Cook County Health & Hospitals SystemP li i FY2012 B d tPreliminary FY2012 Budget

CCHHS Board of DirectorsCCHHS Board of Directors Special Board Meeting

Friday, September 16, 2011

Strategic Plan - VISION 2015Core GoalsCore Goals

I. Access to • Eliminate System access barriers at all delivery sites.• Designate and develop strategically-located sites for development of

comprehensive outpatient services

MissionMission Strategic InitiativesStrategic Initiatives

To deliver integrated health services with dignity and

Healthcare Services comprehensive outpatient services.• Evaluate optimal long-term development of Provident, Oak Forest, and

ACHN sites.

respect regardless of a patient’s ability to pay; foster partnerships with other health providers and communities to enhance the health of the public; and advocate for policies which

II. Quality, Service E ll &

• Develop an integrated, System-wide approach and supportive infra-structure for patient-centered care coordination.advocate for policies which

promote and protect the physical, mental and social well being of the people of Cook County.

Excellence & Cultural Competence

• Implement a program of continuous process improvement: patient care quality, safety, and outcomes.

• Develop a comprehensive program to instill cultural competency.

III Service Line• Develop/strengthen clinical service lines in key disciplines based on

ti t l ti d

• Implement a full range of initiatives to improve caregiver/employee satisfaction

Vision 2015Vision 2015In support of its public health mission, CCHHS will be recognized locally, regionally, and nationally —and by

III. Service Line Strength

patient population needs. • Pursue mutually beneficial partnerships with community providers. • Assure the provision of the Ten Essentials of Public Health.

satisfaction.• Focus on effective recruiting and retention processes.• Develop a robust program for in-service education and professional

skill building.

IV. Staff Development

nationally —and by patients and employees—as a progressively evolving model for an accessible, integrated, patient-centered, and fiscally-responsible healthcare • Foster leadership development and succession planning

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psystem focused on assuring high-quality care and improving the health of the residents of Cook County.

V. Leadership & Stewardship

• Foster leadership development and succession planning.• Develop long-term financial plans and sustaining funding.• Hold Board and management leadership accountable to agreed-upon

performance targets.

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Strategic Plan: Vision 2015gFive Core GoalsI. Significantly improve access.g y p

II. Substantially enhance quality, service excellence, and cultural competence.p

III. Build upon clinical strengths.

IV. Invest in employee and staff development.

V Assure strong leadershipV. Assure strong leadership.

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Strategic Plan: Vision 2015-Year OneFY2011 Preliminary Budget Assumptions Shift from inpatient to outpatient services at Oak Forest while

establishing a Regional Outpatient Center.

Maintain smaller number of inpatient beds at Provident Hospital hil t bli hi R i l O t ti t C twhile establishing a Regional Outpatient Center.

Grow outpatient services county wide.

Expand specialty care services at selected sites.

Improve infrastructure to enhance services for our patients Improve infrastructure to enhance services for our patients.

Improve employee satisfaction, recruitment and retention, and employee development and education.

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p y p

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Strategic Plan: Vision 2015-Year One

• Consolidated to one Patient Management and Patient Accounting system

St ateg c a s o 0 5 ea O eFY2011 Accomplishments

g g y

• Material transformation in Patient Accounting and Rev Cycle improvement

• Converting of Oak Forest Hospital to a Regional Outpatient Center (Oak Forest• Converting of Oak Forest Hospital to a Regional Outpatient Center (Oak Forest Health Center Campus)

• Commenced the conversion of Provident Hospital to a Regional Outpatient Center with a 25 bed low acuity unit

• Began replacement of imaging technology throughout the system

• Completing staff reduction and relocations

• Awarded ACHN Joint Commission and other clinical accreditations

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Strategic Plan: Vision 2015-Year TwogFY 2012 Preliminary Budget AssumptionsJohn H. Stroger Jr. HospitalJohn H. Stroger Jr. Hospital Continue to work toward hospital operational efficiency Invest in improving service delivery, quality patient care and patient

safety initiativessafety initiatives Continue to build the selected service lines in Maternal Child

Health Services, ER/Trauma and Surgical Services Implementing Pre processing Center for scheduling CareLink Implementing Pre-processing Center for scheduling, CareLink,

intake improvement Implement Physician Billing

I l t M d C t t Implement Managed Care contracts

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Strategic Plan: Vision 2015-Year TwoFY 2012 Preliminary Budget AssumptionsProvident Hospital

Expand outpatient surgical services to increase system-wide capacityE d GYN i l i Expand GYN surgical services

Add GI services Expand pre-processing center conceptExpand pre processing center concept Build partnerships with FQHCs to increase referral opportunities for

subspecialtiesI l t h i i billi Implement physician billing

Sustain operational efficiencies

710

Strategic Plan: Vision 2015-Year TwoFY 2012 Preliminary Budget Assumptions Oak Forest Health Center

Continue immediate care center 24/7 coverage Expand primary care services Add pain management and urology services Renovate ‘E’ building Renovate E building Expand digital imaging environment Obtain CON designation as an Ambulatory Surgery Center

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Strategic Plan: Vision 2015-Year TwoFY 2012 Preliminary Budget Assumptions ACHN

