Cook County Health Board Pushes Back On More County Control
Updated 4:10 p.m.
The board that oversees the Cook County-run health system voted unanimously Friday to hold meetings behind closed doors with county leaders who want to take away some of their power.
The health system’s board chairman also called for an even bigger payout from county leaders to cover the increasing cost of treating people who cannot afford to pay for their care. The system, known as Cook County Health, expects to provide nearly $600 million in medical care this year that it will not get paid for. It’s among the biggest issues county leaders face.
Health board members want to talk directly with county leaders about their concerns over the broad new authority Cook County Board President Toni Preckwinkle and some commissioners want over the health system, at a time when the health system board is searching for a new CEO.
The briefings would be held with a few members of the Cook County Board of Commissioners at a time, to avoid violating the Open Meetings Act.
The tug-of-war is over what Preckwinkle and some commissioners perceive as not enough communication and transparency from the health system.
“I think the way we’re structured now is what good government looks like,” health system board member Bob Reiter Jr. shot back Friday.
“My concern is not about Toni Preckwinkle and what her influence or her interaction with the board is,” Reiter added. “But who the next county board president is, who the next slate of commissioners (are), because this ordinance gives a lot of power” to them.
Preckwinkle wants a direct appointee on the health system board who would likely be a county employee. Commissioners would approve everything from the job description for the new health system CEO to the person’s pay and potential severance deal. Currently the health system board has the final say on those items.
Reiter said he’s most concerned with Preckwinkle being able to appoint the board chairperson, instead of that person being elected from the board. The role would be up for approval every year. Reiter also wants to eventually take back labor negotiations — county health system employees are largely unionized — from Preckwinkle’s team. Reiter is the president of the Chicago Federation of Labor.
Health system board members were concerned Preckwinkle’s proposed changes would set a precedent — no matter who is in charge in Cook County — for more power over the health system.
“I believe that President Preckwinkle has a very strong investment and commitment in this system,” said board member Layla Suleiman Gonzalez. “But I don’t know what happens down the line. … I believe this begins to shift us from a government body to an advisory body. And I don’t think that’s an appropriate role for what we want to accomplish in this system. Once we go this far, coming back and kind of recalibrating, is going to be very difficult. … I think we would go back to a system where other influences are in play.”
The health system board was created in 2008 to take the politics out of running one of the largest public health systems in the nation. Cook County Health includes two hospitals, a network of urban and suburban clinics, and a Medicaid health insurance plan for low-income and disabled people.
Board chairman Hill Hammock said the proposed sweeping new authority for the County Board would hinder the health system’s ability to recruit and hire a new CEO.
“What it does not do is address the fundamental problem of this system,” Hammock said of the plan Preckwinkle pitched earlier this month.
That problem, he said, is the nearly $600 million tab Cook County Health expects not to recoup this year for treating the uninsured and others who can’t or won’t pay their medical bills.
“It is not realistic to think that by having a more efficient operation of this system we are going to become self-sustaining,” Hammock said. “We are going to continue and need to have more dependence of the county, and more financial dependence of the county, and I don’t think any of the steps here have anything to say about that, other than we’re going to talk more.”
The health system this year received $112 million as a subsidy. But that mainly goes to help fund the county’s public health department and medical services at county correctional facilities. The health system also infuses $29 million of the subsidy into employee pensions, a spokeswoman said.
All of these proposed changes came after a rocky year for Cook County Health. The health system eliminated hundreds of vacant jobs to fill a budget gap heading into 2020. Then, the system’s board opted not to renew CEO Dr. Jay Shannon’s contract after five years at the helm.
County commissioners want more input into Cook County Health because its financial health is critical to the county’s overall $6.2 billion budget. The health system makes up nearly half of the total county budget.
A spokesman for Preckwinkle did not immediately comment.
Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.