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Cook County Board Business Conducted At Lightening Speed After  2 Hour Retirement Ceremony

12/20/2019

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Cook County Board of Commissioners Meeting
December 19, 2019


The Board devoted the first 2 hours of their meeting to the honoring of retiring employee Martha Martinez, former Commissioner Jerry Butler, and the late Reverend Clay Evans. Testimonials lauded Martinez for thirty-four years of exemplary service.  Former Commissioner Jerry Butler received a touching tribute from the Board. HIs career as a popular vocal artist and member of the Rock and Roll Hall of Fame was noted. Commissioner Butler sang one of his hits, “Let It Be Me” to the delight of all present. The late Reverend Clay Evans was honored as an icon of the black community and for his work on civil rights with Dr. Martin Luther King.

Action Items:
  • Agenda Item 20-0016- The proposed amendment to the Inspector General ordinance regarding reports and public statements was referred to the legislative committee. It requires that the IG share a statement with the head of the affected department and not issue a public statement for ten days. If the department has a response, this must be attached to the public statement. The Civic Federation supported  this amendment during the public comment period.
  • Agenda Item 20-0735- The Board unanimously passed a resolution supporting federal universal background checks for firearms. It is hoped that this will add pressure for passage of gun control legislation in Washington.
  • Agenda Item 20-0721- The Board unanimously passed a resolution to support refugee resettlement efforts in Cook County. Several agencies testified to the challenge of working under current punitive federal policy.
  • Agenda Item 20-0437- Approved an intergovernmental agreement between the pension fund and Cook County. In 2016 the pension was 54% funded. $306.2 million will be contributed for 2020. This infusion of funds has now raised the percentage funded to 68%, one of the highest in the state.
  • Agenda Item 20-0732 - Changes in committee chairmanships were approved. These new assignments will give greater responsibility to the newer members of the Board.
  • Agenda Item 20-0658 - Proposed tax on cannabis was referred to the finance committee.
  • Agenda Item 20-1831- Board approved a commission chaired by Britton to create a new design for the county flag. The deadline is 2021 when the county celebrates its 190th anniversary. High school students will be asked to submit designs in a competition.
  • Agenda Item 20-0726 - Board approved a resolution to support Cook County Health’s construction of a new Provident Hospital. It also provides for the Cook County Board Health & Hospital Committee to hold a hearing to receive an update on the project.
  • Agenda Item 20-0712 - Board approved a resolution to discuss the Cook County Health Formulary Program. The resolution describes how insurance companies use “step therapy” in an effort to control drug costs. Step therapy is when patients first try the less costly drugs to see if they work. This can delay patients getting the treatment they need.
  • Agenda Item 20-0011 - Proposed ordinance regarding zoning for recreational cannabis was referred to committee.
  • Agenda Item 20-0579- Board approved authority for Public Defender to accept $500,000 grant to aid data analytics.

Commissioners Daley, Deer, Suffredin, Arroyo, Sylvestri, Gainer and Moore thanked Dr. Shannon (CCH) for his service to Cook County Health. Dr. Shannon was present and acknowledged their kind words. 

Observer - Georgia Gebhardt               Meeting Length: 3 hours, 20 minutes (includes 40 minute lunch break)
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Cook County State's Attorney Requests Additional Funds to Hire 16 Attorneys

10/28/2018

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Cook County Board of Commissioners Finance Committee Departmental Budget Hearings
October 24, 2018


State’s Attorney


Commissioners Absent: Butler, Fritchey, Goslin, Gainer and Garcia.

State's Attorney (SA) Kim Fox stated that: 
  • Her department inherited over $2 million debt and has paid down 1/2 of that debt so far.  
  • Her strong focus is on data and evidence, integrity and transparency. 
  • The Cook County prosecutor office is second in the country, after LA. 
  • They have a Conviction Integrity Unit and referenced 50 people wrongly convicted.  She mentioned the importance of rebuilding trust. 
  • They have an 85% conviction rate in gun cases (up from 50%).  Her focus is on violent crime. Misdemeanor cases are being looked at as there is a high number.
  • Best practice is 400 cases per Assistant State's Attorney (ASA)   Cook County ASA’s have about 3000 cases. Further, about 50% end in dismissal. A lot has to do with the need for victims to show up in court.  There is no mechanism to screen out dismissal cases.  
  • About 250,000 cases come from suburbs.  
Com. Daley and Silvestri asked about Electronic Monitoring (EM). SA Fox said that she has no position regarding consolidating or what the difference is between EM from the Judges or Sheriffs departments. 

