Minutes of the meeting of the Finance Committee of the Board of Directors of the Cook County Health and Hospitals System held Friday, June 18, 2010 at the hour of 8:00 A.M. at John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison Street, in the fifth floor conference room, Chicago, Illinois.
I. Attendance/Call to Order
Chairman Carvalho called the meeting to order.
Present: Chairman David Carvalho and Directors Luis Muñoz, MD, MPH; Heather O’Donnell, JD, LLM; and Jorge Ramirez (4)
Director Hon. Jerry Butler
Absent: Director Quin R. Golden (1)
Chairman Carvalho stated that Director Golden was unable to be physically present, but would like to try to participate in the meeting telephonically.
Director Muñoz, seconded by Director O’Donnell, moved to allow Director Golden to participate as a voting member for this meeting telephonically. THE MOTION CARRIED UNANIMOUSLY.
Additional attendees and/or presenters were:
Michael Ayres Gina Gaston, MD Terry Mason, MD Johnny Brown Lucio Guerrero Elizabeth Melas Leslie Duffy Helen Haynes John Morales Patrick T. Driscoll, Jr. Daniel Howard John O’Brien, MD William T. Foley Ann Marie Huddleston Gretchen Ryan Sharon Freyer Randolph Johnston Deborah Santana Judith Frigo, MD Roz Lennon Herschel Tolsen Commissioner Bridget Gainer Dorothy Loving Laura Walfeldt
II. Public Speakers
Chairman Batts asked the Secretary to call upon the registered speakers.
The Secretary called upon the following registered public speakers:
1. Richard Boykin Attorney, Barnes & Thornberg 2. George Blakemore Concerned Citizen 3. John Sterling Chief Executive Officer, Synch-Solutions
During his testimony, Mr. Sterling stated that his company’s business partner is MedAssets, and furthermore stated that his company, Synch-Solutions, has been working hand-in-hand with MedAssets on revenue cycle activities. Chairman Carvalho stated that, until Mr. Sterling’s testimony, he has been unaware that Synch-Solutions is involved in this contract. For purposes of disclosure, Chairman Carvalho stated that his employer, the Illinois Department of Public Health (IDPH), has had, from time to time, business relationships with Synch-Solutions; most recently, a bid was received that has been put on hold for budgetary reasons.
Page 1 of 192 Finance Committee Meeting Minutes Friday, June 18, 2010 Page 2
III. Action Items
A. Minutes of the Finance Committee Meeting, May 14, 2010
Director Muñoz, seconded by Director O’Donnell, moved to accept the minutes of the Finance Committee Meeting of May 14, 2010. THE MOTION CARRIED UNANIMOUSLY.
B. Continued discussion and action on items from May 27, 2010 Board of Directors Meeting regarding revenue cycle contractual arrangements (Attachment #1)
Michael Ayres, System Chief Financial Officer, provided an overview of the items presented for the Committee’s consideration. He noted that additional information has been presented for these items, including information prepared in response to questions from Director Ansell. (Attachment #2).
At the May 27th Board Meeting, a request to enter into and execute a contract with PricewaterhouseCoopers (PwC), for performance improvement implementation services, was presented for the Board’s consideration. There were five components, or Statements of Work, within the contract; the five components under the proposed contract were related to revenue cycle; labor and productivity; supply chain; physician funding plan; and the Ambulatory and Community Health Network of Cook County (ACHN) operations. The Board approved the contract on May 27th, but deferred action by the administration from entering into a Statement of Work for revenue cycle, until further action by the Board.
Also presented on May 27th was a request to terminate Contract Number 08-41-245 with MedAssets. This request was deferred, and remanded back to the Finance Committee.
Mr. Ayres stated that they continue to refine the contract with PwC, to develop the non-revenue cycle Statements of Work; this is close to completion, and they are within days of being ready to sign the Master Services Agreement.
Director O’Donnell inquired regarding transition of revenue cycle activities from one vendor to another, and how this might delay or disrupt current activities. Mr. Ayres stated that he did not feel that much time would be lost; there may be a week in which realignment will be needed, and some steps may need to be revisited.
Director O’Donnell clarified that the request for PwC before the Committee relates specifically to the revenue cycle Statement of Work. Mr. Ayres responded affirmatively; however, he noted that the information and materials provided, particularly with regard to Director Ansell’s questions, relate to the overall PwC contract.
The Committee discussed the subject of the management of a contingency contract for revenue cycle activities. Chairman Carvalho stated that MedAssets’ contract originally began as a contingency-based contract. It was concluded that the System found it difficult to manage this type of contract, so the contract moved to a fixed fee contract. William T. Foley, Chief Executive Officer of the Cook County Health and Hospitals System, provided additional information on the subject. He stated that when the MedAssets contract moved to a fixed fee contract, it was felt at that time that the System did not have the ability to manage a contingency-based contract. At this time, however, Mr. Foley indicated that the System is now equipped to manage a contingency-based contract. He added that the System Director of Performance Improvement, Jeanene Johnson, will be working closely with Mr. Ayres.
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III. Action Items
B. Continued discussion and action-revenue cycle contractual arrangements (continued)
Chairman Carvalho stated that what is before the Committee is the proposed action relating to the Statement of Work for revenue cycle for the contract with PwC; also before the Committee is the request to terminate the contract with MedAssets for revenue cycle services. Chairman Carvalho stated that the displacement of MedAssets was proposed to be done under the clause relating to cancellation of contract for convenience. This proposed action has nothing to do with an evaluation of performance; rather, it was a recommendation from the administration to wrap all of this in one contract with one vendor, in order to have it all work seamlessly.
Chairman Carvalho stated that he has been informed that there is an aspect of this matter that will need to be discussed in closed session.
At this time, the Committee recessed the regular session and convened in closed session. See page 7 for the motions made following the adjournment of closed session, and relating to the two contractual requests for Item III(B).
C. **Contracts and Procurement Items (Attachment #3)
Note: This item was taken out of order.
Ann Marie Huddleston, Interim Deputy Director of Supply Chain, presented the requests for the Committee’s consideration.
A presentation was made with regard to the request to enter into and execute a contract with NuCare Services Corporation, for short-term and long-term care services (Attachment #4). The following individuals presented information on the request: John Morales, Chief Financial Officer of John H. Stroger, Jr. Hospital of Cook County; Sharon Freyer, Chief Nursing Officer, Oak Forest Hospital of Cook County; Dr. Gina Gaston, Assistant Director of Case Management; and Laura Walfeldt, Director of Case Management at John H. Stroger, Jr. Hospital of Cook County. Questions were raised and addressed with regard to facility licensure and certification with the State, patient satisfaction and patient involvement in selection of location.
Director Muñoz requested that the Committee receive information relating to the certification from the State that these facilities are meeting regulations with respect to long-term care. Following this request, it was stated that IDPH monitors these facilities. Ms. Walfeldt provided additional information relating to this subject.
During the presentation, Chairman Carvalho asked how the proposed rate compares with the short-term Medicare rate. Ms. Freyer responded that the 2010 Prospective Payment System (PPS) rates for Medicare can range from around $200 to $630. Chairman Carvalho asked if there is a reason for having only one rate for short-term care, rather than a rate based upon Resource Utilization Group System (RUGS) scores that are established by Medicare. Ms. Walfeldt responded that the reason for this is administrative-related. Chairman Carvalho inquired why short-term Categories I and II were created, rather than using the RUGS scores. Gretchen Ryan, of MedAssets, provided additional information. She noted that her comments were in the context of discussion of non-Medicare patients. She stated that with Medicare patients, there are a series of steps that are required in order to receive payment from Medicare. From an administrative standpoint, if the patient does not qualify for Medicare, there is a significantly lesser amount of paperwork that is required, in comparison to the documentation required by Medicare.
Page 3 of 192 Finance Committee Meeting Minutes Friday, June 18, 2010 Page 4
III. Action Items
C. **Contracts and Procurement Items (continued)
Chairman Carvalho requested a list of the facilities to be provided to him1, and inquired whether the Medicare Star Rating System was used in the assessment of the facilities. Ms. Freyer responded that all of the facilities were rated between two and three stars.
The Committee returned to the other requests presented for consideration. The following individuals provided additional information on the requests presented for consideration: Mr. Ayres; Daniel Howard, System Chief Information Officer; Dr. Judith Frigo, Chief Medical Officer for Oak Forest Hospital of Cook County; and Johnny Brown, Chief Operating Officer for John H. Stroger, Jr. Hospital of Cook County.
During the discussion of request number 8, a request to increase the contract with IDPH for State-mandated metabolic tests on newborns born at Stroger Hospital, Director O’Donnell inquired whether the increase includes for the provision of testing for newborns that are not born at Stroger Hospital. Roz Lennon, System Chief Clinical Officer, responded affirmatively. Chairman Carvalho noted that this heel stick test is usually done at birth; he wondered why this test is not being done at the birthing hospitals, in some cases. He stated that, although he is abstaining on the matter before the Committee because it is a contract with IDPH, he will look into the subject at the State.
During the discussion of request number 12, Chairman Carvalho requested that an overview and outline be provided on all of the vendors who are involved in the billing cycle.
Director Ramirez, seconded by Director O’Donnell, moved the approval of request numbers 1 through 28, as amended, under the Contracts and Procurement Items, with the exception of request number 16, which will be discussed in closed session, and conditional approval of request numbers 17, 18 and 22, pending contract compliance. THE MOTION CARRIED.
Chairman Carvalho abstained and voted PRESENT on request numbers 1 and 8.
*Note: following the adjournment of closed session, request number 16 was recommended for approval (see page 6).
D. Proposed Academic Affiliation Agreements (Attachment #5) (Agreements with fiscal impact) These agreements were reviewed by the Quality and Patient Safety Committee on May 18, 2010.
Note: this item was considered concurrently with Item III(F).
Dr. John O’Brien, Chairman of the Department of Planning, Education, and Research of John H. Stroger, Jr. Hospital of Cook County, provided an overview of the agreements presented for consideration. He noted that these have been reviewed and recommended to move forward by Director Lyne’s ad hoc work group on affiliations. Additionally, he stated that one of the components of PwC’s activities will be to evaluate these relationships.
Director O’Donnell, seconded by Director Ramirez, moved to approve request numbers 1 through 23, under the proposed Academic Affiliation Agreements and Supplemental Proposed Academic Affiliation Agreements. THE MOTION CARRIED UNANIMOUSLY.
Page 4 of 192 Finance Committee Meeting Minutes Friday, June 18, 2010 Page 5
III. Action Items (continued)
E. Any items listed under Sections III, V and VI
F. Supplemental Proposed Academic Affiliation Agreements (Attachment #6) (Agreements with fiscal impact) These agreements were reviewed by the Quality and Patient Safety Committee on May 18, 2010.
Note: this item was taken out of order, and was considered concurrently with Item III(D).
IV. Report from System Chief Financial Officer
Mr. Ayres presented a brief update on the following subjects: review of expenses and meeting the budget target; activities related to possible additional retroactive DSH payments; 2009 Audit progress; and Lawson implementation activities.
A. CareLink Communication Plan
Mr. Ayres and Lucio Guerrero, System Director of Public Relations and Community Affairs, presented the CareLink Communication Plan (Attachment #7). Additionally, Ms. Ryan provided additional information on the subject. The Committee reviewed and discussed the information.
During the discussion, with regard to the information listing the stakeholders, Director Ramirez requested that other stakeholders be included, such as key community partners and unions.
Chairman Carvalho stated that it would be useful to know what the co-pay policies of the System’s partners are2. Mr. Ayres responded that he would present this information at the next meeting.
V. Recommendations, Discussion/Information Items A. Presentation of Lawson Financial Statements through March 2010
Ms. Loving presented the Year-to-Date Lawson Financials through March 2010 (Attachment #8). The Committee reviewed the information.
B. Supply Chain Performance Improvement Update i. Update on online resources
Ms. Huddleston presented the Supply Chain Performance Improvement Update (Attachment #9). The Committee reviewed and discussed the information.
Page 5 of 192 Finance Committee Meeting Minutes Friday, June 18, 2010 Page 6
V. Recommendations, Discussion/Information Items
B. Supply Chain Performance Improvement Update (continued)
Chairman Carvalho requested that Ms. Huddleston check into the status of implementing a system to track ex- parte communications3. He referenced the section of the CCHHS Procurement Policy that states that for all Purchases, the Procurement Director shall establish procedures to ensure that communications from individuals outside the System regarding a Purchase shall be memorialized and maintained in the procurement file. It also states that communications about a Purchase from or on behalf of a System Director or elected official shall also be memorialized and maintained in the procurement file.
Chairman Carvalho requested that Ms. Huddleston work with Mr. Guerrero on a communications plan for vendors, in order to effectively communicate the System’s Purchasing process, and to try to get more vendors involved in potential bids or RFPs4. Additionally, he inquired whether a search function will be built into the website, so that information on specific contracts or products can be easily available5. Ms. Huddleston responded that she will find out.
Included in the information provided was an update on the warehouse consolidation. Mr. Morales provided additional information on the subject.
VI. Closed Session Discussion/Information Items
A. **Contracts and Procurement Items
and Discussion of Litigation Matter
Director Muñoz, seconded by Director O’Donnell, moved to recess the regular session and reconvene into closed session, pursuant to the following exceptions to the Illinois Open Meetings Act: 5 ILCS 120/2(c)(1), which permits closed meetings for consideration of “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)(11), regarding “litigation, when an action against, affecting or on behalf of the particular body has been filed and is pending before a court or administrative tribunal, or when the public body finds that an action is probable or imminent, in which case the basis for the finding shall be recorded and entered into the minutes of the closed meeting.”
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 Carvalho and Directors Muñoz, O’Donnell and Ramirez (4)
Nays: None (0)
Absent: Director Golden (1)
THE MOTION CARRIED UNANIMOUSLY and the Committee convened into closed session.
Chairman Carvalho declared that the closed session was adjourned. The Committee reconvened into regular session.
Page 6 of 192 Finance Committee Meeting Minutes Friday, June 18, 2010 Page 7
VI. Closed Session Discussion/Information Items (continued)
Chairman Carvalho stated that, with regard to the contractual requests for Item III(B), the Committee has discussed the open and closed session aspects of this. He provided the summary that follows. For the reasons that were presented at the last several Board and Committee meetings, the administration has recommended, after a request for proposals (RFP) process, to develop a performance improvement package that includes a variety of Statements of Work. The Board has heretofore approved most of the Statements of Work; the Statement of Work that remains to be considered is the revenue cycle services. The recommendation of the administration was that this entire performance improvement package would be most beneficially structured for the System if it were all included in one contract, with one vendor. As he mentioned prior to the convening of closed session, Chairman Carvalho stated that a necessary consequence of that is the termination for convenience of a vendor who is performing similar or the same work for the System; not a termination for any other reason other than for the convenience of the System. This is to allow the System to incorporate all of the Statements of Work in one contract with the vendor who responded to the RFP with a proposal that the administration evaluated as being most beneficial for the System. This has been discussed in multiple meetings; he stated that the Committee is in a position to make the necessary motions for the two contractual requests.
Note: the following two motions containing recommendations for revenue cycle contractual arrangements were separated from the Minutes of the Finance Committee Meeting, and were considered and acted upon separately by the System Board on June 25, 2010. Please see the Minutes of the Meeting of the CCHHS Board of Directors of June 25, 2010 for final disposition.
Director O’Donnell, seconded by Director Muñoz, moved to authorize the issuance of a notice of termination for convenience of the MedAssets contract. THE MOTION CARRIED UNANIMOUSLY.
*Director O’Donnell, seconded by Director Muñoz, moved to authorize the Chief Executive Officer to move forward and enter into a Statement of Work for Revenue Cycle Services under the contract this Board has authorized previously with PricewaterhouseCoopers. THE MOTION CARRIED UNANIMOUSLY.
______
Director O’Donnell, seconded by Director Ramirez, moved the approval of request number 16, under the Contracts and Procurement Items. THE MOTION CARRIED.
Chairman Carvalho voted PRESENT.
______
VII. Adjourn
Miscellaneous – Presentation of Five-year Financial Forecast for Strategic Plan
Chairman Carvalho noted that the Committee received information relating to the Five-year Financial Forecast for the Strategic Plan; however, there was not enough time at the meeting left for discussion. Therefore, it is presented for the Committee’s information, and is expected to be presented, along with the Strategic Plan, at the June 25th Board Meeting for approval. ______
As the agenda was exhausted, Chairman Carvalho declared the MEETING ADJOURNED.
Page 7 of 192 Finance Committee Meeting Minutes Friday, June 18, 2010 Page 8
Respectfully submitted, Finance Committee of the Board of Directors of the Cook County Health and Hospitals System
XXXXXXXXXXXXXXXXXXXX David Carvalho, Chairman
Attest:
XXXXXXXXXXXXXXXXXXXX Deborah Santana, Secretary
Follow-up/further action needed:
1Request for a list of the facilities under the NuCare Services Corporation. Page 4.
2 Request for information on co-pay policies of the System’s partners. Page 5.
3 Follow-up: status of implementing a system to track ex-parte communications. Page 6.
4 Follow-up: work with Department of Public Relations on a communications plan for vendors, in order to effectively communicate the System’s Purchasing process, and to try to get more vendors involved in potential bids or RFPs. Page 6.
5 Follow-up: inquiry on whether a search function can be built into the website, so that information on specific contracts or products can be easily available. Page 6.
Page 8 of 192 Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010
ATTACHMENT #1
Page 9 of 192 Todd H. Stroger President Health & Hospitals System Board Membe Cook County Board of Commissioners Dr. David A. Ansell Warren L. Batts = Chairman Commissioner Jerry Butler Cook County Health & Hospitals System David ~.'~arvalho Jorge Ramirez Vice-Chairman Quin R. Golden Benn Greenspan Cook County Health & Hospitals System Sr. Sheila Lvne William T. Foley CEO 1900 West Polk Street, Suite 220 Dr. Luis R. Mufioz Cook County Health & Hospitals System Chicago, Illinois 60612 Heather E. O'Donnell Tel: (312) 864-6820 Andrea L. Zopp Fax: (312) 864-9994
May 24,2010
The Honorable Warren Batts, Chairman, Board of Directors The Honorable David Carvalho Chairman, Finance Committee Cook County Health and Hospitals System 1900 W. Polk Street Chicago, IL 60612 /' Re: Request to Terminate Contract #08-41-245, MedAssets /,,'
Dear Chairman Batts and Chairman Carvalho:
A three year contract between the Health System and MedAssets was approved by the Cook County Board of Commissioners on May 20,2008. The contract requires MedAssets to provide Revenue Cycle Re-Engineering and Operational Improvement Consulting Services and Accounts Receivable Improvement Services.
After a review of our progress in the revenue cycle area, coupled with the identification of numerous other areas in which the performance of the Health System requires focuse'd and integrated effort, the Health System issued a Request for Proposals for Performance Improvement Implementation Services. In the RFP, the Health System sought to identify prospective vendors to provide implementation services with regard to a full range of performance improvement initiatives, and reserved the right to include revenue cycle services as part of any contract that was pursued. After careful consideration, we believe that optimal improvements will be achieved through use of a single vendor for both performance improvement and revenue cycle efforts. Our goal in doing so is to improve the quality of services, reduce duplication of activities and standardize practices throughout the Health System.
On May 14,2010,we presented a recommendation to the Finance Committee that the Health System enter into a contract with PricewaterhouseCoopers for performance improvement implementation services, including revenue cycle services. In order to move forward with this contract, it will be necessary to transition away from our current revenue cycle vendor, MedAssets. The contract with MedAssets may be terminated upon six months advance written notice to MedAssets. Authorization is requested to issue a notice terminating the MedAssets contract. I am further requesting authorization to negotiate and approve an agreement with MedAssets regarding the amounts payable for the services to be provided during the period prior to the termination date.
Thank you for your consideration. Sinli erely,
Chief Executive Officer / Cook County Health & Hospitals System
Amba8aYesy .% Camamunity Hsel#R NeF~ork* Ceamak Hem1.3h Services 9 tzok Eewabj D+zi?pes9men%of Paubilc #emi$h * Page 10 of 192 John #, Stre~ger,du. HespiPss! a Qak Sores;) HospiPal a P~mvldsntBlospite.11 a Ruth M. Rofhsteiaa C9RZ Ezo%13e- We Bring HealthCARE to Your Community M BOARD APPROVAL REQUEST
, TYPE OF REQUEST: Enter into and Execute Contract PricewaterhouseCoopers, LLC SELECTION BID/RFP/PURCHASING CONSORTIAICOMPARABLE GOVERNMENT BID METHODOLOGY: RFP RFP ACCOUNT# 890-2601520-8230- FISCAL IMPACT: GRANT FUNDED AMOUNT: Professional and Managerial $50 million None Services CONTRACT PERIOD: June 1,2010 through May 31, REQ# 1 CONTRACT# 201 2 REQUESTING DEPT.1AFFILIATE: SPONSOR: CCHHS William T. Foley, Chief Executive Officer I IS THIS REQUEST THE LOWEST IS THIS CONTRACT BIDDERISUPPLIER? Yes SOLE SOURCE? No
I JUSTIFICATION: The Health System has committed itself to a significant transformation designed to reduce overall operating expenses, increase revenues, realign service delivery and implement strategic initiatives designed to improve overall quality and access to care and reduce the system's dependence on funding from Cook County. CCHHS has engaged consultants to identify and quantify areas of improvement throughout the System. This work has been the basis for the development of an all-encompassing multiyear RFP designed to aid management in the implementation of process improvements throughout the System. The project design impacts virtually all areas of operation and will significantly alter where and how work is performed. CCHHS does not have and cannot employ the number of technical experts required to implement these changes. This contract will bring the requisite skills to focus on each area of improvement and will include staff training, allocation, enhancement or replacement as necessary to maintain change. This contract will include revenue cycle services.
TERMS OF REQUEST: This is a full risk all-inclusive contract. Compensation to the vendor is dependent upon identified and realized cash improvement -- fees collected or expense avoided. The anticipated benefited is $313.8 million; fees will be paid on an hourly basis after the first $10 million of realized benefit at a ratio of 6:l for the first $200 million of realized benefit and at a ratio of 7:l if the amount of realized benefit exceeds $200 million; maximum fees are set at as50 million; no fee will be paid for the first $10 million of realized benefit. Contract consists of a Master Services Agreement that will be supplemented with individual Statements of Work identifying and controlling specific project activity.
HAS THlS BEEN REVIEWED BY CONTRACT COMPLIANCE? Pending , WHAT PERCENTAGE OF THlS CONTRACT IS WIMBE? 10125%
ATTACHMENTS II BID TABWATIONS: NIA
11 William T. Folev. Chief Executive Officer CCHHS / ., v
Anthony Tedeschi, m~ef'operatingOfficer CCHHS
CFO: CCHHS
C Ambulatory & Community Ilcalth Nctworli C'cl.mak Health Scrviccs Ilepartment of Public Health John H. Stroprr. .Ir. 1lospit:il of ('ook Count! 0:ik Forest 1iospit:il Provident Ilospital Ruth R.1. Kothstein CORE ('enter
Page 11 of 192 We Bring Health CARE to Your Community Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010
ATTACHMENT #2
Page 12 of 192 Cook County Health & Hospitals System
Todd H. Stroger • President Health System Board Members Cook County Board of Commissioners Dr. David A. Ansell Commissioner Jerry Butler Warren L. Batts • Chairman David N. Carvalho Cook County Health & Hospital System Quin R. Golden Benn Greenspan Jorge Ramirez • Vice-Chairman Sr. Sheila Lyne Cook County Health & Hospitals System Dr. Luis R. Munoz Heather E. O’Donnell William T. Foley • CEO Andrea L. Zopp Cook County Health & Hospitals System
To: David Ansell, M.D. Director Cook County Health & Hospitals System Board of Directors
From: William T. Foley Chief Executive Officer Cook County Health & Hospitals System
Michael Ayres Chief Financial Officer Cook County Health & Hospitals System
Jeanene Johnson Interim Performance Improvement Director Cook County Health & Hospitals System
CC: Chairman Warren Batts and Directors, Cook County Health & Hospitals System Board of Directors
Date: June 15, 2010
RE: Answers to Questions Regarding Contract for Performance Improvement with PricewaterhouseCoopers
We understand your concerns about the magnitude of the proposed performance improvement opportunity, the contingency risk, and the communication requirements and have responded to your concerns in the following section.
1. What are the various work plans and how much revenue (expense reduction) will be generated from each activity?
ANS. See Benefit Realization Schedule attached.
Page 13 of 192 Answers to Questions Concerning Contract for Performance Improvement with PricewaterhouseCoopers June 15, 2010
a. For example- How do the revenue cycle projections of PwC compare to those from other bidders and MedAssets?
ANS: CCHHS received responses to the Performance Improvement (“PI”) Request For Proposal (“RFP”) from the Navigant Consulting Group (“NCI”), PricewaterhouseCoopers (“PwC”) and Quorum Health Resources (“QHR”). MedAssets did not propose on the project because they were unable to provide the all services described in the RFP.
The calculations made by PwC are based their review of the systems business processes, experience in working with comparable organizations and a number of assumptions on what process changes can be achieved. These calculations were not specific given the condition of our data and the time that each consulting group had to evaluate Cook County Health and Hospitals System’s (“CCHHS’s”) processes. What is clear is that CCHHS is significantly behind in the implementation of efficient operational processes. CCHHS does not capture all the revenues that are reimbursable under existing programs and has entered into contracts where alternative arrangements would be either less expensive or more beneficial. To a large extent, PwC’s estimate of benefit is a sophisticated guess given the antiquated nature of CCHHS’s structure.
Navigant Consulting Group NCI did not identify any benefit target for revenue cycle; rather, they added an assessment phase to identify a revenue cycle benefit target.
PricewaterhouseCoopers PwC proposed a revenue cycle benefit of $150 million to be achieved over two years.
Quorum Health Resources QHR did not include any specific benefit targets for revenue cycle.
MedAssets MedAssets targeted a revenue cycle cash target between $72 and $80 million over a three-year period beginning June, 2008. As of May 31, 2009, MedAssets has achieved $76 million in cash.
b. What was the data that PWC used to determine the estimates?
ANS. PwC used the information in the NCI assessment in addition to CCHHS’ financial data provided in the standard data set during the RFP solicitation to establish the preliminary estimates.
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Answers to Questions Concerning Contract for Performance Improvement with PricewaterhouseCoopers June 15, 2010
2. Who has PwC presented their work plans to beyond senior management?
ANS: Senior management, key physician leaders and middle managers across the system were involved in the evaluation and selection of PwC.
The PI RFP Review and Evaluation Committee1 comprised of middle management and staff, met on March 10, 2010 to review and compare proposals and develop a recommendation for the PI RFP Executive Evaluation Committee.
The PI RFP Executive Selection Committee2 comprised of select System Leadership, received oral presentations by all proposers on March 17, 2010 resulting in the recommendation of PwC to the Board of Directors “Board”.
The PI Physician Leadership Steering Committee3 provided input and direction into the design of the seven (7) Physician Funding and Effort Statements of Work as well as the Centers of Excellence Statement of Work (work plans).
Statement of Work Sponsors4 provided direction and input into the development of PwC Statements of Work. Each of these Sponsors involved their key managers and physicians in the development of their assigned Statements of Work.
a. Will the full board get to review their presentation and have the opportunity to ask questions?
ANS: Management has applied an extensive evaluation process in the selection of a comprehensive vendor to partner with CCHHS in its efforts with performance improvement. Management assumes responsibility to answer any questions that the Board may have regarding the recommendations made to the Board. All materials related to the selection of PwC and management’s documentation is available to members of the Board at any time.
1 PI RFP Review and Evaluation Committee Membership: Jeanene Johnson, Interim Performance Improvement Director (Committee Chair), JoAnn Dulski, System Lab Director, Sharon Fryer, Oak Forest CNO, Marty Grant, System Pharmacy Director, Enrique Martinez, M.D. ACHN CMO, Joseph Coty, Safety Director, John Morales, JSH CFO. 2 PI RFP Executive Selection Committee Membership: William Foley, CEO (Chair), Anthony Tedeschi, M.D. Interim COO, Terry Mason, M.D., CMO, Deborah Tate, HR System Director, Dan Howard, CIO, Roz Lennon, CCO, Jeanene Johnson, Interim Performance Improvement Director (Facilitator) 3 Physician Leadership Steering Committee Membership: Terry Mason, M.D. (Chair), Maurice Lemon, M.D., Enrique Martinez, M.D., Robert Weinstein, M.D., Jeff Schaider, M.D., Aaron Hamb, M.D., Judith Frigo, M.D., John O’Brian, M.D., Richard Keene, M.D. David Barker, M.D., Avery Hart, M.D. 4 Statement of Work Owners: Michael Puisis, M.D. (Cermak)., Anthony Tedeschi, M.D. (ACHN & CORE, Supply Chain), Roz Lennon (Labor & Productivity), Terry Mason, M.D. (Physician Effort & Funding), Stephen Martin, Ph.D. (Public Health), Michael Ayres (Revenue Cycle), Deborah Tate (Recruitment, Retention and HR Paired Advisor)
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Answers to Questions Concerning Contract for Performance Improvement with PricewaterhouseCoopers June 15, 2010
b. Has the senior medical (CMOs, Department Chairs) and administrative leadership had a presentation.
ANS: Yes. See the answer to question #2.
c. Union leadership?
ANS: System Leadership has held multiple meetings with the bargaining units to brief them about the upcoming project. System Leadership will continue to involve the bargaining units in communication about the project as it unfolds.
3. How will the $300 million opportunity be broken down by year?
ANS: See the Benefit Realization Schedule attachment.
4. How much is revenue enhancements and how much expense reductions?
ANS: Revenue enhancements planned by PwC represent 70% of the total targeted benefit.
% of total project 70% 30%
5. It seems like a huge turn around to accomplish in 2 years (1/3 of total budget.) (University of Chicago did a $ 100 million in 1 year. Simon did about the same in 1 year?)
ANS: Dr. Simon’s effort in 2007 focused primarily on labor expense reductions; whereas, PwC will take a comprehensive integrated approach across the system looking at revenue enhancement, patient access, service growth and efficiency. In essence, the project proposed by PwC is designed to help transform the system. The scale of the envisioned transformation will require a greater amount of time over a simple expense reduction project. A key element in accomplishing this goal is system-wide organizational commitment. CCHHS’s transformation will require significant change to the philosophy,
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Answers to Questions Concerning Contract for Performance Improvement with PricewaterhouseCoopers June 15, 2010
culture and operational structure throughout the system. We will need to change how we view the delivery of care and the resources required. Employees -- caregivers and the support staff -- must embrace these changes. CCHHS must hold Senior Management responsible for making the changes and management must hold employees equally responsible.
6. I understand the lack of a middle management is driving the need for this- how and when will the handoffs occur (re: professional billing, revenue cycle, etc) to our staff, if ever?
ANS: Each Statement of Work has planned conversion dates where the operational improvements related to the transformation will be formally transitioned to the appropriate owner in the health system. Knowledge transfer is a key component of PwC’s transformation strategy with training and education deliverables built into the Statements of Work. For revenue cycle there are very few middle managers. Most of the leadership functions in revenue cycle are currently assumed by MedAssets. These management functions will be transitioned to PwC upon Board approval of PwC’s contract.
7. How will the contingency fee be managed?
ANS: CCHHS and PwC will jointly agree upon the baseline measurement for each Statement of Work. PwC will receive credit for benefit delivered above the baseline for the associated tasks. PwC and CCHHS will review the calculations monthly.
8. This was stated to be a problem with MedAssets and we switched back away from this. How do we account for improvements already in place with regard to credit?
ANS: The jointly developed baseline will account for PwC’s accomplishments and associated benefit versus benefit delivered by efforts currently underway in CCHHS. There a very prescriptive process directed by CCHHS Finance used to evaluate each Statement of Work benefit. The Office of Performance Improvement will work with each Statement of Work Sponsor (CCHHS System Leader) to define “who gets credit” prior to the start of any initiative. CCHHS’s improvements already in place will be identified on each Statement of Work as “out-of-scope”.
9. What is the communication plan?
ANS: CCHHS and PwC are finalizing a Communication Plan currently. The ultimate goal is to ensure transparency and establish a clear protocol for the dissemination of information to stakeholders both internally and externally. The draft Communication Plans is attached.
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Answers to Questions Concerning Contract for Performance Improvement with PricewaterhouseCoopers June 15, 2010
10. What are the true costs of severing the relationship with MedAssets?
ANS: There are two distinctive exposures determining the contract outcome -- finalizing the MedAssets relationship and converting to PwC revenue cycle interim management. The contract between the parties stipulates that CCHHS can terminate for convenience with 180 day notice. The fee to be paid during this period (based on a schedule in the contract amendment) with the effective date of July 1, 2010 is $3,181,000. As of Friday, June 11, 2010 at 1:15 PM we had not reached an agreement with MedAssets on what role they would play and the compensation to be paid.
Dependent upon timing PwC will assume responsibility for each of the MedAssets initiatives immediately upon MedAssets being relieved of responsibility for that initiative. The potential exposure in that transition lies with the loss of progress being made in the individual initiatives. Each vendor has a different priority and work style that will inevitably cause some disruption in the improvement process. Any costs will be associated with a delay in implementation as a result of the change rather than a reduction of benefit or an increase in expense. It is difficult to anticipate how long or if at all a disruption will occur. Neither CCHHS nor PwC expects any interruption to have a noticeable economic impact. PwC's commitment calls for an acceleration of benefit significantly beyond the process currently being achieved through MedAssets.
11. What are the specific accountabilities of PwC to the Finance Committee of the Board?
ANS: Mike Ayres, CFO, is the project owner for PwC’s engagement supported by the CCHHS Office of Performance Improvement. He reports weekly to William Foley, CEO and the System Leadership team on the progress, successes and issues related to the contract. In addition, the assigned System Leadership team will assume responsibility for implementing specific initiatives. Under Mr. Foley's direction, the Finance Committee and subsequently the Board will be advised monthly as a part of Mr. Ayres report on the project’s progress.
12. How do we measure success?
ANS: There will be tangible and intangible measures of success. The tangible benefit is measured as cash improvement over baseline. This tangible benefit is the primary reason we have entered into the relationship with CCHHS. Other indicators of success include but are not limited to: accelerated realized cash benefit, improved patient through-put, improved census management, improved wait times, patient quality metrics, and heightened employee quality and quantity of work, etc. Key performance indicators will be identified at the start of the engagement and included in each Statement of Work.
Intangible measures will include improved employee training and morale, the solidification of a performance improvement culture, improved community image for managing taxpayer resources efficiently and a renewed focus on patient quality.
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Answers to Questions Concerning Contract for Performance Improvement with PricewaterhouseCoopers June 15, 2010
13. What are the benchmarks?
ANS: PwC and CCHHS will utilize proprietary internal and well-known external national benchmarks and best practices. Benchmarks will be tailored to the unique operating environment at CCHHS by using comparable safety-net and academic health systems. Each Statement of Work will involve using benchmarks and best practices specific to their areas of focus.
