Nurses at Mt. Sinai and Montefiore vote to strike

Vote sets the stage for a possible strike by 7,000 NYC nurses

MANHATTAN & BRONX, Dec. 9, 2011 – Registered nurses at Montefiore Medical Center and Mt. Sinai Medical Center have voted to authorize a strike if hospital management does not settle contracts that provide the best possible patient care, affordable health care for nurses and their families, and decent wages. The nurses at Montefiore and Mt. Sinai now join their colleagues at St. Luke’s-Roosevelt Hospital Center, who voted last month to authorize a strike.

The 7,000 registered nurses at the three hospitals, members of the New York State Nurses Association, are working together to win fair contracts at a time when hospital management at some of the city’s most prestigious and most profitable hospitals are using the difficult economic climate as an excuse not to reasonably compensate nurses for their extraordinary, daily contributions to the well-being of their patients and to the success of the hospital.

“Many New York nurses are working with long-expired contracts. A strike is our last resort,” said Judy Sheridan-Gonzalez, bargaining unit president of Montefiore’s Moses division.

“In 2010, 5 NYC hospital CEOs made almost $18 million!” Sheridan-Gonzalez said, quoting numbers from a Nov. 27, 2011 New York Post article. “We are demanding that we be able to protect our patients with safe staffing ratios. We are also standing up to the corporate agenda that has been squeezing workers across the country to pay more for benefits in order to fix years of their own mismanagement.”

Nurses have been at the negotiating table for months with the three hospitals and management has consistently refused to adequately address the nurses’ concerns about affordable health care premiums, reasonable wages and patient care issues.

The nurses at New York-Presbyterian Hospital had also authorized a strike in late October, but have now reached a tentative agreement that addresses key staffing concerns and would not increase the nurses’ health insurance benefit costs. A ratification vote for the proposed contract is underway.

“The nurses at Mt. Sinai stand together with our colleagues at St. Luke’s-Roosevelt, Presbyterian and Montefiore,” said Jacklynn Price, bargaining unit president at Mt. Sinai. “Our members give patients excellent care, and they need and deserve quality health benefits for themselves and their families, just as we provide care for all of our patients.”
In addition to preparing for a possible strike, the Nurses Association has launched a new 60-second radio ad on several New York-area stations, in which Karine Raymond, a working nurse from Montefiore, seeks support for the middle-class nurses in their contract fight against the millionaire hospital executives.

The nurses will decide in coming days when they will begin the strike notification process with hospital management.

The New York State Nurses Association is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest professional association and union for registered nurses. The association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, research, legislative advocacy, and collective bargaining.

Nurses Association contact: Robin Wood (518) 782-9400, ext. 223

Retirees Sue State over Health Insurance Increases

The Retired Public Employees association group representing about 40,000 retired public employees today Thursday filed suit against Gov. Andrew Cuomo’s increased health insurance for the state workforce — which also applies to retirees.

“He didn’t have the right to do this to current retirees,” contended Stan Winter, president of the Retired Public Employees Association. He was referring to the increased share that state retirees, along with current workers, are now paying toward their health insurance premium.

Read the entire article: Health Insurance

Statement of PEF President Ken Brynien on tax rate reform

Albany – We applaud the Governor’s and Legislature’s effort to address the growing income inequality in New York. The agreement announced today on tax reform is a step in the right direction but unfortunately falls short in obtaining the goal of a fair tax system.

The agreement would give millionaires the largest tax cut at more than 2 percent while the middle class would get the smallest tax cut at less than half a percent.

Tax rate reform should include tax cuts for the middle class, but we support higher tax rates for New York’s wealthiest as proposed in the “Tax the 1 percent” plan developed by the Fiscal Policy Institute. This plan would raise the tax rate for the wealthiest New Yorkers and generate between $4.4 billion and $5.1 billion in annual revenue.

We are urging lawmakers to adopt a true tax reform plan that addresses the basic unfairness in our tax system while raising the necessary revenue needed to provide important services including health care, education, environmental, mental health and human services as well as necessary infrastructure improvements.

