Cook County Health (CCH) Board of Directors Meeting 
May 27, 2022

During Public Comments, eight nurses and nurse representatives reacted to the Cook County Commissioners 10% pay raise approved by the CC Board earlier in May.  The comments were pointed and the tone angry. For two months nurses have been asking for a $5.00 per hour increase as Retention Compensation for their work and their loyalty over the past two years of the COVID pandemic, noting that the System is hiring contract nurses at much higher pay. They are also unhappy that they must use personal sick pay for personal COVID absences.

Having been discussed at several previous meetings, the proposed 2023-25 Strategic Plan was approved by the board with little comment.  The Theme for the next three years is:  Impact, Change, Equity. Strategic Planning Officer, Andrea Gibson, noted that the data table will now include the years 2019-21 and also stated that Disability Access has been moved to a higher priority based upon public feedback.  With approval, the next steps include developing detailed work plans and integrating them into a three-year budget.  Chair Taylor commended the process and said it is a very good framework to deliver quality care over the next three years.

Committee Reports:

• Finance:  Through March,  the System reported a $1.2 million positive variance to budget partly due to lower than budgeted Surgical and OP volumes and lower than budgeted CountyCare claims expense.  CountyCare showed an operating gain of $10 million.   Chair Reiter reported that Deloitte Consulting has been hired to reduce reliance on sole-source contracts by looking at and recommending better time-line planning; and if needed, a restructure of the procurement department. 
• Managed Care:  As of May 6, CountyCare membership was at 434,021 of which 10.3% or 44,704 use Cook County Health services.  The Plan continues to have the largest membership in Cook County at 32.5%.  Second on the list of six is Blue Cross Blue Shield with 25.7% or 336,328.  Fifty percent of CountyCare members are fully vaccinated.  Recognizing the difficulty of increasing this metric, Director Koetting stressed the importance of continued efforts.  
• Quality & Patient Safety:  62.4% of patients recommend Stroger Hospital against a target rate of 71.1%. Readmission rates for the hospital were at 8.75% in January of 2022 against a 9.93% target.
• Human Resources:   The Department is now keeping metrics on its optimization strategy to improve and accelerate the hiring process.  Its monthly report stated that CCH must hire over 2,000 new employees – yet the current hiring process takes an average of 4-6 months per position.  HR has secured four consulting partners to streamline the HR processes and technology.  One of the partners, Incredible Health, has been hired for immediate nurse recruitment.
• Public Health:  HUD provided a grant for CC Public Health to begin work on 9 housing units in April; and the Epidemiology Unit will launch the CC Health Atlas Website for the public by the end of May.

 
Observer:  Diane Edmundson 

Cook County Health (CCH) Board of Directors Meeting
June 24, 2022

Board Report Highlights:

• Board Chair Rocha reported 15 confirmed cases of the viral disease monkeypox in Illinois. CCH and CCDPH are monitoring the situation. Dr. Wellbell is leading the operation. Historically monkeypox has not been fatal in the US and not expected to spread widely. CCH is prepared to diagnosis and immunize.  Priority will be given to those considered high-risk; the vaccine is limited. Director Harrington stressed the importance of messaging and the limitations of vaccines.
• COVID Mortality Rate is at a record low. CCH will provide vaccination for children under five next week. Chairman Reiter questioned whether CDC has guidance on second boosters for those under 50 years and 6 months out from first boost, with high risk for pre-exposure or post exposure, and rebound cases. Rebound cases have different isolation periods. To date, CDC has not provided additional information. The boosters need to be toward omicron variant.
• The Department participated in City of Chicago and Human Resources public safety training, including, Full-Scale Disaster Response Training and Stop the Bleed, a national prevention program.  STOP the Bleed offered Training to NPF organizations, individuals, first responders, and elected officials on how to stop a bleed from gun violence. In a separate event, CEO Rocha joined President Preckwinkle, and Senator Durbin, held a press conference to advocate for gun reform.

Human Resources Report:

• Metrics Review reported separations, 265 resignations, exceed new hires (43 monthly hires), and current vacancies of 263. The strategic plan is to use modernized technology, contemporary practices and external partners in recruitment and retention. Director Harrington commented that COVID impacted the dynamics of care and staffing. 
  
• The department plans to target staffing at Providence and Stroger first. Resources and outside partners are driving force for virtual job fairs and having timely information from a nursing data base. Dr. Hasbrouck asked if salary surveys had been conducted. Plans to review RFPs will address CCH competitiveness and salaries.
• Recruiting and staffing are streamed lined through Brazen Online Platform, Solum, and Incredible Health and launching a Key Hiring Metrics Dashboard improves real time decision making and information.

Managed Care Report:

• Membership increased to 436,000, Managed Medicaid Market is at 32.5, Trends versus CC Market overall up 5% and CC up 8%. Membership versus budget; CCH Continues to exceed budget by a significant margin; it is driven by PHE’s redetermination 50% auto assignment.
• Operations show steady performance and IP Acute Admits. Vaccination rates increased to 56-57%. Claims payment is less than 11 million for claims over 30 days.
• Director Story raised a discussion about the impact of re-determination on the budget and Domestic Spend. CCH is financially stable, due in part to the extended Public Health Emergency Period.  PHE is expected to continue through October (CMS will issue a 60-day notice).  Domestic spend, CCH has seen stable utilization of facilities and planning initiatives to increase utilization. More Care expected to end this December and planning the transition process.

Observer: Gwendolyn Maxie-Brown