Negative Financial Impact on Cook County Health Budget Expected Due to Migrant Health Care and Medicaid Redetermination

Cook County Board of Commissioners Committee Meetings      
Wednesday, April 26, 2023

Finance Committee:

• Comptroller Laurence Wilson presented the January Revenue report for Cook County Health (CCH), which was mostly on budget and the 2022 year end report which had no significant variances. 
• State of Illinois is frequently late on reimbursement to CCH. 
• About $1billion will be spent on immigrant health; the question is “Who Pays?” —County, State, Federal governments? 
• In addition all Medicaid recipients need to reapply (redetermination).  About 1 million more residents are on Medicaid now than before the pandemic due to expanded program and not being required to re-enroll during that time.  There will be a monthly rolling basis of redetermination with letters going to current Medicaid recipients. It is expected that County Care (the Cook County insurance program) will lose members and thus money due to fewer being qualified.

Audit Committee:

• Auditor Mary Modelski gave an update of Open Recommendations from the Auditor’s Office to various departments regarding large projects and department practices. 
• Human Resources Dept. disagreed with many recommendations, particularly with on-boarding new employees and  trainings, and so declined to follow them.  The Auditor can recommend, but not require these to be followed.  It would be up to the Cook County Commissioners to follow-up/change rules, etc.

Environment and Sustainability Committee:

• A resolution calling for further federal action and accountability in connection with Norfolk Southern Corporation’s Operations (Agenda Item 23-1939) was passed in committee.  This relates to the recent derailing in Ohio which released toxic materials.  The sponsor, Commissioner Quezada wanted “to demonstrate solidarity with Ohio and ensure safety of rail systems.”

Technology and Innovation Committee:

• The Technology Department presented updates on several large projects. 
• The IPTS Property Tax Project (which has been a source of controversy and blame) will “go live” in October or November if the property tax bills go out on time.  There will still be two separate systems (Assessor and Board of Review) but with an interface so that the same data is seen by both departments.  The future goal is for both these offices to be on the same system (Odyssey or Tyler) and off the main frame computer which is about 40 years old. 
• Getting off the main frame system is the main goal for the Technology Department for numerous County depts.
• The Criminal Justice BUS computer system works and has been ready to go.  This system computerizes the CJ data and information for easier access and reliability.  However, it was noted that paper carbon copies are still being used.  The solution (BUS System) is there; but not all departments are using it.

Observer - Karin Hribar