CVIndependent

Mon09282020

Last updateMon, 24 Aug 2020 12pm

When the novel coronavirus hit California, Jamille Cabacungan, a registered nurse at UCSF Medical Center, rushed to sign up as a volunteer to treat infected patients.

She hesitated to answer, however, when asked about her preparation for that job.

The hospital is providing the necessary gear, she said, and more heightened training for some nurses. But not for all—and much of her training is coming from videos forwarded to her by the hospital, as opposed to hands-on learning-by-doing. Her colleagues are depending on her—“we don’t want to put our pregnant co-workers or those who live with elderly people at risk,” she added—but the preparation is less intense than she expected, considering the risk involved.

As California’s coronavirus strategy has moved from containment to mitigation, the health-care workers on the first line of response to the epidemic are also finding themselves on the front line of potential infection. From internal conversations to calls for action from their unions, nurses, first responders and hospital staffers have sounded the alarm, raising questions about the safety protocols and spotlighting flaws and lags in response, both in California and nationally.

“Nurses are eager to take care of patients and make sure that our communities are safe, but we need the right staffing, equipment, supplies, communication and training to do this safely,” Deborah Burger, president of the National Nurses United, which represents about 150,000 nurses around the country, said during a public health roundtable earlier this week. 

“Put simply, if we are not protected, our patients are at risk,” Burger said. 

The union has asked the state to notify nurses when patients sickened by the virus are sent to their health-care facilities. They are also petitioning the state to release a full account of the protective gear in stock statewide, including respirators, and information about where these respirators are stored, citing concerns over a shortage of respirators and other personal protective equipment.

The nurses say that some of the workplace safety guidelines for states recommended by the Centers for Disease Control and Prevention are not rigorous enough to sufficiently protect health care workers and their patients.

Earlier this month, the union released a nationwide survey of 6,500 nurses in which only 29 percent said their hospitals had a plan in place to isolate potential coronavirus patients, and only 44 percent said they had gotten information from their employers about how to recognize and handle the virus.

As sick people turn up in emergency rooms, community clinics and school nurses’ offices, the workers who initially treat them run a high risk of infection. After a Vacaville hospital reported the first U.S. instance of community transmission, and the patient was transferred to UC Davis Medical Center in Sacramento, for example, healthcare workers’ unions reported 124 workers were placed under quarantine. (UC Davis Medical Center later said that number was inaccurate but did not provide an estimate.) Concerns have also been raised about health-care workers inadvertently spreading the virus.

Dr. Sonia Angell, director of the California Department of Public Health, said her department is collaborating with all groups involved in response and checking regularly with hospitals and health care facilities to learn where their needs are.

Gov. Gavin Newsom said Tuesday that the collaboration has extended to health-care workers’ unions.

“We certainly can strengthen those lines of communication, but they are open lines of communication, very directly with the governor himself,” Newsom said.

SEIU-United Healthcare Workers West, which represents nearly 150,000 workers across California, is also asking the state to help increase access to coronavirus testing for both workers and the general public. Spokesman Sean Wherley said the union also wants hospitals to make it easier to track workers sent home for possible exposure to the virus, and to provide clearer follow-up.

“They were sent home as a precaution, but not all of them were tested before they were sent home, so what about the risk posed to their families?” Wherley said.

In California and nationally, testing has been an ongoing issue. Though thousands of Californians are self-monitoring and self-quarantining, only 1,075 people have been tested in the state, with a backlog of about 200 tests, Newsom said Tuesday. Commercial labs are supposed to help relieve some of that load.

Workforce shortage is also a concern. “If each positive patient results in five to 10 workers being sent home, how many times can that happen before you have a staffing crisis?” Wherley said.

The California Hospital Association said healthcare staffing hasn’t become an issue at this point, “but it is certainly something everybody has to be cognizant of,” said Jan Emerson-Shea, a spokesperson for the group.

“The discussion has moved from containment to accepting the fact that this virus is here, so there is certainly some concern about how it will affect staff and the ability to continue operating,” she said.

Newsom’s emergency declaration earlier this month on coronavirus allows health-care workers to come from out of state to fill any gaps should California experience a crisis in staffing. Still, state lawmakers—the majority of whom, like Newsom, were elected with the support of organized labor—have been sensitive to health-care workplace concerns.

“Making sure we protect health care workers is extremely critical, because we depend on these very same health-care workers to take care of the patients who may end up in the hospital,” said Sen. Richard Pan, chair of the Senate Health Committee. “If there are any resources (state public-health officials) need, the Legislature would want to make sure they have those resources.”

CalMatters.orgis a nonprofit, nonpartisan media venture explaining California policies and politics.

Published in Local Issues

It wouldn’t be election season without a bunch of big-money interests trying to tell you how to vote—and with hundreds of millions of dollars rolling into initiative campaigns over housing and health care, California hit a new record this year.

The $111 million campaign against Proposition 8 on kidney-dialysis clinics amounts to the most money poured into a single side of a ballot measure in the United States—at least since electronic record-keeping began in 2002, and possibly ever.

