COOK COUNTY FY2021 EXECUTIVE BUDGET RECOMMENDATION: Analysis and Recommendations November 19, 2020 TABLE OF CONTENTS EXECUTIVE SUMMARY ......................................................................................................................................... 4 CIVIC FEDERATION POSITION ........................................................................................................................... 7 ISSUES THE CIVIC FEDERATION SUPPORTS ................................................................................................................ 8 Steps Taken that Position the County to Withstand the Economic Crisis ............................................................ 9 Matching Staffing Levels to Patient Volume and Medical Needs within Cook County Health ............................ 9 Improved Transparency with Cook County Health Financial Information ....................................................... 10 Amendment Made to the Inspector General’s Ordinance Requiring the Inclusion of Agency Responses in Program Investigations ...................................................................................................................................... 11 Finalization of the County Clerk’s Assumption of the Recorder of Deeds Office .............................................. 11 Improved Revenue Transparency through the Independent Revenue Forecasting Commission ....................... 12 Increased Cost Sharing in Retiree Health Plan ................................................................................................. 13 CIVIC FEDERATION CONCERNS ................................................................................................................................ 13 Financial Risks Presented by the COVID-19 Pandemic .................................................................................... 13 Potential Loss of Federal Pandemic-Related Assistance to Cook County Health ............................................. 14 Uncertainty Related to Repeal of the Affordable Care Act ................................................................................ 14 Plans to Build a New Provident Hospital .......................................................................................................... 15 CIVIC FEDERATION RECOMMENDATIONS ................................................................................................................ 17 Create a Regional Healthcare Planning Commission ....................................................................................... 17 Reconsider the Provident Hospital Project ........................................................................................................ 18 The Independent Revenue Forecasting Commission or a Similar Third Party Should Conduct a Review of Cook County Health Revenue Forecasts ............................................................................................................ 18 Livestream Cook County Health Board and Committee Meetings ..................................................................... 19 Move Forward on Holding Meetings on the Sheriff’s Office and other Criminal Justice System Operations ... 19 Clarify Year-End Estimates in Budget Book ...................................................................................................... 20 Reclassify Health Fund Revenue Sources in Budget Book to Align with Operations ........................................ 21 Obtain Statutory Authority for Supplemental Pension Contributions ................................................................ 21 Enact Multi-Year Intergovernmental Agreement with the Pension Fund for Supplemental Contributions in the Absence of State Legislation .............................................................................................................................. 22 Provide Pension Funding Support to the Cook County Forest Preserve District .............................................. 22 The New Clerk of the Circuit Court Should Improve Transparency, Efficiency and Accountability of the Circuit Court Clerk’s Office ............................................................................................................................... 22 ACKNOWLEDGEMENTS ...................................................................................................................................... 24 FY2021 BUDGET DEFICIT & GAP-CLOSING MEASURES ............................................................................ 25 APPROPRIATIONS ................................................................................................................................................. 27 ALL FUNDS APPROPRIATIONS BY FUND................................................................................................................... 27 OPERATING FUNDS APPROPRIATIONS BY OBJECT .................................................................................................... 30 ALL FUNDS APPROPRIATIONS BY CONTROL OFFICER AS A PERCENTAGE OF TOTAL APPROPRIATIONS ................... 31 RESOURCES ............................................................................................................................................................. 34 PROPOSED FY2021 RESOURCES FOR ALL FUNDS .................................................................................................... 34 YEAR-END FY2020 GENERAL FUND REVENUE ESTIMATES .................................................................................... 36 GENERAL FUND AND HEALTH FUND RESOURCE TRENDS ........................................................................................ 38 PROPERTY TAX LEVY FOR ALL FUNDS .................................................................................................................... 42 PERSONNEL TRENDS ............................................................................................................................................ 43 FULL-TIME EQUIVALENT POSITIONS BY FUND ........................................................................................................ 44 FULL-TIME EQUIVALENT POSITIONS FOR ALL FUNDS BY CONTROL OFFICER ......................................................... 44 SALARIES BY CONTROL OFFICER ............................................................................................................................. 45 PERSONAL SERVICES APPROPRIATIONS ................................................................................................................... 46 PUBLIC SAFETY ..................................................................................................................................................... 48 2 PUBLIC SAFETY PROGRAM AREA FY2021 PROPOSED APPROPRIATIONS ................................................................. 49 PUBLIC SAFETY FUND APPROPRIATIONS ................................................................................................................. 50 PUBLIC SAFETY PERSONNEL .................................................................................................................................... 54 PUBLIC SAFETY CAPITAL SPENDING ........................................................................................................................ 56 COOK COUNTY HEALTH ..................................................................................................................................... 57 OVERVIEW ............................................................................................................................................................... 58 KEY FY2021 BUDGET ASSUMPTIONS ...................................................................................................................... 64 APPROPRIATIONS ..................................................................................................................................................... 66 RESOURCES ............................................................................................................................................................. 70 Operating Revenues ........................................................................................................................................... 70 County Tax Allocation ....................................................................................................................................... 73 PERSONNEL ............................................................................................................................................................. 74 FUND BALANCE...................................................................................................................................................... 76 COMPONENTS OF FUND BALANCE REPORTING ........................................................................................................ 76 GFOA BEST PRACTICES AND COOK COUNTY FINANCIAL POLICY .......................................................................... 77 COOK COUNTY PENSION FUND ........................................................................................................................ 80 PLAN DESCRIPTION ................................................................................................................................................. 80 BENEFITS 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