REPORT OF THE COMMITTEE ON HEALTH &
HOSPITALS
The Honorable,
The Board of Commissioners of
ATTENDANCE
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Present: |
Chairman Butler, Vice Chairman Goslin, Commissioners
Beavers, Claypool, Collins, Daley, Gorman, |
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Absent: |
Commissioners Maldonado and Steele (2) |
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Also
Present: |
Elizabeth Reidy, State’s Attorney’s Office |
Ladies and
Gentlemen:
Your Committee on Health &
Hospitals of the Board of Commissioners of Cook County met pursuant to notice
on
Your Committee has considered the
following item and upon adoption of this report, the recommendations are as
follows:
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293933 |
AN AMENDMENT TO THE ORDINANCE ESTABLISHING THE COOK The following is a synopsis of the Proposed Ordinance
Amendment: PROPOSED ORDINANCE AMENDMENT AN AMENDMENT TO THE ORDINANCE ESTABLISHING THE COOK COUNTY HEALTH AND HOSPITALS SYSTEM BE
IT ORDAINED, pursuant to Cook County's home rule authority under
Article VII, Section 6(a) of the 1970 Constitution of the State of Illinois,
by the Cook County Board of Commissioners (“County Board”) that Chapter 38,
Health and Human Services, Article 1, In General, Sections 38-2 through 38-5 of the Cook
County Code are removed from Article I, are inserted into a newly created
Article IV, Cook County Health and Hospitals System, and are thereafter
amended and renumbered as follows: ARTICLE IV. COOK COUNTY HEALTH AND HOSPITALS SYSTEM Sec. 38-70. Short Title. Sec. 38-71. Declaration. Sec. 38-72. Definitions.
Sec. 38-73. Establishment of the
Sec. 38-74.
Sec. 38-75. Nominating
Committee.
Sec. 38-76. Members of the System Board. Sec.
38. Sec. 38-78.
Chairperson/Officers of System Board. Sec. 38-79. Meetings of the
System Board.
Sec. 38-80. General Powers of
the System Board.
Sec. 38-81. Chief Executive Officer.
Sec. 38-82. Strategic and
Financial Plans. Sec. 38-83. Preliminary CCHHS
Budget and Annual Appropriation Ordinance. Section
38-84. Human Resources. Section 38-85. Procurement and
Contracts. Sec. 38- Sec. 38-87. Annual Report of System
Board. Sec. 38-88. Managerial and Financial Oversight. Sec. 38- Sec. 38- Sec. 38-91. Transition. Sec. 38
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Commissioner Suffredin,
seconded by Commissioner Collins, moved the approval of Communication No.
293933 for the purpose of an amendment.
COMMUNICATION
NUMBER 293933
Submitting a Proposed Ordinance Amendment sponsored by
LARRY SUFFREDIN,
PROPOSED ORDINANCE AMENDMENT
ORDINANCE ESTABLISHING THE COOK
BE IT ORDAINED, pursuant to Cook County's home rule authority under Article VII,
Section 6(a) of the 1970 Constitution of the State of Illinois, by the Cook
County Board of Commissioners (“County Board”) that Chapter 38, Health and
Human Services, Article 1, In General, Sections 38-2 through 38-5 of the Cook
County Code are removed from Article I, are inserted into a newly created
Article IV, Cook County Health and Hospitals System, and are thereafter amended
and renumbered as follows:
ARTICLE IV. COOK COUNTY HEALTH AND HOSPITALS SYSTEM
Sec. 38-70. Short Title.
This Ordinance shall be known and
may be cited as the “Ordinance Establishing the
Sec. 38-71. Declaration.
(a) The
(1) Provide
integrated health services with dignity and respect, regardless of a patient's
ability to pay;
(2) Provide
access to quality preventive, acute, and chronic health care for all the People
of Cook County, Illinois (the “County”);
(3) Provide
quality emergency medical services to all the People of the County;
(4) Provide
health education for patients, and participate in the education of future
generations of health care professionals;
(5) Engage
in research which enhances its ability to meet the healthcare needs of the
People of the County; and,
(6) Perform, through the Cook County
Department of Public Health, essential services of a local public health
authority as provided in the Department of Public Health Act, 20 ILCS 2305/1 et seq., and the Civil Administrative
Code of Illinois, 20 ILCS 2310/2310-1 et
seq., and as further detailed in regulations promulgated by the Illinois
Department of Public Health under the Certified Local Health Department Code,
77 Ill. Adm. Code 600.110 et seq.;
provided, however, that the County Board shall continue to serve as the Board
of Health of Cook County.
(b) This Ordinance recognizes the essential
nature of the
Sec. 38-72. Definitions.
For purposes of this Ordinance, the
following words or terms shall have the meaning or construction ascribed to
them in this Section:
Chairperson means the chairperson of the System Board.
Cook County Code means the Code of Ordinances of Cook County,
Cook County Health and Hospitals System also referred to as “CCHHS”, means
the public health system comprised of the facilities at, and the services
provided by or through, the Ambulatory and Community Health Network, Cermak
Health Services of Cook County, Cook County Department of Public Health, Oak
Forest Hospital of Cook County, Provident Hospital of Cook County, Ruth M.
Rothstein CORE Center, and John H. Stroger, Jr. Hospital of Cook County,
(collectively, the “CCHHS Facilities”).
County
means the
Director means a member of the System Board.
Fiscal Year means the fiscal year of the County.
Ordinance means the “Ordinance Establishing the
President means the President of the
System Board means the ten-member board of directors charged with
governing the CCHHS.
See. 38 2.----- Creation of Cook County Bureau of Health Directors.
The Cook County
Board of Commissioners (the “Board”) hereby establishes the Cook County Bureau
of Health Directors (“CCBOHD”) for a term of three (3) years. The President and
the Board shall delegate oversight of the Cook County Bureau of Health Services
to the CCBOHD consistent with this Ordinance. The Directors shall, immediately
upon initial approval by the Board of Commissioners of the appointment of
members of IBOD, assume responsibility for the oversight of all entities
currently within the jurisdiction of the Cook County Bureau of Health Services.
The Directors shall consist of an Interim Board of Directors (“IBOD”) with nine
(9) members. All votes shall require a simple majority of the full IBOD.
Sec. 38-73. Establishment of the
(a) The System Board is hereby created and
established. The System Board shall
consist of ten (10) members called Directors.
The
(b) The System Board shall exist for a
minimum of three (3) years. The System
Board may be terminated by action taken by the Illinois General Assembly to
create a special district governing the CCHHS facilities and services.
Sec. 38-74.
(a) The System Board shall have the
responsibility to carry out and fulfill the mission of the CCHHS by:
(1) Continuing
to provide integrated health services with dignity and respect, regardless of a
patient's ability to pay;
(2) Continuing
to provide access to quality primary, preventive, acute, and chronic health
care for all the People of the County;
(3) Continuing
to provide high quality emergency medical services to all the People of the
County;
(4) Continuing
to provide health education for patients, and continuing to participate in the
education of future generations of health care professionals;
(5) Continuing
to engage in research which enhances the CCHHS' ability to meet the healthcare
needs of the People of the County;
(6) Ensuring
efficiency in service delivery and sound fiscal management of all aspects of
the CCHHS, including the collection of all revenues from governmental and
private third party payers and other sources;
(7) Ensuring
that all operations of the CCHHS, especially contractual and personnel matters,
are conducted free from any political interference and in accordance with the
provisions of the Supplemental Relief Order and Consent Decree established in
the federal civil litigation filed in the Northern District of Illinois under
Case No. 69 C 2145 and titled Shakman, et al. v.
Democratic Organization, et al. and all applicable laws; and,
(8) Performing,
through the Cook County Department of Public Health, essential services of a
local public health authority as provided in the Department of Public Health
Act, 20 ILCS 2305/1 et seq., and the
Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 et seq., and as further detailed in regulations promulgated by the
Illinois Department of Public Health under the Certified Local Health
Department Code, 77 Ill. Adm. Code 600.110 et
seq.; provided, however, that the County Board shall continue to serve as
the Board of Health of Cook County.
(b) The System Board shall be responsible to
the People of the County for the proper use of all funds appropriated to the
CCHHS by the
Sec. 38.2.a.-- Members of the IBOD shall be selected by the following
process.
Sec. 38-75. Nominating Committee.
Sec 38 2.a(i). A Nominating
Committee shall be convened no later than H days after enactment of this
ordinance.
(a) The Nominating Committee
shall elect its chair from among its members and all decisions shall be by
majority vote of the membership. The Nominating Committee shall include one (1)
representative person designated by from each of the
following organizations:which
so agree to participate as its representative The Nominating Committee shall
elect its chair from its own ranks.—All decisions shall be by majority vote. Tho Nominating Committee shall recommend twenty (20)
candidates for nomination and shall transmit their names and qualifications to tho President of the Cook Count)' Board within 30 days of
the Nominating Committee's convening.
