Cook County Finance Committee FY2027 Budget Presentation - October 27, 2026

The Cook County Board Finance Committee met on October 27, 2026, to receive the FY2027 executive budget recommendation from the Bureau of Finance. No agenda or minutes were provided with the transcript. Staff presented a balanced budget plan for a $550.7 million preliminary gap using one-time measures, targeted vacancy reductions, and expense savings without tax increases or layoffs, and commissioners then asked questions and offered comments.

Discussion Items

• Opening presentation: CFO Angela described a historically large $550 million preliminary gap, said the budget was balanced without tax increases or layoffs, and credited intentional reserve use, smart investing, department reductions, and stricter vacancy management. She thanked Bureau of Finance staff.
• Historical and economic context: Deputy CFO Dean noted pension reform, a $1.36 billion reduction in DAP principal, six credit-rating upgrades in five years, full spending of ARPA funds, and over 70 percent of ARPA funds committed to community programs. More than 60 percent of general fund revenues are economically sensitive; forecasters project real GDP growth just above 2 percent with elevated inflation. Aggregate revenues are projected to grow about 1 percent annually after 2028, while expenses grow about 2 percent, worsening projected deficits.
• Fiscal pressures: The road builders litigation restricts about $258 million in transportation-related taxes annually, and HR1 federal Medicaid changes beginning October 2026 are expected to reduce enrollment, increase the uninsured population, and raise uncompensated care. Without action, staff projected the unassigned fund balance would fall below the county floor in 2028 and turn negative by 2029.
• FY2027 totals: The proposed budget is $9.69 billion, a 4.2 percent decrease from FY2026. The preliminary gap was $336 million in the general fund and $214.7 million in the health enterprise fund, totaling $550.7 million. The budget is balanced without tax increases or layoffs. Health care and public safety are about 72 percent of operating costs. The county will contribute $629.9 million to pensions, with the funded ratio projected at 73.3 percent by 2030.
• Budget growth and staffing: The total budget grew 100.8 percent over ten years, a 7.2 percent compound annual growth rate, with underlying core growth about 4.5 percent. General fund headcount is down 478 since 2017. The FY2027 plan reduces general fund positions by 50.7 FTEs through vacancies and long-term leave positions only, with no layoffs; health enterprise staffing stays flat at 7,761 FTEs.
• Gap context: The county faced a $487 million deficit in 2011; the 2027 preliminary gap is about 7 percent of the combined general fund and health enterprise fund budget, compared with almost 21 percent in 2011.
• General fund gap closure: Staff identified $46.3 million in payroll and overtime reductions and $34.7 million in non-personnel reductions, about $76 million total. Sales tax was reforecast $35 million higher, and other fees and taxes were reforecast higher than June projections. One-time measures included $88 million in ARPA interest and $61.2 million from the ARPA sustainability reserve. The transcript gives conflicting figures for the pension stabilization fund: the CFO earlier mentioned an $18 million transfer, while the gap-closure summary listed $80 million from that fund.
• General fund detail: The general fund budget is $2.75 billion. Sales tax is the largest revenue source at $1.55 billion, or 56.4 percent. Salaries, wages, fringe benefits, and overtime are 66 percent of the general fund budget; pension contributions add 13.7 percent, making nearly 80 percent personnel-related. State's attorney and chief judge FTE increases were described as internal shifts from terminated grants or externally supported positions, not new positions. Requested positions were not fully funded in the state's attorney's office, public defender's office, veteran assistance commission, and inspector general.
• Health enterprise fund: The FY2027 health fund budget is $4.7 billion, with CountyCare about 64 percent of funding. Per-member-per-month revenue declines by nearly $400 million, offset by patient service revenue, directed payments, supplemental funding, and a $40 million increase in the county property tax allocation, bringing total property tax support to $208 million. CountyCare claims are about $2.8 billion, or 58 percent of expenses; salaries and wages are $876 million. CCH continues a multi-year cost-cutting strategy with more than $300 million in cumulative savings, assumes a $100 million increase in charity or uncompensated care, and reduces reliance on contract labor.
• Special purpose funds: The county administers about 44 special purpose funds. The equity fund has about $50 million in unallocated reserve and proposes about $69 million in FY2027 allocations, including $3 million for the Stronger Together behavioral health grant program and increased community violence intervention investment, with no new revenue added. The opioid fund has collected about $45 million in settlements and plans about $11.5 million in FY2027 for sheriff overdose prevention, CCH public health overdose prevention, a flexible housing pool, and opioid treatment and harm reduction grants. A new modular home special purpose fund will be funded by program income.

Commissioner Questions and Comments

• Chairman Daly asked about $9.6 million in additional city TIF funding. The CFO said the amount is not yet declared or known, will be one-time money, will not be used to add FTEs, and the President wants to use it to replenish funds used to stopgap the FY2027 budget.
• The Vice Chair praised the budget as a moral document and said the gap was closed without putting the burden on Cook County residents.
• Commissioner Brut asked about the expected increase in uncompensated care. The CFO said the budget assumes $100 million in additional uncompensated care due to HR1, with more detail expected from Cook County Health on Wednesday. Commissioner Brut urged other hospital systems to step up and not shift uninsured patients to the county.
• Commissioner Miller asked about equity fund community violence intervention spending. Kanako explained the FY2027 figure is higher because of $20 million in new commitment plus anticipated carryover; FY2028-29 figures assume the FY2027 budget is expended and a continued $20 million commitment.
• Commissioner Aguilar asked about pending state reimbursements. The CFO said reimbursements are largely PMPM contributions, AOIC reimbursements, and grants; none are significantly behind schedule and they are included in the budget.
• Commissioner Trevor asked for the FY2026 uncompensated care comparison; the CFO did not have it available and said it would be provided before Cook County Health appears. Trevor also asked about reserve drawdowns: the pension stabilization use was reported as 9 percent of that fund, and the ARPA sustainability reserve use was over half of the $159 million fund.
• Commissioner Scott asked what would happen to road builders funds if litigation is unfavorable; staff deferred the question to county counsel.
• Commissioner Fask expressed concern that the public defender's office is losing two FTEs, calling it the lowest-funded criminal justice partner with high caseloads, and said larger offices should be asked to do more with less. Kanako clarified the two-position reduction was an agreed arrangement involving the public defender's office and human resources, though the office had hoped for more positions in its original request.

Key Outcomes

• No formal vote was recorded in the transcribed portion of the Finance Committee session.
• The Bureau of Finance completed its FY2027 budget presentation, stating that the general fund and health enterprise fund are balanced without tax increases or layoffs.
• Staff committed to provide additional data on 2026 uncompensated care before the Cook County Health presentation on Wednesday.
• Questions about road builders litigation were deferred to county counsel, and the county is awaiting the city's final decision on additional TIF funding.
• Committee members generally praised the finance team and said further budget review would continue in the coming days.