Editorial: Nassau medical center pact reflects new realities
At last, a public employee union that understands it must keep the golden goose alive.
As Nassau County and its police unions wrestle over the affordability of their contracts with a broke county, it's worth a look at the progressive deal that recently went down between the Civil Service Employees Association with the Nassau University Medical Center in East Meadow.
First of all, the six-year contract was negotiated without a scary arbitrator in sight. Although it took three years of tough bargaining and concessions, the result not only protects both the employees and the institution, it smartly lays the groundwork for new alliances.
CSEA president Jerry Laricchiuta understood that the tremendous upheaval going on in the health care system would result in winners and losers among hospitals. "There was not a lot of money in this contract, but we all had an interest in the doors staying open," he said.
And the union recognized the tireless efforts of Arthur Gianelli, chief executive of NuHealth, the public benefit corporation that includes the medical center, A. Holly Patterson Extended Care Facility in Uniondale and five local health centers. Gianelli is skillfully navigating through the ongoing consolidation among providers as dramatic changes occur in reimbursement rates.
CSEA, representing 3,500 NuHealth employees, realized that after three years of uncertainty, the future of NUMC, a level one trauma center that accepts all patients regardless of their ability to pay, was still at risk. The contact has no retroactive raises. In the third and fourth years, workers will get a $750 cash payment, not a compounding benefit. In 2015, the final year, there is a 4 percent raise.
NUMC has already reduced its workforce, which is 96 percent unionized, by 350 employees, so Laricchiuta's priority was a no-layoff clause -- and he got it. The only exception is if the state shuts down a program.
For Gianelli, besides holding down wages, the goal was to encourage current employees who contribute to their coverage, as well as new ones, to use NuHealth. New hires who go outside the system for care will pay 22 percent for the first five years and see a sliding scale afterward. If they use NuHealth, there are no premiums or co-payments. This not only lowers the tab for benefits, it puts the money back into the system. And it makes a statement about NuHealth's care by those who deliver it.
Moreover, the self-insurance plan will allow the NuHealth network to join other regional health care systems, such as the North Shore-LIJ Health System, that are seeking to replace traditional insurers.
And the cushy benefit of free health care for life after working just five years will change. The vesting period is now 20 years, and all of the time must be spent at NuHealth. There is also a pool of $200,000 for bonus pay, a fair start toward rewarding merit. And if there's a surplus, there will be profit sharing for employees. "It's good for morale when people feel they are part of the system and not an albatross that you have to get rid of," Laricchiuta said. Union members, from housekeepers to physicians, approved the contract with 94 percent of the vote.
This contract acknowledges that public hospitals are in peril. But so are local governments and school districts. What it shows is that fundamental changes in public employee benefits and work rules in exchange for job security are doable. Some teacher contracts have already done so. The golden goose fable still teaches a lesson. Be mindful that there may be a day when the golden eggs come no more.