Nurse Staffing Continues to be an Issue for Cook County Health

Cook County Health Board of Directors Meeting
October 25, 2024   

After securing approval of the AFSCME31 and SEIU 73 contracts, Acting Chair of this meeting, Robert Reiter, JR. (also the Chairperson of the Finance Cmte) revealed that the number of nursing staff vacancies has been frozen at the request of the County Board.  Although the number of budgeted positions is fixed, there is an increased need for staff due to increased patient load, new services, etc.  In turn, there is increased utilization of registry, which continues to negatively impact finances and employee morale.

The first public speaker, Dominica Flanagan, RN, SANE (Sexual Assault Nurse Examiner) in Pediatrics, 

• expressed her concern for two pediatric victims of sexual assault because she was not called in to interview the victims and assist due to the Executive Order to not call her on her day off.  

Before recessing to executive session, a second speaker, Mr. Blakemore, stated that

• “Health is Wealth.” and wants all CCH employees to use CCH for their health care.  And, US citizens to go to the front of the line.

Board members drilled down into the data in the just received 2022 Public Health report.

• 12-month delay on producing an annual report.  
• Faster results, like those for Covid are less accurate, have duplication and incorrect locations: address of report vs actual location.
• Items discussed were rates based on income and race for: 
  • pre-term birth, stroke mortality, equity and health equity, language preference, sexual orientation, lead abatement.
  • using opioid deaths to focus on specific communities for distribution of Naloxone/Narcan to specific organizations and businesses.  

Discussion of the late addition to the agenda: VI Action Items E. regarding the proposed resolution regarding agency usage and strategies promoted discussion and was referred to Finance Committee for more conversations with the labor partners. 

• CCH Board wants to maintain control and not have the Commissioners take over. 
• The turnover rate is at 18% which is less than the national average of 20%.
• 1264 vacancies; 
• 50% are in interview/offer stages.  
• 38% decrease in resignations over 2022/2023, but December sees higher rate of retirements.  
• 98 net new hires as of now, was 23 last year at this time.  
• 18% utilization of agency (averaged across all Depts & roles).

Other Items of Note:

• New device:  CCH has acquired and deployed a new robotic Lung Cancer Biopsy tool.
• Leader Rounds: 2-3 CCH Board members will make “rounds” to departments.
• New Leadership: Dr. Erik Mikaitis was introduced as the new CEO.
• New Board members: Maya Green, MD, MPH, FACHE and Dr. Inger Burnet-Ziegler
• Departing Leadership: Robert Currie

Observer -  Victoria L Cerinich

CCH Managed Care Committee Meeting –
October 18, 2024

Metrics Reported:
Members as of September 5:                    417,175
ACHN Members                                             31,621
% of CountyCare Members that use CC Health     7.60%

​Highlights from the meeting:

• CountyCare achieved a 90% redetermination rate to continue to lead the Managed Medicaid Market in Cook County with 34.2% of the total market share as of 6/24
• CountyCare received an award for its Food Insecurity Program
• In August 100,000 transportation requests were received.  Previously, LWVCC reported that CountyCare has switched to a new and broader transportation program including public and for-hire options.
• To Increase the 7.60% cited above, CountyCare staff is working with Cermak inmates to build relationships and trust before they are released.in order to retain them for CCH services.
• CountyCare led in the 2024 NCQA Health Plan ratings with prevention and equity, earning a 3.5 Star with the highest measurers for adolescent immunizations, BME percentile assessment, and prenatal immunizations.
• CountyCare working on a TeleHealth RFP which would have the potential for on-demand care for those that need it.  Implementation for selected vendors in early 2025.  To date.  CountyCare has contracted with 10 telehealth providers, adding at least 84 practitioners to the virtual care network.  Behavioral health is the domain more generally available.

Observer:  Diane Edmundson