$400,000,000 Shortfall

the look of incompetence

Preckwinkle prescribes major corrective surgery to fix ills of county’s hospitals and health system. These ills developed during her watch and the media is not accurately reporting her malfeasance. 

• she has been running the hospital system for 9 years
• she has appointed all of the board members and executive staff
• they have run the system into the ground, as spending and patronage hires is out of control
• she will soon propose massive tax increases to make up for the shortfall
• her fellow democrats on the board prefer to say nothing, as they have been bought off
• the media sees nothing

Preckwinkle called for “enhanced collaboration” with the independent board that now runs the Cook County Health System, proposing amendments that would allow her to directly appoint a member to the board.

By Rachel Hinton Jan 15, 2020, 3:59pm CST
Cook County Board President Toni Preckwinkle with physicians and healthcare advocates at John H. Stroger Jr. Hospital in 2012. File Photo. John H. White/Sun-Times

Cook County Board President Toni Preckwinkle is seeking more control and oversight over Stroger Hospital and the rest of the county health system, including appointing a member to the system’s governing board and giving the County Board power over the top health official’s salary and job description.

In a letter to county commissioners dated Tuesday, Preckwinkle called for “enhanced collaboration”
with the independent board that now runs the Cook County Health System, proposing amendments to the underlying ordinance that would allow Preckwinkle to directly appoint a member to the governing board, make the next CEO of the system subject to the “advice and consent of the County Board” and require the system to submit a balanced preliminary budget to commissioners.

The sweeping proposed changes, first reported by WBEZ, come less than two months after the former CEO, Dr. John Jay Shannon, was pushed aside amid Preckwinkle’s ongoing concerns over the system’s financial footing.

In this week’s letter, Preckwinkle proposed making some operations of the health system subject to approval by the Board of Commissioners or to at least include the board in more of the health system’s decisions.

Ironically, the move also comes as Shannon was lauded at a county meeting Wednesday by commissioners honoring the outgoing CEO.

When Shannon was ousted by the independent health board in November, county sources and commissioners said that Preckwinkle — who appoints the 11-member board from recommendations made by a nominating committee — had been concerned with the direction of the health system.Dr. John Jay Shannon, then CEO of the Cook County Health & Hospitals System, looks on as Cook County Board President Toni Preckwinkle speaks with reporters in 2018. File Photo. Ashlee Rezin Garcia/Sun-Times

At the time, Preckwinkle’s spokesman, however, denied she had any role in the vote. And in a statement, the county’s top official said in November that she was grateful to Shannon but argued it was time for “new leadership and vision to continue to fulfill the health system’s historic charitable mission while directly addressing the tough financial and operational challenges ahead.”

The additional member Preckwinkle now wants to add to the health systems board would be directly appointed by her, not necessarily chosen from the nominating committee’s recommendations.


The county’s health system is a $2.8 billion operation that oversees Stroger and Provident hospitals as well as health care at Cook County Jail and other county sites. The health system also conducts a managed-care program called CountyCare.

In her three-page letter of suggestions, Preckwinkle calls for modifying the health board’s powers by requiring the next CEO’s appointment be “subject to the advice and Consent of the County Board.” She’d also give the board of commissioners final approval of the job description of the next CEO in advance of recruitment, as well as approval of the performance measures that will be used to evaluate the CEO’s performance.

The board would also review and approve “salary, termination, term, severance and any contract bonus provisions” for the next CEO.

She would also require the health system to submit a balanced preliminary budget, which the system did not initially have last year.

Preckwinkle also calls for the health system’s policies on “direct access programs to ensure uninsured residents’ access to quality health care to be determined in consultation with” the board president or her designee.

That could begin to address the county’s looming $600 million uncompensated care problem. That figure comes from care the county provides but for which it isn’t paid. It grew to $104 million between 2017 and 2019, prompting Preckwinkle to predict it would be a “principal challenge” for the 2021 fiscal year.