State still ahead on receipts
17 hours ago
The Future of Sather Gate? |
The days of Clark Kerr are over. The belief that the taxpayers of California should pay for the young citizens of California to get as much education as they want for free is no longer politically popular. Would that it were still. The old social democratic belief that America should have the best universal free public education system in the world was a principal source of America’s relative prosperity and economic leadership for a century. Now that the political coalition that supported that belief is gone, America will be a much less exceptional place.
But those days are gone. Chancellors can no longer rely on the legislature of California to fund Berkeley at the level needed to keep it an exceptional university. Berkeley needs another and a different strategy.
In the recent Open Enrollment period, out-of-state retirees had to select insurance through plans managed by ExtendHealth. The University does not subsidize any of these plans, but it does provide $3000 per year per Medicare-enrolled retiree and per Medicare-enrolled family members of that retiree. . . . Such plans help in covering the 30% cost of outpatient doctors, procedures, and tests that are not covered by Medicare. From now on, there is no Open Enrollment for out-of-staters. If they wish to change health plans in the future, they very possibly would be subject to underwriting: that is, subject to decisions on pre-existing conditions, on exclusions, and on age of the retiree. None of these apply to in-state retirees with UC sponsored health plans. If currently out-of-state retirees move back to California, they will be ineligible for the same plans that current retirees can access. Also, the policies brokered by ExtendHealth are state-specific, so any retiree who moves would be again subject to likely changes in costs and coverage.A class of retirees are being booted off UC health care based on their residency outside of California. If it were a question of UC's poor coverage out of state, then retirees would logically be allowed to reenroll in UC health care, but that is not the case. This struck me as another example of discriminatory treatment based on an arbitrary class characteristic. But unlike the case with UCSB Tier 1, this discrimination was initiated by UCOP.
We have been looking at this, Regent Makarechian, and we thought this was a good cohort to start with because frankly their coverage was going to be getting better. . . .To the governor's point about how people don't like disruption and change, we've gotten a lot of blowback from this plan, but we think it is the right direction to move in, and we've given Dwaine a long-term target of flattening our health care costs, and these are some of the steps we're taking to try to do that.Mr. Brostrom had just estimated Obamacare as adding 2-3% (I assume per year) to UC health care costs. Thus Mr. Duckett's job is to cut health care costs by 2-3% year--and probably twice that, given normal cost inflation in the sector. Given the flat revenue picture, this suggests that cuts to total compensation are to remain UCOP's annual project.
Regent Makarechian: They have all agreed to this?
Mr. Brostrom: We have implemented it, yes.
A group of us just realized that the 20% for use of Tier 2 would affect many people who have dependents living out of state--grown-children students taking a gap year, students in boarding schools, students just graduated. An accident and hospital stay for these families would be devastating, as they can no longer enroll in the Anthem Blue Cross guest HMO. And perhaps even worse, retirees on the UC pension living out of state would be in the same situation. I can tell you that my colleagues have no idea of any of this.
I am shocked to learn today that my prescription expenses will increase 500-600% switching from Anthem PPO to UC Care. While their benefits look pretty much the same on the material sent to us, it is not quite the case when you dig in. It comes down to this in my case: Anthem calculates a $45.00 copay for drugs that are not on their "preferred drug list" while UC Care, via Blue Cross, calculates a 20% co-insurance for a drug that is not on their list, with a $3000.00 maximum. I have to have shots that are not on either insurer's lists and that cost $1800.00 to $1900.00 a month. Under Anthem I was paying $45 x 12 = $530 a year. Under UC Care I would have to pay $1850 x 20% x 12=$4440, meaning each year I will pay the $3000.00 maximum.
I found this out just today from one of the "Concierge" at Blue Shield and I find it simply outrageous. It is outrageous that we are told that coverage will remain pretty much the same, outrageous that UC Care manages to hide so well the real costs to us, outrageous that Oakland did not notice or chose not to notice the real costs to its faculty and retirees. My question to you: is there something you can do about this? and if not, what do you suggest that I can do?
