I. · Sandra Martell, RN, DNP – Cook County Department of ... Dan Howard, System Chief...

Minutes of the meeting of the Board of Directors of the Cook County Health and Hospitals System held Friday, September 23, 2011 at the hour of 7:30 A.M. at 1900 West Polk Street, in the Second Floor Conference Room, Chicago, Illinois.

I. Attendance/Call to Order

Chairman Batts called the meeting to order. Present: Chairman Warren L. Batts and Directors David Carvalho; Quin R. Golden; Benn Greenspan, PhD,

MPH, FACHE; Sister Sheila Lyne, RSM; Luis Muñoz, MD, MPH; and Heather E. O'Donnell, JD, LLM (7)

Present Telephonically: Director David A. Ansell, MD, MPH (1) Absent: Vice Chairman Jorge Ramirez and Director Hon. Jerry Butler (2)

Chairman Batts stated that Director Ansell was unable to be physically present, but would like to participate in the meeting telephonically.

Director Golden, seconded by Director Lyne, moved to allow Director Ansell to participate as a voting member for this meeting telephonically. THE MOTION CARRIED UNANIMOUSLY.

Director Ansell indicated his presence telephonically.

Additional attendees and/or presenters were:

Michael Ayres – Consultant to the System Cathy Bodnar – System Chief Compliance Officer John Cookinham – System Interim Chief Financial

Officer Jim DeLisa – System Director of Plant Operations Patrick T. Driscoll, Jr. – State’s Attorney’s Office Claudia Fegan, MD – System Interim Chief Medical

Officer Gina Goodson-Allen – System Director of Recruitment

and Talent Management Helen Haynes – Office of the System General Counsel Dan Howard – System Chief Information Officer Dorothy Loving – Executive Director of Finance

Randall Mark – System Director of Intergovernmental Affairs and Policy

Sandra Martell, RN, DNP – Cook County Department of Public Health

Stephen Martin, PhD, MPH – Cook County Department of Public Health

Terry Mason, MD – System Interim Chief Executive Officer

John O’Brien, MD – System Chair of Planning, Education and Research

Deborah Santana – Secretary to the Board Nita Stith – Supply Chain Management Tom Schroeder – System Director of Internal Audit Kimberly Velasquez – System Director of Budget

II. Public Speakers

Chairman Batts asked the Secretary to call upon the registered speakers. The Secretary called upon the following registered speakers: 1. George Blakemore Concerned Citizen 2. Leslie Curtis Director – National Nurses Organizing Committee

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CCHHS Board of Directors Meeting Minutes Friday, September 23, 2011

III. Board and Committee Reports

A. Minutes of the Board of Directors Meeting, August 26, 2011

Director Greenspan, seconded by Director Golden, moved the approval of the minutes of the Board of Directors Meeting of August 26, 2011. THE MOTION CARRIED UNANIMOUSLY.

B. **Minutes of the Audit and Compliance Committee Meeting, September 6, 2011

Note: this item was considered following the adjournment of closed session. Director Golden, seconded by Director O’Donnell, moved the approval of the minutes of the Audit and Compliance Committee Meeting of September 6, 2011. THE MOTION CARRIED UNANIMOUSLY.

C. Minutes of the Special Board Meeting, September 16, 2011

This item was deferred to the Special Meeting of the System Board, scheduled for Wednesday, September 28, 2011.

D. **Minutes of the Quality and Patient Safety Committee, September 20, 2011

Director Ansell, seconded by Director Muñoz, moved the approval of the minutes of the Quality and Patient Safety Committee Meeting of September 20, 2011. THE MOTION CARRIED UNANIMOUSLY.

IV. Action Items

A. Proposed Resolution – in appreciation of Dr. Terry Mason’s leadership as Interim Chief Executive Officer of the Cook County Health and Hospitals System (Attachment #1)

Chairman Batts, seconded by Director Lyne, moved the approval of the proposed Resolution in appreciation of Dr. Terry Mason’s leadership as Interim Chief Executive Officer of the Cook County Health and Hospitals System. THE MOTION CARRIED UNANIMOUSLY.

B. Proposed Resolution in recognition of Stephen A. Martin, Chief Operating Officer of the Cook County Department of Public Health (Attachment #2)

Chairman Batts, seconded by Director Golden, moved the approval of the proposed Resolution in recognition of Stephen A. Martin, Chief Operating Officer of the Cook County Department of Public Health. THE MOTION CARRIED UNANIMOUSLY.

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IV. Action Items (continued)

C. Approval of Memoranda of Understanding between the Medical Staff of the John H. Stroger, Jr.

Hospital of Cook County and the Cook County Health and Hospitals System and between the Medical Staff of Provident Hospital of Cook County and the Cook County Health and Hospitals System regarding the status of certain members in the Affiliate category of the Medical Staffs of Stroger and Provident Hospitals, respectively. Dr. Claudia Fegan, System Interim Chief Medical Officer, and Helen Haynes, System Associate General Counsel, provided additional information on the item presented. Dr. Fegan stated that there are members of the medical staff that have membership at multiple institutions. Typically, one becomes a member of the medical staff of the first hospital at which one seeks privileges for, and becomes an affiliate member of other subsequent hospitals. In the Bylaws, it is written when that original medical staff appointment ceases to exist, so do all of the affiliate memberships. It is not the intention to eliminate members of the medical staff of Oak Forest Hospital who are also working at Provident and Stroger Hospitals; this will allow those memberships to continue not as affiliates, but as members going forward. Ms. Haynes stated that this is necessary to prevent an inadvertent interpretation of the Bylaws of Provident and Stroger Hospitals; she noted that this will be presented to the Medical Executive Staffs to make minor adjustments in language, in negotiation with the medical staffs, in order to finalize the document.

Director Greenspan, seconded by Director Muñoz, moved the approval of the Memoranda of Understanding. THE MOTION CARRIED UNANIMOUSLY.

D. Report on Amendments to the County Procurement Code and proposed interim procedures Ms. Haynes provided an update on recent revisions to the County’s Procurement Code, adopted by the County Board on September 7, 2011. To ensure that the System’s Procurement Policy remains consistent with the County’s Procurement Code, amendments to the System’s Procurement Policy to reflect these changes are expected to be presented to the System Board for approval in October. However, as most of the revisions to the County’s Procurement Code will go into effect on October 7th, and because the amendments to the System’s Procurement Policy have not yet been presented to and approved by the System Board, Ms. Haynes recommended that the System Board direct the System’s Director of Supply Chain Management, in consultation with counsel, to conform the System’s practices, to the extent deemed necessary, to the amended Procurement Code, beginning October 7th. Ms. Haynes noted that one of the revisions to the Procurement Code is to amend the authority of the Procurement Director to enter into contracts, subject to following an appropriate method of procurement, in amounts up to $150,000; currently, the limit of authority is $25,000 for professional services contracts and $100,000 for all other contracts. She stated that unless this Board elects to direct that the System proceed in a more conservative manner, the Board would approve transactions of $150,000 and greater, which would reduce the number of smaller transactions being presented to the Board. It also grants a broader authority to the Procurement Director to amend, extend, increase (within certain limits) and terminate contracts. The Board discussed the revision increasing the authority of the Procurement Director to enter into contracts in amounts up to $150,000. Director Carvalho noted that the System Board receives a quarterly report on these types of contracts executed under the authority of the Purchasing Director.

