The UAPD Pulse – By Stuart A. Bussey, M.D.

July 6th Safety Now! Rally at Metropolitan State Hospital

July 2, 2011

Wednesday, July 6th
11 am – 1 pm
(lunch provided)
At MSH Main Entrance, 11401 Bloomfield Avenue, Norwalk, CA 90650 (MAP)

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On May 18th, twenty-five workers from Metropolitan State Hospital approached Executive Director Sharon Smith-Nevins and delivered this letter detailing serious safety problems at the facility as well as cost-effective solutions.   The group requested a written response and the chance to sit down with administrators to discuss ways to remedy the serious safety issues–on average, 7 patients and 4 staff members are assaulted at Metro each day.

Read more …

Pension Reform: A Series of Bad Jokes

June 21, 2011

By UAPD President Stuart A. Bussey, M.D., J.D

What do pension reformers and Chicago Cubs’ fans have in common? Both fear that history will repeat itself.

The pension reformers worry that gains in public employee salaries will result in future spiraling unfunded liabilities. While Republicans and Democrats are denigrating public pensions as the major cause of government deficits, pensions actually have a long and noble history.  American Express created the first pension plan in 1875.  By 1935 half the states offered government pensions, and by 1997 half of all workers had one. Congress enacted ERISA in 1974 to regulate private pension plans, for the most part successfully. But the 2005 bankruptcy of not-so-friendly United Airlines resulted in a 50% divestment of employee retirement benefits. The shocking act survived legal challenges and left millions of private employees demoralized.

Could this scenario happen to county and state employees? Stories of highly paid government employees with excessive overtime, and management positions, in their final year were reported as cases of pension spiking. CalPERS actuarial reports of billions of unfunded pension dollars went unquestioned.

The result of all this is a spate of anti-pension bills, seeking changes like pension caps, retirement age increases, and restrictions on how things like bonuses, vehicle and housing allowances and sick leave are included in pensionable compensation. “Negotiating” with the Terminator last year, all the unions agreed to a pension formula reduction for new employees. It was an offer we couldn’t refuse.

But now we are communicating with labor friendly Governor Brown. If his pension reform proposal passes muster with the legislature and public, changes will be moderate and affect only new employees. See page 7 of this newsletter for details on his expected proposal.  UAPD will relentlessly argue the case with California’s actuaries to keep our pensions commensurate with the difficult work our members perform. After all, old actuaries never die, they just get broken down by age and sex!

Workers of America…Unite!

March 22, 2011

By Dr. Stuart A. Bussey, UAPD President

I recently attended a lecture by my old college classmate and former Labor Secretary, Robert Reich.  The title of the presentation was “Is America Going Broke?”  He adroitly used statistics to confirm what we already know—America’s wealth is concentrated in the hands of a small number of people, and the middle class is shrinking.  In 1928 America’s top 1% of earners controlled 8% of the assets; in 2007 they controlled 23%.  These two statistics capture wealth distribution at the moment immediately before the start of Great Depression (1929) and the Great Recession (2008).  Simply put, at both times in our history the “non-wealthy” did not have enough money to effectively support our national economy, so the economy collapsed. 

Now, as the upper crust tries to maintain their economic advantage, they cynically blame unions, especially public employee unions, for the economic downturn.  But organized workers, including UAPD doctors, have strengthened the economy by justly bargaining for middle class gains in salaries and benefits over decades.  Reactionary Governors in several states are now attempting to destroy collective bargaining rights, but we cannot allow organized workers to be scapegoats for the economic crisis.

We are fortunate to have Governor Brown at California’s helm.  I was heartened to see him drop Schwarzenegger’s minimum wage suit aimed at State employees.  As for the State hiring freeze, we’ve seen this intermittently over the years.  One category of workers I would like to see permanently frozen is the Limited Term (LT) position.  The original legislative intent of the LT concept was well meaning—to provide temporary manpower.  But the State’s motives seem to have changed.  LTs are increasingly hired to become “stopgaps” for permanent civil service positions.  Ask the thirty-one LT dentists who were not rehired by CDCR. 

