Dissolve HHS Board
Hold Hospital Leadership Accountable
Hennepin Healthcare Unions call for the dissolution of the insular Hennepin Healthcare System (HHS) Board. Minnesotans deserve public transparency and accountability on where public funds are spent.
Counterpoint: Hennepin Healthcare deserves an accountable board
The current arrangement does not provide that, either to staff or to the public.
By Nathan Paulsen and Kim McNeil
APRIL 16, 2024 — 5:30PM
Between us, we have 29 years of experience working at Hennepin Healthcare. We're deeply honored to work alongside some of the most compassionate, hardworking and dedicated healthcare workers in the country. We're also concerned about the direction of the organization under the unaccountable Hennepin Healthcare System Board that currently governs Hennepin Healthcare.
Unlike HHS administrators, who come and go, we've lived through the changes in question in our health care system. Despite recent claims by Dr. Thomas Klemond, president of the medical staff for HHS, in a recent commentary ("Patients before politics," April 8) there is abundant evidence of poor working conditions, deteriorating benefits, excessive executive salaries and a lack of transparency in our health care system.
We know this because we see it for ourselves. We, along with our colleagues, advocate for a transition from a privatized management model to one that is democratic, accountable and integrated with Hennepin County, ensuring the hospital serves everyone's interests.
Since the HHS Board took control in 2007, CEO pay increased by more than 142%. Meanwhile, that same board sunsetted employee retirement health insurance, shifted vacation and sick time into PTO at a loss for workers, eliminated retention pay, cut 40% from performance raises, undermined union dental insurance, and imposed huge increases to health insurance premiums and deductions. Even as hospital administrators cry poverty at the bargaining table and refuse meaningful wage increases to the workers who deliver services, behind closed doors the CEO received a whopping 15% raise, to $452 per hour.
This is a slap in the face to the thousands of us front-line staff members who saw an inflationary wage cut of nearly one-tenth of our income. Fearmongering administrators feign that dissolution of the HHS board would be disastrous. But that disaster has already struck Hennepin Healthcare workers and patients, that is why we are fighting for transparency and accountability.
AFSCME represents over 2,500 workers at HHS, a large number of whom are workers of color and among the lowest-paid staff in the system. Isolating Hennepin Healthcare from Hennepin County and hand-selecting board members who are superficially "accountable" to workers or the public puts the cost-cutting burden on the back of front-line staff and patients, which has pushed the system to the brink of collapse.
Beyond the financial data Klemond seemingly overlooked, there is a real workplace violence crisis. In 2022, per HHS statistics, there were 455 assault injuries. In inpatient psychiatry alone, there were 89 injurious assaults. Actual incidents of workplace violence are vastly underreported, which HHS administrators acknowledge.
Dr. Klemond should be aware of these facts, and yet disingenuously suggests to the public that there is "little data" to support the assertion that Hennepin Healthcare working conditions are poor. Recently, management provided only a partial workplace violence data set to AFSCME Local 2474, which represents job classes at the center of the workplace violence crisis, such as Protection Officers and Mental Health Workers.
To make informed decisions, the public needs to be told the truth. And it is dangerous to withhold vital information from front-line staff regarding workplace conditions. It also demonstrates a wider problem, which is lack of administrative transparency and disdain for the firsthand experience of the workers who provide patient care daily.
Under HHS Board leadership, inpatient psychiatry was neglected for years, with a work environment that was severely understaffed, with inadequate training, and with a lack of management support for therapeutic interventions. Out of necessity, we came to depend on dangerous procedures such as restraint and seclusion. These procedures disproportionately affect patients of color and were utilized at comparatively high rates. Again, there is data at Klemond's fingertips that he simply prefers to ignore, and our experiences are met with defensiveness and invalidation rather than fierce curiosity, real collaboration and problem-solving.
Ultimately, Hennepin Healthcare and all Minnesotans would benefit from the governance of elected officials rather than an insular board, aligning more closely with transparency and accountability. We, workers and proud union members, are committed to advocating for a responsible and responsive health care institution that prioritizes community and staff well-being.
Nathan Paulsen is a mental health worker. Kim McNeil is a certified medical assistant. The Star Tribune Editorial Board also wrote about this issue on Sunday in "Don't blow up HCMC's governance."
Level The Playing Field
On a familiar path to privatization, which would come at huge cost to the multiracial and multiethnic working class Minnesotans we serve, HCMC was made "quasi-public" in 2007. Since that time - and under the current model - the HHS CEO is only accountable to a reclusive and secretive HHS Board. Behind closed doors, the Board tore up the social contract to provide excellent patient care for all with fair compensation for Frontline Staff: While lavishing administrators with large salaries and bonuses, they have gutted worker wages, slashed benefits, and overseen dangeorus cuts to patient care. Worker-leaders who problem solve patient care issues and advocate for improved working conditions are routinely ignored, dismissed, and punished by out-of-touch and unaccountable administrators.
By dissolving the HHS Board, the CEO will be accountable to Hennepin County Commissioners, who in turn are accountable to us as workers, citizens and voters. In transparent and accountable County hands, our beloved medical institution has a promising future.
Multi-Union Press Conference on April 2nd at the Hennepin County Government Center
Minnesota Nurses Association Statement
Healthcare workers to call for dissolution of Hennepin Healthcare board ahead of Hennepin County Commissioners meeting
CEO Jennifer DeCubellis and current Board of Directors put future of Hennepin County Medical Center at risk with inaction on patient care, nurse retention, and workplace violence crisis
(St. Paul) – April 1, 2024 – On Tuesday, April 2, 2024, nurses with the Minnesota Nurses Association (MNA) and other healthcare workers will hold a press conference in the atrium of the Hennepin County Government Center to call on the Hennepin County Board of Commissioners to initiate dissolution of the Hennepin Healthcare System (HHS) Board of Directors.
