Cook County Health (CCH) Board of Directors Meeting
​March 26, 2021

The 2020 five “ICARE” (Integrity, Collaboration, Accountability, Respect, Excellence) Employees of the Year were congratulated at the board meeting by Joseph Flanagan, Chairman of the Cook County Health Foundation. 

Committee Reports to the Board:
Human Resources:

• CCH labor union contracts are being negotiated with CC Bureau of Human Resources. 
• As of 2/28/2021, 290 Contract Tracers have been hired, 79% by CCH and 21% by Hektoen and 137 positions are in the CCH hiring process. 
• FY2021 Quarter 1 filled positions is greatly increased over FY2020 Q1 due to Contract Tracing hires.

Quality and Patient Safety:

• The Joint Commission, which accredits healthcare facilities after an inspection reviewing facilities, was recently at Provident Hospital.  The end of survey meeting was very positive and CCH is awaiting the official report.
• The 30-Day Stroger Readmission Rate (unplanned admission to Stroger within 30 days after being discharged from an earlier Stroger hospital stay) for Nov 2020 was 9.05% and was closer to the target of 8.56% as previous 2020 monthly readmission rates trended high. 
• he Medical and Surgical Case Mix Index for December 2020 was higher than target which is favorable for reimbursement.

Finance Committee:

• Two grants were received and filed for CC Board/CC Budget Director approval.  A grant from the Dept of Health & Human Services, Substance Abuse and Mental Health Services Admin, will support acupuncture use in the Emergency Dept as a pain reliever in order to reduce admissions.  A second grant from the IL Health & Hosp Assoc is for training/updating staff working with Covid-19 patients and preparing for future disease outbreaks. 
• The finance committee will hold a special future meeting to review all care management contracts. 
• On an accrual basis, CCH is ending January 2021 $3.35M ahead of budget.  The Net Patient Service Revenue was lower than expected due to lower volumes in Jan.  The Jan 2021 Medicare health plan membership is lower than budget, lowering revenue. 
• The Board approved purchase of “Syntellis Performance Solutions”- financial analysis software designed for the complexities of hospitals.  This software will help with future financial planning, the budget process, and decision making because the software will provide a more detailed financial look into CCH’s services and departments.

Managed Care:

• As of 3/4/21, CountyCare has 392,417 members (a 6,600 increase over 2/4/21) with 40,721 enrolled in CCH clinics. 
• CountyCare members increased their use of CCH health services. 
• CountyCare enrollment is expected to increase due to the temporary stopping of state Medicaid eligibility redetermination through 2021 and the 50% auto-assignment increase to CountyCare beginning Feb 2021.

Board Action:

• Mildred Williamson’s appointment to the CORE Foundation Board
• Provident Hospital Emergency Dept Triage & Triage Intervention Guidelines were approved

CEO Rocha Report:

• As of 3/22/21, from all tests conducted at CCH (119,237), the positive rate is 8%.  At Cermak (CC Jail Health Center) testing is done on site with rapid test, then confirmed at CCH.  There is robust testing at Cermak of all detainees to determine health care and housing.  At Cermak, the rolling 7 day positivity rate as of 3/24/21 is 0.4% with a jail census of 5,613.  Testing is important to respond to Covid-19 clusters.
• Monoclonal Antibody treatment is available in the ER when a patient is identified as Covid-19 pos in order to prevent hospitalization.  
• Vaccinations:  As of 3/19/21 Total Doses (1st & 2nd) given to Dept of Corrections & JTDC Employees & Contractors = 4,434 and given to Cermak Health Services Patients = 2,600.
• As of 2/28/21 CCH staff vaccinated = 74% and CCH employees vaccinated = 58%.  As of 2/28/21 there are 5,196 union employees-55% are vaccinated and 896 non-union employees-73% are vaccinated.  
• Vaccination sites:  On 3/22/21, Cook County moved into Phase 1b+. - CCH has five Mega PODs (points of distribution)- open to general public who meet current eligibility criteria. Sites continue to be added for varying populations.
• CCDPH Vaccine Equity Strategy prioritizes communities most disadvantaged and socially vulnerable.  32 suburban communities have been prioritized.
• Since Jan 25, 2021, CCH has administered more than 290,000 doses of Covid vaccine as of 3/26/21.
• Education: March 15 “My Shot” public awareness campaign launched.  Residents of CC share their reason to be vaccinated using billboards, bus shelters, transit, digital, social media and radio.  CCH is working with community based organizations to spread the word in areas most impacted by Covid.  Next phase will focus on 18-34 year olds.
• CCDPH Contact Tracing in suburban CC has more than 180 contact tracers and 60 case investigators.  In February 2021, there were 9,400 actionable Covid pos cases (92% called and 65.4% interviewed) and 91.2% close contacts called and 76% interviewed.  176 cases needed special resources from the Complex Care Coordination Team in order to quarantine or stay in isolation- 32% needed food, 28% needed income assistance, 11% needed medical assistance and 11% needed cleaning supplies.
• CEO Rocha stated Covid variants are in Illinois.  (Check the Illinois Dept of Public Health website for information on variants)

What to look for in the future: 

• The financial impact of the “American Rescue Plan Act of 2021” for CCH

Observed by:  Michele Niccolai                                                 Virtual Meeting length:  2 ½ hours

Cook County Health (CCH) Board of Directors Meeting  –
February 26, 2021

Public Testimony: 

• Regarding the SEIU Local 73, 12-hour strike on December 22, 2020 by CCH essential workers, union representatives gave testimony regarding President Preckwinkle's pushback and CCH's investigatory hearings of members.  The strike came after union members were unable to come to an agreement over pandemic pay and safe working conditions: short staffs and lack of PPE.
• A group of CCH employees from several departments was recognized. for their efforts to improve inpatient bill collections.   Discharged Not Final Billed (DNFB) collections: a delay in completing an inpatient's bill on discharge due to coding or documentation gaps that leads to a delay in payment.  Employee cooperation from IT, Health Information Management and Finance lead to completing patient bills within 4 to 6 days after discharge meeting the target in December 2020 for DNFB collections.

Human Resources (HR)

• Their 2023 Strategic Plan focus includes: an increase in hiring bilingual employees; reduction in the time to hire; developing the cultural competency of the workforce; and maximizing HR information systems. 
• The staff at CCH numbers 6,054 employees, based on the 12/4/2020 payroll. 
• The people leaving CCH through January 31, 2021 have been retirees at 65% and resignations at 29 %.  There is an Employee Exit Survey and the response rate is 26 % which falls within the Industry Wide Standard. By job category, nurses are the largest group to complete the Exit Survey.
• First Quarter FY 2021 filled positions is very high due to Contact Tracing hires.  The Average Time to Hire in FY20 and FY21 has met the goal of 90 days during the Covid pandemic. 
• Covid 19 Contact Tracing Hires:  As of 1/31/2021 285 positions have been filled, 71 case investigators, 203 contact tracers, 6 supervisors/managers, and 5 other. 228 positions are in the hiring process with CCH leading Hektoen Institute in the hiring process.
• CCH is developing an improved volunteer program.  304 National Guard are unpaid vaccination personnel: 143 at Tinley Park Convention Center; 36 at Triton College; 89 at Health Centers North Riverside/Morton College, Robbins & Cottage Grove, Arlington Heights, and Blue Island; 18 at Stroger/Provident/Core and 18 at McCormick Place (not a CCH site).  For the Covid-19 Hot Line launched 12/21/20, 34 volunteers are assigned to give out test results.

