Category Archives: Working at OHSU

What You Need To Know Today About The Employee Benefits Council

Why Should You Care About the EBC and Consensus Decision-Making

A Short History of the EBC

First off, what the heck is an EBC anyway? EBC stands for Employee Benefits Council. It’s a group set up by the Local 328 contract to review health-related benefit plans, recommend plan-design changes and review and recommend contracts with various benefit-plan providers. The EBC is made up of 12 representatives: six from management and non-represented employees (managers, supervisors, faculty, research staff and the HR Benefits office) and six union representatives (two from ONA and four from AFSCME).

The EBC was designed to work by consensus; that is, it tries to get unanimous agreement on changes to benefit plans. Plan changes can happen for a variety of reasons. For example, in the years leading up to the implementation of the Affordable Care Act, the EBC tried to contain costs while maximizing coverage in order to avoid paying the so-called “Cadillac tax” that the ACA called for if health-insurance premiums rose above a certain level. Another example is that the EBC chose to limit the massage benefit, because we saw heavy use by very few people, using out of network providers, which drove up premium costs for everyone else.

Choices about changes like this are hard to make, because no matter what we do in the drive to contain costs and provide excellent benefits, some people will feel like they’ve been helped and others will feel like they’ve been hurt. The consensus process is meant to be a check against rash decisions or financial decisions that will disproportionately hurt others. Among the groups represented on the EBC, AFSCME is unique in that we represent employees, in about 300 job classifications, whose wages vary tremendously. We try to ensure that whatever we do, it does not leave our lower-paid workers in a position where they cannot afford their health care. An extra $25 or $50 has a very different impact on someone making $15/hour than it does for someone making $90,000 or more a year.

Through all of the EBC’s decisions, the consensus process has been the glue that has allowed all of the representatives to make decisions that, over the years, have kept our health-care benefits at OHSU affordable and accessible. So what happens when the EBC can’t reach consensus? Well, our contract addresses that. If consensus cannot be reached, then the EBC votes on the decision. Management/OHSU has three votes, ONA has one vote and AFSCME has two votes. If the vote ends in a tie, OHSU’s president casts the tie-breaking vote.

In all our union’s years of sitting on the EBC, we do not recall ever having to vote or ever having OHSU’s president break a tie.

Until now.

Consensus Breaks Down

This year has seen the first cracks in the foundation of consensus decision-making with the EBC. Within the last two months:

  • The EBC was in the final stages of reaching consensus on recommending changing the third-party administrator of our health plan to Aetna from Moda. President Robertson overruled the EBC and decided that OHSU would remain with Moda.
  • The EBC could not reach consensus on whether to offer a high-deductible health plan in addition to our current plan. The chair of the committee moved quickly to a vote and the vote was tied 3-3, with all union votes being against offering such a plan. President Robertson cast the tie-breaking vote in favor of offering a high-deductible health plan.
  • Several years ago the EBC was approached by our consultants with a proposal to raise deductibles rather dramatically, in an attempt to keep premiums down. In a compromise designed to keep health care affordable, the EBC reached consensus to raise deductibles by $25/year over several years. HR Benefits is now proposing throwing this agreement aside and imposing new, dramatically higher deductibles.
  • HR Benefits has also proposed adding a spousal surcharge of $50/month for every employee whose spouse opts for OHSU’s health insurance when they are eligible for health-care coverage through their own employer. Our union contends that a spousal surcharge is a premium increase, not a plan-design change and therefore needs to be raised at the bargaining table not at the EBC. Local 328 has filed a grievance on this matter; our grievance has already been heard by an arbitrator and we are awaiting a decision.

The EBC has functioned by consensus decision-making for more than two decades. The breakdown of that model will have consequences far beyond the meeting room of the EBC. It will be felt in paychecks, at doctors’ offices and at the bargaining table.

 Where Does This Leave Us?

Why is HR Benefits proposing these changes that take money from OHSU’s employees’ pockets? Well, they have been given marching orders to save more than a million dollars on the OHSU’s health-care benefits budget.

Why? We have asked and have not been answered — unless you consider “to maintain the viability of OHSU” to be an answer of sufficient specificity to justify taking money back from our members and other OHSU employees.

