Cook County Board Health and Hospital Committee Meeting
April 14, 2026 (regular meeting)

Cook County Health (CCH) CEO Erik Mikaitis, along with Kathy Chan and Alexandra Normington, presented  a report on CCH’s Medicaid Impact Workgroup (item # 23-0202).

• CCH is asking everyone to share the Medicaid Facts Microsite:  https://getmedicaidfacts.com 
• Medicaid Eligibility Changes as a result of the bill known as H.R.1 passed in 2025 include: (1) Narrows definition of “qualified immigrant” which will end eligibility for many lawfully present individuals (such as refugee and asylum seekers and victims of domestic violence and trafficking) – effective October 1, 2026; (2) Redeterminations for Affordable Care Act (ACA) adults - twice a year (instead of annual)– effective January 1, 2027; (3) New Federal Medicaid Rules require 80 hours per month of work, school, or volunteering effective January 1, 2027. Federal guidance with more specifics expected June 2026. 
• As a result of these changes, 400,000 people in Illinois are estimated to lose coverage, including 20,000 CCH patients. This could result in a $280 M negative impact on CCH’s budget.
• Up to now, even though County Care has one of the highest retention rates for Medicaid managed care plans, between 11 and 14% lose coverage during every redetermination period:  70% due to paperwork/administration issues; 30% due to no longer being eligible.
• Arkansas implemented work requirements in 2018:  18,000 enrollees lost coverage; 97% of those were eligible; and the State spent $26 M to implement before the program was halted by a federal judge after 4 months.
• Provided Update on the Cook County Health Medicaid Impact Workgroup. In September 2025, Cook County Health hosted a cross-sector convening of 60+ health care providers, payers, foundations, academia, advocates, community organizations, business to mitigate harms from H.R.1 eligibility changes. 
• Three sub-groups have been established: Communicate & Educate, Coalition Building, Innovate & Create. CCH is also working with the National Association of Counties (NACo) to scale best practices, learn from other counties, and leverage collective advocacy opportunities 
• Cook County Health created a communications toolkit in 6 languages that provides resources for partners to share. Materials were purposefully left unbranded to allow other orgs to brand, supporting increased use, visibility and trust. 
• Commissioners Lowry and Anaya spoke of the need to elevate the conversation at the state level and the need for a toolkit for Commissioners who will be lobbying state officials. They emphasized the need for coordinated state messaging. Commissioner Lowry will ask for an update from the County’s legislative lobbying team. 
• Commissioners Miller and McCaskill questioned which members (community and academic) from the suburban community were invited to participate in the CCH Medicaid Impact Workgroup. Kathy Chan responded that currently there is no academic representation and one or two community representatives. CCH leadership agreed to work with Commissioners to increase participation from the suburban community. 
• Commissioners Daley and Stamps asked that the newly created communications toolkit be sent to the Commissioners so it can be tied to their outreach events. Both Commissioners emphasized the need for tighter communication between commissioners and the County’s legislative lobbying team.
• In response to questions from Commissioner Daley regarding the Health System impact of the closing of West Suburban Hospital, Dr. Mikaitis said the Health System received 65 to 70 transfers. Dr. Mikaitis announced that Craig Williams, Executive Chief Operating Officer, will be leaving the Health System for a new position.

Dr. Kiran Joshi, head of the Cook County Department of Public Health (CCDPH) provided the quarterly update on COVID-19 and Infectious Diseases (Item 22-3815):

• A judicial order issued in March temporarily blocks changes to federal immunization recommendations. The halts are temporary, pending either a trial or a decision for summary judgment.
• Despite judicial ruling, the U.S. Dept of Health & Human Services published a revised charter for ACIP (Advisory Committee on Immunization Practices) on April 9 which puts greater emphasis on potential harms from vaccines and allows for membership on the Committee beyond past emphasis on expertise in immunization practice.
• COVID-19 vaccination is still recommended and older adults/those at high risk could consider a booster
• Flu and RSV remain low; COVID-19 remains minimal as of 4/4/26
• 2025-26 Free Flu & Covid Vaccination Clinics: Eight events with community organizations plus 22 with the Access Community Health Network held:  1897 vaccines administered. CCDPH is working to move the vaccinations clinics to larger and public spaces for 2027  
• Commissioner Trevor asked about the weight of recommendations for immunizations from professional organizations and the impact on reimbursement from insurance companies. Dr Joshi answered hat the national association of insurance companies has issued a statement that it supports science-based recommendations which in effect indicate support of the professional recommendations. 