All is, of course, not lost. If you are insured as an individual, your Tier 2 co-insurance contributions are capped at $3,000.00 per year. After that, UC Care pays for everything. Were you also to sign up for an HRA spending account, you could accumulate $2,500.00 in tax-free dollars each year to help with co-insurance costs, and save a little money that way. Still, many of us would find being out-of-pocket for @$2,200.00 an unwelcome challenge in these diminished times. Note, too, that the Tier 2 cap for families is much higher than the cap for individuals. And should we need, while in hospital, to consult a doctor who is not a designated UC Care provider, we would still be responsible for 50% of those costs.
Riverside Community Hospital, the best hospital in the area and a partner with UCR's new medical school, is not included in Tier 1 (UC Select). If enrolled in UC Care, the faculty in the Medical School will not be able to use the hospital where they're training their students, unless they're willing to pay Tier 2 copayments. The nearest UC Select hospital, Parkview Community Hospital, does not have a trauma center.
Insurers devised the new policies on the assumption that consumers would pick a plan based mainly on price, as reflected in the premium. But insurance plans with lower premiums generally have higher deductibles.
In El Paso, Tex., for example, for a husband and wife both age 35, one of the cheapest plans on the federal exchange, offered by Blue Cross and Blue Shield, has a premium less than $300 a month, but the annual deductible is more than $12,000. For a 45-year-old couple seeking insurance on the federal exchange in Saginaw, Mich., a policy with a premium of $515 a month has a deductible of $10,000.
In Santa Cruz, Calif., where the exchange is run by the state, Robert Aaron, a self-employed 56-year-old engineer, said he was looking for a low-cost plan. The best one he could find had a premium of $488 a month. But the annual deductible was $5,000, and that, he said, “sounds really high.”
By contrast, according to the Kaiser Family Foundation, the average deductible in employer-sponsored health plans is $1,135.
The university as a publicly-supported institution [in all of it various forms, from the Ivy League school to the community college] has long served as a critical site for some of the most important humanistic-scientific-technological-etc. innovations in human history, while it has also fostered the value and practice of lifelong learning, of critical thought, of experimentation, of open and perpetually unsettled inquiry, to what might be called the arts of everyday life. And I don't believe this institution is just going to disappear in some sort of cataclysm, although I would place my money on some severe, austere diminishments in the near future.
The fact of the matter is -- whether we inhabit student desks, tenure lines, adjunct positions, or post-graduate/never-graduate somewhere-other-than-here positions -- now might be the time to take a bit more seriously alternative spaces [which might never be "permanent" or "institutional"] for learning, for inquiry, and for knowledge-culture production.
At the same time, we insist on perversely-hopefully laying claim to specific subject areas -- medieval studies, for example -- as collocations of objects and trajectories of thought that we desire to hold close to us, while also placing them in certain perpetual tensions with everything else [even ourselves]. Forms of thinking matter, and there is no need to discard anything. Every area requires special curators and we should seek to increase the ranks of those, for this is a matter of the care as well as of the increase of knowledge.
In this project, UCSF is introducing a new Activity-Based Workplace (ABW) model for office workspace. An ABW is characterized as an open work environment, without enclosed offices. This environment supported by a rich array of alternative work and support spaces (including enough small private meeting rooms and unassigned offices to be used when quiet space is necessary) that can be used spontaneously without prior reservation when spaces for private communications, undisturbed concentration, or meetings are required.
Shared open interaction spaces are provided for every two floors to create “Town Centers” and vertical circulation between floors. Coffee kitchens and a variety of meeting spaces are grouped around each of these interaction spaces to create opportunities for academic interaction,collaboration, innovation, and discourse in a relaxed and social setting. These spaces strongly promote a ‘sense of place’ within the building’s open workstation environment. (page 4)This is the theory. To learn more about the history and the practice, I reviewed as many documents as I could find and spoke to half-a-dozen UCSF faculty and administrators. I told one I wanted to ask her how she felt about the plan to put faculty into cubicles. "They aren't cubicles," she replied.
"Cubicles" means you have half-walls that give you visual privacy. This is like working in a library with a 18-inch separator--only without the quiet.
OK, we'll use their term, Activity-Based Workplace?
No, it's not an activity-based workplace. No one did a functional assessment of what faculty do in their offices, which in the case of these faculty is an especially wide range of different things. This is an occupancy-based design. It is designed to get a lot of people into a set space at a relatively low cost. People are going to have a variety of needs and none of these were taken into account.This was one of the milder criticisms I heard from faculty members. The written record is quite a bit worse.
