The recently-filed lawsuit means the health care providers look to collect over $1.3 million from San Diego County, as well as interest.

A similair suit took place around August of 2004, then for $1.2 million for unpaid services, and covering a different time period than the current suit. According to the 2004 lawsuit, San Diego County was underpaying for health care for jail inmates. The Sheriff’s Department, the hospitals said, contracted lower costs to provide health care for inmates, only to pay less than the contracted amounts. This led to a contract termination with Sharp in 2003.

Found in another article, the sheriff’s departments are required by law to pay for jail inmates’ medical care, with a budget of $33 million to $36 million marked for inmate medical care at the time of the story.

Following the prior lawsuit, San Diego County agreed to pay almost $1.5 million to Sharp and the other hospitals, to settle the lawsuit. Stated in the linked article, the full-billed charges for inmare care totalled about $5 million. The pay agreement was on top of $700,000 already paid to the hospitals for inmate care.

It’s already been said that Sharp has met the Kresge Challenge. This is just one source of income for the non-profit Sharp organization. Many donations keep Sharp HealthCare running and allow Sharp to improve every year. The following donations were including in an e-mail, excluding those already listed on the Kresge Challenge post.

• Dr. Larry and Susan Favrot have made another generous donation to the campaign to name two rooms in the new hospital. This is in addition to the funds that the Favrot family donated to name the library in the Outpatient Pavilion. Dr. Favrot has practiced cardiology at Sharp Memorial Hospital for more than 30 years.
• Wells Fargo, through the Samuel & Katherine French Fund, has donated $100,000 to name the Chest Pain Center in the new Sharp Memorial Hospital. We are grateful for the support of BJ Williams and Jack Charney in securing this gift.
• Hal and BJ Williams made another generous gift to the campaign to name a Patient and Family Pavilion in the new hospital. They are very grateful for the care that they have both received at [Sharp Memorial Hospital], particularly from Dr. Kenneth Roth and Dr. Richard Santore.
• Frances Slavey, a retired nurse who worked for Sharp Cabrillo for over 20 years, has made a generous gift to name the Satellite Pharmacy in the new hospital.
• Willene Coyle donated $20,000 to live + heal + grow: The Campaign for Sharp Coronado Hospital, and Mike and Jeannie Napolitano gave a charitable gift of $1 million.
• Grossmont Hospital Foundation secured a $100,000 sponsorship for the Heroes of Heart Gala from the Virginia Napierskie family. Proceeds from this year’s Gala will benefit Cardiac and Endovascular Services at Sharp Grossmont Hospital.
• The Samuel I. & John Henry Fox Foundation at Union Bank of California awarded $2,500 to support the Sharp HospiceCare Homes for Hospice campaign.
• A new employee wall of honor has been installed in the lobby of Sharp HospiceCare’s office in La Mesa. The wall recognizes Sharp employees who have made a payroll deduction contribution to Sharp HospiceCare, as well as the hospice employees who are participating in the Sharp employee giving program. A total of 77 employees are listed on the beautiful display.

Employees may also donate PTO hours. Since June 1, 2007, over 1,600 hours of PTO have been donated to the Foundations.

Thanks to all those who make donations to Sharp HealthCare! It’s because of these donations that Sharp HealthCare is able to be the greatest health care provider in San Diego, and one of the top in the country.

Back in July of 2006, the Sharp HealthCare Foundation received a grant from The Kresge Foundation for $1 million. The requirement for this grant came as a challenge for the Sharp HealthCare Foundation to raise $8 million within one year, for Sharp’s “Transforming Health Care in San Diego” campaign, and for the new Sharp Memorial Hospital. More than $8.1 million was raised for the challenge, taking the campaign’s total to $48.4 million. The campaign’s goal is $50 million.

The following donations were highlighted in an e-mail to Sharp staff, for their very generous gifts greatly helped make it possible:

• Dr. Patricia Montalbano has made a $1 million gift in memory of her husband, Dr. Frank Montalbano who practiced at Sharp Memorial for more than 30 years and served as Chief of Staff. We will name the medical intensive care unit on the 3rd floor in his honor.
• The Hervey Family Fund of the San Diego Foundation has made a $1 million gift to the campaign in honor of Sharp Memorial Hospital Board Chair, Jim Wiesler and Chair Emeritus, Jim Haugh. It is a fitting tribute to two individuals who have provided outstanding volunteer and philanthropic leadership to Sharp and San Diego.
• Former Foundation Board Chair Dr. Richard Coutts and his wife Stephanie have made a gift of $500,000. We will name the orthopedic floor in the new hospital in honor of the Coutts family — Richard and his father Malcolm were both outstanding orthopedic surgeons at Sharp Memorial Hospital.
• Jim and Mary Jane Wiesler have made a gift of $500,000; Jim has served as the chair of the Board of Directors of Sharp Memorial Hospital for more than a decade and has been instrumental in the planning of the new hospital since 1997.

