The nurses union and Kapi‘olani Medical Center for Women &Children began working with a federal mediator Thursday morning to help resolve their dispute in reaching a new three-year contract.
The talks Thursday were the two sides’ seventh meeting since roughly 600 nurses represented by the Hawaii Nurses’ Association were locked out from returning to work Sept. 14 following a one-day strike.
The latest development occurred two days after Gov. Josh Green and state Attorney General Anne Lopez urged HNA and Kapi‘olani to seek federal mediation to reach a swift resolution to their dispute.
Green said a neutral mediator could help break through barriers and guide both sides toward a fair agreement.
Additionally, he called for gestures of goodwill from both sides — that HNA ensure no services at the hospital are interrupted and that Kapi‘olani continue health care coverage for locked-out nurses beyond Monday.
HNA President Rosalee Agas-Yuu said the union agreed to the federal mediator but disagreed with terms set forth by Kapi‘olani in a letter Tuesday from Kapi‘olani CEO David Underriner to the governor.
Underriner wrote that Kapi‘olani accepted the governor’s invitation with three conditions: that HNA maintains participation with the federal mediator; that HNA negotiates in good faith during this mediation process; and that HNA does not disrupt services, including patient access, whether it be employees, temporary workers, vendors or visitors.
Agas-Yuu said Wednesday in a letter to the governor that these stipulations are perceived as the “continuation of the ‘bullying’ tactics since this lockout began.”
“Holding our medical/dental coverage hostage to ‘silence’ the nurses and setting pre-conditions to bargain, is not bargaining in good faith,” she wrote. “Unfortunately, the bigger concern is that condoning the continuation of this reckless lockout for another five days means that more families in Hawaii will continue to be harmed by this lockout.”
Green responded to Agas-Yuu on Thursday, saying that “having a federal mediator in place and not having to worry about nurses losing benefits, and the hospital not worrying about any interruption of services, is meant to move both parties forward peacefully on the negotiations.”
He reiterated that as governor he is not empowered to take direct action in a private dispute such as this one, specifically in this case, to end a lockout.
Kapi‘olani nurses have been working without a contract since December, and negotiations have dragged out for more than a year.
This is the second time a federal mediator has been called in to work with both parties. An initial effort in May, which involved six meetings, did not resolve the dispute.
Negotiations on Thursday continued past 7 p.m.
HNA held a one-day strike Sept. 13, the second time this year that hundreds of union nurses walked off the job. Kapi‘olani’s lockout took effect the following day and remains in effect, management said, until HNA unconditionally accepts the contract offer.
HNA contends that staffing ratios are a key point of contention and that the nurses simply want parameters in place to safely care for their patients. For instance, they have argued that 4 babies to 1 nurse is too much for the Neonatal Intensive Care Unit, particularly when video equipment can monitor only three at a time.
In California, nurse-to-patient ratios in the NICU are set at 1 registered nurse to 2 or fewer infants at all times.
Kapi‘olani’s Chief Operating Officer Gidget Ruscetta said her negotiating team has been working on a staffing matrix, to address nurses’ concerns, that aligns with the gold standard set by several organizations, including the American Nursing Association.
Hospital executives have said flexibility, rather than fixed ratios, is necessary to adjust to patients’ needs by the hour and the level of care they need.
State Department of Health officials, meanwhile, confirmed that two anonymous complaints regarding Kapi‘olani have been filed with the Office of Health Care Assurance.
“As is OHCA’s standard operating practice, OHCA responded in accordance with the Centers for Medicare &Medicaid Services (CMS) guidelines for hospitals and started a complaint investigation,” health officials said in a statement.
These complaint investigations are confidential, they said, but those that are substantiated may be subject to disclosure through a request to CMS.
In response, Ruscetta said, “It is not uncommon for the Hawaii Department of Health to visit health care facilities as part of its statewide oversight responsibilities. We are working with the DOH to provide the information it is requesting and remain committed to providing quality care for our community.”
