Lake County Community Health Center Governing Council met Feb. 8.
Here are the minutes provided by the council:
1. Call to Order
Chair Smith-Taylor called the meeting to order at 5:31 p.m.
Member Ross-Cunningham joined at 5:35 p.m. and Member Lara joined at 5:40 p.m., so neither were present for the approval of the minutes.
Present 8 - Chair Smith-Taylor, Vice Chair Fornero, Secretary Argueta, Member Bejster, Member Chuc, Member Lara, Member Cunningham and Member Tarter
Absent 1 - Member Washington
2. Pledge of Allegiance
Chair Smith-Taylor called upon Vice Chair Fornero to lead the Pledge of Allegiance.
3. Approval of Minutes
3.1 January 11, 2022 Meeting Minutes
A motion was made by Member Tarter, seconded by Vice Chair Fornero, to approve the minutes of the January 11, 2022, regular meeting. Roll call vote, all in favor, motion carried.
Aye: 6 - Chair Smith-Taylor, Vice Chair Fornero, Secretary Argueta, Member Bejster, Member Chuc and Member Tarter
Absent: 1 - Member Washington
Not Present: 2 - Member Lara and Member Cunningham
4. Public Comment to the Council
None
5. Executive Director's Report
Executive Director Mark Pfister reported on the following:
1. COVID-19 Update: The Omicron variant surge seems to have passed on. We are seeing a reduction in the number of cases and a reduced positivity rate, but that could be due to the fact that at-home tests are no longer being counted towards those rates.
Hospitalizations are dropping. However we are seeing an increase in COVID-19 deaths in Lake County. The hope is that the warmer spring weather will also help to lower the number of cases and that by summer we will be back to where we were at that time in 2021. He cautioned the Council that we are going to be prepared for another surge in the Fall as it does appear that COVID-19 surges in the colder weather months based on the last two years. Vaccinations are still being given in the FQHC's to approximately 1,000 people per week for first and second doses as well as boosters. According to the CDC, in Lake County almost 80% of the population 5 years of age and above are fully vaccinated.
Unfortunately, nationally the 5-11 year old population is not being vaccinated as fast as the 12-17 year old population. We have yet to reach 40% fully vaccinated for 5-11 year olds in Lake County as that continues to plateau and drop off, but we are hopeful it will rebound.
2. North Chicago Health Center Renovations: The renovations continue to go extremely well and we are expecting the building will reopen in March of 2022.
3. Hiring of Staff: We still struggle to fill vacant positions. As an organization we are continually looking at all the methods and ways we can get more people to apply and assure we can bring them onboard, and for staff receiving outside offers, that we can keep them here. In the near future, we will be discussing with the Council hiring and sign-on bonuses being considered for certain individuals and positions, and how certain positions can be upgraded so that staff won't leave the Health Department to go work for other agencies and organizations paying more. As Kim Burke reported last month, the Certified Medical Assistant (CMA) job grade was increased and since then the number of CMA's leaving has dropped.
Secretary Argueta commented that it's great that bonuses are going to be given to retain top talent and asked if thought has been given to holding job fairs to get the community involved and excited about working at the Lake County Health Department. Mark stated that he has been speaking with Lorraine Harris, Human Resources Director, and she informed him that HR is planning on doing some upcoming job fairs with Workforce Development. He added that past job fairs have resulted in new hires and mainly for IT individuals who are still with the Health Department but, unfortunately, they have not been as successful for the medical positions. We are trying to be as creative as possible to show that the Health Department is a great place to work, which it is, and to show people that we have jobs available. Positions are posted on the Health Department site, the County site, Linkedin, and other job sites. There is also a press release going out about a new grant we received and that we are hiring for those positions.
6. Action items
6.1 Provider Credentialing and/or Privileging - Dr. Zun
Dr. Zun presented one provider for credentialing and privileging (Annette Bale, APRN, Psychiatry) and concurs with the findings of the Personnel Committee to recommend approval.
A motion was made by Member Ross-Cunningham, seconded by Member Argueta, to approve the credentialing and privileging for the provider named, as requested. Roll call vote, all in favor, motion carried.