Who made this decision? Asked and not answered.

Are these marching orders coming from Huron Consulting Group, which just decided that it would be a swell idea to grab a million or so benefits dollars back from employees? Asked and not answered.

How are management votes tallied at the EBC? Who decided how their three votes are cast? Asked and actually answered: they don’t know. In the one case where we voted, all management representatives were in favor of the high-deductible plan. They haven’t decided what they would do if the management representatives’ votes were ever split.

HR Benefits has indicated that the spousal surcharge will not be dealt with until we get an arbitration decision. Make no mistake — we will deal with the spousal surcharge at the EBC if our union loses the arbitration or at bargaining if we win the arbitration. This is not going away.

The proposed deductible changes will be dealt with at the EBC. The EBC has dealt with deductibles in the past. We suspect we will not reach consensus on ending the compromise deal we made and instead imposing new, higher deductibles. That will force a vote. You can see where this is going.

The move away from consensus decisions in the service of taking dollars away from our members and others — for secretive and unspecified reasons — is profoundly dangerous. The EBC has worked and worked well for more than 20 years — because of the internal checks and balances required by successful use of consensus decision-making.

Forcing votes on contentious issues and letting them be decided by tie-breaker votes by a brand new OHSU president just prior to our union embarking on contract bargaining is a risky proposition for all concerned. It unnecessarily raises the stakes at the bargaining table and, more importantly, undermines a model of labor management cooperation that — in the case of the EBC — has been remarkably effective for more than two decades.

Let us know what you think.

 

 

Local 328 Builds Workplace Equity Through Educational Opportunities

by Kate Baker, Local 328 Staff Representative

In developing priorities for the 2015 contract negotiations, AFSCME Local 328 identified that there were significant barriers for lower-wage workers wanting to access educational programs needed to advance within OHSU, which disproportionally affected underrepresented employees. Our union brought the issue of workforce development for low-wage earners to the bargaining table. During negotiations, Local 328 and OHSU formally agreed that recruitment and retention of a more diverse workforce is a priority for both organizations.

As a result, the parties formed the Community Employment Committee, consisting of equal representation from union leadership and OHSU management. The committee is focused on serving AFSCME-represented OHSU employees who are historically underserved and diverse in a variety of ways, including race, ethnicity, veteran status, disability, LGBTQ status and economic hardship. Together, Local 328 and OHSU are coming together to build equity within the workforce through education and new opportunities.

Since its formation, the committee has developed a strategic plan to achieve shared goals of increasing career-development opportunities for employees. One element of that strategic plan has come together in the form of grant funding through the U.S. Department of Labor’s NW Promise diversity grant. This grant will provide forty AFSCME represented employees with free job training for certain positions that require certification, support for testing and a program coach. Eligible employees can receive training in the following jobs:

  • Certified Nursing Assistant 1 and 2
  • Medical Assistant
  • Medical Coding Specialist
  • Patient Access Services Specialist
  • Pharmacy Technician
  • Sterile Processing Technician 2

Chinetta Montgomery, former Local 328 Vice President and one of the leaders on the Community Employment Committee, said: “Collectively our local leadership decided that equity and inclusion should be a bargaining priority in all future contacts starting in 2015. During that bargaining cycle, we addressed many different issues that impacted our bargaining unit including workforce development. It took many conversations internally at our local and with our employer but collectively we reached an agreement that is centered on providing opportunities to our underserved members in AFSCME. ”

The committee has been reviewing applications from more than 200 employees and is starting to announce the recipients.

Contract bargaining is about more than just cost-of-living increases and controlling health-insurance premiums — it’s also about establishing innovative programs to better serve our members and local community. Local 328 looks forward to our 2019 contract negotiations and assuring that our members’ needs are responded to.

Biometric screening and the 5% surcharge

The biggest challenge the Employee Benefits Council faces is keeping health care affordable while maintaining and even increasing the benefits available under the plan. It’s a constant process of looking at what people really use, what is cost effective to provide and bearing in mind that even small increases in costs can have disproportionate impacts on lower wage workers.

OHSU is self-insured and our health insurance rates are a direct result of usage plus an administration fee. There’s really nothing else to it. The more the health plan is used the more it costs.

