Category: Cook County Board

Cook County Health Mid-Year Budget Hearing

8/6/2023

Cook County Board Finance Committee – Mid-Year Budget Hearings
July 26, 2023 –

Cook County Health - Israel Rocha, CEO.
2024 Preliminary Budget: $4,034.9 Billion Revenue

Mr. Rocha began by stating that Strategic Plan mission is to compete head on with any health care system in the world. The primary issues discussed during the two-hour hearing were:

Dental Care - Nurses Hiring & Reduction of Agency staff
Abortion Care - Asylum Seekers and the Undocumented

Dental Care

CCH currently has six clinics outfitted to provide dental care. Blue Island is the latest at a cost of $236,000 for space preparation and equipment. The issue is finding staff to provide the dental services at all the locations. Mr. Rocha said the System is look at options and may start sharing staff.

Abortion Care

Commissioner Britton asked about out of state patients seeking abortion care. Mr. Rocha said that the CCH has seen an increase in services needed, particularly with complications.

Hiring & Reduction of Agency Nursing Staff

Mr. Rocha noted that year to date, 800 hires have been made, and turnover is down. The System’s 6.1% turnover is lower than the industry average, but he noted that the average age of the workforce is 51 years. The number of current vacancies is 2,314. When asked about when the use of agency nurses would be reduced, Mr. Rocha talked about the HR’s recruitment efforts for nurses including the very successful job fairs with same-day conditional offers, signing and retention bonuses, and the increased emphasis of benefits such as pension, health, personal leave, and full tuition coverage after one year of service.
Later in the discussion, Commissioner Gainer said that the CCH will always have to rely on agency help, particularly for nurses. Her point is that a realistic number should be set each year for needed agency help to which budget numbers can be assigned.

Asylum Seekers and the Undocumented

As a reminder, the System serves all residents of Cook County regardless of their citizenship or ability to pay. The influx of Asylum Seekers over the last 6-8 months has resulted in unbudgeted expenses. Belmont Cragin is the entry point for health care screenings. Mr. Rocha said that the cost to date has been about $1-$1.5 million per month, but total costs for 2023 are projected at $26 million. Commissioner Morrison asked if the cost of the Asylum Seekers and the Undocumented could be separated for future budgets. Mr. Rocha said that patients are not asked if they are in the US legally to avoid a chilling effect. on seeking care. Some of the undocumented cost is covered by Medicaid and the rest falls under the Charity Care expenses line.
Overall, commissioners were very complimentary of Mr. Rocha’s leadership and progress. Commissioner Miller said that CCH has gone from being a model of reactive care to a model of preventive care.

Observer: Diane Edmundson

0 Comments

Mid- Year Budget Hearings

8/6/2023

0 Comments

Cook County Board Finance Committee – Mid-Year Budget Hearings
July 25, 2023 - Afternoon Meetings

Inspector General – Steven Cyranoski, Interim IG.
$2.3 million Preliminary 2024 budget

At midterm, 15% below 2023 budget. Year-end projection: Under Budget
Budgeted for 19 FTE’s. Currently: 3 vacancies [IG, Deputy IG, Investigator]
No commissioner questions

Public Administrator – Louis Apostal. $1.7 million self-funded 2024

738 investigations to find rightful inheritance ownership
70 properties under management
15 full-time staff – unionized office. 5 outside attorneys
2024 budget will increase by $137,000 – primarily increased compensation costs

Cook County Clerk – Karen Yarborough. $20.6 million Preliminary 2024 budget

Chief Election Officer and responsible for maintaining and providing vital records
No longer under Shakman and received several compliments for achievement
Increased vacancies of between 25-30 due to retirement and termination
Elections: Additional language ballots will be offered along with information sheets in that language.
Commissioner Aquilar asked why a pension deduction was taken out of Election Judges checks. Ans: there is a glitch in the system which is being addressed.
Availability of Election Judges was a question: Ans: The shortfall has been filled by veterans, community college students that can earn a credit for taking a course on being an election judge, civics, and cyber security.
Question: Security of elections and voting by mail. Ans: Election ballot drop boxes are located at early voting sites and are monitored.

