A nonprofit fiscal watchdog group wants Cook County’s inspector general to be more transparent, following a flap with the county-run health care system.
The Chicago-based Civic Federation, which analyzes government budgets and makes recommendations to improve their finances, suggests County Inspector Patrick Blanchard should be required to include responses from agencies he probes in the final reports he releases to the public.
But Blanchard says that could hinder his investigations, and his mission to root out waste, fraud and corruption in county government.
Civic Federation President Laurence Msall pointed to a recent months-long, expensive dispute between Blanchard and the county’s public health system. The volley followed a June report from Blanchard that criticized the system’s Medicaid insurance plan, called CountyCare.
Blanchard alleged CountyCare owed hospitals, doctors and other vendors around $700 million, and raised significant questions about the health system’s accounting practices.
His report included interviews with health system and county officials, but not their formal responses or explanations to his findings. A health system spokeswoman at the time said the government-run system, called Cook County Health, received the report less than an hour before it was publicly released.
“For the Cook County Board members trying to sort out who’s right, for the Cook County voters who are interested. People are trying to figure out what this really means,” said Msall, from the Civic Federation. “It’s an incomplete report to just have the allegations and not have the response of those people who have the involvement in that program.”
Cook County Health is one of the largest public health systems in the nation, with two hospitals and a network of urban and suburban clinics. It’s a medical safety net considered to be the last resort for poor and uninsured patients in Cook County.
Blanchard’s findings sparked anger and confusion among county commissioners. They grilled Cook County Health CEO Dr. Jay Shannon and his chief financial officer about the allegedly massive amount of unpaid bills. Commissioners questioned whether the health system should even be running CountyCare.
Commissioners were upset not just because they felt Cook County Health leaders left them in the dark about their finances, but because the health system’s financial stability — and that of CountyCare — is crucial to the county’s bottom line. The Medicaid plan has become a main money-maker for Cook County government. The health system’s budget makes up nearly half of the county’s overall roughly $6 billion budget.
Adding to the confusion, Shannon disputed some of Blanchard’s findings, but he did not provide an immediate and thorough defense. Instead, the health system hired the global audit and advisory firm Deloitte to analyze Blanchard’s report.
Finally, in September, the health system released Shannon’s detailed explanation and Deloitte’s findings. The firm, whose work cost the health system nearly $275,000, mostly vindicated Cook County Health.
During a public hearing with commissioners to discuss Deloitte’s findings, Shannon said he was “blindsided” by Blanchard’s report, and that it caused “significant and unwarranted reputational damage.”
Msall said both the city of Chicago inspector general and the Illinois auditor general are required to invite responses from agencies they audit as part of their final reports.
In an interview, Blanchard said he considers his public reports to be reviews and investigations, rather than audits. Per county code, Blanchard gives subjects of his probes 45 days to respond to allegations.
“If I started floating drafts to subjects, I think that inhibits the truth-seeking process” and could stifle investigations, Blanchard said.
But Msall said the code Blanchard cited in his report about CountyCare was for an investigation related to inefficient or wasteful management, not fraud or corruption. And so, Msall argues, Blanchard was allowed to issue public statements about it. Hence, his 21-page June report on CountyCare.
The Civic Federation’s recommendation about the county inspector general’s process was among several in the organization’s analysis of the county’s proposed 2020 budget, totaling $6.2 billion.
Any changes to the county code to shift how Blanchard’s office conducts probes would require Cook County Board approval.
Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.