We need to legislate for greater hiring transparency.  UAPD will be doing just that in AB 920, The Public Employee Bill of Rights.   We have seen what unified voices can do in Egypt.  Now from Albany to Madison to Sacramento the chant increases, “Workers of America, Unite!”

2010 Year In Review

January 3, 2011

By Stuart A. Bussey, M.D., J.D.

President, UAPD

At the end of 2010 we mailed out the 2010-12 State Bargaining Unit 16 Contract.  Two years of work from your Bargaining Team went into its construction.  In light of the Great Recession and California budget crisis, I think we did pretty well.   You’ll notice several positive new terms.  For instance, the CME provision has been relocated to Section 10.13 which is now called “Licensure-Continuing Medical Education.”  This association with professional licensure should force the State to be more responsive in granting and paying for your CME leave.  The three furlough days imposed in early 2009 have been replaced by one monthly personal leave day for 12 consecutive months.  Although the State unilaterally took away Lincoln and Columbus holidays before the contract was settled, UAPD managed to negotiate the addition of two new professional development days.  We also got furlough and wage protections during the contract term.  And the whole bargaining unit will see a 5% increase at the top of the pay scale in 12 months (January 1, 2012).

We wrapped up negotiations in June in order to get the most favorable terms along with five other unions.  The Governor and Legislature were playing hardball regarding our pensions.  With public opinion towards unions unfavorable, we had to settle for modest concessions in employee contributions and age limits, as well as slightly reduced pension formula percentages.  But these changes only apply to employees hired after 2010.  I am confident that our new Governor Jerry Brown will be more appreciative than his predecessor of the work that BU 16 members do for our state.  The next contract negotiations should be faster, smoother and fairer.

2010 was a year of many political challenges for our Union.  I am happy to report that we were successful in meeting almost all of them.  Early in the year we got news that Lanterman Developmental Center would be closing by year’s end.  With the help of certain advocacy groups, legislators and other unions, UAPD is crafting an orderly plan to help preserve its DDS physician, dentist, and podiatrist positions and to slowly transition Lanterman patients from the regional center into the community.  It took Agnews Hospital over 4 years to achieve similar results.  In March UAPD beat back a major initiative by the University of California to take control of the health care of California’s 170,000 inmates.   After receiving an elaborate report from Governor Schwarzenegger about Texas inmate healthcare, authored by the Nuphysicia Corporation, the UC Board of Regents heard arguments from both sides at a series of meetings in San Francisco.  UAPD made a full court press in order to keep our prison doctors and dentists in CDCR.  We presented extensive evidence of the flaws in the Texas system and warned UC about the very real monetary and legal liabilities associated with this “sales pitch.”  With excellent turnout and eloquent participation from UAPD staff and our doctor members, we prevailed.  The plan was eventually dropped by the Regents.  The California Prison Health Care budget, however, continues to be a problem.  Federal Receiver Clark Kelso has made it clear in a recent op-ed that he wants the inmate population reduced and CDCR put out of the prison healthcare business.  He wants the Department split it up into Healthcare (run by an independent authority), Rehabilitation, and Parole.  Our Union is closely studying this proposal.

The last few months of this year have demonstrated what the cynical and negligent policies of the State can yield.  CDCR has proposed laying off some of our longstanding dentists from prisons across the state.  The State has curiously asserted that replacing 31 dentists with 63 Registered Dental Hygienists (RDHs) will save money and improve quality.  Neither statement is true, and we are prepared to prove this in a legislative oversight committee early next year.  Meanwhile, most of our permanent dentists who got layoff notices will be able to fill vacant positions.  In the Department of Social Services, where I worked 19 years, case production and bonus money have hit a roadblock with the onset of the “ECAT” system.  This inefficient and fractious program must be modified with the input of our Medical Consultants.  They, as well as Social Security claimants, deserve to have cases adjudicated in California and not have them outsourced.  UAPD further maintains that any earned Bonus case moneys should be PERS-able.  We are fighting this in court.  Finally we have all heard of the escalating violence in DMH hospitals across the State, especially at Napa.  UAPD demands a safe working and therapeutic atmosphere for its doctors, other DMH staff, and the patients that live at these facilities.  We are working nonstop with other unions and legislators to force DMH to take significant action to increase security and deal with the increasing forensic population in their hospitals.

