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.

AFL-CIO Pledges Campaign to Stop Cuts to Medicare, Medicaid, Social Security

By John Reichard, CQ HealthBeat Editor

AFL-CIO President Richard Trumka told reporters Monday that “we will run the campaign necessary” to defeat any Medicare, Medicaid, and Social Security reductions proposed by joint deficit reduction panel. But he stopped short of saying the labor group won’t endorse members of Congress who vote for such cuts.

Trumka did say in the telephone briefing that opposition to potential cuts would be among the factors considered when it comes to making endorsements in the 2012 elections.
Trumka said he “would have a tough time envisioning us endorsing people who actually voted for major cuts to Social Security, Medicare or Medicaid. That would have a dampening effect on any candidate even if they were endorsed,” he added.

Trumka said the labor organization’s executive council would meet later Monday to flesh out the campaign against the cuts, which will involve coordinating with other left-leaning organizations.

“Today we’re asking 700,000 activists to start calling their members of Congress to oppose them,” he said. “We’ll be talking about the type of program or the type of campaign that we issue. It could be — everything from ads, leafletting at the work site, phone banking — a number of different things to let people know who stood with them and who stood against them.”

Trumka said that with the rise of the Occupy Wall Street movement, the public is closely watching lawmakers to see how they respond to the deficit panel.

“This marks the beginning of a critically important time for Congress where our elected leaders are faced with a defining choice: to stand up for the 99 percent of America or to continue the business-as-usual approach of the top 1 percent.”

Whether through added funding to repair infrastructure or aid to state governments to keep teachers and fire fighters on the job, “now is the time for decisive leadership on Capitol Hill,” he said.

“We’re deeply troubled about the possible direction” of the debt panel, he said. “Any person even loosely connected to reality can see that working people and working families have already given up too much while Wall Street and the wealthiest Americans have done all the taking. Inequality is at historic levels.

“It should be a no-brainer that we will finally ask Wall Street and the super rich to pay their fair share. Every politician should look at the occupy movement to know that working families across the nation will make their voices heard to protect core American programs and to hold Wall Street accountable for the mess that they created.”

Trumka denied that he was advocating an uneven approach to deficit reduction. A reporter suggested that was the case, given Trumka’s call for no reductions in benefits but “substantial action on the tax side,” in the reporter’s words. Trumka had suggested earlier in the call that ending the 2001 and 2003 tax cuts for high earners, taxing capital gains as ordinary income, and a surtax on the wealthy were ways to reduce the debt.

“First of all, if you’ve looked at what’s happened so far, there’s been substantial action on the middle income and low income families of this country,” he said. “They’ve already given a lot. They’ve given their homes, they’ve given their jobs, they’ve given back in wages while the rich have done as well as ever. Better than ever.”

John Reichard can be reached at jreichard@cq.com

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

AARP: New Yorkers want a health exchange

Too bad it doesn’t look like they’ll get one anytime soon.

A poll commissioned by AARP found 69 percent of older New Yorkers surveyed — that’s people between 50 and 64 — want the Senate to set up a health insurance exchange when it returns to the Capitol … sometime. The exchange is necessitated by the 2010 health care overhaul pushed by President Barack Obama; state lawmakers negotiated a bill in June, at the end of session, but the Republican-controlled Senate pulled it from the floor calendar at the last minute, citing concerns from Sen. Greg Ball, R-Putnam County.

There are rolling deadlines to get federal money for the exchanges — the next one, I believe, is 12/31 — and people like the American Cancer Society are pushing for action as early as possible. In addition to the dollars, they argue, they need time just to get things up and running.

But in a radio interview last week, Senate Majority Leader Dean Skelos said the Senate would not be back in session this year.

“These poll results offer important insight for policy makers about the preferences of New Yorkers age 50-64,” stated Lois Wagh Aronstein, AARP New York State Director. “Clearly, the establishment of a health exchange needs to be a priority for the Governor and legislature.”

Here’s the poll summary:

Final Ny Summary

Nurses Association Honors Members at 2011 State Nurses’ Convention

NIAGARA FALLS, NY, September 26, 2011 — On September 24, at its annual convention in Niagara Falls, the New York State Nurses Association honored members who have made outstanding contributions to caring for the public and the advancement of the nursing profession.

