COOK

COUNTY
PRELIMINARY
FORECAST
FY 2015
Toni Preckwinkle
PRESIDENT
Cook County
Board of Commissioners

Overview of Cook County 2015 Preliminary Forecast
Overview
The Department of Budget and Management Services (DBMS) prepared this preliminary forecast
report in accordance with Executive Order 2012-1. The report presents a mid-year projection of
year-end revenues and expenses for 2014, and an initial forecast of fiscal year 2015 revenues and
expenditures.
For FY2015, DBMS anticipates a budget shortfall of $168.9 million in the Countys General and
Health Enterprise Funds. Projected expenditures of $2,961.6 million will exceed projected revenues
of $2,792.69 million. The projected shortfall is driven by an increase in projected expenditures of
$75.2 million and a decrease in expected revenues of $43 million in the General Fund, while the
Health Fund anticipates an increase in expenditures that are $50 million greater than the increase in
revenues.

In the General Fund, projected cost increases driving this gap are an increase in expenditures for
projected wages including public safety overtime expenses ($48.1M), employee health benefit
increases ($20.1M), a reserve for insurance claims ($6.7M), and utilities such as gas, electricity and
water ($2.4M). Revenue declines are driven by lower Property Taxes available to the General Fund
due to rising debt service costs (-$22.2M), the reduction of Motor Fuel Tax revenues funding public
safety activities (-$10.0M) and slower than expected recovery on economically sensitive revenues
such as the Recorder of Deeds fees and Sales Tax.

The impact of CountyCare, the Countys managed care program that began as an early
implementation program of the Affordable Care Act, is a significant driver of changes in the
Countys fiscal outlook from 2014 to 2015. Through CountyCare, the health system is reimbursed
for providing healthcare that was previously uncompensated. The Health Fund anticipates a $384.1
million increase in expenditures along with a $334.0 million increase in revenues primarily due to the
full implementation of CountyCare. Beginning July 1, 2014, CountyCare will become a County
Managed Care Community Network (MCCN) and will expand to include all Medicaid populations,
including Family Health Plans (FHP) and Seniors and Persons with Disabilities (SPD).

The 2014 year-end projections of revenues and expenditures forecast a deficit of $85.9 million. The
primary driver of the deficit ($67.3M) is expenditures outpacing revenues within the Health Fund
due to required repayment of unspent 2013 per member per month (PMPM) reimbursement and
expected reduction in reimbursement rates for the Countys Medicaid Expansion program starting
July 1, 2014. It is estimated that the Cook County Health and Hospital System (CCHHS) will be
required to reimburse Medicaid for costs not incurred during the waiver period that total $33.5
million while the new PMPM reimbursement rate effective July 1, 2014 is expected to reduce year-
end revenue by $29 million.
1
General Fund expenditures are also anticipated to be higher than budgeted by $12.0 million, driven
by increases in public safety hiring and overtime. Revenues in the General Fund are expected to end
the year lower than budgeted by $6.6 million.
The table below summarizes projected 2014 and 2015 revenues and expenditures in the
Health and General Funds:

2014 Budget
2014 Year-End
Forecast
2015 Forecast

Health Revenues 950,717,064 1,194,321,842 1,284,756,980

Health Expenditures (1,125,717,196) (1,436,591,414) (1,509,820,606)

General Fund Revenues 1,551,531,625 1,544,893,765 1,507,926,735

General Fund Expenditures (1,376,531,493) (1,388,578,526) (1,451,778,556)
Deficit $ - $ (85,954,333) $ (168,915,447)

Public Forum
A public hearing and online forum will be held on the preliminary budget on July 16, 2014 at 6:00
p.m. in the Cook County Board Room to obtain constituent feedback on budget priorities. The
Department of Budget and Management Services will work closely with residents, elected officials,
and County departments to review potential efficiencies and cost savings opportunities that will
allow for the presentation of a balanced budget recommendation to the Board of Commissioners in
October. More information about the Preliminary Forecast can be found at
http://home.cookcountyil.gov/budget/