PEF is the state’s second-largest state-employee union representing 55,000 professional, scientific and technical (PS&T) employees and other public and private employees.

Nurses take to the airwaves with ads about contract fight

Montefiore, Mt. Sinai and St. Luke’s-Roosevelt nurses join in solidarity radio ad

New York City, Dec.2, 2011 – Thousands of New York’s nurses from some of the city’s biggest and most profitable hospitals are angry at the lack of action from management at their institutions in contract bargaining – and are taking their case to the radio airwaves.

A new 60-second ad is set to run beginning on Monday, Dec.5 on several New York-area stations. It takes Montefiore, Mt. Sinai and St.Luke’s-Roosevelt executives to task for their lack of concern about safe staffing for their patients and affordable health care for the nurses, who are the backbone of the city’s hospitals.

The ad is voiced by Karine Raymond, a working nurse from Montefiore, and professional producer Dani Suzanne Smith.

The ad is part of a coordinated contract campaign by the state Nurses Association to win fair contracts that provide the best possible patient care, affordable health care for nurses and their families, and decent wages.

Nurses at St. Luke’s-Roosevelt have already authorized a strike if no progress halts in their talks; Montefiore and Mt. Sinai will complete strike votes this weekend.

The text of the ad follows:

“NYC is famous for its great hospitals.

But these hospitals can’t function without their thousands of registered nurses – like me, Karine Raymond from Montefiore.

Our employer refuses to increase the number of nurses at the bedside, compromising our ability to give you the care we believe you deserve.

Sadly for patients, hospital executives are acting disgracefully in talks with nurses, even those hospitals are successful and profitable.

It’s shameful that hospitals like mine want to slash our health care coverage, making quality care less affordable for front-line nurses.

But we are standing up for decent benefits for our families, just like we stand up for you, our patients.

Please support me and my co-workers as we defend patients’ rights as well as our own.

This message is brought to you by the registered nurses of Montefiore, Mt. Sinai, St. Luke’s-Roosevelt and the rest of the 37,000 members of the New York State Nurses Association…Please stand with us in our fight for fairness and health care.”

Contact: Mark Genovese 518-782-9400, ext. 353

Insurance Premium Transparency is Good; Next Stop: Provider Transparency

MVP Health Care CEO Dave Oliker shares his thoughts on a wide range of topics related to health care and health reform on his blog. Dave’s posts reflect his unique perspective based on his more than 30 years of experience in the health care industry.

Here’s his latest post:

Determining health insurance premiums every year is a complicated business. A health plan has to look at what services its covered population used this year, see how close it came to predicting that correctly, try to determine how the population will change, then project how much that population will use next year, and how much that is likely to cost.

And that’s the oversimplified version. There are people who are very good at math—actuaries—who do this job. Then, when the health plan files its premium rates with the state, government actuaries analyze and certify the data.

Starting this year, New York’s Department of Financial Services wants to make all that data and all the calculations for every health plan available to the public. I say, good. Transparency is almost always in the public’s interest.

Of course, the public isn’t composed entirely of actuaries. They may not be able to make sense of the numbers they see. Or they may not care to. Or they may be tempted to take a figure out of context to prove a point.

But that’s the risk we take any time we make information freely available. I’m confident that those who look closely at the data will find something significant there, something they might not have just taken my word for: the fact that rapidly increasing health care costs generally drive increased premiums.

It’s true that sometimes, as I explained in an earlier post, a big increase can come from a change in the coverage pool. If the covered population changes drastically, the change in its health care usage—and therefore its premiums—can be drastic too.

But if health care usage stays the same and premiums go up anyway, the culprit is obvious: rising health care costs. That’s what the data show. And once people understand that, they might even want to see the math behind those costs. Why do hospitals (and doctors and pharmaceutical companies and so on) charge what they charge?

If insurance premium transparency is a public good, shouldn’t we have provider transparency too?

Bid to Alter Pension Plans Is Criticized

by Steven Greenhouse

Two of New York City’s top labor leaders voiced anger on Tuesday about the agreement by Mayor Michael R. Bloomberg and Comptroller John C. Liu to overhaul the city’s pension plans.