Alongside these wonderful donations, Sharp employees have contributed over $1.4 million to this campaign. Sharp HealthCare is transforming health care in San Diego, one donation at a time.

Within a few months, there came a week for the people in my department: PFS Week. It’s actually both PAS and PFS week, Patient Access Services and Patient Financial Services. I didn’t know who too many people were back then, but I think it was probably out PAS/PFS Vice President, Gerilynn, having them out, and verbally thanking each employee for the work they do.

This year the items were already on desks before anyone came in. I don’t know how other years prior were. I can imagine it must have taken some time for Gerilynn to sign her name on the package to every items for all PAS and PFS staff. The item came in a yellow package similar in shape and style to Chinese takeout containers.

And inside? I nice, lil’ tote bag.

Last year’s PAS/PFS Week gift was a lunch container, which I haven’t actually used yet. What can I say? I usually take a box of crackers to work. Maybe I’ll take it with me to any non-work events I go to, to show off “Sharp”.

Last December, each desk had a Christmas tree ornament on it.

It feels nice to get little goodies here and there. Not only is Gerilynn a terrific Vice President of PAS and PFS, and a wonderful person, she knows little things over time really add up to something big. I’m glad to work for Sharp HealthCare in the PFS department. Now I need only to actually make use of these items!

The first benefit item is in regards to retiree medical benefits. Sharp employees retiring after the age of 55, and with 20 or more benefit-eligible years at Sharp, are eligible for these retiree medical benefits. Once retired, and up until they are eligible for Medicare, these employees may purchase medical coverage for themselves and their dependents in a basic HMO medical plan through Sharp, which would be at special group rates.

Yes, I still need to look into the Sharp$aver Retirement Plan for myself. Secondly, for eligible RNs via the new contract, there’s an improved Sharp$aver Retirement Plan. With the Sharp$aver Retirement Plan, Sharp matches money put into the account. (I haven’t yet read up on the details.) As per the newly ratified contract, all employees with Sharp more than 20 years and contributing 6% into the Sharp$aver Retirement Plan will see an increase from 4.5% to 5% on January 1st, 2008. On January 1, 2009 it will increase to 5.5%, and then to 6% on January 1, 2010.

Further, on-call pay increases to $6/hour for up to 32 hours per pay period, and $6.75/hour for excess hours over the 32, effective the first payroll period following the ratification.

For full-time and part-time RNs, wage increases begin at 3% after ratification, then increase another 13% though the end of the contract, on October 1st, 2009. For Per Diem RNs, I believe it also totals at 16%, at three 4% increases (unless I’m misreading the terms).

To add to this, Sharp and the Union “will develop a new committee, a Nursing Review Committee (NRC), to address staffing ratio and patient classification issues if they are not resolved at RNAC”.

As for the final item, nurses at Sharp are still free to choose whether or not to pay Union dues. Union members may withdraw their union membership and avoid paying dues if they resign before August 18, 2007.

Here are a couple of paragraphs from within the Union Tribune article:

Nurses also were able to keep in place a pay structure that prevents new nurses from earning higher wages than more veteran workers, a concern directly tied to the growing shortage of nurses.

Union negotiators failed in a push to make Sharp hospitals “closed shops,” which would have required all of the nonprofit company’s 3,400 nurses to join the union and pay annual dues. About 1,700 of the nurses belong to the union, according to union officials.

From the Union Tribute article:

The agreement was reached after the two sides returned to the bargaining table Friday in a late-hour effort to avoid a walkout that could have involved more than 1,000 of the company’s 3,400 staff nurses.

I am glad the strike has been avoided. Our patients who have chosen Sharp HealthCare for their health care needs deserve better than a strike.

Mike Murphy’s e-mail says the same information: “SPNN/UNAC has withdrawn its 10-day Strike Notice and will submit the tentative agreement to its membership for ratification. This means our nurses will not be striking.”