Cc: PwC Work Plan and Benefit Realization Schedule Draft Communication Plan
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Communication Plan- Draft CCHHS 6/15/10
Mode Message Medium Stakeholders Day Planned Date Communicator Author Date Completed
1.00 Project Kick-Off/Initial Roll-out Week 1 HOT Meeting Review FAQs, management memo FAQs, COOs, CMO's, CNO's, Wed TBD Lucio Guerrero, Jeanene Lucio Guerrero, Jeanene Johnson and communication plan Communication System Directors Johnson, Mike Ayres Plan, Management 1.01 Memo Announce to Public Benefit target, experienced team, Press Release Community Thurs TBD Bill Foley Lucio Guerrero, Jeanene Johnson, selection of PwC for efficiencies, cohesive approach to PI PwC performance (incorporating RC) consolidating improvement engagement consultant efforts, best practice 1.02 benchmarks Announce to Public Benefit target, experienced team, Annoucement on Community Thurs TBD Bill Foley Lucio Guerrero selection of PwC for efficiencies, cohesive approach to PI Internet website performance (incorporating RC) consolidating improvement engagement consultant efforts, best practice 1.03 benchmarks PwC Announcement on Benefit target, experienced team, Intranet with CCHHS Employees Thurs TBD Bill Foley Lucio Guerrero, Jeanene Johnson, Intranet efficiencies, cohesive approach to PI FAQs PwC (incorporating RC) consolidating consultant efforts, best practice 1.04 benchmarks PwC Announcement on Benefit target, experienced team, Press Release Community Thurs TBD Bill Foley Lucio Guerrero, Jeanene Johnson, Internet efficiencies, cohesive approach to PI PwC (incorporating RC) consolidating consultant efforts, best practice 1.05 benchmarks Project Overview Prepare County Commissioners and FAQs All Stakeholders Thurs TBD Bill Foley Lucio Guerrero, Jeanene Johnson, Board members with questions they PwC may receive. Prepare leadership to 1.06 answer questions. Management Memo Announce project and prepare Memo plus FAQs 376 Managers Thurs TBD Bill Foley Lucio Guerrero, Jeanene Johnson, 1.07 announcing PwC managers to attend Kick-Off meeting PwC Announcement of PwC Announce project and prepare Knowledge Web Knowledge Web staff Thurs TBD Bill Foley Lucio Guerrero, Jeanene Johnson, Selection managers to attend Kick-Off meeting with Management PwC Memo and FAQs 1.08 Operating Unit Kick-Off Provide management orientation to Training 376 Managers across TBD TBD System Leadership and Lucio Guerrero, Jeanene Johnson, Meeting, JSH, PH, OFH, project System Bill Foley PwC 1.09 Cermak Week 2 Project Overview Project Overview FAQs Bargaining Units Tues-Fri TBD Bill Foley Lucio Guerrero, Jeanene Johnson, 1.09 PwC Project Kick-Off and Project Introduction and Leadership Memo All Managers/ System Tues TBD CEO Lucio Guerrero, Jeanene Johnson, Invitation to Manager Appointment; announce Kick-Off Leadership PwC Forum 1.10 Organizational and Communication Plan Review, project Agenda, Project System Leadership Wed 11- TBD PwC Lucio Guerrero, Jeanene Johnson, planning meeting organization and messaging Overview 12 PM PwC Presentation , Communication 1.11 Plan
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Mode Message Medium Stakeholders Day Planned Date Communicator Author Date Completed
HOT Meeting Project status update TBD COOs, CMO's, CNO's, Wed TBD Lucio Guerrero, Jeanene Larry Patrick, PwC System Directors Johnson, PwC, Mike Ayres
1.12 Executive Steering Begin initiative reporting to ESC- Standard Power System Leadership, Thur TBD PwC Ann Marie Huddleston Committee Supply Chain Point Status COOs, CMOs, CFOs, Report CNOs
1.13 Project Kick-Off at each Describe structure and participation on Detailed Project All Managers/ System Mon-Thur TBD PwC Team Leads & CEO Larry Patrick, PwC operating unit Manager project teams, schedule, operating Level Orientation Leadership Forums guidelines, time commitments, communication plan, financial targets 1.14 Project Newsletter #1 with Project Introduction, rationale and Employee All Stakeholders Mon TBD Office of Performance Lucio Guerrero, Jeanene Johnson, FAQs purpose Newsletter Improvement PwC
1.15 Employee Kick-Off Provide high level overview to staff on High-Level Power Employees system- 3 weeks TBD CCHHS Managers Lucio Guerrero, Jeanene Johnson, Conducted by Managers performance improvement project that Point Project wide Variable PwC Managers will deliver. Presentation Orientation provided at Manager Forum on disk. 1.16 Employee Orientation` One page slide provided for new One page New Employees Aft 6/11 TBD Human Resources Larry Patrick, PwC & Jeanene employee orientation on performance PowerPoint Johnson improvement
1.17 Med-Executive Provide high level overview to staff on High-Level Power Hospital Med Exec TBD TBD CMOs & PwC Larry Patrick, PwC & Jeanene Committee performance improvement project that Point Project Committees Johnson Managers will deliver. Presentation Orientation provided at Manager Forum on disk. 1.18 2.00 On-Going Status Reporting 2.01 Executive Steering First ESC -Project reporting PowerPoint System Leadership, Thur, 10- Weekly PwC and CCHHS Team PwC and CCHHS Team Leads Committee organization, baseline methodology, COOs, CMOs, CFOs, 12 throughout Leads definition of identified, implemented CNOs project and verified
2.01 Board of Directors Project Status Summary Verbal report or Board of Directors 4th Fri Every other CEO or by invitation- PwC Michael Ayres & Jeanene Johnson PowerPoint Mo month' Engagement Exec 2.03 Finance Committee Financial Benefit Achievement Verbal report or Finance Committee 2nd Fri Monthly CFO Jeanene Johnson & PwC PowerPoint Mo 2.04 System Leadership Key Issues and Barriers Verbal report or System Leadership Tues As needed CCHHS Team Sponsors CCHHS Sponsor or Jeanene PowerPoint weekly and Office of Performance Johnson Improvement
2.05 Director/Manager Update Project Status Summary -focus on Memo- MS Word Managers TBD Monthly Michael Ayres, Project Michael Ayres & Jeanene Johnson Memo with FAQs identified benefits and questions Sponsor
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Mode Message Medium Stakeholders Day Planned Date Communicator Author Date Completed
2.06 Medical Executive Project Status Summary Status Report Hospital Physician TBD Monthly Hospital COOs Jeanene Johnson & PwC Committees Service Leaders
2.07 HOT Meeting Project Status Summary Status Report COOs, CMO's, CNO's, Wed Weekly PwC & Jeanene Johnson Pwc Hospital Directors and Wednesday System Leaders 1-2 PM
2.08 Employee Newsletter Project Status Summary- focus on Team -focused Employees Monthly Jeanene Johnson Lucio Guerrero, Jeanene Johnson, posted to intranet site employee contributions article PwC 2.09 Intranet Posting with Project Status Summary- focus on FAQs Employees Monthly Jeanene Johnson Lucio Guerrero, Jeanene Johnson, FAQs employee contributions PwC 2.10 Posterboard Tracker at High-Level Project Graphs Posterboard Leadership On-going Jeanene Johnson Lucio Guerrero, Jeanene Johnson, Corporate PwC 2.11 Knowledge Web Project status announcements Sharepoint Management On-going PwC PwC
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Page 625 of 6of 192 Communication Plan Draft Overview CCHHS 6/15/10 COMMUNICATION PLAN
Objectives 1. Communicate to stakeholders the need for performance improvement as the basis of the Strategic Transformation 2. Identify the burning platform 3. Engage participation and support of stakeholders answering "what's in it for me?" 4. Lay the groundwork for organizational cultural change based on performance improvement Stakeholders 1. Management 2. Employees 3. Physicians, Medical School Affiliations 4. Boards of Directors 5. Bargaining Units 6. Community Strategies 1. Linkage under the Strategic Umbrella roll-out Communication Themes 1. System-wide Transformation 2. A new beginning 3. Financial and operational transformation linked to proposed strategic plan 4. Development of new culture of increased responsibility and work quality 5. Efficiency without sacrificing quality Communication Vehicles 1. Employee Meetings 2. Management Meetings 3. Intranet 4. Extranet 5. Employee Newsletter 6. HOT meetings 7. System Leadership Meetings 8. Department Bulletin Boards 9. Video
Page1 26of of1 192 6/17/2010 10:02 AM PWC Confidential - Internal use only CLIENT NAME: CCHHS ENGAGEMENT: Performance Improvement
Budget Details 18 Month Total May 10 Jun 10Q2 2010 Jul 10 Aug 10 Sep 10 Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Labor, Productivity & Workforce Efficiency Labor, Productivity & Workforce Efficiency $ 5,000,240 $ 30,000,000 $ 422,320 $ 415,000 $ 422,320 $ 415,000 $ 844,640 $ 830,000 $ 422,320 $ 415,000 $ 422,320 $ 415,000 $ 422,320 $ 640,000 Subtotal $ 5,000,240 $ 30,000,000 $ 422,320 $ 415,000 $ 422,320 $ 415,000 $ 844,640 $ 830,000 $ 422,320 $ 415,000 $ 422,320 $ 415,000 $ 422,320 $ 640,000 Supply Chain Distribution and Warehousing $ 215,475 $ 5,000,000 $ 59,050 $ - $ 59,050 $ - $ 118,100 $ - $ 59,050 $ - $ 38,325 $ 5,000,000 $ - $ - KPI Dashboard and Realization Tracking $ 38,843 $ - $ 11,691 $ - $ 2,891 $ - $ 14,583 $ - $ 1,516 $ - $ 1,516 $ - $ 1,516 $ - ERP/Supply Chain IT Maximization $ 92,200 $ - $ 23,050 $ - $ 23,050 $ - $ 46,100 $ - $ 23,050 $ - $ 23,050 $ - $ - $ - Non-Labor Cost Reduction $ 1,512,200 $ 14,000,000 $ 105,550 $ - $ 105,550 $ 200,000 $ 211,100 $ 200,000 $ 105,550 $ 200,000 $ 105,550 $ 500,000 $ 94,550 $ 500,000 GPO Optimization $ 100,875 $ 5,000,000 $ 7,165 $ - $ 7,165 $ - $ 14,330 $ - $ 7,165 $ - $ 7,165 $ - $ 7,165 $ - Organization Development & Process Improvement $ 561,600 $ - $ 110,300 $ - $ 110,300 $ - $ 220,600 $ - $ 110,300 $ - $ 86,100 $ - $ 72,300 $ - Inventory Reduction $ 408,050 $ 1,000,000 $ 94,850 $ - $ 81,050 $ - $ 175,900 $ - $ 81,050 $ 125,000 $ 81,050 $ 125,000 $ 70,050 $ 125,000 Accounts Payable $ 260,030 $ 4,500,000 $ 70,820 $ - $ 70,820 $ 600,000 $ 141,640 $ 600,000 $ 70,820 $ 600,000 $ 47,570 $ 800,000 $ - $ 800,000 Outsourcing & Shared Services $ 742,550 $ 12,000,000 $ 101,450 $ - $ 101,450 $ - $ 202,900 $ - $ 101,450 $ - $ 101,450 $ 500,000 $ 67,350 $ 500,000 Subtotal $ 3,931,823 $ 41,500,000 $ 583,926 $ - $ 561,326 $ 800,000 $ 1,145,253 $ 800,000 $ 559,951 $ 925,000 $ 491,776 $ 6,925,000 $ 312,931 $ 1,925,000 Patient Accounts Virtual Business Office $ 1,713,680 $ - $ 14,120 $ - $ 14,120 $ - $ 28,240 $ - $ 141,167 $ - $ 141,167 $ - $ 141,167 $ - Specialized Pharmacy Billing $ 316,860 $ 2,000,000 $ - $ - $ 160,800 $ - $ 160,800 $ - $ 113,360 $ 25,000 $ 42,700 $ 50,000 $ - $ 75,000 Rev Cycle Project Management $ 3,859,200 $ - $ 160,800 $ - $ 160,800 $ - $ 321,600 $ - $ 160,800 $ - $ 160,800 $ - $ 160,800 $ - RC Patient Access $ 6,394,400 $ 15,000,000 $ 427,200 $ - $ 427,200 $ 75,000 $ 854,400 $ 75,000 $ 427,200 $ 125,000 $ 427,200 $ 250,000 $ 462,400 $ 350,000 Charge Capture / CDM $ 677,500 $ 7,500,000 $ - $ - $ 114,700 $ - $ 114,700 $ - $ 114,700 $ - $ 114,700 $ - $ 114,700 $ - HIM $ 1,114,800 $ 3,000,000 $ - $ - $ 174,000 $ 50,000 $ 174,000 $ 50,000 $ 174,000 $ 150,000 $ 158,600 $ 300,000 $ 158,600 $ 500,000 CDI $ 263,050 $ 7,500,000 $ 65,590 $ - $ 65,935 $ - $ 131,525 $ - $ 65,590 $ - $ 65,935 $ - $ - $ - Care Management $ 2,721,810 $ 20,000,000 $ 206,280 $ - $ 217,580 $ - $ 423,860 $ - $ 217,580 $ - $ 211,930 $ - $ 305,480 $ - Rate Rationalization $ 191,560 $ 5,000,000 $ 47,890 $ - $ 47,890 $ - $ 95,780 $ - $ 47,890 $ - $ 47,890 $ - $ - $ - Patient Accounting $ 8,054,400 $ 62,000,000 $ 414,400 $ - $ 414,400 $ 50,000 $ 828,800 $ 50,000 $ 414,400 $ 150,000 $ 414,400 $ 400,000 $ 414,400 $ 650,000 Vendor Management $ 905,480 $ 3,000,000 $ - $ - $ - $ - $ - $ - $ 99,200 $ - $ 85,400 $ 50,000 $ 85,400 $ 100,000 Subtotal $ 26,212,740 $ 125,000,000 $ 1,336,280 $ - $ 1,797,425 $ 175,000 $ 3,133,705 $ 175,000 $ 1,975,887 $ 450,000 $ 1,870,722 $ 1,050,000 $ 1,842,947 $ 1,675,000 Regulated Payments Admin $ 305,780 $ 12,100,000 $ 88,500 $ - $ 81,000 $ - $ 169,500 $ - $ 22,840 $ - $ 3,980 $ - $ 3,800 $ - DSH $ 361,760 $ - $ - $ - $ 27,132 $ - $ 27,132 $ - $ 27,132 $ - $ 27,132 $ - $ 18,088 $ - Bad Debts $ 398,800 $ - $ - $ - $ 29,910 $ - $ 29,910 $ - $ 29,910 $ - $ 29,910 $ - $ 19,940 $ - GME $ 160,760 $ - $ - $ - $ 12,057 $ - $ 12,057 $ - $ 12,057 $ - $ 12,057 $ - $ 8,038 $ - Medicaid $ 689,280 $ 12,900,000 $ 24,440 $ - $ 85,160 $ - $ 109,600 $ - $ 85,160 $ - $ 85,160 $ - $ 60,720 $ - Add-Ons $ 641,840 $ - $ 24,440 $ - $ 44,680 $ - $ 69,120 $ - $ 44,680 $ - $ 44,680 $ - $ 20,240 $ - Subtotal $ 2,558,220 $ 25,000,000 $ 137,380 $ - $ 279,939 $ - $ 417,319 $ - $ 221,779 $ - $ 202,919 $ - $ 130,826 $ - Implementation Support for ACHN Implementation Support for ACHN $ 2,102,352 $ 15,800,000 $ 175,467 $ - $ 175,467 $ - $ 350,933 $ - $ 175,467 $ - $ 160,800 $ 438,889 $ 160,800 $ 438,889 Subtotal $ 2,102,352 $ 15,800,000 $ 175,467 $ - $ 175,467 $ - $ 350,933 $ - $ 175,467 $ - $ 160,800 $ 438,889 $ 160,800 $ 438,889 Physician Effort and Funding Plan Oversight $ 292,368 $ - $ 24,201 $ - $ 28,042 $ - $ 52,243 $ - $ 28,042 $ - $ 24,201 $ - $ 24,201 $ - Clinical Productivity & Revenue $ 341,094 $ 4,000,000 $ 33,481 $ 222,222 $ 33,481 $ 222,222 $ 66,961 $ 444,444 $ 33,481 $ 222,222 $ 24,346 $ 222,222 $ 24,346 $ 222,222 Physician Roles $ 341,094 $ - $ 33,481 $ - $ 33,481 $ - $ 66,961 $ - $ 33,481 $ - $ 24,346 $ - $ 24,346 $ - Research $ 486,318 $ 2,500,000 $ 47,417 $ - $ 56,509 $ 78,125 $ 103,926 $ 78,125 $ 56,509 $ 156,250 $ 40,873 $ 234,375 $ 40,873 $ 312,500 Teaching $ 467,368 $ - $ 44,867 $ - $ 44,867 $ - $ 89,735 $ - $ 44,867 $ - $ 38,324 $ - $ 38,324 $ - Strategic Funds $ 334,168 $ - $ 30,846 $ - $ 30,846 $ - $ 61,693 $ - $ 30,846 $ - $ 21,032 $ - $ 21,032 $ - Centers of Excellence $ 1,034,600 $ 40,000,000 $ 6,780 $ - $ 60,460 $ - $ 67,240 $ - $ 60,460 $ - $ 60,460 $ - $ 60,460 $ - Medical School Affiliations $ 384,200 $ 30,000,000 $ - $ - $ - $ - $ - $ - $ 153,680 $ - $ 153,680 $ - $ 76,840 $ - Subtotal $ 3,681,210 $ 76,500,000 $ 221,073 $ 222,222 $ 287,686 $ 300,347 $ 508,758 $ 522,569 $ 441,366 $ 378,472 $ 387,262 $ 456,597 $ 310,422 $ 534,722 Engagement Administration PwC Engagement Administration $ 2,135,700 $ - $ 118,650 $ - $ 118,650 $ - $ 237,300 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ - Subtotal $ 2,135,700 $ - $ 118,650 $ - $ 118,650 $ - $ 237,300 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ -
TOTAL $ 45,622,285 $ 313,800,000 $ 2,995,095 $ 637,222 $ 3,642,813 $ 1,690,347 $ 6,637,908 $ 2,327,569 $ 3,915,419 $ 2,168,472 $ 3,654,449 $ 9,285,486 $ 3,298,896 $ 5,213,611 Cumulative $ 2,995,095 $ 637,222 $ 6,637,908 $ 2,327,569 $ 6,637,908 $ 2,327,569 $ 10,553,328 $ 4,496,042 $ 14,207,776 $ 13,781,528 $ 17,506,672 $ 18,995,139
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Budget Details 18 Month Total Q3 2010 Oct 10 Nov 10 Dec 10Q4 2010 Jan 11 Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Labor, Productivity & Workforce Efficiency Labor, Productivity & Workforce Efficiency $ 5,000,240 $ 30,000,000 $ 1,266,960 $ 1,470,000 $ 360,720 $ 1,000,000 $ 360,720 $ 2,000,000 $ 360,720 $ 2,000,000 $ 1,082,160 $ 5,000,000 $ 360,720 $ 2,500,000 Subtotal $ 5,000,240 $ 30,000,000 $ 1,266,960 $ 1,470,000 $ 360,720 $ 1,000,000 $ 360,720 $ 2,000,000 $ 360,720 $ 2,000,000 $ 1,082,160 $ 5,000,000 $ 360,720 $ 2,500,000 Supply Chain Distribution and Warehousing $ 215,475 $ 5,000,000 $ 97,375 $ 5,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - KPI Dashboard and Realization Tracking $ 38,843 $ - $ 4,549 $ - $ 1,516 $ - $ 1,516 $ - $ 1,516 $ - $ 4,549 $ - $ 1,516 $ - ERP/Supply Chain IT Maximization $ 92,200 $ - $ 46,100 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Non-Labor Cost Reduction $ 1,512,200 $ 14,000,000 $ 305,650 $ 1,200,000 $ 94,550 $ 700,000 $ 94,550 $ 700,000 $ 94,550 $ 700,000 $ 283,650 $ 2,100,000 $ 94,550 $ 800,000 GPO Optimization $ 100,875 $ 5,000,000 $ 21,495 $ - $ 7,165 $ - $ 4,965 $ 5,000,000 $ 4,965 $ - $ 17,095 $ 5,000,000 $ 4,965 $ - Organization Development & Process Improvement $ 561,600 $ - $ 268,700 $ - $ 72,300 $ - $ - $ - $ - $ - $ 72,300 $ - $ - $ - Inventory Reduction $ 408,050 $ 1,000,000 $ 232,150 $ 375,000 $ - $ 125,000 $ - $ 125,000 $ - $ 125,000 $ - $ 375,000 $ - $ 125,000 Accounts Payable $ 260,030 $ 4,500,000 $ 118,390 $ 2,200,000 $ - $ 800,000 $ - $ 900,000 $ - $ - $ - $ 1,700,000 $ - $ - Outsourcing & Shared Services $ 742,550 $ 12,000,000 $ 270,250 $ 1,000,000 $ 67,350 $ 500,000 $ 67,350 $ 500,000 $ 67,350 $ 500,000 $ 202,050 $ 1,500,000 $ 67,350 $ 500,000 Subtotal $ 3,931,823 $ 41,500,000 $ 1,364,659 $ 9,775,000 $ 242,881 $ 2,125,000 $ 168,381 $ 7,225,000 $ 168,381 $ 1,325,000 $ 579,644 $ 10,675,000 $ 168,381 $ 1,425,000 Patient Accounts Virtual Business Office $ 1,713,680 $ - $ 423,500 $ - $ 141,167 $ - $ 141,167 $ - $ 141,167 $ - $ 423,500 $ - $ 141,167 $ - Specialized Pharmacy Billing $ 316,860 $ 2,000,000 $ 156,060 $ 150,000 $ - $ 75,000 $ - $ 75,000 $ - $ 100,000 $ - $ 250,000 $ - $ 100,000 Rev Cycle Project Management $ 3,859,200 $ - $ 482,400 $ - $ 160,800 $ - $ 160,800 $ - $ 160,800 $ - $ 482,400 $ - $ 160,800 $ - RC Patient Access $ 6,394,400 $ 15,000,000 $ 1,316,800 $ 725,000 $ 462,400 $ 600,000 $ 304,000 $ 850,000 $ 304,000 $ 850,000 $ 1,070,400 $ 2,300,000 $ 304,000 $ 850,000 Charge Capture / CDM $ 677,500 $ 7,500,000 $ 344,100 $ - $ 114,700 $ - $ 104,000 $ 125,000 $ - $ 250,000 $ 218,700 $ 375,000 $ - $ 375,000 HIM $ 1,114,800 $ 3,000,000 $ 491,200 $ 950,000 $ 152,440 $ 500,000 $ 108,440 $ 250,000 $ 42,280 $ 100,000 $ 303,160 $ 850,000 $ 33,040 $ 100,000 CDI $ 263,050 $ 7,500,000 $ 131,525 $ - $ - $ - $ - $ 50,000 $ - $ 250,000 $ - $ 300,000 $ - $ 375,000 Care Management $ 2,721,810 $ 20,000,000 $ 734,990 $ - $ 305,480 $ - $ 299,830 $ 100,000 $ 200,630 $ 500,000 $ 805,940 $ 600,000 $ 294,180 $ 1,000,000 Rate Rationalization $ 191,560 $ 5,000,000 $ 95,780 $ - $ - $ - $ - $ 250,000 $ - $ 250,000 $ - $ 500,000 $ - $ 250,000 Patient Accounting $ 8,054,400 $ 62,000,000 $ 1,243,200 $ 1,200,000 $ 414,400 $ 1,000,000 $ 414,400 $ 2,000,000 $ 414,400 $ 2,600,000 $ 1,243,200 $ 5,600,000 $ 414,400 $ 3,125,000 Vendor Management $ 905,480 $ 3,000,000 $ 270,000 $ 150,000 $ 57,800 $ 150,000 $ 57,800 $ 150,000 $ 57,800 $ 150,000 $ 173,400 $ 450,000 $ 49,520 $ 150,000 Subtotal $ 26,212,740 $ 125,000,000 $ 5,689,555 $ 3,175,000 $ 1,809,187 $ 2,325,000 $ 1,590,437 $ 3,850,000 $ 1,321,077 $ 5,050,000 $ 4,720,700 $ 11,225,000 $ 1,397,107 $ 6,325,000 Regulated Payments Admin $ 305,780 $ 12,100,000 $ 30,620 $ - $ 13,840 $ - $ 7,600 $ - $ 7,780 $ 2,600,000 $ 29,220 $ 2,600,000 $ 3,800 $ 10,000 DSH $ 361,760 $ - $ 72,352 $ - $ 45,220 $ - $ - $ - $ 18,088 $ - $ 63,308 $ - $ 18,088 $ - Bad Debts $ 398,800 $ - $ 79,760 $ - $ 49,850 $ - $ - $ - $ 19,940 $ - $ 69,790 $ - $ 19,940 $ - GME $ 160,760 $ - $ 32,152 $ - $ 20,095 $ - $ - $ - $ 8,038 $ - $ 28,133 $ - $ 8,038 $ - Medicaid $ 689,280 $ 12,900,000 $ 231,040 $ - $ 43,580 $ - $ 43,580 $ - $ 43,580 $ - $ 130,740 $ - $ 43,580 $ 1,290,000 Add-Ons $ 641,840 $ - $ 109,600 $ - $ 57,890 $ - $ 57,890 $ - $ 57,890 $ - $ 173,670 $ - $ 57,890 $ - Subtotal $ 2,558,220 $ 25,000,000 $ 555,524 $ - $ 230,475 $ - $ 109,070 $ - $ 155,316 $ 2,600,000 $ 494,861 $ 2,600,000 $ 151,336 $ 1,300,000 Implementation Support for ACHN Implementation Support for ACHN $ 2,102,352 $ 15,800,000 $ 497,067 $ 877,778 $ 160,800 $ 438,889 $ 160,800 $ 877,778 $ 160,800 $ 877,778 $ 482,400 $ 2,194,444 $ 160,800 $ 877,778 Subtotal $ 2,102,352 $ 15,800,000 $ 497,067 $ 877,778 $ 160,800 $ 438,889 $ 160,800 $ 877,778 $ 160,800 $ 877,778 $ 482,400 $ 2,194,444 $ 160,800 $ 877,778 Physician Effort and Funding Plan Oversight $ 292,368 $ - $ 76,444 $ - $ 28,042 $ - $ 28,042 $ - $ 28,042 $ - $ 84,126 $ - $ 28,042 $ - Clinical Productivity & Revenue $ 341,094 $ 4,000,000 $ 82,172 $ 666,667 $ 33,481 $ 222,222 $ 33,481 $ 222,222 $ 33,481 $ 222,222 $ 100,442 $ 666,667 $ 33,481 $ 222,222 Physician Roles $ 341,094 $ - $ 82,172 $ - $ 33,481 $ - $ 33,481 $ - $ 33,481 $ - $ 100,442 $ - $ 33,481 $ - Research $ 486,318 $ 2,500,000 $ 138,256 $ 703,125 $ 47,417 $ 390,625 $ 47,417 $ 390,625 $ 47,417 $ 390,625 $ 142,250 $ 1,171,875 $ 38,324 $ 234,375 Teaching $ 467,368 $ - $ 121,516 $ - $ 44,867 $ - $ 44,867 $ - $ 44,867 $ - $ 134,602 $ - $ 44,867 $ - Strategic Funds $ 334,168 $ - $ 72,909 $ - $ 30,846 $ - $ 30,846 $ - $ 30,846 $ - $ 92,539 $ - $ 30,846 $ - Centers of Excellence $ 1,034,600 $ 40,000,000 $ 181,380 $ - $ 60,460 $ - $ 60,460 $ - $ 60,460 $ - $ 181,380 $ - $ 60,460 $ - Medical School Affiliations $ 384,200 $ 30,000,000 $ 384,200 $ - $ - $ 4,285,714 $ - $ 4,285,714 $ - $ 4,285,714 $ - $ 12,857,143 $ - $ 4,285,714 Subtotal $ 3,681,210 $ 76,500,000 $ 1,139,049 $ 1,369,792 $ 278,593 $ 4,898,562 $ 278,593 $ 4,898,562 $ 278,593 $ 4,898,562 $ 835,780 $ 14,695,685 $ 269,501 $ 4,742,312 Engagement Administration PwC Engagement Administration $ 2,135,700 $ - $ 355,950 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ - $ 355,950 $ - $ 118,650 $ - Subtotal $ 2,135,700 $ - $ 355,950 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ - $ 355,950 $ - $ 118,650 $ -
TOTAL $ 45,622,285 $ 313,800,000 $ 10,868,764 $ 16,667,569 $ 3,201,306 $ 10,787,450 $ 2,786,651 $ 18,851,339 $ 2,563,537 $ 16,751,339 $ 8,551,495 $ 46,390,129 $ 2,626,495 $ 17,170,089 Cumulative $ 17,506,672 $ 18,995,139 $ 20,707,978 $ 29,782,589 $ 23,494,630 $ 48,633,929 $ 26,058,167 $ 65,385,268 $ 26,058,167 $ 65,385,268 $ 28,684,662 $ 82,555,357
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Budget Details 18 Month Total Feb 11 Mar 11Q1 2011 Apr 11 May 11 Jun 11 Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Labor, Productivity & Workforce Efficiency Labor, Productivity & Workforce Efficiency $ 5,000,240 $ 30,000,000 $ 283,520 $ 3,000,000 $ 283,520 $ 3,000,000 $ 927,760 $ 8,500,000 $ 283,520 $ 3,000,000 $ 99,200 $ 3,000,000 $ 99,200 $ 3,000,000 Subtotal $ 5,000,240 $ 30,000,000 $ 283,520 $ 3,000,000 $ 283,520 $ 3,000,000 $ 927,760 $ 8,500,000 $ 283,520 $ 3,000,000 $ 99,200 $ 3,000,000 $ 99,200 $ 3,000,000 Supply Chain Distribution and Warehousing $ 215,475 $ 5,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - KPI Dashboard and Realization Tracking $ 38,843 $ - $ 1,516 $ - $ 1,516 $ - $ 4,549 $ - $ 1,516 $ - $ 1,516 $ - $ 1,516 $ - ERP/Supply Chain IT Maximization $ 92,200 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Non-Labor Cost Reduction $ 1,512,200 $ 14,000,000 $ 87,650 $ 800,000 $ 87,650 $ 800,000 $ 269,850 $ 2,400,000 $ 87,650 $ 1,000,000 $ 59,050 $ 1,400,000 $ 59,050 $ 1,300,000 GPO Optimization $ 100,875 $ 5,000,000 $ 4,965 $ - $ 4,965 $ - $ 14,895 $ - $ 4,965 $ - $ 4,965 $ - $ 4,965 $ - Organization Development & Process Improvement $ 561,600 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Inventory Reduction $ 408,050 $ 1,000,000 $ - $ 125,000 $ - $ - $ - $ 250,000 $ - $ - $ - $ - $ - $ - Accounts Payable $ 260,030 $ 4,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Outsourcing & Shared Services $ 742,550 $ 12,000,000 $ - $ 500,000 $ - $ 500,000 $ 67,350 $ 1,500,000 $ - $ 500,000 $ - $ 500,000 $ - $ 1,000,000 Subtotal $ 3,931,823 $ 41,500,000 $ 94,131 $ 1,425,000 $ 94,131 $ 1,300,000 $ 356,644 $ 4,150,000 $ 94,131 $ 1,500,000 $ 65,531 $ 1,900,000 $ 65,531 $ 2,300,000 Patient Accounts Virtual Business Office $ 1,713,680 $ - $ 141,167 $ - $ 141,167 $ - $ 423,500 $ - $ 141,167 $ - $ 141,167 $ - $ 132,607 $ - Specialized Pharmacy Billing $ 316,860 $ 2,000,000 $ - $ 100,000 $ - $ 100,000 $ - $ 300,000 $ - $ 100,000 $ - $ 100,000 $ - $ 100,000 Rev Cycle Project Management $ 3,859,200 $ - $ 160,800 $ - $ 160,800 $ - $ 482,400 $ - $ 160,800 $ - $ 160,800 $ - $ 160,800 $ - RC Patient Access $ 6,394,400 $ 15,000,000 $ 304,000 $ 850,000 $ 304,000 $ 850,000 $ 912,000 $ 2,550,000 $ 304,000 $ 850,000 $ 304,000 $ 850,000 $ 304,000 $ 850,000 Charge Capture / CDM $ 677,500 $ 7,500,000 $ - $ 750,000 $ - $ 1,000,000 $ - $ 2,125,000 $ - $ 1,000,000 $ - $ 1,000,000 $ - $ 1,000,000 HIM $ 1,114,800 $ 3,000,000 $ 30,280 $ 100,000 $ 17,080 $ 100,000 $ 80,400 $ 300,000 $ 14,320 $ 100,000 $ 7,160 $ 50,000 $ 4,960 $ 50,000 CDI $ 263,050 $ 7,500,000 $ - $ 500,000 $ - $ 500,000 $ - $ 1,375,000 $ - $ 500,000 $ - $ 500,000 $ - $ 500,000 Care Management $ 2,721,810 $ 20,000,000 $ 194,980 $ 2,000,000 $ 148,370 $ 2,000,000 $ 637,530 $ 5,000,000 $ 119,490 $ 2,000,000 $ - $ 2,000,000 $ - $ 2,000,000 Rate Rationalization $ 191,560 $ 5,000,000 $ - $ 250,000 $ - $ 250,000 $ - $ 750,000 $ - $ 250,000 $ - $ 250,000 $ - $ 250,000 Patient Accounting $ 8,054,400 $ 62,000,000 $ 414,400 $ 3,825,000 $ 414,400 $ 4,350,000 $ 1,243,200 $ 11,300,000 $ 414,400 $ 4,475,000 $ 414,400 $ 4,500,000 $ 414,400 $ 4,500,000 Vendor Management $ 905,480 $ 3,000,000 $ 49,520 $ 150,000 $ 44,000 $ 150,000 $ 143,040 $ 450,000 $ 46,760 $ 150,000 $ 44,000 $ 150,000 $ 46,760 $ 150,000 Subtotal $ 26,212,740 $ 125,000,000 $ 1,295,147 $ 8,525,000 $ 1,229,817 $ 9,300,000 $ 3,922,070 $ 24,150,000 $ 1,200,937 $ 9,425,000 $ 1,071,527 $ 9,400,000 $ 1,063,527 $ 9,400,000 Regulated Payments Admin $ 305,780 $ 12,100,000 $ 6,240 $ 10,000 $ 7,600 $ 10,000 $ 17,640 $ 30,000 $ 180 $ 10,000 $ 6,060 $ 2,310,000 $ 180 $ 10,000 DSH $ 361,760 $ - $ 45,220 $ - $ 72,352 $ - $ 135,660 $ - $ 63,308 $ - $ - $ - $ - $ - Bad Debts $ 398,800 $ - $ 49,850 $ - $ 79,760 $ - $ 149,550 $ - $ 69,790 $ - $ - $ - $ - $ - GME $ 160,760 $ - $ 20,095 $ - $ 32,152 $ - $ 60,285 $ - $ 28,133 $ - $ - $ - $ - $ - Medicaid $ 689,280 $ 12,900,000 $ 21,790 $ 1,290,000 $ 21,790 $ 1,290,000 $ 87,160 $ 3,870,000 $ 21,790 $ 1,290,000 $ 21,790 $ 1,290,000 $ 21,790 $ 1,290,000 Add-Ons $ 641,840 $ - $ 28,945 $ - $ 28,945 $ - $ 115,780 $ - $ 28,945 $ - $ 28,945 $ - $ 28,945 $ - Subtotal $ 2,558,220 $ 25,000,000 $ 172,140 $ 1,300,000 $ 242,599 $ 1,300,000 $ 566,075 $ 3,900,000 $ 212,146 $ 1,300,000 $ 56,795 $ 3,600,000 $ 50,915 $ 1,300,000 Implementation Support for ACHN Implementation Support for ACHN $ 2,102,352 $ 15,800,000 $ 133,200 $ 1,316,667 $ 133,200 $ 1,316,667 $ 427,200 $ 3,511,111 $ 133,288 $ 1,316,667 $ 35,244 $ 1,316,667 $ 35,244 $ 1,316,667 Subtotal $ 2,102,352 $ 15,800,000 $ 133,200 $ 1,316,667 $ 133,200 $ 1,316,667 $ 427,200 $ 3,511,111 $ 133,288 $ 1,316,667 $ 35,244 $ 1,316,667 $ 35,244 $ 1,316,667 Physician Effort and Funding Plan Oversight $ 292,368 $ - $ 28,042 $ - $ 15,007 $ - $ 71,091 $ - $ 8,464 $ - $ - $ - $ - $ - Clinical Productivity & Revenue $ 341,094 $ 4,000,000 $ 33,481 $ 222,222 $ 12,279 $ 222,222 $ 79,240 $ 666,667 $ 12,279 $ 222,222 $ - $ 222,222 $ - $ 222,222 Physician Roles $ 341,094 $ - $ 33,481 $ - $ 12,279 $ - $ 79,240 $ - $ 12,279 $ - $ - $ - $ - $ - Research $ 486,318 $ 2,500,000 $ 38,324 $ 156,250 $ 21,966 $ 117,188 $ 98,615 $ 507,813 $ 3,272 $ 39,063 $ - $ - $ - $ - Teaching $ 467,368 $ - $ 44,867 $ - $ 25,238 $ - $ 114,973 $ - $ 6,543 $ - $ - $ - $ - $ - Strategic Funds $ 334,168 $ - $ 30,846 $ - $ 27,575 $ - $ 89,267 $ - $ 17,760 $ - $ - $ - $ - $ - Centers of Excellence $ 1,034,600 $ 40,000,000 $ 60,460 $ - $ 60,460 $ - $ 181,380 $ - $ 60,460 $ - $ 60,460 $ 6,666,667 $ 60,460 $ 6,666,667 Medical School Affiliations $ 384,200 $ 30,000,000 $ - $ 4,285,714 $ - $ 4,285,714 $ - $ 12,857,143 $ - $ 4,285,714 $ - $ - $ - $ - Subtotal $ 3,681,210 $ 76,500,000 $ 269,501 $ 4,664,187 $ 174,804 $ 4,625,124 $ 713,806 $ 14,031,622 $ 121,056 $ 4,546,999 $ 60,460 $ 6,888,889 $ 60,460 $ 6,888,889 Engagement Administration PwC Engagement Administration $ 2,135,700 $ - $ 118,650 $ - $ 118,650 $ - $ 355,950 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ - Subtotal $ 2,135,700 $ - $ 118,650 $ - $ 118,650 $ - $ 355,950 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ -
TOTAL $ 45,622,285 $ 313,800,000 $ 2,366,289 $ 20,230,853 $ 2,276,721 $ 20,841,791 $ 7,269,504 $ 58,242,733 $ 2,163,728 $ 21,088,666 $ 1,507,407 $ 26,105,556 $ 1,493,527 $ 24,205,556 Cumulative $ 31,050,951 $ 102,786,210 $ 33,327,671 $ 123,628,001 $ 33,327,671 $ 123,628,001 $ 35,491,400 $ 144,716,667 $ 36,998,807 $ 170,822,222 $ 38,492,334 $ 195,027,778
Page3 29 of of7 192 6/17/2010 10:02 AM PWC Confidential - Internal use only CLIENT NAME: CCHHS ENGAGEMENT: Performance Improvement