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IV. Action Items

D. Report on Amendments to the County Procurement Code and proposed interim procedures (continued)

Director Carvalho, seconded by Director Greenspan, moved to direct the System’s Director of Supply Chain Management to conform practices as closely as possible to the new County Code, in consultation with counsel as to what may be necessary, beginning October 7, 2011, pending the presentation of the proposed Amendments to the System’s Procurement Policy to the System Board for their consideration in October. THE MOTION CARRIED UNANIMOUSLY.

E. CCHHS Financial Statements and Combining Supplemental Schedules, as of and for the Year Ended November 30, 2010, and Independent Auditors’ Report

Michael Ayres, Consultant to the System, and Dorothy Loving, Executive Director of Finance, provided an overview of the items presented. The Board reviewed and discussed the information. Dan Howard, System Chief Information Officer, provided a brief update on the County’s activities regarding the selection of a time and attendance system and enterprise resource planning (ERP) system. Once the Requests for Proposals (RFPs) are issued, it will likely take the County ninety days to six months to select a vendor for these systems; a good estimate of the total timeframe is one year.

Director Golden, seconded by Director Lyne, moved to receive and file the CCHHS Financial Statements and Combining Supplemental Schedules, as of and for the Year Ended November 30, 2010, and Independent Auditors’ Report. THE MOTION CARRIED UNANIMOUSLY.

F. Contracts and Procurement Items (Attachment #3)

Nita Stith, Interim Deputy Director of Supply Chain, presented the requests for the Committee’s consideration. She stated that request number 2 is being withdrawn at this time, due to contract compliance issues. Dr. John O’Brien, System Chair of Planning, Education and Research, provided additional information regarding request number 1. Director Carvalho requested additional information on request number 3, regarding the commercially useful function fulfilled by JJC Group, Inc., with regard to contract compliance. With regard to request number 2, Director Carvalho inquired further as to the reason for the withdrawal of the request. Ms. Stith stated that the System is working through getting the plan for compliance validated with Contract Compliance; discussions are underway, but the matter was not finalized and completed in time for this meeting. Director Carvalho noted that the Board has scheduled a Special Meeting to approve the proposed CCHHS FY2012 Preliminary Budget on September 28th; he requested that this item be placed on the agenda for the Board’s consideration at the Special Board Meeting on September 28th.

Director Carvalho, seconded by Director Lyne, moved the approval of request numbers 1 and 3 under the Contracts and Procurement Items. THE MOTION CARRIED UNANIMOUSLY.

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IV. Action Items (continued)

G. Any items listed under Sections III, IV, V and VIII V. Recommendations, Discussion/Information Items

A. Proposed plan for use of Building C on the Oak Forest Campus for storage for the Clerk of the Circuit Court of Cook County (Attachment #4)

Jim DeLisa, System Director of Plant Operations, provided an overview of the item presented.

Director Carvalho, seconded by Director Lyne, moved the approval of the proposed plan for use of Building C on the Oak Forest Campus for storage for the Clerk of the Circuit Court of Cook County. THE MOTION CARRIED UNANIMOUSLY.

VI. Report from Chairman of the Board

Chairman Batts provided brief comments regarding the proposed CCHHS FY2012 Preliminary Budget and related activities. He stated that he was unable to attend two of the public hearings held, and thanked Director Greenspan and Director Carvalho for their efforts and contributions in his absence.

VII. Report from Interim Chief Executive Officer (Attachment #5)

Dr. Mason provided an overview of his report, which included information on the following subjects: Oak Forest Health Center; recent Cook County Board Meetings; Nominating Committee of the CCHHS Board of Directors; Bond Rating Agencies; Section 1115 Waiver; the Cook County STAR (Set Targets Achieve Results) Report; and Update on Revenue Cycle Activities. The Board reviewed and discussed the information. Randall Mark, System Director of Intergovernmental Affairs and Policy, provided additional information regarding the update on the Section 1115 Waiver. The Board discussed the following subjects related to the matter: the infrastructure and resources needed to implement this program; the financial benefits gained in implementing this program; timeline for submission of waiver application and subsequent activities; and whether there are any risks to which the System could be exposed. Dr. Mason stated that further details and information will be provided to the Board, as the administration moves forward through the process. Dr. Mason congratulated Kimberly Velasquez, Director of Budget, who has announced that she will be retiring at the end of the month. He thanked her for her many years of service to the County.

A. Discussion of proposed CCHHS FY2012 Preliminary Budget

Note: this item was considered following the adjournment of closed session. The Board discussed the proposed CCHHS FY2012 Preliminary Budget, which is expected to be approved at the Special Meeting of the Board scheduled for Wednesday, September 28th. Subjects discussed included, but was not limited to, the following: strategies to address the current projected gap between the System’s proposed budget and the County’s proposed subsidy; current budgeted amount for Access to Care; activities relating to the FY2011 appropriation for dental services and the work being done to set up a dental model; and comparison of past several years of County subsidy amounts.

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VII. Report from Interim Chief Executive Officer

A. Discussion of proposed CCHHS FY2012 Preliminary Budget (continued)

During the discussion regarding the comparison of the past several years of County subsidy amounts, Dr. Mason noted that, if one looks at what has been the subsidy that the County has enjoyed over the years, and takes out the funding for the Juvenile Temporary Detention Center and Cermak Health Services at the Department of Corrections, there’s only $72 million left to fund the entire rest of the System; he added that there used to be nearly $200 million for that purpose. Director Carvalho provided information on the County subsidy amounts for the past several years, as follows:

FY2002 - $225 million FY2003 - $188 million FY2004 - $187 million FY2005 – $204 million FY2006 - $244 million FY2007 - $275 million FY2008 - $436 million FY2009 - $472 million FY2010 - $386 million FY2011 - $272 million (excluding Account 899 – Fixed Charges in FY2011)

Dr. Mason noted that, until FY2011, the appropriation for Account 899-Fixed Charges was included in the County’s Budget, not the System’s Budget. Mr. Ayres provided additional information. He stated that last year, the County transferred $106 million from their expense to the System, and the System had to pay this expense through a reduced subsidy. With regard to the information that will be provided at the October 3rd Public Hearing before the County Board’s Finance Committee, Chairman Batts recommended that the presentation start with the historical numbers in a format that tracks this information and presents it for public consumption. Director Greenspan added that a chart that shows the actual subsidy available for care each year should also be provided.

