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Jose R. Sanchez: Without Mincing Words

EXCLUSIVE INTERVIEW: Jose R. Sanchez, LMSW, LCSW, president of Norwegian American Hospital, said that 52 hospitals are at risk because of the new governor of Illinois.

 

BY EDUARDO ALEGRIA

The president and CEO of Chicago’s only Latino Hospital argues that the proposal to cut $ 1.5 billion from Governor Bruce Rauner’s Medicaid program can mean life or death of several hospitals that mainly serve patients who use this health insurance.

Sanchez is an authorized and respected voice in the country's health sector. He has a career spanning more than 30 years as an executive in the health care field and has extensive knowledge of the industry of health care. Before joining  Norwegian American Hospital, Sanchez was the Senior Vice President of Generations + / Northern Manhattan Health Network, one of the largest health care networks in the city of New York City Health and Hospitals Corporation. During his tenure he oversaw three hospitals, two of which were of level one trauma centers, health centers and 34 community based in East Harlem, Central Harlem and the South Bronx in New York.

He became a licensed social worker in 1979. Sanchez as well obtains a degree in psychology from City College of New York and a Master of Social Work from Adelphi University. In 2002, he was conferred an honorary doctorate from the New York College of Podiatric Medicine. This honor recognizes their measurable achievements and commitment to improving the health situation of the poorest and most disadvantaged populations in the city of New York.

He was appointed by former Gov. Pat Quinn for the State Health Improvement Plan (SHIP) Implementation Coordination Council and the Budgeting for Results Commission. He is one of 24 appointed officials working to implement health care reform. He also sits on the boards of Illinois Hospital Association, Puerto Rican Arts Alliance and City Club of Chicago. In addition, he is a member of the Board of Boricua College in New York. He also serves as president of East Harlem Business Capital Corporation Board of Directors. In October 2009, Sanchez was named among the "Most Influential Latinos" in the United States by Hispanic Business magazine. He is certainly a person you have to listen:

- How is your hospital facing the challenges of health reform?

- Health reform at the federal and state level has created an impact not only on how it will cover services, but in how they will pay those costs. There are 28 states that have agreed to participate in the reform of health and 22 did not. Keep in mind that the expansion of health reform does not bring new money, but it does reduce certain types of programs to cover more people. What we find today is that reform has changed the rules for how the federal government pays hospitals because they are reducing costs and fewer resources to serve those people.

- Who are the most affected?

- The main problem is that there are fewer resources to serve people who use Medicaid and Medicare. They are the most affected because their health care depends on the financial support of the federal money, and hospitals with such patients are the ones who suffer most.

- Is that what happens here in the neighborhood of Humboldt Park?

- This is a poor community and basically everyone uses these two state insurances. This then leads to an additional problem: the undocumented immigrants who have been excluded from health reform. Here there are a lot of those people who end up in the emergency room and we have to address because that's the law. The economic problem comes later because the federal government does not pay us for their care. They represent 10% of our patients.

- This has generated a deficit in your hospital?

- The hospital is not in deficit because we have balanced the budget, but we have a small margin of profit. We are talking about a gross budget of more than $ 300 million and $ 100 million net budget. That all affects us in how we service. We won some money on services we provide but that helps us to provide services to those people that do not pay us.

- How does your administration address them?

- We are a nonprofit organization and provide services as they come. We are always on the problem of balancing our budget. It is a very difficult situation because of the way we fund them all.

- Is the situation untenable?

- It can turn to that if we reduce services that can aggravate health disparities that exist in this community, where we have the highest cases of diabetes in the city. We cannot stop treating these patients.

- How to avoid this difficult situation?

- We do not know because it is basically a political problem since beginning of the health reform. In 2012 it was expected that everything changed for the new services, funds, etc. for which agreements with the state government were signed, the problem is that this new Republican state administration in the government has paralyzed many programs and services that were scheduled, and what is worse, it wants to cut Medicaid funds at $ 1,500 million.

- But it will not change the policy of the governor. So the time to come might be hard for administration, do you have a contingency plan to avoid closing services and programs?

- We have a work plan and every month is adjusted, allowing us to continue providing our services. We know that times are going to be harder and we are designing several alternatives to work. I cannot detail what they are but they aim avoid the closing of services.

- Externally, are you are working with other hospitals that have the same problem?

- Yes, we are currently 52 hospitals in Illinois that suffer with this problem and we meet periodically to discuss the situation and propose solutions. We met with state lawmakers and state health authorities for this purpose. We seek to reach an agreement.

- What are you doing internally in the hospital?

- We continue to make an analysis of where we can reduce costs based on the projections we have, identifying areas of our services that allow us to grow, as the areas of cardiology and cancer. We have a plan but do not think it's enough, depending on the impact that comes from outside.

- Have you ever calculated how much he would impact the hospital if the governor's budget cut was approved by Medicaid?

- Yes, it would impact us $ 13 million annually. The analysis we have done was based on the numbers Medicaid budget cuts proposed, namely that would cease to receive 13% of our budget to our hospital. It is making it very difficult to manage this institution.

- You could say that this hospital is at risk of closing if funds are cut as Medicaid has been raised?

- Yes, according to our analysis of the figures proposed by the governor. Now we can say that our luck is on hold. It puts us in a position to simply disappear.

- If the worst financial picture become a reality, what would happen to the hospital?

- Closing of the emergency room, servicing only to outpatient and stop providing services as a hospital because it will be impossible to keep the hospital within the same structure as it is functioning today.  We most likely wouldn’t meet the basic conditions to serve to the people, I have 30 years in the health sector and I have been president of six hospitals, and I will not allow us to be in that situation.

- What are you going to do?

- I am going to continue to work with the state government on the political side to reach an agreement and internally looking for ways to continue functioning.

- What can you say to the community?

- I can say that as of today, with the state’s policy of wanting to cut the budget to Medicaid, the hospital is in danger of continuing to function.

- But right now the focus is warranted?

- Absolutely, to everyone who comes to our hospital. The law requires us to provide services. Also, it is our commitment to our community.

- Have you considered the possibility of charging patients directly for services if the need arises?

- Look, the economic condition of the community is so precarious that we will always expect them to come in so sick to the hospital, in a state where we cannot deny them services because their life depends on it. Most live with minimum income and they would rather spend their money on food and livelihood priorities.

- What do you expect?

- To continue advocating for changes to the current political criteria; because as it is now, the state government is putting at risk the fate of the hospitals that are servicing the poor in Illinois.

Photo: Eduardo Alegria

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