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Amidst record tax hike, county cuts program for poor
moms, babies
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Daily Herald
July 14, 2008
By Rob Olmstead | Daily Herald Staff
Despite raising taxes $426 million annually earlier this year,
Cook County leaders have decided to stop funding at least $1.8
million a year for a program designed to keep poor pregnant
women and their babies healthy.
The move also will likely mean the layoff of 80 county employees.
County public health officials say the state program will continue
on without its participation, and poor mothers and babies will
receive preventive care.
But it is undisputed that as a result of the county's decision,
at least $1.8 million in funding will be lost.
"I think it's concerning any time a program designed to
prevent infant mortality - is eliminated," Cook County
Commissioner Forrest Claypool said. Claypool said he wasn't
passing judgment on the move just yet, but he indicated he would
be inquiring further into the matter.
Critics of the administration also questioned the timing of
the cuts, which removed the decision from the county board and
put it before a brand new hospital board, meeting Friday for
just the second time, even though problems with funding for
the program were known as far back as March.
"I wish they (county administrators) would have told us,"
said county Commissioner Mike Quigley, who wondered if the cuts
were deliberately delayed to ease their passage by putting them
before a new board. "You can get snookered (by the administration)
really easily - if you don't have the institutional memory here."
But county health administrators insist the state can provide
the same amount of services more efficiently by privatizing
the effort and avoiding ever-spiraling county personnel costs.
And they denied there was any delay in order to ramrod the changes
through a new and unsuspecting board.
"There was no push to push this off on anyone," said
Dr. Stephen Martin, the head of the county's public health department
and a member of President Todd H. Stroger's administration.
The program cuts came to light Friday at the board meeting of
the newly constituted Cook County Health and Hospitals System
board of directors. That board was created as part of the county
budget deal in February with the goal of putting county hospitals
and clinics back in the black financially by turning them over
to an independent board.
Previously, the hospitals and clinics had been run by the county
board.
While Friday's agenda contained items with as many as five paragraphs
to describe innocuous contract purchases, the elimination of
the poor mothers' program was referenced in just a single sentence
and described as a "motion to receive report." The
"report," in fact, was a move to dismantle the program.
Under the program, nurses and other county workers check up
on pregnant and new mothers enrolled in Medicare and their children
as old as 5. Case managers - both at mothers' homes and in health-care
clinics - check in regularly with them to ensure pregnant women
are eating right and getting checkups and that babies are receiving
vaccinations.
The county is then reimbursed by the state for providing the
services, at a contract rate of up to $6 million annually. Any
money the county spent in excess of that was then partially
matched at a rate of 50 cents on the dollar by the federal government.
Martin said the county had been spending $1.8 million more than
$6 million, and the federal government was then kicking in $900,000,
for a total program cost of $8.7 million.
In March, state administrators told the county the federal match
had dried up, Martin told the new board in a memo dated July
7. Martin and county officials then negotiated unsuccessfully
with the state to try to get it to kick in more money.
The state made its decision not to contribute any more funds
in April, Martin said.
So why didn't county officials then come to the county board,
which ran the hospital system at the time?
Martin said they waited in part because the state's fiscal year
didn't start until July 1.
Additionally, there was no good alternative to cuts.
"I would simply be asking them (the county board) to take
something from somewhere else," he said. "That would
not have gone over well either way."
To continue to fund the program, Martin said, "The county
would have to steal from other county health programs to pay
for a state program."
That reticence to approach the old governing body was atypical,
however. Last month, the county board approved a new clinic
in the Skokie courthouse. And just a month or two earlier, the
board approved a long-term contract with a bill-collection agency
it acknowledged the new board might not want.
Tom Green, a spokesman with the Illinois Department of Human
Services, confirmed that the county had notified the agency
it would not continue to administer the program.
As of yet, however, the state has not found any organization
to take over administration of the program, he said.
Martin told the board there will be a transition period of four
to five months while the county still provides the service because
by union contracts it must provide advance notice to employees
it plans to lay off. About 20 nurses are expected to be retained
in other positions that were deliberately left unfilled in anticipation
of the program shutdown, Martin said. But about 40 health advocates
and 40 clerks will likely be laid off, he said.
Asked about the impact on mothers and children by board member
David Ansell, Martin did not directly answer at first, but conceded
when pressed that it could result in lower birth weights in
the target group. And he acknowledged that even if the services
are picked up by another agency, they will be based on a social
service model, rather than the nurses the county currently uses.
The board approved the shutdown on a voice vote, with just one
board member abstaining.