Those union leaders — the presidents of Transport Workers Union Local 100 and Teamsters Local 237 — complained that the mayor’s and comptroller’s offices did not brief them about the proposed overhaul before it was announced two weeks ago, even though the union leaders are trustees on the city’s largest pension plan.

“I don’t know anything about the plan,” said John Samuelsen, the transit workers’ leader.

In a letter dated Monday, Mr. Samuelsen and Greg Floyd, president of Teamsters Local 237, which represents many housing authority workers, joined Bill de Blasio, the public advocate, and presidents of all the boroughs except Staten Island in asking questions about the overhaul. The union leaders’ criticism could make it harder for Mr. Bloomberg and Mr. Liu to persuade Albany to enact legislation needed for the overhaul. Mr. de Blasio and Scott M. Stringer, the Manhattan borough president, are potential mayoral candidates who may oppose Mr. Liu in the race.

Under the overhaul, the city would merge its pension plans’ five boards, which have 58 trustees, into one with about a dozen trustees that would oversee the plans’ combined $120 billion in investments. The plans cover 237,000 retirees and more than 300,000 current city and city-affiliated employees.

The mayor and the comptroller said their plan would most likely yield higher investment returns by minimizing political interference in the pension system and by naming a full-time investment manager. In their letter, the officials asked Mr. Liu to make a presentation at the next pension trustees’ meeting explaining the new board’s structure, the new trustees’ qualifications and how they would be chosen.

They also asked Mr. Liu to explain how the new plan would achieve the comptroller’s hopes of increasing annual investment returns by one or two percentage points, yielding $1.2 billion to $2.4 billion more a year and helping to hold down the city’s budget deficit.

Mr. Floyd said that a majority of the board members of the city’s main pension fund, the New York City Employment Retirement System, were also not briefed before the announcement, and he objected to the proposal to have an unelected person become the fiduciary custodian for the system, replacing the comptroller.

When the plan was announced, the mayor, several union presidents and numerous pension experts praised Mr. Liu for ceding much of his office’s power over pensions to an outside manager.

Michael Loughran, a spokesman for Mr. Liu, said, “The proposal will benefit pensioners and taxpayers alike by transforming an outdated system into a best-in-class investment vehicle.”

Mr. Samuelsen said he feared being squeezed off the new board. “Most important is the fear that we’re going to give large decision-making powers to Wall Street folks, the very people who have made horrific decisions with money over the last decade,” he said.

Analysis: Honeymoon over? Gov. Cuomo faces critics

by MICHAEL GORMLEY, Associated Press

ALBANY, N.Y. (AP) — Gov. Andrew Cuomo is still riding high in polls and may continue to be invincible, but he’s no longer invulnerable.

After more than a half-year’s honeymoon, some critics who were too enamored — or too scared — of the Democrat are beginning to speak out. Cuomo spent his first six months masterfully managing politics in a string of policy wins from cutting the state budget to legalizing gay marriage. Powerful teacher and health care unions let him lead funding cuts to schools and hospitals. Public sector unions watched him threaten layoffs and were forced to accept contract concessions.

But along the way, he has baffled and, ultimately, riled his liberal base.

Now Democrats have to grapple with their progressive leader who tried to evict the Occupy Wall Street demonstrators in Albany. Protesters camping in “Cuomoville” dubbed him “Gov. 1 Percent” for refusing to extend a tax on people making more than $200,000 per year, and catering to the richest minority, which includes his biggest campaign donors.

“We demand that you get your priorities straight,” said Jackie Hayes, 29, of Binghamton, a student at the University at Albany in a brief rally inside the Capitol. “It is a political platform that only serves your ambitions.”

As a result, Cuomo hasn’t spent much time in Albany since the contingent set up camp across from the Capitol. That’s helped him avoid any uncomfortable photos.

Cuomo also was rebuffed by another Democrat. Albany Mayor Jerry Jennings, despite his usually cozy relationships with governors, refused to push protesters out of the city park, even under pressure from Cuomo’s top aides.

