CCHHS Board Approves $112.7M Contract for New Health Center

Cook County Health and Hospitals System Board - April 29, 2016

Significant Decisions Made:
Approval of $112,700,000 Contract for New Health Center which will adjoin John Stroger Hospital, replacing 3 aging structures: Fantus Clinic , the current administration building on Polk St.  and the Hektoen Building.

• Via RFP (request for proposal) Clayco, Inc was selected to lead the development, design and construction of this new nine-story Health Center housing expanded outpatient services and administrative space and adjacent future parking structure. 
• Completion is expected in 2018 at a cost less than estimated for deferred maintenance on the old buildings.
• CCHHS are gambling that a more attractive, efficient facility will serve to retain patients, who are now insured under Medicaid (under the Affordable Care Act) and are increasingly choosing to go to other hospitals.  
• Board members commented that great care was taken in the contract to mitigate cost over-runs and insure local hires.

Significant Topics Discussed:
Concern was expressed by Director Erica Marsh, MD, that the nearly 800 employed HHS physicians  are not being assessed for productivity.  The number of physicians per patient is high compared to other hospitals.

• Doctor generated RVU (Relative Value Units: standardized measure of value for physician reimbursement) are used by other health care organizations to hire or retain and in some cases a doctor must meet a 50% or higher threshold compared to peers to be retained.  This, or comparable data (number of patient visits/encounters per day) is critical to predicting the fiscal sustainability of the organization and should be included in the HHS Strategic Plan under discussion. 
• Dr.Claudia Fagan agreed that there have been complaints that some physicians may only be seeing a couple of patients a day and they are not required to time -in or out.  There is a history at CCHHS of paying lower salaries and not particularly being concerned about the amount of work, because this was a charity hospital.  Most of the physicians are employed and belong to the union. 
• Director Lerner stated that there needed to be a new medical staff structure for the Strategic Plan including labor partners. 
• Productivity monitoring and performance achievement are needed added CEO Shannon.  Dr. Fagen responded “you cannot change culture overnight; it has always been like this at County”. 
• Director Junge (labor attorney) countered that the doctors have employment contracts.

Unexpected Events:
CCHHS Board Member, Lewis Collens, has unexpectedly resigned. The resignation was announced by Chair Hammock who noted the dedicated service as Chair of the Finance Committee that Director Collens had given to CCHHS.  He mentioned that the resignation was for family reasons. 

In an unscheduled visit to the Board meeting, Senator Dick Durbin,  our Illinois US Senator, cautioned the Board on the heroin epidemic. He noted that opiate abuse was on the rise and HHS will be at the forefront. 

• He also noted that the Zika Virus was unlikely to be of much concern to our region this year
• Both of these are central to the mission of CC Dept of Public Health which is administratively a component of HHS.                               

Observer: Susan Kern                                Meeting Length: 3 hours 45 minutes