(1) Civic
Federation of
(2) Civic
Committee of the Commercial Club of
(3)
(4) Healthcare
Financial Management Association;
(5) Suburban
Primary Healthcare Council;
(6)
(7) Metropolitan
(8) Health
and Medicine Policy Research Group;
(9) Chicago
Department of Public Health;
(10)
(11)
(12)
(13) Association
of Community Safety Net Hospitals; and
(14)
(b) Pursuant to Ordinance 08-O-22, “Ordinance
Concerning The Bureau of Health Services Notwithstanding Any Provision in
Existing Ordinances,” which ordinance is amended by this Ordinance, the Nominating
Committee convened, selected the names of twenty (20) individuals and
transmitted these names to the President for nomination to the System
Board. Pursuant to Ordinance 08-O-22,
“Ordinance Concerning The Bureau of Health Services Notwithstanding Any Provision
in Existing Ordinances,” which ordinance is amended by this Ordinance, the
President then selected nine (9) names from among the names submitted by the
Nominating Committee for the office of Director, and forwarded the list of nine
(9) names to the County Board for its approval.
The Board shall
provide necessary funding to allow the Nominating Committee to accomplish its
purpose.
Sec. 38-2.a(ii). The President shall select nine Directors from
tho list of twenty submitted by the Nominating Committee
within H days of receipt. — Once nine (9) nominees have been selected, the
President shall submit the final list of nominees to the Cook County Board of
Commissioners.
Sec. 38 2.a(iii). The
Cook County Board of Commissioners must vote to confirm or reject each of the
nominees, as submitted by the President by majority vote within H days of
submission. If a nominee is rejected, then the President must submit another
nominee from the list of twenty candidates.
Sec. 38-76. Members of the System Board.
(a) One
of the ten (10) Directors shall be the Chairperson of the Health and Hospitals
Committee of the
(b) The
remaining nine (9) Directors of the System Board shall be appointed and removed
as follows:
(1) For
the initial Directors, the
a. Of the nine
(9) Directors first appointed:
1. Four (4) Directors shall serve a term
of three (3) years as designated by the President in his recommendation to the
2. Five (5) Directors shall serve a term
of five (5) years as designated by the President in his recommendation to the
b. After
the expiration of the initial term of each appointed Director, all subsequent
terms shall be for five (5) years.
c. Each
appointed Director, whether initial or subsequent, shall hold office until a
successor is appointed. Any appointed Director shall be eligible for
reappointment, but no appointed Director shall be eligible to serve more than
two consecutive five-year terms.
d. Upon
the expiration of an appointed Director’s term, the successor Director shall be
appointed in the same manner as the process set forth above for the nomination,
selection and appointment of initial Directors; provided, however, that the
Nominating Committee shall recommend three (3) names for each Director position
to be filled at that time.
e. Any
appointed Director may be removed for incompetence, malfeasance, neglect of
duty, or any cause which renders the Director unfit for the position. The
President or one-third (1/3) of the members of the County Board shall provide
written notice to that Director of the proposed removal of that Director from
office; which notice shall state the specific grounds which constitute cause
for removal. The Director in receipt of
such notice may request to appear before the
(2) In the
event of a vacancy in an appointed Director position on the System Board, the
President may recommend a replacement name to the
a. A vacancy
shall occur upon the:
1. Resignation,
2. Death,
3. Conviction
of a felony, or
4. Removal
from the office of an appointed Director as set forth in Section 38-76(B)(1)(e) of this Article.
b. Any appointed Director who is appointed
to fill a vacancy shall serve until the expiration of his predecessor's term.
(c) The appointed Directors are not
employees of the County and shall receive no compensation for their service but
may be reimbursed for actual and necessary expenses while serving on the System
Board.
(d) Directors
shall have a fiduciary duty to the CCHHS and the County.
Sec. 38.2. b.-77. Qualifications of theAppointed
Directors.
The slated
nominees, as proposed to the President of the Cook County Board for his consideration, shall
include among them The appointed Directors shall include persons with the requisite
expertise and experience in areas pertinent to the governance and operation of
a large and complex healthcare system. Among
these areas shall be expertise and experience in the fields of Such
areas shall include, but not be limited to, finance, legal and regulatory
affairs, healthcare management, employee relations, public administration, and
clinical medicine. The Nominating
Committee, the President and the
Sec. 38-78. Chairperson/Officers of
System Board.
(a) The Directors shall select the initial
Chairperson of the System Board from among the initial Directors. The Chairperson shall serve a one-year term
and, thereafter, the System Board shall annually elect a chairperson from among
the Directors.
(1) The
Chairperson shall preside at meetings of the System Board, and is entitled to
vote on all matters before the System Board, unless the Chairperson is the ex-officio member.
(2) A
Director may be elected to serve successive terms as Chairperson.
(b) The Directors may establish such
additional offices and appoint such additional officers for the System Board as
they may deem appropriate.
Sec. 38-79. Meetings of the System
Board.
(a) The President shall call the first
meeting of the System Board. Thereafter,
the Directors shall prescribe the times and places for their meetings and the
manner in which regular and special meetings may be called.
(b) Meetings shall be held at the call of the
Chairperson, however, no less than twelve (12) meetings shall be held annually.
(c) A majority of the voting Directors shall
constitute a quorum. Actions of the System Board shall require the affirmative
vote of a majority of the voting members of the System Board present and voting
at the meeting at which the action is taken.
(d) To the extent feasible, the System Board
shall provide for and encourage participation by the public in the development
and review of financial and healthcare policy. The System Board may hold public
hearings as it deems appropriate to the performance of any of its
responsibilities.
(e) The System Board shall comply in all
respects with “An Act in relation to meetings,” as now or hereafter amended,
and found at 5 ILCS 120/1, et seq.
(f) The System Board shall be an Agency to
which the “Local Records Act,” as now or hereafter amended, and found at 50 ILCS
205/1, et seq. applies.
Sec. 38.2.c. - Compensation for the Directors. — Directors shall be
reimbursed for all reasonable expenses relating to the performance of their
duties, but shall be otherwise uncompensated. “Reasonable expenses” shall
include administrative and secretarial support as
Sec. 38.2.d. - Fiduciary duty. Directors shall have a fiduciary
duty to the Cook County Bureau of Health Services, the President, the Board of
Commissioners, and the citizens of Cook
Sec. 38.2.e. Replacement
of Directors.—If a Director resigns from the 1BOD then
the Nominating Committee shall be convened to propose a replacement. The
process of confirmation shall then be applied as outlined above.
Sec. 38.2.f. Removal
of Directors.—A Director may be removed for cause by a majority vote of the
Nominating Committee after having been provided notice of the intent to remove
said Director with reasonable time for the Director to respond thereto.
Sec. 38-80. General Powers of the
System Board.
Subject to the
(a) To
appoint the Chief Executive Officer of the CCHHS (“CEO”) or interim CEO, if
necessary, as set forth in Sec. 38-81 hereinafter, to hire such employees and
to contract with such agents, and professional and business advisers as may
from time to time be necessary in the System Board’s judgment to accomplish the
CCHHS’ Mission and the purpose and intent of this Ordinance; to fix the compensation
of such CEO, employees, agents, and advisers; and, to establish the powers and
duties of all such agents, employees, and other persons contracting with the
System Board;
(b) To
exercise oversight of the CEO;
(c) To
develop measures to evaluate the CEO's performance and, to report to the
President and the
(d) To
authorize the CEO to enter into contracts, execute all instruments, and do all
things necessary or convenient in the exercise of the System Board’s powers and
responsibilities;
(e) To
determine the scope and distribution of clinical services; provided, however, if the System Board
determines that it is in the best interest of the CCHHS to close entirely one
of the three CCHHS hospitals, such closure will require County Board approval;
(f) To
provide for the organization and management of the CCHHS, including, but not
limited to, the System Board’s rights and powers to approve all personnel
policies, consistent with existing state laws, collective bargaining
agreements, and court orders;
(g) To
submit budgets for the CCHHS operations and capital planning and development,
which promote sound financial management and assure the continued operation of
the CCHHS, subject to approval by the
(h) To
accept any gifts, grants, property, or any other aid in any form from the
federal government, the state, any state agency, or any other source, or any
combination thereof, and to comply with the terms and conditions thereof;
(i) To purchase, lease, trade, exchange, or
otherwise acquire, maintain, hold, improve, repair, sell, and dispose of
personal property, whether tangible or intangible, and any interest therein;
(j) In
the name of the County, to purchase, lease, trade, exchange, or otherwise
acquire, real property or any interest therein, and to maintain, hold, improve,
repair, mortgage, lease, and otherwise transfer such real property, so long as
such transactions do not interfere with the Mission of the CCHHS; provided,
however, that transactions involving real property valued at $100,000 or
greater shall require express approval from the County Board;
(k) To
acquire space, equipment, supplies, and services, including, but not limited
to, services of consultants for rendering professional and technical assistance
and advice on matters within the System Board’s powers;
(l) To
make rules and regulations governing the use of property and facilities within
the CCHHS, subject to agreements with or for the benefit of holders of the
County Board's obligations;
(m) To
adopt and from time to time amend or repeal bylaws and rules and regulations
consistent with the provisions of this Ordinance;
(n) To
encourage the formation of a not-for-profit corporation to raise
funds to assist in carrying out the
(o) To
engage in joint ventures, or to participate in alliances, purchasing consortia,
or other cooperative arrangements, with any public or private entity,
consistent with state law;
(p) To
have and exercise all rights and powers necessary, convenient, incidental to,
or implied from the specific powers granted in this Ordinance, which specific
powers shall not be considered as a limitation upon any power necessary or
appropriate to carry out the CCHHS’ Mission and the purposes and intent of this
Ordinance;
(q) To
perform, through the Cook County Department of Public Health, essential
services of a local public health authority as provided in the Department of
Public Health Act, 20 ILCS 2305/1 et seq.,
and the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 et seq., and as further detailed in
regulations promulgated by the Illinois Department of Public Health under the
Certified Local Health Department Code, 77 Ill. Adm. Code 600.110. et seq.; provided, however, that the
(r) To
be the governing body of the licensed hospitals or other licensed entities
within the CCHHS.
