South Cook News

Cook County Board of Commissioners Health & Hospitals Committee met Feb. 26.

Here is the minutes provided by the committee:

Present: Arroyo, Anaya, Britton, Daley, Degnen, Gainer, Johnson, Lowry, Miller, Moore, K. Morrison, S. Morrison, Silvestri, Sims and Suffredin (15)

Absent: Deer and Tobolski (2)

PUBLIC TESTIMONY

Vice-Chairman Arroyo asked the Secretary to the Board to call upon the registered public speakers, in accordance with Cook County Code.

1. Linda Rae Murray - Health & Medicine Policy Research Group

2. Laurence Msall - Civic Federation

3. George Blakemore - Concerned Citizens

4. Susan Avila - Collaborative for Health Equity

20-1729

COMMITTEE MINUTES

Approval of the minutes from the meeting of 01/15/2020

A motion was made by Commissioner Silvestri, seconded by Commissioner Gainer, to approve 20-1729.

The motion carried by the following vote:

Ayes: Arroyo, Anaya, Britton, Daley, Degnen, Gainer, Johnson, Lowry, Miller, Moore, K. Morrison, S. Morrison, Silvestri, Sims and Suffredin (15)

Absent: Deer and Tobolski (2)

20-1842

COMMITTEE MINUTES

Approval of the minutes from the meeting of 01/22/2020 (Recessed and Reconvened on 1/27/2020 and

01/29/2020).

A motion was made by Commissioner Silvestri, seconded by Commissioner Degnen, to approve 20-1842.

The motion carried by the following vote:

Ayes: Arroyo, Anaya, Britton, Daley, Degnen, Gainer, Johnson, Lowry, Miller, Moore, K. Morrison, S. Morrison, Silvestri, Sims and Suffredin (15)

Absent: Deer and Tobolski (2)

20-1118

Sponsored by: TONI PRECKWINKLE (President), JOHN P. DALEY, DENNIS DEER, BILL LOWRY, LARRY SUFFREDIN, ALMA E. ANAYA, LUIS ARROYO JR, SCOTT R. BRITTON, BRIDGET DEGNEN, BRIDGET GAINER, BRANDON JOHNSON, DONNA MILLER, STANLEY MOORE, KEVIN B. MORRISON, SEAN M. MORRISON, PETER N. SILVESTRI and JEFFREY R. TOBOLSKI, Cook County Board Of Commissioners

PROPOSED ORDINANCE AMENDMENT

COOK COUNTY HEALTH AND HOSPITALS SYSTEM

BE IT ORDAINED, by the Cook County Board of Commissioners, that CHAPTER 28. HEALTH AND HUMAN SERVICES, ARITCLE V. COOK COUNTY HEALTH AND HOSPIALS SYSTEM, SECTION 38-70 - 38-94 of the Cook County Code is hereby amended as Follows:

CHAPTER 38. HEALTH AND HUMAN SERVICES

ARTICLE V. - COOK COUNTY HEALTH AND HOSPITALS SYSTEM

Sec. 38-70. - Short title.

Sec. 38-71. - Declaration.

Sec. 38-72. - Definitions.

Sec. 38-73. - Establishment of the Cook County Health and Hospitals System Board of Directors ("System Board").

Sec. 38-74. - Mission of the CCHHS.

Sec. 38-75. - Nomination and appointment of directors.

Sec. 38-76. - Members of the System Board.

Sec. 38-77. - Qualifications of appointed directors.

Sec. 38-78. - Chairperson/officers of the System Board.

Sec. 38-79. - Meetings of the System Board.

Sec. 38-80. - General powers of the System Board.

Sec. 38-81. - Chief executive officer.

Sec. 38-82. - Strategic and financial plans.

Sec. 38-83. - Preliminary CCHHS budget and annual appropriation ordinance. Sec. 38-84. - Human resources.

Sec. 38-85. - Procurement and contracts.

Sec. 38-86. - Disclosure of interests required.

Sec. 38-87. - Annual report of the System Board.

Sec. 38-88. - Managerial and financial oversight.

Sec. 38-89. - Indemnification.

Sec. 38-90. - Applicability of the Cook County Code.

Sec. 38-91. - Transition.

Sec. 38-92. - Severability.

Sec. 38-93. - Making CCHHS permanent.

Sec. 38-94. - Quarterly reporting.

****

BE IT FURTHER ORDAINED, by the Cook County Board of Commissioners, that CHAPTER 28. HEALTH AND HUMAN SERVICES, ARITCLE VII. COOK COUNTY DIRECT ACCESS PROGRAM,

SECTION 38-159 of the Cook County Code is hereby amended as Follows:

ARTICLE VII. - COOK COUNTY DIRECT ACCESS PROGRAM Sec. 38-159. - Establishing a direct access program.

Effective date: This ordinance shall be in effect immediately upon adoption. For full text of ordinance, click here:

A motion was made by Commissioner Daley, seconded by Commissioner Suffredin, to accept as substituted 20-1118. The motion carried by the following vote:

Ayes: Arroyo, Anaya, Britton, Daley, Degnen, Gainer, Johnson, Lowry, Miller, Moore, K. Morrison, S. Morrison, Silvestri, Sims and Suffredin (15)

Absent: Deer and Tobolski (2)

20-1118

Sponsored by: TONI PRECKWINKLE (President), DENNIS DEER, DONNA MILLER, LARRY SUFFREDIN, BILL LOWRY, JOHN P. DALEY, LUIS ARROYO JR, SCOTT R. BRITTON, BRIDGET DEGNEN, BRANDON JOHNSON, STANLEY MOORE, KEVIN B. MORRISON, SEAN M. MORRISON, PETER N. SILVESTRI and DEBORAH SIMS, Cook County Board Of Commissioners

PROPOSED SUBSTITUTE TO ITEM 20-1118

ISSUED FEBRUARY 24, 2020

(THIS SUBSTITUTE REPLACES ALL PREVIOUS SUBSTITUTES)

HEALTH AND HOSPITALS COMMITTEE MEETING OF FEBRUARY 26, 2020

Sponsored by: TONI PRECKWINKLE (President), DENNIS DEER, BILL LOWRY, DONNA MILLER, LARRY SUFFREDIN, JOHN P. DALEY, Cook County Board of Commissioners PROPOSED ORDINANCE AMENDMENT

COOK COUNTY HEALTH AND HOSPITALS SYSTEM

BE IT ORDAINED, by the Cook County Board of Commissioners, that CHAPTER 38. HEALTH AND HUMAN SERVICES, ARITCLE V. COOK COUNTY HEALTH AND HOSPIALS SYSTEM, SECTION 38-70 - 38-94 of the Cook County Code is hereby amended as Follows:

CHAPTER 38. HEALTH AND HUMAN SERVICES

ARTICLE V. - COOK COUNTY HEALTH AND HOSPITALS SYSTEM Sec. 38-70. - Short title. This Ordinance shall be known and may be cited as the "Ordinance Establishing the Cook

County Health and Hospitals System."

Sec. 38-71. - Declaration.

