State board won’t delay UVM Medical Center budget review


The Green Mountain Care Board said it wouldn’t delay approval of University of Vermont Medical Center’s fiscal year 2019 budget despite ongoing labor strife at the hospital.

The union representing 1,800 nurses at UVM Medical Center last week asked the board to not approve the hospital’s spending plan until they have ratified a new contract that “ensures safe staffing and quality patient care.”

But Kevin Mullin, the chair of the Green Mountain Care Board, says officials will be taking a “business as usual” approach to UVM Medical’s budget deliberations in spite of protests expected at the hospital’s public hearing before the board as the Shelburne News was going to press on Wednesday.

“The hearing is not the final say,” Mullin said Monday. “We’ll make a (budget) decision in mid-September. A written decision must be issued by Oct. 1, and it will be.”

The Green Mountain Care Board is conducting a series of public hearings in its regular review of proposed hospital budgets for fiscal 2019 which begins Oct. 1.

The hearings come amidst the ongoing labor dispute between the hospital and its nurses union.

UVM Health Network’s presentation was scheduled to begin at 9 a.m. Wednesday at Burlington City Hall, and the nurses’ union was expected to have a presence there.

When hospital budget hearings opened Monday, Mullin said the board already has received hundreds of public comments.

“We’ve also fielded some calls from legislators and others, asking about what will transpire on Wednesday (for UVM’s hearing),” Mullin said. “What will transpire is business as usual for the Green Mountain Care Board. The hearing will proceed, as usual.”

The Vermont Federation of Nurses and Health Professionals’ last contract with the hospital expired July 9. Nurses went on a 48-hour strike three days later.

Wages and staffing have been obstacles to a new agreement. The union says nurses are not paid enough and the hospital is inadequately staffed as a result. That has led to nursing burnout, safety concerns and long patient wait times, the union has argued.

Hospital administrators say their vacancy rate is on par with other facilities as health care providers statewide struggle with staffing shortages. They also have labeled their salary offer “fair and competitive.”

After the latest negotiating session ended on Saturday, hospital leaders said their offer had increased to an average 15 percent base salary increase over three years, including annual step increases. That’s up from 13 percent previously.

The hospital’s offer features bigger increases for some nurses depending on job category. It also includes a minimum 10 percent wage hike for nurses who have reached the top of the pay scale and are no longer eligible for step increases.

“We are hopeful this fair and competitive offer will receive the support of our nurses so we can bring this process to a successful conclusion,” said Eileen Whalen, president and chief operating officer of UVM Medical Center.

The union had been asking for a 23 percent salary increase over three years. That’s come down by 1 percentage point, and union leaders said after Saturday’s session that they have been “making some headway at the bargaining table.”

In a prepared statement, the union said: “With executive compensation packages over $2 million, we know (the hospital) can afford to fairly pay the people who are at the bedside, providing the high-quality care the hospital prides itself on.”

Nurses were referring to the hospital’s recent release of its latest Form 990, a federal disclosure filed by nonprofit organizations that lists pay for the hospital network’s executives.

At the top of the list is Dr. John Brumsted, chief executive officer of UVM Medical and the two-state UVM Health Network, who earned $2.1 million in 2016. That includes salary, incentives, insurance and retirement benefits.

Scottie Emery-Ginn, who chairs the UVM Health Network trustees board, said salaries for Brumsted and other administrators are carefully considered and based on comparisons with other academic medical centers’ executives.

“Our approach is to compensate employees at all levels of the organization fairly, using benchmarks and market analysis to hire and retain the best people possible,” she said. She said Brumsted’s compensation, for example, may seem large for Vermont, but that it’s competitive. “It’s at the 50th percentile for other executives with similar jobs throughout the United States,” she said.

The next five top earners listed in the 990 filing were:

  • COO and President Whalen, who earned $1.06 million in 2016, up from 2015 when the hospital reported her compensation at $866,692.
  • Todd Keating, health network chief financial officer: $959,755.
  • Dr. Stephen Leffler, the health network’s chief population health and quality officer: $828,976.
  • Dr. Howard Schapiro, network chief clinical integration officer: $781,438.
  • Spencer Knapp, network general counsel: $742,241.

Nurses union President Laurie Aunchman called the executive pay figures “disheartening,” adding that “the hospital is speaking loud and clear as to what their priorities are.”

The federal form also includes information about UVM Medical Center’s community benefit investments. Administrators said those benefits – which includes things like free care and community grants – totaled $193 million in fiscal year 2017.

That’s an increase of about $20 million from the year before and represents about 16.2 percent of the hospital’s total expenses.

While the outcome of the nurses’ contract situation could have an impact on the hospital’s budget, Mullin said hospitals are allowed to manage their finances during the year. Hospitals also can come back to the board mid-year, if necessary.

“We wish both sides good luck and want to have the best possible workforce and health care in the state of Vermont. But we also want to keep health care costs under control,” Mullin said.

Mullin added that the care board has experience with public protests. In July, picketers marched against proposesd Vermont Health Connect insurance rate hikes prior to a board public meeting. “As I understand, there’s going to be a lot of people picketing out front,” Mullin said. “That’s OK. We’re used to that.”

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