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1199 SEIU Professional & Technical Newsletter June 2012

Vassar Brothers 1199 Technical Workers:

Committed to Patient Care IN THIS ISSUE:

· Surgical Techs Discover Power in Collective Action · Physical Therapy—A Changing Profession · Vassar Brothers 1199 Technical Workers: Committed to Patient Care · Health Homes Refocus Care Into The Community · 1199 Dietitians Take a Close Look at Proposed Licensure Bill · Academic Calendar The Monitor is available online. Go to www.1199seiu.org and click on “professional workers.”

Miguel Lugo (left) and Gerard Lavergne, co-leaders of the HJD Surgical Technologist Committee.

Surgical Techs Discover Power in Collective Action S

urgical Technologists, like other healthcare professionals, have a variety of issues that arise in their work. Some are contentious issues involving scheduling and staffing; some are differences with management over their proper scope of practice; and some have to do with the increasing demands of the surgical technology profession for national certification and continuing education.

As 1199 members, surgical technologists have access to a grievance and arbitration process if they believe management is violating their contract. However, many 1199 surgical technologists are discovering that engaging in a labor/management dialog, where they can articulate their concerns in a recurring forum, can be a more effective way to utilize their union in order to improve working conditions. This is not a solely management-driven process, but one where their union is an equal partner.

There had been a number of problems in the O.R. at the NYU Hospital for Joint Diseases (HJD). Surgical technologist Miguel Lugo claimed that the interests of the surgical techs were often ignored, with “every initiative always RN driven and only involved catering to the nursing needs.� Miguel, along with delegate Gerard Lavergne, took the initiative. They worked with organizer Valry Anderson, VP Saily Cabral, and Debora Hunte from 1199’s Professional & Technical Department to create a professional practice committee of surgical techs at HJD. One of the first issues they tackled was that the techs were doing intra-operative leg-holding. The committee did their research and discovered that this was out of their

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Mt. Sinai Surgical and Central Sterile Processing Technicians.

scope of practice. “After the diligent team work and determination of 1199, we were not only able to prove our point of patient safety, but management stopped surgical technologists from performing this duty,” stated Miguel.

After this accomplishment, the committee took on a number of other issues. Management initially claimed that they had hired a number of new techs for the purpose of leg-holding, and thus would now have to lay off some of those same people. The committee was able to challenge management on this issue, preventing the lay-offs. The committee tackled other issues such as management requiring weekend work from established Mon-Fri. staff, using seniority to determine days off, and pushing to create a service rotation so that techs would have the ability to work in

“The Surgical Technologist Committee has empowered and given a voice to my brothers and sisters. I am proud of being part of the Professional Practice Committee at HJD” Gerard Lavergne, HJD Surgical Tech

different services with different surgeons. On this last issue Miguel states, “Through 1199 we have been able to get management to orientate surgical technologists in other services as well as have an upcoming service rotation for all to learn to work with all surgeons and an ability to do all types of cases.”

Although there have been challenges, the committee has been successful in resolving most of these issues. As part of its work, the committee conducted a staff survey to show management how the surgical techs felt on several issues. In the words of Gerard, “The Surgical Technologist Committee has empowered and given a voice to my brothers and sisters. I am proud of being part of the Professional Practice Committee at HJD. …

Excellent work that I am extremely proud to be part of.”

At Mt. Sinai the big issue in the perioperative department was training, as attaining national certification

has become a priority in many O.R. professions. Surgical Techs, Anesthesia Techs, and Central Sterile Processing Technicians each held their own departmental meetings to work with management on this issue. The result is that assessments have been done for the surgical technologists, and there is planned to be on-site training at Mt. Sinai on Saturdays to prepare the surgical techs to sit for the certification exam.

There are also plans to do the same for the anesthesia techs and the CSPD techs. 1199 organizers Victor Sanches and Tyome Bell helped initiate the process, and now there is a professional practice committee forming among the surgical techs.

At both HJD and Mt. Sinai 1199 Surgical Techs have learned how to use the productive form of a professional practice committee to work with management to solve problems, advance their profession, and create an effective voice on the job.

For more information on 1199 activities with OR workers, contact Debora Hunte at Debora.hunte@1199.org.

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Physical Therapy A Changing Profession Story by: Candace Warrick, DPT, Bronx Lebanon Hospital (right)

For many of us, the pursuit of a career starts with a dream, a dream to work doing something we love. As time passes, professions can change, as they are influenced by new research and advancements in technology, as well as economic and political forces. Physical therapists are well-aware of this.

