Cook County Board President Toni Preckwinkle Wants Sweeping New Authority Over Cook County Health
Wednesday, January 15, 2020
by Kristin Schorsch
Cook County Board President Toni Preckwinkle is pitching a plan to have more sweeping power over the county-run health system, one of the largest public health networks in the nation.
The bottom line: more accountability, transparency and communication from the Cook County Health system and the board that oversees it after a tumultuous year.
“The independent governance board referred to as the System Board has worked tirelessly to improve CCHHS operations, policies and develop long term strategic plans,” Preckwinkle wrote in the Jan. 14 letter to county board commissioners obtained by WBEZ.
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“However, over the last 10-plus years, we have learned first-hand that this work cannot be done by the System Board alone and that enhanced collaboration with Cook County and its experienced departments will further improve CCHHS operations.”
The Cook County Health and Hospitals System – now known as Cook County Health – is a medical safety net for the poor and uninsured in Cook County. It comprises two hospitals, a network of clinics and a Medicaid health insurance plan for low-income and disabled people.
Preckwinkle and commissioners are planning to introduce the proposal on Thursday, WBEZ has learned. The plan would still need final County Board approval.
In the letter to the county board’s 17 commissioners, Preckwinkle laid out a plan to make a variety of legal changes. They include:
* adding an additional member to the hospital board who would essentially report back to Preckwinkle to keep her better informed.
* County Board commissioners would have new powers over Cook County Health leadership. They would approve the job description of the health system CEO, measures to evaluate the chief executive’s performance, as well as salary, termination, severance and bonus payments that the health system board negotiates. Currently the health system board has the final say.
* Cook County Health would need to submit a balanced preliminary budget.
* Preckwinkle would have more of a voice on Cook County Health’s policies for treating uninsured patients.
Preckwinkle's proposal effectively weakens the health system board.
But board Chairman Hill Hammock said in a statement that the medical network worked with Preckwinkle's office on the proposed changes.
"We look forward to the committee hearing and approved language that will result in a stronger health system with the Cook County Board of Commissioners, our independent governing board and health system leadership working together," Hammock said in the statement Wednesday.
Democratic Commissioner Larry Suffredin supports the changes. He said he does not think they weaken the hospital board, which he helped create more than a decade ago.
“We’re not stripping away their ability to run and deal with the day-to-day operations of the medical side and of the CountyCare side,” Suffredin said, referring to the health system’s Medicaid plan. “What we’re doing, though, is on the major financial decisions saying, we need to be involved with them because it is the county treasury that is at risk, not the hospital revenues.”
Preckwinkle’s proposal comes nearly two months after WBEZ first reported that the hospital board opted not to renew the Cook County Health CEO’s contract. The board is conducting a national search to find Dr. Jay Shannon’s replacement.
During his final year at the helm, Shannon faced several financial challenges. He eliminated hundreds of vacant jobs heading into 2020 to help fill a budget gap.
Among his biggest hurdles was how to address the rising amount of medical care Cook County Health provided without getting paid for it. The tab is expected to reach nearly $600 million this year. Preckwinkle has said that tab is what scares her the most about the 2020 budget.
Suffredin plans to propose another change on the heels of Shannon’s departure. He wants to cap severance packages at 20 weeks of pay, per state law. The Chicago Tribune reported that Shannon will receive a year’s salary and health insurance coverage, worth more than $500,000.
Suffredin said the health system is the only part of county government where employees have severance agreements. Besides Shannon, 55 people at the health system have them, Suffredin said.
“What we want to do is rein all that in,” Suffredin said.
County commissioners honored Shannon with a resolution during a board meeting on Wednesday. Recipients are typically peppered with compliments before an audience in the downtown board room, then give a speech and pose for photos. Shannon did not attend.