Budget Details 18 Month Total Q2 2011 Jul 11 Aug 11Sep 11 Q3 2011 Oct 11 Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Labor, Productivity & Workforce Efficiency Labor, Productivity & Workforce Efficiency $ 5,000,240 $ 30,000,000 $ 481,920 $ 9,000,000 $ 99,200 $ 3,000,000 $ 99,200 $ 1,000,000 $ 99,200 $ 600,000 $ 297,600 $ 4,600,000 $ 99,200 $ 600,000 Subtotal $ 5,000,240 $ 30,000,000 $ 481,920 $ 9,000,000 $ 99,200 $ 3,000,000 $ 99,200 $ 1,000,000 $ 99,200 $ 600,000 $ 297,600 $ 4,600,000 $ 99,200 $ 600,000 Supply Chain Distribution and Warehousing $ 215,475 $ 5,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - KPI Dashboard and Realization Tracking $ 38,843 $ - $ 4,549 $ - $ 1,516 $ - $ 1,516 $ - $ 1,516 $ - $ 4,549 $ - $ 1,516 $ - ERP/Supply Chain IT Maximization $ 92,200 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Non-Labor Cost Reduction $ 1,512,200 $ 14,000,000 $ 205,750 $ 3,700,000 $ 59,050 $ 1,200,000 $ 59,050 $ 1,100,000 $ 59,050 $ 1,100,000 $ 177,150 $ 3,400,000 $ 59,050 $ 1,000,000 GPO Optimization $ 100,875 $ 5,000,000 $ 14,895 $ - $ 4,965 $ - $ 4,400 $ - $ 4,400 $ - $ 13,765 $ - $ 4,400 $ - Organization Development & Process Improvement $ 561,600 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Inventory Reduction $ 408,050 $ 1,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Accounts Payable $ 260,030 $ 4,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Outsourcing & Shared Services $ 742,550 $ 12,000,000 $ - $ 2,000,000 $ - $ 1,000,000 $ - $ 1,000,000 $ - $ 2,000,000 $ - $ 4,000,000 $ - $ 2,000,000 Subtotal $ 3,931,823 $ 41,500,000 $ 225,194 $ 5,700,000 $ 65,531 $ 2,200,000 $ 64,966 $ 2,100,000 $ 64,966 $ 3,100,000 $ 195,464 $ 7,400,000 $ 64,966 $ 3,000,000 Patient Accounts Virtual Business Office $ 1,713,680 $ - $ 414,940 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Specialized Pharmacy Billing $ 316,860 $ 2,000,000 $ - $ 300,000 $ - $ 100,000 $ - $ 100,000 $ - $ 100,000 $ - $ 300,000 $ - $ 100,000 Rev Cycle Project Management $ 3,859,200 $ - $ 482,400 $ - $ 160,800 $ - $ 160,800 $ - $ 160,800 $ - $ 482,400 $ - $ 160,800 $ - RC Patient Access $ 6,394,400 $ 15,000,000 $ 912,000 $ 2,550,000 $ 224,800 $ 850,000 $ 224,800 $ 850,000 $ 224,800 $ 600,000 $ 674,400 $ 2,300,000 $ 224,800 $ 600,000 Charge Capture / CDM $ 677,500 $ 7,500,000 $ - $ 3,000,000 $ - $ 500,000 $ - $ 500,000 $ - $ 375,000 $ - $ 1,375,000 $ - $ 250,000 HIM $ 1,114,800 $ 3,000,000 $ 26,440 $ 200,000 $ 3,960 $ 50,000 $ 3,960 $ 50,000 $ 3,960 $ 50,000 $ 11,880 $ 150,000 $ 3,960 $ 50,000 CDI $ 263,050 $ 7,500,000 $ - $ 1,500,000 $ - $ 500,000 $ - $ 500,000 $ - $ 500,000 $ - $ 1,500,000 $ - $ 375,000 Care Management $ 2,721,810 $ 20,000,000 $ 119,490 $ 6,000,000 $ - $ 1,000,000 $ - $ 1,000,000 $ - $ 1,000,000 $ - $ 3,000,000 $ - $ 1,000,000 Rate Rationalization $ 191,560 $ 5,000,000 $ - $ 750,000 $ - $ 250,000 $ - $ 250,000 $ - $ 250,000 $ - $ 750,000 $ - $ 250,000 Patient Accounting $ 8,054,400 $ 62,000,000 $ 1,243,200 $ 13,475,000 $ 414,400 $ 4,000,000 $ 414,400 $ 3,750,000 $ 414,400 $ 2,725,000 $ 1,243,200 $ 10,475,000 $ 414,400 $ 2,700,000 Vendor Management $ 905,480 $ 3,000,000 $ 137,520 $ 450,000 $ 44,000 $ 150,000 $ 46,760 $ 150,000 $ 44,000 $ 150,000 $ 134,760 $ 450,000 $ 46,760 $ 150,000 Subtotal $ 26,212,740 $ 125,000,000 $ 3,335,990 $ 28,225,000 $ 847,960 $ 7,400,000 $ 850,720 $ 7,150,000 $ 847,960 $ 5,750,000 $ 2,546,640 $ 20,300,000 $ 850,720 $ 5,475,000 Regulated Payments Admin $ 305,780 $ 12,100,000 $ 6,420 $ 2,330,000 $ 7,600 $ 10,000 $ 180 $ 10,000 $ - $ 10,000 $ 7,780 $ 30,000 $ 44,600 $ 7,110,000 DSH $ 361,760 $ - $ 63,308 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Bad Debts $ 398,800 $ - $ 69,790 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - GME $ 160,760 $ - $ 28,133 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Medicaid $ 689,280 $ 12,900,000 $ 65,370 $ 3,870,000 $ 21,790 $ 1,290,000 $ 21,790 $ 1,290,000 $ 21,790 $ 1,290,000 $ 65,370 $ 3,870,000 $ - $ 1,290,000 Add-Ons $ 641,840 $ - $ 86,835 $ - $ 28,945 $ - $ 28,945 $ - $ 28,945 $ - $ 86,835 $ - $ - $ - Subtotal $ 2,558,220 $ 25,000,000 $ 319,856 $ 6,200,000 $ 58,335 $ 1,300,000 $ 50,915 $ 1,300,000 $ 50,735 $ 1,300,000 $ 159,985 $ 3,900,000 $ 44,600 $ 8,400,000 Implementation Support for ACHN Implementation Support for ACHN $ 2,102,352 $ 15,800,000 $ 203,776 $ 3,950,000 $ 35,244 $ 1,316,667 $ 35,244 $ 1,316,667 $ 35,244 $ 1,316,667 $ 105,732 $ 3,950,000 $ 35,244 $ 1,316,667 Subtotal $ 2,102,352 $ 15,800,000 $ 203,776 $ 3,950,000 $ 35,244 $ 1,316,667 $ 35,244 $ 1,316,667 $ 35,244 $ 1,316,667 $ 105,732 $ 3,950,000 $ 35,244 $ 1,316,667 Physician Effort and Funding Plan Oversight $ 292,368 $ - $ 8,464 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Clinical Productivity & Revenue $ 341,094 $ 4,000,000 $ 12,279 $ 666,667 $ - $ 222,222 $ - $ 222,222 $ - $ 222,222 $ - $ 666,667 $ - $ 222,222 Physician Roles $ 341,094 $ - $ 12,279 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Research $ 486,318 $ 2,500,000 $ 3,272 $ 39,063 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Teaching $ 467,368 $ - $ 6,543 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Strategic Funds $ 334,168 $ - $ 17,760 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Centers of Excellence $ 1,034,600 $ 40,000,000 $ 181,380 $ 13,333,333 $ 60,460 $ 6,666,667 $ 60,460 $ 6,666,667 $ 60,460 $ 6,666,667 $ 181,380 $ 20,000,000 $ 60,460 $ 6,666,667 Medical School Affiliations $ 384,200 $ 30,000,000 $ - $ 4,285,714 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 3,681,210 $ 76,500,000 $ 241,976 $ 18,324,777 $ 60,460 $ 6,888,889 $ 60,460 $ 6,888,889 $ 60,460 $ 6,888,889 $ 181,380 $ 20,666,667 $ 60,460 $ 6,888,889 Engagement Administration PwC Engagement Administration $ 2,135,700 $ - $ 355,950 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ - $ 355,950 $ - $ 118,650 $ - Subtotal $ 2,135,700 $ - $ 355,950 $ - $ 118,650 $ - $ 118,650 $ - $ 118,650 $ - $ 355,950 $ - $ 118,650 $ -
TOTAL $ 45,622,285 $ 313,800,000 $ 5,164,662 $ 71,399,777 $ 1,285,380 $ 22,105,556 $ 1,280,155 $ 19,755,556 $ 1,277,215 $ 18,955,556 $ 3,842,751 $ 60,816,667 $ 1,273,840 $ 25,680,556 Cumulative $ 38,492,334 $ 195,027,778 $ 39,777,714 $ 217,133,333 $ 41,057,869 $ 236,888,889 $ 42,335,084 $ 255,844,444 $ 42,335,084 $ 255,844,444 $ 43,608,925 $ 281,525,000
Page4 30 of of7 192 6/17/2010 10:02 AM PWC Confidential - Internal use only CLIENT NAME: CCHHS ENGAGEMENT: Performance Improvement
Budget Details 18 Month Total Nov 11 Dec 11Q4 2011 Jan 12 Feb 12 Mar 12 Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Labor, Productivity & Workforce Efficiency Labor, Productivity & Workforce Efficiency $ 5,000,240 $ 30,000,000 $ - $ - $ - $ - $ 99,200 $ 600,000 $ - $ - $ - $ - $ - $ - Subtotal $ 5,000,240 $ 30,000,000 $ - $ - $ - $ - $ 99,200 $ 600,000 $ - $ - $ - $ - $ - $ - Supply Chain Distribution and Warehousing $ 215,475 $ 5,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - KPI Dashboard and Realization Tracking $ 38,843 $ - $ - $ - $ - $ - $ 1,516 $ - $ - $ - $ - $ - $ - $ - ERP/Supply Chain IT Maximization $ 92,200 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Non-Labor Cost Reduction $ 1,512,200 $ 14,000,000 $ - $ - $ - $ - $ 59,050 $ 1,000,000 $ - $ - $ - $ - $ - $ - GPO Optimization $ 100,875 $ 5,000,000 $ - $ - $ - $ - $ 4,400 $ - $ - $ - $ - $ - $ - $ - Organization Development & Process Improvement $ 561,600 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Inventory Reduction $ 408,050 $ 1,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Accounts Payable $ 260,030 $ 4,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Outsourcing & Shared Services $ 742,550 $ 12,000,000 $ - $ - $ - $ - $ - $ 2,000,000 $ - $ - $ - $ - $ - $ - Subtotal $ 3,931,823 $ 41,500,000 $ - $ - $ - $ - $ 64,966 $ 3,000,000 $ - $ - $ - $ - $ - $ - Patient Accounts Virtual Business Office $ 1,713,680 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Specialized Pharmacy Billing $ 316,860 $ 2,000,000 $ - $ 100,000 $ - $ 100,000 $ - $ 300,000 $ - $ 100,000 $ - $ 100,000 $ - $ 100,000 Rev Cycle Project Management $ 3,859,200 $ - $ 160,800 $ - $ 160,800 $ - $ 482,400 $ - $ 160,800 $ - $ 160,800 $ - $ 160,800 $ - RC Patient Access $ 6,394,400 $ 15,000,000 $ 71,600 $ 600,000 $ 71,600 $ 600,000 $ 368,000 $ 1,800,000 $ 71,600 $ 600,000 $ 71,600 $ 600,000 $ 71,600 $ 600,000 Charge Capture / CDM $ 677,500 $ 7,500,000 $ - $ 100,000 $ - $ 75,000 $ - $ 425,000 $ - $ 50,000 $ - $ 25,000 $ - $ 25,000 HIM $ 1,114,800 $ 3,000,000 $ 3,960 $ 50,000 $ 3,960 $ 50,000 $ 11,880 $ 150,000 $ 3,960 $ 50,000 $ 3,960 $ 50,000 $ 3,960 $ 50,000 CDI $ 263,050 $ 7,500,000 $ - $ 375,000 $ - $ 375,000 $ - $ 1,125,000 $ - $ 250,000 $ - $ 250,000 $ - $ 250,000 Care Management $ 2,721,810 $ 20,000,000 $ - $ 1,000,000 $ - $ 1,000,000 $ - $ 3,000,000 $ - $ 500,000 $ - $ 500,000 $ - $ 500,000 Rate Rationalization $ 191,560 $ 5,000,000 $ - $ 250,000 $ - $ 250,000 $ - $ 750,000 $ - $ 250,000 $ - $ 250,000 $ - $ 250,000 Patient Accounting $ 8,054,400 $ 62,000,000 $ 99,200 $ 2,600,000 $ 99,200 $ 2,550,000 $ 612,800 $ 7,850,000 $ 99,200 $ 2,525,000 $ 99,200 $ 2,375,000 $ 99,200 $ 2,350,000 Vendor Management $ 905,480 $ 3,000,000 $ - $ 150,000 $ - $ 150,000 $ 46,760 $ 450,000 $ - $ 150,000 $ - $ 75,000 $ - $ 75,000 Subtotal $ 26,212,740 $ 125,000,000 $ 335,560 $ 5,225,000 $ 335,560 $ 5,150,000 $ 1,521,840 $ 15,850,000 $ 335,560 $ 4,475,000 $ 335,560 $ 4,225,000 $ 335,560 $ 4,200,000 Regulated Payments Admin $ 305,780 $ 12,100,000 $ - $ - $ - $ - $ 44,600 $ 7,110,000 $ - $ - $ - $ - $ - $ - DSH $ 361,760 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Bad Debts $ 398,800 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - GME $ 160,760 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Medicaid $ 689,280 $ 12,900,000 $ - $ - $ - $ - $ - $ 1,290,000 $ - $ - $ - $ - $ - $ - Add-Ons $ 641,840 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 2,558,220 $ 25,000,000 $ - $ - $ - $ - $ 44,600 $ 8,400,000 $ - $ - $ - $ - $ - $ - Implementation Support for ACHN Implementation Support for ACHN $ 2,102,352 $ 15,800,000 $ - $ - $ - $ - $ 35,244 $ 1,316,667 $ - $ - $ - $ - $ - $ - Subtotal $ 2,102,352 $ 15,800,000 $ - $ - $ - $ - $ 35,244 $ 1,316,667 $ - $ - $ - $ - $ - $ - Physician Effort and Funding Plan Oversight $ 292,368 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Clinical Productivity & Revenue $ 341,094 $ 4,000,000 $ - $ - $ - $ - $ - $ 222,222 $ - $ - $ - $ - $ - $ - Physician Roles $ 341,094 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Research $ 486,318 $ 2,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Teaching $ 467,368 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Strategic Funds $ 334,168 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Centers of Excellence $ 1,034,600 $ 40,000,000 $ - $ - $ - $ - $ 60,460 $ 6,666,667 $ - $ - $ - $ - $ - $ - Medical School Affiliations $ 384,200 $ 30,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 3,681,210 $ 76,500,000 $ - $ - $ - $ - $ 60,460 $ 6,888,889 $ - $ - $ - $ - $ - $ - Engagement Administration PwC Engagement Administration $ 2,135,700 $ - $ - $ - $ - $ - $ 118,650 $ - $ - $ - $ - $ - $ - $ - Subtotal $ 2,135,700 $ - $ - $ - $ - $ - $ 118,650 $ - $ - $ - $ - $ - $ - $ -
TOTAL $ 45,622,285 $ 313,800,000 $ 335,560 $ 5,225,000 $ 335,560 $ 5,150,000 $ 1,944,960 $ 36,055,556 $ 335,560 $ 4,475,000 $ 335,560 $ 4,225,000 $ 335,560 $ 4,200,000 Cumulative $ 43,944,485 $ 286,750,000 $ 44,280,045 $ 291,900,000 $ 44,280,045 $ 291,900,000 $ 44,615,605 $ 296,375,000 $ 44,951,165 $ 300,600,000 $ 45,286,725 $ 304,800,000
Page5 31 of of7 192 6/17/2010 10:02 AM PWC Confidential - Internal use only CLIENT NAME: CCHHS ENGAGEMENT: Performance Improvement
Budget Details 18 Month Total Q1 2012 Apr 12 May 12 Jun 12 Q2 2012 Jul 12 Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Fees Benefit Labor, Productivity & Workforce Efficiency Labor, Productivity & Workforce Efficiency $ 5,000,240 $ 30,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 5,000,240 $ 30,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Supply Chain Distribution and Warehousing $ 215,475 $ 5,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - KPI Dashboard and Realization Tracking $ 38,843 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - ERP/Supply Chain IT Maximization $ 92,200 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Non-Labor Cost Reduction $ 1,512,200 $ 14,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - GPO Optimization $ 100,875 $ 5,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Organization Development & Process Improvement $ 561,600 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Inventory Reduction $ 408,050 $ 1,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Accounts Payable $ 260,030 $ 4,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Outsourcing & Shared Services $ 742,550 $ 12,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 3,931,823 $ 41,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Patient Accounts Virtual Business Office $ 1,713,680 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Specialized Pharmacy Billing $ 316,860 $ 2,000,000 $ - $ 300,000 $ - $ 100,000 $ - $ - $ - $ - $ - $ 100,000 $ - $ - Rev Cycle Project Management $ 3,859,200 $ - $ 482,400 $ - $ 160,800 $ - $ - $ - $ - $ - $ 160,800 $ - $ - $ - RC Patient Access $ 6,394,400 $ 15,000,000 $ 214,800 $ 1,800,000 $ 71,600 $ 350,000 $ - $ 275,000 $ - $ 175,000 $ 71,600 $ 800,000 $ - $ 100,000 Charge Capture / CDM $ 677,500 $ 7,500,000 $ - $ 100,000 $ - $ 25,000 $ - $ 25,000 $ - $ 25,000 $ - $ 75,000 $ - $ 25,000 HIM $ 1,114,800 $ 3,000,000 $ 11,880 $ 150,000 $ 3,960 $ 50,000 $ - $ 50,000 $ - $ 50,000 $ 3,960 $ 150,000 $ - $ 50,000 CDI $ 263,050 $ 7,500,000 $ - $ 750,000 $ - $ 250,000 $ - $ 250,000 $ - $ 250,000 $ - $ 750,000 $ - $ 200,000 Care Management $ 2,721,810 $ 20,000,000 $ - $ 1,500,000 $ - $ 250,000 $ - $ 250,000 $ - $ 200,000 $ - $ 700,000 $ - $ 200,000 Rate Rationalization $ 191,560 $ 5,000,000 $ - $ 750,000 $ - $ 250,000 $ - $ 250,000 $ - $ 125,000 $ - $ 625,000 $ - $ 125,000 Patient Accounting $ 8,054,400 $ 62,000,000 $ 297,600 $ 7,250,000 $ 99,200 $ 1,675,000 $ - $ 1,175,000 $ - $ 1,100,000 $ 99,200 $ 3,950,000 $ - $ 850,000 Vendor Management $ 905,480 $ 3,000,000 $ - $ 300,000 $ - $ 75,000 $ - $ 75,000 $ - $ 75,000 $ - $ 225,000 $ - $ 75,000 Subtotal $ 26,212,740 $ 125,000,000 $ 1,006,680 $ 12,900,000 $ 335,560 $ 3,025,000 $ - $ 2,350,000 $ - $ 2,000,000 $ 335,560 $ 7,375,000 $ - $ 1,625,000 Regulated Payments Admin $ 305,780 $ 12,100,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - DSH $ 361,760 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Bad Debts $ 398,800 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - GME $ 160,760 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Medicaid $ 689,280 $ 12,900,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Add-Ons $ 641,840 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 2,558,220 $ 25,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Implementation Support for ACHN Implementation Support for ACHN $ 2,102,352 $ 15,800,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 2,102,352 $ 15,800,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Physician Effort and Funding Plan Oversight $ 292,368 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Clinical Productivity & Revenue $ 341,094 $ 4,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Physician Roles $ 341,094 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Research $ 486,318 $ 2,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Teaching $ 467,368 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Strategic Funds $ 334,168 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Centers of Excellence $ 1,034,600 $ 40,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Medical School Affiliations $ 384,200 $ 30,000,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 3,681,210 $ 76,500,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Engagement Administration PwC Engagement Administration $ 2,135,700 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - Subtotal $ 2,135,700 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
TOTAL $ 45,622,285 $ 313,800,000 $ 1,006,680 $ 12,900,000 $ 335,560 $ 3,025,000 $ - $ 2,350,000 $ - $ 2,000,000 $ 335,560 $ 7,375,000 $ - $ 1,625,000 Cumulative $ 45,286,725 $ 304,800,000 $ 45,622,285 $ 307,825,000 $ 45,622,285 $ 310,175,000 $ 45,622,285 $ 312,175,000 $ 45,622,285 $ 312,175,000 $ 45,622,285 $ 313,800,000
Page6 32 of of7 192 6/17/2010 10:02 AM PWC Confidential - Internal use only CLIENT NAME: CCHHS ENGAGEMENT: Performance Improvement
Budget Details 18 Month Total Q3 2012 Fees Benefit Fees Benefit Labor, Productivity & Workforce Efficiency Labor, Productivity & Workforce Efficiency $ 5,000,240 $ 30,000,000 $ - $ - Subtotal $ 5,000,240 $ 30,000,000 $ - $ - Supply Chain Distribution and Warehousing $ 215,475 $ 5,000,000 $ - $ - KPI Dashboard and Realization Tracking $ 38,843 $ - $ - $ - ERP/Supply Chain IT Maximization $ 92,200 $ - $ - $ - Non-Labor Cost Reduction $ 1,512,200 $ 14,000,000 $ - $ - GPO Optimization $ 100,875 $ 5,000,000 $ - $ - Organization Development & Process Improvement $ 561,600 $ - $ - $ - Inventory Reduction $ 408,050 $ 1,000,000 $ - $ - Accounts Payable $ 260,030 $ 4,500,000 $ - $ - Outsourcing & Shared Services $ 742,550 $ 12,000,000 $ - $ - Subtotal $ 3,931,823 $ 41,500,000 $ - $ - Patient Accounts Virtual Business Office $ 1,713,680 $ - $ - $ - Specialized Pharmacy Billing $ 316,860 $ 2,000,000 $ - $ 100,000 Rev Cycle Project Management $ 3,859,200 $ - $ 160,800 $ - RC Patient Access $ 6,394,400 $ 15,000,000 $ 71,600 $ 1,075,000 Charge Capture / CDM $ 677,500 $ 7,500,000 $ - $ 125,000 HIM $ 1,114,800 $ 3,000,000 $ 3,960 $ 250,000 CDI $ 263,050 $ 7,500,000 $ - $ 1,200,000 Care Management $ 2,721,810 $ 20,000,000 $ - $ 1,100,000 Rate Rationalization $ 191,560 $ 5,000,000 $ - $ 875,000 Patient Accounting $ 8,054,400 $ 62,000,000 $ 99,200 $ 5,900,000 Vendor Management $ 905,480 $ 3,000,000 $ - $ 375,000 Subtotal $ 26,212,740 $ 125,000,000 $ 335,560 $ 11,000,000 Regulated Payments Admin $ 305,780 $ 12,100,000 $ - $ - DSH $ 361,760 $ - $ - $ - Bad Debts $ 398,800 $ - $ - $ - GME $ 160,760 $ - $ - $ - Medicaid $ 689,280 $ 12,900,000 $ - $ - Add-Ons $ 641,840 $ - $ - $ - Subtotal $ 2,558,220 $ 25,000,000 $ - $ - Implementation Support for ACHN Implementation Support for ACHN $ 2,102,352 $ 15,800,000 $ - $ - Subtotal $ 2,102,352 $ 15,800,000 $ - $ - Physician Effort and Funding Plan Oversight $ 292,368 $ - $ - $ - Clinical Productivity & Revenue $ 341,094 $ 4,000,000 $ - $ - Physician Roles $ 341,094 $ - $ - $ - Research $ 486,318 $ 2,500,000 $ - $ - Teaching $ 467,368 $ - $ - $ - Strategic Funds $ 334,168 $ - $ - $ - Centers of Excellence $ 1,034,600 $ 40,000,000 $ - $ - Medical School Affiliations $ 384,200 $ 30,000,000 $ - $ - Subtotal $ 3,681,210 $ 76,500,000 $ - $ - Engagement Administration PwC Engagement Administration $ 2,135,700 $ - $ - $ - Subtotal $ 2,135,700 $ - $ - $ -
TOTAL $ 45,622,285 $ 313,800,000 $ 335,560 $ 11,000,000 Cumulative $ 45,622,285 $ 313,800,000
Page7 33 of of7 192 Cook County Health and Hospitals System CCHHS ‐ Transforming Our System Through Growth and Efficiency
June 2010 OlPOrals Presen ttiDtation Deck kfB for Board dEdti Education
pwc
Page 34 of 192 Contents
• Continuing the Path to Sustainability
• Living Vision 2015 with Sustainability
• Sustainable Transformation at CCHHS
• Return on Investment
• Appendices
CCHHS & PwC 2
Page 35 of 192 CoCotugteattoSustaabtyntinuing the Path to Sustainability
CCHHS 2010 Operations Strategy Plan
I. Access to Healthcare - Leadership Services - Financial Performance II. Quality, Service - Efficiency Excellence & - Quality $313.8M Cultural - Service/Satisfaction $313.8M Competence - Workforce III. Service Efficiency Line Strength - Market Share IV. Staff - Physician Development Partnerships & Stewardship - Strategic Planning
CCHHS & PwC 3
Page 36 of 192 Linking Vision 2015 with Sustainability The pppartnership between CCHHS and PwC creates a roadma p to sustainability and Vision 2015
CCHHS & PwC 4
Page 37 of 192 Sustainable Transformation at CCHHS Making change stick – Subject Matter Specialists, Paired Advisors, Interim Resou rce Assistance and Pw C’s Transform Methodology
Deliverables consistent across all initiatives:
• Communication Plan
Validated • Implementation workplans with timeline, barriers, risks and critical success factors and • Key Performance Indicators tracking and reporting Enhanced • Transition Plan
• Training, coaching, knowledge transfer and education
• Continuous performance improvement plan
• Status reports
CCHHS & PwC 5
Page 38 of 192 Sustainable Transformation at CCHHS PwC deliverables – What CCHHS can expect Initiative Deliverables Revenue Cycle Performance Improvement and Interim Resource Assistance Patient Access • Patient Access Dashboard • Future state Patient Access operating model • Staffing plan with modified job descriptions, performance metrics and organizational structure • Detailed Patient Access redesign work-plans and timeline for initiatives • Design new Patient Access Policies and Procedures to support redesigned processes • Staff training and education plan for both existing and new processes • Patient and community education plan • Job aids, tools, and guidelines to assist staff with performing existing and new job functions • Summary of validated revenue opportunities Case Management and Clinical • Key performance indicators and reporting process Documentation Improvement • Education and Training materials • Implementation and Communication Plans • Job Descriptions
Case Management • Detail Case Management Model and Structure • Roles and responsibilities of Case Managers
CDI • Detailed CDI Design and Process Flow • Roles and responsibilities of Documentation Specialists • Installation of DocTrac monitoring tool Health Information Management • Action plan of non-CDM related coding process including productivity standards (HIM) • Unbilled report for ongoing monitoring and accounts receivable backlog • Quality monitoring report • DNFB/AR backlog monitoring report • Development of policies and procedures relating to the newly created processes and positions • Participation in monthly management meetings and required documentation • Detailed workplans • Implemented policies and procedures • Training and education materials • Deployed and trained staff • Ongoing reporting/monitoring of implementation progress CCHHS & PwC 6
Page 39 of 192 Initiative Deliverables Revenue Cycle Performance Improvement and Interim Resource Assistance (Cont’d) Charge Capture/Charge • Revised CDM Description Master • Training and education materials for staff in regards to new charge capture processes • New or revised charge ticket and charge capture tools • New or revised policies and procedures for for charge capture and CDM updates/maintenance • Creation of revenue tracking dashboard to measure improvements Provider Reimbursement & • Opportunity Grid and KPI Dashboard Regulated Payments • Future State Vision for reimbursement department • Workplan for generating additional revenue from regulated agencies • Design of new processes to gather data necessary to obtain the maximum allowable amount of regulatory payments • List of Implementation barriers, risks and critical success factors • New policies and procedures and educational plan • New or revised contracts with improved pricing • Retroactive settlement realization tracking • Revised policies and procedures Patient Accounting/Vendor • Baseline Key Performance Indicators Management • Future State Operational MModelodel and implementation plan • Quick Hit opportunities • Cash realization and forecasting model • KPI Dashboard to track monthly progress • Finalized Communication and Education Plans • Training and education materials for staff in regards to new operating model • New and revised policies and procedures • IT Support Requirements Specialized Pharmacy Billing • Current state process flows with gap analysis • Implementation and Communication Plan for future state outpatient pharmacy charge capture and revenue management • Revised polices and operational procedures for outpatient pharmacy point of sale procedures, cash/co-pay collection, claim adjudication, rejection and rebilling, and pharmacy accounts receivable • Status and Realization Reports • KPI Performance Reports
CCHHS & PwC 7
Page 40 of 192 Initiative Deliverables Revenue Cycle Performance Key Duties Improvement and Interim Resource Assistance (Cont’d) Interim Resource Assistance Vice President of Revenue Cycle Operations • Create and implement a strategic vision for CCHHS' revenue cycle • Direct and oversees the overall policies, objectives and initiatives across the revenue cycle • Drive performance improvement across the Revenue Cycle Director, HIM • Work with respective team to continue implementation of Documentation Improvement Program • Work with revenue cycle dept to assess, improve and monitor processes related to A/R and DNFB management • Monitor employee workload and productivity and work quality against industry standards and provide training in areas needing improvement • Provide recommendations for hiring , promotion promotion, demotions and terminations as necessary Director, Case Management • Continued implementation of new case and utilization management program • Work with revenue cycle departments to facilitate smooth communications regarding authorizations, denials and appeals with payors • Facilitate daily staffing assignments balancing workload • Track key performance indicators, identify performance performance improvement opportunities and drive change in procedures Director, Patient Access • Oversee the day-to-day operations of Central Scheduling, Pre- Registration, Admissions, OP Registration and any other areas reporting to Patient Access • Monitoring staff functions, assigning duties, resolving operational issues, improving service and interacting with other hospital departments and medical staff Director, Patient Accounts • On-site, day-to-day monitoring of patient accounting workflow and performance • Reporting on continued implementation of approved action plan • Monitoring implementation of policies and procedures, staffing schedules and reporting to CCHHS oversight
CCHHS & PwC 8
Page 41 of 192 Initiative Deliverables Labor & Productivity/Workforce • Design of new Labor & Productivity Model Efficiency • Solucient reporting process with internal quality control • System-wide and department specific monitoring and productivity reporting tools • Strategies to reduce overtime and agency • Revise workforce pppolicies and procedures to include overtime and ag gyency • Input to operationalize new time keeping system Paired Advisors Human Resources • Model for recruitment and retention program • Performance metrics with baselines & targets leveraging PwC Saratoga™ • Methodology for titling and grading jobs system wide •System-wide compensation structure Nursing Services • Nursing Services Quality Dashboard standardized across CCHHS • Management reporting tools and templates • Process & procedures to monitor productivity by shift, day and time period • Crosswalk between Quadramed reports & productivity management tools • Process to ensure that personnel are expensed to appropriate cost centers •Imppylement Position Control Policy across CCHHS Emergency Department • Redesigned ED patient throughput processes • ED Case Management program integrated with System wide program • Updated job descriptions, policies and procedures Laboratory • Design and implementation of a Core Laboratory model • Revised organizational structure • Courier system • System wide approach to collecting and reporting quality indicators • Updated policies, procedures and work flows • System wide Point of Care support system Supply Chain • Vision for Future State • Organization and process redesign •Suppl y Chain and Lawson best practices g a p anal ysis • Prioritized Savings Matrix for all benchmarked Non-Labor Cost reduction initiatives and corresponding realization schedule • Inventory management tools • Payables reconciliations and database • Business case for outsourcing/shared services initiative Interim Resource Assistance Director, Su pplpply Chain • On-site, day-to-day monitoring of supply chain workflow and performance • Reporting on continued implementation of approved action plan • Monitoring implementation of policies and procedures, staffing schedules and reporting to CCHHS oversight CCHHS & PwC 9
Page 42 of 192 Initiative Deliverables Implementation Support for ACHN • Strategic recommendations on operating model, revenue cycle options, and medical home • Detailed process flows and design documentation • Strategic planning recommendations for continued improvements • Fully operational operating model Physician Effort and Funding • Future state clinical staffing plan by service, location with identification of Gaps and Labor Savings Opportunities • Benchmark matrix and qualitative discussion document • Administrative Staffing Plan/Service Analysis by seservicervice, location with identifidentificationication of Gaps and Labor Savings Opportunities • Full funds flow diagram identifying impact on CCHHS • GME and UME benchmarking reports • Assessment of current state of research P&Ls • Integration, Productivity Data Capture and Enhancement, Phased Implementation, Internal Communications, and Training Plans •Compppyensation Plan Recommendations for physicians and extenders • Future operating model • Financial model for programs and investments • Outline of revised budget processes • Revised policies & procedures on protected time • Strategic partners accept revisions to affiliation agreements and/or current practices • Final report • Current state clinical service analysis with capacity comparisons Centers of Excellence • Development plan built on validated needs - based clinical areas • Implementation plan specifically coordinated with ACHN and other operational improvement efforts • Timeline and accountability matrix • Clinical and productivity targets Medical School Affiliations • Summary of existing Academic Affiliated Agreements (AAAs) • Summary of AAA against LCME requirements • Summary of other agreements • Identification of opportunities to incorporate into AAA • Recommendations on AAA management, reporting and controls • Summary Term Sheets for new AAAs • Facilitation of AAA negotiations
CCHHS & PwC 10
Page 43 of 192 Return on Investment PwC fees against our projected benefits versus the opportunity represented in the RFP
Alternate Pricing Model- Shared Risk
$350 Fees (All Inclusive) Benefits $313.8 $305 $300 $292 WttiWe are targeting Millions approximately a $250 $256 6:1 ratio of benefits
$200 $195 to fees.
