Cook County Health Board Meeting -  February 28, 2019 

What did the Board Discuss:

• The first Cook County Health (CCH) Research and Innovation Summit was held February 20, 2019 on the topic of opioids. More than 120 individuals attended. This summit was designed to share CCH's efforts and plans to address the opioid epidemic with other established interest groups and included action planning with health and community leaders.
• County Care managed care members as of February 7, 2019: 320,994 of which 13.7% are using CCH services. These latest numbers are down 10% from the same time last year. The target for 2019 membership is 345,000. Annual redetermination of Medicaid members is a review of their eligibility for Medicaid and requires submission of redetermination forms in a timely manner. Now an automated system drops individuals from Medicaid rolls if the forms are not completed on time. If dropped, the individual looses continuity with their Primary Care Provider and case managers. In order to keep its members, County Care offers to help with the redetermination process. County Care has raised concerns about this process with Governor Pritzker.
• FY 2019 CCH system wide uninsured numbers captured by visit is 44%. The FY 2018 uninsured numbers were 42%. There is a need to get details of these uninsured to see if some are eligible for Medicaid, then assist them in enrollment.
• Governor Pritzker announced that Dr Ngozi Ezike was appointed Director of the Illinois Department of Public Health (requires state Senate approval). She served for more than 15 years at CCH and most recently served as a physician at the Juvenile Temporary Detention Center.
• The Cook County Department of Public Health (CCDPH) has a tobacco prevention and control unit and its goal is to eliminate exposure to secondhand smoke, promote quitting, and prevention of youth smoking. In Suburban Cook County, 16.7% of adults are current smokers. E-cigarettes are currently the most used tobacco product among youths and its use in this group has increased last year. E-cigarette liquid contains chemicals and carcinogens and this liquid can poison children through ingestion or skin absorption.
• It was announced that there would be no election of the CCH Board Vice-Chairman at this meeting.

Board Decision:

• A contract with the Bobby E. Wright Comprehensive Behavioral Health for mobile crisis outreach team. This is a nonprofit on Chicago's Westside that provides mental healthcare, addiction treatment and developmental disability services.

​Items to watch for:

• The final audit of FY2018 in May 2019
• The second CCH Research and Innovation Summit to be held May 22, 2019 on the topic of housing.

 Observed by: Michele Niccolai                                                     Meeting Length: 2 hours 30 minutes

CCHHS Board Meeting - January 29, 2016

Topics Discussed:
Patient Satisfaction at Stroger Hospital:  After one year of data keeping there has been no improvement as indicated in the latest metrics.  Chief Quality Officer Dr. Krishna Das attributed the problem to perceived wait times and cleanliness as key issues. Dr. Das and CEO Dr. Jay Shannon stressed the importance of educating managers to understand the critical link between service quality and patient retention.

Emergency Room Visits: CountyCare 2015 data reveal only a minimal decline in Emergency Room visits from the same period in 2014. County Care was intended to provide a "medical home" for patients to receive care so as to decrease the need for Emergency Room care. Reasons for the minimal decline identified in board discussion included:

1. Complexity of patient problems that require multiple specialists. 
2. Wait times in the ER can be shorter to get speciality care than having to wait to make an appointment at a speciality clinic.
3. Patients are used to getting their care in the ER and patients are reluctant to change their way of accessing care.

Contracts Approved:

• A sole source contract to Community Health Solutions for $4,982,040 to provide contracted staff, including nurses.  Public speakers including CCHHS staff nurses spoke strongly against the contract, citing CCHHS oversight challenges of nonstaff workers and promising strong union opposition.  Deputy CEO Doug Elwell said the contracted positions will come in house within the year. 
• Approval of contract for $1,920,011,725.00, as a pass-through to Valence Health, OptumRx, DentaQuest, and First Transit allowing them to pay service claim reimbursements to CountyCare service providers.

Items To Watch For: 

• Schematic designs for the central campus redevelopment are due to be complete by the end of March.
• A 3-year CCHHS strategic plan is due to be unveiled by June or July, with significant board input.

Observation:
​CCHHS has a professional, effective board of directors. The 11 board members have carefully developed metrics to measure quality and patient safety, human resources, managed care, and finances; managers now provide these data on a monthly basis.  The board will begin benchmarking their data against Kaiser and other major national health care providers. Check out the latest metrics presented to the board.

Observer: Linda Christianson   Meeting Length: 3 hours