The initiative claims that it will remove “big money interests from politics” by banning unions and corporations from using “payroll-deducted funds for political purposes.” The deceptive part is that corporations almost never use payroll deductions to raise political campaign funds but unions do almost exclusively – sometimes in amounts as low as $1 a week.

From the San Francisco Chronicle

The federally-funded electronic health record (EHR) incentive program continues to be a central bargaining issue, and a good portion of the membership meeting was spent discussing how these funds work and how they relate to the current bargaining.  UAPD presented the national legal consensus regarding EHR incentive payments — that the funds belong to providers, not their employers, and that the employers must negotiate if they want to influence how those funds are assigned.  One of the county’s own legal consultants has written in support of the union’s position in an article asserting that:  “In both the Medicare and Medicaid programs, assignment must be voluntary and may be made only to one entity.  In other words, EPs are not required to assign their incentive payments to the hospital, even if the hospital provides them with EHR technology.”  A  majority of doctors in the bargaining unit have already signed onto a petition informing the county that they will not agree to reassign their EHR money until the issue has been settled in bargaining.

The next bargaining date is currently being scheduled, and members will receive  another update as soon as the date is known.

You can read more about the bill here.

UAPD is positioning itself for further attacks on State salaries this year.  The notion of a salary cap could reemerge in another bill or as part of the budget later in the year.  UAPD will continue to monitor the situation in the Capitol closely, and keep UAPD members informed.

Read the full LAO report here.

While acknowledging there are “some legal hurdles to overcome if the state were to contract out for additional inmate medical care services,” the LAO goes on to suggest ways that the State might evade the existing restrictions on outsourcing.  The report uses the fact that the State “lacks employees with sufficient expertise to adequately manage a medical care system” in the prisons as proof that all prison medical care should be outsourced.   When what is clearly needed are new and better managers!  The report is a slap in the face to all the highly-trained doctors now working in the prisons.

UAPD is preparing a response to the report, and will begin speaking to legislators about it next week.  In the meantime, we encourage CDCR doctors to review the LAO report [4]here, and provide us with any insights or information you would like shared with legislators.

UAPD is standing with the Public Employees Committee (PEC), a coalition of 27 city unions, in rejecting all concessions.  The PEC has hired an economist to challenge the City’s budgetary projections, and a healthcare consultant to help craft a unified proposal for revamping the City’s healthcare plans.  On April 13, UAPD and other unions presented the PEC healthcare proposal, which could save the City more than $20 million per year without shifting costs to employees.

In addition to the healthcare proposal, UAPD is seeking a wide range of economic improvements, including increased compensation for board certification, full reimbursement of license fees, the reinstatement of CME reimbursements, payments for those who have assigned EHR incentive payments to CCSF, a pay differential for doctors who hold more than one board, and the elimination of furloughs.

Most importantly, UAPD has demanded that CCSF address the fact that salaries for doctors have actually fallen behind the salaries of some nurse practitioners (NPs) and physician assistants (PAs).  During the April 18th bargaining, the UAPD team listed the many reasons why doctors should earn more than NPs and PAs:  Doctors have a wider scope of practice, they train for longer, they incur more debt, they hold ultimate responsibility for patient outcomes, they clinically supervise the NPs and PAs, and they must sign-off on much of the midlevels’ work.

To correct this imbalance, UAPD has proposed adding two additional steps to the top of every doctor salary range, advancing all existing doctors one step (with everyone below it going at least to step 5), and increasing the salary at every step by 10% at ratification and an additional 10% the following year.   The CCSF representative claimed to be stunned by the proposal, but the UAPD team made clear that the disparity must be fixed.

UAPD will continue to bargain throughout April.  If the Union and the City cannot reach a contract agreement, both parties will enter binding arbitration on May 7 and May 8. At that point, a third party arbitrator would have final say on all outstanding issues.   The UAPD bargaining team has already compiled substantial research to support our proposals and challenge the concessions being proposed by the Employer.

