REPORT OF THE TASK
FORCE ON HOSPITAL GOVERNANCE
The Honorable,
The Board of Commissioners of
ATTENDANCE
|
Present: |
Chairman Goslin and Vice Chairman Murphy, Commissioners |
|
Absent: |
None (0) |
|
Also
Present: |
Commissioners Gorman, Maldonado, Peraica, Quigley,
Schneider and Sims; Michael Prinzi - Assistant
State’s Attorney, Division Chief, Transactions, Municipal Litigation and Real
Estate Taxation Division; Richard Velázquez – Special Counsel to the
President; Dr. Robert Simon - Interim Chief of the Bureau of Health Services |
Ladies and
Gentlemen:
Your Task
Force on Hospital Governance of the Board of Commissioners of Cook County met
pursuant to notice on
The purpose of
the meeting was to take testimony from various representatives of the Civic
Federation, the Metropolitan Chicago Healthcare Council and the National Public
Hospital Association.
Chairman Goslin called the meeting to order, and called upon
Mr. Kevin Scanlan, President and Chief Executive
Officer of the Metropolitan Chicago Healthcare Council.
Mr. Scanlan testified on behalf of
the Metropolitan Chicago Healthcare Council, which is an organization
representing one hundred forty hospitals and healthcare organizations in the
metropolitan Chicagoland area. He stated that
Mr. Scanlan stated that the Bureau
of Health Services has a critical role in the regional health care safety net. The financial viability of all hospitals and
the regional health care safety net continues to be challenged through
increasing numbers of uninsured; significant and ongoing under-funding from the
state and federal government for the Medicaid and Medicare programs; coupled
with an aging population and demands for enhanced technology. Approximately seventy percent of the more
than fifty private hospitals located in
On the issue of governance, Mr. Scanlan
stated that while the Board is contemplating future governance structures, the
focus should be on the future of the Bureau of Health Services. He did not indicate preference to any
particular governance structure; he believed that the Bureau of Health
Services’ governance decisions should be considered and made by the Board of
Commissioners.
Chairman Goslin asked Mr. Scanlan how
the patient load would be absorbed if the Bureau of Health were to be dissolved
or services provided were to be significantly reduced.
Mr. Scanlan replied that they
could not be absorbed, and the result might mean the closure of other
institutions.
Chairman Goslin asked Mr. Scanlan
for information on the Metropolitan Chicago Healthcare Council members’
percentage of “self-pay” patients by institution.
Mr. Scanlan responded that he
would supply it to him.
Commissioner Daley asked Mr. Scanlan
for a breakdown of the $3 billion in annual charitable care.
Mr. Scanlan responded that he
could provide Commissioner Daley with a breakdown of the $2.3 billion in
charitable care provided by the more than fifty private hospitals.
Commissioner Daley stated that some suggestions had been
made to resolve the Bureau of Health Services’ financial position. These suggestions include the closure of
Mr. Scanlan replied that the
closure of
Chairman Goslin called upon the next public speaker.
Ms. Lise Valentine, Vice President
and Director of Research of the Civic Federation read into the record a
statement provided by Mr. Lawrence Msall, President
of the Civic Federation. (See Attachment #1.)
Commissioner Daley stated that a truly independent board
needs taxing authority and needs to be totally separate from the Board of
Commissioners. He believed that if the
Board chose to implement a temporary independent governing structure, the Board
would continue to approve the budget until such time a permanent independent
governing structure with taxing authority was functioning. In order to effect such change in
Commissioner Butler was concerned with the perceived lack of
understanding of the mission of the Bureau of Health Services. He believed that the Bureau of Health was
never given adequate funds and questioned how the Board would pay the costs
associated with independent governance.
Commissioner Silvestri opined that if the Board of
Commissioners has to approve a budget for an independent governance board, then
it is not truly independent. He believed
that an interim period for independent governance should be ten years; interim
periods of one or three years are too short to achieve meaningful successes.
Chairman Goslin called upon the next public speaker.
The next speaker was Reverend Alexander Sharp, Executive
Director of Protestants for the Common Good, and Vice Chairman of the Center
for Tax and Budget Accountability. (See Attachment #2.)
