In the first of four public hearings on the Cook County Health and Hospitals System’s 2010 budget, the tension that dominated recent budget discussions in county board chambers was nowhere to be found.

In fact, it was hard to detect a pulse at Provident Hospital last night, despite the fact that health system board members control the county's second largest budget - nearly $1 billion in taxpayer dollars.

However, health system leaders told those at the sparsely attended event that the system's increased patient volume and negotiations with government leaders has led to increased revenue this year, and a projected revenue increase of about $100 million next year.

The dollars rolling in are softening the burden to taxpayers, as system leaders are requesting $74 million less in county tax subsidies, relying more on the revenue generated from patients and federal funding. And as health system board members prepare to submit their budget to the county board, that’s a good thing.

“A lot of hard work’s gone into the budget in the last year, and more good things are in store for 2010,” said chief financial officer Pitt Calkin.

But system leaders are still projecting its budget to be more than $27 million more than 2009, citing rising costs due to inflation. And that means its expenses still outweigh its revenue by more than $300 million.

If there's a bright spot, it's that the health system is relying less on Cook County to fund its operations.

"I think we are happy - and so should the taxpayers be - that we are reversing a trend of asking for more of Cook County taxpayers," said health system spokesman Lucio Guerrero. "Our tax subsidy is less than last year and we expect that trend to continue.

"In FY2009, we will have saved taxpayers $200 million. That's a good start," he said.

Still its ability to rely on revenue while decreasing its county subsidies show board members that the county health system truly is asserting its independence from the county board, which oversaw operations until last summer. And the fact that the board is avoiding the much publicized budget squabbles that take place at City Hall, and is, in fact, increasing revenue, may be an indication things are working out as hoped.

Health system CEO William Foley said the system does not anticipate an increase in the number of patients it serves, and will benefit from the implementation of 476 “staffing efficiencies,” or layoffs, as well as an additional $20 million in savings on medical supplies from its affiliation with a group purchasing organization.

Foley anticipates spending more than $66 million on capital projeccts in 2010, with $30 million of that being used to implement the system’s long-term strategic plan, which will include a list of yet-to-be-determined projects and improvements.

Calkin said the system is benefitting from an influx of federal dollars it had not received in the past. In 2009, the fiscal year that ends Nov. 30, the health system received $36 million in stimulus funds. It also received $225 million in “disprortionate share hospital” funds, which provide safety net hospitals with extra funding. Some of those dollars were retroactive payments.

System officials anticipate it will receive another $150 million in safety net funds next year, in addition to boosting its revenue from patients by $19 million, in part due to an increase in in-patient surgeries, for a grand total of $579 million in revenue.

Foley said the elimination of 883 vacant positions is saving the system $60 million a eyar.

Only two of the roughly 30 people who attended the meeting last night spoke. One of them, George Blakemore, expressed disappointment more people did not show up.

The health system has scheduled three additional public comment sessions:

• Thursday, Sept. 10 -- 6:30 p.m., Stroger Hospital, 627 S. Wood St.
• Monday, Sept. 14 -- 1 p.m., Cook County Building, Room 169, 118 N. Clark St.
• Tuesday, Sept. 15 -- 6:30 p.m., Oak Forest Hospital auditorium, 15900 S. Cicero Ave., Oak Forest.