Cook County Health is struggling to fill thousands of jobs

The Cook County Health System, which is the largest safety net health system for the region’s most vulnerable low-income patients, is facing staffing shortages.

The health system currently has about 5,550 employees — and is looking to fill about 2,000 vacancies. This means that just over a quarter of the budgeted positions are empty. At the same time, the health system can’t keep up — it’s losing more workers to retirements, resignations and “layoffs” than the system can add to payroll, health system records show.

Most of the losses were due to people leaving, records show.

This problem is not unique to Cook County Health. More than two years into the COVID-19 pandemic, the so-called Great Resignation is happening across the country, especially among burned-out nurses who have left seeking time off, better pay or treatment.

But staff at Cook County Health have been under increased scrutiny in recent weeks as CEO Israel Rocha Jr. and his leadership team unveiled the system’s proposed 2023 budget. Among the goals is to continue expanding medical services for patients, which will help generate more revenue. But some members of the health system’s board question whether there is enough staff to take on that.

“We have a chronic inability to fill the positions at Stroger and Provident,” board member Ada Mary Guggenheim said during a meeting earlier this month, referring to the system’s two hospitals. “The wait times are absolutely horrendous.”

The longest wait is at eye doctors, urologists and plastic surgeons

As of January, the patients who needed an eye doctor, urologist or plastic surgeon, etc., waited the longest. It will take about four to six months to get an appointment, according to the most recent data available from the health system.

Cook County Health is part of the county government. It includes two hospitals – flagship John H. Stroger Jr. Hospital. in the near west and Provident Hospital in the south – as well as a network of urban and suburban clinics and a large Medicaid health insurance plan called CountyCare, which has more than 400,000 members. The majority of patients are black and Hispanic.

The health system is a significant part of the county’s budget, making up nearly half of the government’s proposed $8.11 billion budget in 2023. Cook County Health’s financial viability impacts the county’s bottom line as well as the taxpayers who help subsidizing costs, and patients who depend on the health system for medical care.

In an interview, Rocha said the health system is using temporary agency nurses, who are typically more expensive than salaried nurses, to help treat patients while hiring increases. He emphasized that the health system meets the needs of patients.

“Right now, every hospital in America is relying more and more on an agency [nurses more] than ever because we had a huge change,” Rocha said. “It’s not just Cook County Health Care.”

If the health system didn’t rely on agency staff to temporarily fill vacancies, the health system might have to cut services, meaning less money flowing in, Rocha said.

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

Israel Rocha Jr., CEO of Cook County Health, pictured with Cook County Board Chairman Tony Preckwinkle, says the system is relying on temporary agency nurses more than before to help treat patients.

Up to 6 months to fill jobs

At Cook County Health, human resources leaders have detailed in public meetings how difficult it is to hire people. It takes an average of four to six months to fill a position. The human resources department itself was understaffed to hire employees, but has since hired additional workers as well as created a dashboard to track the hiring process, Valarie Amos, chief human resources officer, said during a recent board meeting .

Her presentation illustrated the comings and goings of Cook County health care: dozens of nurses, clerical staff, security workers and technicians had accepted offers in the past few months.

But more than 50 others have declined for various reasons. Underpayment was the most common.

There are also constant morale problems. Many nurses in Cook County are still demanding extra money they say they are owed after treating patients in the darkest days of the pandemic. Staff shortages in the county health system have long been a problem and contributed to the nurses’ strike last year.

Rolanda Watson has been a nurse there for 29 years. During a health system board meeting late last week, she recalled how she was “placed” in the intensive care unit to treat patients with COVID-19 and also took on other roles.

“When I say deployment [it’s] fitting because I felt like I was going into battle. … We had to do the housekeeping role because they weren’t coming to the ward,” Watson said. “We had to play the roles of tray dispensers because the kitchen staff did not come to the ward. It was such a big problem that morale plummeted.

“Nurses are going broke”

In May, former ER nurse Consuelo Vargas wrote to the board: “I left because I couldn’t leave work feeling frustrated by hospital management every day. Your nurses are getting wrecked and I can confirm that it takes a long time to heal if their wounds heal at all. Today you have an opportunity to stop the hemorrhaging of CCHHS RNs.

Vargas left last year.

As Cook County Health competes for employees, Rocha said the health system has created a program to provide onboarding bonuses to new employees and is working to provide retention bonuses to current employees who agree to work for a certain number of years.

The full Cook County Board must approve the county’s overall proposed budget, which includes the health system’s financial plan. The fiscal year begins on December 1.

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

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