As she made the rounds touting a balanced budget, Cook County Board President Toni Preckwinkle on Thursday was at a loss to explain how she planned to handle a looming nearly $600 million cloud next year for health care that the county provides but for which it is not paid.
On another of her signature issues, Preckwinkle is devoting $1.3 billion of the 2020 budget to public safety-related measures, with part of the money earmarked for hiring 206 employees tasked with working in the courts and to begin expunging marijuana convictions.
At a meeting with the Sun-Times Editorial Board, the Hyde Park Democrat discussed her $6.18 billion budget proposal as well as how it impacts issues she has emphasized throughout her three terms running county government, specifically health care and public safety and criminal justice reform.
But on the amount of uncompensated care the county’s health system provides, Preckwinkle would only say it “will be a fiscal challenge — it already is a fiscal challenge.”
“If I had a magic wand I’d fix it,” Preckwinkle said. “How we’re going to [address uncompensated care] is complicated and difficult and it’s truly something we’re going to work on this year.”
The amount of care the county provides but isn’t paid for grew by $104 million between 2017 and 2019, and Preckwinkle said it would be a “principal challenge” for the 2021 fiscal year.
The $590 million in uncompensated care projected for the coming year will likely grow, adding to the headache for 2021, which already faces a projected deficit of $109.7 million.
Preckwinkle said she had no easy answers for fixing the problem.
Preckwinkle laid the blame on President Donald Trump and former Illinois Gov. Bruce Rauner, but added that other hospitals that don’t do “their fair share” of charity care aren’t helping either. The county has two hospitals but provides 51% of the charity care, she said.
Trump’s work weakening the Affordable Care Act partly resulted in decreased investment in marketing, so county residents were less aware that that was an option to cover their health care expenses.
And Rauner, “bless his rotten heart, decided that he was going to reduce Medicaid rolls by not processing applications,” Preckwinkle said.
The number of applications to Medicaid rose, and while it’s now lower than during the Republican governor’s years, there’s still a lot of whittling away at the backlog to be done.
Many of those booted from the rolls were county patients, but the county continued to provide care and “hope they’ll be back on Medicaid” so the county can be compensated, Preckwinkle said.
“It will continue to be a fiscal challenge and it’s on kind of an exponential curve,” Preckwinkle said.
The county is moving ahead on expungement work and bolstering public safety offices, which Preckwinkle says will start ahead of the county receiving revenue from legalized cannabis because “it has the opportunity to do so.”
“The criminal justice system has ground up black and brown people on drug charges since the 1990s, when we decided we were going to have a war on drugs, and it ended up being a war on black and brown communities,” Preckwinkle said.
So just because the county has to wait for revenue from legal pot, Preckwinkle said residents should not have to wait for their records to be wiped clean.
“So since we have the opportunity to begin to expunge records we had to do that as expeditiously as possible ... besides which we are required by law.”
Though projected revenue from legal weed has dropped from $3.3 million to $0 for 2020, the county is expected to employ 206 people in public safety jobs, including expungement and additional court staff, according to figures from the county.
Included in that are nine new assistant state’s attorney spots and 89 jobs for the Office of the Chief Judge Timothy Evans, said Tanya Anthony, the county’s budget director.
Preckwinkle still sees reducing the county’s jail population as a main hurdle for criminal justice reform, one that fits into her goal of making the county a more equitable place.
Lanetta Haynes Turner, Preckwinkle’s chief of staff, said they’re working on “really looking at the racial disparities at the jail and determining at each decision point how de we reduce bias.”
“To do that, we’re going to have to look at the processes in our criminal justice system, as opposed to our focus previously on bond court and bond court reform,” Preckwinkle said.