“The state’s position is we have to enforce the curfews if we are going to operate the (state) complex,” Cuomo said.

But the little-visited park isn’t used for state activities and other protests usually bypass it for more visible spots at the Capitol’s main entrances. In the park, protesters have cooperated fully with state police, quieted their chants inside the Capitol and even raked leaves as they railed against a government-corporate alliance they say is making the richest 1 percent even richer at the expense of the other 99 percent.

Cuomo’s opposition to extending the state’s so-called “millionaire’s tax,” which he said would drive the rich to neighboring, lower tax states, has made him a rare target among Democrats nationwide, many of whom publicly support the tax.

“The governor has made a historic mistake,” said Bill Samuels, an upstate CEO who founded the progressive organization called the New Roosevelts that seeks to nurture a new generation of reformers in New York. He said Cuomo was wrong to oppose the millionaire tax because CEOs are more concerned with the quality of life, schools and infrastructure when locating businesses, all of which the tax could help fund.

But Cuomo, like his father Mario Cuomo before him, notes he is governing in hard times. The state faces a projected 2012-13 deficit of more than $2 billion.

From 1989 to 1992, boom turned to bust for the Mario Cuomo administration and he went from cutting the top personal income tax rates to hiking taxes, which critics said worsened New York’s decline and led to his defeat. In 1994, Republican Gov. George Pataki immediately started cutting taxes and spending. He served for three terms.

“I once used the line that I’m progressive, but I’m broke,” said Gov. Andrew Cuomo, paraphrasing President Clinton’s line that he’s a “bleeding-heart cheapskate.”

“We have programs and policies that are seeking to advance this state, are advancing the state,” Cuomo said.

“I have to govern in this situation with these facts,” he said. “And I have to represent the people the best way I can with these facts and these facts are we that are in the middle of an economic recession, it is nationwide, the state has a multibillion deficit, and how are you a progressive leader in that context.

“I could argue this is probably a greater test of leadership. How do you make it work in this moment?”

Although opposition is growing, it’s common when a governor changes the status quo. And it’s still just a “nascent revolt” with the public and Legislature still on his side, said Robert Ward of the Rockefeller Institute of Government.

“There’s a function of time, you always get a honeymoon,” said David Grandeau, the state’s former lobbying enforcer praised by good-government groups as Albany’s most effective watchdog in decades.

“He is probably feared more than he’s loved,” said Grandeau, offering that Cuomo is “the best leader New York has had in a generation.”

“Fear is a better motivator, but the fear thing only works as long as someone’s head is on a pike outside city hall,” Grandeau said. “If you combine those two things — time and the bark sometimes is worse than the bite — you are going to find people coming forward.”

Cuomo faced criticism this year after flooding. He promised flood-ravaged towns would be rebuilt better than they were before, but private insurance handled little of the flooding damage and federal assistance was delayed. Weary residents took it out on the governor.

On Tuesday, Cuomo allowed: “I’m not happy with the results.” He reiterated that flood recovery is primarily a federal responsibility.

Cuomo’s immediate opposition is Occupy Albany, a coalition of unions and those seeking the millionaire’s tax to avoid further cuts to schools, hospitals and public services.

“Are we surprised he’s taken such a hard line on this particular issue? Absolutely,” said Ron Deutsch, a longtime Albany lobbyist working for New Yorkers for Fiscal Fairness, a broad labor and school coalition. “I’m not sure he really believes all the rhetoric himself.”

But Deutsch said the push for a millionaire’s tax is gaining traction just as the legislative session approaches and lawmakers prepare to go back to voters to campaign during the 2012 election year.

“You are seeing legislators more emboldened than before because of all the support and because of the Occupy movement,” Deutsch said.

Not least of whom is the powerful and cagey Assembly speaker, Democrat Sheldon Silver.
“The public is clearly with us,” Silver said Tuesday. “I think we and the public can win that discussion.” Then he said of Cuomo, “I didn’t say he wouldn’t change his mind.”

PEF Executive Board approves sending revised tentative contract to membership

Albany – The Executive Board of the New York State Public Employees Federation (PEF) today voted to send a revised contract agreement with the state to the full union membership for ratification.

