Peoria Standard

Peoria County Health Committee met September 26.

Here is the minutes provided by the Committee:

Members Present: Sharon Williams - Chairman, Phillip Salzer - Vice Chairman; Robert Baietto, Allen Mayer, Steven Rieker (via teleconference)

Members Absent: A.J. Querciagrossa, Barry Robinson, Terry Waters

Others Present: Scott Sorrel - County Administrator; Shauna Musselman - Assistant County Administrator; Larry Evans - State's Attorney's Office; Andrew Rand - County Board Chairman; William Watkins, Jr. - County Board Member; Eric Dubrowski - Chief Financial Officer; Julie Ciesla – Finance; Angela Loftus - Asst. Director of Human Resources; Gretchen Pearsall - Director of Strategic Communications; Monica Hendrickson - Health Department; Nicole Demetreas – Treasurer; Dan O'Connell - Facilities Director; Doug Gaa - Sheriff's Office; Tim Turpin, Steve Richter - Heddington Oaks; Mark Little - Chief Information Officer; Kathi Urban – Planning & Zoning

Call to Order:

Chairperson Williams called the meeting to order at 2:10 pm.

A motion to approve the participation of Mr. Rieker via teleconference was made by Mr. Salzer and seconded by Mr. Baietto. The motion carried.

Approval of Minutes:

A motion to approve the minutes of August 29, 2017 was made by Mr. Baietto and seconded by Mr. Rand. The motion carried.

Informational Items / Reports / Other Minutes / Updates:

• Board of Health

➢ Monthly Update

Ms. Hendrickson advised that the Health Department is close to finalizing the contract with the bargaining unit.

• Care & Treatment Board

➢ Monthly Update

No report. No questions or comments from committee.

• Heddington Oaks Update

➢ Marketing Report

Mr. Richter advised that August saw 72 referrals, 23 admissions, 16 discharges and 49 denials. He stated that 41 of the referrals and 15 of the admissions came from OSF. He noted that 10 of the denials were because the facility was unable to meet medical needs, and those denials will be further broken out in future reports detailing which medical needs could not be met. He stated that current census stands at 156.

➢ Financials

Mr. Dubrowski advised that total operating revenues as compared to the same time last year are down by $1 million (16%), Medicaid is down $392,000 (12%), Private Pay is down $277,000 (18%); Medicare is down $60,000 (9%), and Other Charges for Services are down $318,000 (29%). He advised that Property Tax Fund accrual to date totals just over $1 million, and taxes within the FICA/IMRF Funds are $535,000 to date.

Mr. Dubrowski advised that year over year expenditures are down $81,000 (1%), Personnel costs are up $176,000 (5%), and Commodities are down $110,000 (16%).

Current Assets: Operating Cash totals $558,000 of cash and cash equivalent through six months, Pooled Investments of $5.1 million, Accounts receivable, net of allowance of $2.25 million, totals $3.7 million.

Net Position: Net investment in capital assets stands at $765,000, which will continue to decrease monthly due to depreciation of the facility. Unrestricted net position stands at $5.3 million.

Mr. Dubrowski advised that the Policy Directed Operating Income through six months is down $886,000 prior to depreciation, the majority of which is related to patient income.

Aging: Insurances companies currently show a $1.46 million overall balance, $1.12 of which is over 90 days. The amounts due from insurance companies are the most likely to see recoupment, and staff will work collaboratively with the State’s Attorney’s Office to obtain needed information to work with groups such as Meridian, Molina and Humana for recoupment, particularly of the older balances.

Mr. Rieker noted that a portion of the total overall balance is due to rejected or adjusted claims submitted to the insurance companies, and asked if a review of the reasons for those rejected/adjusted claims has been performed in order to improve on the results. Mr. Dubrowski commented that a second bookkeeper has been hired at Heddington Oaks, which will address those issues and ensure more accurate billing. He also advised a more in depth review of billing procedures would be examined. Ms. Williams stated that further discussion on this topic will take place at the October meeting.

Mr. Dubrowski advised that Medicare shows a balance of $888,000, of which $578,000 of which is 90 days or older; $462,000 is over one year.

Mr. Dubrowski stated that the Public Aid and Residents (Private Pay) category contain the majority of large accounts. Public Aid currently has a balance of $1.2 million, of which $681,000 is over 90 days; only $100,00 of that total is over one year. He advised that Medicaid Pending shows a current balance of $1.5 million, with $1.3 million over 90 days and $600,000 over one year. He stated that Private Pay shows a $1.2 million in balance, with $1.1 million over 90 days, and $600,000 over one year.

Mr. Dubrowski commented that after a policy on collections and bad debt has been put in place, a procedure for appropriate write-offs on bad debt can be determined.

➢ Medicaid and PA Accounts

Mr. Turpin advised that federal timeline standards maintains that the State must process an application for Medicaid within 45 days, with a 90-day extension; however, the State has not followed those federal guidelines and are not in compliance. He stated that any application submitted past the 45 days can be considered a prejudicial delay. He advised that any resident already on Medicaid must complete an annual redetermination of entitlement; however, the State is over 12 months in arrears on determining status on several of the residents.

Mr. Turpin advised that staff will confer with the State’s Attorney’s Office on identifying those residents and how best to pursue recoupment of debt, which will have a substantial financial impact on how much can be recouped, and in turn impact the accounts to be written off.

Resolution:

• Heddington Oaks Collections and Bad Debt Policy

A motion to approve was made by Mr. Salzer and seconded by Mr. Mayer. Mr. Dubrowski advised that the policy as drafted has been developed from existing practices, industry recommendations and best practices.

After discussion and questions from committee members, it was determined the policy was in need of further clarification and refinement. A motion to defer the resolution for one month was made by Mr. Mayer and seconded by Mr. Rand. The motion to defer carried, with Mr. Rieker voting aye via teleconference.

Miscellaneous:

Mr. Salzer suggested the possibility of holding fundraisers as a way to assist in alleviating some of the financial expenses at Heddington Oaks.

Adjournment:

The meeting was adjourned by Chairperson Williams at 3:14 p.m.

http://www.peoriacounty.org/download?path=%2Fcountyboard%2FCommittee_Agenda_and_Minutes%2F2017%2FNovember%2F28+-+County+Health+Budget+and+Regular%2FCounty+Health+Agenda+11-28-17.pdf