CountyCare Medicaid Managed Care Plan

• As of February 4, 2021 County Care has a total membership of 385,741, of which 39,751 are in CCH clinics.  This total member increase is 5,300 more over last month, due to increase plan choice and auto-assignment by the state.  There are 1,000 more members in CCH clinics over last month. 
• CountyCare's 31 % market share of all Cook County's Medicaid Managed Care Plans has held steady.  CountyCare's enrollment has increased 17.4% over the past 12 months following the trend of all Cook County Medicaid Managed Care Plans.

Financial Update

• The December 2020 Net Patient Service Revenue was better than expected due to slightly higher charges.  The December admissions were less than a year ago.  A one-time payment of $6M was received from BCBS Equity Program.  
• From the CARES ACT, approximately $6M is to be reimbursed for Covid-19 expenditures. 
• First Quarter FY2021 is on pace to save $5M from completed/near completed Vendor contract negotiations.  Uncompensated care decreased in December 2020 from Dec 2019 and Medicaid revenue increased in Dec 2020 over Dec 2019. 
• Payment denials/write offs met the Dec benchmark of 5%.  More than half of denials were related to prior authorization (focus is on infusion, radiology, outpatient surgery). 
• On an accrual basis, interim financials show that CCH is ending December 2020 $2.32M ahead of budget.  December 2020 Health Plans Financials showed a Loss of $1.6M consists of $0.4M from CountyCare and $1.2M from Medicare.  Membership in Medicare is lower than budget, driving lower than expected revenue and members have more serious health conditions.
• Contracts were approved for purchasing specialty surgery supplies, instrument & equipment repair, mammography equipment upgrades, an ultrasound system, neurological power tool accessories, medical/surgical acute care beds, aortic endo-grafts used by surgeons to repair the aorta, and job posting system maintenance/enhancements.  A software company contract was approved for the "CMS Interoperability and Patient Access Final Rule Integration".  Interoperability is the ability to share data between different computer systems.  Goal is to have data flow securely between CMS regulated payers, providers and to give patients access to their health information.
• Two grants were received and filed for approval by the Cook County Budget Director:  An IDPH grant for "Cities Readiness Initiative Program" which is designed to enhance the response to large public health emergencies needing medicine/medical supplies in large metropolitan centers.  A second CCH Foundation Grant is for mass vaccinations/ support patient recovery.

Cook County Dept. Public Health (CCDPH) serves CC suburbs: 

• The Public Health Accreditation Board has continued accreditation of the CCDPH for 5 years. 
• CCDPH in collaboration with Hektoen Institute has awarded nearly $5M to 42 community-based organizations (CBO) for a 6 month project Dec 2020 to May 2021 for Covid-19 Community Supports and Worker Protection Programs.  Investing in existing community assets, since they are credible and trusted places, will help to reach populations where hesitancy and distrust exist.  These programs are in communities/populations most disproportionately impacted by Covid-19.  The Community Supports program provides outreach, education, expansion existing programs/services, testing.
• The Worker Protection Program provides employers and workers information, resources and support to minimize the spread of disease to promote health and safety in workplaces.

Covid-19 Vaccination: 

• As of 2/16/20, 70% of CCH staff and 56% of CCH employees have been vaccinated. 
• As of 2/19/21 vaccine doses distributed at Chicago & Suburban CCH Points of Distribution (POD) to CCH patients and public who meet current eligibility = 43,636. 
• Vaccine doses distributed to general public who meet current eligibility at Mega PODs = 46,453 and vaccine doses distributed to specific eligible populations at Targeted PODs = 1,264. 
• Other community vaccination access is from CCDPH Mobile Units, CCH/CCDPH Strike Teams (homeless shelters, home-bound and hard to reach populations), Drive-Thru at CC Forest Preserve District sites,  Loyola and Advocate hospitals, Pharmacies, Federally Qualified Health Centers, and Oak Street Health. 
• CC is currently in Vaccine Allocation Phase 1b which includes individuals 65 and over and frontline essential workers. 
• Vaccination registration & appointment information is available at Website: vaccination.cookcountyil.gov     Call center: 1 833 308 1988, M-F  7am to 7 pm.
• Covid-19 Vaccination at CC Department of Corrections & Juvenile Temporary Detention Center; Staff: since 1/20/21 more than 3,500 doses have been administrated.  Detainees and prisoners are Phase 1b.  To date, nearly 1,300 detainees have received their first dose.

