June 1, 2010
In a victory for good government, the Cook County Board of Commissioners on June 1, 2010 voted 13-3 to make permanent the independent Board of Directors overseeing the Cook County Health and Hospitals System (Health System). Without action by Commissioners, the independent Board would have expired in February of 2011.
The Civic Federation, a long-time supporter of the independent Board, was the only group testifying in favor of making it a permanent part of Cook County government. The Civic Federation recommended the creation of an independent Board in 2001, in our Cook County Cost Control Task Force Report, written in cooperation with the Chicagoland Chamber of Commerce.
In testimony on June 1, the Federation told County Commissioners that the vast public health system operated by the County requires an independent Board to provide experienced oversight from leaders who are knowledgeable about the health field. The Health System oversees the operation of three public hospitals, the Cook County Department of Public Health and Cermak Health Services, the hospital for the Cook County Department of Corrections.
The Federation praised the Board’s accomplishments to date, including successfully installing new management across the executive ranks of the Health System, aggressively seeking additional federal funds, implementing a strategic planning process and introducing operational efficiencies into the Health System. The Federation acknowledged that much work remains to be done to transform the Health System into an efficient operation that delivers the most effective healthcare possible to the County’s most vulnerable populations with the resources available. However, the Federation said that this vital but challenging work could not be accomplished without the supervision provided by an independent Board.
The independent Board was created in 2008 as part of an agreement with Cook County President Todd Stroger, who needed support for a controversial 1.0 percentage point sales tax increase. The ordinance that established the Board stated that it would expire in three years. At the time, the Health System was facing a financial and political crisis. Widely regarded as a highly inefficient operation that lacked even basic systems to charge patients and collect bills, the Health System was also tainted by allegations of political patronage. In 2007, Illinois Senator Richard Durbin threatened to withhold federal healthcare funding unless reforms were made.
The 11-member independent Board, led by Chicago businessman Warren Batts, also includes a labor leader, a public health specialist and doctors and administrators at other medical institutions. One of the Directors is Jerry Butler, a Cook County Commissioner who is Chairman of the County Board’s Health & Hospitals Committee.
The Health System’s Board is not totally independent, because its funding comes from the County Board, which must approve its budgets, its strategic plans and any moves to close hospitals. However, the Board was created to oversee the Health System’s day-to-day operations, including hiring and purchasing decisions.
County Commissioners voted to make the Board permanent despite opposition from labor union officials representing Health System doctors, nurses and support staff. The unions, including Local 73 of the Service Employees International Union, argued that no decision should be made on the fate of the independent board until a new Cook County president is elected in November of 2010. Many Health System workers have been upset by recent Board actions, including measures to cut staffing and to reduce operations at Provident and Oak Forest Hospitals.
County Commissioners still have to establish procedures for electing new Directors, which were not clearly spelled out in the original ordinance. Several Commissioners who voted in favor of making the independent Board permanent also noted that that County Commissioners retained the authority to reverse that decision in the future.