Cook County Board Seeks to Amend Health System Ordinance

Cook County Board -  Health & Hospital Committee Meeting
February 26, 2020

Meeting Report 
The CC Health & Hospital Committee had two items on its agenda:

Agenda Item 20-1118 went through two substitute iterations with the final dated February 24, 2020 and contains major amendment changes to the 2008 Health and Hospitalts System Enabling Ordinance that established the independence of the Hospital System from the County President and Board and set up the mechanism for appointing an independent board.   The chair of the committee, Dennis Deer, was not in attendance nor were Commissioners Moore and Tobolski.  Commissioner Arroyo, Vice-Chair, ran the meeting. 

• All commissioners in attendance strongly supported the need for a viable and vibrant county public health care system and it was reflected in each of their remarks.
• Agenda Item 20-1118 was passed out of Committee with the only exception to a unanimous vote being Alma Anaya who voted "present".  Her comments are below as are selected other commissioners:
• Larry Suffredin:  Led off the discussion by stating that he strongly supports the amendments and considers them to allow for "re-balancing" of the relationship between the Cook County and System Boards as well as ensuring collaboration on executive hiring, financial, strategic planning, and labor relations issues.  He offered that the Cook County Board is the Health Board for the County; and he pointed to the large increase in uncompensated care; the two highly critical Inspector General reports; and the increased number of grievances and arbitration cases as reason for the need to re-balance.  
• Sean Morrison:  Stated he often communicated belief that the problem lies with the executive team.
• Bridget Gainer:  Stated that outward collaboration as well as between the Hospital and the CC Board is needed.
• John Daley:  Strongly supportive and stated that nearby U of I Hospital and Rush Hospital are both expanding their ambulatory centers and that the HHS System needs more help from them.
• Alma Anaya:  Stated she does not believe the amendments solves the root cause issues.  She advocates creating a process such as a task force to identify, dissect, and address the problems - particularly financial.  Wants to review and then change rather than "jumping the gun" with the proposed amendments. 

Agenda Item 20-1229 was deferred without discussion.  It would require top executive compensation and severance package approval by the President and County Board and because the matter is also covered in 20-1118, it may be withdrawn

Public testimony

• ​Dr. Lindsay Ray Murray, Health & Medicine Policy Research Group.  Stated that the System cannot cut its way out of its financial deficits.  Called for a blue ribbon commission from a cross-section of health care professionals and experts to thoroughly explore the issues and make recommendations before approving changes to the 2008 enabling ordinance.  H&M Policy Research Group is a member of the nominating committee that provides HHS board nominations to President Preckwinkle for her and the CC Board approval.
• Laurence Msall, Civic Federation.  His main objection is that 20-1118 gives the county board say over the selection and compensation of the CEO.  He said that he has heard of no explanation on how the proposed changes will correct the System’s financial problems. The Civic Federation is also a member on the nominating committee for HHS board nominations.
• Susan Avila, Collaborative Health Equity.  She is also on the H & M Policy Board and worked at Stroger for a number of years.  She stated that there was not enough information before the changes were proposed and is for a comprehensive analysis of the problems and at what works best (Best Practices approach).
• Mr. George Blakemore also spoke and is in favor of more County Board involvement.

Significant Amendment changes included in Agenda Item 20-1118

• The System Board will no longer have sole authority to hire the CEO, or interim CEO, or fix the compensation.  Henceforth, it will recommend, subject to the advice and consent of the Cook County Board and the President’s departments on development of its three-year strategic plan as well as its operational and policy strategy. 
• Requires the Hospital System Board to direct its CEO to collaborate with President Preckwinkle and her departments on development of the strategic plan as well as its operational and policy strategy.
• Increased HHS board membership from 11 to 12 – The twelfth member will be hired by and reports directly to President Preckwinkle and will serve the same 4-year term as the other directors.  This appointee and the CC Board appointee, currently Dennis Deer, cannot serve as chair of the HHS Board.
• Allows the System Board to recommend instead of fix compensation of employees and provides that the compensation must be in line with the county board’s budget appropriation.
• Gives more responsibility to the Cook County Human Relations Bureau in handling grievance issues.
• Provides that the HHS board shall meet 12 times a year.
• Specifically states that the Cook County Board does not delegate Home Rule Authority to the System board.​
  
• Sets a threshold for county approval for capital expenditures at above $150,000 with monthly reporting of such expenditures of $5,000 to $150,000.

Diane Edmundson - Observer