This is a terrible idea, clearly designed by individuals who have no idea what faculty do. Unless the administration's goal is to reduce faculty numbers this cubicle space concept should be scrapped. (p 30 of 50)or this:
The plan for the new Mission Bay office building is untenable and unworkable. We have been meeting to try to figure out how it can be used, since it was presented as a fait accompli, but it will not work. We are an academic institution. Those of us, 80% of my division, who are involved in research, both lab and clinical, have 4-8 hours per day of conference calls and meetings with mentees and collaborators. Those of us with more administrative positions have confidential meetings 2-4 hour per day with applicants, staff, residents, fellows, and medical center issues. We cannot be running in and out of offices or talking with even one other person in public small cubicles. We will not be able to recruit from outside UCSF for new faculty and researchers. It is not too late to redesign the inside of this building, which is still a hole in the ground. (p 2 of 50)Many comments claimed that the open office would make compliance with HIPPA patient privacy law somewhere between inefficient and impossible.
I'm afraid that having this office arrangement for our treating physicians creates an environment that exposes HIPAA (PHI) and personal effects (laptops, phones, etc.) to unauthorized use, including theft. I am not certain whether this arrangement is HIPAA compliant and/or complies with JAHCO regulations, which if it does not (i.e. JAHCO sees this and finds that it is a risk to HIPAA / PHI), could open the Hospital up to fines and/or loss of accreditation. (p 3 of 50)Another of this type:
As a physician scientist I cannot imagine working in an environment with limited or no privacy. I handle confidential patient related issues in my office, I have numerous confidential discussions with the individuals in my lab or with house officers and fellows discussing patients on my service when I am attending, and of course I need quiet but accessible (for patient and staff conversations) private space for writing grants, reviewing data, composing and responding to email, making and taking phone calls often involving confidentiality issues. (p 10 of 50)As in this last case, most of the comments treated the core issue of work quality even when focused on something else. Faculty felt that the open office would interfere with their work processes, hamper their creativity, and reduce their productivity.
After taking the virtual tour, it is hard for me to imagine a less conducive work environment. While we do thrive on collaborations and interactions with our peers, so much of the work that academic faculty perform requires a quiet and private space where focused writing and thinking can occur. Reading, reviewing, and writing grants and manuscripts, as well as a relatively quiet space to meet with a student, trainee, or colleague one on one for sensitive conversations is critical. In addition, participating on conference calls and WebExs, which are frequent occurrences in this era of national and international collaborations, will be challenging. As a faculty who prides itself on creativity and productivity, we must resist the latest business trends that suggest that these environments allow full productivity. If I were to be assigned an office here, I would likely be spending a lot more time in my house, working from home. (p 5 of 50)Another example:
As a new faculty member and physician scientist, I can see how an open model withcubicles could foster collaborations. However, the role of a PI requires a balance between individual effort and collaborative effort. The majority of my time is spent meeting with trainees, reading, writing, meeting with collaborators, and managing my patients. Having a private office is critical to successfully completing all of these tasks since many of these conversations are confidential (ie patient care; feedback to a trainee; current lab strategies) or require concentration (ie grant writing especially in this environment.) Can you imagine having these types of conversations or spending all of our time in an environment like a coffee shop?
