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Cook County Board Holds Hearing on Cook County Health Finances

9/30/2019

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Cook County Board of Commissioners Health and Hospitals Committee
Public Hearing
September 26, 2019


This hearing was requested by the Cook County Board of Commissioners to note and understand discrepancies between the Inspector General (IG) Report and the  rebuttal of Cook County Health (CCH) and the firm—Deloitte—hired by CCH to analyze the Inspector General's Report.  The IG Report generally stated that CCH’s insurance program, County Care, was unsustainable and was being subsidized by Cook County taxpayers.  The IG report looked at ALL of the CCH finances, not just County Care.   CCH disputed this and hired Deloitte to analyze the IG report —mainly the viability of County Care—and report to the Cook County Board.  Deloitte did NOT do an audit as this was done previously by another division at the firm.  It also only looked at County Care and not all of CCH.

There was a lot of confusion by the Board on what was being stated by both the IG Office and Deloitte.  Mainly this was because of the Accounting Systems used by CCH and the various ways accounts receivable, payable, assets, etc. can be interpreted.  All parties are looking  at the financials and cash flow differently.  The main question of the Cook County Board was “Do we have any concerns about the stability and viability of CCH?”

Here are the basic findings as this Observer understood them:

Inspector General Report
  • CCH is using other assets to pay claims in County Care, so the “hospital system is subsidizing the County Care Insurance program.” 
  • There is between $501-$700 million in outstanding bills -—not paid or paid late. 
  • Vendors are not supplying some necessary hospital, medical items because they are not being paid.
  • Transparency of revenues and losses is an issue. 
Deloitte Analysis--
  • Revenues from County Care (provided from governments state and county) have covered its expenses.
  • CCH needs to make more timely payments to providers (90% of claims are processed but not nearly that number are paid) and this is a concern
  • County Care is profitable and can run the program
  • Assets and Liabilities in County Care are sustainable
  • At any point in time, County Care will have a $500 million or so liability because as old bills are paid, new ones come in that need to be paid -a backlog.
  • Funds from the State and County are sometimes not timely, which puts payments behind.

Dr. Shannon (CEO of CCH) Statements:
  • The premiums that County Care receives are more than enough to pay its expenses in County Care and in fact subsidizes some of the charity care and other programs that CCH undertakes. 
  • CCH has suffered reputitional damage due to the IG report.  People will not be willing to use CCH if they don't feel confident in its sustainability and viability. 
  • The State of Illinois needs to speed up its application process for Medicaid enrollees. 
  • CCH is in deficit due to increased charity care and non-payment by individuals who have insurance—NOT because of County Care.

Cook County Budget Office:
  • CCH will be working with the Cook County Budget Office to use best practices and increased transparency in reporting between CCH and Cook County Board. 
  • There is room for improvement on the cash/payments flow system and they are working on it.

Observer :  Karin Hribar                              Length of Committee Hearing:  2 hours and 20 minutes
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Several Contracts Questioned by Commissioners at Cook County Board Meeting Especially for Clerk Of Court Brown

9/30/2019

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Cook County Board of Commissioners -  Meeting - September 26, 2019
Absent:  Commissioner Tobolski             


Board Actions:
  • The Board unanimously voted to DISAPPROVE a contract request (Agenda Item 19-5564) from the Clerk of the Court for $20,000.00 to print 10,000 calendars used in courtrooms and by some attorneys.  Objections raised included that paper calendars are an outdated, ineffective method not used by many in the Court system and that they are a political advertisement for the elected official (Clerk Dorothy Brown).  An ordinance had previously been passed that disallows the name of elected officials on these types of materials.
  • Commissioner S. Morrison questioned contract extensions (even beyond the original extension expiration dates) without RFP bids.  Procurement should have put out this furniture contract (Agenda Item 19-5580) for re-bid.  He asked why this was occurring again and stated  that “this sounds like procurement rules aren't being followed.”  Asset Management countered that there wasn't time to get a new RFP out but it will be ready for the next round.
  • Commissioners S. Morrison and D. Miller both voted NO on a contract for the acquisition of property for $15,000,000.00 for a new health clinic (Agenda Item 19-5233).  This was discussed in closed session at the Asset Management Committee yesterday (9/25/19).  Today the vote for approval by the Board was bundled with several other items with no description.

Items referred to Committees for future discussion and consideration:
  • (Agenda Item 19-5620) Voting Opportunity and Translation Equity Ordinance was referred to Legislation Committee.  This ordinance would have more voting materials translated into more languages for voters who do not speak English.  This would encompass 13,000 voters and would be ready for the March elections.
  • (Agenda Item 19-5629) which would give leniency to municipality-owned parking lots from the new increased Cook County taxes on these lots, was referred to the Finance Committee.