2

Overview of Expenditure Estimates
2014 Year-End Expenditure Estimates
General Fund expenditures by the end of the current fiscal year are projected to be $12.0 million
higher than the 2014 Appropriation. The overage is primarily attributable to increases in public
safety overtime ($24.5M). This increase is partially offset by lower than anticipated hiring in other
departments including personnel savings in the Offices under the President as well as Juvenile and
Adult Probation.
The Health Fund is expected to spend $310.1 million higher than the 2014 appropriation, which is
partially offset by revenues over budget in the amount of $243.6 million, a 25.6% increase. The
reason behind this increase is the higher than expected population CCHHS is serving in
CountyCare, especially as more CountyCare members are served through external providers than
expected. In addition, there are more modest increases in overtime and utility expenses. These
increased costs are partially mitigated by greater than expected attrition at the beginning of the year.
Projected 2015 Expenditures
Total FY2015 expenditures in the General Fund are projected to increase by $75.2 million over the
FY2014 adjusted appropriation, a 5.5 percent increase. This increase is driven by rising personnel
costs ($48.1M), which includes the rising cost of salaries, mandated public safety hiring and
correctional officer overtime. Another key driver of increasing expenses is employee health benefit
cost increases ($20.1M) which are expected to rise at the rate of medical inflation. The final
personnel-related expense that is expected to rise in 2015 is the cost of workers compensation
claims due to the resolution of outstanding claims ($1.5M). There are also several non-personnel
increases including the expected cost of self- insurance settlements ($6.7M) based on an analysis of
current cases and the rising costs of gas, electricity and water ($2.4M). These increases are offset by
minor non-personnel savings ($3.6M).
Health Fund expenditures are expected to increase by $384 million from the 2014 Appropriation, a
34% increase from the prior year. The cost increases are related to an increase in enrollees in
CountyCare, Cook Countys implementation of Medicaid expansion under the Affordable Care Act.
A projected 59% increase in the average monthly number of CountyCare expected enrollees (from
56,131 to 89,500) is anticipated in the forecast. In addition, the Health System expects to serve
additional Medicaid populations through CountyCare, including Family Health Plan (FHP) members
and Seniors and Persons with Disabilities (SPD) members, which increases both costs and revenues.
Corresponding revenue increases partially offset the increase in expenditures, though the cost of
services at other network facilities and pharmaceutical costs are rising more rapidly than anticipated.

3
Overview of Estimated Revenues

Overview

General Fund and Health Enterprise Fund revenues support the Countys general operating fund
and finance the Corporate, Public Safety and Health Enterprise funds and activities. The
preliminary revenue estimate for FY2015 is $2,793 million for the General and Health Enterprise
Funds. This represents an 11.6 percent, or $290.4 million increase from the FY2014 budget. The
total projected revenue for FY2014 year-end is $2,739 million, which represents a 9.5 percent, or
$237 million increase from budgeted revenues.

The Countys General Fund and Health Enterprise Fund revenues are comprised of Property Tax,
Fees, Home Rule Taxes, Intergovernmental Revenues, and miscellaneous Other Revenue sources
such as rental income from leasing space and energy efficiency rebates.

Property Tax
The projected year-end Property Tax collection to the General and Health Enterprise Funds for
FY2014 remains at the budgeted amount of $350.1 million. The preliminary estimate for Property
Tax revenues in FY2015 is $327.9 million, reduced from the prior fiscal year budget by $22.2 million
primarily due to rising debt service obligations.

Fees
The County General Fund receives various fees for certain services that departments within the
Fund perform. The fees charged by various County departments include fees for real estate
transactions, court case filings, permits, and licenses. General Fund fees are anticipated to be $263.5
million for year-end FY2014. This represents a 3.9 percent, or $10.6 million decrease in
comparison to the FY2014 budget. The reduction is due to a decrease in court case filings and real
estate transactions. The preliminary estimate for General Fund fees in FY2015 remains relatively
steady at $260.9 million, a 1.0 percent decrease in comparison to projected year-end FY2014.