The university must support its basic researchers as well as clinicians in order to support the long-term health and success of the institution. Having some areas with an open design is appropriate for fostering collaborations and interactions, particularly since we already have multiple campuses. Having dedicated space (ie an office) for faculty to concentrate is critical for successfully achieving and maintaining our high research, teaching, and clinical care goals. (pp 10-11 of 50)Another:
I am an 80% clinical investigator. On most days, I spend 6-8 hours per day in my current office where I use the space to write grants, papers, and clinical trial protocols. I also use the space for conference calls and in-person meetings. None of these activities can be conducted in an open cubicle without either distracting me from writing activities or distracting those around me. I anticipate that I will need to be in one of the private "shared" rooms all day. Moreover, I use my office to store specialized supplies and pathology slides that support my translational research program. I have concerns that I will not have a place to store these items securely. (pp 5-6 of 50)Another comment from someone with experience in an open office:
I currently work in cubicle-land, and I like my colleagues. Yet even polite, low level conversations adjacent to my desk are highly distracting, especially during grant writing and paper revision work, when it takes time to get into a good flow. We can all agree that constant interruption is counter-productive. I will often work late evenings and weekends, or in the worst-case I will squat in other unoccupied workspaces to avoid unnecessary conversations. Being chased out of my personal work-space to get work done is non-ideal, as I lose printer access and reference materials, and I am visibly absent. If a model of anonymous shared space is adopted for faculty, this would represent a step down from a situation that is already difficult to tolerate. (p 14 of 50)A comment emphasizing the place of individual needs and cognitive differences:
Something of great concern to me is that this plan does not appear to take into consideration the individual needs of faculty, but rather seems to be address us a homogenous group with very similar workstyles, activities, and privacy needs. I believe that faculty are a very diverse group of individuals with very different needs for privacy, quiet, etc. The issue of losing the ability to pump when working with a nursing child is but one critical individual need I see raised here that deserves a great deal of weight. Had I not had a semi-private office when my child was young I doubt I could have managed to keep up with pumping given the schedule I managed, and I know this to be true for others as well. This is but ONE example of a necessary activity that would be very difficult to maintain in the proposed environment. There are many others. Has there been consideration given regarding faculty members with cognitive differences relative to distraction and noise? How would anyone be able to accomplish anything at all if every movement or sound in the open space they share broke their focus? Would these people be housed differently than other faculty? How will the University accommodate members of our community who can't function in such an environment without excluding them? Besides these issues of potential discrimination, the comments other colleagues have shared contain reason enough to recognize that this proposal has many concerns for many different reasons, across the community. (p 15 of 50)A comment linking work needs, routine overwork, and feeling disrespected by the decision:
I have just spent a typical day here at UCSF. I met with postdocs to mentor them, I met with the administrator and an RSC about the grant we're preparing to put in, I met with one of my research teams, and then another research team. Finally now, I'm alone. Thus, from this morning until now (6:15 pm), I have been in nonstop meetings, in my OFFICE. How will this work in the new space we're being forced into? Will I have to demand that I get one of of the offices? (that there are only 1 for every 4 people?). Moreover, I work all the time - on the weekends, evenings, and university holidays. I work really hard for my pay! And then I look again at the photos above and I think of the movie "9 to 5", with all the workers in cubicles, a sea of cubicles. In fact, when the main character got a raise, she moved to....yup, an office! And us, those of us who bring in the grants that keep the university going - #1? And we're being told, nope, you're being put into "open space" (not even cubicles). Y'know, it truly does not feel that the university cares about us. And there's just ongoing confirmation about this since no higher-ups are doing anything to help us. From department chair on up. No one cares. It feels really sad to me. I've put in many years here, bringing in lots of money. But no one cares. (p 20 of 50)And there's this rather direct statement:
The Mission Bay Academic Building, with its 'activity-based workplace' consisting of 40 foot cubicles, is an ill-conceived, wrong-headed misadventure that will deeply, possibly irrevocably, damage UCSF. Its design is based on the utterly misguided and totally untested notion that the working environments used by the electronics industry for teams of baccaulaureate-level technicians and engineers, working together on specific projects, is somehow translatable to university-based academic physicians. It's not. University-based academic physicians are more than mere 'providers'. We teach at multiple levels; students, residents, fellows, junior faculty, in addition to nurses and other ancillary medical personnel – but one cannot teach in a beehive. We write grants, papers, book chapters, manuscript reviews, grant reviews, evaluations and letters of recommendation — but one cannot be creative in a phonebooth. And we discuss patient care with patients, families and other healthcare professionals – but we cannot do this in a public venue. No study has been made of UCSF faculty activities and what space and environment is needed to facilitate essential functions. No solicitation for opinion or advice went to the faculty; this is being forced down our throats with the same foresight and dexterity as the aborted UCSF-Stanford merger, and will be equally successful. No other University or medical center has tried this; it is terra incognita, and we are setting sail without a map, a compass, provisions or leadership.
