niccolai Meeting Length: 3 hours

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Will COVID-19 Transform the Cook County Hospital System?

6/5/2020

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Cook County Health (CCH) Board of Directors Meeting - May 29, 2020
Virtual Audio Meeting due to COVID-19 shut down

Public Comment:

Public comment by a series of Hospital employees struck a similar chord: complaints of inadequate supplies of PPE (personal protective equipment), canceling of paid vacation time , refusal to grant “hazard pay” and criticism of temporary health staff hiring to cover COVID care tasks during the ongoing pandemic.
Dr. Fegan responded that there were adequate supplies of PPE from federal stockpiles which were inventoried twice daily. CCH follows CDC and IDPH utilization guidelines for PPE, adding that shoe and hair-covers are not COVID protective and N 95 masks & disposable gowns were designated for use by staff in close patient contact and with aerosolizing procedures. Additional employee education on proper PPE use would be planned.
Director Reiter was assured that canceled vacation time was rescheduled or financially compensated as defined in the union-negotiated employment contracts, and there was daily communication with the union and invited front-line employees.

Board Discussion/Decisions:

Hospital’s CountyCare, Medicaid managed care plan: 326,631 members, largest in Cook County
COVID-19 testing: 7,704; 2,355 positive patients across all CCH locations; CountyCare received 115 claims for in- patient admissions (low number attributed to lag in submission of charges)
COVID financial impact projected through June is a $75-$100 million revenue loss due to 40% decline in charges since March 15, 2020; decreases across all service lines ; plus $10-$15 million of increased costs: supply/equipment/agency temp. staff; and overtime $8-$12 million
Offsetting COVID financial assistance income: $59 million federal distribution for number of COVID positive patients; $11.1 million received to help offset revenue loss (CARES Act); federal reimbursement for testing/treating uninsured COVID patients, $1 million grant pending for telehealth from FCC;
$40 million grant from IDPH for CC Dept. Public Health with plans for 400 contact tracing hires
Discussed: $429 million Cook County awarded from the CARES Act. Hospital system will pursue payment from this grant!
Board voted to transfer a total of $5,339,739 from various accounts to accounts exclusively for COVID expenses under guidance from the County government in anticipation of applying for this CARES Act grant.
COVID net negative impact: income is $36.6 million below budgeted.
Expected rebound in volume of patient charges for CountyCare once the COVID shut down has loosened restrictions, will require provider payments from capitated payments already received, further undermining the financial outlook
Charity care and self-pay volumes and costs are up $18 million over 2019, likely reflecting high unemployment rates due to COVID shut down
Telehealth success: 44,335 telephone visits via the clinic system since COVID March shut down
CCH preparing for post-COVID opening, ramped up drive thru virus testing, Stroger & Provident
COVID containment at Cook County Jail due to ongoing testing of symptomatic, asymptomatic, new admissions to the jail and surveillance testing.
Outreach to COVID high risk members, providing thermometers and pulse oximeters for home self-testing (telehealth); telemonitoring of diabetes, hypertension, via home use glucometers, blood pressure cuffs etc.

Items to Watch for in the Future:

Post-COVID-19 adaptation of the Hospital system to the “New Normal”

Observed by: Susan Kern, MD Meeting Length: 3 hours and 15 minutes

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Cook County Department of Public Health Receives $40.8 Million Grant for Contact Tracing

Will COVID-19 Transform the Cook County Hospital System?

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