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Shakman Update and County Clerk/Recorder of Deeds Merger Status  Provided to Cook County Board

11/25/2019

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Cook County Board of Commissioners Committee Meetings 
Nov 20, 2019


Highlights from the meetings:

Finance Committee
Commissioner Silvestri stated that at the Litigation Subcommittee meeting on Nov 19, the compliance administrators gave a positive report that the Assessor's office is moving quickly, the Clerk of the Court's pace has picked up and the Recorder of Deeds is at a good point in achieving compliance with the Shakman decrees.  The next status update to the Litigation Subcommittee will be Feb 2020.  It was hoped compliance would be achieved for the Recorder of Deeds before its merger with the Clerk's office, Dec 1, 2020.

Legislation and Intergovernmental Relations Committee
Representatives from the Recorder of Deeds and Clerk's office presented a status update on their merger (agenda item 19-6178).  Agreements have been made between the two regarding open dialog/communications and information sharing.  Work groups have been established.  Areas of early consolidation discussed were procurement and financial (merging bank accounts). Commissioner Suffredin suggested that the Recorder of Deeds and Clerk meet with the League of Women Voters as he said this outside group has continued to send questions regarding the merger process and were involved in the Nov 2016 referendum.

Rules and Administration Committee
The Just Housing Amendment, that Cook County's housing providers do not discriminate against individuals with a criminal history/convictions when they apply for housing, was passed spring 2019 by the Cook County Board of Commissioners.  Interpretive rules for this Just Housing Amendment have been worked out over the past months.  The Proposed Second Substitute to agenda item # 19-4770 on file (regarding the Just Housing Amendment Interpretive Rules) was adopted.  The motion to receive and file the adopted Proposed Second Substitute 19-4770 was passed which sends the rules to the full Cook County board of Commissioners for final approval.  There were many groups at the committee meeting presenting views on affordable and fair housing, criminal justice, disabilities and racial discrimination since historically individuals with a criminal history/convictions have a history of not obtaining safe and stable housing.

Observed by Michele Niccolai
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Cook County Budget Hearings End with Review of the Capital Budget and Review of  Chief Judge's Budget

11/23/2019

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Cook County Board of Commissioners Finance Committee
Last Day of Departmental Budget Hearings
Public Hearing, 
Review of The Capital Budget and the Chief Judge’s Budget
November 4, 2019


Public Hearing on 2020 Executive Budget:  There were about 20 speakers over a 2-hour period.  The main subjects were
  • Concerns about the plan for transitioning patients receiving mental health services from outside entities to those services being provided by Cook County Health (“CCH”) directly.  Commissioner Deere pledged to set up a meeting between these speakers and CCH personnel so the transition plans could be discussed.
  • Concerns about the elimination of funding for Access to Care, which provides health services at discounted rates to patients primarily in suburban Cook County.  The representative for Access to Care stated that about half of the patients seen are not eligible for CCH’s County Care program for those on Medicaid.  As a result, if these patients went to CCH, rather than Access to Care, this would add to the already large and growing amount of charity care provided by CCH.  Commissioner Sean Morrison said he has long supported helping to fund Access to Care because that funding is much less than the costs CCH would incur to provide the services.  Commissioners Sims and Suffredin appeared supportive of again funding Access to Care, but warned that this would likely be the last time.
  • Support by several entities and individuals for CCH and the services it provides and the partnerships it has.
The Civic Federation has done an analysis of the proposed budget and overall supports it as a reasonable one-year plan.  https://www.civicfed.org/CookCountyFY2020.  However, there are concerns for the future; specifically:
  • The growth in uncompensated care at CCH, even as the Civic Federation supports the independent board and says it has had a transformative effect on CCH.
  • The plan to build a new Provident Hospital with inpatient care.  The Civic Federation says there has been little public discussion of this major decision.
  • The need for more transparency by making the capital plans available, such as for the jail, and Phase I of the court utilization study.
  • The need for statutory authorization for the supplemental pension payments the County has been making, which the Civic Federation fully supports.