Observer: Susan Avila 

Finance Committee Meeting
April 15, 2026
Commissioners Closely Reviewing Reallocation of ARPA Dollars

The proposed reallocation of almost $2.3 M of previously committed federal dollars from the American Rescue Plan Act (ARPA) generated the most discussion at the meeting before being approved by the Committee on a vote of 16 yea’s, with Comm. Moore voting present. (Item 26-0828)

• The Commissioners were told that the County had determined that some entities and programs previously awarded ARPA dollars were not going to be able to spend the full amount by December 31, the last date for use of those dollars.  In order to not turn any money back, this proposal is to reallocate the dollars to 3 programs and entities for behavioral health that have demonstrated the ability to spend ARPA amounts already allocated and which entities could put the additional dollars to good use. 
• $112,000 to the Chinese American Service League, $1.2 M to the Communities in Schools of Chicago, and $954,000 to the Juvenile Protective Association.
• Dr. Thomas Nutter, Chief Behavioral Health Officer at Cook County Health, explained that $44 M of ARPA dollars was previously awarded to 52 entities throughout the County for behavioral health programs.  A report on the impact of these grants through 2025 should be released soon.  Commissioner Stamps asked what the metrics for success are.  Dr. Nutter said that some of the metrics are simply how many people were “touched,” by the programs, but other metrics deal with outcomes.
• Comm. Stamps also asked why is additional money being given to these entities, as opposed to seeking new programs and entities.  Chief Financial Officer Tanya Anthony explained that ARPA dollars cannot be awarded now to new entities, but can only be reallocated under existing agreements.  In response to Comm. Sean Morrison’s question, he was assured that what is proposed here is allowed under the ARPA regulations.
• Comm. McCaskill pointed out that none of the 3 entities and programs will be providing the services in South Suburban Cook or the South side of Chicago.  In response to Comm. Stamps, Dr. Nutter did say that some of the 52 entities and programs which originally received grants did provide services in these areas.  Chair Daley said that all people coming before the Board should be prepared to show what and how much is being provided in all areas of the County.

The Committee also voted to authorize the Justice Advisory Council to provide up to $1.02 M to Heartland Human Care Serviced for 1 year starting May 1 for the Supporting Education and Employment Development (SEED) Program. (Item 26-0552)

• This Program provides education and employment services directed to 18 to 26 year-olds who have the opportunity to have criminal charges for selling drugs dismissed upon successful completion of the program’s requirements.  The Commissioners were told that this is the first of its kind diversion programs because of the services provided.
• Comm. Degnen said she was voting yes, but said she was very disappointed that the money being used to fund this extension of the program had originally been designated for environmental programs, such as installation of electric car charging stations.  She said she does not understand why the County had not been able to utilize the money for those programs.

The County Committee heard from the Comptroller that for the first 3 months of the fiscal year (thru Feb. 2026)

• The County’s General Fund has a surplus of $234.5M as compared to budget, due to a positive $204.5M in revenues and $30M less in expenses than budgeted.
• The Health Fund has a slight negative net of -$3 M as compared to budget on a cash basis, with a -$39.5M in revenues and $36.5 M less in expenses than budgeted.
• Illinois owes the County $98 M.
• The Federal government has cancelled $27 M in grants this fiscal year.

Observer:  Priscilla Mims

Finance Subcommittee on Litigation Meeting
April 15, 2026 
Inspector General Report Generates Commissioner Questions

Independent Inspector General Tirrell Paxton presented an overview of the 2025 4th Quarter Report.  (Item 26-0691)

• Commissioner Moore asked what happened when a case was determined to be unfounded, i.e., how did the employee who may have been investigated show that; is there any kind of letter stating that. IG Paxton said that since the fact that there is an investigation is confidential, there should be no need for any documentation of that there was no adverse finding. Comm. Moore cited an individual who feels he needs such documentation. Paxton advised that the individual should contact his office.
• Commissioner Daley asked Paxton to estimate how many cases were referred to appropriate county, state or US legal offices for prosecution and results. Paxton estimated that about 100 cases had been referred and that none had been followed up.
• Commissioner Stamps inquired as to how many Payroll Protection Plan (“PPP”) cases were still being investigated or reviewed. IG Paxton stated that he estimated the remaining PPP cases would be wrapped up within the next couple of months.
• Commissioner Sean Morrison said he was very concerned about the PPP fraud cases as this was costing Federal taxpayers a considerable amount of money. He urged IG Paxton to continue following up on the cases with the U.S., IL and Cook County legal offices. He was interested to note that there were Cook County departments that did not have Do Not Hire lists, which meant that employees could possibly get rehired by another office in the County when they had committed fraud or other county employee violations. He indicated this was an issue that needs further consideration by the Board.

Observer:  Hollis Burgess

Legislative and Intergovernmental Relations Committee Meeting
April 15, 2026
Resolution Urging Illinois to Opt-In to Federal Scholarship Tax Credit Program Deferred

• The meeting began with comments from 14 Public Speakers. After one person spoke in favor of approval of the resolution “Urging the State of Illinois to opt-in to the Federal Scholarship Tax Credit Program” (Agenda Item 26-0974), Chairperson Britton stated that this item was being deferred and would not be voted on by the committee at this meeting, but comments were welcomed. Seven persons then spoke against approval of this item with most indicating such a program would only divert funds from public schools. 