$150 $124
$100 Opportunity Identified in RFP: $65-$71 MM $65 $47 $49 $50 (cap) $50 $36 $19 $16 $24
$- 1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627 Months
CCHHS & PwC 11
Page 44 of 192 Appendices
CCHHS & PwC 12
Page 45 of 192 PwC’s Skills Matrix
CCHHS & PwC 13
Page 46 of 192 Realiz ati on Sch edul e
CCHHS & PwC 14
Page 47 of 192 Physician Effort & Information Related Client Service Operations Supply Chain Improvement Human Resources Funding Revenue Cycle Technology
t n g e t in y n lth lt it m e a u iv e g e s t v n n m n c ro ri o p H o u p s s e i lo n C d n tie n e s e t o ro io Im i o n is v n s ity P t n ti s i M e e k il c ss tu c n g D m n c b & u e r a io n h e io a a r d c o r s e rc n g t ) /J n o e o p te is e a la t a ra P m i b R r p n R e P n n n t R m te ta a s t P O I M s s o t e a is E te s s n L se s n & s e e i n in ( s s y u o l s o d o & C e ic s id e m M c y S S ti a e C n ti s M c R t is a e r m t g ti S l l p t c r a a w ip A o f c M c m g o d n t in y a a & n o o n t iz ie n h r o ra g e i e a d A e n n l lth it it n r m e r b io g n n v ty io s s P t P g in r d g n n n m e n a a p p o te u m P a t n e a e i t n s n in t a e a io a e d e la n e s s ti n s rt L za i t m g R tiv n o ro & e d h n c C M n s M V n s m A o o a e t t n a e - i s n p r t c n te ti c t m n c io ra t / a is t a r e P d m H H z C y n n o p s rg n rd u e o O c u ig t e la A n e a a t t n g M M s n & n u rs e n te i H ili l c e e C e e a o a o m l a d s n e e g s e ta n e n in D m le e n io b u c a s m ty & b th a li m e D ic h N d h e le ve g tr o e e R g m a n T n o ig io l C n b b m o t m b r s t * y a i a c o e m c v s c e n re g b e in n r l D m d R in p n o f e g C d n t se / io u a e ti ia i u s r S i rs th t w i P g e r e r s e is r d a a a a IT s o P o l e n l n o a ti o n n s o ra n re t S iv g c t e im so e o p M e l S ro d a g u id e n ic a n t n y D a l tr a g n a o n l a t m i re /I s ti t u u a e a e o R e e c p g u th f v a , th e re n a o S io e v D C a S /W a a in n h C a n n a io t o a e M r n u ic a e e a is o t m s c n ll g t re ro p in ro l o i e d G l M a a n s -w y t iv r / y g / n a o c d t o o n t n h l v l e e c r C r c tr g p r im e a o e n R u R u t a y n H n & a c a e e c a t e n r n o M P h ti r e n ti a a e c P e a p o P a c s e C a fo a R C N e y d t e P S c G e it U d u e i C M M R s n c ra S o to ti n ti y ts C a u c e C a s S c D n O m D c d C A i R l C n l t M t c n c s s s ra y H s e n o y H m t e t l ri e lo e g si a c io u r n iz P r m f iz M n tm l i n tio l p l i e t g t ia I C n s y c m a a ru ri s n t it y r m l a r g c e n g c a p g l p n s l a t b to u ly n p u rt o n t e i a g o a a lo a g g ty n e n c e h u l a a rn t p m e io n r d e te p l a te li d e n e ic r r A o i i u tr za ri n o p a u o a n a n p ru ic te i r ic e ic te a ri e R e n rg lt g o ia P tr e rm g b s r te in is o o a iv s m rk rn a b a ig a j n te e d ri rs m b b n li t e c p g o ts p a g le m c d a s e n v n a n a ti - ti a a a in c n lf n v a lin 0 ra te s s c C in r n y e a u tr u c d h ro li n m e e u d a m o ti is v c u r r u e p r a o e e tr is p li e li tr a h a re a in h e ill c e e o o h il 4 f n y u e M G U S T P T S P A In C P C E E B P N A L A C U D In A S O G O D S O T C R M S M O C D C S M C P P P F C H B A D S C G P B 3 In E S B D IS Leadership Team Bill Luallen X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Joe Albian X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Dianne Dismukes, RN X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Operations Deedie Root, RN, PhD X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Wanda Pell, RN X X X X X X X X X X X X X X Ann Edwards X X X X X X X X X X X X X X Rick Battaglia, MD X X X X X X X X X X X X X X X X X X X X Nancy Vesey, RN X X X X X X X X X X X X X X X X X X X X X X X X Kristi Kawamoto, RN X X X X X X X X X X X X X X X X X X X X X Janice Buckner, RN X X X X X X X X X X X X X X X X X X X X William Orrell, RN X X X X X X X X X X X X X X X X X Pam McCarey, RN X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Todd Cooper, RN X X X X X X X X X X X Sharon Spreitzer, RN X X X X X X X X X X X X X X X X X X X Richard Wetherbee, RN X X X X X X X X Deborah Albach, RN X X X X X X X X X X X X X X X X X X X X X X X X X X X X Barry Berger, MD X X X X Marcia Liebel X X Christman Morgan X X X X X X X X X X X X X X X X X X X X X X X Heidi Pandya X X X X X X X X X X X X X X Supply Chain Improvement Michael Darling, RN X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Ryan Siemers, MPH, CMRP X X X X X X X X X X X X X X X X X X X X X X X X X X X X Nita Stith, CMRP X X X X X X X X X X X X X X X X X X X X Randy Ryan, MBA X X X X X X X X X X X Marty Ferguson, CMRP X X X X X X X X X X X X X X X X X X X X X Priya Aggarwal, MSHS X X X X X X X X X X X X X X X X X X X X X X X Anish Parekh, MBA, MPH X X X X X X X X X X X X X X X Lisa Varghese, MSHS X X X X X X X X X X X Lindsey Armstrong, MBA X X X X X X X X X X Human Resources Diane Youden X X X X X X X X X Mark Atkinson X X X X X X X X Steve Slutsky X X X X X X X Brian Bray X X X Physician Effort and Funding David Chin, MD X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Gerry McDougall X X X X X X X X X X X X Brett Hickman X X X X X X X X X X X X X X X X X X Barbara Walsh X X X X X X X X X X X X X Margaret Stover X X X X X X X X X X X X X X Bill Dracos X X X X X X X X X X X X X X Tony Armstrong, PhD X X X X X X Pruett Roof X X X X X X X X X X X X Franklin Campbell X X X X X X X X X X X X X X X X Revenue Cycle Jackie Edwards X X X X X X X X X X X X X X X X X X X X X X Leonard Mandel X X X X X X X X X X X X X X X X X X X X X X X Gary Garbrecht X X X X X X X X X X X X X X X X X X X X X Ken Sheridan X X X X X X X X X X X X X X X X X X X X X Jane Moh X X X X X X X X X X X Rick Wichmann X X X X X X X X Ginger Pilgrim X X X X X X X X X X X X X X X Colin Beatty X X X X Cody Waldrop X X X X X X X X X X X X X X X X X X X Edwin Hartai X X X X X X X X X X X X X X X X X X X X X X Kathryn Burg Plaza X X X X X Jeff Vincequere X X X X Lori Kreder X X X Ceakima Shepphard X X X X X X X X Betty Kaczmarek, PharmD, RPh X X X X X X X X X X X X X X Brad Bowman X X X X X X X X Jose Robles X X X X X X X X X X X X X X X X X Clara Kridle X X X X X X X X X X X X Michelle Horton X X X X X X X X X X X X X X X X X X Steve Lutfy X X X X X X X X X X X X X X X X David Thompson X X X X X X X X X X X X X X X X Bonnie Salvatore X X Heather McComb X X Cheryl Baitch X X Jennifer McInnis X X X Anny Pang X X Information Technology William Perry, MHA X X X X X X X X X X X X X X X X X X X X Mike Kraus X X X X X X X X X X X Ezra Uzosike, MS Computer Science X X X X X John Stallworth, MBA X X X X X X Maxine Cheng X X X X X X X X X X X X Raleigh Gresham, MHA X X X X Brian Ivey, MBA X X X X People & Change Reatha Clark X X X X X X X X X X X X X X X X X Jeff Booth X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Larry Patrick X X X X X X X X X X X X X X X X X X X X X X X X Lawrena Colombo X X X X X X Warren Cinnick X X X X MBE/WBE Benford Brown & Associates LLC X X X X X X X X X X X X X X X X X Martin, Harps, Syphoe & Co X X X X X X X X X X X X X X X X X X X X X X X X XPageX X48X of 192X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X The Washington Group X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X * As defined by the State of Illinois Department of Commerce Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010
ATTACHMENT #3
Page 49 of 192 COOK COUNTY HEALTH AND HOSPITALS SYSTEM ITEM III(C) JUNE 18, 2010 FINANCE COMMITTEE MEETING CONTRACTS AND PROCUREMENT ITEMS Begins Request Affiliate / on Page # Vendor Service or Product Fiscal Impact System #
Accept New Grant Illinois Public Health Grant award: 1 Association HIV/AIDS Prevention Direct program $152,800.00 CCDPH 4
Capital Program Items ‐ Proposed Change Orders
For the Oak Forest Hospital and Provident Hospital Pharmacy HVAC PHCC, 2 Ideal Heating Company Upgrade Project $170,314.00 OFHCC 5
For the Build‐Out at Cook County Bureau of Health Services‐Stroger Hospital of Cook County, Fantus Clinic SHCC, and Oak Forest Hospital of Cook Fantus, 3 Madison Construction County Project $118,653.00 OFHCC 6 For the Architectural/Engineering Services Interior Renovation and Build‐ Out at Oak Forest and Stroger SHCC, 4 Nia Architects, Incorporated Hospitals Project $18,274.00 OFHCC 7 For the New Children's Advocacy Rooms at Skokie and Bridgeview Reliable & Associates Courthouses and Public Health Clinics 5 Construction Company at Skokie and Markham Courthouses ($680.88) CCDPH 8
Capital Program Item ‐ Enter Into Contract
For new electrical service for the Cook County Hospital Flammable Liquid 6 ComEd Storage Room Formerly 12KV Building $114,252.85 SHCC 9
Increase Contracts
7 Eligibility Services, Inc. (ESI) Pharmacy billing services $4,000,000.00 System 10
Illinois Department of Public State‐mandated metabolic tests (PKU) 8 Health on newborns born at Stroger Hospital $25,000.00 SHCC 12
Amend Contract Owens and Minor Medical surgical supply non‐GPO 9 Distribution distribution No fiscal impact System 13
Page 50 of 192 COOK COUNTY HEALTH AND HOSPITALS SYSTEM ITEM III(C) JUNE 18, 2010 FINANCE COMMITTEE MEETING CONTRACTS AND PROCUREMENT ITEMS Begins Request Affiliate / on Page # Vendor Service or Product Fiscal Impact System #
Increase and Extend Contracts Administration of the hospital 10 ACS Healthcare Solutions information technology services $3,794,478.00 System 14 Chamberlin Edmonds and 11 Associates Medicaid/SSI/SSDI eligibility services $1,750,000.00 System 15 Electronic billing, insurance Nebo Systems, Inc. ‐ a verification, automated payment subsidiary of Passport posting services and outpatient 12 Health Communications, Inc. collections $1,600,000.00 System 16 Healthcare Revenue 13 Management (HRM) Medicaid eligibility services $175,000.00 System 17 14 Great Lakes Medicaid Medicaid eligibility services $75,000.00 System 18 Maintenance, repair and replacement of chiller systems, cooling towers, 15 Anchor Mechanical, Inc. boilers and absorber $44,136.00 SHCC 19
AmendAmend, IIncreasencrease anandd EExtendxtend CContractsontracts 16 The Sibery Group Professional services $792,000.00 System 20 McKesson Pharmacy Software upgrades, maintenance and 17 Systems, LLC support $433,000.00 System 21 Maintenance and support of Data 18 IBM Center equipment $62,871.11 System 22
Enter Into and Execute Contracts Maintenance and support of clinical 19 Cerner Corporation information systems $10,066,178.00 System 23 PHCC, SHCC, 20 Nucare Services Corporation Short‐term and long‐term care services $6,374,725.00 OFHCC 24 Emergency Department patient 21 GE Healthcare monitoring/telemetry equipment $485,912.16 SHCC 26 Analytical Science Maintenance and support of time and 22 Corporation attendance system $336,000.00 System 28 CareEnhance Review Management Software, in an application hosted 23 McKesson Health Solutions environment $93,967.20 System 29
Renew and Execute Contract
24 Oscar Schiappa, MD Orthopedic physician services $460,008.00 OFHCC 30
Page 51 of 192 COOK COUNTY HEALTH AND HOSPITALS SYSTEM ITEM III(C) JUNE 18, 2010 FINANCE COMMITTEE MEETING CONTRACTS AND PROCUREMENT ITEMS Begins Request Affiliate / on Page # Vendor Service or Product Fiscal Impact System #
Award Bids, and Enter Into and Execute Contracts CHSCC, PHCC, Temporary radiology and laboratory SHCC, 25 STW Healthcare, LLC staffing $2,104,240.00 OFHCC 32
26 Colonial Coach Lines Shuttle bus services $776,000.16 SHCC 35
Scavenger services (biohazardous infectious/chemotherapy chemical 27 Stericycle, Inc. pathological and radiological waste) $489,327.00 OFHCC 38 Customized orthotic and prosthetic 28 Ballert Orthopedic devices $109,911.49 OFHCC 41
Page 52 of 192 BOARD APPROVAL wQUEST
..- DATE: 5-19-10 w*----.--q-.- I HIV/AJUS Prevention Direct TYPE OF REQUEST; I VEbJDOR/SUVPl,iER: - mt&ois Public Heahh Associati~Spri~~kais SELBCTIOM I'H~E~YTBID/WP,PURCWASING CQNSORTWCOMPARABLE GOVERNMENT BID N/A ACCOUN'r #
--Public Wealth - 13 THIS REQUEST THE LOWEST ------IS CONmCT
IISTIFIICATION: A Program by which the Cook County Department of Public Health will provide trained counserors o conduct HIV/AID;(S prevrlation services to include munsellng, Wing, and referral, md partaer eounselhg and eferral, and repart the results to tbe lIllnois Public Hcalth Asoociation.
TEKMS 01;#&QUEST: Thls agreemeal with the Illllnois Public Aenltb A~societion(IPHA) ha4 P maximum amount payable of $152,800.00. 'I'hb agreemerbt is fur 1b~parlod January 1,2010 throrrgk December 31,2010, This grant does not require pre-application approval as It Is an entitlement grant. HAS THIS BEEN REVIE,WED BY CONTRACT COMPLIANCE? No R 1WHAT PERCENTAGE OF TIMCONTRACT IS MBE/WBE1 Na ACHMENQ
BID TABULATIONS: NO
CONTRACT CoMPLtANcE MEMO: No ia .~rn OVEDnialas I 4 JUN 1:3 rUu I
Williant T. Foley, Chief Executive Oliicer
CCHHS CCX):. --_-. Anthony Tedeschi, Ch
Request # 1
Ambulatory & Community Hcnlth Network * Ccrmk Health Services Department of Public Health * *John If. Stroger. Jr. Ilo$pltal of Cook County * Olk Forest Hospitsl Prwldent Hospihl * Ruth MaKothstein CORE Ganter *
We Bring Flealth CANE to Your Community
Page 53 of 192 PROPOSED CHANGE ORDER
Transmitting a Communication, dated May 17,2010 from
BRUCE WASHINGTON, Director, Office of Capital Planning and Policy transmitted herewith for your approval is Change Order No. 4 in the amount of $170,314.00 and a time extension of 212 days is also requested to the contract with Ideal Heating Company, Brookfield, Illinois for the Oak Forest Hospital & Provident Hospital Pharmacy HVAC (Heating, Ventilation and Air- Conditioning) Upgrade Project. It is respectfully requested that this Honorable Body approve this request.
Reason: This change order provides for a revision to the chemotherapy laboratory room conversion consisting of an office area, ante-room and buffer room at Provident Hospital and the relocation of the chemotherapy biohazardous cabinet in Room 5-22 at Oak Forest Hospital.
This change order is due to a request made by the Cook County Health & Hospitals System for the buildout of the laboratory to be in accordance with the new 2009 United States Pharmacopeia 797 Guidelines.
This project is categorized as an HVAC Upgrade Project.
Contract No. 07-53-550 Original Contract Sum: $1,164,000.00 Total Changes to-date: 18,364.00 Adjusted Contract to-date: $1,182,364.00 Amount of this Modification: 170.314.00 Adjusted Contract Sum: $1,352,678.00
Estimated Fiscal Impact: $1 70,3 14.00. Contract extension: March 1, 201 0 through September 28,2010.
28000 Cook County Health & Hospitals
This project was included in the 2009 Capital Impr approved by the Board of Commissioners on April 2,20
Request # 2 Page 54 of 192 PROPOSED CHANGE ORDER
Transmitting a Communication, dated May 27,2010 from
BRUCE WASHINGTON, Director, Office of Capital Planning and Policy
transmitted herewith for your approval is Change Order No. 2 in the amount of $118,653.00 and a time extension of 32 days to the contract with Madison Construction, Orland Park, Illinois, for the Build-Out at Cook County Bureau of Health Services-Stroger Hospital of Cook County, Fantus Clinic and Oak Forest Hospital of Cook County Project. It is respectfully requested that this Honorable Body approve this request.
Reason: This change order is due to a request made by the Health & Hospitals Systems Board that provides for the relocation of the mail order pharmacy located at Oak Forest Hospital of Cook County from the first floor to the second floor. This relocation eliminates the hardship that would be placed on patients and residents who would otherwise have to walk around the building to access the pharmacy.
This change order includes an additional rooftop unit and exhaust fans, air compressor, electrical fixtures, outlets and smoke detectors and upgrades to the fire protection distribution system and piping.
This is categorized as a hospital renovation project.
Contract No. 07-53-562
Original Contract Sum: $2,737,000.00 Total Changes to-date: 32,903.43 Adjusted Contract to-date: $2,769,903.43 Amount of this Modification: 118,653.00 Adjusted Contract Sum: $2,888,556.43
Estimated Fiscal Impact: $1 18,653.00. Contract ex 2009 through August 11,2009.
28000 Cook County Health & Hospitals
This project was included in the 2009 Capital Improvem approved by the board of Commissioners on April 2,2009.
Request # 3
Page 55 of 192 PROPOSED CHANGE ORDER AS AMENDED Transmitting a Communication, dated May 17, 2010 from
BRUCE WASHINGTON, Director, Office of Capital Planning and Policy 2 . transmitted herewith for your approval is Change Order No . .I in the amount of $18,274.00 to the contract with Nia Architects, Incorporated, Chicago, Illinois, for the ArchitecturallEngineering Services Interior Renovation and Build-Out at Oak Forest and Stroger Hospitals Project. It is respectfully requested that this Honorable Body approve this request.
Reason: This change order is for design services to meet Occupational Safety and Health Administration requirements to identify hazardous materials and monitoring of air quality during abatement and, investigation of the structural integrity of the roof and support systems for Oak Forest Hospital - F Building.
This is categorized as a renovation project.
Contract No. 0741-469 Original Contract Sum: $200,000.00 Total Changes to-date: 10,000.00 Adjusted Contract to-date: $210,000.00 Amount of this Modification: 18,274.00 Adjusted Contract Sum: $228,274.00
Estimated Fiscal Impact: $18,274.00.
28000 Cook County Health & Hospitals
This project was included in the 2009 Capital Improvement Program Projects approved by the Board of Commissioners on April 2, 2009.
fJUN 25 ZOi0
Request # 4 PROPOSED CHANGE ORDER
Transmitting a Communication, dated May 24,2010 from
BRUCE WASHINGTON, Director, Office of Capital Planning and Policy transmitted herewith for your approval is a credit Change Order No. #1 in the amount of ($680.88) and a time extension of 24 calendar days is also requested to the contract with Reliable & Associates Construction Company of Chicago, Illinois for the New Children's Advocacy Rooms at Skokie and Bridgeview Courthouses and Public Health Clinics at Skokie and Markham Courthouses. It is respectfully requested that this Honorable Body approve this request.
Reason: This project includes the build-out of two children's advocacy rooms in Skokie and Bridgeview and two public health clinics in Skokie and Markham.
Changes include electrical code corrections, additional drywall and insulation, the addition of signage, changes to millwork, and a credit for asbestos abatement. These changes are categorized either as unforeseen field conditions, user requested changes and errors or omissions on behalf of the architectlengineer. The net sum of all the changes resulted in a credit.
Contract No. 09-53-187
Original Contract Sum: $1,174,405.00 Total Changes to-date: 0 .OO Adjusted Contract to-date: $1,174,405.00 Amount of this Modification: (680.88) Adjusted Contract Sum: $1,173,724.12
Estimated Fiscal Impact: ($680.88). Contract extension: May 26,201 0 through June 18,2010.
20000 County Physical Plant
Request # 5
Page 57 of 192 PROPOSED CONTRACT
Transmitting a Communication, dated June 3,201 0 from
BRUCE WASHINGTON, Director, Office of Capital Planning and Policy requesting authorization for the Purchasing Agent to enter into a contract with CornEd, Chicago, Illinois for new electrical service for the Cook County Hospital Flammable Liquid Storage Room Formerly 12 KV Building.
Reason: This provides for new electrical service at 1913 W. Harrison Street, Chicago, Illinois in conjunction with the above-mentioned project.
Estimated Fiscal Impact: $1 14,252.85
28000 Cook County Health & Hospitals
This project was included in the 2009 Capital Improvement Program Projects approved by the Board of Commissioners on April 2,2009.
This is categorized as a hospital renovation project.
Request # 6
Page 58 of 192 BOARD APPROVA 1, KEQ Uk4M"
JLJS1'IFICA'I'ION: Duet changes in phararlncy billing rrrcthoclolugy aprcd to with thc State effective l3wernbc.r 1,2009, it is r*qi~i~*ctrllo change the piyrnont rnuthcdolopy in this contract. X 'I'ERMS CIF NKQUES'k 'Shis anlatd~nentchanges the methrdnlogy for compeosatinp thc Ct~nrriictorfor providing Pharmacy Bllling Services, llntil this amendment, the ccmtract wir; cntitled to receive payment based upon ii percuntage cvf'collections, Pursuant to this amendment, the Health Systein stull rniakc payrncnt to ESI at the rate of onc: dollar ($1 .OO)pw prcscriptionlphrrnacy service provided during the n~onth,This is a request to attach dollars lo the contract to allow invoices to be paid for relatcd scrvicus. The vendor was paid from revenue under the original contract when the new contract was agreed to thcrc was a change to pay for ocrviccs from appropriations as all other vendors. When thc an~endmntwas con~pleteddollars were not rtttached to the contract so no purchase crrda- could be created. 'rhe daily pharrniicy aolurr~c:is approxinnatefy 10,01#) prescriptions; tlze unr~uulimpact of this is estimated at S4~HH).o(X), Mar~agernentonly wishes to eaeumnber funds fijr one year at (his lirne.
HAS THIS BEEN REVIEWED BY CONTR4CT COMPLIANCE? Yes
WflAT VEH(.'ENTAGE OF THIS CONTRACT IS MBFAVBE? Vendor in compliant
CONTRACT CO
CCiiHS CEO William
CCIIE1S Anthony
CCIIHS Request # h2ichlie1 7
Page 59 of 192 THE BOARD (SF COMMISSIONERS TODD R SfBOCFA PRESIDENT R#lTI'Y HANCOCK PERRY W~UIe~l?trl~ ~ctmt m~N. GIL~~ fib w. UIRBCrOR MBER BtlELC w@a 8~86~1~s llhDD~ kt%? bUftBl *MWL .#OWPW :tmW 1 18 No& lrn WMm*OM rOWCWP0M l@ OW. Cl~kSim. Room XWWW 6611 (LmlM. WRVSWbEDiW IM all Chicxgn, Illinois CIORM-13W ab#~mm UWNY m DM. r~eeaoosuv 1% mjv TEL (3121 603.5501 ~omarWRIO uma m tnu amo amom ism m. KCWIN Rmh Bn ah. IKI1(ONI J, MAIM UM Oh. FAX (3 12) nOf-4547 nahm UL1 mom mu ltll MI.
May 19,201Q
Ms. Leslie Duffy Senior Director Supply Chein Management 1969 W. Ogden, Suite 5360 Chicago, IL 60612 Re: Contract No, H09-25-041
The following bld for the above referenced contt-act: has been revlewed for compliance with the General Conditions regarding the Minority and Wamen Owned Business Enterprises Ordinance and has been found to be responsive to the Ordinance:
ESI (Eligibility Services;, Inc.)
The OMce of Contract Compliance has been advised that no other blddem are being recommended far award. Sincerely,
Contract Compliance Administrator &HP/hrtj
Page 60 of 192 BOARD APPROVAL REQUEST
Increase Contract Illinois Department of Public Health, Springfield, Illinois SELECTION OF METHODOLOGY: BID I SOLE SOURCE/ 'RFPI PURCHASING CONSORTIA/ COMPARABLE GOVERNMENT BID: Sole Source I FISCAL IMPACT: . GRANT FUNDED AMOUNT: I I CONTRACT PERIOD: REQ#/CONTRACT# 6/1/09 through 513 111 0 09-45-173 1 FtEQUESTING DEPTIAFFILIATE: Department of Pathology / Stroger Hospital Laboratory Director, CCHHS , j Johnny Brown, COO, Stroger Hospital IS THIS REQUEST THE LOWEST IS THIS CONTRACT ".a BIDDERISUPPLTER? NO SOLE SOURCE? Yes k i JUSTIFICATION: : Contract 09-45-1 73 (approved by the CCHHS Board on 5/22/09) is for the state-mandated metabolic (PKU) tests on newborn e delivered at Stroger Hospital and are performed at the Illinois Department of Public Health. This is a volume-based test and e even though the birth rate has decreased, infants can be brought in for outpatient repeat testizlg, if necessary. Mothers can be released within 24 hours with a normal birth and the PKU test is equivocal and has to be repeated. By Illinois State Law, the system can not rehse anyone requesting the test.
TERMS OF REQUl3ST: $25,000.00 upcoming This request is to Increase in the amount of to pay for open invoices and cost of tests through 513 1/10. ") This increase is brought about by an unforeseen increase of tests by about 23% fiom what was estimated in the contract-
The CCHHS Board approved this contract on 5/22/09 in the mount of $102,240.00 for 12 months fiom 6/1/09through 51'3 1/10. A new contract fiop 6/1/10 through 513111 1 is already in place.
HAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? Pending Contract Compliance
WHAT PERCENTAGE OF THIS CONTRACT IS MBJVWBE? Pending Contract Compliance
ATTACaMENTS
BID TABULATIONS: No CONTRACT COMPLIANCE MEMO: No P
BY BOARD OF
A~nbulatory& Colnniunity Healtll Nehvork Cermrk Health Services Departn~e~~tof Public Health b John 1-1. Stroger, Jr. Hospital of Conk County Oak 1;orest Hospital Provident Huspitnl Rut11 M. Rothstein CORE Center i We Bring Health CARE to Your Community Page 61 of 192 BOARD APPROVAL REQUEST
1' 5/18/2010 I Medical ~ut-23N& GPO Distribution TYPE OF REQUEST: I VENDORISUPPLIER: . Amend Contract I Owens and Minor Distribution Mechanicsville, VA SELECTION OF METHODOLOGY: BID / SOLE SOURCW RFP/ PURCHASING CONSORTIA1 COMPARABLE GOVERNMENT BID. RFP ACCOUNT # I FISCAL IMPACT: I GRANT F'UNDED AMOUNT: / 890-360,362,365,367 1 None I None 1 CONTRACT PERIOD: I m#/commdT# # June 30,2010-August 17,2011 ~o&act# 809-0001 REQUESTING DEPT/AFFILIATE: SPONSOR: System Supply Chain Management Leslie Duffy RN MBA , Senior Director Supply Chain Management IS THIS REQUEST THE LOWEST IS THLS CONTRACT BIDDER/SUPPLIER? Vendor is lowest qualified bidder SOLE SOURCE? No
JUSTIFICATION: An RFP (H10-009) was advertised on the CCMS website March 30,2010 for a Non-GPO Medical Surgical Product Distributor. A selection committee was formed and a criteria was developed. A criteria matrix was used and the criteria, (weighted scoring) for the successful bidder was established. Owens and Minor was the successful responder out of 7 other responders. This amendment is to allow Owens & Minor to distribute non-GPO medical surgical supplies. I IOwens and Minor received the highest score in. the following areas: 1) Cost, 2) Breath of Contracts, 3) Just in Time Distribution Model, and 4) WBE/MBE Participation. In addition, they will provide a stream line distributor process as well as cost savings and distribution efficiencies for all facilities within the System
ITERMS OF REQUEST: The terms of tbis amendment will be coterminous with the existing Owens and Minor Contracl IHAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? NA - No fiscal impact WHAT PERCENTAGE OF THIS CONTRACT IS MBFJWBE? NA
ATTACHMENTS
BID TABULATIONS: No
CONTRACT COMPLIANCE MEMO: No DIRECTORS OF THE COOK CCHHS COO: HEALTH AND HOSPITALS Anthony Tedeschi, cer
Michael Ayres, Chief ~nadciaI~0dce.r Request # 9
Ambulatory & Community Health Network Cermak Health Services Department of Public Health John R Stmger, Jr. Hospital d Cook County Oak Forest Hospital Provident Hospital Ruth M. Rothstein CORE Center
We Bring Health CARE to You Community Page 62 of 192 BOARD APPROVAL REQUEST
DATE: I PRODUCTISERVICE: Administration of the hospital information technology
I TYPE OF REQUEST: Extend and I VENDORISUPPLIER: ACS Healthcare Solutions1 Dearborn, MI Increase Contract SELECTION OF METHODOLOGY: BID ISOLE SOURCE1 RFPI PURCHASING CONSORTIA1 COMPARABLE GOVERNMENT BID: Bid ACCOUNT # 8901260 FISCAL IMPACT: $3,794,478.00 GRANT FUNDED AMOUNT: NIA
I I CONTRACT PERIOD: I REO#ICONTRAC'IW 9890016 1/07-41-46
JUSTIFICATION: The original ACS contract, number 07-4 1-46, was to provide services from January 1,2007 to December 3 1 2009, with an extension until 6/30/2010. CCHHSI HIS is requesting an extension of 6 months until 1213 112010 to extend services with ACS while CCHHS develops an RFP for IT outsourcing services. CCHHS and ACS have been unable to reach an agreement on the terms of the renewal and are at an impasse. All services currently being performed by ACS will continue to be performed in accordance with the contract as agreed to and in accordance with previously aped upon amendments (CCDs) to the contract.
TERMS OF REQUEST: The original contract number 07-41-46 was approved by the Cook County Board on 9/7/2006 for the amount of $14,607,122.00, This is a request for an increase of $3,794,478.00 and an extension of 6 months from 7/1/2010 through 1213 1120 10.
HAS THIS BEEN REVIEWED BY CONTPACT COMPLIANCE? Pending Contract Compliance IWHAT PERCENTAGE OF THlS CONTRACT IS MBEIWBE? Pending Contract Compliance ATTACHMENTS
BID TABULATIONS: No
CCHHS CEO: BY BOARD OF
Request # I CCHHS CFO: 10 Chief Michael Ayres, L
- Ambulatory & Community Health Network Cermak Hcalth Services Department of Public Hcalth John H. Strogrr, ,lr. Hospital of Cook County Oak Forest Hospital . Provident Hospitrl Ruth M. Rothstein CORE Center
We Bring Health CARE to Your Community Page 63 of 192 BOARD APPROVAL REQUEST t
A2!l!27,2010 -"-_w I Medicaid lSSIISSD1 Eligibility- ...... 1TYPE oe REQUEST I VENDOWSUPPLIER: Extend and Increase Contract ) Ghamberlin Edmonds and Associates, Atlanta, FA. -- t SELECTION NI~!%HODO~OGY: 1 BID~FP~PURCWAS~NOCQMSORTIAICOMPARA~E GOVERNJGE~TBIO Pp-,*-< ...... i GRANT FUNDED AMQUNT: I N/A -""--.. -,--- R~B"@ESTING CONTRACT PERIOD: 1 REQ#/CONTRZ~T#-
Po/! /@ - 9/30/lO (1 * ,, ,-- 06-41-588 - I REQUESTING DEPT/AFFILIATE: 1 SPONSOR NAME &TITLE: Michael Ayres, CFO REQUEST THE LO'*E* IS THtS CONTRACT
".."a JUSTIFICATION: Chamberlin Edrnands and Associates held a contract with the health system to provide eligibility services Extension awarded through September 30, 2009 to complete the run out of claims awarded to them prior to th terminat~onof the contract * Funds ($6.5M) have been exhausted but vendor continues to provide sewices on patient accounts referre under this contract (#06-41-588) Request to extend this contract through September 30,2010 ancl increase the value $1,750,000 NOTE: A new contract (#Hog-73-014)with Chamberim Edmonds and Assoc~ateswas approved by the Board 0 9/18/09 for services from 10/1/09 - 9/30/10 for all new patient accounts referrecl after 10/9/09
1 Reouest 06-41-588 10/1/2009 9/30/2010 $ 1,750,000.00 1 Total __, 0 8.250,W0.0(1 1 TERMS OF REQUEST: Extend and increase contract {#06-41-588) for 10/1/09 - 9/30/10 for $1,750,000 to allow payment of continued sunset services.
WAS THlS BEEN REVIEWED BY CONTRACT COMPLIANCE? Yes
WHAT PERCENTAGE OF THlS CONTRACT IS NIBENBE? Vendor i
ATTACHMENTS
BID TABULATlONSr No
CONTRACT CQMP
CCHHS CEO.- ....
...... "
Page 64 of 192 AS AMENDED BOARD APPROVAL REQUEST
verification, automatsgpaymentoostiw services andoutpatient collections _ TYPE OF REQUEST:-E~%"~~~"&~~~VENDOR/SUPPLIER: Nebo systems. l~~:'-abs~d~ar~ of Passport Increase contract Health Communications, lnc., Oak Brook Terrace, IL -v--* "" _-_ - iBlDlRFP/PURCHASlNG CONSQRT~AMSO~PA~A~~E=VERNMENTBID -METHODOLOGY: RFP ."--.""- w .. ACCOUNT # FISCAL IMPACT: 897 260 $1,600,000 W"rn Requesting CONTRACT PERIOD: I REQ#ICONTRACT# June 1, 201 0 thmhSeptember 30,201 0 ] 78900488 I07-41 -345 I REQUESTING DEPT/AFFILIATE: I SPONSOR NAME & TITLE: Michael ~vre-"~"""~'
Revenue Cycle -"~,",,"~--,,-,,.'.,.q-.." IS THIS REQUEST THE LOWEST HIS CONTRACT 1 BIDDEWSUPPLI ER? NIA SOLE SOURCE? YES I I ----,-,...- -...... --.-.-- JUSTIFICATION: NEB0 Systems Inc, was awarded a contract for the provision of electronic R insurance verification, automated payment posting, electronic billing and outpatient collections. k2venl~ecycle management desires to split the services currently bundled in one contract to separate contracts for each line of business to better manage the performance of the successful vendor(s). The current contract funded at $2.750M is completely exhausted. An extension and increase is I required to meet p
est 07-41-345 611 I2010 9/30/2010
ITERMS OF REQUEST: The original contract was for 6/1/07-5/31/10. The extension for 611110- A 9/30110 will allow time to complete the RFP without a service interruption. HAS THlS BEEN REVIEWED BY CONTRACT COMPLIANCE? Pending WHAT PERCENTAGE OF THlS CONTRACT IS MBENVBE? Pending C
CCHHS CEO--. William T. Foley, Chief
CCHHS COO: ---.,...... " - Anthony Tedeschi,
Page 65 of 192 BOARD APPROVAL REQUEST
SELECTION METHODOLQGY:
/I --'".--..--"."--"4/1 o - 1I 13011 o .'*..",*--,, ""*-..-, '-.--*.-p REQUESTING DEPTIAFFILIATE:
JUSTIRCATIOEI: Healthcare Revenue Management (HRM) held a contract with the health system to provide eligibility services Extension awarded through September 30, 2009 to complete the run out of claims awarded to them prior to the termination of the contract Additional extension awarded through March 31, 2010 @ Intention to have HRM return any incomplete accounts for reassignment to Chamberlin Edrnonds. In retrospect, this is impractical. HRM has already performed significant amount of work on the accounts and transferring them to another vendor would delay resolution and potential loss of revenue for the system and nonpayment for HRM's effort. Request to ex e $1 75,000 I Original 06-41-592 6/26/09 7/1/06 6130109 $1,680,000.00 Extension 06-41-592 711f09 9130/09 $ f B0,000.00 Extension 06-41-592 1115/09 1011 fO9 3/31 11 0 Request 06-41-592
TERMS OF REQUEST: Extend and increase contract to allow payment of continued sunset services.
HAS THlS BEEN REVIEWED BY CONTRACT COMPLIANCE? Pending Contract Compliance
WHAT PERCENTAGE OF THIS CONTRACT IS MIBUWBE? Pending Co
ATTACHMENTQ
BfD TABULATIONS: No
CONTRACT COM
CCHHS COOt.-~u-,- Anthony Tedeschi
Page 66 of 192 BOARD APPROVAL REQUEST
, .,...,...,, ,, .,,,,.-,e-...u., Medicaid Eli ibility Services --,,-- ."...-.-.--- -"/TEFB~PFLIER: .
*".".,. -,,-.',.-"- ---. FISCAL IMPACT: GRANT DEB."KM5u-NT: --"- ....d....~-. REQUESTING CONTRACT PERIOD: .IEmjC GGTHACT# 411 I10 11 /30/1 Q - 06*41-%!.I .,,,..' ,.,.. "-. -.-.-"...... -...,.. "','-- t REQuEsTINt3 DEPT/~FFILIATE: "-+ SPONSOR NAME & TITLE: f Revenue Cycle 1 Michael Ayres, Chi# Financial Off&ec - 1 IS THIS REQUEST THE LOWEST I I5 'i"~f~-CONTRACT 1 EIIODER/SUPPLIER? NIA &LE .--SOURCE? .- NQ - JUSTIFICATION: Great Lakes Medicaid (GLM) held a contract with the health system to provide eligibility services * Extension awarded through September 30, 2009 to complete the run out of claims awarded to them prior to thl termination of the contract a Additional extension awarded through March 31,2010 a lntentron to have GLM return any incomplete accounts for reassignment to Chamberlin Edmonds. In retrospeci this is impractical. ELM has already performed sign~ficantamount of work on the accounts and transferring then to another vendor would delay resolution and potential loss of revenue for the system and nonpayment for GLM' effort. a Request to ext e $75,000
TERMS OF REQUEST: Extend and increase contract (#06-41-591) for 41111 0 - 1 113011 0 for $75,000 to allow payment of continued sunset services. HAS THlS BEEN REVIEWED BY CONTRAC7 COMPLIANCE? Pending Contract Compliance WHAT PERCENTAGE OF THlS CONTRACT IS MBWWBE? Pending ATTACHMENTS
CONTRACT COMPU
." -...... ,.,.,...... --
Page 67 of 192 BOARD APPROVAL REQUEST
1 I Maintenance, Repair and Replacement of Chiller Systems, 1 0Ma 7,2010 TYPE OF REQUEST: I VENDORISUPPLIER: Anchor Mechanical. Inc. Increase and ~se~~dContract Chicago, IL SELECTION OF METHODOLOGY: BID / SOLE SOURCE1 RFPI PURCHASING CONSORTIA1COMPARABLE GOVERNMENT BID: Bid ACCOUNT # FISCAL IMPACT: GRANT FUNDED AMOUNT: 897-449 $44,136.00 None CONTRACT PERIOD: REQ#ICONTRACT# Contract Extension: 07110110 - 10109/10 06-53-778 I REQUESTING DEPTIAFFILIATE: SPONSOR: David Lai, Associate Administrator Stroger HospitalIDepartment of Buildings and Grounds Johnny C. Brown, COO j IS THIS REQUEST THE LOWEST IS THIS CONTRACT I BIDDEWSUPPLIER? yes I SOLE SOURCE? NO
JUSTIFICATION:
This request is necessary to continue maintenance, repair and replacement of chiIler systems, cooling towers, boilers and absorber during the bidding, evaluation, award and execution of the new contract. Current contract period is July 10,2007 Ulrough July 9,2010.
TERMS OF REQUEST: I This contract was originally awarded by the Cook County Board of Commissioners on June 19,2007 in the amount of $71 9,362.00 for 36 months. The proposed contract extension dates are July 10,2010 through October 9,2010 (3 months).
HAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? Pending Contract Compliance 11I WHAT PERCENTAGE OF THIS CONTRACT IS MBUWBE? Pending Contract Compliance Iii IATTACHMENTS APPROVED BID TABULATIONS: ICONTRACT COMPLTANCE MEMO: I( JUN 25 2010 BY BOARD OF L DIRECTORS OF THE COOK COUNTY CCHHS COO: HEALTH AND HOSPITALS SYSTEM Anthony ~edeschiskfOperating Officer
CCHHS CFO:
Request # 15
- AmbuIat.ory & Community Health Networli Cernlak Health Senficcs Department of Public Healtb 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 i Page 68 of 192 BOARD APPROVAL REQUEST
April 22,2010 Professional Services TYPE OF REQUEST: VENDOR/CITY, STATE: Amend, Extend and Increase The Sibery Group Oak Brook, Illinois SELECTION METHODOLOGY: IS THIS VENDOR THE LOWEST RESPONSIBLE BID L1 BIDDERISUPPLIER? NA RWP U GPO rJ COMPARABLE GOVERNMENT BID U SOLE SOURCE X ACCOUNT NO(S). FISCAL IMPACT: 890-260 $432,000.00 (Extension) $360.000.00 (Amendment Adding Services) $792,000.00 Total CONTRACT PERIOD/EXTENSrON PERIOD: REQ NO./CONTRACT NO@). July 1,20 10 through June 30,20 11 H09-72-013 REQUESTING DEPT(S)/AFFILIATE(S) OR SYSTEM: SPONSOR(S) NAME(S) & TITLE(S): CCHHS Administration William T. Foley, Chief Executive Officer
JUSTIFICATION: The original request was for the provision of an Interim Chief Operating Oficer for the Cook Count4 Health and Hospitals System. Subsequent to the original approval there were two additional increases for professional consulting services at Oak Forest Hospital (Addendum #1) and for consulting services to assist with Joint Commission preparation at Stroger Hospital (Addendum #2). This request (Addendum #3) is in three parts. 1. The first part of this request is for a contract increase and extension for the continued provision of a full-time Interim Chief Operating Officer for the Cook County Health and Hospitals System (Addendum #1) for an additional period oi one year, July 1,2010 through June 30,201 1, in the amount of $432,000; 2. The second part of this request is for an extension of the performance period under Addenda #I a~~d2 to encompass the months of April and May 2010, with sufficient finds remaining in this purchase order to cover services during this period; and 3. The thud part of this request is a contract amendment and increase to provide for professional services for a period 01 one year, July 1, 2010 through June 30, 2011, in the amount of $360,000, with discussion in closed session as i1 involves personnel matters.
