So now reconvene the meeting of the Health and Hospitals Committee.

Madam Secretary Secretary, do we still have a quorum?

Yes, sir.

And let me revisit your uh role.

Uh all members are present.

We have added Commissioner Moore to your row.

The following members are remote, Commissioner Britton, Commissioner McCasco, Commissioner Marita, and Commissioner Scott.

You do have a quorum, sir.

Thank you.

We've already done our remote participation motion.

Do we have any additions to the agenda?

Chairman, I'm not aware of any additions to your uh agenda, and there are no speakers for this meeting either.

Great.

Vice Chair and I now moves approval of item 26-1486, the minutes from the meeting of the Health and Hospitals Committee held on April 14th, 2026.

Seconded by Chairman Daly.

All those in favor say aye.

Aye.

All those opposed.

In the opinion of the chair, the ayes have it.

Okay.

Chairman Daly now moves to receive and file.

It's a receive and file, correct?

Correct.

To receive and file item 26-1101, a report titled CCH semi annual agency utilization report for the reporting period October 2025 to March 2026, seconded by Commissioner Aguilar.

And we will now have a presentation.

I think Wynn Biran is going to lead us off.

Is he online?

Or he's he's back.

All right, come on up.

Okay, great.

Okay.

Okay.

When you're gonna start, and I understand Craig Williams is online as well.

Okay.

And I believe we have the presentation.

Awesome.

Thank you.

All right.

Good afternoon, Chairman Lowry.

Good afternoon.

Commissioners.

I'm Wynn Bier and Chief Human Resource Officer at Cook County Health.

I'm here to present our semi-annual update on the agency reduction plan, item 26-1101 on today's agenda.

Uh joining me today is Craig Williams, our executive chief operating officer presenting virtually, and RJ Dabney, Associate Chief Human Resource Officer to my left.

Last year I was here uh with early progress to report.

Today the data shows we've continued to move in the right direction.

Um before the workforce numbers, I want to uh I want to set the frame.

Reducing agency dependency is a physical resilience strategy.

Every position we convert to permanent staff, every agency request will be redirect overtime or internal redeployment.

That shows up in the budget, and you'll see that on the spending side spending slide.

Uh next slide, please.

Really?

Next slide.

And one more, please.

Thank you.

Current state of agencies.

So in September of 2024, we had 1,366 agency FTEs, uh, 18.6% of our total workforce.

By May 2025, when we last reported this body, we had brought the work that number down to 968.

As of March 2026, we're at 698 FTEs or 9% of the workforce.

That's a 51% reduction from our September 2024 baseline, and the decline has been consistent across each reporting period.

I want to address the December 2025 uptick on the chart directly.

That was not a trend reversal.

Guide houses third-party billing work previously performed through an outside outsource vendor and not in our agency numbers.

That transition into agency staffing uh during that period.

In FY24 and FY25, that work didn't appear here.

Now it does.

We've added 135 permanent revenue cycle positions to the FY26 budget to insource the work on a permanent basis.

The underlying picture is 18.6% to 9%, and it's still declining.

So I'll turn it over to Craig to walk through the job code details and spending trend.

Good afternoon.

This is Craig Williams, Executive Chief Operating Officer of Cook County Health.

Um Thank you, Wynne.

This slide shows reduction where these reductions have occurred.

Across more than a dozen job classifications decline since September of 2024 are substantial.

Cross food service workers, we've declined 83%, CORP 5, 78%, medical assistance, 77%, patient care technicians, 76%, Phlebotomists, 70%, ward clerks, 56%, certified uh certified surgical tax 55 percent.

Uh as you can see, um, actually, can you go to the next slide?

I'm sorry.

Um clinical nurse one continues to still be our largest category, but even in that um difficult to recruit um category, we're also down 50 percent uh over this time period.

In total, more than 600 FTEs uh have been hired against the September 2024 baseline.

Positions now filled by permanent CCH employees eliminated through better workforce planning.

Um, next slide.

Um this financial picture tracks um how the the numbers that we presented on the prior slide actually um place forth within our financials.

Um so going back to 2018, um we were relatively low on agency staffing, and you can see during the pandemic uh as we were coming out of the pandemic and a lot was happening across uh the labor workforce across health care, uh we started to see an increase in uh agency spending by FY23 that had reached 212 million, uh driven by post-pandemic labor shortages across health care.

