VA nurses expose under staffing that poses risks to patients

Nurses at the Little Rock Veterans Affairs (VA) hospital recently stood up for their patients by calling attention to a severe under staffing problem at the hospital.

Thirty nurses, members of the American Federation of Government Employees (AFGE) Local 2054, filed a complaint with the VA’s Inspector General and the Arkansas State Board of Nursing charging that the hospital’s under staffing puts patients at risk.

Then on June 26, two dozen nurses held an informational picket at the hospital to call attention to the risks faced by patients.

“We are down 150 nurses. Floating to areas we aren’t skilled in is at an all-time high,” said Barbara Casanova, president of Local 2054 and a registered nurse at the hospital. “We can’t deliver appropriate care under those circumstances.”

“We promised to keep our veterans safe, but we’re very worried that something could go wrong,” continued Casanova.

David Cox, Sr., AFGE president, said that the under staffing problem in Little Rock is not unique; it’s a problem at VA hospitals and clinics all over the US.

According to Cox, there are currently 49,000 unfilled positions at VA hospitals across the country.

“Every vacancy is a missed opportunity to make good on our promise to care for those who have borne the battle,” said Cox, Sr. “One vacancy is a tragedy; 49,000 is a national disgrace.”

Cox said that it has been difficult to attract candidates to fill the vacant VA positions because of two things: a constant barrage of anti-government rhetoric by politicians and special interest groups that want to privatize the VA and “pay and benefit cuts that scare away qualified doctors, nurses, and other health care professionals.”

The anti-government rhetoric is being transformed into policy by the Trump administration, and its actions have exacerbated the VA’s under staffing problem.

One of the President’s first orders of business when he took office was to freeze hiring by government agencies like the VA.

That freeze was lifted in April, but its  effects continue to linger as the VA tries to catch up with a hiring backlog.

Health care professionals who might be interested in taking those jobs may think twice about doing so because those jobs could end up being cut if the VA continues to privatize more services.

President Trump is a big fan of privatization, and his proposed budget for the VA reflects his predilection for privatization.

His budget boosts funding for the VA’s Choice program, which the American Legion’s National Commander calls a “stealth privatization attempt,” by $2.9 billion in 2018 and $3.9 billion in 2019.

To help pay for the increase in funding for the Choice program, which allows local VA administrators to divert patients to private health care providers, the President’s proposed budget cuts veteran disability benefits by $3.6 billion.

“We are alarmed by the cannibalization of services needed for the Choice program,” said Schmidt. “It is a ‘stealth’ privatization attempt which The American Legion fully opposes.”

In addition to the threat that their jobs could be privatized, VA nurses and other federal employees have had to put up with pay freezes and benefit cuts, which Cox said also makes it difficult to fill open positions.

Between 2010 and 2013, all federal employees including those at the VA had their pay frozen.

Between 2010 and 2016, federal employees also suffered lost wages due to furloughs caused by budget impasses and higher pension contributions.

Now President Trump is seeking even more cuts to federal employees’ wages and benefits.

His proposed budget raises pension contributions for most federal employees to 7 percent of an employee’s salary, a 900 percent increase.

Higher pension increases will mean less take-home pay.

If the Trump budget were to be enacted, a federal employee hired before 2013 and earning $50,000 a year would see her pension contribution increase from $400 a year to $3500 a year, amounting to a 6 percent pay cut.

Trump’s proposed budget would also reduce future pensions and eliminate cost-of-living adjustments.

Back in Little Rock, the nurses’ actions that brought attention to the under staffing problem seems to have done some good.

Hospital management at the Little Rock VA said that 54 new nurses have been hired at the facility.

Casanova has been encouraged by the recent hirings, but if President Trump’s budget becomes a reality and privatization increases and wages and benefits decrease, the Little Rock VA and others will be hard pressed to close the staffing gap that endangers the health of its patients.

VA workers rally to stop privatization and closure of VA hospitals

Veteran Administration workers held 38 rallies at VA hospitals across the US to protest a proposal that if enacted would privatize health care services for veterans and shut down all VA hospitals and medical centers.

