CRONA Revised Proposal Re: Side Letters Regarding Newly Constructed Hospitals - 3/30/16 SIDE LETTER Between Stanford Hospital and Clinics And CRONA Re 500 Pasteur Dr. 2016 In conjunction with their 2016-2019 negotiations, Stanford Hospital and Clinics and CRONA discussed the Hospital s plan to open a new hospital at 500 Pasteur Drive. The parties agree that, through Nurse Practice Committee, they will discuss the Hospital s plans to staff the new hospital with Nurses. The parties agree that they will discuss the consolidation or re-aggregation of existing units at least thirty (30) days prior to the Hospital posting Nurse positions in a unit that is subject to such consolidation or re-aggregation. The Hospital acknowledges that its intent is that Nurses who are affected by the move from the existing hospital to the new hospital will be provided the opportunity to maintain their current commitment levels and shifts, and agrees to utilize its best efforts to ensure Nurses are provided such an opportunity. The Hospital also agrees to discuss implementation of this process with CRONA through Nurse Practice Committee. CRONA acknowledges that this Side Letter does not affect the Hospital s management rights under the Agreement, except to the extent it obligates the Hospital to utilize its best efforts to ensure that Nurses are provided the opportunity to maintain their current commitment levels and shifts. SIDE LETTER Between Lucile Salter Packard Children s Hospital And CRONA Re Packard 2.0 2016 In conjunction with their 2016-2019 negotiations, Lucile Packard Children s Hospital and CRONA discussed the Hospital's plan to open a new hospital, a project known as Packard 2.0. The parties agree that, through Nurse Practice Committee, they will discuss the Hospital s plans to staff the new hospital with Nurses. The parties agree that they will discuss the consolidation or re-aggregation of existing units at least thirty (30) days prior to the Hospital posting Nurse positions in a unit that is subject to such consolidation or re-aggregation. The Hospital acknowledges that its intent is that Nurses who are affected by the move from the existing hospital to the new hospital will be provided the opportunity to maintain their 10
current commitment levels and shifts, and agrees to utilize its best efforts to ensure Nurses are provided such an opportunity. The Hospital also agrees to discuss implementation of this process with CRONA through Nurse Practice Committee. CRONA acknowledges that this Side Letter does not affect the Hospital s management rights under the Agreement, except to the extent it obligates the Hospital to utilize its best efforts to ensure that Nurses are provided the opportunity to maintain their current commitment levels and shifts. 11
CRONA s Comprehensive Proposal to Resolve All Open Issues - 4/5/16 CRONA presents the following comprehensive proposal to resolve all open issues. Economic Proposals: 1. Contract Term and Wage Rates - SHC 7 & Appendix A /LPCH 7 & Appendix A a. Three-year agreement beginning April 1, 2016, with the following increases in base wage rates for all classifications at all steps: 7% April 1, 2016; 6% April 1, 2017; and 6% April 1, 2018.SHC b. Salary Placement (SHC): Modify Step 8 in Section 7.1.8 to read Step 8: After 2 years at Step 7 and 4 years of continuous Employer service. 2. Differentials - SHC 7 & Appendix A /LPCH 7, 7.5.4 & Appendix A a. Accept LPCH proposal for $3.00/hour Weekend Differential. b. SHC/LPCH Relief Differential: increase/convert SHC and LPCH Relief Differential to 20% of base wage rate for Limited Relief, Relief A and Relief B; and 10% of base wage rate for Relief C and Relief D. (At LPCH, there is no Relief D so the 10% differential would apply only to Relief C.) c. Specialty and Advanced Nursing Skills Differential: CRONA revises its proposal as follows: SHC 7.*. Specialty and Advanced Nursing Skills. 7.*.1 Nurses who are designated to perform a role requiring specialty or advanced nursing skills, as identified in 7.*.2, will be paid in accordance with the salary schedules set forth in Appendix A and will receive in addition a differential of four dollars ($4.00) per hour for which the Nurse is designated or fulfills the role, whichever period is longer. 7.*.2 The following are specialty and advanced nursing skills subject to the differential described in section 7.*.1: a. Floating b. For Nurses who are Clinical Nurse IIs: 1. Buffer/TL/FASST/Flex/Crisis/Service Head/unit Float Nurse 2. Preceptor/Orientation 3. Ventricular Assist Device/ECMO/Intra-aortic Balloon Pump/CRRT/Artificial Heart LPCH 7.*. Specialty and Advanced Nursing Skills. 7.*.1. Nurses who are designated to perform a role requiring specialty or advanced nursing skills, as identified in 7.*.2., will be paid in accordance with the salary schedules set forth in Appendix A and will receive in addition a differential of four dollars ($4.00) per hour for which the Nurse is designated or fulfills the role, whichever period is longer. a. Floating 1
b. For Nurses who are Clinical Nurse IIs: 1. Buffer/TL/Flex/Crisis 2. Neonatal Nurse for Labor and Delivery (NNLD) 3. Neuro NICU 4. NICU Transport/OB Transport/PICU Transport (Bedside RNs) 5. Preceptor/Orientation 6. Ventricular Assist Device/ECMO/Intra-aortic Balloon Pump/CRRT/Artificial Heart 3. Retirement Plan - SHC 9.16.3/LPCH 8.16.3 CRONA accepts the Hospitals April 1, 2016 proposal. 4. Retiree Medical Insurance - SHC 9.21 & 9.22/LPCH 8.21 & 8.22 CRONA accepts the Hospitals April 1, 2016 proposal, subject to clarification of what is meant by when eligible to do so in the last sentence of the proposal. 5. 2013 Side Letter re: CN 2 Job Description CRONA reserves its position on the Hospitals proposal to remove this side letter pending negotiation of economic terms. 6. 2013 Side Letter re: Lump Sums CRONA has accepted the Hospitals proposal to remove this side letter without prejudice to CRONA s position on economic terms. 2
