The USW Health Care Workers Council believes it is important to pursue a comprehensive view of safe staffing. We must recognize the vital role that all health care workers play in a patient’s overall care.

Every worker in a health care setting plays an important role in delivering quality patient care.

The response to our Safe Staffing Survey has been so strong that we’ve ordered 100 more scrub tops to keep up with demand. Complete your survey today and get your FREE USW SCRUB TOP. The preliminary results of our survey are poignant, and we are very excited to begin compiling results into an official report this winter. While we’re waiting for the last group of responses, here’s a sample of what our members report. It’s clear that unsafe staffing levels and mandatory overtime negatively affect, not only the care we can provide our patients, but also our non-work lives.

healthy meals for my family; I’m staying home and resting instead of going out and being social with friends.”

• A CT technologist in Minnesota says her job has been combined with so many others that it now entails “part of the scheduling, some billing, and some quality control. We used to have (other) staff that did this. Now it seems like the job I actually went to school for is incidental.”

The USW Health Care Workers Council believes strongly that every worker in a health care setting plays an important role in delivering quality patient care and that we must pursue safe staffing for every health care worker and every patient. Help us make our argument for comprehensive safe staffing to elected officials and employers ― TAKE YOUR SURVEY at www.usw.org/resources/hcwc. The survey will conclude November 30, 2013.

Safe Staffing Survey Input• A CNA in Kentucky says she wanted to work in

healthcare “because I’ve always found joy in helping others. But now we are so understaffed that I feel like I can only do the bare minimum for my patients and their families. I clean their rooms, but I can’t care for them like I want to ― like they deserve.”

• A case manager in Ohio says, “Supervisors don’t understand how many people it takes to do our job. On days where we actually have enough people to do proper patient education and provide good service, management says we’re overstaffed and sends people home ―pushing their cases onto the rest of us. We work through breaks and after shifts to make sure we get the work done.”

• A personal support worker in Ontario writes that, “Sometimes I’m too tired (after work) to maintain my home and tasks such as housecleaning and preparing

FALL 2013

Whether you are at the bargaining table or preparing for a grievance, the Union should have the same information the Company is using to make deci-

sions. A wide variety of information might be necessary for the Union to be able to make informed and intelligent pro-posals or to investigate a possible violation of an existing Collective Bargaining Agreement.

Just like everything else in a healthcare setting, when it comes to information requests, “if it’s not documented, it didn’t happen.” There are several best practices that the Union should follow to increase the chances of receiving request-ed information and to build the strongest case for a success-ful unfair labor practice charge if the need to file arises.

Best Practices

• For each item requested, clearly articulate why the in-formation is necessary and relevant.

• Because employers do not have to provide information if they can show it is “unreasonable” or “unduly burden-some,” be concise and specific.

• Verbally remind the employer of the requested informa-tion and verbally reiterate why it is necessary and rel-evant.

• Document all verbal and written requests made by the Company and by the Union in a checklist. Include what was requested, when the request was made, what in-formation was provided, and when the information was provided.

• Take extensive notes in bargaining and in any meeting with the Company where you discuss information re-quests. These notes, along with your checklist, will be necessary if you need to file an unfair labor practice charge.

The scope of information an employer may be required to furnish is extensive, but not all-inclusive. Generally, informa-tion relied upon by the employer when making a proposal on mandatory subjects of bargaining – wages, hours, and terms and conditions of the working environment – is

Information is Power: Tips for Successful Information Requests

required. For example, the employer may be required to provide:

• Wage rates

• Written and oral work rules

• Hours of work

• Disciplinary actions

• Job classifications

• Copies of CBAs at the company’s other locations

• Fee schedules - subcontracting information

• Insurance plans and information

• Performance appraisals

• Pension plans

• Health and safety data

• Attendance records

• Names of employees transferred to another location

• Details regarding plant closure if made for economic reasons

• Home addresses and phone numbers of bargaining unit employees

Did You Know?

• According to the NLRA, the obligation to provide infor-mation is part and parcel of the duty to bargain.

• Refusal to supply the requested information is a viola-tion of Section 8(a) (5) of the NLRA.