VIII. Closed Session Items

A. Proposed Salary Offers B. **Minutes of the Audit and Compliance Committee Meeting, September 6, 2011 C. **Minutes of the Quality and Patient Safety Committee Meeting, September 20, 2011

Director Muñoz, seconded by Director Lyne, moved to recess the regular session and convene into closed session, pursuant to the following exceptions to the Illinois Open Meetings Act: 5 ILCS 120/2(c)(1), regarding “the appointment, employment, compensation, discipline, performance, or dismissal of specific employees of the public body or legal counsel for the public body, including hearing testimony on a complaint lodged against an employee of the public body or against legal counsel for the public body to determine its validity,” and 5 ILCS 120/2(c)(17), which permits closed meetings for consideration of “the recruitment, credentialing, discipline or formal peer review of physicians or other health care professionals for a hospital, or other institution providing medical care, that is operated by the public body.”

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VIII. Closed Session Items (continued)

On the motion to recess the regular session and convene into closed session, a roll call was taken, the votes of yeas and nays being as follows:

Yeas: Chairman Batts and Directors Ansell, Carvalho, Golden, Greenspan, Lyne, Muñoz and O’Donnell (8)

Nays: None (0) Absent: Vice Chairman Ramirez and Director Butler (2) THE MOTION CARRIED UNANIMOUSLY and the Board convened into closed session.

Chairman Batts declared that the closed session was adjourned. The Board reconvened into regular session.

Director Greenspan, seconded by Director Golden, moved the approval of the proposed salary offers presented in closed session. THE MOTION CARRIED UNANIMOUSLY.

Note: following closed session, the Board returned to the discussion of Item VII(A) - the Report of the Interim Chief Executive Officer, Discussion of Proposed CCHHS FY2012 Preliminary Budget.

IX. Adjourn

As the agenda was exhausted, Chairman Batts declared the MEETING ADJOURNED. Respectfully submitted, Board of Directors of the Cook County Health and Hospitals System

XXXXXXXXXXXXXXXXXXXXXXX Warren L. Batts, Chairman

Attest:

XXXXXXXXXXXXXXXXXXXXXXXXX Deborah Santana, Secretary

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Cook County Health and Hospitals System Minutes of the Meeting of the Board of Directors

September 23, 2011

ATTACHMENT #1

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DRAFT

R-11-**

COOK COUNTY HEALTH AND HOSPITALS SYSTEM BOARD OF DIRECTORS

RESOLUTION

Sponsored by

WARREN L. BATTS, CHAIR, JORGE RAMIREZ, VICE CHAIR,

DAVID A. ANSELL, M.D., THE HONORABLE JERRY BUTLER, DAVID CARVALHO, QUIN R. GOLDEN, BENN GREENSPAN, Ph.D.,

SISTER SHEILA LYNE, RSM, LUIS MUNOZ, M.D., AND HEATHER E. O’DONNELL

DIRECTORS

WHEREAS, in May of 2011, Terry Mason, M.D., Chief Medical Officer of the Cook County Health and Hospitals System, was appointed by the Health System Board of Directors to serve as the Health System’s Interim Chief Executive Officer; and WHEREAS, in assuming the role of Interim Chief Executive Officer, Dr. Mason continued to demonstrate his dedication and unwavering commitment to the medically underserved residents of Cook County, Illinois and to the Cook County Health and Hospitals System; and WHEREAS, in stepping into this leadership role, Dr. Mason advocated for the Health System and its mission with the System’s various stakeholders throughout the community; and WHEREAS, during his tenure as Interim Chief Executive Officer, Dr. Mason provided enthusiastic leadership and wise counsel to members of the Health System’s Senior Leadership Team and worked collaboratively with the Health System Board of Directors in advancing the Health System’s mission and its Strategic Plan: Vision 2015. NOW, THEREFORE, BE IT RESOLVED, that the Board of Directors of the Cook County Health and Hospitals System, on behalf of the more than five million residents of Cook County served by the System, does hereby recognize and extend its appreciation to Dr. Terry Mason for his outstanding service as Interim Chief Executive Officer of the Cook County Health and Hospitals System. Approved and adopted this 23th day of September, 2011. WARREN L. BATTS Chair, Board of Directors

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September 23, 2011

ATTACHMENT #2

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PROPOSED RESOLUTION

Sponsored by

WARREN L. BATTS, CHAIR, JORGE RAMIREZ, VICE CHAIR, DAVID A. ANSELL, M.D., THE HONORABLE JERRY BUTLER, DAVID CARVALHO,

QUIN R. GOLDEN, BENN GREENSPAN, Ph.D., SISTER SHEILA LYNE, RSM, LUIS MUNOZ, M.D., AND HEATHER E. O’DONNELL, DIRECTORS

HONORING DR. STEPHEN A. MARTIN JR.

WHEREAS; the Cook County Department of Public Health is the state-certified local public health agency serving 125 incorporated municipalities in 30 townships, covering a 700 square mile area, with a large urban population of approximately 2.3 million residents; and WHEREAS; Stephen A. Martin, Jr. Ph.D., M.P.H. was appointed the Chief Operating Officer of the Cook County Department of Public Health in 2002; and WHEREAS; Stephen A. Martin, Jr. has been responsible for public health programs and services for one of the nation’s largest metropolitan health departments, ranging from policy development; emergency preparedness; communicable disease control and prevention; epidemiology; health promotion; maternal and child health; STD/HIV; violence prevention; and environmental health; and WHEREAS; Stephen A. Martin, Jr. played a leadership role in updating numerous public health laws and regulations at the state and local level; and WHEREAS; Stephen A. Martin, Jr. has significantly improved the use of information technology with special emphasis on early surveillance in communicable disease prevention to better serve residents of suburban Cook County; and WHEREAS; Stephen A. Martin, Jr. successfully lead his staff, volunteers and residents through the 2009 H1N1 pandemic to ensure residents were protected from the virus; and WHEREAS; Stephen A. Martin, Jr. holds a Ph.D. from the University of Michigan in Epidemiologic Science, and a M.P.H. in Epidemiology and a B.S. in Biology from Tulane University; and WHEREAS; Stephen A. Martin, Jr. is a member of the American College of Epidemiology, American Public Health Association, Society for Epidemiologic Research, and the Council of State and Territorial Epidemiologists; and WHEREAS; Stephen A. Martin, Jr. is a fellow of Leadership Greater Chicago, the Institute of Medicine of Chicago, member of the Council on Education for Public Health, the Northern Illinois Public Health Consortium, Illinois Department of Public Health–LHD Executive Advisory Group, and the State of Illinois Maternal and Child Health Advisory Board; and WHEREAS; Stephen A. Martin, Jr. serves on the faculty at the Texas A&M University School of Rural Public Health, University of Illinois at Chicago School of Public Health, and the University of North Texas Health Science Center. NOW, THEREFORE, BE IT RESOLVED, that the Board of Directors of the Cook County Health and Hospitals System, does hereby recognize the efforts of Dr. Stephen A. Martin, Jr. during his tenure as Chief Operating Officer for the Cook County Department of Public Health and the outstanding dedication he provided to protecting the health of suburban Cook County residents. Approved and adopted this 23rd day of September, 2011. WARREN L. BATTS Chair, Board of Directors

