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Board moves to limit health care to residents

Thursday, March 22, 2007
Daily Southtown
by Jonathan Lipman and Gregg Blesch

Cook County's neighboring counties have until Dec. 1 to work out a deal with Cook or their patients will be turned away from Stroger Hospital and the county's other health facilities, under a proposal expected to be approved soon.
The resolution passed unanimously Wednesday out of the Cook County Board's legislative committee, but it's "not a declaration of war on these other counties" and does not apply to patients needing emergency care, committee chairman Larry Suffredin (D-Evanston) said.
But it does put a deadline on dealing with a problem Cook County leaders long have complained about -- the roughly $100 million a year in patient care that Stroger Hospital and other county medical facilities provide to patients from outside the county.
"That's fine, as good people we, want to see everybody healthy," said Commissioner Peter Silvestri (R-Elmwood Park), the sponsor of the proposal. "But the people of Cook County should not be footing the bill."
The full board is expected to approve the resolution April 3. It will require Cook County's health bureau to present agreements with surrounding counties to the county board by Sept. 1, and they must be approved and in place by Dec. 1, the start of the county's fiscal year.
Other counties "are not running away from this," Suffredin said. "They realize they owe Cook County a debt of gratitude and maybe some money."
Suffredin said it was too early to predict what level of funding other counties might offer, but he thought the amounts would be more than symbolic. The agreements may include benefits besides cash, such as administrative help in qualifying patients for Medicaid.
Will County Executive Larry Walsh was in Springfield on Wednesday and could not be reached for comment on Cook County's plan. His chief of staff, Matt Ryan, did not return messages.
Vic Reato, spokesman for the Will County Health Department, said he wasn't familiar with Cook County's resolution or how Will County might respond to it.
"There was talk here that there was going to be a Will County committee formed to explore this issue," Reato said. "Apparently that never happened. I think we have referred some patients (to Cook) in the past, but as I recall not a large number at all."
Those referrals are not intended to shift the financial burden to Cook County but to make sure that patients get the best possible care, he said.
"Cook County has more resources in terms of expertise," Reato said.
Failure to bill Medicaid and other hospital billing problems were a major factor in Cook County's recent $500 million budget crisis that led to the layoffs of about 1,700 employees.
At Tuesday's county board meeting, officials said they had found 77 boxes full of more than $200 million worth of patient bills that never were sent out.
The county's increasing caseload of indigent patients has been made worse by other counties' public health departments, who send their patients to Cook County for specialty care they can't provide, Suffredin said.
"The health departments of these various counties have actually given people Metra tickets and maps on how to find the Stroger (Hospital) emergency room," he said. "Those patients when they arrive, arrive with a diagnosis."
As budget negotiations intensified in January, Cook County's health bureau chief, Robert Simon, tried to cut off patients from outside the county from getting medical services. Board President Todd Stroger overturned the decision days later after a political backlash.
Simon "did it instantaneously," Suffredin said. "This is going to involve some discussion."


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