Cook County Board Of Commissioners
Health & Hospitals Committee Meeting
January 14, 2025

Dr. Kirin Joshi, newly appointment Interim Chief Operating Officer for the CC Public Health Department, received a very warm welcome.  He started with a presentation highlighting: 

• Covid activity low.  Flu and RSV activity high.  ICU admissions are highest for Flu. Covid 19 admissions continue, primarily in adults over 65.
• Wastewater detections for RSV and Flu are increasing.  Same for Covid-19 but less dramatically.
• Fall 2024 study of patients at VA hospital examined almost 45,000 COVID -19 infections, and analyzed if the case received the fall 2024 vaccine. It found that the vaccine reduced hospitalizations by 65%, Emergency room and urgent care visits by 57%, and outpatient visits by 56%.
• Cook County Health is rotating vaccination clinic hours at its 13 locations.  Vaccinations are for Covid and Flu but not RSV.  Locations and hours are promoted on its website.
• M-Pox infections in Suburban Cook County.  There have been no new infections for 3 months and residents continue to be vaccinated.  As of January, there were 155 total cases, 17 hospitalizations, I death, and 3,889 residents vaccinated.  In Chicago, 1,332 new cases, 83 hospitalizations, and 4 deaths.
• H-5 Avian Influenza A (Bird Flu).  First human death reported in January 25.  The person had underlying medical conditions and contact with sick/dead wild birds.  67 cases confirmed in humans in the US since March 2024 with no human-to-human transmission.  Risk continues to be low.  Recommendation is to clean shoes, tools, equipment; a bird feeder is OK.
• Cervical Cancer Mortality Rates.  Cancer is not a communicable disease, but a primary cause of cervical cancer is the HPV virus via sexual contact.  Vaccination against HPV is very effective.

​Commissioner Questions: 

• Commissioner Quezada asked if Joshi had an update on the status of combining Covid 19 and the Flu vaccines.  Answer:  No Update.  Also asked if an individual could tell the difference between Flu and the RSV virus symptoms.  Answer:  No.
• Commissioner Stamps asked about new migrants getting screened and vaccination.  Ans:  Yes, at Belmont Cragin location on W. Fullerton.
• Commissioner Anaya asked about the risk of consuming chicken with bird flu.  Ans:  If medically vulnerable, don’t consume meat or eggs.
• Commissioner McCaskill wants to bring the clinics to the people [mobile clinics] and perhaps pair with the Park District.  Ans:  Good idea.
• Chairperson Lowry announced that starting now, the County’s Birthday Health Screening for Breast and Prostate screening goes into effect.  Call before your birthday month to schedule 312-864-4289. If no insurance, can still receive.  Ages start at 40 for women for mammogram and 45 for men for prostate screening..

Observer:  Diane Edmundson

Cook County Board of Commissioners Committee Meetings
Jan. 15, 2025

Emergency Management and Regional Security Committee - 1pm

• Executive Director Ted Berger of Dept of Emergency Management and Regional Security presented the report on 4th quarter expenditures for the Disaster Response and Recovery Fund (25-0467). The report was a financial overview.
• Com. Aguilar thanked Berger for the efforts which resulted in $400M for Chicago, $200M for Cook County, and $96 M for Cicero. The work involved coordinating work with municipalities and with HUD and FEMA.
•  Comm. Daley asked if Berger felt confident we could coordinate with other municipalities if we were in a situation like the current emergency needs in Los Angeles County. Berger stated he did and had been in contact with LA Dept. of Emergency Management and, in fact, had developed a relationship with them when Chicago hosted the DNC over the summer.
• He stated Cook County is involved in an AARPA funded program supporting updated emergency operations planning. Funds in use also support updating plans in municipalities for recovery, continuity of government, and emergency operations.  He stated that long-term recovery and preparation includes development of volunteer community response teams.
• Chair K. Morrison thanked the Director and his teams to help address needs this past year, particularly in the aftermath of tornados, noting this need will continue.
• Com. Britton made the motion and Com Anaya seconded that the report be received and filed.  Passed. 

