97% voted for the Bridge Agreement

On Thursday Community General employees ratified the Bridge Agreement, as negotiated by 1199SEIU and hospital management.

The Bridge Agreement was supported by 97% of the voters.

Ratification of the new collective bargaining agreement is a notable accomplishment that helps set the stage for Community's employees making the transition to Upstate University Hospital at Community General.

Collective bargaining began on February 11 and continued through the last week of April. There were 12 bargaining sessions, in all. Community's labor agreement expired April 30, and a tentative agreement was reached on May 13.

My sincere thanks to all members of the labor bargaining team who helped reach the agreement, and congratulations to Community's management team for its concerted efforts over the many weeks of discussion.

Onward!

Widespread support

This week we saw an example of union dues at work. 1199SEIU sent over-sized postcards to thousands of Central New York residents, objecting to the "ill-conceived takeover of Community General" by SUNY Upstate Medical University.

Residents are asked to call State Senator John DeFrancisco and Assembly Member Bill Magnarelli. Presumably, they are expected to affirm SEIU's position that Community General Hospital's combination with Upstate is "rushed" and "badly-flawed."

Actually, the combination has been very carefully planned. Upstate has gone to great lengths to assure that vital patient services remain at Community General's campus, and it is taking steps to broaden and deepen patient care here.

Upstate intends to employ most of Community's workforce, and it has made special efforts to transition Community General's employees. The State Legislature even passed a special law allowing Community's employees the option of remaining in Community's pension plan after they join Upstate.

Some people who got the post card told me they called the legislators' offices but with a message the opposite of what SEIU intended. "I support the Upstate plan," one of them told me this week in the cafeteria, "and that's what I told them."

SEIU's post cards do not state the real reason for its opposition. The real reason is that most Community General employees would become public employees. That means they would join the public unions, and SEIU would lose the membership.

SEIU stands pretty much alone in its opposition. The Upstate-Community plan has widespread support.

Elected officials have already endorsed the plan in letters to the Department of Health:

State Senator John DeFrancisco: "I write you in full support of Community General Hospital’s application. . . . (as) essential for continued available services, and assuring uninterrupted employment . . . and providing high levels of care to patients.” (February 22, 2011)

State Senator Dave Valesky: “I believe the merger of the two entities is critical for the continuation of quality health care in Central New York and will benefit the entire region.” (March 21, 2011)

Assembly Member Bill Magnarelli
It is my belief that Upstate Medical University’s acquisition of Community General Hospital is the most reasonable approach . . .and is in the best interest of the community-at-large.” (May 5, 2011)

A number of community health planning organizations have also endorsed the Community-Upstate plan. They are:

▪ Hospital Executive Council
▪ Crouse Hospital/ University Hospital Affiliation Council
▪ Community Health Information Planning Service,and
▪ Central New York Health Systems Agency.

Why 1199SEIU is worried

A recent letter writer to the Post-Standard suggested that Community General’s plans with Upstate University Hospital are somehow part of an “attack” on workers’ rights.

The writer said: “At a time when the rights of workers are under attack, it is important for people concerned with social justice to speak out when management and policy makers display insensitivity to process for the resolution of labor concerns. Such appears to be the case in the plans for the acquisition of Community General Hospital by Upstate Medical University.”

But the letter writer misunderstood what is happening at Community General. When Community becomes part of Upstate University Hospital, employees will continue to be represented by unions.

This is not a question of union vs. non-union. It is simply an issue of how Upstate structures its operations in a way that maximizes community benefit, fosters its mission, and preserves the most jobs for Community employees.

This week 1199SEIU held a rally in downtown Syracuse at which critical comments were made about Upstate for its approach in working to preserve the employment of Community workers. I would think that’s exactly what a union should be working for. But 1199SEIU cannot guarantee anyone's future without a job.

It is Upstate that offers Community workers continued jobs at the Community campus as part of the larger health care system.

To understand what’s behind 1199SEIU’s concerns, look at what’s happening.

In 2009 A.L. Lee Memorial Hospital (with over 200 employees) closed in nearby Fulton, NY. 1199 had a labor contract with Lee Memorial. The former hospital is now an urgent care center operated by Oswego Hospital.

This year Community General (with 1,100 employees) will become part of SUNY Upstate Medical University. 1199 represents about 800 of Community’s workers.

In our region at least two other hospitals with 1199 labor contracts also contemplating mergers with larger hospitals.

No wonder 1199SEIU is worried.

When I was asked about the rally and some of the statements made by 1199SEIU, I told reporter Jim Mulder: “As a business, 1199 is understandably worried about maintaining its client base.”

Jim's news report on the rally was published yesterday.

