Cook County Board of Commissioners
May 13, 2025

Asset Management Committee
The Bureau of Asset Management presented its annual report on the Build Up Cook Program, highlighting their work in underserved communities. The Committee also approved a resolution declaring indoor air and indoor environmental quality as a public health crisis.

• The Bureau is using ARPA (America Rescue Plan Act) funds to provide resources to underserved communities for badly needed infrastructure projects such as fire hydrant replacements and sewer and stormwater projects.
• The projects are managed by Asset Management staff, using County contractors.
• One project highlighted was being able to help the Village of Robbins when a supply water main broke. The Bureau of Asset Management worked with other Cook County Departments to get it quickly repaired.
• The Bureau is also using funds for workshops so that community employees develop the skills to manage projects and obtain financing through grants.
• The Bureau wants to continue the workshops beyond the ARPA funding to help communities find and obtain grants from State funding options.   It is anticipated federal funds for infrastructure projects will not be forthcoming.
• To read more about the Build Up Cook Program, see the County website, https://arpa.cookcountyil.gov/build-up-cook.   The report was received and filed. Item 25-1896.
• The Committee approved a resolution declaring indoor air quality as a public health crisis.   The Committee took action on this issue at its meeting last month when the Commissioners approved a contract with the University of Illinois to develop a process for evaluating the air quality in Cook County buildings. Item 25-2342.

League Observer:  Kathi Graffam

Health and Hospitals Committee
Aaron Galeener, Chief Administrative Officer of CountyCare, and Dr. Yvonne Collins, Chief Medical Officer of CountyCare (the Medicaid managed health plan operated by Cook County Health) presented a PowerPoint overview of CountyCare services. 

• Health Benefit for Immigrant Adults (HBIA) Medicaid program is being sunset by Governor Pritzker effective July 1, 2025 which will affect over 16,000 CountyCare members and approximately 32,000 statewide, likely to have a significant financial impact.
• Commissioner Aguilar, Stamps, Degnan, and Vasquez asked what threats to CountyCare Medicaid the current Congressional debate calling for Medicaid cuts were.  Galeener said federal Medicaid cuts might include work requirements, as well as decreased federal funding for those Medicaid recipients who are covered by the expanded Medicaid coverage provided under the Affordable Care Act (“ACA”) which provides 90% federal funding for this group of individuals vs 51% for traditional Medicaid recipients. He said this could impact over 100,000 CountyCare members and a potential loss of $100 million in revenue. ACA expansion programs have a trigger to sunset in Illinois if federal contributions fall below 90%, Galeener noted.
• Commissioner Degnan asked what programs CCH/CountyCare will need to cut?  Galeener said programs that are “value added” components of Medicaid in Illinois that are not required by Federal Medicaid.  He indicated that increasing redetermination of eligibility from once a year to 6 months might be implemented.
• CCH’s housing program as a social determinant of health is funding organizations who are engaged in locating shelter for CountyCare members who are homeless or live in a shelter. Flexible Housing Pool (CountyCare invested $5 million in 2020 and $3 million in 2025) and other CountyCare housing programs currently house 432  individuals.  Health outcomes for persons housed by this program show 33% reduction of inpatient stays, 19% reduction in ER visits, 22% reduction of jail registrations, 30% reduction in all cause mortality.  Commissioner S. Morrison questioned whether CCH should be paying toward housing-- not in the mission of hospital system.  Galeener commented that “we are a health care entity, need better solutions to housing  and need to transition them to more sustainable affordable programs”.  (Item 23-0202) motion to defer adopted.

League Observer: Susan Kern

Audit Committee
The Committee periodically follows up on open audit recommendations. Bill Carroll, Deputy Auditor, reported on the four audit items currently open.  The report was received and filed.  Item 25-2074.

• The oldest and most concerning item was a finding from the 2015 audit of the Clerk of the Court concerning the process on uncollected revenue on traffic court fines.   The audit recommended that the Clerk’s office make every effort to collect the fines before turning them over to a collection agency.  Once they are given to a collection agency, there should be closer monitoring of the revenue.
• In 2015 the uncollected amount was $3M and has increased since then.  Commissioner Sean Morrison pointed out that the collection agencies take 30%-40%.
• Mr. Carroll reached out to the new Clerk of the Court administration and is setting up a meeting with the Finance Manager. He will review their current process.  Commissioner Degnen asked to be included in the meeting. 