• This applies both to bargaining AND contract enforcement. Health Care Provider (Hospitals and Nursing Homes) Specific Items to Request

Consider requesting the following items in addition to the standard USW Information Request submitted with a con-tract re-opener or first contract.

Around the Union.Oak Hill Ratifies Successor Agreement USW members at Oak Hill nursing home in Waterloo, Illinois, ratified their third collective bargaining agree-ment. Oak Hill is owned by Monroe County of Illinois. Improvements in wages, shift differential, holiday eli-gibility, holiday pay, breaks, vacation, funeral leave, and personal days off were hammered out in a series of meetings between November 2012 and May 2013.

Columbia Rehabilitation and Nursing Center wins First Contract Employees of Columbia Rehabilitation and Nursing Center (CRNC) in Columbia, Illinois, overwhelmingly ratified their first collective bargaining agreement. Negotiations took place over sixteen (16) months. Workers at CRNC learned a bitter lesson three (3) years ago when the nursing home at which many of them had worked for many years was sold. Pay, benefits, and working conditions were changed overnight and employees had no recourse. Now, workers have the protection and security provided by their contract.

St. Mary Ratifies Successor Agreement The nearly 800 members at St. Mary Medical Center in Apple Valley, California, ratified a strong successor agreement this September. The new CBA will be in effect for four years and contains economic gains including annual across the board wage increases, increased shift differential and preceptor pay. About the new contract, Bargaining Unit President Marly Sandoval says, “We made marked improvements in several areas of our contract, which better protect the rights of our members. Not only have we solidified the important role of seniority in job bidding, layoff, and recall, we’ve also strengthened language around dis-cipline and discharge so that infractions are no longer a life sentence in your personnel file.”

The basics:

• Tax documents

• Audited financials (past 3 years)

• Unaudited financials (past 3 years)

• Cost reports (past 3 years)

• Hourly cost data

Hospitals and Nursing Homes

a) Number of licensed beds (annually for past 3 years)

b) Average Daily Census (quarterly for past 3 years)

c) Patient days of care (annually for past 3 years)

d) Patient mix (quarterly for past 3 years)

e) Payor mix (quarterly for past 3 years)

f) Nursing staff mix (quarterly for past 3 years). Please provide the number of nurse aides, LPN/LVN, and RN positions on the payroll.

g) Staff turnover rates

Hospitals Only

Don’t forget to find the hospital’s quality measures at http://medicare.gov/hospitalcompare/

a) Outpatient visits (total number and associated revenue), annually for past 5 years

b) Inpatient visits (total number and associated revenue), annually for past 5 years

Nursing Facilities Only

Don’t forget to find the NF’s quality measures at http://medicare.gov/nursinghomecompare/

a) Medicaid Per Diem Rate (annually, for past 3 years)

b) Medicare Per Diem Rate (annually, for past 3 years)

Around the Union.

The 6,000 health care workers who are USW members at Kaiser Permanente Health

System in California expect effective leadership and a world-class contract.

To ensure members get what they deserve, a leadership team from Local 7600 held a two-day strategic planning session in Fontana, Calif., to set objec-tives and strategies to meet them.

“The truth is, no matter how good you are – and members of Local 7600 are exceptional – there’s always room for improvement,” said District 12 Assis-tant to the Director Chris Youngmark.

Local 7600 represents health care workers at three hospitals and 11 clinics and support facilities at Kaiser Permanente, one of the nation’s largest not-for-profit health plans.

In total, Kaiser serves more than 9.1 million patients and customers, in-cluding about 7 million who live in California where it is based. Its system includes 37 hospitals, 611 medical offices and more than 175,000 em-ployees. Its operating revenue was $50.6 billion last year.

Local 7600 is part of a coalition of unions that represent Kaiser’s em-ployees through a labor management agreement known as the Kaiser Part-nership.

Through the coalition, union members have won collective bargaining agree-ments that set standards in the overall health care industry. The contracts

include consistent across-the-board wage increases, enhanced employer contributions to the employee pension plan and comprehensive health insur-ance benefits with low out-of-pocket costs.

“Negotiations and everyday relation-ship building through the partnership are powerful and effective ways of representing our members and our patients,” said Local Vice President Janis Thorn.