Sec. 38 3.------ Powers and Responsibilities of the IBOD.
The Interim Board
of Directors shall have as its primary purpose, the following powers and
responsibilities:
1) Ensuring the
availability and access to high quality health care services, including primary
and preventive care, for all medically indigent Cook County residents;
2) Ensuring efficacy in
service delivery;
3) Ensuring sound fiscal
management of all aspects of the Bureau of Health Services, including the
collections of all governmental and private third party payers and other
revenues;
4) Ensuring
that all operations of the Bureau of Health Services, especially contractual
and personnel matters are conducted free from any political interference in
accordance with all applicable law;
5) Oversight of
the Chief of the Bureau and the development of measures to evaluate the Chiefs
performance, including the reporting of such measures to the Board at six (6)
month intervals;
6) Approval of
annual operations and capital budgets which shall be submitted to the Board for
final approval;
7) Approval of
all personnel policies, consistent with existing state laws, county ordinances,
personnel codes, collective bargaining agreements and
court orders;
8) Approval of
all leases, intergovernmental agreements and contracts, including all vendor
and private third party payer agreements, with the prior approval of the Board
of Commissioners of Cook County;
9) Acquisition,
sale, repair and maintenance of all Bureau property and assets, with the prior
approval of the Board of Commissioners of Cook County;
10) Conducting
long range strategic and fiscal planning, including the establishment and
maintenance of operational and capital reserves specifically allocated to the
CCBOHS;
11) Conducting
audits in the manner now or hereafter provided for the audit of County funds
and accounts. A copy of the audit report shall be submitted to the President,
the Chairman of the Finance Committee of the Board, the Chairman of the Health
and Hospitals Committee, and the Director of the County Office of the Auditor;
12) The Board shall
elect its chair from its own ranks; and
13) The Board
shall provide necessary funding to allow the IBOD to accomplish its purpose.
Sec. 38-81. Chief Executive Officer.
(a) The System Board shall appoint a Chief
Executive Officer of the CCHHS (“CEO”) or an interim CEO as necessary.
(b) The System Board shall conduct a
nationwide search for a CEO which shall be concluded no later than one hundred
eighty (180) days from the date of the
(c) The CEO shall have the responsibility for
(1) Full operational and managerial authority
of the CCHHS, consistent with existing federal and state laws, court orders and
the provisions of this Ordinance;
(2) Preparing and submitting to the System Board
the Budgets and Strategic and Financial Plans required by this Ordinance;
(3) Operating and managing the CCHHS
consistent with the Budgets and Financial Plans approved by the
(4) Overseeing expenditures of the CCHHS;
(5) Subject to Section 38-74(A)(7) of this
Ordinance, hiring and discipline of personnel in conformity with the provisions
of this Ordinance, all state laws, court orders, and collective bargaining
agreements;
(6) Negotiating collective bargaining
agreements as set forth in Sec. 38-84(C); and
(7) Carrying out any responsibility which the
System Board may delegate; however, said delegation shall not relieve the
System Board of its responsibilities as set forth in this Ordinance.
(d) The CEO shall report to the System Board.
(e) The CEO shall provide, through the System
Board, quarterly reports to the
Sec. 38 4.----- Chief of the Bureau of Health Services; appointment and powers.
The IBOD shall, as
soon as practical, select an Interim Chief of the Bureau of Health Services to
take over all administrative responsibilities.—The IBOD shall conduct a
nationwide search in order to select the Chief of the Bureau of Health
Services.—Such search shall be concluded no later than 180 days from the
enactment of this Ordinance.—All current Bureau staff shall assist in the
transition.
The Chief of the
Bureau of Health Services shall have full operational responsibility and
independent managerial authority for all entities within tho
Bureau, consistent with all applicable federal, state and county law and
regulations:
1) Establishing
Bureau of Health Services operational and capital budgets subject to IBOD
approval;
2) Hiring
and firing of personnel in conformity with all state laws, county ordinances,
personnel codes, court orders and collective bargaining agreements;
3) Development
and implementation of personnel policies consistent with all existing state
laws, count)' ordinances, personnel codes, court orders and collective
bargaining agreements, subject to IBOD approval;
4) Selection
of outside vendors and consultants in conformity with all count)' ordinances;
5) Negotiating
and executing leases, intergovernmental agreements and contracts, including
private third party payer agreements, subject to the approval of the IBOD for
all such transactions in excess of a specified dollar amount, to be set by tho IBOD, subject to the prior approval of the Cook County
Board of Commissioners; and
6) The
purchase, sale or repair of equipment consistent with the Cook County
Procurement Ordinance.
The Chief of the Bureau of Health
Services shall submit a report quarterly to the Health & Hospitals
Committee of the Cook County Board of Commissioners regarding the status of
Bureau operations.
Sec. 38-82. Strategic and Financial
Plans.
(a) As soon as practicable following the
establishment of the System Board, the President shall provide to the System
Board copies of the audited financial statements and of the books and records
of account of the Bureau of Health Services for the preceding five (5) Fiscal
Years of the County.
(b) The System Board shall recommend and submit
to the President and the
(c) Each Strategic and Financial Plan for each
Fiscal Year, or part thereof to which it relates, shall contain:
(1) A description of revenues and
expenditures, provision for debt service, cash resources and uses, and capital
improvements, each in such manner and detail as the County’s Budget Director
shall prescribe;
(2) A description of the strategy by which
the anticipated revenues and expenses for the Fiscal Years covered by the
Strategic and Financial Plan will be brought into balance;
(3) Such other matters that the County
Board, in its discretion, requires; provided, however, that the System Board
shall be provided with a description of such matters in sufficient time for
incorporation into the Strategic and Financial Plan.
(d) Strategic and Financial Plans shall not
have force or effect without the approval of the County Board and shall be
recommended, approved and monitored in accordance with the following:
(1) The System Board shall recommend and
submit to the President and the County Board, on or before one hundred eighty
(180) days subsequent to the date of the appointment of the initial Directors
or as soon as practicable thereafter, an initial Strategic and Financial Plan
with respect to the remaining portion of the Fiscal Year ending in 2008 and for
Fiscal Years 2009 and 2010. The Board
shall approve, reject or amend this initial Strategic and Financial Plan within
forty-five (45) days of its receipt from the System Board.
(2) For the 2011 Fiscal Year and every
second year thereafter, the System Board shall develop a Strategic and
Financial Plan covering a period of two (2) Fiscal Years. The System Board shall recommend and submit
each Strategic and Financial Plan to the President and the County Board for the
County Board’s approval not later than thirty (30) days prior to the
commencement of the Fiscal Year prior to the first Fiscal Year to which the
Strategic and Financial Plan applies.
(3) The System Board shall include in each
Strategic and Financial Plan estimates of revenues during the period for which
the Strategic and Financial Plan applies. In the event the System Board fails,
for any reason, to include estimates of revenues as required, the
(4) The
(5) The System Board shall report to the
President and the
(6) For each Strategic and Financial Plan
applicable to a Fiscal Year subsequent to the current Fiscal Year, the System
Board shall regularly reexamine the revenue and expenditure estimates on which
it was based and revise them as necessary. The System Board shall promptly
notify the President and the
Sec. 38-83. Preliminary CCHHS Budget
and Annual Appropriation Ordinance.
(a) The System Board shall not make
expenditures unless such expenditures are consistent with the County’s Annual
Appropriation Bill (“Annual Appropriation Ordinance”) as provided in 55 ILCS
5/6-24001 et seq.
(b) The System Board may, if necessary,
recommend and submit to the President and the County Board, for approval by the
County Board, a request for intra-fund transfers within the Public Health Fund
to accommodate any proposed revisions by the System Board to the line items set
forth for the Bureau of Health Services in the existing Fiscal Year 2008 Annual
Appropriation Ordinance.
