Saturday, September 15, 2007
Crain's Chicago Business
by Mike Colias

A committee backed by U.S. Sen. Richard Durbin is preparing to recommend that direct oversight of Cook County's embattled health system be taken out of the hands of President Todd Stroger and the board of commissioners, according to people with knowledge of the panel's work.
Appointed by Mr. Stroger in the spring at the prodding of Mr. Durbin, the panel is expected to stress independent oversight as a key to stemming an unfolding crisis at the three-hospital system, which each year serves some 1 million residents, many of them indigent. The call for outside control is expected to be among dozens of recommendations from the nine-member group made up of local business and health care leaders, the sources say.
It would be the latest in a drumbeat of calls from outside groups urging greater expertise for the Cook County Bureau of Health Services, which is among the few public hospital systems in the nation controlled directly by politicians. But this proposal carries added weight because of Mr. Durbin, a fellow Democrat who's made clear that Mr. Stroger must take steps to fix the system before Illinois' congressional delegation works to secure more federal money (Crain's, May 14). Federal funding accounts for more than half of the system's patient revenue.
Health management experts say wresting budgetary and personnel decisions from the board president would eliminate politically connected hiring that critics contend has long bred ineptitude in the system. But the loss of patronage jobs would be a blow to Mr. Stroger.
It's unclear just how far the panel's recommendations will go, or what form of oversight it might call for. Larry Goodman, CEO of Rush University Medical Center and chairman of Mr. Stroger's blue-ribbon committee, says its report hasn't been finalized, adding, "It is not the right time to comment on what might or might not be in it."
But some county commissioners recently have warmed to the idea of ceding control of the health bureau to an outside group, at least temporarily, to oversee reforms. The 17-member county board must okay any change in oversight.
"I think more commissioners will support a change in governance as a way to pull out of the free fall we're in now and get this hospital system stabilized," says Larry Suffredin, D-Evanston. Commissioners Forrest Claypool, D-Chicago, and Gregg Goslin, R-Glenview, have expressed similar views.
Mr. Stroger is "eagerly awaiting the analysis and recommendations" of the committee, his spokeswoman says. She declines to comment on the idea of independent governance for the health bureau.
The system is reeling from a $105-million cut in its current budget, to $724 million, which forced service cuts and nearly 1,000 layoffs, sapping morale among doctors and nurses.
Still, the health bureau is roughly $65 million off budget for the fiscal year, which ends Nov. 30, despite efforts by interim health chief Robert Simon to boost revenue by fixing a dysfunctional billing system and other problems.
A newly formed coalition of 50 non-profit groups, including a few powerful unions, also is calling for outside oversight.
"We think that's a necessary step to assure public trust," says John Cameron, political director for a local chapter of the American Federation of State, County and Municipal Employees.