Cook County Health and Hospitals Committee
January 13,2026
Commissioners Hear Public Health and Disparities Reports
Quarterly Public Health Report

• Dr Kiran Joshi, Chief Operating Officer of the Cook County Department of Public Health presented the quarterly COVID-19, and infectious disease PowerPoint update. The U.S. Center for Disease Control (CDC) announcement made on Jan. 5 now recommends childhood vaccines for fewer diseases with some vaccinations recommended only for some high-risk groups or after consultation with a health care provider: Hepatitis B, RSV, Rotavirus, Hepatitis A, Meningococcal disease, Flu, COVID and the 2nd dose of Human Papillomavirus (HPV). 
• Illinois vaccine recommendations differ from the CDC and will be made by the IL Immunization Advisory Committee.  Insurance companies will pay for them (PA-104-0439 signed into law in December 2025 by Governor Pritzker). 
• The Cook County Department of Public Health will continue to follow Illinois childhood vaccination recommendations. Commissioner Degnen wondered how many parents will follow CDC vs IL vaccination recommendations.   (Item 23-3815)

Semi-annual Disparities Report

• Dr Kalyani Perumal, Chair Division of Nephrology at Cook County Health provided an update on kidney disease/treatment in Cook County.  Risk highest in African Americans, with 3.4 times greater risk, followed by Hispanics with a 1.5 times greater risk than overall population.  9 of 10 adults are unaware of their disease. Ambulatory nephrology care is provided at Stroger/Blue Island/Provident & Core Center as well as renal clinics. 
• Extensive questions from Commissioners.  Com. Stamps: “how do we get the word out, is there a checklist for potential kidney disease?” Response: diabetes and hypertension are primary risk factors. Primary healthcare teams must use screening labs: blood for creatinine and urine for protein. Avoid pain medications that can affect kidney, follow low salt, low fat diet and exercise.  
• Com. Aguilar: “is lack of early detection a part of high incidence of kidney disease in Hispanics?”  Response: kidney disease screening needs to start in high school.  
• Com. Vasquez: “are there plans to expand kidney screening & services to other communities?” Response: yes.  
• Com. Anaya asked about early detection for kidney disease.  Response: screen for family history of kidney disease, diabetes, polycystic kidney disease, hypertension, autoimmune disorders—if present considered “high risk”.  (Item 26-0433)

Observer:  Susan Kern, MD

Finance Committee
January 14, 2026
Preliminary FY2025 Results Show County Finished in the Black

• Syril Thomas, the County Comptroller, reported that on a preliminary cash basis, the County’s General Fund ended Fiscal Year 2025 with a positive $111.3 M, composed of $109.4 M more in revenues than budgeted and $1.9 M lower expenses than budgeted.  The higher revenues were primarily attributed to the County’s sales tax.  Mr. Thomas also reported that on a preliminary, cash basis the Health Fund ended FY2025 with a positive $81.6 M, composed of lower than budgeted revenues of $239.6 M, but lower than budgeted expenses of $321.2 M.  The Federal government cancelled $4 M in grants to the County. (Item 26-0585)
• Cook County Health provided a report for FY2025 on an accrual basis, which is deemed more accurate than cash.  That reflects an overall positive result of $82 M, with lower revenues than budgeted of $240M, primarily due to decreases in Medicaid enrollment and the resulting increase in charity care as a result of Illinois no longer covering some non-citizens.  However, actual expenses were $321 M less than budgeted, primarily due to staff vacancies and a reduced use of contract labor.  $3 M of the total $4 M in Federal grants that were cancelled impacted the Health Fund.  (Item 26-0583)
• The Finance Committee approved a county-wide contract with Lexis Nexis Vital Check Network to process payments to the County made with credit or debit cards across all offices from Feb. 1, 2026 thru Jan. 31, 2031.  Zahra Ali, the Chief Administrative Officer, said that the Dept of Revenue will cover all costs in its budget, but that overall, the County expects to bring in more revenues by allowing payments via credit and debit cards.  (item 26-0220)