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September 23, 2011

ATTACHMENT #3

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COOK COUNTY HEALTH AND HOSPITALS SYSTEM

ITEM IV(F)

SEPTEMBER 23, 2011 BOARD OF DIRECTORS MEETING

CONTRACTS AND PROCUREMENT ITEMS

Request

# Vendor Service or Product Fiscal Impact

Affiliate /

System

Begins

on Page

#

1

Rush University Medical

Center

Service ‐ Cardiothoracic Physicians

Assistants Program No fiscal impact SHCC 2

2 PricewaterhouseCoopers

Service ‐ Cerner / Siemens Re‐

engineering and Physician Billing

Vendor Management $6,270,330.00 System 4

3 McKesson Technologies, Inc.

Service / Product ‐ Nurse scheduling

software $1,500,849.00 System 6

Amend Subagreement to the Master Affiliation Agreement

Execute Contract

Amend and Increase Contract

Page 1 of 7 of 42

Cook County Health & Hospitals System

BOARD APPROVAL REQUEST

REQUESTING DEPARTMENT: Department of Planning, Education and Research

. Department of Surgery, Division of Cardiothoracic Surgery

John O'Brien, M.D., a a o P ann4hQI. Education and I SPONSOR: if:: OUttt/tt

Research, CCHHS Tanda Russell, Direct of Perioperative Service~, .riJ ()1 1 i "' CCHHS ·\!)J<_ ~1/"1 r•

DATE: 09/09/2011 TYPE OF REQUEST: Amend Subagreement to the Master Affiliation Agreement

PRODUCT I SERVICE: Service - Cardiothoracic Ph_y_sician Assistants Program VENDOR/SUPPLIER: Rush University Medical Center, Chicago, Illinois

FISCAL IMPACT I ACCOUNT: GRANT FUNDED AMOUNT: None N!A CONTRACT PERIOD: CONTRACT #: 07/01/2010 thru 06/30/2013 H09-25-025

COMPETITIVE SELECTION METHODOLOGY: [BID I RFP I GPO I OMP] N/A

X NON-COMPETITIVE SELECTION METHODOLOGY: [SOLE SOURCE} Single Feasible Provider

PRIOR CONTRACT HISTORY: The Master Affiliation Agreement {04-41-730) between the Cook County Health and Hospitals System and Rush Medical Center has been in place since 2004. This Master Agreement allows for medical educational, research and clinical programs between Rush Medical Center and Stroger Hospital. The Cardiothoracic Program allows for Graduate Medical Education in Cardiovascular Surgery.

Contract No. Description Bd .. APproval Start Date End Date Amount Months H09-25-025 Original 06/26/2009 07/01/2009 06/30/2010 $528,236.00 12 H09-25-025 Renew 06/25/2010 07/01/2010 06/30/2013 $1,788,675.00 36

Subagreement H09-25-025 Amend 10/01/2011 06/30/2013 None 20

Subag reement

NEW PROPOSAL JUSTIFICATION: This is a request to amend the current subagreement to provide Physician Assistant coverage as opposed to Resident coverage. Due to resident staff shortages, Rush Medical Center can only send one resident. This proposed agreement would allow the Department of Surgery to utilize the remaining contractual funds for physician assistant coverage not currently utilized by residents at Rush Medical Center. Thi ... nn fie,..-!> I ;n'\,.,...::.,., or

change. APPROVED FINANCIAL BENEFIT: [Prior Cost versus New Cost] Savings calculation: N/A Percent: N/ A SEP 2 3 2011

TERMS OF REQUEST: BY BOARD OF

This is a request to amend the subagreement H09-25-025 to the Master 'ri~~~~~~~~ ::lude physician assistant coverage for a period of 20 months from 1 0/01/2011 .... w"~ .... ~...,~'oJ, ..... ~.,...~ ...... ~ ..... + .. :.=..::::;.:..;.:.:..::::..::~.:.::.:~

CONTRACT COMPLIANCE HAS FOUND THIS CONTRACT RESPONSIVE? N/A

Request #1

• Ambulatory & Community Health Network • Cennak Health Services • Department of Public Health • • John H. Stroger, Jr. Hospital of Cook CountY • Oak Forest Hospital • Provident Hospital • Ruth M. Rothstein

CORE Center •

We Bring Health CARE to Your Community Revised 03/01/2011

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DATE: I PRODUCT I SERVICE: 09/09/2011 Service- Cardiothoracic Physician Assistants Program TYPE OF REQUEST: J VENDOR I SUPPLIER: Amend Subagreement to the Master l Rush University Medical Center, Chicago, Illinois Affiliation Agreement l ·

ATTACHMENTS BID TABULATIONS: N/A

CONTRACT COM~CtMEM0\ N/A

CCHHSCOO:~~ Carol Schneider, --~.~':·.im.·. C. hi.ef. ()j.7;e a .. t1.pg. O .. ·fficer / ' \ . ,. f(! I" (} •. I f/ /,1

' '! I V f •1 r ,r/ /i li j;~ CCHHS CEo:( d it·~,~~ r ,.:J1·DZ 1

/

Terry Mason, lntenm.Cnief Exe!cutive Officer I

• Ambulatory & Community Health Network • Cennak Health Services • Department of Public Health • • John H. Stroger, Jr. Hospital of Cook County • Oak Forest Hospital • Provident Hospital • Ruth M. Rothstein

CORE Center •


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Cook County Health & Hospitals System ~ · .~-:·.


REQUESTING DEPARTMENT: Department of Finance

PRODUCT I SERVICE: DATE: 09/09/2011 Service -Gerner I Siemens Re-engineering and Physician Billing Vendor

Management TYPE OF REQUEST: VENDOR I SUPPLIER: Amend and Increase Contract PricewaterhouseCoopers, LLP, Chicago, Illinois FISCAL IMPACT I ACCOUNT: GRANT FUNDED AMOUNT: 890-260 CCHHS (2011-A) $1,490,900.00 N/A 890-260 CCHHS (2011-B) $1,936,970.00 890-260 CCHHS (2011-C) $2,322,960.00 890-260 CCHHS (2011-D) $519,500.00 Total: $6,270,330.00 CONTRACT PERIOD: CONTRACT #: 07/13/2010 thru 07/12/2013 H10-25-113 X COMPETITIVE SELECTION METHODOLOGY: [BID I RFP I GPO I OMP]

RFP NON-COMPETITIVE SELECTION METHODOLOGY: [SOLE SOURCE] N/A

PRIOR CONTRACT HISTORY: The Board of Directors of CCHHS approved execution of contract H1 0-25-113 with PricewaterhouseCoopers, LLP to provide performance improvement implementation services. As per existing agreement with PwC, under scope of services section (I-B), this contract allows for the provision of additional Statements of Work (SOW) to be added, changed and/or modified given the nature of the healthcare environment.