Non-economic Proposals: 1. Commitments - SHC 6.6/LPCH 6.6 & Side Letter: (a) CRONA accepts the Hospitals proposal to add new Section 6.6 (Voluntary Requested Reduction in Scheduled Commitment) to the contracts. (b) CRONA is in agreement with the Hospitals April 1 concept for side letters re reduced commitments. See CRONA s attached revised proposed side letters in response to the Hospitals April 1 proposal. 2. Call - SHC 7.7 & Side Letter/LPCH 7.7 & Side Letter: (a) The parties have reached agreement on language for side letters addressing call: LPCH Side Letter Re On Call In Units Other than O.R. s and P.A.C.U. s; and SHC Side Letter re On Call and Overtime Issues. (b) CRONA accepts the Hospitals April 1 proposal for sleep room language in both contracts (LPCH 7.7.1, SHC 7.7.2). As part of this, CRONA will agree to the deletion of the reference to sleep rooms in the LPCH 1998 Side Letter. (c) CRONA revises its proposal for contract language limiting the amount of call a Nurse may be required to take, and proposes as LPCH Section 7.7.2 and SHC Section 7.7.4: A Nurse with a 0.8 or greater commitment may not be required to take call in an amount exceeding twelve (12) hours per week. A Nurse with a commitment of less than 0.8 may not be required to take call in an amount exceeding sixteen (16) hours per week. 3. Benefits - SHC 9/LPCH 8: CRONA agrees to the Hospitals April 1 proposal. 4. Side Letters Re Attendance and Absences Due to Illness, Pre-Approved Vacations, and Pre-Approved Education Hours: CRONA agrees to the Hospitals April 1 proposal regarding Pre-Approved Vacation and Pre-Approved Education Days policies, including (a) confirmation of changes that will be made to policies at both hospitals, and (b) SHC s proposal to expand the current policy s provisions regarding pre-approved vacation to all non-in-patient units by no later than 90 days after the contract s effective date. CRONA agrees to the Side Letters proposed by the Hospitals with one proposed modification to the title of the Side Letters, such that the letters are Re Attendance and Pre- Approved Vacation and Education Days Policies. 3
5. Educational Assistance - SHC 10.4.2/LPCH 9.5.2 & Side Letters: (a) CRONA accepts the Hospitals April 1 proposal regarding edits to the Educational Assistance policies. (b) The parties are in agreement regarding distribution of the Hosted HR tip sheet. (c) CRONA accepts the Hospitals April 1 proposal regarding changes to Section 9 (LPCH) and Section 10 (LPCH), including the re-formatting, subject to discussion of the placement of current SHC Section 10.4.6 regarding Shift Differential for Required Educational Classes. The current SHC Section 10.4.6 refers both to required and non-required classes. CRONA proposes that the current Section 10.4.6 (proposed new Section 10.5.4) either (i) be reformatted such that it is a new Section 10.6 (with corresponding re-numbering of subsequent sections); or (ii) be placed, as proposed by CRONA in its March 30 proposal, as paragraph (c) in the proposed new Section 10.4.5, consistent with the organization of the LPCH contract (see new LPCH Section 9.7). 6. Floating - SHC 12.5/LPCH 11.5: See attached revised proposal. 7. Sustainable Schedules - SHC 13: CRONA withdraws its proposal. 8. Return from Leave - SHC 30: CRONA accepts SHC s April 1 revised proposal, subject to the following modification (redlined against Hospital s proposal): The Employer will provide CRONA every sixty (60) days the names of Nurses who have been released to return to work with permanent restrictions and who have not been returned to work within sixty (60) days of that release. Upon request from CRONA, the Employer will meet with a representative of CRONA to discuss the feasibility of finding employment for the Nurse. 9. Side Letters Regarding Newly Constructed Hospitals: CRONA maintains its March 30 proposal. 10. PNDP - SHC 35/LPCH 32 and PNDP Document: (a) CRONA maintains its March 25 revised response and counter-proposal on contract language. (b) CRONA proposes to modify the Hospitals April 1 revised panel-composition language by changing the phrase will be limited to communications to will be included in communications. 4
CRONA Response to Hospitals Proposal for Side Letters Re Reduced Commitments - 4/5/16 CRONA proposes the following modifications to the proposed side letters on reduced commitments (redlining is against Hospitals proposal). CRONA provides the text of the SHC Side Letter below, but proposes the same language for the LPCH Side Letter. SIDE LETTER Between Stanford Hospital and Clinics And CRONA Re Reduced Commitments 2016 In conjunction with their 2016-2019 negotiations, CRONA and the Hospital discussed numerous issues related to the interest of certain Nurses in obtaining part time positions. For purposes of the 2016-2019 Agreement only, the parties have agreed as follows: 1. Effective upon ratification of the 2016-2019 Agreement, vacant part time positions that the Hospital decides in its discretion to re-post shall be posted internally (pursuant to the provisions of Section 19 (Internal Transfers)) as part time positions with the same shift and commitment level. If the position is not filled by an internal applicant, the Hospital may re-post the position with a different commitment level. 