League Observer:  Kathi Graffam

Cook County Board Of Commissioners Committee Meetings
September 17, 2024

AUDIT COMMITTEE
Although not on the Asset Committee agenda, at its September 19 meeting, the board approved a Professional Consulting Service contract with Iron Mountain Information Management to develop a materials and records storage assessment, implementation plan, and digital files/digitization.  The contract is for $1.2 million and the duration 16 months until 1/31/26.
Auditor, Mary Modelski, reported that several items from the 1st quarter were closed and that during the second quarter progress is being made with the "employment reimbursement process" and with the Clerk of the Court "traffic citations".  She went into more detail on the recommendation to Consolidate the Grant RFP Process stating that a stakeholder process was established in August to work on centralizing the grant management system.                                                                                                     
#24-3722 - the ARPA Fixed site emergency shelter report for people experiencing homelessness.   Two hotels are in the process of being purchased to house the homeless.  ARPA monies were used to provide a 30-year loan which will come due in 2053.  The Audit Department recommended the monitoring process needs to be improved and defined for the long term.   Comm. Daley asked that the Audit Department add this specific ARPA project to its regular auditing schedule.  Currently, it does not follow up on ARPA grants
#24-3681 - The Audit Department conducted an audit of the Work Order System in the Facilities Management Custodial Services Section.  It specifically recommended that the work order system be defined:  what it is and what it covers or not. Three recommendations were made: Under policies and procedures, how staff is assigned; Under standards, spell what specifics to help with efficiency; and get better metrics from its “Famous Compute System”, specifically regarding staff shortages.
#24-3949 - ARPA Hyperfocal and In-Home Vaccination and Vaccination Incentive Program.  The COVID vaccination incentive program of the gift cards received scathing criticism from several commissioners.  12,000 $100 cards were purchased and 8,000 distributed.  Blackhawk, the card vendor reduced the value of the card each month it wasn’t used by $6.00.  There was no contract but an emergency purchase order, and the Chief Counsel has demanded a reimbursement, not just on the remaining balance but the entire purchase order amount.

LEGISLATIVE & INTERGOVERNMENTAL COMMITTEE
During a very short meeting, the committee approved the appointment of Patricia N. Jjemba to the Juvenile Temporary Detention Center Advisory Board, and approved a resolution offered by Commissioner Gordon to request that the IL General Assembly approve SB3948, an amendment to the missing persons identification act to streamline processes to allow an agency to more quickly attempt to obtain the missing person’s DNA; would require, rather than allow, law enforcement to collect additional information such as fingerprints and biological samples; and provides that a waiting period may not be observed before accepting a missing person report.
Commission Gordon also requested and received approval of her request to Urge Congress to approve the “Protect our Letter Carriers Act (H.R.7629) to enhance postal workers safety.

HEALTH & HOSPITAL SYSTEM COMMITTEE
#24-4143 – Birthday Health Screening Program. The members approved the amended resolution calling for an annual prostate and mammogram health screen at Cook County Health locations – which would be free to those without insurance or other coverages.  Cook County Health’s, Dr. Fagan, noted that black males have a 60% higher mortality rate than white males, and over 16% of CC residents are age 65 or older. 
SEMI-ANNUAL BEHAVIORAL HEALTH REPORTS
Office of Behavioral Health – Department of Public Health:   Both the Jail and the Juvenile Detention Center are increasing developing individual behavioral health treatment plans.  70% of those in the JDC are receiving therapy.  The jail is housing more individuals charged with more serious offenses; therefore, an increased number are also receiving mental and drug therapy.  Naloxone is used extensively and being more broadly distributed even after discharge.
Public Defender’s Office:  It was noted by the presenter that the Defender’s office is not a treatment provider, but does assist in identifying needs and getting help.  It will soon launch a community assist center to provide case management and clinical services as well as putting together treatment plans.  Several new mental health clinicians have recently been hired bringing the total to six.  The Office made 104 referrals in the last quarter which is on par with previous quarters.
Circuit Court:  Established guidelines in 2015 based on evidence-based data.  In its Problem-Solving Courts, Probation Officers work with collaborative, community-based services on a team basis.  Accountability is part of the program.  The presenter noted that Narcan is now available at all public libraries.
States Attorney:   Used this reporting period to highlight the issue of Petitions for Firearm Restraining Orders.  A petition is usually filed by a family member.  The Petitioner must be at least 18 years old.  The petition leads to a Writ of Detention Examination for an emergency court order to bring the individual in question to the hospital for examination.  Every effort is made to have the writ brought to a judge on the day the petition was received.
Sheriff’s Office:  The presenter talked about the Sheriff’s Smart and Thrive drug and mental health treatment center.  Participation requires a court order.  At the center during the last period, 1,000 males and 300 females participated.  The Sheriff’s office also has a community-based re-entry program.

Observer - Diane Edmundson

Cook County Board Of Commissioners
Health & Hospitals Committee Meeting
October 17, 2023

The Public Health Department: presented both a verbal and written 3rd Quarter Report which is also being presented to the Cook County Health Board on Friday, October 27, 2023 and will be available to the public after the meeting.

