It was an unusual display of emotion during an otherwise routine government budget meeting. On Thursday, Cook County Board Commissioner Alma Anaya told a packed room about her childhood experiences of “horrific violence in my own home,” as she pushed a new program to assist victims of domestic violence.

“I found myself, my teenager years, packing a bag and leaving with mom and my siblings, trying to escape the abuse,” said Anaya, the oldest of four children. “But often we found ourselves back in the situation and it was because … my mom had no resources. She had no connections. She had no family here in Chicago.”

The final time they left, her family lived in a car. They couch-surfed with family members. They lived in motels.

Later in the meeting, commissioners approved Cook County’s $6.2 billion budget for 2020, and included in it the pilot program Anaya pitched. The idea is to help domestic violence victims navigate the court system, including things like learning about orders of protection against alleged abusers. The budget takes effect Dec. 1.

Anaya wasn’t the only person to bring personal experiences to the board room. Consuelo Vargas, an emergency department nurse at John H. Stroger Jr. Hospital, pleaded with commissioners not to approve a budget with vacant nursing jobs.

“It doesn’t take a health care professional to see how cutting nursing positions in the ER will prolong wait times, how cutting trauma nurses will lead to fewer lives being saved, how fewer bedside nurses will lead to more preventable infections and bed sores,” Vargas said. “These proposed cuts are not only immoral because they hurt my patients, but they ultimately won’t solve the structural issues of the health system.”

Stroger is the flagship institution of the county-run health system, and one of two hospitals the county runs. The system, called Cook County Health, is leaving hundreds of jobs vacant to shore up its finances.

As the main medical safety net in the region, Stroger provides 51% of all the free care in Cook County to people who are poor or uninsured — without getting paid for it. This occurs despite county government running just two of the 68 hospitals in the county, state records show. It’s a swelling problem Cook County Health CEO Dr. Jay Shannon is racing to address.

In response to Vargas’ concerns, Shannon told commissioners the 2020 budget should have “adequate nursing positions” for the services patients need. He later said wait times in the ER have not increased despite Stroger having the busiest emergency department in the Midwest, with more than 100,000 annual visits.

The 2020 budget has no new taxes or tax hikes. The spending plan focuses on boosting equity in criminal justice, health care, public transit and jobs, particularly in the south suburbs. The 17-member county board overwhelmingly approved the budget.

Commissioner Sean Morrison, a Republican from south suburban Palos Park, was the lone commissioner to vote no.

“The 2020 budget continues to grow both the size and scope of the county government,” Morrison said. “This rate of growth in spending is not sustainable for the long-term fiscal health of our county, and it is not fair to Cook County taxpayers.”

He said the county’s operating budget has more than doubled since 2011. Some of the increased budget is due to Cook County Health launching a new Medicaid business in 2013. The health insurance plan, called CountyCare, now covers more than 300,000 people countywide.

The budget passage ended months of negotiating among Cook County Board President Toni Preckwinkle, commissioners and the elected and appointed leaders who run the public jail, courts, and health system, among other agencies. The health system and public safety combined make up about two-thirds of the total budget.

The budget commissioners approved is about $22 million more than the original proposal. A county spokesman said grants and money from a City of Chicago tax surplus would cover the bulk of the additional spending.

Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.