Observer:  Priscilla Mims

Audit Committee
January 14, 2026
2026 Audit Plan Approved

• Heath Wolfe, the County (internal) Auditor,  outlined the plan for audits during 2026 for Cook County Government and the Forest Preserve. This item had been deferred. Audit will utilize outside auditors for IT security audits, so more audits can be performed.
• Commissioner Gainer asked if the County needs to be prepared if the Federal Government investigates the County’s use of ARPA funds. She asked what percent of the $1.4 B in programs has been reviewed or audited, and is there an industry standard for number of audits for that amount of money.  Mr. Wolfe was not aware of a standard but would reach out to industry organizations for guidelines.  He also will provide the commissioners with the number of ARPA reviews and audits that have been done.
• Another issue is the Audit department staffing. Mr. Wolfe was hired 6 months ago. There are currently 9 openings and 23 filled positions.  There are three offers out on the openings. Mr. Wolfe has worked on the staffing.  Several job descriptions had to be rewritten.  He is utilizing industry job posting sites and his connections from previous positions.  Commissioner Gainer recommended using outside auditors to ensure good coverage of ARPA funds if necessary.  There will be a review of staffing after 3 months.  She recommended coming back to the Board for additional funds if indicated.  
• The audit plan was approved.  (Item 25-4392)

Observer:  Kathi Graffam

Cook County Environmental & Sustainability Committee
January 14, 2026
Committee Reviews Environmental Justice Policy Framework Report

• The Environmental Justice policy framework started in 2019, involved a team including community voices.  Many public events were scheduled in order to include and engage multiple communities. 
• From the research informing the report, common themes are (1) Air quality (inconsistent monitoring and industrial emissions); (2) Water and flooding (lead contamination); (3) Climate resiience; (4) Green space and food access (increased tree planting); (5) Community engagement (education for youth and multilingual engagement); (6) Policy implementation; and (7) Other (utility costs).
• There were very few responses opposed to the county developing an environmental justice policy. 

What is next:

• Hire additional environmental justice staff
• More active engagement

Couple of notes:

• New hire: Tiffany Davis, Sr. Environmental Justice Specialist, from Colorado 
• Environmental justice public policy intersects with public health.
• The federal government declined the state’s request for federal funding for disaster relief related to the recent flooding. 

Observer:  Laura Davis 

Asset Management  Committee
Jan. 13, 2026
Contract to Analyze Preservation/Adaptive Reuse at Oak Forest Approved

• The Real Estate Department requested additional funds for the project that is evaluating if existing buildings on the Oak Forest Campus could be preserved and reused for County services.   The initial investigation identified 9 buildings that could be reused, with a potential savings of $61 M.   This request is to further analyze the potential use of those buildings.
• Commissioner Britten asked that the analysis include the potential revenue to the County by selling the buildings rather than rehabbing them.    
• The project was approved. (Item 26-0030)

Observer:  Kathi Graffam

Legislation and Intergovernmental Relations Committee
January 14, 2026
Committee Approves Appointments

• The Committee approved the appointment of 5 individuals to the Cook County Housing Authority Board. All appeared either in person or on Zoom and all had many years of various types of experience in Affordable Housing including finance, development, land use, and law.  
• The Committee also approved the appointment of 3 individuals to the Cook County Emergency System Telephone Board. Two of the three appeared online and both had law enforcement and emergency phone system experience. 
• Commissioners had no questions but did extend thanks for their willingness to serve on these volunteer boards.
• Appointments will be voted on by Cook County Board at their next meeting.

Observer - Cynthia Schilsky

Cook County Board of Commissioners Finance Committee Meeting
October 28, 2025

Cook County Health (CCH) – Chief Executive Officer Dr. Erik Mikaitis and Chief Financial Officer Pamela Cassara
Proposed 2026 Budget:  $5.218 Billion              Proposed 2026 Positions:              7,866
Actual 2025 Budget:        $5.252 Billion              Actual 2025 Approved Positions:   7,817
Difference:                    ($     34 Million)                  Difference:                         +   48
Dr. Mikaitis and Ms. Cassara presented the budget, explaining how Cook County Health (CCH) has cut expenses by 10% this year and the concerns for the government funding decreases anticipated in the next two years.  