The less healthy we are, the more we use the plan, and costs go up.

There are many approaches to having a healthier workforce – providing tools for chronic disease management, smoking cessation programs, encouraging exercise and healthier eating.

Another way to contain costs is by early detection of risk factors which may be treated before they escalate to far more expensive illnesses.

Early treatment of high blood pressure with medication is far less expensive than treating stroke victims in the ICU, for one example.

In order to encourage early detection the EBC has agreed that by getting a simple biometric screening, plan participants will be exempted from a 5% surcharge on health benefits.

The biometric screening that will be available would cost about $100 if the test was done on normal PPO insurance. Plan members will not be charged for the screening. The screening we are using is designed to be as noninvasive as possible and still get enough information to aid in early detection and prevention of chronic illness.

The health information obtained by the screening is not accessible by OHSU, they will not get any of the results.

We value our members’ health and we know that we can best provide health insurance security for members and their families into the future by having a healthier workforce.

Regular screenings are an important part of a plan for personal self care. We are also trying to encourage healthy eating by offering free salads to employees once a month in the hope that this one meal will start to raise awareness of the critical role of diet in long term health.

By getting a simple biometric screening you can avoid the 5% surcharge and take a major step toward protecting your health

How Do NIH Cuts Affect Local 328 Members?

IN MY OPINION: By Tara Karnes

How does the National Institutes of Health’s proposed 18% budget cut on research affect me?

I am not in research and my work, as a custodian, seems far removed from the national debate on NIH budget cuts. I mean; a eighteen percent budget cut does not seem like much. So, why would this concern me?

Well, for one thing my job is to clean the Bio Medical Research building at Oregon Health and Science University. And I hear things.

Down those hallways I hear the hum of ultracentrifuges; cranky large freezers holding cells or proteins, and what else… I do not know. I pick up the garbage and sweep up used Pasteur pipettes under the feet of upcoming research scientists. Many of whom, spend hours attached to microscopes like a stereotypical cliché mad scientist. Sweeping underfoot of these researchers I listen to their conversations and concerns, worries and fears about how NIH budget cuts will effect their work, and so… I decide to do some research about this issue on my own.

Here is what I discovered…
The goal of the NIH’s mission is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability. That sounds pretty good since health care is a major concern for most people. I know this personally; because my daughter had a tumor and was given a cadaver bone transplant replacing a cervical bone in her neck. Knowledge from research allowed a team of doctors repair my daughter’s health.
What does an NIH budget-cut mean?

The proposed budget for NIH is a 18% deficit in their budget. The equivalent of a 5.8 Billion dollars!And according to NIH director, Francis Collins, he says, funding research offers short and long-term benefits, both by developing new treatments for deadly diseases such as cancer and diabetes, as well as stimulating the economy.
In fact, for every $1.00 invested in the NIH returns $2.00 dollars in goods and services to the economy within a year! That is something we need! Right?!

We not only care about healthcare but we care about our economy too right? I know I do! Our government’s administration has plans to slash NIH overhead cost payments to universities and research institutes. Hey wait a minute! I work at a university and in a research building!

Oregon numbers FY 2016
• $275 million in NIH funding
• 616 NIH grants awarded
• 43 NIH-funded institutions
• 41 NIH-supported clinical trials initiated at Oregon institutions
• 26 Oregon businesses received NIH funding totaling $21 million

Each grant awarded by the NIH means jobs. Not just research jobs, but jobs for students, and office jobs, like clinical coordinators, and of course my JOB! Under each researcher is a host of other jobs that support that research.

That is pretty important is me and it should be to you too!

As a AFSCME union member I want to encourage all fellow members to ask your unit stewards about the NIH budget cuts and how those cuts will effect our OHSU jobs, people you know and the community.

Please feel free to contact me directly at karnes@ohsu.edu
I will be happy to share what I have learned so far in my own research of NIH budget cuts.