NEW PROPOSAL JUSTIFICATION: This is a request to amend and increase the current contract with PwC to provide four additional Statements of Work to allow for the implementation of the standardized charge capture, physician documentation and billing for services performed by CCHHS.

Statement of Work: Revenue Cycle Charge Capture I Patient Access, COM Special Projects (2011-A) The work to be completed within this SOW is related to the performance of operational support and the design and implementation of the Charge Capture I Patient Access and GDM Special Projects that include roll out to 15 clinics/departments. PwC will provide subject matter expertise and perform activities that are typically performed by a Revenue Integrity Department; these activities are incremental to the agreed upon activWtfim1t(-9rlginal transformation scope SOW: W N 1. Design charge capture process, develop detailed mapping of orders to charges in Gerner and between Gerner

and Siemens, and support implementation rollout to 15 clinics/departments; PwC will work closely with GGHHS HIS and Gerner EMR build teams to standardize physician documentation and charge capture process.

2. Training and Education: PwC will provide training and education utilizing the train-the-trainer approach. Knowledge and understanding of the unique aspects of the System will be utilized along with leverage of the vendor training material to develop recommendations on focused training and education.

Request Statement of Work: Revenue Cycle Siemens Migration: Phase II (2011-B) #2 In collaboration with CCHHS and Siemens resources, PwC will provide oversight support to the planning and implementation efforts for continued efforts from the Phase I outstanding items. PwC will conduct planning sessions with CCHHS and Siemens to complete design and implementation timeline planning for the roll out of Phase II. PwC will work closely with GGHHS and Siemens to: 1. Determine the appropriate staging for the deployment of the recommended changes that will help mitigate any

disruption in current operations;

• Ambulatory & Community Health Network • Cermak Health Services • Department of Public Health • • John H. Stroger, Jr. Hospital of Cook County • Oak Forest Hospital • Provident Hospital • Ruth M. Rothstein

CORE Center •

We Bring Health CARE to Your Community Revised 03/01/2011 of 42

PRODUCT I SERVICE: DATE: 0910912011 Service -Gerner I Siemens Re-engineering and Physician Billing Vendor

Management TYPE OF REQUEST: VENDOR I SUPPLIER: Amend and Increase Contract PricewaterhouseCoopers, LLP, Chicago, Illinois

Statement of Work: Revenue Cycle Siemens Migration: Phase II (2011-B) continued 2. Support the planning and implementation of the recommended changes that will enable optimization of the

Siemens applications; and 3. Support the mapping of Gerner charge services to Siemens charge description master including support for the

testing of interfaces and training of resources.

Statement of Work: Revenue Cycle Optimization: Gerner and Related Systems (2011-C) PwC will provide subject matter expertise and perform activities to support the completion and optimization of the original Gerner build. As part of this implementation effort, PwC will support CCHHS to validate current processes compared to leading practice health systems, develop design specifications to provide IT for the building of a standardized physician documentation form, order sets by specialty mapped to Gerner charge services and Siemens charge description master file. A phased approach will be utilized to support the implementation across fifteen (15) clinics/departments. Training will be conducted utilizing the train-the-trainer approach and a detailed prioritized implementation plan will be developed to support continued roll out to the remaining clinics.

Statement of Work: Physician Billing Vendor Management (2011-D) PwC will perform activities that are typically performed by a vendor Management Department. Currently this department does not exist at CCHHS. Activities include but are not limited to: 1. Utilize workflow information obtained from physician interviews, analysis of data and scope of services provided

by the Physician Billing Vendor to provide operational support related to physician billing and education tasks 2. Provide current state CCHHS insight to the billing vendor, highlighting areas of opportunity and gaps related to

physician charge capture, documentation, clinic structure and reporting. PwC will work with CCHHS and Physician Billing Vendor to support work plans focusing on accurate and compliant physician services billing to build momentum that translates into financial or operational gains.

FINANCIAL BENEFIT: [Prior Cost versus New Cost] Savings calculation: NIA Percent: Nl A

TERMS OF REQUEST: This is a request to amend contract H1 0-25-113 to include additional SOWs to support the Revenue Cycle Transformation efforts and to increase the contract amount by $6,270,330.00.

CONTRACT COMPLIANCE HAS F~ THIS CONTRACT RESPONSIVE?

ATTACHMENTS 1 "--~ BID TABULATIONS: N#A ~ CONTRACT C~~puf;~, M.EMO: /~~in~ "

! I j lLJ ;1 • r{/(./(•1 CCHHS CEO: '"'---- . L· L 7 . . t

Pending

Terry Mason, Interim Chief Execu~ive Officer /


CORE Center •

We Bring Health CARE to Your Community Revised 03/01/2011 of 42

._· · · · · ··<·co~k County H~aJth & Hospitals System .. :_=· ... . -. · .. ~:.':\ _:~;:J.tf~ ' " '$ y • I -~~


REQUESTING DEPARTMENT: SPONSOR: r) /) Roz Lennon, Chief Clinical Officer, CCHHS L~, \ Dan Howard, Chief Information Officer, CCHHS ~ ~

Health Information Systems

DATE: PRODUCT I SERVICE: V' 09/09/2011 Service I Product- Nurse Scheduling Software TYPE OF REQUEST: VENDOR I SUPPLIER: Execute Contract McKesson Technologies, Inc., Alpharetta, Georgia FISCAL IMPACT I ACCOUNT GRANT FUNDED AMOUNT: 890-441 CCHHS $1,500,849.00 N/A CONTRACT PERIOD: CONTRACT#: 10/01/2011 thru 09/30/2016 H11-25-097

COMPETITIVE SELECTION METHODOLOGY: [BID I RFP I GPO I OMP] N/A

X NON-COMPETITIVE SELECTION METHODOLOGY: [SOLE SOURCE] Single Feasible Provider

PRIOR CONTRACT HISTORY: Previous contract was supported by this vendor and has expired. Approval of payment was issued by the Cook County Health and Hospitals System on 01/22/2010.

NEW PROPOSAL JUSTIFICATION: McKesson Technologies, Inc. is CCHHS provider for the automated nurse staffing office systems (ANSOS) that is currently used throughout the Cook County Health and Hospitals System. This software application will help CCHHS more effectively schedule, staff and manage human resources across the continuum of care. This proposal includes support and maintenance for a period of five (5) years, an upgrade to the current ANSOS software, license expansion, implementation services as well as hardware necessary for the project. McKesson Technologies, Inc. has implementation and training tools to quickly train staff while ensuring that the needs of CCHHS are met.

FINANCIAL BENEFIT: [Prior Cost versus New Cost] Savings calculation: $59,127.84 Percent: 6% This proposal represents a decrease in average annual cost from $198,825.57 for support and maintenance in the previous contract, to approximately $187,000.00 per year for support and maintenance of the upgraded system and additional licenses.

