Cook County Health 2022 Budget Presented at Budget Hearing

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.

Other Highlights of his presentation:

• County Care now has 415,000 members which has driven up both anticipated revenues and expenses for 2022.  Focus will continue to be on increasing the use of in-house medical care vs members using outside providers.  Emphasis will be on closing service gaps, investing in the nursing staff, and increasing emergency and dialysis services at Provident.  
• Neurology, Oncology, behavioral services will all be increased offerings at Provident, Stroger, and several of the community health centers.  The ultimate goal is to offer these services at all or most of the centers.  Also reported that a new state-of-the-art health center was opened in 2021 on W. Fullerton named Belmont Cragin.
• Public Health received funding from the Center for Disease Control and the County will increase its tax allocation by $10 million each year contingent on revenue.
• Surgical rooms are being increased and modernized at both Stroger and Provident. Provident is resuming emergency ambulance runs.
• There is the potential for national recognition of Provident Hospital’s Dialysis and Renal Center.

Commissioner Questions

1. When will the vaccine for ages 5-11 be available.  Answer:  expect vaccine on hand in two weeks.  To date every suburban school has been contacted.  Emphasis will be on schools and family doctors to answer questions and vaccinate.
2. Have outstanding accounts receivables improved.  Ans:  Yes.  In 2021 to date cash collection increased by $24 million.  Also, the System is establishing a claims reserve for County Care.
3. Commissioner Miller wants to see the ambulatory care clinics much more robust and all offering life style services.  She also wants more services provided in the Southland area.
4. Anaya asked that Telehealth be expanded.
5. A question on the pandemic effects on the staff was answered this way: There were many more retirements.  The System is asking itself “how do we energize our staff?” Need more patient education. Need increased emphasis on Mental Health. Mr. Rocha stated he will be offering a new Strategic Plan at the end of 2022. 

Diane Edmundson - Observer