If you are as concerned as I am, please email your representative.
To contact, and look up, your personal representative go to http://www.house.gov/representatives and also share your message with:

U.S. Rep. Greg Walden, chair of the House Energy and Commerce Committee, https://walden.house.gov/contact-greg
U.S. Senators Jeff Merkley https://www.merkley.senate.gov/contact
and Ron Wyden https://www.wyden.senate.gov/contact/

Referenced:

https://www.statnews.com/2017/03/16/trump-budget-science-research
https://www.usatoday.com/story/news/nation/2014/04/23/nih-budget-cuts/8056113/
https://www.nih.gov/about-nih/what-we-do/mission-goals

More “Hands On” Supervision In Food And Nutrition

In Food and Nutrition Patient services, nearly one hundred employees help to prepare and transport meals to patients. Generally these meals are prepared, loaded on to trays, and then placed in carts that are then transported to room service associates on the corresponding nursing unit.

Every day in the morning and the evening, there is a “stand-up” meeting in the kitchen for food service workers.

During the stand-ups, the manager on duty will gather everyone in a circle and go over important updates for the day. While a stand-up is in progress, patient meals still need to be delivered, so occasionally a room service associate will come down to the kitchen to grab their cart of patient meals, in an effort to not interrupt the stand-up meeting and ensure the patients are receiving their meals on time.

On Sunday March 12, during a daily afternoon “stand-up” meeting for food service workers in the kitchen, a supervisor grabbed a worker by the arm and yanked them.

In this instance, a room service associate came down to retrieve their cart, and one of the food service workers saw them waiting outside of the stand-up circle. The food service worker silently grabbed their cart and began to wheel it toward the waiting worker through the stand-up circle, when the supervisor grabbed him by the arm and yanked them away from the cart. The pull was enough to throw the worker off balance, in front of the entire staff assembled for the meeting. According to many witnesses of the event, there was no imminent danger to the employee that would explain this action.

This event bears a resemblance to the recent event in which an employee was pushed by a superior in the kitchen, which has put some of the workers in the kitchen on high alert, for fear they will be grabbed or shoved by a manager and have to go through the same lengthy process that it took for the previous matter of physically inappropriate behavior by a superior in the kitchen to be settled.

We are hoping that OHSU will take the correct action in this matter.

Maria Frazier loved her job

Maria Frazier loved her job.

Last week, Maria and her mother drove to the AFSCME office on Burnside to talk to us about the events following her discovery of a small noose in her workplace. During our conversation, she kept coming back to that — she loved her job. She was good at it. She helped patients.

That’s what makes the events following the noose incident painful. In the long run, Maria’s love for her job didn’t seem to matter very much to the people who were responsible for ensuring that OHSU is a safe, harassment-free workplace.

She recalled the events of that day: “I was walking through the office and ran into the practice administrator. I showed him the noose and he said he had to take it down. He hadn’t seen it before. There were other people in the office but they didn’t say anything or remark on it. I was with a coworker and she said this was unacceptable. [The practice administrator] took it down and I walked to my desk. I showed my immediate supervisor the picture and she said that it wasn’t there yesterday. She was surprised. “

“I went to my desk and called my family and [called] a friend and showed her the photo (I emailed her the photo). They were shocked. I told her that I felt uncomfortable and I was going to be leaving. My family told me I could get an escort if I feared for my safety. I just left without an escort.”

Maria said she was told to contact Human Resources. It was about a week after the incident when they finally called her. Maria didn’t feel like HR was an effective advocate for her.

“When you have friends, you are going to protect them and make sure that you don’t risk your financial stability. They don’t care. It’s a waste of time, no one cares, just get another job.”

“No one from Affirmative Action called me, no one contacted Dr. Gibbs [OHSU Vice President for Equity and Inclusion], no one asked for follow-up. It’s all about them being friends.”

To Maria, it felt as if OHSU’s priorities were backwards. Its lack of action had the effect of “making me feel like I was the cause of the problem because I reported it. I was the problem. They didn’t make me feel like I was the victim of a hate crime or of discrimination. They made me feel like [the employee who put us the noose] was the victim. It was like he was the one who got hurt, because someone told on him.”

“I was hurt when they found no racial intent. I was hurt by it, and was made to feel that I’m overly sensitive and I should go get the free counseling. I was insulted by it. It’s like they are saying that racism is here and it’s up to me to learn how to accept it.”

“At this point I don’t feel like anything is going to change. I had confidence in a system which had failed.”

For Maria, the losses keep piling up.

