Health and Hospital System Board Meeting November 14, 2014

Called to order at 8:00 a.m. by acting chair Jerry Butler.  Two new board members, Ricardo Estrada and Emilie Junge, were in attendance. 

Committee reports:
Doreen Weise reported that Gladys Lopez had provided a report on numbers and placement of new hires but did not share the specific information with observers.

CEO Dr. Jay Shannon reported that 3300 staff now have flu vaccination; Sen. Durkin and CC President Preckwinkle will host a roundtable on the ACA at Erie Family Health Center; community health workers will be trained at Malcolm X College, though their role has not yet been clarified; Patrick Kennedy is spearheading an effort to raise awareness and remove the stigma associated with mental health treatment; one new patient with ebola will be treated at the University of Nebraska; there is now ebola in Mali.

CEO of Ambulatory Services Debra Carey explained that 2 RFPs will be issued to upgrade the central medical campus, including Fantus Clinic, Stroger Hospital, Pasteur Park, the power plant, the Polk Admin. building, the old Cook County hospital, parking garage, and existing Core facility.  The first goal is to address core clinical needs, with an RFP to be issued November 24 to replace Fantus Clinic*, the Polk Building, parking, and provide amenities like food service.  A tour/bidders conference will take place December 16.  The second RFP will be issued December 18 to develop real estate that can yield revenue for the County, with a tour/bidders conference January 9, 2015.

*Fantus Clinic encompasses 60,000-80,000 square feet, with 244,000 annual visits, providing a general medicine clinic, ambulatory screening, gynecology, psychiatry, pharmacy, pediatrics, and a laboratory.

Legal counsel Raymond Johnston reported that most planning is budgeted for and goes through the Office of Capital Planning. If the state of Illinois' 1115 Waiver is successful, federal funds will assist.

Peter Daniels, COO of Hospital-Based Services, reported that an assessment of existing facilities is
ongoing, along with an inventory of special needs, staffing requirements, and collaboration with Cook County's office of capital planning and real estate to review space allocations, administrative support, and parking plans.

Ideally, final responses to the RFP will be submitted by May 2015, a review in summer, shovel in the ground by the end of 2015, an 18 month to 2-year timeline for the project.

Board member Wayne Lerner cautioned that these projects most often take longer; a 2019-2020 timeline might emerge, and CCHHS should look to what the needs might be then, what the inpatient population might be several years from now, and to plan for future space and IT needs.  He suggested that the CCHHS board should have an opportunity to review ongoing plans, and to provide some oversight. "Duly noted," acting chair Butler responded.

The meeting adjourned to closed session at 9:30 a.m.

submitted by Linda Christianson

Proposed 2015 Cook County Executive Budget: October 27, 2015 Public Hearing at Skokie Courthouse, 5600 Old Orchard Road

The following Commissioners were present at the public hearing: Moore, Goslin, Steele, Daley, Suffredin and Silvestri. This was the last opportunity for members of the public to provide comments on the proposed budget. The courthouse was full. There was a mixed reaction to the budget, below is a summary of the testimony.

There were several speakers, including church groups, a member of the McGaw YMCA in Evanston, and representatives from the Erie Health Clinic, that were supportive of the budget levels and the care that they receive and are provided by different centers in the Health and Hospital Systems.They believe that programs such as Access to Care, in partnership with County Care provide a needed service to people who are underinsured or with no insurance. Commissioner Suffredin commented that these programs were very important and that the Board will continue to support them. There was a speaker from Women’s Business DevelopmentCenter who also voiced support of their continuing partnership with Cook County.

Several speakers from church groups and Illinois Collaboration on Youth asked for a $1 million grant to support programs to combat violence in Cook County. There is a need for more community based programs in support of alternatives to incarceration of minor offenses, programs to help youth and initiatives to stop gun violence. In addition, there is an urgent need to reform the criminal justice system.

The National Nurses Association raised issues of the closure of several health clinics and felt this was a bad policy and has an impact on patients.  The patients now face extra costs to get to clinics that are not in their neighborhoods. In addition, nurses are worried that because of the closures, people will not go to clinics to receive proper immunizations, STD services, and care for women and children along with other services. It was also stated that there is concern for those clinics in courthouses. The process of entering a courthouse can be scary to some, especially undocumented people.