There was a question regarding the money spent on outside counsel, which is significantly different between inside or outside counsel. SA Fox asked for money to hire 16 attorneys (the number that was lost previously). This would allow her to decrease outside counsel and save money. Request is for $945,000 up to $1.3 million for FTE’s.

SA Fox discussed a felony review guidebook for Chicago Police Department with the goal to have consistency with charging. 

Suffredin asked about the revenue generated from civil diversion: Narcotic forfeiture fund (modeled after New York) and the Records automation fund where money comes from the state.  More money is not being generated because they don’t have enough resources.

SA Fox discussed community justice centers for the south and west sides. Idea is to invest resource in prosecutorial engagement. Prosecutor office is involved at the end of the process rather than front end. SA Fox wants more money for resources to put in crime reduction investment and prevention. 

Observer - Laura Davis
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Cook County Budget Hearings Continue for Second Day

7/30/2018

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Cook County Board Finance Committee - July 24, 2018 
Midyear Budget Hearing - Day 2 - Morning Session

 I arrived right at 9AM for the hearings and there were 2 commissioners present (Suffredin and Morrison) other than Chariman Daley. Seven more arrived by 9:30AM and 3 more by 11AM. Absent for the entire morning session were Commissioners Goslin, Gainer, Butler, and Fritchey.  Commissioner Sims asked everyone the core mission of his or her department and if there was any waste to cut. She did this even when both questions were answered in the original presentation. Commissioner Morrison asked everyone what new taxes they would propose, if any. Most took no stand on this issue.


Board of Review (BoR): I came in just as their presentation was wrapping up, but  I heard all of the questions.
  • Their budget is only 1% of the whole county’s budget so any increase in personnel should be considered, according to the 3 BoR Commissioners present (Patlak, Rogers, and Cabonargi).
  • Their biggest problem was losing experienced analysts in the past year. They would like 11 new ones.
  • Their staff picked up 16,00 extra overtime hours in the past year and were not given more money for this. This was equal to 13 FTE’s.
  • Most of the hearing was about community events called workshops in which the tax appeals  process was explained to the public. Many commissioners participated in these events. Also the B of R said it was a good way for staff to see the properties that were being discussed. More appeals are to be expected this year.

The Assessor: This presentation and Q and A session was extremely short. It lasted maybe 15 minutes.
  • Assessor Berrios said he would have no trouble keeping within his budget this year due to new technology. This has helped to eliminate positions that became unnecessary.
  • Commissioners seemed focused on Senior exemptions and the process that it entails. Ways of simplifying the process were mentioned.

Cook County Health and Hospitals System (CCHHS): A short report was given to each commissioner.
  • Dr. Shannon said that no new revenues would be requested this year or for FY 2019. They will live within their budget mainly due to the fact that they now have 330,000 new patients enrolled in County Care (up from 270,000). Most new patients come with Medicaid funds which includes federal reimbursement for now.
  • They have been able to solve any deficit spending by renegotiating contracts with vendors.
  • Some of their proudest achievements other than the above include getting Cermak hospital out from under its consent decree (this is the jail hospital at Cook County Jail), a technology award for having all patient records electronically filed, and for expanding its charity care (care to those with no insurance at all). 
  • In addition, the future looks to be one of 5-6% growth for a number of reasons. They expect more community centered clinics, especially those that deal with dialysis and dental care, and they have taken on the mental health services for kids in the JTDC (juvenile detention).
  • They also hope to get to the underlying causes of bad health such as poor diet, housing and lack of job opportunity. He did not say exactly how a health care system would manage those issues, but he is working to obtain grants to study these issues.
  • He is working on a better system of bill collection to alleviate previous problems.
  • Comm. Boykin asked about the issue of gun violence as a health epidemic and what CCHHS was doing about it. Dr. Shannon listed many solutions. He said that he agreed with the commissioner and cited last weekend’s shooting statistics: 20 of 35 shooting victims were taken to Stroger.
  • He said that in the case of a juvenile detainee, CCHHS was linking services he was getting while incarcerated with those out in the community once he was released.
  • CCHHS is expanding its care under Mental and Behavioral issues in order to treat the whole person. This would include linking that patient with substance abuse programs and programs for depression or anxiety.
  • CCHHS is working with Westside United and Rush Hospital in order to improve health in several west side neighborhoods.
At one point the hearing got a bit controversial as Commissioner Moore asked about a lawsuit against a doctor in a malpractice case. States Attorney Kim Foxx, who was on deck to speak next, answered that this matter was in litigation and could not be discussed in open hearing. Chairman Daley stifled any more conversation on this issue.

