Collective Bargaining in an Era of Healthcare Reform; How One System Saved $18 Million Through Negotiations Brian Sweeney, RN, FACHE Vice President for Clinical & Support Services Joseph Anton, RN Vice President for Clinical & Support Services
Transcript
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Collective Bargaining in an Era of Healthcare Reform; How One
System Saved $18 Million Through Negotiations Brian Sweeney, RN,
FACHE Vice President for Clinical & Support Services Joseph
Anton, RN Vice President for Clinical & Support Services
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I.Organizational profile & union environment II.Contract
negotiations III.Strike preparations IV.Outcome and return on
investment Agenda 2
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Describe how to formulate a strike plan to strengthen your
negotiating position and minimize revenue loss from a work
stoppage. Identify tactics to reduce operating expenses associated
with a collective bargaining agreement. Demonstrate how to assemble
a negotiating team that will lead to optimal outcomes. Objectives
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I. Organizational Profile and Union Environment 4
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Philadelphia, PA 953 bed academic health system 3 hospitals
46,000 admissions 100,000 ED visits 8,000 employees 3 unions
Organizational Profile 5
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Affiliate of National Union of Hospitals & Health Care
Employees, AFSCME, AFL-CIO 72,500 national/17,000 local/1,ooo
Jefferson members Experienced leadership team Simultaneous
negotiations with 4 hospitals Previous strikes Key positions: EVS,
nursing assistants, transport sterile processing, nutrition, mail
room & supply chain Key Facts District 1199c 6
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Different TimesHigher Stakes 7
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II. Contract Negotiations 10
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Secure a realistic and responsible collective bargaining
agreement given ACA Maintain high quality care Protect patients,
visitors, and staff Continue academic activities Maintain
image/reputation Minimize revenue loss Provide consistent messaging
Negotiation Objectives 11
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Engage multidisciplinary teams Analyze data Develop formal
plans Synchronize timelines Communicate effectively Educate union
Approach 12
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Hospital administration University administration Human
resources Internal counsel Outside labor counsel Support financial
administration Negotiating Team 13
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Total annual cost of contract = $52.5 million Wages - $36
million Health and welfare - $12 million Pension - $3.9 million
Training/legal - $720,000 Starting Point 14
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Challenges: Highest wages in marketplace Payroll drives pension
costs Union will oppose anything reducing dues Goals: Preserve
current workforce salaries Two tiered wage structure # 1 - Wages
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Challenges: Multi-employer plan Most costly benefit Rich plan
with low co-pays High ED utilization & low PCP engagement
Goals: Maintain contribution rate for 30 months Reduce benefit
costs Activate disease management # 2 - Health and Welfare Benefits
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Challenges: Grossly underfunded Freeze is best option Limited
options with federal requirements $62 million withdrawal liability
Rate increase in 2014 Goals: Migrate to defined contribution plan
Develop hybrid alternative # 3 - Pension 17
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Challenges: Poor attendance Paying OT to cover call outs Right
to use time Implement for non-union employees first Goals: Migrate
to ETO plan Resolve other matters first # 4 - Earned Time Off (ETO)
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III.Strike Preparations
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Potential scenarios Contract ratification prior to expiration
Contract expiration/pre- announced strike 10-day notice Unannounced
walkout Contract Ratification or Strike? 20
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Strike Preparations Challenges: Take firm position to reduce
1199C expenses, increasing likelihood of a strike Uncertain when
strike will occur Goals: Minimize disruptions to operations
Maintain security for patients, visitors, and staff Maintain
image/reputation through aggressive PR
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Financial Implications of Strike Strike estimated to cost $1.5
million for 8 weeks Reduction of 1199C payroll helps offset
expenses Reduced admissions budget Unable to quantify risk of
PR/media exposure
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Confidential playbook Formal written document Multidisciplinary
involvement Clear written procedures with accountability Set
timelines Developing A Strike Plan 23
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Staffing plan - day 1-7 - internal Redeploy non-clinical staff
Train within 7 days of contract expiration - visible Staffing plan
- day 8+ - external Large, experienced national firm Cost
Authorization to deploy Logistics Replacement Staffing 24
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Jefferson Outside security firm Philadelphia Police US Marshall
Service Security 25
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Hired outside crisis communication firm Developed tools for
departmental managers FAQs, progress reports Trained spokespersons
for media inquiries Prepared statements for patients, media, &
vendors Monitored social media PR/Communications 26
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Verified vendors will deliver Stockpiled medical/surgical
supplies, pharmaceuticals, and office supplies Secured refrigerated
trailer for perishables Identified off site depots for deliveries
Used undercover vehicles for deliveries Supply Chain 29
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Prepared injunctions Emergency arbitration hearing Conducted
management education Reviewed communication Hold union accountable
for following laws Notification to DOH/Joint Commission Legal and
Regulatory 30
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Test the plan Did people read it? Did we miss anything? Are we
ready? Scenarios Access to loading dock will be impeded for an
extended period of time given an excessive number of protesters.
What is the alternate plan? How is it implemented? Table Top
Exercises 31
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Leads implementation of the strike plan Staffed 24/7 Labor
hotline Monitor campus security Coordinate deliveries,
communication and staffing Monitor media activity and coordinate
response Labor Operations Center (LOC) 32
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Coordinate logistics for inbound staff Travel, hotel, meals,
transportation Identification Health screening and immunizations
Scheduling Record keeping Training with department managers
Staffing Center 33
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Demonstrate preparation to reassure patients/staff Protect
perimeter Coordinate efforts with law enforcement Videotape picket
line activities to gather evidence Provide executive protection
Escort employees and vehicles safely in and out Security
Responsibilities 34
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Rallies 35
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IV.Outcome and ROI 37
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Settled on July 1 st at 3 am Six year agreement Health and
welfare reopener in July 2014 $18,609,304 million in savings over
life of contract Wages/pension - $12,391,486 Health and welfare -
$1,913,868 ETO -$4,303,680 Results 38
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Cost of strike preparedness - $262,000 Legal fees - $240,000
Public relations firm - $36,000 Total -$540,000 Return 35 x initial
investment ROI 39
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OT hours per pay Before - 1,310 After - 591 Time off hours per
pay Before - 5,887 After 2,388 ETO 40
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Engage operational leaders in negotiations and strike
preparations Link negotiations to strike preparations Ensure
preparations are visible Be sure you are ready to take a strike!
Continue communication on terms after ratification Understand role
of other hospital settlements After action review we will do it
again in 6 years Lessons Learned 41