The Evolution of Physical Therapy In the beginning, the evolution of the Physical therapy profession was driven by the need to provide services to individuals injured in World War I and to victims paralyzed by the polio virus. At that time, physical therapists were known as Reconstruction Aides who were graduates of nursing and physical education.

Many of these individuals became known for their expertise and began to provide services in private practice and hospitals. The profession’s distinction evolved by contributions from those who, through their expertise, developed new approaches to practice. Examples include Signe Brunnstrom, who staged recovery after cerebrovascular accident, and Margaret Rood, who used principles of neurophysiology to treat patients with cerebral palsy. New ideas and methods of practice keep the profession and educational needs on a progressive path to prepare future educators and students of physical therapy for new trends in technology, healthcare, economic, and political arenas.

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The Change in Educational Requirements Educational development in the profession of physical therapy has taken many turns to face challenges created by societal needs. The physical therapist does not just treat the ankle, the knee, the back, etc.; the physical therapist considers the whole person who may have multiple co-morbidities, environmental and social issues that may influence the treatment and discharge plan, as well as possible referral to another provider. How many times has one experienced a call for a consult for a patient deemed medically stable for discharge to home, but the patient has been immobilized for 3 weeks on a ventilator and lives alone in an apartment on the 4th floor with no elevator?

Each level of advancement, including a Bachelor’s degree, Master’s degree, and now, a Doctorate of Physical Therapy (DPT), has allowed the physical therapist to evolve from a technician to a primary care provider.

Presently the American Physical Therapy Association’s (APTA) Vision 2020 projects that most graduating physical therapists will have achieved their Doctorate of Physical Therapy by 2020. New applicants for a physical therapy program can only expect to graduate with a Doctorate, as many colleges have phased out their Master degree programs.

Physical Therapists at Bronx-Lebanon Hospital Many have taken advantage of the 1199 educational benefits.

Higher education prepares the professional to act as a first line provider, benefitting not only the practitioner but the patient/client as well. The Doctorate of Physical Therapy has been developed to prepare the therapist for the ongoing changes in healthcare policy, and to move the profession in the direction of autonomous practice, which is a natural and necessary development.

The Role of 1199 Advancements in technology have opened up new doors for educational institutions to stay competitive and expand their programs by offering online courses. Many schools that have a Physical Therapy program offer a transitional DPT (t-DPT). For many physical therapists already working in the field, returning to school may be a daunting task.

Physical therapists with 1199 have a great opportunity to prepare for upcoming changes through the 1199 Training Fund’s support. The 1199 Continuing Education Program offers financial support that encourages members to advance their education and stay on top of their professional requirements. 1199’s financial support for online education made it possible for many in our Department of Physical Therapy to achieve our t-DPT, and currently many others are working towards their t-DPT while working and raising their families. 1199 recognizes that online programs allow members flexibility to work and raise a family while advancing their educational level. This support demonstrates how 1199 wants members to be on top of their game, since the Union is only as strong as its members.

For information on how you can get involved with 1199 activities for Rehab professionals, contact Joseph Chinea at joseph.chinea@1199.org.

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Vassar Brothers 1199 Technical Workers:

Committed to Patient Care Story by: Dolores Chase

R

ecently, some of the 1199 professionals at Vassar Brothers Medical Center were gracious enough to share their thoughts on why they chose their career path, why they work at Vassar Brothers, why they choose to stay, and what their future aspirations are.

Founded in 1887, Vassar Brothers Medical Center is a 365 bed facility located in Poughkeepsie, NY. It has been long recognized for its excellence, especially in cardiac care, cancer care, and women’s and children’s issues. Vassar Brothers is continuously growing and expanding services to the community. Its reputation, as well as the recommendations of colleagues and friends, is what attracted many of the Techs who work here.

While their backgrounds are varied, these techs share a strong commitment to their chosen professions and dedication to the patients they serve.

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The techs profiled came to their professions from many different places. Jason Biasotti, a registered respiratory therapist (RRT), takes great pride in the quality of people who work at Vassar Brothers: “We have the cream of the crop here. It is a great place to work.” Beginning his 17th year here, he notes that “it was actually respiratory therapists who were instrumental in bringing in the union.”

“While other hospitals have been cutting back, Vassar Brothers has succeeded in expanding services. 1199SEIU and management have an understanding that we need to work cooperatively in order to grow Vassar Brothers.”

