SEIU, Cal­i­for­nia hos­pi­tals cre­ate partern­ship that aims to be model

SEIU, hos­pi­tals strike unique deal to work to­gether

Modern Healthcare - - EDITORIAL - Ashok Sel­vam

The big­gest health­care union in Cal­i­for­nia reached a pact with the state hospi­tal as­so­ci­a­tion that calls for im­me­di­ate steps to make nice and a pledge to work to­gether to im­prove and re­duce the costs of care, and could pro­vide a tem­plate for part­ner­ships in other states.

The three-page agree­ment be­tween the Cal­i­for­nia Hospi­tal As­so­ci­a­tion and Ser­vice Em­ploy­ees In­ter­na­tional Union-united Health­care Work­ers West calls for the as­so­ci­a­tion to in­tro­duce the union brass to hospi­tal ex­ec­u­tives. The SEIU, in ex­change, dropped its sup­port of two bal­lot ini­tia­tives aimed at hos­pi­tals. CHA spokes­woman Jan Emer­son­Shea said the sides de­vel­oped the con­cept last fall at the bar­gain­ing ta­ble: “Hos­pi­tals share many of the same val­ues and goals that or­ga­nized la­bor does,” she said.

Those goals of the agree­ment—called the Part­ner­ship for Healthy Cal­i­for­nia—in­clude im­prov­ing the qual­ity of health­care, re­duc­ing costs and de­creas­ing the rate of chronic dis­ease in the state. There’s no timetable for when specifics will be de­cided, but even in the part­ner­ship’s in­fancy, SEIU-UHW Pres­i­dent Dave Re­gan says he has an idea on how he de­fines suc­cess. “I think if we’re suc­cess­ful that over the next 10 years that Cal­i­for­ni­ans will be­come health­ier and that the rate of chronic dis­eases will de­cline,” Re­gan said.

“This is un­prece­dented, it in­volved real risks on both sides,” he said. “I think there’s a gen­uine sense if we can make this work in Cal­i­for­nia, you can make this work any­where in Amer­ica.”

A na­tional SEIU spokesman de­clined to say whether the union is pur­su­ing sim­i­lar agree­ments in other states, though he pointed to the Part­ner­ship for Qual­ity Care, a coali­tion that in­cludes the SEIU and in­di­vid­ual hos­pi­tals and sys­tems in sev­eral states. “There are ex­am­ples out there of things that are in mo­tion in the public’s eye that show hos­pi­tals and our unions do­ing things to­gether,” SEIU spokesman Carter Wright said.

The CHA can’t force any of its 500-plus hos­pi­tals to hold union elec­tions. But the agree­ment could help the SEIU form re­la­tion­ships and ex­pand its more than 150,000 mem­ber­ship base, said Judy Thorp, man­ag­ing di­rec­tor of Chicago-based Huron Con­sult­ing Group. “SEIU just wanted to get a stronger foothold within the health­care in­dus­try, and es­sen­tially this could be one way to do it,” she said.

A spokes­woman from the Amer­i­can Hospi­tal As­so­ci­a­tion said she couldn’t re­call a sim­i­lar agree­ment be­tween a state hospi­tal group and a union. Whether other states and unions will fol­low the model is un­clear, as the SEIU and CHA have yet to share spe­cific de­tails on how they’ll make im­prove­ments.

The SEIU-UHW pulled back sup­port for a bal­lot mea­sure that would have re­quired not­for-profit hos­pi­tals to de­liver care worth at least 5% of their an­nual net rev­enue or lose prop­erty tax ex­emp­tions, and an­other that sought to pro­hibit all hos­pi­tals from charg­ing more than 25% of the ac­tual cost of care. The agree­ment could save the CHA as much as $58 mil­lion to $60 mil­lion, Emer­son-shea said, be­cause the as­so­ci­a­tion was pre­pared to spend that much on cam­paigns to bat­tle the two mea­sures.

About a third of state hos­pi­tals were ex­empted, in­clud­ing those op­er­ated by pub­licly funded hospi­tal dis­tricts. Emer­son-shea noted that many of the more union­ized hos­pi­tals were also ex­empt. That in­cludes Cal­i­for­nia’s two largest providers, which weren’t men­tioned by name on the ini­tia­tives: the for­mer Catholic Health­care West—san Fran­cisco-based Dig­nity Health—and Oak­land-based Kaiser Foun­da­tion Hos­pi­tals. The ini­tia­tives ex­cluded sys­tems “that are part of an in­te­grated non­profit health sys­tem or part of a safety net non­profit health sys­tem as de­fined by the mea­sure.” By the cri­te­ria of the bal­lot mea­sure, Kaiser was the only sys­tem in the state that qual­i­fied as an in­te­grated not-for-profit, and Dig­nity was the only safety net sys­tem.

John Bor­sos, sec­re­tary/trea­surer of the Na­tional Union of Health­care Work­ers, said he’s sus­pi­cious of the closer rap­port be­tween the SEIU and the CHA. The NUHW rep­re­sents about 9,000 work­ers and was formed in 2009 with for­mer SEIU-UHW lead­ers, in­clud­ing Bor­sos. He said the move rep­re­sented the SEIU-UHW sav­ing face: “I think it was just a PR stunt to be­gin with,” Bor­sos said. “There was no sup­port in the Leg­is­la­ture; it had no chance of suc­ceed­ing.” The NUHW is push­ing a bal­lot mea­sure that would limit re­tire­ment ben­e­fits for ex­ec­u­tives work­ing in health­care dis­tricts funded by tax­pay­ers, only al­low­ing those hos­pi­tals to of­fer them if they pro­vide the same ben­e­fits to all em­ploy­ees. The ini­tia­tive was mo­ti­vated by the news last year that Sali­nas (Calif.) Val­ley Me­mo­rial Health­care Sys­tem paid for­mer CEO Sam Down­ing a re­tire­ment and sev­er­ance pack­age worth $4.9 mil­lion.

Emer­son-shea said the CHA op­poses that bill, say­ing it could keep hos­pi­tals from re­cruit­ing top-notch ex­ec­u­tives.

GETTY IMAGES

The deal could help the SEIU gain mem­bers in Cal­i­for­nia, where strife be­tween the union and hos­pi­tals flared in a protest out­side San Fran­cisco Gen­eral Hospi­tal this spring.

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