The proposal was drafted by seven members of the Commission for Care, a commission appointed by Congress in 2014 to recommend ways to improve care and accessibility at the VA.

Members of this rump group, which met in private, include executives from four for-profit hospital companies and an employee of the Koch brothers, the right-wing duo, who have spent millions funding political candidates who support privatizing government services.

The commission will soon release its recommendations, and VA workers and veterans are concerned that the commission’s recommendations will reflect the thinking expressed in the report from the rump group.

“Even though the vast majority of veterans oppose privatizing the VA, there are many people who would benefit financially from dismantling the VA and forcing veterans into a network of for-profit hospitals and insurance companies,” said AFGE National President J. David Cox Sr., president of the American Federation of Government Employees (AFGE), the union that represents 230,000 VA employees. “VA employees across the country are speaking out against these corrupt business interests with a clear message: it’s time to put people ahead of profits.”

Veteran’s groups have also expressed opposition to the proposals in the report, which has been dubbed “the strawman document.”

Recently, eight leaders of veterans organization signed a letter to the Commission for Care chairperson expressing their opposition to ideas in the document.

“On behalf of our combined 5 million members, the vast majority of whom use the VA health care system, we write to express our grave concerns with the ‘proposed strawman document’ that was discussed and disseminated during your March meetings in Washington, DC,” reads the opening sentence of a letter.

Among other things, the veteran groups’ leaders were concerned about the proposal on pages 19-20 of the document that calls for closing VA hospitals and medical centers, halting all construction of new VA facilities, halting all renovations of existing facilities,  and transitioning veterans in need of care to private hospitals and care providers.

The document envisions that in twenty years all VA hospitals and medical centers will be closed, and the VA will exist only to write voucher checks to private health care providers.

The Commission for Care was created in 2014 when the media reported that veterans were experiencing long waits for care at VA hospitals.

As it turns out, the long waits were not typical of the system, and the media reports were a bit exaggerated; nevertheless, Congress acted to address the problem by appropriating funds to hire more staff and improve VA facilities. It also allowed veterans facing delays in service to seek help from private providers.

As a result, the VA has added 14,000 health care workers, opened up 3.9 million more square feet of clinical space, and added 20 million provider hours of care.

It also cut its compensation and claims backlog by 87 percent and overhauled its scheduling system.

Those who have actually studied the VA’s performance such as RAND have concluded that “the quality of care provided by the VA health system generally was as good as or better than other health systems on most quality measures.”

But the authors of “the strawman document,” chose to ignore the progress made and good work done by the VA and, instead, to pursue their own agenda.

According to the veterans’ leaders, veterans want to see improvements at the VA but not at the cost of eliminating VA facilities and the “veteran-centric” services they provide.

The veteran leaders also criticized “the strawman document” for ignoring wishes of veterans “who would choose to receive care at VA medical facilities rather than seek care from disparate community providers.”

The VA rallies by AFGE members, many of whom like Cox are veterans themselves, was meant to call public attention to the possibility that VA services could be privatized for the benefit of private interests rather than for veterans themselves.

“Veterans should not be reduced to a line item on a budget sheet,” said Cox. “They have served our country with honor and distinction, and their medical care shouldn’t be left to the whims of profiteers and claims adjusters.”

 AFGE locals have organized 38 rallies to date in 19 states: Alabama, Alaska, California, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New York, North Carolina, Ohio, Pennsylvania, Texas, Washington, West Virginia, and Wisconsin.

 

Petition protests Social Security office closures

A group of people representing union and retiree organizations on October 2 presented a petition with one-half million signatures to the Social Security Administration in Washington DC urging it to stop closing local offices and to restore the face-to-face services on which people applying for benefits depend.

Representatives of the American Federation of Government Employees (AFGE), the Alliance for Retired Americans, and Social Security Works joined together to rally and present the petitions.

Support rallies were held in New York City, Oakland, and Columbus, Ohio.

Because of budget cuts, the Social Security Administration during the last three years has closed 80 local offices and 500 contact stations.