TERMS OF REQUEST: This is a request to execute H11-25-097 for a period of 60 months from 10/01/'i. b1APPftG)¥6Dnt )f $1 ,500,849.00.

CONTRACT COMPLIANCE HAS FOUND THIS CONTRACT RESPONSIVE: Y ~s SEP 2 ~, ZO 11

ATTACHMENTS /·-"·>~ BID TABULATIONS: N/A / CONTRACT COMPLIANCE ~s

CCHHS COO:~ - ""' Carol Schneid~,J ntenm' ~h ~~ Opera~Otfice:. CCHHS CEO:'. ___ i vi_ '-·l['} /Z /(ft l Terry Mason, lnterim~Chief Exefutive Officer

BY BOARD OF DIRECTORS OF THE COOK COUNTY HEALTH AND HOSPITALS SYSTEM

Request# 3


CORE Center •


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THE BOARD OF COMMISSIONERS TONI PRECKWINKLE

PRESIDENT

EARLEAN COUINS 1St Dis! PETER N. SilVESTRI ROBERT STEEL£ 2nd Dist. BRIDGET GAINER JERRY BUTLER 3rt! Oist JOHN P. OA:..EY WIWAM M. BEAVERS 4tn Dist. JOHIJ A. FfUTCHEY DEBORAH SIMS 5th De;t lARRY SUfFREDIN JOAN PATRICIA MURPHY 6!0 D1Sl. GREGG GOSUN JESUS G. GARCIA 7tn Dis! TIMOTHY 0. SCHNEIDER EDWIN REYES Btn Dist. JEFFREY R. TOBOLSKI

El.lZASETH ANN DOODY GORMAN

August 31, 2011

9tfl DIS!. 10th Oist 11th D1Sl. 12th Dist. 13th 01S! 14!11 Oist. 1srn Dis: 16th Dist. 17111 Dis~.

Ms. Girvena LeBlanc, BA, .MP A Supply Chain Management Procurement Department John H. Stroger, Jr. Hospital 1969 W. Ogden Avenue, LL250 Chicago, IL 60612

Re: Contract No.: Hll-25-097 Amount: $1,500,849.00

Dear Ms. LeBlanc:

COOK COUNTY OFFICE OF CONTRACT COMPLIANCE

LAVERNE HALL DIRECTOR

1 I 8 North Clark Street. Room l 020 Chicago, Illinois 60602-1304

TEL (3 !2) 603-5502 FAX (312) 603--4547

The following bid for the above referenced contract has been reviewed for compliance with the General Conditions regarding the Minority and Women Owned Business Enteq>rises Ordinance and has been found to be responsive to the professional service goals of 35% participation_.

Bidder: McKesson Technologies Inc.

M/WBE JJC Group, Inc. Computer Products & Supplies futemational

Status MBE(9) WBE(7)

% 25% (D) 10% (D)

The :MBEIWBE participation for the above-referenced contract number is provided specifically from:

Sale of Hardware to support the new upgrade, modules and users on the ANSOS One-Staff platform -commercial offthe shelfhardware to be purchased from a 3rdparty·MBEIWBE totaling $357,818.00.

The remaining portion of the contract totals $1,143,031.00 relates to the sole proprietary software ofMcKesson Technologies, Inc. McKesson Technologies, Inc. is the only vendor capable of providing maintenance, support and upgrade of the ANSOS Nurse Scheduling software.

The Office of Contract Compliance has been advised by the Requesting Department that no other bidders are being recommended for award.

~~cpk LaVerne Hall Contract Compliance Administrator

LH!lar

@ !>rimed on R::cyclcd Paper

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September 23, 2011

ATTACHMENT #4

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Transmitting a Communication, dated September 13, 2011 from

Anna Ashcraft, Director, Real Estate Management Division

The Office of the Clerk of the Circuit Court has requested temporary storage space for files and records it is mandated to store and maintain until space at the County's Hawthorn Warehouse facility is available.

Building "C" at the Oak Forest Hospital Campus has been vacant for some years. In order to avoid leasing additional space for this temporary need, thereby minimizing costs to the taxpayers, the County, with concurrence of the Health and Hospital Systems Board, intends to make this space available to the Clerk of the Circuit Court to meet this need until the build -out of the County's Hawthorne Warehouse facility is completed in late 2012.

Approval is recommended.

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OFFICE OF THE PRESIDENT

BOARD OF COMMISSIONERS OF COOK COUNTY

TONI PRECKWINKLE PRESIDENT

August 29, 2011

Honorable Dorothy A. Brown

118 NORTH CL.ARK STREET

CHICAGO, ILLINOIS 60602

(31 2) 603·6400

TOO (312) 603-!52!55

Clerk of the Circuit Court of Cook County Richard J. Daley Center, Room 1001 Chicago, Illinois 60602

Dear Clerk Brown:

This is in response to your letter of July 8, 2011, regarding the need for temporary storage space for files. We appreciate your patience and continued cooperation in the process of completing the Hawthorne Warehouse, which will provide what we hope will be a long-term solution to your storage needs.

To address your temporary space need, I have asked the Cook County Real Estate Management Division to investigate the options you proposed in your letter, as well as other solutions. Fortunately, space has been identified in a County-owned facility which can be made available quickly to accommodate the majority of this need, eliminating or greatly reducing the cost to taxpayers.

The solution we are proposing is as follows:

1. The County will clear all remaining salvage items from the ground floor of "Building C" at the Oak Forest Hospital Campus and make it available at no cost for your use until the Hawthorne Warehouse is completed. It is my understanding that your staff has inspected the area and determined that it will accommodate approximately 800 skids, or 32,000 boxes, of the 56,000 boxes for which space is needed this year. We will devote substantial County staff resources to clearing the space for your use, and delay any County or other use of the space until Hawthorne is available. Though staff informs me that this approach will require additional work on the part of your staff, it is my hope that with a combination of our resources we can avoid contracted services, thus avoiding cost to the taxpayer.

® Printed on Recyclt.~d Paper of 42

2. The Real Estate Management Division will continue to identify County-owned space and work to make it available. In addition, space may be identified through our continuing collaboration with the City of Chicago which could provide a low-cost option for this use.

3. If additional storage is still required, Real Estate Management will then proceed with either a short-term lease or a records storage facility arrangement such as you proposed in your letter. With the major portion of the files having been accommodated in County facilities, the cost incurred should be significantly reduced.

I want to thank you and your staff for your cooperation in this matter. The Real Estate Management Division, led by Ms. Anna Ashcraft, will continue to work with Mr. Moody to assure that you have the space necessary to fulfill your duties, while minimizing costs to the taxpayer.

