| REPORT: |
The Board of County Commissioners (BCC) Regular meeting adjourned at 11:45 a.m. in order to convene the BCC - Public Health Trust (PHT) Joint meeting at 11:46 a.m.
All BCC members were present.
The following PHT Board of Trustees members were present: Mr. Jose (Joe) Arriola, Chairman; Ms. Mojdeh L. Khaghan, Vice Chairwoman; and Mr. William J. Heffernan, Treasurer.
The following PHT Board of Trustees members were absent: Dr. Irene Lipof, Secretary; Rep. Carlos Trujillo, Member; and Mr. Robert Zarco, Member.
In addition to the County staff members previously mentioned, the following additional staff was present: Assistant County Attorneys Eugene Shy and Christopher Kokoruda.
Mr. Jose Arriola, PHT Chairman, commented on the BCC’s friendship, support and trust of the Jackson Health System (Jackson). He indicated that he was proud of Jackson’s financial gains; that services were being delivered at an excellent rate; that miracles were being delivered every day; that Jackson today was an improvement from the past; and that Jackson’s employees were extremely motivated and dedicated. Mr. Arriola stated that there were many challenges ahead in Tallahassee, FL and Washington, DC; noting issues relating to funding cuts to the basic core needs in our community existed. He thanked the BCC for their support, noting they always stood behind Jackson.
Mr. Carlos Migoya, President and Chief Executive Officer, Jackson, commented on the 25 year history of the renowned Jackson’s Ryder Trauma Center, offering cutting-edge treatment and life-saving expertise. He advised that local hospitals entered the trauma world; however, they did not have a University of Miami (UM) partnership and two decades of experience. Mr. Migoya stated that Jackson took the unprecedented step of expanding the UM/Jackson trauma service to Jackson South. He reported Jackson South opened its trauma center on May 4th and already cared for hundreds of patients’ despite opposition from out-of-state, for-profit hospital corporations. Mr. Migoya noted South Dade residents were safer because we all stood together to bring this program to life.
Mr. Migoya pointed out that Jackson’s first residency program in partnership with UM, designed specifically to train the next generation of emergency-room doctors began this year. He reported that Jackson was among the country’s largest training centers for young physicians, with 1,125 residents and fellows currently training in 125 unique Jackson programs with around 70 percent settling in South Florida.
Mr. Migoya reported on Jackson’s efforts to expand urgent care centers, noting the first urgent care center opened a few weeks ago in Country Walk, serving one of our county’s busiest neighborhoods, offering a high-end facility, extended hours, and all the technology expected from an academic health system. He indicated that at least five more centers would open over the next 12 to 18 months, starting with North Miami this fall, then Cutler Bay and South Beach during the winter, and Miami Gardens and Doral in 2017.
Mr. Migoya stated that all the centers were close to Jackson hospitals, letting the facilities support each other, with serious cases referred from the urgent care to a nearby emergency room. He said that the project reflected the growing partnership between UM and Jackson, adding that this was the first joint program after more than 60 years of affiliation. Mr. Migoya added the desire that “UHealth Jackson Urgent Care” was just the first of many programs where Jackson and UM can be seen as a unified team in the community.
Mr. Migoya commented that the urgent care centers were one of the most popular ideas in the Jackson Miracle-Building Bond approved by voters in 2013, along with a children’s ambulatory care pavilion in West Miami-Dade. He added that a new Jackson West campus in the City of Doral was underway and provided details on that facility, noting Miami-Dade County was now going to have a facility built exclusively and especially for the unique needs of rehab patients.
Mr. Migoya advised that the 10-year capital plan projects would cost $1.8 billion, making this the largest investment our community has ever made in Jackson. He noted a strong team of in-house leaders as well as the experienced program-management experts from AECOM would ensure we stay on task, on time, and on budget. Mr. Migoya added that decisions were made based on solid data which aligns with the PHT’s strategic plan. It quickly became apparent that South Florida had a major disconnect between its healthcare construction needs and resources, said Mr. Migoya. He explained that the work was so specialized that it was almost impossible for growing businesses to win a major contract; therefore, a unique mentor-protégé program was developed.