There were some disappointments this year that I need to mention.  At the Yountville State Veterans Affairs Home, the Holderman acute care hospital was closed for “financial reasons.”  This despite vigorous objections from many unions, legislators and community groups that the contracting out of acute services is a big money waster.  UAPD went to court, filed an injunction, and won an SPB decision, but was eventually overruled in Superior Court.  There is very questionable leadership and decision making in the upper levels of the California Department of Veteran s Affairs.  UAPD still intends to shine the light on these wasteful contractors.  The same is true of the regarding contractor situation at Atascadero Hospital where the Court ruled against us as well.

2011 lies ahead as a year of great possibility.  As the state deficit mushrooms over 25 billion dollars, UAPD will bend the new Governor’s ear to explain why civil service employees are a much better deal for the State than contractors.  We will specifically discuss CDCR, DMH, DDS, DSS, DHS, PHS, VA and CSU policies with him and the State legislators, including our own UAPD member, newly elected Assemblyman Dr. Richard Pan of Sacramento.

I invite you, then, to study your new contract and come up with some new ideas to improve our State jobs and working conditions.  I truly admire and appreciate all that you do for our union and the State.

Dr. Bussey Addresses Potential Dental Layoffs in CDCR

December 14, 2010

Dear UAPD Colleague:

As a dedicated and hardworking dentist in CDCR, our union owes you admiration, respect and the duty to fight tooth and nail for your jobs. We have and will continue to exercise all of our legal and political influence to prevent the 31 layoffs which were recently proposed by CDCR and the Department of Personnel Administration (DPA) under the Schwarzenegger administration.

On November 10th and 19th UAPD met with representatives from CDCR and the DPA to challenge the 93 surplus notices (SROAs) that were mailed out to some of you. We pressed CDCR to explain exactly why it plans to cut 31 positions. UAPD made sure that they heard our main arguments loud and clear:

1.    Dentist layoffs will compromise the concept and practice of constitutionally equal care for inmates under the Perez court order.
2.    Using expensive dental contractors while laying off dental employees makes no economic sense.
3.    Hiring 63 dental hygienists (RDHs), with their limited scope of practice, would not make up for the loss of full service dentists; plus, it will create liabilities for inmates, dentists, and the State.
4.    There will be no significant financial savings to the State in such a paradigm.
5.    Why is the State still advertising for new dental hires despite the planned layoffs?
UAPD also objected to the way CDCR has abused the concept of limited term (LT) positions. The Legislature’s original intent for LT positions was to offset California’s manpower shortages during the early 1990s.  The intent was not to bust unions or to manipulate employees by turning them into long term “at will” employees. Senior UAPD Representative Zegory Williams and I have met with the State Personnel Board (SPB) attorney, who is investigating possible illegal extensions of any two-year LT contracts.

We have made some progress in these negotiations with CDCR and DPA. They have acknowledged that every effort will be made to place permanent dentists slated for layoffs into open or current LT positions. They also agreed that any LT positions remaining after layoffs will be converted into permanent positions, and that reemployment options will be expanded beyond the local county to which the layoff notice was sent. We have asserted the importance of correctly calculating seniority, accurately following contract language, and maximizing transfer opportunities for the affected dentists.

UAPD remains committed to the concept that these layoffs should be prevented altogether. We are combing over the suspect data which CDCR is using to justify the layoffs. UAPD staff has prepared a white paper which presents the economic and legal arguments against the layoffs. We also met with the Chief Consultant to the Chair of the Assembly Budget Subcommittee, which oversees CDCR’s budget, about the need to confront CDCR officials about their highly questionable data and reasoning. We hope that our new Governor Jerry Brown will agree with our logic. We will keep you informed of progress and events on all fronts.

