Category: Cook County Health (CCH)

Cook County Board Creates Loan Program for Municipalities

8/3/2022

Cook County Board of Commissioners - Committee and Board Meetings
July 27, 28, 2022

Finance Committee July 27, 2022

The Commissioners recommended for approval an ordinance that authorizes the County to give loans to local government entities that are impacted by the expected late property tax bill issuance and collection. The plan would set aside up to $ 500 million, but initially $300 million will be distributed. The loans would go to municipalities that have credit ratings less than the County’s and would have difficulty going to the public for credit. It would be for 0% rate. It will cost the County $5 million. The Commissioners had met previously with members of the Finance group and so there was little discussion. (Item 22-3521) The ordinance was approved in the Board Meeting.
Commissioner Suffredin moved to defer the proposed Elected Official Compensation Review Ordinance. This would require periodic review of the compensation of elected officials. The Commissioners are waiting on a fiscal note from the Department of Finance. The League of Women Voters of Cook County (LWVCC) supported this ordinance, and their letter was entered into the record. (Item 22-3931)

Health and Hospitals Committee July 27, 2022

The monthly report on the status of COVID was deferred. The Commissioners asked for an update on Monkeypox as well as COVID. Mr. Rocha, Cook County Health (CCH) CEO said that 70% of the current COVID cases are the new sub-variants BA4 and BA5. The CCH is recommending that everyone gets the booster shots and wear masks when in close contact of others. There are 5 community centers in suburban Cook County where residents can get vaccines or treatment. Over 1 million vaccinations have been given. Vaccination rates for children are low, for children under 5 less than 15%. Parents are reluctant to have their child vaccinated. ( Item 21-0541)
The Commissioners asked for an update on Monkeypox as some of them have gotten reports of residents not being able to get vaccinations. Dr. Hasberg reported that it is now called MPV. The CCH is following the CDC’s recommendations. The CCH has launched an education campaign to health providers and have updated their website with information. They are doing testing and providing vaccinations. They are also doing contact tracing. There have been 19 confirmed cases in Cook County. People who have had close contact with a confirmed case can get vaccinated now. 150 have been given. They have just started vaccinating people in high- risk groups, but who did not have known contact. They anticipate getting more vaccinations in the fall and then will ramp up the vaccinations to that demographic. At the Board meeting a resolution was approved to have a meeting with CCH specifically on MPV. (Item 22-4699)
The Commissioners approved the quarterly report from CCH. Dr. Ruben reported on the contact tracing program for Covid. In order to reach communities that had low vaccination rates and reluctance to participate in contact tracing, the CCH developed a network of community- based organizations to engage people. They anticipate that they will use the same network in their efforts for equity, trying to encourage residents to use medical resources for chronic diseases. (Item 22-1354)
The semi- annual report on healthcare disparities was received and filed. Mr. Rocha outlined CCH’s plan to reduce healthcare disparities in minority areas. He cited the primary issues of poverty and lack of health insurance in the South and Near West side communities. They have awarded grants to community groups to work on such issues as worker protections, lead poison prevention, connecting people to resources, and improved public transportation. The other major issue they want to investigate is why some people don’t utilize the medical system even when it is easily accessible. (Item 22-3674)
Commissioner Miller asked that going forward, she would like to see specific data for outcomes for minorities in the 11 strategic communities cited in the 2025 Strategic Plan. She also wanted to see data for minorities that do not live in underserved communities.

Cook County Board of Commissioners Meeting July 28, 2022

Several Commissioners spoke in support of the resolution for the Cook County Board to call on the Illinois General Assembly and U.S. Congress to prohibit the sale of assault style weapons. The resolution was approved. (Item22-4305)
The proposed County Commissioner vacancy in office ordinance amendments were referred to the Legislation Committee. This provides that a vacancy should be filled by appointment by a political committee unless the vacancy is for more than 28 months and then it should be filled at the next general election. LWVCC is in support of this amendment. (Items 22-4661, 22-4662)
The resolution to hold a hearing on the risks of data sharing with ICE was approved. The object is to determine if County government data regarding residents is available to private data brokers. The Committee will also discuss the best practices for protecting the rights of all Cook County residents. (Item 22-2815)
Several collective bargaining agreements with Cook County employees were approved. During the public speakers’ time, nurses from the CCH system spoke in favor of approval.
Several more ARPA grants were awarded including funds for the Forest Preserve.

