HONOLULU (HawaiiNewsNow) -
The Hawaii Nurses Association
and Kaiser Permanente Hawaii confirm they have been in talks to plan a
restructuring of Kaiser care that could mean new assignments and some layoffs.
Sources say there is a fairly complete plan on the table,
which protects most current nursing assignments and gives a full year of paid
employment to others while they find new assignments.
Discussions were held away from the public spotlight, as
is standard for labor negotiations, but the HMO and the union confirmed the
talks, and sources revealed new details of the plan, after worried nurses began
mentioning the talks to media and patients.
"I don't know if I'll still have a job then," a
nurse told a patient who was scheduling an appointment in six months' time and
remarked that she would see the nurse then.
She probably will. What her union has been discussing
with Kaiser management, sources say, is a plan under which any nurse who gets a
layoff notice would actually be transferred to a nursing pool while the nurse
seeks a new assignment and, in some cases, acquires new training or
certification.
Proposals put on the table in labor negotiations don't
necessarily remain there at the end, but in this case the proposal accords with
national Kaiser policy when operations are reconfigured.
Kaiser Hawaii has roughly 900 nurses of whom 100 could
eventually be faced with seeking a different assignment, sources said.
Management confirms it will close the Honolulu Urgent
Care Center, which typically treats only 30 patients a day. Patients will
instead be treated upstairs by the other doctors and nurses at the clinic.
Sources said there is also a plan to develop a unit that specializes in caring
for patients with diabetes.
An internal memo obtained by Kristen Consillio of the
Honolulu Star-Advertiser referred to 47 pending job cuts among registered
nurses in Kaiser clinics across the state. Kaiser has been leaving some
openings unfilled, and already has enough to absorb most of the nurses who lose
existing assignments.
Medical clinics across the country, struggling to control
the rise cost of health care, have found that it saves money to stop using
registered nurses for work that can be done by licensed practical nurses and
medical assistants. A registered nurse can make twice what they do.
Registered nurses say their greater education provides a
safety benefit, but management sources at Kaiser and in two other local medical
organizations say there are other ways to ensure safety that are more
affordable.
Health care costs have been rising several times faster
than overall inflation for many years. But there is a complicating addition
factor for labor and management alike: the Affordable Care Act, better known as
Obamacare, is changing the rules for health service billing, and compensation
for acute care clinic operations could be reduced. Neither side can be sure of
the impact since the federal government is under enormous pressure to reduce
spending and all expenditures are being revisited.
Kaiser management and the nurses association are having
daily communications on the plan.