(c) For Fiscal Year 2009 and each Fiscal Year
thereafter, the System Board shall recommend and submit a Preliminary Budget
for the CCHHS to the President and the County Board, for approval by the County
Board, not later than forty-five (45) days prior to the first date for
submission of budget requests set by the County’s Budget Director.
(d) Each Preliminary Budget shall be
recommended and submitted, in accordance with the following procedures:
(1) Each Preliminary Budget submitted by the
System Board shall be based upon revenue estimates contained in the approved
Strategic and Financial Plan applicable to that budget year.
(2) Each Preliminary Budget shall contain
such information and detail as may be prescribed by the County’s Budget
Director. Any applicable fund deficit for the Fiscal Year ending in 2008 and
for any Fiscal Year thereafter shall be included as an expense item in the
succeeding Fiscal Year’s Budget.
(e) The County Board shall approve each
Preliminary Budget if, in its judgment, the Budget is complete, is reasonably
capable of being achieved, and will be consistent with the Strategic and
Financial Plan in effect for that Fiscal Year. The Board shall approve or
reject each Preliminary Budget within forty-five (45) days of submission to the
(f) The CCHHS’s
Annual Appropriation shall be monitored as follows:
(1) The
County Board may establish and enforce such monitoring and control measures as
the County Board deems necessary to assure that the revenues, commitments,
obligations, expenditures, and cash disbursements of the System Board continue
to conform on an ongoing basis with the Annual Appropriation Ordinance. If, in the discretion of the County Board,
and notwithstanding the approved Annual Appropriation Ordinance, the County
Board imposes an expenditure limitation on the System Board, the System Board
shall not have the authority, directly or by delegation, to enter into any
commitment, contract, or other obligation that would result in the expenditure
limitation being exceeded. Any such commitment, contract or other obligation
entered into by the System Board in derogation of this Section shall be voidable by the
(2) The
System Board shall report to the President and the
(3) After
approval of each Annual Appropriation Ordinance, the System Board shall
promptly notify the President and the
(4) The
County Comptroller is hereby authorized to process invoices and make payments
against line items set forth in the Annual Appropriation Ordinance at the
direction of the System Board or, if authorized by the System Board, at the
direction of the CEO. The System Board shall provide the Comptroller with all
documentation necessary for the Comptroller to perform this accounts payable
function and to perform the budget control function. The Comptroller shall also issue payroll
checks for employees within the CCHHS.
Section 38-84. Human Resources.
(a) Notwithstanding the provisions of the Cook
County Code, including, but not limited to, provisions pertaining to Personnel
Policies, the System Board shall have authority over all human resource
functions currently performed by the Cook County Bureau of Human Resources with
regard to all employees, including physicians and dentists, within the CCHHS,
including, but not limited to, position classification, compensation,
recruitment, selection, hiring, discipline, termination, grievance, affirmative
action, performance management, probationary periods, training, promotion and
maintenance of records. The System Board
shall adopt written rules, regulations and procedures with regard to these
functions. Until such time as the System
Board adopts its own rules, regulations or procedures with regard to these
functions, the existing Personnel Rules, regulations and procedures of the
County shall apply. The System Board may
exercise the authority granted in this Section, in whole or in part, pursuant
to its discretion and consistent with existing collective bargaining agreements
and obligations.
(b) Employees within the CCHHS are employees
of the County, and as such shall be free from any political interference in
accordance with the Supplemental Relief Order and Consent Decree established in
the federal civil litigation filed in the Northern District of Illinois under
Case No. 69 C 2145 and titled Shakman, et al. v.
Democratic Organization, et al.
(c) The CEO shall participate with the County
in negotiating collective bargaining agreements covering CCHHS employees. All such collective bargaining agreements
must be approved by the System Board and the
(d) The System Board or the CEO shall not
hire or appoint any person in any position in the CCHHS unless it is consistent
with the Annual Appropriation Ordinance in effect at the time of hire or
appointment.
(e) Nothing herein shall diminish the rights
of Cook County employees who are covered by a collective bargaining agreement
and who, pursuant to this Ordinance, are placed under the jurisdiction of the
System Board, nor diminish the historical representation rights of said
employees’ exclusive bargaining representatives, nor shall anything herein
change the designation of “Employer” pursuant to the Illinois Public Labor
Relations Act. The System Board shall
honor all existing collective bargaining agreements, between
Section 38-85. Procurement and Contracts.
(a) The System Board shall have authority
over all procurement and contracts for the CCHHS. The System Board shall adopt written rules,
regulations and procedures with regard to these functions which must be
consistent with the provisions set forth in the Cook County Code on Procurement
and Contracts; provided, however, that approval of the County Board or County
Purchasing Agent required under the Cook County Code on Procurement and
Contracts are not required for procurement and contracts within the CCHHS. The System Board shall act in place of the
County Board in any contract, bylaws or agreement with the County which
requires the approval or other action of the County Board unless expressly
prohibited otherwise in this Ordinance or unless the contract expressly
provides that the System Board shall not have such authority. Until such time as the System Board adopts
its own rules, regulations or procedures with regard to Procurement and
Contracts, the existing provisions of the
(b) No contract or other obligation shall be
entered into by the System Board unless it is consistent with the Annual
Appropriation Ordinance in effect.
(c) Any multi-year contracts entered into by
the System Board must contain a provision stating that the contract is subject
to County Board approval of appropriations for the purpose of the subject contract;
and that in the event funds are not appropriated by the County Board, the
contract shall be cancelled without penalty to, or further payment being
required by, the System Board or the County.
The System Board shall give the vendor notice of failure of funding as
soon as practicable after the System Board becomes aware of the failure of
funding. Multi-year contracts shall also contain provisions that the System
Board’s or County’s obligation to perform shall cease immediately upon receipt
of notice to the vendor of lack of appropriated funds; and that the System
Board’s or County’s obligation under the contract shall also be subject to
immediate termination or cancellation at any time when there are not sufficient
authorized funds lawfully available to the System Board to meet such
obligation.
Sec. 38-586. Disclosure
of Interests Required.
(1)(a) Any
Director, officer, employee, agent, and or professional or
business adviser of the IBOD System Board or the CEO who has
direct or indirect interest in any contract or transaction with the IBOD
CCHHS, shall disclose this interest in writing to the System
Board which shall in turn notify the President and the County
Board of such interest, and the IBODSystem
Board.
(2)(b) This
interest shall be set forth in the minutes of the IBOD System Board,
and the Director, employee, officer, agent, and or
professional or business advisor or CEO having such interest shall not
participate on behalf of the IBOD CCHHS in any way with regard
to the authorization of any such contract or transaction unless
the System Board or County Board waives the conflict.
(c) The
(d) Employees of CCHHS shall be bound by the
Sec. 38-87. Annual Report of System
Board.
(a) The System Board shall submit to the
President and the
(b) Included in the report shall be any
recommendations for additional legislation or other action which may be
necessary to carry out the mission, purpose and intent of the System Board.
Sec. 38-88. Managerial and Financial
Oversight.
(a) The
(1) The
(2) The
County Board may initiate and direct financial and managerial assessments and
similar analyses of the operations of the System Board and CCHHS, as may be
necessary in the judgment of the County Board, to assure sound and efficient
financial management of the System Board and the CCHHS.
(3) The
(4) The
(b) The System Board and the CCHHS shall be
subject to audit in the manner now or hereafter provided by statute or
ordinance for the audit of County funds and accounts. A copy of the audit
report shall be submitted to the President, the Chairperson of the Finance
Committee of the County Board, the Chairperson of the Health and Hospitals
Committee, and the Director of the County Office of the Auditor.
Sec. 38-689. Indemnification.
The members of the
Nominating Committee and the IBOD shall be indemnified by the County in a like
manner as any county employee or officer for any cause of action against them
arising out of the performance of their duties as members of the Nominating
Committee or IBOD.
(a) The County shall defend and indemnify
patient care personnel and public health practitioners, including, but not
limited to, physicians, dentists, podiatrists, fellows, residents, medical
students, nurses, certified nurse assistants, nurses aids, physicians
assistants, therapists and technicians (collectively “practitioners”) acting
pursuant to employment, volunteer activity or contract, if provided for
therein, with the County with respect to all negligence or malpractice actions,
claims or judgments arising out of patient care or public health activities
performed on behalf of the CCHHS. The
County shall also defend and indemnify the members of the Nominating Committee
and the System Board with respect to all claims or judgments arising out of
their activities as members thereof which defense and indemnification shall be
subject to the same provisions which apply to the defense and indemnification
of practitioners as set forth below.
(b) The County shall not be obligated to
indemnify a practitioner for:
(1) Punitive damages or liability arising
out of conduct which is not connected with the rendering of professional
services or is based on the practitioner’s willful or wanton conduct.
(2) Professional conduct for which a license
is required but the practitioner does not hold a license.
(3) Conduct which is outside of the scope of
the practitioner’s professional duties.
(4) Conduct for which the practitioner does
not have clinical privileges, unless rendering emergency care while acting on
behalf of the CCHHS.
(5) Any settlement or judgment in which the
County did not participate.