“I loved my job. I still think about the patients. I fought for them, I fought insurance companies for my patients. They lost a valuable employee. At the end of the day, because of the color of my skin, no one noticed that anything was wrong. I think about the people who would hug me, who were very sick, and saying ‘Maria, this might be my last visit.’ I think about them.”

 

 

 

 

 

 

 

Apology Accepted?

At a “standup” meeting in Food and Nutrition on Thursday, Jan. 5, the supervisor who pushed Local 328 member John Kusluch toward a wall and put his finger in John’s face apologized to the workers present. (John was not in attendance at the meeting.) The supervisor told the workers that John was okay with the outcome and that, earlier, John had shook his hand and accepted his apology.

After John’s shift ended on Thursday, we asked him about that.

John said that the supervisor and the supervisor’s manager had met with him earlier in the day. “You could tell he was scared for his job, and it felt like he was being told to apologize.”

“He personally apologized and acknowledged that he wouldn’t want to be treated that way.” John continued, “Apology is the first step, but more corrective action needs to be taken.”

 At this time John and the supervisor have only minimal contact, as their shifts overlap by just one hour.

OHSU has said that the supervisor did not “push” John and has characterized the supervisor’s actions as “placing his hands on [John’s] shoulders and turned him 90 degrees.” John disputes this, saying that while he was never off balance or physically touching the wall, it’s because the supervisor had his hands on John’s shoulders and moved him enough to overcome John’s initial resistance. John did not offer resistance because he “didn’t want to escalate things more.”

This raises an interesting question. If OHSU says the supervisor is not guilty of “pushing” because there was no resistance, what would have been the outcome if John had resisted?

Is it OHSU’s expectation that employees must resist physical contact — must escalate an encounter in order to justify disciplinary action against the aggressor? Is this the standard that OHSU would also apply in a sexual harassment case? That when an employee doesn’t resist, it mitigates the offense?

John is aware that our union has filed a grievance on the matter. The remedy our union is seeking in the grievance is that the supervisor no longer be allowed to work with John and that the supervisor take anger-management classes provided by the OHSU/AFSCME Career and Workplace Enhancement Center. John said that, as far as he knows, the CWE classes are voluntary and not mandated for supervisors.

John added, “There’s a code of conduct; you can’t just pick and choose which rules to follow. I think the reaction should be fair to what a normal employee would get. I told [the manager] that, and she said that even though this was an egregious act, she doesn’t see it as anything that would be treated differently between employees and supervisors.”

“Everyone was shocked that it happened. One of the supervisors that witnessed said it wasn’t appropriate. Coworkers are afraid of what he is going to do to them. People say things like ‘How is this okay? How can they allow this to happen?’ My coworkers think it’s ridiculous that he got away with it. It’s almost a running joke that you can do anything you want in the kitchen if you say you’re sorry afterwards”

“An apology is nice, but I think he still should be let go. If I had done that to him I wouldn’t have lasted [another] day on the job.”

“I’m really not feeling well today, but since I’ve already used two days of sick leave, I could be disciplined or fired for calling in sick. So I’m here, not feeling well, working in the kitchen.”

“I think what he did is worse than me calling in sick.”

Demand Action, Not Words, from OHSU

Following our union’s editorial on our blog — How Safe Is OHSU? —  about the need for OHSU and Local 328 to do more to ensure an equitable and diverse community in the workplace, OHSU President Robertson released a statement calling for OHSU to be an “an inclusive culture that is safe and creates a respectful and healthy environment for all” and went on to talk about how health-care providers may face discrimination from patients and how that will not be tolerated.

Following a Portland Tribune article about an OHSU employee experiencing a noose being hung in her work area, OHSU announced that there will be a campus-wide Martin Luther King, Jr. Day event on Friday, Jan. 13: “Dr. King’s legacy and commitment to social justice is a unifying moment for our campus community. As OHSU elevates its commitment to equity and inclusion, you are invited to join in reflecting on Dr. King’s teachings and embracing the challenges that we as individuals, our institution and our nation currently face in our collective struggle to realize his dream.”

Equity and inclusion is a larger issue than patients wanting to change doctors and celebrating Dr. King’s uplifting message. It is about broadening our vision. It is about taking action. It is about disrupting the status quo.