Committee Recommendations Approved:
Very quickly and without much explanation the following committee items were approved by the Board of Commissioners (I may have missed some that were bundled with other items and approved):
  • (Agenda Item 19-3776) Proposed Cook County Health Preliminary Budget
  • (Agenda Item 19-5556) a new State’s Attorney program to reduce violence—“a new approach”
  • (Agenda Item 19-0768) an approved substitute ordinance for the Charitable Rotating Bond Funds which prevents fees, court charges and attorney fees from being taken out of this posted bond.  Also it would not prevent a Public Defender from being appointed to the bonded defendant.
  • (Agenda Item 19-5845) sets up a new Special Purpose Fund in the Assessor’s Office in order to receive their share of GIS distributed funds.​
 Observed by:  Karin Hribar         Length of meeting: 1 hour 50 minutes (includes 45 minutes of public speakers)                               
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Full Day of Committee Meetings for Cook County Board

9/29/2019

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Cook County Board of Commissioners 
Committee Meetings - September 25, 2019

The Cook County Board of Commissioners held 14 committee meetings lasting from 9:30am until 5:00pm.  For the most part any actions taken in the committee meetings will need final approval by the full Board at their meeting to be held on 9/26.

Highlights from the meetings:

Finance Committee - Questions were asked of the Comptroller during his report about the  Health Fund variance which he reported as an unfavorable variance of $426m.  There was discussion of the timing of revenues/expenses; whether the reporting is done on a cash or accrual basis; what is causing the variance. Nothing was resolved and Comm. Daley said more information would be provided at the hearing scheduled for the next day.

Zoning and Building Committee - Approved an ordinance amendment that apparently prohibits roosters and limits fowl to 5 on lots of less than an acre. and also has something to do with the regulation of horses. (Agenda Item 19-1648) As there was no discussion, the observer is uncertain as to exactly how this amendment changes the ordinance in question.

Transportation Committee - John Yonan, Supt. Dept. of Transportation and Highways, gave a report outlining a 3 year pilot program focused on south Cook County that will work to establish a more equitable transportation network throughout the county. His department is working with RTA, Metra, CTA, and Pace to integrate fare systems and decrease fares in an effort to increase ridership. Next steps involve negotiating intergovernmental agreements. The report was received and filed. (Agenda Item 19-5211)

Rules and Administration Committee - The committee approved a document with suggested modifications to the The Just Housing Amendment Interpretive Rules (Agenda Item 19-4770) that if passed by the board at the 9/26 meeting will be sent to the Human Rights Commission (HRC). It will then be up to the HRC to possibly hold hearings and work with the advocates to make any further revisions to the rules for implementation of this amendment. The HRC is responsible for enforcement once the rules are established. Comm. Suffredin stated that it is the job of the Cook County Commissioners to ensure that the rules reflect the intent of the Ordinance and that is why they are submitting these suggestions to the HRC. When the HRC finishes drafting the rules they will come back to the Rules Committee and then should go to the CC Board for final approval at the October board meeting. Comm. Sean Morrison requested that the SA give an opinion on the legality of the rules as well. The ordinance is supposed to go into effect by the end of the year so they want to get these rules finalized. There were several speakers again at this meeting voicing their support and or concerns with the rules.

Health and Hospitals Committee - Approved an ordinance amendment updating the Lead Poisoning Prevention ordinance. (Agenda Item 19-4222). Dr. Terry Mason gave his third quarter report on the Dept. of Public Health and focused on the nursing services provided.

Business and Economic Development Committee - Approved a contract for Administrative Services to oversee the 2020 Census in Cook County to ensure an accurate count. They will provide a plan for each Commissioner District by December 2019 and provide monthly updates on the implementation of the plans. The Commissioners requested that the plans be sure to include suburban Cook and not just focus on the city.

Legislation and Intergovernmental Relations Committee - Approved an ordinance amendment that requires the chief sponsor of any board action that will impose additional duties or cost on a department, agency or elected official to request a statement from the affected department, agency or official outlining the additional duties and cost. This is to be done before the action is  voted on. (Agenda Item 19-4912)

Homeland Security Committee - Had a presentation about the Multi-jurisdictional Hazard Mitigation Plan. A plan is necessary if federal disaster funds are ever needed. 121 communities are included in this plan. 

Asset Management Committee - Approved a contract for demolition services to demolish Divisions 1 and 1A at the Jail. Demolition will take about 18 months once they get going. (Agenda Item 19-4975)  The committee went into an Executive Session that lasted 70 minutes to discuss acquisition of real estate (Agenda Item 19-5233 ) No comments were made after the session and they voted to approve with 1 dissenting vote by Comm. Sean Morrison.

Criminal Justice Committee - Approved a Substitute Ordinance known as Article III - Protections for Charitable Rotating Criminal Bond Funds and Third-Party Sureties. The changes ensure that if a bond is posted by a non profit or third party that is not legally obligated to post bond, then fees, court charges, and attorney fees will not be taken out of the cash posted. It also ensures that such posting of bond will not prevent a person from representation by a Public Defender. (Agenda Item 19-0768) There was no discussion and it was approved.