Board of Review [BOR] – Cardenas, Steele, Rogers.
$18 million Preliminary 2024 budget

Currently, analysts are working 20 hours mandatory overtime to get appeals processed and sent to the next office for mailing out the 2022 tax bills which are already late.
The BOR asked for money to bring each of the 3 Districts to 50 analysts. Currently a total of 105 analysts. Daley asked if granted, could the Board guarantee that the tax bills will go out on time. Ans: No as there are too many other offices involved in the process. Said it is anticipating 400,000 appeals in 2024. The previous analyst ratio was 1-1200 appeals. Now 1-1600 appeals.
Steele, who has 17 years in the Assessment Industry including the CC Assessor’s office, noted that the Assessor looks at properties in comparable groups while the BOR reviews each property individually.
Steele published a BOR report for 2022 and is in the process of working on a Standards Manual.
February’s request for a cost comparison between switching to or fully integrating with the Tyler system should be ready in late August. Cardenas noted that the BOR has just two IT employees.
Cardenas said that transparency is at the front of the BOR’s mission, and that it has already reduced the appeal time by 6 weeks. He also said the website has been improved as have FOIA responses

Land Bank – Jessica Caffrey, Executive Director. Primarily self-funded
Ms. Caffrey is relatively new to the Land Bank having worked for the County in previous roles including coordinating the development of the Old Stroger Hospital and the building of the Cook County Health’s Administrative Building on Polk.

The Land Bank’s goal is to “create the market” by acquiring 4-5 houses per block in a blighted area which can change the entire block and market
It acquires vacant, available property through tax sales and other means
96% of all its properties are resold to homeowners
$9.8 million in real estate value has been created in Inglewood
Created $2.5 million in revenues as of May 1, 2023
Reduced aged inventory which is property that is on the books over two years
Staff: 13 positions including 3 vacancies.

Observer: Diane Edmundson

0 Comments

Cook County Board Approves Programs to Help Communities

8/2/2023

0 Comments

Cook County Board of Commissioners Meeting
July 20,2023

Board Action:

Approval of the use of $1.2 M in ARPA funds for projects in the Proviso and North Lawndale areas to house recently released prisoners. Besides housing, residents will be provided with wrap-around services. It is estimated 300 people will be serviced. (Agenda Item 23-2303)
Approval of $333,000 to help Cook County communities build emergency readiness. (Agenda Item 23-2677)
Approval of up to $18M in ARPA funds to be awarded to the MWRD. The MWRD will manage 16 projects for stormwater management. The program will help communities implement current projects and also help them plan for future needed projects. (Agenda Item 23-3566)
Approval of an appropriation of $7.7M for the Invest in Cook County Program for 2023. This grant program contributes to Cook County communities’ transit, pedestrian, and roadway improvements. Since its initiation, Invest in Cook County has given grants of $56 M. (Agenda Item 23-3911)

Observer: Kathleen Graffam

0 Comments

Cook County Board Committee Meetings

8/2/2023

0 Comments

Cook County Board of Commissioners Committee Meetings
July 19, 2023

Legislation & Intergovernmental Relations Committee

Item 23-3320 Recommended for approval The Committee approved an amendment to the Inspector General selection ordinance which required a bipartisan committee of equal number of Commissioners from different parties. Since there is only one Republican commissioner now, the ordinance had to be changed. The change was that if there is not enough representation of both parties, the President can appoint another commissioner.
Item 23-3719 Recommended for approval Amends the ordinance covering sick leave to add that it may be taken for mental health issues.