Submitted by Nancy Marcus

Cook County Departmental Review meetings for 2015 Budget

Cook County State's Attorney Anita Alvarez

Ms. Alvarez spoke on many accomplishments and steps taken in her office over the past few years.  These are especially concentrated in diverting low level offenders to other programs and situations rather than extensive jail time.  These include the following:

• Proposed legislation that would shift resources from lower risk offenders to those with a higher  propensity for gun violence.  This would reduce criminal class and penalties for low level marijuana and theft crimes, but increase penalties for illegal, repeat felony gun offenders.  Possession of less than 1 oz. of marijuana for the first two arrests would be a petty offense and only with the third arrest would a misdemeanor be charged.  Also mid-level possession and delivery would have lower felony penalties.
• Field testing for drugs at the charging stage (when officers arrest) would have a pilot program started with the Chicago Police Department.  This would alleviate caseloads at the state police crime lab and also expedite narcotics cases and decrease time in custody for cases that are dismissed.
• More cases have been dismissed under felony and misdemeanor deferred prosecution programs (felony-800 dismissals and misdemeanor-1,000 dismissals).  An expanded pilot program will begin at the Markham courthouse.  These programs will use a validated risk assessment to determine eligibility for deferred prosecution.
• A new program to provide services (for homelessness, mental illness drug abuse) for those in engaging in prostitution will be started.  Since there is no longer a felony penalty for this crime, (state law change) some of these services were recently eliminated.  Now the services will be available with out the felony guilty sentence.

Alvarez is advocating best prosecutorial practices (from the Atlanta National Conference of Prosecutors) with regard to gang violence reduction; illegal weapons trafficking; the link between mental illness and gun violence; and the connection between domestic violence and gun violence.

Community Justice Centers have been a priority for the State's Attorneys Office.  They have proved to be very successful in reducing certain categories of crime (murder, sexual assault, aggravated assault).  These four current centers are designed to help solve crime problems in the community, not just arrest and prosecute.  A University of Chicago study last year supported these centers as an effective strategy to prevent and address crime.  The centers are very cost-effective, especially on the north side.  Alvarez has asked for more funds to start more of these centers, but no additional funding was provided in the Budget.

Three additional state's attorneys to expand diversion programs in the criminal division are provided in the budget.

Other points brought up during questioning by the Commissioners include the following:

• Technology integration is not going as fast as it should, but has speeded up in the last 10 months. This is run through Clerk Dorothy Brown's  ICJS Program, which attempts to bring more efficiencies to the Court system.  There is currently no wi-fi in the suburban courtrooms so all data and information must be done by hand.
• There has been a decrease in cases over two years old.  Currently 1200 cases have been in process for 2 years or more.  This is mostly in the southern part of the county due to an increase in cases and a languishing of cases by some judges.
• The Bond Court Initiative has identified defendants eligible for diversion programs and I-Bonds. The average days in custody have decreased from 40 to 17 due to this program.  These diversion programs have saved almost $2 million and prevented criminal backgrounds for many offenders.
• Gun violence is a top priority for this office.  This is not just a Chicago/Cook County problem, but is in all major metropolitan areas.

Inspector General Patrick Blanchard

The Inspector General's Office has the job of uncovering fraud, waste, public corruption and investigating misconduct and unlawful political discrimination (Shakman patronage issues).  There are currently 18 employees in this office.  Mr. Blanchard was just re-appointed for another 6-year term by the Board of Commissioners.  There has been an 18% increase in complaints brought to his office in the past year; this is up 40% from when this office began 6 years ago.  There are currently numerous indictments in process throughout the county government. There is litigation concerning ethics laws going on now in the Assessors Office.  The Health and Hospital System is also 

covered by this office.

Most of the questions and comments by commissioners related to referring candidates for jobs or internships within County government.  There was a lot of concern that political hiring ordinances, which were approved by the Board of Commissioners, might have gone too far and prevent commissioners from recommending good, potential job candidates.  There was a wide variation among the commissioners as to what should be appropriate input in job referrals.

Other issues brought up concerned security of e-mail in the Inspector General's Office during investigations and  statute of limitations on prosecutions (relating to shady vendor contracts).  Most commissioners seemed quite pleased with the work of this office.

Public Defender Abashi Cunningham

The Public Defenders Office has 683 total employees.  The new budget increases the employee count by 10.4 employees, but an additional 15 employees beyond this is requested by Mr. Cunningham.  In answer to a commissioner's question, it was stated that 35% of employees are African-American.   He said that at any given time, 5% of staff is on leave for FMLA and other related issues.  The Public Defender would like additional funds beyond what was provided in the President's Budget, stating that spending more on additional attorneys would save the county money in the long run and defendants would spend less time in jail.

