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Mental health groups oppose cuts, privatization

Mental health activists concerned about potential service cuts and privatization will hold a town hall meeting Friday with Chicago Health Commissioner Bechara Choucair.

Mental health providers and consumers will join Choucair on a panel, Friday, August 5, 5:30 p.m., in the Joyce Auditorium of Mercy Hospital, 2525 S. Michigan, 2nd floor.

The groups are demanding to be included in a task force on city-county collaboration formed by Mayor Emanuel and County President Preckwinkle.

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Hearing on Oak Forest Hospital

Another hearing on Cook County’s proposal to close Oak Forest Hospital takes place Monday, and patients, staff and community residents are expected to testify against the plan.

A hearing of the Illinois Health Facilities and Services Review Board takes place Monday, April 18, 10 a.m. at Bremen Township Hall, 15350 Oak Park Avenue in Oak Forest.

“We’re very concerned that the county is rushing to close it down without a better plan for the transition,” said Carol O’Neill, a former Oak Forest staffer. “There are a lot of unanswered questions.”

“The issue is that there needs to be a safety net” to provide care for the uninsured and underinsured — “so folks aren’t dying in the streets,” said John Gaudette of Citizen Action Illinois.

Last month the health facilities board voted against the county plan after a report from the Illinois Department of Public Health said the proposed closing would worsen the shortage of intensive care and long term care beds in the area.

The board is expected to reconsider the matter in May. Several vacant seats on the board may be filled by then.

The Cook County Health and Hospital System has proposed eliminating emergency, surgical and inpatient services at Oak Forest and turning it into an outpatient acute care facility. The plan is projected to save $25 million a year. The emergency room would become an urgent care clinic, open from 7 a.m. to 11 p.m.

“We have clinics” in the south suburbs, said Lee Mayberry, a longtime patient at Oak Forest. “What we need is a hospital.”

O’Neil expressed concern over increased risks for long-term care patients who might be moved to nursing homes.

Mayberry said a number of long-term care patients died within months after being moved to nursing homes when the county tried to close the unit in 2007.

He had high praise for the staff of Oak Forest.

The facilities board also cited vagueness over the county’s timeline for opening the proposed outpatient facility.

Candidates forum on County health system

One of the key issues in the race for Cook County Board president — maintaining Cook County’s crucial health services in a time of economic strain — will be the focus of a candidates forum tonight, hosted by the Emergency Network to Save Cook County Health Services.

Democrats Dorothy Brown, Toni Preckwinkle, and Todd Stroger; Republican John Garrido; and Green Party candidate Tom Tresser have agreed to attend, with Phil Kadner of the Southtown Star moderating.  The forum takes place at the Chicago Temple, 77 W. Washington, starting at 6 p.m. tonight.

In December the Emergency Network warned County Board members that rolling back the Cook County sales tax risks undermining efforts by the new independent health system board to improve the system’s cost-effectiveness.

Candidates will be asked for their views on maintaining adequate resources to fund the system – and if they support further sales tax reductions, how they plan to fund health services next year, particularly with one-time federal stimulus assistance expiring, said Lynda DeLaforgue of Citizen Action Illinois.

Candidates will also be asked their view of the independent board, which is currently set to expire in 2011.

County health cuts opposed

The Emergency Network to Save Cook County Health Services is calling on the County Board to reject health cuts when it votes on a 2009 budget later this month.

Quentin Young and other leaders from the coalition of 70 groups will speak at a press conference Wednesday, February 18 at 9:30 a.m. at the County Building.

At recent public hearings on the budget, county leaders repeatedly stressed that the health system would not be touched, said Patrick Keenan-Devlin of Citizen Action-Illinois.

But at last week’s finance committee meeting, after commissioners approved a 4 percent across-the-board cut to the County Budget that exempted the health system — and after five commisioners had left the meeting — an amendment cutting the health budget by 2 percent (or $14 million) was approved. The vote was 8 to 4, with 5 absent.

“In this economy, with people losing their jobs and insurance, we can’t afford a county health system that is just getting by,” Keenan-Devlin said. “We need to be investing in health care services, not cutting back.”

He praised the work of the health system oversight board appointed in 2008. They’ve launched a “very thorough” national search for a new health and hospitals CEO and begun studying reimbursement issues (and asking for a functional accounting system), he said. The budget they submitted in December restored some cuts in ambulatory clinics and some nursing positions and restored cuts to Cermak Health Services at the County Jail, where the oversight board is seeking to address accreditation issues.

On top of the “draconian cuts in 2007,” Keenan-Devlin said, “the system cannot sustain further cuts.

“We believe the money is in the system, and there’s no need for cuts like this,” he said, pointing to County President Todd Stroger’s projection of a 25 percent decline in sales tax revenues this year, which he called unrealistic and inflated.

County medical staff to march

Cook County medical staff will rally to oppose more health care cuts on Monday, February 18 at 10 a.m. at Chicago Temple, 77 W. Washington.  They’ll march to the County Building to demand Cook County rebuild, restore and reform its health bureau.  They’re backed by community and civic groups in the Emergency Network to Save Cook County Health Services.