Observer - Cynthia Schilsky
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Cook County Board Committee Postpones Action On Just Housing Amendment Interpretive Rules

9/13/2019

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Cook County Board of Commissioners Committee Meetings
September 4, 2019


Rules Committee
Chair Larry Suffredin announced at the beginning of the meeting that the Committee would hear all the public comments, but would not take any action on the proposed Just Housing Amendment Interpretive Rules from the Department of Human Rights and Ethics.  Instead, the Department and Committee would consider all the comments, written and verbal, and consider whether any changes were warranted.  (Agenda Item 19-4770)
  • These Rules are to provide guidance in interpreting the requirements of the recently passed Amendment to the Cook County Human Rights Ordinance which prohibits discrimination in housing based on criminal history.  The Human Relations Committee separately met and voted to postpone the effective date of this Amendment until December 31, 2019, to allow time for the Interpretive Rules to be finalized and disseminated to landlords and other people involved with housing.  (Agenda Item 19-4848)
  • There were over 20 speakers and the main concerns were with
    • The exemption in complying with the Rules for public housing.
    • The inclusion in the Rules of categories of convictions; instead speakers urged that these be eliminated so that each person would be treated individually.
    • The look-back period for convictions, with realtors and landlords wanting a 7-year period and others wanting the proposed 5-year period reduced to 3 years.
    • The requirements that anyone denied housing based on a criminal background has 5 business days to notify the housing provider of the intent to dispute the denial and an additional 5 business days to provide evidence that disputes the accuracy or relevancy of the basis for the denial; landlords and realtors urged that the time periods be reduced to 48 hours to notify and 72 hours to provide the evidence disputing the bases of the denial.
Chair Suffredin stated that he hopes to have the Proposed Interpretive Rules on the September 25 agenda of the Committee, so they can be approved by the Board on September 26.

Legislation & Intergovernmental Affairs Committee
  • The League of Women Voters of Cook County provided written and verbal comments pointing out that the 2nd Quarter Report from the Clerk and Recorder on the planning for the upcoming merger in December 2020 did not include a timeline of benchmarks as required by the Board resolution from 2017 requiring these quarterly reports.  The Clerk’s representative stated that future reports would contain such a timeline. (Agenda Item 19-4656)
  • Voted to recommend the Board approve the Ordinance Amendment which would require all boards, commissions, advisory committees, and task forces created by the Cook County Board to post a notice of its meetings with the Secretary to the Board. (Agenda Item 19-4820)  (The Cook County Board did approve this at their September 5 meeting.)

Finance Committee
  • Voted to recommend the Board approve the Substitute for the proposed Surviving Spouse Tax Abatement, which provides for applications to the Board of Review for a reduction in property taxes for the surviving spouse of policeman, soldier in Iraq or Afghanistan, or rescue worker who dies during the performance of his/her duties. (Agenda Item 19-4797) (The Cook County Board did approve this at their September 5 meeting.)  See the LWVCC Observer Report from the July 25 Board meeting for more information.

Observer - Priscilla Mims
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Equipment Upgrades Approved for Cook County Sheriff’s  Department

9/11/2019

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Cook County Board of Commissioners Meeting - September 5, 2019

Board Actions:

A Request to enter into and execute a contract with Axon Enterprise, Scottsdale, AZ     
Axon Enterprise provides law enforcement grade weapons and tech services.  The contract is for 5 yr, 9/12/2019 - 9/11/2024.  Explanations were provided for the Commissioners’ many questions.  It was explained that this contract will provide upgrades and expansion of the existing body worn cameras and TASER weapons inventory that are needed to supply more Cook County Sheriff Department Officers with equipment.  Axon is the only company that sells law-enforcement grade weapons which are sold strictly to law enforcement agencies.  The TASER will activate their body worn camera; it is the only weapon that will activate the camera.  The cloud storage system is unique to Axon.  The cameras’ recordings will be sharable with the Public Defender’s Office.  The contract was approved.  (Agenda Item 
19-5076)  

The Fair Transit of South Cook County Pilot Study was referred to the Transportation Committee for a more detailed presentation.  Commissioner Miller stated that the Public Meeting in the South Suburbs was well attended.  Supt. Yonan explained that this 3 year Pilot Program is ready for implementation.  The program has several goals, including modest service improvement and improved coordination with PACE, Metra, and CTA.  Another benefit of the program should be facilitating access to employment.  Yonan explained that Year 1 is the implementation phase.  Years 2 & 3 are to  evaluate the impact of improvements.  (Agenda Item 19-4276)

Criminal Justice Committee - Charitable Bond Fund     Commissioner Suffredin reported that the Criminal Justice Committee is waiting for responses from the State’s Attorney’s Office and from the County Clerk regarding questions of  implementation of this program.  The Committee will return with a completed proposal at the next meeting.

Observer -  C. Cosentino                                             Meeting Length -    2 hr.  25 min
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