You read it here first

Yesterday I made the case for Community joining Upstate at an evening meeting of the Board of the Central New York Health Systems Agency (HSA). The HSA is a health planning agency for the region.

The HSA heard from Community and from Dr. John McCabe, Upstate University Hospital's CEO, as well as from the public. Among those speaking were members of Community's Board of Directors, employees from Community, and officials from 1199SEIU.

You can view the PowerPoint presentations from Dr. McCabe and me by going to the combined Community-Upstate website.

Also addressing the meeting was Ron Lagoe, Executive Director of the Hospital Executive Council (HEC). For almost 30 years the HEC has been the cooperative arm of the four Syracuse hospitals, working together to improve the health care system. The HEC members are Community General Hospital, Crouse Hospital, St. Joseph's Hospital Health Center, and Upstate University Hospital. Last evening the HEC said "the acquisition of Community General Hospital by University Hospital is consistent with the Hospital Executive Council objectives of improving efficiency and outcomes for regional health services..."

Following the public discussion, the HSA Board of Directors voted unanimously in support of a resolution that supports "the process and development of the proposed affiliation and acquisition of Community General Hospital by Upstate Medical University." The resolution is predicated on continuing services at Community's campus, enhancing the role and mission of Upstate, integrating private practice and teaching responsibilities, considering the suggestions of the public, and continuing to engage the HSA.

Last evening's public discussion was covered by the Post-Standard, YNN, WSYR, and CNY Central, but the news media left before the HSA Board voted -- so you read about it here first.

Earlier this week, I participated in a half-hour discussion about the CGH-Upstate combination with George Kilpatrick, along with Dr. David Duggan, Upstate's Chief Medical Officer. You can see that discussion on WCNY's Central Issues.

More discussion on SEIU

Paul Levy referenced my recent post about the SEIU corporate campaign in his blog, Running a Hospital. Paul is the CEO of Beth Israel Deaconess Medical Center.

Paul's posting elicited some lively follow-up comments, including one that seemed to compare picketing my house to put pressure on contract negotiations at a nursing home with the civil rights protests of the 1960's! Another comment on Paul's blog said, "The hubris is takes to compare any modern day union...to civil rights workers...is staggering." After reading the comments on Paul's blog, I added my own:

Captains-of-industry imagery and class-stereotypes are powerful tools for motivating and for bullying, and the SEIU is masterful at using these tools. Employing the signs and symbols of civil protest, however, does not automatically confer legitimacy on one’s point-of-view or actions.

The SEIU is an organization, like any other. It has no special status as somehow “more moral” or “more politically legitimate.” Because it alleges something does not make it true.

In the days since the SEIU picketed at my home, numerous SEIU members have told me they disapproved of the activity. Some have apologized. They have usually done so after briefly looking over a shoulder so as not to be overhead.

One local labor leader called me last weekend to express personal support and to take issue with the SEIU’s tactics. Significantly, this leader said he was not comfortable expressing such an opinion publicly.

To read Paul's post and the comments it prompted, go to Corporate Campaign in Upstate New York. See also the comments on my initial post, as well.

SEIU's corporate campaign

Yesterday members of SEIU 1199 picketed my home. Interestingly, the picketing was not intended to influence me at Community General Hospital, where I am CEO. Instead, SEIU seeks to use me to pressure one of Community’s employees who serves on the Board of Iroquois Nursing Home. I have declined to apply the pressure.

Earlier this year SEIU conducted an organizing campaign at Iroquois. Having won its election on March 7, 2008, SEIU is negotiating its first contract – a process that is not apparently proceeding to its liking, judging by the calls and personal visits I have received from Al Davidoff, SEIU Vice President.

SEIU has made Iroquois the object of a “corporate campaign” intended to pressure, to intimidate, and to publicly embarrass the organization. As a tactic, corporate campaigns have been used by SEIU with organizations across the country, including such notables as Beth Israel Deaconess Medical Center, Sutter Health Care, and even the California Nurses Association. Anyone interested in learning more about this tactic need only search the Internet for “SEIU corporate campaign” and read the links that appear.

Corporate campaigns employ the methods of community organizing, political action, and public relations, such as letter writing, telephone calls, picketing, and publicity. SEIU corporate campaigns target elected officials, as well as candidates for office, and they involve outside organizations in an effort to bring additional pressure on the Board and management of a target organization – in this case, Iroquois Nursing Home.

Along with St. Joseph’s Hospital Health Center and Crouse Hospital, Community General Hospital shares the responsibility to appoint Board members to Iroquois. We three hospitals established Iroquois to meet a community need some 15 years ago, under the auspices of Plaza Corporation, Inc. Plaza is the sole member of Iroquois Nursing Home and Rosewood Heights Nursing Home. Plaza's two nursing homes are independent, not-for-profit corporations, separately licensed by New York State, each with its own Board of Directors.