The Health Enterprise Fund receives fees from patient fees and supplemental payments for care
provided at County Hospitals. In addition, the Cook County Health and Hospital System (CCHHS)
operates CountyCare, which will become a Managed Care Community Network (MCCN) on July 1,
2014. CountyCare receives a fixed per member per month reimbursement for each of its members.
CCHHS is projected to end FY2014 with fees totaling $1.19 billion, a 25.6 percent, or $243.6 million
increase to the FY2014 budget. These increased fees are, however, offset with higher than
anticipated expenditures for patient care expenses at CCHHS as well as external network providers
and pharmaceutical costs. The increased 2014 revenues are mainly attributed to the increased
number of enrollees into CountyCare. CCHHS had expected full-year membership of 56,131
patients in CountyCare, but over 90,000 members are enrolled as the 1115 Waiver period concludes
at the end of June, 2014. CCHHS preliminary estimate for fees in FY2015 increases 7.6%, or $90.4
million to $1.28 billion compared to year-end FY2014, with some attrition anticipated in the second
half of the year. The continued rise is due to an increase in disproportionate share hospital (DSH)
4
supplemental payments and a projected retention of CountyCare enrollees as additional MCCN
choices for CountyCare patients become available during the second half of 2014 and into FY2015.

Home Rule Taxes
Several of the Home Rule Taxes are on track to meet or exceed the FY2014 budgeted amounts.
The projected year-end revenues of $775.3 million exceed budgeted revenues by $11.1 million, or
1.5 percent. The County Use Tax projected year-end revenue for FY2014 is $69.9 million,
representing a 2.4 percent, or $1.6 million increase from the budget due to improved vehicle sales.
The Gas Tax is projected to reap the benefits of enhanced compliance activities. The Gas Tax is
projected to earn $12.4 million, 14.2 percent more than the budgeted amount. A revenue source
that has underperformed is the Sales Tax as the regional economy continues its slow recovery from
the recession and experienced particularly slow activity during an unusually cold winter. Sales Tax
revenues in FY2014 are projected to be $3.2 million, or 1.0 percent lower than FY2014 budget.

The preliminary estimate for revenues for Home Rule Taxes for FY2015 is $770.7 million, which is
$6.4 million more than prior year budgeted revenues of $764.3 million. The estimated increase in
Home Rule Tax revenues are primarily linked to modestly improved Sales Tax collections as a result
of economic forecasts suggesting a moderate improvement in conditions during FY2015.

Intergovernmental Revenues
The projected year-end Intergovernmental Revenues for FY2014 is $136.8 million, this represents a
$2.1 million, or 1.5% decrease from the budgeted amount. The lower than expected revenues are
due in-part to Off-Track Betting commissions as an increase in gambling alternatives are estimated
to contribute to a decline in expected revenues by $1.0 million. The preliminary estimate for
Intergovernmental Revenues for FY2015 is $129.1 million, which is $9.7 million less than the prior
year budget. This decline is driven predominantly by the planned decrease in Motor Fuel Tax
funding in the amount of $10 million.

Other Revenues
The County is projecting to receive miscellaneous Other Revenues totaling $19.2 million in FY2014;
this represents a $5.1 million decrease from the FY2014 budgeted. The decrease is driven by lower
than expected parking fees. The preliminary estimate for Other Revenues for FY2015 is $19.4
million, which is a minimal increase of $0.2 million compared to FY2014 year-end revenues due
primarily to additional rental income at the George W. Dunne Building.
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11
2015 Special Purpose Funds Outlook

The Countys Annual Appropriation Bill contains Special Purpose Funds in addition to the General
Fund. Special Purpose Funds are established for a specific and dedicated purpose, and are
considered to be self-balancing.