(6) The defense of any criminal or
disciplinary proceeding.
(c) To be eligible for defense and
indemnification, the practitioner shall be obligated to:
(1) Notify,
within five (5) days of receipt, the Cook County Department of Risk Management
and the Civil Actions Bureau of the Cook County State’s Attorney’s Office of
any malpractice claim made against the practitioner and deliver all written
demands, complaints and other legal papers, received by the practitioner with
respect to such claim to the Department of Risk Management.
(2) Cooperate
with the State’s Attorney’s Office in the investigation and defense of any
claim against the County or any practitioner, including, but not limited to,
preparing for and attending depositions, hearings and trials and otherwise
assisting in securing and giving evidence.
(3) Promptly
notify the Cook County Department of Risk Management and the Civil Actions
Bureau of the Cook County State’s Attorney’s Office of any change in the
practitioner’s address or telephone number.
(d) All actions shall be defended the
Sec. 38-90. Applicability of the
Except
as otherwise provided herein, provisions of the
Sec. 38-91. Transition.
(a)
The
(b)
In order to avoid unnecessary duplication of services, the System Board,
on behalf of the CCHHS, may, at its discretion, continue to utilize various
ancillary services provided through the Office of the President, including, but
not limited to, those services provided by the Office of Capital Planning and
Policy, the Bureau of Information Technology, the Department of Risk
Management, the Department of Facilities Management, the Department of Real
Estate Management, the Office of the Comptroller, and the Office of the County
Auditor.
(c) Any contracts entered into by the County
on behalf of the Bureau of Health prior to the adoption of this Ordinance shall
remain in effect; provided, however, that the System Board shall act in place
of the County Board in any contract, bylaws or agreement with the County which
requires the approval or other action of the County Board unless expressly
prohibited otherwise in this Ordinance.
Sec. 38 792. Severability.
Any provision of this
Ordinance declared to be unconstitutional or otherwise invalid shall not impair
the remaining provisions of this Ordinance.
Sec. 38-8. Termination of IBOD.
The Cook County
Bureau of Health Directors and this Ordinance shall terminate after three (3) ycars from the effective date of this Ordinance, unless the
Cook County Board of Commissioners acts to renew its powers and
responsibilities.
Commissioner Suffredin explained the difference between his
amendment and Vice Chairman Goslin’s amendment which
will follow. Commissioner Suffredin
stated that in his amendment Chairman Butler as the Chairman of the Health
& Hospitals made an ex-officio member of the board without a vote. He further explained that in Vice Chairman Goslin’s amendment Chairman Butler will be made an
ex-officio member with a vote and the board will be increased to ten (10)
independently appointed individuals.
Commissioner Suffredin went through other parts of the
ordinance and pointed out what other information is included in the ordinance. He stated that the changes become significant
because they came through negotiations with the President’s Office and State’s
Attorney’s Office looking at Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) and all of the State and Federal regulations that are
necessary to make the independent board work.
Vice Chairman Goslin, second
by Commissioner Gorman moved the amendment which deals only with the sections
of the ordinance that deals with the establishment of a Health System Board of
Directors and the membership of that organization.
Chairman Butler recognized Commissioner Claypool.
Commissioner Claypool stated that a number of Commissioners
including himself drafted two (2) different amendments on the original
ordinance and on the amendment to the original ordinance that is before the
Committee, and now it has been simplified and not sure on how to put in play
the final amendment which the Commissioners would like to see discussed.
Chairman Butler asked Vice Chairman Goslin to read his
amendments into the record.
Vice Chairman Goslin,
seconded by Commissioner Gorman moved the following amendments:
Sec. 38-72. Definition.
System Board means
the ten eleven
Sec. 38-73. Establishment of the
(a) The
System Board is hereby created and established.
The System Board shall consist of ten (10) eleven (11)
Sec. 38-75. Nominating Committee.
(c) Pursuant
to this Amendatory Ordinance, the number of Directors on the System Board shall
increase from nine (9) to eleven (11), one of whom shall be the Chairperson of
the County Board’s Health and Hospitals Committee, serving ex officio. Accordingly, the President shall now select
one (1) additional name from among the names initially submitted to the
President by the Nominating Committee for nomination to the System Board, and
shall transmit that name to the County Board for its approval, pursuant to Sec.
38-76 (b) (1) of this Ordinance.
Sec. 38-76 Members
of the System Board.
(a) One of the ten
(10) eleven
(11)no voting
rights. This Director shall serve as a
liaison between the
(b) The
remaining nine (9) ten (10)
(1) For
the initial Directors, the nine (9) ten (10) names, the President shall
direct the Nominating Committee to reconvene and to select and submit an
additional three (3) names for each Director still to be appointed.
(a) Of
the nine (9) ten (10)
1. Four (4) Five (5) Directors
shall serve a term of three (3) years as designated by the President in his
recommendation to the
and,
Sec. 38-78. Chairman/Officers of System Board
(1) The Chairperson shall preside at meeting
of the System Board, and is entitled to vote on all matters before the System
Board, unless the Chairperson is the ex-officio
member.
On the motion made by Vice
Chairman Goslin, seconded by Commissioner Gorman, to approve the amendments to
the Proposed Ordinance Amendment (Communication No. 293933), Commissioner Peraica
called for a Roll Call, the vote of yeas and nays being as follows:
ROLL
CALL ON MOTION TO APPROVE THE
AMENDMENTs
TO THE PROPOSED ORDINANCE AMENDMENT
(COMMUNICATION
NUMBER 293933)
|
Yeas: |
Chairman Butler, Vice Chairman Goslin, Commissioners
Claypool, Collins, Daley, Gorman, |
|
Nay: |
None (0) |
|
Present: |
Commissioner Beavers (1) |
|
Absent: |
Commissioners Maldonado and Steele (2) |
The motion to approve
CARRIED.
Chairman Butler asked Commissioner Claypool to introduce his
amendment to Communication No. 293933.
Commissioner Claypool,
seconded by Commissioners Quigley and Murphy moved approval of the amendments
to the Proposed Ordinance Amendment (Communication No. 293933), as amended,
introduced by Commissioners Claypool, Collins, Maldonado,
COMMUNICATION
NUMBER 293933
PROPOSED
ORDINANCE AMENDMENT
Sponsored by
THE HONORABLE FORREST
CLAYPOOL,
EARLEAN COLLINS, ROBERTO MALDONADO,
JOSEPH MARIO MORENO, JOAN PATRICIA MURPHY, MIKE QUIGLEY,
COUNTY COMMISSIONERS
ORDINANCE
ESTABLISHING THE
COOK
COUNTY HEALTH AND HOSPITALS SYSTEM
BE
IT ORDAINED, pursuant to Cook County's home rule authority under
Article VII, Section 6(a) of the 1970 Constitution of the State of Illinois, by
the Cook County Board of Commissioners (“County Board”) that Chapter 38, Health
and Human Services, Article 1, In General, Sections 38-2 through 38-5 of the Cook
County Code are removed from Article I, are inserted into a newly created
Article IV, Cook County Health and Hospitals System, and are thereafter amended
and renumbered as follows:
ARTICLE IV.
COOK COUNTY HEALTH AND HOSPITALS SYSTEM
Sec.
38-70. Short Title.
This Ordinance shall be known and may
be cited as the “Ordinance Establishing the
Sec.
38-71. Declaration.
(A) The
(1)
Provide integrated health services with dignity
and respect, regardless of a patient's ability to pay;
(2)
Provide access to quality preventive, acute, and chronic health care for all the People of Cook County, Illinois (the
“County”);
(3)
Provide quality emergency medical services to all
the People of the County;
(4)
Provide health education for patients, and participate in the education of future generations of health care
professionals;
(5)
Engage in research which enhances its ability to
meet the healthcare needs of the People of the County; and,
(6)
Perform, through the Cook County Department of
Public Health, essential services of a local public health
authority as provided in the Department of Public
Health Act, 20 ILCS 2305/1 et seq.,
and the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 et seq., and as further detailed in
regulations promulgated by the Illinois Department of Public Health under the Certified
Local Health Department Code, 77 Ill. Adm. Code 600.110 et seq.; provided, however, that the
County Board shall continue to serve as the Board of Health of Cook County.
Perform, through the Cook County
Department of Public Health, essential services of a local public health
authority as provided in the Cook County Board of Health Ordinance, Sections
38-26 through 38-40 of the Cook County Code, other Cook County Ordinances
imposing duties upon the Cook County Department of Public Health, and the
regulations of Cook County Department of Public Health promulgated thereunder; the Department of Public Health Act, 20 ILCS
2305/1 et seq.; the Civil
Administrative Code of Illinois, 20 ILCS 23 10/23 10-1 es
seq.; and as further detailed in regulations promulgated by the Illinois
Department of Public Health under the Certified Local Health Department Code,
77 Ill. Adm. Code 600.110 et seq.; provided, however, that the County Board
shall continue to serve as the Board of Cook County.