Dr. King said: “Human progress is neither automatic nor inevitable…Every step toward the goal of justice requires sacrifice, suffering, and struggle; the tireless exertions and passionate concern of dedicated individuals.”

We need more than just words, more than easy and public actions — and not for only the privileged and visible.

Words and tributes may set the tone, declare our values and define a mission. Actions will reveal who we are. Are the rank-and-file working people at OHSU included in OHSU’s vision? Where is this articulated? Have they been invited to the table where decisions on OHSU’s actions will be made?

Are the working people of OHSU invited to participate in OHSU’s reflection and call-to-action event on Jan. 13? Will they be released for an hour or two from work to add their voices to this celebration of the legacy of Dr. Martin Luther King, Jr.?

Or will the diverse working people of OHSU, those who don’t bring in big grants or bill insurance companies for their services, be conspicuous by their absence when Dr. King’s legacy is celebrated and OHSU “elevates its commitment to equity and inclusion”?

 

 

Up Against The Wall At OHSU

By Dennis Ziemer, Local 328 Staff

The Food and Nutrition department at OHSU employs more than 300 employees; nearly 100 of them are involved in preparing, transporting and serving meals to patients. The job doesn’t end there — these employees have the task of making sure that sanitation is held to the highest standards. The safety of OHSU’s patients is a top priority, but lately the Food and Nutrition employees have had concerns about their own safety.

If employees are concerned about possible contamination or safety issues in the dishwashing operation, for example, the matter is brought to the attention of Food & Nutrition management. Employees can usually do so without fear of disciplinary action — or a physical reaction from the supervisor — because being attentive to safety is part of the job. At least that’s what the employees thought.

Recently, a cargo container has been repurposed as a temporary dishwashing unit and is being used during a remodel of the dish room in the hospital. Along with frequent breakdowns of the “dishwasher,” Food and Nutrition staff have found large amounts of mold and mildew in the area where dishes are cleaned and clean dish trays pass through. Management has closed down the cargo-container dishwashing unit more than once and redirected the cleaning of dishes and trays to other facilities on campus. Each time, the container was to be cleaned and reopened as soon as possible.

The temporary dishwashing unit has raised other safety concerns with employees. Without rain gear or other water-protection garments, the employees could not enter the container without getting drenched by errant sprayers, but OHSU does not provide rain garments to these employees. Food and Nutrition employees frequently had to wear wet clothing throughout the workday if they were assigned to dishwashing.

December 8, 2016, was an icy and snowy day. Food and Nutrition  workers asked what they were going to do about the dishes during this inclement weather, since the makeshift dishwashing unit is outside. Acting as the lead staff person, John Kusluch told them that the supervisor’s plan was for them to take the dishes to other dishwashing facilities on campus, which would mean lots of extra work hauling dishes. After John told the staff this, a supervisor for Patient Food Service came out of his office to correct the statement to say that it was not his idea, but his manager’s.

John apologized to him, telling him that other supervisors had told him that it was this supervisor’s idea. The supervisor then accused John of spreading rumors and told John again that it wasn’t his plan. The supervisor walked away, but a minute later returned to John, put both of his hands on John’s shoulders and dragged John towards a wall about a foot away. After this, the supervisor started waving his finger in front of John’s face, in what appeared to be threatening manner, reiterating that it wasn’t his idea.

Since this event, Local 328 has filed a grievance and OHSU has investigated the matter. Our union and HR met during step 1 in the grievance process, but no response has been received at this time according to union staff representative Dennis Ziemer. HR interviewed several employees who witnessed this event, including other supervisors who were also concerned about the physical actions by John’s supervisor. HR determined that the physical reaction by the supervisor was an inappropriate action, but since it didn’t appear to be retaliatory it didn’t warrant removing the supervisor during the investigation. It also appears that because John maintained his balance, wasn’t knocked down or visibly hurt or, incredibly enough, isn’t female, the supervisor who became physical with John will keep his job and will maintain his authority over the same staff who witnessed his inappropriate actions.

Since this event, John and other Food and Nutrition staff don’t feel safe coming to work. An additional grievance has have been filed by our union, addressing concerns about the safety of these employees and the patients they serve.