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

Cook County Health and Hospitals System (CCHHS) Annual Board Meeting
June 29, 2018

The CCHHS Board requested that Human Resources properly designate positions with a unique job code if the job requires bi-lingual skills. These positions would be more highly compensated due to the requirement for these skills. It is felt that filling these positions appropriately would increase the cultural competency of staff along with ensuring proper care for patients. It was indicated that a bi-lingual worker would be especially helpful in working with many Out Patients. The Board also requested that Human Resources review the process for exit interviews with Department heads’ as there is currently a lack of helpful information being received.

Other Committee Actions or Discussions:

• Managed Care Committee-Increase of membership from 331,000 to 338,326. Board wanted a breakdown of the membership and the number of people who would be aging out of Medicaid.
• Quality and Patient Safety Committee-Discussed the 2018 proposed plan. Board talked about their concern about maternal deaths and the reasons behind them along with how to increase the number of woman who chose to give birth within the system.
• Audit/Compliance Committee-Fraud/waste/abuse have maintained from last year. New contract requires there to be one investigator per 100,000 members so with our 338,000 plus members, we will need 4 investigators. The issue of revenue recovery will continue to be a major issue for the system and the results from the systems in place and those being put into place will be closely monitored. Board Chairman Hill Hammock and CEO Jay Shannon presented these revenue recovery strategies to Cook County Board at a hearing on June 5.

Other Data Presented to the Board:
As part of the Cook County Department of Public Health 3rd quarter report, an update was given on current TB Prevention efforts. It has been found that those most affected with the disease live in the suburbs and 70% are foreign born and have been living in the United States for 5 or more years. The city of Des Plaines in the Northwest suburbs is the most infected area. There has been no direct correlation between TB and Poverty Rates.The current treatment is provided by nurses as part of a program called Directly Observed Therapy (DOT}. This program provides for a new treatment that takes 12 weeks instead of the old method that averaged 6 months. Each patient is assigned to a nurse who assumes responsibility for ensuring each of their patients takes their medication. This means these nurses are driving around the county doing DOT on a daily basis. 

Observers - Bill Edmundson and Jackie Buttafuoco                     Meeting Length: 3 hours

Cook County Health and Hospitals System Board Meeting - April 27, 2018

What did the Board Decide?

• Board president asked the Finance Committee to do a “deep dive” on significant revenue and expense deviations – and in particular – claims, payments, increase in charity care numbers, and overtime issues.  Director Robert Reiter is the new Finance Chair replacing departed Ric Estrada.  
  
• Approved contract for new space to consolidate the County’s Public Health Operations.  Will be located on Roosevelt Road in Hillside.
  
• Accepted the resignation of Director Virginia Bishop for health reasons.  The Cook County Health & Hospital Committee of the Cook County Board of Commissioners will be asked to convene and recommend replacement nominations.

What did the Board Discuss?

• Behavioral Outpatient Services.  A behavioral staff member asked the board to bring this department back to Stroger.  It was moved to Austin Clinic and Provident Hospital when the old Fantus Clinic was torn down.  Dr. Shannon responded that most of the need is on the south and west sides which is where services are offered in addition to Telephone Psychiatry services.  It is not scheduled to return to the new clinic or Stroger.  However, all 15 ambulatory clinics have services. Director Richardson asked for metrics and continued feedback at future board and committee meetings.  
  
• While no discussion ensued, the Board was told that the System anticipates a “final” Shakman review from the Department of Justice regarding the Cermac Jail Health Facility.
  
• A report was given on the Districts Behavior Health progress since the Evidence-Based Strategies were initiated three years ago.  The report is yet to be posted with the board agenda nor were the April 27 board minutes available as of May 7, 2018.  In 2017,  over 53,000 patients were screened for baseline mental health evaluation, treatment options, referral locations, and follow up.
  
• The Public Health Department presented a quick overview of its quarterly report.  Highlights include their focus on high risk infants, screening newborns for hearing, and a reporting system for adverse birth outcomes - the Adverse Pregnancy Outcomes Reporting System [APORS]. 

Observer - Diane Edmundson