Sincerely,

Toni Preckwinkle President

cc. Kurt Summers, Chief of Staff Maria Saldana, Chief, Bureau of Economic Development Anna Ashcraft, Director, Real Estate Management Division

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THE BOARD OF COMMISSIONERS TONf PRECKWJNKLE

PRESIDENT EARU:AN COU.INS 1510151. R08CRT ST'SElJ1 2nd Dlst. JERRYBIJT\..ER 3<d Olsl WilliAM 1.11. BEAVERS oillhOist OO:B()fl.t.H SIMS Sill Dis!. JOAN P. MURPHY 6111~.

JESUS G. GARCIA 7l.h01sl EOWINREYES 81110151.

PETEA N. SILVESTRI SU!Oisl.

To:

cc.

From:

Date:

8RIOOET GAINER 10111 Dis!. JOHN P. DALEY f1Ch01$1. JOHN A. FRiiCiieY 121h0ist LAWRENCE SUFFREOIN 13th Drat GReGGGOSUN 14th DISC. TIMOTh'V 0. SCI-M:IOER 15th Oist. JEFfReY R. TOOOt.SKI teen orst. B.llABEni~ DOCOVGORMAN 171h [)j$1,

MEMORANDUM

Herntan Brewer, Director Office of Capital Planning and Policy

MariaN. Saldana, Bureau Chief Bureau of Economic Development

Anna Ashcraft, Director ;;r}A Real Estate Management Division £YV'P'l August 12, 2011

BUREAU OF ECONOMIC DEVELOPMENT

MARIA SALDANA, BUREAU CHIEF

OFFICE OF CAPITAL PLANNING & POLICY George W. Dunne Cook County Offtee Building

69 W. Washington, Suite 3000 Chicago, Illinois 60602-4053

TEL: 312-603-0300 FAX: 312-.603-9997

Re: Circuit Court Clerk Request for Additional Storage Space (Updated)

As you know, the Office of Capital Planning and Policy is in the process of renovating space at the County's Hawthorne Warehouse for use by the Clerk of the Circuit Court. It is anticipated that this build out will not be completed until the fall of 20 I 2.

By letter dated July 8, 2011, the Clerk of the Circuit Court informed the President that her office will need additional storage space for the accession of 2011 files (approximately 56,000 boxes or 1,400 skids) and bulk supplies starting in the fall of 2011, and will need to utilize that space until the Hawthorne Warehouse build~out project is completed. The Clerk requested that the County either lease space for this need, or retain records storage services. The locations proposed by the Clerk would cost between $150,000 to $220,000 per year.

Over the past three weeks the Real Estate Division has developed the following alternative approach to meeting this need.

Phase 1: Working with the Clerk's representatives, we have detennined that approximately 800 j'kids could be stored in Building C at Oak Forest Hospital. This will require assistance from the Bureau of Administration in clearing the salvage material that is stored at this location. This partial solution will relieve the immediate need and allow tiine to identify other County facilities with available space. The Clerk will store rarelyaccessed files in this location.

StorageSpaceOptionsCCC B/10/2011 Paoe1

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Phase 2 The Bureau of Administration is accelerating salvage operations and working with departments to itnplen1ent appropriate records destruction, which we believe will make additional space available over the next few months. This effort could possibly accommodate 200 to 400 skids.

Phase 3: By October, we will determine whether non-County storage will be necessary and approximately how many skids must be accon1modated. Several options are available:

a) The first choice would be a stnall warehouse owned by the City of Chicago that we learned through our collaboration efforts could be made available. We will enter into discussions as to the cost of this solution, which would accozntnodate approximately 300 skids.

b) If 1nore space is still required, we can either lease space available on a short term basis at II N. Wabash or retain a records storage service. These options are smnmarized as follows, for storage of 400 skids (16,000 boxes):

i. 15,000 square feet is currently available at 11 N. Wabash on a month to month basis at $6.00 per square foot, or $90,000.00 for twelve xnonths.

ii. R4 Services Records Management: One time charge to code & inventory @$.95/box Monthly Storage @$.14 per box per month Total cost for one year

iii. Pickens J(anc Moving & Storage One time charge to code & inventory @$25/box Monthly Storage @$.15/box per month Total cost for one year

$15,200 $26.888 $42,080

$20,000 $28.800 $48,800

This approach will keep the cost as low as possible and delay or avoid actions requiring Board approval. A one-page summary is attached for your use.

StorageSpaceOptionsCCC 8/10/2011 Page2

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DOROTHY BROWN OU!I\1< Of' THG CIRCUIT COUAT

Rlch11rd J. Daley Ceruer Room 1001

Chicago, Illinois 60602 (312) 603-5030

FAX (312) 603-4557 www.c;ookcountyclerkofcourt.org

OFFICE OF THE CLERK OF THE CIRCUIT COURT OF COOK COUNTY

July 8, 20 1 1

Honorable Toni Preckwinkle President, Cook County Board 118 North Clark, Room 53 7 Chicago, Jllinois 60602

Rc: Eme1·gcncy Request for· File Storage Space (Follow up t•equest to letter sem March 29, 20!1)

Dear President Preckwinkle:

The Office of the Clerk of the Circuit Court is happy that the County is moving forward with the build out of the Hawthorne Warehouse facility, which has recently been rescheduled to be completed in September 2012. However, there have been continued delays, which coupled with this new completion date, has created a critical urgency for our office to acquire additional temporary storage space for a large portion of the files and records that we are mandated to store and maintain.

It i~:pstima!cd that effective August of201l . .dY¢ will be at full cm>-acit}! ·in nll.pfour f!lCP...sJQl'age areas fet• inactive files. For this reason, the Clerk's Office 11eeds your immediate assistance in securing space for our files until the completion of the Hawthorne facility.

Please consider the following options to resolve this critical mu.tter:

1) Lease war·cbouse space to accomm()date appt·oxinudely 56,000 boxes (or 1,400 sldds) on a monthly basis, from now until the Hawthorne Warehouse moveuht date, at an e.'timated tost of$18, 493.00 per month, or an estimated eost through September 2012 of $221,916.00;

2) Procure a service that would be responsible for the storage of the boxes in a slull'cd fncility, at an estimated cost of $7, 840.00 per month, or an estimated cost through September 2012 of $94~080.00.

Thank you for giving thjs yout' prompt attention. Ifyotl hAve questions and/or need additional intbm1ation before making your decision, please do not hesitate to contact me at your earliest convenience or have your staff contact Fred Moody, Associate Clerk of Facilities & Records Management, at 3121 w603-47l8. We look tot-ward to working together to advance this project

cc: K\ll' Summers Jr·., Chief of Staff' to Cook County Board President

Dfl:fm

Eduna Wilks, Chief of Staff/Executive Clerk for Public Policy & Human Resources John Chatz, Executive Clerk for· Court Operations & Administration Fred Moody, Associate Clerk of Facilities & Records Management Bureau

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CLERK OF CIRCUIT COUI~T

2011 FILE ACCESSION SPACE REQUEST

FACT SHEET

• The Clerk of the Circuit Court has requested storage facilities for 1400 sl<ids of court records to tnake space for new filings at the courthouses. ·

• Real Estate Managetnent Division researched the Clerk's proposed solutions, bearing an annual cost of between $150,000 and $220,000.