Here are three industries spending huge sums to influence your vote:

Landlords and real estate agents outraising rent-control advocates 3-to-1

Landlords are largely bankrolling the campaign against Proposition 10, which would allow local governments to expand rent control.

“They don’t want to see their property values decline; it’s that simple,” said Steve Maviglio, spokesman for the No on Prop 10 campaign, which has raised $74.7 million.

Prop 10 would repeal a 1995 state law that forbids cities from applying rent control to single-family houses, or any type of home built after 1995; that 1995 law also allows landlords to raise apartment rent any time a tenant moves out. Instead, the ballot measure would give cities the option to expand rent control to cover more homes—making it harder for landlords to turn a profit.

“It’s about their future, their bottom line. That’s why they’re spending so much,” said Charly Norton, spokeswoman for the Yes on Prop 10 campaign, which has raised $25.9 million, mostly from the AIDS Healthcare Foundation.

Supporters say Prop 10 is necessary, because homelessness is on the rise, and a growing share of Californians spend more than half their income on rent. Opponents say it will worsen the state’s housing shortage by discouraging developers from building more homes.

Donors against Prop 10 include corporate property owners like Blackstone, Essex and Equity Residential, as well as many individual landlords. The biggest donor is the California Association of Realtors, which has given $8 million to the campaign.

The Realtors' association also has poured $13.2 million into the campaign for Proposition 5, making it the sole funder of that push to change California’s property-tax law.

Californians now generally pay much higher property taxes if they buy a new home after selling a house they’ve owned for many years. That’s because property taxes are based on the sales price of a house, not how much it’s worth as it appreciates over time. This initiative would allow three categories of homeowners—those over 55, disabled or who lost their homes in natural disasters—to keep the property-tax levels of the home they sold if they buy a new home. Real estate agents say it would encourage older Californians to sell their homes, making more houses available in our tight market. (Experts disagree.) Of course, it also would boost their commissions.

“It will give a huge windfall to the real estate industry,” said Mike Roth, spokesman for the campaign against Prop 5, which has raised about $3.2 million, largely from public-employee unions that could see cuts if the government loses tax revenue.

Steve White, president of the California Association of Realtors, insisted it’s about “meeting a need. The unaffordability of housing in California … is largely dictated by lack of availability,” he said. “We have tens of thousands of homes that could be waiting for all those tens of thousands of younger families.”

Dialysis clinics outraising labor opponents 5-to-1

The most expensive fight on the California ballot this year is over Proposition 8, which would limit profits for dialysis companies. The businesses are fighting back, pouring $111 million into the campaign against Prop 8—most of it from two dialysis companies, DaVita and Fresenius.

“Prop 8 was designed to have a negative impact on dialysis clinics in California, and that’s why the groups that are opposed are fighting it so heavily,” said Kathy Fairbanks, spokeswoman for the No Prop 8 campaign.

She said the measure wouldn’t allow dialysis clinics to be reimbursed by insurance companies for many routine business expenses. Ultimately, that would cause companies to close clinics, Fairbanks said, giving patients fewer places to seek treatment.

Workers at dialysis clinics are not unionized. A labor group that represents other health-care workers has had its sights on organizing dialysis workers, and put Prop 8 on the ballot as part of a much larger feud within the industry.

“This record amount of (campaign) spending speaks to the priorities of the dialysis corporations, which is to protect their profits,” said Sean Wherley, spokesman Service Employees International Union-United Healthcare Workers, the sponsor of Prop 8.

The Prop 8 campaign has raised $20.3 million, most of it from SEIU United Healthcare Workers. The union argues that dialysis clinic companies are netting huge profits while allowing shoddy health and safety conditions at some clinics. Limiting the companies’ profits to 15 percent, as Prop 8 calls for, would encourage the clinics to put more money into improving patient care, the union argues.

Ambulance companies outraising labor opponents more than 600-to-1

Colorado-based company American Medical Response put Proposition 11 on the ballot and contributed most of the $29.9 million raised to support it. The measure would allow private ambulance companies to require workers to remain on call during breaks, so they can respond to an emergency even if it comes while they’re eating lunch. That’s already the common practice, but this measure comes in response to a court ruling that security guards cannot be required to stay on call while they’re on breaks. Ambulance companies don’t want to be held to the same standard.

“If applied to the ambulance industry, it would have a significant public safety risk,” said Marie Brichetto, spokeswoman for the Yes on Prop 11 campaign.

Opponents—the emergency responders who work on ambulances—aren’t raising much money; the American Federation of State, County and Municipal Employees union contributed just $47,000 to oppose Prop 11.

“This is a classic ‘big corporation against its own employees,’” said Jason Brollini, president of the United EMS Workers union that is affiliated with AFSCME.

He contends the ambulance companies’ real motive with Prop 11 is to eliminate any liability they could face from employees who sue over not getting the extra pay they’re supposed to receive when their breaks are interrupted by an emergency call.

CALmatters.org is a nonprofit, nonpartisan media venture explaining California’s policies and politics.

Published in Politics