A newspaper in Hawaii has obtained a copy of a secret memo
between Kaiser Permanente and one of
its "partnership unions" that details a backroom deal to lay off dozens of the
union’s members. News of the deal has sparked a backlash from union members kept in the dark about the plans.
The secret memo -- between Kaiser and the Hawaii Nurses Association --
describes plans to lay off one-quarter of the Registered Nurses at Kaiser’s
outpatient clinics in Hawaii “as part of an extensive ‘redesign.’” On
February 4th, at least 47 RNs will receive layoff notices, according to the Honolulu Star-Advertiser. Kaiser plans
to replace the laid-off workers with lower-wage employees.
Here are some excerpts from the article, which was published on January 28:
Despite the labor management partnership, union nurses complain that there had been virtually no communication from their employer or the union up until a few weeks ago.Kaiser RNs wrote in a letter distributed to the Hawaii Nurses Association on Friday that they strongly disagree with the union's position of accepting the redesign plan "initiated solely by Kaiser management" and are urging the union not to finalize an agreement until members are given an opportunity to meet with the organization."This plan jeopardizes patient safety and will impact quality of care and patient satisfaction," the nurses said in the statement. "This is a plan that has had no input from the frontline worker that knows the demands of clinic operations."
So… what are officials at Kaiser and the partnership union saying
to the public?
Both Kaiser and the Hawaii Nurses Association, which have a so-called "labor management partnership" …have been tight-lipped about the cost-cutting measures and workforce reductions. Kaiser declined multiple requests for comment, while union president Joan Craft did not return calls or emails.
Typical, right? Well, check out this quote from NUHW in the
Honolulu article:
John Borsos, secretary-treasurer of the National Union of Healthcare Workers, representing 4,000 health care workers at Kaiser in California, said the company has notified some 1,000 mainland workers — none of whom is a member of his union — of layoffs in 2013."It's outrageous," he said. "Kaiser's made $8.2 billion (nationally) in the last three years. There's absolutely no justification for it. They're experiencing record profits and they're laying people off."
The article in the Honolulu Star-Advertiser also describes the profits that Kaiser is pocketing in Hawaii.
Meanwhile, back on the mainland, partnership unions like SEIU-UHW have been working
closely with Kaiser's execs to lay off an estimated 1,000 workers in California. And SEIU-UHW's staffers have been coaching Shop Stewards about how to evade questions about Dave Regan's secret layoff deal with Kaiser. In one recording, an SEIU-UHW staffer is heard offering the following tips to Shop Stewards:
What we want to make sure is communicated to the members, and in our facilities, is that everyone know that SEIU-UHW along with the Coalition of Unions are against the layoffs. Okay? If any questions come up in your facilities where they wanna know, “Did SEIU-UHW know?” No, we did not know, right?
Finally, here’s the full article from the Honolulu, where --
coincidentally -- partnership union officials have done a lot of secret
deals.
Honolulu Star-Advertiser
Layoffs loom over registered nurses
Kaiser plans to use
staff with less skill to fill some positions targeted for cuts as a part of its
"redesign"
By Kristen Consillio
Jan 28, 2013
Kaiser Permanente Hawaii plans to eliminate nearly one-quarter
of its clinic registered nurses, replacing some of them with lower-skilled
licensed practical nurses and medical assistants.
The state's largest health maintenance organization is
proposing to cut at least 47 registered nurses in primary care positions at
some of its 18 clinics statewide as part of an extensive "redesign,"
Kaiser said this month in a memo obtained by the Star-Advertiser.
The HMO boosted rates Jan. 1 by 5.3 percent for 155,000
employer-sponsored plan members and 9.7 percent for roughly 14,400 individuals,
in addition to raising monthly premiums for 8,950 seniors on Medicare. Kaiser
offered contract buyouts to 280 nurses late last year and now plans to issue
layoff notices Feb. 4, according to nurses familiar with the situation.
The company said in the memo to the Hawaii Nurses
Association that it also will close the Honolulu Urgent Care Center, which has
an average volume of 30 patients per day, and cut operating hours at the Moanalua
Ambulatory Treatment Center from 12 hours, seven days a week, to 10 hours, six
days a week.
