Beginning Wednesday, I’ll assume my duties as a reporter covering Cook County government for Chicago Current, a new newspaper with a tight focus on local politics. It’s relying on pretty much the same team that we had at the Chi-Town Daily News, and we have high hopes for the project.

That said, my focus has shifted far away from this blog, which I used to keep up with the health beat, kill time, and hopefully inform people about some of the things happening in Chicago, especially with the Cook County Health and Hospitals System.

Thank you for reading. This new job is probably the death knell of Chicago Health Beat, but I may post here occasionally. If you want to stay current with any new happenings on this blog, please follow it on Twitter (@Chicago_Health).

Thanks again. It’s been a trip.

-Alex

Employees began receiving layoff notices today. The cuts include 700 vacant positions and 335 filled positions, mostly in support roles, including food service and maintenance.

Health system leaders said last month they had identified nearly 500 positions that could be eliminated, and included those savings in its 2010 budget proposal. Its 2009 budget included provisions for 900 layoffs, while adding 450 new medical staff jobs.

“When the Cook County Board of Commissioners established the independent health system, they required us to undergo a performance improvement assessment study,” CCHHS CEO William Foley said in a statement. “We have completed that study and found that there were some areas that needed adjustments in staffing.

“This is a rebalancing effort to make sure that we have the right amount of people in the right place at the right time to make sure our patients are getting the quality care they deserve.”

The cuts are scheduled at all CCHHS locations. Medical staff positions are among those being cuts, specifically at facilities where staffing exceeds patient demand, such as OB/GYN services at Provident Hospital, where there is on average just one birth a day, and just one a shift at Stroger Hospital.

The health system has been working with Navigant Consulting to identify areas where it can improve. At a town hall meeting at Truman College last night, CCHHS board chairman Warren Batts said the health system is over-staffed, noting that at Stroger Hospital, the staff-to-patient ratio is about 9-to-1, a rate he says is one-third more than other health systems.

The health system board elected to let employees go after the holidays, and is assisting those laid off in finding new jobs.

Rep. Greg Harris is calling for public hearing's on the medical group's decision to abandon its Ravenswood location. PHOTO: Lake Effect News

The Tribune reported:

“We need a strong partner who can weather the storm of the financial crisis,” said Dr. Leonard Cerullo, a neurosurgeon who in 1987 founded the group that operates as Chicago Institute of Neurosurgery and Neuroresearch.

“NorthShore University HealthSystem is committed to investing in the technologies and programs necessary to deliver the safest and most effective treatment options for patients suffering from brain and spine disease.”

But Ald. Gene Schulter (47th) expressed concerns about the move, and called it “disastrous” for the neighborhood.

State Rep. Greg Harris (D-Chicago) stepped into the fray, and demanded public hearings from the Illinois Health Facilities and Services Board, according to the Illinois Observer. The first hearing took place Oct. 9.

“This action, which occurred rather suddenly, would result in a great loss of specialized medical care to the community, the loss of around 300 jobs in a difficult economy,” Harris wrote in a recent e-mail (to the Observer), “and would leave a key structure vacant and deserted on the hospital campus.”

Lake Effect News reported that hospital officials blamed low occupancy and multi-million dollar loans for the hospital’s decision to move the suburbs (which must be approved by the state). CEO Peter Breen also said the hospital lost about $30 million over the last two years.

The state will continue to hear public comments – via snail mail and fax – through Nov. 12. Comments should reference Project 09-045 and be sent to Mike Constantino, Supervisor, Project Review Section, Health Facilities Service and Review Board, 525 W. Jefferson, 2nd Floor, Springfield, IL 62761, or by fax at 217-785-4111.

For a good write up on the hearing, check out the Lake Effect News story.

For all the positive changes, there have been as many that have ticked people off. People complain the board is accountable to no one. Others say board members are nothing but political shills.

The Tribune reports today how the board is starting to annoy Cook County Board President Todd Stroger, who granted the health system independence in exchange for votes on the penny-on-the-dollar sales tax.

“I think that we may have to remind you that we exist, Mr. Foley,” Stroger said, silencing chattering observers at a recent County Board meeting. “Sometimes I think that you think we’re invisible, that we’re not part of the whole picture.”

Stroger, whose spokesman told this blog he would tout the health system’s successes in the upcoming campaign, is finding an uncompromising team at the health board. While county commissioners have final say on the system’s budget (nearly $1 billion), Foley and his team opted to cut the health system’s tax subsidies by 19 percent, meaning it is relying less on county dollars and more on its own revenue, further establishing its independence of county commissioners.

(The Tribune notes the health system ran independently for years in the 1970s before coming back under control of the county.)

Small business owners who feel slighted after the health system signed a three-year, $500 million supply contract with a group purchasing organization called Novation feel the health system has ulterior motives. And others feel the decision to axe services and staff at county facilities is lacking transparency.

As for those major changes to health care delivery? The health system board held the first of seven town hall meetings on the strategic plan last night in South Holland. Not surprisingly, people were up in arms about the changes, which would eliminate in-patient care at Oak Forest and Provident Hospitals.

The SouthtownStar reports:

“We never said we wanted one service or another, we want comprehensive care,” Oak Forest Hospital nurse Brenda Langford told officials.

Foley said the plan would rearrange the county system’s limited resources to maintain access for increased efficiency. Hospital partnerships would help fill the inpatient care needs, he said.

Despite his assurances, the crowd cast doubt that the plan amounted to more than service cuts in the Southland.