Finance Committee

Item 23-3116 Deferred The item was for the approval of the use of $20 M in ARPA funds to assist suburban Cook County residents pay water bills. Money could go to pay directly for a person’s water bill. The plan was to use CEDA (The Community and Economic Development Association) as they currently help individuals with their water bills. CEDA is about to lose its federal funding. The funding would also go to help a municipality with a high-water burden. That program is to be managed by Elevate, a private company. Elevate would need to negotiate with the municipality to ensure that the funds would go to pay for water, that fees and rates would be modified for residents, and that resident water would not be turned off. At this point it is not known which suburbs would participate and what the conditions would be. Commissioner Daley asked what suburbs would be targeted and what reports would there be. Commissioner Degnen suggested a smaller amount be authorized to initiate the programs and when more details were available, more money could be given. Since there were so many unknowns the item was deferred.
The second part of Item 23-2116 was authorization of $1.24M to implement a Community Information Exchange Program to share client profiles among healthcare and social services. This would allow more holistic care to an individual and build connections among providers.

Transportation Committee

Item 23-3259. Recommended for receiving and filing. This was a report on a pilot program in South Cook, The Fair Transit Program, that is subsidizing fares on Metra and Pace to encourage the use of public transportation in the south region. The Metra Electric has seen ridership return to pre-Covid levels. The Commissioners approved the continuation of the pilot.

Health & Hospitals Committee

Behavioral Services Reports from CCH, Sheriff, Office of the Chief Judge, State’s Attorney, and Public Defender were reviewed. The Committee recommended for receiving and filing.
Much of the conversation focused on substance abuse programs. CCH is finding that recovery coaches who continue a relationship with a patient after they leave the hospital have shown to help the patient stay clean. They are also implementing emergence naloxone vending machines in neighborhoods, where residents can get this to help with overdoses.
The Sheriff’s office reported that the jail does individual assessments on new inmates and it has its own substance abuse programs that are offered to the inmates. They also give released prisoners naloxone if indicated.

Asset Management Committee

Item 23-3313 Recommended for approval This contract contained several capital projects.
Earl Manning, Director of the Office of Capital Planning and Policy , has established a pre-qualified program for small minority firms to make it easier for them to participate in smaller projects. The businesses do not have to submit the paperwork for each potential job as in the past.

Contract Compliance Committee

Item 23-0820 Recommended for receiving and filing. This was the annual diversity report. Nicole Mandeville, Director of Compliance, reported on the past 4 years of county spending on contracts. 32% of contracts in 2022 went to M/W/DBE owned companies.

Audit Committee

Items 23-3381 & 23-3378 Recommended for receiving and filing Outside Audit of Cook County for fiscal year 2022. The auditors did see errors in accounting entries for CC and CCH which required adjustments for the financial statements. There were weaknesses in the controls on the Oracle accounting system such as not deleting terminated users. The auditor recommended allowing more time to close the books at year end to find needed corrections.
Item 23-3382 Recommended for receiving and filing Report on Federal Awards There were findings of non-compliance with Federal Grant Awards requirements. Commissioners Degnen and Daley noted this was more than usual. Commissioner Degnen will be meeting with the department to discuss improvements in process.

Observer - Kathleen Graffam

0 Comments

Mid-Year Budget Hearings

8/2/2023

0 Comments

Cook County Board Finance Committee
Mid-Year Budget Review Meetings on July 25, 2023

Budget Overview

Revenue will decline next fiscal year because the State has changed the statutes on sharing the Personal Property Tax (part of the corporate income tax) and Cook County will see a change from $133M this year to $75M next year.
Sales tax will remain level
Income from County Care at CCH will decline because participants have to go through Medicaid redetermination post Covid and it is projected there will be less members.
Labor costs will increase $27M and IT costs will increase $20M next year.

Cook County Health (CCH)

FY 24 will have a shortfall of $3M due to the redetermination and increased labor costs. The union agreements included retroactive COLAs.
Asylum seekers medical costs have been $26M this year.
CCH has managed $265M of ARPA funds in 70 programs. They provide monthly reports on the programs to the Board. There is a sustainable working groups looking at how to continue the programs after 2026 and the end of ARPA funds.

