Bargaining Unit 17 – Update
Health Facility Evaluator Nurses
Update as of April 6, 2020
We know that you are in a fluid emergency situation, and we thank you for the hard work and sacrifices you make on a daily basis to care for California. We are continuing to advocate for you with the Department about issues that are changing almost daily. We wanted to update you on conversations we have had with the department on PPE and working weekends. Below are some of the updates we wanted to share with you.
The Union has been advocating on an ongoing basis for adequate PPE for employees. We have also been asking the employer about regular replacement of the PPE that is being used. We have pointed out that Article 10 of our contract requires the department to provide a safe and healthful environment for all employees.
During our conversation, we were notified that CDPH just received a shipment of approximately 1,500 surgical masks. These masks will be sent out to the district offices by Monday or Tuesday for HFENs. We advocated for the Department to make alternative arrangements for employees who are not provided adequate PPE. The most recent feedback we have received, is “if an office has masks then they should be conducting in-person visits to facilities when necessary. If they don’t have masks, then they can call out for more resources or use video conferring to make these infection control visits”. CDPH says they are currently working on ordering more PPE. Below is the distribution list for the current order of masks:
CDPH stated it is currently working with DSS about procedural issues. The Union brought up the issue of how HFENs are paid when they work the weekend and made clear to the department that pay should be according to the schedule that was agreed upon to work with approval by the HFEN supervisor. We requested an HFEN and DSS weekend training schedule as well as clarity from CDPH on how management will communicate to HFENs working the weekend. The department responded: “HFENs have been advised to create an actual schedule of calls/visits with the LPA vs making themselves available for a period of time”. The department stated they have reached out to DSS for the schedule but were unable to provide a list at this time. We will continue to request this during the week to be prepared for the upcoming weekend.
Please let us know if there are other issues, concerns, or additional questions you would like to see the Department answer. If you believe you have not been paid overtime properly or not receiving adequate PPE, please call the Member Resource Center at 866.471.SEIU (7348).
FAQs and Background
CDPH was directed to assist DSS staff in performing infection control training at facilities regulated by DSS. Due to the high demand, CDPH implemented a temporary change in schedule for many classifications in CDPH including Health Facility Evaluator Nurses as of Monday, March 23rd. The notice to the union was sent on March 22nd and stated that all alternate workweek schedules had been cancelled temporarily and converted to 5/8/40 schedules. The department has stated that staff that meet the criteria for COVID-19 concerns (65+ or underlying health conditions) were taken into consideration when making assignments with DSS, and they are not assigned to go out. Impacted staff were directed to communicate with their management and would not be assigned to this project. Below are questions we asked the department and their response as of March 24th:
1. How long do you expect this change of schedule (5/8/40) will be effective for?
At this time we cannot determine how long the change of schedule will last. It is and dependent on how quickly CDPH and DSS can schedule and conduct training visits. It is a temporary change.
2. Exactly how will the HFENs be deployed?
Our goal is to deploy CDPH HFENs as close as possible to their home base district office to minimize travel. We do not intend to have, for example, Santa Rosa staff deployed to Fresno, but if DSS has facilities in Eureka, staff will have to travel and incur overnight stays for these visits.
3. The emails and documents sent to our members reference an “LPA” position. What is an LPA and how does their role relate to ours and the DSS?
LPA stands for “Licensing Program Analyst.” This is DSS’ equivalent of our Health Facility Evaluator Nurse (HFEN) position. LPA’s conduct enforcement surveys and investigations for regulatory compliance with DSS regulations/statutes.
4. How will HFEN/LPA roles differ regarding the training?
Our understanding of the process is that upon initial contact by DSS assigned to the facility, the facility is sent a detailed checklist of actions that the facility should act upon. During the field visit, the LPA reviews the checklist to determine if actions had been taken/are underway. HFENs serve in a supportive role to conduct observations of the physical environment, listen to responses of the facility staff, augment and provide basic infection control training, and answer clinical questions that the facility staff may have (i.e. proper ways to take temperature, how to sterilize thermometers, signs and symptoms to be aware of, etc.).
5. What will the process be to request exemptions regarding employees who are providing health care, have no daycare reserved, or have other special circumstances?
Yes, exceptions will be made. Managers have been advised to be flexible in shifting work week schedules. This may take a week or a little longer to smooth out a transition. We want to make this as seamless as possible for staff.
6. Can the trainings be done off-site using iPhone and Tablets?
Or through video conferencing? This would reduce the need and use of PPE and risk of spread of infection and exposure to and from our staff to the community and to their families. We were just notified that the Department of Social Services has received approval that the infection control training provided to their licensed facilities will change from an in-person visit to a video platform training effective immediately. If, during these video conferencing trainings, staff detect infection control related to the living conditions that are a risk to health and safety, then DSS and CDPH would go onsite. As mentioned, those facilities that do indicate a positive COVID-19 resident will have a telephonic or video “visit.”
7. What does management mean when they say trainings can be done “off-site”?
Does that mean that they can be done virtually over the phone or through tablets or videoconferencing software such as telemedicine? Would the employees be free to choose where to do the training and how to do it? The type or how the training will be conducted is entirely dependent on the equipment available by the provider/facility. Some may only have phone service capability. We imagine that DSS would set up a conference call or use WebEx type conference that our staff would participate from either their office or at home if they are teleworking.
