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
Cook County Health Board of Directors Meeting
September 24, 2021
Human Resources Committee
Separations are outpacing hires. There was a net of 91 fewer employees this past quarter. Resignations lead the separations. There is an 8% turnover rate, up 7% over the 3rd quarter last year. Unfortunately HR is understaffed so hiring has slowed and average time to fill positions is up. The market is very competitive right now.
Managed Care Committee
Membership numbers continue to increase and are up 10% over prior year. September 18, 2020 there were 371,248 members and September 9, 2021 there were 411,664 members. County Care’s market share increased to 10.7%, a slight increase from 10.5% a year earlier. The membership numbers are over budget in part due to paused redetermination. The call center and encounter rates have worsened. Claim’s payments have improved.
Quality and Patient Services Committee
Quality metrics are mostly unchanged except HbA1C indicator which is down to 66.7% (lower is better) toward a goal of 24% in outpatients. At the start of the year it hovered near 90%.
The agenda item receiving the most engagement from the board involved the 32 million dollar contract request for MHN ACO LLC. There is a contract already in place but an extra 32 million dollars is needed to be paid to finish off the contract which expires at the end of December 2021. This provider covers care coordination for County Care subscribers. The increase is primarily due to the increase in subscribers. There was a lot of discussion on getting bids for this contract. County Care has not started the bid process even though the contract only has 3 months left. The board was concerned that the time left was inadequate and they offered help in getting this done. CEO Rocha will work with the managed care committee on a timeline for a request for proposal for next year's contract. It was pointed out that the current company is a high performance vendor.
There was a transfer of 14 million dollars from salaries to Registry help and Human Resources.
All employees must be vaccinated by October 1. So far 83% are fully vaccinated with 92% having started the vaccine series. The hospital is making vaccinations available around the clock and are holding town halls to answer questions. Also, they are working with the unions. The gap on vaccination rates by race has decreased
Items to Watch for in the Future:
Observed by: Lisa Slankard Meeting Length: 2 ¾ hrs
Cook County Health (CCH) Board of Directors Meeting
October 25, 2019
CEO Dr. Jay Shannon summarized recent Cook County Health (CCH) positive developments:
But CCH faces serious funding challenges: it is $30m over budget in charity care despite $25m in new revenue this year. In 2020 CCH anticipates providing $590m in uncompensated care, for which the only designated funding sources are the federal DSH ($157m) and BIPA ($132m) allocations. The demand for charity care has grown by $100m since 2017. CCH is now providing about 60% of all charity care in Cook County. Of Stroger Hospital’s total patients, 47% are on Medicaid, 15% Medicare, 5% insured, and 35% uninsured. The possible solutions to the funding gap do not inspire hope: more state and federal funding, possibly County funding from a sales tax.
Significant contract awards:
Observed by: Linda Christianson Meeting Length: 3 hours
Cook County Health and Hospitals System (CCHHS) Board Meeting - March 29, 2018
What did the Board decide?
What else did the Board discuss or refer to committee?
Unexpected Votes, Events, Testimony or Items to Watch for in the Future:
Any Other Comments or Observations:
Observer - Linda Christianson Meeting Length 2.5 hours
Cook County Health & Hospital Systems (CCHHS) Board Meeting - March 2, 2018
What did the Board Decide?
What did the Board Discuss?
Items to Watch For in the Future
Observers - Susan Kern, MD & Michele Niccolai Meeting Length: 3 hours
Cook County Health & Hospital Systems (CCHHS) Board Meeting - May 26, 2017
Significant Decisions Made:
Significant Topics Discussed:
Items to Watch in the Future:
Observers: Diane Edmundson, Bill Edmundson Meeting Length - 2 1/2 hours
Individual authors are credited at the end of each report.