Implement primary care strategy to support managed care contractingcontracting

Expand specialty services at Oak Forest and Provident Implement physician billing Implement pre-processing center, CareLink and centralized

scheduling Continue to focus on improving customer servicep g

911

Strategic Plan: Vision 2015 Year TwoStrategic Plan: Vision 2015-Year TwoFY 2012 Preliminary Budget Assumptions

Office of the Chief Health Administrator Pharmacy, Information Technology, Patient Accounts, Legal,

Compliance, Internal Audit, System Administration, Finance and Human Resources

Major system contracts including PWC and IT support

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Strategic Plan: Vision 2015 Year TwoStrategic Plan: Vision 2015-Year TwoFY 2012 Preliminary Budget PWC Impact

• Statement of Work• ACHN/Core• Cermak• Cermak• Operations• Physician Funding & Effort• Public Health• Revenue Cycle• Cerner/Siemens Reengineering• Supply Chain

• Revenue Cycle Benefit

• Staff Augmentation

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Strategic Plan: Vision 2015-Year TwogFY2012 Preliminary Operating Budgets

Department Name2011 Adjusted with

5% ReductionCCHHS 2011

Current 2012 DifferenceDepartment Name 5% Reduction Current 2012 DifferenceJohn H. Stroger Jr. Hosp 408.4 433.3 25.5Office of the Chief Health Admin 155.5 188.0 32.5Provident 62.9 52.1 (10.7)Ambulatory 49.6 46.5 (3.1)Oak Forest Hospital 49.6 35.8 (13.8)CORE Center 11.3 11.9 0.6Health – Fixed Charges 112.1 108.8 (3.3)

Total 849.6 877.2 27.7

Cermak Health Services 41.1 39.1 (1.9)JTDC 3.5 3.9 0.4Department of Public Health 17 6 17 3 0 3

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Health 17.6 17.3 0.362.3 60.4 (1.8)

Salary Adjustment

Facility Reduction Available Funding

240-Cermak - -

241-Juvenile-JTDC - -

890-Office of the Health Adm (7.4M) 1.8M

891-Provident Hospital (3.8M) 1.0M

893-ACHN (4.7M) 1.2M

894-CORE (0.3K) 0.08K

895-Public Health - -

897-Stroger Hospital (35.3M) 8.8M

898-Oak Forest Health Services - -

TOTAL (51.5M) 12.9M

FY 2011 FY 2012Salaries & Wages $489.1M $517.7MOvertime $ 23.3M $ 23.6M

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Overtime $ 23.3M $ 23.6M Registry Services $ 7.5M $ 6.6MDifferential Pay $ 14.9M $ 14.2MFloat Pool - $ 2.5M

Personnel Fiscal Year

Facility2011

Approved2012*

FTE Changes2012

Deleted2012 New

2012Net

Transfers2012

Request

2012Request0.2 FTE

Cermak 516 0 9 9 (32 0) 11 1 (1 0) 504 0 504 0Cermak 516.0 9.9 (32.0) 11.1 (1.0) 504.0 504.0

Juvenile JTDC 36.8 0.2 0.0 0.0 0.0 37.0 37.0

Office of Chief 554.3 54.7 (43.0) 20.0 8.0 594.0 498.0

Provident 462.9 127.1 (104.0) 18.0 (35.0) 469.0 405.0

ACHN 705.1 50.9 (134.0) 51.0 6.0 679.0 585.2

CORE 67.4 3.6 0.0 0.0 (1.0) 70.0 64.4

Public Health 170.8 6.2 0.0 0.0 (1.0) 176.0 176.0

Stroger 3,614.9 475.1 (177.0) 243.0 35.0 4,191.0 3,631.8

Oak Forest 509.9 245.6 (414.0) 0.0 (10.0) 331.5 331.5Total 6,638.1 973.3 (904.0) 343.1 1.0** 7,051.5 6,232.9

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* Positions change the FTE status from FY2011** Position Transfer from Dept 564 to Dept 897

Strategic Plan: Vision 2015-Year TwoFY2012 Preliminary BudgetSources of Revenue (in millions)Sources of Revenue (in millions)

$75.1$131.0$131.0

Medicare

Medicaid

Commercial

$140 0

Other Patient

Other Rev

DSH

$239.2$17.2

$

$6.0

$140.0 DSH

BIPA

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$1.2Total Revenue: $610M

FY2012 Preliminary Budget y gWhere are we:

•Performed rigorous review of all operating units’ expenses and services to conform to the strategic plan

•Budgeted patient revenue at realistic level

•Held numerous conversations with Presidents office on alternatives to reduce duplication, consolidate appropriate functions and remove barriers

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FY2012 Preliminary Budget Next Steps:

•Continue to work with Presidents office on identifyingContinue to work with Presidents office on identifying funding sources

C t l t t l b d t i k i l di•Create a plan to control budget risks including

•Vacant and new positions

•Transformational activities in supply chain, revenue cycle clinical service improvement volume growthcycle, clinical service improvement, volume growth

•Clinical staff ratios with removal of vacant and new position f nding

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position funding

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FY2012 Preliminary Budget

Summary

Budget 2011 Projected Actual 2011

PreliminaryBudget 2012Actual 2011 Budget 2012

Approp $911.8 $911.8 $937.6

Revenue 638.0 548.0 610.0

(273.8) (363.8) (327.6)

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