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City to ask hospitals to provide services the city now offers

Thursday, October 19, 2006
Pioneer Press
by BOB SEIDENBERG | City Editor

Evanston stands among the few local communities that maintain their own in-house health departments, but the setup could change based on some comments Monday by aldermen and Mayor Lorraine H. Morton. During a budget program review session at the Civic Center, Morton joined several aldermen in urging staff to pursue talks with the local hospitals administrators about how the hospitals might deliver services the city now provides. Alderman Elizabeth Tisdahl, whose 7th Ward includes Evanston Hospital, suggested that pressure placed on hospitals recently about the amount of charity care they provide presents "an incredible opportunity" for the city to save money. The city currently employs seven nurses and a half-dozen other staff members affiliated with clinical services stationed at the Health Department. The department is housed on the ground level at the Civic Center, 2100 Ridge Ave. Health teams provide services to qualifying families. Services include family planning, dental care and childhood immunizations. The number of registered clients in the dental clinic alone averages 1,645 annually. The department's sexually transmitted diseases division logs 1,200 clinic visits a year. Nurses immunized 800 people and performed 140 school physicals. The cost of the department's personal health services ran to about $1.5 million in the last budget, officials said during their presentation. City Manager Julia Carroll and Jay Terry, city director of Health and Human Services, said they have had some preliminary discussions with officials at Evanston Hospital and St. Francis Hospital about how the two institutions would be willing to help. However, staff was reluctant to carry the talks further without a clear policy direction from aldermen, Carroll told council members Monday. Encouraged to negotiate The mayor and aldermen were more than clear, saying they want the city to explore the issue, aggressively if possible. "If there's ever a time to get serious about this, now is the time because the hospitals are under fire," Morton told the city manager. "I often wondered why we gave flu shots at the city when they give them at drugstores," she continued, "but it's something we've been doing over the years." Alderman Ann Rainey, 8th Ward, said St. Francis already performs some services for the community, such as providing a corporate day-care program with 20 slots open for members of the community. She asked that she and Tisdahl be included in future discussions on the issue. Alderman Lionel Jean-Baptiste, 2nd Ward, noted council interest in the issue dates back to 2001. He said he wonders why the city has been slow to move forward. He added later, though, that negotiations should be pursued in a way so that any current city employees "are not left out in the cold." Alderman Melissa A. Wynne, 3rd Ward, said officials must make sure there's no drop in the level of services provided if the responsibility shifts to the hospitals. She said an agreement also should include a condition allowing the city to monitor services rendered by the hospital, to ensure they will meeting standards. Morton said "no hospital is going to let Evanston monitor what they are doing." Nevertheless, "that's a goal we should strive to have," replied Wynne. Recreation expenses in focus The Health and Human Services discussion followed a presentation from the city's Parks, Forestry and Recreation Department. The department, with $12.2 million in budgeted expenditures, accounts for 14 percent of the city's general fund budget. It also serves as an important revenue generator, bringing in $4.2 million through its recreation programs. During discussions, Jean-Baptiste raised concern that one of the notions about the recreation program is that "you pay to play," while residents unable to pay "are left out." On the other hand, Alderman Delores Holmes, 5th Ward, said program revenue isn't coming close to covering the city's costs to deliver the services. Douglas Gaynor, director of Parks, Forestry and Recreation, said that while the city does provide some fee assistance and scholarships, the amount now is relatively small. Gaynor said officials face a challenge as they also work on finding ways to make more programs available. He, Jean-Baptiste and others have been involved in discussions of a "youth engagement" program that seeks to involve teenagers in city activities to a greater extent. Carroll said officials also face a challenge. "If you don't have pay to play, somebody is not paying a fee and you're going to have more programs subsidized by the taxpayers," she told aldermen. If the city were to charge true costs, including covering overhead, programs would be priced "out of the market," she said. The council's policy direction on the issue is important, Carroll said, because "it's a constant balance between the marketplace, providing services and serving those who can't pay."

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