This was kind of a long Cook County board meeting, many issues were brought up, since Dick Devine and his quite a bit of his prosecutors were there they brought up the cost of living raises first, not only with this group but with all non union groups. Another big issue was what was the responsibility of the board and the community health because of mandatory STD screening being eliminated at the detention centers? Another hot issue was why there are so many vendors collecting payment for the Bureau of Health, and why don't they have some sort of performance evaluations? Why wasn't the Oak Forest property approved to be sold in this approved budget still not sold? And why are the unions costing so much, mostly due to negotiations? Tony Peraica was quite quiet this meeting. Earlean Collins again, showed the most common sense, pointing out the costs to the Bureau of Health when the STD screening changed to voluntary, the cost and distruption to the budget when union negotiations take a long time and so much back pay must be paid, and the fact that this County Board has to show that they can spend the money they have responsibly before they can go to the public and ask for more taxes. More than 100K detainees come into the Cook County Detention center each year, a breeding ground for STDs, STDs that they bring back out into the public, causing more to use the Bureau of health. Dr. Simon brought up the high cost of cancer treatment at Cook County, would this be smaller if people were screened sooner?
The July 10Th Cook County Board Meeting
Noticeably absent was Andre Garner, has he bailed already? Lance Tyson was there the last half of the meeting after Todd Stroger left, apparently he is still recovering and can't finish a full day of work since coming back after surgery.
This meeting started out with applause as President Todd Stroger was back the first time at a Board meeting after surgery.
Todd Stroger started out by thanking everyone for all the cards and flowers and said it makes him feel good to know people are concerned about him. even if people throw rocks and put you in the hospital, and he giggled and said he was joking and that
he knows everyone loves him.
The meeting had an audience of a lot of Cook County Prosecutors, including Dick Devine.
Then the meeting started with Commissioner Larry Suffredin recognizing Dick Devine, the Cook County State's Attorney. There were a lot of Cook County Prosecutors there as well. Commissioner William Beavers interrupts and says that this is not on the agenda for today's meeting, and Daley said he is chairing this part of the meeting and he recognizes Commissioner Suffredin and lets Larry Suffredin continue. Commissioner Suffredin went on to point out that two meetings ago he suggested to use newly identified funds from the settlement of Rosemont and CNA insurance
to give COLA (cost of living) raises to the prosecutors at Cook County, and that because they are non union they did not get raises and this is affecting moral. Commissioners John Daley, Forrest Claypool, Larry Suffredin, and Mike Quigley are on the committee to help find funds to give COLA raises. Commissioner Beavers interrupts again and wonders why he only sees two black prosecutors when
this does not represent the population of Cook County. He asked why isn't there more? Commissioner Jerry Butler said the Public Guardians are being overlooked in the raises as well.
Commissioner Joseph Moreno said he works in a law office with his partners, 4 of which were Cook County Prosecutors who left because of pay and like Commissioner Peraica they both work in the Cook County Courts, and that 46 million dollars is what is needed to fund the raises.
Commissioner Deborah Sims said all of these Commissioners were in the room when the budget was passed and did not think of all these faces when they passed the budget. She said Moreno, Daley, Butler, herself, Steele, Murphy and Suffredin were the only ones looking at the three letter word, taxes to solve this issue at budget time. Sims went on to say that money does not fall out of the sky and we can't print it, so we have to figure out which ugly taxes need to be increases, and that not just Cook County prosecutors, guardians but all Cook County employees are affected by lack of COLA.
Commissioner Forrest Claypool said that he must speak up because there was an alternative budget at the time that this huge patronage creature needed to be dealt with. That this alternative budget was to get rid of bureaucracy and and give 59 departments COLA'a, 28 departments health care increases and 26 departments step increases.
Commissioner Joan Murphy said she wanted to recognize Commissioner Suffredin for all his work and what they did to cut 17% across the board, and that they were all chopping from the top and that has hurt the Health system, and moral is
bad. She went on to say that they need to look at a tax but she will not support a property tax.
Commissioner Gorman said that under difficult circumstances we crafted a budget but we need COLA for nonunion employees and that many good people are leaving as patronage payroll occurs.
