Wantagh resident Vanissa Fernandez has been a member of United Healthcare Workers East for the past 10 years. As a recreational therapist at a nursing home in Woodbury, she and two colleagues are responsible for 48 patients.
“When I started, we had six people for about 50 patients,” she said. “Now there are only three of us.” Staffing has been reduced through attrition rather than termination, but employees have not been replaced.
Fernandez works at a mental health facility, and the patients for whom she is responsible deal wih a wide range of conditions, from schizophrenia to Alzheimer’s and mental retardation.
Since many therapists work part-time, a full complement is not on the job every day. And when employees are sick or on vacation, Fernandez is sometimes on her own. “Management says it isn’t in their census to hire more people,” Fernandez said. “Census” refers to the ratio of patients to staff. According to Fernandez, there has been no explanation of the 50 percent reduction in staff, despite no correspnding reduction in the patient load.
“Working conditions and wages would be fair if we were adequately staffed,” she said. “It’s only unfair because now I’m doing two people’s jobs.” She described her work as more mentally exhausting than physically demanding, adding that she has a good working relationship with non-union management.
Members of United Healthcare, which is made up of nursing home employees and hospital workers and is part of the Service Employees International Union Local 1199, have been working without a contract since the end of the summer. They came to a tentative agreement last week with one of two informal ownership groups in what has been a protracted contract negotiation.
The second bloc of owners, the Greater New York Healthcare Facilities Association, has yet to reach an accord with the union.
The negotiations affect more than 20,000 nursing home workers throughout the metropolitan area, including Nassau County, and the two ownership groups represent about 180 nursing homes. GNY is made up of about 65 mainly for-profit homes; the other group of roughly 120 facilities includes both nonprofit and for-profit homes.
Employees had authorized negotiators to call a strike if the two parties failed to reach an agreement. Local 1199 has a total of about 400,000 members, making it the largest union local in the country.
Health care companies are among the largest groups of private employers on Long Island, according to the state Department of Labor. The most recent contract covered both for-profit and nonprofit facilities, as well as some home health aids.
From the outset of the negotiations, the union outlined three main areas of concern: compensation, pension contributions and staffing. The preliminary agreement, which has yet to be ratified by the membership, provides for a 3 percent annual wage increase for the life of the three-year contract. Details of pension contributions were not immediately available. Workers who have been on the job since at least 2009 are protected from layoffs. Staffing issues are still being worked out.
The union is asking for a “fair wage hike and an increase in pension contributions, relative to cost-of-living increases,” said Milly Silva, the head of United Healthcare’s nursing home division. Employees are also concerned about health care costs. “They need affordable health care, just like anybody else,” Silva said.
She agreed that staffing issues were critical. “The question is, do we have adequate staff and sufficient resources to provide quality care?” Siva asked. “Right now, we don’t have enough CNAs” — certified nurse assistants — “to do the work.”
Michael Balboni, GNY’s executive director, acknowledged the shortage of CNAs. “It’s hard to find qualified people who will work that hard for a wage that’s only a little more than they’d make at McDonald’s,” he said.
The starting wage for union health care workers is about $18 an hour, compared with about $11 an hour for fast-food workers. Experienced CNAs earn proportionally more, depending on length of service. And licensed vocational nurses make even more.
Silva acknowledged that other types of work were competitive, and mentioned Amazon. “The pay differential isn’t that big,” she said, “and the work is easier.”
Balboni said that nursing home care is “supposed to be a partnership with the State of New York.” The State Department of Health requires a certain minimum level of staffing. “If an issue arises, the DOH will investigate,” he said. “If the issue is acute, they issue a finding of immediate jeopardy” which must be corrected within 24 hours.
According to Balboni, further reductions in staff are to be expected, with the increase in technology. “It’s better for the patients,” he said. Medical records could be automated, and robotics could be used for heavy lifting. Technology could also be used for admissions.
The union counters that current inadequate staffing can lead to serious errors. “There could be errors in medications,” Silva said, “or taking patients to the wrong after-care activity.”
Balboni acknowledged that “management hasn’t made an investment in training,” and said it would become a bigger issue as sophisticated technology and telemedicine become more widespread.
The union hasn’t taken a position on telemedicine.
Union contracts have not included cost-of-living adjustments since 2007, according to Silva. Since Long Island is one of the most expensive counties in the U.S., “We’re not keeping up,” she said.
Negotiations with the GNY ownership group resume this week.