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Cook County Board to Hold June 5 Hearing on Inspector General Report on Hospital System

5/21/2018

Cook County Board of Commissioners Finance Committee and Board Meeting
May 16, 2018

FINANCE COMMITTEE MEETING
Public Speaker at the meeting - Mike Belsky, Executive Director Center for Municipal Finance, Harris School of Public Policy, University of Chicago, spoke in favor of the ordinance to establish a Consensus Revenue Forecasting Commission for Cook County.

Significant Topics Discussed
1. Cook County Health and Hospitals (CCHHS) Quarterly Report was presented and filed.

Commissioner Daley announced that there would be a Special Hearing on June 5, 2018, 9:00 am to discuss the issues presented in the Inspector General’s Report, and failure to bill properly.
Commissioners are deferring questions to this meeting.
Chairman of the CCHHS Board, all CCHHS Board Members and the Cook County Financial Team including the CFO of Cook County have been invited to attend.
There was discussion as to whether to include a representative such as a Union member to represent employees at this hearing. This could cause the meeting to go to Executive Session. It was decided that the purpose of this Special Hearing was to discuss the issues in the Inspector General’s Report and if employee issues arise a separate meeting would be organized to deal with employees

2. A Resolution establishing a foundation for the benefit of the sheriff’s Office of Cook County was passed.

A not-for-profit Foundation to be created to accept charitable contributions either financial or gifts in kind to support the missions of the Sheriff’s Office.
Gifts will be used to improve the life of those incarcerated and those who are being released.
Example of gift in kind, The Dr. Willie Wilson Foundation donated Feminine Hygiene products to the CC Sheriffs office to be donated to detainees and those recently released from jail.

3. An Ordinance to establish a Consensus Revenue Forecasting Commission for Cook County, which was deferred to the next meeting or later for further study. (Garcia, Boykin, Suffredin)

The Commission will be responsible for evaluating and forecasting revenue including but not limited to Sale Taxes, Property Taxes, Cigarette Taxes, Fuel Taxes and other sources of County Revenue.
The forecast will be completed by September 15 of each fiscal year and will be updated quarterly
Commission will have seven members appointed by the County Board President and confirmed by the Cook county Board to include Chairman of the Business & Economic Development, Chairman of the Pension Committee, Chairman of the finance Committee, the CFO of Cook county, an economist working at the Federal Reserve Bank of Chicago, an academic economist working at the university in Cook County, and one member of the public with expertise in public finance. This will be a 3-year term.
Pros, when you can forecast the revenues it is easier to create a budget and shortfalls could be determined earlier. This will provide for a more open and transparent budget process.
Cons, Commissioners believe this is already done and do not need a separate Commission. Budget process should begin earlier for there to be more time to question the budget.

COOK COUNTY BOARD MEETING

Highlights from the meeting:
1. Ordinance Amendment increasing fines for Public Morals Violations - referred to Criminal Justice Committee.

This ordinance would increase the fines for public nuisance issues such as public urination and public drinking.
It also added Community Service for those who could not pay the fines

2. Proposed Ordinance Amendment authorizing Video Gaming in Unincorporated Cook County - referred to the Finance Committee.

Committee Items Requiring Board Action

Resolution creating Cook County Prevailing Wage Advisory Task Force passed with no discussion or public comment on this issue
Resolution creating a Funeral and Cemetery Violence Task Force passed. This creates a task force to deal with the violence that occurs with Gang related funerals.

Items to Watch for in the Future

Special Hearing June 5 for CCHHS and the Inspector General Report
Ordinance to establish a Consensus Revenue Forecast Commission. This was deferred for more study. Look for this in the near future possibly in June.

Observer: Nancy Marcus Length of meeting - 5 hours with a lunch break

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Hospital System CFO in Hot Seat at Cook County Board Meetings

5/11/2018

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Cook County Board of Commissioners and Committee Meetings - April 25, 2018
Meeting Length - 4 hours, including breaks. Committee meetings started at 10am.

FINANCE COMMITTEE MEETING
The Finance Committee, which met from 10:09am to 11:40am, spent considerable time grilling the Cook County Health and Hospitals System (CCHHS) CFO about the $174 million in denials in 2016 and 2017 as reported in the Inspector General’s (IG) 4/13/18 quarterly report for 1Q 2018.

Commissioners, Boykin, Daley, Gainer and Morrison asked most of the questions in trying to determine what led to the loss of $174 million - $108 million in 2016 and $66 million in 2017. Boykin referenced the report stating that denials can be attributed to scheduling, patient registration, coding errors, physician and nurses, inadequate and inaccurate coding. He noted that 1/3 was written off because of untimely filed medical bills.
In response to Comm. Gainer’s question, the HHS CFO said yes – the $174 million was lost due to missed collection deadlines and clerical error.
The Finance Committee talked briefly about another topic, but then Comm. Gainer asked about the CCHHS collection rate. The CCHHS CFO responded that the charges are different from billing and different from collections. Typically, patient collectibles are 30% or a $50 million loss on $175 million in charges.
In response to questions, it was revealed that there had been about 1,200 patients treated for gunshot wounds at a cost of $35,000 per patient. However, it was unknown what percentage was covered by insurance.
It was clarified that the $174 million written off was separate from uninsured. $317 million that was written off for charity care.
Comm. Boykin expressed frustration with the responses he received. Comm. Suffredin stepped in, stating that the CCHHS CFO came to the meeting prepared to address the monthly report – not the IG report. He suggested a special meeting to address the IG report be scheduled.

Comm. Daley wrapped up the Finance Committee meeting stating that they need clarity on the $174 million in losses.

ZONING AND BUILDING COMMITTEE MEETING
Next the Zoning Committee met from 11:40 am to 12:50 pm. They passed a bunch of recommendations.

BOARD OF COMMISSIONERS MEETING
Pres. Preckwinkle called the meeting to order at 11:54 am, then went into recess at 12:26 pm; reconvened at 1:08 pm and adjourned at about 2:08 pm.

Regarding 18-3099 a lease agreement for CCHHS, a question was asked about the expenditure of $1.5 to $2 million to lease space rather than incorporate it in the new building. It appears to be a bonding issue, which limits the capitalization plan. It was noted that the rent will be $23/SF with 79 free parking spaces, which is $2 less than market comps in the Medical District around Stroger. Staff felt it was the best deal in the newly renovated space.
There was also reference to the Inspector General’s report on CCHHS billing issues at the Board meeting, that had been previously referred to in the Finance Committee meeting.

Items to Watch for in the Future

Special hearing on the $174 million in CCHHS denial of billing by insurance companies.

Other Comments or Observations

Several members from the Illinois Committee of Blind Vendors spoke during public comment. They referenced the “Blind Lives Matter” movement, that the unemployment rate for people who are blind is 70%, as well as an Enterprise Program for the Blind (a training program). They referenced the Blind Vendors Act. (I found reference to the BVA in the 1/17/18 Board meeting materials where it was referred to the Asset Management Committee’s 2/7/2018 meeting, which appears to have been cancelled. There does not appear to have been another meeting.)
They mentioned that blind vendors have the right of first refusal on federal and state property and are looking for commission-free opportunities and partnerships like they have with state and federal. They advocated for the commissioners to vote in favor of the Blind Vendors Act of Cook County.

Observer - Peggy Pissarreck

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Cook County Board to Hold June 5 Hearing on Inspector General Report on Hospital System

Hospital System CFO in Hot Seat at Cook County Board Meetings

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