Over the last two years, the local has empowered hundreds of members through the grievance process and won more than $1 million in settlements and back pay awards.

“It’s not enough to have a great con-tract,” said Rosemary Vanderdoes, a contract specialist with the local and one of the 35 leaders present. “As a union, we must collectively continue to enforce and enhance the rights of our members every day.”

When necessary, members of Local 7600 show strength with collective action. Hundreds of protestors took to the streets in January to picket after the health care provider failed to follow the correct procedure in a series of job eliminations where se-niority should have been the control-ling factor.

By combining the grievance proce-dure, collective action and issue-based bargaining, Local 7600 forced Kaiser Permanente to spend $800,000 to remedy the problem.

Kaiser Local 7600 Embarks on Strategic Plan

Like other providers in the health care sector, Kaiser Permanente is making changes to adapt to the new regula-tions that come with the Patient Protec-tion and Affordable Care Act of 2010.

“Jobs are being redesigned and com-bined, new technology is being intro-duced and new systems are coming online to document just about every aspect of care delivery,” said Mandy Hartz, coordinator of the USW Health Care Workers Council.

Hartz said the local union must file information requests, demand dis-cussions over mandatory subjects of bargaining, file grievances, and gen-erally make sure the members’ needs are being met and that the union has a say in how the changes are imple-mented.

“Kaiser Permanente is ahead of the curve when it comes to implementing these changes, and that means Local 7600 must also be ahead of the curve,” Hartz said.

The local was praised by District 12 Director Robert LaVenture for its rich tradition of servicing members and helping the community. He noted the local is a regular participant in edu-cational conferences and maintains one of the top Women of Steel pro-grams in the district.

“By taking the time to develop a stra-tegic plan with set objectives, strate-gies to achieve those objectives, and specific timelines to measure prog-ress, Local 7600 is setting an example for how to build effective local unions,” he said.

RN, 71%

RN, 12%

LPN/LVN, 6%

LPN/LVN, 18%

Aides, 23%

Aides, 70%

0%

25%

50%

75%

100%

Hospital Nursing Facility

Nursing Staff Mix, U.S.

National Perspective: Did you know that nursing aides make up nearly one quarter of nursing staff in hospitals and 70% of nursing staff in nursing facilities?

As part of a five day Health Care Workers Coun-cil conference for members of Local 1-207 in Alberta, Canada, Minister of Seniors George

VanderBurg spoke to attendees about the pressing issues facing care givers and residents of long term care facilities in the province. Together, the group openly and compassionately discussed the need for improvements in how elderly Albertans receive care.

Minister VanderBurg, part of the ruling conserva-tive party in Alberta, empathized with the challeng-es that long term care workers face to provide the best care possible. “We all want what is best for our moms and dads,” he said.

The members present, all of whom work in a variety of private and public long term care facilities, talked to VanderBurg about the various consequences of understaffing across the sector. Delayed toileting, cold meals, inadequate bathing, and workplace vio-lence were among the issues discussed. In order to cover the morning care before break-fast, staff in some facilities must begin waking resi-dents as early as 5:30 a.m. “Because there are so few staff compared to residents, those people who

Alberta Nursing Home Workers Discuss Understaffing with Minister VanderBurg

were forced awake at 5:30 a.m. can sit for hours be-fore they can eat their breakfast. By the time they sit down to eat, their food is cold. No one wants to eat a cold meal, so then they are hungry but refuse their now cold, unappetizing meal,” said one member of Local 1-207.

Regarding a new bathing policy, which was cham-pioned by VanderBurg and the Minister of Health, members agreed that residents should have the choice to be bathed at least twice a week. “It’s one way that we can show them the care they deserve,” says VanderBurg. However, members shared per-spectives to illustrate that implementation of the new rule has been inadequate. “The bottom line is you have doubled our work from six showers a day to twelve showers a day, but our staff was not dou-bled,” said one member of Local 1-207.

Like many laws, the intent behind the new regula-tions is commendable, but care providers must have the funding to implement those regulations.

“I want our system at the end of the day to provide the absolute best we can provide,” says VanderBurg.