On Tuesday, July 9th, the following testimony by Health & Medicine’s Executive Director Margie Schaps was presented to the Cook County Board at their Budget Hearing. Schaps urged the Board to approve a budget that will allow the Health System to succeed and flourish while allowing it to fully implement a strategic vision that will ultimately reduce costs and improve the health of the residents of the County.

My name is Margie Schaps, and I am the Executive Director of the Health & Medicine Policy Research Group.  I want to thank President Preckwinkle and the Board for allowing me the opportunity to testify in support of a fully funded Cook County Health and Hospitals System budget.  Since 1981, Health & Medicine has been an organization committed to developing and supporting systems and policies that create health equity.

I have testified before the County Board and the Health System Board since our inception and always in the interest of supporting a strong Cook County Health System for the most marginalized and excluded people in our County.  We spend a lot of time researching best practices and developing solutions that will provide better, more efficient and effective health care for all—particularly those served by public systems.

The Cook County Health System plays a critical role in this County with a mission to take care of all in need.  At this particular moment in history, we face several challenges that demand that our public health system steps up in new and creative ways.

1. Demographic shifts happening in Cook County are significant. We are witnessing many people of color and low-income people leaving the city proper for the suburban areas.  These suburbs are often not equipped with the bricks and mortar health centers and services more readily available within the city.  The County Health System will be challenged to serve this population where they live and work—in their suburban communities.
2. We are all learning that to adequately address health and well-being, actual provision of healthcare is only a part of what is required. Cook County is and should continue to be poised to be a national leader, experimenting with structures and non-traditional partners that are embedded in communities to develop a high quality, highly efficient healthcare delivery system focused on: primary care, prevention, and addressing underlying social determinants of health, as well as high touch intervention for those with multiple chronic conditions, mental illness, substance use disorders, and more.  Healthcare workforce initiatives like developing a cadre of community health workers should be a priority to address community needs.  Food access in food deserts around the County is a continuing challenge that the health system should be applauded for addressing, and we must continue to support the expansion of these efforts.  Non-traditional partners in education, transportation, and housing can yield creative solutions to addressing some of the most persistent challenges that often lead to preventable and expensive hospitalizations.
3. The aging of the population of the County presents both challenges and opportunities for the health system to think about and plan for an expanded workforce and new models of care to support older adults to remain healthy and at home, in supportive living communities, or in skilled facilities when necessary.
4. Healthcare nationally, and therefore locally, has been in turmoil for the past 10 to 15 years, and will continue to be into the foreseeable future. We still have over 400,000 people in our County without health insurance, some not eligible for insurance, and many of the recently insured seeking healthcare for the first time in decades with complex behavioral and physical health needs—requiring more staff time, a greater array of services, and therefore at a greater cost than the system was accustomed to. The County Health System has embraced the huge responsibility of caring for hundreds of thousands through CountyCare and coordinating services for incarcerated people to help ensure that they don’t return to prison because of untreated mental illness. This system should stand proud in its commitment not only to expanding Medicaid services, but also in serving those who are not able to access Medicaid or other insurance options.
5. The opioid crisis continues to plague our community, and the Cook County Health System is called upon to continue its leadership as a provider of care and in taking a public health approach to this persistent challenge.
6. We can be a national model for efficient and effective care that will truly improve the health of the public, as well as lower medical costs in the long run.  We know how to do this, and we can do it with leadership and continued investment in the system.

CCHHS is unique and is a treasure to our County. Its practice is priceless—they train healthcare providers who are mission driven and experts in working with patients with complex needs; they have forged relationships with health centers, support services, hospitals, and related services across the County to ensure continuity and high quality care for their patients.

New programs and collaborations are commendable, but we have to be in this for the long run—real savings will take time, but will happen.  It is the job of this Board to approve a budget that will allow the health system to succeed.  We must continue to provide the needed resources for the system to flourish and provide the services they are obligated to provide, and allow the system to fully implement the strategic vision that will ultimately reduce costs and improve the health of the residents of the County.  It is your responsibility to provide care for those most marginalized in our County.  We must fully support the health system.