• They anticipate that the cuts in state and federal funding will result in $400M revenue loss over the next two years. This includes Illinois eliminating the Health Benefits for Immigrant Adults ($111M affecting 8,000 patients) and Federal changes in eligibility for Medicaid recipients. The ARPA funds for 2026 that CCH has already received cannot be clawed back by the federal government.
• Commissioner Trevor expressed concern that the potential stopping of Affordable Care Act subsidies will result in thousands of uninsured residents because health insurance will become unaffordable. She had an estimate that 33% could lose their coverage. These people will turn to CCH for services.  Dr. Mikaitis said that this group may not choose to have the preventative services needed and this will result in more serious issues.   Also, there could be a significant impact to smaller hospitals that may have to close.
• CCH has been able to reduce use of agency staff by 40% which has resulted in a $30M savings. They have improved and accelerated the hiring process and anticipate that they can continue to reduce agency staffing. They are also reviewing processes for improvement that result in savings such as supplies. They are also creating ways for people to use the health clinics rather than the emergency rooms.
• The ICE operations in Cook County have impacted CCH and several Commissioners had questions about it.  There has been an 83% decline in visits from new arrivals. Dr. Mikaitis said the decline is due to immigrants leaving the area and fear of ICE detentions. He is concerned that this population will not have preventative care and that will result in more severe issues seen at emergency rooms.  Several questions concerned the training for employees.  All CCH employees have taken online training on dealing with ICE agents and alerting security and legal.  ICE has not tried to enter buildings to arrest somebody, but they have brought detained people in for medical help.  The ICE agents can legally stay with the detainee in a hospital room (not in surgery) but cannot talk to other patients.
• Commissioner Anaya asked for an update in increasing bilingual staff. They have increased the Spanish speaking interpreters by 9.  They now have 14 Spanish and 3 Polish on-site interpreters.  They also have an online system for all languages which has proved to be very useful and patients are willing to use it. CCH Behavioral Health department is trying to recruit a Spanish speaking psychiatrist but, as yet has not been successful.
• Commissioner Britton asked about their policy on renting versus buying.  CCH is working with Real Estate Management on evaluating their space and trying to consolidate in county-owned property.  CCH is co-locating food help with medical help. It has food pantries and healthy meals programs.  They are working with other providers and philanthropy to plan for the potential SNAP stoppage.
• CCH has established a Pathways program to interest area students in medical professions working at CCH. They work with local high school, college, and graduate students.

Observer:  Kathi Graffam

Cook County Board Committee Meetings 
Sept. 16, 2025

Health & Hospitals Committee Public Hearing
Committee Receives Update on Maternal Health Care and Morbidity and Mortality Rates in Cook County

• Following up on two similar hearings over the past 2 years, Commissioner Miller, the lead sponsor for holding this hearing (Item 25-0917), noted that disparities between Black and Latina women vs. other were made worse by Covid.  Now the disparities are expected to be exacerbated by the Federal cuts to Medicaid and to SNAP (Supplemental Nutrition Assistance Program. Nevertheless, she noted that up to 80% of deaths are preventable and progress is being made.
• Nine public speakers ranging from individuals with serious maternal health problems to the CC Physicians Association, Women in Medicine, the IL Dept of Public Health, and speakers from Family Focus (advocacy/service org.) They all prioritized the importance of continuing to provide funding for maternal health and several emphasized the importance of providing post-partum medical coverage for 12 months.
• Dr. Wm McDade, MD, PhD and adjunct Professor of Anesthesiology at the Rush Medical College stated that during 2018 to 2022, there were 6,283 pregnancy-related deaths in Cook County, including 1,891 late maternal deaths.  American Indian and Alaska Native women had the highest death rate followed by non-Hispanic black women.  Cardiovascular disease was the leading cause of the overall deaths.  Cancer, mental and behavior disorders, and drug and/or alcohol induced deaths were all important contributing causes of late maternal death. Inadequate access to care, information, communication, and warning signs along with social determinants all lead to inequity.
• Dr. Joshi, Cook County Public Health Chief Operating Officer noted that in Suburban Cook County, black infant mortality is three times higher than for others.  Causes of maternal death include hemorrhaging, hypertension, obesity, infection, and thromboembolic disorders.  Cook County’s goal through its Doula program and other services wants to surround the maternal patient with all the services needed pre-during-and post pregnancy.
• Cook County’s Cermak facility provides health care for those in the Cook County Jail, which include: primary care clinics available for all individuals, STI (sexually transmitted infection) screening offered during intake process; perinatal clinic for pregnant and postpartum women; medication assistance; termination care, family planning services including a gynecology clinic, ultrasound for dating only, and referrals to Stroger Hospital for maternal-fetal medicine, antepartum ultrasound and delivery.