Office of the President

Cook County reporting of ARPA funds is good according to Results for America.
$281M of medical debt of individuals has been paid by Cook County.
$110M has been spent for reducing gun violence. Cook County is working with the City and the State on this issue.
Technical help has been provided to 13,000 small businesses.
Commissioner Sean Morrison asked for more detailed reporting on the medical debt elimination—how are recipients chosen, which hospitals and locales.
Commissioner Gainer asked if HR hiring process is improving. Ms. Turner said that was being reported in the Performance Management website.

Chief Judge - Tim Evans

The court system now has a permanent hybrid process.
The courts will need more employees to support the Safe-T act for night and weekend shifts.
Judge Evans explained the operation of the restorative justice program and its success in decreased recidivism of its participants compared to people who go through the regular court system.
Commissioner Gainer asked for more reporting on the residents in the Juvenile Detention Center, particularly in education. There have been reports that special needs students are not being accommodated.

Sheriff - Tom Dart

The jail will be within budget for FY 2023.
Sheriff Dart explained why there was a need for a new helicopter, particularly for use in carjackings.
The sheriff office provides back up for many suburban police departments. They are the only police in Ford Heights, Dalton, and Harvey.
The office implemented a mental health incident support program. Responders are trained on de-escalation procedures and provided a tablet that they can use when dealing with a mental health crisis. The tablet connects them with a mental health expert to help them deal with the issue. This has been implemented with 15 communities.

Observer: Kathleen Graffam

0 Comments

Commissioners Approve 12-Week Paid Parental Leave

7/5/2023

0 Comments

Cook County Board of Commissioners Committee Meetings
June 28, 2023

The Commissioners had a full day of Committee meetings filled with much substance. Highlights below include

Approval of the 12-week paid parental leave for offices under the President (not for employees who work for the other County Elected Officials)
Differing views about the conditions inside the Juvenile Temporary Detention Center
Updates on the status of revenues vs. expenses for this fiscal year and on the long-term revenue forecast
Update on what the different County offices are doing with respect to domestic violence cases

12-week paid parental leave

The Finance Committee voted to direct the Bureau of Human Resources to put together a policy for paid parental leave for 12 weeks. To qualify, the employee must have been full-time for at least 12 months and must be a birth parent, non-birthing biological parent, intended parent of a gestational surrogacy, parent of adopted child, or foster parent placed with a foster child of 17 or younger. Employees will be limited to 1 such leave per 12 months.
Commissioner Degnen, the principal sponsor along with President Preckwinkle, explained that the policy would for now only cover employees under the offices of the President. Each other Elected County Official must take their own steps to adopt such a policy. Commissioner Degnen said the Board can and should encourage such steps by assuring the Electeds that the Board would make sure the money was there to cover the costs of such a policy.
Commissioner Gainer said that she had left the City of Chicago’s employment years ago because it had no such policy. She expects that having such a policy now at Cook County will enable many good employees to remain at the County.
Commissioner Kevin Morrison stressed that people who opt to take this leave should know there will be no retributions as a result - particularly that they will not miss out on promotions.
Commissioner Miller emphasized that this policy should assist in improving the significant maternal mortality and morbidity rates that the Commissioners heard about the previous day by allowing birth mothers to have the time to obtain the care they need. Commissioner Miller also said that this policy was another plus for attracting and retaining good workers at Cook County (again referencing yesterday’s meetings where they heard about the challenges of hiring).
The Board approved this item (#23-3117) at the Board meeting on June 29.