Observed by Kathi Graffam

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Nursing Shortages Continue to Concern Cook County Board

5/18/2022

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Cook County Board of Commissioners Meeting
May 12, 2022

Commissioners Anaya, Miller, and Gainer questioned Cook County Health’s Chief Executive Officer Israel Rocha concerning a proposed transfer of funds and the continuing problem of filling nursing positions. Commissioner Gainer asked CEO Rocha to report back to this Board next month on the measures being taken to improve the hiring process. Commissioner Sims said part of the problem is due to following all the steps required under the Shakman consent order. CEO Rocha said his staff has been working with the Office of the Independent Inspector General to see what changes could be made.

The Board approved the following:

Appointment of current County Comptroller Lawrence L. Wilson as Acting Chief Financial Office as of June 11 to replace Ammar Rizki who is stepping down as Chief Financial Officer on June 10. Mr. Rizki will take that same position at the Obama Foundation. (Item 22-3267)
An amendment to the intergovernmental agreement with the Metropolitan Water Reclamation District for the County’s Office of the Independent Inspector General to continue to provide such services to the MWRD for an additional year, from May 17, 2022 to May 16, 2023. (Item 22-3020)

The Board referred to the Legislation and Intergovernmental Relations Committee:

The proposed appointment of Dr. LaMar Hasbrouck as Chief Operating Officer of the Cook County Department of Public Health. (Item 22-3342) Separately, the Commissioners passes a resolution honoring Dr. Rachel Rubin and Dr. Kiran Joshi for their service as Interim Co-Leads of the Department. (Item 22-3308)
A proposed resolution announcing a new flag for Cook County. However, there were blanks where the name of the flag and the designers should be. (Item 22-341)

The Board referred to the Rules Committee:

A resolution declaring racial or other discriminatory covenants in real estate recordings to be void pursuant to the County’s Human Rights Ordinance. The Count Clerk has said her office stands ready to process applications to eliminate such covenants from deeds. (Item 22-3150)
Proposed changes to the “public facing rules and regulations” of the Board of Ethics Procedural Rules as a result of the change in the County’s Ethics Ordinance. (Item 22-3155)

The Board referred to the Technology and Innovation Committee:

An extension of the contract with Tyler Technologies for the period of April 1, 2023 thru March 31, 2026 for an additional $8.4 million for the centralized property tax system for the Assessor, Clerk, and Treasurer. (Item 22-2917) This system has been a source of controversy, including in the issues regarding the delays to the 2nd installment property tax bill to be sent out this year.
Approval of $6.3 million for a new case management system for the State’s Attorney’s office to replace the current Juvenile Justice system that is on the main frame, as well as the Adult Criminal system (not on the main frame). When this work is completed, the State’s Attorney will no longer have any processes on the main frame. (Item 22-1112)

The Board referred to the Litigation Finance Subcommittee the 2022 1st Quarter Inspector General’s Report.

League Observer: Priscilla Mims

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Cross Agency Coordination Improves Effectiveness of Implementing Initiatives

4/16/2022

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Cook County Board of Commissioners Meeting
April 7, 2022

The Board Approved:

