Analysis of Cook County Department of Public Health Functions

This report provides a comprehensive analysis of the Cook County Department of Public Health (CCDPH). It begins with the historical context of Cook County, established in 1831, and outlines the legislative and administrative functions of the CCDPH, including its home rule status and governance structure. The report details the CCDPH's programs, such as the Old Cook County Hospital redevelopment project, opioid grants, and public health awareness initiatives. It then explores the organizational and administrative structure, including key personnel like the Chief Operating Officer and Chief Executive Officer of Cook County Health. The report examines the decision-making process, mayoral control, and budgetary information, including employee numbers and expenses from 2018 to 2020. Furthermore, it analyzes how the agency delivers services through various programs, emphasizing the use of technology for service delivery and the "one-stop shop" principle. The report concludes with a discussion on potential actions to decrease waste and improve effectiveness, such as improving clinical work in medical facilities and fostering public participation.

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Management
The Cook County Department of Public Health
Purpose and function of the agency
The Cook County of Illinois, Chicago was established in January of 1831.it was
formed by an act of the state legislation of Illinois. It was the 54th county that was established
in Illinois and on May 7th of the same year the Cook County elected its first representatives
and officials. As an urban county, Cook County contains more than 800 local government
units that are within the county’s boundaries. It is also established that the county is the 19th
largest local government in America according to the 2005 population census. The Cook
County health department is among the busiest in the country.
Legislative
Its function and purpose are legislative and administrative in nature. According to
Article 7, Section 6 of the Illinois state constitution, it is a home rule county. It is governed by
a 17-board member commission and the commissioners are the elected members of each
single district. The county member board which includes the Board president and the
commissioners are elected on a four year term limit by the Illinois people (Baum, 67). As an
area of function, the county has 128 municipalities within the region with Chicago being the
most known and populous. The total square miles of the county is 946 square miles. The

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unincorporated 15% jurisdiction are under the Board of Commissioners of Cook County. The
principal responsibility of the county government as mandated by the state law is to offer
protection of property and persons, provision of public health care and the county highway
and roads maintenance. They are also responsible for the prudent financial management of
the resources allocated to the county.
Department Programs
The current programs of the county ranges from public health to fixing of the public
highways. The current program ongoing is the redevelopment of the Old Cook County
Hospital redevelopment project which is a collaborative program between the developers,
preservationists, local government leaders and designers. The program began on 1st October
2019.
Cook county opioid grants and story map for daily awareness with partnership from
the Cook County Bureau of Technology is another program.
Other programs include the public health awareness of behavioral health such as mental
illness, chronic diseases, communicable diseases and emergency preparedness. Other
programs include the data & report computations on diseases and injury data on suburban
people of Cook County. Environmental health programs enforcement of Cook County of
Illinois and the health issues relating to the Suburban Cook County.
Organization and Administration
The Cook County Department of Public Health (CCDPH) is a nationally accredited
and state certified health department which serves more than 2.5 million residents and more
than 127 municipalities that surround the city of Chicago. It is headed by a Chief operating
officer who has a Board of commissioners.

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Executive Personnel
The organization and the administrative structure of CCDPH are headed by: the executive
Personnel
1. Terry Mason, MD and Chief Operating Officer CCDPH
2. John Jay Shannon, MD and Chief Executive Officer of Cook County Health (CCH).
CCH is among the biggest and the largest public health systems in the country. In addition
to CCPDH, there are also other facilities such as the John H Stroger Provident and Jr.
Hospital, Correctional health centers at the cook county juvenile and temporary detention
centers, the Ruth Rothstein Center and a Medicaid managed care health plan.
3. Tony Preckwinkle- President Cook County Board of Commissioners.
The Cook County Board of Commissioners is the regulatory authority of the CCDPH. It is
presided over by the president of the board.
Decision making structure
The Manager or the CEO administers all the administrative decision making processes.
Mayoral Control
How does the Mayor or top official of the local government control the department?
The government of Chicago Illinois has the legislative and executive branches. The Mayor of
the City is the CEO elected on a four year term. The mayor is the appointing authority and
appoint commissioners and other officials who oversee the department such as CCDPH. The
mayor is also able to fire or dissolve the commission of board members depending on their
ability to deliver and performance.
Number of Budgeted Employees

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Year Number of employees
2018 300
2019 320
2020 340
Budgeted amount and expenses
Item 2018 2019 2020 Operating
margin
Total
margin
Budgeted amount $ 394. 9
million
$ 422.6
million
503.7 m 1% 7%
cutting spending
budget
417.2 m
Reimbursement for
city costs
32.5 m
Revenue enhancement
costs
17.2
million
Portfolio management 78.2 m
Economic
development
16.2
million

