Deficit in Current CCHHS Budget Primarily Attributed to Pension Expenses

Cook County Health and Hospitals System Board Meeting -  October 28, 2016

Significant Topics Discussed:

• A $240 million deficit in the current Cook County Health and Hospitals System (CCHHS) budget was attributed to pension expenses ($183m), self insurance costs ($12m), and revenue shortfall ($44m).
• Only 66% of CountyCare members see a doctor at least once a year.  Chairman Hammock asked that an action plan be prepared for improving utilization.  Board member Mary Richardson-Lowry commented, “We have to get to the issue of why people aren’t speaking highly of us.” CountyCare currently has 147,000 members; September’s CountyCare revenue was $16m, only 63% of the budgeted amount of $26m.
• Metrics: Only half of scheduled surgeries at Stroger start on time; 75% of patients are willing to recommend the hospital; 75% are satisfied with their visits to CCHHS ambulatory clinics.
• Due to the current “labor hold” only 77 nurses were hired in September, vs. 362 in September of 2015. Chairman Hammock explained that unions must “release” the positions in order to fill them, and three unions, SEIU, AFSCME, and the nursing union, together represent 50% of all CCHHS employees. 112 days are required, on average, to hire a new employee. Overtime is currently at 8%, v. a goal of 5%.
• A new WEPlan, a multi-agency initiative involving planning, transportation, food distribution, and assessing the need for services in order to combat poverty, chronic disease, behavioral health, and health inequities was presented by Dr. Terry Mason, CEO of Cook County Department of Public Health.

Contract Concerns:  Questions centered on amounts, number of bidders, and whether services contracted could be brought in-house.  Examples: 

1. Almost $1.5m was approved to outsource some nursing services, which Deputy CEO Doug Elwell attributed to the “labor hold.”  
2. A $40m contract was approved for Information Technology management services.  “Our hospital is being hacked at an alarming rate,” said Elwell.  “This /IT/ has historically been a very difficult area to recruit.”  
3. A $3,135 two year contract with Deloitte Consulting was approved to develop a system wide job classification system to cover all employees, looking at the value of  CCHHS compensation packages compared with that of other employers.

Announcements from Dr. Jay Shannon, CEO:   

1. A $243,000 grant to provide mental health services
2. The opening of the Roseland Triage Center
3. A Medicaid Redetermination Event at Stroger Hospital with 8,000 invitees
4. Deborah Carey will replace Karen Duncan as manager  of hospital-based services. 

Board member Mary Gugenheim congratulated Dr. Shannon on his presentation at the Oct. 18 budget hearing before the Cook County Board, successful due to vetting of County board members beforehand and attention to detail.

Observer -  Linda Christianson                                            Meeting Length - 3 hours