“Budget cuts have degraded the Social Security Administration’s ability to service millions of baby boomers who are becoming eligible for retirement,” said AFGE in a media statement about the event.

The union also warned that a strategic plan being proposed by the Social Security Administration “will drastically reduce community field offices and transition (services) to a web-centric customer service mode.”

The strategic plan, known as Vision 2025, has not been released yet, but in July, the agency released a report that made recommendations that will likely be included in the new strategic plan.

The report recommends reducing face-to-face contact between local Social Security workers and people seeking benefits by making the agency’s “virtual channels (e.g., online, phone, video conferencing) . . .  the primary means of means of service delivery.”

“Many people who rely on Social Security are the least likely to have knowledge, ability, and resources to use the Internet services,” said Witold Skwierczynski, president of AFGE Council 220, at the Washington DC gathering. . . “People need experts to guide them.”

“It is outrageous that (the Social Security Administration) is closing offices when baby boomers are retiring in massive numbers and need the aid of experienced . . . staff to handle the rapidly rising number of new Social Security applications.”

In an opinion piece appearing in Government Executive, David Cox, president of AFGE, said that instead of closing offices and allowing staff to dwindle through attrition, the Social Security Administration needs to enhance face-to-face services even if it means fighting for more resources.

“We should not be afraid to fight for the resources needed to build a (comprehensive service delivery system),” he writes.

But fighting for adequate funding is not presented as an option in the Vision 2025 report.

The report, entitled Anticipating the Future: Developing a Vision and Strategic Plan for the Social Security Administration for 2025-2030, was written by a panel convened by the National Academy of Public Administration.

The panel was chaired by Jonathan Bruel, the former executive director of the IBM Center for the Business of Government, a research and policy group funded by IBM whose purpose is to connect government agencies with services provided by businesses.

Also serving on the six-member panel was Alan Balutis, senior director of the Cisco Internet Business Group, and Jim Huse, senior advisor at HJ Steininger, a consulting firm that helps governments “implement challenging programs.”

The report acknowledges that the Social Security Administration “has excelled in providing personal service to its customers” but goes on to say that the agency’s emphasis on face-to-face services “seems to hamper its ability to identify and develop new opportunities to improve services (e.g., online delivery, self-service, and automation).”

According to the report, the Social Security Administration currently uses some technology to deliver some services, but acknowledges that there have been problems with it that require human intervention.

Of those applications that have been submitted online, 95 percent had information missing that required a call back by a Social Security worker.

The current web site has had other problems as well. For example, criminals set up fraudulent accounts through the MySocialSecurity web portal and benefits were paid to these phony accounts.

Despite these problems, the report recommends increasing the agency’s reliance on automation and notes “as more work becomes automated, it become less necessary to maintain the current (workforce) structure.”

But Cox argues that expanding a flawed automated system and over relying on automated tools will hurt the agency’s customers.

Doubling down on a complex, error-prone MySSA website will do nothing to make up for the rapidly growing service gap,” writes Cox. “According to a 2013 survey by the Pew Research Center, more than 40 percent of Americans over the age of 65 do not even use the Internet. Nearly 60 percent lack a broadband connection. But the problems don’t end there. Even for those who do use the Internet, those who file for benefits online often mistakenly leave out important information that could result in a loss of benefits.”

One important service that automated systems can’t do well is informing people about benefits to which they are entitled but not aware of.

“Social Security representatives give people different options, something they haven’t considered,”  said Dianne Flemming, a Social Security recipient at the Washington DC rally. “(People) don’t know what type of benefits they are eligible for.”

Union blames understaffing for VA problems

The American Federation of Government Employees blamed understaffing for the long waits for medical care at Veterans Administration hospitals and urged Congress to act quickly on a recently introduced bill that will fund the hiring of more frontline staff.

“The prevalence of long wait lists are a symptom of the vast understaffing of VA medical facilities,” said David Cox, president of AFGE. “In order to reduce wait times and improve access to VA care that veterans earned through service to our country, we must fix the number one cause of this crisis: understaffing. There is no solving the wait list issue without first solving the staffing issue.”