Committee on Human Relations - 1:15pm

• 4th quarter report of Complaints with Commission on Human Rights from the Dept of Human Rights and Ethics. Tamaya Wright, legal counsel for the Dept. presented the report (Item 25-0399).
• There were 302 inquiries-from both employers and employees- which is a decrease from 3rd quarter. 112 cases are pending which is higher that last quarter. 80 new cases were filed 4th quarter, a significant increase. The majority of those filings were about paid leave.  A new case management system was launched in Sept. which the department believes might have impacted the number of cases filed.
• In response to a question from Com Anaya, Counsel Wright explained that further analysis would be needed to determine whether inquiries led to investigations or dismissals and that could be done soon. Exec. Director Lewis responded to Com Anaya that follow-up would also be needed to determine the number of cases from 4th quarter were rolled over to 1st quarter of 2025 and how many were dismissed. Anaya explained her concern was whether more resources were needed in their office. She was told the office currently has 4 investigators and 3 vacancies.
• Com. Trevor noted that the majority of cases were inquiries were about paid leave, a new policy, and asked how large an increase there would be if that group was taken out; Dir. Lewis’ response was that the numbers would likely be about the same as 3rd quarter absent other changes. School districts and park districts have been impacted by the paid leave changes.
• Com. Quezada made the motion and Com. Trevor seconded that the report be Received and Filed. Passed. 

Committee on Technology and Innovation - 1:30pm

• Technology Strategic Plan Report for 2025 was deferred to Feb meeting to accommodate scheduling concerns.
• Motion to Approve Item 25-0263, Contract Amendment with Oracle Technology Service was made by Com. Quezada and seconded by Com. Trevor. Derrick Thomas, Chief Information Officer for the Bureau of Technology presented the 5yr amendment to the Oracle contract.  He explained this is for maintenance of Oracle e-business suite for procurement, budget, and financials. Ceiling is $27.8M. No consulting services are planned. Expected services are annual software maintenance and tech support. Through Oracle Cloud Service, the County hosts Enterprise Service Bus, which is a data exchange service for Criminal Justice Dept. and Chicago police Dept and IL Dept of Corrections and other programs. This was approved by the Boards last year. 
• Mr Thomas reported that the County’s participation in Oracle Support Rewards has resulted in earned rewards of $223K for the county to date. It receives a 25-cent credit for every dollar it spends toward hosting their products.  The savings goes toward reducing costs of maintenance. Motion approved. 

Note
Reminder from Chair Morrison for commissioners get approval 24 hr. in advance for remote attendance. 

Observer: Carolyn Cosentino

Cook County Board of Commissioners
Committee Meetings
December 18, 2024

Criminal Justice Committee
The meeting began with 45 minutes of Public Comment from advocates and family members of those persons who have died while incarcerated at the Cook County Jail. Comments focused on the need for better procedures to ensure the health and safety of persons while they are incarcerated. Also requests for more transparency and better notification procedures when deaths occur. 

​Public Comment was followed by a presentation from representatives of the Sheriff’s Office and Cook County Health (Cermak Hospital) to educate the County Board about the policies and procedures in place to address the health and safety of detainees. (Agenda Item 25-5416) The following points were made during the presentations:

• 40,000 people per year cycle through the Cook County Jail System
• In 2023 44% of inmate deaths involved drug soaked paper
• Initial assessments for health risks and medications are done on all individuals when they go through intake
• The Sheriff’s Office has programs for individuals with Substance Abuse and/or Mental Health Issues as well as anti-violence and anger management programs. 
• Naloxone is available across the compound and training of personnel is done. 
• Attempts are being made to review all mail so that drug soaked paper does not get into the jail. 
• Cermak does initial assessments on approximately 82 persons per day

Commissioner Questions and responses:

• Comm. Quesada asked for the numbers of deaths and cause of death. In 2024 there have been 10 deaths and in 2023 there were 18 deaths. In 2024 2 were natural causes, 1 overdose, 1 suicide, 2 homicide, 1 accidental overdose and 3 undetermined to date. In 2023 there were 6 from natural causes, 8 overdoses, 1 suicide and 3 homicides. He also asked about the procedure known as “cross watching” which is when staff have to oversee more than one unit. Response was that it does occur when staffing is not adequate. It is not prohibited but also not ideal and is used judiciously when necessary.
• Comm. Anaya asked how the jail and the health system collaborate to ensure that individuals receive the care they need while incarcerated. Inmates are assessed for health needs when they enter the system and can request health services anytime if they want to. Cermak îs not an emergency facility but they will respond as necessary but also outside emergency services are enlisted when necessary. 