• To reduce costs, REM has worked with the Clerk's representatives to locate unused space at Oak Forest Hospital to accotnmodate 800 skids.

• Additional space in County-owned buildings 1nay be found through accelerated disposal and salvage operations.

• The City of Chicago has offered use of a warehouse that would accoin1nodate 300 skids.

• We will determine by Novetnber if additional space will be needed.

• If additional space is needed, REM has identified solutions ranging fron1 $42,000 to $90,000 in annual cost.

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September 23, 2011

ATTACHMENT #5

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Interim -CEO REPORT

Cook County Health & Hospitals System Cook County Health & Hospitals System Board of Directors Meeting

September 23, 2011

Presented by:Dr. Terry Mason

Interim Chief Executive Interim Chief Executive Officer

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Oak Forest Health CenterSeptember 11

• All nine remaining patients discharged to facilities of their choice by 8/31/2011

• IDPH survey for closure with no deficiencies

• All campus signage changed to reflect transition from hospital to health center

• Initiated changes for over 60 patient forms to reflect transition from hospital to health center

• Starting week of 8/29/11, approximately 30 letters sent to regulatory and member organizations for notification of transition from hospital to health center

• Public Notices run on 8/28/11 in the Chicago Sun‐Times and 9/16/11 in the Chicago Tribune for notification of transition from hospital to health center

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September Cook County Board Meetings

September 7

R R 68 illi d ll b hi d b d • Revenue Report 68 million dollars behind budget

September 20

• Proposed FY2012 Preliminary Budget

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Nominating CommitteeNominating Committeeof the Cook County Health and Hospitals

S tSeptember

21 System21

• Initial meeting to fill the vacancy left by the resignation of Director Initial meeting to fill the vacancy left by the resignation of Director Andrea Zopp for the term expiring June 30, 2012

• Each of the 14 committee members/organizations to submit one name

• Committee nominating process is 45 days• Three names submitted to President Preckwinkle by 10/31/2011

• The President submits nominee to County Board for approval

• County Board has 14 days (or next regular meeting of the County Board) to approve or reject the appointmentto approve or reject the appointment

• Next meeting of the Nominating Committee is 10/6/2011

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The Proposed FY 2012 Preliminary BudgetSeptember

6 96‐9

• Line item review of each business unit1st Pass by Director of the Budget for 3 daysIntensive review – senior staff and each department – currently p yunderway ‐will bring required staff for 10‐3‐2011

FY 2012 budget (no closures of facilities, no layoffs),approximately 327 6 million gap appropriation to Revenueapproximately 327.6 million gap appropriation to Revenue–subsidy –Continue to work with the Presidents office.

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Bond Rating AgenciesSeptember 12‐1412 14

• Preparation Meeting with County Finance

• Standard & Poors – affirmed AA

• Moody’s – affirmed AA

• Fitch – downgraded to AA‐ Fitch downgraded to AA

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Waiver – 1115 Concept Paper Submitted , HMA, Randy Marks, ACHN, Ayres

Septembery , , y

The Social Security Act authorizes multiple waiver and demonstrationThe Social Security Act authorizes multiple waiver and demonstration authorities to allow states flexibility in operating Medicaid programs

Section 1115 Research & Demonstration Projectsprovides the HHS Secretary broad authority to approve projects that test policy innovations likely to further the objectives of the Medicaid program

Section 1915(b) Managed Care/Freedom of Choice WaiversSection 1915(b) Managed Care/Freedom of Choice Waiversprovides the Secretary authority to grant waivers that allow states to implement managed care delivery systems, or otherwise limit individuals' choice of provider under Medicaid

S ti 1915( ) H d C it B d S i W iSection 1915(c) Home and Community-Based Services Waiversprovides the Secretary authority to waive Medicaid provisions in order to allow long term care services to be delivered in community settings

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STAR ReportSeptember 27

R i i h P id ’ Offi• Review with President’s Office,Mock Review completed 9‐22‐2011 with internal senior team

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M h R C l B fMarch 2007 • Revenue Cycle ‐ Before

$130 mil. in unpaid hospital bills found County to recover only $30 mil.

More than $130 million in unpaid Cook County hospital bills have been found stuffed into boxes -- and officials said 40 or 50more boxes could be stashed somewhere else. While finances and bookkeeping were long known to be a problem in thehospital system, County Board members learned Tuesday [March 20, 2007] just how big the problem had become duringthe tenure of the ex-Board President. The 77 boxes recently discovered were each stuffed with about 2,500 billing forms…there could be another 40 or 50 similar boxes hidden elsewhere. That's millions more in free services people received, withthe county never once attempting to collect payment from the patient or Medicaid. "We've never hidden the fact thatfinances have been mismanaged " the hospital chief said "We inherited this We just needed time and money to fix it "finances have been mismanaged, the hospital chief said. We inherited this. We just needed time and money to fix it.The hospital chief operating officer said that because many of the bills are so old, the county likely won't be able to collecton most of them. He expects the county to recover only about $30 million. …state and federal leaders are hesitant todeliver any more money for county health services until the finances are improved. To that end, the County Board Presidentsaid he's following a recommendation from Sen. Dick Durbin to establish a panel of outside experts to regularly reviewhospital operations and ensure improvements are made. That includes shipping those boxes of bills to a company that ishospital operations and ensure improvements are made. That includes shipping those boxes of bills to a company that isnow scanning in each one -- at 10,000 a day --to see which ones the county could expect to get paid for...

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CCHHS Revenue Cycle Transformation PerformanceIncremental Cash Over Historical Baseline

$35

k

$25

$30

in M

illi

ons

Pw

C f

ield

wo

rkb

egin

s Siemens Migratio

n12-1-10

$20

Col

lect

ion

s

$10

$15

Prior Vendor Baseline Baseline Cash Computation

Cash Incremental to Baseline Health System Adjusted Patient Deposited Cash

Linear (Baseline Cash Computation) Linear (Cash Incremental to Baseline)

10Note: 1.) Reduction in January is due to the impact of the Siemens migration 12/1/10 delayed claims release.

2.) Factors impacting 2011 FYTD deposited cash are placeholder estimates; validation in progress.

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119/23/2011 11 of 42

129/23/2011 12

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On the HorizonSeptember

• Everybody Counts – Care‐link, Billing initiatives

Acknowledgment of Kimberly Velasquez ‐ Budget Director Retirement

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Thank You – The CCHHS Board of Directors ‐ for

the Opportunity to ServeSeptember

the Opportunity to Serve

T h i i i d f h i

•

To the remaining executive and support team for their support

To the Medical Staff – especially the bargaining team

The Labor Organizations

The Employees of the CCHHS

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