Aye: 8 - Chair Smith-Taylor, Vice Chair Fornero, Secretary Argueta, Member Bejster, Member Chuc, Member Lara, Member Cunningham and Member Tarter
Absent: 1 - Member Washington
6.2 Provider Reappointment - Dr. Zun
Dr. Zun presented six providers for reappointment (Mussarat Arshad, MD, Pediatrics; Spiros Lafazanos, DDS, General Dentistry; Maria Molnar, DMD, Doctor of Dental Medicine; Craig Showalter, MD, Addiction Medicine; Leslie Villalobos, APRN, Family Practice; Syeda Zahedi, MD, Family Medicine) and concurs with the findings of the Personnel Committee to recommend approval.
A motion was made by Vice Chair Fornero, seconded by Member
Ross-Cunningham, to approve the reappointment of the providers named, as requested. Roll call vote, all in favor, motion carried.
Aye: 8 - Chair Smith-Taylor, Vice Chair Fornero, Secretary Argueta, Member Bejster, Member Chuc, Member Lara, Member Cunningham and Member Tarter
Absent: 1 - Member Washington
6.3 Annual Approval of Cooperative Operational Agreement - Pfister
Mark Pfister reminded the Council that this item was on the January 11, 2022, agenda for discussion and that members were to review the agreement and submit any comments and suggested changes to him or Lisa Kroeger. No comments and suggested changes were received, so the agreement remains unchanged and is now presented for approval.
A motion was made by Member Tarter, seconded by Member Lara, to approve the BOH/GC Cooperative Operational Agreement, as presented. Roll call vote, all in favor, motion carried.
Aye: 8 - Chair Smith-Taylor, Vice Chair Fornero, Secretary Argueta, Member Bejster, Member Chuc, Member Lara, Member Cunningham and Member Tarter
Absent: 1 - Member Washington
6.4 Governing Council Member Reappointment - Pfister
Mark Pfister informed the Council that Chair Smith-Taylor's membership is now due for renewal for her second two-year term.
A motion was made by Member Ross-Cunningham, seconded by Vice Chair Fornero, to approve the two-year reappointment of Member Smith-Taylor. Roll call vote, all in favor, motion carried.
Aye: 8 - Chair Smith-Taylor, Vice Chair Fornero, Secretary Argueta, Member Bejster, Member Chuc, Member Lara, Member Cunningham and Member Tarter
Absent: 1 - Member Washington
7. Presentations
None
8. Discussion Items
8.1 CQI Update - Hayes
Christina Hayes, CQI Coordinator, reviewed the information and attachment provided in the agenda packet. She noted that what is more important than the improvement in the screening rate is what happens with those screenings. Over the past year, 358 screenings were positive for depression of which 167 referrals were placed. Of those 358 screenings, 122 indicated a possible suicide risk of which 71 referrals were placed for behavioral health. Many of those patients are already linked to behavioral health services which is why there is not a higher rate of referral. In 2022, the focus will be on improvement of depression symptoms and depression remission in our current patient population while continuing to conduct the depression screenings.
Member Bejster commended Christina and the members of her team involved with this particular PDSA initiative as it was a concern previously discussed in terms of mental health needs related to the pandemic. The numbers truly highlight not only the importance of the screenings but also in making those connections to care and it is wonderful that those resources are available within the FQHC's. She looks forward to seeing how this work continues and the resulting improvements. Mark thanked Member Bejster for her comments and noted that staff are currently working on UDS numbers to submit by February 15, so we took advantage of that opportunity to highlight and present this particular PDSA to the Council. Storyboards for some of our other QI projects will be brought to the Council at future meetings. This is also one great example that the Health Department is a "one stop shop" for our patients and clients.
This matter was presented
9. Medical Director Report
9.1 Medical Director Report - Dr. Zun
Dr. Zun reviewed the highlights of his report and its attachment as provided in the agenda packet. He noted that the meeting held in late January with the hospital presidents to discuss specialty care support for our unfunded patients did not go as well as hoped. A mechanism by which to send those unfunded patients to area hospitals for specialty care could not be agreed upon. Other means of providing that specialty care to those patients is being explored and there is ARPA grant funding that can be used towards that purpose. Funds from the dental grant presented to the Council at the December 14, 2021, meeting have been received so we are starting to train the Community Health Workers (CHW) to be Dental Health Community Workers (DHCW). This will allow them to add pediatric patient oral health discussions to the work they are already doing in the Lake County communities.
