Cook County Health Board of Directors Meeting –
December 17, 2021

Human Resources:

• The Human Resources (HR) department is down to four recruiters from nine in 2020.  To help with the backlog, it hired contracted recruiters.  In January 2022, four agency recruiters will start and four former recruiters will come on board in a part-time capacity.  
• Strategic plans for 2022 include hiring a consultant to help overhaul the entire hiring process and also to help answer the question:  “how do we rebrand ourselves” to be more competitive in a very competitive health hiring market.

Human Resources Metrics

• Turnover of 10% to date is higher than normal, particularly in nursing.  Covid a factor
• To date, 614 positions filled:  453 external hires, 76 promotions, and 85 transfers.
• Avg time to fill a vacancy continues at 105 days.
• Separations to date total 653:  215 Retirements, 396 Resignations, Discharges 42.  

Managed Care

• Membership is now at 422,266 - 10% of which are Ambulatory Care Center members. Number expected to drop mid-2022 due to state reactivating the assignment process which was halted during 2020-21 Covid. 
• 42% of the Plan’s membership have had at least 1 dose of the Covid vaccine. This number includes 5 year olds and up.  36% are fully vaccinated as of 12/3/21.
• A 2022 Strategic Price Increase will focus on room & board which is approximately 55% below market and the surgery rate which is approximately 78% below market.
• Medicare membership revenue of $13,044 continues to lag well behind budget of $30,974.  

Quality & Patient Care

• The 30-day readmission rate is to up 10.78% against a goal of 9.93%.
• There was a significant drop in the “Recommend the Hospital” index from 87.91% in May to 63.16% driven by scores for cleanliness, nurses treating patients with respect, and buzzer response.
• The committee is reviewing its dashboard process for metrics and said it may present a new format in 2022.

Finance Committee

• On an accrual basis as of October 31, CCH shows a $12 M positive variance.  On a cash basis,$40 M.  This is partially due to a slowdown in CountyCare utilization of CCH facilities.
• County Care membership 414,000 as of October 31, 2021 with an operational gain of $10 M.  Both revenues and expenses are higher due to membership growth.
• The quality and quantity of patient TV use was discussed - particularly education and/or training programs.  This could be an area for savings.
• Primary Care and ER revenues are below budgeted expectations.
• The $10 cash payment required for charity care services was eliminated in 2021.

CEO Report:
Last month, CEO Rocha reported that moving forward, divisional updates will be provided to ensure that the CCH Board of Directors “has a deeper understanding of operational successes, opportunities and challenges”.   Areas to be covered include: Stroger Hospital, Correctional Health, Provident Hospital, Public Health, Ambulatory Care, Cook County Health Plan Services, Administrative [regulatory, legislative, strategic initiatives, etc.]

Highlights for this month include:
Provident Hospital:  

• Completed ICU monitor installation.  ICU beds delivered and nursing station construction is completed.
• Funding identified for new phlebotomy chairs, lab chairs, and updated refrigeration.
• Phase 2 Ambulatory Bay renovation work to begin in December.
• Installation of MRI scanner has begun in the new and enhanced diagnostic imaging center.
• Developing a plan to increase dialysis volumes.

Ambulatory

• YTD primary care volume is tracking with budget. Specialty care continues to lag.
• Working on year-end push to increase mammograms, eye, and colorectal screenings among managed care patients.
• Increasing scrutiny of the specialty schedules to understand which are underutilized and re-appropriate them to needed areas.

Note:  All of these reports can be found HERE.

Observer:  Diane Edmundson

Cook County Health Board of Directors Meeting
November 19, 2021

CCH Board President, Lyndon Taylor, announced that the board will no longer hear reports from the various committee meetings.  Instead, if a committee has held a meeting since the last Board meeting, the committee chair will highlight important issues and ask if there are questions.  If a committee has not met, it will make a presentation to the board members.  All committee minutes will be voted on at one time. 
 
CEO Rocha reported that moving forward, divisional updates will be provided to ensure that the CCH Board of Directors “has a deeper understanding of operational successes, opportunities and challenges.”   Areas to be covered include:
 
. Stroger Hospital                                                                            . Correctional Health
. Provident Hospital                                                                       . Public Health
. Ambulatory Care                                                                           . Cook County Health Plan Services
                            Administrative [regulatory, legislative, strategic initiatives, etc.]
 
Rocha also stated that his monthly reports will include strategic highlights and that 95% of the System’s employees are fully vaccinated and 98% have had at least 1 dose.
 
Human Resources

• Turnover of 10% to date is higher than normal, particularly in nursing.  Covid a factor
• 1,035 positions are open
• Average time to fill a vacancy is 105 days
• Contract staff still needed to support the HR team – it is also needed to fill nursing and other vacancies
• Although a new effort, job fairs are helping to identify candidates – finding qualified nurses is critical

 
Managed Care

• County Care has proposed a Medicaid/Medicare Plan to capture Medicaid patients who will soon turn 65 and be eligible for Medicare.  This will require investment and increased cost as the System will need to increase its capacity to serve geriatric patients including pharmacy needs
• The Cook County Budget was amended to include $30 million to establish reserves

 
Finance Committee

• On accrual basis as of September 30, System shows a $42 M positive variance.  On a cash basis $97 M. 
• County Care membership 410,000 as of Sept. 30, 2021 with an operational gain of $9 M.  Both revenues and expenses are higher due to membership growth.
•  2021 savings from contract re-negotiations:  Goal $16.5 M    To date: $12.2

 
Public Health

• Every 5 years Illinois state law requires certified local health departments to complete an assessment of community health needs.  Cook County calls theirs “We Plan 2025”.  Dr. Joshi presented the Cook County Department of Public Health’s Plan which was very thorough.  Director Koetting cautioned that there can be a risk of getting outside of the control of the Public Health Department – he said to be realistic vs theoretical on how people actually “get access to health care needs”

 
Note:  All of these reports can be found on www.cookcountyhealth.org
Observer:  Diane Edmundson