Short Shrift

Nursing assistant Tanya Espinoza says that even before having her pay cut she was unable to afford health insurance for her family
Raoul Benavides

On March 5, Ramsey County officials traveled to the State Capitol to persuade legislators that they needed to boost the salary of the county's top administrator. Under state law, local governments are prohibited from paying their employees more than $114,288 annually--or 95 percent of what the governor receives--but waivers have become routine in recent years. The county was hoping to increase the pay of its recently hired manager,David Twa, to $140,000.

Ramsey County officials informed the legislators that Twa had already received at least one more lucrative job offer since arriving in October, and that he'd taken a pay cut in order to work for the county. "Ramsey County commissioners have a long track record of being fiscally conservative," county commissioner Jan Wiessner assured them.

At the same time, across the Mississippi River, a very different meeting regarding Ramsey County employee salaries was taking place. In an arbitration hearing at the offices of the American Federation of State, County and Municipal Employees (AFSCME) Council 14 in South St. Paul, county officials were defending their decision to cut the pay of workers at the Ramsey Nursing Home by $1.02 an hour.

The money in question was set aside by the state legislature in order to subsidize salaries for long-term care workers. Owing to a budget crunch at the nursing home, however, Ramsey County had decided that, as of January 1, it would no longer pass that money along to employees. AFSCME believed that its workers were contractually entitled to the funds. The decision impacts some 250 workers--nursing assistants, laundry workers, custodians--at the county-owned nursing home.

Although the two hearings were completely unrelated, union officials and nursing home employees were put off by the county's seemingly hypocritical stances. "We don't think taking money away from the lowest paid people in the county is a way to resolve a countywide budget issue," says Joyce Carlson, a business representative for AFSCME Council 14. She notes that a buck an hour might not mean a lot to top administrators like Twa, but for some of the workers at the nursing home it means an almost 10 percent cut in pay. "That hurts," says Carlson. "That's a huge part of your income. We're talking about something that can be really devastating when you're making under $20,000."

There is little doubt that the Ramsey Nursing Home is in dire financial shape. Owing to last year's state budget cuts, the facility is facing a $546,000 revenue shortfall. A primary reason for the financing gap is the state's decision to freeze daily reimbursement rates for nursing home patients. This resulted in Ramsey Nursing Home receiving roughly $345,000 less than expected. In addition, other technical changes, such as shortening the period during which a nursing home can continue to be reimbursed while a patient is in the hospital, have further strapped the institution.

"Bottom line, there is a financial crisis," says Victoria Reinhardt, another county commissioner. "It was caused by the state budget cuts, and we're trying to do our best to figure out what a creative solution is here."

The situation is so grave that Ramsey County officials have discussed shuttering the nursing home, even though it provides a vital service to elderly residents. The facility has been, on average, at 99 percent capacity over the last decade, and there is almost always a waiting list. Also, the facility deals with a particularly difficult clientele--more than 60 percent of residents suffer from dementia (compared to roughly 40 percent in nursing homes statewide), and roughly half of its 180 patients have been transferred from other facilities, in large part because of behavioral problems. "If we didn't have as difficult a case mix as we have, it wouldn't cost us as much, and therefore we wouldn't be in as much of a bind as we are," argues Reinhardt.

Furthermore, Patricia Reller, administrator of the nursing home, says that the facility has been forced to make cuts across the board, from fuel costs to administrative expenses. "We looked at every line item in the entire facility," she says.

All these rationalizations mean little to nursing home employees. Although the waiver request seeking to boost the top county administrator's pay was rejected by the state's Department of Employee Relations last week, it's not going to make life any easier for workers like Tanya Espinoza. A single mother who's worked as a nursing assistant at the facility for two years and now makes $12.21 an hour, Espinoza says that even before the pay cut she was unable to afford health insurance for herself and her son. "I don't get child support either," she says, citing the bind the pay cut has meant for her. "My paycheck is what me and my eight-year-old son depend on. It's either pay my bills or put food into the house."

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