With the labor contracts for 69 nursing homes set to expire this month, state health officials are preparing for the possibility of a large-scale strike.

Representatives for both sides say the negotiations are in the early stages and no strike plans are imminent. But because so many contracts are in play, state officials are taking extra precautions.

“Given the number of potential homes that could potentially be impacted at this time, the department has engaged in a significant planning process,” state Department of Public Health spokesman William Gerrish said.

That includes assigning approximately 200 staff from different parts of the department to make unannounced visits to nursing homes if strikes occur. The department is responsible for ensuring that nursing home residents continue to receive care and services during a strike.

The department has also asked the nursing homes to provide portions of their strike contingency plans earlier than usual to give officials time to review them.

Nursing homes always prepare contingency plans in advance of possible strikes, but the number of facilities with expiring contracts this month makes planning for replacement workers more complicated, said Matthew V. Barrett, executive vice president of the Connecticut Association of Health Care Facilities.

“It’s a much more difficult endeavor on the staffing side in a potential labor action of this magnitude, because all of the homes need to draw from a limited supply of labor,” he said. “In a limited job action involving only several homes, it would be far easier to address the replacement workers.”

Deborah Chernoff, spokeswoman for the New England Health Care Employees Union, District 1199, which is negotiating 57 contracts, said the union has not taken strike votes or begun gearing people up for a labor action.

“We’re still relatively early in the negotiation process,” she said.

It’s not unusual for negotiations to continue past the contract’s expiration date, either with a formal extension or an understanding that the terms of the expired contract will still apply, Chernoff said.

As for the progress of talks, she said, “we’re seeing a fairly wide range of responses”–from progress in negotiations with one nursing home to another that she said was “taking its cue from the Governor of Wisconsin.”

Barrett, whose association represents about 40 nursing homes negotiating contracts, said he hopes they can be resolved.

“The budget is pending. Everybody needs to be mindful of the economic climate and the fiscal constraints that we’re in,” he said. “At this time, we’re staying at the bargaining table and urging all employees to do so.”

Close to 70 percent of the state’s nursing home residents are covered by Medicaid, and the facilities rely heavily on state funds. Nursing homes have not received an increase in reimbursement rates since 2007–the subject of a pending federal lawsuit by their association.

Under Gov. Dannel P. Malloy’s proposed budget, nursing homes stand to receive an increase in reimbursement rates through an increased provider tax. By taxing the facilities and distributing the money back to them, the state can receive federal money, part of which would go to the nursing homes.

But even if the nursing homes get more money in the final state budget, whether the funding goes to wages and benefits or to help nursing homes make up for years of flat funding will likely still be a matter of dispute.

“Even if it were much more generous in terms of funding than it is, if it was a 10 percent increase, we would still be fighting with the nursing home operators about whether any of it was going to go to the workers,” Chernoff said.

Chernoff said the unions don’t expect to get big increases. “But we also don’t want to see 30 years of trying to build standards so that these could be the kinds [of jobs] you could actually support a family on destroyed,” she said.

The union’s preliminary statewide offer calls for annual raises of 4 percent for four years. Chernoff said it’s an opening offer and that there will be different local proposals based on individual contracts.

Barrett said the increases the union is seeking are unsustainable given the lack of rate increases in recent years.

“While it’s very good news that [the budget] has that provider tax in it, those dollars really provide stability to a system that’s been in financial distress for a number of years,” he said. “It wouldn’t be our view that there’s the kind of dollars in the system that would be needed to satisfy or address all of the issues that are on the table in the collective bargaining process.”

Beyond the tight state budget and bad economy, Chernoff cited other factors that can affect the negotiations, including the federal budget. Some nursing homes receive Medicare payments for providing rehabilitation services to seniors and could face uncertainty if the federal government cuts Medicare payment rates. Because Medicare tends to pay higher rates than Medicaid, facilities that treat Medicare patients can use some of the Medicare funding to help cover losses from Medicaid.

Chernoff also pointed to Malloy’s plan to expand the Money Follow the Person program, with a goal of having 5,200 people receiving care at home, rather than in nursing homes, by 2016. Although she questioned whether the workforce exists to make such a shift possible, Chernoff said the possibility of nursing homes losing residents adds an element of uncertainty into their financial projections. Barrett said he doesn’t expect the proposal to affect the negotiations because the state’s aging population means the demand for nursing home services will increase even if some people receive care at home.

Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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