In a media release Thursday, Southern United Nurses/National Nurses United (SUN/NNU) raised concerns with overtime and staffing in an attempt to justify its announced one-day strike by ARH Registered Nurses at two ARH locations on Thursday May 1, 2014. ARH is surprised at this SUN/NNU claim since there has not been significant discussion of staffing and overtime during contract talks.

These claims are far different from the main sticking points cited by SUN/NNU during its negotiations with ARH.

Economic issues, such as the Registered Nurses’ request for triple-pay for working on holidays, coupled with a cumulative 15% across-the-board pay raise spread over three years, are the real reasons for the deadlock and impasse in these negotiations. There has been little mention of staffing or overtime issues during negotiations.

One area where staffing has been raised in negotiations concerns mandatory overtime. In its “Last, Best and Final” contract proposal presented to SUN/NNU on April 14, ARH has proposed to modify the existing contract prohibition against mandated overtime of Registered Nurses based on their seniority. ARH has proposed to raise the seniority cap on mandatory overtime from its current limit of 16 years or greater seniority. This is due to the fact that during the proposed contract period, approximately 31 percent of ARH’s nursing workforce would come under the 16-year seniority mandatory overtime prohibition and would not be available to work when needed. This limitation on the ability of ARH to mandate necessary overtime creates significant staffing challenges.

As far as overtime work is concerned, the normal work shifts of the Register Nurses include one week in which the nurse works three, 12-hour shifts. The next week of the pay period, the nurse works four 12-hour shifts. This schedule results in an average of four hours of overtime every pay period. This is a negotiated schedule between ARH and the SUN. This schedule was negotiated for the convenience of the nurses. It allows the nurse to enjoy four days off in the week the nurse is scheduled to work three shifts and 3 days off in the week the nurse is scheduled to work four shifts.

Another item cited by SUN/NNU in its press release was an increase in health insurance premiums.

ARH has made significant efforts to minimize health insurance premium increases for our employees. However, inflation, the Patient Protection and Affordable Care Act (ACA) requirements that have taken effect since the last contract, and other external factors have caused ARH’s health insurance costs to increase, as they have for virtually all employers across the country.

Our nurses currently are paying 2.5 percent of salary based upon an assumed average monthly salary in out of pocket medical insurance premiums. For 2014, ARH is proposing a slight increase (1%) in the Registered Nurses salary participation for health insurance premiums, with the subsequent year increases of ½% (one half percent) with participation in a Wellness Plan. The Wellness Plan offers lower premiums for participating in the wellness initiatives built into the ARH Wellness Plan – tobacco free lifestyle, health provider screening visit, health assessment and annual flu shot.

Overall, the cost of health insurance at ARH is very affordable compared to the market. For example: Nurses under the contract will be paying $132 for single coverage and $226 for family coverage per month. If the nurse and/or family use ARH services, there are only minimal co-pays and no deductibles. You would be hard-pressed to find comparable coverage at these rates on the newly rolled out Health Exchanges.

The big driver of the increase in premium is the added coverage and cost afforded under the Affordable Care Act to include:
• The elimination of lifetime maximums
• Coverage of dependent children until age 26
• Reduction of waiting time for enrollment by 30 days
• Added PCORI tax assessed to the employer
• Increased coverage for wellness care
• Increase costs related to added administrative requirements

We believe these premiums are both fair and modest considering the average health insurance premium increase nationwide is 6.5% on average, with reports of increases as high as 8% regionally. Another contributing factor to the increase in health insurance costs is the new reinsurance fee. As required by the ACA, a reinsurance fee of $63 per year, per covered person, will be assessed. It is mandated by the ACA that this fee be charged from 2014-2016.

A federal mediator involved with negotiations is urging both sides to reach an agreement prior to the existing contract’s expiration on April 30, 2014. Should agreement not be reached, ARH has notified SUN/NNU of its intention, in view of the deadlock and impasse in negotiations, to move forward with implementation of its “Last, Best and Final” offer upon the expiration of the current collective bargaining agreement.

ARH has a responsibility to its patients and communities to continue to provide care as normal if SUN/NNU strikes ARH in Hazard and Beckley. The hospitals are prepared to continue operations notwithstanding SUN/NNU’s announced one-day strike.

We have a contingency plan in place to ensure that our service to our patients will go on uninterrupted during any strike. The level of care will not be compromised.

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