REPORT OF THE COMMITTEE ON HEALTH AND HOSPITALS

 

June 11, 2007

 

The Honorable,

The Board of Commissioners of Cook County

 

ATTENDANCE

 

Present:

Chairman Butler, Vice Chairman Goslin, Commissioners Beavers, Claypool, Collins, Daley, Gorman, Moreno, Murphy, Quigley, Schneider, Silvestri, Sims,  and Suffredin (14)

 

Absent:

Commissioners Maldonado, Peraica and Steele (3)

 

Also Present:

 

Sylvia Edwards – Acting Chief Operating Officer Oak Forest Hospital of Cook County, Robert R. Simon, M.D.- Interim Chief, Bureau of Health Services Patrick T. Driscoll, Jr. – Deputy State’s Attorney, Chief, Civil Actions Bureau and Walena M. Valencia –Chief Financial Officer, Oak Forest Hospital of Cook County, Shirley Bomar-Cole – Acting Director, Oak Forest Hospital of Cook County and Sharon Freyer – Associate Director Nursing, Oak Forest Hospital of Cook County

 

Ladies and Gentlemen:

 

        Your Committee on Health and Hospitals of the Board of Commissioners of Cook County met pursuant to notice on Wednesday, June 11, 2007 at the hour of 1:00 P.M. in the Board Room, Room 569, County Building, 118 North Clark Street, Chicago, Illinois.

 

        Your Committee has considered the following items and upon adoption of this report, the recommendations are as follows:

 

283387

DEPARTMENT OF PUBLIC HEALTH, by Stephen A. Martin, Jr., Ph.D., M.P.H., Chief Operating Officer, transmitting a Communication, dated November 16, 2006:

 

requesting to receive and file the Maintaining Business Continuity During An Influenza Pandemic Report for the Cook County Department of Public Health.

 

*Referred to Health and Hospitals Committee on 12/06/06.

 

Chairman Butler stated at the request of Stephen A. Martin, Jr., Ph.D., M.P.H., Chief Operating Officer of the Department of Public Health the above Communication No. 283387 be deferred.

 

Commissioner Beavers, seconded by Commissioner Murphy, moved to deferred Communication No. 283387.  The motion carried

287204

BUREAU OF HEALTH SERVICES, by Robert R. Simon, M.D., Interim Chief, Bureau of Health Services transmitting a Communication:

 

requesting authorization for the Purchasing Agent to enter into a contract with New York Boys Management, LLC, Crown Point, Indiana, for short term care for skilled services for unfunded patients for the Bureau of Health Services.

 

Reason:   After receiving and evaluating four (4) Request for Proposals (RFPs), New York Boys Management, LLC was chosen because they were the only vendor who met the licensure, all inclusive rate, and bed availability requirements for the services needed by Oak Forest Hospital of Cook County.

 

Estimated Fiscal Impact:  $13,249,500.00 [Year 1:  $4,215,750.00 [$1,053,937.50 - (891-272 Account); $2,107,875.00 - (897-272 Account); and $1,053,937.50 - (898-272 Account)]; Year 2:  $4,380,000.00 [$1,095,000.00 - (891-272 Account); $2,190,000.00 - (897-272 Account); and $1,095,000.00 - (898-272 Account)]; and Year 3:  $4,653,750.00 [$1,163,437.50 - (891-272 Account); $2,326,875.00 - (897-272 Account); and $1,163,437.50 - (898-272 Account)].  Contract period:  July 1, 2007 through June 30, 2010.  Requisition Nos. 78910576, 78970535 and 78980354.

 

Approval of this item would commit Fiscal Year 2007 and future year funds.

 

*Referred to Health and Hospitals Committee on 06/05/07.

 

Commissioner Beavers asked for a summary of Communication No. 287204.

