Whitesburg KY
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Fiscal court’s vote to support nurses leaves ARH upset

The Letcher Fiscal Court voted unanimously last week to adopt a resolution supporting members of the Kentucky/West Virginia Nurses Association who are on strike against Appalachian Regional Healthcare. Court members also said that ARH may lose nearly $2 million in government funding if the hospital chain doesn’t reach a labor agreement which meets the terms of the striking nurses.

ARH responded to the court’s action this week by saying it will “seriously consider this resolution as we evaluate the future operations of ARH in Letcher County.”

During a special meeting on October 5, Letcher County Judge/Executive Jim Ward told members of the nurses association that if the fiscal court withholds $100,000 in severance tax money already promised to ARH and $500,000 more the hospital chain has requested over the next three years, ARH risks losing out on matching funds and grants totaling $1.8 million if it fails to offer the nurses a contract they will approve.

Ward told the nurses the losses to ARH could rise to as much as $6 million if the fiscal courts in Perry and Harlan counties follow Letcher County’s lead. Ward said he had already spoken with Perry County Judge/Executive Denny Ray Noble about the matter, and would speak with Harlan County Judge/Executive Joseph Grieshop as well. Fiscal courts in all three counties agreed earlier this year to allocate a portion of their severance tax receipts to fund ARH projects, including a women’s center at Whitesburg.

“We have to do this right,” said Judge Ward. “The Perry County Judge asked me to fax a copy of this resolution to him. We want you all back to work, but we have to do this right for the citizens of Letcher County. If I go to the hospital, I want you all taking care of me, not someone else.”

Last week’s court meeting was called by Ward to address the labor dispute between the nurses and ARH. The resolution adopted by the court urges ARH to settle the strike as quickly as possible.

“The nurses provide high quality care for the citizens of Letcher County and deserve to have a labor agreement that is fair,” the resolution says. “The Letcher County Fiscal Court disapproves of and is disappointed in the hospital for using out-of-county replacement nurses to fill the position of those on strike. This will result in a lower standard of care for the citizens of Letcher County and make it more difficult to reach a fair labor agreement.”

The resolution goes on to urge ARH “to restore order to our community, put our citizens back to work, and to stop endangering the health of our citizens by providing a fair labor agreement for the Kentucky Nurses Association.”

In its response this week, ARH says the fiscal court’s “lack of support (for ARH) will most likely be very damaging to the future interests of economic development in seeking new business for the county.”

The response is contained in a letter to Ward from ARH President and Chief Executive Officer Jerry W. Haynes.

“I have received the resolution passed by the Letcher County Fiscal Court on October 5,” Haynes wrote to Ward. “ARH management worked diligently before and during the contract negotiations to resolve outstanding issues in hopes of reaching an agreement with the Kentucky/ West Virginia Nurses Association union. The action by the Fiscal Court, of taking sides in this collective bargaining process, only serves to complicate the efforts to reach an agreement that is fair for everyone.”

Haynes also told Ward that when the strike is settled, ARH management and board of directors “must seriously consider this resolution as we evaluate the future operations of ARH in Letcher County.”

The court approved the resolution condemning ARH after striking nurses asked the court to withhold $100,000 it promised ARH earlier this year to help build the planned women’s center. Nurses told court members they are striking because the quality of patient care has gone down dramatically because of understaffing. They said having more nurses on the job is much more important to them than getting pay raises. The nurses told court members that working shifts up to 16 hours makes it difficult to provide quality care to patients, and that the long hours also take a toll on their families.

District Five Magistrate Wayne Fleming told the nurses he felt the court was lied to at its July meeting when ARH officials requested $200,000 in coal severance taxes every year for three years, totaling $600,000, to be used as matching funds for a women’s health center for Whitesburg. The court voted instead to authorize $100,000 for 2007 and to address the matter again at a later date after seeing how labor relations went at Whitesburg ARH.

Fleming said the latest action by ARH of bringing in strikebreakers while union members were on strike for a labor contract was offensive to the court and to the people of Letcher County.

“Shame on ARH,” Fleming told the nurses attending the meeting. “Shame on ARH. They came in and lied to us when they begged for our money. … Money is the blood of ARH. Its employees are the soul. They are bringing in scabs from Lexington, feeding them for nothing and putting them up. Four or five years ago, ARH was one of the best in Kentucky. I know what these nurses go through. My wife worked there, 16- and 18-hour shifts. You can’t do that. The main thing for you all is patient care. ARH is about money. I think ARH will fold up if they keep this up. Every hospital in every county around Letcher County is making money except ARH. It’s bad management. I would like for every fiscal court that promised them money to rethink it.”

Fleming said he has mixed feelings about the money because the county desperately needs a women’s center. However, he said at the same time, the treatment of Letcher County citizens by large corporations is very important to him as well.

