Less than five weeks from the November general election, Cook County Board President Toni Preckwinkle has good news for taxpayers and voters alike: There are no new taxes or tax hikes in her proposed $8.75 billion budget for 2023.
Preckwinkle is offering bold spending plans, thanks to roughly $1 billion in federal COVID-19 relief money the county has to spend over multiple years. But she needs workers to pull these plans off, and faces more than 4,000 vacancies. She also wants to hire more than 200 additional employees.
Many of the vacancies are at Cook County’s public health system, which aims to expand services. But like other hospital networks across the nation, the county is struggling to retain and recruit nurses and other medical providers who have burned out or are in search of better working conditions more than two years into the pandemic.
“On one hand, we’re trying to do a bunch of new and different things,” Preckwinkle said during a briefing with reporters on Wednesday. “On the other hand, we’re in the midst of a staffing crisis in health care more broadly.”
Preckwinkle unveiled her proposed budget on Thursday to the Cook County Board of Commissioners. The annual event comes as Preckwinkle seeks a fourth, four-year term. In fact, the entire board, which must approve the budget, is up for reelection, though some commissioners have opted not to run again or can’t run after losing in the June primary election.
During her budget speech Thursday, Preckwinkle sought to reassure anyone who lacks trust in government in light of major issues facing the nation, such as racial reckoning, a lethal pandemic, or the state of democracy as elections loom.
“Shirley Chisholm once said, ‘You don’t make progress by standing on the sidelines, whimpering and complaining,’ ” Preckwinkle said of the first Black woman elected to Congress. “‘You make progress by implementing ideas.’ Here’s how we’ve embraced that.”
She laid out how the county would continue to roll out initiatives fueled by its Equity Fund Taskforce and buoyed by federal pandemic dollars. She noted how her speech came on the same day Cook County began accepting applications for a guaranteed income pilot program, which she aims to eventually make permanent.
“We’re working towards a more just, prosperous and equitable future,” Preckwinkle touted.
Cook County is one of the biggest counties in the U.S., with a vast circuit court system, jail, public health system and large Medicaid health insurance plan called CountyCare for low-income and disabled residents. The majority of the county’s budget goes to public safety and health care.
Preckwinkle’s optimistic financial roadmap with no new taxes or increases was expected. In June, she said these tools would likely be off the table in 2023. Last month, commissioners even eliminated a tax — the so-called wheel tax — effective next year. This tax acted like a vehicle sticker, charging a fee to unincorporated Cook County residents every year to register their vehicles. Preckwinkle argued the tax was regressive and disproportionately impacted Black and brown residents who could least afford to pay.
Preckwinkle’s proposed spending plan is packed with programs and initiatives to make Cook County a more equitable place to live and work.
“We’re working hard to make this budget not just responsible, but transformative,” Preckwinkle said during her Wednesday briefing.
There’s $71 million to provide $10,000 grants to small businesses, and $42 million for the guaranteed income pilot program, where 3,250 households would get $500 a month for two years. Another $14 million aims to expand a program that helps provide housing for patients and hire more behavioral health specialists to support homeless patients, among other needs.
The list of county initiatives goes on. More money to boost economic development, erase medical debt, hire more attorneys and social workers to implement new rules related to the Pretrial Fairness Act, and invest in technology to get property tax bills out by the end of the year.
Those property tax bills are already projected to be months behind, which has created a ripple effect — revenue the county relies on will also be late. The county plans to cover that gap with cash, then pay itself back when the tax bills are finally paid, said Dean Constantinou, Cook County’s deputy chief financial officer.
During her speech, Preckwinkle touted the county’s financial accomplishments. The county is on a path, she said, to fully fund pensions by 2043.
“This is something not a lot of governments can say,” Preckwinkle emphasized.
She previously expected to enter 2023 in the red by $18.2 million. But county financial leaders now say the government is projected to generate more revenue than officials thought, including $124 million in additional sales taxes, which helps eliminate the projected gap.
Sales tax is the largest money-maker for the county. Constantinou ties the forecasted rise in extra sales tax revenue to inflation. Goods and services cost more, which means people are paying more sales tax that the county collects.
Still, this silver lining could be a cautionary — and costly — foreshadowing of challenges ahead.
“Absolutely, we’re worried about a recession,” Constantinou said. “We’re always concerned about a potential recession.”
In the coming years, the county expects deficits from the health system ranging from $61 million in 2024 to $39 million in 2027. County leaders partly attribute this to likely losing thousands of enrollees in CountyCare when the state once again requires people to renew their health insurance coverage. This process was put on hold during the pandemic, and Medicaid enrollment swelled.
The county could lose money as CountyCare enrollment declines because the insurance plan is paid per member. CountyCare now has around 426,000 members, and is projected to lose some 56,000 enrollees by this time next year.
The debut of the proposed 2023 budget kicks off a series of public hearings, when everyone from county residents to appointed and elected officials can weigh in. Virtual hearings where residents can comment are scheduled for Oct. 13. Commissioners are slated to vote on Nov. 17. If approved, the new budget takes effect on Dec. 1.
WBEZ’s Kristen Schorsch covers public health and Cook County government. Follow her @kschorsch.