Nurses who asked not to be identified said the cuts are
being driven by Kaiser's fear of lower reimbursements in 2014 as a result of
the federal Affordable Care Act.
About 195 registered nurses work in the clinics, and roughly
850 work in the organization. RNs at Moanalua Medical Center, Kaiser's sole
hospital on Oahu, are not affected. RNs can apply for 31 openings throughout
the organization, according to the nurses.
Both Kaiser and the Hawaii Nurses Association, which have a
so-called "labor management partnership" that puts physicians,
managers and union members in unit-based teams to collaboratively solve
problems, have been tight-lipped about the cost-cutting measures and workforce
reductions. Kaiser declined multiple requests for comment, while union
president Joan Craft did not return calls or emails.
Despite the labor management partnership, union nurses
complain that there had been virtually no communication from their employer or
the union up until a few weeks ago.
Kaiser RNs wrote in a letter distributed to the Hawaii
Nurses Association on Friday that they strongly disagree with the union's
position of accepting the redesign plan "initiated solely by Kaiser
management" and are urging the union not to finalize an agreement until
members are given an opportunity to meet with the organization.
"This plan jeopardizes patient safety and will impact
quality of care and patient satisfaction," the nurses said in the
statement. "This is a plan that has had no input from the frontline worker
that knows the demands of clinic operations."
John Borsos, secretary-treasurer of the National Union of
Healthcare Workers, representing 4,000 health care workers at Kaiser in
California, said the company has notified some 1,000 mainland workers — none of
whom is a member of his union — of layoffs in 2013.
"It's outrageous," he said. "Kaiser's made
$8.2 billion (nationally) in the last three years. There's absolutely no
justification for it. They're experiencing record profits and they're laying
people off."
Locally, Kaiser reported a profit of $2.3 million through
the first nine months of 2012, the latest data available. That follows a $4.3
million profit in 2011.
Kaiser, which has about 4,400 employees at the Moanalua
Medical Center and Clinic and 18 clinics statewide, eliminated 35 union and
management positions in October in an effort to streamline operations.
Kaiser said late last year that voluntary buyout letters
were sent to nurses in an effort to redesign the way health care is delivered
and adjust staffing levels in an increasingly competitive market to ensure the
HMO had the "right workforce to be nimble in the marketplace." About
25 nurses accepted the buyouts.
Registered nurse Garry Johnson, a University of Northern
California nursing professor who was on Oahu last week to present a lecture
for critical care nurses, said health care organizations across the country are
replacing licensed practical nurses with registered nurses — the opposite of
what Kaiser is doing — because of their broader scope of practice.
"The RN is more trained to intervene with more
acute-care patients," he said. "It's a big safety concern. It's
really regressive for Hawaii and this organization to be planning to move away
from that when the movement is completely in the other direction."
Registered nurses have as much as four years of education,
compared with 18 months for licensed practical nurses and less than a year of
training for medical assistants, he said.
Licensed practical nurses and medical assistants aren't
trained for RN duties such as administering intravenous medications or
assessing ailments, and are paid about half the salary of a typical RN, who
makes $50 an hour on average in Hawaii.
Johnson pointed to a recent study, "Failure to
Rescue," by Linda Aiken, that describes the relationship between nurses'
level of education and survival rates and patient outcomes.
"The bottom line for her study is nurses with lower
levels of education were not recognizing that patients were actually
deteriorating," he said. "The more educated the nurse, the more the
patients were likely to survive."
He added that California used the study to enforce
nurse-to-patient ratios.
Eliminating RNs eventually will cost the system more,
Johnson added.
"At the end of the day, they don't end up saving
money," he said. "When patients go south, they start to deteriorate
and become sicker, and not all of them are going to die. Some of them will end
up in the (intensive care unit) or higher levels of care … and that all costs
money."
Kalihi resident Aukuso Pelefoti said he fears the changes
will jeopardize care for his children, ranging in age from 8 to 13.
"That means the quality of care is not going to be the
same as before," he said. "It doesn't make sense. If they're trying
to cut costs, maybe cut their hours, but don't replace the quality of staff. My
kids have been at Kaiser since they were babies. If the quality of care is
going to go down, that means we'll have to look someplace else. One thing is
for sure: If that's the case, goodbye, Kaiser."
