Board of Directors

We’re still waiting on the live feed to begin, but when it starts you should be able to watch the meeting from this link: https://www.facebook.com/Cookcountyhhs

In the meantime, here’s a link to today’s agenda: https://cookcountyhealth.org/wp-content/uploads/03-26-21-Board-Notice-and-Agenda.pdf

The meeting’s up and going. Following roll, the board is honoring the 2020 employees of the year. Each employee will be awarded a $1,000 check.

Following the employee recognition, we move onto public comment.

There’s no public comment today, so we’ll be moving right along to board and committee minutes. First up is the Human Resources Committee.

We’ll be hearing from Carrie Pramuk-Volk, who will provide us with a brief rundown of the progress of vaccinations in Cook County.

Earlier this month, at the @CookCtyHealth Quality and Patient Safety Committee meeting, we heard from several people that the county needs to do a better job of distributing this vaccine in a way that’s racially equitable.

If you’d like to see more, check out Erin Rusmi’s notes from that meeting: https://docs.google.com/document/d/1xIZTUnJz1_cCCfSu-lTQCuhX_6YiFZiejHD1VOaxaJw/edit

Pramuk-Volk’s presentation is now underway

If you’d like to see the slides from her presentation, you may do so at this link: https://cookcountyhealth.org/wp-content/uploads/Metrics-HR-03-26-21.pdf

Due in large part to the contract tracing efforts that have taken place this year, Pramuk-Volk says that hiring activity is way up from this time last year.

2/2 chart on the left pertains to first quarter hiring activity https://t.co/L07hgIMpUl

That concludes the HR report. We actually didn’t get much of an update on vaccinations. We’re told we’ll hear more about that later.

We’re skipping the Managed Care Committee for now, so we’ve jumped ahead to our report from the Quality and Patient Safety Committee. Leslie Frain is providing the report.

The Quality and Patient Safety slides may be found here:
https://cookcountyhealth.org/wp-content/uploads/Metrics-QPS-03-26-21.pdf

It’s a jargon-heavy presentation and is focused completely on Stroger.

Basically, readmissions are a bit higher than they would like at Stroger. Not as many patients said they would highly recommend Stroger as the board would like (it was about 4 percent short of its goal).

Stroger’s Case Mix Index (CMI) exceeded its goal, which is good. As I understand it, a higher CMI means the hospital gets more reimbursement from insurance agencies.

Board member Ada Mary Gugenheim adds that there was an internal employee safety report, but says she will not go into detail of its findings.

She says there were some improvements from last year’s report, but CCH still has “a long way to go.”

There were no questions following the Quality and Patient Safety Committee report, so we moved onto the Finance Committee.

CCH Director Robert Reiter quickly passed the mic to Charles Jones, who provided a rundown of contracts and procurement items.

The full list of items is at the bottom of the meeting agenda.

There are no questions following Jones’s report, so Reiter asks @CookCtyHealth Chair M. Hill Hammock if the finance team may present a new item. Hammock says go for it.

Jones says they’d like to negotiate and execute a contract for software that would automate parts of the budget process.

The fiscal year 2021 impact would be $440 thousand, and over the next two years it would cost a total of over $900 thousand.

Andrea Gibson, the CCH interim Chief Business Officer, chimes in and says the reason they aren’t going through the normal process for this contract is because they’d like to use this software as they prepare the 2022 budget.

Gibson is asked the blunt question we’re all thinking:

“What does this software do?”

The big thing, Gibson says, is that it makes it much easier to analyze volumes, revenues, and expenses for individual services.

Previously, the budget team has had to do this analysis manually.

Hammock says he’s been in favor of analytical technology improvements and supports this contract.

Director Mary Driscoll asks for concrete examples, down the road, as to why this contract is useful.

The board approves the new item.

There’s a little more to the Finance report. Gibson says a recent $5 million radiology grant from the state has helped immensely. Because of that, Gibson says they were able to transfer $5 million back toward staffing initiatives.

Gibson then continues with the @CookCtyHealth year-to-date financial update. This report went through January 2021, and may be found here: https://cookcountyhealth.org/wp-content/uploads/Metrics-Finance-03-26-21.pdf

As shown here, CCH is behind by $40.8 million with regard to its cash report.

Gibson says she isn’t very worried about this. She believes this will improve as more people make their CountyCare payments throughout the year. https://t.co/YHKZCAL2dN

Membership in CountyCare has increased, and Gibson says she expects enrollment in CountyCare to continue growing.

