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Cook County commissioners move to reclaim health powers
County commissioners are closer to clawing back some control from an independent board that has governed Cook County Health since 2008.

Thursday, March 05, 2020
Crain's Chicago Business
by A.D. Quig

Cook County commissioners took a definitive step toward granting themselves and Board President Toni Preckwinkle more power over the Cook County Health and Hospitals System.

Hospital system finances have come under scrutiny from the county’s independent inspector general, and the move to reorganize the independent board comes on the heels of the departure of CFO Ekerete Akpan and CEO Jay Shannon. Charity care costs have been on the rise, prompting concerns from some commissioners about a tax hike to fill the gap.

Cook County’s Health & Hospitals Committee voted to approve the changes: 14 in favor, with Commissioner Alma Anaya voting present, and two members absent. All 17 members of the county board on are the committee, so when the full board meets to vote on the measure tomorrow, it's expected to be approved.

Among the largest changes: Preckwinkle will have a direct appointment to the hospital system board, bringing the number of members up to 12. Shannon’s replacement, and all future CEOs, must be approved with the advice and consent of the Cook County Board. The hospital system board will approve the job description and performance evaluation of that CEO.

That CEO must collaborate with Preckwinkle's administration on operational and policy issues. Preckwinkle administration officials will also “assist the system board in developing the strategic and financial plan.” Read the full memo on the changes below.

Preckwinkle and Commissioner Larry Suffredin argued Shannon’s exit was a good opportunity to revisit the governing ordinance that lays out the powers and responsibilities of CCH’s independent board. That board was created amid a financial and political crisis at the hospital system in 2008.

“Once a new CEO is brought on, it is equally important that the commissioners and I have greater clarity about how the system is operating,” Preckwinkle wrote in a Crain’s op-ed. “If passed, the amendments to the enabling ordinance will strengthen the governance of Cook County Health and improve patient care. Time is of the essence. Allowing Cook County Health to continue down its current path is not an option.”

Nearly all members of the independent board were on board with the change, with Commissioner John Daley stressing it's "not a power grab."

Commissioner Sean Morrison, the board’s only Republican, said the move puts the board "on a good path" to "make sure that we uphold fiscal responsibility."

The near-universal support from commissioners was a far cry from just a month ago, when members initially pushed back against the changes, suggesting they do little to address CCH’s biggest problem: the rising cost of charity care. Some members also suggested it might allow future boards and board presidents to compromise CCH’s mission to provide care to everyone, regardless of ability to pay.

In a statement, current CCH board chair M. Hill Hammock said, "We look forward to working with the President’s Office and the County Board to strengthen the health system and protect its mission to care for all regardless of income, insurance or immigration status.”

Laurence Msall, president of the Civic Federation, a fiscal watchdog, echoed those previous concerns. His main issue is over selection of the new CEO, a search currently underway.

 

“This provision goes to the heart of the authority of an independent board and would make it more difficult to attract a top-notch CEO,” Msall told commissioners in testimony today. The changes, in sum, “could reverse the unquestionable progress that has been made by the health system since the independent board was created."

One of Suffredin’s priorities is still in place: the CCH board will not have home-rule powers, meaning future hires will be subject to state law governing severance packages.

Shannon’s departure raised Suffredin's ire after the Chicago Tribune reported he was entitled to a $542,000 severance package and an annual pension of more than $250,000.

Now the Cook County Board, as part of this measure, will have sign-off power over severance and other such contract provisions. Suffredin previously described Shannon’s payout as “outrageous and disgraceful,” and Preckwinkle said she only recently became aware of details of his exit package.

 

 

 



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