Cook County Health reports agency staffing down from 18.6% to 9% of workforce; projects lower FY26 agency spend

Cook County Health reported to the Health and Hospitals Committee that agency staffing has fallen sharply since the pandemic, with officials saying the share of the workforce provided by staffing agencies dropped from about 18.6% in September 2024 to roughly 9% by March 2026.

"The data shows we continue to move in the right direction," Wynn Buren, chief human resources officer at Cook County Health, told the committee as he opened a semi‑annual update on agency use. Buren said the numbers translate to a decline from about 1,366 agency FTEs in September 2024 to 968 by May 2025 and 698 as of March 2026.

Craig Williams, Cook County Health's executive chief operating officer, said the reduction is evident across many job classifications. "Across more than a dozen job classifications to decline since September 2024 are substantial," Williams said, citing examples such as food‑service workers (down about 83%), medical assistants (about 77%) and patient care technicians (about 76%). He said more than 600 FTEs have been hired against the September 2024 baseline and converted to permanent county employees.

Officials attributed a December 2025 uptick on the agency‑use chart to work from Guidehouse that moved into agency staffing during a settlement transition and was then added to the FY26 budget as 135 permanent revenue‑cycle positions. "That was not a trend reversal," Buren said, explaining the shift reflected a change in how that work was counted and is being recruited to be performed in‑house.

Williams reviewed agency‑spending history and projections, saying the peak agency spend was cited near $212 million in previous years. He reported FY24 at $190 million, FY25 near $155 million and a FY26 projection of about $118 million, while adding the FY26 number could come in lower as additional agency positions are converted to permanent hires.

Buren said process and governance changes supported the reductions: departments must submit a business case for agency requests, senior leaders and HR evaluate requests, and an agency‑use committee reviews approvals against staffing needs, budget vacancies, union agreements and other criteria. "Every approval is documented, and every denial has a stated reason," he said.

Committee members pressed for more detail on several points. Commissioner Trevor asked for specifics about the Guidehouse transition; Buren said those positions were included under a settlement agreement and are being recruited for internal hire. Commissioner Daley asked whether absenteeism contributed to agency reliance; staff said absenteeism is a factor and offered to provide absenteeism data to commissioners. Commissioner Stamps asked how the effectiveness of hiring events is measured; Buren said CCH participated in 14 hiring events since December 2025, extended about 142 offers from nursing‑focused events, and confirmed 101 external new hires with a 71% offer‑acceptance rate.

Officials also discussed longer‑term workforce pipelines. Buren described apprenticeship and short training programs and partnerships with city colleges; Nick Shields, chief external affairs and civic engagement officer, said CCH is planning outreach with Chicago Public Schools and suburban Cook County high schools. Shields described the Providence Scholarship Fund as having distributed more than $4 million to over 200 scholars and said an additional $1.5 million is planned for the next cycle, with the next scholarship graduation set for June 23.

Votes at a glance: the committee approved the minutes from the April 14, 2026 meeting by voice vote, and took a roll‑call vote to receive and file the CCH Semi‑Annual Agency Utilization Report (item 20 61101). The clerk recorded 13 ayes and 4 absent on the receive‑and‑file motion, which carried.

The presentation closed with staff offering to provide follow‑up data requested by commissioners, including absenteeism figures and documented outcomes from hiring events. The committee adjourned and noted the next meeting begins the following day at 9:30 a.m.