State’s Attorney:  Presentation was given by Cook County States Attorney Kim Foxx.
  • Ms. Foxx said that this past year has been tough because last summer she missed an entire hiring cycle. Most of her new hires come in the summer after new grads finish law school and the bar exam. She was down in staff since her office did not have enough money to hire last summer. This summer is better and she is trying to live within her current budget.
  • In FY 2019 she would like $1.97M more to hire 20 FTE’s.
  • On civil cases she needs more experienced lawyers since she represents every county employee who needs defending. The conviction integrity unit has only 5 attorneys and 268 new cases came in this year. Her attorneys have 2-4x the amount of cases recommended by the American Bar Association.
  • The SA Office also has attorneys working with the Chicago Police Department (CPD)  on intelligence gathering in the Englewood and Harrison districts in order to solve gun crimes. Training CPD and suburban police chiefs in how to gather evidence can save money if there are less faulty convictions.
  • Comm. Suffredin commended her for doing a good job. 
  • Ms. Foxx appealed to simple math often. Hiring outside counsel, she said would cost anywhere from $300 to $500 per hour on civil cases. Her attorneys cost about $90 per hour.

The Public Defender (PD): Presentation given by Cook County Public Defender Amy Campanell. She put up a big poster board with her core mission and with a list of some of the duties performed by her office.
  • Ms. Campanelli  said that in FY2018 positions that were vacant for a long time were slowly being filled and that she was on target to live within her current budget.
  • She wanted more staff in FY 2019  especially to start a mental health unit, but did not give a specific price tag unless asked.  She said that she had asked for this several years in a row . She now had a business plan worked up in which she would use student interns who were psychology or social work majors at local universities to help. Their assistance would be at no cost to the county. Early psych evaluations can also speed up the disposition of many cases. Comm. Deer asked her how much a mental health unit would cost the county. She said that she could do it for a mere $225,000. This would save money at trial since many psych professionals testify at a cost of $500 per hour.
  • She also noted that now the PD is on call for arrestees in every police district in Chicago. She even gave out the PD phone number several times. A recent survey of 120 arrestees showed that 22 were released because the arrests should never have happened. This saves the county money. PD’s helped this to happen.
  • She has also asked for more grant money to employ social workers and more lawyers to work with detainees awaiting trial who might be in danger of losing custody of their children.

Observer - Jan Goldberg
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Hospital System CFO in Hot Seat at Cook County Board Meetings

5/11/2018

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Cook County Board of Commissioners and Committee Meetings - April 25, 2018
                                       Meeting Length - 
4 hours, including breaks. Committee meetings started at 10am.

FINANCE COMMITTEE MEETING
The Finance Committee, which met from 10:09am to 11:40am, spent considerable time grilling the Cook County Health and Hospitals System (CCHHS) CFO about the $174 million in denials in 2016 and 2017 as reported in the Inspector General’s (IG) 4/13/18 quarterly report for 1Q 2018. 
  • Commissioners, Boykin, Daley, Gainer and Morrison asked most of the questions in trying to determine what led to the loss of $174 million - $108 million in 2016 and $66 million in 2017. Boykin referenced the report stating that denials can be attributed to scheduling, patient registration, coding errors, physician and nurses, inadequate and inaccurate coding. He noted that 1/3 was written off because of untimely filed medical bills. 
  • In response to Comm. Gainer’s question, the HHS CFO said yes – the $174 million was lost due to missed collection deadlines and clerical error. 
  • The Finance Committee talked briefly about another topic, but then Comm. Gainer asked about the CCHHS collection rate. The CCHHS CFO responded that the charges are different from billing and different from collections. Typically, patient collectibles are 30% or a $50 million loss on $175 million in charges.
  • In response to questions, it was revealed that there had been about 1,200 patients treated for gunshot wounds at a cost of $35,000 per patient. However, it was unknown what percentage was covered by insurance. 
  • It was clarified that the $174 million written off was separate from uninsured. $317 million that was written off for charity care. 
  • Comm. Boykin expressed frustration with the responses he received. Comm. Suffredin stepped in, stating that the CCHHS CFO came to the meeting prepared to address the monthly report – not the IG report. He suggested a special meeting to address the IG report be scheduled. 
Comm. Daley wrapped up the Finance Committee meeting stating that they need clarity on the $174 million in losses. 