In response to healthcare workers’ demands in recent months, Hennepin County Commissioners approved additional funding meant to protect workers’ healthcare benefits and imposed new checks on HHS spending on executive compensation. Despite these steps, HHS executives continue to refuse public transparency and accountability on where public funds are spent.
Workers are calling on Hennepin County Commissioners to take drastic, urgent action to protect the future of Hennepin County Medical Center amid the ongoing crisis of patient care, workplace violence, and worker retention. MNA nurses will be joined by healthcare workers from the American Federation of State, County and Municipal Employees (AFSCME) and the Hennepin County Association of Paramedics and EMTs (HCAPE).
Star Tribune Article
Nurses want Hennepin County to take back control of HCMC
The demand comes after months of criticism of Hennepin Healthcare System leaders and HCMC working conditions by staff.
By Christopher Magan Star Tribune
APRIL 2, 2024
LEILA NAVIDI, STAR TRIBUNE
Sara Franck, president of AFSCME 2474, speaks during a press conference at Hennepin County Government Center in Minneapolis on Tuesday. Nurses with the Minnesota Nurses Association (MNA), health care workers from the American Federation of State, County and Municipal Employees (AFSCME) and the Hennepin County Association of Paramedics and EMTs (HCAPE) held a press conference ahead of a meeting in which they will call for dissolving the Hennepin Healthcare System Board of Directors.
Nearly four months after the Hennepin County Board implemented more financial oversight of the organization that runs HCMC, nurses say working conditions have not changed and the hospital needs new leadership.
They want commissioners to take back control of the safety-net hospital from Hennepin Healthcare System, an organization created by the County Board over a decade ago to run the county's health care facilities.
Leaders from the Minnesota Nurses Association and other HCMC unions say Hennepin Healthcare has not done enough to address rising insurance costs, staff shortages, declining patient care and workplace safety problems. They say workers who speak up are ignored and talked down to by leadership.
"We are here after months of inaction," Jeremy Olson-Ehlert, a registered nurse at HCMC and union leader, said during a Tuesday news conference before a County Board meeting. "We cannot keep nurses at the bedside under these conditions."
Commissioners have the power to dissolve Hennepin Healthcare and take back oversight of HCMC and the other health clinics with a two-thirds majority vote of the County Board.
Not all caregivers think that is a good idea.
Dr. Thomas Klemond, HCMC medical staff president, agrees nurses and other workers face ongoing challenges, but he worries dissolving the organization that runs the hospital "would likely make things worse."
HCMC, like many hospitals with a lot of poor and uninsured patients, faces serious financial and staffing shortages in the aftermath of the coronavirus pandemic, Klemond said. He thinks the Hennepin Healthcare Board, which is composed of community members, staff and local leaders, is best positioned to respond to those challenges.
"So much of what we do is not well supported by the health care system that we have," Klemond said.
County board, hospital leaders react
Hennepin Healthcare Board Chair Babette Apland said hospital leaders take the issues raised by caregivers seriously and are working to address them. She also maintained the volunteer board that currently leads Hennepin Healthcare was the best model for navigating difficult times.
"Moving away from this diverse community-based and expert leadership is not in the best interest of Minnesota's largest safety-net health care system," Apland said in a statement.
County Board Chair Irene Fernando said she was in the process of gathering more information about the problems nurses are raising. She acknowledged two letters nurses sent to the board in March outlining their frustrations and said follow-up meetings were in the works.
Fernando and other commissioners said it was too early to respond directly to nurses' demands for the County Board to take back control of HCMC.
New oversight, ongoing questions
Caregivers at HCMC have been speaking up about problems since last year. A big focus is on changes hospital leaders made to insurance plans in 2023 to help close a $127 million budget shortfall.
Nurses, EMTs and other staff say those changes drove up employees' out-of-pocket costs and will make it even harder to recruit and retain hospital staff. They noted HCMC has more than 100 open nursing positions.
In response to calls for more transparency, the County Board put new controls on Hennepin Healthcare when it approved its $1.5 billion annual budget in December. New guardrails included limits on layoffs and changes to executive compensation as well as a financial audit and probe of how insurance changes affect workers.
Two Hennepin Healthcare board members, including the incoming board chair, quit in December after the new oversight was approved by the county.
Analysis by county staff is ongoing, with results of the audit and benefits study expected in the coming months. Recent updates to the County Board from County Administrator David Hough noted the Hennepin Healthcare Board approved a performance review and pay raise for CEO Jennifer DeCubellis and discussed other leadership pay changes at their January meeting.
HCMC staff have criticized recent executive pay hikes, including a 15% raise DeCubellis got in 2023, as another example of problematic leadership. Hennepin Healthcare officials have said DeCubellis' pay is competitive and that she would not accept a salary increase this year.
County leaders and the Hennepin Healthcare board held a joint quarterly meeting March 28 to discuss the hospital system's financials and the new oversight. Most of the meeting was closed to the public, as allowed under state law to protect the hospital's competitiveness, county officials said.
"We are not alone in the challenges we face," Apland said during the public portion. "We have a duty to adapt to these challenges and make sure Hennepin Healthcare is viable."
Jeremy Olson-Ehlert, an RN and MNA co-chair at HCMC, spoke during a press conference at Hennepin County Government Center in Minneapolis on Tuesday.
