Some Contentious Issues at Sept. 20th Board Meeting

All board members were present except commissioners Suffredin and Steele. Fifteen to 20 minutes of the meeting were taken up with resolutions and commendations honoring work for the county, birthdays, etc. Parts of the meeting were difficult to follow as last minute items appeared with no way for the audience to know their topics since we were not given copies, nor were they adequately summarized for the observers.

Comm. Fritchey brought up the monitoring of Special Purpose Funds, calling them "shadow budgets." Another special purpose fund was approved for the Clerk's Office for automation, but much of it would not actually provide for any automation.

The County now has a new head of Homeland Security and has made an agreement with Johnson Controls to take out the equipment from patrol cars that has been installed over the past several years, due to its malfunction. There was no indication at this meeting what the cost would be and who would pay it.

A discussion centered on the process and cost of the Taleo computer system which is used to screen applicants for jobs in the county. Comm. Sims felt it was too restrictive in screening and that department heads should have more discretion on applicant qualifications.

Comm. Gainer bought up the need for an outside construction manager for the large capital construction underway in the county. It was pointed out that the county is not able to determine if construction is done correctly due to this lack of professional oversight. This will be done once bids are requested and approved, which is taking longer than desired.

Two issues frequently discussed at board meetings came up again. The bi-monthly Human Resources reports were questioned by many commissioners. Issues were the large pay raises given to many employees--some in the 20-25% range. During the budget hearings, the department heads will be asked to justify these raises.

Second, was questioning of the Purchasing Dept. as to why contracts are still being extended rather than being re-bid. Lourdes Koss, head of Purchasing, stated the department is working on reorganizing and so these extensions should end.

Karin Norrington-Reeves, head of the Bureau of Economic Development, reported on the status of job training programs. The County will no longer be a direct service provider for this, but rather will only administer. Private agencies, such as the Chicago Federation of Labor, have been hired to provide training for recently unemployed adults and career development for school-aged children. Comm. Gainer asked for reports on the effectiveness of these programs.

There was a contentious discussion about commissioners and their staffs taking the required 10 furlough days, which was voted on, with no relevant amendments presented, in the last budget. Comm. Fritchey was upset that his report was very inaccurate, leading people to believe his office wasn't complying. Several commissioners (Collins, Beavers, Sims, Murphy) have refused to comply in taking the pay cut through furlough days. President Preckwinkle and Comm. Schneider stated that it sets a bad example for the other 23,000 county employees when the commissioners themselves do not follow the requirements. Other elected offices have also not complied with furlough days (that need to be taken by the end of this month) and Preckwinkle hinted that this non-compliance may be reflected in their budget approvals this coming year.

Cook County Board Meeting September 7, 2011

The meeting was called to order at 10:10 a.m. by President Toni Preckwinkle. Finance Chair, John Daley, immediately requested that #8 on the Agenda be removed from active discussion and read into the record. This was a Resolution calling for the joining of the national moment of remembrance of the 10th Anniversary of the September 11 terrorist attacks beginning at 1:00 p.m. The resolution was unanimously sponsored, and Chair Daley's request was passed and read into the record without discussion.  Several Commissioners spoke to the approved resolution and the national tragedy.

The following major issues were discussed and voted upon:

1. Procurement Code Changes
2. Vehicle Policy
3. Dental and Medical Plans
4. Budget Review
5. Cannabis possession
6. Immigration and Customs Enforcement (ICE) Detainees

Health and Hospitals System Special Board Meeting - September 16, 2011

The HHS Board met in a special meeting to discuss the proposed 2012 HHS Preliminary Budget. Dr. Mason, Interim CEO, began the presentation by stating that the budget that has been prepared to present to the President has proposed revenues of $315m less than proposed expenditures. Since this will need to be justified to President Preckwinkle and the CC Board he outlined the core goals from the Strategic Plan that provide the basis for the proposed budget. Dr. Mason stated that the system intends to continue to shift from an inpatient model of care to an outpatient model and work on employee satisfaction issues.

Since personnel is a significant part of the budget the number of positions in the budget became the focus of discussion. At the present time there are 839 vacant positions - which are being left in the budget - and an additional 343 positions are being added across the system. In the budget as presented these positions are budgeted at 0.2 FTE for salary purposes. Dr. Ansell wanted to understand if this meant that the intent was only to fill 20% of these positions. Dr. Mason stated that the amount for salary to fill these positions was $12.9m and that was the limit for hiring for vacant positions. Director O'Donnel wanted to know what the prioritization was for filling vacant positions, which led to a discussion of whether money was determining the direction of the system or there really was a strategic plan that determined how to allocate money to execute the plan.

Mr. Carvalho then made what he felt were introductory remarks that probably should have started the meeting. He stated that the budget process this year is on a different timeline than it has been in the past due to several transitions - a new CC President, a new HHS CEO, a different menu of taxes for funding the county, and the desire to approve the CC Budget prior to the beginning of the fiscal year on December 1. HHS budget personnel have been working with the President's office to establish a timeline so the President will be able to pull together her proposed budget to present to the CC Board. What is being presented at the meeting is still a work in progress that will continue to be refined. Three public hearings are scheduled for next week and this budget is being presented to the commissioners at their next board meeting for comment.

Mr. Ayres, Interim CFO, presented these comparison summary numbers for the 2012 budget:

Proposed budget for 2012

Appropriations $937.6m Revenues - $610.0m Difference ($327.6m)

Budgeted in 2011

Appropriations $911.8m Revenues - $638m Difference ($273.8m)

Actual in 2011 (anticipated)

Appropriations $911.8m Revenues - $548m Difference ($363.8)

There was also discussion of the Price/Waterhouse/Coopers contract which is due to end in June of 2012. In the 2012 budget it shows as an expense of $17.5m. Dr. Mason stated that most deadlines for replacing PWC had been missed and there was a definite need to plan for what will happen when their contract ends and the county needs to perform the duties that this contract has provided for.