Barbara Zittel, RN, PhD, former executive secretary to the State Board for Nursing, received the association’s highest honor of Honorary Recognition. The award is given to the member who has rendered distinguished service or valuable assistance to the nursing profession. Zittel’s leadership of the State Board for Nursing helped to secure needed legislative, regulatory and administrative changes that include the establishment of the Statewide Peer Assistance for Nurses Program, protection of the title “nurse,” clarification of differentiated practice for RNs and LPNs, and a model for the educational advancement of nurses.

Susan Casadone, RNC, release-time nurse at St. John’s Riverside Hospital in Yonkers, NY, received the Economic and General Welfare Award. The award is presented to the member who promotes terms and conditions of employment and practice consistent with the responsibilities of registered nurses. Casadone helped to successfully organize the nurses of St. John’s Riverside Hospital in 1999 and as president of her local bargaining unit, continues to establish vital support networks and information for bargaining unit members.

M. Gorete Crowe, RN, ADN, staff nurse at Westchester Medical Center, received the Legislative Award. The award is presented to the member who has directly influenced the conceptualization, interpretation, mobilization of support or enhancement of significant legislation. Crowe has held numerous leadership positions within the association and is currently chair of the Council on Legislation where she is a strong advocate for nursing practice regarding violence in the workplace, mandatory overtime and safe nurse-to-patient ratios.

Dorothy Williams, RN, BA, retired nurse manager at Memorial Sloan Kettering Cancer Center in New York City, received the Membership Award. The award is presented to the member who promotes membership and active involvement of other nurses in the affairs of the association. Williams has been a member of several association committees and currently serves on the Membership Committee and as a Statewide Peer Assistance for Nurses (SPAN) group facilitator.

Irene Macyk, RN, MS, PCNS-BC, director of nursing education for Steven and Alexandra Cohen Children’s Medical Center of New York in New Hyde Park, received the Nursing Education Award. The award is presented to the member who promotes innovative educational methods, patterns or systems. Macyk, a consistent advocate of educational support and lifelong learning, was instrumental in developing a program at her facility that uses evidence-based strategies for improving patient safety during intershift handoff reports.

Victoria Arrick, RN, staff nurse at Westchester Medical Center, received the Nursing Practice Award. The award is given to the member whose work clearly reflects standards of practice enunciated by the profession. Arrick is an advocate for safe workplace environments for direct care practitioners, safe staffing for quality care, and educational advancement. As a mentor and preceptor of new nurses, Arrick emphasizes adherence to the Nurse Practice Act and the need for evidence-based practice in the workplace.

Margaret Armento-McDowell, RN, MSN, president and administrator of Bermac Home Aids in New Paltz, NY, received the Nursing Service Administration Award for creating a climate which promotes professional practice. Much of Armento-McDowell’s career in behavioral, home and public health has involved supervision and coordination of staff. She is characterized by colleagues as an innovative nurse leader and consistent advocate for patient care.

Robert J. Herzog, a dentist in Buffalo, NY, received the Statewide Peer Assistance for Nurses Award (SPAN). The award is given to the member who creates a climate that promotes opportunities for nurses to recover from alcohol/drug use, misuse and addiction. Herzog regularly offers his office space for SPAN advocate meetings and as facilitator of one of only four Caduceus Groups in the state, he extends an open invitation to nurses to join this group for recovering medical professionals.

Elizabeth Dollinger, graduate of St. John Fisher College Wegman’s School of Nursing, received the Nursing Student Leadership Award. The award is given to the student nurse whose leadership is demonstrated by participation in volunteer activities of community service or other healthcare organizations. Dollinger has spearheaded numerous volunteer opportunities at the school of nursing, including traveling to Kenya with fellow students and faculty to provide benches and equipment for a newly established clinic in that country.

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 at Brooklyn Hospital Approve Contract

Agreement avoids possibility of nurses’ strike

Brooklyn, September 14, 2011 – The resolve of the 500 registered nurses at the Brooklyn Hospital Center in demanding a fair contract has paid off. The nurses Tuesday ratified an agreement with hospital management that acknowledges the hospital’s distressed financial situation, but also provides nurses with the ability to support their families and maintain their quality of life.

