NY Nurse February (Capital Region/North Country)

New York

nurse capital Region/North Country Edition | February 2019

the official publication of the new york state nurses association

Ellis Medicine RNs give input on new procedure, p. 3 Ellis Medicine RNs Denise Davella, Nicole LaRosa, Jennie Collins and Nancy Brandon

Protect Our Care: No Cuts!, pp. 7-10

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New York Nurse february 2019

Why nurses strike

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By Judy SheridanGonzalez, RN, NYSNA President

s I write this, thousands of nurses in New York are taking strike votes.

Thousands more are struggling with impossible patient loads. Most of us leave work exhausted and unfulfilled, unable to deliver the kind of care we’re trained for. Like teachers, we’re responsible for a precious yet vulnerable population, are beloved by the communities we serve and exploited by the systems we work under.

Nursing today

Advocating for patients. Advancing the profession.SM Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP First Vice President Anthony Ciampa, RN Second Vice President Karine M. Raymond, RN, MSN Secretary Tracey Kavanagh, RN, BSN Treasurer Patricia Kane, RN Directors at Large Anne Bové, RN, MSN, BC, CCRN, ANP Judith Cutchin, RN Seth Dressekie, RN, MSN, NP Jacqueline Gilbert, RN Nancy Hagans, RN Robin Krinsky, RN Lilia V. Marquez, RN Nella Pineda-Marcon, RN, BC Verginia Stewart, RN Marva Wade, RN Regional Directors Southeastern Yasmine Beausejour, RN Southern Sean Petty, RN Central Marion Enright, RN Lower Hudson/NJ Jayne Cammisa, RN, BSN Western Chiqkena Collins, RN Eastern Martha Wilcox, RN Executive Editor Jill Furillo, RN, BSN, PHN Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 x 159 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2019, All rights reserved

Some of us have nightmares, remembering we left out important documentation, forgot to do a task or share critical information with the nurse on the next shift. Or we worry about patients discharged too soon, or families whom we know will return shortly with a grandmother no one can care for, as outside supports for her simply don’t exist.

We leave work haunted by the image of an emergency room that resembles a post-disaster rescue tent, or an in-patient floor with patients’ feet dangling off stretchers serving as their hospital “beds,” housed in open corridors, with only thin screens for privacy. We agonize about the new mom we didn’t get to work with on breastfeeding and basic issues surrounding bringing a new baby home.

We invent work-arounds for computer documentation or unrealistic policies that impede our ability to interact with our patients with intelligence and compassion. We suffer the indignities—and even violence—visited upon us by frustrated patients and their family members, as we serve on the front lines of a dysfunctional medical system that we have absolutely no say in or control over. Meanwhile, administration blames us for everything that goes wrong within that system, even as we point out its inefficiencies and failures on a regular basis.

What do nurses want?

We want to practice our profession with the respect it deserves. We want to care properly for our patients. We want to rejuvenate the joys of compassionate care, to ensure its rewards will excite our youth and encourage

Members on informational picket lines, February 13

them to pursue nursing as a career.

We want the necessary tools to do our job. We want to go home knowing we can also care for our families and ourselves.

Recently, one of our young nurses blogged the following: “This is the first morning I left the hospital feeling like an excellent nurse…able to spend quality time with my patients.

My 95+ y.o. shared her secrets to a long life while I helped brush her teeth and wig, visited with former patient and saw his wounds were healing incredibly well, and my cute little noninteractive patient finally spoke to me and took her p.o. meds…”

Why is a day like that an aberration? Did an oversight occur, resulting in adequate staffing for the shift? Shouldn’t every shift be filled with such experiences?

They’re not listening

Every health system in which NYSNA nurses work receives Protests of Assignment (POAs) on a regular basis. These POAs are combined into “Patient Care Chronicles,” providing an overview of the abysmal working conditions that result in an increasing number of nurses leaving the profession.

Understaffing—the refusal of our hospitals to adhere to minimum nurse-to-patient ratios or reasonable

caseloads for community care providers—results in preventable morbidity and mortality rates for our patients. But our employers refuse to listen to us when we try to salvage what’s left of the nursing profession and insist upon being able to fulfill our role in caring for our patients.

The last resort

All workers strike for dignity and respect in the workplace and for improvements in the quality of our own lives. Those of us who provide essential services are constantly told, “There’s no money in the budget.” Who’s accountable for such budget decisions? We see enormous waste, unnecessary lavish expenditures, taxes that starve the working class while providing endless benefits to the super-wealthy. As community advocates, we can’t stand by while monies are diverted from healthcare and education in order to enrich corporate coffers.

