Health care professionals at four clinics in New Mexico’s capital city won a union election in the hopes of making a more democratic workplace after facing poor management, a retaliatory and ineffectual board of directors, unsustainable firings, resignations and layoffs.
Still, structural problems remain.
In interviews with Source NM, nine current and former health care workers at Santa Fe’s La Familia Medical Center say organizing to recover what has been lost is just beginning.
On Wednesday morning, La Familia workers learned management and the clinic’s board of directors cut $2 million from the budget, and are immediately laying off 17 navigators and case managers who worked in the clinic’s medication assisted treatment and Hepatitis C programs.
Overall pay for all hourly staff was also cut by 10%, according to a current staff worker who asked to remain anonymous because they are not authorized to speak publicly about internal company operations, and they fear the same retaliation others have experienced.
Managers also chose not to hire anyone to fill open staff positions at the clinic. The hiring freeze does not include doctors, nurses and dentists, whose positions are now protected by their union.
La Familia Chief Development Officer Jazmin Milz said Tuesday the clinic’s medication assisted treatment and Hepatitis C programs are being “restructured” and will now be run by case managers from the clinic’s Healthcare for the Homeless program.
Bosses cut working hours for case managers at Healthcare for the Homeless, even though they are now being asked to take on more work for these other two programs, according to a current employee who asked to remain anonymous.
Former La Familia doctor Wendy Johnson said the program’s work with unhoused patients saw a small minority of people treated for opioid use disorder and Hepatitis C. Now they’ll take over case management for all of them, the current employee said.
Milz said case managers at Healthcare for the Homeless have the expertise to do the extra duties. They haven’t been given any training or any clarity about what it means to absorb both of those programs, the current employee said.
The Hepatitis C program’s leader was an expert in that treatment and could talk with patients through the system, Johnson said. No one at La Familia has the same level of expertise, she said. The case managers don’t do it all the time every day, but could be trained, the current employee said.
The program leader had been vocal about problems at the clinic, and resigned under duress, Johnson said.
The rest of their staff were laid off on Wednesday.
“It really starts to look like retaliation, and it’s just clearly bad for patients,” Johnson said. Johnson herself was fired after speaking out about problems at the clinic.
Milz said managers cut positions they don’t consider essential, and whose layoffs would have the least impact on patient care.
“What we needed to do was to make sure that we were financially stable and able to take care of the patients that we have,” Milz said.
Milz said the company, under the leadership of interim chief executive officer Brandy Van Pelt-Ramirez and interim chief medical officer Dr. Gary Giblin, “are hoping to help this organization heal and move forward.”
Van Pelt-Ramirez took over after Julie Wright, who was hired by the board earlier this year but fired shortly after providers won the election.
“What we’re looking to do is to give our patients the best care that they can get,” Milz said. “It will take everyone’s collaborative efforts to make those changes happen, and for us to be here long-term.”
An adobe wall leads to the main building of La Familia Medical Center in Santa Fe. (Photo by Austin Fisher / Source NM)
Management never voluntarily recognized union
La Familia providers said the only way to improve conditions at this point is to regain some of their power by forming a union. Management has made it difficult for working parents to balance their work and family lives, including abruptly extending their schedules to prevent them from picking up their children from school or getting home to their families.
Wright made it clear she thought the workers are lazy and ungrateful for the raises they got in January. But doctors say Wright was abusing the clinic’s former medical director and allowing other managers to be misogynist against another doctor, and racist against a staff member.
Milz said on Wednesday every grievance is investigated and addressed. However, the doctors and nurses have found no matter how many individual grievances they filed against Wright, they did not solve the problem.
During last month’s union vote, all but one of the 17 providers who did vote supported the union.
One in 10 residents of Santa Fe County are a patient at La Familia’s seven locations across Santa Fe, according to the company’s website.
The vote makes the Union of American Physicians and Dentists (UAPD) the exclusive representative for a bargaining unit of 19 providers who were still employed by the clinic in early August.
The providers filed to be a union on July 25, according to the National Labor Relations Board. Johnson’s firing and the union drive were first reported by the Santa Fe New Mexican.
In an interview with talk radio host Richard Eades, La Familia management said they support the union. The day before the vote, the company put out a statement saying managers “respect their collective decision to unionize.” But workers say managers have in fact opposed the union at every turn.
The election could have been avoided since the majority of providers had already signed cards expressing support for the union, but management never voluntarily recognized them.
UAPD President Dr. Stuart A. Bussey said the nearly unanimous vote by nearly all providers speaks to their strong desire to refocus La Familia back to high quality patient care and stem workers from leaving.
“We hope the union will help restore the provider voice in the clinic operations so clinicians and patient-serving staff can return to giving the community the kind of excellent and compassionate care La Familia has been known for for 50 years,” Bussey said.
At the time of the election, almost half of providers together representing decades of local experience had either resigned because of being overworked, were wrongfully dismissed, or were demoted. Milz on Wednesday declined to answer any questions about the union.