 

Robert R. Simon, M.D., Interim Chief, Bureau of Health Services stated the passage of the  budget of February 23, 2007, indicated that Oak Forest Hospital of Cook County reduce the number of nursing home beds and. Oak Forest Hospital of Cook County was not allowed to do a decertified portion of beds at Oak Forest Hospital of Cook County.  Oak Forest Hospital of Cook County is licensed as a general hospital with CMS-certified long- term care beds and is not licensed by the Nursing Home Care Act.  The staff at Oak Forest Hospital of Cook County talked with the patients and their families, asking if they would voluntarily move into top notch nursing homes facilities. Many voluntarily agreed.  The Bureau of Health Services is waiting on the Illinois Facilities Planning Board’s approval to end long-term care services at Oak Forest Hospital. Further, Dr. Simon stated a large number of funded patients voluntarily went into nursing home facilities.  There are unfunded patients residing at Oak Forest Hospital of Cook County and we are trying to get a Request for Proposal approval. The cost is $350.00 per day for patients moving into a qualified nursing home facilities that provide the same services as Oak Forest Hospital of Cook County.  The savings for 33 patients is $4.2 million a year.

 

Commissioner Beavers asked what an unfunded patient is.

 

Dr. Simon responded unfunded patients do no have Medicaid or Medicare.

 

Commissioner Quigley asked whether the Bureau of Health Services is getting out of the long term care business.

 

Dr. Simon stated Oak Forest Hospital of Cook County will no longer serve long term care patients.

 

Commissioner Murphy inquired about the length of time for short term care patients.

 

Dr. Simon responded a short-term care patient stay in the hospital is 30 days or less.

 

Commissioner Suffredin asked about the reasoning for removing the funded patients out of Oak Forest Hospital of Cook County for whom we do get reimbursement.

 

Walena M. Valencia, Chief Financial Officer, Oak Forest Hospital of Cook County, stated the revenue we get from the State of Illinois is $165.00 dollars per day.  The revenue from Medicare is $275.00 per day so we are significantly losing money whether the patients are in the facilities or not.  

 

Sylvia Edwards, Acting Chief Operating Officer, Oak Forest Hospital of Cook County, stated the long term care portion of the operation can cost $50 million.  The Bureau of Health Services only gets reimbursed $13 million for that particular service of the hospital.  The reimbursement for the acute care is a higher reimbursement with fewer patients. 

 

Dr. Simon reiterated for an acute care hospital with 70 beds the cost would probably be about $54 to $60 million out of the entire $118 million out of the budget.  It is basically $50 million dollars for maintaining the buildings at Oak Forest Hospital of Cook County.

 

Commissioner Sims voiced concerns regarding collecting payments from patients who fail to pay their bill.

 

Shirley Bomar–Cole, Acting Deputy Director, Oak Forest Hospital of Cook County, stated it isn’t actually the nursing homes that do the attachment if you are eligible for Medicaid.  Medicaid is the biggest payer of long term care not Medicare.  It is Medicaid that does the spin down and attaches the assets.  The individual institution is not able to do that.  Our finance and social service department are aggressive in doing the financial screening regardless whether they come from within our system or not.

 

Commissioner Sims continued to inquire about collecting funds from unfunded patients.

 

Ms. Cole replied all the unfunded patients that we are referencing are not citizens.  They are not eligible for Medicaid, Medicare and Supplemental Social Security Income.

 

Commissioner Silvestri asked if Cook County was flush with money would this be a good idea.

 

Dr. Simon responded it would be a good idea for the County to have some kind of long-term intermediate care facilities to operate the way a private nursing home operates not like a hospital based facilities.  If the county was flush with money the county should be doing a lot of other services for those patients.

 

Commissioner Beavers asked for the correct number of buildings for the hospital.

 

Ms. Edwards responded there are three buildings with no patient care activity in them.  There’s the J building which has the acute care, the B building which is for rehab and skill patients, the E building that have patients and currently the F building with no patients.

 

Commissioner Schneider asked Pat T. Driscoll, Jr., State’s Attorney to research the entitlement issue of the contract, raised by Commissioner Suffredin.

