TO: UAPD Represented Physicians and Dentists
FROM: David Abella, AHS Associate General Counsel and Chief Negotiator
Athena Buenconsejo, AHS Labor Relations Director
Date: July 18, 2018
SUBJECT: AHS Management – Bargaining Update on AHS/UAPD Negotiations
The Union of American Physicians and Dentists (UAPD) and Alameda Health System (AHS) have been negotiating a successor agreement to follow the MOU that expired in June 2017.
Most recently, negotiations between the parties have focused on wages.
AHS’s current wage proposal for all PT/FT Providers is 3% at ratification, then 2.5% and 2%, respectively, in each subsequent anniversary year of the contract. AHS is not proposing any retroactivity for the period of time that the parties are without an Agreement.
Additionally, AHS is proposing to simplify and improve the current incentive program for Ambulatory Care Providers by pegging baseline productivity to the California median, as reported by Federally Qualified Health Centers (FQHC) to the California Health and Human Services Agency (Department of Health Care Services). AHS proposes to reward productivity in excess of the median (See attached FQHC California median report). The median reported by FQHC’s is 3,089 patients per year, per 1.0 full-time equivalent (FTE).
In addition, Ambulatory Physicians will have the opportunity to acclimate to the proposed incentive plan. After receiving the Union’s feedback, AHS proposed a graduated measurement that initially rewards productivity below the California median, in accordance with the following:
|AHS PROPOSED INCENTIVE PAY PLAN – Effective between July 1, 2018 and June 30, 2019
(measurements are per quarter)
|· 675 patients per quarter = $20/visit over 675, but less than 725
· 725 patients per quarter = $30/visit over 725, but less than 772
· 772 patients per quarter = $50/visit over 772
By July 1, 2019, AHS seeks to have its productivity aligned with the FQHC median at 3,089 physician visits per year (per full-time equivalent) or 772 physician visits per quarter (per full-time equivalent).
|AHS PROPOSED INCENTIVE PAY PLAN – Effective between July 1, 2019 and June 30, 2021
(measurements are per quarter)
|· 772 per quarter = $50/visit over 772|
AHS’s incentive plan is designed to reward Ambulatory physicians for their hard work and still preserve the quality of healthcare provided. It must be noted that because AHS receives federal and state funding, it is imperative that productivity targets are met; otherwise, such funding is placed at risk. (See attached State of California – Health and Human Services Agency, “State Plan Amendment (SPA) 18-003: Changes to Reimbursement Policies for FQHCS and RHCS.”)
Conversely, the Union’s latest proposal seeks the following:
|UAPD PROPOSED Wages|
|Effective June 27, 2018||Ambulatory Physician salary of $112.81.
|Effective June 27, 2018||Increase Ambulatory SANs salary by 10%, then an additional 3% increase effective on this same date.
|Effective June 27, 2018||Increase Dentist salary by 7%, then an additional 3% increase effective this same date.|
|Effective May 2017
Unit 18 wages:
Psychiatrist II: $326,000/year
Psychiatrist III: $358,600/year (10% differential)
Any hours worked between 1600-2400 (evening hours) will have a 15% differential.
Any hours worked between 2400-0600 (night hours) will have a 30% differential.
Unit 24 wages:
$200/hour for any hours worked between 0600-1600.
$230/hour for any hours worked between 1600-2400.
$260/hour for any hours worked between 2400-0600.
$250/hour for the 1900-0700 shift formerly known as night emergency pay. All limiting MOU language for this shift will be eliminated.
In addition to the above, the Union is seeking a 10% weekend differential for Ambulatory and Dental and a 15% evening differential for all hours worked after 5pm.
The Union’s counter proposal to AHS’s incentive plan is outlined below. The plan, as proposed by the Union, falls below the median productivity for California FQHC’s.
|UAPD PROPOSED INCENTIVE PAY PLAN – Effective July 1, 2018|
|· 840 patients per 4-month period = $50/visit over 840, (“each physical and new patient encounter will be counted as the equivalent of 2 (two) encounters for purposes of this section”)|
|UAPD PROPOSED INCENTIVE PAY PLAN – Effective March 1, 2019|
|· 873 patients per 4-month period = $50/visit over 873, (“each physical and new patient encounter will be counted as the equivalent of 2 (two) encounters for purposes of this section”)|
Based on the current position of the parties, AHS and UAPD are far apart on economics, including economic incentives.
Negotiations are scheduled to continue on July 24, 2018. We remain hopeful that the parties can come closer together as AHS remains committed to good faith, efficient bargaining that leads to a fair, multi-year agreement.