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Cook County Hospital gets increase in funding for uninsured

Tuesday, May 05, 2009
Evanston Sentinel
by Bennett Johnson

The Cook County Health & Hospitals System (CCHHS) has reached an agreement with the Illinois Department of Healthcare and Family Services (HFS) that will provide CCHHS Disproportionate Share (DSH) program revenues for State Fiscal Year 2009 at an estimated $70 million more than in State Fiscal year 2008. 

This funding increase is related to the recently approved intergovernmental agreement, federal and state Medicaid state plan amendment, and state law passed by the General Assembly in 2008 and is intended to support medical care and services by CCHHS for Medicaid and the uninsured.  The agreement has been signed by the appropriate County officials and is expected to be signed by the state.

These revenues help supplant losses the System endured including the more than $100 million in supplemental Medicaid revenue that was lost in recent years due to federal regulations phasing down permissible reimbursements to public hospitals and the significant growth in the uninsured which resulted in hundreds of millions in cost.  CCHHS is the largest provider of Medicaid and uncompensated care in the state by a large margin. The government funding “should help the long term viability of the County health System,” Interim Chief Executive Officer David Small said.

DSH funding is the singular source of federal funding to assist hospitals with the costs of caring for the uninsured.   The Cook County Health and Hospitals System is the top provider of safety net healthcare services in the State of Illinois. In December, 2008, the federal Center for Medicare and Medicaid Services (CMS) approved a Medicaid State Plan Amendment allowing for renewal of the Illinois Hospital Assessment Program bringing billions in funding to Illinois and Illinois hospitals over 5 years beginning July, 2008.

As part of that approval, CCHHS hospitals were approved by CMS to participate in the drawing from Illinois' DSH allocation to help offset costs of caring for the uninsured.  For more than a year, CCHHS management has worked intensively in partnership with HFS to seek means to remediate the Medicaid losses incurred by the System over recent years.  These DSH monies help do so.   As has been true for more than fifteen years, Cook County remains a net contributor to the State of Illinois Medicaid program, adding no net costs to the State of Illinois Medicaid program.

“On behalf of the staff and the residents served by CCHHS, we want to express our gratitude to State Legislative leadership for enacting the enabling legislation in support of the Hospital Assessment and Disproportionate Share Medicaid State Plan Amendments.  We thank also Director Maram, HFS staff, the Office of the President of the Cook County Board, the Board of Commissioners, and CMS for their collaboration over many months in seeking means to assist the financing of medical care to those most in need”, Small added.


“Finally, CCHHS thanks the Obama Administration and the Illinois Congressional delegation, with special gratitude to Senators Durbin and Burris for their attention in the American Recovery and Reinvestment Act to Medicaid financing, raising state DSH allotments, and other funding streams to improve healthcare delivery and access for those most in need in this time of extraordinary economic crisis.”


The Cook County Health and Hospitals System Board of Directors approved a new procurement policy that will move the health system one step improve operations and the delivery of services mandated by the Cook County Board of Commissioners when it created the independent board, according to System officials.

The measure will create a centralized purchasing system for all the System healthcare affiliates. It includes several provisions that will modernize the procurement procedures currently used by the System's health facilities and set ethical standards that are designed to preserve the integrity of the System's purchasing process.

According to David Small, “It provides for the System to be good stewards of the public trust by seeking to spend public dollars in the most efficient fashion in support of delivering quality healthcare while remaining fully committed to the County's policy to promote equal opportunity in the procurement process.”

“The System's procurement policy is consistent with the County's Ordinance on Procurement and Contracting, including the goal that the participation by minority and women owned businesses be not less than 35% of the total aggregate value of contracts awarded by the System annually,”  Small concluded.

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