On Tuesday, August 29th, Health & Medicine Executive Director Margie Schaps testified before the Cook County Health and Hospitals System with regards to their proposed 2018 budget.

Good evening, and thank you for the opportunity to provide testimony on the proposed 2018 health system budget. I’m Margie Schaps, the Executive Director of the Health and Medicine Policy Research Group, a policy, research and advocacy organization founded by Quentin Young in 1981 to create policies and systems that support the public’s health.

Between Quentin and myself, I daresay it’s likely that not a year has gone by since 1981 that we haven’t testified on the health system budget and the strategic direction of the system.

Health and Medicine has been steadfast in our commitment to a strong, vibrant and fully funded public hospital and health system that serves all in need in our County.

I want to applaud the system for the many accomplishments over the last year, increasing mental health and substance use services, movement toward integration of primary care and behavioral health, a more extensive care coordination program including the deployment of community health workers, being awarded one of the state’s new MCO contracts, expanding oral health services, beginning to address social determinants of health through the new transportation program, housing initiatives and farmers markets, and aggressively beginning to pursue being a welcoming institution for all.

As threats at the federal level mount to unravel the ACA, undermine basic civil liberties and destroy funding and services for all, but particularly the most marginalized, this health system bears and extra burden to lift up the community and support equity in whatever ways it can.

With that in mind, I urge the health system to:

• Work with the county commissioners, the President of the county board and the Sheriff’s office to move the newly created mental health positions at the County Jail under the Health system budget, rather than the public safety budget. This will ensure greater coordination and continuity for the patients
• Use whatever leverage is possible to demand that other local hospitals do not “dump” high need, uninsured patients into the county system, but rather share the burden of taking care of high need patients
• Ensure that the new plans for training staff and implementing policies to become a welcoming institution for all are adequately and fully implemented, and continuously monitored for implementation and outcomes.
• Continue to build upon the already begun programs addressing social determinants of health by coordinating with advocacy and policy and service organizations in a transparent way to address root causes of ill health—one opportunity for collaboration right now would be advocacy for safe zones for opiod and other drug users. Safe zones exist in other cities and countries and have shown dramatic reductions in drug use among people served in these setting.
• Advocate for a fully funded health system that supports public health and population health, and expanded community based services, in particular full dental care at all CCHHS facilities
• And finally, commit to becoming a trauma informed institution and begin the process of training staff to become trauma informed providers. This will reap enormous benefits for patients and staff and has been shown repeatedly to reduce health care costs.

Thank you very much for the opportunity to address this body. Health and Medicine stands ready, as always, to partner with CCHHS in the difficult tasks that will advance health equity.