 

Commissioner Murphy inquired on the cost of Medicaid or Medicare.

 

Ms. Sharon Freyer, Associate Director of Nursing responded that Medicare would be based on the Minimum Data Set assessment and the amount of money paid depending on the patients needs.  The Medicaid reimbursement is $165.00 per day is what Oak Forest Hospital of Cook County is receiving for Medicaid patients.  The average payment of Medicare is $275.00 per day.

 

Commissioner Beavers, seconded by Commissioner Daley, moved the approval of Communication No. 287204.  

 

Commissioner Suffredin called for a Roll Call, the vote of yeas and nays being as follows:

 

ROLL CALL ON MOTION TO APPROVE THE ORDINANCE

(COMMUNICATION NUMBER 287204)

 

Yeas:

Chairman Butler, Vice Chair Goslin and Commissioners Beavers, Collins, Daley, Gorman, Moreno, Quigley, Schneider and Silvestri (10)

 

Nays:

Commissioners Claypool, Murphy and Suffredin (3)

 

Absent;           Commissioners Peraica and Silvestri (2)

 

The motion to approve CARRIED.

 

 

 

 

 

287205

OAK FOREST HOSPITAL OF COOK COUNTY, by Sylvia Edwards, Acting Chief Operating Officer transmitting a Communication:

 

requesting authorization for the Purchasing Agent to enter into a contract with New York Boys Management, LLC, Crown Point, Indiana, for long term care for current unfunded patients at Oak Forest Hospital of Cook County.

 

Reason:    After receiving and evaluating four (4) Request for Proposals (RFPs), New York Boys Management, LLC was chosen because they were the only vendor who met the licensure, all inclusive rate, and bed availability requirements for the services needed by Oak Forest Hospital of Cook County.

 

Estimated Fiscal Impact:  $5,594,902.00 (Year 1:  $1,817,152.00; Year 2:  $1,861,500.00; and Year 3:  $1,916,250.00).  Contract period:  July 1, 2007 through June 30, 2010.  (898-272 Account).  Requisition No. 78980348.

 

Approval of this item would commit Fiscal Year 2007 and future year funds.

 

*Referred to Health and Hospitals Committee on 06/05/07.

*Approved on 6/11/07.

 

Commissioner Beavers, seconded by Commissioner Daley, moved the approval of Communication No. 287205.  

 

Commissioners Claypool, Murphy and Suffredin voted No and Commissioner Sims voted Present on Communication No. 287205. 

 

ROLL CALL ON MOTION TO APPROVE THE ORDINANCE

(COMMUNICATION NUMBER 287205)

 

Yeas:

Chairman Butler, Vice Chair Goslin and Commissioners Beavers, Collins, Daley, Gorman, Moreno, Quigley, Schneider and Silvestri (10)

 

Nays:

Commissioners Claypool, Murphy and Suffredin (3)

 

Present:

Commissioner Sims (1)

 

Absent:           Commissioners Peraica and Silvestri (2)

 

The motion to approve CARRIED.

 

 

 

 

Chairman Butler asked the Secretary to the Board to call upon the registered public speakers.

 

1)         Horatio Esparza - Progress Center

2)         Brenda Langford - National Nurses Organizing Committee

3)         Gregory Kelley – SEIU Local 20

4)         Obed Lopez-Zacarias – Citizens Health Organization

 

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

 

 

 

YOUR COMMITTEE RECOMMENDS THE FOLLOWING ACTION WITH REGARD TO THE MATTERS NAMED HEREIN:

 

Communication Number 283387                            Withdrawn

 

Communication Number 287204                            Approved

 

Communication Number 287205                            Approved

 

 

 

Respectfully submitted,

Committee on Health and Hospitals

 

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Jerry Butler, Chairman

 

 

Attest:

 

 

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Matthew B. DeLeon, Secretary

 

**The complete audio recording of this meeting is available from the office of the Secretary to the Board.