Jason Biasotti, Registered Respiratory Therapist, Neonatal Specialty Certification, two BAs. Certifications in Adult and Pediatric Life Support.

Jeanette Jackson is a special procedures technologist who has worked at Vassar Brothers for six years, and says, “This is the job I will do until I retire.” Jeanette worked many jobs before this career, including as a secretary, file clerk, nursing attendant, and teaching assistant. “I even worked in car rental,” she said.

“I love the work I do now because we are treated as professionals, and no two days are the same. We are constantly professionally challenged by the doctors, and we are always leaning new things.”

Jeanette Jackson, Special Prodecures Technologist, 1199 Delegate.

Dion Kirkwood, a CT Tech, was convinced by his wife, who was studying to become an RN, to go into radiology. Dion is considering becoming a Physician Assistant, and knows if he chooses this path he can count on the training benefits from 1199.

“We have only a short period of time to impress the patient and make them comfortable. Our modality is a diagnostic one, so often we’re the reason they find out they have cancer. We want to make the experience as easy, comfortable and safe as possible. Our secret weapon is heated blankets. The patients always seem to relax when we put the warm blanket on them.”

Dion Kirkwood, CT Technologist.

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(Vassar Brothers 1199 Technical Workers: Committed to Patient Care ...continuesd)

Moises Castillo, a former marine, is a special procedures tech who is originally from the Dominican Republic. He has traveled extensively. “This is an immigrant country,” he says. “My traveling has given me an understanding of other cultures, and in this career, you have to deal with many different types of people.”

“While other hospitals have been cutting back, Vassar Brothers has succeeded in expanding services. 1199SEIU and management have an understanding that we need to work cooperatively in order to grow Vassar Brothers.”

Moises Castillo, Special Procedures Technologist. He immigrated from the Dominican Republic. Has a son in Pharmacy School.

Kelley Markham-Stewart is a CT Tech who went to school in Massachusetts, then came to New York and worked in Albany. While in Albany she heard that “Vassar Brothers was the place to be.”

“I love CAT Scan because it is fast-paced and it is the perfect balance between direct patient care and technology.”

Kelly Markham-Stewart, CT Technologist. Specialty Certified in Cat Scan.

Ron Breau is a Cardiovascular Technologist. His interests are varied, as he enjoys riding his motorcycle, and is a black belt in Tae Kwon Do. He had experience working at Vassar as a radiologic technologist and a special procedures tech. He says, “When I went over to the cardiac cath lab, many people told me I would be bored out of my mind. But they couldn’t have been more wrong. I love what I do.”

“The cases are all different because every patient is different. Doing the same type of procedure helps me practice my craft and get better at it. Also there is something to be said about diagnosing something like clogged arteries, and being able to do a full intervention and fix them.”

Ron Breau, Cardiovascular Technologist. Has four sons, one in the Navy.

For information on how you can get involved with 1199 activities for imaging or respiratory professionals, contact Dolores Chase at doloresc@1199.org.

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Health Homes Refocus Care Into The Community T

here is a growing consensus that the healthcare system in America is broken. Patient outcomes tend to be less promising than in other advanced countries, while costs are significantly higher. In order to address these problems, the American medical community has experimented with alternative ways of delivering care.

In several states, including New York, one of those ways is through a Health Home. The Accountable Care Act, President Obama’s health initiative, has created strong incentives for this new form of care.

The New York State Department of Health (DOH) describes a Health Home as “a care management service model whereby all of an individual’s caregivers communicate with one another so that all of a patient’s needs are addressed in a comprehensive manner.” This system is designed to manage the care of people with complex, multiple and chronic conditions. By caring for these patients in their own communities, caregivers hope to prevent them whenever possible from landing in area hospitals or ERs. Clinicians have advocated for Health Homes because they are realizing that the people with the highest medical costs are also those who are receiving the worst care.

For example, in the impoverished urban community of Camden, NJ, Dr. Jeffrey Brenner calculated that one percent of the patients who made use of the city’s medical facilities accounted for thirty percent of their cost.

Presently Health Homes in New York are designated for high-need Medicaid patients, though they are considering extending services to Medicare patients. 975,000 New York State Medicaid patients have been identified as qualifying for this care. They fall under the following

“This population needs more intensive case management, more person-toperson contact.”

Erica Cuevas, Substance Abuse Counselor Montifiore (right)

categories: Developmental Disability, Behavioral Health, Long Term Care, and Chronic Medical Conditions.

