Toni Preckwinkle highlights the changing culture at County

Addressing the Chicago Medical Society (CMS) Council on Feb. 21, County Board President Toni Preckwinkle says she believes there is hope down the road for the Cook County Health and Hospital System (CCHHS).

She is partnering with the governing Independent Board of Directors, and CEO Dr. Ram Raju, to lay a new foundation for public health delivery, investing in the services that uphold County’s mandate and mission.  A new foundation is the only way, Preckwinkle said, to push “the boundaries on what had for too long been the status quo.”

Meanwhile, in 2014, the Affordable Care Act will dramatically expand the number of insured people, giving the 100,000 existing County patients a new lifeline.  The legislation incentivizes providers to keep people healthy and away from expensive services.  Preckwinkle called health reform a good thing because public health providers will finally receive compensation for the care they deliver.

However, she says, the legislation challenges the CCHHS to be more competitive.

“We have to make sure our system operates effectively and efficiently enough to support 100,000 newly insured patients.  Because, the question we will soon face is this: if individuals have the choice – will they continue to choose County?” Preckwinkle asked.  “Or will we become a system for those who fall through the social safety net and the undocumented for whom we get no reimbursement?”

“Last year alone, the CCHHS provided more than $500 million of uncompensated care to a patient population that has a high percentage of individuals with complex, serious illnesses,” she said.

Preckwinkle says the Independent Board assembled Vision 2015, a comprehensive plan to eliminate waste, lower costs and improve services.  Every decision made—by the Board, Dr. Raju, and Preckwinkle--is shaped by four basic principles: fiscal responsibility, innovative leadership, transparency and accountability and improved services.

In just nine months, the Board passed two budgets, solving a roughly $800 million gap.  No easy task, the Board also cut 50% from the president’s office, and Preckwinkle reported that she herself took a 10% pay cut.

She said that currently, in Springfield, legislators are considering a proposal that could have a significant impact on our health system.  “The state of Illinois formally sent a request to the federal government seeking a Section 1115 Medicaid Waiver for the CCHHS.  This waiver would allow current patients of CCHHS to enroll in a Cook County Medicaid network with absolutely no cost to the state of Illinois if their income is less than 133 percent of the federal poverty level.”

Preckwinkle explained that these are patients who are not currently eligible for Medicaid, but will be eligible under the Affordable Care Act.  “This would mean more than 100,000 patients currently in the CCHHS system could gain coverage.  And it’s important to emphasize—these are patients who are already being treated by our system without compensation.”

Emphasizing that the health care system’s problems are the County’s problems, the Board President said that while she stands firmly by the independent provision of health care, “if there are administrative areas—budget and finance, human resources, etc., where we can be of assistance, then we will assist.”

The County Board President stressed that care cannot be simply sorted into categories--public health, private, and charity.  Pointing out there are no simple answers for improving the public health system, she said progress will depend on effective collaboration across many sectors.

Preckwinkle said that she came before the CMS Council to emphasize that County is serious about engaging health care stakeholders to engage and work together, so efforts can move forward.  “I want to hear from you!” she concluded.

CMS continues to play a role in County governance.  As a member of the nominating committee that selects candidates for the Independent Board, CMS makes recommendations whenever a vacancy opens up on the Board.

The CCHHS includes two hospitals: Stroger and Provident, a Regional Outpatient Center at Oak Forest; a growing ambulatory and community health network; the Cermak correctional health care facility; the Ruth Rothstein CORE Center for HIV/AIDS prevention, care and research and the Department of Public Health.