A mid-year projection of year-end revenues and expenses for Fiscal Year 2018 is available here. The year-end projections describe budgetary shortfalls and surpluses associated with the FY2018 budget approved by the Cook County Board of Commissioners in November.

The total budgeted revenue for FY2018 is $1,800 million for the General Fund.  The projected year-end revenues of $1,809 million are higher than budgeted revenues by $9 million, or less than half a percent.  This projected increase in revenues is attributed to higher than anticipated revenues in the County Sales Tax due to a non-recurring accelerated payment from the State of Illinois to compensate for increased receipts in comparison to the prior year.  Also, effective with the State’s FY2019 budget, the 2 percent service fee imposed by the State on municipalities for the collection and remittance of sales tax revenue has been reduced to 1.5 percent, further attributing to the favorable revenue projection. 

The total budgeted revenue for FY2018 is $2,043 million for the Health Enterprise Fund.  The projected year-end revenues of $2,551 million are higher than budgeted revenues by $508 million, or 25 percent.  The projected increase in revenue is attributed to the increase in enrollment in the Managed Care Medicaid expansion program, commonly referred to as CountyCare, which is allocated and collects reimbursements on a per member per month basis. 

The County imposes various General Fund fees for certain services it performs. The fees charged by various County departments include fees for vital records, real estate transactions, court case filings, and delinquent taxes. General Fund fees are anticipated to be $197.6 million for year-end FY2018, which is a negative variance of $21.9 million, or 10 percent.  The primary driver of the negative variance relates to fees generated by the County Treasurer’s office.  The fees consist of penalties on delinquent taxes.  Due to the positive state of the economy and enhanced communications to inform impacted residents, there are fewer delinquent taxes.       

The County is projecting to receive Investment Income of $1.8 million, at the budgeted amount.  Investment Income is the interest garnered on County fund cash balances. 

Indirect Costs are charged to Grants and Special Purpose Funds to reimburse the General Fund for pension and administrative resources.  The projected year-end Indirect Costs revenues for FY2018 are $11.6 million, on par with budget. 

The Health Enterprise Fund receives revenue from patient fees and supplemental payments for care provided at County Hospitals.  In addition, the Cook County Health and Hospitals System (CCHHS) operates a Managed Care Community Network (MCCN) known as CountyCare.  CountyCare receives a fixed per member per month reimbursement for each of its roughly 332,000 members.  CCHHS projects that it will end FY2018 with fees totaling $2,479 million, a 26 percent, or $508 million increase to the FY2018 budget.  The increased FY2018 revenues projected by CCHHS are attributed to increased enrollment in the Managed Care Community Network.  CCHHS experienced CountyCare membership growth from 140,000 members per month to an estimated 332,000; outpacing the projected 225,000 members per month budgeted in the FY2018 budget.

Year-end expenditures in the General Fund are projected to have a $6.0 million negative variance.  The overage is primarily attributable to higher than anticipated salary and wages ($5.8M) and reserve for claims ($4.5M).  These increases are partially offset by lower than anticipated overtime spending ($8.4M).

The Health Fund year-end expenditures are projected to be above the FY2018 appropriation by about $510 million due to higher than budgeted member enrollment in CountyCare, causing a large increase in managed care claims. Projected overtime costs are expected to exceed the budgeted amount by $4.4 million while regular employee salaries will be under budget due to employee turnover and position vacancy rates. Additionally, maintenance of facilities budgets is projected to be over budget by $5.2 million to continue to meet Joint Commission accreditation.