REPORT OF THE COMMITTEE ON HEALTH & HOSPITALS

 

September 17, 2007

(recessed and reconvened on September 18, 2007)

 

 

The Honorable,

The Board of Commissioners of Cook County

 

ATTENDANCE

 

Present:

President Stroger and Chairman Butler, Vice Chairman Goslin, Commissioners Beavers, Claypool, Collins, Daley, Gorman, Maldonado, Moreno, Murphy, Peraica, Quigley, Schneider, Silvestri, Sims, Steele and Suffredin (17)

 

Absent:

None (0)

 

Also Present:

Robert R. Simon, M.D.- Interim Chief, Bureau of Health Services; Patrick T. Driscoll, Jr. – Deputy State’s Attorney, Chief, Civil Actions Bureau.

 

 

Ladies and Gentlemen:

 

        Your Committee on Health & Hospitals of the Board of Commissioners of Cook County met pursuant to notice on Monday, September 17, 2007 at the hour of 10:00 AM in the Board Room, Room 569, County Building, 118 North Clark Street, Chicago, Illinois.

 

Pursuant to Cook County Code, Section 2-108 (f)(2), Chairman Butler stated due to the lack of a quorum the Committee on Health & Hospitals will stand in recess until September 18, 2007 at 10:00 a.m.

 

        Your Committee has considered the following item and upon adoption of this report, the recommendation is as follows:

 

 

289092

RESOLUTION DIRECTING THE BUREAU OF HEALTH SERVICES TO DISCONTINUE FILLING PRESCRIPTIONS FOR NON-COOK COUNTY RESIDENTS (PROPOSED RESOLUTION).  Submitting a Proposed Resolution sponsored by Joseph Mario Moreno, County Commissioner; Co-Sponsored by Joan Patricia Murphy and Peter N. Silvestri, County Commissioners.

 

PROPOSED RESOLUTION

 

RESOLUTION DIRECTING THE BUREAU OF HEALTH SERVICES TO

DISCONTINUE FILLING PRESCRIPTIONS FOR NON-COOK COUNTY RESIDENTS

 

WHEREAS, the Bureau of Health Services and its hospitals and clinics serve as the anchor for the safety net serving the metropolitan Chicago region’s ever-increasing number of uninsured or underinsured citizens, not only in Cook County, but also the neighboring counties and in some cases beyond; and

 

WHEREAS, the Bureau of Health Services not only provides health care services, but also pharmacy prescription services to said citizens; and

 

WHEREAS, for the period of September 1st, 2006 to December 31st, 2006, 6% of all prescriptions were filled and delivered to non-Cook County resident patients for a total of 257,000  prescriptions at a cost of $4.6 million; and

 

WHEREAS, under the leadership of the Board of Commissioners and President Stroger, the Bureau of Health Services has and continues to make a concerted effort to resolve its financial shortcomings; and

 

WHEREAS, despite these ongoing efforts, further cuts in core services may result without increased funding; and

 

WHEREAS, Cook County cannot continue to provide care for the indigent population for both residents and non-residents of Cook County, without increased assistance from other governments, providers, insurers and health care stakeholders; and

 

WHEREAS, in order to avoid additional cuts in services, the Bureau of Health Services must consider ceasing the provision of non-emergency medical services including pharmaceuticals to Non-Cook County resident patients; and

 

WHEREAS, this measure is needed to preserve the already limited county healthcare resources to provide for the residents of Cook County and stop this loss of revenue to our taxpayers.

 

NOW, THEREFORE, BE IT RESOLVED, that the Cook County Board of Commissioners does hereby request that the Bureau of Health Services discontinue the provision of non-emergency pharmaceuticals to Non-Cook County resident patients, thereby conserving healthcare resources for the residents of Cook County.

 

PROPOSED RESOLUTION AMENDMENT (PENDING)

 

NOW, THEREFORE, BE IT RESOLVED, that the Cook County Board of Commissioners does hereby request that the Bureau of Health Services discontinue the provision of non-emergency pharmaceuticals to uninsured Non-Cook County resident patients, or those not eligible for Medicare and Medicaid Benefits effective December 1, 2007 unless the patients residing county enters into a Governmental Agreement with Cook County to reimburse the county for such services thereby conserving healthcare resources for the residents of Cook County.