USA Today reports that more than 57,000 veterans in need of medical care have had to wait more than 90 days to see a doctor. An additional 64,000 veterans who sought care over the last ten years at VA facilities never got to see a doctor.

According to AFGE, since 2009 2 million veterans have entered the VA health system but over the same period of time staffing has increased only 9 percent.

The VA’s inability to keep up with its rapidly rising caseload is due to Congress’ failure to properly fund the services that the VA provides.

To address this problem, Sen. Bernie Sanders and Sen. John McCain have crafted a bill that increases VA funding by $500 million. The funding would be used to hire more doctors and nurses.

“The measure provides for the hiring of new medical personnel in an expedited manner at hospitals and clinics that lack enough doctors, nurses and other medical staff to provide quality care in a timely manner and ensures dedicated funding is available to hire health care professionals,” said Sanders.

The bill will also allow the VA to lease 26 new medical facilities that would expand access to care and give veterans living more than 40 miles from a VA hospital or clinic to use private clinics instead of the VA.

Sanders said that the bill whose title is the Veterans Access to Care Through Choice, Accountability, and Transparency Act of 2014 is not perfect but it is a good first step toward improving veterans health care.

“While this is not the bill that I would have written, we have taken a significant step forward with this agreement,” said Sanders.

One problems with the bill is that it expands the outsourcing of health care services.

“As many Veterans Service Organizations have expressed, such a move could jeopardize the quality of patient care since veterans will be left largely on their own to navigate care between providers lacking specialized knowledge of this population, without the critical care coordination for their complex medical needs that only the VA can provide,” said Cox.

Cox said that outsourcing should be used only as a last resort and pointed to the great strides that the VA has made in expanding access in rural areas through smart investments in telehealth and mobile clinics.

“We need to double-down on these proven systems and deliver to our veterans the quality, specialized care they earned through their service to our nation,” he said.

Cox also said that while it’s good that the bill allows for the hiring of more doctors and nurses, it should have increased funding for more support staff and more clinic space.

“The proposed $500 million to hire new doctors and nurses is critical to getting veterans in the door and provided with quality care,” said Cox. “However, we cannot forget that our medical teams need the proper infrastructure to ensure quality care, patient privacy and clinic productivity. Therefore, as VA increases the number of front-line providers at its facilities, it also needs to provide them with enough support staff and clinic space to get the job done.”

Sanders is hopeful that the Senate will take action on the compromise soon, but there may be a problem with its passage in the House.

The House recently passed its version of the VA bill, but it doesn’t included the $500 million for hiring new staff that is the key feature of the Senate bill.

Unions mobilize members to fight federal lockout

Unions representing locked out government workers are mobilizing members to urge leaders of the US House of Representatives to allow a vote on a Senate resolution that will end the shutdown of the federal government.

More than 800,000 federal workers have been locked out since the shutdown began on October 1.

The shutdown is the latest blow to a federal workforce charged with protecting lives and property, ensuring the health of the nation, providing essential social services, and promoting the quality of life.

David Cox, president of the American Federation of Government Employees (AFGE) said that federal workers have endured the brunt of the sacrifices caused by “manufactured” budget crises.

Federal workers’ pay has been frozen for three years, last spring federal workers were furloughed to help pay for the sequestration budget cuts, and they are constantly confronted with the possibility of permanent layoffs.

Now because a minority members within in the House of Representatives whose goal, according to Cox, is “anybody’s  guess,” have refused to vote on a Senate resolution that would keep the government operating, half the government workforce has been locked out and the other half is expected to work without a paycheck.

AFGE is mobilizing locals across the country to organize members to attend meetings with members of Congress to urge them to support an up or down vote on the Senate resolution.

AFGE members and other unionized federal workers will be at an October 4 rally in Washington organized by the Congressional Progressive Caucus.

In urging members to attend October 4 rally,  Colleen Kelley, president of the National Treasury Employees Union (NTEU), said that federal employees have suffered enough.

