Preckwinkle budget passes as Cook County sets migrant health care fund
Cook County Board President Toni Preckwinkle’s $9.26 billion budget for 2024 unanimously cleared its final hurdle Thursday, free of new taxes, fines and fees.
But while the 17-0 vote was marked by kind words from commissioners, the Chicago area’s continuing migrant crisis took center stage, thanks to a late budget amendment setting aside $100 million dedicated almost entirely to asylum-seekers’ health care.
“Whatever tomorrow and the day after may bring, this fund is aimed at increasing the county’s capacity to compassionately respond to emergencies,” Preckwinkle said shortly after the budget’s passage, which she said reflects “our values, priorities and principles, as well as the progress we’re making.”
The purpose of the new fund, sponsor Kevin Morrison, D-15th, said, is “to ensure a dedicated funding source can be accessed immediately in case of a declared disaster,” which would have been useful in the first months of the COVID-19 pandemic, before federal money made its way to local governments.
“I was surprised to learn we did not already have a disaster fund,” Morrison said. “An ounce of prevention is worth a pound of cure.”
While funds can also be used for natural disasters, including flooding or storms, the vast majority of funding is supposed to go to the migrant mission: $70 million would be “allocated for new arrival health care costs,” according to the budget amendment, $20 million would be “allocated for municipal or local government costs” related to the migrant mission, and $10 million would be allocated for other disasters that may happen in 2024.
The county’s health system has provided care to more than 13,000 new arrivals at a cost of roughly $2 million per month. The state stopped reimbursing the county for that care in February. Cook County Health budgeted $24 million for migrant health care costs next year. Once those funds are spent, CCH can tap the emergency fund.
Though finance officials faced some pointed questions about when and how the funds could be used, the amendment still passed the Finance Committee unanimously. Even the board’s lone Republican, Sean Morrison, said “the plan is sound.”
To pay for the new emergency fund, the county will shift planned spending around, tapping leftover funds from 2022 to seed it.
While that money was initially supposed to shore up pensions, the county will draw down its Pension Stabilization Fund instead. The change of plans doesn’t impact the county’s efforts to fully fund its pensions by 2047, budget officials say.
This is the fifth county budget in a row that does not include any new taxes or fees. Combined with the fact that proposed job cuts only hit vacant positions, the proposal made for an easy final vote.
Compared to their neighbors in Chicago Mayor Brandon Johnson’s office and the Chicago City Council, Preckwinkle and the board are facing far fewer budget pressures.
Reforms passed in Springfield this summer have put Cook County worker pensions on a path to full funding in the coming decades. Roughly two thirds of the county’s $1 billion in federal American Rescue Plan Act dollars are still unspent. At the end of the 2022 fiscal year, the county also had $1.2 billion left over in unrestricted general operating reserves, allowing officials to “carve a staircase” into the expected “fiscal cliff” when ARPA funds run dry. The county’s debt service burden is also considerably lower than the city.
In all, the number of full-time positions at the county will shrink to roughly 23,350, a decrease of about 400 compared to this year. The county has struggled to fill vacancies and instituted a number of sweeteners to recruit and retain employees. Almost 20% of the entire budgeted workforce — about 4,650 positions — were vacant when Preckwinkle introduced her budget.
Those sweeteners include across-the-board raises, added back pay for county employees and a more expansive vacation policy. Retroactive raises dating back to December 2021 cost $101.6 million in 2023, and other raises will cost $84.2 million in 2024, according to county budget officials. Another 5% pay hike for county employees will land in June 2025.
County employees will be able to bank vacation days at a higher rate and with fewer years of service next year. Under the change, those with one to four years of service could accrue a maximum of 30 working days of vacation. Those working for the county for five to nine years could accrue a maximum of 40 working days, and those with 10 or more years of service could accrue a maximum of 50 working days off.
Cook County Health has struggled in particular with vacancies, fueling a reliance on contract workers. The hospital system is expected to spend $175 million on registry services by the end of this year, and budgeted nearly $200 million for similar costs next year, according to budget watchdog the Civic Federation.
Preckwinkle’s budget proposes spending close to $240 million in ARPA funds next year, including $40 million on a relaunch of a small business grant program, $20 million for local infrastructure projects, and $118 million on expanded services at Cook County Health, including offering new mental health services.
Even after the ARPA funds are all spent, Preckwinkle’s proposal for next year sets aside $158 million to continue funding special projects after 2026, including the county’s guaranteed income program.
The county board separately agreed to pay three major settlements totaling nearly $27 million on Tuesday. The largest is due to Victoria Marin, who filed a medical malpractice lawsuit after her son, Sebastian, developed neurological disabilities following his birth at St. Anthony’s Hospital and care at Cook County’s Stroger Hospital. According to the family’s 2019 lawsuit, Sebastian “developed motor and mental deficits, cerebral palsy, and requires extensive medical and therapeutic services.” The board agreed to pay $13 million.
The board also voted to pay a $3.1 million settlement to the estate of Taft Simmons, whose family sued after Simmons fell, hit his head and later died from a massive stroke and cardiac incident while being treated for heart problems at Stroger Hospital. A lawsuit claimed because of his condition, he should have been helped by a nurse when getting up to use the bathroom.
In the third case, the board approved a $10.75 million settlement to Adam Gray for an alleged violation of civil rights. Earlier this year, Gray was awarded $27 million by a federal jury that found Chicago police officers coerced a false confession, fabricated evidence, and violated his civil rights to frame him for a 1993 arson that killed two people on Chicago’s Southwest Side.
