Summer 2014

Today, maybe, you have a headache. Or your back hurts. Or you’ve come down with a case of the grumps and merely want to show up, do what you have to do, and roll on home at the appointed hour.

But you don’t.

Why? I suspect because in your heart of hearts, you know that every day, each of us is an ambassador for Kaiser Permanente—at work and away from work, too. And it’s important we represent the organization well.

On one level, this is self-serving: It helps ensure KP has a vibrant future and we continue to have the best jobs in health care.

On another level, it’s pretty cosmic. Given how big and well-known Kaiser Permanente has become, it’s easy to forget that our approach to health care upends U.S. norms. But as we succeed in delivering our brand of health care in this market, others take notice—and begin to adopt our methods. We have the power to revolutionize health care delivery for the benefit of everyone.

So it’s important that KP stay around, and we can do that only if we “grow membership”—by keeping the members we have and attracting new ones.

This issue of Hank explores how the Labor Management Partnership is helping to reach out and bring more members into the KP fold. It lays out how, at every level and layer of the organization, partnership motivates and enables people to step outside their traditional roles to act in ways that benefit us all.

Regardless of our particular job, we each have a part to play, every day, grumps or no grumps, in the work of helping Kaiser Permanente grow bigger and stronger. That means you. And that means me.

Colorado

More than 60 trained champions are helping to motivate co-workers in their facilities to live a healthy lifestyle. Employees, managers and physicians are taking part in health fairs, 5Ks, healthy potlucks and Instant Recess™ sessions throughout the region. The region is also participating in the Spring Into Summer Challenge, a program-wide, team-based KP Walk activity to encourage walking during the longer daylight hours. Teams are forming with people of all fitness levels, especially employees who aren’t normally active. “Any change toward a healthy lifestyle is a success,” says Susan Mindoro, Total Health labor liaison for UFCW Local 7.

Georgia

The Southwood Specialties gastrointestinal UBT in Georgia increased efficiency and saved money by scheduling contract physicians, patients and nurses more strategically. The department handles both anesthesia cases (which require a physician to perform) and also sedations (which can be done by nurses). This Level 4 team figured out how to schedule contract physicians for four days a week instead of five by tracking which patients needed what level of care—making the most efficient use of a very expensive resource. The project required agreement, communication and coordination between the GI providers and teams at four KP clinics in Georgia to schedule their cases accordingly. The project saved $113,000 between April 2013 and January 2014.

Hawaii

After the nurses at Hawaii’s Ambulatory Surgery and Recovery unit created a brochure that standardized the information given to members during their visits, patients have a better understanding of wait times, department hours, visiting hours, where to get parking validated and the location of key departments. The team surveyed selected patients three times from October 2012 to April 2014. Team members tweaked information in the brochure based on feedback, says Maria Scheidt, an RN and member of the Hawaii Nurses Association, OPEIU Local 50. After the first survey, 70 percent of patients reported they received and understood the brochure. After the second survey, 90 percent said they understood it. By the third survey, the nurses had successfully educated 95 percent of patients.

Mid-Atlantic States

From Virginia to Maryland to Washington, D.C., nutritionists in UBTs identified children at risk for obesity and recruited them for Kaiser Permanente’s Healthy Living for Kids and Families course. Piloted in Northern Virginia, the project tracks the success of 11- to 14-year-old patients in establishing healthy eating habits, increasing daily activity and bolstering self-esteem. By drinking less soda or juice, exercising each day and curbing television viewing, a third of participating children at one medical center lost an average of 5.8 pounds in three months. Team members credit their partnership with pediatricians and the families for the results. 

Northern California

The region’s new Real-Time Attendance Estimator does what no other tool has done before: It projects into the future. The tool lets a cost center see how sick day use is affecting its ability to meet its year-end attendance goal by calculating the number of sick days that could be taken in an upcoming pay period without derailing progress toward that goal. If the number of sick days being taken needs to be reduced to meet the goal, the estimator shows that, too. The information is shown as a signal light—easy to print out and post.

Northwest

Fifty-eight percent of staff members in the Northwest who are eligible for the Total Health Incentive have taken the Total Health Assessment—one of the highest participation rates program-wide. Members of unit-based teams are finding ways to help cover each other so they have time to take the assessment. Managers are backing the effort, which is a key step in earning the incentive. “Since the UBT agreed that the THA would be a project, I supported folks completing the assessment during work time since it is work- and goal-related,” says Jason Curl, department administrator for Primary Care at Tualatin Medical Office. 

Southern California

The region’s Jobs of the Future Committee has assigned four subgroups to identify trends in technology and innovative care delivery methods. The subgroups are inpatient nursing, ambulatory nursing/primary care, laboratory and diagnostic imaging. Each is led by labor and management partners. The groups are researching the impact of innovations on today’s jobs and making recommendations regarding training and recruitment of the workforce of the future to best support these initiatives. Work already is starting, for instance, at the South Bay Medical Center, which is exploring new staffing models as part of its plan to open a mini-medical office building—which is in turn part of the larger Reimagining Ambulatory Design initiative. In Kern County, UFCW has collaborated with management on a mobile health van project to optimize staffing for this creative way to deliver care.

 “I was almost devastated,” says Karen Cardosa, a grocery clerk in Albany, Oregon, “when UFCW told us they were no longer offering Kaiser Permanente as an insurance option.”

Cardosa and her family had been KP members for years through the union’s Local 555 Employers Health Trust. That changed in 2009 when a variety of issues resulted in KP losing the account, which covered many Local 555 members. The union continued to represent nearly 2,000 Kaiser Permanente pharmacy and radiology employees, who—as KP staff members—continued to have KP health care.