Nurses decide to strike when it becomes a matter of life and death for our patients. When months and years of meetings, documentation, evidence, petitions, letters, research, protests, speeches, essays, negotiations, pickets, rallies and media outreach fail to achieve these goals, our employers leave us with no other choice.

NURSES STRIKE TO SAVE LIVES.

capital/ north region

NEW YORK NURSE/CAP-NORTH

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february 2019

Ellis nurses have their say

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ou might not know much about transcatheter aortic valve replacement (TAVR), but the groundbreaking, risky procedure could be the surgery needed to save your next patient’s life.

TAVR is often reserved for those for whom open-heart surgery would pose an immediate risk. As a result, it is absolutely essential for a cardiac hospital to ensure that patients have a full range of options to make the best decision possible.

A critical voice

The Wright Heart Center at Ellis Medicine is home to one of the Capital region’s leading cardiac programs. With an incredibly adept staff of doctors and surgeons, technologically advanced facilities— and talented nurses, Ellis Medicine is known as the place to go for cardiac procedures and surgery.

A little over a year ago, the hospital announced it would begin training the staff to implement TAVR, a minimally invasive surgical procedure that repairs aortic

valves that fail to open properly, preventing blood to flow from the heart smoothly. The only problem was nurses were never included in the conversation.

An active role

A crucial stage of TAVR is the recovery period, during which nurses are critical to ensuring that patients get the support and care they need. By excluding nurses from the conversation in the roll out of TAVR, a key voice was missing.

Denise Davella, RN, currently works in the Cardiac Cath Lab at Ellis and believes TAVR directly impacted nurses because these patients were going to need to recover from the procedure.

“While you’re in procedure, obviously you have the physicians there and you’ve got all the ancillary staff, but afterwards it’s the nurse that’s going to be solely responsible for this patient and at the bedside,” said Davella. “What we were concerned about is where exactly were these patients going to be recovered? And what kind of protocol was going to

be in place? Are patients going to go to the recovery room? Are they going to go directly to ICU?” Davella continued, “There had to be some kind of criteria that dictated where these patients were going to best be recovered to provide a safe and appropriate level of care.”

Like most nurses, Davella wants to make sure patients get the best care possible, which meant having input from nurses.

A new procedure

“We made it perfectly clear to administration that the direct bedside care provider needs to have an active role in any of these kinds of procedures,” she said. “I think it really drove home the point to administration that we’re not just going to allow decisions to be made for us. We want to be part of the decision-making process.”

Ultimately, the hard work and efforts of the Ellis Medicine nurses paid off. They were included in the decision making-process and had their voices heard in the rollout of TAVR.

“We made it perfectly clear to administration that the direct bedside care provider needs to have an active role in any of these kinds of procedures.”

– Denise Davella, RN

(L-R) Ellis Medicine RNs Freya Smith, Denise Davella, Lorraine Pizzo and Ramona Schwartz

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New York Nurse february 2019

Make them pay their fair share!

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By Jill Furillo, RN, NYSNA Executive Director

According to the Joint Committee on Taxation the 2017 federal tax law will cost the federal budget an estimated $1.5 trillion over the next decade in lost taxes.

ake no mistake: New York and other states became targets of the federal government when they expanded Medicaid for those in need. This malicious attack on vulnerable patients—on health systems that provide care to the under-served, uninsured and others who rely on fair and equitable funding—will do irreparable harm to millions of Americans.

That’s why we’re working with a coalition to fight cuts to healthcare and to make the super wealthy pay their fair share.

The federal tax rates that go into effect with the 2018 tax year filing are a giveaway to the very rich on a massive scale. According to the Joint Committee on Taxation the new tax law will cost the federal budget an estimated $1.5 trillion over the next decade in lost taxes.

Scions of corporate America

Not fully satisfied with all the money the most privileged will receive from the reduction in tax rates, the new law gives them even more, creating “a powerful incentive for super-wealthy Americans to shelter large amounts of income in corporations,” says the Center for Budget and Policy Priorities. Once qualified as corporate money, the super-rich take advantage of slashed corporate tax rates. The law, reports the Tax Policy Center, “has turned us into a nation of tax shelter hunters.”

What about our nation’s children? The Child Tax Credit that gave some relief to working families in past years has been changed.

The result is that 10 million children under 17 in low-income households will receive a token $75 or less, while a family of four with $400,000 in annual income qualifies for a credit of $4,000.

