NURSES—Contract Is No Cure

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COUNTY NURSES CURIOUSLY PLACATED DESPITE WINNING ALMOST NOTHING

If all goes as planned, some 4,500 L.A. County nurses will dutifully cast their mail votes by Nov. 21 and approve a new three-year contract that gives them almost nothing they were seeking. The 12 percent raise over three years is just 1 percent more than the county’s standing 11 percent offer, which the nurses’ union rejected. Meanwhile, the union’s other primary demand, improved staffing, remains a far-off improbability, with county health officials maintaining that they just don’t have enough money. Yet nurses, who were chanting angrily on picket lines last month, now seem curiously placated. How did this happen? What seems to have turned the trick, amazingly, is county officials agreeing to assemble a committee to brainstorm ways of coping with the chronic staffing shortage. The committee which will have no legal, binding power is to have 50-50 representation from administration and nurses. Even county officials concede that convening a committee will do little to improve staffing levels. “Any change in staffing level is going to mean an increase in funding level. Having a committee does not preordain an outcome or a (staffing) level,” said Joel Bellman, spokesman for county Supervisor Zev Yaroslavsky. Department of Health Services Director Mark Finucane also conceded that the committee’s work will be non-binding. Still, he stressed that the county has made a commitment to improve staffing by involving nurses in those decisions. “What will be binding is the goodwill and patient-care interest of everybody negotiating this,” he said. “That ethic is as important as anything that can be put on paper.” That said, no one involved in the contract talks was willing to talk about the financial impacts of the salary hikes or potential staffing increases. Finucane did say the county might seek funding from Sacramento or Washington to cover higher staffing levels. But earlier this year, the feds provided L.A. County with a $1.2 billion bailout for health services that came with a warning that it would be the last money provided for that reason. No matter where the county turns, finding that money is now part of the nurses’ charge. “Involving them in staffing patterns also means they have to be involved in resources issues,” Finucane said. “I don’t see this working as the nursing reps simply delivering a bill of goods to the department to be filled.” Why would county nurses go for such a deal? County nurse Patricia Margaret, a member of the nurses’ negotiating team, said she’s been fighting for more staffing since 1974. This time around, she said, the county’s willingness to form the committee clinched the contract deal. She vowed that the panel will make sure the agreement stands up even in the face of the department’s deficit. “Because we do the work, we’re confident we can find the answers to this,” Margaret said. “They usually tell us they don’t have any money and then walk away. Now that we’re on this committee, we can say, ‘What about this?'” That attitude is a far cry from the situation less than a month ago, when a number of the county’s 4,500 nurses joined rolling walkouts by other county workers aimed at improving working conditions, getting higher pay, and forcing the county to nearly double the number of nurses it employs. Cardinal Roger Mahony quickly convinced all those workers to end their one-day strike on moral grounds. Still, the county Department of Health Services and Service Employees International Union Local 660 seemed poised for a tug of war set against a projected $880 million deficit in county health funding over the next five years. Almost before the battle was joined, however, county and union officials announced a settlement but provided few details. In the end, the nurses appear to have traded staffing commitments for a 1 percent increase in the county’s standing offer of an 11 percent pay hike. Bart Diener, assistant general manager of Local 660, said the administration also agreed to lift a hiring freeze for professional staff that was imposed five years ago. However, the move only applies to nurses. Health Department spokesman John Wallace said a 3 percent pay hike for the first year of the contract has been worked into the department’s 2000-01 budget. Future increases are as yet unaccounted for, but will be funded through a five-year cost-cutting plan introduced last month, he said. Among other measures, that plan calls for a 2 percent cut in staff other than nurses, mostly to cope with the expiration of the federal bailout that ends in 2005. Wallace said the target layoffs will come from the ranks of administration, as well as through attrition across the department. Lopping off 2 percent of personnel through 2005 would cut $171.4 million from the budget over five years, he said. Also looming is the implementation of a state law setting minimum nurse-to-patient ratios. Gov. Gray Davis signed legislation in October 1999 that requires the state Department of Health Services to deliver the guidelines by January 2002. However, the legislation provides no state money to implement the guidelines. The SEIU has already submitted its proposal to the state for nurse-to-patient ratios in L.A. County that it hopes will be adopted. Unless the committee to be formed under the contract agreement comes up with staffing levels in the next 13 months, a standard will be set by the state. Robin Podolsky, press deputy to Assemblywoman Sheila Kuehl, D-Los Angeles, said the state standards aren’t likely to be excessive and most hospitals already will be in compliance. That’s why there was no money provided by the bill to pay for increased staffing, she said. “We’re not expecting a sudden burden at all county hospitals,” Podolsky said. “When it becomes clear how many (are noncompliant), then the whole issue of funding can be addressed.”

Assemblyman Gil Cedillo, D-Los Angeles, said the state-established ratios would set a floor for staffing levels and would bolster the union’s negotiating position if Local 660 determined higher levels were needed. Cedillo, who represented Local 660 during a strike in 1991, said he’s tired of hearing about the budget problems in the county Department of Health Services and how they impact staffing levels. “They keep talking about the health care budget as if it’s a free-standing budget. It’s like if your parents said, ‘Our budget’s balanced. We just don’t have money for (our child),'” Cedillo said. “What’s available in the (jail) budget? What’s available in the welfare budget? I don’t think we benefit by trying to segregate a certain department.” Whatever way the county decides to approach the challenges, union leaders have faith in the new contract. “Commitments have been made and we intend to hold them to that,” said Annelle Grajeda, general manager of SEIU Local 660.

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