As the budget battle continues, what many call a disturbing picture of Cook County government emerges. Last fall, opponents in the campaign for board president debated charges of mismanagement.

Critics say the root of Cook County's half-billion dollar crisis can be traced to its public health system. After arriving patients, including those of Medicaid, fill out paperwork, apparently employees are not processing the documents. Consequently, the county is losing tens of millions of dollars each year in federal reimbursements.

"If Cook County just cleaned up how it billed for Medicaid. This isn't increasing a fee or taxes. It's just doing better what you're supposed to be doing to beginwith. That would generate almost $100 million," said Ralph Martire, Office of Taxes and Budget Accountability.

Martire, whose watchdog group monitors tax and budget issues, also says county lawyers and top-level bureaucrats lost $243 million more dollars in 2006 because they did not even try to collect other federal funds specifically earmarked for Cook County's public health system.

"The money is coming into Illinois, it's just staying at the state level rather than coming back to the county. And under Federal Law, it's clear the county should get 100 percent of that intergovernmental transfer," said Martire.

Commissioners from both parties now agree the health bureau money hemorrhage is due in large part to incompetent and/or do-nothing middle managers.

"If you're in the position to apply for these grants or make sure the paper work is done and you don't do it, you shouldn't be here," said William Beavers, (D) county commissioner.

"We have incompetence up and down this government, and these people are protected because they're politically connected, they donate money to administration, to the 8th Ward, principally Todd Stroger, John Stroger," said Tony Peraica, (R) county commissioner.

Newly-elected president Todd Stroger has vowed no tax increases.

Currently, an average of only 8 percent of a property tax bill goes to support Cook County government. The rest of its money comes from sales taxes, fees, and licenses, as well as grants from the federal and state government. As mismanagement allegations continue, taxpayer advocates vow to resist any attempt to raise the existing levy.

"We provide $3 billion a year in tax revenues to county government, the citizens of Cook County, but that money is not all well spent," said Lawrence Msall, Civic Federation of hicago.

With only four weeks left to negotiate and finalize the budget, the commissioners are being asked to cut every other department -- including public safety -- to make up for what could have been collected by the health bureau.

Several commissioners want the Stroger administration to conduct an office-to-office evaluation of health bureau bureaucrats to get rid of the ones who aren't doing the job.

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