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What's in store for the exec tapped to lead Cook County Health
New York public hospital executive Israel Rocha Jr. could take the helm at a particularly challenging time for the two-hospital system.

Wednesday, October 07, 2020
Crain's Chicago Business
by Stephanie Goldberg & A.D. Quig

In the midst of the gravest public health crisis in generations, Cook County Health has been searching for a permanent leader. It found one in Israel Rocha Jr., an executive at NYC Health + Hospitals, the largest public health system in the nation.

Cook County Health’s independent board of directors has proposed Rocha as CEO, and the Cook County Board of Commissioners is expected to weigh in later this month. Cook County Board President Toni Preckwinkle said today that she intends to support Rocha's appointment.

"The young man who’s been proposed to lead our health and hospitals system comes from New York and shares, I think, that commitment to a focus on racial equity and inclusion in his own health care experience, and we look forward to working with him,” Preckwinkle told reporters at an unrelated press conference. "This is a very challenging time for health care professionals at every level, particularly in public hospitals. As you’re probably aware, half of our patient load in Stroger (hospital) was COVID-19 patients, so we had a disproportionate share of the burden of caring for pandemic patients. I’m sure that was his experience in New York as well."

Cook County Commissioner Dennis Deer, chair of the Health & Hospitals Committee and a member of the CCH board, declined to say how the health board decided on Rocha. As for how Rocha will fare with commissioners, Deer said most are concerned about three things: the financial stability of the system, how Rocha would handle CCH's rising uncompensated care costs, and how he will get up to speed on local issues.

NYC Health + Hospitals

Israel Rocha Jr.

Rocha, 42, declined an interview request through a CCH spokeswoman. "Out of respect for the formal process, it would be premature for me to say anything more than I look forward to the next steps," he said in an email from the spokeswoman.

As a vice president at NYC Health + Hospitals, Rocha has served as CEO of Elmhurst Hospital since 2016 and CEO of Queens Hospital since earlier this year.

The 11-hospital system, with 42,000 employees, was inundated with COVID-19 cases this year, having gone from no hospitalized coronavirus patients on March 1 to 3,700 patients by April 1, system CEO Dr. Mitchell Katz recently told Modern Healthcare. The experience challenged the system to think differently about keeping up with demand, as increasing staffing numbers only hikes costs, Katz said.

Rocha "has deep experience with handling the unexpected twists and turns of this virus. . . .He has run a hospital that is of similar size and scale and has a similar payer base and population,” said Cook County Commissioner Bridget Gainer. “He also has a lot of experience politically. This is a hospital in which you need to be both able to run a strong clinical organization but navigate a political one as well."

The Cook County Board of Commissioners recently regained more control over hospital system decisions, granting Preckwinkle a direct appointment to the independent board and the power to approve all future CEOs.

Additionally, Rocha will have to manage a number of constituencies—everyone from maintenance workers to doctors, the health system's board, Cook County commissioners and the board president, Gainer said. Plus a diverse mix of payers and different clinical settings at hospitals, clinics and the county jail.

Cook County Health covers Stroger Hospital on the Near West Side, Provident Hospital on the South Side, a network of clinics, an insurance company and medical services for detainees at the Cook County Department of Corrections, as well as the county's Department of Public Health.

Rocha is no stranger to the challenges that come with working at a public health system with a mission to care for all patients regardless of ability to pay. Under his leadership, Elmhurst Hospital in New York increased patient revenue by about $50 million a year, improved clinical quality measures and patient satisfaction, eliminated its operating budget deficit, and secured money to build a new emergency department, neurosciences center and ambulatory surgical center, according to his bio on the NYC Health + Hospitals website.

Cook County Commissioner Larry Suffredin said a committee vote will likely be held Oct. 19 or 21 and that Rocha's compensation package will be discussed in executive session.

Suffredin added that Rocha's experience guiding Elmhurst through COVID during the worst of the city's experience with the virus is a point in his favor, as is his work with OneCity Health, a subsidiary of NYC Health + Hospitals similar to CCH-run CountyCare.

Rocha's experience in Washington, D.C., might also help CCH navigate federal funding, Suffredin said, noting that "he’s a transformational leader.” He worked for Texas Congressman Ruben Hinojosa from 2000 to 2007, starting as a legislative assistant and working his way up to deputy chief of staff.

Before he joined NYC Health + Hospitals, Rocha was CEO of the Doctors Hospital at Renaissance Health System in Edinburg, Texas. He worked there from 2009 until 2016 and helped transition it from a general acute-care hospital into a comprehensive academic medical center affiliated with the University of Texas System. He is a Texas native with degrees from Columbia University and New York University.

Before the COVID-19 pandemic, Cook County Health was under pressure to cut spending and address a rising burden of uncompensated care without a permanent leader. Now, facing a projected $187 million budget deficit for fiscal 2021, the system is planning a series of cost-cutting initiatives, including layoffs and outpatient clinic consolidations.

Plans to build a $240 million, mostly outpatient facility to replace Provident were put on hold until a permanent CEO takes the helm. But other changes at the hospital appear to be underway, including consolidating patients and services at Provident from the system's Woodlawn and Near South outpatient clinics, which are closing; moving some elective surgeries to Provident from Stroger; and converting Provident’s emergency department into a standby emergency department, which means a registered nurse is on duty at all times and a doctor is on call.

“Deb Carey has done a terrific job as interim CEO and I think everybody will be relieved and excited to have a permanent leader in place that can help navigate these troubled times,” said Margie Schaps, executive director of the Health & Medicine Policy Research Group.

Carey, who previously was deputy CEO of operations and is to return to that role, took the helm on an interim basis in January after John Jay Shannon's contract was not renewed by the health system's independent board.

“Having come from New York, I have confidence that (Rocha) understands the pandemic well and the challenges of big cities that have a lot of people whose lives are challenged by a lot of things that relate to health—social determinants like food insecurity, housing insecurity, job insecurity,” Schaps said.

In addition to the COVID-related challenges facing Cook County Health and other providers, the health care system is bracing for a potential repeal of the Affordable Care Act. Oral arguments are scheduled to begin Nov. 10 in the Supreme Court to determine the fate of the landmark health care law, which expanded the state’s Medicaid program and established a health insurance marketplace for uninsured individuals, increasing the number of people in Illinois with health insurance by more than 800,000. An unknown additional number have gained coverage under ACA provisions banning insurers from rejecting people based on pre-existing conditions and allowing young adults to stay on their parents' insurance until age 26.

A repeal would not only impact coverage for pre-existing conditions and preventive services like cancer screenings, but also result in at least 300,000 Cook County residents losing coverage.

The loss of coverage would result in higher charity care costs for health care providers and Cook County Health in particular. The system's two public hospitals, Stroger and Provident, provided more than half of all free care for low-income patients—about $348 million worth—in the county in 2018, according to the latest state data.WBEZ first reported that Cook County Health’s independent board proposed Rocha as CEO.


 


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