2. The Hospital has an interest in staffing its acute care units and clinics with a mix of full time and part time regular positions. a. To that end, the Hospital will staff its acute care units and clinics using a standard that no more than eighty percent (80%) of the headcount of rregular nnurses in each acute care unit or clinic at the Hospital consists of regular full time positions. This standard shall not apply to any unit or clinic in which there are three (3) or fewer Regular Nurses. b. To the extent an acute care unit or clinic at the Hospital has a staffing mix of rregular nnurses above this standard, the Hospital, upon the written request of a rregular full time Nurse in that unit, shall restructure re-post existing full time position(s) and, pursuant to the provisions of Section 19, shall, within thirty (30) days of the request, post as part time position(s) in a sufficient number to bring the number of full time positions in the unit to eighty percent (80%) or lower. To the extent operationally feasible, the Hospital shall offer a mix of part time positions, with a target of offering half of the part time positions as 0.8 or 0.75 commitments and half at commitments levels of 0.70 or less. A Nurse who has accepted a part time position posted pursuant to this paragraph shall be placed on a schedule reflecting her or his reduced commitment as soon as possible, but in no event later than forty-five (45) days after the Nurse s acceptance, absent extraordinary circumstances. The obligations of paragraph 2(b) of this Side Letter shall be effective on April 1, 2017. 5
3. For purposes of this Side Letter, a part time position is defined as a regular position with a FTE lower than.90, and a full time position is defined as a regular position with a FTE of either.90 or 1.0. 6
CRONA Revised Proposal Relating to Floating - 4/5/16 SHC 12.4 Floating to Different Work Locations. 12.4.1 When the Employer floats a Nurse who is regularly assigned to a location or locations to another location at which the Nurse is not regularly assigned to work on the day in question, the Employer must seek volunteers and will make every effort to provide a minimum of two (2) hours notice. For purposes of this section, the main medical center campus shall be considered to be one location. 12.4.2 For Nurses who are regularly assigned to work at the main medical center campus and are floated to work at a different location, the Employer will reimburse bridge tolls and mileage incurred in traveling to that location as provided by applicable law. For Nurses in the Float Pool and who are regularly assigned to work at a location or locations other than the main medical center campus, and who work at more than one location during a shift, the Employer will reimburse bridge tolls and mileage incurred in traveling between the locations during the shift as provided by applicable law. 12.4.3 Except in cases of critical staffing shortages, as determined by the Employer, a Nurse shall not be floated to a different work location more than one time per shift and will not be required to return to the original location within that shift. 12.4.4 Nurses assigned to locations other than the Mmain Mmedical Ccenter Ccampus may regularly be assigned to multiple locations. Such Nurses who travel to or between regularly assigned locations for work at the time of their regular assignments are not deemed to be floating for purposes of this section, but such Nurses may be entitled to paid travel time and reimbursement for mileage, pursuant to applicable law. LPCH 11.4 Floating to Different Work Locations. 11.4.1 When the Employer floats a Nurse who is regularly assigned to a location or locations to another location at which the Nurse is not regularly assigned to work on the day in question, the Employer must seek volunteers and will make every effort to provide a minimum of two (2) hours notice. For purposes of this section, the main medical center campus shall be considered to be one location. 11.4.2 For Nurses who are regularly assigned to work at the main medical center campus and are floated to work at a different location, the Employer will reimburse bridge tolls and mileage at the IRS rate based on the distance from the medical center to the location to which the Nurse has been floated and back. For Nurses in the Float Pool and who are regularly assigned to work at a location or locations other than the main medical center campus, and who work at more than one location during a shift, the Employer will reimburse bridge tolls and mileage incurred in traveling between the locations during the shift as provided by applicable law. 7
11.4.3 Except in cases of critical staffing shortages, as determined by the Employer, a Nurse shall not be floated more than one time per shift and will not be required to return to the original location within that shift. 11.4.4 Nurses assigned to units not located on the Mmain Mmedical Ccenter Ccampus may regularly be assigned to multiple locations. Such Nurses who travel to or between regularly assigned locations for work at the time of their regular assignments are not deemed to be floating for purposes of this section, but such Nurses may be entitled to paid travel time and reimbursement for mileage, pursuant to applicable law. 8