Mr. Migoya pointed out that Jackson was overstaffed in 2011 for the volume of patients being treated, noting he promised that the hospital would swing in the other direction when there were enough patients to create more demand. He announced five years later, there were nearly 12,000 nurses, therapists, technicians, and other healthcare support staff working for Jackson. The new facilities opening in the next few years would create 500 to 1,000 more permanent, high-quality, good-paying jobs, said Mr. Migoya. He emphasized that this was the way economic growth was supposed to happen, with Jackson providing a better product, performing more surgeries, attracting more patients, and scheduling more appointments.
Mr. Migoya advised that Jackson’s maternity program grew more than 13 percent in the last fiscal year, noting almost none of that growth was in the traditional area of high-risk maternity. He stated that most of the growth was routine, low-risk, deliveries with healthy moms and healthy babies, noting these were families that could choose any hospital in the County; however, choose Jackson.
Mr. Migoya reported that Jackson improved or maintained its financial stability indicators with 51 days cash on hand, noting an expectation to remain at these levels for the foreseeable future. He indicated that Jackson projected it would close the fiscal year with a slightly larger surplus than budgeted. Mr. Migoya discussed an upcoming financial challenge, noting the bond only provided $830 million for a $1.8 billion capital plan; therefore, the balance needed to come from operating revenue. He added that some of Jackson’s competitors were suing to block the Jackson West license, even though it was fully approved by state regulators, noting Jackson’s limited resources were being spent to fight these lawsuits, money that should be going toward Jackson’s mission.
Mr. Migoya mentioned that quarterly town hall meetings were held at each hospital where he warned employees that it was great Jackson earned $50 or $60 million annual surpluses for the last few years, but those days were over. He said it was going to take everything we’ve got to stay in the black in 2017 with a barely break-even budget.
Mr. Migoya noted the unprecedented partnership developed with Jackson’s labor unions made Jackson stronger. He advised that under the leadership of Service Employees International Union (SEIU) Local 1991, President Martha Baker, a model created at the legendary Kaiser Permanente system in California was being used. Mr. Migoya said this labor management partnership leveraged the ideas and experience of front-line caregivers, making Jackson’s clinical care more effective and more efficient.
Mr. Migoya pointed out that Jackson’s Transplant Institute saved hundreds of lives every year, with 564 organ transplants through August. He said that Jackson recruited the best specialists who have trained around the world; a heart and lung surgeon from Germany, an intestinal specialist from Brazil, a liver surgeon from Turkey, and a medical director from South Miami. Mr. Migoya noted together they’re building a program with astounding success rates, saving the lives of people who would otherwise have to travel across the country for care, if they could find anyone at all. He mentioned Jackson performed living-donor kidney transplants an average of once a month.
Mr. Migoya commented that Jackson Behavioral Health Hospital was a hidden gem. He spoke of Dialectical Behavioral Therapy (DBT), an intensive outpatient program designed for treating people with severe, complex, multi-diagnostic conditions. Mr. Migoya said that Jackson was recognized by the federal Health IT Challenge for using DBT with adolescents, including a cellphone application and web interface making it more comfortable for teens. He noted this therapy, which teaches mindfulness and acceptance, can be adapted to treat a wide range of challenges like drug addiction and post-traumatic stress disorder (PTSD).
Mr. Migoya reported that Jackson team members were consistently recognized for excellence because of their innovative approach to compassionate care. He pointed out that Jackson’s leaders were recently honored by the Greater Miami Chamber of Commerce, Legacy Magazine, the Children’s Trust, and the Coral Gables Chamber.
Mr. Migoya mentioned that healthcare was not just changing us all as patients; but also changing us as consumers, noting Jackson took steps to help its patients navigate the business of their care. He spoke of advances making it easier to apply for financial assistance programs like Medicaid and the Affordable Care Act, as well as simplifying the process to register for the Jackson Prime charity-care program.
