The Jackson Health System and its unions announced Tuesday a wide-ranging agreement that settled the hotly contested issue of emergency room staffing and resolved class-action grievances and a federal lawsuit sparked by the layoffs last spring.
“This was a true negotiation of all our outstanding issues,” said Martha Baker, president of SEIU Local 1991, which represents Jackson’s nurses and other healthcare professionals. “It’s truly a win-win.”
Chief Executive Carlos Migoya said in a prepared statement that the decisions were “difficult” but “in the transformation of Jackson we always analyze all of our business assumptions and latest data as we look for new opportunities to provide high quality healthcare at lower costs.”
The central issue involved management’s agreement to stop its quest to out-source physician and certain other staffing at the Jackson Memorial adult ER and the Roxcy Bolton Rape Treatment Center -- a move that had drawn the heavily publicized ire of many feminist leaders.
Baker and others had gone many local radio and television shows to decry the out-sourcing possibility as the beginning of “privatizing Jackson.”
Under the deal, management reserves the right to explore out-sourcing for the Jackson Memorial pediatric ER as well as the Jackson North and Jackson South ERs. But if those departments are out-sourced to other companies, the employees in them will be able to remain Jackson employees.
“Keeping these critical public services in-house is absolutely what’s best for patients and Jackson’s bottom line,” Baker said in a prepared statement.
The other major Jackson union, American Federation of State, County and Municipal Employees Local 1363 also won a victory when management decided to abandon its exploration of out-sourcing the Central Business Office operations -- a move that would have thrown about 100 AFSCME employees out of their jobs.
Viviene Dixon-Shim, president of the AFSCME local, pointed out that the group had been producing constantly improving results and there was no need to replace them.
Many of the other settlements involved settling union protests arising from management’s decision to eliminate 1,100 positions last spring that included the dismissal of about 370 full-time clinical nurses, with about 300 part-timers hired to take their place -- a change management said it needed to get flexible scheduling.
SEIU filed a lawsuit, formal grievances and planned to take an official protest after declaring a negotiating impasse to the county commission.
All those issues were resolved Tuesday, when management and labor negotiators agreed to a complex series of scheduling changes that in the long run will reduce scheduled overtime while bringing back some of the part-timers to full-time work status.
Another issue involved a contract clause that meant SEIU workers lost 40 hours of personal leave unless a union task force could find $15 million in efficiencies to reduce system costs. The agreement Tuesday acknowledged that the task force had found savings and restored the 40 hours of leave.
The financial parts of the agreement will need to be approved by Jackson’s board and the Miami-Dade County Commission.
In other news Tuesday at the committee meetings of Jackson’s board:• Chief Strategy Officer Jeffrey Crudele said state changes in Medicaid payments starting July 1 could cost Jackson at least $45 million – and “the impact could be much greater.” For-profit hospitals, meanwhile, are likely to see their Medicaid payments significantly increased, Crudele said.
• The board expressed concern when Migoya said that the University of Miami was planning to open a second pediatric bone marrow transplant program, in addition to its present one at Jackson Memorial.
Jackson has started heavily promoting its transplant program, which uses UM doctors working at Jackson Memorial. By UM looking to do transplant elsewhere, board member Joe Arriola said, “This is a real stab in the back.”
After the meeting, UM spokeswoman Christine Morris responded to a request for comment with a brief statement: “We continuously work with our expert doctors and leadership at Jackson to make sure that our patients get the best possible care.”• The Jackson board approved a consent decree that resolved a Department of Justice complaint that started four years ago about sub-standard inmate health services. Assistant County Attorney Randy Duvall said most of the issues have been resolved gradually over time.
• Jackson earned a $1.5 million surplus in December, but days of cash on hand was an ultra-low 12 days -- far below the 174 days of cash that a financially healthily public hospital would be expected to have.