Many 1199 institutions will be taking on the role of a Health Home. This will result in some new jobs, and will create a new demand for some of our existing professionals. In a letter to the Montefiore staff, the CEO Dr. Steven Safyer wrote that “we will draw on the strengths of nurses, social workers, pharmacists and nutritionists to provide care tailored to the unique circumstances of our patients’ lives.”

Montefiore is part of the Bronx Accountable Healthcare Network (BAHN), which also includes the Albert Einstein College of Medicine Division of Substance Abuse (DoSA). Management has held meetings with the substance abuse counselors to prepare them for new responsibilities in DoSA’s role as a health home. Substance Abuse Counselor Erica Cuevas described these responsibilities as “engaging the patient to be more compliant.” She stated it (continues, next page) 9

“I’m grateful to be able to serve this community, to make a difference. It’s definitely a learning process.”

Alice Montalvo, 199 Delegate (above)

Health Homes Refocus Care Into The Community (continued) will involve more follow-up and outreach work to make sure patients don’t miss their appointments and take their medications.

While Erica supports the idea behind the health home, she has some concerns. “This population needs more intensive case management, more person-to-person contact,” she said. For example, one of her clients, a Vietnam Veteran, has medical issues along with severe PTSD. “His problems don’t even allow him to apply for benefits that he’s entitled to.” While Erica does her best to make sure he gets the medical appointments he needs, she is limited in getting him engaged with other providers. She strongly feels an investment in community follow-up workers needs to be made in order for this care model to be successful.

Lutheran Medical Center, in partnership with Maimonides Medical Center, will also function as a health home. Both Lutheran and Maimonides have created two new 1199 titles for this purpose: care manager, a social worker position, and care navigator.

One of the first people to fill this latter position at Lutheran is 1199 delegate Alice Montalvo. She explained 10

the first steps being taken: “We’re getting lists of people identified by New York State who have multiple chronic conditions and who over-utilize the E. R. We will try to recruit them to be part of our Health Home.” Once people are in the health home, Alice will utilize computer programs to track all the outreach being done with these patients and whether appointments are being kept, to coordinate all their care from different providers. When there are problems such as the patient missing appointments or going to the E.R., Alice will notify the care manager, who will then initiate follow up with that patient. Alice loves the team aspect of her work. “I’m grateful to be able to serve this community, to make a difference. It’s definitely a learning process.”

There is no doubt that the healthcare system needs to change, and the Union realizes that it needs to be part of the change in order to continue to thrive. Much of this change will involve managing care in the community in an attempt to reduce the costs associated with hospitalization and emergency rooms, and to keep people healthier in order to prevent admissions. As Alice says, “This is the future. It’s going to grow.”

1199 Dietitians Take a Close Look at Proposed Licensure Bill 1199 Dietitians have been meeting regularly to discuss a proposed bill to license dietitians and nutritionists in New York State. While generally supportive of the effort to make the practice of dietetics and nutrition a licensed profession, they take issue with some of the particulars of the bill.

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nder the proposed legislation, the requirements to be licensed as a dietitian and/or nutritionist (LDN) would be to complete at least a bachelor’s degree in dietetics or nutrition, or by completing a BA or higher that includes a major course of study in dietetics and nutrition.

One would also have to pass an exam, and to complete at least 900 hours “in the practice of dietetics and nutrition in a planned, continuous, experience component under the supervision of an individual licensed pursuant to this article…” On January 1, 2016, this hourly requirement will increase to1200 hours. If the legislation passes, during its first year people would be able to be grandfathered in if they had either the CDN or the RD, meaning they would be exempt from taking the exam.

1199 dietitians and nutritionists have raised many concerns about the proposed legislation. First, because there are a number of dietitians who do not have either the CDN or the RD credential, the members are calling for a grandfathering clause that would be based on pure experience alone, verified by a clinical director, along with the BA required by the legislation.

Second, many members are concerned about the 900 or 1,200 hours of supervised experience, which sounds like an internship requirement similar to that of the RD. Many dietitians point out that there is a shortage of internship slots in the institutions, and that such a requirement at this time would create a shortage of licensed personnel and present an unreasonable barrier for otherwise qualified people to practice in this profession.

1199 will be proposing an experience grandfathering clause, and intends to discuss solutions to the internship problem. The Union has already raised these concerns with the New York State Dietetic Association, and is trying to work with the professional associations to arrive at a common agreement on how licensing should proceed.

1199’s political strength allows it to be an effective participant in this process, and allows its dietitian members’ voices to be heard, giving them a say in shaping the legislation that will govern their profession.