We are regularly asked to attend meetings to fine-tune the way we will live in these rat cages, which is analagous to asking those on a slave ship whether they want to be chained to a starbord or portside bunk. This is not a mere a generational issue; it is not that older faculty cling to books and papers like middle-Americans clinging to their guns and religion. The paperless office is a fantasy that exists only on Star Trek; there are endless examples, from the need for original signatures to the vast amounts of literature that are not available on line. My work has been substantially assisted by my computer, but it cannot replace the trove of information at my fingertips in my files.
It is my prediction that 1) talented younger faculty will be more readily recruited away by other Universities; 2) recruitments will be substantially more difficult, especially at the level of division chiefs, who need offices for their myriad duties; 3) productivity, especially in grants and peer-reviewed papers, will fall; 4) this 'experiment' will ultimately fail, costing UCSF substantial money and lost presige. It is difficult to envision a more effective tactic for reducing UCSF back to the rustic quaintness of Toland Medical College. This is not the way a great University treats a great faculty. (p 7 of 50)A number of faculty saw the degradation of workspace and of their creative process as reducing UCSF's stature, leading to new problems of retaining and recruiting faculty.
At least for research faculty, it’s not just a matter of having to break into work and leave one’s desk to take a phone call from a patient, but it is also difficult to picture not being able to temporarily stop work to have a short private meeting with someone. Faculty would expect to be able to stay in their chair with their work in front of them, have someone come in and close the door, have a few words, and the person leaves. This is basic. Being able to lock my office is important to me. If I have a visitor, they can lock their bags in my office while they give their seminar or do other things. I can feel comfortable that my own possessions are not publicly accessible when I’m not there. If I am concentrating on writing grants or papers, I need to be able to close my door, have quiet, and still be in my own space. If I did not have an office, I would probably work from home except when I had meetings or other commitments. When writing NIH grants, we are supposed to include a Facilities and Resources page in which an entire category is called Office. Writing that I have a cubicle or creative work space or whatever euphemism one wants to apply will make the study section members not take me seriously. Lastly, it all comes down to STATUS. If I get a phone call from a colleague at Stanford or Harvard, or from a Program Official at NIH, or from a prospective graduate student, and I have to tell them to hang on while I go find a private place for a phone call, they will assume I have low STATUS. I will not be taken as seriously by my peers or others with whom I need to deal professionally. That alone is a deal breaker. As part of an academic’s career progression, an office is one the basics that we assume we will obtain either in our first independent position or shortly thereafter. UCSF is notorious for taking longer than most places to do this, but to not do it at all would seriously shrink the number of good people who might otherwise take a faculty position here. Given the promise of a position without an office, basic research faculty will only come to UCSF as a last resort. (p 32 of 50)By my rough count, faculty sentiment ran 100% against the ABW office format. There were some comments that made helpful suggestions for adapting. But the number that actively supported ABW was zero.
We're doing something unusual. It's original. And we won't have the problem of faculty offices that are 50% unoccupied even during the day. It would be a comfortable space with good light. I wouldn't call this decline. I would call it a step forward in how to steward university and public resources.Responding to my question about whether he saw merit in the concerns about privacy and concentration in the open workspace, he replied,
I understand their concerns, and I would have them too. They've never worked in a design like this. But the open space is like a library. You do your ordinary work there. But you can answer a phone there. There's a noise-cancelling system in this space. You can't understand people who are 20 feet away from you. You can certainly answer phones in these spaces, have low-volume conversations in them. Because other people are there, you have to build a culture of quiet. In other professions, like architecture and law, they work beautifully. People keep them quiet, and they do most of their work there. If you want to have a consultation or write a grant, you can go into a focus room. There are 376 of these focus rooms in the building. There's one focus room for every four workstations. there will be roughly 700 faculty in the building, maybe 350 at any one time, plus another 700 or 800 staff. So there should be no problem with anyone having a focus room at any time. They are ten feet away from the workstations. You can turn your head and find an empty one.
But [I interrupted] there's no wood door you can't see through, behind which you can bang your head against the wall or burst into tears or whatever your ritual is.
No that's not true. You can close the door. And you can stay in there for a week to write a grant. You can do anything you want with those rooms--except turn them into private offices.