In Solidarity and Wishing you Happy Holidays,

Stuart Bussey, M.D., J.D.
UAPD President

Chilean Miners, UAPD Docs

November 22, 2010

By Dr. Stuart A. Bussey, UAPD President

It was pure inspiration to watch thirty-three Chilean copper miners pulled up from their tomb into the light. These men put themselves into harm’s way to do their job. Luckily, the Chilean Government took the lead in their $20 million rescue. But can UAPD doctors similarly rely on their government to rescue them from their dangerous working environments?

Staff and I spent a lunch hour last week at Napa State Hospital (NSH), listening to the concerns and suggestions of our members regarding the recent murder of a Psychiactric Technician on NSH grounds. We analyzed the increasing assault trends at the five Department of Mental Health (DMH) hospitals since the “Recovery Model” was implemented in 2006. Medical staff requests to administration for more staffing, more police, working alarms, video surveillance and more secure units have gone unheeded.

Assaults and intimidation of UAPD doctors occur in sectors other than mental health; they happen in DDS and CDCR, in the Los Angeles County jails, in clinics and ERs, even in private pain management centers. Security conditions at Alameda County are only somewhat better since the murder of a UAPD doctor several years ago; she was strangled by a patient in her office during an intake exam. One social security disability claimant brought a gun into a courtroom close to our Medical Consultants’ office. Wherever there are lapses in custody and security, it is a concern for our doctors.

UAPD wants to reverse this trend of patient-staff violence. We are meeting with DMH staff and legislators to discuss substantive solutions like increased community and hospital police presence, creation of a high security ward, better surveillance technology, and if necessary, legislation to return violent, but legally sane, patients to prison. We need your help too—to alert us to dangerous conditions, to file safety grievances, provide suggestions and give testimony. California should go the extra mile to save its workers, just like Chile did.

Fall is UAPD Meeting Time

August 22, 2010

By Dr. Stuart A. Bussey, UAPD President

I would like to encourage you to attend this year’s UAPD Statewide Membership Meeting Weekend, which will take place October 22 – 23, 2010 in San Diego. Some highlights of the weekend are:

Free CME: On Friday morning, the UAPD Continuing Education Program continues with a special four (4) credit CE/CME entitled “Doctor-Patient Communication & Privacy: New Laws and Technologies.” In this class UAPD doctors and other experts will provide an analysis of Electronic Health Records, Telemedicine, and other technologies that may change the way we communicate with and about our patients.

Statewide Membership Meetings: On Saturday morning, members can attend one of five statewide membership meetings. For the first time, we will be holding a separate membership meeting for California State University (CSU) doctors. In addition, there will be membership meetings for State-employed, County-employed, Private Practice/IPA, and Retired doctors. Agendas for the meetings will be developed over the coming weeks.

Steward Training: Senior Labor Representative Patricia Hernandez, J.D., will train state stewards and county leaders in grievance handling, dispute resolution, and contract enforcement. The training, which is open to all interested members, will serve as an introduction for new stewards and a refresher course for experienced ones.

Registration forms have already been sent to all UAPD members. Those of you who attended last years meetings know how useful and entertaining they were, and this year promises more of the same. I hope to see many of you there!

Beware of Docs-In-a-Box

June 22, 2010

By Dr. Stuart A. Bussey, UAPD President

The well dressed man on the TV screen sounded as if he were reading movie lines to the inmate sitting across the room on the exam table.  “Mr. Fleming, it appears you have had a heart attack…a helicopter will take you to the hospital for treatment.”  It was so smooth and effortless, and all sponsored by NuPhysicia, a small Texas telemedicine company which, with Governor Schwarzenegger’s blessings, is trying to convince the University of California (UC) to take over from CDCR as employer to UAPD’s 800 prison doctors and dentists.

