Nurses picketed at St. Francis hospital last week, as strikes began against three Honolulu hospitals.

Nurse wage gains likely
will spread in industry

The pressure will be increased
to boost the pay of other workers

By Lyn Danninger

Recent wage gains negotiated by the Hawaii Nurses Association on behalf of registered nurses employed at some of the state's largest hospitals will eventually affect the finances of the entire state health care industry, say those familiar with the situation.

"I don't think there's any question that there will be a ripple effect as far as nursing homes go, said Bob Ogawa, president of the Hawaii Long Term Care Association, which represents 26 of the state's skilled and long-term care nursing facilities.

"There will be two things: A widening of the gap in wages (for nurses) employed at other health care facilities and you can also assume that at the next negotiations relative to other free-standing nursing facilities, there will be added pressure," he said.

Long-term care and skilled nursing facilities are particularly vulnerable, having already felt the financial pinch from decreased government reimbursements, especially from the state's Medicaid program. At some facilities those payments cover as many as 90 percent of patients.

"We calculate the current Medicaid reimbursement rates cover between 80 percent and 85 percent of the actual cost of care," Ogawa said. "On average we rely on Medicaid between 75 percent and 80 percent. Some with a higher percentage of private (insurers) are obviously doing OK but there are some with close to 90 percent of patients covered by Medicaid."

At the most recent Long Term Care Association monthly meeting, members already discussed updating wage and benefit surveys at the facilities to find out where everyone stands, Ogawa said.

The ripple effect of wage increases for the registered nurses will also gradually make its way into other health professions, said Joan White, a health care consultant with Planning Solutions Inc. White was recently appointed director of The Hawaii Uninsured Project, a group of health care industry representatives which seeks to solutions for the growing number of uninsured and underinsured people in Hawaii.

"There is pressure on every other sector of the labor pool in health care and when those costs go up of course they will eventually be passed on to the consumer," White said.

Because the health care industry is also one of the state's largest employers, other areas of the industry will also likely face wage increases sooner or later, she said.

"It will ripple down to the paraprofessionals like those who work in primary care, physicians' offices, home care agencies, long-term care facilities, plus others like technicians and respiratory therapists," she said.

How long it will take for wage increases to move through the various professions and jobs which make up the industry will depend on a couple of factors, White said.

"If it involves collective bargaining, that would be when the contracts are up. But in non-collective-bargaining areas, it could happen more quickly since they are not bound by contract," she said.

Already increasing health care costs are having an impact on a variety of areas not strictly considered part of the health care industry.

At the state Executive Office on Aging, which operates Kapuna Care, 6,600 people were served last year through the program which helps provide custodial care and help with day-to-day tasks for the elderly.

But contractors are telling the agency that unless they can raise wages for their workers, they will not be able to bid on upcoming contracts, said Marilyn Seely, who headed the agency under the Cayetano administration.

"Even though these are relatively low wage jobs, it's part and parcel of the same problem, so we are already feeling it," she said.

At the Hawaii State Primary Care Association, which operates a number of health centers throughout the state, Director Beth Giesting said that although the clinics don't rely heavily on registered nurses to provide direct care, further inflation in the health care industry just deepens what has already become a serious problem.

"The impact will be felt in some way in everyone's life because of insurance benefits and health care access," Giesting said. "It's not just nurses' pay or a strike, it's part of the larger health care crisis. It's forces coming together at the same time."

St. Francis Healthcare System
Queen's Medical Center
Kuakini Health System

Hawaii Nurses Association

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