Dr. Mason further stated that there is a fundamental problem in HHS handling their mission of providing care to all and being fiscally responsible, for there is no such thing as "free medical care", and providing free care to those who cannot afford to pay will continue to be a challenge.

Mr. Batts, HHS Board Chairman, wanting to wrap up the 2 hour discussion, stated that while this was not a budget that the board was happy with it was perhaps the best that management could do at the present time. Mr. Carvalho then made a motion that the board approve the following process for moving forward with the budget process:

1. Present the budget as they have it now as the Proposed 2012 HHS Budget to the CC Board on Sept. 20 at their board meeting for comment
2. Hold 3 public hearings on this proposed budget next week as scheduled to get public comment
3. Vote on a final revised version of the 2012 Proposed HHS Budget at the HHS Board meeting on Sept. 28
4. Submit the final version of the 2012 Proposed HHS Budget to the CC Board for their approval at the October 4 CC Board Meeting

The motion was approved with Director Golden voting present. Mr. Carvalho stated that the HHS budget needs to be completed before the President can proceed with the rest of the budget process. The meeting adjourned at 10am.

Cynthia Schilsky

LWVCC Observer

Forest Preserve Commission Mtg. Sep 8 2011

This meeting almost always begins with a meeting of the Finance Committee, and today was no exception. There were a number of contracts approved. Nothing controversial. The good news is that quite a bit of money is coming in from federal funds in the context of the Great Lakes Restoration Initiative. It comes thanks to the involvement of the US Fish and Wildlife Service and the Friends of the Forest Preserve. Monies come from grants from the federal government, there are no explicit outlays from local governmental untis, but the grants are"matched" by staff and volunteer time organized through the FP and the FOTFP. People are put to work doing restoration activities in areas where the need is greatest. A number of these sites are down in the wetlands in the Calumet area.

For the general meeting, there was an announcement of upcoming Public Lands Day Sep 24, 2011. Also, Benjamin Cox of Friends of the Forest Preserves spoke as an invited guest about the improvements in care and relations with regard to ecosystem care.

There is an ongoing mess in regard to Journals of Proceedings of the Forest Preserve Commission for meetings held between 2005 and 2010. Records were not kept properly and omissions were made. This is being dealt with in the Rules Committee but it looks like we will never have perfect records from that time period and the Board cannot guarantee the "accuracy, legality, reliability or content of any of the information contained herein...."

There has also been some activity, which is in conformance with FP guidelines, toward acquiring contiguous land. This is ongoing and was one of the initiatives that President Preckwinkle put in her budget to take strategic advantage of the current low land-price environment.

The meeting ended about one hour after it started.

Cook County Health and Hospitals System Board Meeting - August 26, 2011

The Cook County HHS Board Meeting was called to order at 7:40am by Chairman Warren Batts. Public speakers presented concerns with inadequate nursing staffing, need for restoration of dental services, concern over the termination of 34 Mental Health Specialist 3 positions at Cermak Hospital, and concern over the closing of Oak Forest Hospital.

Mr. Carvalho, Chairman of the Finance Committee, indicated the proposed 2012 HHS budget that the board needs to present to President Preckwinkle for her Executive Budget is not yet complete, and therefore not ready for approval by the board at this meeting. He also stated that Mr. Ayres, the CFO for HHS, has resigned effective the end of August. A contract for Mr. Ayres services on a part time basis for 3 months to facilitate the transition to a new CFO was presented for approval. After some discussion of the reasons for offering this contract, the vote on the contract was deferred until further discussion in closed session.

Mr. Batts stated that he had attended the Certificate of Need hearings concerning the closing of Oak Forest Hospital and praised President Preckwinkle for her commitment to facilitating the process for finally getting approval for the closing. The opening of the Specialty Care Clinics at Oak Forest is scheduled for Sept. 1 and he stated the board would need to follow up on how the change in operation of Oak Forest impacts health care in the southern suburbs.

Dr. Mason, interim CEO, distributed copies of the STAR Report that was submitted to the President's office. He explained that it was part of the President's push for performance management and they will be held accountable by the President's office. HHS will also need internal meetings on how to meet the metrics that have been established. The report includes 95 measures which the Boston Consulting Group helped to define. Mr. Carvalho raised concerns about the measures used which led to a discussion among the board members on what should be measured and how to go about doing that. This also included discussion of how to use consultants, what is involved in standards for patient safety and quality control, and what is the future of health care in Cook County and how is it planned for.

Dr. Mason also announced that a RAMA (Random Area Medical Access) Event was held at Malcolm X College on Aug. 19-21. This was a free medical clinic sponsored by an outside group with assistance from Cook County. About 2000 people were seen and provided with optometry services and glasses, dental services, primary care and women's health services.

Mr. Ayres presented his report on the difficulties in presenting a balanced budget for HHS. There are supply chain problems that include an inability to fill open positions. Operations problems include the challenge of managing overtime due to inadequate staffing and the silo reporting structure within the system results in inefficiency. The fundamental problem as he sees it is the payor mix. If you take care of people who are unable to pay, the money has to come from somewhere. Again there was discussion of the use of contractors and how they are used, instead of having Cook County employees do the work that the contractors are doing. Dr. Ansell suggested that they need to spend more time discussing this issue.

At 9:50 the board went into closed session for discussion of human resources issues and returned to open session at 11:05am. Upon returning to open session they voted on Mr. Ayres contract which was approved. The meeting adjourned at 11:12am.

Cynthia Schilsky, Observer