The fight back in New York State

There are 75,000 apartments in New York City owned by people who do not live in the city full time.

Our allies at the organization, Strong Economy for All Coalition, have proposed several state tax initiatives that would bring more fairness and offset the federal tax cuts.

Assembly Speaker Carl Heastie and the Assembly Majority Confer-

ence have proposed new state tax brackets “to capture the explosion of income and wealth among multimillionaires and billionaires,” says Strong Economy. By their account, additional brackets for marginal income over $5 million a year, $10 million and $100 million would raise over $2.1 billion annually.

There is also attention to “carried interest,” a gaping loophole that allows the richest to pay the lower capital gains tax rate on fees they reap from investorclients. To address this gross inequity, Governor Andrew Cuomo included a state-level “carried interest fairness fee” in his budget.

Estimates are that this fee would raise over $3.5 billion a year.

Look around at the towers in the sky proliferating New York City’s skyline. One condo sold recently for $238 million to Chicago hedge fund billionaire Ken Griffin—the most expensive residence ever sold.

There are approximately 75,000 apartments in New York City owned by people who don’t live in the city full time.

Third, fourth, fifth residence…

That’s why Strong Economy and its allies are proposing a Pied-àTerre Tax. It’s a sliding scale surcharge on luxury condos and other residences that are second, third, fourth—even fifth—homes of the

richest of the rich. The highest surcharge would apply to homes valued at more than $25 million. In 2017, New York City had a 15 percent one-year increase in residents with over $30 million in assets— it’s now home to 103 billionaires.

Senator Brad Hoylman and Assembly Member Deborah Glick are sponsors of legislation that would put in place both a carried interest fairness fee and the pied-àterre tax.

A tax on the uber wealthy would raise billions. This money could be directed to better the public schools, fund needed infrastructure, housing and healthcare for all.

Which takes us to the Medicaid cuts triggered by the federal attack on New York and other states (see pp. 8-10). These billions in additional tax revenue described above would help address the Medicaid shortfall we are facing today. The federal tax policy falls hardest on the real safety net hospitals that provide care to the underserved, communities of color and rural residents where healthcare resources are scarce. These tax revenues would make all the difference addressing the compelling health needs of today.

With our coalition fighting for greater equality in taxation, we can make the difference in the lives of working New Yorkers!

NEW YORK NURSE

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february 2019

“We’ve had enough.”

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urses around the country are assaulted in the workplace every day. In fact, acute and long-term subacute care hospitals have the highest rate of workplace violence of any work setting nationwide. At Bellevue Hospital Center, part of the NYC Health + Hospitals system, a recent incident had NYSNA members saying enough is enough.

In early February, a NYSNA member working in the Bellevue ED was brutally assaulted by a highly agitated patient. The patient was restrained, but was able to get out of the wrist restraints. Hiding behind a curtain, the patient then attacked the nurse as she left the staff lounge. If a colleague hadn’t seen her being pulled into a nearby room, the nurse might have sustained permanent injury or possibly been killed.

Recently assaulted Bellevue ED nurse’s co-workers at the courthouse to show support during a grand jury hearing of her assailant.

A near miss

New York City Health and Hospitals Police Department (NYHP) arrested the patient and the RN who was assaulted has pursued this case, working with the District Attorney’s Office to make sure her assailant has been charged.

In a show of solidarity and support, several of her colleagues accompanied her to the grand jury hearing.

According to Bellevue LBU Vice President Christina DeGaray, RN, this event somehow stood above the many workplace violence incidents that occur at Bellevue on a regular basis. “We saw this as a ‘near miss.’

It could easily have ended up as a fatality. After years of asking for safety improvements and access control we’ve had enough,” said DeGaray DeGaray, who works in the Bellevue ED, says that this incident was a result of many failures.

“Understaffing meant that there was no one directly observing an out-of-control patient who was in restraints. It also meant that the assault almost wasn’t observed by anyone, which could have had disastrous consequences. A shortage of hospital police officers means that security personnel are often pulled out of the ED to deal with emergencies elsewhere in the

hospital. And the type of restraints used weren’t adequate.”

LBU leadership recognized that union action was necessary when follow-up meetings between ED unit staff and nursing administration resulted in no timely plans for effective change. In fact, nursing management didn’t even consider the unit understaffed when the assault occurred.

NYSNA leadership took action by visiting units throughout the hospital and soliciting input from members on risk factors for violence on their units and suggestions for improvements. During these visits LBU leaders were moved by the number of nurses, patient care technicians, behavioral health associates and NYHP officers who gave accounts of their own assaults.

