Suffredin- For a Better Cook County  

Forest Preserves
Public Safety
Cook County Budget
Forest Pres. Budget
Property Tax Appeal
Health & Hospitals
Land Bank Authority
Policy Resolutions
Unsung Heroine


  Office phone numbers:  

The Cook County Code of Ordinances are the current laws of Cook County.


Search current and proposed Cook County Legislation in Larry's exclusive legislative library.

  Eighteen of the 20 largest banks in the world and more than 50 foreign banks have offices in Cook County.

A stronger pulse
Carvalho, like Batts before him, needs to give Cook's health system intensive care

Wednesday, August 15, 2012
Chicago Tribune

The independent panel that runs Cook County's health system has a new chairman, David Carvalho. Chosen by his fellow board members last week, he replaces the no-nonsense Warren Batts, who grappled with meddling county pols and spreadsheets that dripped red ink.

Carvalho needs to lead the health panel with the same do-it-better-for-less attitude that Batts championed in his four years as the panel's first and only chairman. Here's why:

As is, the county health system clings to annual fantasies of overly optimistic revenues, only to bust its budgets year after year. That doesn't build confidence, either among members of the Cook County Board or among taxpayers whose dollars fund much of the medical care. What's more, the system never has the momentum, or the money, to focus primarily on delivering better quality care. That's never been more crucial than it will be as more of its patients gain the freedom to get their care elsewhere.

Carvalho has a strong background. He chaired the panel's Finance Committee the last four years and, before that, helped get Stroger Hospital built. He knows that the county's system has an improving but still thready pulse: As of the end of July, the health system was $21.7 million short of its budget in collecting patient fees, health system CEO Ram Raju tells us.

But that's better than the numbers at the same point in 2011: Then, the county was $60.1 million short.

Credit Raju's aggressive streamlining for the improved bill of health. Raju has whittled down a mountain of backlogged billing statements that weren't being mailed to patients and their insurers, and he has helped the county grab more federal funding.

This is vital because as the county's health and hospital system budget goes, so goes the financial health of Cook County government. Last year, for example, the health system burst its $911 million budget by nearly $170 million. At the same time, the county's roughly $3 billion total budget hemorrhaged red by nearly the same amount. That is, the county had a deficit mostly because its health system had a deficit. This year, as of the end of May, county government was running an $11 million surplus — yes, a surplus — that would be larger if the health system was delivering all of its expected revenue.

Carvalho leads a panel with four new members but the same urgent mission: Stabilize the patient.

One key: Attract and retain Medicaid patients. In 2014, when Obamacare fully kicks in, thousands of county patients suddenly will be covered by insurance. They can choose where they get their care. Carvalho & Co. need to make sure the county keeps most of those patients and their Medicaid reimbursements.

The county needs to make the system "more attractive to patients," Carvalho tells us, "or once they have choices, they will go elsewhere." If that happens, the system will be left mainly with the uninsured poor who can't pay for the services they receive. No insurance or government program will reimburse Cook County taxpayers for their care.

That's one reason Cook County officials are asking federal officials for permission to add 115,000 of those new Medicaid patients to the rolls early, before their 2014 eligibility. Most of these patients already are being treated in county clinics and hospitals. Signing them up for Medicaid early wouldn't cost the state a penny it isn't already paying. The federal reimbursement, which covers about half of Medicaid treatment costs, could be a $198 million windfall for the county health system, Raju tells us.

These early arriving Medicaid patients would be able to obtain care only in the county's system until 2014. After that, yes, they could go anywhere for treatment. But those months would give the county a prime opportunity to earn the loyalty, trust — and future business — of those patients.

Raju is driving a smart shift in focus from inpatient care to outpatient services. That shift to a more robust primary care model provides preventive and other early services so that people don't end up in the hospital for expensive stays that they — and hard-pressed county taxpayers — can't easily afford.

Carvalho is a lawyer, not a doctor, but he needs to be a healer of the county's health system. The patient is improving. But it needs intensive care.

Recent Headlines

U.S. appeals judges: Go fight over lawsuits with Dorothy Brown in state court
Sunday, November 13, 2918
Chicago Sun-Times

She's been waiting 15 months for her rape kit to be processed. A new proposal to track evidence aims to change that.
Wednesday, November 14, 2018
Chicago Tribune

Preckwinkle to unveil policy roadmap for Cook County for next five years
Wednesday, November 14, 2018
Chicago Sun-Times

COMMENTARY: Here's how the Shakman case curbed Cook County patronage
Tuesday, November 13, 2018
Chicago Tribune

Appeals court backs Dorothy Brown in lawsuit over public access to electronic records, says judge overstepped authority
Tuesday, November 13, 2018
Chicago Tribune

What’s Next As Voters Overwhelmingly Support Higher Minimum Wage, Paid Sick Time
Monday, November 12, 2018
Journal and Topics Online

Cook County Board President Toni Preckwinkle's security chief fired after review spurred by watchdog report
Thursday, November 08, 2018
Chicago Tribune

An earlier opening day: 2019 Cook County forest preserves permits go on sale Nov. 15
Thursday, November 08, 2018
Chicago Tribune

Cook County opening 2019 picnic permit sales Nov. 15
Monday, November 05, 2018
Special to

The Cook County Land Bank looks to go commercial
Monday, November 05, 2018
RE Journal

Nov. 15 is new opening date for Cook County forest preserves permits
Monday, November 05, 2018
Daily Herald

Cook County Gun Dealer, Minimum Wage Referendums On Ballot
Monday, November 05, 2018

The Abandoned WWI Monument One Chicago Man Is Determined To Save
Friday, November 02, 2018
Chicago Patch

Cook County freed from federal oversight
Thursday, November 01, 2018
Chicago Daily Law Bulletin

First-of-its-kind trauma recovery center serves survivors of domestic violence, hate crimes, sexual assault, gun violence in Cook County
Monday, October 29, 2018

Northbrook opts in to Cook County paid sick leave ordinance, more uncertainty for employers, lawyer says
Monday, October 29, 2018
Cook County Record

First-of-its-kind Advocate Trauma Recovery Center serves survivors of domestic violence, hate crimes, sexual assault, gun violence in Cook County
Monday, October 29, 2018
WLS Channel 7

Cook County sheriff, CVS team up on safe prescription painkiller disposal
Saturday, October 27, 2018
Chicago Sun-Times

HOPE Court, created to keep probationers out of prison, shut down amid problems
Friday, October 26, 2018
Chicago Sun-Times

Can Kaegi really reform the assessor's office?
Friday, October 26, 2018
Crain's Chicago Business

all news items

Paid for by Larry Suffredin and not at taxpayer expense. A Haymarket Production.