TERMS OF REQUEST: Original CCHHS Board approved 06/26/09: $432,000.00 Previous increase approved amount 08118109: $340,000.00 Previous increase approved 01/26/10: $415,240.00 This increase requested: $792.000.0Q Adjusted amount $1,979,240.00 BY BOARD OF 1 IIRECTORS OF THECOOKCOUNTY HAS THIS CONTRACT BEEN FOUND RESPONSIVE BY CONTRACT Cc I ATTACHMENTS I BID TABULATIONS: NA I CONTRACT COM
Page 69 of 192 BOARD AYPKC)VAI, HEQIJRST
ERN iM ENT BID I
- " ..""-",-",-- -- - ISC'AI, 1M PACT:
UIU TABU1,A'i'IONS: N/A
00NTItAC:'1* C:OMPIJIAN<:ISMEMO: I'e~bding
Page 70 of 192 BOARD APPROVAL REQUEST
Ambulatory & Community Health Network b Cermak Health Services Department of Public Health John H. Stroger, .lr. Hospital of Cook County Oak Forest Hospital Provident Hospital Ruth M. Rotbstein CORE Center
We Bring Health CARE to Your Community Page 71 of 192 BOARD APPROVAL HEQUEST
t'Kt JlJlJC I /.3F,KV 1C. rd: Maintenance and Support of Clirrical lltforrnation Systems.
...... Enter into and Exerutr...... C:c>nfr:irt ...... -...... Sf; I.;EC:'I'IC)h'
-...... "'" ...... - "", ..- GRANT FlINI3EI) AMOUNT: ... N/A .....-...... -... ,.-- .....--...... -,.. I NEO#ICONI'RACT# ..... 4/ 1/20 10-(ii30/20 I I ...... Ii...... H 1629-070 ----., ...... ----" 1 RI;:QI!ESTINC; 1)1[",1"TiAF'FILIAl'E: SPONSOR: / I ,..,-.,-.,N IS/...... CCNHS ...... '"'..,,...... C'.,""flan,,--.-- Wnu- ...... 11S THIS HEQliES'I' THE LOWEST / 1S TH IS CONTKAC I
IFIC'ATION: This 15 a request to enter into and cxectrte contract number 1110-25-070, betuec~iCook County Health and Htjspitnls System arid C'enier Ct~rporatiur~.Shis ccbntracr is a nlaintenance and support contract for the rinie period 7 1 40 10-6 30t20 I I, fix the purpose of' continued srtpport and iniple~nerttutic~nfor the Clinical infortnaticm s)stems at CCIIt1S. The increase over lasl >ear is in ~p~~ortat Board initiatives prcsentcd 011 Marc11 261h 201 0; funcl~o~talityincludes support and rrt~plementationtitr the upgrades ta nuning, phjsicran, eleclroriic inedical record (EMK) documentatior~as well b bl) Auolnation and enhanccd tracking, Cerner C'orptriatior~has proprietary rights to the existrtlp safware and is the I'f>RMSOF REQUESl*: I his 13 a reque5l Ibr S;1(1,066,17X.(JOto enter into rnciintenancc and suppnrt contract betueen C'ook C'ounty Ilealtli and fjospitnis Syh1etl.r and Cerner Cot poi.ation fi3r a period of 1 year (7: 1/20 i 0-0!30!20 1 1 ). HAS 'THIS BEEN REVIEWED BY CON'J'RAC'T COMPLIANCK? f'cndic~gCorktract C:on~pliance WHAT PERC'EN'TACE OF THIS UONPJ"RAC"rIS MUE/WSE1? Pending Contract Cornplialtrc A'II'ACHM ENTS BID 'I'ARUI,ATION8: No C'C)NTRAC~'TCO OF THE COOK COUNTY C'C'HHS C'O0:- Antfrotry l'cdcschi, Chief O Request # 19 iulator.\. R <"oat~t~~i~rit!iic;ilth Net~tl~lr* I ern~akfle;rllb Ccrv'lces I)c.p;trtrrlct~tof Ibuhiic Ileaitit I#.41rtrgcr. .It.. fttt We Bring 1 lcalth ( %WI' to Your (:ommunity Page 72 of 192 BOARD APPROVAL REOUEST .--- AS AMENDED I DATE: 5/18/2010 I PRODUCT/SERVICE: SHORT TERM CARE & LONG TERM CARE I I I SERVICES TYPE OF REQUEST: Awtwd, Enter VENDOWSUPPLIER: NUCARE SERVICES CORPORATION into, and Execute Contract Lincolnwood, IL SELECTION OF METHODOLOGY: RFP ACCOUNT # FISCAL IMPACT: GRANT FUNDED AMOUNT: $0.00 891-272 891- $775,625 897-272 897- 2,326,875 898-272 898- $3,272,225 TOTAL $6,374,725 CONTRACT PERIOD: REQ#/CONTRACT# H10-72-086 08/01/2010 TO 07/31/2011 REQUESTING DEPTIAFFILIATE: CCBHS IS THIS REQUEST THE LOWEST IS THIS CONTRACT 1 BIDDEWSUPPLIER? N/A (based upon approval matrix) I SOLE SOURCE? NO JUSTIFICATION: The Cook County Bureau of Health & Hospital Systems is in need of short term care & long term care service for their patients with identified needs. Volume determined as follows: Short Term Care to be allocated to the following affiliations accordingly 60% Stroger, 20% Provident, and 20% Oak Forest. Short Term Care 25 patients at $425.00/day average x 365 = $3,878,125.00 The entire Long Term Care is to be allocated to Oak Forest. Long Term Care 45 patients x $152.00/DAY x 365 = $2,496.600.00 TOTAL $6,374,725 TERMS OF REQUEST: NUCARE will provide long term care & short term care for the Cook County Bureau of Health & Hospital Systems for the period of one year from 8/1/2010-7/31/2011. HAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? Yes WHAT PERCENTAGE OF THIS CONTRACT IS MBEIWBE? Vendor is c ATTACHMENTS BY BOARD OF BID TABULATIONS: No DIRECTORS OF THE COOK COUNTY CONTRACT COMPLIANCE ME I HEALTH AND HOSPITALS SYSTEM CCHHS COO: Request # 20 Ambulatory & Community Health Network Cermak Health Services Uepartn~el~tof Public Health John H. Stroger, Jr. Ilospital of Cook County Oak Ful*est Hospital Provident JJospital Ruth R.1. Rothstein CORE Center = Page 73 of 192 We Bring Health CARE to Your Community THE BOARD Of- (=OMMISSIONERS COOK COUN'fY TODD a S'rlaOcu OFlCE OF CONTRALT COMPLIANCE PRSIDENT UWCOLUNS 111 Obl ~wIS4, WLVETIP UDk RWWmEL4 &M OM, ORlDBFl EAlhYR lhDM ;IRV sUILf8 3rl DML JOIN P. IlmDR WLUUI Y ~FAP dul D~I. r~llnwCUYRIOL la oet I 1e North Clark Stm, Rwrn 1 UIWlUn SrMC 5hORl. UIW SUffIVW 18sDh Chi~o,lllinoir 60602.1305 JMN MtRleB MlRW 0th Dkl GRCIGQtU ~~ Oh. TEL (312) m-ss02 ~WWOIIORLIIO mob^. nyIOmro.w~m~m im~m W ARC6 IYn PkI. *mnON'l J. ERMA ldlL DI FAX (3 13 603-4547 mTnrmr WJV umtab wt. May 28,201 0 Ms. hslie D-L@Y Senior Director Supply Chain Management 1969 W. Ogdcn, Suite 5360 Chicago, IL 60612 'kRFP 'H-104008Long Term Cure Facility Services and Short Term Care Faellfty Services The following bidders for thc above dierend Request-for-Proposal have bean reviewed for compliaace with the Gea4ral Conditians regarding the Minority and Women Business Enterprim ie and have bewl found responsive to the Or-. * Nucare Services Corp. Sincerely, %hP""b6Betty H k Perry Direkor, Contract 'Compliance Page 74 of 192 BOARD tlPPRO\rAIdRKQUKST r-, ...... -- I ""P.""? TY I'E OF KIIQI,!EST: Enter into and I VENDOWSUPPLIGR: G E Iiealtl~cnre .... Execute Contract --- I "- U.'3uwotosa, W1 "-,.-.,".--"-- SE1,ECTION OF MF;TWOI)OI,C)GY: HID / SOI,,ESOZllRCFA KFP/ R.IRCEI ASING CONSORI'IAI COMYAKABLE GOVERNMENT BID: Sole Source ACCOlJNT # 7171 l;ISCAId XMPA CT: $485.9 12.16 GRAET F1:NDED AMOIJNT: Nonei ,,,.,‘",*"""*~ _._._.__.," ...... "-1...... i ONTR TRACT Fl!;WIOD: 014/2010 through 6/13/2011 1110-25-027 -.- -...... --I ~"~"RE(JI:.K'.STINC;DEPT/AFFII..I.~TII: JIIS-B.D. I..---...... 1 1s TlIlS KEQIIEST THE LOWEST -.-...... a ... ] SOI,E SOURCE? Yes JIISrII'ICATION: The telemetry sybtcm is for ccr~liitc111anitorlng of JIIS-Lmerpcncy 1)q>artrt1a11and I)bservation llnit. 'lhc tno~liltnupgrade u~llgive us th~.abrlitp to have eenvillized physician iir~dnurse momtwing of cardlac tracings ?'he Ffnerget~cy Depmtment uill be able to do 12 lead LKCi's in 1ri;tpe and id I ctotlons in a lapid manner which wi I I improve patient clocttlnentatlorl ,md dccre~isedtx)r, to balltxx~tiines for acute myocii~'tli;rl~nl~wctions.. This will ~FOsatisfy the requiremetlt for elwtron~cd~xurnenulcon of all pat~cntvitals rn the Emcrpcrtcy IJepartlncnt. TERMS OF REQIJEST: rcquest is to enter into and cxccutc: contract # I31 0-25-027 rn the :mniount of 5185.012,16 for a pcriod ot 12 nnonths from 6/14/2OI 0 through (71'1 3/201 I 1tAS TUIS BEEN HEVIEWED BY CON'L'tL4C'T C%)MPI,IANCE:? Yes IWHAT I'EHCEN1l'AGE OF THIS CONTIZAC.'I' IS MBWWBE? Vendor is cornpliant ATTACHMENTS IZID TABULATIONS: No I JUN 2 5 2010 I I \Villiam T. E'oley, Chief Exec~rteOficer CCW HS COO: Anthuny 'Tedescbi. CCIIHS ...... me ..... -..... -.- - Michael Request # 21 Amhulatory $c Community Health Network * Cermak Health Services Department of Public lieslfh John liI. Stroger, Jr. Wmpitd uf Cook Ctwnty Oak Forest liXmpitd Provident Wmi3ital Ruth M. Rathstein CVRC <.%niPr * We Bring Haalth CARE cu Your Community Page 75 of 192 COOK COUNTY OWICE OF CONTW ACT COMPLIANCE .E RE'ITY HARCOCK PERRY DIRFCTOli f 116 North Clork Stmct. Rnorn 1020 Chicago. lllinolr fi06M.13fW f TEL 1.7 121 603-5502 Y. FAX (? 12) 603-1547 " n June 4,2010 Ms. Leslie Duffy Senior Director Supply Chain Management 1969 W. Ogden, Suite 5360 Chicago, IL 60612 Re: Contract No. H10-25-027 Dear Ms. Duffy: The following bid for the above referenced contract has been reviewed for compliance with the General Conditions regarding the Minority and Women Owned Business Enterprises Ordinance and has been found to be responsive to the Ordinance: GE Medical Systems Information Technologies, Inc. a GE Healthcare Business the Office of Contract Cornpllance has been advised that no other bidders are being recommended for award. Sincerely, Betty Wancock Perry Contract Compliance Administrator BHP/hrtj Page 76 of 192 BOARD APPROVAL REQUEST I DATE: 1 PRODUCTISERVICE: Maintenance and Support- - of Time and Attendance I 11 5/10/2010 I system I I TYPE OF REQUEST: Enter into and / VIENDOR/SUPPLIEB: Analvticd Science Cornoration Execute ~onhract I Ft. Meyers Beach, FL SELECTION OF METHODOLOGY: BID I SOLE SOURCE.RFP/ PURCHASING CONSORTW COMPARABLE GOVERNMENT BID: Sole Source ACCOUNT # I FISCAL IMPACT: I GRANT FUNDED AMOUNT: NIA 8901441 1 $336,000.00 CONTRACT PERIOD: I REQ#ICONTRACT# 06/01/10-5/31/12 I HI&-069 REQUESTING DEPTIAFFILIATE: Hospital- 1 SPONSOR: Dan Howard, CIO Information Systems/ CCHHS IS THIS REQUEST THE LOWEST IS THIS CONTRAC~ BIDDER/SUPPLIER? No SOLE SOURCE? Yes JUSTIFICATION: Analytical ~cienckCorporation is the sole source vendor for the time and attendance system currently used throughout Cook County Health and Ehspitals System. This contract is necessary to maintain software and hardware that supports the time aid attendance application that is utilized at CCHHS. TERMS OF REQUEST: The contract is for a period of two (2) years kom 0fY1/10 through 5/31/12 in the total amount of $336,000.00. HAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? Pending Contract Compliance WHAT PERCENTAGE OF THIS CONTRACT IS MBFJWBE? Pending Contract Compliance 1) BID TABULATIONS: No (1 CONTRACT COMP+IANCE MEMO: Pending /-- CCHHS CEO: I WiUiam Foley, Chief Executive Officer / CCHHS COO: Anthony Tedeschi, chief opera6ng OfRcer Request # 22 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 IA1e Ering Ilalt! CARE to Yew Cc~my~xity Page 77 of 192 1 BOARD APPROVAL REQUEST 1 X 1 DATE: I PRODUCTISERVICE RWUESTED: CareEnhance Review Management- I ? June 9,2010 I Software, in an application hosted environment TYPE OF REQUEST: Enter into and I VENM)RISUPPLIER: 1 11 execute contract McKesson Health Solutions, Chicago, 1Z. SELECTION BID/RFP/PURCHASING CONSORTWCOMPARABLE GOVERNMENT METHODOLOGY: Sole Source BID ACCOUNT # FISCAL JMPACT: GRANT FUNDED AMOUNT: NIA 890-441 $93,967.20 CONTRACT PERIOD: I REQ#/CONTRACT# July 1,2010 through June 30,2013 OC 8%35 H10-25-0010 REQUESTING DEPTlAli%nIATE: SPONSOR NAME & TITLE: Michael Ayres, CFO Health information Services IS THIS REQUEST THE LOWEST IS THIS CONTRACT I I BIDDERJSUPPLIER? NO I SOLE SOURCE? Yes JUSTIFICATION: This is a soIe source solution which Utilization Management needs to gain control of denials for services by third party payers. This internet based product will be deployed system wide, with training included in the total price. TERMS OF REQUEST: This is a request to enter into and execute an agreement with McKesson, Interqual for the provision of software for Clinical staff as well as Utilization Review staff to reduce the numbex of service denials for not medically necessary Iadmissions. This is a three year system wide solution. HAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? Pending contract compliance IWHAT PERCENTAGE OF THIS CONTRACT IS MBENlrBE? Pending contract compliance ATTACHMENTS IBID TABULATIONS: No BY BOARD OF DIRECTORS OF THE COOK COUNTY CCHHS COO Request # 23 Page 78 of 192 BOARD APPROVAL REQUEST DATE: 5/10/2010 PRODUCT/SERVICE: Services, Orthopedic Physician I i I TYPE OF REQUEST: Renew and I VENDORISUPPLIER: Oscar Schiappa, M.D. Execute Contract Chicago, IL SELECTION OF METHODOLOGY: BID / SOLE SOURCW RFP/ PURCHASING CONSORTW COMPARABLE GOVlERNMENT BID: Sole Source ACCOUNT # 898 / 260 I FISCAL IMPACT: $460,008.00 I GRANT FUNDED AMOUNT: None CONTRACT PERIOD: $120110 - 8/19/12 I REQ#/CONTRACT# 08-41-390 JUSTIFICATION: This request is to renew the current contract for a two year period kom 8/20/10 thru 8/19/12 for the provision of orthopedic services. Dr. Schiappa has 30 years experience with the Health and Hospitals System facilities and is already credentialed by the Oak Forest Hospital Medical Staff Credentialing Committee. TERMS OF REQUEST: The original contract was authorized by the CCHHS Board on 12/5/08 in the amount of $460,008.00 Ifor a two year period fiom 8/20/08 thru 8/19/10. I HAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? Yes WHAT PERCENTAGE OF THIS CONTRACT IS MBEIWBE? Vendor is Compliant ATTACHMENTS BUD TABULATIONS: No CONTRACT COMPLIANCE MEMO: Yes BY BOARD OF DIRECTORS OF THE COOK COUNTY Request # 24 Ambulatory & Community Health Network Cermak Health Services Department of Public Health John H. Stroger, Jr. Hospital of Caok County Oak Forest Hospital Provident Hospital Rut. M. Rothstein CORE Center VJc Ering Health CARE to Your Community ik Page 79 of 192 I k THE BOARD OF COMMISSIONERS COOK COUNTY TOlln El. STROGER OmCE OF CONTRACT COMPLIANCE PRESIDENT BE'ITY IUNCOCK PERRY DIRECNIR ----- ..-, -.-. WCLW LD. KAW m ~tn WUR~VC~OL IWI net 1 18 Nmh Clork .SVcn. Ronm 1020 DCWRM 51W Ilh bk WRY 9UffREmN 1% PhL Chiwo. Illinois (KIIIM-IJOL XIAN MRlClP UUUW 11) DBL GRIGOWII 1- WII. TEL (3 12) bO.l-SSl2 JOmwo ~omg am ~rrnuam O. scwmm rm oii lrWlU RneS Olh MI. hYIIW J, RRIICA rSn &I. FAX (3 12) ljM -4547 WICRI AN# mnV GMllll 1?lh Old. May 7,2010 Ms. Leslie Duffy Senior Director Supply Chain Management 1900 West Polk Street, Suite 220 Chicago, IL 60612 Re: Contract No. 08-41-390 (Renew $460,008.00) Dear Ms. Durn: The following bid for the above referenced contract has been reviewed for compliance with the General Conditions regarding the Minority and Women Owned Business Enterprises Ordinance and has been found to be responsive to the Ordinance: Oscar Schiappa, M.B. The Office of Contract Compliance has been advlsed that no other bidders are being recommended for award. %up~mBetty Haneock Perry Contract Compliance Administrator BHP/hrtj Page 80 of 192 BOARD APPROVAL REQUEST - TYPE OF REQUEST: Award and VENDORISUPPLJER: STW Healthcare, LLC Execute Contract. . Hazel Crest, IL I I(/ SELECTION OF METHODOLOGY: LID / SOLE SOURCE/RFP/ PURCHASING CONSOR'I'IN COMPAR4BLE I I GOVERNMENT BID: Bid FISCAL IMPACT: GRANT FUNDED AMOUNT: 240,891,897,898 I260 240 - $ 110,660.00 None 893 - $ 285,250.00 897 - $1,060,780.00 898 - % 647.550.00 ( Grand Totai = $2,104,240.00 -I CONTRACT PERIOD: REQ#/CONTRACT# H09-73-015 6/18/10 - 6/17/11 REQUESTING DEPTIAFFILIATE: SPONSOR: ICOlinical Laboratory Departments, CCHHS Joanne M. Dulski, Laboratory Director, CCHHS Radiology Departments, CCHHS Dr. Bradley Langer, Chairman of Radiology, CCHHS I Johnny C. Brown, COO, Stroger Hospital IS THIS REQUEST THE LOWEST IS THIS CONTRACT BIDDERISUPPLI ER? Yes SOLE SOURCE? NO JUSTIFICATION: This contract will provide temporary stafing services for the CCHHS facilities. The contract opened for bids on April 6,2010 and the lowest bidder, STW Healthcare, LLC was the lowest qualified bidder meeting Ispecifications and responsive to the MBElWBE Ordinance. TERMS OF REQUEST: This contract is being awarded by sections (Section 1, $1,784,230; Section 11, $320,010.00) for a 12 month period from 6/18/10 thru 6/17/11 in the following manner: I _I I Section - Radiology Section I1 -Laboratory 240 - $ 75,480.00 240 - $ 35,180.00 891 - $279,650.00 891 - $ 5,600.00 897 - $809,600.00 897 - $251,180.00 898 - $619,500.00 898 - $ 28,050.00 I . .. HAS THIS BEEN REVIEWED BY CONTRACT. . COMPLIANCE? yes ATTACHMENTS COOK COUNTY Ambulatory & Community Hmlth Nctwol'li Cern~akI-lealtb Services Department of Public Health ,lohn 14. Stroger, Jr. I-lospital of Cook County Oalc Forest Hospital Provident llospital Ruth M. Kothstein CORE Center We Bring Health CARE to Your Community Page 81 of 192 MRLQN UILLINS in B~L J.R .w. SILWSTRI 9111WA. Roew ~ELP Dki, 6fflWlZ $A1@8 tM &I. . . , JERRY DUTLCR 3tll DL'I. aHNC MLEY 1llhpL +." MUAMM, PEIIMIIB 4th Bk. FoRRESI CL~YP~~L 1ah kt. I 18 Nonh Clark 9rcct. Room IMn ocearun SIM 5111 DM. URRY BWFEIIIN 13th bt. Ciiicngn. Illinois 6OW2-If 04 JOAN PhlRlCn MWMY a~!i*I. ERHQGDSLIN iet~m~. JDSEPU MaRlO hlORDYO 7tkmC TIMOTHY Ll. aHNEIDER 15m olst, ' TEL.012)603.5SIli ~WIAROTS lhh OllL APHONV J. RRNW ' . r6m Ubl. FAX (3 1.2) €03-4547 EmJPrnl MN LUODPMP~W17UI DM!. April 30, 2010 . Ms. Leslie Duffy - Senior Director Supply Chain Management 1900 West Polk Street, Suite 220 Chicago, 7L 60612 . . . . Re:- Contract No. HO9-73-015, Dear Ms. Duw: The following bid for the above referenced contract has bben revlewed for compliance with the General Conditions regarding the Minority and Women Owned Buslness Enterprises Ordinance and has been found to be responsive to the Ordinance: Bidder; STW Healthcare, LLC Section I: Bid Amount: $1,784,230.00 Section II Bid Amount: $ 320,010,OO M\WBE Status Dollar Amount -YO STW Healthcare, LLC MBE-6 $1,893,846,00 90% VG Thomas Staffing WBE-6 $ 2101394.QO(D) lO0h The Office of Contract Compliance has been advised that no other . bidders are being recommended for award. Sincerely, Contract Compliance Administrator BHP/hrtj Page 82 of 192 STAFFING, TEMPORARY RADIOLOGY AND LABORATORY FOR COOK COUNTY HEALTH & HOSPITALS SYSTEM TABULATION OF BIDS CENTRALIZED HOSPITAL PURCHASING COOK COUNTY Contract No.: H09-73-015 Requisition No.: VARIOUS B.O.Date: 4/6/20 10 BIDDER: STW MAXIM SHC SERVICE, HEALTHCARE, HEALTHCARE INC. D/B/A LLC SERVICES, INC. SUPPLEMENTAL D/EJ/A MAXIM HEALTH CARE STAFFING SOLUTIONS SECTION I: $1,784,230.00 $2, 197,710.00 $2,637,126.00 SECTION II $320,0 10.00 $382,540.00 $353,025.00 GRAND TOTAL: $2, 104,240.00 $2,580,250.00 $2,990,146.00 - - NOTE: THE FIGURE READ ALOUD AT THE BID OPENING FOR STW HEALTHCARE. LLC - SECTION I WAS $1,783.930.00. A REVIEW OF THE ARITHMETIC AND EXTENSIONS OF UIT PRICES REFLECT A BID OF $1.784.230.00 Page 83 of 192 B.OARDAPPROVAL, REQUIEST DATE: April 30,2010 PRODUCT/SERVICE: Shuttle Bus Sexvice I I I TYPE OF REQUEST: Award & I VENDORISUPPLIER: ColoniaI Coach Lines Execute contract Mt. Rospect, I. SELECTION OF METHODOLOGY: BID / SOLE SOURCE1 RFPI PURCHASING CONSORTW COMPARABLE GOVERNMENT BID: Bid ACCOUNT # 8971190 FISCAL IMPACT: $776,000.16 GRANT FUNDED AMOUNT: None I 1 / CONTRACT PERIOD: 7/22/2010 thmugh 7/21/2012 I REQ#/CONTRACT# H10-72-018 Re-bid n ' REQUESTING DEPTIAFFILIATE: ProfessionaI Affairs SPONSOR: JAIIIIKI~C Brown - John H. ~troger,Jr. Hospital COO -John & Str IS THIS REQUEST THE LOWEST JS THIS CONTRACT BIDDERtSUPPLIER? Yes SOLE SOURCE? No JUSTIFICATION: Colonial Coach Lines is the lowest qualified bidder meeting specifications and was found to be responsive to the Minority and Women Owned Business Enterprises Ordinance as determined by Contract Compliance. There was only one bidder responding to the original bid opening date. The contract was advertised on 3/1/10 and went to Re- bid on March 23,2010. TERMS OF REQUEST: This request is to award and execute Contract # H10-72-018 Re-bid for a period of 24 months from 7/22/2010 through 7/21/2012 in the amount of $776,000.16. The ariginal. contract period was awarded by the Cook County Board on 1/9/2007 for the amount of $969,381.36. HAS THIS BEEN REVIEWED BY CONTIUCT COMPLIANCE? Yes WHAT PERCENTAGE OF THE CONTRACT IS MBEIWBE? 35% IATTACHMENTS BID TABULATIONS: Yes CONTRACT COMPLIANCE MEMO: Yes CCHHS COO: BY BOARD OF Anthony Tedeschi OIRECTCRS OF THE COOK CO CCHHS CFO: Michael Ayres, Request # 26 Ambulatory & Community Health Network Cermak Health Services Department of Public Health John H. Strager, Jr. Hospital of Cook County Oak Forest Hospital Provident Hospital Rut. U Rothstein CORE Center We Bring Health CARE to Your Community Page 84 of 192 la DIN. &h DlBL tm DM. lPlL DIB. Jrn Oh rm ma- 4fh kt. l2lh w, 5th DIN. 1m orst LVIW~W. Irrmurn ~WUL-I 4 14 m Oltl. IArn oht. im Oh, ituh nkl. TEL (312) 603i5202 0th 1mh M. FAX (3 12) 0094547 1% nbt. April 27, 201-0 Ms. Leslie DuFfy Senior Director Supply Chain Management 1900 West Polk Street, Suite 220 Chicago, IL 60612 Re; Contract No, H10-72-018 ear Ms. Duffy: The following Bid for the above referenced contract: has been reviewed for compliance wRh the General Conditions regarding the Minority and Women Owned Business Enterprises Ordinance and has been found to be responsive to the Ordinance: Bidder:, Colcrniaf Coach Llnes Bid Amount: $776,000.16 J!lui!& Status Dollar Amount % Truck Tire Sales, Inc. MBE-9 $194,000.00 25% West Fuels, Inc, WBE-7 $ 77,600.00 10% The Office of Contract Compliance has been advised that no other bidders are being recommended for award, Sincerely, '"pLCo3,PT8- ncock Perry : contract compliance Administrator BHP/hrtj Page 85 of 192 SHUTTLE BUS SERVICES BETWEEN JUVENILE TEMPORARY DETENTION CENTER GARAGE AND JOHN H. STROGER,JR HOSPITAL OF COOK COUNTY FOR JOHN H. STROGER,JR. HOSPITAL OF COOK COUNTY TABULATION OF BIDS CENTRALIZED HOSPITAL PURCHASING COOK COUNTY Contract No. :HI 0-72-0 18 REBID Requisition No.:08970061 B.O. Date: 3/23/2010 BIDDER: COLONIAL COACH LINES BASE BID: $776,000.16 Page 86 of 192 BOARD APPROVAL REQUEST E DATE: 5/13/10 1 PRODUCTISERVICE: Scavenger Services, Biohazardous ri InfectiouslChernotherapy Chemical Pathological & Radiological Waste TYPE OF REQUEST: Award 61 VENDORISUPPLIER: Stericycle, Inc Lake Forest, TIL 60045 Execute Contract SELECTION OF METHODOLOGY: BID / SOLE SOURCE/ RFPI PURCHASING CONSORTIA/ COMPARABLE GOWRNMENT BID: Bid ACCOUNT # FISCAL IMPACT: $489,327.00 GR4NT FUNDED AMOUNT: None 898 / 215 CONTRACT PERIOD. 6/1l/10 thru 611W13 REQ#/CONTRACT# H09-72-068 Rebid n RJ3QUESTING DEPT/AFFILXATE: SPONSOR: SyIvia Materials Management / Oak Forest Hospital Oak Forest Hospital IS THIS REQUEST THE LOWEST IS THIS CONTRACT I BIDDERJSUPPLIER? Yes I SOLE SOURCE? No JUSTIFICATION: Stericycle, bc. is the only qualified bidder meeting specifications and was found to be responsive to the Minorily and Women Owned Business Enterprise Ordinance as determined by the Contract Compliance Administrator. The contract was advertised on March 1,2010 and went to re-bid on March 23,2010. TERMS OF REQUEST: This is a 36 month contract from 6/11/10-6/10/13. The total cost is $489,327.00 HAS THIS BEEN REVlEWED BY CONTRACT COMPLIANCE? Yes WHAT PERCENTAGE OF THIS CONTRACT IS MBEWBE? 35% ATTACHMENTS BID TABULATIONS: Yes CONTRACT COMPLIANCE MEMO: Yes , CCHHS COO: Michael Ayres, Chi Request # 27 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 Page 87 of 192 From: 1 HE EIOAPD QF C~MM~~~IC])JERB 'IPrrO K RrBWEE PRESPErn May 12,2010 Ms. kslCe DufYy Senbr Director Supply Cham pianagemekt 1900 West P~lkStreet:, Suite 220 . Chlcago, IL 6Q612 Dear Ms, Rum: The following bid Mr the above raRrenced contract: has been reviewed for mmpllance with the Goner41 Conditions reyarding the Mlnorlty and WQmen Owned Busjnsss'EnRrpr4ses Ordlnanee and has been found rn km responsive to the Ordif'tance; Bldder: ~ten'cycie,II ' Bid mount: $489,327.0U l!mB.E $&atus urh t %. Arnedcan newage Supplies, Inc HBE-6 $122,32?% 25% B & L Distributors, Inc. WE7 $48,932,70 10% The Qffltsof Contract Cornpltance has been advked.that no Other bidders sra being recommended for award. . . Sincerely, Page 88 of 192 SCAVENGER SERVICES: BlOHAZARDOUS ~CT~!C~h'l(XlE~YCHEMICAL PA THO LOGIC^ & ~IOLOGIC-aWASTE FOR OAK FOPJ3T HOSPITAL OF COOK CObNTY CEhTRALIZED HOSPITAL PURCEUSING COOK Contract No.:H09-72-068 REBID Requisition No.:08980009 B.O. Date: 31231201 0 BIDDER: STEMCYCLE, WC. I BASE BID: 9469,327.00 . . 1 I I NOTE: THE FlGURE READ ALOUD AT TEE BID OPENMG FOR SERICYCW. WC, UrAS $524.827.U0, A REVENT OF THE AIUTHhGTTC AND EXTENSEONS OF WMT PRICES REFLECT A BID OF $4 89.327.00 Page 89 of 192 BOARD APPROVAL REQUEST DATE: 4/19/10 PRODUCTISERVICE: Devices, Customized Orthotic and Prosthetic TYPE OF REQUEST: Award & VENDORJSUPPLIER: Ballert Orthopedic Chicago IL 60659 Execute Contract SELECTION OF METHODOWGY: BID / SOLE SOUIRCEI RFPI PURCHASING CONSORTW COMPARABLE GOVERNMENT BID: Bid ACCOUNT # FISCAL IMPACT: $109,911.49 GRANT FUNDED AMOUNT: None 898 / 360 CONTRACT PERIOD: 6/12/10 thru 6/11/13 I REQ#/CONTRACT#- OMP H10-72-0019 REQUESTING DEPTIAFFILIATE: SPONSOR: Sylvia Edwards, COO CB$Vd3 Physical Therapy / Oak Forest Hospital Oak Forest Hospital IS THIS REQUEST TIIE LOWEST IS THIS CONTRACT BmDER/suPPLmR? Yes SOLE SOURCE? NO I JUSTIFICATION: Ballert Orthopedic is the lowest qualified bidder meeting specif~ationsand was found to be responsive to the Minority and Women Owned Business Enterprise Ordinance as determined by the Contract Compliance Administrator. I)I TERMS OF REQUEST: This is a thirty-six (36) month contract from 6112'10 through 611Y13. The total cost is $109,911.49 IHAS THIS BEEN REVIEWED BY CONTRACT COMPLIANCE? Yes IWHAT PERCENTAGE OF THIS CONTRACT IS MSEIWBE? 35% I BID TABULATIONS: Yes II CONTRACT COMPLIANCE MEMO: Yes Request # 28 Ambulatory & Community Health Network Cermalr Health Services Department of Public Health John H. Stroger, Jr. Hospital of Cook County Oak Forest HospitaI Provident Hospital Ruth M. Rothstein CORE Center We Bring Health CARE to Your Cornunity Page 90 of 192 COOK CQUNm omcx OF CDN~ACTCUMFL~AWCE Ms. Leslie Puffy Senlor Di~&r Supply Chain Management 190D West Polk strest Suite 220 Chicago, 11,60612 . -,. . : ~~n&actNo. OMP-Y10-72-0019 he following bid for Me %bow referenced contract has been revlewd for compliance wlth the Gensral Conditions regarding the Minority and Women Owned Business Enterprises Ordinance and has been faund to be responsive to the Ordinance: Bidder: Balled Orthopedic Bld Amount: $109,911 "49 . MUbr_rT_E sE&!g. poiiq.c.,&mount Fullerton Xndt~strialSupply, Inc. MBE-9 $27,477.87(1$ 25% Meadows Office Supply WBE-8 $10,99i.l;5(1) 10% I The Office of Contrack CarnplianCe has been advised that no other blddsrs are king r%ccrrnrnendedfor award. , .-. . -.- . - -. ~jncer;.)~, ' Page 91 of 192 Page 92 of 192 Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010 ATTACHMENT #4 Page 93 of 192 CONTRACT SERVICES FOR UNFUNDED LONG TERM CARE/SHORT TERM CARE CCHHS PATIENTS FINANCE COMMITTEE JUNE 18, 2010 Page 94 of 192 Why are we doing this? In 2007 Oak Forest Hospital received a mandate from the Bureau to exit the Long Term Care business due to budgetary constraints Cost at that time was estima t ed at $50 million for Logong Term Care Services Short Term Skilled Nursing services were also discontinued at the same time 3‐year contract was entered into on August 1, 2007 with the New York Boys Club for Long Term Care and Short Term Care Services Page 95 of 192 Clinical Considerations for Selecting NuCare y Quality monitoring programs with evidence based practice including but not limited to: y Acquired Pressure ulcer monitoring (rate < 2%) y Fall Management (rate < 3%) y Multi‐drug resistant organism rate (< 1%) y Surgical site Infection rate (< 1%) y Central Line Infection rate (< 1%) y Medication Error rate (< 1%) y Note: NYBC provided only QC Monitoring Program‐No Data y High Tech Skilled Nursing price inclusive of high end medications (Daptomycin, Primaxin, Fortaz, etc.) and wound vac y In House Dialysis y Clinical Nurse evaluator available 24/7 for admissions‐NYBC did not have this service available. y Commitment to in‐house personnel for advancement through education Page 96 of 192 Operatiilonal Considerat ions for Selilecting NuCare Quality y Enables the CCHHS Board to provide the same quality STC/LTC services provided within the OFH setting to those patients admitted to contracted skilled nursing facilities Efficiency y Reduces inputs (OFH staff costs, overtime, cost of operating the facility, medication expenses, etc. ) associated with providing STC/LTC within the OFH setting y Removes discharge barriers associated with increased ALOS. The costlier alterna tive would be that patien ts would remain in the hospital until the completion of treatment without a STC/LTC contract Page 97 of 192 Operational Considerations for Selecting NuCare y Firm commitment by NuCare to accept patients with Compassionate Release from the Department of Corrections y NuCare able to accept patients with history of felony convictions (including sex offenders) y CCHHS continues to meet the STC/LTC needs of unfunded patients Page 98 of 192 VENDOR COMPARISON NU‐CARE* NEW YORK BOYS y LTC CAT 1 $152/DAY y LTC CAT 1 $193/DAY y LTC CAT 2 N/A (1) y LTC CAT 2 $433/DAY y STC CAT 1 $400/DAY y STC CAT 1 $440/DAY y STC CAT 2 $450/DAY y STC CAT 2 $750/DAY *$425.00 blended rate negotiated for all short term care Cat1 & Cat2. (1) Less than 1% would qualify for LTC CAT2 status Page 99 of 192 VENDOR COST ON ANNUAL VOLUMES TYPES OF ANNUAL NYB NU‐CARE DIFFERENCE SERVICE VOLUME Original RFP Volume LTC CAT 1 10,585 $2,038,932 $1,618,200 $420,732 LTC CAT 20 0 0 0 STC CAT 1 4,522 $994,840 $1,921,850 $90,440 *Blended rate of (2,261) [50%] $425.00 for all STC cat 1& 2 STC CAT 2 0 $1,695,750 0$678,300 (2,261) TOTAL $4,729,522 $3,540,050 $1,189,472 Page 100 of 192 Impact of the STC/LTC Program for the CCHHS Provides a Placement Facilitates Timely Alternative Patient Discharges for the Unfunded Decreases Reduces STC/LTC Improves Length of Stay Costs for CCHHS Bed within the CCHHS Flow & Availability CCHHS Page 101 of 192 .. Questions??? Page 102 of 192 Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010 ATTACHMENT #5 Page 103 of 192 COOK COUNTY HEALTH AND HOSPITALS SYSTEM ITEM III(D) JUNE 18, 2010 FINANCE COMMITTEE MEETING PROPOSED ACADEMIC AFFILIATION AGREEMENTS Begins Request Hospital Department/Division or Affiliate / on Page # Partner Affiliation Description Fiscal Impact System # Cooperative Educational Master Agreements 1 Advocate Lutheran Hospital Department of Surgery No fiscal impact System 3 2 Advocate Christ Hospital Department of Surgery No fiscal impact System 4 Program Addendums Rush University Medical 3 Center Department of Burn/Trauma $1,233,065.00 SHCC 5 Rush University Medical 4 Center Department of Psychiatry $144,056.00 SHCC 6 Community College District 5 No. 508/Malcolm X College Department of Medicine $22,500.00 SHCC 7 University of Illinois Medical Center / Metropolitan Toxicon Fellowship Program in Medical 6 Chicago Healthcare Council Toxicology No fiscal impact SHCC 8 System / 7 Advocate Christ Hospital Department of Surgery/Urology ($138,530.00) SHCC 9 West Suburban Medical 8 Center Department of Emergency Medicine ($207,000.00) SHCC 10 9 Our Lady of Resurrection Department of Emergency Medicine ($302,000.00) SHCC 11 Renewal of Program Addendums Rush University Medical 10 Center Department of Medicine $9,887,111.00 SHCC 12 Rush University Medical 11 Center Department of Surgery $4,376,321.00 SHCC 13 Rush University Medical 12 Center Department of Pediatrics $2,929,695.00 SHCC 14 Rush University Medical 13 Center Department of Medicine $2,199,926.00 SHCC 15 Page 104 of 192 COOK COUNTY HEALTH AND HOSPITALS SYSTEM ITEM III(D) JUNE 18, 2010 FINANCE COMMITTEE MEETING PROPOSED ACADEMIC AFFILIATION AGREEMENTS Begins Request Hospital Department/Division or Affiliate / on Page # Partner Affiliation Description Fiscal Impact System # Renewal of Program Addendums (continued) Rush University Medical Department of Surgery / 14 Center Cardiovascular $1,788,675.00 SHCC 16 Rush University Medical 15 Center Department of Surgery / Orthopedics $1,485,347.00 SHCC 17 McGaw Medical Center / 16 Northwestern University Department of Surgery / Orthopedics $1,045,230.00 SHCC 18 McGaw Medical Center / Department of Surgery / 17 Northwestern University Otolaryngology $840,446.00 SHCC 19 University of Illinois at 18 Chicago Department of Pathology $653,268.00 SHCC 20 McGaw Medical Center / 19 Northwestern University Department of Surgery / Urology $214,935.00 SHCC 21 McGaw Medical Center / 20 Northwestern University Department of Surgery / Neurosurgery $207,248.00 SHCC 22 Page 105 of 192 BOARD APPROVAI, REQUEST' -...,-.