• Presentations were made on SDI treatments and diseases, targeting campaigns for colleges, and public relations campaigns for individuals to increase knowledge and where to go for help. CC Public Health has a communicable disease unit that excludes Chicago, Evanston, Oak Park, Skokie, and Stickney Township which have their own public health departments.  The program engages in surveillance, investigation, interviews, partner services, education, and support.
• Gonorrhea, Chlamydia, Syphilis, HIV, and Monkey Pox are the main SID's targeted for treatment and reporting statistics.  The current marketing campaign slogan is:  "Don't guess, get a test".  Mail back test kits are now available from CCH. The public should check the website for specifics.
• Also discussed was the youth tobacco seller ordinance passed in July of 2023, which consists of compliance check and required signage.  Starting this fall, CCDPH in partnership with the CC Sheriff's office is conducting random, unannounced inspections where flavored tobacco products are sold in unincorporated Cook County.  
• Opioid Epidemic:  Resolution #23-5053 Treatment not Trauma carried with enthusiastic concurrence.  At this time, there are vending machines for Narcon in the emergency rooms at Stroger, Provident, and the Austin Clinic.  Plans are to expand availably to CC court houses, and a new methadone clinic is opening at the Austin Health Center in January of 2024.   ARPA monies are the source funding.  
• All ambulatory clinics have or will soon have an embedded mental health professional to provide services on location.
• At Cermac, recovery coaches help ensure a three times better success for inmates with a drug and/or mental health problem.  The jail currently has a 2,400 caseload.
• County Care follows members and provides services for mental health and drug addiction.  The system monitors a combination of opioids and certain other drugs which has already stopped "a lot" of prescriptions and overdoses.
• CCDPH will do an assessment of where in Cook County communities methadone clinics can be successful.
• CCDPH's Dr. Joshi said that the department is looking at how CCH can be more trauma informed.  When asked what phone number can be given to drug users that want help but are not critical, Dr. Joshi said to call the Behavior Health Hot Line at 833-626-4244.  He also said that the 988 help number the county is installing is not ready but will eventually be available.
• Dr. Joshi then announced that CCH is convening a Behavioral Health Summit for early 2024.  More information to follow.

​The Joint Finance and CCH Health Meeting to discuss the use of contract staff rather than permanent hires was called to order and after 4-5 public speakers [union employees] was recessed at 4:45 p.m. with a reconvened date and time to be announced.
 
​Observer:  Diane Edmundson

Meetings of the Cook County Board of Commissioners Health & Hospitals Committee
June 27, 2023

The Cook County Health & Hospitals Committee held a public hearing to examine maternal health morbidity and mortality rates, particularly with regard to Black and Latino mothers.  Earlier, the Committee held a regular meeting to deal with business, which included a presentation on the Department of Public Health’s strategic plan and an update from Cook County Health’s senior staff on the hiring situation.

Hearing on Maternal Morbidity and Mortality (Item #23-2260)

• Congresswoman Robin Kelly (IL, 2nd Dist) spoke first and said that 84% of maternal deaths are preventable!  Moreover, maternal deaths are continuing to rise.  Rep. Kelly applauded Illinois for being the first state to extend post-partum coverage under Medicaid.  She said that currently 36 states have such coverage for 12 months.
• Illinois State Rep Mary Flowers (31st Dist) told the Committee that a bill she sponsored that is sitting on Governor Pritzker’s desk to sign would help train doctors to do intubations during childbirth. (HB2820)
• Dr. Lamar Hasbrouck, COO of the Cook County Department of Public Health, explained that pregnancy-related mortality includes deaths during pregnancy and up to 1-year after delivery.  The term “maternal morbidity” refers to illnesses caused or exacerbated by pregnancy and childbirth.  The statistics for suburban Cook County are consistent with what Rep. Kelly reported:  morbidity rates went up during the years 2016-2020, with Black mothers having a 60% higher rate than White.  He said that currently they don’t know why.  With regard to mortality, overall from 2015-19, there were 24.4 pregnancy-related deaths per 100,000 live births; but for Blacks the numbers were 56.6 deaths per 100,000 live births.
• Cook County Public Health had some maternal and child programming that it wants to expand.  It wants to improve the quality and coordination of maternal care after delivery.  The Department is exploring collaborative approaches with Harris County (that includes Houston) and Wayne County (that includes Detroit).
• The Chief Medical Officer for County Care said that it has a “Brighter Beginnings” program that provides monetary rewards for mothers who come in for pre-natal and post-natal care.  Approximately 79% of the deliveries County Care handled were by mothers in disproportionately impacted zip codes. 
• Midwife Carrie Elizabeth Stewart urged that the focus for improving the situation be on healthcare deserts in the County, particularly the South Suburbs. 