“Federal employees have mortgages and kids in college and elderly family members that need care,” said Kelley. “Because of the sequester cuts, which were also the result of this Congress not doing its job, many of them have already been sent home from work without pay over the last few months. And now, they are out of work and don’t know when they will be able to go back to do the important work they do for the public.”

In addition to supporting an up or down vote on the Senate resolution, NTEU is mobilizing members to support H.R. 3223, a bill that the House of Representatives will take up on October 4.

If passed, the bill will ensure that furloughed workers will be paid once they are allowed to return to work.

“Remind your members of Congress that you have already had your pay frozen for three straight years and many of your colleagues have been required to pay more toward their retirement benefits,” said a message to members on the NTEU website. “Moreover, many of you have been furloughed several days this year already as a result of sequestration.”

What is sometimes lost in the media coverage of the shutdown is the important services that federal employees provide and the impact that the shutdown is having on these services.

At a recent media conference on the shutdown carried by C-Span, some furloughed employees explained the impact.

Amy Fritz of the National Weather Service builds computer models that helps predict and track tropical storms and hurricanes.

“I can’t go to work now,” said Fritz. “It’s hurricane season and if something should happenI can’t do my job.”

Fritz, who holds two masters degrees, said that without a paycheck, she will have a hard time repaying $130,000 in student loans she took out to finance her education.

Marcello Del Canto, a budget analyst for the Substance Abuse and Mental Health Administration, said that because of the shutdown, millions of people who need substance abuse and mental health services can’t get them today.

Carter Kinsey, a scientist with the National Science Foundation, said that she is proud to be a federal employee, but that the shutdown and other recent sacrifices demanded of federal employees is “very discouraging.”

She is concerned that the sequestration and shutdown will make federal work unattractive to highly qualified people like those with whom she works.

Steve Hopkins of the Environmental Protection Agency said that he went into government work to provide a service mandated by Congress, but now he can’t do it because a minority in Congress won’t act to end the shutdown.

He added that recent furloughs at his agency caused by sequestration cost employees an average of $2,500.

“President Obama has promised that he will not negotiate to end this crisis, and we strongly support that position,” said AFGE’s Cox. “Recent similar standoffs have been resolved largely on the backs of federal employees, taking away our pay, retirement, and jobs.  This time, we expect the administration to hold firm, and resist the temptation to give in by cutting federal retirement or Social Security.  There is no justification for using federal employees to pay ransom.”

AFGE holds first annual Gay Pride Training Summit

The American Federation of Government Employees held its first annual Gay Pride Training Summit in Pittsburg.  Organizers of the summit provided union activists with training and tools to fight discrimination against lesbian, gay, bisexual, and transgender employees in the workplace.

“For far too long issues facing LGBT workers have been pushed to the side,” said AFGE National President J. David Cox Sr. “As the leading labor union for federal and D.C. government workers, AFGE is committed to actively fighting on behalf of our LGBT brothers and sisters, and fostering a space where all members are welcomed and motivated to participate in the growth of our union.”

AFGE, the largest union of federal workers, also hopes that the summit will encourage more LGBT members to become union leaders.

With this in mind, the summit included a session on developing leadership skills for union building and for effectively representing all workers.

AFGE National Vice-President for Women’s and Fair Practices Augusta Y. Thomas said that LGBT workers face an array of daunting challenges and that it’s the union’s and union member’s responsibility to stand up to these challenges. Some of these challenges take place out of the workplace and require the union to take a stand against discrimination in and out of the workplace.

“The issues facing our LGBT brothers and sisters on the job are very serious and it is our responsibility to represent workers equally,” said Thomas. “In a majority of states in this country workers can be legally discriminated against based on their sexual orientation. This is unjust and absolutely a cause to be taken up by the union. This training arms our labor activists with the tools they need to represent and provide an inclusive environment for LGBT members.”

In addition to hearing presentation by leaders of AFGE, those at the summit heard presentations from Asian Pacific American Labor Alliance Executive Director Gregory Cendana, Transgender Law Center Executive Director Masen Davis, and Pride at Work Executive Director Darren Phelps.