Today, it’s a new story. Thanks to a 36-month KP offering that was finalized in April, Kaiser Permanente is again an option for up to 15,000 UFCW members and dependents in the Northwest region who are covered by the health trust.

“Our work with LMP is probably some of the most important work done in Public Sector strategy in the last two years. Working with our union partners, we’ve been able to come to the table with customer solutions that meet everybody’s needs—including the unions that aren’t part of KP, who have tremendous influence in purchase decisions. We are unique in having a strong labor partnership in our own business, and we can speak that language.”

—Kate Kessler, a Member Sales and Service Administration director

“When I was hired four years ago, my manager told me my Number One job was to get UFCW back,” Ehren Cline, a KP Sales and Account manager. Cline, including Jeston Black, the region’s senior labor liaison, and other colleagues partnered with Dan Clay, president of Local 555, to do just that.

“KPNW brought us a package we couldn’t refuse,” Clay says. An affordable price, high quality, a new hospital, expanded clinics and a new billing system helped seal the deal.

Clay’s own union members pushed for the new commitment.

“I have not been to a union meeting in the last five years where someone didn’t ask, ‘When do we get to go back to Kaiser?’” Clay says.

But something else was also at play. Thanks to Labor Management Partnership, Kaiser Permanente enjoys a joint union-management approach to winning and keeping health plan members that is almost unheard elsewhere in this country.

Read on and learn how it all comes together.

How the LMP Growth Campaign Works

Click to enlarge.

For more than 10 years, Kaiser Permanente’s Child Health Program has been veiled in relative obscurity despite the extraordinary service it offers.

Even more unknown is the role KP enrollment processors in Northern California, who are represented by OPEIU Local 29, are playing in helping the charitable health program fulfill KP’s mission of serving our communities.

“I like to say that we’re the best-kept secret of KP,” says Sharlene Jones, an enrollment processor who screens applicants for eligibility and guides them through the sign-up process. The community benefit program provides comprehensive medical, dental and optical coverage at little or no cost to children ages 19 and younger whose family income falls below the federal poverty level and who have no other coverage options.

Since August, the Oakland-based enrollment processors have attended more than 40 health coverage enrollment or outreach events across Northern California, from informational sessions at small medical clinics to large events like the “We Connect Health Care” enrollment and resource fair in Fresno, which drew thousands of people. The processors answer any question thrown at them about the Child Health Program and help enroll those who qualify.

“Our processors are able to help families right on the spot,” says Sara Hurd, a former employee who until recently led outreach for the program. “They know what challenges are and how to work through them.”

Long-lasting value

The Child Health Program has a goal of enrolling 80,000 qualified children across Northern and Southern California. The work the Local 29 members are doing to help meet that goal fits within the framework of Labor Management Partnership efforts to grow the number of Kaiser Permanente members—and to establish positive member relationships that can last a lifetime.

As outreach coordinator, Hurd’s priority was getting the word out about the program and forging relationships with community organizations. She also served as the sole contact for prospective applicants at outreach events—but she didn’t have the detailed enrollment knowledge the Local 29 processors have.

Maury Rosas, manager of Charitable Health Coverage operations, reached out to enlist the processors’ help. Including them in the work, Hurd says, “has been invaluable”—and as of May 2014, more than 77,000 children were enrolled.

“We needed people who really understood what the applications are about and could help people with eligibility,” Rosas says. Before he requested their help in the field, the enrollment processors’ interactions with potential qualifying applicants were by phone or letter.

“We’re able to answer their questions,” Jones says. “It allows us to put a face on KP.”

Many of the processers who attend the events have bilingual certification and are skilled in walking applicants through enrollment in Spanish.

“It’s important to show (the public) that we’re not just sitting behind a desk, pushing papers,” says Miriam Garcia, an enrollment processor. “We’re the labor force behind it all….We’re here to work with the community and are proud of KP.”

Demonstrating a commitment

The effort has been an unqualified success, Rosas says, from community agencies asking for repeat visits to the response of the children’s parents.

“They took me by the hand and walked me through the process of completing the application and made me feel comfortable with the process,” says Rufina Garcia, speaking through a Spanish interpreter. Garcia enrolled her three children in the program at an outreach event in March. “This has been the first time when I could walk in and give my information and be signed up right there.”

Delivering on KP’s mission in partnership between labor and management also helps build relationships with potential union-oriented purchasers of health care, says Katy McKenzie, a consultant to LMP and its membership growth work.

“It goes a long way when you’re talking to unions that represent low-wage workers,” McKenzie says. “They see that we actually do care about caring for people and our communities. It’s not just about selling something to them.”

McKenzie and others involved in the growth work helped promote the Child Health Program to unions representing low-wage or part-time workers, such as laundry or home care workers—people who don’t get dependent health care coverage as part of their job benefits or who can’t afford what is offered to them.

 “It’s a great opportunity to see that management is working with labor as a team,” Miriam Garcia says. “We’re not only supporting KP, but we’re supporting our own labor force.  We’re showing that we can work together and make a change. We’re helping make a change that carries over into the community.”

That kind of caring makes an impression. Rufina Garcia, who only has catastrophic medical coverage for herself, says she would choose Kaiser Permanente for her whole family given the chance.

“It has been a wonderful experience,” she says. “The way they treat my children is incredible. (The doctors and nurses) are very caring—they have more patience and actually listen to the kids….I believe they take better care of my children.”