While the County Board seems stalemated on its budget crisis, the Medical Staff Mobilization Committee has endorsed recommendations of the Center for Tax and Budget Accountability, which director Ralph Martire spelled out in a column last month.

County Board’s health reform plan blasted

Reports that Todd Stroger is giving up control of Cook County hospitals may be overstated, according to a coalition of health care and civic organizations.

Among problems with a new County Board proposal for an independent health governance body, announced this week by Commissioner Gregg Goslin, are provisions for Stroger to appoint all its members and for the County Board to approve its budget.

The proposal for an advisory committee to suggest members for the new health board is no more than window dressing, said Patrick Keenan-Devlin of the Emergency Network to Save Cook County Health Services.  Stroger “would not be required to adhere to the committee’s suggestions,” he said.

Allowing the President of the Cook County Board to appoint all members of the new board “will leave it beholden to his interests,” said William McNary of Citizen Action/Illinois. “The Goslin plan would only continue the status quo, which is rapidly weakening America’s second-largest public health system.”

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County Neglects Millions in Medicaid Funds

With a proposal to triple Cook County’s sales tax reportedly under consideration, the county has failed to collect tens of millions of dollars in federal reimbursements for Medicaid and Medicare patients, according to a new report detailing the county’s “structural deficit.”

The failure of the Bureau of Health Services to establish a billing system has cost the county at least $40 million a year, said Heather O’Donnell of the Center for Tax and Budget Accountability, co-author of a new analysis of Cook County’s revenue system.

The report offers a big-picture view of budget issues in order to advance discussion of long-term solutions, “rather than just putting another finger in the dike,” O’Donnell said.

Deficits Loom

Despite being constitutionally required to have a balanced budget, Cook County has run annual deficits for several years, according to the report — over $200 million in fiscal year 2002 and $479 million in fiscal year 2006.

Even with severe cuts in this year’s budget, a deficit over $120 million is expected, the report said. At current levels of services and revenue growth, the report projects annual shortfalls of a half billion dollars by 2010 and a $1.5 billion in ten years.

The county has been plugging budget gaps for years without addressing the basic problem: the revenue system doesn’t grow with the economy, while many costs of essential county services outpace inflation, O’Donnell said.

Property taxes, which provide a quarter of the county’s $2.8 billion operating budget, have been capped at $720 million for the past ten years; the second largest tax source, the sales tax (providing 13 percent of revenues), “only partially grows with the economy” because Illinois law excludes consumer services, the largest and fastest growing segment of the state’s economy, according to the report.

Medicaid Cuts

Meanwhile federal Medicaid cuts have reduced reimbursements by $139 million in the last two years. Medicaid funds now provide just half of the $810 million health budget, down from 65 percent three years ago, according to the report. And new federal regulations mean the county will get $500 million less in Medicaid funds in the next five years.

At the same time health care costs are increasing sharply, and demand for public health services is rising steadily.

The first step in addressing revenue issues is to begin collecting federal and state Medicaid and Medicare funds that are being lost because “the county doesn’t have a billing system in place to collect those dollars,” O’Donnell said.

Leaving Money on the Table

“It’s unconscionable that you have a public health system that is hanging by a thread, and they are leaving money on the table,” she said. Earlier this year the county “closed clinics and laid off doctors and nurses — and if nothing is done they are going to have another round of cuts next year,” she noted.

While the county needs to find revenue sources that grow with the economy, “they can’t ask taxpayers to pony up with higher tax rates when there are federal dollars they could go after if they had a billing system in place,” O’Donnell said. “They have a public duty to collect the revenue that is due to them” from other agencies.

CBTA expects to release a second report analyzing revenue alternatives for the county in coming weeks.

Charge County ‘Dumping’ Patients

As concern mounts that Cook County is “dumping” disabled patients from Oak Forest Hospital’s long-term care unit, the scheduled closing of the unit may have to be postponed

A spokesperson for the Illinois Health Facilities Planning Board said today that the county’s application to close the unit had been deemed incomplete and returned by the board.

After a completed application is accepted, the board has 60 days to review the closing and to hold public hearings if they are requested. That could make it difficult to get on the agenda at the board’s August 28 meeting.

The long-term care unit, which housed 220 severely disabled patients, was slated to close September 1. Last week a County spokesman expressed confidence that the IHFPB would give final approval to the closing “soon.”

Scores of patients, including many who are paralyzed, have already been transferred to nursing homes. All transfers have been voluntary, according to statements by interim health chief Robert Simon at County Board meetings. Others dispute that.

“So far as the families [of patients] that we’ve talked to, none of the transfers has been done voluntarily,” said Kathleen Oskandy, an aide to County Commissioner Roberto Maldonado.

She said patients’ families are being told they have a deadline of two to three weeks to move. “They’re being pressured,” she said. “It’s troubling.” They also have reports that patients are being sent “to facilities that are not providing proper care,” she said.

Maldonado has called for a moratorium on transfers until the closing is approved.

“They are not leaving voluntarily,” said Horacio Esparza, director of Progress Center South, an independent living center in Park Forest. He called on commissioners to follow up with patients who have been discharged to determine the terms under which they were moved as well as how they are currently faring.

“It’s not just about money; these are human beings,” he said.



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