The agreement ends the possibility of a strike by the nurses and was reached just days after the New York State Nurses Association, which represents the nurses at Brooklyn Hospital Center, presented the hospital with a strike notice.

The three-year contract, which runs from 9/13/11 to 9/12/14, includes a two percent across-the-board salary increase in July 2012, a $500 lump sum bonus in April 2013 and a three percent across-the-board salary increase in January 2014.

The nurses’ primary issues during negotiations were their health insurance benefits and pension. Nurses will contribute to their health insurance premiums, but in January 2014 will be upgraded into the NYSNA Benefit Fund’s top-tier plan. The contract maintains the current pension plan, freezing the nurses’ progression of seniority “steps” during the life of the contract, but granting an increase of two steps at the expiration of the contract.

“Thanks to the nurses’ willingness to stand up for themselves, we were able to negotiate a fair contract,” said Roberta Murphy, MS, RN, associate director of the New York State Nurses Association’s Economic and General Welfare program. “We are pleased to have averted the possibility of a strike and to be able to return fully to the business of caring for our patients.”

Nurses at Brooklyn Hospital Plan to Strike Sept. 19

Nurses issues 10-day strike notice to hospital Tuesday

Brooklyn, September 7, 2011 – Following another unproductive day at the negotiation table, the New York State Nurses Association, which represents the 500 registered nurses at the Brooklyn Hospital Center, Tuesday issued the required ten-day notice of a strike and announced plans to strike Sept. 19.

“For their patients and their community, the nurses regret the fact that a strike is looking increasingly unavoidable, but they will not accept a contract that downgrades their ability to support their families,” said Roberta Murphy, MS, RN, associate director of the Economic and General Welfare program of the New York State Nurses Association.

“This is not about the hospital being unable to provide a fair and reasonable contract to the nurses; they have said they are choosing other priorities. Investing in retaining experienced nurses and recruiting well qualified new ones is a priority that would provide a strong return to the hospital in terms of quality patient care,” Murphy said.

The Nurses Association remains willing to negotiate a fair contract with Brooklyn Hospital management, and negotiations are scheduled for September 8, 13, 14, and 15. Negotiations have been ongoing since the nurses’ most recent one-year contract expired in December 2010, but have been unproductive.

Hospital management is seeking concessions that cut nurses’ pension, health benefits, and take-home pay. The union is willing to work with management on a reasonable contract in light of the current economic climate, and in fact is proposing ways to provide substantial cost savings to the hospital. Hospital management, however, seems fixated on slashing the nurse’s benefits.

Management is seeking to downgrade the nurses’ pension plan, cutting benefits and removing the option for nurses to retire at 60 without penalty. They are also seeking cuts in the nurses’ health insurance benefits and overall are asking for concessions that would cost experienced nurses at least an estimated $6,180 per nurse over three years and equate to a pay cut of $1,680.

“The nurses still hope to avoid a strike, but we are absolutely resolved that we are not going to accept a contract that does not recognize the value of the critical work nurses do every day. This is a quality-of-life issue for the nurses and a serious issue for the community, which has an interest in knowing that its local hospital is committed to retaining and recruiting highly qualified nurses,” Murphy said. “We are asking the local community to stand with us by letting hospital management know that the community supports its nurses.”

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 at Brooklyn Hospital Overwhelmingly Vote to Strike

Nurses demand a contract that recognizes the value of their work

Brooklyn, September 6, 2011 – Nurses always consider striking a last resort, but in response to management contract proposals that would degrade the nurses’ quality of life, the registered nurses of the Brooklyn Hospital Center voted September 1 and 2 to authorize a strike. Members of the 500-person bargaining unit turned out overwhelmingly to let management know they would not accept an unfair and unreasonable contract that cuts their pension, health benefits and take-home pay.

“As nurses, we are absolutely committed to providing the best quality care to our patients and the community, but hospital management has taken the stance that they are not going to acknowledge the nurses’ value,” said Roberta Murphy, MS, RN, associate director of the Economic and General Welfare program of the New York State Nurses Association, which represents the registered nurses at Brooklyn Hospital.