ZONING AND BUILDING COMMITTEE MEETING
Next the Zoning Committee met from 11:40 am to 12:50 pm. They passed a bunch of recommendations. 

BOARD OF COMMISSIONERS MEETING
Pres. Preckwinkle called the meeting to order at 11:54 am, then went into recess at 12:26 pm; reconvened at 1:08 pm and adjourned at about 2:08 pm. 

  • Regarding 18-3099 a lease agreement for CCHHS, a question was asked about the expenditure of $1.5 to $2 million to lease space rather than incorporate it in the new building. It appears to be a bonding issue, which limits the capitalization plan. It was noted that the rent will be $23/SF with 79 free parking spaces, which is $2 less than market comps in the Medical District around Stroger. Staff felt it was the best deal in the newly renovated space. 
  • There was also reference to the Inspector General’s report on CCHHS billing issues at the Board meeting, that had been previously referred to in the Finance Committee meeting. 

Items to Watch for in the Future
  • Special hearing on the $174 million in CCHHS denial of billing by insurance companies.

Other Comments or Observations
  • Several members from the Illinois Committee of Blind Vendors spoke during public comment. They referenced the “Blind Lives Matter” movement, that the unemployment rate for people who are blind is 70%, as well as an Enterprise Program for the Blind (a training program). They referenced the Blind Vendors Act. (I found reference to the BVA in the 1/17/18 Board meeting materials where it was referred to the Asset Management Committee’s 2/7/2018 meeting, which appears to have been cancelled. There does not appear to have been another meeting.)
  • They mentioned that blind vendors have the right of first refusal on federal and state property and are looking for commission-free opportunities and partnerships like they have with state and federal. They advocated for the commissioners to vote in favor of the Blind Vendors Act of Cook County.

​Observer - Peggy Pissarreck                      
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Cook County Commissioners Find Problems with Contracts

2/12/2018

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Cook County Board of Commissioners Meeting - February 7, 2018

Significant Topics Discussed:

  • Although most contracts were passed, commissioners expressed concern that too many extensions are given to contracts in the county without RFPs to open bidding to other vendors and organizations.  Also of concern is that some contracts  are not completed within the designated timeframe and the performance of some vendors is not acceptable.  There do not seem to be penalties against vendors who do not complete their contracts on time or correctly accomplish the goals of the contract (Comm. Morrison).
  • Commissioners are concerned that they receive the contract for approval too late to do anything but “rubber stamp” it (Comm. Fritchey).  
  • Agenda Item 18-1914 (passed)  an extension of Securus Technologies to provide telephone service for jail inmates.  The cost for inmates to phone anyone within the USA is 12.5 cents per minute, which is a good rate compared to other jurisdictions.  Extensions for this contract have gone on for almost 10 years.
  • Agenda Item 18-1277 (on hold until legal language cleared up) is a contract with Northwestern University to provide mental health services for minors at the Juvenile Temporary Detention Center (JTDC).  Northwestern wants an indemnification  clause which would relieve them of any medical mal-practice consequenses.  The county does not provide this in their contracts.
  • Agenda Item 18-1649  A hearing was held in the Legislation and Intergovernmental Affairs committee regarding the performance of the Clerk of the Court’s office in completing electronic filing of court cases and  an updated case management system.  The county has already designated $40 million toward this mandatory directive by the  Administrative Office of the Illinois Courts (AOIC).  Concerns were expressed by the Board regarding the extension of 6 months to complete this (now extended to July 1, 2018); a convenience fee of $2.95 that is still being charged to obtain case files; and a federal court case regarding media difficulty in obtaining court case information.