Following Gibson’s presentation we moved onto a CountyCare report from Aaron Galeener, CountyCare’s interim Chief Executive Officer.

The report:
https://cookcountyhealth.org/wp-content/uploads/Metrics-Managed-Care-03-26-21.pdf

Galeener says CountyCare holds the highest market share of the Cook County Managed Medicaid Market with 380,287 enrolled as of January 2021.

Galeener also noted that Blue Cross Blue Shield overtook Meridian for the No. 2 spot on this list. Here’s the full breakdown: https://t.co/9Qk6QuY7pe

We got more up to date numbers as Galeener moved through his presentation. His report shows membership above 390,000 this March.

Despite projecting CountyCare membership to decline this year, Galeener says that membership has continued to increase throughout the year.

The main contributors to the rise in membership, he says, has been increased auto-assignment into CountyCare. Galeener adds that the state has also paused redeterminations, which has kept more folks in the program.

The expectation is that there would be a drop in membership if the state continues redeterminations or changes its auto-assignment policy. Currently, 50 percent of Cook County residents who are auto assigned are put into CountyCare.

Following Galeener’s report, the board approved @ToniPreckwinkle’s appointment of Mildred Williamson to the CORE Foundation Board.

The CORE Foundation is a partnership between Cook County Hospital and @RushMedical. According to CCH’s website, the CORE center is one of the largest HIV/ AIDS clinics in the country.

The board moved onto the report from the chair of the board M. Hill Hammock.

Hammock says he recently got his vaccine and proposed meeting in-person for the April @CookCtyHealth board meeting.

TBD on an in-person meeting. Hammock told board members to reach out with their preferences re: meeting in person.

We moved onto the report from the Chief Executive Officer Israel Rocha Jr.

Rocha began his report with a rundown of CCH’s testing results. He acknowledged that the county has seen similar increases in positivity rates that we’ve seen in Chicago and elsewhere in the state.

Rocha then provided a breakdown of all CCH testing as of March 22. The broad look showed some of the inequities that we’ve seen throughout the entire pandemic.

When it comes to ethnicity, for example, people who are Hispanic/Latino accounted for 21 percent of CCH tests and 40 percent of CCH’s positive results.

A little frustrating that Rocha’s report only included total numbers, but we move on.

Rocha proceeded with an update regarding the Cermak Health Services Center, which provides healcare to detainees at the Cook County Department of Corrections.

Rocha said that the population at Cermak continues to rise, which is making it more difficult to enforce social distancing and maintain what he called “single celling.”

Rocha, citing data from the Cook County Sheriff’s jail census, informed the board that the jail population is higher than it was in February 2020.

As of March 24, the jail current population is 5,613.

There are about 600 detainees awaiting transfer to the IL Department of Corrections. All people transferring to prison must now be fully vaccinated.

Data concerning vaccinations at the DOC and JTDC: https://t.co/5osOTnrNIP

Rocha continued with a vaccination update regarding CCH staff.

As of February 28, 74 percent of CCH staff has been vaccinated while 58 percent CCH employees have been vaccinated.

Here’s a breakdown of how CCH employees have been vaccinated by race: https://t.co/5FmqANH6Ig

Broken down by job category: https://t.co/waz9gdT0D8

These are union vs. non-union numbers: https://t.co/v2t0Dyquox

Rocha says they have been working with union leadership and will be doing secondary outreach with lagging departments in order to encourage everyone to get this vaccine.

He says that outreach will begin next week and will include conversations about why they’re asking employees/staff to vaccinate and will answer any questions people have about the vaccine.

Now some general updates from Rocha:

-The county moved into Phase 1b+ on March 22.

-CCH opened their fifth mega site in Forest Park on March 25. It has the capacity to do 3–5 thousand vaccines per day.

Rocha says they’ve booked more than 17,000 appointments at the United Center.

One last update: CCH has started transitioning the community vaccine services currently at their health centers to either a mass site or to mobile efforts that are hyper-focused on priority populations.

We’ll get more information on who CCH deems a priority population later.

More than 1.2 million unique registrants have signed up for the vaccine since the county launched its http://vaccine.cookcountyil.gov site on January 25.

People can also call 1-833-308-1988, Monday–Friday, 7 a.m. to 7 p.m. if they’d like to sign up.

