Cook County Health Mid-Year Budget Hearing

Cook County Board Finance Committee – Mid-Year Budget Hearings
July 26, 2023 –

Cook County Health  - Israel Rocha, CEO.    
2024 Preliminary Budget:  $4,034.9 Billion Revenue

Mr. Rocha began by stating that Strategic Plan mission is to compete head on with any health care system in the world.  The primary issues discussed during the two-hour hearing were:

• Dental Care             -   Nurses Hiring & Reduction of Agency staff       
• Abortion Care        -    Asylum Seekers and the Undocumented

Dental Care

• CCH currently has six clinics outfitted to provide dental care.  Blue Island is the latest at a cost of $236,000 for space preparation and equipment.  The issue is finding staff to provide the dental services at all the locations.  Mr. Rocha said the System is look at options and may start sharing staff.   

Abortion Care

• Commissioner Britton asked about out of state patients seeking abortion care.  Mr. Rocha said that the CCH has seen an increase in services needed, particularly with complications.

Hiring & Reduction of Agency Nursing Staff

• Mr. Rocha noted that year to date, 800 hires have been made, and turnover is down.  The System’s 6.1% turnover is lower than the industry average, but he noted that the average age of the workforce is 51 years. The number of current vacancies is 2,314.  When asked about when the use of agency nurses would be reduced, Mr. Rocha talked about the HR’s recruitment efforts for nurses including the very successful job fairs with same-day conditional offers, signing and retention bonuses, and the increased emphasis of benefits such as pension, health, personal leave, and full tuition coverage after one year of service.  
• Later in the discussion, Commissioner Gainer said that the CCH will always have to rely on agency help, particularly for nurses.  Her point is that a realistic number should be set each year for needed agency help to which budget numbers can be assigned.  

Asylum Seekers and the Undocumented

• As a reminder, the System serves all residents of Cook County regardless of their citizenship or ability to pay.  The influx of Asylum Seekers over the last 6-8 months has resulted in unbudgeted expenses.   Belmont Cragin is the entry point for health care screenings.  Mr. Rocha said that the cost to date has been about $1-$1.5 million per month, but total costs for 2023 are projected at $26 million. Commissioner Morrison asked if the cost of the Asylum Seekers and the Undocumented could be separated for future budgets.  Mr. Rocha said that patients are not asked if they are in the US legally to avoid a chilling effect. on seeking care.  Some of the undocumented cost is covered by Medicaid and the rest falls under the Charity Care expenses line.
• Overall, commissioners were very complimentary of Mr. Rocha’s leadership and progress.  Commissioner Miller said that CCH has gone from being a model of reactive care to a model of preventive care.

Observer:  Diane Edmundson