MFT Illinois First (1st) 501
Used to plan, design, construct, maintain and operate highways in Cook County and is paid for out
of proceeds from the State distribution of Motor Fuel Tax. For 2015, Motor Fuel Tax funds are
expected to cover the 2015 budget of $23,234,167.

Animal Control Department 510
Prevents the transmission of rabies and other diseases from animals to humans. The department
forecasts revenue in 2015 to be $3.4 million, with $4.2 million in expenditures and a $6.7 million
positive fund balance.

County Clerk Election Division Fund 524;
Board of Election Commissioners- Election Fund 525
Funds the cost of elections using property tax revenue. In 2015, the funds expenses will decrease
by $19.5 million due to the off year in elections. This increases the amount of property tax revenue
available to other obligations such as the cost of debt service.

County Recorder Document Storage System Fund 527
Funds the equipment, materials and necessary expenses to implement and maintain the Recorder of
Deeds document storage system. Fees are charged for record retrieval and other items. 2015
revenue estimates are $3.3 million, with $4.5 million in expenditures, resulting in a 2015 fund balance
estimated of $2.1 million.

Circuit Court Automation Fund 528
Maintains the automated systems that support the activities of the Circuit Court, meet the needs of
Court constituents, and provides constant access to both internal and external users. For 2015,
revenues are estimated to be $12 million, with slightly lower expenditures aimed at reducing the
negative fund balance over time. The fund is projecting a negative $6.1 million balance for 2015
year-end.

Clerk of the Circuit Court Document Storage Fund 529
Manages Circuit Court records. Projected revenues for 2015 are $11 million, with expenditures
estimated to be $9.5 million. The projected 2015 ending fund balance is estimated to be a negative
$3.1 million, which the Clerk of the Court is working to address over several years.


12
Cook County Law Library 530
Provides legal information resources to legal professionals, judiciary, government officials, litigants
and the residents of Cook County at six locations. In 2015, revenues are estimated to be $6.1
million, with $5.3 million in expenditures. The fund is projecting to be in balance by the end of
2015.

Circuit Court-Illinois Dispute Resolution Fund 531
Fees from civil filings disbursed to dispute resolution centers. The fund is projected to receive
$190,000 in revenues in 2015, with estimated expenditures at $181,000. Due to a prior years fund
balance, the fund is projecting to have a positive balance of $158,886 by the end of 2015.

Adult Probation/Probation Service Fee Fund 532
Collects fees from certain adult offenders by order of the court, based upon the defendants ability
to pay. Revenue estimates for 2014 are projected to be just over $4 million, which is $350,000 lower
than initial revenue projections. 2015 revenues are estimated at $4 million, $3.6 million in
expenditures, and a projected fund balance of $1,018,314 by the end of 2015.

County Clerk Automation Fund 533
Funds automation of the County Clerks Office non-election activities, and is funded by vital
records. 2015 revenue estimates are $1.1 million with expenditures projected at $1.4 million. The
County Clerk Automation fund is projected to have a 2015 surplus of $12,827.

County Treasurer-Tax Sales Automation Fund 534
Funds automation-related expenses in the Cook Countys Treasurers Office. In 2015, there is an
estimated $9.6 million in revenue with estimated expenditures of $10 million. There is a projected
2015 positive ending fund balance of $15.6 million.

Intergovernmental Agreement/ETSB 535
Provides telephone service to unincorporated Cook County and municipalities who are part of the
Emergency Telephone System Board 911 telephone system. Revenue for 2015 is expected to be
$1.2 million with expenses projected to be $1.3 million. The fund balance will be a negative $3.3
million fund balance, if expenditures are not reduced and a multi-year plan will be required to
correct the current imbalance.

Juvenile Probation-Supplementary Officers 538
Administrative Office of the Illinois Court funds supports additional Juvenile Probation Officer
positions. Revenue estimates for 2015 are estimated at $3.3, with expenditures equal to revenues.
The Department of Budget and Management Services is working with the Office of the Chief Judge
to stabilize this fund which is projecting a significant negative balance of $15.3 million and will
require a plan to correct the historic imbalance.