CCH Covid-19 testing: 

• As of 2/21/21, from all tests conducted at CCH (107,334) the positive rate of patients is 8%.
• Covid-19 testing at Cermak (CCH health center at CC jail) remains a high priority and plays a critical role in the containment of Covid-19 at CC jail.  The rolling 7 day positivity rate as of 2/23/21 = 0.8% even as the jail census as of 2/22/21 = 5,435.

Observer:  Michele Niccolai                                   Virtual Meeting length:  2+ hours

Cook County Health (CCH) Board of Directors Meeting - January 29, 2021 
All directors were present, and there were no public comments submitted.

Report of Israel Rocha, Chief Executive Officer:

• Annual I-C-A-R-E employee awards were announced. I-C-A-R-E includes Quality, Integrity, Collaboration, Accountability and Excellence.  CEO Rocha talked about the importance of these qualities for the System and its employees to thrive.
• He then turned to a status report on Covid-19 reporting numbers as of January 27, 2021.  Confirmed CC cases 448,546; deaths 8,756; and total tests 5,625,530.  The new Covid website is up and running: vaccine.cookcountyil.gov, and the phone number is 1-833-308-1988.  Cook County residents can sign up to receive the vaccine, but it was made very clear that the holdup to the vaccination program is not the operational aspects but the availability of the vaccine supply.  Residents who sign up will be notified and given a date only when the Department of Public Health can ensure the vaccine is available.  The Chicago and Suburban Cook County Health Departments are working together.  Chicago will give vaccinations to suburban CC residents working in the city, and CC Health will do likewise for city residents working in Suburban Cook County.
• CCH is involved in a suburban Cook County community support program that includes $5 million awarded to 42 community-based organizations and a “Mask-Up Campaign”.  Community organizations are providing masks and care packages.
• On January 27, Cermak (Cook County Jail health facility) reported a rolling 7-day positivity rate of 4.4% and a census count of 5,324.  2000 of the staff members have been vaccinated and detainee vaccinations are in progress.
• CEO Rocha reported that 2,825 or 49% of the 6,033 staff have been vaccinated -– job category percentages include Doctors 80%; Nurses 49%; non-union 62% and union 47%.  An effort to educate employees on vaccine safety is under way.

Committee Reports:

Human Resources:

• Year-end Report [11-30-20]:  325 total positions were filled [146 externally].  Average time to fill positions was 91 days against a goal of 90 days.  Separations totaled 546 of which 271 were resignations, 288 retirements, 36 discharges, 11 deceased, and 50 laid off.  Chair Hammock asked for a summary of exit interview reports listing the reasons given for leaving Cook County Health.
• Covid Hiring as of January 22, 2021:  154 tracers, 93 Case investigators, 6 Supervisors, 7 Leadership.  Another 33 are scheduled to come on board in the next two weeks.  

Managed Care as of January 4, 2021: 

• County Care Managed Care Organization (MCO) continues to have the highest enrollment in Cook County at 380,386 or 31% of which 38,695 or 10.2% actually use the CCH hospitals and ambulatory care centers.  Because it has received Illinois’ highest quality ranking among the Cook County MCOs, County Care’s share of the State’s auto assignment will rise to 50% on February 1.  
• The State has continued to pause its annual redetermination requirement.  This along with the newly reopened Federal ACA enrollment opportunity is expected to further the rise in CCH’s MCO enrollment.  It is also expected that until later this year the System will receive a fee for service reimbursement rather than the current Medicaid rate for undocumented Cook County residents aged 65 and older who meet the financial need requirement.

