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Cook County Committees Hear about the Build Up Cook Program, CountyCare, and Open Audit Items

5/21/2025

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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
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  • Home
  • About
    • LWVCC Interest Groups >
      • Cook County Budget & Structure Group
      • Criminal Justice
      • Forest Preserve Interest Group
    • LWVCC Action and Testimony
    • LWVCC Activities
  • Observer Reports
    • Cook County Board Observer Reports
    • MWRD Board Observer Reports
    • Forest Preserve Board Observer Reports
    • CCH Board Observer Reports
  • Voter Info
  • Resources
    • Cook County Board
    • Forest Preserve Board
    • Cook County Elected Officials
    • MWRD Board
    • Cook County Health Board
    • Member Resources