---p-+p--- TYPE OF RFCUKST: Advocate I.,uthi:ran IIuspitai 1775 W Dempster Park Ridge, IL 6068 -.-*--y---"s-.-".p*.F-%""*---"-.---,"- :RIOI): 07/01/10- 06/30/15 .---- '"*'~--.~~~-,~.-.",,,-,"-....~'"..".....-".%"-~-~~-~.--.-~~-~- STING DEPTJAFFI.I.IATE OR SYSTEM: and I'lanning EAxlucarion and .f RY THE ADZIOC WORKING GROUP ON MEDICAL SCHOOL Page 106 of 192 BOARD APPROVAI, KICQCEST f Depntlmat of Surgery -- ...... TYPE OF REQUEST: PAWN,EK, CITY, STATE: k(~lIOPE.RAUVE EDI.JC'ATIC>I\jN. MASTER ACREEMEN (L'EMA) X r1civcx:ite Christ Flosl~iral S11BACiKI~GMIiNT' - ACC'(~UN'l*NO. 1 'TO'TAI. 50.00 --- I CONTRACT NO. REASOIV: This Cwpcrative Education Master Agcctncnl will pl-ovide Cwk C'ounly Il~~lrh& Iltxpirals System Kesidcnts to rotate at Advtrare Christ Mdical renter and Hi)pe Ch~ldren'sHtjspital TERMS OF HFQI:EST: (INC:I,IJDE # OF FTF, WY) This CEMA rquc\t, 1410-25-077. shall he effective for' five (5) years, cornn~encingJuly 1. 2010 and ending .rune 30,201 5. lhis rcy ue\t has no fiscal in~pact. /' Terry Masan, Chief Medical offilcer I CCHtIS CUC): ...... --a Anthony 'I'edeschi, CCfitIS ...... Michael Request # 2 Page 107 of 192 HOARD APPROVAI, REQUEST Deper~rnaltcrf 13t1mi'l'mumo. -,.--*-.. . ----...... -.. ' - ?'Y 1% OF REQIJEST: P.%KTNEK,C~Y, S'TA'TE: C,'QOI'l"RATIV.G ED1ICATIONAI., MASER ACjKEEMENT (C:Ekj& i j Rush linivwsity Medic:il Cblter. j Cl',MA WNEWAI., 1725 it'. I.hrrisc.,ri ( COOIsE.RATIVEMr2S"SER FIJNT3INC; AGREEMENT :::i Chicago, n.. 000 12 PKOCft AMADDENDlTM I / RI OR SYSTEM: .JOI\; H. Stroger 'I'Tc~,i;pil;ll ...... - REASON: In iin el'fort tu improve the clinical and acknowledgement of BurnfTrauma, shall incltlde rntre than the traeiitional ,. sirrgical tippi-oach to the trauma victim and will focus on the areas of injury and violence prcventicn, emergency medical sctrviccs, and the clinical lri~umaand born services of the initial asscsslrlent and stabilimtion, ol~artiveintexvention and rehabilicatinn. The itgreement ends June 30. 201 3, This is a new program addendum no prior year information ib avai Ii TERMS OF REQUEST: (INC1,UDE #OF EwSEYCIY) 'I'hc C'FMA 04-41-730 wvas authku*i~edby the Cook County Board on 00/15/20W for a paicxl fron~07fO 1/2004 through 06130120 14. l'hc ncw prgranl ctddcndum to the C'EMA, H 10-25-073. shall be eftcutlbe for 3 ycan ci)mmenesnp cm 07/01/2010 through 06130/2013 for a total of %1,,733.065.CH). Yeat 1 - up to 6 Fl'E PCfY tiom JSfl Yea1 7, = LIPto 6 ITI'E WY from JSW Year 3 ;. up to 6 FrE PGY from JSlI E rir)l.IOC WORKING GROIJP ON hIIZDIDICALa SCH001, " ...... Request- # Page 108 of 192 13OARll APPROVAI, KEQUEST ---. ...,.,.."...- I'kpa~rnent of Ps ychiaa PART~R,C~Y, STATE: MASTER AO1tIIEMEX (CEMA) r Rtistl LJnivcr>ityMedical Cntr CEMA WNI4WAI. 1725 W. HanAison CX>OPl?RAT1VEMASTER FIJNDINCi ACiUI'iEMENT !i Ch.ia$go.li. 606 1.2 PROGRAM AlIDENDUM X MZKE Will, OF PRCIGRAM Al>UEPr'DIJAII S[JRA(jM.E$.1EN'l i '; ---.-,"..,..".~..,.-- .,....,.- ACCOZJNTNO, FISCI~I.IMP.ACT: 897-272 f'ER YEAR: Year 1 = $46.148.00 Year 2 =%47.994.0(3 l Year 3=fh4!9,9 14.00 +-"- "..-'"------* --.-"- i RI~QZJES'I'INI;lJEF1'JA FZ.'IJ,IATE C)R SYSTEM: j and the ilopanmenl of psych tat^.). I I ! --...--.--. 1, Johnny -----,"-C'. Brown. C:OO-llosplcal ~>irector/ &SON: This agrmrrlt reniaal will hefir the h-nthg and mhnncine services m psychiatry, by cxpandinZ-** patient covmage in-lhe clinic ancl antTgcncy delrritrtmeni. In addition ii pr'ovrde\ L:are to patients in the dermatology clin~cthat crettte their own skin dimhe beca~~szof their rncntal ilhlms. It dso affords us an n~lpcwtatlityto collaborate with acadetnic partner. TERMS OF REQIIEST: (IYCLIJDE # CJF I'l'li: WY)The CFMA 04-3 1-?30 was ar~tlltrrizcdby the Cook Crunty Htmcl on 06/,/15/20Wi'or a peritd Trom 07/01/2004 through 0613012014. lhis program addendum to the C'EMA, 1109-25-085. is tor 3 year perkxi commencing 0710112011) through 006/3W2013 in the anwbunl oS$144,050.00. KING GKOllP ON .MEDICAI, SCHOOL CC'IIFfS cn2C):..,..,"" Page 109 of 192 BOARD APPROVAI, REQZJES'I" C'omrnu1ldy C'ollcgc D~\tric~No 508 Malcolm X College 1900 West Van 13mcn Suet Ch~aigo,H, 6061 2 REdSON: Th~sitern was lei~ewcdB apprc)vfxl by the Director I.qnc on 12/01/2009. Msllcolrn X Ccdlege l~ssa Physician's Assistant Prtlgrm that 11h co-spc~nsol~edby Johtl H. Stroger Ib5pital. Our rde in their program kar, traditrondlly ken to provide clrn~calrdiitrons :+rid claumm uistructcrs. Annzl;tlly, a line item In PEK's budget is approved to pay gueu lcctura-\ tor their prepara~iuntlnie (one hour of preparation allotted for every hour of instructrcm). TISRMS OF REQUEST: (INCLUDE # OF &TEWY) This request ia to enter lrito and execute an Acadsmic hftili;it~ott~'This ageemen1 shall be effcciivc comrnenang on 11/01/200Whri~~gh1)9/.30/201 3, 'fie fiscal impdct 1s S57fhaur for prepardtion time for lecturcs provltful, tlot to exceed the amount budgeted 111 PER (BU 8970288 - line 521050). Page 110 of 192 BOARD APPKOVAId REQUEST -- Plannolg. Education and Resea1c.h ".-- TYI'K 01:REQUEST: PARTXEH, CITY, STATE: C'OOI~I!HdYl'IVkEDTK:ATIONAI- MAS?'ER AGREFMENT (CIUMA) i ^ IJnivers~tjof Ill Medical Center CkMA KFNEWAI, 1710 W. Taylor St COOPERATIVE MASTER FIJNDINCi AC~KEEMENT C'hici~go,I11 60612 PRCIGRAM i\L>DlNI)IM m SI JBAC;RI I....-"*J~j_o~ll~yc'. ~rclwn, C'CX). ~trcye- REASON: hrlen~ora~~durnof Agreement i~tweenStroger IIospltal and the Board of 'li-uste.cs-c3"the Un~versltyof Illit~nisand the hletropolitan Chicago Wealthcare Council to sponsor ahedical toxicology fellllowshrp nnd educational program. 'I'he fIosp~talIS ~zquchtingto rcnew the Toxikon agreement for 5 ycius. 'I'he Toxikon Felloicship Yrogrm in Medical Toxicdogy shall he r~ognircllas a Fe1lowsh~pRogrram bponsorerl by the C:aunty through Suogw klt-~tupitalof Cmk Caur~tyas wh~chis aftillatcd with the IJn~vzt'srtyctf Ill~nois~ind the Illino~sPoison ('enter. Residents in Toxicology Pr-ogl'ams afiliilted with the Tovikon consrntlum will ccmtitiue to utlli7e the Il11n~vsHealth and Hospital Sybtems for the Clinical component of thew respective prc>gr,lrr?c TERMS OF REQUEST: (INCLIYDE # OF WEPGY) The ('EMA !J1ii11 be effective for threc (5) years, comn~encingJuly I, 2009 and ending Junc 30, 2013. The Toxikon Fellowship Progrim i\ a Cliriical Toxicology Itatation l'rogran~which provides for training of physicidns in the field of toxicology. A fellow IS a phy\icinn who participates in such a progrim and s rotator is a temporary trainee in the WORKING GKOZIP ON MEDICAI, SCHOOL """ C.Cll1iS coo:- .,,. .. .. Anttio~iyTedcschi, Page 111 of 192 i De rux~tlz?cnt td Sur rervlUr~~l~y - " ""- % * -"-" PARlVEW, CITY, STATE: I COOl'EKi\TIVE 13L)1K'BTIONAId MASTER ACiRI:I*,ME1N'Is iC'f3hfii) Advwate i'twist Ibsp~tal TEMP. Kl-,NC WAI . 4440 W Y5Ih Swcet, 182 South 1 1 CC~OPEILYIIVEMASTER FI 1NDlNO AOKFEMRN'I Oak Lawn. II. 60353 ' / PROGRAM AII1IENDU.M X -‘I"--- .--..----".-,,.."...... , ...,...... +..,.,,',,...... --- --',..."" ,.,, , ,,.." ,,., ~",.--."~-.------j TOTAL, ($1 38.530.00) / CONTRACTPERIOD: 07~lll0x~i.3 I CONTR,kC:T NO. =-*" ---" -"-- REQUESTING DEM'JAF W'I'IIIIS ;mdrhc Lkpart1.11ent -1 3. Johnny C. ~ro\vn,._/d~> ...... ,,,'..-..",.<.,"- REASON: Program Addendum to Coopel-ativeEducarional hMastcr tlgreemeni hjr Rotaions of system Urology Kcsidents to Advocate Chris1 Medical Center and Hope C:hildren's Hospital and John ti, Stt'oger, Jr, Hospital of Cook County TERMS OF REQITES'r: (lNC~ldtrDE# OF lWB PGY) The CEMA ClEMA request, HI0-25-077, shall be effective fbr five (5) years, cmunet~cingJuly 1.2010 and ending Junc 30,2015. The original program addendum to the CEMA. 1111)-25-078, shall bc effective for thee ((3) year\ commencing July 1,20 10. and ending June 30,201 3. This 1s a revenue generating contract wh~chthe anticlpatd rehiilt will be 1E; 138,530.00. G'CIIIIS CMO: - - ('CNIIS COO: __. Anthony Todeshi, CCf-IIISCEO:-- Request # William T. Fdcy, U. 7 Page 112 of 192 BOARD APPROVAL REQUEST b---....----." ".".-- "" ""."*- ,. , TYPE OF REQUEST: CITY, STATE: C00WkA'l'IVE EDUCA'I.IONAI. MASTER AGREEMEN1 (CIMA) CEMA REhTWAI. est Suburbnn Mcdical Center C~K)PEKATIVUMAS"1'Eli f:UNL)INCi :\GRiiEMENT i 1 B-~eC'ourt (Erie at Austin) ' PROGRAM .4l)DENllilM El ak Park, lllinola 60302 SVSAGRkEMEN'r i ACCOUN'K KO. 897-~(JO PF;K YEAR = 15207,M10.001 NO. k110-25-073 The Department of Emergency Mcdicinc John O'Brien M.D. ---..".-"....--.-,..*.'.,. -...... ,...... ~...--~*, ...... ,~'-,..,"-"---".-*''." REASON: John Stroger Jr Hospital Emupency Medicine residents to rotate at West suburban Medicill Cefita in the department ofEmergency Mtxlicine lo provide the Enlefgmeq Mcrtlicine Re,irlenth with Cornsvlmity Hospital Emtl'gcncy Depa~zn~a~t Educational Bxpcrience. TERMS OF RIEQLrEST: (INCT,UIIR # OF FTE PGY) ?'he CFMA 06-41-564 was authcrri~cclby the C:c~]k Cotlntj Board on 0~10617,OC)(>fw a pericxl t'rom 07K111"h through 00/30/2016. The Program Addendum. W 10-25-073. sl~~llIx effecti~r fils three (3) years, con~rntncingduly 1, 2010 dlrcagh June 313, 201 3. Ishisis a revenue generatrng coritracl which the arlticipitted reult will be $207,004.00 over the 3 year petitd. 15 18 PGY-3 Residents BY TIIE ADMOC! WORKIKG CROUP ON MEDICAL SCIICXX RELATIONSHIPS? , CCI1IIS <:00:" _" Anthony Tedeschi, CCHHS CEO: William T, Foley, Chief Executive Office Request # Page 113 of 192 Boaar, APPROVAL KEQUEST / Emergency Modicine I --"",-... "..,-""",."-"""--- /~.YPEF-UEST: I PARTNER, CITY, STATE: . COI)PEK;\'I'IVE BD17CrZTIONAl., MASTER AGREEMENT (CEMA) ; CEMA RENEWAL Our Lady of Kesurrec-lion CIO(.)PEKA"I"IVEMASTER. 1TJNl:IING AGRE,EW,NT :' : 7135 N. Talcotl I PROGlZt%.?dADL3ENL)UM Id C'tricago,- Il lino~s6063 1 A,":,"G,"CFNT i 1 ..-""-~w ...... ----- I FISCAI. IMPACT: 0 '1 0'1'AI. 1%302,01X).00) - CONTRACT PERIOD: 711 01201 0 - W30120 13 CONTRACT NO. HI 0-25-0?0 C.'hain~lan.Planning. ~duatioP1&Reseasch Johnny C. Brown ,.)( KbiASON: Tlt15addendnrn ail1 provide John Stroger Jr. Ibspital Etncrgc~~c)Mdic~ne Resicicnts (EMR)to sotatr: at C)tu Lady of Resurs~tionin the Dcpxt~i~cntof Emcrpency Mediclne to provide the EMlt's iwth exposure to cornmunit) hospital emergency tned~cinewith spcciitl empJ~trsisplacd on zall resuscitation performed in Lhe emergency departnlent . TERMS OF REQUEST: (1NCLUL)E # OF F1'E PGY) 'I'hrl YI.~~gr;imiA(1Je11durft \hall be effectrve for three (3) ycura, commencing July 1, 2010 and entling June 30, 2013. This is a rebcnue palerating contract wh~chT~IC antlcipnted re5~1ltwrll h$302,000.00 over the 3 yew period. ADHOC WORKING C'KOUP ON blF~:UIC:Al, SCZ.IOOL ...... " ...."- CCHIIS CEO: Request # William T. Foleg, Chief Executive CJfIl~et 9 Page 114 of 192 BOARD A I'PHOVAI, REQUEST D~pmttnentol' Medicine TY YE 01' KEQIJEST : PARTNER, CITY, STATE: C:C)Of'l:.RtYl'lVE OL)IJCA?'IONAL MASTER /\QmEMGN'r(CfiMA) c-: Rush IJnivessity Medicat Cnt.r. CEMA RI2NEW AI.. 1725 W. 1.rarrison COOPERA4T1V13MASTER I':IINDINO ACiREEklliNT i; Chicago, E 60612 PRCE RAM ADDEN l'SllM i ': REN1'.WAL4 O'F PKCKiRAM zZDL)~~NI)~IM@ FISCAL IMPACT: 897-272 PER YEAR: Year 1 = $3.190.809.W / Year 2. = ,83.294,020,00 Year 3 = $3,396,282.00 '~0l'i\~=$0,887.1 11 .00 -- ---.. - *-"- CONTHAC1' PERIOD: 7/1/2010-6/30/2013 CONTRACT %O. -~~."...".'--.,"--"~ ' REASON: This aprccmcnt renewal will benefit the hospital stlpplcrncnting and enhancing scr-vices in cardiology, Endocrinology, Ciasuoenterolagy, Hernatobgy/OncoI~)gy.Infectious Disease, CORE center operatiorrs, Neurology. Pulrnonxy/C.:riticaI C!we, Rheumittology, Nephrology, and Lkrmatology. It allows the ht~pitl~lto hire fiiculty in specialties as well as bcnetit ti.om the services of fellows and residents it] the specialties in patietlt cui: and educat ioii . It also aflbrds 11s an ctpp)rtunil:y to tol laboi.ate with rtrrdemic parmer, Ttlz $883K inc~easewas due to thi: addition of the faculty physiciao sub agreement of $784K and on6 addition;ll I .O fTE nephrdogist. TERMS OF REQZIES'I': tINCI,III>E # OF kTE PGY) 'I'hr: (1EMA 04-41-730 was null~orizctlby thc C'mk rounty Board on OQl/lY2004for a paidfi'om 07/01/2004 throt~gh0(1/30/2013. 'The original program addendum to the CEMA. 1109-25-008, was :iulhu'ijlai by the C'C'HNS Board un 6/26/09 for 1 year from 07/01/200)9 through 06/30/2010 in the amount of S2,41 I ,I49.00 1 I .I) Fry KiY fi.oni I'Zuah 6.3 FTE Attendings from Rush 8.1 FI'E Ancillary staff Froin Rpsh d WAS TIlIS RFQC'EST d BY TIIH AI)IIOC WORKING GROUP ON MEDICAL SCIlOOL Terry Mason, Chief Medical Page 115 of 192 -- -- BOARD APPROVAL REQUES'I' Department of Surgery -- ."-a -" .----- TY PE OF R~~:.~~UI*:ST: PARTNER,CITY, STATE: C'OC)PE:KIITIVE EDTX'ATIONAL MASTER AGREEMENT (CEMA) -3 Rush Ilniveislrj Medical <:entt.r CEMA RENEWAL 1725 W. Harrison COOPERATIVE MASTER FLNDlNG AGREEMENT i Ch r c;lgo. 11 -6061 2 PROGRAM AUDENI>LIM RI",NEWAI, OF PR0GRrLh;l ADDENDUM @ SIJBAC'rRlZIJMENT 1 -"."" -"---- -* - - ". "" ACUOCJNT NO. FISC'AI, IMPACT: $97-272 PER YEAR: Yew l = 5 1,401,04fi.OCt Year 2 =51,458,015600 Ye*at,?r3=% 1,s L 6,147.OQ CONTRACT ~~iiiijb31112o1~-6/30j2013 CONTRACT NO, HOff-25-011 i and the Department of Sur i wa, COO Suttger ~crs~~talj ---- "- "--" - REASON: 'This agreement renewal will benefit thehospital by maintaining an integrated residency program in General Surgaq and Clin~calhffemveness Propam oTRush IJnirersi~Mcd~cal Cmta. These programs provide purt graduate education and quality ~rnprobcrncntbuppart for inpattent and outpatient primary care throughout the system. It also affords US w oppclrtunlty to oc~ilnhaale wlh ;in academic partna. This agreement supplements and enhances lhs required clinical serv~ccsprovlded to the hosprt,il'\ patients by subspccialist, we would not otherwise be iiblc to recrult TEKhIS OF REQIIES'T: (INCI-UDE fl: OF FTE PGY): The C:liMA 04-41-730was authorized by the Cwk Cmlit~tyRoard on 06/15/04 for a period Ron1 7/1/04 - 6/3WT4. 'The origitlal plogratn adda~dumto the CZEMA. H09-25-011, was suthcx+izcdby UCIIIIS Roard on 6/26/09 for ;I I year ftcnn 7/1/09 -- 1d.30110 in the amount of $2,300,062.00, 2 1.5 FTF, (;en Surg Residents * 0.5 ETE Ge~~~ri~rsl~~~di~ 0.2 I,ivzr Surgeon 0.5 Breast Surgeon I: / WAS THIS REQL~ES~REVIEWEDfill THE AIIIIOC j+'ClRKTNG GROUP Terrv Masnil. Chief l Officer 1 CCIIHS COO:-,q,,.,,,., Anthony Tedeschi, Request # IWilliam % Fuley, Chief Eacutive Ofim 4f 11 Page 116 of 192 -- BOARD APPROVAL REQUEST Rush IJniversity Med.icaI Center 1725 W. Iiat-rison FEJ'NDlNG AGREEMENT r ; Chicago, 8.606 1 2 1 i i ..I' KO. I100-25-027 ! i I j I I I 1 ! to medical education, research and clinical progmms. This will benefit the hospital by permitting Xth parties to deliver clu;ility ; care wile reduc4np costs and itnplavit~gefficiency. l'hepediatric addendum is $61K csver the prior year run rate. The incralse is ;trtrii~uredto the addition of' one A.llt~gyFellow to rhe ildderldum. TERMS OF R.;QUEW: (INCLIJDE # OF FfE KY) The CEMA 04-4 1-730 was authorized by the Cook County Board an (If)/,11512004 for ;I peri(xl f~orn07/0 112004 through 06/30/2014. ?Ae original pro yarn addendum to the CEMA, H09-25-02?, was anthtui~xtiby CC.THX-IS Botlrd on OW2fJ2009 for 1 yea' from 07/0112009 through 06/30/20 10 in fie anloun t of $9 I5,WO.M). 0.4 FF,Administrative Support 3.5 FI'E Attending Support to varbus Divisi i 1.0 lZCY5Allergy Fellow i CCHHS CMO:...--,.. i Terry Muon, Chie CCHHS COO: .. . Anthony Tcdeschi, I 4i Page 117 of 192 BCJARD APPROVAL REQUEST -m< "" - -- -"- -. ---- De a~%rn_e"fofM@igine -" " """*.-- TYPE OF RE~"~ST: PARTNER, CITY, STATE: C00PEKrZ'I'lVE EI)IX'ATIONA12 MASTER AGREEMEN?' (CEM A) Rush IJntberGty Medical C'ntr iCkMA RENEWAL, i)'1725 W. Han iron PEW YEAR: Year I =: 92,199,(326.00 Year 2 =O Yea 3=O 'l"C)TAI,=$2,1r)9,920.00 REQ NO. REASON: Thi\ agmncnt rcnewsl \bill henc'iit thc cst~nutcullo() .IS11 p;~tieneswho will require qxc1ali7edelectrophy\iology studies tor 11 t'i-thtcari.,r\ing atshqthrn~asevery yeis.. These procedures rerluirc spcc~al~~wilalxwatury pcsh{)nnel, and subspcclal~zd phys~c~anbcrvic.e> (requintrg ~pwilichuhspec~alty btji~d certificarion), Our patrents will be transferred to Rush for the prtdurc. TERMS OF REQIJES'l': (IN<.'l,lil)E #OF Fl'E PGY) ------ " - " " - """ "- P Request # 13 Page 118 of 192 BOAR11 APPROVAL MQCESTBOARD APPROVAL REQUEST ] ~p;lrrrnefi~~~f~ay/C'ardiovasculu 1 PARTNER, CITY, STATE: Rush I rniverhity Medical C'ntr CEMA RENEWAL 1725 W. ITarrison (.00PI:RhT1Vt: MASTCK PLINWNC. AGREEMENT I Chic;igo, 11,606 IS, PKOGItAM AUI)fiN DIJM 3 I RENEW AT., 01:'PKOCilZAM AT~l:l:f~S.N1)11&J1.1 SUBAGR.EEME3T ! ACCOtlNT NO, PlIK YEiZK: Year 1 = 65'79,5 18.00 Year 2 =$50(,,005.00 Year 3=S613,152.00 Johnny C. Brown, COO, Stroger Ho2itakJt I ----*-m '."--. REASON: 'Ihis Promam hddei~durnwill ci~mhinethe acdcmic and clinical re~ou~cesof the Kush l!nivcrsity Medical Collqe & Mcdical C'enter with tho cducat~onaland training experience of Strops Hospiti~lof Cook County. This agreement supplements and enhances the requ~redclll~rciil serklces provided to the hospltal'c patients by sub-s;peciaiisr we would not otherwise bc able ro rsruil. TERTklS OF RICQIJEST: (INCLUDE # OF FTE PGY) ?'he (BMA 05-41 -730 was ;luthorizrd by the E'cxtk Clrrunty Board cm 06/15/7001 fur a perird from 0510 1/2W thrcluglt M~/.1012013. Tt~eoriginal pri~gritmaddendum to the CEMA. HQ9-25-025,was authorrzed by C-CIllI.IS Board tm 06/26/2008 for I year from 07/01/2009 tl~rouphO6/30/2010 in the amount of $528.236.00. I PC;Y6 iTE C*wd~othoracicKesidznts 1 PGY5 FTE Cwcl~othoracicKoldcnt 2 FIX Physician Assistants 0.5 PSE Viisr:\~l;irSurgeon 0.1 C 'wd~acSurgeijn KING C';ROIJP ON MEDICAX.. SCHOCIL, WELtlTlONSfl CCMHS CMO:....,...... Terry Mason, Chief Request # 'I: William Foley, Chief Executive Clffticcr 14 Page 119 of 192 BOARD APPROVAI, REQUPST Dztn~entof Surgerylfhaopedrcs -- PARTNER, CU". STATE: ('OOPERA'KIVE EC)LIC:ATJO&AJ1 MASTER AGREEMENT (CEMA) - Rush Universit> Medical Czritet CFMA RENEWAL 1725 W. 1I;lrrisotl C'OOPI OR SYSTEM: John and the Departmenr of Surgery ------bohng C.~rttwn, !EASON: mi$Program Addendum will combine ihe acakrnic and clinical rcw)sucs;?ihe Rush IJniverrity f hledlcal Collcgc and Mcdicai ('cntcr with the educational and tratr~ingexperience of Stroger Ibspital crf' C'ook C:oun~).'i'hls agreement supplements and cnhanccs thc rqu~rodclinical services provided to the hospital's patient\ by subaptrc.iallbl, wc &odd not othawse bc able to r0cm11t.Thc IS136Kincrease owthe prim yeas run rate is a~trlbutedto the add~tlonof 2 additional PA'S. TERMS OF REQUEST: (INC1,lJDE # OF FTE PGY) 'The CEMA autha-i~dby the Cook <:ot~ntyBoard on Old1 5/04 for a pcriud from 7/1/04 thru 6/30/12 thc cx-~gi~alprogram adde~~dutnto the CEMA was authorif.et1. by the CCHHS Boiisd on 7/16/09 for a 1 year pericd 7/1/09 -6/3(UiO in the amount of $358,807.00. I PCiY 2 Fi'E Ik ttiopedic Rexidetlts I P(;Y 2 1:l'f.i Chd~opedicKesidalts 2 PGY4 Y I'E Orthi~pcd~c1 Request # Willianr T. Foley, Chief Exccutivc Off~cer 15 Page 120 of 192 BOARD A PPROV:II, REQUES'I' -- I Department ofSur.pr~"Lt,dO~~,egcs 1 PARTNER, CITY, STATE: CO~IPEKtZ'I'IVt",El>llCATIONAL MAS7'T?,R AGREEMENI'(CXMA'r i i McC;aw Medical C:enter /NU CEMAIENBWAL 645 N. Michigu~Aye, Suite 1058A : CCX'jPERrZ'l'IVE M AS'T'KR RINDING AGMiEMENT i ' C:hicago, 11, 6061. 1 PROGRAM' A1):T"ENDIJM I REPU'EWA%OE.PRO(3KhM ADDENDM X S[,JBAGRIZEMBMr (: ." -*--, -...... - ...... -.me-""- ACCOIINT NO. FISCAI, IMPACT: 897-272 PER.YEAU Year 1 = $334.838,00 'Ifear 2 =$348,23 1.00 Ycrir -3=$3(,2,161.00 -.".- ...... - ...... -...... TOTAI..=fE1,035.230.00 - 7/1/2010-6/3W2013 -----I- CONTRACT NO. I.109-25-078 L-YY.. "- *-"*,.".- ', REQUESTXFU'G L)KFI-I'JAFIGLIATE0R'mohn H. i and the I3epiutmenl of Surgery Jr~hnO'Arien, M.D. 1 Chainnim, Planriing. ,-...... -. iE1!m~;GEarn Addendun, wili-carnbine the iicadcn~icsnti'clirricai resources cof the McCiaw Medical Center of Nortl~westcmUniversity with the tducatictnal and c.rainirrg erxpc~ienceof Straga. tkospital of Cook County. 'This agrecrnetlt supplen~entsand enh;x.nces the required clinical services provided tn the hospital's patients by subspecialist. we ivo~rldncir otherwise. lx: able lo recruit. TERMS OF KKQUEST: (INCI,UI)E # OF kTE K;Y) The C'IiMA 06-11 -501 was autho~.~/dby rlie C:cxjk C'ounty Boiird on Oi,/C)6/2006 for a period Frotll 07/01/2006 through ON3CJ/Zllb. Tt~coriginal progriim addendurn to the CXMA, 1109-25-078, was ituthari~dby ("'C:HHS Board on 06/26/2009 for I year from 0710 1/?009 through 06f30/2010 in the iunount of $49 1,2 15.(X). ADHOC WORKING GROUP OK MEDICAI.. SCHOOL ...... ...... -...I -.-..-...... Page 121 of 192 ...... _____ c:ook (~ount' llt.lalth & llospitals s, stenl AS AMENDED BOARI> A"PPROV AL REQUEST DATE: 5/24/2010 HOSPITAL DEPARTMENT/DIVISION: t-;;;~;:;-;~=-;;:-;;;:;;::-;::=------+--=:..:::.c:a:.:.rt::::.n:.:::1e:::.:n.::..t~of Surg~,2~Q!~.!!!I"-vn~u,_o_lo""")"'"---fll TYPI: OF REQUEST: PARTNJ-:R, CJTY, STA T.E: COOPERATIVE EDlJC ATIONAL MASTER AGREEMENT {CEMA) McGaw Medical Center /NU CEMA RENEWAL 645 N. Michigan Ave. Suite 1058A COOPERATIVE MASTER FUNDING AGREEMENT 11 Chicago. IL 60611 PR SUBAGREEMENT' r j ACCOUNT NO. FISCAL ll\1PACT: 897-272 PF:R YEAR: Year l = $269,236.00 Year 2::::$280,005.00 Year 3=$291.205.00 TOTAL=$840.446.00 CONTRACT PERIOD: 7/1/2010-6/30/2013 CONTRACT NO. ll99 2S 014 810-25-185 RF~QUfi:STING DEPTJAFFILIATE OR SYSTEM: John H. Srroger Hospital SPONSOR NAME, T~TJ .. ~: _ and the Department of Surgery John O'Brien, M.D. VV'J., ~) Chairman, p·lanning, EducaTI\m 8?R~search ------·-- Johnn 'C Brown, COO, St!oger Hos itaL ) REASON: This Program Addendum will combine the academic and clinical resources of the McGaw Medical Center of Northwestern ·university with the educational and training experience of Strogcr Hospital of C.-0ok County. This agreement supplements and enhances the required clinical services provided to the hospital's patients by subspecialist. we would not otherwise be abk~ to recruit TER~lS OF REQUEST: (INCLUDE# OF FTE PGY) The CEMA 05-43-527 was authorized by t.he Cook County Board on 03/0I/2005 for a period from 07/01/2005 through 06/30/2012. The original program addendum to the CEMA. H09-25-074, was authorized by CCHHS Board on 06/26/2009 for 1 year from 07/01/2009 through 06/30/2010 in the amount of $2 L0.584.00. 1 PGY2 FfE ENT Resident lPGY3 FTE ENT Resident 1PGY4 FTE ENT Resident lPf1Y5 FTE ENT Resident Y TJU: ADHOC WORKING GROUP ON MEDICAL SCHOOl_, APPROVED 'f JUN 2 5 2010 BY BOARD OF DIRECTORS OF THE COOK COUNTY HEALTH AND HOSPITALS SYSTEM Request# 17 BOARD APPROVAI, REQ'C'ES'I' ---.-...... ,,."...- ---.-...... ,,."...- Patho1c)gy -- TY YE OF REQUEST: CCX)PERATIVE EDIJ(:ATIONAXd MASTER AGREEW,Wr (C'EMA) i I LJniversiw of' Illinois at ChicanoL C'I'MA RENEWAI 1740 w faylot C'CXIPEHIYI'IVB MASTER FUNDING ACrREEhfiW ' I Chicago, IL 60612 PROCiRAM A1lllf:Nl)liM ,' RENEWAI, (11: PROGRAM Al>DENDZThrl@ StJBAGKEEMEN'T "-$ -- -""-- 4C'C'Ol.INT NO. / FISCAL 1M PACT: PER YI7rZR: Year 1 = $320,229.00 Year 2 ==%333.039.00 ] ~t~r~r,=s6~:3,2(~8.~.-..--." --..."-.--. -- CONTRACT PERIOD: 7/1./210-6/30/1012 I RE0 NO. REQEESTING DE~JAFFILIATEOR SYSTEMI SPONSOR NAME, John I-I. SWoger kfospi tal and the 'I>qxapmrmrd Patkobgy John. O'Rrien Chairman Planning, Ilesearch Johnny C. 13rown,~@' 1 COO Hospital ~irecttir REASON: 7'11is agreement. renewal will ccnibine the Surgical Rtttolqy fellows at PJ'IC: to rotate at ISFI. 'l'hey will provide valuable clinical services in 3 very busy department, as they have finished pathology residencies already. dS1.3 provides salary support for the clinical activities of four FTE fellows who rotate at J'S13 at: all times. TERMS OF REQUEST: (INCLUDE Ji OF FTE W) The CEMA 05-43-527 was authurixed by the Cook County Board crn 03/01/2005 f(rr a perltd froin b7/01/3005 thtough 06/,/?0/2011.'IAe ori@tial progrum addendum to the CEXlA, H09-25 M4, has ~uthori~c~fby CCiitlS Buasd on OfEM2009 for 1 year horn 07/01/2009 through 06/30/2010 in tllr amount df $320,229.00. WAS THIS BY TIiE AIJIIOC WORKING (;KOUP ON MEDZCAI, SCHOOI, REIdilTIONSN CC:IilIS CMO: 'I'erry Mason, Chi CCHIIS COO: Anthony Tedeschi, ~~iief~per*aTG$Ofdcer Page 123 of 192 BOARD AYPROVAI, REQUEST McGaw Medical ~cnterlNI.T W5 N. Michigan Avc.. Suite IOSXPI Chicago, lI, 6061 1 .---- .---- Year 1 = %68,854.C)O Year 2 = S71,60X.(W Year 3= $74,473.00 'I"C1TAL=%214,935.00 ...... "",-,-" ...... 1 ---" .--..--,,-,.-,-*---. -. CONTRACT PEK1O.E): 7/1/2010-hl'30/2013 REQ NO. 1109-25-0'76 REASON: 'Phi\ I.'rog;~mAddendurn will combine the academ~cand clinical resources of the M~~Ciawh.lzdical Center of h'mthwestern Unlvers1t-j wit13 thc dueiticmiil and training exymrcnce of Strogcr Musp~talof Cook County. fh~sagreement sugpternents and eiihances the requued clirllcal saiices p~ov~dedlo tho husp~td'spatient5 by sub-specialist, we would nd otlierwiw be iible to rcc~uit. Tl'lRMS 01; REQUEST: (INCLUDE # OF FTE PGY) IleCII!MA 06-4 1-561 was authwc/txi by {he Ct~kcounty Uo'ud on O#06/200(, for a period from 07-01-2006 through 06/30/201Ct. The origu'tal Progrcim Addendum to the C:I!MA, WOO-25-076. was authaved by the C'CMIS Board on 06/26/2009 for 1 year &om 07/01/200 through OCJ'30/2010 111 the amount of'$71,979.00 \VAS TlIIS KEQUES'I' RE PIEWRD BY THK AI3IIOC WORKMG CROUP ON MEDIQAI, SCHWI* Terry ma sot^, Chief Medical ?fficer (XI1HS COO: --- Anthony Tedcschi Request # 19 Page 124 of 192 BOARD APPROV.41, REQUEST Depel~ment of' S~cryNeurasurgery -" -" - "W . -- TYPE OF REQUEST: PARTNER, CITY, STATE: COOPERATIVE kDI JCATIONAI,MASTf :R ACiREEMI3WI"(CEMA) Mcli;tw hldical C'ctntc~'of Norttiwestcr~~ ('EMtZ KE;.NEWAIZI, I.lnivc.rsity COOPERAl'lVE MASTER FIJNDINU AC3llt;EMENT 045 N Michigan Are., Ste 1058-A PROGRAM ADDENDUM ' ' Chicago, 1Id 6061 1 SlJI3i2GRI:f:MBIu"I "- " " "- ---" - AGCOUXT NO. FISCAL IMPACT: I'EK YEAR: Ycar 1 - $101.592.00 Year 2 =%105,056.00 Year 3=50 -,". -". *" ."< """". I CONTRACT NO. HOB-25-075 *,..*" "-- John II. Stroger NOS~~;~ and thc I3epartrnent of' Surgery Joht~O'Rrien, M.D. Chainnan. Plann~ng.Faiucation & ..--me WASOh': Thts Propam Atidendurn will combine the warfemlc mtl clinical resources of the McGaw Med~calC:enla uf Northwestern University with the ~tciucationiiland tratning experience of Stroger Ilospltal of Ccmk Co~lnly,This agreement supplc~nentsand enhiinces tile reclilired clinical services protideti to the hcrsp~tnl's patients by aubspecialist, we would not otherwise ht: able to recrurt. TERMS OF REQlJES'T: (IJVCLUDE #OF FTE WY) The C'LMA 06-31-561 was 'tuthorized by the Cook County Board on Ot306/2006 for a pa~txifrom 0?/01/400b throu2.h 000/30/3016. The originai program addendum to the C't. Mil, H09-25-075, was authoriztrl by CCEIIiS Board on 06/26/2000 fix I year lion1 07/01/2000 through 0(1/30/2010 In the atnilunt of $137.58 I .oo. * I .O PGYJ FTE Neurosurgery Residetlts WAS 1'HIS REQU WORKJNC; GRO'L'P ON MEDICAL SCNOOI. REI2Arl'IUNSIIIPS Page 125 of 192 Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010 ATTACHMENT #6 Page 126 of 192 COOK COUNTY HEALTH AND HOSPITALS SYSTEM ITEM III(F) JUNE 18, 2010 FINANCE COMMITTEE MEETING SUPPLEMENTAL PROPOSED ACADEMIC AFFILIATION AGREEMENTS Begins Request Hospital Department/Division or Affiliate / on Page # Partner Affiliation Description Fiscal Impact System # Cooperative Educational Master Agreement University of Chicago 21 Hospitals Department of Medical Education No fiscal impact SHCC 2 Renewal of Program Addendums Rush University Medical 22 Center Department of Medicine $1,140,099.00 SHCC 3 University of Illinois at 23 Chicago Department of Medicine $308,221.00 SHCC 4 Page 127 of 192 BOARD APPROVAL REQUEST DATE:5/24/2010 I HOSPITAL DEPARTMENTDIVISION: Department of Medical Education TYPE OF REQUEST: PARTNER, CITY, STATE: COOPERATIVE EDUCATIONAL MASTER AGREEMENT (CEMA) University of Chicago Hospitals CEMA RENEWAL 5841 S Maryland COOPERATIVE MASTER FUNDING AGREEMENT Chicago, IL-60637 PROGRAM ADDENDUM 1 RENEWAL OF PROGRAM ADDENDUM SUBAGREEMENT ACCOUNT NO. FISCAL IMPACT: 1 897-272 ( PER YEAR: $0.00 TOTAL=$O.OO CONTRACT PERIOD:7/1/210-6/30/2015 CONTRACT NO. H10-25-084 REQUESTING DEPTJAFFILIATE OR SYSTEM:John H. Stroger Haspital SPONSOR and the Department of Planning, Education and Research John O'Brien REASON: This CEMA renewal allows agreements for JSH residents to rotate to University of Chicago Hospitals and for University of Chicago residents to rotate at JSH. This item was Reviewed & Approved by the States Attorney as well as by Director Lyne (on 3/12/10). It also affords us an opportunity to collaborate with academic partner. TERMS OF REQUEST: (INCLUDE # OF FTE PGY) This CEMA request, H10-25-084, shall be effective for five (5) years, commencing July 1, 2010 and ending June 30,2015. This request has no fiscal impact. WAS THIS REQUEST REVIEWED BY THE ADHOC WORKING GROUP ON MEDICAL SCHOOL RELATIONSHIPS? on 3/12/10 CCHHS CMO: I Terry Mason, chief ~edicakfficer CCHHS COO: Anthony Tedeschi, Chief operang Officer CCHHS CEO: William T. Foley, C Request # 21 Page 128 of 192 BOARD APPROVAL REOUEST- AS AMENDED I Department of Medicine TYPE OF REQUEST: ( PARTNER, CITY, STATE: COOPERATIVE EDUCATIONAL MASTER AGREEMENT (CEMA) Rush University Medical Cntr CEMA RENEWAL 1725 W. Harrison COOPERATIVE MASTER FUNDING AGREEMENT Chicago, IL 60612 PROGRAM ADDENDUM RENEWAL OF PROGRAM ADDENDLM X SUBAGREEMENT ACCOUNT NO. 1 FISCAL IMPACT: PER YEAR: Year 1 = $418,233.00 Year 2 =$356,542.00 Year 3=$365,324.00 TOTAL=$1,140,099.00 I CONTRACT PERIOD:7/1/210-6/30/2013 ) REQ NO. H09-25-010 REQUESTING DEPTJAFFILIATE OR SYSTEM:John H. Stroger Hospital SPONSOR NAME, T1TLE:J OBrien and the Department of Medicine Chairman, Planning Education & Rese Johnny C. ~rownd% Chief Operating er Hos~italDirector REASON: This agreement renewal will benefit the hospital by maintaining an integrated residency and fellowship program in General Medicine and Palliative Medicine and Primary Care and Medical Informatics and Clinical Effectiveness Program of Rush University Medical Center. These programs provide post graduate education and quality improvement support for inpatient and outpatient primary care throughout the system. It also affords us an opportunity to collaborate with academic partner. TERMS OF REQUEST: (INCLUDE # OF FTE PGY) The CEMA 04-41-730 was authorized by the Cook County Board on 06/15/2004 for a period from 07/01/2004 through 613012014. The original program addendum to the CEMA, H09-25-010, was aurthorized by theCCHHS Board on 6/26/2009 for on e year from 07/01/2009 through 06/30/2010 in the amount of $383,673.00. 