He spoke in support of an interim independent governing board, and if
possible, a permanent independent governing board. He referenced portions of the Goodman Report
and challenged that the Bureau’s revenue uncollectables
were overstated in the report. He
believed that they were in the range of $40 million to $140 million, not $200
million.
Commissioner Daley remarked that the
Commissioner Silvestri reminded the Task Force members that
a recent bill to shift $100 million in subsidies to the Cook County Bureau of
Health Services failed to pass in
Commissioner Collins stated that a coalition should be
organized to lobby in
Commissioner Sims stated her opposition to independent governance. She envisioned irreconcilable conflict over
budgetary matters between an independent governance board and the Board of
Commissioners. She believed that the
Board should instead give the President the same amount of time proposed for
the temporary trusteeship to turn around the Bureau’s financial position. A national search should be conducted to find
an expert to run the hospitals under the current governance structure.
Commissioner Maldonado stated that he agreed with
Commissioner Sims in principle, as he was opposed to privatization of the
Bureau of Health Services. He was also
concerned that there may be transparency issues related to adding another layer
of government through an independent governance board. The temporary trusteeship is the only option at
this time that he supports.
Chairman Goslin called upon the next public speaker.
Quentin Young, M.D., Chairman of Health and Medicine Policy
Research Group, spoke on behalf of the establishment of a temporary
trusteeship. He believes that it is
impossible to solve the Bureau of Health Services’ financial problems without
new taxes.
Commissioner Daley pointed out that a temporary trusteeship
would still need to come to the Board for revenue.
Chairman Goslin called upon the next public speaker.
Lynne Johnson, Director of the Chicago Foundation for Women,
spoke in favor of a temporary trusteeship.
(See Attachment #3 – which includes the statement of Mary Morten, Acting Executive Director of the Chicago Foundation
for Women.)
Chairman Goslin called upon the next public speaker.
George Blakemore, a concerned citizen, spoke in favor of an
interim trusteeship.
Commissioner Moreno asked Robert Simon, M.D., Interim Chief
of the Bureau of Health Services, whether an independent board would solve the
Bureau of Health Services’ revenue problems.
Dr. Simon responded that it would not; most institutions
across the country are experiencing huge financial problems regardless of the
type of governance. As he had mentioned
at the meeting of the Task Force on Hospital Governance on
Chairman Goslin responded that efforts to have Mr. Gage
attend a Task Force meeting had been unsuccessful due to scheduling problems.
Dr. Simon responded that he would assist in the efforts to
engage the assistance of Mr. Gage.
Dr. Simon requested to clarify an earlier statement
regarding loss of employees. He stated
that the Bureau had 1,049 employees in the entire clinic system in 2002. However, in 2007 there was
a total number of 552 employees in the entire clinic system. The clinic system cannot function at that
level; for Fiscal Year 2008 a request was made for 425 new positions.
At the request of Chairman Goslin, Dr. Simon addressed
remarks made by Commissioner Peraica with regard to clinic closures that
occurred in 2007 and the subsequent effects of such closures. It was alleged that emergency room visits increased
as a result of the clinic closures.
Dr. Simon replied that the statement was inaccurate. There was no increase at the Bureau of Health
Services’ emergency rooms; he verified that the surrounding hospitals
experienced minimal increases in emergency room visits.
Commissioner Schneider indicated that he was in favor of an
independent governing board. However, he
questioned who would ultimately provide financial oversight over an independent
governing board with taxing authority.
Chairman Goslin stated that the intent was to retain
financial oversight by the Board of Commissioners. He added that any transfer to an independent
governing board would have strings attached, allowing for ultimate oversight by
the Board of Commissioners.
Commissioner Butler cited an article in Healthcare IT News,
which ranked Stroger Hospital of Cook County number one in the category of
“Major Teaching Hospitals” in completeness and accuracy of their medical coding
practices used to bill Medicare for inpatient medical services.
Commissioner Silvestri,
seconded by Commissioner Butler, moved to adjourn. The motion carried and the meeting was adjourned.
|
|
Respectfully
submitted, Task
Force on Hospital Governance XXXXXXXXXXXXXXXXXXXXXXXXXX Gregg
Goslin, Chairman |
Attest:
XXXXXXXXXXXXXXXXXXXXXXXXXXX
Matthew B. DeLeon, Secretary
** The audio recording for this meeting is available from
the Office of the Secretary to the Board,