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The mayor is also able to fire or dissolve the commission of board members depending on
their ability to deliver and performance.
Functional Analysis
How does the agency deliver these services?
Today, in connection with the development of technology, getting state and municipal
services from home is becoming more and more urgent - without queues, in the comfort of
the native walls. For each service, recipients are indicated, a list of necessary documents, cost
and payment procedure, terms and results of the services. It also publishes related legal acts,
addresses and telephone numbers of departments. Among them - receiving applications
(recording) for an appointment with a doctor; assignment and confirmation of qualification
categories of specialists working in the healthcare system of the City; accepting applications,
registering and providing information about specialized medical care. In addition, through the
site you can apply for registration and provision of information on high-tech medical care,
filling out and sending electronic prescriptions to pharmacies, registration and providing
information on the organization of medical care provided for by the legislation of the Chicago
Region for a certain category of citizens, issuing permission to engage in traditional medicine
(Muennig, 24).
Service and program delivery
A network of CCDPH branches located in many cities of our region has been created
in the Chicago Region. The CCDPH’s work is based on the “one-stop shop” principle,
according to which the provision of services is carried out in one place on a free basis after a
single request from the applicant.

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Through the CCDPH in the field of healthcare, you can get 6 services: 3 licensing services, a
service for the assignment and confirmation of qualification categories of specialists working
in the healthcare system, a service for receiving applications, registering and providing
information on the drug provision of certain categories of citizens entitled to the provision of
a set of social services, as well as the service of issuing permission to engage in traditional
medicine.
What actions could be undertaken by the department to decrease waste and improve its
effectiveness
Improving clinical work in medical facilities
An integrated approach to transformations in the inpatient unit, based on the central
role of doctors and medical care processes, can help hospitals and the healthcare system as a
whole provide medical care that is more financially stable, patient-centered and
understandable for the doctors themselves. Against the background of rising financial costs,
most inpatient hospitals in the United States are forced to significantly reduce the cost of
activities, while improving the quality of care and treatment (Arrieta,34). The reasons for this
situation are well known: employers, insurance companies and patients require tightening
cost controls (Choi, 68). In addition, in order to stimulate a reduction in the total cost of
treatment, innovative payment models based on the effectiveness of treatment (“payment by
treatment results”) are increasingly being used (Neumann, Peter J., 12).
Public participations and physical locations
In this regard, programs are being implemented in many hospitals and healthcare
systems to optimize operational activities, such as the principles of lean manufacturing, the
Six Sigma concept, and programs to quickly improve performance. At the same time, medical
services account for a significant portion of operating expenses in most hospitals. If the

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processes of medical services are not substantially changed, hospitals will not be able to
reduce operating costs by 5-10%, while at the same time improving quality, which, according
to most experts, is necessary to overcome existing economic problems.
Thus, the direct participation of doctors in improving operational efficiency plays a
crucial role. To reduce operating costs by 5-10%, a medical organization should reduce the
variable costs of non-core activities by about 30% if cost-cutting measures do not cover the
organization’s direct medical activities. Achieving such cost savings for most hospitals is
unrealistic (Sanders, 8). Experience on the ground confirms that doctors can be actively
involved in improving efficiency and they are ready to change approaches to treatment
(Graves, 65).
Overview
Improving clinical activity includes elements of traditional programs to improve the
work of hospitals (especially the implementation of the principles of lean manufacturing), but
it is not limited to them, since it is focused not only on improving the quality of medical care,
but also on non-medical aspects of the activity . As part of this work, various tools for
improving processes are used, as well as methods for standardizing transformation
management in order to increase the operational efficiency of working methods in hospitals.
The ultimate goal is to reduce the overall cost of treatment by maintaining or improving
quality.

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Works cited
Arrieta, Alejandro, et al. "Updated cost-effectiveness assessments of PCSK9 inhibitors from the
perspectives of the health system and private payers: insights derived from the FOURIER
trial." JAMA cardiology 2.12 (2017): 1369-1374.
Baum, Sarah E., et al. "Evaluating one health: are we demonstrating effectiveness?." One
Health 3 (2017): 5-10.
Choi, Bryan Y., Charles Blumberg, and Kenneth Williams. "Mobile integrated health care and
community paramedicine: an emerging emergency medical services concept." Annals of
emergency medicine 67.3 (2016): 361-366.
de Almeida, John R., et al. "Cost‐effectiveness of transoral robotic surgery versus (chemo)
radiotherapy for early T classification oropharyngeal carcinoma: A cost‐utility analysis." Head
& neck 38.4 (2016): 589-600.
Graves, Nicholas, et al. "Cost-effectiveness of a national initiative to improve hand hygiene
compliance using the outcome of healthcare associated Staphylococcus aureus
bacteraemia." PLoS One 11.2 (2016): e0148190.
Muennig, Peter, and Mark Bounthavong. Cost-effectiveness analysis in health: a practical
approach. John Wiley & Sons, 2016.
Neumann, Peter J., et al., eds. Cost-effectiveness in health and medicine. Oxford University
Press, 2016.
Sanders, Gillian D., et al. "Recommendations for conduct, methodological practices, and
reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health
and medicine." Jama 316.10 (2016): 1093-1103.

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