Significant Decisions Made:
  • Agenda Item 18-2022 (passed) a resolution supporting stronger ethics legistation (like the county has) at the state and other local levels.
  • Agenda Item 18-2050 (passed) a resolution declaring gun violence in Cook County a Public Health Emergency and advocating for additional resources to combat violence.
  • Agenda Item 18-1750 (passed)  requiring a quarterly report from all agencies and departments involved with costs of gun violence—Medical Examiner, Hospital System, Sheriff, etc.
  • Agenda Item 18-2017 (passed) a resolution to study integration, consolidation, and modernization of all IT services in the County (to save money and increase efficiency.) Following the study (in 120 days) there would be a Governance  ordinance drafted by the Chief Information Officer.
  • Agenda Item 18-2073 (passed) a resolution to form a commission for revenue forecasting and evaluation of revenue types.
  • Agenda Item 18-2128 (passed)  Sheriff offering to help suburban Cook County in investigating police shootings since the county has more resources than most suburbs.
  • Agenda Item 18-2142 (sent to Finance committee) this report on the tax assessment process by the Civic Alliance, which was initiated several months ago, “will be out next week and will be available on-line” (President Preckwinkle).  This has been a very controversial  topic regarding Assessor Berrios’ Office.  Issues of fairness and accuracy of assessments have been reported by the media and other organizations.

Items to Watch for in the Future:
  • Results of Civic Alliance study on tax assessments.
  • Completion of e-filing and case management systems by the Clerk of the Court.

Other Observations:
Commissioners seem to be taking a more active role in how contracts are awarded and whether they are completed on time, accurately, and with reasonable cost. 

Observer - Karin Hribar
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Cook County Board Approves New Procedure for Public Comment at Meetings

7/27/2017

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Cook County Board of Commissioners Meeting – July 19, 2017   
   
Significant Decisions Made:  
  • A proposal by Commissioner Garcia to prohibit law firms handling property assessment appeals from contributing to election funds for any candidate for Assessor was referred to the Finance Committee. (Agenda Item 17-4188)
  • Passage of the new witness slip ordinance -  Authorization to speak will only be granted to individuals who have submitted in writing their name, address, subject matter, etc. 24 hours in advance of the meeting. (Agenda Item 17-3293) Commissioner Suffredin publicly thanked the League of Women Voters and the Better Government Association for their support of this amendment to the rules of organization.
  • After extensive discussion and testimony of twenty south suburban mayors and presidents, seeking repeal of a requirement that all contractors working on Class 8 projects have a certified U. S. Department of Labor Apprenticeship Program, the revised ordinance passed with a 9 to 6 vote.  The communities promised to work with the Board to revise the issue. (Agenda Item 17-4339)
  • An amendment to the Cook County Property Tax Assessment Classes returning small Bed & Breakfasts with no more than six rooms to Class 212.  Two years ago the Assessor’s office had changed their classification to Commercial which dramatically increased their property taxes.  Testimony indicated that owners live in all of the affected B&Bs as their personal homes. (Agenda Item 17-3303)

Significant topics  discussed:
  • The Comptroller and his staff reported on some of the finances of the County.  Sales tax receipts are down about $5m from projections and not likely to be recouped.  This was attributed to online sales.  The Clerk of the Court receipts are down about $1.4m due to a decrease in the number of tickets issued.
  • Comm. Boykin questioned Dr. Shannon, Cook County Health and Hospitals CEO, about increased costs to Stroger Hospital because of all the murders and gun violence.  This was followed by a discussion of how Dr. Shannon made the ten percent cuts to his budget as ordered by President Preckwinkle.  He indicated he cut 3 physicians, 21 nurses, and also cut contract usage and other related actions. He indicated that he had vacancies in other areas of the hospital and most of the laid off staff would be able to find other positions.  This led to a discussion of vacant, funded positions that he still can use, and Commissioner Boykin questioning if all vacant position in the county are eliminated and all hiring is frozen “is there a need for a layoff”.  The discussion ended there.
  • There was also a discussion questioning if the Comptroller’s staff still has to drive to Springfield to pick up the multi-million dollar checks from the State.  He answered Yes, but they are still trying to achieve electronic transfer and eliminate the driving.

Other observations:
  • The meeting lasted until 6:30 p.m.  This observer left at four p.m.  The actual Board Meeting with the pledge and prayer began about two thirty in the afternoon having been preceded by several committee meetings.  It was a “survival of the fittest" meeting.

Observer - Syvia Tillman                                    Meeting lasted:  9:30 a.m. until after 6:30 p.m.  
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