FY24 came in at 150 million, and FY25 at F at 155 million.

Excuse me, FY24 was 190 million.

Um our FY26 uh projection, which really is the result of the work we've done since 2024, um, has us trending to about 118 million dollars.

So you know, almost 70 million dollars off of our high point.

Um, one note in that figure um then we did a projection based on uh March yeah to date spending.

Uh that doesn't actually take into account the full uh amount of agency conversions.

So we do anticipate that number will come in a little bit lower than the 118.

I'll turn it back to Wynne for the process and government governance update.

Uh next slide, please.

Okay.

Uh these reductions are a product of process change.

We've overhauled how agency requests are reviewed and approved.

Every department now requires a business case.

Senior leader sign off HR review committee evaluation and budget procurement approval before engaging an agency.

Departments have to exhaust internal options first, overtime, redeployment, permanent hiring, agency staffing is the laptop is the last option, no longer the default.

We continue to refine the process across all clinical areas as we mature the model.

And I believe there's one more uh next slide, please.

And then with the agency use committee, this body overseeing the process includes finance operations and HR leadership.

Every request is evaluated against cons uh consistent set of criteria, board and CEO priorities, patient care needs, overtime availability, union agreement and compliance, and alignment with budget vacancies.

HR tracks all decisions and oversees the compliance.

Every approval is documented and every denial has a stated reason.

So Craig, I'll hand it back over to you for the close.

Thanks, Wen.

So a year ago, um, this team reported just under 19% agency dependency for our total workforce, but we did have a plan of motion.

Um at the May 2025 update, we're at 968 agency FTEs.

As of uh this March, we're down to 698, which is about 9% of our workforce.

Um the spend is projected at 118 million against a 212 million dollar peak, and hundreds of physicians are converted to permanent staff.

Uh the revenue cycle in circuit in sourcing work is underway, and hiring pipelines continue to mature, and we expect the trend to continue.

Um Wynn and I are happy to take any questions that you may have.

Thank you.

So, first of all, let me say thank you for the presentation, and let me also underscore that this effort is very impressive, and it isn't just about the reduction of agency.

Uh it's really about the provision of full-time work for the residents and the families of Cook County.

So job very well done.

And uh commissioners' comments.

Uh, Commissioner Trevor.

Thank you, Chair, and I'd also like to I share the sentiment this is a substantial decrease.

I just wanted to just get asking to revisit a comment that you made about the change from November 25 to December 25.

Uh involved guidehouse.

Can you give a be a little bit more specific specific about what happened in that time period?

Yeah, that's that is work performed um that we entered in a settlement agreement and and we are we brought those positions in-house to hire for us.

So that added to our agency number, so we track them as agency, but we also added those positions into our budget.

So we are now recruiting for those positions to bring them in-house.

Thank you.

Uh, and also just uh a slight pet peeve on this uh graph here is that I mean uh uh uh you're talking about a um a 50% reduction from September of 24th through March of 26.

Um just in terms of presenting the data, it is kind of um I think makes it a little bit more difficult to read when you set the baseline at 600.

Um the the you kind of have to do a second glance to try and figure out exactly um what the proportional change is.

So um I would just caution being careful of where you set the baseline on a graph like this.

But thank you.

Understood.

Chairman Daly.

Thank you, Mr.

Chairman, and thank you for your presentation.

And let me thank the administration for their improvement and agency and this report, especially with the agency reduction.

So would the number one reason being and the agency out would be the shortage of positions and does the absentee isn't play into it at all.

I I think that's part of it.

We're always going to be chasing that.

So we have to make sure that we're staffed appropriately to meet our patient needs.

So we'll have absenteeism, we'll have vacations, we'll have time off that people are taking and we'll also have challenges in hiring that we need to account for.

But the absentee is a is a factor do you have any idea what I don't have data on that I can look at could be submitted to the chair at submitted job members.

Thank you.

Thank you.

Commissioner Stamps thank you.

Thank you for your report.

Relative to recruitment event and strategy I saw this really beautiful flyer for hiring events and there were quite a few so I want to know what do you utilize to assess the effectiveness of your job fare participation.

Are there resulting in actual people hired and if so what is it and what is the data you can provide for that.

Yeah that's a great great question Commissioner I can start um this year job fairs have been our most effective tool for for reducing vacancies since December 2025 we participated in 14 hiring fairs events focused on our highest clinical needs including nursing emergency department and the operating room and med surge four of those were Cook County Health's own dedicated hiring fairs the remaining 10 were external events.

