CCH Board of Directors Meeting

Cook County Health Board of Directors Meeting
February 23, 2024

Before the public testimony and the remaining agenda items, the Board recognized: 

1. a successful first Forum on Behavioral Health – over 700 participants from more than 300 organizations participated on 15Feb2024;
2. 2024 Press Ganey Horizon Award for High Reliability;
3. Other awards received by – Diabetes & Endocrinology, Corrections team;
4. four doctors are on the Chicago Magazine Top Docs list;
5. five members recognized by Commitment to Excellence
6. Civic Leadership Academy award to Gina Massuda Barnett, Deputy Dir, Public Health Programs.

Oral testimony:  Karen Rush, DuPage County Resident, in-person
Request Cook County HHS to recognize that the frequent flooding of parking lots and homes is a health hazard.  Asks that CCHHS examine the land owned by Cook County and if it contributes to the flooding that Cook County improve land management to mitigate the flooding. Submitted written information & photos.
Public Speaker had technical difficulties. (Recording is not available as of 28Feb2024)

Item IV. Board and Committee Reports.

• Minutes of the Board and each committee were accepted and approved. 
• Donna Miller, Cook County Commissioner 6th District, reported that since the last CCHHS Board meeting, a resolution supporting doula and social services support services aimed at improving maternal health outcomes was proposed by Cook County to the National Association of Counties was unanimously approved for presentation to all NACO members. 
• The Quality and Patient Safety Committee has reorganized their meeting agenda to put Action Items earlier in appearance to provide more time for discussion.  
  

Link to Slides on Managed Care Metrics.
https://cookcountyhealth.org/wp-content/uploads/Item-IVD-Managed-Care-Metrics-02-23-24.pdf
Board Member concerns:

1. Fewer CountyCare Managed Care (MCO) members over 2023: Board member asks for way to acknowledge MCO members who return to or renew with CountyCare.  (Loss of members due to resumption of redetermination: member must rejoin or pick new MCO annually fall when they validate their eligibility.) Reduced enrolment in CountyCare has a negative effect on income.
2. CountyCare members who do stay or return to CountyCare tend to need more acute care.  Outreach to existing and new members is focusing on a broad spectrum of profiles.

VI. Recommendations, Discussion/Information Items

1. Quarterly report from the Cook County Dept of Public Health.

• Lowest childhood vaccination coverage in 10 years.
• As low as 10% in some jurisdictions.
• Three exemptions identified: medical, religious and philosophical.  Presenter said that Illinois permitted all three types of exemptions.  (This Observer researched and Illinois Public Health only recognizes medical and religious.)
• Illinois and Cook County are at risk for cluster outbreaks; measles cluster outbreak is possible.
• CCHHS expanded the public education spend to $310K in 2023 and will continue the spending trend.  Media includes Face Book, Instagram and Snapchat, broadcast media (purchased and invited as subject matter expert source), bus ads on PACE routes, print (community media in English and Spanish, Lawndale Citizen, local vaccination clinics.
• HPV is included in marketing but this is a smaller, targeted group
• https://cookcountyhealth.org/wp-content/uploads/Item-VIA-Q1-CCDPH-Report-02-23-24.pdf​

Board member concerns:

1. Causes for very low rates 55% or less in some school districts.
2. Asked staff to use “Boost Up” metrics to report on potential correlation between data and vaccine rates.
3. Schools must request visits by public health nurses (PH RN). Presently, only 24 PH RNs on staff.
4. PH RN role and trajectory is different than traditional clinical RN, but must have changed over time.
   1. Focus is on case management of lead poisoning, premature infant care and expanding vaccination rates.
   2. Will need more PH RNs if asked to expand roles.
5. COVID clinic visits can engage persons who need other vaccines, but capacity/time is limited.
6. Outside contracted RNs provide home health visits and can give vaccines.
7. Board members suggested connecting with other MCO’s which also have financial incentives to maintain healthy members and vaccinations are a tool.

Item VII. Resolution/Recognition and Board Member testimony on contributions of Director Otis L. Story, who is leaving the CCHHS Board.  Mr. Story was directly appointed by Pres. Preckwinkle.

VIII. Interim CEO Report

1. https://cookcountyhealth.org/wp-content/uploads/Item-VIII-CEO-Report-02-23-24.pdf
2. Nursing Update.
   https://cookcountyhealth.org/wp-content/uploads/Item-VIIIB-Nursing-Update-02-23-24.pdf
   1. First ever CCH Nursing School Summit: 50 Participants.
   2. Contract Labor decline from total of $12.7M for 2022 down to $7.5M for 2023.
      1. Board wants these savings to be used to meet long term goals for patients & staff. 
      2. 17% of Nurses are expected to retire in next three years.
      3. FTE needed = 2179, filled =1282, Vacancies = 896 (41%)
      4. Six Nursing Workforce Strategies 
         1. Innovative Staffing Models
         2. Mentorship/Professional Development Program
         3. Focus on Self Care & Personal Development
         4. System & Workflow Redesign
         5. Virtual Nursing – Research & Evidence Based Practice
         6. Transformational Leadership

ITEMS TO WATCH FOR THE FUTURE

1. 1. Qualification for Magnet Award in Nursing excellence in 2024.  Will use a consultant for next steps toward Magnet Award.
2. Strategic Deployment goals were consolidated from 250 to 60 and finally 27.  These 27 were further grouped into seven pillars;
   1. Patient Safety, Clinical Excellence & Quality
   2. Health Equity, Community Health & Integration
   3. Workforce: Talent & Teams
   4. Human Experience: Employee Wellness and Engagement; Patient Satisfaction
   5. Fiscal Resilience
   6. Optimization, Systemization & Performance Improvement
   7. Growth, Innovation and Transformation

Virtual Observer - Victoria L Cerinich