As the three members of Plaza, Crouse, St. Joseph’s, and Community have the responsibility to appoint qualified community representatives to the boards of both Iroquois and Rosewood. Community’s appointees to Iroquois have served as Directors there from four to 15 years each.

Board members have the legal responsibility for nursing home governance. They are fiduciaries – that means, the Directors have legal responsibilities to the residents of the nursing home and to the communities served by the nursing homes.

About a year ago, the Iroquois Board elected one of the Community-appointed Directors as it chairperson. SEIU thinks that makes Community responsible for decisions made by the Iroquois Board. Mr. Davidoff has asked me to intervene with the Community employee serving as Board chairperson. The intention is to bring pressure from Community General Hospital's management upon a hospital employee who has fiduciary responsibilities at Iroquois.

I have explained to Mr. Davidoff – as I did to his predecessor, Marshal Blake – that Community sees Board membership at Iroquois as a community service, not as a puppet of Community’s administration.

Mr. Davidoff has informed me that SEIU would seek to generate unfavorable publicity for Community General Hospital, unless I make an effort to interfere with the Board of an independent, not-for-profit facility. That apparently is the price one pays for doing the right thing in the face of an SEIU corporate campaign.

Special memories

Today the census in Community General’s licensed nursing home is in the single digits. Our census was 48 just 90 days ago when New York State announced it would provide the funding to help Community comply with the Berger Commission.

With the funding, Community and Van Duyn Home and Hospital were able to go forward with plans to downsize our combined nursing home capacity. On November 5 I announced specific dates for the closure of Community’s 50 nursing home beds. Our census had already started to fall – it was 41. By December 15, when we formally reported the 30-day closure plan, the census was 13. Today we have just seven residents.

Community has cooperated with the Berger Commission decisions, both in negotiations with New York State and with Onondaga County, Van Duyn's owner. I have written much about the Berger Commission and its impact on Community and Van Duyn in previous posts.[1]

The Berger Commission has attracted nationally attention, and the current issue of Modern Healthcare, reports:

One year after becoming law, New York’s landmark experiment in mandated hospital closures, mergers, and restructuring is proceeding as planned. In fact the majority of affected hospitals and nursing homes are meeting or exceeding the June 30, 2008 deadline, according to state Health Commissioner Richard Daines.

With Van Duyn, Community's mandate is to downsize nursing home beds and to coordinate medical planning. In association with Onondaga County we have responded directly.

1. Community has transferred residents from our sixth floor nursing home to Van Duyn and to other area residential health care facilities. This has been done gradually and smoothly with respect for patients and their families. There has been no negative impact on the area's nursing homes which collectively operate at about 97% occupancy. In addition to the closure of Community's 50 nursing home beds, Van Duyn plans to decertify another 13 beds next year.

2. This week Community and Onondaga County signed an agreement to form a joint planning company that will oversee and coordinate planning on the Community-Van Duyn shared medical campus. This agreement was reported last evening on WTVH-TV in Syracuse with speculation as to what such coordinated planning might mean. There are no specific plans for shared “food, laundry or and nursing facilities,” as reported. But the joint planning company, when it becomes operational next year, will look to improve clinical specialization and coordination and will seek opportunities for cost savings and medical campus development.

3. Finally, New York State has committed some $12.8 million to Community and Van Duyn. These funds will be used for capital improvements in Community’s medical-surgical areas and in Van Dun’s long term care service areas, as recommended by the Berger Commission. They will also help the to-be-formed joint company begin its coordinated planning process.

Despite this good news, the fact remains that 48 residents have been (and are being) relocated from Community to other facilities. In addition, some 60 full-time and part-time employees will no longer have jobs on Community’s sixth floor.

The loss of jobs has been (and is) a source of concern and upset within the hospital, as evidenced by SEIU1199's requests for the hospital to maintain these positions, despite the loss of work. Unfortunately, Community cannot afford to do this, as I explained in a letter to the labor union's officers on December 3.

Special thanks are due to our sixth floor management and employees for the professional and sensitive ways they have worked with residents during this disruptive and sometimes heart-wrenching process.

Two weeks ago, sixth floor residents received holiday tree ornaments as mementos of the time they have lived at Community. Employees visited former residents who are now at other nursing homes to give them the ornaments. It was a sensitive gesture, illustrative of the care and purpose with which employees (who are themselves affected by the sixth floor closure) have addressed the transition with residents.

Congratulations to Maureen Cerniglia, Community’s Director of Continuing Care and licensed nursing home administrator. After closure, she will become the licensed nursing home administrator at Van Duyn under the administration of County Executive-elect Joanie Mahoney.