The e-mail contained information regarding Union negotiations, and Sharp policies for nurses.

Noted in the e-mail were actions take by SPNN/UNAC. I need to write up a page on all abbreviations used, so at least I keep track of them for myself, let alone readers. Claims of actions taken include SPNN/UNAC making inaccurate and disparaging allegations and statements about Sharp HealthCare, and the work Sharp employees do daily. Also, SPNN/UNAC has questions Sharp’s status of tax exemption, citing Sharp’s charity care as not being enough to qualify for this status. This lead to filing the “largest quality of care claim in the history of California” with the Department of Health Services, meant to bring light to unfavorable health care quality, alongside the lawsuit filed over missed breaks.

It is my personal understanding that SPNN/UNAC failed to raise certain concerns during prior discussions, and instead have worked to ruin Sharp’s good standing views to the public. If I may interject a touch of personal bias, I would not want someone representing me to disparage my place of work while trying to help me. What I might gain would be at the same time my company’s loss, which could be felt if consumers chose another health care provider as their provider of choice. If Sharp HealthCare is the best in San Diego, and Sharp is such a bad place, this really says something about our competition in the health care field. Sharp HealthCare has actively worked at improving the environment for not only its patients, but its employees as well.

Mike Murphy’s e-mail outlines remaining issues between Sharp and SPNN/UNAC, which is good, as there are still many things I don’t know about.

The first issue listed is the Union calling for an increased voice in quality of care. Sharp’s response has been an offer to “clearly identify within the contract that the Registered Nurse Advisory Committee (RNAC) should be utilized to present and discuss any quality of care concern.” There is also a proposed committee in case the aforementioned method cannot be resolved. Union or no union, I would hope that any Sharp employee would have an equal chance to propose improvements in the area which they work. Not all changes can be implemented for a variety of reason, and I hope fellow employees will understand this. If you propose an improvement in something, but the improvement is unreasonable for any reason, a logical next step would be either to find a way to overcome that reason, or consider alternate methods to reach the same (or a similar) goal.

The second issues is retirement benefits. Sharp HealthCare is confident its retirement program, as a whole, “is very competitive in the San Diego market place.” While I’m not going to judge the retirement program when I know little about it (but it’s something I definitely need to look into this year, as I’ve been working at Sharp for more than a year now, with no plans to find a new employer), I do feel it’s a bit shortsighted to be “competitive in the San Diego market place” only. Why not “competite in the southern California marketplace”? Or California as a whole? I don’t know must about the retirement program, nor do I know how Sharp HealthCare compares with other health care providers nationally. Therefore, this is not a criticism of my employer’s benefits, only a hope that one day every aspect of Sharp HealthCare may be brightly compared on a national level. We’re already competing nationally when it comes to quality of health care, and being a top place to work in IT. As a final thought, there are companies which have given health care benefits which turned out to be unrealistic, requiring them to pay out money to countless employees after retirement. This kind of benefit can only drain a company’s monetary resources, thus removing the company’s ability to do what it does. I would not want to see Sharp HealthCare lose its ability to provide quality health care in the interest of providing extraneous benefits due to employees not planning for their own retirements (which, again, is something I need to look into this year!)

The third cited issue is “reasonable access” for Union representatives to each of Sharp’s hospitals. From the e-mail, “Sharp has defined reasonable access as two to three representatives per shift (depending upon hospital size), two times a week.” I can understand this, as my first thought was, “allowing too many people too often can disrupt the flow of work”. The Union rejected a definition of “reasonable access” prior, although I do not know if the definition they rejected is the same quoted here from the e-mail; the e-mail states offering “a more generous” definition, which was rejected. I would like to see the Union’s definition of “reasonable access”, as I find myself wondering if Sharp’s isn’t too disruptive for employees and potentially for patients.

The final item mentioned is “Closed Shop”. Before reading about this, I wondered if the use of capital letters meant this was a term with a specific meaning. I decided to look it up on Wikipedia. Quoted from Wikipedia, with my own emphasis added:

A closed shop is a business or industrial establishment whose employees are required to be union members (often of a specific union and no other) as a precondition to employment.

