By John Dorschner
Carlos Migoya, a veteran banker with no healthcare experience, was picked Wednesday night to become the next chief executive of the financially troubled Jackson Health System by a 9-5 vote of the governing board.
After negotiating a contract that could pay him up to $975,000, Migoya will likely take over the system on June 1, only a month before Miami-Dade’s public hospitals are expected to enter a severe cash crunch that could require drastic cuts.
Much of the debate Wednesday among the members of the Public Health Trust, which oversees Jackson, centered on whether the system should be led by a seasoned hospital professional or a banker with strong business experience who has never worked in healthcare.
Migoya was a banker for more than 30 years and spent 10 months last year as the unpaid Miami city manager.
The two finalists not chosen: Myles Lash, 64, a veteran hospital administrator and consultant, and Ram Raju, 59, the chief operating officer of New York City’s huge public hospital system. Raju received five votes in the final tally, though he lost to Migoya.
The board held a preliminary vote after three hours of interviews with the finalists that offered no clear leader: six members supported Migoya, five backed Raju and three voted for Lash.
The two-hour debate that followed focused on Raju’s experience with a huge hospital system versus Migoya’s familiarity with the local community.
Incoming Trust Chair Marcos Lapciuc said he favored Migoya’s local connections because he could “bring all the stakeholders to the table” to create a community solution to Jackson’s problems.
Joe Martinez, chairman of the Miami-Dade County Commission and a Trust member, praised Migoya for coming up with the idea of partnering with local clinics, such as the Leon Medical Centers. “The other guys are not from here. They wouldn’t know that.”
Joe Arriola, the University of Miami representative on the Trust, said that after conferring with UM President Donna Shalala and medical school dean Pascal Goldschmidt, the university leadership strongly supported Migoya.
“We need a radical, very quick financial change,” Arriola said. He said Migoya was “really heads and shoulders above everyone else.”
Board member Martin Zilber said Raju would be the safe choice, because he’s an experienced hospital executive with good credentials. But, he add, “I believe we’re in a hospital where safe doesn’t work,” saying that Jackson needed a bold change, such as Migoya.
Board member Gladys Ayala said that Raju was “absolutely, unequivocally the best choice” because of his experience “with the largest healthcare system in the country… We will send a message that we are not serious about turning around this system if we choose someone who has no experience in healthcare.”
Trust member Georgena Ford said she was concerned about Migoya’s background check, performed during the search for a new CEO, which showed that while he worked for the city of Miami, he admitted following a request by the mayor to call the police chief and ask that the police postpone a raid on gambling machines until after an election.
At the end of the debate, those voting for Migoya: Martinez, Lapciuc, Zilber, Angel Medina, Jorge Arrizurieta, Arriola, Ernesto de la Fe, Abraham Galbut and Stephen Nuell.
Voting for Raju were Ayala, Ford, Sally Heyman, Joaquin del Cueto and Robin Reiter-Faragalli. Chairman John Copeland did not vote.
Migoya will replace current CEO Eneida Roldan, who announced in November she would leave when her two-year contract expired because County Commissioner Carlos Gimenez had questioned her “integrity and moral fiber” when she said she hadn’t known about a “golden parachute” offered to the head of Jackson’s international marketing program. Roldan earns $665,000 a year.
Jackson’s new chief executive will face huge challenges from the beginning. The system is projected to run out of cash in July and it could lose up to $200 million next year in state funding if the most severe Medicaid cuts are enacted by the Florida Legislature.
The system lost $93 million in fiscal 2010 and $244 million in fiscal 2009. Through the first five months of this fiscal year, Jackson has lost $42.2 million. Its continuing losses keep eroding its cash reserves, which executives expect to result in a major crisis this summer.
Healthcare experts have urged major reductions in labor costs, a revamping of Jackson’s $130 million annual contract with UM, finding new reve