CHICAGO - The Cook County, Ill., Board of Commissioners will begin debate today on a measure that would shift control of the massive and financially troubled health bureau to an independent governing board.

The move comes a week after county President Todd Stroger announced his nine selections for the new board, whittled down from an original list of 20. The board might be expanded to include 11 members in total, according to Commissioner Joan Patricia Murphy, vice chair for the board task force on hospital governance.

Under the current proposal - which is based largely on recommendations by a blue-ribbon committee that studied the system last fall - the governing board would have total control over clinical and financial decisions, though the full county board would retain final authority on the budget.

Widely dubbed a patronage dumping ground for county commissioners and executives, the county bureau of health accounts for roughly a third of the county's total annual spending plan, operating under an $850 million budget as part of the county's $3.2 billion budget.

Several state leaders, including U.S. Sen. Dick Durbin, D-Ill., have urged the board to hand control of the bureau over to an independent board of medical and financial executives. The health care system includes three hospitals and 26 clinics across the Chicago area.

Some commissioners initially seemed to resist relinquishing control of the system, greeting some of the blue-ribbon committee's recommendations with open skepticism at earlier meetings. But now Murphy said officials are considering a move that would serve to completely divorce the two systems by asking Illinois to give the health system taxing authority.

"If we're going continue with the governance board, then maybe this is the way we should go," Murphy said. "Otherwise all the decisions are out of our hands, only we will have to go to the taxpayers and say we need more money. Maybe they should be responsible for that."

The system was at the center of a long and contentious debate this year over whether to raise Cook's sales tax in order to plug the county's estimated $300 million deficit, which included a $70 million deficit in the health bureau. In late February, facing a government shutdown, commissioners approved Stroger's unpopular proposal to raise the sales tax by 1%, generating an estimated $450 million annually.

At today's meeting the board is expected to begin debate on Stroger's nine nominations for the board. They include: Norman Bobins, former president of the former LaSalle Bank; Heather O'Donnell of the Center for Tax and Budget Accountability; Andrea Zopp of Exelon Corp.; Chicago attorney Barbara Hillman; Quin Golden, formerly of the Illinois Public Health Department; Benn Greenspan of the School of Public Health at the University of Illinois at Chicago; F. Daniel Cantrell, an aide to U.S. Rep. Danny Davis and the former director of a Chicago health center; David Carvalho of the Illinois Public Health Department; and Jorge Ramirez of the Chicago Federation of Labor.

Cantrell has already attracted controversy after it became public that his former Chicago clinic failed to pay more than $1 million in payroll taxes as it went bankrupt.

In advance of the new governing board, Robert Simon recently left his post as chief of the hospital system, and has been replaced in the interim by David Small, the former chief operating officer. One of the governing board's first duties will be to select a new chief, Murphy said.


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