The headline on the Cook County budget website reads: “The Cook County 2012 budget: How did we get here?”

And “here” includes an estimated $315 million dollar shortfall, which roughly equates to 10% of the county’s total annual operating budget.

“We’re in a tough spot, like governments at all levels,” said Cook County Board President Toni Preckwinkle during an interview with Eight Forty-Eight’s Alison Cuddy on WBEZ Monday.  “And we’re going to a have to make some tough choices between now and the middle of October when we have to submit our budget to the Board of Commissioners for action.”

The Board’s president refused to provide specifics about targeted cuts, but she has hinted that layoffs are possible and has maintained that she’s planning to go ahead with a partial roll-back of the county’s sales tax.

In the meantime, Preckwinkle says her budget team is working on the specifics of a plan, and they have “gotten great cooperation” from union leaders about ways to make county operations more efficient.

However, it’s unlikely that one of the efficiencies will be a merging of the county’s health services with the City of Chicago’s.  Some have suggested the two entities would be better if combined - and more efficient for taxpayers.

Chicago Mayor Rahm Emanuel’s administration has issued a request for proposals from firms seeking to run the city’s network of health clinics.  But Preckwinkle said budget constraints make it unlikely that the Cook County Health and Hospitals System would pursue the RFP.  “I don’t expect us to submit a bid,” she said.

The Health and Hospitals System is scheduled to hold the first of three public hearings regarding its preliminary 2012 budget on Monday night in Skokie.  The system, which operates independently from the county board, recently projected at $327 million dollar shortfall for next year, though Preckwinkle says her office estimates the shortfall to be closer to $240 million.

“I’m a great believer in independence, but they have to run it responsibly,” she said.

According to Preckwinkle, the system’s first budget proposal called for more money than last year, a request she quickly rejected.

“We have a $315 million shortfall [in the county], so there’s no way anybody’s getting more money than they did last year,” she said.

Audio of the complete conversation can be heard by clicking the link atop the page.

Music Button: Mocean Worker, “Swagger”, from the album Candygram for Mowo!, (Mowo! Inc.)