Links:  Maternal Health Resolution_June_Sept 2025 amended.pdf  (CC Health & Cermax Slides)
            McDade CCB Presentation Final.pptx  (Slides with lots of data)
Observer:  Diane Edmundson

Cook County Health & Hospitals Committee Regular Meeting
Committee Hears about the Environmental Health Services of the Cook County Department of Public Health

George Papadopoulos, MPH, LEHP presented the Cook County Department of Public Health (CCDPH) 3rd Quarter Report (Item 25-2514) to the Committee:

• Focus of the CCDPH report was on the Environmental Health Services. The Environmental Unit has a staff of 25 including 10 Licensed Environmental Health Practitioners. The Unit is funded 57% from Grants and 43% from the Corporate Health Fund. 
• The number of lead poisoning cases that this Unit is responsible for investigating in FY2025 increased by 50% from 2024. The IL Dept of Public Health in FY25 lowered the lead level that initiates an inspection by CCDPH unit. The Department is planning in FY2026 to expand the lead inspection program. 
• CCDPH is responsible for inspecting all Cook County swimming pools and tattoo and tanning facilities. However, the CCDPH only covers the unincorporated areas of Cook County for Retail and Food Protection Program, Retail Tobacco, Vector Control, Lead Poisoning, Nuisance, Mobile Home Parks, and Water/Sewage.  
• CCDPH on a regular basis collects and analyzes the data from all 4 of the County mosquito abatement districts.

Observer: Susan Avila 

Cook County Board of Commissioners Finance Committee
Tuesday, July 29, 2025, Afternoon

Cook County Health (“CCH”)
Appearing for CCH:  Pam Cassara (Chief Financial Officer), Craig Williams (Chief Operating Officer), and Robert Reiter (Member of the Board and Finance Committee Chair)
Presentation by Ms. Cassara:

• Known cuts in funding/patient care reimbursement:  An estimated $111 M yearly loss due to Illinois ending the Illinois Health Benefits for Immigrant Adult Program as of July 1, 2025, with 8,000 CCH patients losing that coverage.  Unless Congress takes action, there will be a $120 M loss due to the Federal Disproportionate Share Hospital (“DSH”) funding slated to be cut as of October 1, 2025.  
• Based on the recently passed Federal Budget Bill, effective on January 1, 2027, Medicaid work requirements to be implemented, resulting 10% of individuals losing Medicaid coverage and an estimated reduction of reimbursement to CCH of $88 M each year.  Medicaid eligibility redeterminations are also to be changed from yearly to every 6 months.  The result will be loss of coverage for an estimated 5-12% of individuals, though they may be eligible to re-enroll.  That could result in a $50 M reduction in reimbursements to CCH.
• Compounding effects of all these reductions are (1) more uninsured patients treated by CCH, (2) more cuts to other social service programs that negatively impact community health, leading to (3) greater demand for care at CCH, (4) access to care as other safety nets reduce service or close, and (5) more charity care costs at CCH.
• Earlier this year, CCH projected that it would have a budget gap of almost $120 M for 2025.  CCH then took action and has reduced the gap to a little over $8 M.
• There has been a decline in use of workers from agencies at CCH.  At the beginning of FY2025 there were 1,380 positions filled with agency workers.  That has been reduced by about 1/3 to 968.  With new initiatives, hope to reduce by another 1/3, which the COO explained is likely the lowest can reasonably go.  One of the big successes is converting agency employees to CCH employees,

Almost all the Commissioners had questions related to understanding a contract with Guidehouse, which contract is currently the subject of a labor grievance and an upcoming arbitration hearing. After a number of questions and different responses, this observer’s understanding is