Legislative and Intergovernmental Relations Committee

• An amendment to the Board Rules was proposed requiring that any reports and documents pertaining to board agenda items must be attached to the original filing of the item. If not attached initially they must be filed 48 hours prior to a meeting or the item must be withdrawn, deferred or referred to committee. (Agenda Item 24-6376) The item was approved. The League of Women Voters of Cook County did submit written comments to the board supporting this amendment. 
• A technical amendment to the Paid Leave Ordinance was approved to address some of the concerns that school districts have been raising with this ordinance. (Agenda Item 24-6496) Comm. Britton stated that he has been attending municipal meetings over the past few weeks and more entities are opting out of the County's Paid Leave Ordinance. He said that by not excluding Park and School Districts from the ordinance it has probably resulted in fewer people being covered than was originally intended. Comm. Morita said that they will continue to work with the school districts to ensure that their concerns are addressed. 
• A representative from the Assessor’s Office presented an Update on “split-classed, commercial mixed-use properties” -  a new definition for the sub category of 3-18 under multi-use Class 3 property assessments. (Agenda Item - 24-6504) This classification addresses properties that have commercial space as well as residential space and considers square footage as well as % of living space vs commercial space.  Several speakers spoke during the Public Comment at the beginning of the meeting about the tax burden being placed on certain small business owners due to the reclassification of 3-18 properties in the last assessments. The presentation outlined the process the Assessor’s Office used to change the definition of the 3-18 to address the concerns of the 30 property owners in the south suburban area and the city who will benefit from this change. In the next assessment of the northern suburban area there could be more properties that will be affected.  

Finance Committee

• During the Cook County Health Financial Report, CCH reported that there has been a 14% decrease in the utilization of agency workers throughout the system, an initiative that Comm. Degnan and  Anaya have been pursuing. Comm. Gainer asked whether this was a sustainable decrease and what factors changed to allow this to happen. CCH staff stated that salary adjustments and reassessing staffing needs/requirements were key. Also some agency employees are converting to County employees which is expected to result in a savings. Comm. Gainer also requested information about how much the agencies are paying their contracted employees and how much the agency is keeping. CCH said they would attempt to get that information.

Observer - Cynthia Schilsky

Cook County Board of Commissioners
Health and Hospitals Committee 
December 17, 2024, 1:30pm
​
Dr. Hasbrouck, head of Cook County Public Health, did a presentation on Data Collection through a Health Equity lens. 

• He emphasized fast versus slow data collection and explained why it took so long for some data to appear (up to two years delay).  The slow data is more trustworthy than the fast data.  Data from 2022 is now available in 2024.  National Data and Illinois Dept of Health data is likewise as slow as Cook County for many health statistics.  The reason data takes so long to be accurate is that it needs to be “cleaned” and analyzed.  He said there were many examples of the same individual going to multiple Cook County clinics with the same health concern, and CCH has to make sure they are not double or triple counting that same person.  In many cases the clinics are reporting data by fax or paper rather than entering it via a spreadsheet.
• Ways to access health data for CC, include the apps, Health Atlas and Shiny.
• Com. Anaya wanted to make sure CC and Chicago were synced better than they are now.  Dr. Hasbrouck said they meet on a regular basis and the data would be available on Health Atlas in the next 3 to six months.
• Com. Daley wanted to know why COVID results were available so much faster (week to week) while current data takes years.  Apparently COVID reporting was mandated while other data is not, by Illinois Dept of Health.  Daley also asked how citizens can learn about health stats, and Dr. Hasbrouck says they help produce newsletters and work with the 31 communities within Cook County.
• Com. Trevor asked about early warning signs like wastewater testing, and Hasbrouck said those and police data are gathered by their data contractor.
• Com. Aguilar was also concerned about data timeliness.

Observer - Amy Little

Cook County Board of Commissioners 
Health and Hospitals Committee Meeting
November 20, 2024


The Committee approved a nonbinding resolution that Cook County Health's (CCH) agency-hired personnel should not exceed 20% of the budgeted full time equivalents (FTE) personnel for each job classification approved in the annual budget.

