Issue link: https://nnumagazine.uberflip.com/i/447665
14 J U N E 2 0 0 5 C A L I F O R N I A N U R S E Prop. 72, which would have required the state's largest employ- ers to provide health insurance for their workers, but also gave $20,000 to Prop. 64, the corporate-backed initiative to gut the Unfair Business Practice Law, and $25,000 toward workers com- pensation reforms that in some cases drastically cut payments to injured workers. The criterion appears to hinge on whether CHCI believes the measure would result in more money or less money for its hospital members. "CHA provides the cover for hospitals to engage in political campaigns that hospitals would have trouble engaging in by them- selves," said Burger. "CHA is out there as the hospital association so that individual hospitals don't have to sully their names by tak- ing positions which are not in the best interests of patient care." CHA is also registered with the Internal Revenue Service as a federal Section 527 committee, popularly known as "stealth PACs" because they can raise unlimited amounts of money and have historically had such lax reporting requirements. But according to online filings with the IRS, no activity reports have been filed since October 2002. Sometimes lobbying and political activity is not enough, however, and that's when CHA turns to the courts. On December 30, 2003, just days before California was to become the first state in the nation to implement minimum RN-to-patient ratios, and years after hospitals already knew they should be preparing to meet ratios, CHA filed a lawsuit in Sacramento County Superior Court against the Department of Health Services, claiming that hospitals should not have to be in compliance around the clock. The lawsuit was essentially a back-door attempt to reverse the years of work that had gone into establishing ratios, but CHA lost that case when the judge ruled in May 2004 that the standards did apply "at all times" and that anything otherwise would be "meaningless." When CNA sued Schwarzenegger and DHS late last year in challenge to their emergency order rolling back ratios, CHA stepped into the case as an intervening party. During oral argu- ments, CHA's lawyer tried to bolster DHS' position. But the judge in that case also ruled against DHS and CHA, saying that the gov- ernor had exceeded his authority and couldn't show any emer- gency that warranted an end run around the regular rulemaking process. All this legal work costs money. According to CHA's 2003 tax returns, it spent about $500,000 on legal fees. It spent $170,000 in 2002, and $388,000 in 2001. Tax returns for 2004 are not yet available. It's unclear if CAHHS helps pay for CHA's legal activities. CAHHS spent $521,000 on legal fees in 2003, $205,000 in 2002, and $459,000 in 2001. When all its activities are considered—the money, the influ- ence, the lobbying, the PAC activity, the lawsuits—CHA clearly emerges as a strongman for the hospital industry. It's an industry that often portrays itself as not for profit, as struggling, as caring only about serving the public good. But they have another priority: making money. CHA's members are more than willing to give millions of dollars to their trade group to help them do just that. "It's clear from the data that CHA has spent more time developing a master plan to influence gov- ernment and politicians than a plan to comply with ratio laws to protect patients or retrofitting standards to make hospitals safe," said Gerber. "These millions reflect the huge shift hospitals have made from being community health resources to corporate business- es that prioritize quarterly profits over long-term goals like providing quality healthcare through expe- rienced providers." Despite CHA's extensive network of funds and connections, nurses have held their ground on issues like the ratio law by drawing on the power that comes from being in one of the professions most respected by the public, and by acting collectively through CNA. "Look at how much they spend," said Burger. "I think we've done really well. They may have money, but people trust us because they know we'll do the right thing." ■ $100K+ CONTRIBUTORS TO CHA ISSUES COMMITTEE (CHCI) 1 Tenet Healthcare Corporation, Dallas $ 755,800 2 Kaiser Permanente, Oakland $ 657,808 3 Catholic Healthcare West $ 321,640 4 Adventist Health, Roseville $ 279,400 5 Sunrise Hospital and Medical Center, Las Vegas (HCA) $ 190,200 6 St. Joseph Health System, Orange $ 141,375 7 Community Medical Centers, Fresno $ 140,754 8 Sharp Healthcare, San Diego $ 131,085 9 Little Company of Mary Health Services, Torrance $ 130,890 10 Memorial Health Services, Long Beach $ 124,856 11 Cedars-Sinai Medical Center, Los Angeles $ 106,423 12 HCA Columbia, Nashville $ 100,000 SOURCE: Data collected since 2000 by California Secretary of State KEY CHA HOSPITAL EXECUTIVES NAME HOSPITAL SYSTEM POSITION WITH CHA Donald Ammon, president and CEO Adventist Health, Roseville Chair of Board of Trustees J. Kendall Anderson, president and CEO John Muir-Mt. Diablo Health System Past chair of Board of Trustees Carol Bradley, chief nursing officer Tenet California Member of Board of Trustees Mark Costa, chief operating officer Providence Health System, Little Company of Mary service area Secretary-Treasurer of Board of Trustees Lloyd Dean, president and CEO Catholic Healthcare West, San Francisco Member of Board of Trustees Darlene Garrahy, trustee Tri City Medical Center Program vice chair of CHA Governance Forum Martha Marsh, president and CEO Stanford Hospital and Clinics, Stanford Univ. Medical Center Chair-elect of Board of Trustees Deborah Proctor, president and CEO St. Joseph Health System, Orange Member of Board of Trustees F. Camille Ranker, treasurer Mendocino Coast Healthcare District Chair of CHA Governance Forum Carl Williams, director Citrus Valley Health Partners General vice chair of CHA Governance Forum Cover | Story