• The contract is to provide consulting services and actual workers for billing and collecting from entities providing coverage for patients who have received CCH services.  There are about 287 workers under the contract, with 140 of them doing entry level work in coding and related services.  Of these, 72 are the subject of the grievance by the union which says that they should be union jobs.  
• The complications for replacing the 140 with CCH employees include the specialized knowledge/training needed for proper coding to be able to collect on bills and that the 72 coders are located outside the U.S., which means that they cannot easily train their replacements.  
• CCH management said that even if all the workers provided by Guidehouse were to be replaced, there would still need to be some of the management consulting services under this or a new contract with another entity because of the expertise required that keeps changing. In fact, the current contract is coming to its end and an RFP is out for bid.
• CCH management also said that they are in the process of going through all their contracts to see if there are other positions that could be otherwise covered by the union contracts.  At this point, they are not sure that Guidehouse is the only instance,

Other information provided in response to Commissioner questions:

• There are 10 to 15% of appointments that are no-shows all across the system, but this is nothing new.  There has been an 80% reduction in new arrivals (immigrants), which resulted in a reduction of 37,000 appointments with the closing of Belmont-Cragin for that service, but overall the total appointments across the system is only a reduction of 6,000.  So thus far, there does not appear to be a chilling effect on people coming for service.  Mandatory staff training has been done for all employees to know what to do if ICE agents come onto CCH facilities. (Comm. Anaya and Degnen questions)
• CCH works hard to make sure there is sufficient staffing across all facilities.  Absences and unfilled positions are often staffed by agencies, but the process for filling staffing needs has been changed to include the Bureau of Human Resources to ensure that departments do not automatically call for agency workers without appropriate review.
• There are 19 interpreters on staff that are deployed across the system as needed, but in addition, a number of staff people are bi-lingual and there are separate job classifications for that.  In addition, there are translation services provided through hand-held devices.   (Comm .Anaya question.)
• Comm. Degnen asked if there was a tech solution to help with Medicaid redeterminations.  The COO explained that redeterminations are done on the State level in accordance with Federal requirements.  CCH can assist people in complying, but not change the way they need to apply.
• Comm. Stamps asked how CCH was ensuring that equitable care is provided across Cook County and no “health deserts” exist?  The response was that care is not being cut anywhere; the concern is that there will be a large increase in uncompensated care as a result of Federal and State actions.  The costs for that care would have to be covered by Cook County and its taxpayers.

County Clerk- Monica Gordon
Clerk Gordon’s presentation:

• Ran a successful 2025 Consolidated Election in April: results posted within 2 hours of polls closed, with all precincts opening on time.
• Implementing a new election management system.
• Installed the first “Smart Drop Box” for mail-in ballots at the headquarters at 69 W. Washington that will allow voters to track the processing of their ballots. Will expand to other locations.
• Implementing a new Clerk Recording System that was totally built in house, saving approximately $7 M.  Includes a mail-tracking system.
• Implemented a new queue system for Vital Records with ability to make appointments and also get texts that your place “in line” is approaching.  Has also reallocated resources to help. As a result, the long lines waiting to access Vital Records should be gone.
• The process for implementing the new Integrated Property Tax System being developed by Tyler Technologies has been challenging.  Significant problems, especially with the tax redemption services, has caused the Clerk to create a manual system until the new system is operational. 

Commissioner questions and responses:

• Comm. Lowry and Stamps:  how do you get more people voting, especially young people?  One new pilot program will have early voting sites at 14 high schools run by student election judges for a few days prior to election. Clerk is adding 2 new early voting sites in Bridgeville and Countryside.  Clerk also wants to do more education of what government does at local levels so people understand why their votes matter to their daily lives.
• Comm. Anaya:  Why the additional overtime this year?  Due to transition to Real I.D. which resulted in a huge demand for birth certificates.  Clerk had employees doing other jobs help with that, with those employees then working at night or on weekends to do their normal work.  Do not expect that in 2026.
• Comm. Stamps and McCaskill:  Clerk clarified that those incarcerated after being convicted are not eligible to vote.  Upon release, the State is supposed to be providing a packet of information that includes that they can now register to vote in Illinois. Those in Cook County jail awaiting trial are able to vote and the Clerk works with the Sheriff to both register detainees to vote and provide early voting.