Surviving Spouse Tax Abatements for surviving spouse of fallen police officers, soldiers, or rescue workers program will continue. Rather than receiving a refund, the line item for Cook County property tax will read as zero. This change was made with the Treasurers’ Office so the individual does not have to pay the tax and then receive a refund. 20 people have been in the program and two new members have recently become part of it. (22-2649)
Contract for technical assistance sought by Justice Advisory Council: This relates to changes in pre-trial policies, practices, and operations required under the SAFE-T Act and involves significant cross-agency planning and implementation. Approved as amended in errata. (22-2558 )
HOME Investment partnership Program loans of $1.25 M to support the development of Bellwood Senior Apartments, an affordable senior housing of 80 units and $3 M to support the Chicago Heights Veterans affordable housing development of 82 units (22-2328 and 22-2378)
The Board approved receipt of an additional $32M for Emergency Rental and Housing Assistance. Cook County has dispersed $132M to date. Streamlined processes and cooperation between government dept. supported the success of the program. The additional monies is from funds not used across the country and reallocated by the US Treasury Dept. (22-2738)

Other Items of Interest:

Joint committee meeting for Finance and Technology will be held to discuss second property tax billing with concern about possible delays. This meeting cannot be held until after technology upgrade in the Board room is completed. Without the upgrade, live-streaming would not be an option, thereby restricting public and press involvement. The work was scheduled 2 months ago. It will be scheduled as soon as possible as all parties are aware of the urgency of questions involved. Public speakers today emphasized need for predictability and transparency (22-2803)
The Bureau of Human Resources filed a report concerning the salaries of elected officials in Cook County to determine appropriateness or if increases are warranted. Deloitte Consulting Group analyzed the peer groups reflecting Cook County’s population and other variables. Their conclusion is that county elected officials’ compensation is below market rate for similar elected officials across the country, below 50th mean percentile. This was referred to Finance Committee. (22-2471)
There are concerns about potential violations by ICE obtaining information from private data brokers across the country. A public hearing will be scheduled by the Legislative and Intergovernmental Relations Commtt. (22-2815)
Monday, April 18, 5pm a public hearing will be help where 6 new flag designs for Cook County will be presented and discussed by their designers.

Meeting length 2hr 32min.

Observer: Carolyn Cosentino

Cook County Board of Commissioners Committee Meetings.
April 5, 2022

Health and Hospitals Committee

Change Institute is monitoring 2023 Strategic plan. Racism is a public health crisis. Life expectancy correlates with zip code. The resolution is meant to monitor Cook County Health (CCH) programs and progress in addressing disparities in health outcomes. Commissioner Moore stated this is an essential compliment to CEO Rocha’ partnership with Change Institute (22-1702)
Funding for Covid testing and vaccines has been exhausted so providers may not be reimbursed. CCH and Cook County Public Health (CCPH) will continue to provide these services free; group events can still be organized. CCH locations are available across Chicago, Cook County and at Stroger and Provident hospitals.
Illinois Department of Public Health has taken over contact tracing; will monitor high risk facilities and high risk populations.
Covid Data is not broken down beyond county level for type of variant. Existing vaccines have been effective against the new strain of Covid, VA2, for reducing spread, hospitalizations, and deaths. Case counts are beginning to rise, much higher among unvaccinated by over 1000x. Concerns remain over booster rate. Mask guidance for indoor settings may be revised as monitoring continues.
Behavioral Health Report indicated that staffing shortage here and across the nation continues; this includes triage social workers for crisis calls and recovery coaches, AP RN’s for injection services.
Cermack Health services provides service to detainees in Cook County Jail, total daily census averages 6,000. Screening intake for every inmate entering jail is made to assess and address needs. Patient safety includes evaluation of emerging needs and suicide prevention measures. (22-2245)

Observer - Carolyn Cosentino

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Cook County Health 2022 Budget Presented at Budget Hearing

10/29/2021

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Cook County Board Finance Committee
Departmental Budget Hearings
Oct. 26, 2021

The meeting scheduled for 9 a.m. was held at 10:30 due to CCH scheduling issues. It continued until 1:15 for 2 hours and 45 minutes due to commissioner questioning and compliments.

Cook County Health - presented by CEO Israel Rocha and former Interim Budget Officer, Andrea Gibson

Proposed 2022 Budget: $ 3.889 Billion 2021 Budget: $3.388 Billion
Proposed 2022 FTEs: 7,560 2021 FTEs: 6,803

CEO Rocha’s comments
Both internal and external factors were considered in developing the 2022 budget; and while he stated that this is a conservative budget, he also stated that is has taken into consideration the importance of meeting the needs of patients, staff, and growth challenges. Health Equity runs through all budget allocations.