Mr. Migoya acknowledged the County Commission for making the Jackson First health insurance plan available to all County employees. He said that nearly 20 percent of Jackson’s staff was enrolled in the plan and hoped it would grow even more in 2017. Mr. Migoya noted the plan would steer more Jackson employees to Jackson caregivers while also reducing the cost of providing care, with the lowest premiums and almost no co-pays. He indicated that offering the same plan for other County employees would improve health outcomes and further lower the County’s insurance costs.
Mr. Migoya commented on Jackson’s focus on population health management. He pointed out that it meant spending more energy keeping people healthy and more time coordinating their care when they’re sick, with less waste and better outcomes. We’re still in the early days of this complex work, but pilot projects with Jackson Prime patients were making an impact, with fewer trips to the emergency room and patients getting the help they needed to manage their wellness in healthier ways, said Mr. Migoya.
Mr. Migoya concluded that Jackson served this community for 98 years and was getting stronger. He mentioned that it was a privilege to enter his sixth year as the steward for this great institution, noting he was grateful every day to work with this supportive group of elected leaders, the incredible team of volunteer Trust Board members, and especially the thousands of nurses, doctors, therapists, and other professionals making Jackson’s miracles daily.
Chairman Monestime applauded Jackson’s comeback story in the book of Miami-Dade County. He commented on Mr. Migoya being an effective leader and on the importance of Jackson to this community.
Commissioner Bovo acknowledged Mr. Migoya and his staff for their hard work turning the hospital around. He expressed concern that children were travelling out of Florida to receive specialized treatments, noting South Florida should become more of a destination attracting sick family members for much needed medical care.
Commissioner Diaz mentioned that he was looking forward to the completion of the Jackson West facility.
Commissioner Edmonson expressed her appreciation to Mr. Migoya, Mr. Arriola, and the entire PHT Board, noting she always felt included by them as part of their governing body. She commented on the tremendous PHT growth under their leadership.
Mr. Migoya pointed out that Commissioner Edmonson had never missed a PHT Board meeting or a Citizen’s Resident Council meeting.
Commissioner Sosa advised that Jackson’s doctors and nurses made a difference in this community. She said that Mr. Migoya also made a difference in bringing good doctors and attracting paying patients to Jackson. Commissioner Sosa inquired about Jackson’s preparations for the approaching hurricane.
Mr. Migoya reported that Jackson was a trauma center and prepared for a Category 4 hurricane.
Commissioner Souto pointed out that he was a Jackson patient and placed a great level in trust in their medical expertise.
Commissioner Jordan commended Jackson for their progress. She asked Mr. Migoya about the status of the property being transferred to the University of Miami, noting the BCC enacted legislation preventing the property from being used for services competing with Jackson.
Mr. Migoya advised Commissioner Jordan that Jackson was currently engaged in conversations about that property, noting the outcome would be something valuable both to the County and Jackson. He said that complete details would be provided to the BCC when finalized.
Commissioner Moss thanked Mr. Migoya, Mr. Arriola, PHT Board Members, and Union staff for Jackson’s turnaround and the progress made serving this community. He noted he too could personally attest to the miracles that happen at Jackson. Commissioner Moss expressed support for the Jackson/UM continued relationship.
Commissioner Levine Cava commended Jackson on the miracles made daily at Jackson. She pointed out that she supported efforts to reverse the loss of public funding, noting the BCC unanimously approved legislation urging the State to expand Medicaid and Low Income Pool (LIP) program funding.
Mr. Arriola expressed his appreciation to Mr. Don Steigman, Chief Operating Officer, Jackson, for his diligent efforts on a daily basis, noting he was the heart and soul of the organization.
Chairman Monestime acknowledged Ms. Baker and SEIU members for their efforts. He also expressed his appreciation to the PHT Board Members.
There being no further business, the BCC – PHT Joint Meeting adjourned at 12:23 p.m., and the BCC Regular meeting resumed at 12:23 p.m. |