Special thanks, also, to Joseph T. Barry, MD. Dr. Barry was recently honored as a member of the medical staff with the STAR award for his demonstration of “star” qualities (sensitivity, thoughtfulness appreciation respect). He has served as our sixth floor medical director for 19 years.


[1] “A positive side to Berger compliance,” November 9, 2007; “When our sixth floor will close,” November 5, 2007; “State funds will help compliance with Berger Commission,” October 2, 2007; “No secrets,” August 12, 2007; “Today's news about the Berger Commission,” August 14, 2007; “What's up with the Berger Commission,” July 28, 2007; “Q&A on CGH and Van Duyn,” January 20, 2007; “What the Berger Commission said,” December 2, 2006; and “My testimony before the Senate Health Committee,” December 1, 2006.

State funds will help compliance with Berger Commission

This morning’s Post Standard reports the allocation of $12.8 million of New York State HEAL NY funds for Community General Hospital and Van Duyn Home and Hospital. These funds will be used to comply with the requirements of the Berger Commission. I’ve written before about the Berger Commission.

The funds are necessary because the Berger Commission requires the affiliation of CGH and Van Duyn. These changes are part of a larger state plan affecting 74 institutions – the closure of nine hospitals and seven nursing homes, plus changes in the affiliations or bed configurations of another 48 hospitals and 14 nursing homes.

The state’s decision to fund changes at CGH and Van Duyn comes after many months of dialogue between CGH and Onondaga County, the operator of Van Duyn. County Executive Nick Pirro and his staff fought diligently for the affiliation scenario called “A,” under which the County would continue to own and operate Van Duyn. Scenario “B” would have involved the more complex and more costly process of transferring the ownership of Van Duyn to CGH. Both Onondaga County and the Civil Service Employees Association (CSEA) sued New York State to prevent such a change in ownership.

Our discussions with the County have been straightforward and cordial throughout this process. We have also had a number of discussions with the state, and these too have been helpful. The state remained noncommittal about scenarios “A” and “B” until about 5:00 p.m. last Friday, September 28, when it faxed the announcement of its grant allocation to the County and to CGH.

Although the state has not formally accepted scenario “A,” the funds it has allocated are based on the costs identified for “A” – so “A” appears to be the de facto decision of the state. Here is a summary of what the scenario “A” affiliation involves:

1. CGH and Onondaga County will create a new not-for-profit corporation, called the Onondaga Hill Corporation (OHC) to conduct strategic planning for CGH and Van Duyn. The OHC’s plans are intended to create operating efficiencies, to improve organizational effectiveness, and to develop a more integrated continuum of care on the CGH-Van Duyn medical campus.
2. Van Duyn will remain a county-owned facility, subject to OHC planning activity. CGH will remain a private, not-for-profit organization with its planning also subject to the OHC. Both CGH and Onondaga County will appoint OHC directors, with CGH designating the majority of them.
3. CGH and the County will decertify a total 63 long term care beds. Van Duyn will decertify 13 beds, and Community General will ultimately close its 50-bed skilled nursing facility, converting that space into fully renovated acute hospital capacity. After these changes, there will remain 513 long term care beds on the campus, all of them at Van Duyn. (The Berger Commission did not require any change in CGH’s licensed 306 acute care beds.)

The state funds will reimburse Onondaga County and CGH for the legal and planning costs incurred in complying with the Berger Commission. The funds will also cover the transition costs involved in closing CGH’s 50-bed long term care unit, they will fund the planning work of the OHC, and they will fund facility renovations at both CGH and Van Duyn that are consistent with the Berger Report.

Changes for nursing home residents can be disruptive and stressful. That means we need careful plans for the closure of CGH’s sixth floor skilled nursing unit. These plans have yet to be developed, and they too will be subject to approval by the State Health Department. We are committed to assuring that transitions for residents and their families are fair and respectful.

Of CGH’s 1,200 employees, about 50 will be affected by the closing of the sixth floor long term care beds. These employees may be eligible for positions elsewhere in the hospital, and we expect some may transition to Van Duyn or other community long-term care facilities. We will do our best to communicate fully with employees and to work with SEIU1199 in assuring fair and respectful transition opportunities.

You’ll notice I’ve used the word “allocation,” not “award,” in describing the HEAL NY funds. That’s because there are a number of steps to be completed before the state money is actually awarded and paid. These steps include state approval of a work plan and the sign-off by the Office of Comptroller, among other things.

The state’s decision to fund compliance comes 10 months after the Commission issued its report. It is a necessary step. It is a positive step. But it isn’t the end of the process – only the beginning.