Preckwinkle and County Board win bigger role in health system but still looking for Rx for its ailments

The Cook County Board of Commissioners on Thursday delivered the final stamp of approval on Board President Toni Preckwinkle’s push to give themselves and her more oversight and control over the county’s health system.

But with that power comes greater responsibility for a rash of ailments with no easily identifiable antidotes. Those include a growing problem called uncompensated care, health care that the county provides but for which it is not paid.

“We’re looking at a variety of ways in which we can address that challenge, but it is clearly the biggest challenge we face, it’s not just here, it’s across the country,” Preckwinkle said. “Everywhere there’s a problem.”

The sweeping changes the County Board approved on Thursday included adding a member to the County Health System board who is appointed directly by Preckwinkle and giving her and commissioners more say in the system’s budget and top leadership.

Preckwinkle called any characterization of the changes as a power grab “ridiculous.”

“The Board of Commissioners is responsible for raising the revenue to support the health and hospital system,” Preckwinkle said, noting that the system is half of the county’s budget. “So we’ve always been responsible for the health and hospitals system. There’s an independent governing board, but when you have no financial responsibility for raising the resources to fund the operations, you play a critical role.”

The measure to revamp the system, which amended the ordinance that created the independent governing board for Cook County Health, passed with 15 votes, one absence and Commissioner Alma Anaya casting the sole present vote.

Anaya said the updates only “scratch the surface” on the issues plaguing the health system.

Ashlee Rezin Garcia/Sun-Times file

“I think it doesn’t really analyze the internal inner workings of the health and hospital system, and I think that takes much more than just beginning lines of communication,” Anaya said. “I think it takes a little bit more analysis, and a task force would make more sense, in my opinion, to be able to determine what those issues are and what have caused the problems that we are now facing.”

Anaya said there’s been talk of creating a task force to delve into the deeper issues at the health system, but nothing official has been created yet.

Preckwinkle’s push for more oversight came last month when she sent a memo to commissioners calling for “enhanced collaboration” with the independent board that now runs the Cook County Health System. The “enhanced collaboration” the updated ordinance will create was born in part from last year’s budget negotiations, Preckwinkle said.

The county’s health system is a $2.8 billion operation that oversees Stroger and Provident hospitals as well as health care at Cook County Jail and other county sites. The health system also conducts a managed-care program called CountyCare.

In October, Preckwinkle said she had no “magic wand” to fix the uncompensated care issue and on Thursday she reiterated that there were no easily identifiable solutions for that growing issue.

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 county projected the amount of uncompensated care to be around $590 million for the 2020 fiscal year, but it’s expected to grow, continuing the financial headache for at least the next fiscal year.

In the month since Preckwinkle first pushed for greater oversight, the health system has paused plans for a new Provident Hospital and ousted its chief financial officer, Ekerete Akpan. Preckwinkle has also hired a new deputy chief of staff, Otis Story Sr., who will serve as her liaison to the system’s board.

Story previously served as the CEO of East Orange General Hospital in East Orange, New Jersey from 2015 to 2017 and was hired within the last month, Nick Shields, Preckwinkle’s spokesman, said.

Interim Cook County Health CEO Debra Carey will present a plan “sometime later this spring” focusing on the challenges the health system faces, including uncompensated care, Preckwinkle said.

“I’d be a bad elected official if I said there was no solution to the problem,” Preckwinkle said. “It’s a challenge, and we’ll figure out how to address it.”