• Prior to the start of its formal agenda the Committee heard 20 minutes  of testimony from 5 CCH union workers regarding support of Resolution 24-5841.  Impacts of having many agency employees working in the hospitals included reduced permanent staff morale and productivity.  Staffing shortages were attributed to lower pay and no sign-on bonuses for permanent hires compared to agency personnel.  Disrespectful behavior of agency personnel toward staff and patients were also noted as issues impacting patient returns for treatment. 
• There were comments against the Resolution. 
• Resolution 24-5841:  Chairman Lowry, Vice Chairwoman Anaya and several Commissioners spoke in favor of the Resolution and thanked Commissioner Degnen and her cosponsors for working with the local union representatives and hospital staff, drafting the Resolution, and then amending it to define specific goals and timeframe to meet them.  Resolution 24-5841 was approved 14-0 with 3 absentees.
• The amended Resolution 24-5841 Goal is to reduce the CCH System’s agency staff levels to not exceed 20% of the budgeted FTE in every department within 5 years.  Progress updates will be provided to the Board of Commissioners, Board of CCH, and the public via biannual reports and an annual hearing.  The Resolution will sunset in 2029 (or sooner if compliance is complete).

Mr. Craig Williams, CCH Chief Administrative Officer, presented the CCH Agency Reduction Plan’ (Oct 2024). 

• While the system-wide agency use is ~10%, several departments contract >20% of staff from agencies, including out of state companies
• FMLA backfilling is often addressed using agency staff
• Job classifications utilizing 20-50% agency staff include Hospital Security, Nurse, Respiratory Therapist, MRI Technician, Medical Technologist, Phlebotomist III, Building Service Worker, Clerk, Food Service Worker, and Transporter
• CCH will add budget for departments who have exceeded budgeted FTE to right-size them;  new agency FTE additions have been paused
• Permanent staff turnover is improving (7-8% vs. 20% US average) as is personnel engagement 

​Observer - Susan Gregory                       

Cook County Board of Commissioners
Committee Meetings
November 20, 2024   

Finance Subcommittee on Litigation 

• A Public Speaker stated that he objected to the proposed settlement of his complaint against the Board of Review for his termination.   He wants to be reinstated as well as having a monetary settlement.
• The Commissioners discussed all items before them in closed session and voted to receive and file.

Audit Committee
 24-5692  Proposed Fiscal Year Audit Schedule
Mary Modelski, Auditor,  reported that the 2025 schedule will include among other audits:

• ARPA programs
• JAC grant utilization to check controls previously recommended have been implemented
• Chief Judge case management system
• Procurement
• Forest Preserve financial processes including concession revenue.

Legislation and Intergovernmental Relations Committee
24-5896 Proposed Changes to the Vacation and Excused Absence with Pay ordinance.
There were several public speakers that addressed this proposed change to the ordinance.  The current ordinance applies to full time, part-time and seasonal workers in Cook County.  It requires that employers allot 1 hour of paid leave for any reason for every 40 hours worked in a 12-month period. The amendment would exempt school districts and park districts.
Several representatives from suburban school districts and park districts explained the problems with the current ordinance:

• For many teachers and others who work under existing contracts, these days are in addition to those agreed in the contract.  This results in more time the regular teacher is away from the classroom.
• When those contracts are renegotiated, these days will be included, probably at the cost of sick days.   Teachers can accumulate sick days toward their requirement, so they will lose some of that benefit.
• It requires more substitute teachers who are in short supply.   The cost of the substitutes is increased.
• Park Districts will have to cut the number of young people hired during the summer because of the increase in cost.
• Home rule municipalities can opt out of this ordinance and then the schools  and park districts within its boundaries would be exempt.  However, many school districts and park districts cover more than one municipality and so there would be unequal treatment of employees. 

Speakers from Women Employed and the Shriver Institute spoke in favor of keeping the original ordinance as it gives a benefit to the lower earners.
Commissioner Sean Morrison pointed out that the Illinois State Law on paid leave exempts school districts and park districts.
Commissioner Britton reiterated the issue of some municipalities being able to opt out while others can’t.   He pointed out that this will have more of an impact on southern and western suburbs who have fewer home rule towns.   This could result in higher property taxes. 
The Commissioners who did not support the change acknowledged the issues for the districts, but felt it was more important to protect the lower income workers across Cook County.  
The ordinance amendment failed to pass.

Observer:  Kathi Graffam