The County Board hereby establishes the Cook County Health and Hospitals System ("CCHHS or System") which shall be an agency of and funded by Cook County. All personnel, facilities, equipment and supplies within the formerly constituted Cook County Bureau of Health Services are now established within the CCHHS. Pursuant to the provisions contained herein, the CCHHS and all personnel, facilities, equipment and supplies within the CCHHS shall be governed by a Board of Directors ("System Board") as provided herein. The System Board shall be accountable to and shall be funded by the County Board and shall obtain County Board approval as required herein. The County Board hereby finds and declares that the CCHHS shall:

Provide integrated health services with dignity and respect, regardless of a patient's ability to pay;

Provide access to quality preventive, acute, and chronic health care for all the People of Cook County, Illinois (the "County");

Provide quality emergency medical services to all the People of the County;

Provide health education for patients, and participate in the education of future generations of health care professionals;

Engage in research which enhances its ability to meet the healthcare needs of the People of the County; and,

Perform, through the Cook County Department of Public Health, essential services of a local public health authority as provided in the Cook County Board of Health Ordinance, Sections 38-26 through 38-40 of the Cook County Code, other Cook County Ordinances imposing duties upon the Cook County Department of Public Health, and the regulations of the Cook County Department of Public Health promulgated thereunder; the Department of Public Health Act, 20 ILCS 2305/1 et seq.; the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 5/5-1et seq.; and as further detailed in regulations promulgated by the Illinois Department of Public Health under the Certified Local Health Department Code, 77 Ill. Adm. Code 600.110100 et seq.; provided, however, that the County Board shall continue to serve as the Board of Health of Cook County.

This article recognizes the essential nature of the Mission of the CCHHS as set forth in Section 38-74, and the need for sufficient and sustainable public funding of the CCHHS in order to fulfill its mission of universal access to quality health care.

CCHHS shall cooperate with the Cook County Board of Commissioners and the Office of the Cook County Board President and the President’s various Bureau Chiefs on operational matters, uncompensated care policies, determining appropriate benchmarking and reporting (including but not limited to revenue and finance enhancements, operational and quality improvements and expenditure authority), strategic plans and the legislative policy agenda for CCHHS to ensure efficiency across County operations.

The System Board can best fulfill its mission by consistently and regularly consulting with the Cook County Board, in its official capacity and as the Board of Public Health and the Office of the President in the development of policies, procedures, and operational decisions. However, no reference herein to CCHHS working with, collaborating with, cooperating with, or otherwise interacting with the County Board or the Office of the President is intended to revoke or diminish the System Board’s authority to act independently on the matters under consideration except where otherwise provided in this Article.

Sec. 38-72. - Definitions.

For purposes of this article, the following words or terms shall have the meaning or construction ascribed to them in this section:

Chairperson means the chairperson of the System Board.

Cook County Code means the Code of Ordinances of Cook County, Illinois.

Cook County Health and Hospitals System also referred to as "CCHHS", means the public

health system comprised of the facilities at, and the services provided by or through, the Ambulatory and Community Health Network, Cermak Correctional Health Services of Cook County, Cook County Department of Public Health, Oak Forest Hospital Health Center of Cook County, Provident Hospital of Cook County, Ruth M. Rothstein CORE Center, and John H. Stroger, Jr. Hospital of Cook County, (collectively, the "CCHHS Facilities").

County means the County of Cook, a body politic and corporate of Illinois. County Board means the Board of Commissioners of Cook County, Illinois. Director means a member of the System Board.

Fiscal Year means the fiscal year of the County.

Ordinance means the Ordinance Establishing the Cook County Health and Hospitals System, as amended.

President means the President of the Cook County Board of Commissioners.

System Board means the 11-member board of directors charged with governing the CCHHS.

Sec. 38-73. - Establishment of the Cook County Health and Hospitals System Board of Directors ("System Board").

The System Board is hereby created and established. The System Board shall consist of 11 members called Directors. The County Board delegates governance of the CCHHS to the System Board. The System Board shall, upon the appointment of its Directors as provided herein, assume responsibility for the governance of the CCHHS. Effective February 27, 2020, the System Board shall consist of 12 members.

Notwithstanding any provision of this article, the Cook County Board of Health Ordinance, Sections 38-26 through 38-40 of the Cook County Code of Ordinances, and other provisions of the Cook County Code of Ordinances conferring authority and imposing duties and responsibilities upon the Board of Health and the Cook County Department of Public Health, shall remain in full force and effect.

Sec. 38-74. - Mission of the CCHHS.

The System Board shall have the responsibility to carry out and fulfill the mission of the CCHHS by: Continuing to provide integrated health services with dignity and respect, regardless of a patient's

ability to pay and working with the Office of the President to determine and establish uncompensated care policies; and

Continuing to provide access to quality primary, preventive, acute, and chronic health care for all the People of the County;

Continuing to provide high quality emergency medical services to all the People of the County;

Continuing to provide health education for patients, and continuing to participate in the education of future generations of health care professionals;

Continuing to engage in research which enhances the CCHHS' ability to meet the healthcare needs of the People of the County;

Ensuring efficiency in service delivery and sound fiscal management of all aspects of the CCHHS, including the collection of all revenues from governmental and private third-party payers and other sources and working with the Office of the Cook County Board President, and the Cook County Bureau of Finance to ensure sound fiscal management and financial reporting; Except where otherwise permitted herein, ensuring that all operations of the CCHHS, especially contractual and personnel matters, are conducted free from any political interference and in accordance with the provisions of the Supplemental Relief Order and Consent Decree CCHHS Employment Plan and Supplemental Policies established in the federal civil litigation filed in the Northern District of Illinois under Case No. 69 C 2145 and titled Shakman, et al. v. Democratic Organization, et al. that may be modifed from time to time and all applicable laws; and

Perform, through the Cook County Department of Public Health, essential services of a local public health authority as provided in the Cook County Board of Health Ordinance, Sections 38-26 through 38-40 of the Cook County Code, other Cook County Ordinances imposing duties upon the Cook County Department of Public Health, and the regulations of the Cook County Department of Public Health promulgated thereunder; the Department of Public Health Act, 20 ILCS 2305/1 et seq.; the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 5/5-1et seq.; and as further detailed in regulations promulgated by the Illinois Department of Public Health under the Certified Local Health Department Code, 77 Ill. Adm. Code 600.110100 et seq.; provided, however, that the County Board shall continue to serve as the Board of Health of Cook County; and Work with the Office of the President to determine and establish, appropriate benchmarking and reporting (including but not limited to revenue and finance enhancements, operational and quality improvements and expenditure authority), strategic plans and the legislative policy agenda for CCHHS.

The System Board shall be responsible to the People of the County for the proper use of all funds appropriated to the CCHHS by the County Board.

Sec. 38-75. - Nomination and appointment of directors.

(a) Upon confirming that a vacancy in the office of Director has occurred or will occur, a Nominating Committee of 14 13 persons including a Chair shall be appointed by the President and convene to prepare a list of nominees consisting of a total of three nominees per vacancy except the President’s designated appointment. This list shall be provided within 45 days of the President's request. If the number of nominees accepted by the President is fewer than the number of vacancies, the Nominating Committee will submit replacement nominees until the President has accepted that number of nominees that corresponds to the number of vacancies.

(b) Nominating Committee.