Departmental Review Meetings for the 2015 Budget, October 22, 2014

BUREAU OF TECHNOLOGY

Simona Rollinson, director of the Bureau of Technology began by explaining what her department did. She stated that her department was responsible for the County’s data center, wide area high-speed network, office technology and phone and wireless devices. They also plan, develop and manage software applications, websites and geographic information systems (GIS) to improve workflow process in County offices and meet County residents and business needs for simple responsive transparent and cost effective government. Some of their recent accomplishments include:

• Implemented County-wide email systems
• Installed a jail inmate phone and broadband system and integrate technology to manage criminal justice system
•  Designed and implemented a video conferencing network to improve communication with municipality
•   Reduced telephone cost by reducing the total number of telephone system 
•  Improve property

Some of the issues facing this department are the cost of maintaining Technology and improving Technology. The concern is that by the time they bid-accept and implement systems they are outdated and the maintenance cost of these systems is high.  The cost of consultants in particular has made the cost of maintaining and improving technology very expensive. Disaster recovery system is also very costly. It was suggested that they look into consulting with smaller firms instead of the larger companies.

Commissioners Suffredin, Gorman and Sims all expressed frustration with the Bureau of Technology. They feel that money is allocated to purchase new technology and by the time it is ready to go it is outdated. There has been a lot of turnover in the job of director and all the new directors have asked for more money to improve services but the Commissioners do not see that services have improved. Commissioners suggested that top IT people should be brought in to help with the system with better cooperation from all departments. Commissioner Gorman wants a chart of the past, present and future needs of technology. 

SHERIFF'S DEPARTMENT

Sheriff Tom Dart stated that as of today there are 11,677 people incarcerated at Cook County Jail, the average amount is 9,000. 38% of those incarcerated suffer from a mental illness. There are 1700 on electronic monitoring with 70 of those not having a place to go. There is a need to increase the amount of beds and the department is working on this. The biggest issue is that many of these people cannot pay the bond and have no place to go due in part because many of these people suffer from mental illness.

There has been a decrease in the number of employees hired and there is a need to consolidate courthouses especially the old ones like 51^st & Wentworth and Harrison & Kedzie.  By consolidating these courthouses they will save money, provide better security and better services. Sheriff Dart is pleased with the program of using detainees with minor offenses to teardown abandoned houses.

Sheriff Dart stated that they are in a good position with staff, however, there is an overtime issue that has some concern. Overtime is expensive. The issue is more prevalent with employees of the Department of Corrections. They call in sick more often than those of other departments.

Commissioner Suffredin asked if Sherriff Dart will see an issue if the Pension Bill is passed.  Andrea Gibson from the Sheriff Department budget review stated that they are preparing for if bill passes but no extra money has been set aside.

In technology, the Sheriff’s Department purchased a new computer system and is working with local police departments to have them join this system. This system is a cooperative system that will allow the Sheriff’s Department to share information on criminals, etc. with local municipalities. 

CLERK OF THE CIRCUIT COURT

Clerk Dorothy Brown stated that the Clerk of the Circuit Court serves the citizens of Cook County and participants in the judicial system in an efficient, effective and ethical manor. There were 4 key items that the Clerk’s office strived to do:

11.  21^st Century information technology

·         Website that is easy to use and clearly organized

·         Online traffic ticket system

·         An online interactive court system connecting Judges, State’s attorney, public defender to allow them to file online and to send records

·         System with the Sheriff to send information electronically on whether to retain or detain prisoners.

·         Image and document system to be able to send records and forms electronically so that they do away with paper and especially carbon paper.

·         Smart Kiosk in criminal courts to receive court information.

Bottom line she wants her department to become totally paperless.

22.  Customer Service: Strives to provide great customer service to citizens.

33.  Operational Efficiency: all of the new electronic systems will provide greater efficiency to the office.

44.  Financial accountability: going paperless will lower the cost. The commissioners were glad to see that there will be an end to this department use of carbon paper. This will save money. They also closed a warehouse with the saving of 1.2 million however they are in the process of opening a Records and Digitization Center in Cicero, which should improve the system at a cost savings. Clerk Brown stated that her department is going Lean and Green.

The Commissioners commented that they are pleased with the changes to this department. Clerk Brown requested that the Commissioners promote the use of electronic traffic ticket system in their districts. There is a saving to municipalities that use the Electronic E-Ticket system. There were no large increases to her budget for 2015.

Submitted by Nancy Marcus