​Observer:  Priscilla Mims

Cook County Board Of Commissioners
Committee Meetings 
​June 10, 2025

Health and Hospital Committee
The Committee passed the resolution declaring maternal morbidity and mortality as a public health crisis.  IL Senator Leticia Collins and Representative Camille Lilly gave supportive public testimony. (Item 25-2301)

For the quarterly report for the Cook County Department of Public Health (CCDPH) (Item 25-2513):

• Denise Gilbert, Director of Nursing at CCDPH, reviewed public health nursing initiatives within the Department. Hearing and Vision screening had been on hiatus, but has been reactivated and provides screening and assistance in referral for follow up care. Data informs their work, and it is also available to the community.  
• CCDPH website contains the Community Health Atlas which provides comprehensive population, health behavior, disease, maternal child health, and injury data for residents of suburban Cook County, and CCDPH’s jurisdiction. 
• CCDPH nurses developed EveryMotherEveryChild.org website for every stage of pregnancy, regardless of gender identity or sexual orientation with fact sheets. 

For the CCDPH’s semi-annual Disparities Report (Item 25-2612):

• There is a long, slow decline in vaccination coverage in suburban Cook County. Schools with vaccination rates that are lower than 91% are scattered throughout the County. 
• Action by CCDPH includes a focus where there is greatest need:  schools with vaccination rates between 82-88% (lowest protection) AND high a high ranking on the Social Vulnerability Index.  That Index quantifies the potential for a community to experience greater negative effects for external stresses on human health, such as disasters or outbreaks.
• CCDPH is establishing vaccine clinics, patient education and targeted communication via media and community partnership.

League Observer: Susan Avila 

Audit Committee
The Committee reviewed the Audit Report on the Housing and Resources for Justice Involved Individuals, which is an ARPA-funded pilot project. (Item 25-2747)

• The Justice Advisory Council (JAC) is managing the program that helps recently released people find housing and pay the first three months’ rent.   The program will also provide prorated support depending on the person’s income and effort for the rest of a one-year lease.  
• The original plan was to house 300 people but only 26 had been successfully served at the time of the audit. During the audit process it was noted that subrecipient agencies were not timely reporting metrics and payroll costs were not reported correctly.  Both had been corrected by the time the audit was completed. 
• The JAC determined that it needed to revise the program and provide more assistance in obtaining the housing. The JAC has added relocation coordinators that walk the participants through the search and paperwork. The JAC also found other agencies that could refer people.   Since last November, 56 people have been housed and the JAC is working with about 13 people a month.
• Since the program has less participants than planned, its budget has been amended and some of the funds have been diverted to other ARPA programs.  The JAC is investigating private grants to keep the program going beyond 2026.
• Commissioner Gainer suggested they also work with the Land Bank that has connections with contractors that build rental property.  

League Observer:  Kathi Graffam

Finance Committee

• There was just one item on the agenda:  Commissioner Sean Morrison’s proposed ordinance amendment proposing to add language to the Class 2-12 real estate classification, Item 25-2835.  Commissioner Morrison explained that there would be no vote on the item, but that this meeting was an opportunity to discuss the proposal.  After obtaining more information and further discussion, the Board could then decide whether to make any changes to the requirements for the Classification or leave it as is.  Accordingly, the item was deferred after discussion.
• Comm. Morrison said that he understood the intent of the 2-12 classification was to give small business owners who live above their business a tax break by taxing the entire property at the residential rate of 10 percent of the assessed value.  However, the current language of the ordinance for 2-12 classification does not require the owner to live at the property. In contrast, other properties under a different classification are split, with the portion that is commercial being taxed at 25% of the assessed value and the residential portion taxed at 10% of the assessed value.  
• Comm. Morrison’s proposal would add the requirement that the owner use the property as the principal place of residence, receive a homeowner’s exemption, and file a yearly declaration of eligibility for the 2-12 classification with the Assessor each year.
• Comm. Morrison said that his staff found there were almost 14,000 properties classified as 2-12 currently and that the staff looked at about 6900 and found that about 50% had tax bills going to entities other than the owners of the property.  He has estimated that an additional $171 M would be collected if the property was split between commercial and residential.
• The Assessor’s Office was represented by the Chief of Staff, Scott Smith, and the Chief Legal Advisor. Mr. Smith said that about 1/5 of the current 2-12 properties do have homeowners’ exemptions.  He said that typically these properties are assessed at $100,000 or less. There was concern about what additional workload the office might be expected to do if the 2-12 classification was changed.  The office will provide more information in response to Comm. Morrison’s questions.  
• Comm. Trevor expressed concern that other renters in the building might not be able to continue to afford to live there if the property taxes increased for the entire property as a result of the property having to be split between residential and commercial.  She said that there should be a transition plan in place should a change in the classification be made.