(1) The Nominating Committee shall consist of one representative from the following organizations:

a. Civic Federation of Chicago;

b. Civic Committee of the Commercial Club of Chicago;

c. Chicago Urban League;

d. Healthcare Financial Management Association;

e. Suburban Primary Healthcare Council;

f. Illinois Public Health Association;

g. Metropolitan Chicago Healthcare Council; Illinois Health and Hospital Association

h. Health and Medicine Policy Research Group;

i. Chicago Department of Public Health;

j. Cook County Physicians Association;

k. Chicago Federation of Labor;

l. Chicago Medical Society;

m. Association of Community Safety Net Hospitals; and

n. Midwest Latino Health Research Center.

(2) All decisions of the Nominating Committee shall be by majority vote of the membership.

(c) The President shall submit the nominees he/she selects to the County Board for approval of appointment. The President shall exercise good faith in transmitting the nomination(s) to the County Board.

(d) Appointment of Directors. The County Board shall approve or reject each of the nominees submitted by the President, as well as the President’s direct appointment, within 14 days from the date the President submitted the nominees, or at the next regular meeting of the County Board held subsequent to the 14-day period. Where the County Board rejects the President's selection of any nominee for the office of Director, the President shall within seven days select a replacement nominee from the remaining nominees on the list received from the Nominating Committee. There is no limit on the number of nominees the County Board may reject. The County Board shall exercise good faith in approving the appointment of Directors as soon as reasonably practicable. In the event the nominees initially submitted to the President by the Nominating Committee are exhausted before the County Board approves the number of nominees required to fill all vacancies, the President shall direct the nominating Committee to reconvene and to select and submit an additional three nominees for each Director still to be appointed.

Sec. 38-76. - Members of the System Board.

(a) General. Except for the President’s direct appointment, tThe appointed Directors are not employees of the County and shall receive no compensation for their service, but may be reimbursed for actual and necessary expenses while serving on the System Board. Directors shall have a fiduciary duty to the CCHHS and the County; and Directors shall keep confidential information received in close sessions of Board and Board Committee meetings and information received through otherwise privileged and confidential communications.

Number of Directors. There shall be 11 Directors of the System Board. Effective February 27, 2020 there shall be 12 Directors.

(c) Ex Officio Director. One of the 11 Directors shall be the Chairperson of the Health and Hospitals Committee of the County Board who shall serve as an ex-officio member with voting rights. This Director shall serve as a liaison between the County Board and the System Board. The Ex Officio member of the System Board shall not serve as the Chairperson.

(d) President Appointment. Effective February 27, 2020, one of the 12 Directors shall be a direct appointment of the President; said direct appointment may also be an employee of the County. The direct appointment member shall not serve as the Chairperson.

(d) (e) Terms of Directors.

(1) Ex Officio Director. Upon appointment or election of a successor as Chairperson of the Health and Hospitals Committee of the County Board, the successor shall immediately and automatically replace the prior Director as ex officio Director with voting rights.

(2) President’s Direct Appointment. Effective February 27, 2020, the President shall be permitted to have one direct appointment on the System Board. The President’s direct appointment shall be subject to the advice and consent of the County Board. The President’s direct appointment shall have the same rights as any other Director and shall be subject to the same four year term and background qualifications as the Directors.

(3) The Remaining Directors. The remaining ten Directors of the System Board shall serve terms as follows. For purposes of this section, Initial Directors means the Directors who were appointed to serve on the System Board when it was first established.

a. For the initial Directors,

1. Three of the Initial Directors serving at the time this amendment is enacted, other than the ex officio Directors, shall serve terms that expire June 30, 2012.

2. Three of the Initial Directors serving at the time this amendment is enacted, other than the ex officio Directors, shall serve terms that expire June 30, 2013.

3. Four of the Initial Directors serving at the time this amendment is enacted, other than the ex officio Directors, shall serve terms that expire June 30, 2014.

4. The System Board shall vote upon and submit the list of names of the Directors whose terms shall expire June 30, 2012, the list of names of the Directors whose terms shall expire June 30, 2013, and the list of names of Directors whose terms shall expire June 30, 2014, to the President for approval and subsequent recommendation to the County Board for its approval.

b. Thereafter Directors appointed shall serve four-year terms.

Each appointed Director, whether Initial or subsequent, shall hold office until a successor is appointed.

2. Any appointed Director who is appointed to fill a vacancy, other than a vacancy caused by the expiration of the predecessor's term, shall serve until the expiration of his or her predecessor's term.

(e) (f) Vacancy. A vacancy shall occur upon the: (1) Expiration of Director's Term,

(2) Resignation,

(3) Death,

(4) Conviction of a felony, or

(5) Removal from the office of an appointed Director as set forth in paragraph (fg) of this section. (f) (g) Removal of Directors. Any appointed Director may be removed for incompetence, malfeasance, neglect of duty, or any cause which renders the Director unfit for the position. The President or one-third of the members of the County Board shall provide written notice to that Director of the proposed removal of that Director from office; which notice shall state the specific grounds which constitute cause for removal. The Director, in receipt of such notice, may request to appear before the County Board and present reasons in support of his or her retention. Thereafter, the County Board shall vote upon whether there are sufficient grounds to remove that Director from office. The President shall notify the subject Director of the final action of the County Board. The President may remove and replace his or her direct appointment at any time.

Sec. 38-77. - Qualifications of appointed directors.

The appointed Directors shall include persons with the requisite expertise and experience in areas pertinent to the governance and operation of a large and complex healthcare system. Such areas shall include, but not be limited to, finance, legal and regulatory affairs, healthcare management, employee relations, public administration, clinical medicine, community public health, public health policy, healthcare insurance management, managed care administration, labor affairs, patient experience, civil or minority rights advocacy and community representation.

Criteria to be considered in nominating or appointing individuals to serve as Directors shall include: Background and skills needed on the Board;

Resident of Cook County, Illinois;

Available and willing to attend a minimum of nine monthly Board meetings per year, and actively participate on at least one Board committee; and Willingness to acquire the knowledge and skills required to oversee a complex healthcare organization.

The Nominating Committee, the President and the County Board shall take this section into

account in undertaking their respective responsibilities in the recommendation, selection and appointment of Directors.

Duties of individual Directors include, but are not necessarily limited to, the following:

Regularly attend Board meetings including a minimum of nine meetings per year;

Actively participate on and attend meetings of committee(s) to which the Director is assigned; Promptly relate community input to the Board;

Represent the CCHHS in a positive and effective manner;

Learn sufficient details about CCHHS management and patient care services in order to effectively evaluate proposed actions and reports; and Accept and fulfill reasonable assignments from the Chair of the Board.

Sec. 38-78. - Chairperson/officers of the System Board.

The Directors shall select the initial Chairperson of the System Board from among the initial Directors. The Chairperson shall serve a one-year term and, thereafter, the System Board shall annually elect a chairperson from among the Directors.

The Chairperson shall preside at meetings of the System Board and is entitled to vote on all matters before the System Board.

(2) A Director may be elected to serve successive terms as Chairperson.

The Directors may establish such additional offices committees and appoint such additional officers for the System Board as they may deem appropriate; however, at a minimum, the Directors shall establish standing finance, human resources, audit and compliance, quality and patient safety, and managed care committees.

