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California’s Climate Change: Single-Payer

June 7, 2017

By Stuart A. Bussey, MD, JD, UAPD President

Two seemingly unconnected events last Thursday remind us that we live in a progressive, independent-minded state. First, the California Senate passed SB 562 (Lara/D), the Healthy California single-payer bill. This bill purports to solve our state’s health care access problem, which has been partially relieved by the ACA and is now threatened by the new AHCA bill. The California Assembly is preparing for the weighty debate on how exactly to pay for SB 562’s universal coverage. Cost estimates range from $330 billion/year (UMass study) to $400 billion/year (legislative analysis). These figures are comparable to the 2016 estimate of California’s health care cost of $370 billion. Much of this money would be available as repurposed Medicare and Medi-Cal money — and the Feds would have to agree. The State, under Healthy California, would take on the role of single insurer. The plan would be governed by a nine member board of experts who would authorize payments to hospitals, doctors, ancillaries and pharmaceutical firms in a hybridized and collectively bargained fee-for-service paradigm. The collective bargaining part of the bill could elevate UAPD as a preeminent representative of many of California’s providers. Physicians probably would be working at discounted rates of reimbursements, but they would at least be paid promptly and by one entity (the State). They would not have to play tiresome reimbursement and authorization games with dozens of profit-motivated insurance companies. Doctors should spend less time billing and more time with their patients.
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UAPD Files Charges Against State Hospitals

May 10, 2017

Several months ago, Napa State Hospital management distributed a memorandum to the medical staff stating that they had decided to utilize the Personal Duress Alarm System (PDAS) as the primary method to contact physicians, because management had determined that the hospital’s pager system was unreliable. UAPD was staunchly opposed to this new policy.

After Psych Tech Donna Gross was murdered by a patient on NSH grounds in 2010, enormous efforts went towards winning a host of safety improvements at the State hospitals.  That work continues to the present. The PDAS is a state-of-the-art system chosen, developed, and continuously refined with employee input.  At no time did the state legislature, Cal-OSHA, Coalition unions, or the DSH contemplate any use for PDAS except as a personal alarm. And, as PDAS’s sole purpose is to alert all staff in the vicinity of an emergency request for help due to attack, the system has the potential to save lives. Diverting its use for any other purpose undermines the system’s effectiveness. Nevertheless, recognizing that the hospital’s current pager system indeed is not reliable, the UAPD agreed to meet with DSH in order to negotiate implementation of the new policy.
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CSU Bargaining Off to Good Start

May 10, 2017

Last week UAPD and CSU starting formal bargaining over terms and conditions of employment for our members in Unit 1.  UAPD and the bargaining team are optimistic about this round of bargaining.  After a State audit revealed unnecessary spending, and news articles publicized cuts in student services at the same time as the student fees were raised at some campuses, CSU has come into bargaining with an understanding that change is needed.

CSU is taking a proactive approach in addressing the issues around recruitment and retention.  They have been meeting with the UAPD Bargaining Team for the past year to establish new classifications, which will allow campuses to hire needed employees at a more competitive salary.  UAPD and CSU have tentatively agreed to two new classifications and some revisions to the original physician classification.  The team is still negotiating the salary ranges for each classification, as well as the implementation and the reclassification of the current unit members.   UAPD will communicate that information with the membership as soon as it becomes finalized.  
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Ending the CDCR Psychiatrist Staffing Crisis

May 3, 2017

Rosen, Bien, Galvan and Grunfeld, LLP is a legal firm that represents the plaintiffs in Coleman v Brown, which addresses mental health care in California prisons.  The original judge in the case ordered that a Special Master be appointed to monitor compliance with the court orders to improve care.  The current Special Master is Matthew A. Lopes, Jr..

In recent weeks, UAPD has been working closely with Michael Bien and others at the firm.  Together we are trying to persuade the Special Master and the Court that there is a severe psychiatrist shortage within CDCR, and that the State is doing too little to correct it.  UAPD has provided the attorneys with data and physician testimony that they will share with the Court (with names redacted).  You can download a copy of the letter provided by UAPD to the attorneys here.   UAPD will update members on the progress of the case.

If you would like to provide further information that UAPD will share with the Plaintiffs’ Attorneys, you can do that here:  CDCR PSYCHIATRIST STAFFING ISSUES

State Contract Goes into Effect

May 3, 2017

Governor Jerry Brown signed SB 131, the bill containing the UAPD contract for State Bargaining Unit 16.  Now that the UAPD contract has been approved by membership, the Legislature, and the Governor, it will be in effect now through July 1, 2020. 