(B) This Ordinance
recognizes the essential nature of the Mission of the
CCHHS as set forth in Section 38-74 of this Article and the need
for sufficient and sustainable public funding of the CCHHS in order to fulfill its mission
of universal access to quality health care.
Sec.
38-72. Definitions.
For purposes of this Ordinance, the
following words or terms shall have the meaning or construction
ascribed to them in this Section:
“Chairperson” means the chairperson of the
System Board.
“Cook County Code” means the Code of
Ordinances of
“Cook County Health and Hospitals
System,” also referred to as “CCHHS”, means the public health system comprised of the facilities at, and
the services provided by or through, the Ambulatory and Community Health Network, Cermak Health Services of Cook County, Cook County Department of Public Health, Oak Forest Hospital of Cook County, Provident
Hospital of Cook County, Ruth M.
Rothstein CORE Center, and John H.
Stroger, Jr. Hospital of Cook County, (collectively,
the “CCHHS Facilities”).
“County” means the
“
“Director” means a member of the
System Board.
“Fiscal Year” means the fiscal year of
the County.
“Ordinance” means the “Ordinance
Establishing the
“President” means the President of the
“System Board” means the ten eleven
See. 38 2.----- Creation of Cook County Bureau of Health Directors.
The Cook County Board of Commissioners
(the “Board”) hereby establishes the Cook County Bureau of
Health Directors (“CCBOHD”) for a term of three (3) years. The President and
the Board shall delegate oversight of the Cook County Bureau of Health
Services to the CCBOHD consistent with this Ordinance. The Directors
shall, immediately upon initial approval by the Board of
Commissioners of the appointment of members of IBOD, assume responsibility for
the oversight of all entities currently within the jurisdiction of the Cook
County Bureau of Health Services. The Directors shall consist of an Interim
Board of Directors (“IBOD”) with nine (9) members. All votes shall require a simple majority of
the full IBOD.
Sec.
38-73. Establishment
of the
(A)
The System Board is hereby created and
established. The System Board shall
consist of ten (10) eleven (11)
(B)
The System
Board shall exist for a minimum of three (3) years. The System Board may be
terminated by action taken by the Illinois General Assembly to create a special
district governing the CCHHS facilities and services.
(B) Notwithstanding any provision of this
Ordinance, the Cook County Board of Health Ordinance, Sections 38-26 through
39-40 of the Cook County Code of Ordinances, and other provisions of the Cook
County Code of Ordinances conferring authority and imposing duties and
responsibilities upon the Board of Health and the Cook County Department of
Public Health, shall remain in full force and effect.
Sec.
38-74.
(A) The System Board shall have the
responsibility to carry out and fulfill the mission of the CCHHS by:
(1)
Continuing to provide integrated health services
with dignity and respect, regardless of a patient's ability to pay;
(2)
Continuing to provide access to quality primary,
preventive, acute, and chronic health care for all the People of the
County;
(3)
Continuing to provide high quality emergency medical
services to all the People of the County;
(4)
Continuing to provide health education for
patients, and continuing to participate in the education of future
generations of health care professionals;
(5)
Continuing to engage in research which enhances
the CCHHS' ability to meet the healthcare needs of the People of the County;
(6)
Ensuring efficiency in service delivery and
sound fiscal management of all aspects of the CCHHS, including the
collection of all revenues from governmental and private third
party payers and other sources;
(7)
Ensuring that all operations of the CCHHS,
especially contractual and personnel matters, are conducted free
from any political interference and in accordance with the provisions
of the Supplemental Relief Order and Consent Decree established in the
federal civil litigation filed in the Northern District of
Illinois under Case No. 69 C 2145 and titled Shakman, et al. v. Democratic
Organization, et al. and all applicable laws; and,
(8)
Performing, through the
Cook County Department of Public Health, essential
services of a local public health authority as provided in the Department of
Public Health Act, 20 ILCS 2305/1 et seq.,
and the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 et seq., and as further detailed in
regulations promulgated by the Illinois Department of Public Health under the Certified
Local Health Department Code, 77 Ill. Adm. Code 600.110 et seq.; provided, however, that the
County Board shall continue to serve as the Board of Health of Cook County.
Perform, through the Cook County
Department of Public Health, essential services of a local public health
authority as provided in the Cook County Board of Health Ordinance, Sections
38-26 through 38-40 of the Cook County Code, other Cook County Ordinances
imposing duties upon the Cook County Department of Public Health, and the
regulations of the Cook County Department of Public Health promulgated thereunder; the Department of Public Health Act. 20 ILCS
23065/1 et seq.; the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1
et seq.; and as further detailed in regulations promulgated by the Illinois
Department of Public Health under the Certified Local Health Department Code,
77 Ill. Adm. Code 600.110 et seq.; provided, however, that the County Board
shall continue to serve as the Board of Health of Cook County.
(B) The System Board shall be responsible to
the People of the County for the proper use of all funds appropriated to the CCHHS by
the
Sec. 38.2.a.----- Members of the IBOD shall be selected by the
following process.
Sec.
38-75. Nominating
Committee.
Sec 38 2.a(i).--- A Nominating Committee shall be convened no later
than H days after enactment of this
ordinance.
(A)
The Nominating Committee shall elect its chair from among
its members and all decisions shall be by majority vote of the membership. The Nominating Committee shall include one
(1) representative person designated byfrom each of the
following organizations:which
so agree to participate as its representative—The Nominating Committee shall
elect its chair from its own ranks.—All decisions shall be by majority vote. Tho Nominating Committee shall recommend twenty (20)
candidates for nomination and shall transmit their names and qualifications to tho President of the Cook Count)' Board within 30 days of the Nominating
Committee's convening.
(1)
Civic Federation of
(2)
Civic Committee of the Commercial Club of
(3)
(4)
Healthcare Financial Management Association;
(5)
Suburban Primary Healthcare Council;
(6)
(7)
Metropolitan
(8)
Health and Medicine Policy Research Group;
(9)
Chicago Department of Public Health;
(10)
(11)
(12)
(13)
Association of Community Safety Net Hospitals; and,
(14)
(B)
Pursuant to Ordinance 08-O-22, “Ordinance
Concerning The Bureau of Health Services Notwithstanding Any Provision in
Existing Ordinances,” which ordinance is amended by this Ordinance, the
Nominating Committee convened, selected the names of twenty (20) individuals
and transmitted
these names to the President for nomination
to the System Board. Pursuant
to Ordinance 08-O-22, “Ordinance Concerning The Bureau of Health Services
Notwithstanding Any Provision in Existing Ordinances,” which ordinance is
amended by this Ordinance, the President then selected nine (9) names
from among the names submitted by the Nominating Committee for the office of
Director, and forwarded the list of nine (9) names to the County Board for its
approval.
(C)
Pursuant to this Amendatory Ordinance, the number of Directors on the
System Board shall increase from nine(9) to eleven (11), one of whom shall be
the Chairperson of the County Board’s Health and Hospital Committee, serving ex officio. Accordingly, the President
shall not select one (1) additional name from among the names initially
submitted to the President by the Nominating Committee for nomination to the
System Board, and shall transmit that name to the County Board for its approval
pursuant to Sec. 38-76 (b) (1) of this Ordinance.
The Board shall provide necessary
funding to allow the Nominating Committee to accomplish its purpose.
Sec. 38-2.a(ii). - The President shall select nine
Directors from tho list of twenty submitted by the
Nominating Committee within H days of receipt. — Once nine (9) nominees have
been selected, the President shall submit the final list of nominees to the
Cook County Board of Commissioners.
Sec.
38 2.a(iii). — The Cook County Board of
Commissioners must vote to confirm or reject each of the
nominees, as submitted by the President by majority vote within H days of
submission. If a nominee is rejected, then the President must submit
another nominee from the list of twenty candidates.
Sec.
38-76. Members of the
System Board.
(A)
One of the ten (10) eleven (11)no
voting rights. This Director shall serve
as a liaison between the
(B)
The remaining nine (9) ten (10)
(1)
For the initial Directors, the nine (9) ten (10) names, the
President shall direct the Nominating Committee to reconvene and to select and
submit an additional three (3) names for each Director still to be appointed.
(a) Of the nine (9) Directors first appointed:
(i) Four (4) Five (5)Directors
shall serve a term of three (3) years as designated by the President in his
recommendation to the County Board; and,
(ii) Five (5) Directors
shall serve a term of five (5) years as designated by the President in his
recommendation to the County Board.
(b) After the expiration of the initial term of
each appointed Director, all subsequent terms shall be for five (5) years.
(a) Each appointed Director, whether
initial or subsequent, shall hold office until a successor is appointed.
Any appointed Director shall be eligible for reappointment, but no appointed Director shall
be eligible to serve more than two consecutive five-year terms.
(b) Upon the expiration of an appointed
Director’s term, the successor Director shall be appointed in the same
manner as the process set forth above for the nomination, selection and
appointment of initial Directors; provided, however, that the Nominating
Committee shall recommend three (3) names for each Director position to be
filled at that time.