13
Social Services/Probation and Court Services Fund 541
Collects fees from certain adult offenders by order of the court, based upon the defendants ability
to pay. Revenue for 2015 is projected to be $2.8 million, with equal expenditures. There is a
projected $2.1 million positive fund balance for this fund by year-end 2015.

Lead Poisoning Prevention Fund 544
Reduces the dangers of lead-based paint in Cook County dwellings; prevents lead poisoning through
lead abatement and mitigation; educates residents to the dangers of lead based paint; and
disseminates lead-poisoning prevention materials to residents of lead mitigated dwellings. The 2015
projected fund balance is $9.2 million, with $1.2 million in expenditures and no revenue. The Lead
Poisoning Prevention fund is financed by the repeal of Torrens Fund in January 2014, which
represents a one-time transfer to this account.

Geographical Information Systems 545
Provides maintenance and access to Cook Countys enterprise geographic information system. The
estimated revenue to this fund for 2015 is $8.2 million with expenditures of $14.2 million. There is a
positive fund balance projected to be $12.7 million for year-end 2015.

Sheriffs Youthful Offender Alcohol & Drug Education 546
Provides an educational alternative for youthful offenders and their parents to assist the court and
community in decreasing alcohol and other drug use. The preliminary projected revenue for 2014 is
$2,400, equal to expenditures. With a $2,400 revenue estimate for 2015, also equal to expenditures,
the fund balance for 2015 is $14,258.

States Attorney Narcotics Forfeiture 561
Supports work with the State, City and County Agencies on various drug related cases. Revenue is
estimated to be $4.2 million in 2015 with expenditures equal to revenue. There is an estimated fund
balance of $0 for year-end 2015.

States Attorney Bad Check Diversion Program 562
Offers a pre-trial educational diversion program for first time bad check passers, provides restitution
to victims, and helps avoid an increased caseload in the criminal justice system at no cost to the
victims or taxpayers. Projected 2015 revenues are estimated to be $0, and therefore this fund will be
eliminated in 2015. There is a projected negative fund balance of ($1,466).

TB Sanitarium District 564
Serves to prevent, diagnose, treat, and care for all Cook County residents afflicted with tuberculosis.
In 2015, revenue is projected to be $1.2 million and expend $6.2 million, for a projected FY2015
ending fund balance of $9.7 million. The fund balance originates from a surplus of real estate taxes
from the State, and is required by the State to be used exclusively for the purposes of this fund.



14
Clerk of the Circuit Court Administrative Fund 567
Utilized for the Clerks Office administration to improve information technology, operational
efficiency, improved customer service, employee development and training and financial
accountability. For 2015, estimated revenues are $850,000 with expenditures slightly lower at
$747,652. The projected 2015 year-end fund balance of $13,025 is anticipated to be addressed with
additional cost reductions.

GIS Fee Fund 570
This special purpose fund provides and maintains a countywide map through a geographic system.
In 2015, the Recorders Office revenue estimate is $2 million, with a 2015 expenditure estimate of
$3.5 million. Based off projected revenue and expenditures, the fund is projecting a negative balance
of $1.3 million, a result of decreased real estate revenue, which the fund will work to address prior to
the final recommendation.

Rental Housing Support Fee Fund 571
The Rental Housing Support Fund was established to assist in addressing the need for rental
housing. A state surcharge funds this program. In 2015, the Recorders Office estimates revenue for
this fund at $286,013 and expenditures at $252,000.

Childrens Waiting Room 572
Court services fees are credited to this fund to operate and administer the childrens waiting rooms
in Cook County. Revenue estimates for 2014 are assumed to be at $2.7 million, $400,000 less than
original projections. With 2015 projected revenue at $2.75 million and $2.2 estimated expenditures,
the 2015 fund balance is projected to be just under $1 million.