Sec. 38-79. - Meetings of the System Board.

The President shall call the first meeting of the System Board. Thereafter, the Directors shall prescribe the times and places for their meetings and the manner in which regular and special meetings may be called.

Meetings shall be held at the call of the Chairperson, however, no less than 12 meetings shall be held annually; standing committee meetings shall be called by the various committee chairs and the frequency of said meetings shall be established by the System Board.

A majority of the voting Directors shall constitute a quorum. Actions of the System Board shall require the affirmative vote of a majority of the voting members of the System Board present and voting at the meeting at which the action is taken.

To the extent feasible, the System Board shall provide for and encourage participation by the public in the development and review of financial and health care policy. The System Board may hold public hearings as it deems appropriate to the performance of any of its responsibilities.

The System Board shall comply in all respects with the Illinois Open Meetings Act "An Act in relation to meetings," as now or hereafter amended, and found at 5 ILCS 120/1, et seq.

The System Board shall be an Agency to which the Local Records Act, as now or hereafter amended, and found at 50 ILCS 205/1, et seq. applies.

Sec. 38-80. - General powers of the System Board.

Subject to the Mission of the CCHHS and consistent with this article, the System Board shall have the following powers and responsibilities:

To appoint the Chief Executive Officer of the CCHHS ("CEO") or interim CEO, if necessary, as set forth in Section 38-81 hereinafter, to hire such employees and to contract with such agents, and professional and business advisers as may from time to time be necessary in the System Board's judgment to accomplish the CCHHS' Mission and the purpose and intent of this article; to fix recommend the compensation of such CEO, employees, agents, and advisers as appropriated by the County Board; and, to establish the powers and duties of all such agents, employees, and other persons contracting with the System Board; the appointment of the CEO or interim CEO shall be subject to the advice and consent of the Cook County Board of Commissioners;

To exercise oversight of the CEO and require the CEO to meet with the President or his/her designee on a monthly basis to address various operations, including but not limited to, human resource and labor issues, financial performance, strategic goals, capital planning initiatives, operational initiatives, determine benchmarking, set uncompensated care policies and determine the CCHHS legislative agenda;

To develop measures to evaluate the CEO's performance and to report to the President and the County Board through the Health and Hospitals Committee at six-month intervals regarding the CEO's performance;

To authorize the CEO to enter into contracts, execute all instruments, and do all things necessary or convenient in the exercise of the System Board's powers and responsibilities;

To determine the scope and distribution of clinical services; provided, however, if the System Board determines that it is in the best interest of the CCHHS to close entirely one of the two CCHHS hospitals, such closure will require County Board approval; provided further, however, that if the System Board determines it is in the best interest of the CCHHS to purchase additional hospitals, or to add or reduce healthcare-licensed, risk-bearing entities in CountyCare, the CCHHS shall, 15 calendar days before final approval, provide notice to the President and the Cook County Board of Commissioners, informing such persons as to the basic nature of any such transaction and shall offer to meet with such persons to brief them in more detail on specifics relating to such a transaction;

To provide for the organization and management of the CCHHS, including, but not limited to, the System Board's rights and powers to approve review all personnel policies, consistent with existing state laws, collective bargaining agreements, and court orders; however, collective bargaining agreements shall be negotiated by the Cook County Bureau of Human Resources with input from the System Board and the CEO, regarding management rights;

To submit budgets for the CCHHS operations and capital planning and development, which promote sound financial management and assure the continued operation of the CCHHS, subject to approval by the County Board and provide the budget recommendation to the Cook County Chief Financial Officer and Budget Director at a minimum two weeks in advance of the presentation the System Board;

To accept any gifts, grants, property, or any other aid in any form from the federal government, the state, any state agency, or any other source, or any combination thereof, and to comply with the terms and conditions thereof;

To purchase, lease, trade, exchange, or otherwise acquire, maintain, hold, improve, repair, sell, and dispose of personal property, whether tangible or intangible, and any interest therein;

In the name of the County, to purchase, lease, trade, exchange, or otherwise acquire, real property or any interest therein, and to maintain, hold, improve, repair, mortgage, lease, and otherwise transfer such real property, so long as such transactions do not interfere with the Mission of the CCHHS; provided, however, that transactions involving real property valued at $100,000.00 $150,000.00 or greater shall require express approval from the County Board any such transactions valued under $150,000.00 but greater than $5,000 shall be reported to the Bureau of Asset Management on a quarterly basis;

To acquire space, equipment, supplies, and services, including, but not limited to, services of consultants for rendering professional and technical assistance and advice on matters within the System Board's powers;

To make rules and regulations governing the use of property and facilities within the CCHHS, subject to agreements with or for the benefit of holders of the County Board's obligations; said rules and regulations shall be shared with the Bureau of Asset Management for advice and feedback prior to implementation and the final rules and regulations governing such use shall be filed with the Bureau of Asset Management upon approval by CCHHS;

To adopt, and from time to time amend or repeal bylaws and rules and regulations consistent with the provisions of this article;

To encourage the formation of a not-for-profit corporation to raise funds to assist in carrying out the Mission of the CCHHS;

To engage in joint ventures, or to participate in alliances, purchasing consortia, or other cooperative arrangements, with any public or private entity, consistent with state law;

To have and exercise all rights and powers necessary, convenient, incidental to, or implied from the specific powers granted in this article, which specific powers shall not be considered as a limitation upon any power necessary or appropriate to carry out the CCHHS' Mission and the purposes and intent of this article;

To perform, through the Cook County Department of Public Health, essential services of a local public health authority as provided in the Cook County Board of Health Ordinance, Sections 38-26 through 38-40 of the Cook County Code, other Cook County Ordinances imposing duties upon the Cook County Department of Public Health, and the regulations of the Cook County Department of Public Health promulgated thereunder; the Department of Public Health Act, 20 ILCS 2305/1 et seq.; the Civil Administrative Code of Illinois, 20 ILCS 2310/2310-1 5/5-1et seq.; and as further detailed in regulations promulgated by the Illinois Department of Public Health under the Certified Local Health Department Code, 77 Ill. Adm. Code 600.110100 et seq.; provided, however, that the County Board shall continue to serve as the Board of Health of Cook County; and To be the governing body of the licensed hospitals or other licensed entities within the CCHHS; and The delegation of authority to the System Board from the Cook County Board of Commissioners shall not be considered a grant of home rule authority.

Sec. 38-81. - Chief executive officer.

Subject to the advice and consent of the Cook County Board of Commissioners, the System Board shall appoint a Chief Executive Officer of the CCHHS ("CEO") or an interim CEO as necessary.

The System Board shall conduct a nationwide search for a CEO which shall be concluded with a goal of no later than 180 days from the date of the County Board's approval of the appointment of the initial System Board or from the date the position of CEO becomes vacant. The System Board shall provide the County Board with a copy of the job description for the CEO in advance of recruitment as well as the performance measures used by the System Board to evaluate the CEO’s performance. The recommended salary, termination, term, severance and any contract bonus provisions negotiated by the System Board for the CEO shall be subject to the review and approval of the County Board. If the appointment is not approved, a new search shall be conducted by the System Board. If the compensation package is not approved by the County Board, the System Board must renegotiate the compensation package and if unsuccessful, a new search shall be conducted by the System Board.