(c) Any appointed Director may be removed for
incompetence, malfeasance, neglect of duty, or any cause which
renders the Director unfit for the position. The President or
one-third (1/3) of the members of the County Board shall provide written notice to that
Director of the proposed removal of that Director from office; which notice
shall state the specific grounds which constitute cause for removal. The Director in receipt of such notice may
request to appear before the
(2)
In the event of a
vacancy in an appointed Director position on the System Board, the President
may recommend a replacement name to the
(a) A vacancy shall occur upon the:
(i) Resignation,
(ii) Death,
(iii) Conviction of a felony, or
(iv) Removal from the office of an
appointed Director as set forth in Section 38-76(B)(1)(e)
of this Article.
(b) Any
appointed Director who is appointed to fill a vacancy shall serve until the expiration of his predecessor's term.
(C)
The appointed Directors are not employees of the
County and shall receive no compensation for their service but may be
reimbursed for actual and necessary expenses while serving on the System Board.
(D)
Directors shall have a fiduciary duty to the
CCHHS and the County.
Sec. 38.2. b.-77.
Qualifications of theAppointed
Directors.
The slated nominees, as proposed to the
President of the Cook County Board for his
consideration, shall include among them The appointed Directors shall include persons with the requisite
expertise and experience in areas pertinent to the governance and operation of
a large
and complex healthcare system. Among
these areas shall be expertise and experience in the fields of Such areas
shall include, but not be limited to, finance, legal and regulatory affairs,
healthcare management, employee relations, public administration, and clinical
medicine. The Nominating Committee,
the President and the
Sec.
38-78. Chairperson/Officers
of System Board.
(A) The Directors shall select the initial Chairperson
of the System Board from among the initial Directors. The Chairperson shall serve a one-year term
and, thereafter, the System Board shall annually elect a chairperson from among the Directors.
(1)
The Chairperson shall preside at meetings of the
System Board, and is entitled to vote on all matters before the System Board, unless
the Chairperson is the ex-officio
member.
(2)
A Director may be elected to serve successive
terms as Chairperson.
(B) The
Directors may establish such additional offices and appoint such additional
officers for the System Board as they may
deem appropriate.
Sec.
38-79. Meetings of the
System Board.
(A)
The President shall call the first meeting of the
System Board. Thereafter, the Directors shall prescribe
the times and places for their meetings and the manner in which regular and
special meetings may be called.
(B)
Meetings shall be held at the call of the
Chairperson, however, no less than twelve (12) meetings shall be held annually.
(C)
A majority of the voting Directors shall constitute
a quorum. Actions of the System Board shall require the
affirmative vote of a majority of the voting members of the System Board
present and voting at the meeting at which the action is taken.
(D)
To the extent feasible, the System Board shall
provide for and encourage participation by the public
in the development and review of financial and healthcare
policy. The System Board may hold public hearings as it deems appropriate to
the performance of any of its responsibilities.
(E)
The System Board shall comply in all
respects with “An Act in relation to meetings,” as now or
hereafter amended, and found at 5 ILCS 120/1, et seq.
(F)
The System Board shall be an Agency to
which the “Local Records Act,” as now or hereafter amended, and found at
50 ILCS 205/1, et seq. applies.
Sec.
38.2.c. - Compensation for the Directors. — Directors shall be
reimbursed for all reasonable expenses relating to the performance of
their duties, but shall be otherwise uncompensated. “Reasonable expenses”
shall include administrative and secretarial support as
Sec.
38.2.d. - Fiduciary duty. Directors shall
have a fiduciary duty to the Cook County Bureau of Health Services, the President, the Board
of Commissioners, and the citizens of Cook
Sec. 38.2.e.----- Replacement of Directors.—If
a Director resigns from the 1BOD then the Nominating Committee shall be convened to propose a replacement. The
process of confirmation shall then be applied as outlined above.
Sec. 38.2.f.------ Removal of Directors.—A Director may be removed for
cause by a majority vote of the
Nominating Committee after having been provided notice of the intent to remove
said Director with reasonable time for the Director to respond thereto.
Sec.
38-80. General Powers
of the System Board.
Subject to the
a.
To appoint the Chief Executive Officer of the CCHHS (“CEO”) or interim
CEO, if necessary, as set forth in Sec. 38-81 hereinafter, to hire such
employees and to contract with such agents, and professional and business advisers as may from time to time be
necessary in the System Board’s judgment
to accomplish the CCHHS’ Mission and the purpose and intent of this Ordinance;
to fix the compensation of such CEO, employees, agents, and advisers; and, to establish the powers and duties of all such
agents, employees, and other persons
contracting with the System Board;
b.
To exercise oversight of the CEO;
c.To develop measures to evaluate the CEO's
performance and, to report to the President and the
d.
To authorize the CEO to enter into contracts, execute all instruments,
and do all things necessary or convenient in
the exercise of the System Board’s powers and responsibilities;
e.
To determine the scope and distribution of
clinical services; provided, however, if
the System Board determines that it is in the best interest of the CCHHS to
close entirely one of the three CCHHS hospitals, such closure will require
County Board approval;
f.
To provide for the organization and management of
the CCHHS, including, but not limited to,
the System Board’s rights and powers to approve all personnel policies,
consistent with existing state laws, collective bargaining agreements,
and court orders;
g.
To submit budgets for the CCHHS operations and
capital planning and development, which promote sound financial management and assure
the continued operation of the CCHHS, subject to approval by the
h.To accept any gifts, grants, property, or any other
aid in any form from the federal government, the state,
any state agency, or any other source, or any combination thereof,
and to comply with the terms and
conditions thereof;
i.
To purchase, lease, trade, exchange, or otherwise
acquire, maintain, hold, improve, repair, sell, and dispose of personal property, whether tangible or
intangible, and any interest therein;
j.
In the name of the County, to purchase, lease,
trade, exchange, or otherwise acquire, real property or any interest therein, and to
maintain, hold, improve, repair, mortgage, lease, and otherwise transfer such real property, so long as
such transactions do not interfere with the Mission of the CCHHS; provided, however, that transactions involving
real property valued at $100,000 or greater shall require express approval from the County Board;
k.To acquire space, equipment, supplies, and
services, including, but not limited to, services of consultants for rendering
professional and technical assistance and advice on matters within the System
Board’s powers;
l.
To make rules and regulations governing the use of
property and facilities within the CCHHS, subject to agreements with or for
the benefit of holders of the
m.
To adopt and from time to time
amend or repeal bylaws and rules and regulations consistent with the provisions of this Ordinance;
n.To encourage the formation
of a not-for-profit corporation to raise funds to assist in carrying out the
o.
To engage in joint ventures,
or to participate in alliances, purchasing consortia,
or other cooperative arrangements, with any public or private entity, consistent with state law;
p.
To have and exercise all rights and powers necessary, convenient,
incidental to, or implied from the specific powers granted in this Ordinance, which specific
powers shall not be considered as a limitation upon any power necessary or appropriate to carry out the CCHHS’ Mission and the purposes and
intent of this Ordinance;
q.
To perform, through the Cook
County Department of Public Health, essential
services of a local public health authority as provided in the Department of
Public Health Act, 20 ILCS 2305/1 et seq.,
and the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 et seq., and as further detailed in
regulations promulgated by the Illinois Department of Public Health under the Certified Local Health Department Code, 77 Ill.
Adm. Code 600.110. et seq.; provided, however, that the County Board shall continue
to serve as the Board of Health of Cook County; and,
To Perform, through the Cook County
Department of Public Health, essential services of a local public health
authority as provided in the Cook County Board of Health Ordinance, Sections
38-26 through 38-40 of the Cook County Code, other Cook County Ordinances
imposing duties upon the Cook County Department of Public Health, and the
regulations of the Cook County Department of Public Health promulgated thereunder; the Department of Public Health Act. 20 ILCS
23065/1 et seq.; the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1
et seq.; and as further detailed in regulations promulgated by the Illinois
Department of Public Health under the Certified Local Health Department Code,
77 Ill. Adm. Code 600.110 et seq.; provided, however, that the County Board
shall continue to serve as the Board of Health of Cook County.
r.
To be the governing body of the licensed hospitals or other licensed
entities within the CCHHS.
Sec. 38 3.----- Powers and Responsibilities of
the IBOD.