 

 

 

 

 

 

 

 

 

BE IT FURTHER RESOLVED, that this resolution shall be implemented through the following recommendations from the Bureau of Health Services:

 

1. Provide emergency service and fill prescription for emergency department visits regardless of county of residence.

 

2. All clinic visits for out-of-county patients must be referred to Limit of Liability (LOL) with appointment for screening, etc. before prescription is filled.

 

Limit of Liability (LOL) provides the out-of-county patients who have no form of payment, with a list of collar counties Public Health Departments and County Board office numbers for any assistance programs available to indigent patients in their county.

 

3. All in-patients will be given only a 1 month supply of medication and referred to Limit of Liability (LOL) (should already be done) for processing. If the patient qualifies for a program, continue to provide prescription services as we would for an in-county resident. If not, Limit of Liability (LOL)_ provides the same list of other counties information as in #2. Patient is advised that they must get their refills through their own county’s system.

 

4. Recommend that a strong attempt be made to contract with collar counties to pay Medicaid rates for scripts and clinic visits by their medically indigent patients.

 

5. No mail order prescriptions will be filled after a letter is sent with the final refill. A letter should be sent to non-county residents stating that “this will be the last script filled (one month supply) and to contact their local county public health department.” For emergency refills, the patient will need to come to the Emergency  Room or Ambulatory Screening Clinic. This would be humane and more than that which is offered in other places. 

 

*Referred to the Committee on Health and Hospitals on 9/06/07.

 

Commissioner Moreno, seconded by Commissioner Murphy, moved the approval of Communication No. 289092.

 

Commissioner Silvestri suggested that the resolve clause be amended to include effective December 1, 2007 unless the patients residing county enters into a Governmental Agreement with Cook County to reimburse the county for such services.

 

Commissioner Silvestri, seconded by Commissioner Peraica, moved to amend the resolution by including the following language in the “Now therefore be it resolved” paragraph:  Effective December 1, 2007 unless the patients residing county enters into an Intergovernmental Agreement with Cook County to reimburse the county for such services.  The motion carried.

 

Commissioner Suffredin suggested to the sponsors if they would consider amending the resolution to add Dr. Simons’ five (5) points.

 

Commissioner Moreno, seconded by Commissioner Murphy, moved to amend the resolution by adding the five (5) points from Dr. Simon.  The motion carried.

 

Chairman Butler asked the Secretary to the Board to read the second amendment into the record.

 

Matthew B. DeLeon, Secretary to the Board advised the Committee that the second amend is in the new Now, Therefore, Be It Resolved Clause.  Further, a new Be It Further Resolved Clause should be added to reflect the following language:  that this resolution shall be implemented through the following recommendations from the Bureau of Health Services:

 

1. Provide emergency service and fill prescription for emergency department visits regardless of county of residence.

 

2. All clinic visits for out-of-county patients must be referred to Limit of Liability (LOL) with appointment for screening, etc. before prescription is filled.

 

Limit of Liability (LOL) provides the out-of-county patients who have no form of payment, with a list of collar counties Public Health Departments and County Board office numbers for any assistance programs available to indigent patients in their county.

 

3. All in-patients will be given only a 1 month supply of medication and referred to Limit of Liability (LOL) (should already be done) for processing. If the patient qualifies for a program, continue to provide prescription services as we would for an in-county resident. If not, Limit of Liability (LOL)_ provides the same list of other counties information as in #2. Patient is advised that they must get their refills through their own county’s system.

 

4. Recommend that a strong attempt be made to contract with collar counties to pay Medicaid rates for scripts and clinic visits by their medically indigent patients.

 

5. No mail order prescriptions will be filled after a letter is sent with the final refill. A letter should be sent to non-county residents stating that “this will be the last script filled (one month supply) and to contact their local county public health department.” For emergency refills, the patient will need to come to the Emergency  Room or Ambulatory Screening Clinic. This would be humane and more than that which is offered in other places. 

 

Commissioner Moreno, seconded by Commissioner Silvestri, moved the approval of Communication No. 289092 as amended. The motion carried.

 

Chairman Butler asked the Secretary to the Board to call on the public speaker.

 

PUBLIC SPEAKER

 

1.         George Blakemore, Concerned Citizen

 


Commissioner Silvestri moved to adjourn the meeting, seconded by Commissioner Steele.  The motion carried and the meeting was adjourned.

 

 

 

Respectfully submitted,

Committee on Health & Hospitals

 

 

 

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Jerry Butler, Chairman

 

 

Attest:

 

 

 

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Matthew B. DeLeon, Secretary