Quality & Patient Care: 

• Stroger’s readmission rate on November 20, was 8.69% against a target of 8.56%.  Heart failure continues to be the leading cause. 
• Unfortunately the rate of patients that would recommend Stroger dropped to 64.39 % from a 77.9% rating reported at the December 4 board meeting.  The target is 71.3%.    

Finance:  

• In December, the System approved an emergency purchase of $8.4 million with Dialysis Care Center Holdings to operate the renal dialysis center at Provident.
• The board approved a $2,069,820 contract with Specialty Consulting for environmental assessments at the Oak Forest Health Campus, the CCH Administration Building, the Department of Public Health’s Forest Park, and Provident Hospital.  The Cost for 2021 is $1.7 million and will be funded by Cook County’s capital improvement budget.
• On an accrual basis, the System ended the year $35 million ahead of budget due to emergency funds received from the Federal government.  Revenues were up due to emergency Medicaid payer mix improvement, a decrease of 16% in patient volumes, and the receipt of $153 million in CARES Act funding.  Expenses were over budget but most Covid expenses were reimbursed.  In addition uncompensated care, including Charity Care, was down due to Covid.  
• CountyCare had an operating loss of $51 million in FY2020.  The new Medicare plan is not expected to show a profit for the next year or possibly two.  As of January 2021, there is an intergovernmental agreement with the State to reduce the revenue payback.  It was noted that due to Covid there was significant drop in claims, but that was offset by the higher cost of inpatient claims.  Board member Curry asked for a separate Medicare financial report.
• Domestic spend was $225 million compared with the $173 million budgeted.  Mr. Rocha said that he and Mr. Galeener, Interim CEO of CountyCare, are working on a revenue generating strategy.   Board member Koetting asked to be included in discussions to improve profitability.  He commented that he would not support a “wholesale” adoption of the strategies used by other MCOs.
• Grants:  The System’s lawyer described the new grant review procedure due to a change in the County appropriation ordinance and resolution for FY 2021 that did not include grants.   The CC Board will no longer approve, but will receive and file them.  Going forward the County Board must approve grants over $150,000 and the County budget director will approve grants under $150,000.  The lawyer assured the directors that the new process was not intended to eliminate CCH’s control over grants.

Observed by:  Diane Edmundson                                    Meeting Length:  3 hours

Cook County Health (CCH) Board of Directors - December 4, 2020
  
Acting CEO Debra Carey was thanked for the outstanding job she did this year in guiding Cook County Health (CCH) through the pandemic and the fiscal challenges. CEO-Elect Israel Rocha begins on Dec 7, 2020. He observed the meeting. All directors were present.

The Center on Health Equity and Innovation will go live with their new CMIS software on 1/1/2021.   $12 million was brought in from outside sources to fund this in 2020 and a $47 million grant was received covering a 4 year period.

Dr Lakshmi Warrior, a co-leader for the Cook County Racial and Health initiative was congratulated for being named one of the 40-Under-40 by Crain’s Chicago.

Committee Reports:

• Human Resources - The results of the biennial Employee Engagement survey were presented. The response rate was 56% up from 52% in 2018. The engagement indicator rose from 3.8% to 3.83%. They will use the data to develop action plans. The hiring of contact tracers has hit a snag in that several of the people hired are in quarantine and can’t come in to complete the hiring process (i.e. the employee physical). COVID has made hiring nurses difficult and agency nurses are still being used, but some have left for other states where they can earn as much as $200 an hour.
• Managed Care - CountyCare wants to renegotiate the PMPM with the state, and the state has expressed a willingness to consider.  Currently, CCH is required to give 10% of PMPM revenues back to the state.  Monthly enrollment reached 374,000 in October.
• Quality and Patient Care - The readmission rate is still too high primarily due to heart failure patients. There is a gap in care coordination. The Stroger recommendation rating is now up to 77.97%. The target is 71.3%
• Finance - 2020 financial numbers look good.  Could end the year with a small surplus based on resolution of Cares Act reverting back to the June requirements.  The January report should have final 2020 results.