For more information on getting involved with 1199 Dietitian activities, contact Farah Hargett at farahh@1199.org.

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1199 SEIU League Training & Upgrading Fund Institute For Continuing Education

2012 CONTINUING EDUCATION CALENDAR TUESDAY, JUNE 19, 5:30pm – 9:00pm Leadership, Management and Professional Practice for the LPN 3 hrs, LPNs Location: Cherkasky/Davis Conference Center ONSITE ONLY

SATURDAY, JULY 14, 8:45am – 2:00pm The New Health Care Laws: A Changing Industry 4 hrs, Interdisciplinary** Location: Cherkasky/Davis Conference Center ONSITE, LIVE VIDEOCAST, LIVE WEBCAST

TUESDAY, SEPTEMBER 18, 5:30pm – 9:00pm

WEDNESDAY, OCTOBER 17, 5:30pm – 9:00pm TBD 3 hrs, Respiratory Therapists Location: Cherkasky/Davis Conference Center ONSITE ONLY

SATURDAY, OCTOBER 20, 7:45am – 3:30pm TBD 6 hrs, Pharmacists/Pharmacy Techs Location: The Times Center ONSITE, LIVE VIDEOCAST, AND LIVE WEBCAST

FRIDAY, OCTOBER 26, 7:45am – 3:30pm

TBD

6th Annual Heart Disease Symposium

3 hrs, Interdisciplinary: CASACs Location: Cherkasky/Davis Conference Center ONSITE ONLY

6 hrs, Interdisciplinary** Location: The Times Center ONSITE, LIVE VIDEOCAST, AND LIVE WEBCAST

WEDNESDAY, SEPTEMBER 19, 5:30pm – 9:00pm

THURSDAY, NOVEMBER 8, 5:30pm – 9:00pm

Stages of Neuro Recovery: Cerebral Vascular Accident (CVA) 3 hrs, Rehab Therapists Location: Cherkasky/Davis Conference Center ONSITE ONLY

SATURDAY, SEPTEMBER 29, 7:45am – 3:30pm An Interdisciplinary Approach to Chronic Pain Management 6 hrs, Interdisciplinary** Location: The Times Center ONSITE, LIVE VIDEOCAST, LIVE WEBCAST

SATURDAY, OCTOBER 6, 7:45am – 3:30pm CSPD and Surgical Technology: Partners in Sterility and Surgical Procedures 2012 6 hrs, Surgical Technologists/CSPD Location: Cherkasky/Davis Conference Center ONSITE ONLY

Register today. Call: 212-894-4390 Please call for specific location on each seminar. Email: Institute @1199Funds.org www.1199Funds.org - click “Training & Employment,” and then on “Continuing Education.”

Emerging Careers in the Imaging Profession 3 hrs, Imaging Techs Location: Cherkasky/Davis Conference Center ONSITE ONLY

TUESDAY, NOVEMBER 15, 5:30pm – 9:00pm TBD 3 hrs, Medical Coders Location: Cherkasky/Davis Conference Center ONSITE ONLY

SATURDAY, DECEMBER 1, 8:45am – 4:30pm Physical and Mental Stress Management in the Health Care Work Environment 6 hrs, Interdisciplinary** Location: The Times Center ONSITE, LIVE VIDEOCAST, AND LIVE WEBCAST

** Interdisciplinary seminars are usually accredited for Physicians, Pharmacists and Pharmacy Techs, Physician Assistants, Nurse Practitioners, Respiratory Therapists, Radiologic Techs, Dieticians, RNs and LPNs, Social Workers, Clinical Laboratory Practitioners, Rehab Therapists (OTs and PTs), CASACs. Please call for specific professions.

1199SEIU Professional & Technical Department Staff Listing and Areas of Responsibility: Dolores Chase - Imaging, Respiratory, EMS Workers, Medical Records Coders -- 212-261-2385, DoloresC@1199.org Joseph Chinea - Social Work, Substance Abuse Counselors, OT/PT/Speech -- 212-857-4302, , joseph.chinea@1199.org Farah Hargett - LPN’s, Physician Assistants, Dietitians -- 212-261-2246 - FarahH@1199.org Debora Hunte - Laboratory, Pharmacy, Surgical Technicians, Central Sterile Technicians -- 212-857-4398, debora.hunte@1199.org David Kranz, Director - All other professions not mentioned above -- 212-261-2494, davidk@1199.org 2179-123