Proposed Maui County Council Resolution supports “safe staffing ratios” at Maui Health facilities

Tamara Paltin, West Maui County Council member, will introduce a resolution urging Maui Health System, a Kaiser Foundation Hospital LLC, to “provide a fair contract to the health care workers at Maui Memorial Medical Center, Kula Hospital, and Lānaʻi Community Health Center, in the best interests of all residents of the County of Maui.”

The resolution surfaces before the Maui County Council at 9 a.m. today (Nov. 26, 2024). Paltin’s resolution comes after the recent three-day strike by members of the United Nurses and Health Care Employees of Hawaiʻi held Nov. 4-6. Negotiations continue with the parties meeting virtually on Nov. 14 and in-person bargaining dates planned for Dec. 11, 12 and 19.

Registered nurses from the ER and ICU at Maui Memorial Medical Center plan to testify on the importance of safe staffing ratios to the health and safety of their patients, according to a union news release.

“It is deeply unacceptable and unsettling for Kaiser to prioritize patient safety standards in one state while denying the same protections to Maui’s community,” according to Josh Masslon, RN, ICU, noting a resistance to same safe staffing ratios granted in California.

Maui Now reached out to Maui Health for comment on Monday. This story was updated to reflect the received on Tuesday morning.

“Maui Health is committed to reaching a fair and timely agreement and has bargained in good faith to reach over 25 tentative agreements. Maui Health’s current offer of 18% across-the-board (ATB) increases combined with other pay increases over the four-year contract closes the current gap between Maui Health wages and Kaiser Permanente wages. With the other wage increases including for longevity, some job classifications will receive an increase of over 27% over the life of the contract,” according to a statement from Maui Health.

Maui Health maintains that it adheres to “safe, industry-standard, evidence-based staffing protocols that prioritize patient outcomes and safety.”

According to the Maui Health statement: “The ‘safe staffing ratios’ that the union is proposing are already in place, as publicly acknowledged by union leaders themselves. The ‘variable staffing’ model we propose was developed in partnership with union members, including nurses, and nurse leaders, and includes the staffing levels the union is requesting, as well as the implementation of a patient acuity tool to ensure staffing decisions are driven by real-time patient data including a patient’s condition and severity of illness, and the experience and skill level of the nurse. The staffing model is designed to ensure flexibility so we can allocate staffing based on our patients’ changing needs. We are committed to working with the union to refine this approach and ensure that both patient safety and staff well-being are fully addressed in any staffing model we implement.  Unfortunately, the union continues to demand that inflexible, fixed ratios be mandated as the sole determiner of staffing, which does not account for other factors critical to safe patient care. This kind of rigid staffing is not mandated in any hospital across Hawaii and works against the needs of our island healthcare system and the communities we serve.”

Maui Health reports it is dedicated to making headway in upcoming discussions.

Maui Health previously reported that tentative agreements had been reached, before the strike began, on all non-economic items. Unresolved issues remained wages, benefits and staffing.

The union maintains that the primary issues remain safe staffing and wages.

“The UNHCEH bargaining team has proposed the same staffing ratios that Kaiser agreed to in its contract with RNs in California. Studies show that for every patient added to a nurse’s workload, mortality rates increase by 7%,” the union said in a news release. “Prior to the strike, management invited nurses on the union bargaining team to a collaborative process to develop safe staffing language for the contract. All the clinical professionals on both sides agreed: the RNs on the bargaining team and the nurse-managers on management’s side—all folks who work with patients. Management higher-ups who never touch patients wiped the agreement away and stuck on their refusal to agree to safe staffing language.”

The union reports a June 2024 study by the Hawaiʻi State Rural Health Association, “Maui Together,” indicates that 39% of medical professionals are contemplating moving to the Mainland. Another 40% are considering a reduction in hours, and 35% are thinking about leaving medicine altogether. “The stresses, moral injury and burnout from short staffing are huge contributing factors,” the union said.

If passed, certified copies of the resolution will be transmitted to Hawaiʻi Gov. Josh Green, Hawai’i Department of Health director Kenneth S. Fink, MD, and Maui Health System CEO Lynn Fulton, among others.