“My heart goes out to you,” said Fleming. “We support you. We will look long and hard at taking taxpayers’ money and giving it to people from central Kentucky. And shame on Jerry Haynes. I can’t believe a poor boy from Letcher County would turn on his own people like he has. The fiscal court supports you. We will walk the picket line with you. They don’t have their money yet.”

Several of the nurses urged the court to withhold the money from ARH, saying the resolution would mean nothing to the chain. One nurse said she objected to the court giving her tax money to ARH and others agreed.

An intensive care nurse from Whitesburg told the court that ICU nurses have a dangerous patient-to-nurse ratio, and that nurses have to do almost everything for the patients. She said one day she was so rushed she was brought to tears by a request from one sick woman who was asking for crushed ice. “She told me she knew I was covered up but if she could just have one glass of crushed ice.”

Other nurses said the hospital is forced to operate without enough equipment to allow each nurse to have essential items such as blood pressure cuffs. One nurse said that her floor had one cuff for the entire floor and it made it difficult for nurses to complete their regular rounds or attend to the needs of patients.

“You mean you’re operating with a shortage of equipment too?” asked District Two Magistrate Archie Banks.

Banks went on to say that he doesn’t understand ARH’s logic in paying massive amounts of overtime to nurses just to avoid hiring an adequate labor force. He said that by hiring enough workers, ARH could not only improve patient care considerably, it would probably save a good deal of money as well.

“It’s more expensive to pay all that overtime than it is to hire enough people,” said Banks. “That makes no sense. You can hire more people easier than paying time and a half.”

Wilma Maggard, a Letcher County resident who works at Hazard ARH, attended the meeting as vice president of Local 104 of the Kentucky Nurses Association. Maggard told the court ARH has hired a company which specializes in breaking strikes.

“They hired Yessin & Associates consultants and said they wanted to change communications policy,” said Maggard, “If they had typed in communications consultants instead of union busting consultants they might have gotten it right.”

Maggard said the main holdup in negotiations is the existence of a “successor clause” in the old contract with the nurses. Maggard said the successor clause means if the hospital chain were to be sold, the new buyer would be legally obligated to continue with the terms of existing labor contracts through the life of the contract. Maggard said ARH is adamant that the clause must go.

“That was taken out (of the contract ARH put on the table),” said Maggard. “They said they are standing firm on keeping it out.”

Several nurses told the court that members of the United Steelworkers union, which includes licensed practical nurses, technicians, housekeeping and kitchen staffs, and other workers, have been forbidden by management to put bumper stickers on their cars or paint their windows in support of striking nurses.

Steelworkers representatives attending the meeting said that union members were told they could not decorate their cars in support of the strike, wear clothing supporting the nurses, have signs of support, or wear black in support of the nurses. During the Steelworkers’ strike, nurses were required to work but showed their solidarity with the Steelworkers by wearing black in support of the strike. They painted their car windows and had signs in support of the Steelworkers. The union members said they were told the reason they can’t show support for the nurses union was because it might “upset the patients.”

All the nurses who addressed the fiscal court said they wanted to make it clear to the court and to the citizens of Letcher County that the strike is not about compensation but about adequate staffing and having control of their overtime.

The nurses said they got into nursing to provide quality care and that in the small community atmosphere of Letcher County they have come to know many of the patients at the hospital well and consider them to be family. They said that improving patient care through adequate staffing is their primary concern.

“Our work comes from the heart,” said Joan Ramsey. “These are our people. We want to care for our people in our hospital. We want you to know that you are important to us and we will treat you with respect.”

In his letter to Ward, Haynes said the Whitesburg hospital might be closed now if the ARH wasn’t able to hire the replacement nurses.

“You have indicated in the resolution your disappointment in ARH using agency nurses to fill the positions of those on strike,” Haynes wrote. “This statement is disappointing, and have you considered the consequences if ARH had not hired agency registered nurses? Had ARH chosen not to take this course of action, a number of hospitals, including the Whitesburg ARH, may have been closed or forced to significantly curtail services, thus denying health care to the majority of the citizens in the area. And, as unfortunate as it would be, some of the ARH hospitals might never re-open. In addition, approximately 30 percent of the registered nurses at Whitesburg have chosen not to strike and are providing care in the hospital and home health services operation, as they always have.”

The ARH hospital chain, which is based in Lexington, was founded by the United Mine Workers of America to provide adequate healthcare for residents of the Appalachian coalfields. The first UMWA Miners Memorial Hospital opened in Middlesboro in 1955. Others followed until there were 10 all together. All 10 were dedicated in June of 1956 in a ceremony presided over by John L Lewis, then the president of the UMWA.

In 1963, an agreement was reached to transfer the hospitals from the UMWA to Appalachian Regional Hospitals. ARH currently has hospitals in Hazard, Whitesburg, Harlan, Middlesboro, McDowell, Morgan County and South Williamson in Kentucky and in Beckley and Summers County in West Virginia. It also operates clinics and health care stores in its service area.

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