Womens Justice Services Fund 573
Operates rehabilitation programs provided by the Sheriffs Department of Womens Justice Services,
including mental health and substance abuse services. This fund is projected to collect $65,000 in
2014, $10,000 more than original projections. With 2015 projected revenue of $65,000, equal to
projected expenditures, the 2015 projected fund balance is $68,087.

Court Funds: The Mental Health Fund 574; Peer Court Fund 575;
Drug Court Fund 576;
Various court services fees are credited to the appropriate funds to operate and administer court
programs. Combined, these funds are projected to collect $1.8 million in 2014, $390,000 lower than
initial projections. In 2015, the Mental Health Fund is projecting to receive $800,000 in revenue,
equal to expenditures, resulting in a negative balance of $211,806. The Peer Court Fund has 2015
projected revenues of $450,000, equal to expenditures, resulting in a $38,413 negative fund balance.
The Drug Court Fund is projecting to receive $400,000 in revenues, equal to expenditures, in 2015,
resulting in a negative $139,719 fund balance.


15
Vehicle Purchase Fund 577
Fees from violations of Illinois Vehicle Codes support the acquisition or maintenance of law
enforcement vehicles. Estimated revenue for 2015 is $130,000 with $400,000 in expenditures,
resulting in a positive $588,648 estimated year-end fund balance.

Assessor Special Revenue Fund 579
Revenues generated by the Assessors Office from marketing opportunities used to pay for costs in
the Assessors Office. Revenues and expenditures are projected at $368,000 in 2015, with a positive
fund balance projection of $67,493.

Circuit Court Clerk Electronic Citation Fund 580
Establishes and maintains electronic citations, used to defray the Clerks expenses of establishing
and maintaining electronic citations in any traffic, misdemeanor, municipal ordinance, or
conservation case upon a judgment of guilty or grant of supervision. The 2015 revenue projection is
$450,000, with equal expenditures.

States Attorney Records Automation 583
Supports expenditures for hardware, software, research and development costs and personnel
related to Records Automation. Fees are collected by Defendants upon a finding of guilty or
supervision in a court of law. This Special Purpose Fund is projected to collect $158,000 in 2015,
with equal expenditures, and a 2015 projected fund balance of $105,010.

Public Defender Records Automation 584
Identical to the States Attorney Records Automation fund, this fund supports expenditures for
hardware, software, research and development costs and personnel related to Records Automation.
Fees are collected by Defendants upon a finding of guilty or supervision in a court of law. This
Special Purpose Fund is projected to collect $158,000 in 2015, with equal expenditures, and a 2015
projected fund balance of $101,710.

Environmental Control Solid Waste Program Fund - 585
Fund established for the collection of fees associated with Environmental Controls Solid Waste
Program. The Solid Waste Program improves the quality of the environment for the residents of
Cook County through inspection, compliance and sustainability. 2015 projected revenues are
estimated at $406,000, $385,486 in expenditures, with a projected fund balance of $20,601.

Land Bank Authority - 586
Fund established to reduce and return vacant and abandoned properties back into productive and
sustainable community assets. The Land Bank Authority was established in 2014, and projects $1
million in revenues and $990,000 in expenditures. In 2015, revenues are estimated at $3.45 million,
equal to expenditures, resulting in an ending fund balance of $10,000.
16
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s
t
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m
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e
.

17
TONI PRECKWINKLE
PRESIDENT
COOK COUNTY BOARD
OF COMMISSIONERS
John P. Daley
Chairman, Committee on Finance
Jerry Butler
Earlean Collins
John P. Daley
John A. Fritchey
Bridget Gainer
Jesus G. Garcia
Elizabeth Liz Doody Gorman
Gregg Goslin
Stanley Moore
Joan Patricia Murphy
Edwin Reyes
Timothy O. Schneider
Peter N. Silvestri
Deborah Sims
Robert Steele
Larry Suffredin
Jeffrey R. Tobolski
Ivan Samstein
Chief Financial Offcer
Andrea Gibson
Budget Director