It doesn’t matter that Cook County’s sales tax increase was upheld Wednesday. Layoffs at the Cook County Health and Hospital System are going to happen, according to a budget presented to the board that slashes the system’s county tax subsidies by nearly 20 percent. More than 1,800 jobs will be eliminated by next spring.

Health system spokesman Lucio Guerrero confirmed yesterday that about 500 more jobs will be eliminated, in addition to the 900 that are already being eliminated.

He said no determination has been made regarding which positions will be cut, nor will officials know until a consultant releases a report in October. The cuts will include both vacant and filled positions.

Emilie Junge, regional coordinator for Doctors Council SEIU, which represents about 750 doctors across the health system, says her union is unsure how the layoffs might affect doctors.

“We think the system is down to the bone, unless they’re talking about cutting at a higher level and not cutting frontline workers,” she says. “It’s sort of hard to evaluate until we see what positions are being cut.”

Local SEIU 73, which represents about 1,700 county hospital and clinic staffers, had no comment. Spokesman Jonathan Labe says the union will most likely comment during public hearings on the health system’s budget, taking place next week.