The 39 healthcare professionals (HCPs) who work at the Boston Visiting Nurses Association (BVNA) will go on strike for seven days beginning 9 a.m. on Monday, July 26 after attempting to win a fair and equitable first contract following their 2019 vote to unionize with the Massachusetts Nurses Association (MNA).
Since then, the BVNA healthcare professionals — whose nurse colleagues have long been unionized with the MNA and whose existing contract should easily serve as a concrete model for what the HCPs are trying to achieve — have spent 19 months at the table fighting for a contract that improves patient assignments and provides contractual equity on items such as health insurance and retirement security.
- Strike begins at 9 a.m. Monday, July 26 outside BVNA’s Dorchester office located at 150 Mt Vernon St.
- Daily Pickets (Monday, July 26 thru Sunday, Aug. 1) will be held daily from 9 to 10:30 a.m. and 4 to 5 p.m. at 150 Mt Vernon St., Dorchester
- Daily leafleting outside of key hospitals and medical facilities that refer discharged patients to the BVNA; facility locations and times TBA
Established in 1886, the Boston VNA — which is owned by Worcester-based VNA Care — is the oldest organized VNA in the country. Its HCPs include physical therapists, occupational therapists, social workers, and speech therapists, and they provide essential in-home care and recovery services to thousands of patients across Greater Boston. The medical needs of Boston VNA patients are varied and complex. They include post-surgical conditions such as total hip or total knee replacements; stroke; Parkinson's Disease; Multiple Sclerosis; Amyotrophic Lateral Sclerosis (ALS); cardiopulmonary conditions; amputations; and post-trauma care.
The Boston VNA HCPs do not want to go on strike but have been forced to because VNA Care refuses to agree to essential contract provisions. “We have been committed to our patients, to our union, and to this negotiation process,” said Debra Nowak, MNA co-chairperson and a physical therapist. “We stand in solidarity as we take all steps necessary to protect our patients and secure a contract that adequately supports and empowers our clinicians.”
Handling of Patient Assignments is Main Sticking Point
- VNA Care refuses to safely limit the daily patient care assignments given to HCPs.
- Excessive caseloads make it extremely difficult for HCPs to provide the level of care patients deserve, especially patients who need complex treatments following hospitalizations or surgeries.
- Instead, VNA Care wants unlimited ability to assign cases to HCPs with no regard for the complexity of patient care requirements.
HCPs are forced to triage their patient assignments, leaving some patients waiting longer or ending up with less care than they deserve. When patients leave a hospital or outpatient clinic following surgery or the diagnosis of a complex illness, they increasingly rely on caregivers like the Boston VNA HCPs. The lack of enforceable patient care standards is a major problem for HCPs and their patients.
Additional Roadblocks to Agreement Created by VNA Care:
- VNA Care wants the right to increase health insurance costs or decrease coverage unilaterally. HCPs are seeking the same health insurance arrangement VNA Care has with its registered nurses.
- VNA Care does not want to guarantee any retirement contributions for HCPs. The HCPs have proposed receiving the same 401K match as other network employees.
- VNA Care is proposing to cut sick time for newer HCPs, from 13 days annually to six, a change that would only force clinicians to work while sick and threaten the safety of patients. The agency is also proposing to reduce bereavement days.
- VNA Care refuses to agree to a wage scale that properly values the care HCPs provide. Wage scales are standard in union contracts; they provide for fair and transparent pay increases and help with recruitment and retention.
“We are dedicated to this process and to getting a fair and equitable contract,” said Rod Hemingway, MNA co-chairperson and an occupational therapist. “They have not respected us and have decided they just don’t want to give us the predictability we need. A contract will give our members stability in wages and benefits, so we can plan our lives and care for our families. People want to grow roots down deep at the Boston VNA. We want to care for our patients and make the agency the best it can be. When new staff come in, we want them to stay and become trusted, experienced healthcare professionals. There is no reason we can’t be the agency of choice.”
“It is frustrating that they are purposefully delaying our contract. They are coming to the table for show, not to make any progress, and are not even willing to give us equity with the nurses,” said Nikki Ducey, a physical therapist and MNA co-chairperson. “Our nurse colleagues agree the workload is the same and should be counted the same. We are working together to treat patients, and for our own employer to value us differently — less than, actually — is awful. We are looking for predictability and reliability, but they want complete discretion. I have been here almost 10 years and they have taken so much away. They took away the retirement match and I have not had a raise in five years. To not know what those benefits will look like from year to year is very discouraging.”
Background on BVNA HCPs and Negotiations
The HCPs voted to join the MNA as part of a National Labor Relations Board election in late 2019. The MNA also represents the registered nurses who work for the Boston VNA, who have a separate contract.
In recent years, many hospital-based services for patients have shifted to in-home services, making HCPs an essential and ever-expanding part of the American healthcare system. Hospitals now move patients back home faster than before, as doing so reduces costs and opens in-hospital beds. This has led to a dramatic increase in the size of the region's at-home patient population, as well as in the complexity of those patients. However, the working conditions for the HCPs who care for at-home patients have not kept pace with environmental changes or the market, which is what prompted the Boston VNA's HCPs to unionize with the MNA.
On July 15 the HCPs delivered a letter describing their contract struggles to Rita S. Advani, chairperson of the BVNA’s Board, at her luxury apartment in downtown Boston. The letter detailed VNA Care’s refusal to agree to key contract provisions around patient care conditions, health insurance, and retirement security and the affect that refusal is having on HCP staff and the patients they serve.