CHICAGO | The Cook County Health and Hospital System Board on Wednesday approved its proposed budget closing the gap for subsidies between itself and County Board President Toni Preckwinkle's office from $74 million to $35.5 million.
The budget would take effect Dec. 1 and go through Nov. 30, 2012 and still needs to be approved by the Cook County Board.
But before the measure passed, staff, including nurses, as well as concerned citizens, demanded the budget not compromise patient care or lead to drastic cuts in staff. Some complained that the system was relying far too heavily on consultants.
The preliminary budget looks largely like what the board introduced at its last meeting, with costs projected at $931,318,446. Of those, Michael Ayres, the system's acting CFO, said $104,686,887 are fixed costs mandated by the county for pension and malpractice insurance. The board approved discretionary costs of $826,631,559, including an additional $1 million for access to care items.
Originally, the system expected revenues of $610 million but because revenue that had been expected for 2011 won't be realized until 2012, the gap between the subsidy that the health systems will ask for from the Cook County Board and the one that Preckwinkle has publicly favored has shrunk to $35.5 million.
Ayres explained that this largely was due to a Centers for Medicaid and Medicare fee of about $30 million that CCHHS thought, as recently as three weeks ago, would be collected in 2011. Ayres went on to explain there would be no change in this year's budget. That's because while the system did expect to collect it in 2011, the fee wasn't identified when the budget was originally proposed.
Preckwinkle issued a favorable statement to the news, "Since we passed a budget the previous fiscal year, we have made it a priority to work closely with the Independent Governing Board of the Cook County Health and Hospitals System. When we released our preliminary budget in July, CCHHS had a projected budget gap of $126 million. Our collaboration has helped reduce that gap first to $79 million as part of their initial budget projection, and most recently we have worked to narrow the gap down to roughly $35.5 million."
Despite the two sides growing closer, many staff and concerned citizens warned of the dangerous ramifications of further cuts.
"Any degradation in our service capacity will tip us toward an unsafe or unsustainable environment for patient care," said Dr. David Goldberg, who works at the county's Stroger Hospital.
Michelle Graham, a nurse in the system, attacked the furlough and shutdown days that Preckwinkle and the County Board approved last March.
"They must be eliminated from our system," Graham said.
Dorothy Ahmad, a nurse at Stroger Hospital, said she believes that CCHHS has misplaced priorities, saying, "We need more nurses so that we can deliver quality care at the bedside ... We have consultants on consultants; we have consultants monitoring consultants."
The proposed budget sets aside $47,073,401 for consulting work while calling for only about 20 percent of the current nursing vacancies to be filled. A proposed amendment to increase that number to 50 percent failed at the meeting.
George Blakemore, a frequent speaker at public events, said the health systems board won't be truly independent unless it's able to become a taxing district and collect its own taxes, thus freeing itself from relying on Cook County government subsidies.