The board is made up of 137 union leaders representing PEF members from every state agency. Ballots for ratification will be mailed immediately to union members. Votes must be returned by Thursday, November 3 for counting that day by the American Arbitration Association in Manhattan.

“The Executive Board recognizes the changes we were able to obtain under the revised agreement address many of the concerns of our members,” said PEF President Ken Brynien.

“Today’s vote gives hope to the 3,496 members who face losing their jobs if the contract is not approved. The revised agreement balances the needs of all of our members and I am strongly encouraging our membership to ratify the new agreement to save the jobs of their co-workers while preserving the level of service to taxpayers,” Brynien said.

The revised agreement is a four-year contract that includes reimbursement for the nine furlough days, payable at the end of the agreement. Additionally, since the deficit-reduction leave would now be a wage deferral, there is no effect on final average salary for purposes of retirement. The agreement also includes changes to the productivity enhancement programthat would allow members greater opportunity to use vacation time to offset health insurance costs.

The agreement calls for no salary increases for years 2011, 2012 and 2013. A salary increase of 2 percent is included for 2014. The lump-sum payment included in the earlier tentative agreement would be exchanged to reimburse furlough days.

Downloads:

Tentative Agreement
Heads of Agreement with the State
Side by side comparison of the July and October tentative agreements

St. Luke’s-Roosevelt nurses take strike vote this week

Manhattan, Nov. 1, 2011 — Registered nurses at Manhattan’s St. Luke’s-Roosevelt Hospital will vote from Tuesday, Nov. 1 – Friday, Nov. 4 to decide if they will strike the hospital in the coming months.

The 1,367 nurses, members of the New York State Nurses Association, have been at the table with hospital management for months – but have been unable to reach a settlement, due to the hospital’s refusal to move on issues important to the nurses and their families.

Two major issues separating the parties are management’s desire to raise employee premiums for health benefits, up to $100 a month, and also a pay offer that does not keep up with metropolitan area costs.

“The hospital says it cares about nurses and their families, but their stance in bargaining shows the opposite attitude,” said Elaine Charpentier, the NYSNA negotiator. “These key issues affect all our nurses, as health care and salaries are worries for all New Yorkers.”

The association has proposed reasonable financial packages that address the hospital’s concerns, but management has rejected them. In addition, the hospital has not addressed the association’s concerns about staffing, safe patient handling and workplace violence.

“We hope when we return to the table that management will offer a proposal that doesn’t hurt nurses and their families,” said Charpentier. “We are committed to quality care for our patients and community, by having a hospital whose working conditions can help recruit and retain the best nurses possible.”

St. Luke’s-Roosevelt nurses are the second NYSNA bargaining unit in Manhattan to cast a strike vote within the past two weeks over unreasonable management contract demands. New York-Presbyterian nurses voted last week to authorize a strike.

NYSNA is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest union and professional association for registered nurses. The Association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, legislative advocacy and collective bargaining.

The Future of the 340B Drug Pricing Program: Challenges and Opportunities

by Jeffrey R. Lewis

former President of PS2 Health Care and now

serves as the Chief Operating Officer of EHIMRx

Executive Summary

Since 1992, numerous “safety-net” health care providers have enjoyed the opportunity, guaranteed under federal law, to purchase outpatient pharmaceuticals at a significant discount from a manufacturer’s market price. This program, usually referred to in shorthand as ‘‘the Section 340B program” or “340B,” referring to the statutory provision under which it is established,1 has grown significantly over the years, not withstanding resistance from some quarters of the pharmaceutical industry. The availability of 340B drugs, in many cases, makes the difference between a safety-net provider being able to offer an effective pharmaceutical program to its patients (with the attendant benefits of monitoring compliance with drug regimens and avoiding potentially harmful drug interactions) and its patients having no access at all to affordable drugs. However, decreasing reimbursement, market forces, and the changes and uncertainties in federal health care reform and the federal administration of the program will present challenges, and likely opportunities, for providers participating in the 340B program.

Read the entire paper: 340B Drug Pricing