Personally, I find this to be a bad situation for potential nurses. If I want to work somewhere without being represented to join a union, without having to pay dues for services I do not want, I hope Sharp HealthCare remains such a place. While the job I perform isn’t the kind which Unions would be interested in seeing unionized, my words still apply were I aiming for a job where unions are typically seen. Were I to become a teacher, it would be my choice not to join a teachers union, for example. Some nurses might prefer to use their own methods for suggesting improved health care services. Such nurses might be planning their own retirement savings. These nurses might be working hard in hopes to be paid what their worth for the work they perform, rather than being paid based on their job title alone. Other nurses may find a being part of a Union more suited to their needs. Let’s keep it a choice.

Within the e-mail, Mike Murphy suggests a Closed Shop, which would require all nurses working at Sharp to pay Union dues (money from their paychecks) to SPNN/UNAC, would increase SPNN/UNAC’s income by “$1.6 million annually in membership dues and fees or more than $4.5 million over the three years of a new agreement”. He states that Sharp will not take away the freedom of its nurses to choose whether to join a union, and pay union dues.

Whether there is a strike or not starting tomorrow, Sharp has contracted replacement nurses. The quality of care and dedication to Sharp’s patients who have chosen use for their care must not be diminished during a striking period.

Later in the week, an update e-mail was sent out by Mike Murphy.

In this e-mail, various topics related to the negotiations are addressed. It tells about the development of a new proposal for formally addressing quality concerns. This sounds like it’s a step in the right direction. Hopefully a system will be put in place where nurses can provide ideas and insights into the need for improved care directly to higher positions within Sharp, which hopefully will result in detailed explanations as to why said ideas cannot be implemented (if they cannot be), with room for partial implementation, or instead reply positively on how to take the first steps toward implementing the requested improvements.

Also presented in the e-mail is proposal for medical coverage for long-term Sharp Registered Nurses over a certain age. As well, there is mention of further discussion (which has already by the time I’m writing this) with the Union on “hospital access”

Because I’m only seeing one side of the story, I visited the UNAC of California web site. I don’t know if there’s a more informative web site to check for Union members, so this will be my starting point. They have a PDF format file covering questions and answers about the strike, which appears to be informative for striking RNs.

According to the page：

SPNN nurses never make a decision to strike lightly. UNAC members haven’t gone on strike since 1980. However, (Sharp) management gave the union its “last, best and final” offer of a new contract. That offer shows a lack of respect for our hard work and our desire to have a strong voice in improving patient care. So our only recourse is to strike. We cannot force (Sharp) management to continue negotiating if they take the position that they are finished and no longer want to talk. By going on strike, we will show that we refuse to accept this unacceptable contract offer.

Unfortunately, this conflicts with e-mails about hopes of Sharp and nurses to continue discussions, rather than entering a strike. I do not know if “our desire to have a strong voice” refers to the Union, or to nurses.

The next question addresses something I have been wondering about. A newspaper article (in the San Diego Union Tribune) had stated that RNs voted overwhelmingly in favor of the strike. It took me by suprise to learn that so many of Sharp’s Registered Nurses voted this way. From this page, the following tells who decided RNs should strike.

Informational meetings were held throughout the day on Friday, June 29. Voting by secret ballot, the overwhelming
majority of SPNN nurses attending those meetings voted to authorize a strike.

Contrary to what the newspaper article I read said about a majority of nurses voting for the strike, it turns out it was a majority of the nurses who attend the meetings. Just as it’s the involved parents who go to PTA, it’s likewise the involved RNs who agree with the Union’s views who will be at the meetings. This is not a criticism of said meetings, only an observation, as the Union Tribune stated, “Union nurses at Sharp HealthCare hospitals voted overwhelmingly yesterday to authorize a strike,” giving the appearance to me that all Union RNs voted. Very “live and learn” for me here.

The next question is a good one, asking why an RN should strike if they like working at Sharp and caring for their patients. The given answer is:

Woman enters hospital with loaded rifle (06/29/2007)—At Sharp Mesa Vista Hospital, when a mentally ill woman’s appointment is rescheduled, she leaves and returns with a rifle. No shots were fired.

Sharp Health Plan president and CEO committed to community (06/29/2007)—This one requires subscription, and I didn’t check the full story at work, so I cannot summarize the article.

McCarthy breaks ground on 5-level parking structure for Sharp (06/29/2007)—The groundbreaking has taken place for a new five-level parking structure for Sharp HealthCare. This will provide parking for patients, as well as for 1,000 Sharp employees, helping clear the streets and traffic in the area.