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Cook County Modernization Project—Update

October 10, 2012

In 2010 the Civic Federation embarked on the Cook County Modernization Project to provide a roadmap for creating a county government that is more efficient, less costly and more accountable. The report addressed all Cook County functions, but particular emphasis was paid to improving operational efficiency in the the Offices under the President, reforming the overall governance structure and proposing reforms for the Health System. The report also contained detailed information and analysis regarding Cook County’s governance and administration, budget and pension fund.

The Modernization Project contained recommendations that could be implemented in the first 100 days of County Board President Preckwinkle’s administration as well as others that required a sustained, multi-year effort. The Modernization Project recommendations were a mixture of new ideas and previously proposed solutions that were never implemented by prior County administrations. The recommendations included a timeline for action and identified the responsible county officials to lead and implement the changes.

In March 2011 and included in last year’s analysis of Cook County’s proposed FY2012 budget, the Civic Federation released reviews summarizing the status of all 36 recommendations made in the Modernization Project, as well as a dashboard rating system for recommendations. The report found that the County had made substantial progress in implementing many of the recommendations. For example, in its March 2011 update, the Civic Federation reported that the the County had adopted an ordinance to fully repeal the one percentage point sales tax increase of 2008 and had adopted a budget that included some significant cost reductions. The administration took steps to incorporate performance measurement into the budget process and made attempts to centralize some key administrative functions.

In the coming weeks Cook County will release its proposed FY2013 budget. Despite cost savings initiatives implemented over the past year, the County projects a budget deficit of approximately $115 million. Additional updates to the Modernization Project recommendations may be needed based on the FY2013 proposed budget.

Identified below are actions that are consistent with the Modernization Project recommendations taken by the County under the leadership of County Board President Preckwinkle over the past year.

  • The FY2012 budget made significant efforts to help close a $315.2 million budget deficit using spending cuts, revenue enhancements and layoffs; however, the Health System is expecting a significant shortfall in revenues by end of the fiscal year. (Recommendation #2 – Close the FY2011 Budget Deficit)
  • The County continues to adhere to the President’s Set Targets, Achieve Results (STAR) performance management program by issuing quarterly reports. (Recommendation #8 – Integrate Performance Measurement into Budgeting and Make the Information Public)
  • For the first time since 2002, the County released its FY2011 Comprehensive Annual Financial Report within six months of the close of the fiscal year. (Recommendation #11 – Produce Audited Financial Statements within Six Months of Close of Fiscal Year)
  • In April 2012 the County announced two alternative service delivery initiatives for 1) managed competition for County custodial services and 2) third-party administration of the County’s employee absence and leave management. (Recommendation #17 – Implement Alternative Service Delivery Options)
  • President Preckwinkle created the Unincorporated Cook County Task Force at the end of 2011 to examine the issue of subsidy to residents of unincorporated areas of the County. The Task Force presented its initial report to the President on April 30, 2012 with the recommendation to eventually eliminate unincorporated areas of the County. The Task Force is currently still in place and has been divided into two working groups, focusing on infrastructure and policing. (Recommendation #16 – Eliminate Subsidy for Unincorporated Areas)
  • The Health System is waiting for approval from the federal government for a Medicaid expansion plan that will provide the System with early access to individuals who will be eligible for Medicaid beginning in 2014 under national healthcare reform. The program is expected to substantially increase the System’s revenue, but depends on aggressive assumptions about service delivery improvements and patient enrollment. (Recommendation #18 – Aggressively Pursure Medicaid Patients and Revenues)
  • The Health System’s FY2013 preliminary budget was approved by the Cook County Board on October 2, 2012 and is based on keeping the County subsidy largely unchanged from FY2012. The Health System’s total appropriations increased based on expectations of additional revenue from the proposed Medicaid expansion plan. (Recommendation #3 – Give Health System Budgetary Flexibility)

The dashboard below illustrates progress made on the Civic Federation’s Modernization Project recommendations. A short narrative on each recommendation is provided following the dashboard chart.