Safety demands

Many spoke of their feeling of isolation and confusion about what to do next and whom to call. As a result of this feedback, the LBU leadership is requesting that management develop a single-page fact sheet to be given to all injured employees containing information on the workers’ comp process, time and leave grants and names and phone numbers of who to call for information and assistance.

The LBU leadership has also compiled a list of safety demands using information gained from these unit visits and recommendations from NYSNA’s Occupational Health and Safety Representative based on an onsite inspection. The LBU leadership and ED unit nurses met with nursing management to present their safety demands.

Nurses throughout the facility are also signing a petition and writing letters to nursing and hospital management to keep the pressure on hospital leadership.

Keeping the pressure on

NYSNA members have reached out to other unions at Bellevue as well, because unsafe conditions affect all employees. They will continue pushing nursing management and will move up the ladder to the CEO and head of security. They intend to keep the pressure on until they can get firm commitments on safety improvements and clear timelines for when changes will occur.

Says DeGaray, “We have to take this into our own hands. We need more than lip service from management. We will persist in our fight until we believe the hospital is taking sufficient action to protect us and other employees.”

“We will persist in our fight until we believe the hospital is taking sufficient action to protect us and other employees.”

–Christina DeGaray, RN

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New York Nurse february 2019

Info pickets at two Brooklyn hospitals

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urses at two Brooklyn hospitals—The Brooklyn Hospital Center and Wyckoff Heights Medical Center—took to the streets for informational picketing on February 13, joining thousands of NYSNA members protesting

across New York. The presence of Brooklyn nurses demonstrated to the city that NYSNA nurses are united across New York City in their campaign for safe staffing and quality care for all communities.

In all, thousands of RNs participated in the info pickets from

Montefiore’s Bronx campuses at Bronxcare Health System in South Bronx (formerly BronxLebanon Hospital) to NewYorkPresbyterian in Washington Heights, Manhattan, and the Allen Hospital (for psychiatric care) to Manhattan’s Mount Sinai Hospital, Mount Sinai West and Mount Sinai St. Luke’s.

Safe staffing is the key issue at both The Brooklyn Hospital Center and Wyckoff Heights Medical Center, and nurses made their case with signage and flyers. Their negotiations for fair contracts and staffing ratios continue.

NYSNA nurses are united!

Supporting Plattsburgh’s bravest

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here are few braver, more integral members of our community than firefighters. Instead of running from danger, firefighters run toward it to protect and serve our communities. Despite their fierce dedication to public service and putting their lives on the line, Plattsburgh Professional Firefighters Local 2421 were long denied the respect and fair treatment they deserved.

For over a decade, firefighters were without a contract and denied raises. Because they are legally barred from striking, they have had to endure years of arduous legal proceedings. Nevertheless, their perseverance through the yearslong struggle shows their true commitment to public service and the resiliency of their union.

Safe staffing remains an issue

After a series of arbitrations and appeals to the New York Supreme Court and Court of Appeals, the firefighters are set to finally receive retroactive wages and, last year,

Brett Eney, firefighter, with letter of support from the CVPH NYSNA Executive Committee

were able to negotiate a new contract. However, they continue to face staffing issues despite being unable to operate certain equipment without a minimum number of staff.

NYSNA stands in solidarity with the brave firefighters of Local 2421 in their fight for safe staffing and will continue to support them until they get the resources they need and the fair treatment they deserve.

New York

nurse special edition | february 2019

the official publication of the new york state nurses association

Cuts that hurt those most in need

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New York Nurse february 2019

We’re saying NO! to $1.1 billion cut in healthcare funding!

W Jessica Ramos, State Senator, Queens, SD-11

Karines Reyes, RN, Assembly Member, Bronx, AD-87

e have a big job to do to stop the more than $1 billion in cuts to healthcare funding now proposed by the state. But working with our allies in labor, with community advocates, religious organizations and public health experts, we can do it.

The cuts were triggered by actions at the federal level—the 2017 Tax Law that takes effect with tax filings now underway.

The federal cuts are an outrageous assault on working people and benefit America’s most elite (see column of Executive Director Jill Furillo, RN, p. 4). The cuts are a broadside attack on healthcare and push back on our efforts and those of our allies to achieve greater equality in healthcare services: full and fair funding for those most in need.