COVID-19 Update:

• Testing has substantially increased but so have cases. The jail has become a problem again after getting it under control during the summer. The number of detainees is increasing. 
• Vaccine update- CCH is prepared for the vaccine's arrival. Extra cold storage units are in place and a plan for vaccinating employees is ready. At this point it will be available on a volunteer basis. Due to the side effect profile - sore arm, fatigue, headache for 24 hours - the roll out will not be by department. This will allow for affected employees to call out sick without putting undue strain on departments.

New Business:

• Chair Hammock requested a summary of the CCH and County Care Finance Reports for the board – and in particular, the new directors.
• The Racial Health Equity and Innovation Report will host a Webinar in February 2021 

Observed by:  Lisa Slankard                            Meeting Length: 3.25 hr

Cook County Health (CCH) Board Meeting
October 30, 2020

From Public Health to Finances to Human Resources to the Managed Care Program, Cook County Health officials reported that COVID-19 impacted most sectors of the System's operations.  

Public comments:   The League of Women Voters of Cook County and Civic Federation's comments urging the continuation of live streaming and archival recording of board and committee meetings post pandemic was the first to be read - followed by a number of nurses’ statements that Covid-19 testing in the new Blue Island community facility isn't safe due to space limitations and staff shortages. 

Committee/Department Reports:

• Human Resources: The new chair is Mary Driscoll.  312 contract tracing positions are in the recruitment phase with 255 in the interview process and 1 person hired.  Position approval related to Covid and revenue shortfalls has slowed down the hiring activity for non-Covid openings.  Of the 520 positions in H.R., 54% have been approved for active recruitment.  Currently, the average time to fill a position is 91 days against a target of 90 days.  Through September, 622 separations have occurred vs 480 in 2019 - over 100 due to layoffs.
• Managed Care:  The new chair is Vice President, David Menar.  Membership in County Care has consistently increased since the start of COVID and the loss of employer health insurance.  Through October 5, total membership was 373,645 which is 2,000 higher than September and within 500 of the 2020 budget projection.  10.4% or 38,815 of these members use Stroger services.  Illinois Medicaid gives County Care its highest ratings among the Cook County Managed Care Providers.  County Care’s market share in Cook County is 31.4% which is the highest percentage followed by Meridian and Blue Cross Blue Shield at 26% and 25% respectively.
• Quality & Patient Care: The average re-admission rate is 10% which is partly due to COVID.  Patient experience ratings inched up under the “communication with doctors category” and slightly down for “communication with nurses”.  Stroger’s hospital patient recommendation rating is at 70.8%.  Several directors commended the staff for their efforts to get the ratings headed in the right direction.
• Finance:  The board approved the acceptance of four grants totaling over $1.6 million.  Almost $1.5 million is from the city of Chicago for mobile units, Stroger, and Provident contact tracing services.  Directors discussed in detail the one year contract with the Hektoen Institute for Medical Research amounting to almost $2.75 million for temporary staffing services.  The contract would allow for up to 60 new hires including one manager, 8 case investigators, 2 case investigator supervisors, and 50 contact tracers. This number is added to the number hired by Hekteon under a 7-23-20 contract and by the System’s Human Resources Department.  Concerns centered on ensuring appropriate discussions and agreement with the AFSME union.  Assurance of contact and discussion was given, and the board approved the contract but requested follow up. As of August 31:   financial results are ahead of budget by $80 million  Negative variances are expense overages, partly due to COVID-19 costs and the loss of revenue due to reduced volumes.  Patient activity revenues have improved to just 22% lower than normal.  Surgery revenue is even closer to normal.   Recent guidelines of how to calculate revenue loss have changed which may negatively affect the amount of the $153.4 million CARES Act monies that can be kept.  DSH monies may also be in jeopardy as Illinois ran out of money in September.
• Public Health:  The System wants to increase the 2020 flu vaccine uptake, particularly for people at higher risk for serious flu and COVID-19.  It is in a collaborative partnership with 23 health providers.  Regarding its COVID-19 response to date, the Cook County Department of Public Health (CCDPH) has investigated over 5,500 cases including over 150 schools with a case or close contact; responded to over 10,000 inquiries; and provided 1,700 individualized recommendations. Compliance efforts in workplaces is ongoing and soon the Department will implement the Worker Protection Program as part of the COVID-19 contact tracing initiative.  This will include conducting pro-active education and outreach to workplaces and workers in Suburban Cook County. In addition, Public Health is planning for COVID-19 vaccinations when the vaccine is available.  Two doses will be needed between 3-4 weeks apart, and it must be the same kind of vaccine for both shots.

