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October 2018
TONI PRECKWINKLE
President, Cook County Board of Commissioners
**Embargoed until 1 p.m. October 10**
Executive Summary
Criminal Justice Administered by the Cook County Justice Advisory Council, in 2019 the
County will award $4.08 million in two-year grants to 20 community-based
(Safe and Thriving organizations to support violence prevention, recidivism reduction and
Communities) restorative justice.
Public Infrastructure & Assets The County Clerk is purchasing new state of the art election equipment in
(Smart Communities) suburban Cook County to help secure election results from cyber attacks.
In FY2019, the Offices Under the President will establish the Office of
Operational Stewardship
Research, Operations and Innovation to implement solutions to make
(Open Communities) operations more efficient and cost effective. 3
**Embargoed until 1 p.m. October 10**
Property Taxes*,
$766.1
66.8% of the budget are funds for a restricted purpose: Capital, Self –Insurance, Pension, Special Purpose Funds,
Election Fund, Grants and CountyCare.
Public Health and Public Safety are 88% of operations, excluding pensions & debt service
4
**Embargoed until 1 p.m. October 10**
Operating Budget by Office
Treasurer, 0.3%
Board of Election
Commissioners, 0.02%
25,613
25,000 23,985 23,660 23,650 23,706 23,439
23,169 23,233
22,017 22,171 22,239
20,000
15,000
10,000
5,000
-
2010 2011 2012 2013 2014 2015 2016 2017 2018 2018 (A) 2019
Grants 779 725 665 590 505 484 481 409 408 408 421
SPF 1,014 1,117 1,080 1,050 1,030 929 910 989 953 953 912
Health Enterprise 7,627 6,638 7,058 6,668 6,744 6,747 6,736 6,865 6,895 6,895 7,141
General Fund 16,193 15,505 14,857 14,861 15,371 15,546 15,312 14,971 13,762 13,916 13,765
TOTAL 25,613 23,985 23,660 23,169 23,650 23,706 23,439 23,233 22,017 22,171 22,239
6
*2018(A) – Adjusted after Office of the Chief Judge settlement, restoring 154 positions.
FY2019 Operating
Budget Overview
500.0
400.0
300.0 17.7
487
200.0 200.6
315.2 315.9
267.5
100.0 198.8
152.1 168.9 174.3
97.6 81.8
0.0
2011 2012 2013 2014 2015 2016 2017 2018 2019
• General Fund revenue increased $45.6M over Preliminary projections/$56.1M or 3.1% over FY2018 budget
• Health Fund revenue increased $57.5M over Preliminary projections/$647M or 31.7% over FY2018 budget
• Tax Allocation to Health Fund remains flat at $101.9M, supporting Public Health and Correctional Health
• Expenditure drivers include:
• Increase in CountyCare membership*
• Expanded surgery, dialysis, health center capacity*
• Increase in employee medical benefits
• Decreases in personnel expenses – vacancy eliminations and step freezes
▲ County Sales Tax growth: $52M – improved economic conditions, reduction in State admin fee
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**Embargoed until 1 p.m. October 10**
Health Enterprise Fund Review
CountyCare membership growth and expanded services to the community
Health Enterprise Fund revenue growing 31.7% over FY2018 budget
▲ Managed Care (CountyCare) Revenue – up $611M
Membership growth:
• 2018 projected: 225,000
• 2018 actual: 332,000
• 2019 projected: 345,000
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**Embargoed until 1 p.m. October 10**
County Health Fund Allocation
CCHHS Operating Tax Allocations has declined by 63% since 2011, while they
continue to provide over half a billion dollars in uncompensated care
Direct Operating Tax Allocation Legacy Liability Tax Allocation
$300 $350
$250 $300
$250 $116 $107
$200 $113
$200 $86
$214 $193 $191
$150
$110 $93 $150
$100 $41 $29 $100 $172 $184 $186 $175
$50 $102 $102 $125 $150 $136 $141 $152
$63 $61 $61 $65 $71 $80 $83 $50
$0 $0
2011 2012 2013 2014 2015 2016 2017 2018 2019 2011 2012 2013 2014 2015 2016 2017 2018 2019
Tax Allocation for Hospital and Ambulatory Acturially Recommended Supplemental Contribution
Tax Allocation for Public Health and Correctional Health Statutory Pension & Legacy Debt Service
$500
$400
$300
$502 $543 $536 $505 $505
$438 $473
$200 $405
$314
$100
$0
2011 2012 2013 2014 2015 2016 2017 2018** 2019**
**Projected 12
Long-Term Fiscal
Planning
General Fund-Net Surplus/(Deficit) Projection ($B) Health Fund-Net Surplus/(Deficit) Projection ($B)
$2.3 $3.0
Billions
Billions
$2.2 $2.8
$2.1 $2.6
$2.0 0 0 0 -10 -23
0 $2.4
$1.9
$1.8 -49 -116 -179 -224 $2.2
$1.7 $2.0
Revenue Expense
$1.6 $1.8
Revenue Expense
$1.5
$1.6
$1.4
$1.3 $1.4
2015 2016 2017 2018 2019 2020 2021 2022 2023 2015 2016 2017 2018 2019 2020 2021 2022 2023
Millions
pace with -$20
$767,917,106 31.3%