We are organizing with our allies to counter these attacks on the under-served, communities of color, immigrant neighborhoods, and rural areas where hospitals are few and far between. From dense urban neighborhoods to sparse

Safety Net Hospitals 26 New York hospitals face critical funding issues. In 2017, they provided nearly 200,000 discharges and 3.5 million ER and ambulatory visits.

Medicaid Rates There has been no increase in 10 years. Hospitals and nursing homes need funding to provide quality care and to support record Medicaid enrollment. rural communities, healthcare funding for New Yorkers is critical to people’s well-being.

Gains turned back

We saw Medicaid expand under President Barack Obama’s Affordable Care Act. Still, there were no increases in Medicaid

Timothy Kennedy, State Senator, Buffalo, SD-63

Lucia Gomez, Political Director, NYC Central Labor Council Rallying against cuts to healthcare at the New York State Black, Puerto Rican, Hispanic and Asian Legislative Caucus in Albany, February 16

reimbursement rates until last November when a 2 percent increase in reimbursement to hospitals and 1.5 percent increase to nursing homes went into effect.

Those have now been rescinded.

That’s because the federal government’s tax plan cut funding to healthcare with results that reach into communities most in need: NYSNA members feel it, too, as some of our family rely on healthcare assistance. We frontline nurses see the results of an underfunded and inequitable system in the lives of our patients every day.

We are standing up with a coalition of fellow unions, elected leaders, community groups and healthcare activists to demand a stop to the cuts. On February 16, we demonstrated in Albany against the cuts in front of the New York State Department of Health headquarters.

State budget reduction of $275 million

In response to the latest attack by the federal government on the health system, an unexpected budget shortfall confronts New York State. The state government is now proposing more than $1 billion in cuts to hospitals and other providers in its annual budget.

These are real dollars lost with real consequences for the health and safety of New Yorkers.

The $550 million comes from two sources.

The first $275 million is a reduction in the state share of Disproportionate Share Hospitals (DSH) program funding.

Keep in mind that the DSH program is intended to support hospitals providing a disproportionate share of healthcare services to lowincome Medicaid and uninsured patients.

Specifically, this money comes from reducing what’s termed the Indigent Care Pool (ICP) allocation for private hospitals. ICP is part of the overall DSH funding and is supposed to address the needs of uninsured patients and Medicaid enrollees.

Continued on page 10

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New York Nurse february 2019

No to cuts in healthcare Continued from page 8

New York State has a large number of people who qualify under the terms of the ICP, so this cut digs deep into the care needs of our state’s population.

Minus $275 million in federal funds

Judith Cutchin, RN, NYSNA Board Member and President, NYSNA’s H+H/ Mayorals Executive Council; Pat Kane, RN, NYSNA Treasurer (background right)

The second $275 million is federal matching money the state loses. These are federal dollars that match state monies to help support safety net hospitals. Safety net hospitals care for the uninsured and for those receiving Medicaid in large numbers.

Many safety net hospitals are on the edge financially. Reimbursement rates for Medicaid patients are estimated to be in the range of 70-90 percent. That means that hospitals actually lose money when Medicaid patients are treated in their emergency departments or are admitted to the hospital. This is fundamentally inequitable. Why are safety net hospitals underpaid for the care delivered to Medicaid patients? How can they be expected to survive given this money-losing scenario?

Don’t cut, redistribute!

The state is proposing to limit the $550 million in cuts to hospitals that operate above a certain level of profit. However, this reduction in funding for profitable private hospitals should not be done. Once relinquished, these funds will be gone.

But these funds ought to be redistributed to safety net hospitals—the facilities working provide care to patients in real need and to help these hospitals survive financially.

In other words, we must fight the cuts and redirect the money to real

safety net hospitals serving urban and rural populations that qualify for care.

Cutting reimbursement rates

There is a second cut in funding that threatens care for the state’s most vulnerable. This comes from a $190.4 million reduction in the current state share of Medicaid reimbursement rates for next year and the same for the following year, for a total of $380.8 million.

There is a corresponding loss in federal matching funds again, which means a loss of $380.8 million over two years. All in all, Medicaid cuts in this category would total $761.6 million over two years.

This is yet another blow to the funding of healthcare for New Yorkers most in need.

What shocks even more is that an increase of 2 percent in reimbursement rates for hospitals implemented last November after many years without any increase in Medicaid: from an increase to a decline, all at a time when need is going up.

These cuts—the $761.6 over two years—would likely result in across-the-board reductions to all hospitals and nursing homes, cutting into the critical services of real safety net providers.