Commissioner Peter Silvestri who is also head of the Litigation Committee, said that the last budget was approved to sell Oak Forest Property to fund COLA's, and we need to fund this or we will loose good people, we should sell this
property before raising taxes, and we should spend money we have better and collect revenue from the Bureau of Health.
We have to show we can collect and spend money wisely before raising taxes to give the public confidence before we ask them for more taxes
Commissioner Earlean Collins said we have to restore integrity of how we prioritize the dollars we get and spend wisely.
She said she is in agreement with Silvestri. Collins went on to say that we try to find all kinds of hardware, software, sweet contracts,or get money from the Bureau of Health or get rid of the Bureau of Health but we need to get rid of nepotism, since we are not a municipal government we have to rely on peoples taxes, but only if we spend it wisely, and she will not support a tax until they can spend money wisely.
Commissioner Jerry Butler said that they are making all of this a case of safety and health, and that 90% of people are in the court system because of the war on drugs. Butler went on to say that what little revenue the county generates, 750 million dollars, comes from the Bureau of Health. He said that 26th and California (Cook County Court, and Jail) is where the problem is. The Health Bureau provides for the poor and indigent and stop beating up the Bureau of Health.
Commissioner Sneider said that Claypool had an alternative budget and that he stood behind him. Sneider went on to say that we need to look at waste before taxes and we need to see how many park bench inspectors are needed.
President Stroger then joined in and said make me a list of who needs to go, if someone is not doing their job he needs to know.
Commissioner Snieder had a question on the Bill for Systems Solutions, Mary Jo Morris from the Clerk's office said it was a hardware contract and that throughout the contract departments order hardware as it is received they are encouraged to turn in paperwork.
He also questioned Standard Parking which billed for $139,531.66 and had a bill dated April 15Th through May 14Th. John Joyner said it was a an account for
parking at the Juvenile detention center garage and it was a two month bill misdated and it needs to be corrected. He said that they got $150,000 in revenue for two months, and that Cook County made $11,000 on this.
Commissioner Gorman asked where the funds were coming from to pay for two decontamination vehicles from Modak Inc.
Commissioner Daley said it was from the homeland security funds.
Commissioner Deborah Sims asked about the bill from Lexus Nexus for $38,450. She was told that it is a partial payment, and monthly payment for all departments and the Chief Judges department representative confirmed that.
Commissioner Sneider wanted further clarification on the 3.2 million dollar settlement for inmates that were tested for STD's.
Patrick Driscoll, Chief Civil Actions States Attorney said it was because of the way the testing was done, with the method and lack of privacy. Now only voluntary testing is done.
Commissioner Claypool said that for years this testing has prevented a pandemic and epidemic spread of STD's in the community and that the Cook County Jail is an incubator for STD's and that not testing will cause a great health effect in the community.
Dr. Simon said there is now a new system in place and Eileen Katura from the said that they are now screened for symptoms and then the detainees are treated for symptoms and it is all voluntary, tests for HIV, STDs, and treatment as well as screening.
She went on to say that since February they have screened 3000 detainees on a voluntary basis. Claypool said "Voluntary" that is the key word.
Commissioner Collins said because of a law or lawsuit they don't screen? Driscoll said that they used to screen the group up to age 35 because this was the highest incident category. Commissioner Collins said it costs more money when they come out
in the community and spread disease and then they have more of a Bureau of Health problem with more being treated in the community. And that this is an example of why cutting the mandatory screening at the Jail is going to cause more
Commissioner Daley said they are doing it on a voluntary basis and hopefully the courts could come up with a good system. Commissioner Sims asked if the Jail had the same method of testing as the Bureau of Health and she was told yes. Katura said 20,000 detainees go to the ER each year to get treated for STDs, and that a privacy issue is what is stopping all screening. Driscoll said that the law suit was
due to Civil rights laws.
Commissioner Murphy said are they now screened with privacy? She was told that they try to screen for TB, STDs and mental health.
That there are around 300 new detainees coming in each and every day so they have to go through a rapid process. Commissioner Peraica asked if detainees with symptoms are let into the general inmate population. Dr. Katura said they treat symptomatic STDs right away and they are sent to the ER. Peraica said they need to redesign the intake facility at the jail because only a see through chain
link fence separates detainees, and there is not a proper screening area for the 100,000+ detainees a year.