Earlier Meeting
Report from Cook County Health (CCH) Senior Staff on operations (Item #23-0202, which was deferred to allow for subsequent reports)

• Dr. Israel Rocha, CCH CEO, and Valerie Amos, Human Resources head, presented a report on the hiring situation, starting by putting CCH’s experience in perspective with national.  
• The national turnover of nurses is 25.9%, while CCH’s is half that.
• The industry average for # of days to hire is 90.  Currently, CCH’s is 91, about half what it took last year.  
• Overall, CCH has 2,200 vacancies, but since December, it has actually had a  gain of 115 net hires (total external hires of 422 minus 287 separations).  
• CCH is also doing planning by analyzing how many employees will be eligible to retire (50 years or older and 30 or more years of service).
• Efficiencies in the hiring process have occurred, saving an estimated 7,023 hours of staff time this year.  For example, because the same questions should be asked during interviews, the questions are now automated.  Hiring fairs have proved to be a good tool  There have been 36 with over 1,000 attendees and 293 have accepted contingent offers there and then.
• A representative of SEIU Local 73 spoke during the public comment period, taking issue with a statement she said CCH had made that the large number of vacancies was due to lack of applicants.  She provided statistics about the number of applicants.  She said that while the time it takes to hire has improved, it still takes 102 days.  She said that the union wants to partner with CCH to reduce the number of contract hires.
• Commissioner Gainer suggested that the CCH Human Relations work with the County’s to help the County reduce the time to capture hiring information – CCH can do it in about 3 weeks vs. the 90 days the Bureau of Human Relations says it takes it.
• Commissioner Degnan was told that the majority of the positions fall under the Shakman requirements, but that CCH regularly reviews to make sure the employment plan procedures remain necessary and CCH works with the County’s Inspector General to modify if appropriate.
• Commissioner Trevor asked CCH to seek information on the number of days it takes competitors to hire.

Department of Public Health Strategic Plan for 2023-25 (Item #23-1562, which was approved)
Dr. Hasbrouck explained that this is composed of 5 elements:

• Strategic communications
• Community partnerships and collaboration
• Workforce and workplace
• Infrastructure and operations
• Integration and systems alignment

As part of the implementation, the intention is to identify metrics that matter and provide quarterly updates.  In response to Commissioner Morita’s question, Dr. Hasbrouck said that the Department meets almost monthly to coordinate with the other public health departments in Cook County, including Chicago, Evanston, Oak Park, and Skokie.

Observer - Priscilla Mims

Cook County Board: Health & Hospital Committee Meeting
October 18, 2022

The following reports were received and filed:  

• Alternative Health Intervention & Response: 
  • This report is the result of Commissioner Degnen’s resolution that last year focused on establishing for suburban Cook County  a mobile crisis team to respond to mental health crisis with trained mental health specialist. 
  • Commissioner Degnen at the meeting noted that establishment of the team for this year will need to be delayed sometime in 2023. The task force activity working on this project are expanding usage of the 988-emergency number and facing issues with the workforce and hospital capacity for care.   
• Covid 19/ Contract Tracing Update: 
  • CCDPH expecting a surge of COVID 19 in Nov. Concern about low rates of vaccinations and will be working over next months to increase levels of vaccination.
• Cook County Health System Strategic Plan 
  • Review of Strategic plan generated questions regarding the changing of the Health System’s mission statement.  What was emphasized is that the team was committed to a shorter mission statement maintaining the wording "regardless of the ability to pay" and adding the word "access".  
• Cook County Health: Mental Health Services Quarterly Report
  • Reports from Health System’s Department of Behavioral Health & Psychiatry; Cermak Health Services; Juvenile Temporary Detention Center Health Services (JTDC); Cook Department of Public Health
  • A common theme with each of these agency reports is a marked increase in need for mental health services. Discussion focused on numbers of juveniles confined in their rooms which presenter while did not have data felt that few were being confined to their rooms. 
  • The Cook County Department of Public Health did report training of 145 suburban law enforcement over 3 months in usage of naloxone and have documented through this training were able to reverse 20 overdoses.
• Behavioral Services Quarterly Report: Office of Chief Judge
  • Instituted with ARPR monies a collaborative program focused on youth diversion from criminal justice system. 
  • Pilot program demonstrated of 135 youth with gun charges 79% completed the outlined treatment program with charges dropped. 
• Cook County State’s Attorney Office & Cook County Sheriff’s Office: Behavioral Health Services Report:
  • Both agencies reported on working to expand community mental health services. The State’s Attorney Office reported that there were significant lower number in the pool for diversion coupled with community agencies that they partner with facing backlog of referrals. 

Items to watch in the future:

• Capacity for the expansion of mental health services 

Observer:  Susan Avila

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