Chair Smith-Taylor asked if she is correct in her understanding that outside entities are not accepting our referrals. Dr. Zun explained that the attempt was to find one stop shopping for our unfunded patients so they could go to one hospital system or multiple hospital systems to get the specialty care they need. Currently, we have an arrangement where our breast cancer patients can go to three area hospital systems on a rotating basis to receive their specialty care. We were attempting to set up that same arrangement for the other specialties, but we were not able to work it out as the hospital presidents asked for more information and more data. Mark added that this is very disappointing, that he has told the hospital presidents that a long-term solution needs to be reached as it is ridiculous that we have to beg our community benefit hospitals for this care. The majority of hospitals in Lake County are not-for-profit which means they don't pay any taxes to anyone in Lake County or the State of Illinois. Rather than paying taxes, they are supposed to provide community benefit dollars, such as charity care. Unfortunately, they are spending those community benefit dollars on things that are already a part of their business model such as training and CME's and, interestingly enough, they wanted him to go back and ask the County for more property tax dollars to help fund specialty care. The County Board has held the tax levy across the county flat for several years. This discussion is not over as he has asked the hospital presidents to go back to their systems to find out what is needed from us and what their system is going to allow them to do because while the president may be in charge of the hospital, they are not in charge of the entire hospital system limiting their ability.
This matter was presented
10. Director of Healthcare Operations Report
10.1 Director of Healthcare Operations Report - Burke
Kim Burke reviewed the highlights of her report and its attachment as provided in the agenda packet. She noted that staff are actively planning on how and where we are going to administer COVID-19 vaccinations once approved for the 6-month to 4 year olds. They envision doing it in the FQHC's in conjunction with scheduled appointments but then also have some mechanism in place for those patients without a scheduled appointment. She reminded the Council that the North Chicago Health Center was removed from the HRSA Scope of Service during its shutdown for renovations, therefore it will need to be brought to the Council to be added back to the Scope of Service as soon as a reopening date has been determined. Once approved by the Council, the revised Scope of Service will be submitted to HRSA, and once approved by HRSA we can make plans to move everything and everyone back in. We are also having staffing challenges in our Patient Access Center (PAC) with approximately 35% of those positions vacant. PAC staff are responsible for scheduling appointments. We are working with HR on creative recruitment and retention strategies. In regard to the FQHC Metrics Dashboard, there has been improvement in Third Next Available Appointment due to the hiring of three pediatricians and one family practice physician. Three of them are already at a schedule of 100%. One pediatrician remains at 75% but that is only because we don't currently have enough dedicated CMA support. Once we hire more CMA's, that provider's schedule will also be at 100%. It was discovered that the No Show Rate numbers reported last month included rescheduled patients in addition to no shows. The rescheduled patient numbers have now been removed and this month's No Show Rate percentages reflect only the true no shows. While those numbers did go down, it is still too high and we continue to dig into the reasons why.
This matter was presented
11. Director of Finance Report
Pam Riley, Director of Finance, informed the Council that the December and draft November report will be provided at the March 8, 2022, meeting as Finance is also experiencing staffing shortages.
12. Added to Agenda
None
13. Old Business
Mark Pfister informed the Council that Member Brown resigned as of January 24, 2022. He, the Chair, and the Vice Chair scheduled a meeting with Member Brown as discussed and agreed upon at the January 11, 2022 meeting, but Member Brown did not attend. When the Chair followed up with him via email as to when he would like to reschedule, he responded with his resignation. Chair Smith-Taylor then sent him a note thanking him for his time and service to the Council.
14. New Business
None
15. Executive Session
None
16. Adjournment
A motion was made by Member Ross-Cunningham, seconded by Vice Chair Fornero, that this meeting be adjourned. Chair Smith-Taylor adjourned the meeting at 6:14 p.m.
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