The CEO shall have the responsibility for:

Full operational and managerial authority of the CCHHS, consistent with existing federal and state laws, court orders and the provisions of this article; however the CEO shall work with the Office of the President and his or her designees to collaborate on various operational initiatives that impact County policies and appropriations, including but not limited to, human resource and labor issues, financial matters, operational initiatives, address capital needs, determine benchmarking, set uncompensated care policies and determine the CCHHS legislative agenda.

Preparing and submitting to the System Board the Budgets and Strategic and Financial Plans required by this article;

Operating and managing the CCHHS consistent with the Budgets and Financial Plans approved by the County Board;

Overseeing expenditures of the CCHHS;

Subject to Subsection 38-74(a)(7) of this article, hiring and discipline of personnel in conformity with the provisions of this article, all state laws, court orders, and collective bargaining agreements; Assisting the Participating in negotiations with the Cook County Bureau of Human Resources regarding management rights and providing input to the Cook County Bureau of Human Resources in negotiating negotiation of management rights for CCHHS in various Negotiating collective bargaining agreements as set forth in Section 38-84(c); and

(7) Carrying out any responsibility which the System Board may delegate; however, said delegation shall not relieve the System Board of its responsibilities as set forth in this article.

(d) The CEO shall report to the System Board and shall also meet monthly with the Cook County Board President and his/her designees regarding CCHHS operations and shall collaborate with the Office of the President and his/her Bureau Chiefs on various operational initiatives that impact County policy and appropriations, including but not limited to, human resource and labor issues, financial matters, operational issues, informational technology issues, address capital needs, determine benchmarking, set uncompensated care policies and determine the CCHHS legislative.

(e) The CEO shall provide, through the System Board, quarterly reports to the President and County Board concerning the status of operations and finances of the CCHHS and issue other reports as may be required by the County Board or the President.

Sec. 38-82. - Strategic and financial plans.

(a) As soon as practicable following the establishment of the System Board, the President shall provide to the System Board copies of the audited financial statements and of the books and records of account of the Bureau of Health Services for the preceding five Fiscal Years of the County.

(b) The System Board shall recommend and submit to the President and the County Board Strategic and Financial Plans as required by this section.

(c) Each Strategic and Financial Plan for each Fiscal Year,

(1) A description of revenues and expenditures, provision for debt service, cash resources and uses, and capital improvements, each in such manner and detail as the County's

Budget Director shall prescribe;

(2) A description of the strategy by which the anticipated revenues and expenses for the Fiscal Years covered by the Strategic and Financial Plan will be brought into balance;

(3) Such other matters that the County Board or the President, in its discretion, requires; provided, however, that the System Board shall be provided with a description of such matters in sufficient time for incorporation into the Strategic and Financial Plan.

(d) Strategic and Financial Plans shall not have force or effect without the approval of the County Board and shall be recommended, approved and monitored in accordance with the following:

(1) The System Board shall recommend and submit to the President and the County Board, on or before 180 days subsequent to the date of the appointment of the initial Directors or as soon as practicable thereafter, an initial Strategic and Financial Plan with respect to the remaining portion of the Fiscal Year ending in 2008 and for Fiscal Years 2009 and 2010. The Board shall approve, reject or amend this initial Strategic and Financial Plan within 45 days of its receipt from the System Board.

(2) The System Board shall develop a Strategic and Financial Plan covering a period of three Fiscal Years and a representative of the County Board President and the Cook County Chief Financial Officer or his/her designee shall assist the System Board in developing the Strategic and Financial Plan.

(3) The System Board shall include in each Strategic and Financial Plan estimates of revenues during the period for which the Strategic and Financial Plan applies. In the event the System Board fails, for any reason, to include estimates of revenues and (4) The County Board shall approve each Strategic and Financial Plan if, in its judgment, the Strategic and Financial Plan is complete, is reasonably capable of being achieved, and meets the requirements set forth in this section. After the System Board submits a Strategic and Financial Plan to the President and the County Board, the County Board shall approve or reject such Strategic and Financial Plan within 45 days or such Strategic and Financial Plan is deemed approved.

(5) The System Board shall report to the President and the County Board, at such times and in such manner as the County Board may direct, concerning the System Board's compliance with the Strategic and Financial Plan. The President and the County Board may review the System Board's operations, obtain budgetary data and financial statements, require the System Board to produce reports, and have access to any other information in the possession of the System Board that the President and the County Board deem relevant. The County Board may issue recommendations or directives within its powers to the System Board to assure compliance with the Strategic and Financial Plan. The System Board shall produce such budgetary data, financial statements, reports and other information and comply with such directives.

(6) For each Strategic and Financial Plan applicable to a Fiscal Year subsequent to the current Fiscal Year, the System Board shall regularly reexamine the revenue and expenditure estimates on which it was based and revise them as necessary. The System Board shall promptly notify the President and the County Board of any material change in the revenue or expenditure estimates in that Strategic and Financial Plan. The System Board may submit to the President and the County Board, or the County Board may require the System Board to submit, modified Strategic and Financial Plans based upon revised revenue or expenditure estimates or for any other good reason. The County Board shall approve or reject each modified Strategic and Financial Plan pursuant to paragraph (d)(4) of this section.

Sec. 38-83. - Preliminary CCHHS budget and annual appropriation ordinance.

(a) The System Board shall not make expenditures unless such expenditures are consistent with the County's Annual Appropriation Bill ("Annual Appropriation Ordinance") as provided in 55 ILCS 5/6-24001 et seq.

(b) The System Board may, if necessary, recommend and submit to the President and the

County Board, for approval by the County Board, a request for intra-fund transfers within the Public Health Fund to accommodate any proposed revisions by the System Board to the line items set forth for the Bureau of Health Services in the existing Fiscal Year 2008

Annual Appropriation Ordinance.

(c) For Fiscal Year 2009 and each Fiscal Year thereafter, the System Board shall recommend and submit a balanced Preliminary Budget for the CCHHS to the President and the County Board, for approval by the County Board, not later than 45 days prior to the first date for submission of budget requests set by the County's Budget Director.

(d) Each Preliminary Budget shall be recommended and submitted in accordance with the following procedures:

(1) Each Preliminary Budget submitted by the System Board shall be based upon revenue estimates contained in the approved Strategic and Financial Plan applicable to that budget year.

(2) Each Preliminary Budget shall contain such information and detail as may be prescribed by the County's Budget Director. Any applicable fund deficit for the Fiscal Year ending in 2008 and for any Fiscal Year thereafter shall be included as an expense item in the succeeding Fiscal Year's Budget.

(3) Each Preliminary Budget submitted by the System Board shall be balanced with expenditures matching the revenue estimates for the fiscal year. Such revenue estimates may include requested appropriations from the County Board which will be subject to County Board approval.

(e) The County Board shall approve each Preliminary Budget if, in its judgment, the Budget is complete, is reasonably capable of being achieved, and will be consistent with the Strategic and Financial Plan in effect for that Fiscal Year. The Board shall approve or reject each Preliminary Budget within 45 days of submission to the County Board or such Preliminary Budget is deemed approved. Such Preliminary Budget shall be included in the President's Executive Budget Recommendation.