Other Items of Interest: 

• Interim CEO, Debra Carey stated that Stroger is one of only two sites in Illinois and one of 24 hospitals in the United States to lead a landmark trial to recruit adults who recently tested positive for COVID-19 to participate in a clinical trial of monoclonal antibodies for the Prevention of Covid-19.  The System is also participating in a Phase III controlled trial for a COVID-19 vaccine known as AZD1222 plus another six trials and studies including being the first hospital in Illinois to participate in a study to understand the effects of COVID-19 on acute myocardial infarction patients.
• In attendance were the three new CCH Board members Robert Currie, Raul Garcia, and Joseph Harrington.
• Moved to the November board meeting is the report from the Audit and Compliance Committee’s special meeting on October 14, 2020 and the report from the Center on Health Equity and Innovation. In addition, Director Guggenheim asked for a report on the COVID-19 mortality numbers of CCH staff.

Observer:  Diane Edmundson                         All 12 board members were present at the 3 hour meeting

Cook County Health (CCH) Board of Directors Meeting
August 28, 2020                                                                                                                                                     

Proposed Budget Discussion:

• Public speakers representing CCH employees and the SEIU labor union  objected to the proposed closing of the Woodlawn and Near South Clinics, conversion of the Provident Emergency Room to standby status and shuttering of the Oak Forest facility to help close a $187 million  deficit in the budget. 
• Despite cuts of 123 employees at Stroger, Provident and the clinics, there is a net increase of 134 FTEs System wide (from 2020)  due to the need for increased COVID-19 associated staffing at Cermak Health (provider of health services for Cook County Jail) and the transfer of CountyCare Managed Care employees to Stroger.
• The projected expense reductions of $55 million leave the remaining $133 million hole in the budget to be filled by increased revenues including Cook County Tax allocation increase of $30 million to $112.7 million.
• State IL , increased Medicaid payments to CCH :are paying the Fee For Service rate rather than lower  CountyCare Managed care rate
• Undocumented patients over 65 are now eligible for Medicaid reimbursement
• Planned improvements in bill collecting/ decrease in bill denials

 FY 2021 Budget Calendar: 

• Public hearings on budget Sept. 1 & 9, 2020
• CCH Board vote on proposed budget, Sept. 11,2020
• Cook County Board Meeting discuss/approve CCH Budget, Sept.24,2020

What else did the Board discuss or decide?

• Interim Chief Business Officer, Gibson reported the System showed  $94,065 million net income June 30,2020 but this was a result of Federal CARES act funding in excess of $122 million.  Revenues from charges are still 20% below 2019 due to COVID-19 shut-down and slow recovery of patient visits.
• Director Reiter made a plea for the Cook County Board to relook at the CCH tax subsidy which does not cover the 41% of patients who require uncompensated care.
• Dr. Joshi,  presented the quarterly report from the Cook County Dept. of Public Health, with an excellent COVID-19 PowerPoint update. He noted that there is a current resurgence of COVID positive testing (6.8%) primarily a younger population attributed to socialization without distancing/masking.

Items to Watch for in the Future: 

• Cook County Health, 2021 Budget hearings!

Virtual Meeting Observed by: Susan Kern, MD                  Meeting Length:  3 hours, 30 minutes