Testimony to the Finance Committee of the Cook County Board of Commissioners

(October 2, 2007) - The AIDS Foundation of Chicago (AFC) is alarmed by the impact of recent service cuts at the Cook County Bureau of Health Services and the prospect of additional service reductions in 2008. Without forceful leadership, the healthcare safety net for hundreds of thousand of county residents will simply disappear. People with HIV/AIDS are among the thousands of low-income residents directly affected by the piecemeal dismantling of Cook County’s public healthcare system. Consider the following:

•The Cook County Bureau of Health Services is the state’s leading provider of HIV-related healthcare, serving an estimated 1 in 3 HIV-positive patients in Chicago (1 in 5 in Illinois). An estimated 5,500 HIV-positive people receive their healthcare at the Ruth M. Rothstein CORE Center.

•HIV-related healthcare and voluntary HIV testing services were disrupted for hundreds of patients when 13 community clinics were closed earlier this year.

•CORE Center clients no longer have on-site access to X-ray services or the evening STD screening clinic. Voluntary STD and HIV testing services were also eliminated at Cook County Jail. An estimated 8,000 to 10,000 County residents do not know they have HIV and will not learn unless testing services are readily available.

•In an attempt to improve third-party reimbursement, thousands of patients have received county bills that they can’t afford to pay. And some have even been referred to payment collection agencies.

•Fewer staff in the County’s three hospitals—Stroger, Provident, and Oak Forest—means less attention to quality management, which could put the hospitals’ accreditation in jeopardy. Los Angeles County’s King-Harbor Hospital closed abruptly this summer after losing accreditation.

•The Cook County Department of Public Health, with responsibility for HIV and STD prevention services in suburban Cook County, is severely under-funded to adequate fulfill its mission.

Immediate actions needed to stabilize and improve county health services include:

•Appropriate New Revenue: Investments in new billing systems, shepherding the accreditations process, and restructuring the Bureau of Health—without additional cuts to essential staff—will require an investment in new funding. Cook County officials will need to identify the revenue generating mechanism best suited to allow increased appropriations to the Bureau of health services.

•Place the Health Bureau in Receivership: It’s time for the Cook County’s health system to be professionally managed by an independent and autonomous governing board that will adopt private-sector healthcare management strategies. Under a new management structure, the Bureau can pursue a wide-scale restructuring.

•Partnerships: Saving the Bureau of Health will require stronger partnerships with state and federal agencies, community health clinics, and the private sector. Only by placing the Bureau in receivership and investing in its future can trust be renewed in the Bureau to attract and inspire stronger partnerships.

The Cook County Bureau of Health is the largest provider of medical care to the uninsured, under-insured, and Medicaid population in Illinois and the 3rd largest public hospital system in the nation. Protecting this legacy for the people of Cook County must be a high priority for the President and Board of Commissioners. We hope you will take immediate actions to safeguard and improve the health system in Cook County.

Testimony submitted by:

David Ernesto Munar
Vice President for Policy & Communications
AIDS Foundation of Chicago
411 S. Wells Street, Suite 300
Chicago, IL 60607

Take Action to Save the Cook County Health System!

Center for Tax & Budget Accountability Report Explains Cook Structural Deficit (PDF)

Northwestern University Report: An Action Agenda for the Cook County Health System (PDF)

Read AFC's 2006 Testimony on County Health System