Issue Paper

February 27, 2002

To: Interested Legislators

From: John Sauer, Executive Director and Tom Ramsey, Director of Government Relations

Subject: Opposition to 2001 Senate Bill 211 and Assembly Bill 457, The Health Care Worker Mandatory Overtime Prohibition Bills


As the statewide trade association representing not-for-profit and county nursing facilities, community-based residential facilities (CBRF) and residential care apartment complexes (RCAC), we wish to express our opposition to SB 211/AB 457 and respectfully request that you join our not-for-profit long-term care providers in opposing these bills.

WAHSA members oppose SB 211/AB 457 for the following reasons:

• There is no justification for the use of mandatory overtime if a facility’s sole purpose of mandating overtime is to cut costs or to compensate for poor planning. Mandatory overtime is unhealthy for the worker and places in jeopardy resident care. But if mandatory overtime is used to provide caregivers where caregivers otherwise would not be available, its use is justified.
  
  
• The fiscal effect of each bill is $2.9 million GPR and $10.9 million all funds in 2002-03. Even if we supported these bills on their merits, which we don’t, WAHSA members believe we cannot afford SB 211/AB 457 at a time the State is facing a budget deficit of $1.1 billion.
  
  
• WAHSA members believe the $2.9 million fiscal note for SB 211/AB 457 may be significantly understated because it did not include the fiscal impact these bills would have on the State’s 420 Medicaid-certified nursing facilities. Since SB 211/AB 457 do not define the “all other options” which first must be exhausted before overtime could be mandated, the bills are silent on whether facilities which are temporarily short staffed would be required to contract for outside services (“pool help”) prior to being permitted to mandate overtime. If we assume, as the Department of Veterans Affairs does in the attached fiscal note to AB 457, that nursing homes would have to contract for pool help prior to any imposition of mandatory overtime, the additional cost to the Medicaid program could be significant. How significant we won’t know without a fiscal note.
  
  
• The use of “pool help” not only is significantly costlier than the use of a facility’s own staff; of even greater importance and concern is the negative impact that pool utilization can have on staff morale, resident continuity of care and, ultimately, a facility’s quality of care. Most nursing facilities attempt to avoid its use at all costs; SB 211/AB 457 appear to mandate it.
  
  
• We are aware of no WAHSA member which has mandated overtime in their CBRFs or RCACs. In a 9/10/01 survey of our nursing home members, 52 of the 76 respondents (68.4%) indicated they did not use mandatory overtime; the remaining 24 of the 76 respondents (31.6%) indicated they had a mandatory overtime clause in their contracts but only 8 of those 24 facilities (10.5% of the total) indicated they actually had invoked that mandatory overtime clause. WAHSA members are asking whether mandatory overtime in long-term care facilities is a problem in need of a legislative solution.
  
  
• Fifteen facilities which responded to our survey indicated that mandatory overtime was a bargainable item in their union contracts. If a union contract contains a provision which permits mandatory overtime, doesn’t that assume the workers and their bargaining team had higher priorities and is it appropriate for the Legislature to become indirect participants in that collective bargaining process?
  
  
• Of the WAHSA members which indicated they had invoked mandatory overtime, they did so primarily in response to three circumstances: inclement weather, sick calls, and “no shows.” If these are “unforeseeable emergencies,” then no WAHSA members mandate overtime under the provisions of SB 211/AB 457. However, since neither bill defines “unforeseeable emergency,” facilities simply don’t know whether they are in compliance with the provisions of SB 211/AB 457 which prohibit the imposition of mandatory overtime.
  
  
• Unlike other health care providers, nursing homes must meet statutorily-imposed daily minimum nurse staffing requirements. In order to meet those statutory requirements, facilities need to know today who is going to work tomorrow. The “poor management” practices described at the public hearings on the two bills don’t apply to nursing homes, at least those that wish to abide by the law. And for those that don’t, SB 211/AB 457 will be irrelevant anyway.
  
  
• SB 211/AB 457 present nursing home operators with a unique dilemma: If they cannot find adequate staff, do they comply with SB 211/AB 457, not mandate overtime but violate the statutory minimum staffing requirements or do they mandate overtime to comply with the statutory minimum staffing requirements but violate the provisions of SB 211/AB 457?
  
  
• SB 211/AB 457 are intended to protect patient/resident safety. Is there a logical explanation why voluntary overtime is not a risk to patient/resident safety but mandatory overtime is?
  
  
• Proponents of SB 211/AB 457 must answer this simple question: At a time of a nursing shortage, where facilities are doing everything humanly possible to recruit and retain needed staff, why would any manager needlessly irritate and risk losing staff by unnecessarily mandating overtime? At least for long-term care providers, if they didn’t have to mandate overtime, they wouldn’t, both from a business standpoint and from a quality care standpoint.
  
  

Please vote for the defeat of SB 211/AB 457.

WAHSA 204 South Hamilton Street Madison, WI 53703
Telephone: (608)255-7060 FAX:(608)255-7064