NuPhysicia has been involved in the delivery of healthcare by the University of Texas Medical Branch (UTMB) to Texas’s 120,000 inmates since the early ‘90s.  Now it wants to expand telemedicine into all areas of California’s prison health care system.  Interestingly, NuPhysicia is partially owned by UTMB, and one of its founding board members, Dr. John Stobo, is now acting as an avid proponent of the plan in his role as senior vice president for health sciences and services at UC.  Aside from this potential conflict of interest, there are several serious problems with this UC telemedicine proposal.

For one, the purported savings of a billion dollars a year to California because of this plan is grossly exaggerated. It would be more in the range of 17-35 million dollars a year, and that’s not including offsets for infrastructure, extra personnel and prisoner lawsuits. So where do you think the majority of savings would come from?—the severe downsizing of medical and dental staff and cuts to salaries! UC is a notoriously anti-union employer.  Most importantly, quality and continuity of care and the doctor-patient relationship would greatly suffer with the indiscriminate, unrestricted use of telemedicine.

UAPD doctors and staff have vigorously presented these arguments to the press, the Legislature, the Receiver and especially to the UC Regents. We will continue to fight for real, human and consistent inmate care in the face of the “ Docs-in-the Box .”

People Power Challenge

April 22, 2010

Because of the vast monetary resources involved, the medical profession is always under of public and government scrutiny. With the passage of Health Care Reform we are awakening to the dawn of a more socialized form of health care. In the name of cost saving the Governor has just released his proposal to shift our union’s prison doctors from the State bureaucracy to the UC bureaucracy. Doctors may feel like pawns in these political maneuvers, but by standing together with Big Labor we can exert PEOPLE power.
By Dr. Stuart A. Bussey, UAPD President

AFSCME’s PEOPLE program has been going strong for years. Monthly contributions to this fund come from members in every state. The objectives of the PEOPLE program are relevant to UAPD’s membership: to educate, organize and mobilize members in support of legislative and political programs which benefit members; to develop state and national legislation (e.g, collective bargaining for private doctors); to educate members on the records of electoral candidates; to endorse those whose actions promote our welfare; and lastly to improve our welfare through unity of action within our Labor family.

Over a dozen UAPD members recently attended the annual PEOPLE Convention in Sacramento. We were embarrassed to learn that UAPD has one of the lowest levels of member participation of any local. An MVP membership in California PEOPLE requires only an $8/month commitment. Most AFSCME members in other locals make a fraction of our salaries, yet they contribute at that level. If we as doctors want political benefits and influence within the House of Labor we should contribute to its upkeep. I urge you to fill out and return the donation form on the back page of this newsletter and help to increase UAPD’s PEOPLE power!

Health Care Reform Lessons From Haiti

February 22, 2010

By Dr. Stuart A. Bussey, UAPD President

Say what you want about slow or disjointed medical relief efforts in Haiti. Yes, there is chaos and immense human suffering. Hundreds have been saved and hundreds of thousands have not. But at least there are no insurance companies or attorneys making things worse.

Whether you work for a state or county employer or are under the thumb of an insurance payor, you have to acknowledge a certain degree of awe and envy of the providers on the ground in the Caribbean. There are no formularies to follow, no prior authorizations, no claims or utilization review, no attorneys, medical directors or hospital administrators looking over your shoulders in the makeshift ORs. Just doctors helping people. For those of us fortunate enough to have volunteered service in the Third World, a grateful smile is adequate reimbursement.

Governments around the world are now passionately responding with ingenuity and flexibility to this enormous health crisis, superimposed on an already impoverished nation. It is “health care reform” in the extreme. In contrast, our own health care reform proposal is staggering to an uncertain finish line. If any insurance reforms are passed, they will be few—pre-existing condition may be allowed, policy rescissions and lifetime caps disallowed. It would be just a start. Payors, however, will likely retain most of their administrative and bargaining power over doctors. Moreover, they may control greater numbers of patients if there is any individual mandate to buy their products.

It’s a far cry from the hands-on health care delivery going on now in Haiti. Perhaps we should educate our insurance executives. Let’s airlift them over to Port-au-Prince to do triage and assist with amputations.

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