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

Health and Hospital Committee Meeting
March 11, 2025
Following are some of the details from the presentations and reports presented to the Committee:

Cook County Public Health (CCDPH) 1st Quarter 2024-25 Report (Item 25-1251):  Dr. Kiran Joshi, Interim COO focused on program and policy initiatives serving youth in suburban Cook County:  

• Early Childhood - A map highlighted the stark differences in resources available across Cook County:  e.g., access to good schools, health resources, and safe environments, highlighting infant mortality, asthma rates, and fresh food consumption.  
• K-12 – In 2022 28.5% of students had used electronic vapor products, a decrease since 2020.  More females than males have used these products (33% to 24%), and about 41% of LGBTQ+ students reported use.  Chlamydia rates were highest among 15-24 year olds and is a major public health concern. About 34% of students in suburban CC reporting persistent feelings of sadness or hopelessness.  Female rates were higher than male.  National data shows a 78% increase in suicide rates among Black youth ages 10-19 between 2000-2020.  In suburban CC, the rates are lower; but gender disparities by sex show that high-school females are almost 2.5 times as likely as males to have attempted suicide.
• Young Adults – The CCDPH provides technical assistance for community partners in two-year institutions and community-based organizations, public education, media campaigns, and data and reports.  It also conducts sexually transmitted and HIV surveillance and publishes reports to help community organizations plan services and advocate for fair polices.  Coming soon, will be an at-home STI test kit to support easy, confidential testing.  CCDPH also distributes free condoms via its website

Office of the Chief Judge – Semi-annual behavioral health reports thru November 30, 2024 (item 25-1340): 
Behavioral health programs include:  

• Adult Problem-Solving Courts for drug, mental health, and veterans
• Adult Probation and Social Services Departments for domestic violence and intervention 
• Adult Probation for substance use disorder treatment
• Juvenile Probation counseling, and
• Juvenile Probation multi-systemic therapy services
• Goal of the problem-solving courts is to promote community safety and reduce recidivism.  It is a non-adversarial, voluntary alternative to incarceration. 
• Mission of the juvenile probation work is to keep all court involved children in the community, where they can receive equitable, focused, individualized intervention and opportunities to prevent further system involvement.    

Cook County Public Defender’s Office – Semi-annual behavioral health report thru November 30, 2024 (Item 25-1338):  

• This office is not a treatment provider but rather it provides consultation, assessment, and case management.  It works collaboratively by providing direct linkage to service providers and other social services to support clients functioning within the community and to reduce recidivism.  
• Future initiatives include:  Community defense centers and internship program development.     

Observer:  Diane Edmundson

Finance Committee Meeting
March 12, 2025

• The Comptroller reported on the 2 months of FY 2025 ending Jan. 31, 2025:  General Fund --favorable $11.6 M for General Fund and Health Fund on a cash basis– unfavorable $72 M.  Item 25-1630.  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 $109.3 M to the County.
• The CCH report for the 2 months ended Jan. 31, 2025 on an accrual basis shows an unfavorable $34.1 M.  Item 25-1167. 
• Chair Daley asked about the impact on CCH with the Governor’s proposal to halt Illinois’ funding for Medicaid for adult immigrants from 42 to 64 years.  The funding for this in 2024 equaled $111 M.  However, assuming this halt goes forward, it would not take place until mid-year.  The CCH Chief Financial Officer told the Commissioners that CCH expects to be able to close the gap for this year.  Chair Daley asked that in the future the verbal reports at the meetings highlight this situation.

Observer:  Priscilla Mims

Legislation & Intergovernmental Relations Committee Meeting
March 11,2025
The committee approved several amendments to the Ethics Ordinance. (Agenda Item 25-1324) 

• One amendment changed the definition of “doing business” with the County from $10,000 to $25,000. 
• Two were concerned with one-year restrictions for former county personnel to accept employment with or compensation from an entity if the employee had been instrumental in awarding a contract for $25,000 or more (up from $10,000) to that entity, or for that former employee to enter into a contract with the County for services valued at $25,000 or more (up from $10,000).   
• Another maintained the $10,000 amount for “doing business” in the section on limitations of contributions to candidates and elected officials.

Comm. Degnan asked about the genesis of the monetary amount for post-employment restrictions. Jennifer King, Executive Director of the Cook County Department of Human rights and Ethics, responded that the changes were to keep the Ethics Code in alignment with the recent changes to the Procurement Code. 
Observer - Cynthia Schilsky

Transportation Committee Meeting
March 11, 2025
All items on the agenda were approved, including:

• Several items for providing preliminary engineering services with different locations in the County.  Some funding came from ARPA funds the County has received from the federal government. (Includes Item 25-0785),
• Appropriating funds for the Amtrak Chicago Hub Improvement Program in Chicago (25-0755). 
• An agreement between Cook County Dept of Transportation and Highways and Illinois Medical District Commission, with the latter being the lead for preliminary and design engineering to enhance mobility along Harrison Street, identified as needing critical improvements to enhance mobility, accessibility and safety. (25-0342).
• An agreement between the County and City of Evanston to retrofit Divvy stations to improve access to public transportation and commercial districts. It will provide a 40% increase. 

