New York privatizing state hospitals; unions seek reversal

A special session of the state legislature in December failed to block a controversial order that will close and privatize nine healthcare facilities in New York state starting in January. The closings include three valuable public teaching hospitals: the State University of New York (SUNY) Health Sciences Centers at Stony Brook, Brooklyn and Syracuse.

The plan, issued by a state healthcare commission, took effect Jan. 1. It has drawn an outcry from concerned unions, including the AFT-affiliated New York State United Teachers (NYSUT), the New York State Public Employees Federation (PEF) and the United University Professions (UUP), whose members testified at standing-room-only hearings across the state and mustered hundreds for a rally at the state capitol Dec. 13.

At stake is the plight of growing numbers of uninsured families.

“Millions of New Yorkers have no health insurance,” says NYSUT executive vice president and AFT vice president Alan Lubin. “Privatizing and closing the very hospitals that provide them care could literally be a death sentence for some of these uninsured New Yorkers.”

The most immediate concern to the union is the commission’s order to merge SUNY Upstate Medical Center in Syracuse with Crouse Hospital.

PEF president Kenneth Brynien, also an AFT vice president, says the union is not opposed to an affiliation between the two facilities, “but we are absolutely opposed to the idea of relying on the failed operating model of Crouse.” Crouse Hospital, with average occupancy rates of less than 50 percent, recently emerged from bankruptcy after running up $91 million in debt,
$62 million of which must be repaid.

Brynien says the commission—also known as the Berger commission after chair Stephen Berger, chairman of private investment firm Odyssey Investment Partners—ignores a 2000 study finding SUNY Upstate’s operating structure competitive and successful. Upstate Medical Center is financially sound and has an average occupancy rate of 80 percent.

“It’s like treating a heart attack by amputating a leg,” says NYSUT president and AFT vice president Richard Iannuzzi. “Privatizing vital healthcare services and eliminating physician training and education programs will only make New York’s healthcare problems worse.”

Privatizing healthcare in central New York also could take jobs out of a shaky local economy, adds Jemma Marie Hanson, Region 11 coordinator for PEF, who points out that Upstate Medical Center operates a major burn unit.

As it stands now, she says, for every dollar the state puts into public hospitals, it gets $12 back into the economy. “We’re the ones giving back to the state,” she points out.

The commission also recommends a privatization feasibility study of two other SUNY teaching hospitals: Stony Brook on Long Island and Downstate Medical Center in Brooklyn. “These hospitals treat a large indigent population whose care could be threatened by privatization,” Brynien says.

This privatization process could affect 30 percent of UUP’s 32,000 members. PEF represents about 900 healthcare professionals at SUNY Upstate Medical Center and an additional 2,000 healthcare professionals at SUNY Downstate and SUNY Stony Brook.

If these facilities are privatized, the employees would lose their status as state employees, including pension rights, union contract rights and civil service protections.

AFT vice president Candice Owley reflects on what’s happened since Milwaukee lost its only public teaching hospital about a decade ago. The private hospital that replaced it can turn away Medicaid patients, make it hard for anybody without insurance to be admitted, raise fees and close unprofitable wards without public debate.

“It was an enormous loss to our community,” she says, and recommends that AFT members fight tooth and nail to stop privatization or at least push for some kind of accountability model like a public-private partnership.

Back in New York, Hanson notes that putting the fate of public hospitals in the hands of a private commission circumvented the normal legislative process.

Among the next steps AFT members can take is promoting state legislation expected early this year that would return the decision to elected lawmakers.

Labor board ruling provokes international protests
AFT legal counsel offers practical steps locals can take to offset Kentucky River

The list of nations accused of violating human rights and international labor laws now includes the United States, thanks to a recent decision by the majority Bush-appointed National Labor Relations Board that could strip union rights from as many as 8 million U.S. workers.

In late October, the nonprofit organization U.S. Human Rights Watch wrote to NLRB chair Robert Battista expressing “deepest concern” over the board’s ruling in three cases known collectively as Kentucky River and centering on one case, Oakwood Healthcare Inc.

As reported in the November/December issue of Healthwire, the board’s decision in Oakwood expands the definition of “supervisor” under federal labor law to include nurses and other employees with very limited authority over co-workers. It effectively allows employers to strip these “charge nurses” and others of their union protections and potentially fire them for engaging in union activity. Even rotating charge nurses who spend as little as 10 percent of their time in such assignments could be labeled as “supervisors.” If employers take this bait, the decision could keep millions of workers out of unions.

Oakwood violates “the principles of freedom of association as established in international law,” Jamie Fellner, director of U.S. Human Rights Watch, warned the NLRB. “The board majority turned its back on international human rights and labor rights standards and flouted U.S. obligations under international law.”

The AFL-CIO also has taken the NLRB’s attack on fundamental labor rights to the international community. In October, the labor federation filed a protest with the United Nations’ International Labor Organization. Oakwood illustrates “how far outside the mainstream of accepted international law the U.S. is moving,” says Craig Becker, legal counsel to the AFL-CIO.

What you can do
While Oakwood plays out on the world stage, AFT general counsel David Strom advises AFT nurses not to refuse charge duty with the idea of avoiding the label “supervisor.” Any concerted refusal to perform charge duty could be considered a partial work stoppage, which is illegal under the National Labor Relations Act (NLRA).

A better strategy, Strom says, is to negotiate contract language developed to protect union members from being classified as supervisors. In short, your employer should agree in your contract not to challenge the status of employees in the bargaining unit; not to assign supervisory duties to union members; and not to assign bargaining unit work to supervisors. To get a copy of sample language and an analysis, contact the AFT legal department at 202/393-7472.

Strom also urges locals to keep developing their capacity for comprehensive campaigns that can derail any employer efforts to take advantage of Oakwood. Already, in Toms River, N.J., a hospital is delaying a union election by claiming that charge nurses there are ineligible to vote.

Finally, Strom advises strengthening solidarity in the ranks to guard against such employers, who try to divide and weaken the union by singling out “supervisors.”

Local leaders couldn’t agree more. “When you’re under the cloak of your employers, how are you going to say patient care is deteriorating?” asks Anne Goldman, a special representative with the Federation of Nurses/UFT in New York City and a member of AFT Healthcare’s program and policy council. “We’re the voice of patient care and the union gave us that voice. How dare [the NLRB] try to silence us?”

What’s next
Meanwhile, our AFT legislation and legal departments are working with the AFL-CIO on a legislative fix. This legislation will become a key component of the union movement’s agenda as a new, more labor-friendly Congress takes over in January.