Union petition challenges Porter’s change in benefits

MIDDLEBURY — Members of Porter Medical Center’s nurses’ union on Thursday held a gathering to present hospital administrators with a petition opposing a Porter decision to raise the minimum number of hours that employees need to work in order to qualify for health insurance benefits.
Porter administrators are countering that requiring a minimum 30-hour workweek (up from 20 hours) for qualifying for health insurance is consistent with regional and national trends, and is an important step in righting PMC’s precarious financial ship. The change is projected to save Porter $200,000 annually.
“Our employees are our greatest resource, and it is imperative that we do all we can to provide them with appropriate compensation and benefits, but it is our patients, residents and community who we are here to serve — and it is the mission and responsibility of the leaders of PMC to ensure that those necessary and appropriate services are sustained for the people of this region,” said Porter spokesman Ron Hallman.
The benefits change announcement drew swift opposition from representatives of the Porter Federation of Nurses and Health Professionals. The union late last year worked to negotiate a three-year pact covering the more than 140 full- and part-time nurses who work at Porter Hospital, Helen Porter Healthcare and Rehabilitation Center, and the network of around a dozen physicians’ offices affiliated with Porter Medical Center.
“The union has filed a grievance around this,” said union President and Registered Nurse Alice Leo.
But Leo stressed that the union’s petition drive regarding the benefits change for part-timers is being done on behalf of all affected workers, and not just nurses. The petition, as of Thursday, bore 1,027 signatures. Leo said many of those who signed hail from Addison County. Some of those who signed are current Porter workers, though she said some of her colleagues declined to sign for fear of retaliation.
“We are asking the community to support the restoration of health care benefits for Porter employees,” Leo said of the petition.
“Porter is a health care institution that’s taking away health insurance benefits for its employees, and that doesn’t make any sense,” she added.
Hallman said the decision to make the benefits change — which takes effect on Jan. 1 — was made after careful study and in recognition of some sobering trends in community hospital financing. He pointed to a May 16, 2015, Modern Healthcare Magazine report indicating that 58 rural hospitals in the U.S. have closed since 2010.
The overall financial condition of PMC was characterized as “fragile” this past August during the institution’s budget hearing before Vermont’s Green Mountain Care Board, according to Hallman. It was at that time that Porter officials presented a consolidated budget showing a $1.7 million loss for fiscal year 2015 and a budgeted operating loss of $210,000 for the current fiscal year, which began Oct. 1.
“The cumulative operating loss for PMC from fiscal year 2012 to fiscal year 2016 is $11 million,” Hallman said.
It has been largely the infusion of tenuous federal funding that has allowed PMC to backfill some of its shortfalls and maintain current staffing and benefits levels, according to Hallman. He in particular singled out the 340B federal drug program that produces additional non-operating revenue and expense savings on pharmaceuticals.
“However, the 340B program has been, and remains, under constant pressure by the federal government and pharmaceutical manufacturers as a target for elimination,” Hallman said. “If this were to occur without improvement to the operating margin of the organization, Porter projects that it could be in default of its bond covenants within two to three years, putting the entire organization — hospital and nursing home — at tremendous risk.”
With that in mind, PMC officials have been looking at potential new revenue sources and ways of trimming operating expenses. In addition to the projected $200,000 savings through the health benefits change, PMC is looking to save another $200,000 by shifting from the current premium-based health insurance plan for its employees to a self-insurance plan, according to Hallman. If self-insured, PMC would assume all of the risks — and potential savings — for those included in its health plan.
Porter administrators first anticipated that 64 employees would be directly affected by establishing a minimum 30-hour workweek to qualify for health benefits, according to Hallman. But officials reached out to those 64 workers and were able to resolve the health insurance dilemma for the vast majority of them, he said. They did this through such means as finding additional work hours within PMC to push some employees to 30 hours a week, helping some obtain insurance through Vermont Health Connect, advising some to join a spouse’s health plan or Medicare, and taking advantage of a “look-back” provision under the Affordable Care Act that allows people to qualify for benefits in 2016 as a result of the hours they actually worked in 2015.
“As of now, only a handful of employees will need to enroll in the Vermont Health Connect exchange and no PMC employee is at risk of not qualifying for either Porter or other coverage,” Hallman said.
It should also be noted, according to Hallman, that PMC will also begin offering a single benefit plan to all employees of PMC to reduce disparities among the various plans that currently exist at Porter Hospital and Helen Porter Healthcare and Rehabilitation Center (the nursing home). Helen Porter workers are currently offered health insurance options featuring larger deductibles than the plans offered to the hospital workers, according to Hallman.
Reporter John Flowers is at johnf@addisonindependent.com.

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