So we did university career fairs, community job fairs and professional association events where we had a presence and we're actually sourcing candidates.

The results have been significant across our nursing focus hiring fairs held between December 25 and April 26 we extended 122 142 offers of those 101 candidates were confirmed as external new hires and 65 already having completed orientation and 36 beginning orientation this month or offer acceptance rate across the nursing hiring events was 71 percent.

Thank you so much for that it is just thank you.

You're welcome but can I get that can I get that please can you share that to you as a part of your report I think it's important for TAR for Commissioner Stamps that when you have these then you have like the homework that you just shared that said as a result of these was the outcome it's just helpful for me and I appreciate it.

The other um thing that I was interested in as you know since I've come to the board nearly three years ago now I went so fast.

In June one of the things I've been saying is that it's important for us to build what we need now and into the future and so the sheriff's department is doing some of that with the pipeline that they have that's going to be starting with CPS provided they are approved by the state.

Do you guys have anything in the works of doing some more robust um development of high school students into these careers that we may need uh now and into the future particularly since we're right here in the medical district and there's a high school crane CPS that touts itself as a medical high school and then there's Malcolm X.

I just think there's a very natural pipeline that we could be taking advantage of in addition to populating one of our um uh underserved disinvested from high schools in the in a in a community yeah I can speak a little bit to that um we have an EMTB uh the apprenticeship program that's 18 weeks um we have an MA program that we're we're preparing to start that will be 12 weeks we have certification programs we're partnering with city colleges for uh medical assistance and patient care technicians we also had a career health expo um uh recently that I believe we had 98 students come through and that was just a few weeks ago so there are things that we're doing to work with and uh to address the things that you were uh mentioning thank you I'm really interested in high schools more so than uh city colleges city colleges have kind of um began to to specialize themselves and that's great but I'm I really am interested in a repopulating a lot of the Chicago public high schools that are going to be in danger uh when the when the um school moratorium ban is lifted in 2027 of how can we be really innovative and imaginative to repopulate our high schools and to provide them with the skills that they're going to need now and into the future.

We have opportunity here, like I'm like I'm saying, like there's Crane High School touts itself as a medical high school.

So where are we looking to be really innovative so that we can relieve ourselves of some of this dependency on agency workers because we are developing our own networks, our own cadres of nurses and in and all the other medical technicians that we're going to need.

And you know, we're this, you know, we're in a STEM environment.

I mean, it checks all the boxes.

I'm just asking, you know, is there really any real intention and innovation around what what's possible?

Uh Commissioner uh Nick Shields, Chief External Affairs and Civic Engagement Officer, great to see you again.

You as well.

We just had a meeting with uh CPS about pipeline uh just in general and what we can do uh far beyond uh what's currently happening.

So we have a plan to have our um doctors, nurses, et cetera, going into CPS schools.

This is a conversation we're having with them for the fall and figuring out ways in which we can expand upon that.

I hear you loud and clear.

And I would quite frankly, I would love to partner with you on it and to develop some ideas in which we can continue to uh further that pipeline.

So um we are on the same page, and it's not just for CPS.

The long-term long-range goal is to also include suburban Cook County as well.

Absolutely.

You have some amazing thriving high schools that I know.

If we were to offer um career paths that make sense that are relevant, that are going to lead into sustainable work, much like we did in the 70s and 60s and 70s, where you know it was because of the trades and the programs that were offered in Chicago public schools that led to a really robust middle class.

And so, with the with the elimination of what we knew to be trades and people being able to leave high school with skills for relevant sustainable work, we have to reimagine what that can be.

And um, our dependency on contract employees or agency employees or all that, like we're at there's gonna be some point upon which we cannot afford it, and the need is only getting greater, and we know that we're facing some real um tough days ahead with everything that's happening in the medical sphere.

So I think that we have to be revolutionary in that idea and move beyond just you know, doctor for a day kind of things or or these other kind of let me expose you to my career to saying no, we have to build what we need now into the future.

And so, yes, I would I welcome a partnership with you, Mr.

Shields, to just really explore that.

And I don't think it's just limited to what we're seeing in our medical field.