(f) The CCHHS's Annual Appropriation shall be monitored as follows:

(1) The County Board may establish and enforce such monitoring and control measures as the County Board deems necessary to assure that the revenues, commitments, obligations, expenditures, and cash disbursements of the System Board continue to conform on an ongoing basis with the Annual Appropriation Ordinance. If, in the discretion of the County Board, and notwithstanding the approved Annual Appropriation Ordinance, the County Board imposes an expenditure limitation on the System Board, the System Board shall not have the authority, directly or by delegation, to enter into any commitment, contract, or other obligation that would result in the expenditure limitation being exceeded. Any such commitment, contract or other obligation entered into by the System Board in derogation of this section shall be voidable by the County Board. An expenditure limitation established by the County Board shall remain in effect for that Fiscal Year or unless revoked earlier by the County Board.

(2) The System Board shall report to the President and the County Board at such times and in such manner as the County Board may direct, concerning the System Board's compliance with each Annual Appropriation Ordinance. The President and the County Board may review the System Board's operations, obtain budgetary data and financial statements, require the System Board to produce reports, and have access to any other information in the possession of the System Board which the President and the County Board deem relevant. The County Board may issue recommendations or directives within its powers to the System Board to assure compliance with the Annual Appropriation Ordinance. The System Board shall produce such financial data, financial statements, reports and other information and comply with such directives.

(3) After approval of each Annual Appropriation Ordinance, the System Board shall promptly notify the President and the County Board of any material change in the revenues or expenditures set forth in the Annual Appropriation Ordinance. In Fiscal Year 2009 and thereafter, the System Board has the authority to make intra-fund transfers within the Public Health Fund, if necessary, to accommodate any proposed revisions by the System Board to the line items set forth in the Annual Appropriation Ordinance. Such transfers shall be reported by the CEO in the quarterly reports required in Subsection 38-81(e) of this article.

(4) The County Comptroller is hereby authorized to process invoices and make payments against line items set forth in the Annual Appropriation Ordinance at the direction of the System Board or, if authorized by the System Board, at the direction of the CEO. The System Board shall provide the Comptroller with all documentation necessary for the Comptroller to perform this accounts payable function and to perform the budget control function. The Comptroller shall also issue payroll checks for employees within the CCHHS.

Sec. 38-84. - Human resources.

(a) Notwithstanding the provisions of the Cook County Code, including, but not limited to, provisions pertaining to Personnel Policies, the System Board shall have authority over all human resource functions currently performed by the Cook County Bureau of Human Resources with regard to all employees, including physicians and dentists, within the CCHHS, including, but not limited to, position classification, compensation, recruitment, selection, hiring, discipline, termination, grievance, affirmative action, performance management, probationary periods, training, promotion and maintenance of records. The System Board shall adopt written rules, regulations and procedures with regard to these functions. Until such time as the System Board adopts its own rules, regulations or procedures with regard to these functions, the existing Personnel Rules, regulations and procedures of the County shall apply. The System Board may exercise the authority granted in this section, in whole or in part, pursuant to its discretion and consistent with existing collective bargaining agreements and obligations.

The System Board and the CCHHS Human Resources Department shall collaborate monthly with the Cook County Bureau of Human Resources to ensure efficiency and uniformity to the extent practicable in human resource functions and policies. Except as otherwise limited herein, the System Board shall have authority over the following human resource functions with regard to employees, including physicians and dentists, within the CCHHS: position classification, compensation, recruitment, selection, hiring, discipline, termination, affirmative action, performance management, probationary periods, training, promotion and maintenance of records. The System Board shall adopt written rules, regulations and procedures with regard to these functions subject to the approval of the Chief of the Bureau of Human Resources for Cook County. The System Board or the System Board’s designee shall collaborate with the Cook County Bureau of Human Resources to ensure position classification and compensation are in accordance with the annual appropriation. The recommended salary, termination, term, severance and any contract bonus provisions or compensation policies negotiated by the System Board for the CEO or other Direct Appointments of the System Board or CEO shall be subject to the review and approval of the County Board. The System Board may exercise the authority granted in this section, in whole or in part, pursuant to its discretion and consistent with existing collective bargaining agreements and obligations.

(b) Employees within the CCHHS are employees of the County, and as such except where otherwise permitted herein, shall be free from any political interference in accordance with the Supplemental Relief Order and Consent Decree CCHHS Employment Plan and Supplemental Policies established in the federal civil litigation filed in the Northern District of Illinois under Case No. 69 C 2145 and titled "Shakman, et al. v. Democratic Organization, et al." which may be amended from time to time.

(c) Collective bargaining agreements shall be negotiated by the Cook County Bureau of Human Resources with input from the System Board and the CEO subject to the President’s direction. The CEO or designee shall participate cooperate with the County in negotiating collective bargaining agreements covering CCHHS employees and CCHHS may participate in negotiations with the Cook County Bureau of Human Resources in regard to negotiating management rights and work rules. All such collective bargaining agreements must be approved by the System Board and the County Board.

(d) With respect to CCHHS bargaining unit employees, the Chief of the Bureau of Human Resources for Cook County shall be granted the authority to settle contract or disciplinary employment-related grievances, arbitrations and mediations without approval of the System Board at the same settlement authority level as the Cook County State’s Attorney’s Office has in litigation matters. At the level where a collective bargaining agreement provides for grievances to be presented to Human Resources, the Chief of the Bureau of Human Resources for Cook County shall have sole authority to respond to and adjust said grievance. When exercising this authority, the Chief of the Bureau of Human Resources or designee, will at a minimum discuss the implications of the decisions with CCHHS Human Resources. CCHHS shall implement any resolutions or settlements reached by the Chief of the Bureau of Human Resources for Cook County regarding a CCHHS employee within 30 days of receipt of the resolution and/or settlement. Any extensions of time to implement a resolution or settlement must be approved by the Chief of the Bureau of Human Resources for Cook County. The Chief of the Bureau of Human Resources for Cook County shall have the authority to implement any resolutions or settlements where CCHHS has failed to implement within 30 days.

(e) With respect to CCHHS employees, the Chief of the Bureau of Human Resources for Cook County has been granted the authority over all labor relations matters regarding the unionized employees of CCHHS. Labor Relations matters include but are not limited to collective bargaining (successor agreements), impact bargaining (bargaining with union representatives regarding policy and work rule changes and terms and conditions of employment), and mid-term bargaining; interpretation of collective bargaining agreements; and implementation of collective bargaining agreements. CCHHS shall not enter into agreements with unions, verbal or written that amend or modify the terms of existing collective bargaining agreements and/or practices without consulting the Bureau of Human Resources Labor Relations Division. CCHHS shall comply with all lawful directives from the Director of Labor and/or the Bureau Chief of Human Resources for Cook County concerning labor matters and/or compliance with the collective bargaining agreements within an established timeframe. If there is an opposing view on the interpretation of the collective bargaining agreements and/or any policy or rule governing a unionized employee, the interpretation of the Bureau of Human Resources Labor Relations Division will govern.