inflation -$30
Growing with -$40
$1,145,091,591 46.7%
economy
-$50
Other
Growth/Decline $171,032,158 7.0% -$60
patterns FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY20
Grand Total* $2,450,651,351 100.0%
County Treasurer Clerk of Circuit Court
• Cook County’s base property tax levy has not increased in over 20 years
• Most local governments increase their levies annually by the rate of natural growth
• If Cook County took natural growth over the last 20 years, the base levy would be $1.18B
• If natural growth were included in the FY2019 budget, the value would be $24M
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**Embargoed until 1 p.m. October 10**
Fulfilling Sales Tax Commitments
Increased Sales Tax funding allowed the County to address legacy
liabilities and critical transportation infrastructure needs
FY2016 FY2017 FY2018 FY2019*
Taxable Sales - Historical Correlation
10.0% Value of 1% Increase $308 $474 $445 $475
$500 $1 $2
5.0%
$55 $27 $58
$400 $65 $65 $65
0.0% $3
$300
Millions
$25
-5.0% $10
$200
$354 $353 $350
$271
-10.0% $100
-15.0% $0
FY2016 FY2017 FY2018 FY2019*
Proj: 18
2001
2002
2006
2007
2012
2013
1997
1998
1999
2000
2003
2004
2005
2008
2009
2010
2011
2014
2015
2016
2017
• National Gross Domestic Product (GDP) is a • The County Board approved a 1% increase
good indicator of Taxable Sales in Cook County effective January 1, 2016 to help fund:
• Over the last 10 years the correlation between • Additional Appropriation to address the
GDP and County Taxable Sales has been 80.4% Pension Fund’s liabilities
• Sample of independent forecasts for 2019: • Increased Transportation Funding by stopping
2019 National Gross Domestic Product Forecasts Motor Fuel Tax diversion
Federal Reserve 4.50% • Increased debt service costs
Survey of Professional Forecasters 4.90%
Wall Street Journal Survey 4.70% • Pay Go Capital equipment purchases 16
As of Q3 2018
**Embargoed until 1 p.m. October 10**
Addressing Pension Fund Liabilities
Pension Fund’s funded ratio increased to 60.1% in just 2 years; without
supplemental funding the ratio would be 56.1%
• The County has an annual Intergovernmental Agreement (“IGA”) with the Pension Fund, which
includes supplemental payments in addition to the statutorily required maximum contribution
• These payments will total, by the end of FY18, close to a billion dollars, allowing the Pension
Fund to keep its assets invested and take advantage of strong market performance
Projected Funded Ratio with Supplemental Projected Funded Ratio Without Supplemental
120.0% Funding Funding
80.0%
100.0%
60.0%
80.0% 40.0%
20.0%
60.0%
0.0%
2018
2020
2022
2024
2026
2028
2030
2032
2034
2036
2038
2040
2042
2044
2046
2048
2050
40.0% -20.0%
-40.0%
20.0% -60.0%
-80.0%
0.0%
2018
2020
2022
2024
2026
2028
2030
2032
2034
2036
2038
2040
2042
2044
2046
2048
2050
-100.0%
-120.0%
$0.68 $0.58
$2.00
$0.24 $0.24
$1.20 $1.20
$0.50
$0.00
FY14-FY15 FY15-FY16 FY16-FY17 FY18-FY19 FY19-FY20*
Violence Prevention Recidivism Reduction Restorative Justice Alternatives to Detention and Employment Services
*planned
Other FY2019 public safety initiatives:
• Public Defender expanding the Police Station Representation Unit and piloting mental
health services to:
• Provide better counsel to those held in custody at Police stations
• Identify clients with potential mental health issues early to help expedite the dispositions of
their cases 19
**Embargoed until 1 p.m. October 10**
CCHHS Service Innovations
Improving service delivery and expanding programs to address
community health needs
• Establish dialysis services in Provident community based on needs assessment
• Increase surgery services and outpatient dental services based on community demand
• Establish mental health services for court-involved youth
• Grow outpatient services to maximize facility efficiency and improve timely access to
healthcare
• Invest in care coordination to improve care and outcomes
Monthly
Monthly Average Projection Difference
FY19 v.
Visit Type FY 2016 FY 2017 FY 2018 * FY 2019 FY18
Surgical Cases 1,238 1,233 1,245 1,320 6%
Emergency Visits 12,901 12,074 12,037 12,750 6%
Primary Care Visits 18,436 18,482 18,144 19,051 5%
Specialty Care Visits 20,230 20,143 21,325 22,391 5%
Deliveries 83 98 81 90 11%
*based on first 7 months of FY2018
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**Embargoed until 1 p.m. October 10**
Budget Calendar
Oct. 10 – Early Nov. November Dec. 1, 2018 – Nov. 30, 2019
Budget
Gather Feedback Pass Budget
Accountability
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