Of course, we’ve heard lots of stories about folks having trouble with getting through to vaccination sites and successfully signing up.

I’ve been hitting up @BlockClub_CHI’s coverage to stay informed. Definitely recommend checking their reporting out if you need more info.

As of March 24, 547,305 people have received at least one dose of the COVID-19 vaccine in suburban Cook County (24 percent of the population).

278,725 people have gotten both shots in suburban Cook County (12 percent of the population).

CCH expects to have provided more than 250,000 vaccine doses by next week. Rocha says the speed at which CCH is able to hit their milestones keeps increasing.

Rocha: It took us about four weeks to hit the hundred thousand mark, two weeks to get to two hundred thousand, and in about one week we’ll nearly be to the three hundred thousand mark.

Now Rocha is talking a bit about CCH’s “MyShot” vaccination information, engagement and education campaign. Expect to see testimonials from Cook County residents talking about why they took the vaccine featured on billboards, bus stops, and social media.

The next phase of this outreach program will launch later this month and will target people 18–34, who Rocha says are, statistically, not as likely to take the vaccine.

Following Rocha’s report, we heard from Dr. Joshi of the Cook County Department of Public Health. Joshi began his presentation with a reiteration that we aren’t through the pandemic yet and that we need to stay diligent with our hand-washing, distancing, etc…

Joshi says the strategy at the health department is shifting toward equitable vaccine distribution. The second bullet point outlines who specifically is being prioritized. https://t.co/4HdauiT0VR

Some of the activities include the county department of health’s partnership with Jewel-Osco, which has served about 4,500 people to date.

Joshi says they’re looking to expand these efforts.

Cook County Department of Public Health (CCDPH) Priority Communities ⬇️⬇️ https://t.co/nqaB3kAkAy

The CCVI score on there is the “COVID-19 Community Vulnerability Index,” which factors in several things such as rates of poverty, ability to access transportation and epidemiological factors (think: risk of diabetes, underlying conditions).

Some other interesting tidbits about the CCDPH response included in the image below.

Food establishments/workplace complaints have demanded the most attention from CCDPH. The department has also investigated more than 300 cases/close contacts in suburban Cook County schools. https://t.co/LA0A9YBXOo

The report continued with a focus on Cook County’s contact tracing efforts. The county’s contact tracing initiative includes 180 contact tracers and 60 case investigators.

Some quick hits:

-Cook County had 9,400 actionable COVID positive tests in February.

-They reached out to 92 percent of those people and interviewed 65 percent of folks.

-Contact tracers have interviewed 76 percent of people who have had close contact with an infected person.

That concluded the CCDPH and Rocha’s report. The floor was then opened up for questions from @CookCtyHealth board members.

Director Harrington kicked it off and commended the work of everyone involved in the CCDPH. He then asks what is considered close contact and wants to know why contact tracing is no longer part of the weekly COVID report they are receiving.

Close contact pertains to anyone who has been within six feet of an infected person for more than 10–15 minutes. Dr. Joshi says he will make sure the directors always have a contact tracing update going forward.

Hammock wants to know if everyone living at nursing homes and congregate care settings in suburban Cook County have had the opportunity for vaccinations.

He’s told they have been. But the challenge has been convincing residents and staff to take vaccine.

They are currently doing focus groups with the city of Chicago to try and figure out why there is vaccine hesitancy among staff and residents.

That concluded the questions. Rocha took the floor once more to commend the work of the county’s response team, and then segued into talking about the media coverage Cook County has received as part of its response.

Which felt a bit weird, to me, to be celebrating that. But I guess it’s worth celebrating positive coverage when you have Loretto Hospital just down the road.

Anyway. Commissioner Dennis Deer took the floor next.

“Man, we have a fantastic CEO, a fantastic Department of Public Health, and along with our fantastic board here, we can’t go wrong.”

“Good words,” Hammock said.

Contrary to what’s on the agenda, Hammock continued and said there would be no closed session for today’s meeting. As is the norm at @CookCtyHealth meetings, they voted on all items at the end.

Everything passed, except Request Nos. 5 and 16 of contracts and procurements.

A motion to adjourn the meeting was brought. Hammock reminded people to think about meeting in person come April, and the meeting ended.

Which also concludes my coverage for @CHIdocumenters from today’s @CookCtyHealth Board meeting! Thanks so much for following along.

If you value this reporting, please continue to support us through @city_bureau, or join up at http://Documenters.org! Till next time.