“Oak Forest is the only hospital out there for poor folks,” Joe Sneed, of Harvey, said.

Many who were in attendance questioned whether neighboring hospitals would admit patients who now come to Oak Forest as a last resort.

“We’re going to reward them for kicking patients out,” Chicago Heights resident Ray Arbalo said.

Foley said the plans make sense because the system is not expecting any big revenue increases in the near future. Its revenue increased about $200 million in 2009, thanks to a bevy of federal dollars the county had never before taken advantage of.

The next town hall meeting is tonight at 6 p.m., at Truman College, 1145 W. Wilson. For a complete schedule, click HERE.

It wasn’t good when any of the healthcare workers skipped the soap, but it was definitely worse when the peripatetic workers failed to wash their hands, the researchers found. If a single peripatetic worker flunked the hygiene test, the spread of disease was three times worse than if a nurse or doctor did. In fact, they calculated that if just one peripatetic worker refused to wash his or her hands, the effect was the same as if ALL healthcare workers washed their hands only 77% of the time, they wrote in a study published online today in Proceedings of the National Academy of Sciences.

Yuck. That’s all I can say.

The Chicago Health Department will set up free clinics to administer vaccines for H1N1 swine flu at six City Colleges of Chicago campuses, the city’s health commissioner told a City Council committee Tuesday.

The centers will be up and running in the next few weeks.

October 19, 2009
South Suburban College
15800 South State Street
South Holland, Illinois

October 20, 2009
Truman College
1145 West Wilson Avenue
Chicago, Illinois

October 21, 2009
Niles Senior Center
999 Civic Center Drive
Niles, Illinois

October 22, 2009
Math and Science Academy
8601 West Roosevelt Road
Forest Park, Illinois

October 27, 2009
Austin Town Hall Park
5610 West Lake Street
Chicago, Illinois

October 28, 2009
Chicago Urban League
4510 South Michigan Avenue
Chicago, Illinois

October 29, 2009
Cicero Town Hall Community Center (in Spanish)
2250 South 49th Avenue
Cicero, Illinois

In preliminary plans released on the health system’s Web site yesterday, a PowerPoint presentation shows the board is considering eliminating in-patient care at Oak Forest and Provident hospitals, creating a number of health care “hubs” for primary and specialty services, and partnering with other hospitals on other services.

The plans will be up for discussion at a town hall meeting Oct. 19 in South Holland, the first of six seven such meetings scheduled throughout the county, where health system leaders will solicit feedback from the public.

The independent board, under the leadership of CEO William Foley, has been crafting the strategic plan for months, following a series of town hall meetings in Cook County that began in July. Board members listened to the public, who said there needed to be more nurses, more clinics and better access to affordable health care. The board also met with nearly two dozen independent agencies and organizations to gather input. At the town hall meetings over the summer, board members asked the public a tough question: What one services would you keep?

Given the tough economy, it was a harbinger of the plan, which is big on cuts and reorganization, even as the health system rakes in more than $200 million more than it did last year.

The plan also calls for the creation of health care “hubs,” three to five that offer primary and outpatient services, which would increase access to care.

Partnerships with other hospitals and academic centers would increase the county’s ability to offer specialized care, such as for cancer, diabetes and heart disease.

The most dramatic changes, though, are the proposal of eliminating in-patient care of Oak Forest and Provident hospitals. Provident would expand its outpatient and specialty services, while Oak Forest would expand its outpaeint and rehabilitation offerings. Patients who need in-patient care would instead report to the third county hospital, John H. Stroger, Jr., Hospital.

“Certainly we have a hard time conceiving that they would all either go to Stroger for inpatient care or they would all be absorbed by the community hospitals,” Dr. Homer Abiad, president of the Oak Forest medical staff, told the SouthtownStar. “The system and the governing board are aware of the influx of under-served populations in the south suburbs. They’re aware of that but somehow the plan is still sort of looking at … how can we get away with not providing inpatient services to this community.”

The draft of the plan makes no mention of about 500 expected layoffs. There’s been no official comment from the health system or likely opponents of the strategic plan, which also lobbies for an extension of the independent board’s initial three-year commitment.

Here is a link to the PowerPoint presentation.

The vast majority of group homes for disabled adults are licensed with the Department of Public Health, which provides a set of rules to ensure resident safety: on-site inspections when complaints are filed; background checks for employees; education and training for nurses; and CPR certification and other basic levels of competency.

While operating illegally, some unlicensed homes do operate with these same set of high standards. But most do not, experts said, often providing residents with cramped and substandard living conditions, dispensing medicine improperly and illegally, and organizing loosely structured activities that could be unsafe for residents.

At least seven families have filed complaints about the Deicke Home with the Department of Public Health since December 2007.

They included claims that staff handed out medicine without verifying who the residents were or whether the medicine belonged to them; that medicine was given to the wrong person, or medication was not given out at all; that families were forced to sign consent forms allowing unlicensed staff to administer medications; and that residents were actually regressing in their development by unstructured activities.

In July, the Chi-Town Daily News shed light on unlicensed group homes for the mentally ill. The state has no oversight on these homes, unless they receive state or federal dollars, or if they provide nursing care. But some entrepreneurs prefer to operate under the radar, purporting to offer services, like nursing or medication management, without the expertise or license to do so.

Lawmakers told the Daily News they would work with the General Assembly to require all group homes to be licensed by the state. Given the state’s response to the Tribune’s series on the failure of nursing homes to vet violent offenders, we could see legislation on group homes in the winter.