Review of Capital Budget: 
  • Several Commissioners, possibly prompted by the Civic Federation’s comments, asked questions about the justification for $50 million for building the new Provident Hospital.  The CCH Chief Financial Officer stated that the costs of operating the current facility are very high and the analysis showed that it was more efficient to build a new facility that could provide needed specialized and outpatient care than to try to rehab the current building.  
  • There is some funding to start the process of redesigning the Board and Commissioner spaces, including making them much more accessible.  Commissioner Anaya pointed out that a prior study on accessibility had been done and suggested that be looked at as a starting point.  
  • Commissioner Suffredin asked what happens to the County’s share of the State Motor Fuel Tax fund should DuPage reach 1 million residents.  In that case, the two counties would split the fund, thereby significantly decreasing the amount the County currently receives.  The Commissioner suggested that there may be a need to seek new legislation in Springfield to revise the formula for disbursing money from the fund.
  • During the discussion of the Capital Equipment portion, Tom Lynch, the County’s Chief Information Officer, stated that currently there are good relationships between the Bureau of Technology and  the IT functions under the other elected officials, a much needed improvement as compared to the past.  

Review of the Budget for the Chief Judge: 
Chief Judge Timothy Evans answered questions for the different areas under his supervision, including the Adult Probation Department (which encompasses pre-trial services such as electronic monitoring, as well as supervising some sentenced offenders), the Judiciary, the Public Guardian, Forensic Services, Social Services, Juvenile Probation, and the Juvenile Temporary Detention Center (for those awaiting trial).  The Chief Judge pointed to his web site, www.cookcountycourt.org where performance metrics and other data may be found.
  • The Chief Judge cited the large drop in the Cook County jail population as a result of the bail reform measures he has instituted.  He also pointed out that the Administrative Office of the Illinois Courts is now providing an additional $24 million to reimburse Cook County for the costs of the court system.  This money is going into the County’s General Fund and is not earmarked for the Chief Judge’s budget.  He is seeking more money than is currently proposed in the budget so that another 100 law clerks could be hired.  There are currently 92 clerks for over 400 judges.
  • In a letter dated Oct. 3, the Sheriff proposed that the Chief Judge’s Probation Department take over the electronic monitoring that the Sheriff is now doing and merge it into the electronic monitoring the Adult Probation Department is doing.  The Sheriff has offered to transfer positions and money from his budget to accomplish this.  The Chief Judge says that there are a number of issues that must be dealt with first, including obtaining approval from the Illinois Supreme Court.  When pressed by Commissioners, he said that it likely would take longer than 6 months to determine whether merging the electronic monitoring programs was feasible and then to effectuate such a merger.
  • Leonard Dixon, the head of the Juvenile Temporary Detention Center, said that the N.E. Casey Foundation has recently assessed the Center for the 3rd time and says that it is in the best shape the Foundation has ever seen.  The average population is down to about 200, but these are the young people that need the most services.  There are over 200 community programs that come into the Center.

​Observed by Priscilla Mims
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Cook County Board Passes Balanced $6.2 Billion Budget for 2020

11/21/2019

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Cook County Board Finance Committee Meeting and Board Meeting  November 21, 2019

After the Finance Committee considered and passed 15 amendments to the proposed budget, the Cook County Board then passed the 2020 budget, as amended. (Item 19-5916) by a vote of 15 yeas, 1 nay, and 1 absent.  The one negative vote was cast by Commissioner Sean Morrison who expressed concern over the total size of the budget and how it has more than doubled since 2011.  He said that he would have preferred to maintain the amount budgeted for 2019 and use the additional revenues to further bolster the pension fund.  Commissioner Morrison did not, however, offer any amendments to do so.  Commissioner Tobolski was absent, as he was throughout the budget meetings.

