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Saturday, November 23, 2013

Saturday, November 23, 2013

UCSB Health Care Update: The Rest of Tier 1 is Yet to Come

On Friday morning I along with the rest of UCSB's campus received an email from UCSB's Senate Divisional Chair Kum-Kum Bhavnani with the promising subject line, "Success with Tier 1 Provision in UC Care!"

"President  Napolitano just announced that there will now be a Tier 1 option in the Santa Barbara area with Sansum Clinic as a provider.  We are very pleased about this outcome.

"We are very appreciative of all the efforts of the Chancellor, the Health Care Task Force, the Universitywide Committee on Faculty Welfare, and the senior executives at the Office of the President.  Please read the attached memo of today from Vice-President Dwaine Duckett about Open Enrollment.

"Thank you for all of your support in our collective efforts to communicate our concerns.
"With best wishes,
"Kum-Kum Bhavnani, Chair, Academic Senate
"Simonetta Falasca-Zamponi, Chair, Council on Faculty Issues and Awards "

Well this is good news, I thought.  

And I pondered two further things.

First was my appreciation for the work of the Senate and local administration--and also for the work of the UCSB Faculty Association and CUCFA.  The FA led a public charge on the issue. Thanks to UCSB FA president Nelson Lichtenstein wrote the press release that got the Chronicle of Higher Education to cover the story, which then triggered a public defense by UCOP and helped to get what had been a back-channel discussion out into the open.  Thanks also to board member Bob Williams, who wrote an Independent op-ed that brought the issue to the attention of the town and of various officials.  Thanks to Aranye Fradenburg, who co-write various statements and kept people focused.  Because of these and other people, the FA forcefully articulated the inequity argument, and continued to write Janet Napolitano, as did the Riverside FA about their similar issue: no Tier 1 participation for their quality local hospital, which meant 20% payments (with Tier 2) rather than co-payments.  Other individual faculty galvanized local politicians. CUCFA president Pat Morton  wrote to President Napolitano just the day before this announcement, calling Tier 1 "grossly inadequate" as well as discriminatory. 

Then came an email from Aranye Fradenburg, who noted that although this is good news, "Sansum is not a hospital." 

This is the second issue.  Neither Chair Bhavnani nor Mr. Duckett mentioned the participation of Cottage Hospital.  But that, after all, was the real issue in contention.  Perhaps Cottage would be part of a longer document or will be the next step in fixing the problem?  So I pestered a few  people about the matter of whether Santa Barbara would have Tier 1 hospitalization, as well as Tier 1 at Sansum clinic..

One of them wrote to HR as follows:
Do you know what the situation with Cottage will be?  That is to say, if we are hospitalized by order of a Sansum Clinic doctor who uses Cottage, will we have to shift to Tier 2 or 3 for Cottage services?
And HR replied:
Services at Cottage hospital will be at the Blue Shield Preferred (Tier 2) benefit level.  You will have an annual deductible and 20% coinsurance.  The annual maximum for Tier 2 is $3000, that is the most you will pay in a year for services with Blue Shield Preferred providers.
Please let me know if you have questions.

I do have a question.  What happened to the idea of getting Santa Barbara's only hospital, Cottage, in UC Tier 1?  

I found the Chancellor's memo on the subject at the HR site. It confirmed that,
President Napolitano has just announced to our Academic Senate leadership that under her directive, negotiations between UCOP and Sansum Clinic have been successfully completed. As a result, Sansum will become a Tier One (Select Tier) provider in the UC Care plan.
There is further information about how "the Systemwide Human Resources and Benefits group is offering UC Santa Barbara community members the opportunity to make enrollment choices and changes through February 2014," although open enrollment still closes November 26th. 

I have written to senior administrators to ask whether the matter is now closed, with Cottage hospital locked into Tier 2.   I certainly hope not.  This would mean, to repeat, that UCSB does not have an in-area Tier 1 hospital, and that its employees will pay 20% of all charges up to their annual ceiling to use Cottage.

Since they did not acknowledge the ongoing Cottage hospital issue in their announcements, UCSB's Senate and administration may not be planning to continue the campaign.

2 comments:

Ellen McCracken said...

Great analysis, Chris. The issue of inequity is still here, with faculty and staff at UCSB and UCR being forced to pay up to $3,000 more per year for UC Care than other UC employees across the state. We still have the problem of employees who need to travel for work not being adequately covered, and the related psychological stress this causes while away doing work duties. If you can't afford to pay $3,000 more than other UC employees per year should you need hospital services (including labs, ultrasounds, etc.), and you work in Santa Barbara, your only choice is Health Net, which doesn't cover health care while away except emergencies. I understand that the Faculty Association is investigating legal options to help us out of this untenable situation. Our highly compensated administrators need to do their job immediately to find a remedy for this discrimination.

Chris Newfield said...

thanks for the detail Ellen. I hadn't heard about looking into legal remedies. I still think that if UCOP can't set up Tier 1 with Cottage, for whatever reason, they should set up a version of the Health Reimbursement Arrangement (HRA) they have created for out-of-state retirees. Peter Taylor told the CHE that only 600 UCSB employees are affected by the absence of Tier 1 hospitalization coverage, so if every one of them used up their entire deductible up to $3000, UC Care would be out $1.8 million. This is a lot less than the $5.9 million Mr. Taylor implied in that article (18,400 UC employees paying an extra $323 per year to "subsidize" 600 UCSB employees). Without factoring in other details like the family deductible, it may in in practice be less than that, given the number of healthy people who will pick UC Care because they travel or for some reason other than chronic illness. And it might be only for one year as they keep negotiating with Cottage. This doesn't seem like it needs to be such a huge problem.

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