Another rainy day in the City.
At last Cook County Board meeting the subject of shutting down the referral computer used by primary care doctors at clinics, that is used to refer patients to specialists at the Cook County medical facilities was written about extensively in local newspapers. Dr. Simon said he cut down the Sirus (sp?) systems because if patients go to the ASC (Ambulatory Screening Clinic) and see a primary care doctor the County will get more Federal reimbursement. Dr. Simon said that if they go to the clinics that are associated, with the Advocate, Adventist, or whatever health care network they are associated with clinics, they should be referring patients to their hospitals, and not Cook County because the primary care doctor's get the most federal reimbursement. If this is true, then I could see Dr. Simon's point. A lot of hospitals want top dollar for their services and the federal government does not reimburse at top dollar. Dr. Simon pointed out that 10-20 million dollars of costs are incurred by the 16-20% of patients referred from non-Cook County primary care doctors. Commissioner Beavers had Simon step up to the microphone to answer questions because "he sounded like he was in a ditch".
But then again I have a PPO and I see how much discount the PPO gets off the bill and wonder, if I paid cash this bill would be outrageous, I would not get a discount. I wonder how this billing system is so crazy, wouldn't it cost less to have one set price, and not dependent on which insurance or which payment method? Commissioner Sims brought up that patients could just have their tests results faxed over to the ASC, if they don't bring with them. Now seriously, aren't Doctors offices so busy that they don't have time to fax everything everywhere? Is this a feasible option? How long will it take to get something faxed over? Will patients have to return to the clinic again because the results are not there for their visit?
Will the receiving fax at the ASC be so bogged down with faxes that it will be someones full time job to sort through all of them and make sure all pages go with each other? Couldn't they just keep the referral system up to hold test results?
Judge Nowicki who is assigned to uphold the Shackman certification in hiring was at the meeting. Judge Nowicki was also very unprepared to answer any questions at the meeting. One question she did answer to Commissioner Peraica was will the costs of her services go up, and she answered yes.
The Anderson Elevator contract was debated. Commissioners Sims and Steele were not happy with the quality of the work, especially on the floors with regards to tile coming up in elevators. Commissioner Sims remarked that it looked like it was the same grade as kitchen tile, Bruce Washington who was in charge of the project assured them that only commercial grade tile was being used and that the work is not complete.
Commissioner Peraica asked controller Fratto why $100,000 fees were being charged on an $800,000 account by Seaway Bank? No answer. My question is why does Cook County do so much business with Seaway Bank? Also many departments are over budget this year, in the first quarter most are at 32%-42% or more of their expenditures, the answer was because of layoffs and paying out compensation times and vacations. It was also commented that the cigarette tax revenue was down, and it could be because of all the no smoking regulations.
Maras O'Leary, the Chief Information Technology officer left, when asked why President Stroger said she was fired for cause, and that's as far as went with that.
Commissioner Peraica asked Zelda Whittley, under sheriff how the program of more home monitoring devices was going, because some prisioners who cost $130 a day could be home at $16 a day. Apparantly they are still working on that. Commissioners Quigley and Maldonado said they have been meeting with Sheriff Dart and encourage more to do so since he is willing to work on things with them. Was that supposed to be a direct jab at President Stroger?
Dr. Martin was there explaining that children with high lead levels from certain incomes were eligible to have lead removed from their homes. Commissioner Peraica wanted to know where the homes were, so they knew where money was going. Due to HIPA, the privacy information patient act, they could not disclose that information. Commissioner Peraica insisted they should know approximately where the homes were without disclosing the minor children's names.
The janitor issue was brought up again, this time in regards to when the marriage court would be moving out of the Cook County Building. At this time there is not date on that, and the Cook County Building will continue to be cleaned by janitors from the Sheriff's department.
Crain's point of view“Due to draconian budget cuts, the county is forced to examine every aspect of health service delivery,” states the letter, signed by the county’s interim health chief Robert Simon.
The county will review the system and report back to its referral partners by the end of May, the letter states.
For patients who need an urgent referral, Dr. Simon instructs physicians to send them to the county’s main outpatient screening center on the campus of John H. Stroger Hospital — a facility notorious for long wait times.
The move is seen by many local providers as “a layer of bureaucracy to keep people out of the specialty clinics,” said Wendy Cox, CEO of Chicago Family Health Center, which operates four primary care clinics on the South Side.
“These people still need care,” Ms. Cox said. “You’re not shutting off the demand. All you’re doing is creating a bottleneck for people to get in for treatment.”
Dr. Lee Francis, vice president of medical services at Erie Family Health Center, in a letter to Simon wrote that suspending the system will result in more costs because physicians will not have access to patients' medical records and will have to reorder tests. He added that the health bureau "will incur the expense of hundreds, if not thousands, of additional ambulatory" visits.