The 15 amendments that were passed added an additional $23 million to the proposed budget which came from:
  • additional grants that were identified ($10 million), 
  • a larger than expected TIF surplus declared by Chicago ($9 million), and 
  • the rest from utilizing monies in several Special Purpose Funds
The amendments included:
  • $1.5 million to fund Access to Care, which carried a requirement of quarterly reports to identify where patients live in Cook County to see whether in fact these patients would otherwise have cost Cook County Health significant dollars by having to provide these patients uncompensated care.  It was stressed the money to fund Access to Care came from a one-time revenue source (the TIF surplus) and the County did not expect to provide funding beyond 2020.
  • A reduction of $140,000 from the Clerk of the Court’s budget to be used to fund a pilot program for the State’s Attorney to aid those who are victims of domestic violence.  The Clerk of the Court’s representative expressed support for the program, but opposition to reducing that budget.  Most of the money came from two positions that have not been filled since 2016.  Commissioner Anaya, the sponsor, explained that this amendment was very personal to her as she had grown up in a household with domestic violence and she did not understand until later that her mother did not leave because she felt she had nowhere to turn.
  • $300,000 from an unfilled Manager of Records Management position in the Clerk’s office and some of the TIF surplus to fund the recently passed Voting Opportunity & Translation Equity Ordinance that requires ballots and related material to be translated into additional languages.
  • $500,000 transferred within Cook County Health’s budget to fund prevention efforts and testing for sexually transmitted infections.
  • $120,000 from the Solid Waste Special Purpose Fund to provide up to 2 schools with solar paneled roofs and funds to develop related STEM-related programs (science, technology, engineering, and math).

Chairman Daley and Commissioner Silvestri thanked a number of people at the end, including the League for observing the budget meetings and providing questions for a number of departments.

Observer:  Priscilla Mims
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Cook County Board Approves Homeland Security Department Name Change

11/16/2019

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Cook County Board of Commissioners Committee Meetings - Oct. 23, 2019
Board Meeting - October 24, 2019


The Cook County Board quickly passed an ordinance creating a name change for CC’s Homeland Security Department.  The new name is: Department of Emergency Management and Regional Security.  The renaming occurred after a CC Homeland Security vehicle created alarm among attendees at an Evanston street fair because they did not differentiate between the Cook County and the US Immigration Homeland Security vehicle signage and therefore were concerned that US ICE Agents were there to round up people with potential immigration issues.  

Other Agenda items Passed:
  • 19-5620, Ordinance requiring ballots to be printed in additional languages in time for the 2020 elections.  Requires the County Clerk to determine by March 1, 2020, and at least every 3 years thereafter, limited-English-proficient populations of 13,000 or more Cook County residents and then produce special language ballots.
  • 19-5845, The creation of the “Assessor GIS Fund” with language stating that the revenue collected for the Assessor by other County offices from providing GIS data shall go into this new fund.  The County Board retains appropriation authority.
  • 19-6117, The renewal of a Springfield lobbying contract.  Commissioner Lowery asked for the lobbyist to come to a board meeting or hearing.  Commissioner Suffredin responded that a meeting will be scheduled after the IL General Assembly veto session is over.
  • 19-6389, The Human Relations Committee requested a hearing to discuss the final report from the CC Committee on addressing bias, equity, and cultural competency.
  • 19-5830,  A review of County policies as well as holding and incarceration practices in light of the recommendations from the Convention on the Rights of the Child and the Global Study on children who are confined, jailed, and/or jailed in adult facilities.  

Items Referred to Committee:


To Business & Economic Development Committee
:
  • 19-6176, Requesting approval to enter into an Interagency Agreement to provide funding to launch and operationalize the Southland Development Authority for large scale and long term economic development in the South Suburbs.  Initial amount of $300,000 used to hire an Executive Director for the SDA and based on the SDA’s ability to secure additional material funding.
  • 19-5333, Resolution to establish an enterprise zone in a 15 contiguous square miles of a depressed area including the City of Chicago Heights and several more.  Intergovernmental agreements will be required.
  • 19-5632, The Bureau of Economic Development recommends the investment of $4 million in Community Development Block Grant Section 108 funds for low interest financing to support the long term redevelopment of two Housing Authority of Cook County (HACC) high rise properties with 226 units of affordable senior housing in the Village of Wheeling and the City of Niles.