League Observer:  Priscilla Mims

Workforce Housing and Community Development Committee

• There was no discussion, but the Committee approved a proposed loan of $2.6 M from the HOME Investment Partnership Program to Carefree Development for the construction of Carefree Village, a 55-unit affordable rental housing for seniors located in Oak Forest.

League Observer:  Susan Gegory

Cook County Board of Commissioners
Committee Meetings
April 8 and 9, 2025

Health & Hospitals Committee
April 8, 2025
Dr. Joshi, interim Chief Operating Officer of the Cook County Department of Public Health (“CCDPH”) presented the quarterly update on Covid-19 and other infectious diseases of concern for Suburban Cook County. Item 23-3815 

• COVID-19 & RSV: low activity with few emergency department visits. 
• Flu:  moderate activity, but trending down. 
• Avian influenza: no human-to-human transmission has been detected yet; cases are primarily in agricultural workers with poultry and dairy cattle; 70 cases nationally/none in IL. 
• Measles, none in IL so far.  
• CCDPH nurses administering MMR (measles, mumps and rubella) vaccine at residences and work with medical providers on measles testing; vaccinations will be initiated as a Public Health measles response when cases arise.
• Fall flu vaccines:  the FDA external advisory committee meeting which normally determines the flu vaccine formula each year was cancelled; the manufacturers of the flu vaccine are moving forward based on the World Health Organization recommendation. 
• The meeting of the Advisory Committee on Immunization Practices (“ACIP”) was postponed to mid-April.  The ACIP determines who should get vaccines, which is important for medical insurance coverage.

Numerous questions, primarily on measles and vaccination safety, from Chair Lowry, and Commissioners Kevin Morrison, Aguilar, Moore, Trevor, Miller, Sean Morrison, and Daley.  

• How do we track immigrants, especially new ones, and the general population for vaccination status? Dr. Joshi said checking school records for required vaccinations and whether there is vaccination exemption for religious or medical reasons.  
• Do health providers know how to recognize measles, and can there be transmission by asymptomatic individuals?  Dr Joshi responded that they were working on communications to health providers for recognition and treatment of measles cases which is a reportable disease to Public Health.  
• There is messaging on the safety and effectiveness of vaccines to counter concerns patients may have on largely unproven adverse vaccine effects.

Observer:  Susan Kern  

Asset Management Committee
April 9, 2025
All items were approved. Most discussed by the Commissioner was the proposal to hire firms to be the Construction Manager at Risk for maintaining Stroger Hospital.

• The Bureau of Asset Management and the Chief Procurement Officer proposed awarding a Construction Manager at Risk (“CmaR”) contract to Power/Ujamaa 7 LLC. for ongoing upgrades and maintenance of the Stroger Hospital with a budget of $373,000,000.00. Stroger is 22 years old and they want to maintain the systems and structure so it will have a life span of 50-70 years.   This will require major ongoing projects such as roof replacement, LED lighting, elevator modifications, mechanical, electrical, and plumbing updates for both the Hospital and its Powerhouse.    
• The CMaR process is different in that design and construction are developed together and the one general contractor oversees all the needed projects and sources the subcontractors.   Asset Management Staff will weigh in on the choice of the subcontractors, which will all have to meet the standard Cook County procurement requirements concerning diversity and residence. Asset Management staff proposed reporting back to the Commissioners once a year on project and cost status.    
• There were several questions from the Commissioners who were concerned about the main contractor sourcing the subcontractors, the Commissioners not approving those separate contracts, and the length of time between reports. Commissioners Gainer and Sean Morrison were particularly concerned that the Board would not have closer oversight on the subcontractors. Earl Bitoy of the Bureau of Administration, Ms. Granata, Earl Maning of Asset Management, and staff from the Chief Procurement Office, and the Health and Hospital Procurement Office assured the Commissioners that this process would be the most efficient and cost effective with over-run guarantees. This was approved by the Health and Hospital Board Finance Committee on April 3.   
• This Item 25-0002 was approved with Commissioner Anaya voting present and Commissioner Sean Morrison voting no.