Despite repeated efforts by the Academic Senate Clinical Affairs Committee (CAC) starting in 2007, faculty concerns about the need for faculty office space and education space in the new hospital were not addressed. CAC eventually learned that faculty offices and education space would be located in a separate building; however, the plan for the activity-based workspace was not discussed with CAC.
Meetings with faculty and departments were "information only," not iterative consultations, and came late in the process. . . .[W]e know that there were no meetings involving the Pediatrics faculty or its leadership about this issue until it was a fait accompli, and the meetings were just for information, not input. One meeting told us about the existence of the activity-based workplace model a couple of months ago, and another meeting described its structure and function.There was no "upstream engagement" with the future users of the building--neither with the faculty in the relevant units nor with the Academic Senate as such. The administration's consultation was with the "stakeholders committee," but the term "stakeholder" is vague enough to allow avoidance of the kinds of early "iterative consultations" with actual faculty that shared governance requires.
Although there’s as much money coming to this campus from clinical as from bench science research grants, this design treats clinicians as second-class. The bench scientists have new facilities with all these huge private areas. People who deal with patients or do field research—where UCSF is a world leader—are being stuck in non private spaces where they will struggle to do their basic job. This is terrible planning from that point of view. Obviously the campus really values basic science. The lovely space is a recruitment device. People associate labs with the biotech industry and think well, we’re losing money now, but when funding gets better we’ll have a huge group in place to churn out intellectual property and profits.This has been a standard way of thinking about academic science—that laboratories are an investment with a future upside, while instruction and clinical research are costs that the institution itself does not recover. I’ve critiqued this revenue model elsewhere, but even were it correct, ABW uniquely concretized an implied hierarchy and intensified faculty resentment.
The problem is we have a hospital across the street where we have enormous fundraising activity going on. We're still $500 million in need there. We have the Sandler Neurosciences Building that we need another $100 million for--that's already up and occupied. We have another building called the Diller Cancer building and there's need there. So we have a lot of fundraising going on. For that reason we never planned to support this academic building with philanthropy.
Some of the groups going in need to be near the new hospitals. Some are there for reasons we don’t know. My guess is that it has something to do with increasing the IDC [indirect costs rate]. If a research unit is off campus, the campus receives only 26% as the rate. If the unit is on campus, the campus recovers double the IDC—the rate is over 50%. It’s true that there’s no rent on campus and that an off-campus UCSF research unit has to pay rent on the non-UCSF office space. But rent is always less, usually a lot less, than the extra 26% or 27% that is deducted from an on-campus grant. Also, rent is controlled by the faculty PI [principal investigator], and IDC are controlled by the administration.
I know the administration says that rents are skyrocketing and they don’t want us to have to pay them. But there’s a lot of leasing going on the new buildings- the new neurosciences building is leased. I think they’re not trying to reduce leased space, they’re trying to recover another big piece of IDC that will go directly to the administration and rebuild reserves.
The process outlined here starts from the premise that simply refusing the open-space model is not sufficient. The faculty are ready to participate by offering alternatives to the open space design that are cost competitive. We outline below proposed steps that will lead to the review and consideration of multiple options, and ultimately to decisions that reflect financial reality and appropriate faculty consultation.
the majority of the faculty accept this, including people going into the building. They're willing to try to make it work, and will do whatever it takes to mitigate any problems that arise, and of course there will be things that need to be fixed, as there are in all these buildings. The great majority of the faculty say, "ok we're in, let's go, let's make this work." There are a few hotheads, and we're trying to work with them. But we haven't had faculty leave. We've been able to recruit into the building.
I’m not looking for your pity; I want your own righteous indignation. Because you, too, deserve an office. We deserve better. We all deserve offices. But it gets worse. We’ve been told that our small squat in the vast openness of our open-office layouts, with all its crossstalk and lack of privacy, is actually good for us. It boosts productivity. It leads to a happy utopia of shared ideas and mutual goals. These are the words of imperceptive employers and misguided researchers. The open-office movement is like some gigantic experiment in willful delusion. . .
This a trap. This is saying, “Open-office layouts are great and if you don’t like them, you must have some problem.” Oh, I have a problem. It’s with open-office layouts. And I have a solution too: Every workspace should contain nothing but offices. Offices for everyone. . . Take those long tables, the ones currently lined with laptops at startups, and give them to an elementary school so children can eat lunch at them.