All pay increases in the new contract are effective starting May 1, 2017.  Payroll implementation is expected to take several months.  Once the State completes the payroll implementation process, all doctors will receive payments retroactive to May 1, 2017. 

You can read the summary of the entire agreement here.  You can download the summary of the economic agreements here.

UAPD and Santa Cruz County to Discuss Compensation Incentives

May 3, 2017

On May 5, UAPD and Santa Cruz County teams will meet for the first time to discuss policies for the compensation incentives that go into effect this July 1.  Doctors will become eligible to receive a Quality Incentive of up to 5% of their base hourly rate, and a Productivity Incentive of up to 10% of their base hourly rate. The policies will standardize the elements for earning the incentive. Elements such as availability for patient visits, staff support and administrative time will determine the amount of the Productivity Incentive. The Quality Incentive shall be based on progress notes, standards for psychotropic medication, peer reviews and EHR standards. 

Once the UAPD team feels we have made sufficient progress, a general membership meeting to discuss this topic will be called.  In the meantime, feel free to contact Albert Munoz with questions or comments (amunoz@uapd.com).

LA County Pharmacist Update

May 3, 2017

As some of you may know, UAPD has been partnering with SEIU Local 721 on several County issues.  One of which is the bully boss campaign.  We have met in protected forums with Dr. Christina Ghaly and other DHS-HR staff to discuss incidents where front line staff felt bullied or harassed by their supervisors.  The meetings have taken place at County facilities including Olive View and MLK Outpatient Center.

Following these forums, there has been removal or reassignment of some pharmacy managers, where their behavior has been found to be too egregious to tolerate.

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UAPD in LA County Looking Forward…

May 3, 2017

The County of Los Angeles provides services to the over 10 million residents who call Los Angeles County home. With more than 35 departments and 200 commissions, the County operates one of the largest local government organizations in the world. Given the size of this County, it is imperative that UAPD position itself strategically if we are to be successful moving forward.

It is therefore never too early to start gearing up for negotiations for new collective bargaining agreements, to replace those that will be expiring in the upcoming months. We will be faced with a lot of challenges and uncertainties, for example: will the county lose federal dollars? How do we make up any loss in revenue? How do we continue to deliver quality care? What are the alternatives? UAPD members will have the opportunity to engage and participate in the process to solve some of these critical issues.

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More Washington Providers Join UAPD

April 18, 2017

We would like to congratulate the providers at MultiCare Legacy Urgent Care Centers who voted by an overwhelming margin to join UAPD. By a 43-7 vote, Legacy providers sent a resounding message that they want collective bargaining rights and a voice in providing care to patients.

Now begins the process of better understanding the specific priorities of Legacy providers so we can start contract negotiations as soon as possible. In the next week, Legacy providers will receive a bargaining survey that will help us evaluate their concerns on compensation, working hours, benefits, and other issues.

UAPD is excited to begin preparing to negotiate a contract for Legacy providers, and will continue working to unionize providers at MultiCare and other institutions.

Read more about: Featured, Washington

State Telemedicine Issues

April 15, 2017

When the telepsychiatry program was first launched by the Department of Corrections, psychiatrists were told that they would not have to cover On-call assignments. The Department then decided to start requiring them to cover on-call assignments. The Department changed telepsychiatry working conditions without noticing the UAPD.   The UAPD met with the Department to discuss a proposed policy. CDCR has not updated the policy to reflect the agreed upon changes from the last meeting. Nonetheless, CDCR has added additional telepsychiatry sites without noticing the UAPD.  The UAPD has filed a Cease and Desist regarding implemented changes to the program without notice to the union.  There is new language in the State tentative agreement regarding teleprograms.

Multiple grievances have been filed on telemedicine issues at the prisons   When the telemedicine program was first launched by California Correctional Health Care Services (CCHCS), physicians were told that they would not have to cover on-call assignments. The department then decided to start requiring them to cover on-call assignments, without noticing the UAPD. A grievance was filed, and the Department responded by notifying the UAPD that they were initiating a telemedicine on-call pilot program. That program failed and the Department concluded that they will not be requiring telemedicine doctors to cover on-call assignments.  There is currently no language in the union contract regarding teleprograms. The UAPD has proposed language to address concerns.

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