The Committee also approved the following items:

• Two items concerning the Oak Forest Campus, site of the now closed Oak Forest Hospital:  (1) an amendment to a contract with EGM Architects to assess the infrastructure integrity of the existing buildings for possible preservation, reuse, and TIF potential; and (2) an amendment to the contract with GSG Consultants to determine if some of the buildings could be used for private redevelopment.   Commissioner Morrison asked why this was being done since the buildings at Oak Forest are outdated and all the utilities, such as the underground heating system, cannot be repaired. Only one Cook County office of Emergency Management and Regional Security is in the complex.   Elizabeth Granata, Chief of the Bureau of Asset Mgt., said that now they were working on preservation of some of the buildings with architectural and historical significance instead of demolition of all of them. The plan is to redevelop them for other uses than Cook County offices.  Items 25-011 and 25-0012 
• Cook County Health will pay the lease for another tenant in the Austin Wellness Center, Hektoen Institute which provides HIV testing.  The cost for 5 years will be $194,000 dollars.  This will ensure the institute can survive if their federal funding changes.  Item 25-1588 
• A project to determine best practices for evaluating healthy buildings in Cook County government facilities with the University of Illinois and Champaign County.  This project was initiated by the late Commissioner Deere.  Item 25-1599. 

Observer:  Kathi Graffam

Rules and Administration Committee
April 9, 2025
The Committee reviewed and approved the proposed changes to the “Public Facing Rules and Regulations” pertaining to the Procedural Rules issued by the Department of Human Rights and Ethics for the Cook County Paid Leave Ordinance.  Departments charged with implementing County ordinance draft rules which are then sent to Cook County Board for approval.  Item 25-1343

• The changes were to clarify the effective dates relating to employees of school districts and park districts.  The Cook County ordinance is consistent with the State law, except that the County does not exempt school and park district personnel from the requirement that paid leave be offered.  The lack of this exemption has been a point of controversy among the Commissioners in the past.
• Commissioner Britton, whose district is in the north suburbs, asked how many of the suburbs with home rule have opted out of the County ordinance.  Jennifer King, the Executive Director, did not know, but Commissioner Britton said that those in his district have all opted out.  He has one community which does not have home rule status, so it cannot opt out.  
• Commissioner Sean Morrison, whose district is also in Suburban Cook echoed Comm. Britton’s concerns.  
• Both Commissioners, along with all other members of the Committee, voted to approve the rules changes, citing that, given the ordinance, the changes were the best that could be done.  They also thanked Executive Director King for all her time and effort.

Observer:  Priscilla Mims

Finance Committee
April 9, 2025

• The Comptroller reported on the 12 months of FY 2024 ending Nov. 30, 2024:  General Fund was favorable as to budget by $223.3 M, with revenues greater than budget by 4.8% and expenses less than budgeted by 5.2%.  Also reported for the same period for the Health Fund, on a cash basis, favorable of $203.5 M, with revenues greater than budget by 0.2% and expenses less than budget by 3.9%.  Item 25-2208.  
• The Comptroller also reported on the 3 months of FY 2025 ending Feb. 28, 2025:  General Fund –favorable by $2.8 M; and Health Fund on a cash basis– unfavorable by $108 M.  Item 25-2209.  The Comptroller pointed out that a more accurate picture of the Health Fund is on an accrual basis, as contained in the next report from Cook County Health (“CCH”).    Illinois currently owes $108.1 M to the County.
• For the  CCH  monthly report, there are 2 knowns that will have a negative impact as compared to budget:  the ending of the program for Medicaid reimbursement for adult immigrants from 42 to 64 years; and the Federal Government reducing funds for the Department of Public Health by $2 M.  Item 25-1168. 

Observer:  Priscilla Mims