Lake County Community Health Center Governing Council met Jan. 10.
Here are the minutes provided by the council:
1. Call to Order
Chair Fornero called the meeting to order at 5:31 p.m.
Present 7 - Vice Chair Smith-Taylor, Chair Fornero, Member Argueta, Member Bejster, Member Chuc, Secretary Lara and Member Tarter
Absent 2 - Member Ross Cunningham and Member Hernandez
2. Pledge of Allegiance
This matter was presented
3. Approval of Minutes
3.1 December 13, 2022 Meeting Minutes
There were no questions or comments from Council members.
Chair Fornero called for a motion to approve the minutes of December 13, 2022. Motion by Member Tarter, second by Member Chuc. Voice vote, all in favor, motion carried.
Aye: 7 - Vice Chair Smith-Taylor, Chair Fornero, Member Argueta, Member Bejster, Member Chuc, Secretary Lara and Member Tarter
Absent: 2 - Member Ross Cunningham and Member Hernandez
4. Public Comment to the Council
None
5. Executive Director's Report
Mark Pfister, Executive Director, reported on the following:
1. He congratulated the new Executive Committee, Chair Charles Fornero, Vice Chair Miriam Smith-Taylor, and Secretary Maria Elena Lara, on their election in December. He is pleased that the tradition of an all consumer executive committee continues and looks forward to working together.
2. For the record and for when HRSA does their next site visit, it has been confirmed that all consumer members of the Governing Council have had at least one patient visit within the last two years.
3. COVID-19: Even though Lake County is in medium community level, some increases in hospitalizations are being seen. Case counts are not being looked at as strongly as home testing is not tracked. There is concern that there will be a winter surge as there is a new variant that biologically has greater cell adherence allowing it to invade the cell easier. The great news continues to be that hospitalizations, severe illness, and death have been greatly reduced due to vaccinations. And while there are some case increases in long-term care facilities, there is not an increase in hospitalizations or deaths. Chair Fornero asked if there is a concern that Lake County will move to high community level. Mark explained that while it has been fluctuating, Lake County has been at medium community level for the last two weeks and community levels are updated every Thursday by the CDC. And while more cases of the new variant are being seen, it hasn't really hit Illinois yet. People should be getting their bivalent booster dose if they haven't yet. Our FQHC patients are being given the bivalent booster and our community health centers are still administering approximately 50 first and second doses every week. Chair Fornero asked about the surge in cases in China. Mark explained that China had a very controlled situation over the last few years and now it's no longer controlled and that is why it's spreading dramatically.
4. The hospital presidents meeting is tomorrow, Wednesday, January 11, 2023. One of the priorities in the Lake County Community Health Improvement Plan (CHIP) is access to health care and, in particular, uninsured patient access to specialty care which Mark has been working on with the hospital presidents. His strategy for tomorrow's meeting is ensuring all of the hospitals are ready to go in moving toward incorporation of Access Lake, the 501(c)3, so that it can start receiving other funding streams to assist with access to specialty care. Member Argueta asked if it will also include psychiatric care. Mark explained that the goal is to start with the medical piece and then expand over time with other partners, so psychiatry could potentially be added later.
6. Action items
6.1 Governing Council Committee Appointments for 2023 - Fornero
Chair Fornero presented his committee appointments for 2023. There were no questions or comments from Council members.
Chair Fornero called for a motion to approve the 2023 committee appointments. Motion by Member Bejster, second by Member Argueta. Voice vote, all in favor, motion carried.
Aye: 7 - Vice Chair Smith-Taylor, Chair Fornero, Member Argueta, Member Bejster, Member Chuc, Secretary Lara and Member Tarter
Absent: 2 - Member Ross Cunningham and Member Hernandez
7. Presentations
7.1 FQHC Management Restructure - Burke
Kim Burke, Director of Healthcare Operations, reviewed the slides provided in the agenda packet. Chair Fornero asked how reimbursement is done for value-based care and quality outcomes now that we're moving from a fee-for-service model. Kim explained that when a value-based reimbursement contract is entered into with the insurance companies, there are 3 different ways to get reimbursed. The first is still receiving payment for each visit, it just may be a lower amount. The second is called pay for performance where the managed care companies take our UDS measures data, called HEDIS data by insurance companies, and reimburse us a set amount based on the visit type plus we get the quality metrics. The third is called shared savings where they take our client base and look at how much insurance companies spent in the last year on that client base. A year later they look at that same client base and if the insurance companies spent less than the prior year that means there was a savings because of the work we did to keep our clients out of the hospital. So depending upon what we can negotiate, we get a percentage of that savings. Shared savings is where we get the greatest reimbursement, but it results in healthier patients, improved patient outcomes, which is our primary reason for doing it. Member Chuc asked if the savings are passed on to the staff in any way for the good work they're doing. Kim explained that one of the things being looked at but that has yet to be developed is ways to compensate staff as a result of large payments received from the insurance companies. Member Tarter asked where HRSA stands in the move from fee-for-service to value-based. Kim stated they are all for it. Member Tarter asked if this will impact the 330 grant. Kim explained that it won't affect the 330 grant because of our payor mix and our number of uninsured clients, it only changes how we get reimbursed for our insured client population. Mark clarified that this is a 3-5 year proposition because there is a lot of work to do so we will still be in fee-for-service for at least the next 3 years with the goal of receiving more shared savings as we improve health outcomes for our clients. Kim added that this all goes together with Access Lake because if we don't have specialty care for our clients, whether they're insured or not, they're going to end up in the emergency department which from an insurance company perspective costs a lot more than paying for someone to see a specialist. Value-based care wraps up everything we're doing into a really good package for our clients.