People in San Francisco recently remembered April 18th as the anniversary of the Great 1906 Earthquake. But an important aftershock occurred in SF on this date in 1972, exactly 40 years ago…the UAPD was born. Dr. Sanford Marcus, a local surgeon supported by 250 private physicians and dentists signed the Charter of the Union of American Physicians and Dentists. This excerpted mission statement rings truer than ever today   “…to enable doctors to give of themselves, unhindered by extraneous forces, for the welfare of their patients…” Dr. Marcus was angry at the way doctors were “pushed off the pedestal” and manipulated by hospitals and insurance companies.

As health care has evolved into a $3 trillion enterprise these forces have become more complex and ubiquitous. Pharmaceutical and durable companies, ancillary competitors, EHR and telehealth technologies, managed care administrators and execs all seek their share of the pie. The cornerstone of our profession , the doctor- patient relationship, has been compromised. The largest force of all is Government. Regulations, forms, oversight, healthcare lobbies and class action suits. And importantly for UAPD, Government as our Employer.

UAPD has had its share of successes over the decades fighting for our members. In 1975 we orchestrated the Anesthesiologists’ strike which led to MICRA reform. In the 1980s we formed SEPA and established collective bargaining  for State employees. We stood alone and stood down Governor Pete Wilson in his attempt to destroy unions and collective bargaining. In 1997 under President Weinmann we affiliated with our influential parent union, AFSCME. We formed our own Private IPA. We showed great resolve in regaining our LA County unit after they were discriminated against. Our détente with the prison receivers resulted in great salary increases for our members. Our coalition with other unions has exposed the safety problems of DMH. We continue to organize other California counties and nonprofit clinics. Our efforts to grow now extend into Oregon and Arizona. In numbers there is strength.

And yes, there have been bumps in the road.  The Terminator. Furloughs and layoffs.  Hospital closures.  Adverse publicity. Professional jealousy.  Increasing workloads. But none of these tarnish your sacrifice and dedication to society and your colleagues, the wisdom,vision and courage that you all possess in doing your difficult and noble jobs as doctors. Doctors with the foresight to belong to UAPD, still great after 40 years.

In Solidarity,

Stuart A. Bussey, MD, JD, UAPD President

California workplace safety officials have fined Coalinga State Hospital more than $20,000, alleging in part that the psychiatric facility, which mainly treats sex offenders deemed too dangerous for community release, failed to keep staff members safe from assault and has an inadequate employee alarm system.  –Los Angeles Times

Instead of fixing the problems that led to the citations at all five state hospitals, DMH is spending time and money contesting Cal/OSHA’s findings. The department has filed an appeal of the Napa and Metropolitan citations, and is expected to do the same for the citations issued against the other three hospitals. State-employee unions including UAPD have already received legal-party status in the Cal/OSHA appeals process, so they can try to hold DMH accountable for its inaction. A hearing on the Metropolitan citations is scheduled for May 10 – 11, 2012.

As part of the Safety Now! coalition, UAPD also protested ratio changes during a rally at Metropolitan State Hospital on March 21.  The rally garnered excellent press coverage for the issue.

While UAPD is doing everything in its power to stop the Department of Mental Health (DMH) layoffs entirely, we must also take steps to mitigate the effects of a layoff if one should occur.  This includes meeting with the State to discuss its layoff plans.  On March 30th, UAPD met with staff from DMH to request information that the Union will need if layoffs do occur.  DMH has notified UAPD that it now plans to implement layoffs on July 12, 2012, which is two weeks later than their initial target date.

On April 3rd UAPD participated in a “meet and confer” with DMH and the Department of Personnel Administration (DPA) over the issue of layoffs.  The State reiterated its intention to layoff psychiatrists at Metropolitan, Napa, and Patton State Hospitals and physicians at Atascadero State Hospital.  Because DMH does not yet have a list of its contractors and vacant positions, it is still unclear how many doctors would be impacted if the Department’s plans were to go forward.  UAPD will update members as soon as those numbers are known.

DMH doctors who attended the meeting made clear that care has already begun to suffer under growing caseloads and that adequate staff-to-patient ratios result in better outcomes and increased safety.  For its part, DMH claims that operating within its existing budget necessitates treatment staff cuts.

The Department is now calculating raw and complete seniority scores which it will make available to employees by the end of the month.  Employees will have an opportunity to challenge their own seniority score if they believe it to be inaccurate.