Once again a gradual repeal of the 1% county sales tax was proposed. Surprisingly, it was sponsored by Comm. Moreno, who had voted against repeal numerous times previously. He indicated it was the right thing to do, his constituents wanted the repeal, and his primary election loss was partly due to his previous support of the sales tax. This proposed ordinance, however, was once again defeated (7 to 10), although for different reasons than before.
CFO Ayers of the Health and Hospital System (HHS) reported on the hospital revenue shortfall. There has been a reduction of volume of services at Provident Hospital resulting in a 60% decline in patient fees. He indicated this hospital is not being used effectively for patient services. Initiatives have begun to get Medicaid to pay for more procedures and to have a better billing system for insured payers. A system to better collect Medicare co-pays is also in process.
Comm. Collins proposed an ordinance allowing the Health and Hospital System to become completely independent of the County Board and allow it to levy its own taxes. Numerous reasons were given for voting against this: too many taxing bodies already exist in Cook County (over 1,600); HHS Board is not elected and so would not be accountable to taxpayers; this is premature in that there is no system currently set up for future board selection. The proposal failed , with only 6 commissioners voting in favor of it.
The quarterly report by HHS CEO Foley was presented. Among the findings: increase in numbers of people using county clinics and hospitals (up 14%). He stated that better staffing, record-keeping, and configurations of clinics would mean less use of expensive emergency rooms and shorter wait times for appointments--currently a 4 month wait for mammograms. Hub clinics incorporating mental and dental health need to be developed and partnering with outside hospitals would provide better and less costly health care for residents.
As far as funding, he requested that money saved by HHS should remain with HHS instead of going into the general fund of Cook County as is currently done. More consistent funding from the County is needed for better planning and "enterprise funds," as in the California health system, are being investigated. Improvements to the HHS include internal auditing, greater efficiencies, enhanced revenue collection and more federal funding.
With regard to staffing, Foley stated that management needs streamlining, workforce needs rebalancing (having the right kind of staff for the services provided), and more positions need to be eliminated. This will provide a $70 million savings. The graduate medical training program (doctor training) will be evaluated for cost v. benefit.