This matter was presented
8. Discussion Items
8.1 CQI Update - Hayes
Christina Hayes, CQI Coordinator, reviewed the information provided in the agenda packet. Member Argueta commended the improvement in 14 metrics and staying on target for five and asked if there were challenges in those achievements and what those challenges were. Christina explained that different challenges are faced on a daily basis such as technology, staffing, and time. Successes are achieved by bringing everyone together and ensuring they're working together toward the same goal and that they understand what it is we're trying to do and why. It's all about improved client outcomes so by ensuring clients are getting everything they need those positive improvements are going to follow.
This matter was presented
8.2 LCHD/CHC Payer Mix FY2022 - Burke
Kim Burke reviewed the information provided in the agenda packet. There were no questions from Council members.
This matter was presented
8.3 Annual Review of Cooperative Operational Agreement - Pfister
Mark Pfister explained that the review of the Cooperative Operational Agreement is an annual requirement of both Governing Council and the Board of Health. Council members are to review and submit any comments or suggested changes to Lisa Kroeger. It will then be on the February agenda of Governing Council and the Board of Health for ratification and approval. The only change at this point is to page 5 of 5, Miriam Smith-Taylor, Chair, was removed and Charles Fornero, Chair, added. Chair Fornero asked for an explanation of the preamble, "The Board of Health is empowered....and will make application with the Lake County Community Health Center Governing Council for a Section 330 of the Public Health Service Act..." Mark explained that since the Health Department is a governmental entity, the Board of Health has the statutory authority over Health Department buildings and personnel, and the Governing Council controls the FQHC operations. However, the employees at the FQHC's are employees of the Board of Health or County of Lake government. So the preamble is saying that the Board of Health is a co-applicant with the Governing Council. If the Governing Council decided that it wanted to have its own board and create its own 501(c)3, it could terminate this agreement with the Board of Health and do everything on its own, per paragraph 10, Termination, on page 3 of 5, but that is not something we recommend as the Governing Council has the value of being connected to Lake County government and receives tax levy from County of Lake. Without the tax levy, the Governing Council and the Executive Director would have to work to obtain donations and other investments to fund the offset of what is not being received from the 330 grant and revenue from fee-for-service or other funding.
This matter was presented
8.4 Governing Council Member Self-Evaluation Results - Pfister
Mark Pfister reminded the Council that the annual self evaluation is a requirement of HRSA. He reviewed the compiled results stating he is very pleased with them as they are a clear indication that the Council is working very well together and with the Executive Director.
This matter was presented
9. Medical Director Report
9.1 Medical Director Report - Dr. Zun
Les Zun, M.D., Medical Director, reviewed his report as provided in the agenda packet. In regard to dental sealants, Mark noted that Dr. Cockey was given the challenge of getting dental sealants to 99% or above and dental hygienists and assistants have done that. Mark would now like dental sealants to be at 100% as it is something every child can benefit from.
This matter was presented
10. Director of Healthcare Operations Report
10.1 Director of Healthcare Operations Report - Burke
Kim Burke, Director of Healthcare Operations, reviewed her report as provided in the agenda packet noting that the Staffing Update will be a regular part of her report going forward. Mark added that the clerk positions for the Patient Access Center are remote and that if any Council member knows of someone who may be interested, to encourage them to apply.
This matter was presented
11. Director of Finance Report
There was no financial report as Finance Department staff are still processing year end. The next financial report will be provided at the regular meeting on Tuesday, February 14, 2023.
12. Added to Agenda
None
13. Old Business
None
14. New Business
Member Argueta shared that on December 25, 2022, she called the crisis line and the person who assisted her was phenomenal and helped her resolve her situation. Unfortunately, her experience at the hospital was very bad. While the work being done through Access Lake is great, there needs to be improvement in the hospital setting for behavioral health patients. Mark thanked her for her comment and stated he will pass it on to the crisis center staff. He added that he met with Lake Behavioral Hospital on Monday and they are continuing to expand their services but that he needs to speak with their corporate office regarding increased charity care.
15. Executive Session
None
16. Adjournment
Chair Fornero adjourned the meeting at 6:45 p.m.
https://lakecounty.legistar.com/View.ashx?M=M&ID=1062297&GUID=20070938-2A35-431D-9334-3D3EE9202ED0
Alerts Sign-up