More inequality to address

What can we do about Disproportionate Share Hospital (DSH) funds that are under attack at the federal level? How do we stop subsidizing profitable private New York hospital systems that do not need the money? Keep in

Terrence Melvin, Secretary/Treasurer, NYS AFL-CIO

Michelle Gilliam, Political Director, TWU - Local 100

“Watch List Hospitals”** Kingsbrook Jewish Medical Center Wyckoff Heights Medical Center Interfaith Medical Center Flushing Hospital Montefiore Mount Vernon Nyack Hospital Good Samaritan Hospital **NYSNA nurses comprise RN workforce

mind again that DSH is federal, state and local funding intended to support hospitals providing a disproportionate share of healthcare services to low-income Medicaid and uninsured patients.

New York distributes DSH funding in a broad manner that allows many profitable hospitals to receive large DSH allocations. This is despite the fact that some facilities receiving funds are profitable hospitals with high percentages of privately insured patients. This is fundamentally wrong. These profitable hospitals neither need nor deserve these funds.

There is more to this inequality.

“Bad debt” is included in the formula for allocating these funds and it includes charges for patients on whom the hospital has made a profit. Still, these debts are called “charity care” and are reimbursed by the government.

Taking from real safety nets

This inequality—making money from patients and then getting reimbursed more as charity care—was disallowed by President Obama’s Affordable Care Act. But the phase out of bad debt still allows profitable hospitals to seek reimbursements on an ongoing basis.

This practice takes money from real safety net hospitals and from patients in need.

NYSNA is working with a coalition of other unions, public health experts, community advocates and others to address these inequalities and to stop the cuts.

Your participation is critical to this effort.

Patients over profits!

NEW YORK NURSE february 2019

Beck Notification If you are represented for collective bargaining by NYSNA, you have the right to be or stay a nonmember and pay an agency fee equivalent to dues. If you choose to be a nonmember, you are entitled to object to paying for activities unrelated to the association’s duties as a bargaining agent and to obtain a reduction in fees for such activities. If you submit a timely objection, the agency fee that you will be required to pay will include costs incurred by the union for expenditures related to collective bargaining, contract administration, grievances and arbitration, and other matters affecting wages, hours, and other conditions of employment.

In 2018, the most recent calendar year for which a calculation was done, the agency fee charged to timely non-member objectors represented 86.71% of the dues amount for that year.

If you choose to be a nonmember, please be aware that you will deny yourself the opportunity to exercise the full rights and benefits of union membership. Full membership rights include, among other things, the rights to: (1) vote on acceptance or rejection of proposed contracts covering your wages and working conditions, thereby ensuring your input on issues central to your working life; (2) participate in development of contract proposals; and (3) vote for your union officers.

A copy of NYSNA’s agency fee objection policy is published annually in the New York Nurse. You can also request a copy from NYSNA’s Membership Department.

Agency Fee Objection Policy 1. To become an objector, a non-member who is represented by NYSNA shall notify NYSNA. Such objection must be in writing, signed by the non-member and mailed to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001. The objection must be postmarked between March 15 and April 15. A non-member employee who initially becomes a bargaining unit member after April 15 in a particular year and who desires to be an objector must submit written signed notification to the NYSNA Membership Department within thirty (30) days after the employee has become subject to union security obligations and been provided with notice of these procedures.

activities outside of areas related to collective bargaining; litigation expenses to the extent related to non-chargeable activities; and member-only activities.

2. Agency fees payable by non-member objectors will be based on NYSNA’s expenditures for those activities undertaken by NYSNA to advance the employment- related interests of the employees the Union represents. These “chargeable” expenditures include: preparation for and negotiation of collective bargaining agreements; contract administration including investigating and processing grievances; organizing within the same competitive market as bargaining unit members; meetings, including meetings of governing bodies, conferences, administrative, arbitral and court proceedings, and pertinent investigation and research in connection with work-related subjects and issues; handling work-related problems of employees; communications with community organizations, civic groups, government agencies, and the media regarding NYSNA’s position on work-related matters; maintaining membership; employee group programs; providing legal, economic, and technical expertise on behalf of employees in all work-related matters; education and training of members, officers and staff to better perform chargeable activities or otherwise related to chargeable activities; and overhead and administration related to or reflective of chargeable activities. Non- chargeable expenses are those of a political nature. The term “political” is defined as support for or against a candidate for political office of any level of government as well as support for or against certain positions that NYSNA may take, which are not work-related.