2021 Accomplishments

Mitigated COVID at CC Jail
Established a health line for employees
900,000 Covid shots administered
Established an Office of Health Equity
County Care again received the highest recognition from the State for its coverage and options.

The COVID Pandemic impact on the 2022 budget:

FY 2019 patient volumes were used as a baseline as all volumes were down in 20-21.
Medicaid has been expanded to those previously considered charity care which includes undocumented seniors 65+. And beginning in January undocumented seniors 55+ will also be covered.
The County Care Management Program has grown beyond expectations due to the state not requiring the usual annual re-determination of Medicaid eligibility.

Resolution to Review Compensation of Elected Officials Approved by Cook County Board Finance Committee

10/18/2021

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Committee Meetings of the Cook County Board of Commissioners
Oct 5 & 6, 2021

Note: all items listed below as being approved by a Committee do not become effective until the Board approves them at the Board meeting held on October 7.

October 5 Meeting Highlights:

Health and Hospitals Committee

Agenda Item 21-0541 CCH and Public Health Dept update on Covid. Deferred Cook County Health (CCH) established a mandate for employee vaccination or weekly testing. As of Oct 1, 83% of the employees are fully vaccinated and 92% had one dose.
21-5290 Resolution declaring mental health a public health crisis. Passed Commissioners Amaya, Degnen, and Kevin Morrison said their constituents want more money spent on mental health services. Commissioner Miller said American Rescue Plan Act funds should be spent on improving these services. Commissioner Daley said that there needs to be coordination with other existing services including private hospitals.

Legislation and Intergovernmental Relations Committee

21-5410 Ordinance to codify the existence, duties and appointments for the Commission on Women’s Issues. Passed The Commission was formed in 1995 by resolution. The purpose of this action was to put it into the County ordinances.
21-0565 Proposed resolution to celebrate Indigenous People’s Day and Reconciliation Day Deferred There were several public speakers in favor and against the proposed resolution. One point often raised by the public speakers and the Commissioners was though it is important to recognize the wrongs done to Indigenous People, there was no reason to take away a day that honors the contributions of the Italian Americans. The State of Illinois has named the last Monday of September as Indigenous Peoples Day. Several Commissioners thanked Commissioner Johnson for initiating the process and resulting difficult conversations that were illuminating.

October 6 Meeting Highlights

Finance Committee

21-5258 Calling for a review and recommendation regarding elected officials’ compensation. Passed. Comm. Suffredin proposed to initiate a process to engage an economist and an outside compensation consultant to review the compensation of Cook County officials and compare it to other counties. The last review was in 2000. The committee would prepare a report on the comparison and recommend salaries to the Commissioners. The report would be prepared by February of 2022. The Commissioners would then decide if any action was needed. Any such increase would be effective in the next fiscal year in 2023 after the election for the offices. The Clerk of the Court would be excepted since it isn’t up for election until Nov. 2024.
21-4303 Proposed amendment to the Procurement Code. Deferred to Nov Mtg. It would require that the Chief Procurement Officer shall make every effort to have at least one woman and one African American or Hispanic on any evaluation committee for an RFQ or RFP.
21-4102 Approval of Unarmed Security Contract for the Juvenile Detention Center (JDT) Passed 11 Aye 4 present Commissioner Sean Morrison No Leonard Dixon of the JDT reported that supplemental guards were needed at the facility because they are currently experiencing a 23% absentee rate. He is recommending a three-year contract with Monterrey Security Consultants to provide 22 officers. The JDT has 400 FTEs in security staff and currently 100 vacancies. The standard absence had been 10-15%. The vacancies are due to COVID, retirement, FMLA, injuries, and difficulty in hiring. The JDT brought in a psychologist to help the staff with the stress of the job. He anticipates that it will take them 3 years to rebuild to full staff. The JDT can have an average of 200 detainees. Comm. Sean Morrison had previously asked to see the contracts and supporting documents and had not received them. He was concerned that the vendor could commit to handling all the requirements. Comm. Daley asked for a follow up report on how the JDT was reducing the absentee rate.