Commissioner Peter Sivestri said it in is the public health interest to test, and that the "Reception area", he also said what a name, has to
be redesigned so it is not so degrading but it costs money. He also said don't other detainees have a public health interest in not getting STDs? And that even if they are symptomatic they will only get treated on a voluntary basis as confirmed by Driscoll.
On to the overages in the budget. Commissioner Peraica pointed out that $580,000 was paid for overtime at Provident Hospital alone so far and the health care budget is already 50% over. Thomas Glaser, CFO Bureau of Health said that the AZT drugs were all paid for early and that it was a whole years supply, this is part of it. Dr. Simon said they are only going to be 60 million dollars over budget. He went on to say that they must pay overtime for hip replacements because there is a waiting list they must get down. Donna Dunnings, CFO said that she will transfer funds in September. Glaser said that 32 million dollars for year will be shortfall because of off loading of old receivables.
Commissioner Quigley wanted to know why they are going to wait for September and that the Commissioners will have to decide on priorities. Daley said first it will be submitted to the president to go over the budget for '08 and his staff.
Commissioner Quigley said that September is too late, because they go into the August hibernation and they need to know is they are 30 million dollars short how will they make up for it.
Donna Dunnings CFO said it is illegal to transfer from negative funds and that the surplus covers that. But Quigley said why are you letting them do it then? Dunnings said they they let them know they are in overage. Quigley said they are still doing it?
and you are letting them? Then Dunnings said maybe she was not communicating properly? and that she meant at the end of the year? And Quigley said maybe I am not communicating properly but I was talking about now? Quigley said before they leave in August they need this figured out.
Peraica asked about the 30-35 million dollar shortfalls in July. He said they are at 300% over budget, or three times what they were projected to be, and he comes up with 80 million dollar shortfall. He said that Federal and State money can not be counted on to take care of this. Dr. Simon said he will stand by the 30 million dollar overage and that radiation oncology has been very costly, and that there
are more cancer patients at Stroger Hospital than in any other in the State. Simon said he has been candid since day one with giving good news and bad news and he will stand by the 30 million dollar shortfall. Peraica said OK.
The next issue that came up was for 4 million dollars to Chamberlain Associates, who already had a contract for 1.4 million dollars, approved last year for processing claims and wanted 4 million dollars more.
The first Commissioner to ask questions was Tony Peraica. Thomas Glaser, CFO Bureau of Health answered questions. He went on to say that claims are turned over to vendors after 90 days and the people who work at Cook County can't handle the volume.
Peraica said that there should be a competitive RFP process to bid for services especially since it is $4 million more. And that this looks like an emergency basis contract. Glaser said that they have an immediate need, and that they can generate this from the 40 million dollars in claims they will get. He said that Chamberlain and Edmonds specialize in SSI and SSD. Peracia wanted the clarification that they will get 9 1/2% fee.
Commissioner Moreno wanted to know what the other vendors got.
ESI gets 12%, HSM gets 7 3/4% and Great Lakes get 7-8%.
Moreno also wanted to know if they did a comparison of these companies? As far as productivity? Glaser said in mid April they sent out a bid and HSM said they were to small to handle the volume, ESI wanted to use their patient account system and train employees at the county. Great Lakes sent and email, but not a formal bid.
Moreno wanted to know if there were caps on the collections? Glaser did not know.
Moreno asked if it was 4 million for 12 months? Glaser did not know.
Daley said if they are short on intake people how many would they need? Glaser said 171 workers were needed by Dr. Simon's proposal and he is not sure how many would go to this. Daley asked what about performance evaluations on these four companies? Glaser said they were working on an evaluation process.
Commissioner Murphy wanted to know how many patients a day were on intake? He said that right now there are 16 workers in this area, with an average of 9-10 a day and they have attendance problems there. They get 50-60 applications a day, and if they had more workers on the inpatient outpatient said they could eliminate a contractor. Murphy wanted to know how many outside contractors is the goal. Glaser said one or 2 and not the 4 they have. Commissioner Maldonado asked what does Chamberlain do then? Glaser said they do medicare and medicaid.