1.0 FTE PGY from Rush 5.0 FTE PGY to Rush 0.25 FTE Attendings from Rush 0.2 Attendings to Rush 3.8 FTE Administrative, medical informatics/other staff . WAS THIS REQUEST REVIEWED BY THE ADHOC WORKING GROUP ON MEDICAL SCHOOL RELATIONSHI CCHHS CMO: ~-i"Lu+- qi,/,a Terrv Mason, Chief Medical Officer CCHHS COO: - Anthony Tedeschi, Chief opedgOfficer Request # 22 Page 129 of 192 BOARD APPROVAL REQUEST- AS AMENDED I DATE:5/24/2010 I HOSPITAL DEPARTMENTIDNISION: I Department of Medicine TYPE OF REQUEST: I PARTNER, CITY, STATE: COOPERATIVEEDUCATIONAL MASTER AGREEMENT (CEMA) University of ~llinoisat Chicago CEMA RENEWAL 1740 W Taylor COOPERATIVE MASTER FUNDING AGREEMENT Chicago, IL 60612 PROGRAM ADDENDUM RENEWAL OF PROGRAM ADDENDUM X SUBAGREEMENT ACCOUNT NO. FISCAL IMPACT: 897-272 PER YEAR: Year 1 = $151,089.00 Year 2 =$157,132.00 TOTAL=$308,221.OO CONTRACT PERIOD:7/1/210-6/30/2012 RE0 NO. ~09-25-068 REQUESTING DEPTJAFFILIATE OR SYSTEM: John H. Stroger Hospital SPONSOR NAME, and the Department of Medicine John O'Brien, M.D. Chairman, Planning, Research Johnny C. Brown && Chief Operating Officer Hospital Director REASON: This agreement renewal will combine the fellowship in Nephrology between UIC and JSH. JSH provides salary support for the clinical activities of two FTE fellows who rotate at JSH at all times. TERMS OF REQUEST: (INCLUDE # OF FTE PGY) The CEMA 05-43-527 was authorized by the Cook County Board on 03//01/2005 for a period from 07/01/2005 through 6/30/2012. The original program addendum to the CEMA, H09-25-068, was aurthorized by theCCHHS Board on 6/26/2009 for on e year from 07/01/2009 through 06/30/2010 in the amount of $150,118.00. 2.0 FTE PGY's WAS THIS REQUEST REVIEWED BY THE ADHOC WORKING GROUP ON MEDICAL SCHOOL RELATIONSHIPS? on 1/20/10 CCHHS CMO: 1/1I b~fi(C(,h Terry Mason, Chief Medical Officer CCHHS COO: Anthony Tedeschi,Chief operatigg Officer CCHHS CEO: William T. Foley, afsutiveofficer/ Request # 23 Page 130 of 192 Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010 ATTACHMENT #7 Page 131 of 192 CARELINK COMMUNICATIONS PLAN June 18, 2010 Lucio Guerrero Director CCHHS Public Affairs and Community Outreach Page 132 of 192 Goal y To educate hospital staff and public of the impending Carelink policy change, ensure that all employees can speak confidently about the changes and make them understand how their participation is crucial to the success of the changes.We also need to make sure that theyyp are no surprises for the public – they must have a clear understanding of the policy. Page 133 of 192 Strategies y Active and immediate internal communication to all staff about Carelink – include FAQs, addressing the questions they may get from the public. y Educate the public about Carelink through signage and fliers at all entrances and pp.oints of service. y Communicate with public officials to let them be aware of the changes. Page 134 of 192 STAFF Page 135 of 192 Message to staff y Your continued partici pati on is vititlal to CCHHS. We need you. We need your support. y Your opin ion counts. CCHHS is ffllully commi tted to earni ng and strengthening your loyalty. We will continue to hear and address your concerns. y Continued care – no one will be denied care. y This policy change is an idindustry stan dar d. CCHHS is now consistent with other public hospital systems, which have alreadyyp adopted this p pyolicy Page 136 of 192 Communication Tool Kit y Intranet y complete policy for review (Due: July 2) y FAQs (Due: Ju ly 2) y Personalized emails blast y Newsletter story about the policy and need for it (August newsletter) y Flyers Page 137 of 192 PUBLIC Page 138 of 192 Key Message to public y Care will not be interrupted. y Change will be seamless. y We will help you qualify for programs that you are entitled to. y People who can not afford to pay anything will have a “zero” option. Page 139 of 192 Communication Tool Kit y Simple flyers at each registration desk (Due: July 2) y Posters that encourage participation in the “new” Carelink (Due: July 2) y Press release that tells about the program, pushing the angle that others do it, this is about finding the right program for ppp,eople, assuring the p ublic that we are making sure that people are accountable for their healthcare, and emphasizing that those who don’t have the means to pay will not be requiredld to pay (July 7) y Ed Board meetings y Publi c Access TV (Sept ) y Website (Sept) Page 140 of 192 Public officials Page 141 of 192 Key Messages to public officials y This is industry standard. y There will be a zero option. y No one w ill be turne d away. Page 142 of 192 Communication Tool Kit y WTF meetings with Commissioners (June/July) y Letter from WTF (July 7) y FAQs to Commissioners (July 2) Page 143 of 192 County/Safety Net Hospital Charity Guideline Comparison Cook County Health &Hospitals System, Chicago, I1 3 Plans 100% Visit $10, Pharmacy $4 Per Med Plan 1 = <=250% 50% Visit $10, PhannacyS4 Per Med Plan I1 = 251%-350% 25% Visit $10, Pharmacy $4 Per Med Plan 111 = 351%-450% Parkland Health & Hospital System, Dallas, TX 100% Level 1=Clinic $10, ED $20. I/P $30, Pharmacy $5,$10, $15 Plan 1 = <=133% Level I1 = Clinic $20, ED $50. I/P $90, Pharmacy $5, $10, $15 Plan 11 = 134%-200% I I I I Pre-Payment Plan = Flat Co-pays if paid within 7 days of Los Angeles County Medical Center, Los Angeles, CA 3 Plans 100% Clinic $60, ED $100, No pharmacy benefit 1m Co-Pay $0.00 Variable IIP $300-$500 Eligibility based on income with varying co-pays nme m servlce I I I I I Deposit $0.00 Rate z Deposit Clinic $7, ED $22, Pharmacy $0. l/P $500 Rate N Deposit Clinic $15, ED $60, Pharmacy $5, I/P $500 Rate A Deposit Clinic $15, ED $BOP Pharmacy $7,1/P $500 Rate B Deposit Clinic $20, ED $110, Pharmacy $7, IIP $5MI Rate C I Deposit Uinic $20, ED $140, Pharmaq $15, I/P $500 Rate D Deposit Clinic $25, ED $185. Pharmacy $20, IIP $500 Rate E Deposit Clinlc $25, ED $230, Pharmacy $20. IIP $585 Rate F Deposit Clinic $35, ED $315, Pharmacy $30, IIP$805 Rate G Deposk Clinic $35, ED $345, Pharmacy $30,1/P $900 Rate H I Deposit ainic$40. ED $365, Pharmacy $35, IIP $945 Rate I - Deposit Cliiic $70, ED $500, Pharmacy $50, IIP$1500 . RateR Deposit Clinic $70, ED SSW, Pharmacy $50, 1IP $1500 Rate S I I I I ( Deposit Clinic$70, ED $500. Pharmacy Full Price, llP $1500 ( Rate T I Jackson Health System, Miami, FL 4 Plans 100% Clinic $10, ED $10,1/P$300, Pharmacy $5 Diiounted at 100%with co-pays Clinic Deposit $35, ED Deposit $35, Deposit IIP $500, Pharmacy 75% Deposits are required Co-pay $10 Clinic Deposit $65, ED Deposit $65, ~IPDeposit$750, Pkarmacy 50% Deposits are required r- Co-pay $18 0% Deposit $90, Pharmacy $10 Deposits are required Page 144 of 192 Revision Date 6/17/2010 Page 145 of 192 ~astrevised June 9,2010 CareLink Implementation Timeline I + Resource Jun 2010 Jul2010 Aug 2010 Sep 2010 Od2010 Start Finish ID Task Name Names MI~IM3(mOlsn7l7/4~7/11~7/18I7n5611 ~M,IM~)~~~~SI~IM~IMSIS~SII~~~~ 1 Staffing Wl2OlO 91812010 68d T v recruiting, hiring,tralnlng of 25 6/7/2010 9/8/2010 68d CEA Eg HCR & DSS employees Credentialing, badges and 6/7/2010 9/8/2010 68d MDAS orientation of new staff 4 Gain system access for Carelink staff 6/7/2010 9/8/2010 68d MDAS 5 Process development Wl2010 8/2/2010 41d v v Develop Carelink workflows and 6/7/2010 7/7/2010 23d MDAS processes ldentii process to handle Pharmacy - 7 patients who are not currently 6/7/2010 8/2/2010 41d MDAS s enrolled 8 Communication W12010 612112010 lld I 9 To internal CCHHS employees 6/7/2010 6/21/2010 1ld CCHHS 10 External -to the public 6/7/2010 6/21/2010 lld MDAS - CEN - 6/2512010 15d 11 Create Carelink brochure 6/7/2010 CCHHS m 12 lmplementatlon Wl2010 101Y2010 87d m v Identification of space at all three 6/7R010 7/7/2010 23d MDAS l3 facilities for Carelink staff Order and install mmputers, bii cw - 8Rm10 6114/2010 l4 hubs, CCHHS IT infrastructure work CCHHS = Create Carelink Patient CEN 6/7/2010 7/7/2010 23d Management System App CCHHS 16 Complete Verification checklist 6/7/2010 7/7/2010 - 23d CEA 17 Get signoff on Embossing Machine 6/7/2010 6/14/2010 6d CEA -I MD S/ 18 Pilot Oak ForesfflP ED 7llROlO 7/7/2010 - & ld cE: I DAS 1 19 Oak ForesffClinic 8 Pharmacy BNMlO ~010 Id FEA 1 MDAS 1 20 ProvidenfflP & ED 8/2/2010 8/2/2010 id CEA I MDAS 1 21 ProvidenffClinic & Pharmacy 9/8/2010 9/8/2010 Id CEA I MDAS 1 22 StrogerllP & ED 9/8/2010 9/8/2010 Id CEA I MDAS I 23 StrogerClinic & Pharmacy 1015/2010 1W512010 Id CEA Page 146 of 192 I CareLin k FA Q's Q: I currently have LOL do I have to apply for CareLink? A: If you are currently approved for LOL you will remain eligible for the duration of the period originally approved. If you have had any changes to your situation such as income, residency, or household composition you will be required to complete a new application to determine your new eligibility level. Q: How long will I be covered by CareLink? A: CareLink coverage will now be available to patient s for 12 months from the date of application for both inpatient and outpatient services. Additionally, patients may be eligible for 12 months of retroactive coverage. Retroactive coverage will only be applied to uninsured self-pay accounts. Q: Will I be able to get my prescriptions through CareLink? A: Patient's enrolled in CareLink will be eligible for prescriptions through CCHHS pharmacies at a cost of $4 per prescription. Q: How much will I have to pay for services under the CareLink program? A: Patients eligible for services under the CareLink program will be responsible for a co-pay of $10 per clinical service and $4 per prescription for a 30-day supply. Co-payments are due at the time of service. Q: What happens if I don't have my co-payment? A: You will still receive treatment. Patients are still financially responsible for their co-payments and you will receive a bill. Patients unable to pay the $4 co-payment per prescription will be issued a one-time 14-day supply. Q: Will CareLink replace the Limit of Liability program (LOL)? A: Yes. CareLink is replacing the Limit of Liability Program (LOL) in its entirety. Q: Do I have to be a Cook County Resident to be eligible for CareLink? A: Yes. Under Cook County's new financial assistance program guidelines you must be a resident of Cook County in order to be eligible for CareLink. Page 147 of 192 Q: I have applied for Medicaid and/or SSI and my application is pending. Can I still apply for Care Lin k? A: Our financial assistance team will work with patients who are pending Medicaid and/or Supplemental Security lncome (SSI) to ensure all necessary paperwork is properly completed and submitted to the Illinois Department of Human Services or Social Security's Supplemental Security lncome Program. CareLink benefits will not be available unless denied Medicaid or SSI for reasons other than non-compliance. Pharmacy benefits will be available with the $4 co-pay per prescription. Q: What documents will I be required to provide in order to apply for CareLink? A: All applicants will be required to provide various documents, such as; Valid photo ID Proof of Cook County Residency Proof of lncome Number of persons in the household Q: Will CareLin k cover 100% of charges? A: CareLink discounts are established by Cook County utilizing the Federal Poverty lncome Levels published annually by the government as well as several other pieces of information, such as income and family size. Q: If I do not qualify for a 100% discount under the CareLink program can I make payment arrangements for the remaining balance? A: Absolutely. Our Patient Financial Services team will be happy to work with patients to make reasonable and affordable payments for the remaining balance. Q: Where is CareLink accepted? A: The new CareLink program will be honored at all Cook County Health & Hospitals System facilities. This includes John H. Stroger Hospital, Provident Hospital, Oak Forest hospital, all hospital based clinics and satellite community clinics. Q: Do I have to be US citizen to be eligible for CareLink? A: No. The residency requirement only requires you to be an established resident of Cook County. Page 148 of 192 Q: How long does it take to get an answer on whether or not I have been approved? A: Eligibility determinations will be made on the same day you apply, if all supporting documentation required is supplied at the interview. Q: Are non-medically necessary services covered by CareLink? A: No. Only medically necessary services as determined by a Cook County staff physician are covered. Cosmetic surgery is not covered by CareLink. Q: Can I still declare my financial situation without providing supporting documentation for charges under $1,000.00? A: No. Under the new CareLink guidelines all applicants are required to provide all necessary documentation to support an application for assistance. Q: Do I have to apply for and be denied assistance by the Illinois Department of Human Services and and/or Social Security's Supplemental Security Income Program (SSI) in order to apply for CareLink? A: Yes. CareLink is a Cook County financial assistance program and is only available after all other possible sources of assistance have been exhausted. Cook County has Financial Counselors available at each facility to assist you with this process. Page 149 of 192 Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010 ATTACHMENT #8 Page 150 of 192 Cook County Health and Hospitals System Financial Statements for the Month Ended February 28, 2010 As of June 1, 2010 Page 151 of 192 Index 1. Mission Statement Basic Financial Statements: 2. Attestation Statement 3. Management Discussion and Analysis 4. Balance Sheet – Assets 5. Balance Sheet – Liabilities and Net Assets 6. Income Statement Supplementary Schedules: 7. Budget vs. Actual – Cash Receipts 8. Budget vs. Actual – Expenditures 9. Budget vs. Actual – Expenses per Adjusted Patient Days 10. Payer Mix 11. Utilization Factors 12. Disclosure Checklist Page 152 of 192 COOK COUNTY HEALTH & HOSPITALS SYSTEM MISSION STATEMENT The Cook County Health and Hospitals System will deliver integrated health services with dignity and respect regardless of a patient's ability to pay; and, Foster partnerships with other health providers and communities to enhance the health of the public; and, Advocate for policies, which promote and protect the physical, mental and social well being of the people of Cook County. Page 153 of 192 Board of Directors Cook County Health and Hospitals System The accompanying financial statement of Cook County Health and Hospitals System and the related Management's Discussion and Analysis for the month ended February 28, 2010 have been prepared by Management who is responsible for their presentation and disclosure. The statement have not been compiled, reviewed or audited by independent accountants. CCHHS maintains an internal control structure designed to provide reasonable assurance that assets are safeguarded and that transactions are properly executed, recorded and summarized to produce reliable records and reports, To the best of Management's knowledge and belief the statements were prepared in conformity with generally accepted accounting principles (GAAP) and governmental accounting standards using the accrual basis of accounting and are based on recorded transactions and Management's best estimates and judgment. The accompanying supplemental schedules are for informational purposes only and are not required by GAAP. The Actual vs. Budget reports were prepared using the modified accrual basis of accounting (non GAAP budget basis) in conformity with budgetary fund accounting used by Cook county government. William T. Foley, Chief Executive Officer ______ Michael D. Ayres, Chief Financial Officer ______ Dorothy M. Loving, Executive Director of Finance ______ Page 154 of 192 Summary The Cook County Health and Hospitals System finished the three months of the fiscal year with overall revenue of $208,784,477 and overall expenses was $244,008,018. Operating Revenue Net patient revenue for three months was $98,824,278 and other revenue was $959,841. Operating Expenses Operating Expenses at the end of three months was $244,008,018 broken down as follows: Salaries and Wages – $133,810,174 Benefits - $35,500,303 Supplies – $24,187,850 Purchased Services, Rental, and Other - $30,624,363 Depreciation - $8,718,705 Utilities - $261,281 Insurance - $10,905,342 Non Operating Revenue Non operating revenue was $109,000,358. The largest portions of this are attributed to sales tax in the amount of $55,110,897 and property tax in the amount of $34,221,153. This information is an integral part of the accompanying consolidated financial statements Page 155 of 192 Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) February 28, 2010 Stroger ACHN Total Stroger & Oak Forest Provident Bureau of Dept of Hospirtal (Clinics) ACHN Hospital Hospital Health Hospitals Total Public Health Cermak Grand Total ASSETS CURRENT ASSETS: Cash and cash equivalents: Cash in banks 1,853,184 1,523 1,854,707 433,393 233,978 - 2,522,078 1,889 - 2,523,967 Cash held by Cook Co Treas 350,533,976 350,533,976 61,910,210 85,433,835 199,820 498,077,841 67,343,393 1,891,047 567,312,281 Due from working cash fund 59,385,553 34,607,331 93,992,884 - - - 93,992,884 - - 93,992,884 Total cash & cash equivalent 411,772,713 34,608,854 446,381,567 62,343,603 85,667,813 199,820 594,592,803 67,345,282 1,891,047 663,829,132 Property taxes receivable: Tax levy - current year 13,849,419 8,265,225 22,114,644 3,306,090 4,250,688 802,908 30,474,330 3,517,032 - 33,991,362 Tax levy - prior year 64,192,903 33,249,514 97,442,417 13,299,806 17,095,656 3,236,518 131,074,397 14,154,768 - 145,229,165 Total property taxes rec 78,042,322 41,514,739 119,557,061 16,605,896 21,346,344 4,039,426 161,548,727 17,671,800 - 179,220,527 Receivables: Patient AR-net of allowances 157,101,434 37,844 157,139,278 18,513,140 18,927,643 - 194,580,061 - - 194,580,061 Third-party settlements - - - 62,366 - - 62,366 - - 62,366 Other receivables 272,246 16,882 289,128 95,956 30,498 - 415,582 - 1,674 417,256 Due from State - sales taxes 14,506,570 7,582,980 22,089,550 2,967,253 3,956,337 659,390 29,672,530 3,296,948 4,473,692 37,443,170 Interacct (payable)receivabl (113,415,560) - (113,415,560) 16,783,138 (12,240,362) 108,857,580 (15,204) (1,629) - (16,833) Total receivables 58,464,690 7,637,706 66,102,396 38,421,853 10,674,116 109,516,970 224,715,335 3,295,319 4,475,366 232,486,020 Inventories 6,130,898 - 6,130,898 867,103 498,100 - 7,496,101 - 169,437 7,665,538 TOTAL CURRENT ASSETS 554,410,623 83,761,299 638,171,922 118,238,455 118,186,373 113,756,216 988,352,966 88,312,401 6,535,850 1,083,201,217 CAPITAL ASSETS: Depreciable assets - net 416,244,309 6,788,063 423,032,372 29,415,387 25,246,637 5,439,519 483,133,915 51,827 102,797 483,288,539 TOTAL ASSETS 970,654,932 90,549,362 1,061,204,294 147,653,842 143,433,010 119,195,735 1,471,486,881 88,364,228 6,638,647 1,566,489,756 Page 156 of 192 Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) February 28, 2010 Stroger ACHN Total Stroger & Oak Forest Provident Bureau of Dept of Hospirtal (Clinics) ACHN Hospital Hospital Health Hospitals Total Public Health Cermak Grand Total LIABILITIES & NET ASSETS CURRENT LIABILITIES: Due to Cook County Treasurer - 229,634,791 229,634,791 323,859,690 553,494,481 - 553,494,481 Accounts payable 14,669,208 667,384 15,336,592 3,556,817 5,369,542 11,552,101 35,815,052 962,010 939,401 37,716,463 Accrued salaries, wages, & other liabilities 830,188 103,405 933,593 157,678 148,053 96,334 1,335,658 31,458 78,910 1,446,026 Compensated absences 24,353,724 3,009,686 27,363,410 4,611,951 4,643,489 2,703,328 39,322,178 1,646,287 1,760,743 42,729,208 Deferred revenue 112,792,202 - 112,792,202 25,241,279 22,443,810 - 160,477,291 - - 160,477,291 Third-party settlements 1,593,901 - 1,593,901 - - 1,593,901 - - 1,593,901 Due to others - - 213,371 1,486,393 - 1,699,764 - - 1,699,764 TOTAL CURRENT LIABILITIES 154,239,223 233,415,266 387,654,489 33,781,096 34,091,287 338,211,453 793,738,325 2,639,755 2,779,054 799,157,134 LONG-TERM LIABILITIES: Reserve-tax objection suits 3,201,811 1,658,857 4,860,668 663,543 853,333 160,815 6,538,359 705,558 - 7,243,917 TOTAL LIABILITIES 157,441,034 235,074,123 392,515,157 34,444,639 34,944,620 338,372,268 800,276,684 3,345,313 2,779,054 806,401,051 OPERATING NET ASSETS: Invested in capital assets, net of related debt 416,244,309 6,788,063 423,032,372 29,415,387 25,246,637 5,439,519 483,133,915 51,827 102,797 483,288,539 Beginning balance 423,494,484 (197,611,005) 225,883,479 91,057,291 87,282,701 (187,745,594) 216,477,877 80,033,283 6,793,842 303,305,002 Bond depreciation 6,230,413 215,799 6,446,212 810,349 622,962 834,297 8,713,820 - 4,885 8,718,705 Excess revenue (expenses) (32,755,308) 46,082,382 13,327,074 (8,073,824) (4,663,910) (37,704,755) (37,115,415) 4,933,805 (3,041,931) (35,223,541) Ending balance 813,213,898 (144,524,761) 668,689,137 113,209,203 108,488,390 (219,176,533) 671,210,197 85,018,915 3,859,593 760,088,705 TOTAL LIABILITIES & OPERATING NET ASSETS 970,654,932 90,549,362 1,061,204,294 147,653,842 143,433,010 119,195,735 1,471,486,881 88,364,228 6,638,647 1,566,489,756 Page 157 of 192 Cook County Health Facilities Combining Income Statement of General Funds (Unaudited) February 28, 2010 Stroger ACHN Total Stroger Oak Forest Provident Bureau of Hospitals Dept of Hospirtal (Clinics) & ACHN Hospital Hospital Health Total Public Health Cermak Grand Total REVENUE: Net patient service revenue 40,673,362 45,720,232 86,393,594 6,650,785 5,778,791 - 98,823,170 1,108 - 98,824,278 Other revenue 655,152 101,331 756,483 81,776 43,700 - 881,959 51,662 26,220 959,841 Total Revenue: 41,328,514 45,821,563 87,150,077 6,732,561 5,822,491 - 99,705,129 52,770 26,220 99,784,119 OPERATING EXPENSES: Salaries and wages 76,577,997 9,538,309 86,116,306 15,023,153 13,508,609 8,886,035 123,534,103 2,997,191 7,278,880 133,810,174 Employee benefits 19,207,089 2,732,091 21,939,180 4,116,177 3,837,484 2,768,778 32,661,619 801,453 2,037,231 35,500,303 Supplies 2,402,750 6,330,849 8,733,599 1,031,224 898,747 13,066,851 23,730,421 15,461 441,968 24,187,850 Purchased svs, rental & other 8,286,770 1,327,280 9,614,050 1,729,943 2,694,290 15,278,012 29,316,295 399,937 908,131 30,624,363 Depreciation 6,230,413 215,799 6,446,212 810,349 622,962 834,297 8,713,820 - 4,885 8,718,705 Utilities 22,630 23,395 46,025 115,238 96,675 - 257,938 3,343 - 261,281 Insurance expense 6,818,121 1,101,059 7,919,180 1,885,928 1,100,234 - 10,905,342 - - 10,905,342 TOTAL OPERATING EXPENSES 119,545,770 21,268,782 140,814,552 24,712,012 22,759,001 40,833,973 229,119,538 4,217,385 10,671,095 244,008,018 GAIN (LOSS) FROM OPERATIONS (78,217,256) 24,552,781 (53,664,475) (17,979,451) (16,936,510) (40,833,973) (129,414,409) (4,164,615) (10,644,875) (144,223,899) NONOPERATING REVENUE: Property taxes 13,950,987 8,317,847 22,268,834 3,327,139 4,277,757 808,009 30,681,739 3,539,414 - 34,221,153 Cigarette taxes 1,361,941 812,913 2,174,854 325,165 418,070 78,969 2,997,058 345,912 - 3,342,970 Sales taxes 21,315,847 11,142,375 32,458,222 4,360,060 5,813,413 968,902 43,600,597 4,844,511 6,665,789 55,110,897 Interest income - - - 269 (538) - (269) - - (269) Retirement plan contribution 8,833,173 1,256,466 10,089,639 1,892,994 1,763,898 1,273,338 15,019,869 368,583 937,155 16,325,607 TOTAL NONOPERATING REVENUE 45,461,948 21,529,601 66,991,549 9,905,627 12,272,600 3,129,218 92,298,994 9,098,420 7,602,944 109,000,358 NET INCOME (LOSS) (32,755,308) 46,082,382 13,327,074 (8,073,824) (4,663,910) (37,704,755) (37,115,415) 4,933,805 (3,041,931) (35,223,541) Page 158 of 192 Year-To-Date Cash Receipts Actual to Budget Comparison by Payer Type (Non-GAAP Budget Basis) John H. Stroger, Jr., Hospital of Cook County Through February-2010 Payer Type Actual Budget Variance Medicaid $ 35,016,642 $ 41,987,500 $ (6,970,858) Medicare 11,457,956 10,232,877 1,225,079 Third Party 1,771,750 2,563,149 (791,399) Self-Pay 946,531 765,617 180,914 Totals $ 49,192,879 $ 55,549,143 $ (6,356,264) Provident Hospital of Cook County Through February-2010 Payer Type Actual Budget Variance Medicaid $ 948,181 $ 6,525,000 $ (5,576,819) Medicare 2,136,493 1,972,603 163,890 Third Party 568,010 574,209 (6,199) Self-Pay 37,168 42,230 (5,062) Totals $ 3,689,852 $ 9,114,041 $ (5,424,189) Oak Forest Hospital of Cook County Through February-2010 Payer Type Actual Budget Variance Medicaid $ 3,764,029 $ 8,362,500 $ (4,598,471) Medicare 867,681 986,301 (118,620) Third Party 159,225 166,861 (7,636) Self-Pay 75,954 79,714 (3,760) Totals $ 4,866,889 $ 9,595,376 $ (4,728,487) CCHHS Totals Through February-2010 Payer Type Actual Budget Difference Medicaid $ 39,728,853 $ 56,875,000 $ (17,146,147) Medicare 14,462,130 13,191,781 1,270,349 Third Party 2,498,985 3,304,219 (805,234) Self-Pay 1,059,653 887,561 172,092 Totals $ 57,749,621 $ 74,258,560 $ (16,508,939) The data reflected in this report comes from the Comptroller's ledger. Page 159 of 192 Cook County Health Facilities Appropriated Expenditures Budget and Actual (Non-GAAP Budget Basis) February 28, 2010 Year to Date Budget Actual Variance STROGER HOSPITAL Salaries and wages 82,752,781 86,116,306 (3,363,525) Supplies 16,704,002 8,733,599 7,970,403 Purchased svs, rental & other 14,660,884 9,614,050 5,046,834 Utilities 3,361,151 46,025 3,315,126 Total 117,478,818 104,509,980 12,968,838 OAK FOREST HOSPITAL Salaries and wages 15,475,463 15,023,153 452,310 Supplies 1,526,313 1,031,224 495,089 Purchased svs, rental & other 3,246,727 1,729,943 1,516,784 Utilities 831,230 115,238 715,992 Total 21,079,733 17,899,558 3,180,175 PROVIDENT HOSPITAL Salaries and wages 14,216,546 13,508,609 707,937 Supplies 1,897,637 898,747 998,890 Purchased svs, rental & other 5,900,292 2,694,290 3,206,002 Utilities 571,028 96,675 474,353 Total 22,585,503 17,198,321 5,387,182 BUERAU OF HEALTH Salaries and wages (5,853,853) 8,886,035 (14,739,888) Supplies 17,217,382 13,066,851 4,150,531 Purchased svs, rental & other 25,955,095 15,278,012 10,677,083 Utilities 0 - Total 37,318,624 37,230,898 87,726 DEPT OF PUBLIC HEALTH Salaries and wages 3,131,377 2,997,191 134,186 Supplies 68,770 15,461 53,309 Purchased svs, rental & other 953,462 399,937 553,525 Utilities 25,890 3,343 22,547 Total 4,179,499 3,415,932 763,567 CERMAK Salaries and wages 8,678,296 7,278,880 1,399,416 Supplies 290,860 441,968 (151,108) Purchased svs, rental & other 1,803,896 908,131 895,765 Utilities 0 - - Total 10,773,053 8,628,979 2,144,074 GRAND TOTAL Salaries and wages 118,400,610 133,810,174 (15,409,564) Supplies 37,704,965 24,187,850 13,517,115 Purchased svs, rental & other 52,520,355 30,624,363 21,895,992 Utilities 4,789,299 261,281 4,528,018 Total Page213,415,229 160 of 192 188,883,668 24,531,561 Cook County Health Facilities System Expenses per Adjusted Patient Days Budget and Actual (Non-GAAP Budget Basis) As of February 28, 2010 Institution Budget Actual Variance Stroger $ 4,003 $ 3,886 2.94% Oak Forest $ 3,630 $ 3,446 5.05% Provident $ 4,501 $ 4,232 5.97% Page 161 of 192 100% 80% 90% 10% 20% 30% 40% 50% 60% 70% 0% Jun-08 11.0% 27.4% 4.6% 56.9% Jul-08 10.8% 27.4% 4.7% 57.1% Aug-08 10.8% 27.5% 4.7% 57.0% Sep-08 10.8% 27.8% 4.7% 56.7% Oct-08 10.6% 28.8% 5.2% 55.5% Nov-08 10.5% 29.1% 5.2% 55.2% Payer Mix ByCharges Mix Payer Dec-08 8.0% 38.5% 5.0% 48.6% Medicare Jan-09 8.6% 35.0% 5.7% 50.7% Feb-09 8.8% 34.4% 6.0% 50.8% Medicaid Page 162of192 Mar-09 8.8% 35.4% 6.1% 49.7% Apr-09 9.0% 35.9% 5.3% 49.8% Commercial May-09 8.9% 35.8% 5.3% 50.0% Jun-09 9.0% 35.7% 5.3% 50.0% Jul-09 Self-Pay 9.0% 35.3% 5.3% 50.4% Aug-09 9.2% 34.8% 5.3% 50.7% Sep-09 9.2% 34.3% 5.2% 51.3% Oct-09 9.2% 33.8% 5.4% 51.6% Nov-09 9.3% 33.3% 5.4% 52.0% Dec-09 12.2% 29.1% 5.4% 53.3% Jan-10 10.3% 27.9% 6.2% 55.6% Feb-10 10.5% 28.8% 6.1% 54.6% Cook County Health & Hospitals System Utilization Factors 2010 YTD YTD YTD %% J.H. Stroger Hospital February Total Budget Variance Variance Admissions 1,816 5,811 5,856 (45) -0.8% Patient days 8,350 27,509 28,433 (924) -3.2% Adjusted Patient Days 13,926 46,860 45,083 1,777 3.9% Emergency Room Visits 9,297 29,176 32,657 (3,481) -10.7% Case Mix Index 1.2863 Average Length of Stay 5.0 5.0 - 0.0% Provident Hospital Admissions 331 1,034 1,161 (127) -10.9% Patient days 1,269 3,970 4,579 (609) -13.3% Adjusted Patient Days 2,188 6,791 7,201 (410) -5.7% Emergency Room Visits 2,922 8,726 9,760 (1,034) -10.6% Case Mix Index 0.9127 Average Length of Stay 3.7 4.0 0.3 7.5% Oak Forest Hospital Admissions 300 812 757 55 7.3% Patient days 1,853 5,230 5,544 (314) -5.7% Adjusted Patient Days 3,285 9,631 9,182 449 4.9% Emergency Room Visits 2,262 7,248 7,838 (590) -7.5% Case Mix Index 0.8922 Average Length of Stay - Acute 3.8 6.9 3.1 44.9% Average Length of Stay - Rehab 16.2 15.2 (1.0) -6.6% Total System Admissions 2,447 7,657 7,774 (117) -1.5% Patient Days 11,472 36,709 38,556 (1,847) -4.8% Adjusted Patient Days 19,399 63,282 61,466 1,816 3.0% Emergency Room Visits 14,481 45,150 50,255 (5,105) -10.2% Cook County Health & Hospitals System ACHN - Clinics Fantus/Stroger Campus 32,058 104,828 100,719 4,109 4.1% West Cluster 6,379 19,023 19,799 (776) -3.9% South Cluster 5,748 18,236 17,083 1,153 6.7% South Suburban Cluster 4,693 14,906 12,289 2,617 21.3% Total ACHN Visits Page 48,878 163 of 192 156,993 149,890 7,103 4.7% COOK COUNTY HEALTH AND HOSPITALS SYSTEM FINANCIAL STATEMENT DISCLOSURE CHECKLIST Fiscal Year 2010 OBJECTIVE: The object of this checklist is to help determine if the form and contents of the financial statements are in conformity with the accounting standards applicable to financial statement basis of accounting. DISCLOSURE PRINCIPLES: Note: Management can comply with a disclosure principle by making disclosure in body of financial statements or in the notes accompanying the financial statements. In a compilation engagement, management's election to omit substantially all disclosures applies to all disclosure principles in GAAP financial statements. If no, state reason Yes, N/A, No? (immaterial, estimated, etc.) FINANCIAL STATEMENT REFERENCES: 1. Do the financial statements reference footnotes (MD&A) or selected information? Yes GENERAL DISCLOSURES: A. Estimates: 1. General disclosure about use of estimates (MD&A)? Yes 2. Disclosure of possible changes in estimates? Yes B. Vulnerabilities do to concentrations in following areas disclosed?: 1. Customers? Yes 2. Suppliers? Yes 3. Lenders? Yes 4. Products? Yes 5. Supply of materials, labor or supplies? Yes 6. Location of assets in geographic area? Yes C. Related parties (FASB 57): 1. Known common control and economic dependency disclosure? Yes 2. Known transactions with related parties disclosed? Yes OTHER DISCLOSURE AREAS TO BE CONSIDERED: 1. Method of consolidations? Yes 2. Accounting changes including changes in GAAP and in estimates? Yes 3. Business combinations? Yes 4. Discontinues operations? Yes 5. Going concern? Yes COMMENTS: Completed by ______Date ______Reviewed by ______Page 164 of 192 Date ______ Cook County Health and Hospitals System Financial Statements for the Month Ended March 31, 2010 As of June 7, 2010 Page 165 of 192 Index 1. Mission Statement Basic Financial Statements: 2. Attestation Statement 3. Management Discussion and Analysis 4. Balance Sheet – Assets 5. Balance Sheet – Liabilities and Net Assets 6. Income Statement Supplementary Schedules: 7. Budget vs. Actual – Cash Receipts 8. Budget vs. Actual – Expenditures 9. Budget vs. Actual – Expenses per Adjusted Patient Days 10. Payer Mix 11. Utilization Factors 12. Disclosure Checklist Page 166 of 192 COOK COUNTY HEALTH & HOSPITALS SYSTEM MISSION STATEMENT The Cook County Health and Hospitals System will deliver integrated health services with dignity and respect regardless of a patient's ability to pay; and, Foster partnerships with other health providers and communities to enhance the health of the public; and, Advocate for policies, which promote and protect the physical, mental and social well being of the people of Cook County. Page 167 of 192 Board of Directors Cook County Health and Hospitals System The accompanying financial statement of Cook County Health and Hospitals System and the related Management's Discussion and Analysis for the month ended March 31, 2010 have been prepared by Management who is responsible for their presentation and disclosure. The statement have not been compiled, reviewed or audited by independent accountants. CCHHS maintains an internal control structure designed to provide reasonable assurance that assets are safeguarded and that transactions are properly executed, recorded and summarized to produce reliable records and reports, To the best of Management's knowledge and belief the statements were prepared in conformity with generally accepted accounting principles (GAAP) and governmental accounting standards using the accrual basis of accounting and are based on recorded transactions and Management's best estimates and judgment. The accompanying supplemental schedules are for informational purposes only and are not required by GAAP. The Actual vs. Budget reports were prepared using the modified accrual basis of accounting (non GAAP budget basis) in conformity with budgetary fund accounting used by Cook county government. William T. Foley, Chief Executive Officer ______ Michael D. Ayres, Chief Financial Officer ______ Dorothy M. Loving, Executive Director of Finance ______ Page 168 of 192 Summary The Cook County Health and Hospitals System finished the four months of the fiscal year with overall revenue of $291,217,710 and overall expenses was $332,958,331. Operating Revenue Net patient revenue for four months was $131,383,967 and other revenue was $1,302,400. Operating Expenses Operating Expenses at the end of four months was $332,958,331 broken down as follows: Salaries and Wages – $177,040,178 Benefits - $47,771,828 Supplies – $34,244,956 Purchased Services, Rental, and Other - $46,505,839 Depreciation - $11,628,196 Utilities - $1,226,879 Insurance - $14,540,455 Nonoperating Revenue Nonoperating revenue was $158,531,343. The largest portions of this are attributed to sales tax in the amount of $86,226,183 and property tax in the amount of $45,330,981. This information is an integral part of the accompanying consolidated financial statements Page 169 of 192 Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) March 31, 2010 Stroger ACHN Total Stroger & Oak Forest Provident Bureau of Dept of Hospirtal (Clinics) ACHN Hospital Hospital Health Hospitals Total Public Health Cermak Grand Total ASSETS CURRENT ASSETS: Cash and cash equivalents: Cash in banks 677,865 1,513 679,378 484,410 412,544 - 1,576,332 1,889 - 1,578,221 Cash held by Cook Co Treas 376,275,093 376,275,093 66,672,899 90,406,547 199,820 533,554,359 75,508,409 4,591,843 613,654,611 Due from working cash fund 60,515,262 34,607,331 95,122,593 - - - 95,122,593 - - 95,122,593 Total cash & cash equivalent 437,468,220 34,608,844 472,077,064 67,157,309 90,819,091 199,820 630,253,284 75,510,298 4,591,843 710,355,425 Property taxes receivable: Tax levy - current year 18,465,892 11,020,300 29,486,192 4,408,120 5,667,584 1,070,544 40,632,440 4,689,376 - 45,321,816 Tax levy - prior year 35,915,826 18,599,173 54,514,999 7,439,669 9,559,367 1,816,267 73,330,302 7,923,575 - 81,253,877 Total property taxes rec 54,381,718 29,619,473 84,001,191 11,847,789 15,226,951 2,886,811 113,962,742 12,612,951 - 126,575,693 Receivables: Patient AR-net of allowances 171,946,337 37,844 171,984,181 19,726,521 15,319,078 - 207,029,780 - - 207,029,780 Third-party settlements - - - 62,366 - - 62,366 - - 62,366 Other receivables 272,246 16,882 289,128 95,956 30,498 - 415,582 - 1,674 417,256 Due from State - sales taxes 14,506,570 7,582,980 22,089,550 2,967,253 3,956,337 659,390 29,672,530 3,296,948 4,473,692 37,443,170 Interacct (payable)receivabl (112,244,606) (112,244,606) 16,492,251 (13,115,338) 108,857,580 (10,113) (1,629) - (11,742) Total receivables 74,480,547 7,637,706 82,118,253 39,344,347 6,190,575 109,516,970 237,170,145 3,295,319 4,475,366 244,940,830 Inventories 8,837,680 - 8,837,680 832,298 498,100 - 10,168,078 - 174,946 10,343,024 TOTAL CURRENT ASSETS 575,168,165 71,866,023 647,034,188 119,181,743 112,734,717 112,603,601 991,554,249 91,418,568 9,242,155 1,092,214,972 CAPITAL ASSETS: Depreciable assets - net 414,167,505 6,716,130 420,883,635 29,171,564 25,038,983 5,161,420 480,255,602 51,827 97,912 480,405,341 TOTAL ASSETS 989,335,670 78,582,153 1,067,917,823 148,353,307 137,773,700 117,765,021 1,471,809,851 91,470,395 9,340,067 1,572,620,313 Page 170 of 192 Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) March 31, 2010 Stroger ACHN Total Stroger & Oak Forest Provident Bureau of Dept of Hospirtal (Clinics) ACHN Hospital Hospital Health Hospitals Total Public Health Cermak Grand Total LIABILITIES & NET ASSETS CURRENT LIABILITIES: Due to Cook County Treasurer 210,555,346 210,555,346 334,608,400 545,163,746 - 545,163,746 Accounts payable 17,501,351 733,689 18,235,040 3,738,489 4,946,902 14,955,587 41,876,018 966,648 468,706 43,311,372 Accrued salaries, wages, & other liabilities 3,350,116 434,203 3,784,319 574,592 590,723 371,731 5,321,365 (95,453) 298,063 5,523,975 Compensated absences 24,353,724 3,009,686 27,363,410 4,611,951 4,643,489 2,703,328 39,322,178 1,646,287 1,760,743 42,729,208 Deferred revenue 124,071,422 - 124,071,422 25,241,279 22,443,810 - 171,756,511 - - 171,756,511 Third-party settlements 1,593,901 - 1,593,901 - - - 1,593,901 - - 1,593,901 Due to others - - 213,371 1,486,393 - 1,699,764 - - 1,699,764 TOTAL CURRENT LIABILITIES 170,870,514 214,732,924 385,603,438 34,379,682 34,111,317 352,639,046 806,733,483 2,517,482 2,527,512 811,778,477 LONG-TERM LIABILITIES: Reserve-tax objection suits 3,201,811 1,658,857 4,860,668 663,543 853,333 160,815 6,538,359 705,558 - 7,243,917 TOTAL LIABILITIES 174,072,325 216,391,781 390,464,106 35,043,225 34,964,650 352,799,861 813,271,842 3,223,040 2,527,512 819,022,394 OPERATING NET ASSETS: Invested in capital assets, net of related debt 414,167,505 6,716,130 420,883,635 29,171,564 25,038,983 5,161,420 480,255,602 51,827 97,912 480,405,341 Beginning balance 430,690,994 (204,807,515) 225,883,479 91,057,291 87,282,701 (187,745,594) 216,477,877 80,033,283 6,793,842 303,305,002 Bond depreciation 8,307,217 287,733 8,594,950 1,080,465 830,616 1,112,396 11,618,427 - 9,770 11,628,197 Excess revenue (expenses) (37,902,371) 59,994,024 22,091,653 (7,999,238) (10,343,250) (53,563,062) (49,813,897) 8,162,245 (88,969) (41,740,621) Ending balance 815,263,345 (137,809,628) 677,453,717 113,310,082 102,809,050 (235,034,840) 658,538,009 88,247,355 6,812,555 753,597,919 TOTAL LIABILITIES & OPERATING NET ASSETS 989,335,670 78,582,153 1,067,917,823 148,353,307 137,773,700 117,765,021 1,471,809,851 91,470,395 9,340,067 1,572,620,313 Page 171 of 192 Cook County Health Facilities Combining Income Statement of General Funds (Unaudited) March 31, 2010 Stroger ACHN Total Stroger Oak Forest Provident Bureau of Hospitals Dept of Hospirtal (Clinics) & ACHN Hospital Hospital Health Total Public Health Cermak Grand Total REVENUE: Net patient service revenue 61,841,455 55,748,051 117,589,506 11,038,871 2,753,402 - 131,381,779 2,188 - 131,383,967 Other revenue 885,126 143,496 1,028,622 114,257 64,622 - 1,207,501 67,745 27,154 1,302,400 Total Revenue: 62,726,581 55,891,547 118,618,128 11,153,128 2,818,024 - 132,589,280 69,933 27,154 132,686,367 OPERATING EXPENSES: Salaries and wages 101,668,352 12,850,137 114,518,489 19,474,155 18,043,779 11,697,945 163,734,368 3,775,446 9,530,364 177,040,178 Employee benefits 26,036,756 3,648,061 29,684,817 5,488,236 5,121,979 3,691,704 43,986,736 1,068,604 2,716,488 47,771,828 Supplies 1,677,248 8,998,897 10,676,145 1,533,829 942,857 20,847,253 34,000,084 37,526 207,346 34,244,956 Purchased svs, rental & other 14,143,730 1,860,781 16,004,511 2,806,647 4,637,337 20,781,934 44,230,429 576,722 1,698,688 46,505,839 Depreciation 8,307,217 287,733 8,594,950 1,080,465 830,616 1,112,396 11,618,427 - 9,770 11,628,197 Utilities 779,601 29,128 808,729 243,439 167,113 - 1,219,281 7,597 - 1,226,878 Insurance expense 9,090,827 1,468,079 10,558,906 2,514,571 1,466,978 - 14,540,455 - - 14,540,455 TOTAL OPERATING EXPENSES 161,703,731 29,142,816 190,846,547 33,141,342 31,210,659 58,131,232 313,329,780 5,465,895 14,162,656 332,958,331 GAIN (LOSS) FROM OPERATIONS (98,977,150) 26,748,731 (72,228,419) (21,988,214) (28,392,635) (58,131,232) (180,740,500) (5,395,962) (14,135,502) (200,271,964) NONOPERATING REVENUE: Property taxes 18,469,943 11,022,399 29,492,342 4,408,959 5,668,664 1,070,747 40,640,712 4,690,269 - 45,330,981 Cigarette taxes 2,120,178 1,265,423 3,385,601 506,169 650,789 122,927 4,665,486 538,465 - 5,203,951 Sales taxes 28,704,726 19,282,183 47,986,909 6,549,181 9,378,359 1,676,712 65,591,161 7,838,029 12,796,993 86,226,183 Interest income 2,368 - 2,368 675 (291) - 2,752 - - 2,752 Retirement plan contribution 11,777,564 1,675,288 13,452,852 2,523,992 2,351,864 1,697,784 20,026,492 491,444 1,249,540 21,767,476 TOTAL NONOPERATING REVENUE 61,074,779 33,245,293 94,320,072 13,988,976 18,049,385 4,568,170 130,926,603 13,558,207 14,046,533 158,531,343 NET INCOME (LOSS) (37,902,371) 59,994,024 22,091,653 (7,999,238) (10,343,250) (53,563,062) (49,813,897) 8,162,245 (88,969) (41,740,621) Page 172 of 192 Year-To-Date Cash Receipts Actual to Budget Comparison by Payer Type (Non-GAAP Budget Basis) John H. Stroger, Jr., Hospital of Cook County Through March-2010 Payer Type Actual Budget Variance Medicaid $ 47,554,700 $ 58,136,538 $ (10,581,838) Medicare 14,311,343 13,757,534 553,809 Third Party 2,703,913 3,446,012 (742,099) Self-Pay 1,308,595 1,029,329 279,266 Totals $ 65,878,551 $ 76,369,414 $ (10,490,863) Provident Hospital of Cook County Through March-2010 Payer Type Actual Budget Variance Medicaid $ 1,143,348 $ 9,034,615 $ (7,891,267) Medicare 2,607,944 2,652,055 (44,111) Third Party 761,007 771,992 (10,985) Self-Pay 53,743 56,775 (3,032) Totals $ 4,566,042 $ 12,515,437 $ (7,949,395) Oak Forest Hospital of Cook County Through March-2010 Payer Type Actual Budget Variance Medicaid $ 5,489,332 $ 11,578,846 $ (6,089,514) Medicare 1,110,749 1,326,027 (215,278) Third Party 213,065 224,233 (11,168) Self-Pay 102,189 107,273 (5,084) Totals $ 6,915,335 $ 13,236,380 $ (6,321,045) CCHHS Totals Through March-2010 Payer Type Actual Budget Difference Medicaid $ 54,187,381 $ 78,750,000 $ (24,562,619) Medicare 18,030,036 17,735,616 294,420 Third Party 3,677,985 4,442,237 (764,252) Self-Pay 1,464,527 1,193,377 271,150 Totals $ 77,359,929 $ 102,121,230 $ (24,761,301) The data reflected in this report comes from the Comptroller's ledger. Page 173 of 192 Cook County Health Facilities Appropriated Expenditures Budget and Actual (Non-GAAP Budget Basis) March 31, 2010 Year to Date Budget Actual Variance STROGER HOSPITAL Salaries and wages 111,256,517 114,518,489 (3,261,972) Supplies 22,457,603 10,676,145 11,781,458 Purchased svs, rental & other 19,710,745 16,004,511 3,706,234 Utilities 4,518,880 808,729 3,710,151 Total 157,943,745 142,007,874 15,935,871 OAK FOREST HOSPITAL Salaries and wages 20,805,900 19,474,155 1,331,745 Supplies 2,052,043 1,533,829 518,214 Purchased svs, rental & other 4,365,044 2,806,647 1,558,397 Utilities 1,117,543 243,439 874,104 Total 28,340,530 24,058,070 4,282,460 PROVIDENT HOSPITAL Salaries and wages 19,113,356 18,043,779 1,069,577 Supplies 2,551,268 942,857 1,608,411 Purchased svs, rental & other 7,932,614 4,637,337 3,295,277 Utilities 767,715 167,113 600,602 Total 30,364,954 23,791,086 6,573,868 BUERAU OF HEALTH Salaries and wages (7,870,180) 11,697,945 (19,568,125) Supplies 23,147,814 20,847,253 2,300,561 Purchased svs, rental & other 34,895,183 20,781,934 14,113,249 Utilities 0 - Total 50,172,816 53,327,132 (3,154,316) DEPT OF PUBLIC HEALTH Salaries and wages 4,209,962 3,775,446 434,516 Supplies 92,457 37,526 54,931 Purchased svs, rental & other 1,281,876 576,722 705,154 Utilities 34,808 7,597 27,211 Total 5,619,104 4,397,291 1,221,813 CERMAK Salaries and wages 11,667,487 9,530,364 2,137,123 Supplies 391,045 207,346 183,699 Purchased svs, rental & other 2,425,238 1,698,688 726,550 Utilities 0 - - Total 14,483,771 11,436,398 3,047,373 GRAND TOTAL Salaries and wages 159,183,042 177,040,178 (17,857,136) Supplies 50,692,231 34,244,956 16,447,275 Purchased svs, rental & other 70,610,700 46,505,839 24,104,861 Utilities 6,438,946 1,226,878 5,212,068 Total Page286,924,919 174 of 192 259,017,851 27,907,068 Cook County Health Facilities System Expenses per Adjusted Patient Days Budget and Actual (Non-GAAP Budget Basis) As of March 31, 2010 Institution Budget Actual Variance Stroger $ 4,366 $ 3,959 9.33% Oak Forest $ 3,986 $ 3,476 12.78% Provident $ 4,857 $ 4,284 11.81% Page 175 of 192 100% 10% 20% 30% 40% 50% 60% 70% 80% 90% 0% Mar-09 Apr-09 8.8% 35.4% 6.1% 49.7% May-09 9.0% 35.9% 5.3% 49.8% Medicare Jun-09 8.9% 35.8% 5.3% 50.0% Payer Mix ByCharges Mix Payer 9.0% 35.7% 5.3% 50.0% Jul-09 Medicaid Aug-09 9.0% 35.3% 5.3% 50.4% Page 176of192 Sep-09 9.2% 34.8% 5.3% 50.7% Oct-09 9.2% 34.3% 5.2% 51.3% Commercial Nov-09 9.2% 33.8% 5.4% 51.6% Dec-09 9.3% 33.3% 5.4% 52.0% Self Pay Self 12.2% 29.1% 5.4% 53.3% Jan-10 Feb-10 10.3% 27.9% 6.2% 55.6% Mar-10 10.5% 28.8% 6.1% 54.6% 10.6% 29.1% 6.0% 54.3% Cook County Health & Hospitals System Utilization Factors 2010 YTD YTD YTD %% J.H. Stroger Hospital March Total Budget Variance Variance Admissions 2,072 7,883 7,873 10 0.1% Patient days 9,495 37,004 38,226 (1,222) -3.2% Adjusted Patient Days 15,854 62,714 60,612 2,102 3.5% Emergency Room Visits 10,729 39,905 43,906 (4,001) -9.1% Case Mix Index 1.2664 Average Length of Stay 4.8 5.0 0.2 4.0% Provident Hospital Admissions 376 1,411 1,560 (149) -9.6% Patient days 1,462 5,432 6,156 (724) -11.8% Adjusted Patient Days 2,476 9,267 9,681 (414) -4.3% Emergency Room Visits 3,527 12,253 13,122 (869) -6.6% Case Mix Index 0.9755 Average Length of Stay 3.9 4.0 0.1 2.5% Oak Forest Hospital Admissions 294 1,106 1,017 89 8.8% Patient days 1,869 7,099 7,454 (355) -4.8% Adjusted Patient Days 3,311 12,942 12,345 597 4.8% Emergency Room Visits 2,682 9,930 10,538 (608) -5.8% Case Mix Index 0.9306 Average Length of Stay - Acute 3.7 6.9 3.2 46.4% Average Length of Stay - Rehab 22.7 15.2 (7.5) -49.3% Total System Admissions 2,742 10,400 10,450 (50) -0.5% Patient Days 12,826 49,535 51,836 -2,301 -4.4% Adjusted Patient Days 21,641 84,923 82,638 2,285 2.8% Emergency Room Visits 16,938 62,088 67,566 -5,478 -8.1% Cook County Health & Hospitals System ACHN - Clinics Fantus/Stroger Campus 38,947 143,775 135,411 8,364 6.2% West Cluster 7,943 26,966 26,618 348 1.3% South Cluster 7,652 25,888 22,967 2,921 12.7% South Suburban Cluster 6,225 21,131 16,522 4,609 27.9% Total ACHN Visits Page 60,767 177 of 192 217,760 201,518 16,242 8.1% COOK COUNTY HEALTH AND HOSPITALS SYSTEM FINANCIAL STATEMENT DISCLOSURE CHECKLIST Fiscal Year 2010 OBJECTIVE: The object of this checklist is to help determine if the form and contents of the financial statements are in conformity with the accounting standards applicable to financial statement basis of accounting. DISCLOSURE PRINCIPLES: Note: Management can comply with a disclosure principle by making disclosure in body of financial statements or in the notes accompanying the financial statements. In a compilation engagement, management's election to omit substantially all disclosures applies to all disclosure principles in GAAP financial statements. If no, state reason Yes, N/A, No? (immaterial, estimated, etc.) FINANCIAL STATEMENT REFERENCES: 1. Do the financial statements reference footnotes (MD&A) or selected information? Yes GENERAL DISCLOSURES: A. Estimates: 1. General disclosure about use of estimates (MD&A)? Yes 2. Disclosure of possible changes in estimates? Yes B. Vulnerabilities do to concentrations in following areas disclosed?: 1. Customers? Yes 2. Suppliers? Yes 3. Lenders? Yes 4. Products? Yes 5. Supply of materials, labor or supplies? Yes 6. Location of assets in geographic area? Yes C. Related parties (FASB 57): 1. Known common control and economic dependency disclosure? Yes 2. Known transactions with related parties disclosed? Yes OTHER DISCLOSURE AREAS TO BE CONSIDERED: 1. Method of consolidations? Yes 2. Accounting changes including changes in GAAP and in estimates? Yes 3. Business combinations? Yes 4. Discontinues operations? Yes 5. Going concern? Yes COMMENTS: Completed by ______Date ______Reviewed by ______Page 178 of 192 Date ______Cook County Health and Hospitals System Minutes of the Finance Committee Meeting June 18, 2010 ATTACHMENT #9 Page 179 of 192 FinanceFinance Committee Committee Meeting Meeting Update:Supply Supply Chain Chain ManagementManagement JuneJune 18, 18, 20102010 Page 180 of 192 Agenda • CCHHS Project Status Warehouse Consolidation Highlights • Transparency • Key Performance Indicators Primary distributor GPO • Next Steps CCHHS Finance Committee Meeting June 18, 2010 1 Contact: Ann Marie Huddleston 214-679-2384 Page 181 of 192 CCHHS Project Status CCHHS Project Status Identified Expected % Project ID Dept Initiative Implementation Steps Savings* Implementation Complete Status $250,000 - 1.1 Lab Lab Distribution TBD 10% G •Lab + SCM drafting RFP $400,000 •Custom packs are being Custom Surgical $250,000 - 2.1 Surgery Apr-2010 100% G delivered $300,000 Packs •SCM quantifying savings •Converted Covidien endomechanical to Novation GPO pricing for an estimated savings of $46k; realized Suture & Endo- $340,000 - April 2010 (Endo) savings to be quantified and 2.2 Surgery 50% G mechanical $450,000 Aug-2010 (Suture) tracked •Converted BBraun suture to Novation Ethicon contract pricing; savings to be quantified •Surgery developing suture RFP $1,800,000 - •Sole source contracts mailed to 2.3 Surgery Orthopedic Products TBD 20% G $2,000,000 vendor *Identified by Navigant or CCHHS CCHHS Finance Committee Meeting June 18, 2010 2 Contact: Ann Marie Huddleston 214-679-2384 Page 182 of 192 CCHHS Project Status CCHHS Project Status (continued) Expected Identified % Project ID Dept Initiative Implementa Implementation Steps Savings* Complete Status tion Food •Delivering products to Stroger & Oak Forest $350,000 – 3.1 FANS (product & Mar-2010 100% G •Estimated implemented savings of $270k; further $500,000 service) validation required •CCHHS Board approved converting from Angelica to SCM Laundry & $700,000 - Standard Textile 4.1 Aug-2010 90% G Clinical Linen $1,103,000 •Savings to be implemented is $946k per year; further validation required •Approved Owens & Minor Primary Med/Surg Distributor contract for GPO items Consolidate •Non-GPO items’ distribution approval pending June to Primary $600,000 - 4.2 SCM Jun-2012 30% G CCHHS Board meeting $1,008,000 Med/Surg •SCM continuing to work with O&M and GPO to convert Distributor items and quantify savings; ~700 of 1200 have been converted $38,033 - $384,812 Warehouse 4.3 SCM (recurring) Jan-2011 20% G •See next slide for details Consolidation $14,915 (one-time)** *Identified by Navigant or CCHHS **Liquidation of Paper Stock and X-Ray Film CCHHS Finance Committee Meeting June 18, 2010 3 Contact: Ann Marie Huddleston 214-679-2384 Page 183 of 192 CCHHS Project Status Warehouse Consolidation Highlights Team Warehouse Consolidation. Team Members include John R. Morales, CFO-JHSH, Paul Wolff, Interim Director-CCHHS Materials Management, Dan Ruiz, Director-JHSH Materials Management, Warehouse Staff Initiatives • Reduce rental expense for warehouse operations • Consolidate inventory/other to items needed for operations only • Convert obsolete or marketable commodities into cash • Be in make-ready condition to relocate to the Hawthorne Facility upon notice from Capital Planning Business Case & • Reduce operating expenses for warehouse storage as a component of JIT planning going forward Benefits • Generate savings from warehouse operations by moving away from maintaining E&O Inventory and non-essential items to only value added inventory and related items • Seize the opportunity to convert commodity scrap into cash • Availability and use of Cook County Warehouse (Hawthorne) in 2011 onward; no chargeback or budgetary allocation has been proposed resulting in projected reduced operating expenses for the CCHHS Income and/ors Proposed one-time revenue $14,915 from the sale of paper stock ($3,200) and Used/Unused X-Ray film ($11,715) n s o Savings i Revenue from the sale of Steel Racking TBD; revenue from misc. scrap sales TBD n t o u i Cost savings l t o u Lease savings l $29,906 from Provident Lease @ 5 months in 2010 [$71,775 full year impact 2011]; lease savings also include property taxes of S o $1,711 for 2010 (Provident); utilities total projected savings for 5 months = $6,416 S Total lease savings for 2011 will be $290,312 [JHSH (11 mo.) $218,537 + Provident $71,775]; property taxes saved will include approximately $16,000 [JHSH] and approximately $3,500 [Provident] for 2011 For 2011, combined utilities savings will total approximately $75,000 (note utilities expense savings assumptions were based on 2009 Actual Utilities Expense) Labor/overtime $0.00 for base labor at this time; not included in initial project scope; overtime must be approved beforehand by the JHSH CFO or the JHSH COO; goal for OT is $0.00 except for specific coverage as presented by management for approval Implementation • Notice of Lease Termination served to Landlord in May 2010; vacate Provident warehouse by July 31, 2010 Next Steps • Complete the sale of paper stock and X-Ray film; pursue sale of steel racking and other scrap materials • Consolidate the warehouse inventories and prepare for move to the Hawthorne warehouse in January 2011 Timeline All key steps to vacate the Provident warehouse are projected to be completed by late June or early July Potential Barriers to No barriers to successful on-time completion of this project have been noted at this time Implementation Champions John R. Morales, Paul Wolff, Dan Ruiz, Leslie Duffy Page 184 of 192 4 Transparency Requirements • Cook County Health and Hospitals System Procurement Policy (approved 4/9/2009) §2.2.a. (page 9) • Bid notice Chicago Sun Times newspaper advertisement System web site Bulletin board (intranet) • Recommended award posted System web site Intranet CCHHS Finance Committee Meeting June 18, 2010 5 Contact: Ann Marie Huddleston 214-679-2384 Page 185 of 192 Transparency External Web Site • Process to access Log onto cookcountyhealth.net Click on Contract Info (center tab) Click one of the options on the right (upcoming, current, awarded) • Information available Upcoming contracts- those available for bid in the future Current contracts- those out for bid now Awarded contracts- those that have been selected; purchase order has been issued to the vendor CCHHS Finance Committee Meeting June 18, 2010 6 Contact: Ann Marie Huddleston 214-679-2384 Page 186 of 192 Transparency Internal CCHHS intranet • Process to Access Log onto CCHHS intranet Select Stroger Hospital* (top right) Select Finance (bottom left) Select Contract- Approval Contracts (top left) • Information available Transmittal information Board approval dates *Working with HIT to change from “Stroger” to “CCHHS” CCHHS Finance Committee Meeting June 18, 2010 7 Contact: Ann Marie Huddleston 214-679-2384 Page 187 of 192 Key Performance Indicators GPO Supply Expense Allocation • CCHHS’ SCM goal is fully develop our internal capacity while achieving industry benchmarks Current Industry Standard GPO Allocation of Non-Drug Supply Expense GPO Allocation of Non-Drug Supply Expense 91% 80% 9% 20% Non-GPO Spend Non-GPO Spend Novation GPO Spend Novation GPO Spend Source: AmeriSource - from 5/1/09 through 4/30/10 CCHHS Check Register File Total SupplyExpense - CCHHS Financial Statements for 12 months ending 11/30/2009 O&Mannualized spend - from O&MMay2010 total spend multiplied by12 months CCHHS Finance Committee Meeting June 18, 2010 8 Contact: Ann Marie Huddleston 214-679-2384 Page 188 of 192 Key Performance Indicators Primary Distributor Spend • CCHHS is accessing a primary distributor to reduce cost through Lower acquisition cost Reduced touches Improved customer service from the vendor JIT/LUM Primary Distributor Spend Across CCHHS (by hospital, by month) $800,000 $700,000 $600,000 $500,000 Provident $400,000 Cermak $300,000 Oak Forest $200,000 Stroger $100,000 $0 Oct 2009 Nov 2009 Dec 2009 Jan 2010 Feb 2010 Mar 2010 Apr 2010 May 2010 Source: Owens & Minor CCHHS Finance Committee Meeting June 18, 2010 9 Contact: Ann Marie Huddleston 214-679-2384 Page 189 of 192 Key Performance Indicators GPO Procurement Relationship (60% to 70%) (1% to 3%) CCHHS Finance Committee Meeting June 18, 2010 10 Contact: Ann Marie Huddleston 214-679-2384 Page 190 of 192 Key Performance Indicators KPIs Compare Group: 400+ bed hospitals, CMI <= 1.50, (N=67) Source: CCHHS Financial Statements and Utilization Factors for the Month Ended January 31, 2010 Notes • Benchmarks are from Thomson Reuters Healthcare (formerly Solucient), and are for the most recent reporting period: Oct-Nov-Dec 2009 • JSH data only currently available for January 2010; February and March will be available after 6/18/2010 Finance Committee Meeting; April and May will be available after July Finance Committee Meeting. Thereafter, data will be available on a one month lag basis. • Oak Forest and Provident data is not yet ready for publication. CCHHS Finance Committee Meeting June 18, 2010 11 Contact: Ann Marie Huddleston 214-679-2384 Page 191 of 192 Next Steps Overview • Process enhancements Ref Initiative Task Status Due Quantify, implement 1 Office Supplies In progress 8/1/2010 and realize ongoing 2 Determine vendor requirements projects 3 Determine formulary Define current & 4 Identify potential vendors design future 5 Request vendor response processes (e.g., 6 Forms Not started Contracting, 7 Communicate with Forms Committee Procurement, 8 Determine vendor requirements Inventory, etc.) 9 Identify potential vendor Implement Value 10 Cycle counts Analysis (clinical + 11 Conduct regular stock room cycle counts Complete business product evaluations) 12 Focus on suture cycle counts In progress 13 Disaster Supplies Not started Transition Contract Compliance in-house 14 Current state analysis 15 Future state design Vendor credentialing 16 Gap analysis • Quantify savings 17 Develop implementation plan Dispose hospital 18 Socialize initiative equipment via County web auction CCHHS Finance Committee Meeting June 18, 2010 12 Contact: Ann Marie Huddleston 214-679-2384 Page 192 of 192