Three resolutions dealing with environmental concerns were approved as a package: 

• Resolution “Urging Passage of the Climate Change Superfund Act” ( SB2981/HB4773) – which requires payments from entities deemed responsible for climate change to support climate resilient infrastructure and mitigation efforts. (Item 26-0977)
• Resolution “Urging Members of Congress to Reject Legal Immunity for Big Oil and Fossil Fuel Companies” - urging the US congress to reject all legislation granting fossil fuel companies immunity from climate-related lawsuits and shield them from legal and legislative accountability.  (Item 26-0978) 
• Resolution Urging the Passage of SB1531 (The Disposable Food Service Container Act) which would eliminate polystyrene foam disposable food service containers in Illinois by 2030. (Item 26-0978)
• Comm. Degnan spoke to the necessity of addressing the many environmental issues resulting from climate change and pollution and requiring those responsible for creating problems to pay for efforts to alleviate the effects. She stated that giving immunity to oil and fossil fuel companies should not be allowed. She also emphasized that the environment is everyone’s concern and should not be politicized. Several commissioners thanked her for bringing these issues forward. 

Observer - Cynthia Schilsky

Health and Hospital Committee Meeting
April 14, 2026 – (special meeting)
Commissioners Learn of Educational Efforts on CTE

Dr. Kiran Joshi, head of the Cook County Dept. of Public Health, and Chris Nowinksi of the Concussion and CTE Foundation, provided information on the damage awareness programs for Chronic Traumatic Encephlopathy (CTE). 

• CTE is a brain disease likely caused by repeated head injuries, often occurring in contact sports or military combat.
• Dr Joshi reported on the following educational awareness programs: School personnel education; Public education through social media channels; and working with Park District Association Partnership to raise awareness through newsletters and other events. 
• Multiple persons presented public testimony focused on the personal experience with CTE emphasizing education for both the public and medical community.  
• Commissioners Stamps, Miller, Morrison and McCaskill followed the presentation with more personal experience and the need to outline the risk factors for CTE and preventive measures. 

The motion to defer item # 26-0649 was passed unanimously.

Observer: Susan Avila 

Cook County Board of Commissioners Meeting
April 16, 2026
Board Continues to Approve Transfer of ARPA Dollars to Ensure Use by End of 2026

President Preckwinkle expressed the Board’s condolences to the family of former Commissioner Dennis Deer on the death of his widow.  Most items were either approved, referred to committee or received and filed with no discussion.

• Two items were approved which transfer unspent ARPA dollars from other programs to the County’s Down Payment Assistance Program tor prospective buyers of homes.  (Items 26-1120 and 26-1149).  Commissioner Scott expressed support and received leave to have a Club 720 representative also speak in favor.
• Two resolutions in support of pending Illinois legislation were passed:  IL SB2801 and HB4471 prohibiting licensed firearm dealers from selling or transferring any semi-automatic handgun that can be converted into a machine gun manually (item 26-1199); and HB4312/SB3020, to expand the definition of harassment to include electronic harassment and authorizing appropriate measures to protect victims of domestic violence (Item 26-1191). 
• All proposed re-appointments of individuals to various boards were approved.  The one new appointment of Olive Brown to the Housing Authority of Cook County was referred to the Legislation Committee (Item 26-1188)

Among the items referred to Committee were 

• A request for the County Clerk’s office to appear to provide an update on the March elections and any new initiatives (Item 26-1147; referred to Legislation & Intergovt. Relations).
• Representatives from relevant departments to discuss improving processes in distribution of property tax revenues to the 685 taxing bodies in Cook County (Item 26-1230; referred to Legislation & Intergovt. Relations);
• Hiring consulting services to help with distribution of Federal dollars for housing and recovery from disasters in 2023-24 (Item 26-1064 referred as amended to Finance); 
• Continuation of the Recuritment Incentive and Retention Bonus Pay Program (Item 26-1251; referred to Finance)
• A public hearing on the state of Cook County Government’s labor (Item 26-1249, referred to Labor)

Public speakers included:

• Representative of Posen, IL, asking for assistance with expenses, particularly 911 dispatch. item 26-0868
• Minister asked to move funds from State’s Attorney and Sheriff’s Office to prevention programs.
• Two speakers on treatment of those jailed by county and conditions of jails.
• Two speakers on financial literacy issues and programs. Re item 26-1190
• Three people who aired personal problems with system (county or otherwise)
• Speaker complaining money and services going to immigrants instead of county residents

Observer:  Hollis Burgess