Maldonado asked what is their track record? Glaser did not know. Maldonado said how can we give 4 million more to someone we don't know their track record? So this needs to go to committee for further investigation or this is a leap of faith contract. Commissioner Collins said she also wants all the other groups to be looked at better. Dr. Simon does not want this deferred to committee because they need to generate income and that they worked for Rush Hospital (as Dr. Simon does too, I might add here) and that they have increased payments at Rush by 55%. He said they have a contingency contract so they need to go ahead and generate funds.
Commissioner Butler then brought up the Great Lakes email again, then John Cookingham CFO came in to say that the email said they could accomplish the job but did not send a formal proposal. Butler wants a copy of the email.
Commissioner Daley does not want it deferred to committee because he said there should be a 30 day cancellation clause, and they can start collecting now. Commissioner Claypool said the Chamberlain contract goes to '09 and it should go to committee. Commissioner Sims said it looks like a contract to her too.
Commissioner Gorman said shouldn't they still collect while it is in a committee? Peraica said they need to look at last years performance first so this does not end up in litigation where it will cost more.
Beavers asked if anyone proof reads? There are too many corrections? The clerks office said that the corrections are do to department amendments.
Moreno back on subject asked how do we look at who gets the back logs on billing and find out who is the best? Now we have companies doing the same work and what will be shifted to Chamberlain? Glaser said ESI was going to use Chamberlain as part of their proposal. Sneider says why can't we do our own or get down to one or two companies?
Commissioner Bulter said we always beat up the Bureau of Health to get money now they are trying to do this the best we can so we should approve it.
A vote was taken and 6 yes, 11 no so this will not go to committee.
Commissioner Gorman wanted to know why $135,00 was due to a call center, Risk Management Solutions, because they have made a few payments in the sum of $167,000 and the contract was $135,000 which they are now asking for?
Lisa Walik the Director of Risk management said that they had start up calls for the call center that injured workers used to find clinics that were contracted at a lower rate.
Commissioner Moreno takes over as President pro tem while Stroger left because he is not up to working full days yet.
Moreno said that the call center has saved 1.8 million dollars by referring workers compensation and injuries to contracted centers. Commissioner Snieder said there was payments already, but Maldonado said they delivered services so we have to pay them.
A vote was taken 6 yes 9 no to committee, Silvestri and Quigley out of the room on vote, no further investigation on payments to Risk Management Solutions.
On the Oak Forest property sale, Murphy said don't delay this so they can sell it, Quigley said the Real Estate department wants to delay it so they can, rather Anna Ashcraft said do a presentation of the land to be sold. They want to keep 100 acres for the Cook County Forest Preserve district which includes a lake and a cemetery.
The Board approved a resolution to let the US Attorney investigate police torture.
Commissioner Collins said many tortures happened and many gave confessions based on that were falsely accused and prisoned and are not able to find work so this is important.
Commissioner Sneider asked Dr. Simon if he had taken into account all the union raise when they are budgeting for all the other raises? Dr. Simon said it's a good question and they have to look into that for the budget. Sneider pointed out that the $119 million would be wrong and that it would be $160 million needed with this factor.
Jonathan Rothstein, Special Assistant of Labor Relations was next to be questioned.
Dunnings said the union negotiated raises were already budgeted for in this budget.
Murphy brought up that the law enforcement union always goes to litigation which is more costly so their unions raise should be approved, because it will be less costly, and Commissioner Goslin said to approve their contract until 2010 because it will be more cost effective.
Jonathan Rothstein said that they negotiate employee insurance, and contributions which will go up with co payments.
Commissioner Collins said who does the Union negotiations? What is the average time for negotiations? Rothstein could not answer this because there are 50 different contract and 35 different unions, he says he does pattern barginning because this is more cost effective and some they do themselves and others they use an outside source.
Collins said this is very important because these union contracts drag out so far that then the County owes back pay and this causes budget problems, so then you also have legal fees with contracts and this needs to be looked at so they can negotiate on a timely basis and save money.
The next resolution went to Committee because all the terminology had to be clarified on since the county is a subdivision of the state, and municipalities such as libraries etc are subdivisions of the county or state?