(f) Where the Director of Labor and/or Chief of the Bureau of Human Resources for Cook County determines that training is needed concerning a collective bargaining agreement or other labor relations matter, CCHHS shall schedule the training within the timeframe directed by the Chief of the Bureau of Human Resources and cooperate with the Bureau of Human Resources in scheduling and ensuring that appropriate staff are trained within the established timeframe and with consideration of clinical and operational schedules. The training programs implemented by the Bureau of Human Resources will be reviewed with CCHHS Human Resources Department prior to implementing said training.

(g) The System Board or the CEO shall not hire or appoint any person in any position in the CCHHS unless it is consistent with the Annual Appropriation Ordinance in effect at the time of hire or appointment. The System Board shall have the authority to recommend the appropriate compensation for employees hired to work within CCHHS subject to the approval of the Chief of the Bureau of Human Resources for Cook County and the Director of the Department of Budget and Management Services and consistent with any applicable collective bargaining agreements.

(h)(e) Nothing herein shall diminish the rights of Cook County employees who are covered by a collective bargaining agreement and who, pursuant to this article, are placed under the jurisdiction of the System Board, nor diminish the historical representation rights of said employees' exclusive bargaining representatives, nor shall anything herein change the designation of "Employer" pursuant to the Illinois Public Labor Relations Act. This ordinance is subject to all existing collective bargaining agreements between Cook County and exclusive bargaining representatives, which cover employees under the jurisdiction of the System Board. (i) CCHHS shall implement any decisions of the Employee Appeals Board within 30 days after receipt of the decision from the Chief of the Bureau of Human Resources for Cook County unless a decision to appeal has been approved by the Chief of the Bureau of Human Resources. Any extension of time to implement a decision of the Employee Appeals Board must be approved by the Chief of the Bureau of Human Resources for Cook County. CCHHS shall have no right to appeal any decision of the Employee Appeals Board without the approval of the Chief of the Bureau of Human Resources. The Chief of the Bureau of Human Resources for Cook County shall have the authority to implement any decision of the Employee Appeals Board where CCHHS has failed to implement the decision within 30 days without an approved extension or approved appeal by the Chief of the Bureau of Human Resources.

(j) Any person who willfully takes any official action without authority as provided in this section including but not limited to: collective bargaining, failing to implement grievance resolutions and settlements, failing to implement directives of the Bureau Chief of Human Resources of Cook County as to labor matters and failing to implement decisions of the Employee Appeals Board may be subject to discipline up to and including termination of employment. The Chief of the Bureau of Human Resources for Cook County shall have the authority to investigate violations of this section. If the Bureau Chief of Human Resources of Cook County recommends discipline of any employee pursuant to this section, the CCHHS shall within 30 days implement the recommendation and conduct a pre-disciplinary hearing where applicable or provide a written explanation to the Chief of the Bureau of Human Resources for Cook County explaining why the discipline was reduced or not initiated.

Sec. 38-85. - Procurement and contracts.

(a) The System Board shall have authority over all procurement and contracts for the CCHHS. The System Board shall adopt written rules, regulations and procedures with regard to these functions, which must be consistent with the provisions set forth in the Cook County Code on Procurement and Contracts; provided, however, that approval of the County Board or County Purchasing Agent required under the Cook County Code on Procurement and Contracts is not required for procurement and contracts within the CCHHS. The System Board shall act in place of the County Board in any contract, bylaws or agreement with the County which requires the approval or other action of the County Board unless expressly prohibited otherwise in this article or unless the contract expressly provides that the System Board shall not have such authority. Until such time as the System Board adopts its own rules, regulations or procedures with regard to Procurement and Contracts, the existing provisions of the Cook County Code pertaining to Procurement and Contracts shall apply. The System Board may exercise the authority granted in this section, in whole or in part, pursuant to its discretion.

(b) No contract or other obligation shall be entered into by the System Board unless it is consistent with the Annual Appropriation Ordinance in effect.

(c) Any multiyear contracts entered into by the System Board must contain a provision stating that the contract is subject to County Board approval of appropriations for the purpose of the subject contract; and that in the event funds are not appropriated by the County Board, the contract shall be cancelled without penalty to, or further payment being required by, the System Board or the County. The System Board shall give the vendor notice of failure of funding as soon as practicable after the System Board becomes aware of the failure of funding. Multiyear contracts shall also contain provisions that the System Board's or County's obligation to perform shall cease immediately upon receipt of notice to the vendor of lack of appropriated funds; and that the System Board's or County's obligation under the contract shall also be subject to immediate termination or cancellation at any time when there are not sufficient authorized funds lawfully available to the System Board to meet such obligation.

Sec. 38-86. - Disclosure of interests required.

(a) Any Director, officer, agent, or professional or business adviser of the System Board, or the CEO who has direct or indirect interest in any contract or transaction with the CCHHS, shall disclose this interest in writing to the System Board which shall, in turn, notify the President and the County Board of such interest.

(b) This interest shall be set forth in the minutes of the System Board and the Director, agent, or professional or business advisor or CEO having such interest shall not participate on behalf of the CCHHS in any way with regard to such contract or transaction unless the System Board or County Board waives the conflict.

(c) The Cook County Board of Ethics shall have jurisdiction over the investigation and enforcement of this section and over the sanctions for violations as set forth in Sections 2-601 and 2-602 of the Cook County Code of Ethical Conduct.

(d) Employees of CCHHS shall be bound by the Cook County Code of Ethical Conduct set forth in the Cook County Code, Chapter 2. Article VII, Ethics.

Sec. 38-87. - Annual report of the System Board.

(a) The System Board shall submit to the President and the County Board, within six months after the end of each Fiscal Year, a report which shall set forth a complete and detailed operating and financial statement of the CCHHS during such Fiscal Year.

(b) Included in the report shall be any recommendations for additional legislation or other action which may be necessary to carry out the mission, purpose and intent of the System Board.

Sec. 38-88. - Managerial and financial oversight.

(a) The County Board may conduct financial and managerial audits of the System Board and the CCHHS.

(1) The County Board may examine the business records and audit the accounts of the System Board or CCHHS or require that the System Board examine such business records and audit such accounts at such time and in such manner as the County Board may prescribe. The System Board shall appoint a certified public accountant annually, approved by the County Board, to audit the CCHHS' financial statements.

(2) The County Board may initiate and direct financial and managerial assessments and similar analyses of the operations of the System Board and CCHHS, as may be necessary in the judgment of the County Board, to assure sound and efficient financial management of the System Board and the CCHHS.

(3) The County Board shall initiate and direct a management audit of the CCHHS as deemed advisable and approved by the County Board. at least once every year. The audit shall review the personnel, organization, contracts, leases, and physical properties of the CCHHS to determine whether the System Board is managing and utilizing its resources in an economical and efficient manner, The audit shall determine the causes of any inefficiencies or uneconomical practices, including inadequacies in internal and administrative procedures, organizational structure, types of positions, uses of resources, utilization of real property, allocation of personnel, allocation of salary,

purchasing policies and equipment.