8. How many masks were distributed to each DO?
Below are the number of N95 masks sent to district offices. Fit testing is not required since staff are not providing direct care nursing and have been instructed not to enter resident rooms.
Santa Rosa – 3 boxes = 50
San Diego – 3 boxes = 50
Orange County – 3 boxes = 50
Sacramento – 3 boxes = 50
East Bay – 3 boxes = 50
San Bernardino – 3 boxes = 50
Riverside – 3 boxes = 50
SFS/LSC Riverside – 2 box = 30
Fresno – 2 box = 30
Bakersfield – 2 box = 30
Ventura – 2 box = 30
Chico – 2 box = 30
San Francisco = 2 box = 30
San Jose – 2 box = 30
Stockton – 2 box = 30
LAMU – 2 box = 30
PCB LA – 2 box = 30
9. How many times can the HFENs reuse the mask (if they have been given one)?
Is there any sterilizing or cleaning instructions? How should the mask be stored and transported? We provided offices the following link from the CalOSHA webpage on donning and doffing and reuse of masks. https://www.youtube.com/watch?v=Tzpz5fko-fg
10. What is the process for employees with compromised immune systems, are 65+, or have other health conditions to request alternatives to this assignment?
Managers are talking/working with each individual HFEN to determine if they are able to conduct these field visits. The process appears to be working well. There have been no complaints from staff indicating they met the criteria but were required to conduct a visit.
11. Will there also be special circumstances made for employees providing direct care to elderly parents, those who have Comorbidities, or those caring for family members with a compromised immune system?
Yes to our knowledge, all those factors are being considered.
12. Is this potential OT work mandatory or voluntary?
It all depends on how quickly DSS must complete these visits, how DSS schedules the visits geographically, how many HFENs are available to be paired, and how CDPH may readjust work week days. One strategy for management staff to consider is if they can smooth out the work week days to provide weekend coverage (i.e., some staff may be given a work day or two off in exchange for conducting weekend visits), we may be able to minimize the need for overtime.
13. Will employees be placed on standby for all 7 days?
If so, will they receive On-Call pay? No. We are working with DSS to provide as much advance notice to staff on the visits they need to conduct.
14. Will employees be required to work seven (7) days a week?
See the response to number 13. Working 7 days a week may be required in some cases.
15. What will the new schedules look like for the HFENs?
How do we ensure they still have rest periods and that we are not burning them out? With the recent change in direction from DSS that the majority of trainings will be conducted via video platform, it is unclear how many trainings will be conducted each day. The new direction will certainly mean that more trainings can be completed each day as compared to when on-site presence was required. That being said, lunch breaks will be honored and there will be ample times throughout the day for breaks.
16. Who is in charge of the schedules for the HFENs?
Is it decided by CDPH management or by DSS management? If there is a problem with scheduling, who should employees go to? DSS is in charge of scheduling these visits. CDPH has one point of contact for DSS. This staff person is coordinating the schedules from individual CDPH offices and relaying to DSS. HFENs who have problems with schedules or if they need to change a schedule (due to unforeseen causes (medical appointment, sick family, etc.) need to work with their district office supervisor/manager and that information will be forwarded to our main contact person in CDPH.
17. Has every HFEN been paired with someone at DSS? Was it voluntary?
No, not every HFEN is paired. Some have been excused due to age or other health concerns. Some volunteered (including supervisors and district managers). For the remaining staff, it was required duties to be performed.
18. Will HFENs be required to do their previous work at the same time?
If so, what is the priority assignment? For the most part, all normal work assignments/duties are suspended. Our federal partner, the Centers for Medicare and Medicaid (CMS) suspended all federal activities with the exception of Immediate Jeopardy complaint and facility reported incident investigations as well as conducting infection control training at skilled nursing facilities. The Governor, through his declaration of emergency, has also suspend all state licensing survey activities with the exception of licensing surveys to bring on new resources or expand capacity for current providers. At this point in time, CMS has not provided any instructions or guidance on how or when states will proceed to begin normal activities and what expectations made be set, if any, for work not completed during this time period.
19. Are HFENs required to track who got trained at each of these facilities?
Does the training need to be done for all three shifts at each of these facilities? DSS is keeping track of which facilities received training.
20. If a HFEN needs training, will it be provided?
HFENs do not need training for this project. Infection control practices and protocols are a routine part of their current job. However, our HAI unit did produce a YouTube video and PowerPoint slides to provide some general guidance to providers and these resources were made available to staff for review.
21. Will the HFENs be doing any direct patient care in these facilities?
We have some nurses that haven’t had to do direct patient care for 10-20 years. No, they have been explicitly directed not to provide any direct patient care or to enter rooms of residents who may be self-isolating.
22. Will HFENs be compensated extra for this assignment (outside of the OT pay)?
No. This is a redirection of staff during a time when normal work activities are not currently being done.
23. The documents sent also have a checklist for the “Rapid Assistance and Support Team”. What team is this referring to? Who is on it?
The team consists of the DSS LPA and our HFEN staff.