Cook County Health faces staffing issues

Cook County Health, which is largest safety net health system for the region’s most vulnerable low-income patients, faces a staffing shortage.

The health system currently has about 5,550 employees and is looking to fill some 2,000 vacancies. This means that just over a quarter of the budgeted posts are vacant. At the same time, the healthcare system can’t keep up – it’s losing more workers to retirements, quits and ‘layoffs’ than the system can add to the payroll, records show. of the health system.

Most of the loss was due to people who quit, records show.

This issue is not unique to Cook County Health. More than two years after the start of the COVID-19 pandemic, the so-called Big resignation is happening across the country, especially among exhausted nurses who have quit, looking for rest, better pay or treatment.

But Cook County Health staff have come under greater scrutiny in recent weeks, as CEO Israel Rocha Jr. and his management team showcased the system 2023 budget proposal. One of the objectives is to continue to develop medical services for patients, which would help generate more income. But some members of the health system’s board of directors have questioned whether there are enough staff to handle it.

“We have a chronic inability to fill niches at Stroger and Provident,” board member Ada Mary Gugenheim said at a meeting earlier this month, referring to the two hospitals in the system. “The wait times are absolutely appalling.”

In January, patients waited the longest if they needed to see an ophthalmologist, urologist or plastic surgeon, among other specialties. It would take about four to six months to get an appointment, according to the latest data available from the health system.

Cook County Health is part of the county government. It includes two hospitals – the flagship John H. Stroger Jr. Hospital on the Near West Side and Provident Hospital on the South Side – as well as a network of urban and suburban clinics and a large Medicaid health insurance plan called CountyCare which has over 400,000 members. The majority of patients are black and Latino.

The healthcare system is a significant part of the county budget, accounting for nearly half of government spending. proposed budget of $8.11 billion in 2023. The financial viability of Cook County Health impacts the county’s overall bottom line, as well as ratepayers who help subsidize costs and patients who rely on the health system for medical care.

In an interview, Rocha said the health care system uses temp agency nurses, who are typically more expensive than nurses who are on the payroll, to help treat patients while hiring ramps. He stressed that the health system responds to the needs of patients.

“Every hospital in America right now is leaning more heavily on the agency than they’ve ever had because we’ve had a huge shift,” Rocha said. “This isn’t just a Cook County health matter.”

If the health system did not rely on agency staff to temporarily fill vacancies, the health system might have to cut services, which means less money coming in, Rocha said.

“You can get into a place where you keep cutting revenue and staff and revenue and staff, and you get to a very dangerous place,” Rocha explained.

At Cook County Health, human resources officials have detailed in town hall meetings how difficult it is to hire people. It takes an average of four to six months per position. The human resources department itself didn’t have enough staff to recruit employees, but has since hired additional workers and set up a dashboard to help track the hiring pipeline, Valarie Amos said, head of human resources at a recent board meeting. .

His presentation illustrated the whereabouts of Cook County Health: Dozens of nurses, office workers, security guards and technicians had taken up offers over the past few months.

But more than 50 others refused for various reasons. Insufficient pay was the most common.

There are also lingering morale issues. Many Cook County Health nurses continue to demand additional money owed to them after treating patients in the darkest days of the pandemic. Rolanda Watson has been a nurse there for 29 years. At a health system board meeting on Friday, she recalled how she had been “deployed” in the intensive care unit to treat patients with COVID-19 and had also taken on other roles. .

“When I say deployment (it’s) appropriate because I felt like I was going into battle. … We had to fill the housekeeping roles because they wouldn’t come to the unit,” Watson said. “We had to fill the roles of distributing the trays because the kitchen staff did not come to the unit. It was such a big deal that morale went down.

In May, former emergency department nurse Consuelo Vargas wrote to the council: ‘I left because I couldn’t leave work feeling disappointed in the direction of the hospital every day. Your nurses are breaking and I can attest that healing takes a long time if their wounds don’t heal at all. Today you have the opportunity to stop the bleeding of RNs from CCHHS.

Vargas quit last year.

As Cook County Health competes for employees, Rocha said the health system has created a program to give signing bonuses to new hires and is working to offer retention bonuses to current staff who agree to join. work for a specified number of years.

The entire Cook County Council must approve the overall county budget proposal, which includes the health system financial plan. The fiscal year begins on December 1.

Kristen Schorsch covers public health and Cook County on WBEZ’s government and policy team. Follow her @kschorsch.