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What's wrong with county health system? Ask leader

Friday, November 03, 2006
Daily Southtown
by Gregg Sherrard Blesch and Jonathan Lipman

Dr. Daniel Winship, who resigned Wednesday as head of Cook County's $1 billion-a-year health system, fought Thursday to restore his reputation after taking kicks for the bureau's ugly deficit.
"It's been pretty hurtful," Winship said in a phone interview arranged by a public relations firm. "I've never been maligned like that."
Cook County Board President Bobbie Steele, who asked for his resignation, meanwhile announced that two longtime county employees would take his place until after the election.
Steele was appointed to finish the term of retiring President John Stroger and will relinquish it either to Democrat Todd Stroger or Republican Tony Peraica, depending on the outcome of  Tuesday's election.
Winship touted accomplishments in two years on the job at the Bureau of Health, and he blamed county commissioners for limiting his authority to fulfill their financial projections, which he said were flawed in the first place.
"I would say my hands have been tied ever since I've been here," Winship said, asked if he had leeway to make personnel cuts necessary to make the bureau more efficient.
Steele said on a radio show last month that "the people in the bureau (of health) are some of the biggest liars I have ever seen."
Since taking office Aug. 1, she has lashed out at the leadership of the health bureau for a series of failures including revenue collection that fell $68 million short while its officials continued to tell commissioners the money would materialize.
Winship said Steele has assured him she was not referring to him with her "liars" comment.
Steele, asked separately about the comment, said, "I was not specifically pointing out Dr. Winship."
In a letter to commissioners, Steele called Winship a "person of high integrity and character."
But Winship had to go, she said.
"There are deficiencies we think we can overcome with new leadership," Steele said. "Billing, collections and the like."
Winship, who was hired by John Stroger in August 2004 and earned a salary of $277,000, said a number of reforms he initiated haven't been in place long enough to show obvious gains.
In his tenure, he said, the system moved toward electronic billing, standardized registration, established a mail-order pharmacy and sought a contractor to overhaul the revenue cycle.
As advice to his successors, he offered: "Look outside of your departments now. The system is larger and far more complex than you ever dreamed."
Those successors are Dr. Linda Rae Murray and Dr. Carolyn C. Lopez. Murray runs the county's system of community clinics, while Lopez is chair of Stroger Hospital's department of family practice.
Murray and Lopez said their first task would be getting the bureau's departments better coordinated to work together.
Steele said a permanent replacement would be chosen by her successor.
Both Stroger and Peraica have said they would make major changes in the health bureau and would mount a national search for a new leader.
Stroger said he wants to create an independent body to advise the health bureau.
"There's a plan, but we haven't put it out yet, so I don't know if I want to tell you," he said.
He supported Winship's resignation.
"There seem to be some problems with the hospital," Stroger said. "When that happens, the head of the bureau of health needs to take some blame for it."
Peraica was more blunt.
"(Winship) didn't create (the problems) -- they were there before he got there -- but he did nothing to correct them," Peraica said.
Peraica also was unimpressed with Steele's interim replacements.
"I am not enthused because I think it's more of the same ... the same kind of insiders minding the store," Peraica said.
At Thursday's meeting, health officials continued to frustrate Steele.
The health bureau's director of policy analysis, Randall Mark, told Steele that he was still "in the process" of setting up a billing program for Medicaid Part D prescription drug plans with the county's contractor.
"We've been in the process for three months," Steele said crossly. "We approved this in what, June? July? I'm just baffled."
Commissioner Roberto Maldonado (D-Chicago) said he believes the county has lost out on $30 million in fees by failing to get its Medicaid billing sorted out.



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