The Interim Board of Directors shall
have as its primary purpose, the following powers and responsibilities:
-1-)------- Ensuring the availability and access to high
quality health care services, including primary and preventive care, for all medically indigent Cook County
residents;
2)------ Ensuring efficacy in service delivery;
3)------ Ensuring sound fiscal management of all aspects of
the Bureau of Health Services,
including the collections of all governmental and private third party payers and other revenues;
4)---- Ensuring that all operations of the Bureau of
Health Services, especially contractual—and—personnel—matters—are—conducted—free—from—any—political
interference in accordance with all
applicable law;
5)---- Oversight
of the Chief of the Bureau and the development of measures to evaluate
the Chiefs performance, including the reporting of such measures to the Board at six (6) month intervals;
6)---- Approval
of annual operations and capital budgets which shall be submitted to the Board for final approval;
7)---- Approval
of all personnel policies, consistent with existing state laws, county ordinances, personnel
codes, collective bargaining agreements and court orders;
8)---- Approval of all leases, intergovernmental
agreements and contracts, including all vendor and private third party
payer agreements, with the prior approval of the Board of Commissioners of Cook County;
9)---- Acquisition,
sale, repair and maintenance of all Bureau property and assets, with the prior approval of the Board of Commissioners
of Cook County;
10)-- Conducting
long range strategic and fiscal planning, including the establishment and maintenance of operational and capital
reserves specifically allocated to the CCBOHS;
11)-- Conducting audits in the manner now or hereafter
provided for the audit of County
funds and accounts. A copy of the audit report shall be submitted to the
President, the Chairman of the Finance Committee of the Board, the Chairman of
the Health and Hospitals Committee, and the Director of the County Office of the
Auditor;
12)-- The Board shall elect its chair from its own
ranks; and
13)-- The Board shall provide necessary funding to allow
the IBOD to accomplish its purpose.
Sec. 38-81. Chief Executive Officer.
(A)
The System Board shall appoint a Chief
Executive Officer of the CCHHS (“CEO”) or an interim CEO as necessary.
(B)
The System Board shall conduct a nationwide search
for a CEO which shall be concluded no later than one hundred eighty (180) days
from the date of the
(C)
The CEO shall have the responsibility for:
(1)
Full operational and managerial authority of the CCHHS,
consistent with existing federal and state laws, court
orders and the provisions of this Ordinance;
(2)
Preparing and submitting to the System Board the
Budgets and Strategic and Financial Plans required by this Ordinance;
(3)
Operating and managing the CCHHS consistent with
the Budgets and Financial Plans approved by the
(4)
Overseeing expenditures of the CCHHS;
(5)
Subject to Section 38-74(A)(7) of this Ordinance,
hiring and discipline of personnel in conformity with the
provisions of this Ordinance, all state laws, court orders,
and collective bargaining agreements;
(6)
Negotiating collective bargaining agreements as
set forth in Sec. 38-84(C); and
(7)
Carrying out any responsibility which the System Board
may delegate; however, said delegation shall not relieve the System
Board of its responsibilities as set forth in this Ordinance.
(D) The CEO shall report to the System Board.
(E) The CEO shall provide, through the System Board,
quarterly reports to the
Sec. 38 4.----- Chief of the Bureau of Health
Services; appointment and powers.
The IBOD shall, as soon as practical,
select an Interim Chief of the Bureau of Health Services to take over all
administrative responsibilities.—The IBOD shall conduct a nationwide search in order to select the Chief of the
Bureau of Health Services.—Such search shall be concluded no later than 180 days from the enactment of this
Ordinance.—All current Bureau staff shall assist in the transition.
The Chief of the Bureau of Health
Services shall have full operational responsibility and independent managerial authority for
all entities within tho Bureau, consistent with all
applicable federal, state and county law and regulations:
1)------ Establishing
Bureau of Health Services operational and capital budgets subject to IBOD approval;
2)------- Hiring and firing of personnel in conformity with
all state laws, county ordinances, personnel codes, court orders and
collective bargaining agreements;
3)------ Development and implementation of personnel
policies consistent with all existing
state laws, count)' ordinances, personnel codes, court orders and collective
bargaining agreements, subject to IBOD approval;
4)------ Selection of outside vendors and consultants in
conformity with all count)' ordinances;
5)------ Negotiating and executing leases,
intergovernmental agreements and contracts, including private third party payer
agreements, subject to the approval of the IBOD for all such transactions in excess of a specified dollar amount,
to be set by tho IBOD, subject to the prior approval of the Cook
County Board of Commissioners; and
6)------ The purchase, sale or repair of equipment
consistent with the Cook County Procurement Ordinance.
The Chief of the Bureau of Health
Services shall submit a report quarterly to the Health & Hospitals
Committee of the Cook County Board of Commissioners regarding the status of
Bureau operations.
Sec.
38-82. Strategic and
Financial Plans.
(A)
As soon as practicable following the establishment
of the System Board, the President shall provide to the System
Board copies of the audited financial statements and of the books and
records of account of the Bureau of Health Services for the
preceding five (5) Fiscal Years of the County.
(B)
The System Board shall recommend and submit to the
President and the
(C)
Each Strategic and Financial Plan for each Fiscal
Year, or part thereof to which it relates, shall contain:
(1)
A description of revenues and expenditures,
provision for debt service, cash resources and uses, and capital
improvements, each in such manner and detail as the County’s Budget
Director shall prescribe;
(2)
A description of the
strategy by which the anticipated revenues and expenses for the Fiscal Years
covered by the Strategic and Financial Plan will be brought into balance;
(3)
Such other matters that the County Board, in its discretion,
requires; provided, however, that the System Board shall be
provided with a description of such matters in sufficient time for
incorporation into the Strategic and Financial Plan.
(D)
Strategic and Financial Plans shall not have force
or effect without the approval of the County Board and shall be recommended,
approved and monitored in accordance with the following:
(1)
The System Board shall recommend and submit to the
President and the County Board, on or before one hundred eighty (180)
days subsequent to the date of the appointment of the initial Directors or as
soon as practicable thereafter, an initial Strategic and Financial
Plan with respect to the remaining portion of the Fiscal Year
ending in 2008 and for Fiscal Years 2009 and, 2010 and 2011. The Board shall approve, reject or amend this
initial Strategic and Financial Plan within forty-five (45) days of its receipt
from the System Board.
(2)
For the 2011 Fiscal Year and every second year thereafter, The System Board shall develop an
initial Strategic and Financial Plan covering a period of two (2) three (3)
Fiscal Years. The
System Board shall recommend and submit each Strategic and Financial Plan to
the President and the County Board for the County Board’s approval
not later than thirty (30) days prior to the commencement of the Fiscal Year
prior to the first Fiscal Year to which the Strategic and Financial Plan
applies.
(3)
The System Board shall include in each Strategic and
Financial Plan estimates of revenues during
the period for which the Strategic and Financial Plan applies. In the event the System Board fails, for any
reason, to include estimates of revenues as required, the
(4)
The
(5)
The System Board shall report to the President and
the
(6)
For each Strategic and
Financial Plan applicable to a Fiscal Year subsequent to the current Fiscal
Year, the System Board shall regularly reexamine the revenue and
expenditure estimates on which it was based and revise them as necessary.
The System Board shall promptly notify the President and the
Sec. 38-83. Preliminary CCHHS Budget
and Annual Appropriation Ordinance.
(A)
The System Board shall not make expenditures
unless such expenditures are consistent with the County’s Annual Appropriation
Bill (“Annual Appropriation Ordinance”) as provided in 55 ILCS 5/6-24001 et seq.
(B)
The System Board may, if necessary,
recommend and submit to the President and the County Board, for approval by the County Board, a
request for intra-fund transfers within the Public
Health Fund to accommodate any proposed revisions by the System Board to the
line items set forth for the Bureau of Health Services in the existing Fiscal
Year 2008 Annual Appropriation Ordinance.
(C)
For Fiscal Year 2009 and each Fiscal Year
thereafter, the System Board shall recommend and submit a
Preliminary Budget for the CCHHS to the President and the County Board,
for approval by the County Board, not later than forty-five (45) days
prior to the first date for submission of budget requests set by the County’s
Budget Director.
(D)
Each Preliminary Budget shall be recommended and
submitted, in accordance with the following procedures:
(1)
Each Preliminary Budget
submitted by the System Board shall be based upon revenue estimates contained
in the approved Strategic and Financial Plan applicable to that budget year.
(2)
Each Preliminary Budget shall contain such information and detail as may
be prescribed by the County’s Budget
Director. Any applicable fund deficit
for the Fiscal Year ending in 2008
and for any Fiscal Year thereafter shall be included as an expense item in the succeeding Fiscal Year’s Budget.
(E)
The County Board shall approve
each Preliminary Budget if, in its judgment, the Budget is complete, is
reasonably capable of being achieved, and will be consistent with the Strategic and Financial Plan in effect for that Fiscal Year. The Board shall approve or reject each Preliminary
Budget within forty-five (45) days
of submission to the
(F)
The CCHHS’s Annual Appropriation shall be monitored as
follows:
(1)
The County Board may establish and enforce
such monitoring and control measures as the County
Board deems necessary to assure that the revenues, commitments,
obligations, expenditures, and cash disbursements of the System Board continue
to conform on an ongoing basis with the Annual Appropriation Ordinance. If, in the discretion of the County
Board, and notwithstanding the approved Annual Appropriation Ordinance, the
County Board imposes an expenditure limitation on the System Board, the System
Board shall not have the authority, directly or by delegation, to enter into
any commitment, contract, or other obligation that would result in the
expenditure limitation being exceeded. Any such commitment, contract or other
obligation entered into by the System Board in derogation of this Section shall
be voidable by the
(2)
The System Board shall
report to the President and the