Observer:  Carolyn Cosentino

Technology & Innovation Committee Meeting
March 11, 2025

• Without discussion, the Committee voted to receive and file the Chief Information Security Officer Report for Fiscal Year 2024 which provided an update on the different County areas adoption of the information Security Framework and a summary of advice and recommendations for each area.  
• This report was not posted on Legistar.  The Observer inquired why not and was told by the office of Vice Chair Sean Morrison that the report contained confidential information and was exempt from the posting requirements. 

Observer:  Victoria Cerinich 

Cook County Board of Commissioners
Committee Meetings 
February 5, 2025
Rules and Administration Committee
The Committee approved 2 amendments to their rules concerning the Consent Agenda aspect of their meetings. 

• The first amendment requires that the Consent Agenda be limited to 60 minutes and will be held prior to the regular board meeting. It will be separately noticed. (Agenda Item 25-0984) 
• The second amendment established the dates and times for the meetings to be held at 9am the same day as the regular board meeting. (Agenda Item 25-0986)

Commissioner comments: 

• Comm. Britton stated this would be a more efficient use of their time and while it is important to recognize people/groups perhaps doing it in district should be more frequently considered. 
• Comm. Miller wanted to know what other bodies restricted their Consent Agenda and Comm. Scott stated that the Chicago Board limits oral recognition to 3 at their meetings and has done so for several years. 
• Comm. Miller and Degnan were concerned about the process - how ordinances would be prioritized and who decides that. 
• Comm. Stamps and Anaya wanted to know how the picture taking with the President would be incorporated. 
• Comm. Britton stated that a quorum would be necessary so it behooves everyone to be there at 9am for the meetings. Comm. Britton also said that the issues raised by the commissioners were the issues that needed to be considered and discussed as they institute this change in the Consent Agenda procedure.

Finance Committee

• Analysis of Revenues and Expenses for the County were presented by the Comptroller and representatives from Cook County Health (CCH). Both revenue and expense variances were reported as negative with timing issues being the cause. 
• Comm. Gainer had questions regarding a report from CCH about salaries of contracted persons vs employees. She stated the report was thorough and transparent and wanted more clarity on the long term plans for addressing the discrepancies - whether training of employees would address filling the positions or the positions were too specialized and would continue to be contracted out.  
• Comm. Sean Morrison’s questioned whether CCH reports were based on an accrual basis or cash basis. CCH said they do their finances on an accrual basis but convert to a cash basis for reporting as part of the Cook County Budget. 
• The Market Survey Report on Elected Official Compensation (Agenda Item 25-0739) was received and filed without comment. 

Transportation Committee
Department of Transportation and Highways Superintendent Jennifer (Sis) Killen provided a presentation on the department’s ADA Transition Plan. Highlights of her presentation:

• The plan fulfills a Federal requirement relating to ADA ensuring that all the facilities and services in the public right-of-way along the roadways maintained by the County are compliant with the ADA standards. 
• The report focused on curb ramps, crosswalks and pedestrian signals and indicated the plan is to improve all assets over the next 25 years. 
• An ADA Coordinator has been named (Andrew Warner) to answer questions from the public and to oversee communication about the goals and progress of the plan.
• Commissioner concerns were about ongoing trainings for personnel and how it is determined who is responsible for payment for any construction or repairs. Response was the Federal government does do training. Installation is done by the entity responsible for maintaining the right-of-way which can be the County, the City or a municipality or township. All repairs must be made to the current standards.

Legislation and Intergovernmental Relations Committee
The Committee had a presentation of the annual report for the Board of Ethics for Fiscal Year 2024 (Agenda Item 25-0829). 
Highlights of presentation:

• Ethics Board is supposed to have 5 members - have 3 recently appointed members and 2 vacancies.
• Office has 12 staff and 1 dedicated Ethics Investigator.
• Now have a searchable data base for Campaign Contributions as well as an online form to file disclosures and requests. 
• Ethics investigations appear to focus on gifts and conflicts of interest.
• Comm. Anaya asked about some of the numbers presented but there was no further discussion of the report. 

Technology and Innovations Committee
The committee heard presentations on the Technology Strategic Plan Report (Agenda Item 25-0262) from the Bureau of Technology, and the offices of the Board of Review, the Assessor, the Treasurer, the Sheriff, the County Clerk, The Clerk of the Circuit Court, the Chief Judge, and the State’s Attorney.
Highlights from the reports:

• The Bureau of Technology has a dual role of providing IT support to the President’s office as well as maintaining IT throughout County government offices. 
• Retirement of the Main Frame is projected to be April of 2025. There are still 2 applications that utilize the Main Frame - Jury Administration under the Chief Judge and some parts of the Property Tax system - but all seem to have committed to getting off by April of 2025.
• Each office outlined their projects and goals for the next year and many are developing plans for incorporating AI into their work. 
• Almost all offices indicated a need for upgraded equipment and software - some thanking the commissioners for providing funds in their budgets to do this and others indicating they would need funds in the future.
• The Board of Review (BOR) and the Assessor seemed to indicate that they both will now have a new system IasWorld that will allow them to share data although the BOR did say that their public facing portal remains as a different system.
• Commissioner questions and comments centered on keeping to established timelines for implementing systems, holding vendors accountable to ensure that systems can be up and running by deadlines, and requesting that offices work together on implementing systems that need to communicate with each other. 

Observer - Cynthia Schilsky

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
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