To Legislative & Intergovernmental Affairs Committee:
  • 19-6194, Amendment to the Ethics Ordinance that adds calendars, vehicles, and equipment to the list of items that may not have a name or image of an elected official paid for with public funds during an election year if that official is running for re-election.
  • 19-5979, the proposed ordinance to dissolve the Injury Compensation Committee and Advisory Board as it is no longer needed.  Appears to be an effort to clean up the Code to eliminate provisions that are no longer relevant.
  • 19-6158, the 3rd quarter report from the Recorders office on its consolidation with the Clerk’s office.  Commissioner Suffredin stated that a hearing will be scheduled.  

To Rules Committee:
  • 19-4770, Another Just Housing Amendment to a  previously passed ordinance defining “demonstrable risk” and  requiring landlords to rent to individuals with criminal records after a 5 year period of time with a clean record [sex offenders are not eligible].  Because landlords are very unhappy with the original ordinance, Commissioners continue to work on compromises.

Other Items of Interest: 
  • Although approved without discussion, four public speakers attended the board meeting and asked the commissioners not to appoint Alderman, George Cardenas, to the Environment Committee.  Mr. Cardenas was selected by Mayor Lightfoot to represent the City. 
  • The States Attorney’s office received multiple grants from the US Department of Justice to add staff for specific purposes including investigating cold cases older than 3 years; hiring an intellectual property crime attorney and clerk; and increased trauma support for sexual assault victims.
  • The Justice Advisory Council received a 4 year $1 million grant from the U.S. Department of Justice to create a regional coordinated system for returning citizens to receive the appropriate pre and post release (from prison) services.  Goal:  to reduce recidivism.   #19-6162

Observed by:    
Diane Edmundson
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Cook County Sheriff Highlights Program Offerings during 2020 Proposed Budget Hearing

11/16/2019

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Cook County Board of Commissioners - Finance Committee
Departmental Budget Hearings
October 30, 2019, afternoon session


Cook County Sheriff

Overview of Proposed Budget for Sheriff's Office

  • As outlined in the Proposed Budget Book, expenditures remain very near 2019 figures, including FTE count and salaries - no raises expected.
  • Sheriff’s Office will continue to focus on reducing violent crime in areas most at risk.
  • A Community Corrections Dept. has been created to increase transparency for Electronic Monitoring.
  • RENEW AND SWAP Programs will be continued
  • Non-Union job titles will be updated to clarify their duties and responsibilities.
  • The $7M now available in the operating budget due to reductions in the Jail population and facilities has been used to replace high mileage marked and unmarked police vehicles ($5M) and $2M for various other programs.
Sheriff Dart stressed that he strongly believes in analyzing people’s needs and then implementing programs to meet them, rather than just incarcerating.  The goal should be on preparing offenders to successfully function in the community, he said.  After discussing the budget for 15-20 minutes, he focused on questions from the Commissioners and the numerous programs currently available at Cook County Jail.

PROGRAMS
  • RENEW -formerly an unsuccessful “boot camp” program. It is now reconfigured to use inmates to do demolition work such as removing fixtures, tearing down walls in old buildings, etc.  Not only does program provide training, but receives money from sale of iron/copper/wiring and such. Workers can participate while in jail and up to 6 months after return home.
  • FEMALE COOKING PROGRAM - Privately funded.  This was an idea suggested by the women residents and has proved very successful.
  • FATHER & SON GET-TOGETHERS – Play chess and other board games while visiting.
  • There are many other programs at the jail ranging from photography to art to yoga.    A Pilot Program is being considered to utilize these programs for offenders on electronic monitoring while living at home, making use of time to prepare for life after release.
ELECTRONIC MONITORING
  • The question of cost for electronic monitors was discussed. There are currently approximately 2,300 offenders on electronic monitoring.  700 alarms go off every day, and these have to be investigated.  Taking out the garbage, being late in returning home from work due to transportation issues, faulty wiring can set off the alarms.  Phone calls and home visits are sometimes required.  This is a labor intensive and costly procedure. 
  • Another issue discussed was solitary confinement. THERE IS NO SOLITARY CONFINEMENT AT COOK COUNTY.  Offenders are out of cells at least 4 hours a day, outside if possible.  They are ankle chained to a table with other inmates to enable conversation and group interaction, board games and such.  Dart emphasized, this is a jail, not a prison.
  • RECIDIVISM- Sheriff Dart stated 3,000 of the jail population require mental health care.  While incarcerated, they receive these services; however, when released into the community, mental health services are scarce, and unfortunately, after 3-6 months, many former residents return.  
THE FUTURE –
  • The Sheriff intends to increase focus on domestic violence, affordable housing, and services for the LGBT communities.  Asked if the legalization of marijuana will have an impact on incarceration, he did not think so, except possibly an increase in DUI.
  • The hearing ended after 2 hours when Sheriff’s staff brought in 2 therapy dogs.  

