Jackson Health System Axes 189 Positions

MIAMI (CBS4)- Carlos Migoya, Jackson Health System's chief executive, said Thursday he is eliminating 189 positions for an annual savings of $13.3 million.

Most of those positions are vacant. Forty-nine employees will be affected, Migoya said, but some of those will be able to move to other vacancies within the system, which has lost $337 million the past two years.

Migoya said the eliminations would not change patient care. He didn't offer details on what kinds of positions would be cut. The reductions amount to 1.7 percent of Jackson's 11,100-member workforce, according to CBS4 news partner The Miami Herald.

In other developments at a Thursday meeting, members of the new Financial Recovery Board heard that Jackson had essentially decided to start over in its attempt to out-source inmate healthcare – an arduous process that has been going on for more than a year and a half in attempt to save the system money.

Former Chief Eneida Roldan originally wanted the out-sourcing to begin in October 2009. That was delayed by a formal bidding process that attracted Miami-based Armor Correctional Health Services and the national firm, Prison Health Services. A formal bidding council made up of Jackson and county managers spent months studying the competing bids before declaring PHS the winner.

In January, Jackson started negotiating with PHS to get the best possible deal. Lobbyists and attorneys for Armor complained that Armor too should be allowed to talk to Jackson about improving its bid. On Thursday, the board voted to formally waive the competitive bidding process and begin negotiations anew with the two companies.

Jackson's 2011 budget projected that inmate out-sourcing would save the system $8 million this fiscal year, but board members said Thursday they were uncertain how much inmate care now costs Jackson and whether any money could be saved by out-sourcing.

Board Chairman Marcos Lapciuc said he had heard that inmate care presently cost about $70 million a year. Board member Joaquin del Cueto said he'd "heard it was as low as $25 million," the figure shown in some Jackson financial statements.

Nine months ago, The Miami Herald asked Jackson how much inmate healthcare cost. The system has yet to answer.

"We need to make sure [Jackson] will save some money," Lapciuc said. "It is still not entirely clear, at least to me" that the out-sourcing will result in savings. Lapciuc asked for the names of the lobbyists of the two groups, so that the board could see who was trying to influence the process.

Migoya said, "If there's not going to be a savings, obviously we're not going to make a recommendation." He said County Manager Alina Hudak was "very concerned" about the delays in the process.

In other Jackson developments, Chief Financial Officer Mark Knight told The Herald that because of improved recent financial performance and some new initiatives, he now estimated that Jackson will lose about $80 million this fiscal year, which ends Sept. 30, down from earlier estimates of $106 million.

Knight said that Jackson still faced a severe cash crisis in July and August, but if an anticipated $35 million payment arrived from the state this summer, that would reduce the problem.

Knight told the board Thursday that Jackson was in arrears in paying the state $7.5 million for the Public Medical Assistance Fund, which helps pay the costs of the state's uninsured. Knight said Jackson fell behind in its payments last year because of lack of cash, but needed to deal with the debt or the state wouldn't renew its hospital license. The board approved paying the fund over the next 12 months.

The board also Thursday approved an agreement with the University of Miami and Florida International University so that FIU's medical students could get experience at Jackson Memorial. UM had previously blocked the FIU students because of medical liability concerns, but the Legislature removed those worries in the session just ended by granting UM doctors sovereign immunity for their Jackson activities.

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