(4) The County Board may direct the System Board to reorganize the financial accounts and management and budgetary systems of the System Board or CCHHS in a manner that the County Board deems appropriate to achieve greater financial responsibility and to reduce financial inefficiency. Any such reorganization shall be in keeping with best practices adopted by the Professional Financial Accounting Standards Board.

(5) The County Board may consult directly with CCHHS management or the System Board to recommend management related changes based upon the recommendations of any management audit initiated by the County Board. If the System Board or CCHHS does not accept the recommended changes, then a public hearing of the County Board shall be held at which the Chairperson of the System Board and the CEO of the CCHHS must explain why the changes were not accepted.

(b) The System Board and the CCHHS shall be subject to audit in the manner now or hereafter provided by statute or ordinance for the audit of County funds and accounts. A copy of the audit report shall be submitted to the President, the Chairperson of the Finance Committee of the County Board, the Chairperson of the Health and Hospitals Committee, and the Director of the County Office of the Auditor.

Sec. 38-89. - Indemnification.

(a) The County shall defend and indemnify patient care personnel and public health practitioners, including, but not limited to, physicians, dentists, podiatrists, fellows, residents, medical students, nurses, certified nurse assistants, nurses' aides, physicians' assistants, therapists and technicians (collectively "practitioners") acting pursuant to employment, volunteer activity or contract, if provided for therein, with the County with respect to all negligence or malpractice actions, claims or judgments arising out of patient care or public health activities performed on behalf of the CCHHS. The County shall also defend and indemnify such practitioners against liability arising out of the preparation or submission of a bill seeking payment for services provided by such practitioners for the CCHHS, to the extent such liability arises out of the negligent or intentional acts or

omissions of a person or persons, other than the practitioner, acting on behalf of the CCHHS. The County shall also defend and indemnify the members of the Nominating Committee and the System Board with respect to all claims or judgments arising out of their activities as members thereof which defense and indemnification shall be subject to the same provisions which apply to the defense and indemnification of practitioners as set forth below.

(b) The County shall not be obligated to indemnify a practitioner for:

(1) Punitive damages or liability arising out of conduct which is not connected with the rendering of professional services or is based on the practitioner's willful or wanton conduct.

(2) Professional conduct for which a license is required but the practitioner does not hold a license.

(3) Conduct which is outside of the scope of the practitioner's professional duties.

(4) Conduct for which the practitioner does not have clinical privileges, unless rendering emergency care while acting on behalf of the CCHHS.

(5) Any settlement or judgment in which the County did not participate.

(6) The defense of any criminal or disciplinary proceeding.

(c) To be eligible for defense and indemnification, the practitioner shall be obligated to:

(1) Notify, within five days of receipt, the Cook County Department of Risk Management and the Civil Actions Bureau of the Cook County State's Attorney's Office of any claim made against the practitioner and deliver all written demands, complaints and other legal papers, received by the practitioner with respect to such claim to the Department of Risk Management.

(2) Cooperate with the State's Attorney's Office in the investigation and defense of any claim against the County or any practitioner, including, but not limited to, preparing for and attending depositions, hearings and trials and otherwise assisting in securing and giving evidence.

(3) Promptly notify the Cook County Department of Risk Management and the Civil Actions Bureau of the Cook County State's Attorney's Office of any change in the practitioner's address or telephone number.

(d) All actions shall be defended [by] the Cook County State's Attorney. Decisions to settle indemnified claims shall be made by the County or the State's Attorney's Office, as delegated by the County, and shall not require the consent of the indemnified practitioner. If

a practitioner declines representation by the State's Attorney's Office, the County shall have no obligation to defend or indemnify the practitioner.

Sec. 38-90. - Applicability of the Cook County Code.

Except as otherwise provided herein, provisions of the Cook County Code shall apply to the System Board and the CCHHS and their Directors, officers, employees and agents. To the extent there is a conflict between the provisions of this article and any other provision in the Cook County Code, the provisions in this article shall control.

Sec. 38-91. - Transition.

(a) The County Board recognizes that there will be a necessary transition period between the adoption of this article and the point at which the System Board is capable of assuming all of its powers and responsibilities as set forth in this article. The Office of the President shall cooperate with the System Board during this transition to enable the System Board to assume fully its authority and responsibilities in as timely a manner as practicable. Such cooperation shall include accommodating requests from the System Board to provide adequate staffing at the CCHHS through the transfer or reassignment of personnel to the CCHHS, including, but not limited to, personnel to perform human resource and procurement/contracting functions.

(b) In order to avoid unnecessary duplication of services, the System Board, on behalf of the CCHHS, may, at its discretion, continue to utilize various ancillary services provided through the Office of the President, including, but not limited to, those services provided by the Office of Capital Planning and Policy, the Bureau of Information Technology, the Department of Risk Management, the Department of Facilities Management, the Department of Real Estate Management, the Office of the Comptroller, and the Office of the County Auditor.

(c) Any contracts entered into by the County on behalf of the Bureau of Health prior to the adoption of this article shall remain in effect; provided, however, that the System Board shall act in place of the County Board in any contract, bylaws or agreement with the County which requires the approval or other action of the County Board unless expressly prohibited otherwise in this article.

Sec. 38-92. - Severability.

Any provision of this article declared to be unconstitutional or otherwise invalid shall not impair the remaining provisions of this article.

Sec. 38-93. - Making CCHHS permanent.

The Cook County Health and Hospitals System and this article shall continue, unless the

Cook County Board of Commissioners acts to revoke its powers and responsibilities.

Sec. 38-94. - Quarterly reporting.

(a) The Health and Hospitals System shall report to the Board of Commissioners quarterly on

the cost that the office incurs due to processing medical cases involving firearms.

Secs. 34-95-34-108. - Reserved.

BE IT FURTHER ORDAINED, by the Cook County Board of Commissioners, that CHAPTER 38. HEALTH AND HUMAN SERVICES, ARITCLE VII. COOK COUNTY DIRECT ACCESS PROGRAM, SECTION 38-159 of the Cook County Code is hereby amended as Follows: ARTICLE VII. - COOK COUNTY DIRECT ACCESS PROGRAM

Sec. 38-159. - Establishing a direct access program

In consultation with the Cook County Board President or his/her designee, the Chief Executive Officer of the Cook County Health and Hospitals System (herein referred to as CEO), or his/her designee, is hereby authorized and empowered, subject to the policy approval of the Cook County Board President and the County Board acting in their official capacity and as the Board of Public Health, to establish a direct access program to ensure uninsured residents of Cook County have access to quality health care:

(1) Leveraging CCHHS' existing charity care program.

(2) Building on the infrastructure and operations systems of the CountyCare Health Plan to ensure proper care coordination, provider relations, and data analytics.

(3) Maximizing the community partnerships and linkages established over the past 180 years of service to the residents of Cook County.

Health & Hospitals Committee Committee Minutes February 26, 2020

A motion was made by Commissioner Daley, seconded by Commissioner Suffredin, to recommend for approval as substituted 20-1118. The motion carried by the following vote:

Ayes: Arroyo, Britton, Daley, Degnen, Gainer, Johnson, Lowry, Miller, Moore, K. Morrison, S. Morrison, Silvestri, Sims and Suffredin (14)

Present: Anaya (1)

Absent: Deer and Tobolski (2)

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