Tuesday, June 12, 2007
Chicago Tribune
by Mickey Ciokajlo

Cook County will pay private nursing homes to care for undocumented immigrants who are currently staying at county-owned Oak Forest Hospital under contracts advanced Monday by a committee of the County Board.

County commissioners voted 9-3 to approve two three-year contracts totaling $18.8 million to outsource long-term and intermediate care for those patients. The county receives no state or federal reimbursements for them.
Despite the cost, officials estimate the move will save the county about $10 million a year as part of a significant restructuring in the Bureau of Health Services under board President Todd Stroger's budget that was approved earlier this year.

"This is the rock and the hard place," said Commissioner Jerry Butler (D-Chicago), chairman of the Health and Hospitals Committee that approved the contracts. "It's always difficult to try and do what we are doing now. But unless we do it, we will never know if it will work."

Stroger has also proposed outsourcing janitorial services at Oak Forest Hospital, laying off 96 workers at an estimated annual savings of $1.5 million. Commissioners have so far delayed that effort in hopes of finding another way to achieve the savings, possibly through union concessions.

Dr. Robert Simon, interim chief of the health bureau, said that as part of the plan to close the hospital's 220 long-term-care beds, dozens of the patients for whom the county receives reimbursements have already voluntarily been moved to private nursing homes.

Those patients agreed to be moved even though the county's application to decertify as a long-term-care facility is still pending before the Illinois Health Facilities Planning Board, Simon said.

Oak Forest has about 30 long-term patients who are deemed "unfunded," nearly all of whom are undocumented immigrants, said Sylvia Edwards, the hospital's acting chief operating officer. They came into the county system for reasons such as suffering a traumatic accident or a debilitating work injury.

In addition, the hospital each day provides care for about 30 other undocumented immigrants who are in need of six to eight weeks of intensive therapy but will not remain in the facility long-term.

The two contracts with New York Boys Management LLC advanced Monday would place those unfunded patients in either a nursing home in Bridgeview or another on Chicago's Far South Side.

Commissioner Larry Suffredin (D-Evanston), who voted against the contracts, said he was concerned the county had already moved out some of its patients for whom it received reimbursements at a time when cash flow is a problem. Suffredin also questioned whether the county was placing itself in a position where it would be legally required to pay for the care of the unfunded patients, a cost that could escalate in future years.

"I believe that these contracts will in the end create a greater financial burden on Cook County," Suffredin said.

A separate contract to outsource janitorial services was heard Monday in the Labor Subcommittee, but Chairwoman Joan Murphy (D-Crestwood) did not call for a vote. Murphy said she plans to meet with the union in hopes of saving most of the jobs while still achieving the savings in Stroger's budget.

In other committee action Monday, the state's attorney's office informed the Finance Committee that Stroger's move to extend the reach of his inspector general's investigative powers to cover other countywide elected officials is likely unconstitutional. A Stroger spokeswoman said he is seeking another legal opinion from outside counsel.

Also, the Finance Committee advanced changes to the county ethics code to require the Cook County assessor's office and the Board of Review to post information about property-tax appeals on their Web sites. A separate change to the code would make lobbyists, tax lawyers and zoning lawyers who do business with the county fall under the same campaign contribution limits as other contractors, which is $1,500 annually or $3,000 in an election year.