The Nurses Association remains willing to negotiate a fair contract with Brooklyn Hospital management, and negotiations are scheduled for September 6. Negotiations have been ongoing since the nurses’ most recent one-year contract expired in December 2010. Labor law requires that the union provide at least 10-days advance notice before going out on strike.

“We are willing to go back to the table with management, but they must understand that the nurses are united and resolved to do what it takes to get a fair and reasonable contract. We are also asking the local community to stand with us and support the nurses who spend every day caring for patients,” Murphy said.

The nurses have received a brief reprieve on one of their concerns. After more than a week of not having their employer-provided health insurance coverage, the Brooklyn Hospital nurses have had that benefit reinstated retroactive to August 28 – for 30 days. Despite the fact that the hospital has a legal obligation to maintain the nurses’ benefits and working conditions while negotiations are ongoing, hospital management originally allowed the nurses health insurance to lapse.

The registered nurses at Brooklyn Hospital understand the challenges facing the hospital and have repeatedly sacrificed for the good of the hospital. In fact, the union’s current contract proposals provide substantial cost savings to the hospital.

“Management is taking advantage of concerns about the overall economic climate to advance proposals that undercut the nurses’ quality of life,” Murphy said.

Management is seeking to downgrade the nurses’ pension plan, cutting benefits and removing the option for nurses to retire at 60 without penalty. They are also seeking cuts in the nurses’ health insurance benefits and overall are asking for concessions that would cost experienced nurses at least an estimated $6,180 per nurse over three years and equate to a pay cut of $1,680.

“A proposal like this won’t allow Brooklyn Hospital to recruit and retain experienced, professional nurses. It’s bad for the nurses, bad for the hospital and bad for the community,” Murphy said.

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.

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:

The Hidden Taxpayer
Posted on August 31, 2011 by MVP Health Care

Nationally, as I’ve said, there’s a fair chance that cuts will be made to Medicaid and Medicare providers as part of deficit reduction. And since costs will continue to rise, those cuts will force providers to charge commercial insurers more to make up the difference, ultimately shifting the financial burden to the average taxpayer in the form of higher health insurance premiums.

In other words, a hidden tax.

That’s what’s happening in New Hampshire right now. Actually, there’s a clearly stated tax in New Hampshire-hospitals have to pay the state 5.5 percent of net patient revenue as a Medicaid Enhancement Tax-the hidden part is the way the tax now gets passed on to commercial insurers and their subscribers.

Let me explain. That tax has been there for years, since the early nineties. It was a funding tacticNew Hampshirewas using with the federal government: the state taxed the hospitals, the feds provided the state matching Medicaid funds for the state taxes paid by the hospitals, and then the state gave the taxes back to the hospitals and kept the Medicaid matching funds. Whew, sounds a little complicated.

At some point the federal government called a halt to all of this but hospitals still more or less got back in Medicaid reimbursement what they paid the state in taxes. Until now: the New Hampshirebudget for 2012-13 prevents the state from giving the state hospital tax back to the hospitals. New Hampshireis now keeping both the state hospital taxes and the Medicaid matching funds. Which means at least some of that hospital tax money is going into the general fund.

This may keep New Hampshire from having to raise taxes in other areas (as the Speaker of the House has stated), but it doesn’t keep New Hampshire citizens from having to pay more. When the state doesn’t reimburse hospitals for the tax (which was never even meant to be a real tax-just a mechanism for drawing federal funds), the hospitals are left with a significant deficit. They have to make up for that deficit in other ways-like increasing the amount paid by individuals who have commercial health coverage.

Health care costs go up for those who are privately insured, while the states tax receipts increase. Put another way, the privately insured now pay the hospital tax.

In this case, it’s not the tax that’s hidden-just who pays it.

To visit the Health Care Perspectives blog, click here: http://mvponhealthcare.wordpress.com/

A Summary Analysis of HHS’ 244-Page Exchange Rule Proposal

The Department of Health and Human Services released a 244-page proposed rule for the establishment of exchanges and the qualification of health plans to participate in these exchanges. The regulations can be found here. Below are some highlights of the major issues covered.

Click this link for the full report: PLANS