Conditions at the Juvenile Temporary Detention Center (“JTDC”)

The Audit Committee held a hearing to discuss Equip for Equality’s report on conditions inside the JTDC, which is under the authority of the Cook County Chief Judge. The Chief Judge did not speak, but was present throughout.
Equip for Equality (“EFE”) is the private not-for-profit legal advocacy organization designated by the Governor to operate the federally mandated Protection and Advocacy (“P&A”) System for people with disabilities in Illinois. EFE conducted observations and interviews with staff and detainees at the JTDC and the Chicago Public School that operates there from late 2021 thru early 2023. The full report can be found at https://www.equipforequality.org/files/jtdc_report.pdf
EFE recommends ending the practice of isolating youths and the use of a “holding” pod for those who either act up in the school or refuse to go to school. EFE also recommends the end of the policy of having youths in the holding pod sit “on the wall” while they are given packets of work and utilize overturned chairs as desks, all the while not being able to talk to anyone.
JTDC Superintendent Dixon and other supervisory JTDC staff stated there was no such “policy,” but admitted that this practice is used. Supt. Dixon explained that this is used to prevent harm to others, as well as for the youths themselves. There are serious gang issues within the JTDC, and the youth detained there are generally accused of serious crimes, including murder and attempted murder.
EFE is particularly focused on those detained in the JTDC who have special needs and the failure to accommodate that in the school. However, Supt. Dixon explained that the staff are not advised by the Chicago Public Schools (“CPS”) as to when any of the youth there have special needs. The prior memorandum of understanding between CPS and the JTDC lapsed a long time ago and a new one is just now being negotiated which presumably would provide for such information to be given to the JTDC.

Current Fiscal Year and Long-Term Revenue Forecast

The Comptroller reported to the Finance Committee that both the General Fund and Health Enterprise Fund have positive balances due to revenues exceeding expenses: $162 M for the General Fund and $108 M for the Health Fund.
Dean Constantinou, Deputy Chief Financial Officer, presented the quarterly update on the long-term revenue forecast developed by the County’s Independent Revenue Forecast Commission. The forecast is for slow economic growth into 2024, which should have a positive impact on revenues, particularly the sales tax which, as of April, is projected to be 1.3% over budget. As a result of projected small surpluses going forward over the next 5 years, the County’s Fund Balance should continue to be above the maximum desired under the County’s policy, resulting in additional funds being available.
The forecast is also for revenues to exceed expenses in the Health Fund going forward. County Care membership is expected to peak in June and then drop off. After November of 2024, the forecast is for membership to remain flat.

Domestic Violence

The Criminal Justice Committee heard from representatives from the offices of the State’s Attorney, Sheriff, Chief Judge, and Clerk of the Circuit Court on what is going on with respect to domestic violence cases. The Public Defender was not available. Prior to the meeting, Commissioner Anaya, the sponsor of the item (23-2711) calling for the hearing, had met with each office explaining what she wanted covered.
The State’s Attorney’s representative talked about the Domestic Violence Mental Health Court pilot that started in February. The focus is on familial conflicts with outpatient and inpatient treatment for both defendants and victims. So far, there have been 50 cases and 5 graduates.
The State’s Attorney is recommending (1) technology upgrades to the domestic violence court at 555 W. Harrison, (2) creation of a shared screening data base among agencies, and (3) the elimination of paper communications.
The Clerk of the Court’s representative reiterated the need for a single system among the criminal justice offices, and said that there is one that all offices have access to: the Clerk of the Court’s Case Management System. What needs to be done now is make sure all offices are trained on using it. The representative explained that each office still needed its own system to manage its work load – other offices, for example, should not have access to the State Attorney’s case management system.
Honorable Judy Rice, the Acting Presiding Judge of the Domestic Violence Court, reported that there are 1500 new cases each month, both criminal and civil. There are monthly meetings among all the entities (DV advocacy, Sheriff, Clerk of the Court, State’s Attorney, DV Judges, etc.) and the Chief Judge’s office supports increased staffing for all. Since the pilot program for “After Hours” Domestic Violence Court (9 pm to 3 am on weeknights and 1 pm to 6 pm on weekends) there have been 543 cases.

Observer: Priscilla Mims

0 Comments

<<Previous

Cook County Health Mid-Year Budget Hearing

Mid- Year Budget Hearings

Cook County Board Approves Programs to Help Communities

Cook County Board Committee Meetings

Mid-Year Budget Hearings

Commissioners Approve 12-Week Paid Parental Leave

Author

Archives

Categories