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BART standoff continues as board modifies contract

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The BART Board of Directors voted 8-1 on Nov. 21, with conservative young Director Zakhary Mallett in dissent, to approve a hard-won contract with its unions, after removing Section 4.8, the paid family leave section that the district says was inserted by mistake.

The motion also directed management to negotiate a settlement over that issue with its unions, which have already approved the contract and now must decide whether they are willing to do so again without that provision or whether the possibility of another BART strike is once again looming.

The next day, BART's largest unions, SEIU Local 1021 and ATU Local 1555, issued a joint statement: "We consider the Board's actions to be unprecedented and illegitimate, and we're considering our next steps, including possible legal action. The BART Board of Directors has disregarded the vote of more than 2,000 BART workers and has chosen to subvert the collective bargaining process, and we take their actions seriously."

After meeting in closed session for about two hours, Vice President Joel Keller began the open session with a motion to remove Section 4.8 from the contract, approve the rest, and direct management to negotiate with the unions.

Mallett, the 25-year-old newbie who lives in unincorporated West Contra Costa County but whose District 7 includes part of San Francisco, spoke first: "Even before this hiccup, I was not in the position to support this contract. I find it too costly."

But he was the only one to take that stance, with the rest of the directors calling the underlying contract a fair compromise, even if all said they couldn't support the paid family leave provision that would add anywhere between $4 million and $44 million to a contract that was already going to cost the district an additional $67 million.

Director Gail Murray noted that the unions had given up raises for years when BART had budget deficits, and now that the district is running surpluses, it's reasonable to give workers raises that amount to about 2 percent per year for four years.

"Our employees kept the system going...They're the reason why we keep 40-year-old cars still running," Murray said, later adding, "To say this contract is not a good contract is wrong."

The rest of the board agreed, even while acknowledging it is more than they hoped to pay given the district's capital needs and aggressive expansion plans.

"We're probably paying more for this than we anticipated we would pay, and labor is probably giving up more than they want to, but that's the nature of collective bargaining," Keller said, who also began what turned into a chorus of criticism for how district negotiators signed off on a provision the board never agreed to.

"We ended on a sloppy note and that's regrettable," Keller said, pledging that if he's elected president next month — an ascension that is customary for the vice president — he plans to launch a full investigation into what happened.

"I'm pained that we put ourselves in such adversarial positions with each other and that we lost the lives of two employees," Director John McPartland said of the protracted labor negotiations and the fatalities that occurred while the unions were on strike Oct. 19. He called the contract "more than fair and equitable."

Director James Fang, who represents western San Francisco, sounded the strongest criticisms of BART management and negotiators. "Yes, it was a mistake, but nobody has come forward and said 'there was a mistake and I'm responsible," Fang said, later adding, "The ones who signed this must be held to account."

Fang then went further, albeit without specifics, when he said, "Every bit of management advice we've received has not worked out to the district's best interests."

Director Robert Raburn echoed Fang's calls for accountability: "I'm still not clear on how that [contract provision] arrived and it hasn't been accounted for by anyone at the district who said 'I am responsible.'"

But he also said that the provision was clearly an error and not something arrived at through the negotiations: "Both parties agreed on a $67 million package and we should keep that intact because it's fair."

Reached by the Guardian while union leadership was conferring to plan next steps, SEIU Local 1021 Political Director Chris Daly told us, "We are about as up in the air as we've ever been."

He called it "unlikely" that union leadership would simply submit the board-revised contract to an up-or-down vote by union membership, saying that he doesn't think it would be approved.

And Daly echoed the concerns expressed by several BART directors about how this mistake happened and why nobody has taken responsibility or been held accountable: "If I were on that board, I'd have the general manager's head, there's no two ways about it." (Steven T. Jones)

SF General reduces psych care

A 22-bed psychiatric unit at San Francisco General Hospital will be taken out of service, and reopened only if the facility experiences a high caseload of patients exhibiting the worst signs of psychiatric crisis.

As of Nov. 19, five patients were receiving care in that unit, 7B, according to spokesperson Rachael Kagan. None had symptoms that rose to the level of requiring acute care. Instead, they were classified as sub-acute patients, a distinction that essentially means they didn't present an immediate threat to themselves or others.

But under a new policy that will take effect after they have been released, all 22 beds in 7B will be closed — unless they are needed for acute patients who do reach that critical threshold. The unit will be staffed only if patients can't be accommodated in the hospital's other acute psych unit, which has 21 beds.

The decision was made in response to a changing financial picture under federal health care reform, Kagan explained.

"There is a big push ... to ensure hospitals are only providing acute care," Kagan said, and this trend is driving efforts to reduce sub-acute patients. "It fiscally makes more sense," she added, because insurers pay higher rates for acute care than for lower levels of treatment.

Yet some hospital staff members are nervous about the implications of this shift, because it means fewer patients will be able to access psychiatric care at SF General unless they represent a danger to themselves and/or the general public — at a time when demand for these services is on the rise.

"To us, it's a matter of priority for the city," said Brenda Barros, an employee at SF General who is active with hospital union SEIU 1021. "Do you want to take care of these people, or don't you?"

Some staff members are doubtful that 7B will reopen. An internal SF General memo issued Nov. 18 informed the 7B staff: "Our census will be gradually reduced until we won't have any more patients. Then 7B will be closed." The memo added, "this came from [SF General CEO] Sue Currin due to budgetary constraints."

However, a second internal memo went out the following day, to "clarify" the first one. In that message, Nursing Director Kathy Ballou wrote: "We are not closing psych beds or any beds." Instead, beds in 7B would be closed unless "we get acute patients needing that level of care," she wrote. "As in other hospitals, we are accountable to our operating budget."

Further complicating matters, said Barros, is that patients can fluctuate rapidly between needing acute care and a lower level of attention. "They absolutely can swing back and forth." She added that patients initially requiring a lower level of care could experience worsening conditions if they're unable to secure an appointment in time to get help, and delays are very common.

Kagan emphasized that the unit wasn't being closed down, but did confirm that sub-acute patients would no longer be able to receive treatment in 7B. Instead, those patients will be placed with various service providers throughout the city, she said. "The goal is to move the patients to their appropriate placement."

Meanwhile, this shift coincides with an overall rise in citywide demand for psychiatric services. According to a report delivered to the Police Commission earlier this year, SF General had 6,293 patient admissions for psychiatric holds in 2012, a sharp increase from 5,837 in 2009.

While there were deep cuts to the city's Department of Public Health during the economic downturn, Mayor Ed Lee has recently trumpeted a boost to city coffers thanks to growing economic activity. But if the city's financial health has improved, it seems odd that its safety-net hospital would be put into the position of reducing psych care due to budgetary pressures when that kind of care is sorely needed.

For Barros, it's a matter of whether or not city officials will decide to allocate more funding for mental health services. "If they don't have enough money in Public Health," she said, "then they need to put more into Public Health." (Rebecca Bowe)


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