Banning mandatory overtime

"It is declared to be the public policy of this State to establish a maximum work day and work week for hourly wage health care facility workers, beyond which the workers cannot be required to perform overtime work, in order to safeguard their health, efficiency, and general well-being as well as the health and general well-being of the persons for whom these workers provide services."

Translation: in the state of New Jersey, in all health care facilities, no employee shall be forced to work overtime.

This legislation, passed unanimously by the New Jersey Senate and by 77 to 1 in the Assembly in late June but is still awaiting the governor's signature, is a supplement to the New Jersey State Wage and Hour Law. It prohibits requiring hourly wage workers to work in excess of eight hours per day or in excess of 40 hours per week, "except in the case of an unforeseen emergent circumstance when the overtime is required only as a last resort." The recently passed bill also specifies that acceptance of such overtime would be "strictly voluntary, and the refusal of such work would not expose workers to discrimination, dismissal, discharge or any other penalty or employment decision adverse to the employee."

Who fought for this law? The Federation of Nurses and Health Professionals and its affiliated Health Professionals and Allied Employees, which is centered in New Jersey and Pennsylvania, and the coalition of unions and community groups it belongs to: Patients First. Now, the groups are rallying the community to urge New Jersey Gov. Christie Whitman to sign the bill into law.

It was HPAE and Patients First that made sure the bill--now law--on the use of safer needle devices was introduced and passed in the state. And it was FNHP members in New Jersey and Wisconsin who ensured passage of whistleblower protection bills. In fact, it is health care professionals working together for the passage of laws and for the election of supportive legislators that is winning more and more legislation beneficial to health care workers and their patients, says FNHP program and policy council chair Candice Owley (see "Critical Issues,").

"Forced overtime ... should be prohibited in a health care setting where patients' lives are at stake," says Owley. "Employees should not be forced to choose between keeping their jobs and neglecting their children. No patient should ever have to receive care from an employee who could easily make errors due to fatigue."

While locals of the Wisconsin FNHP, which Owley heads, have made great strides in establishing contract protections that prevent or restrict the use of mandatory overtime, "more must be done," says Owley. The WFNHP has launched a campaign for legislation to ban forced overtime for health care workers.

Years of intense lobbying have borne fruit for the Federation of Nurses and Health Professionals of the New York State United Teachers/AFT (NYSUT). Thanks to their efforts, the state now has legislation protecting health care workers against accidental needlesticks and prohibiting retaliation if they blow the whistle on hospital practices that hurt patients.

The legislation passed the Senate and Assembly in the closing hours of this year's session in mid-June. Both bills are as yet unsigned.

"These two bills are absolutely critical not only to the state's hard-working nurses, but to maintaining quality patient care in hospitals all over the state," said NYSUT executive vice president Alan B. Lubin.

The so-called needlestick bill protects nurses by requiring hospitals to purchase hypodermic needles that have protective shields or automatically retracting needles.

The Whistleblower Protection for Health Care Professionals Act protects nurses and other health care employees from retaliation by their employers if they blow the whistle on hazardous practices that jeopardize patient care.

"Health care employees should be able to work in an environment that fosters the improvement of health care, not one that ... keeps employees in fear of retaliation if they speak out," said Pat Beck, a Syracuse school nurse who chaired the FNHP/NYSUT advisory committee for the past two years.

In an almost straight party-line vote, the House of Representatives in late June narrowly passed (217-214) a Republican leadership bill that relies on private insurance companies to supply prescription drug benefits to low-income seniors.

The bill--the Medicare Rx 2000 Act (H.R. 4680)--provides subsidies to insurance companies to offer a prescription drug benefit but does not provide a guaranteed benefit or premium. It also would not be affordable for many middle-income seniors or provide effective catastrophic coverage.

"The Republican leadership's plan has more to do with providing political cover for the fall elections than with the health care of Medicare beneficiaries," AFT president Sandra Feldman said in a statement about the plan. "It should be rejected soundly."

The National Council of Senior Citizens calls it "a fraud and a callous partisan attempt to create the illusion of sensitivity to the desperate need of millions of seniors for affordable prescription drugs."

The insurance industry generally opposes the bill as unworkable. President Clinton has promised a veto. And, prior to the House Republican plan, Clinton announced that he would submit an expanded Medicare prescription drug plan to Congress to guarantee that no Medicare beneficiary would have to pay more than $4,000 a year for prescription drugs. The Clinton-Gore plan would be financed by funds from the federal budget surplus. There would be a $250 deductible each year under the GOP plan, but none under the president's plan.

At the AFT convention this summer, the union pledged its support for federal legislation that provides affordable and fair drug coverage for Medicare recipients.

In October of this year, the "prospective payment system (PPS)," which affects home health care funding, takes effect. While the new funding formulas provide some relief to home health care and visiting nurse agencies attempting to provide high-quality and needed in-home care for Medicare patients, it doesn't go far enough to restore cuts made through previous legislation. During the FNHP's Lobby Day in June, Jim Doelling, president of the Federation of Visiting Nurses and Health Professionals, Local 5022 in Rhode Island, and his members met with their representatives on Capitol Hill to push for better funding. Doelling says that the 15 percent reduction in home health care funding, which is being delayed for one year, should be eliminated completely. The new PPS is fairer "but it is still not sufficient to meet the needs and cost of the increasing number of frail and sick patients who are being sent out into the community."