I think when I looked at the demographics and the numbers of what's happening in the ASA's office, there's real opportunity here to get students with diverse backgrounds, diverse experiences into all of these county areas, and they could be repopulated with our students that have a uh a lived experience that makes sense in a lot of the work, and there are county young people, and we can do a lot to repopulate our schools, not just in CPS, but much of what we're seeing that's happening in education around this country is um they are experiencing a lot of things in suburban cook as well.

So I think it's a real opportunity for us.

Completely agree with you, bottom line, and look forward to collaborating on that.

Nick, I'd like you to restate what you shared in a committee meeting earlier today, total number of Providence Scholarship recipients with this cohort, total uh resources that will be expended as part of this effort.

And then we're gonna get a breakdown relative to the total amount, how many high school students, how many college students, how many post-college students?

Happy to get that breakdown.

So uh, as we all know, the Providence Scholarship Fund has been around for four years.

We've given out more than four million dollars, and that is to more than 200 um Providence Scholars.

I mentioned a little bit earlier that we had a um Providence Scholar come into the hospital system yesterday.

Uh his name is Lon, and he wanted to visit it with one of the mentors uh that he's had since he became a Providence Scholar.

Now he's been a Providence Scholar for three years and has received funding for the last three years.

Uh that was an initiative that the president wanted to ensure was that they didn't our students, if they qualified, they didn't just give one year, but they would be fully supported for multiple years.

So he's been through all three years.

Um grew up in the uh uh Marquette Park area.

Uh Commissioner Samps, he's going to Yale, right?

And he says a part of that is because of the province scholarship.

Okay.

So uh that's just a microcosm of all the stories um that we uh have with this incredible program.

fully supported for multiple years so he's been through all three years um grew up in the uh uh Marquette Park area uh commissioner stamps he's going to yale right and he says a part of that is because of the problem scholarship okay so uh that's just a microcosm of all the stories um that we uh have with this incredible program so again 200 scholars uh have received awards 106 for the last year our next graduation of scholars are the folks who get that certificate that um notice that they are going to uh become a scholar for the upcoming uh season will be uh june 23rd would love to see everyone there and um that'll be another 1.5 million so we've already invested four and that'll be another 1.5 that's a huge investment and so thank you for that and i and I thank the president and her absence for that level of uh visionary investment in our young people but I think what is so important to me is not just talking about the investment but being able to share these stories that you're sharing is the microcosm not with just the county but in documents that we can share out because oftentimes we don't do the best job of telling our own story and we bury the lead and there's so much incredible work that's happening at the county level that we need to do a better job of sharing out with our constituents to say this is the work of county and um I like personally and it's not just the Yale I'm sure there's some other young people that have come through that program and it may not be Yale it may be some maybe Howard it may be some other institution but I think it's important for us to to share that that this is the benefit of this level of investment in these kinds of students that come from communities like these thank you Chairman Daly just to follow chair um the point that commissioner Steam's brought I think the on the job first success I would suggest going forward to include it in the package and that I again I came in at the last minute that would go for anyone testifying in the future on previous committees or any items that are before us we ask that you come prepared the questions that are usually asked time and time again is just what has been done what what is currently you're asking and also you should have available what's been done in the past so going forward this is going to continue it's not it doesn't take record scientists to complete it you have the information in your group or should have it especially when you come and testify before any of these committees thank you thank you any other questions comments all right hearing none seeing none we have a motion on the floor to receive and file item 26-1101 roll call this is to receive and file item number 261101 commissioner aguilar aye commissioner naya thank you commissioner Britton aye commissioner daily commissioner degnan is absent the previous votes were all aye commissioner gainer is absent commissioner miccasco is aye thank you commissioner miller aye commissioner miller is aye commissioner more commissioner more is aye commissioner marida commissioner marita are you still with us commissioner marita is absent commissioner kevin morrison commissioner Sean Morrison is absent commissioner Scott Commissioner Scott are you still with us commissioner scott is absent commissioner stamps aye commissioner stamps is aye commissioner Trevor aye following votes for all aye commissioner Vasquez aye thank you and Mr Chair aye we have commissioner's present and aye commissioner marita is present and aye chairman we have 13 ayes and four absent votes thank you so having no further business before this committee vice chair and I are now moves adjournment seconded by Commissioner Moore all those in favor say aye all opposed we're adjourned see you tomorrow what nine thirty first meeting tomorrow is at 9 30 9 30 rules thanks everybody