CCHHS Takes Another Look at the Strategic Plan

November 5, 2009 Meeting of Cook County Health and Hospitals System Board

During the public comment period, a nursing representative spoke regarding the issuance of 100+ layoff notices to nurses. She claimed that management had not provided a list and that there was a data problem regarding seniority. The nurses look for a process that is fair and accurate. She also challenged the patient/nurse ratio used in determining staffing.

Chairman Warren Batts, while looking at other systems, reviewed a report on Grady Hospital in Atlanta and the recent improvements achieved there over a two year period. Grady hospital is now part of a 501(c)3 Foundation that permits community investment, diminishing its dependence on County support, and staffed by the medical schools of Emory and Morehouse Universities. The Board received a complete report.

CEO William Foley reported that the Performance Improvement final report from Navigant Consulting will be ready for the next meeting in two weeks. Some consulting expertise will be required to implement it and an RFP will be channeled thru the Finance Committee for review.

The Board and management noted that the Strategic Plan needs refinements. After a huge response at the meetings of the public and employees, it was clear that proposed locations, transitions and partnerships need further examination, in conjunction with financial projections. The 3-year financial plan needs to be extended to 5 years. The goals remain intact but there must be analysis of hub-sites. Advisory groups, including patients, need to be engaged for input. The Board will be asked to approve the concepts and time lines at the next meeting.

A late addition to the agenda brought a proposal from the Director of Facilities Management for the County to consolidate CCHHS employees in trades and engineer positions with the County roster. Layoffs might be better absorbed by moving the affected employees to openings throughout the County as needed. It would mean transferring this line item in the CCHHS budget to the Corporate budget. The facilities management director said it would streamline capital planning and regulatory compliance. Board members questioned attention to diversity. The proposal was referred to the Finance and HR Committees for further discussion.

Committee reports were accepted and the Board adjourned to Executive session to hear issues regarding employees, litigation and collective bargaining.


--Submitted by Observer Nancy Staunton

Status of the Cook County Budget Review

The Finance Committee is on track to complete the meetings with the individual elected officials and department heads to discuss the proposed 2010 budget by Monday, November 9.  Chairman Daley said on Nov. 3 that amendments to the proposed budget are due by November 12 from the Commissioners for the “amendment book” that will be distributed prior to the meetings to vote on budget amendments.  However, Commissioners may still offer amendments during these meetings (termed “floor amendments”).  Commissioners are expecting to vote on the budget prior to Thanksgiving, or about one month after receiving the proposed budget from the President on October 22. 

--Submitted by Observer Pris Mims

CC Board Finance Committee, Budget Review of County Assessor, November 3, 2009

Cook County Assessor James Houlihan explained that he is seeking a $3.5 million increase over the 2009 budget, with the increase primarily due to wage increases. The number of employees would remain the same. Mr. Houlihan understands that the Board may decide to reduce his proposed budget by 5% if there is an across the board reduction, but he said that the resulting reduction in employees would slow the work of his office. Mr. Houlihan urged the Board to consider the resulting costs. He said that each day that property tax bills are delayed costs the county $50,000 in interest, not to mention the negative effect on local taxing bodies which may need to take out short term loans when bills and resulting payments are delayed. He said that delays this year have been caused by the number of appeals to proposed assessments, as well as the complications in processing 8 different exemptions for over 1 million parcels. Some of these exemptions, such as the senior freeze, are income tested, and are particularly difficult for his office to process, as well as requiring annual filings that have to be reviewed.

Assessor Houlihan explained that there were several reasons why so many property tax bills that have just been received reflect an increase. A number of the taxing bodies increased their levies for 2008. The 7% cap is also being phased out and that is reflected in a lower homeowner exemption than would have otherwise been applicable. Finally, for parcels in the south and western suburbs, the bills reflect a higher reassessment that went into effect for 2008, which was at the height of the property boom. The Assessor is in the process of lowering assessments for 2009 due to the fall in market value, but that does not affect the assessment for 2008. Remember that we pay property taxes one year late. This year’s bills are for 2008.

However, he said that the higher state multiplier that is reflected on the bills does not impact tax bills. The multiplier is used by the State to equalize assessments across all counties for purposes of determining the amount of school funding from the State. The State uses a multiplier for Cook County because it is the only county that classifies property (recently changed to 10% of market value for residential and 25% for industrial). Other counties assess at one-third the market value across the board, said Mr. Houlihan.

Assessor Houlihan says he supports the consolidation of the areas in the county involved with the property tax process in order to streamline the process, though he thinks that the cost savings will be negligible.

--Submitted by Observer Pris Mims

CC Board Finance Committee, Budget Review of Cook County Board of Commissioners, Nov. 3, 2009

Each Commissioner’s budget and that of the Board Secretary were included in this review.  There was discussion that the Board Secretary’s budget should be reduced by at least 5% from 2009.  Commissioner Silvestri said that he thinks it is wrong that he and 6 other Commissioners have reduced their budgets by 5% from 2009 in accordance with the President’s request, while 6 others have proposed increases and 4 have stayed the same.  Further he noted that he and only some of the other Commissioners reduced their budgets by 4% last year in compliance with an across the board reduction.  While in the ensuing discussion, no individual names were used, the proposed budget reflects that Commissioners Collins, Sims, Murphy, and Reyes have sought increases (ranging from $24,000 to $50,000); Commissioners Steele, Beavers, Moreno, Suffredin, Peraica, and Gorman  have essentially held their budgets the same or with negligible increases (less than $5,000); and Commissioners Butler, Silvestri, Gainer, Daley, Claypool (who is not running for re-election), Goslin, and Schneider have all reduced their budgets (ranging from $17,500 to $28,000).

Commissioner Schneider, who is in his first term, said he recognized that the Commissioners will not have the same budgets because longer-serving Commissioners will have longer-serving staff who, in accordance with county practices, will have higher salaries.

--Submitted by Observer Pris Mims