The main focus of our Bargaining team has been to negotiate affordable health plans, address short staffing issues that affect everyone’s work, including the ability to schedule vacations, and obtain equity in wage increases.

WAGE INCREASES

The hospital has proposed a merit-based wage increase. All full time and part-time 1 and 2 employees would receive increases based on their evaluation.

• Exceeds standards = 1% + cost of living (currently 1.5%)
• Meets standards = Cost of living (1.5%)
• Needs improvement = No increase.

The hospital’s economic proposal eliminates the Specialty Pay section for nurses. All other differentials (shift, lead, on-call) remain the same.

HEALTH PLANS

The hospital’s proposal raises annual premium costs for the Bargaining Unit by about $675,000. It also eliminates the free health plan. Management stated that the costs would be offset by them waiving the deductible for diagnostic x-rays and labs done at HPMC, but we don’t have information proving that!

HEALTH PLAN COMPARISONS

PLAN 1

Plan 1 is currently free for employees at all coverage levels (i.e. individual, family, etc). The employer proposed that employees pay a portion of the premium costs with proposed annual premium costs ranging from $420 to $4,320.

• It appears that the employer’s new proposal eliminates the higher smoker deductible. These smoker deductibles were $300 more than the non-smoker deductibles for both individual and family coverage levels.
• The employer proposed to increase the out-of-pocket maximum for individuals by $350, and $700 for families.
• The employer proposed to increase the co-pay for outpatient services from $50 to $250 for Tier 2 providers.
• The employer proposed a waiver of the deductible for diagnostic x-ray and lab services for care received at HPMC.
• The employer added a “professional services” category to its inpatient and outpatient benefit descriptions and proposed covering these services up to 80 percent for care received at HPMC and 60 percent for Tier 2 providers. Based on the SPD, this does not appear to be a change in plan design for Plan 1 as professional services are covered at the same level under the current plan.

PLAN 2

The employer proposed increases in annual premium costs ranging from $288 to $3,360 for Plan 2.

• The employer’s proposal increases deductibles from the current $250 to $500 for individuals and from current $500 to $1000 for family coverage levels for care received at HPMC, and from current $500 to $1000 for individuals and $1000 - $2000 for family coverage levels for care provided by Tier 2 providers.
• The employer proposed to increase the out-of-pocket maximum for individuals by $350, and $700 for families for care provided by Tier 2 providers.
• The employer proposed a $50 increase in the co-pay for inpatient services for care provided by a Tier 2 provider.
• The employer proposed that hospital charges, including professional services, for care received at HPMC would only be covered at 80 percent. These services are currently covered at 100 percent.
• The employer proposed a $75 increase to the co-pay for outpatient services for care provided by a Tier 2 provider.
• The employer proposed that professional services for outpatient care received at HPMC will only be covered at 80 percent; it appears that those charges are currently covered at 100 percent.
• The employer proposed a waiver of the deductible for diagnostic x-ray and lab services for care received at HPMC.
• Employer proposed a $5 increase in the co-pay for outpatient mental health services provided by a Tier 2 provider.

PLAN 3

The employer proposed increases in annual premium costs ranging from $252 to $3,552 for Plan 3.

• The employer’s proposal increases deductibles from the current $250 up to $500 for individuals and from current $500 to $1000 for family coverage levels for care received at HPMC, and from current $2000 to $2500 for individuals and from current $4000 to $5000 for family coverage levels for care provided out of network.
• The employer proposed a reduction in the out-of-pocket maximums, $150 for individuals and $300 for families for care provided at HPMC.
• The employer proposed a $5 increase in co-pays for physician and specialist office visits for Tier 2 providers.
• The employer proposed a $50 increase in the co-pay for inpatient services for care provided by a Tier 2 provider.
• The employer currently covers “professional services” for inpatient services at 80 percent; the employer proposed to reduce coverage to 60 percent for Tier 2 providers.
• The employer currently covers “professional services” for outpatient services at 100 percent; the employer proposed to reduce coverage to 80 percent for care received at HPMC.
• The employer proposed a $25 increase in the co-pay for outpatient visits to Tier 2 providers.
• Employer proposed a $10 increase in the co-pay for outpatient mental health services provided by a Tier 2 provider.
• The employer proposed a waiver of the deductible for diagnostic x-ray and lab services for care received at HPMC.

STAFFING PROBLEMS

• At some point in every shift, nurses are out of ratio so they do not get meal periods and breaks.
• There isn’t enough staff to cover all the units so staff are constantly being floated.
• Turnover for the ICUs alone runs around 47%.
• Turnover for the Emergency Department is around 50%.
• Vacations are denied for “staffing” reasons.
• Employees are unable to get a single day off when requested.

COSTS OF NURSING TURNOVER

• Temporary RNs
• Overtime
• Productivity losses
• Closed beds
• Patient deferrals
• Lapses in quality of care
• Increased patient length of stay
• Inefficient discharge planning
• Inconsistent use of policies and procedures
• Communication problems
• Nurse fatigue and burnout
• Errors

By creating an environment that mitigates nurse turnover and boosts satisfaction the organization will save money. It costs around $150,000 to train a critical care nurse. It also provides:

PROPER STAFFING:

• Improves staff satisfaction
• Improves patient safety
• Improves patient/family satisfaction
• Encourages previous customers return when necessary
• Gives the hospital a competitive edge in the local market.