​Observer: Carole Cotter

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Charity Care Is The Challenge in FY2020 Budget for Cook County Health

11/16/2019

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Cook County Board of Commissioners- Finance Committee
Departmental Budget Hearing
Oct 29, 2019


Cook County Health (CCH)
  • CCH proposes an austere FY2020 balanced budget of $2.8 billion, of which approx $1.8 billion is related to County Care (CCH's Medicaid Managed Care plan).  
  • In Cook County FY2020 budget, the Cook County Tax Allocation given to CCH represents less than 5% of CCH's operating revenue. 
  • The CCH FY 2020 budget anticipates $590 million in uncompensated care (charity care, unpaid patient bills, insurance companies not reimbursing claims) of which $409 million will be for charity care.
  • The budget includes 6601 FTEs and no layoffs (750 vacant positions were taken out of the budget), expenses for expected increases for drugs, medical equipment, and for employees' wages/benefits. 
  • The Cook County Budget allocation of $83 million to cover CCH health services provided to Cook County Jail, the Juvenile Temporary Detention Center and Public Health functions falls short of CCH's anticipated expenses. 
  • $513 million patient fee revenue is projected for health care services from insured individuals (not County Care members) through their Medicare or other commercial insurance. 
  • The FY2020 budget for Stroger Hospital is decreased by 8% and Provident Hospital budget increased by 5.4% due to planned increase in services
  • County Care  receives approx $1.8 billion payments for its members from Medicaid administrator.  Of this amount CCH anticipates earning $173 million for providing health care services to County Care's members.  Other healthcare providers outside of/not associated with Cook County Health system receive $1.5 billion from County Care for providing health care services to its members.  
  • Charity Care is the largest and most important/challenging  expense/issue in CCH's FY2020 Budget.  Charity care at CCH is anticipated to grow at 4% for a total of $409 million.  CCH in 2019 provides over 50% of charity care in Cook County.  DSH (Disproportionate Share) and BIPA (Benefits Improvement and Protection Act) are federal funds paid to CCH to offset charity care. In the FY2020 these payments are approximately $289 million.  In the current year, CCH will spend more than $377 million for charity care, a budget gap.  CCH spends $1 million/day for charity care and this means that in FY2020, CCH will run out of money before the end of the year to pay charity expenses. The ever increasing burden for CCH stems from more individuals being uninsured and underinsured.  Also another major reason for this charity burden on CCH is that other Cook County hospitals will treat uninsured patients for emergency conditions but discharge these patients with referral/instructions to seek follow-up care at CCH (these institutions decline to treat these patients for follow-up care).
  • Plans are in place to improve the growth of CCH health system and revenue with new/expanded services such as chronic ambulatory dialysis at Provident campus, expansion of surgical services at Provident and Stroger hospitals.  CCH anticipates continued growth in extramural funding which brought in more than $25 million over the past three years.  CCH FY2020 budget anticipates County Care membership of 326,000 (as of today membership slightly over 320,000).  CCH will continue to seek additional Federal, State, and Cook County money and continue improvements to revenue cycle capture of money (clinical documentation, billing, coding, collections).
  • The budget gap between DSH and BIPA federal funding and CCH's growing charity expense outlay is CCH's greatest  FY2020 Budget challenge.  CCH will always provide health care regardless of the ability of the patient to pay, but this budget challenge will force CCH to make necessary difficult choices in restricting/cutting back services/delay getting equipment.
Observed by: Michele Niccolai
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