Cook County Hospitals System Bottom-line May be Threatened by Decrease in Medicaid Enrollees and Federal Rule Changes for Immigrants

Cook County Health & Hospitals System (CCHHS) Board Meeting  
September 28, 2018               
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Threats to 2019 CCHHS budget predictions presented by CCHHS Administration and Staff:

• Illinois Healthcare & Family Services actuaries predict a decrease in Medicaid Affordable Care Act (ACA) enrollees in Illinois by 5% and a drop in the Medicaid FHP category in Cook County by 10% in the next year reported Hospital System CountyCare/Managed Care staff. 
• CEO Shannon added that the US Dept. of Health and Human Services  is chipping away at the ACA provisions such as proposed imposition of work rules which may result in loss of Medicaid eligibility.
• Further threats to the increased volume of patients on which the 2019 Hospital System proposed budget is predicated may be the proposed change in Federal Immigration rules.  Federally funded programs including Food stamps, WIC, & other Public Aid, when  accessed for the legal children of illegal immigrant parents, are considered to be benefiting the entire family.  This may be considered a violation of the “public charge law” which will be held against the adults when applying for Green Card/Visa/ Citizenship.  
• CEO Shannon warned that immigrants might be fearful of accessing the Hospital System. 
• Nearly 80% of CCHHS patients are Medicaid (36%) or Uninsured/immigrants (42%)

What did the Board Decide?

• Approved 73-million-dollar Sole Source contract (MHN ACO, LLC) for care coordination at Federally Qualified Health Clinics (FQHCs) covering approximately 117,000 of the 335,039 CountyCare members. This improves health and reduces cost of care.

​What else did the Board discuss:

• Heather Prendergast, MD introduced as a new CCHHS Board Director. She is an Emergency Room physician, in leadership positions, at U. of Illinois Hospital which has a similar patient demographics as CCHHS.
• A Public Testimony speaker reported that limited patient/visitor parking due to the Central Campus Redevelopment construction may hinder patient use of the Hospital System. CEO Shannon responded that this would be addressed.
• Shakman Decree (law to prevent political hiring) imposed by the Courts on Cook County decades ago is set to be lifted next month as compliance in hiring has been achieved at CCHHS.

Items to Watch For in the Future:

• CC Board President, Preckwinkle to appoint County Commissioner representation on Hospital Board after Mid-term Elections when new CC Board is seated
• Hospital System 2.97-billion-dollar Budget hearings at CC Board scheduled in October 2018
• New Professional/Administration Tower to open for business in October, 2018

Meeting Length: 2 hours 30 minutes 
Observers - Susan Kern, MD,  Michele Niccolai, Sarah Edwards, & Ellen Hunt