The following are examples of expenditures classified as arguably non-chargeable: lobbying, electoral or political

4. Along with the auditor’s report, non-members and new employees will be given the foregoing explanation of the basis of the reduced agency fees charged to them.

That explanation will include a list of the major categories of expenditures deemed to be “chargeable” and those deemed to be arguably “non-chargeable” and the auditor’s report verifying the breakdown of “chargeable” and arguably “non-chargeable” expenditures.

3. NYSNA shall retain an independent auditor who shall submit an annual report verifying the breakdown of chargeable and arguably non-chargeable expenditures and calculating the percentage of arguably non-chargeable to chargeable expenditures (the “fair share percentage”).

The auditor’s report shall be completed promptly after the conclusion of the fiscal year. The report shall be provided to any non-member who submits an objection.

5. The fees paid by non-member objectors shall be handled as follows. (a) Newly-Hired Non-Members. NYSNA will place or maintain in an interest bearing escrow an amount at least equal to the agency shop fees remitted by newly-hired non-member(s) (or by an employer on behalf of newly-hired non-member employee(s)). A newly hired non-member employee will be mailed a copy of this Policy. The non-member will have the later of the date he/she is subject to the obligations of the union security clause or thirty (30) days from the date of mailing to object or to join NYSNA. If the non-member employee joins NYSNA, then the full agency shop fee remitted on his/her behalf is credited from the escrow account to the Association’s general treasury. If the newly-hired employee does not join NYSNA and does not file an objection within the thirtyday objection period, then the escrowed amount will be credited to NYSNA’s general treasury. If the newlyContinued on page 12

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New York Nurse february 2019

Agency Fee Objection Policy Continued from page 11

hired non-member timely objects, an amount at least equal to the fair share percentage shall continue to be escrowed pending resolution of a challenge (if any) by the objector. Once the challenge is resolved, the amount of the non-chargeable balance plus interest will be returned to the non-member from the escrow. (b) Resignation. In the case of an employee who resigns NYSNA membership (or who continues in nonmember status) and who timely objects, NYSNA will place or maintain in an interest-bearing escrow account an amount at least equal to the fair share percentage of the agency fees received from the non-member or employer on behalf of the non-member and the nonmember is permitted to challenge the fair share fee percentage during the thirty (30) day period noted in the annual publication of the Association’s objection procedure. If the non-member files a timely challenge, amounts at least equal to agency fees collected from the non-member employee or employer will continue to be placed or maintained in the escrow account pending resolution of any challenge. If the nonmember does not file a challenge within the challenge period, then only the fair share fee amount will be credited to NYSNA’s general treasury and the balance paid to the non-member from the escrow plus interest.

6. A non-member objector may file a written challenge to the calculation of the fair share fee and percentage, challenging any of the items of the expenditures as

O 1199 joined our float and celebration of the Lunar New Year.

Yvonne Lam, RN, Woodhull Hospital

chargeable. Such a challenge must be submitted within thirty (30) days of the date the non-member objector is provided an explanation of the basis of the reduced agency fees and initiation fees charge to them. Such a challenge must be in writing, signed by the non-member and sent to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001. If NYSNA does not agree with the challenge either as to the expenditures or as to the percentage of amount of dues to be paid, it will notify the timely objecting non-member in writing that he/she has thirty (30) days thereafter to request arbitration; and if he/ she fails to do so within that time, then such non- member waives the right to arbitration. A request for arbitration must be in writing, signed by the person filing the request, and sent to the NYSNA Executive Director, 131 West 33rd Street, New York, NY 10001.

7. If more than one challenging non-member objector timely requests arbitration, NYSNA will consolidate all such challenges into one annual arbitration proceeding.

NYSNA will provide an impartial arbitration proceeding through the American Arbitration Association and will pay the administrative costs and the arbitrator’s fees. The challenger will be responsible for any fees associated with his or her representation at the hearing.

8. NYSNA will administer this policy in a manner that is consistent with the objectives of the policy and the applicable federal and state law to provide a fair and equitable procedure regarding nonmember employees. NYSNA reserves the right to change the policy set forth above.

Year of the Pig!

n February 17, NYSNA members were thrilled to join thousands welcoming the Year of the Pig and march in the 20th Annual Lunar New Year Parade and Festival in Manhattan.

The colorful street party featured elaborate costumes, music, food, lion dancing and martial arts performances. The traditional Chinese holiday is celebrated by Asian com-

munities all over the world and is always a momentous event in New York City, home to the largest Chinese population outside of Asia.

The NYSNA float wound its way through the streets of Chinatown to the cheers of a jubilant crowd.