Technology Committee

21-5079 Chief Technology Officer’s major project report. Deferred to the November meeting
The Clerk of Court technology officer reported that they were making progress on the Odyssey system, that allows electronic access to court documents and dates. Initially, Judge Evans delayed the Court from implementing the system. He has since given approval for Phase 1 and 2 to be implemented. The traffic court is in the last phase and will be implemented by the end of the year.
The completion of the Integrated Tax Processing System will be delayed until September of 2024. Comm. Sean Morrison referred to a letter that all the Commissioners received from Treasurer Pappas with concerns about the project. The vendor is Tyler Information Systems and they were originally contracted in 2015 with a completion date of 2019. The contract was performance based and Tyler has not been paid for implementation projects since 2017 although the implementation is continuing. They are also contracted for ongoing licensing and maintenance of the system. Comm. Sean Morrison said Tyler’s performance is disappointing. Comm. Kevin Morrison said he may call a special meeting to address the issues. Since it is a contract issue, the committee would have to meet in executive session.

Observed by: Kathi Graffam Time: 7 hours total

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Cook County Board Mid-Year Budget Hearings Continue

7/24/2021

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Cook County Board Finance Committee Mid Year Budget Hearings
July 20, 2021
Presentations - Office of the Cook County Treasurer and Cook County Health

Highlights of Presentations:

Treasurer

The office is currently under budget with regard to expenses, but expects to come in at budget by year-end.
The office has received $4.9 million over budgeted revenues thus far, mainly due to higher than expected people paying delinquent taxes
Purchased two vans to re-purpose customer service employees to enable them to serve taxpayers in their communities rather than in the CC building.
Also go to community events at churches, festivals, etc. to assist taxpayers with tax related issues.
Treasurer touted the studies done by her staff and noted that she is hiring to establish a kind of "think tank" section in her office to conduct more studies, concentrating on the inequities within the tax system.
The office has a staff of 58 employees. Continued concentration will be in technology hiring.

Cook County Health

. In total, Cook County Health (CCH) currently has $2.4 M more in revenues than expenses.
. There are 1,284 vacancies among the 6,802 budgeted positions.
. Most of the questions centered around Covid and the Delta variant, which will not be reported here. There was emphasis on providing guidance to suburban school districts. CEO Rocha said that for now they are waiting for the CDC to provide guidance. If necessary, the CC Public Health Department will step in to do so.
. Commissioner Degnan asked about grant funding and the potential to increase it. CEO Rocha responded that for a public hospital system we do a good job, but the goal is to have "extraordinary" results. CCH will be making investments to develop an institute for grant funding.
. Commission Sean Morrison asked if CCH has established a dollar value for requested 2022 funds from the county. Answer: not yet, but should have by the August preliminary budget presentation.
. He also asked about efforts to improve the revenue cycle. CEO Rocha stated that a new Chief Revenue Officer is now in place and noted that through the first quarter of 2021 revenue retrieval has increased to 30% and can be expected to move to the mid-30's by year end. Interim Budget Director Gibson noted that the System is looking at non-direct patient care to improve.
. In March 2021, a "patient homecoming" project was launched to promote the return of patients to the ambulatory care centers. He stated he is very excited about the progress to date.
. Daley asked about outreach to retired nurses. CCH noted that a few came back for the mass vaccine sites and that the system is definitely open to more coming back to the system.

Observed by: Diane Edmundson

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Cook County Board Creates Loan Program for Municipalities

Nursing Shortages Continue to Concern Cook County Board

Cross Agency Coordination Improves Effectiveness of Implementing Initiatives

Cook County Health 2022 Budget Presented at Budget Hearing

Resolution to Review Compensation of Elected Officials Approved by Cook County Board Finance Committee

Cook County Board Mid-Year Budget Hearings Continue

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