Members were excited to participate in the festivities, celebrate Asian culture and spread the messages of safe staffing and qual-

ity, affordable healthcare for all New Yorkers.

“As a Chinese American, I am proud to serve my Asian community with dedicated nursing care,” said Yvonne Lam, RN, of Woodhull Hospital. “All patients deserve healthcare justice and fair, quality treatment. I hope city and state officials hear us and support reasonable nurse-to-patient ratios.”

NEW YORK NURSE february 2019

Medical Mission to India

T

he first medical mission of 2019, comprised of 20 NYSNA nurses, departed for India on January 21.

The group traveled to New Delhi, India’s capital, to voluntarily offer their medical services to a population considered forgotten by history—Dalits.

Historians think that this social status is based in ancient Hinduism, which delineates four major social classes or varnas.

At top are the Brahmins, usually described as priests and scholars.

At bottom, there is a fifth group isolated from traditional Indian society—the Untouchables or Dalits. This lowest caste is relegated to the most undesirable jobs, such as cleaning sewers.

Their plight is compared to those subjected to Apartheid in South Africa and some conditions of slavery in America.

With drums beating persistently, NYSNA’s nurses got ready for their first day of the medical mission. As much as they had been prepared to see and experience, the group was shocked at the degree of poverty and lack of cleanliness in which people lived.

Largely abandoned by the state and without essential services, our nurses had no small task in providing care. They dove in, providing health services and medications to a patient population of Dalits.

Care for 700

For the first time, a group of health providers arrived at a dump site on the outskirts of Delhi. Under a tent on top of the city’s largest dump site, our vol-

unteers provided health services to nearly 700 people. In addition to the 20 nurse members of NYSNA, another 100 members of the UNA (United Nurses Association) of India took turns during the three days, doing their best so that all patients would receive care and be treated with respect and dignity.

[This article was compiled with the assistance of NYSNA International Affairs Liaison Rony Curvelo.]

(All photos) NYSNA nurses take part in medical mission, Delhi, India

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New York Nurse february 2019

Oneida nurses know that safe staffing is one of the most concrete ways to ensure patients get the quality care they deserve.

RNs at Oneida Healthcare attend a labor management meeting.

Oneida nurses tackle staffing

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his month, NYSNA nurses made their voices heard in Oneida at the labor management meeting, taking on some of the biggest issues facing bedside caregivers.

In their meeting, NYSNA members addressed one of the most pressing issues facing nurses today—safe staffing. Oneida nurses know that safe staffing is

one of the most concrete ways to ensure patients get the quality care they deserve and that nurses are able to do their job effectively. High patient-to-nurse ratios prevent nurses from doing the work they love to do, including taking time to spend with a patient and giving them the individualized care they need.

Beyond discussing safe staffing on the Medical Surgical and OB

units, the meeting also focused on making sure nurses have adequate supplies and income security.

All NYSNA members stand in solidarity with nurses at Oneida in their fight for equal and fair treatment, including enforcing safe staffing ratios to protect both patients and nurses, supporting a living wage, and giving nurses the resources they need.

Westchester and Hudson Valley RNs unite NYSNA members in WestchesterHudson Valley are always ready to get involved, and this month was no

exception. More than 80 members from multiple facilities gathered at this month’s interregional meeting

to exchange ideas on advocating for legislation that protects both patients and profession. Attendees discussed strategies for passing the Safe Staffing for Quality Care Act and the New York Health Act, and more than 10 elected officials who were in attendance committed their support. Members also offered their support to the thousands of New York City public and private sector nurses going through contract negotiations.

The solidarity of NYSNA nurses across the state and their steadfast dedication to fighting for quality, affordable healthcare continues to be a testament to lawmakers and the public that the union is a powerful force for building healthier communities in New York state.

NEW YORK NURSE february 2019

new york city

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– St. Joseph RNs–A speedy ratification long island

All out for safe staffing

Around the state 9

westchester /hudson valley

A wake-up call for WMC

western region

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Standing up for public sector RNs

central region

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St. Elizabeth’s gears up for negotiations

staten island

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The last “Black Angel”

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NEW YORK NURSE february 2019

Non-Profit US Postage Paid NYSNA

131 West 33rd Street, 4th Floor New York, NY 10001 3 Cap/North

INSIDE

Stopping violence on our units, p. 5

North Country nurses support firefighters over staffing, p. 6

FOR MORE INFORMATION CONTACT YOUR NYSNA DELEGATE OR REP.