This week, Michigan Medicine and MNA/UMPNC continued negotiations. The following FAQ is designed to address questions from our nurses regarding current MNA/UMPNC negotiations.

Q. What is included in the proposal that Michigan Medicine offered to MNA/UMPNC?

A. Key elements of the most recent proposal include the following:

• For Framework and RSAM nurses, certified nurse midwives, CRNAs and CNSs: Increases of 5%/5%/5%/5% for each year of the contract (for Framework and RSAM nurses, the increases are based off Level C). Total – 20% across-the-board increases over term of agreement.
• A new salary step model for nurse practitioners that will enable those practicing on blended teams with PAs to be compensated in a consistent fashion as their PA colleagues along with annual increases and lump sum payments that average 20% over the term of a four-year agreement.
• A $5000 signing bonus for all bargaining unit members actively employed at the time of ratification, payable in two installments if a final tentative agreement is reached by July 14, 2022.
• The signing bonus is available to every nurse in the bargaining unit and will be prorated based on appointment fraction
• Introduction of a new charge nurse differential
• Increases to shift and weekend differentials beginning in FY24.
• Elimination of mandatory overtime within the next 24 months or sooner.

It is important to note that this is not everything included but highlights key elements of the economic proposals. We will not propose any changes to benefits, including health care premiums and the 2:1 retirement match program.  

Q. Why did Michigan Medicine email the proposal to nurses? Did they offer it to the MNA/UMPNC bargaining team first?

A. Michigan Medicine presented the proposal to MNA/UMPNC at the bargaining table on Thursday, June 30. Health system leadership also emailed details of the proposal to members of our nursing community to make everyone aware of what was offered. With the contract having expired, we felt it was important for all nurses to be aware of the offer we made to MNA/UMPNC because nurses will be impacted by a pause in salary increases until a new agreement is ratified.

Q. I am hearing that Michigan Medicine is asking for many “concessions” in the contract. What are those concessions?

A. Every contract negotiation is a time for Michigan Medicine and MNA/UMPNC to identify areas in the contract that can be changed to introduce process improvements and make those proposals to the other team. Michigan Medicine has proposed making several changes including:

• Payroll Process: changes that would reduce payroll complexity and allow for further automation of our payroll process, which is needed to help ensure nurses are paid correctly and on time.  This includes redefining the first shift of the day to align with all other Michigan Medicine employees, a step that is needed to more fully automate our payroll system.
• On Call System: Implementing a system-wide on-call system to help eliminate the use of mandatory overtime. Our proposal replaces the requirement that a majority of the bargaining unit votes to accept an on-call system, with the use of functional vacancy metrics that would trigger implementation of on-call schedules.
• Incremental PTO: We have proposed capping the use of incremental PTO at 48 hours per year because there is a contractual process for scheduling PTO. Nurses can still pre-schedule up to 75% of their annual PTO accrual during the dedicated bidding period, and then request additional hours and request time off before a schedule is posted using the PTO scheduling process that is outlined in the contract.  Nurses will still have ability to utilize incremental PTO to meet unanticipated PTO needs within the proposed 48-hour cap noted above.
• Attendance: In conjunction with the proposal for an on-call system and changes to the staffing incentive process, we have proposed to streamline the attendance problem solving process  in an effort to support staffing on units and reduce the need for mandatory overtime.

Q. Can Michigan Medicine offer backpay, or pay retroactively, for step increases after the contract expired?

A. No, Michigan Medicine is prohibited by state law from enabling pay increases or advancement to the next pay step on their wage scale until a new contract is ratified. Salaries and wages are determined by the collective bargaining agreement, so when that expires, there is no agreement to follow.

We are also prohibited by law from offering “backpay” or making increases retroactive, so any salary increases, or step advancements, will be effective as of the date a new contract is ratified.

Q. How much of the health system’s annual budget goes toward investing in people?

A. More than 60% of Michigan Medicine’s budget is allocated for people – our faculty and staff. 

Q. Why isn’t Michigan Medicine offering raises above inflation?

A. The salary increases offered in our most recent proposal are consistent with increases in other recently ratified nursing union contracts across the country. These increases will take the average nurse salary at Michigan Medicine to $121,541/year. This does not include on-call rates, incentive programs or shift differentials.

Michigan Medicine employs approximately 30,000 individuals across the state of Michigan, all of whom contribute to our mission of advancing health to serve Michigan and the world. Our aim is to provide a market competitive salary increase for all our team members, taking into account the affordability for our payers and patients. 

We have always been proud to offer our nurses competitive wages and a generous 2:1 retirement match, and the proposal we have offered to MNA/UMPNC continues that commitment.

Q. The University of Michigan has a multi-billion-dollar endowment. Why can’t that money be used to offer salary increases?

A. Funds that are donated to the university as part of an endowment have specific guidelines on how the funds can be used. The distribution policy for the Fund is set by the Board of Regents and restricts the amount of money that can be withdrawn from the Fund each year. The U-M Standard Practice Guide includes an explanation of the University Endowment Fund. 

The U-M Office of Budget and Planning also has a video that explains how endowments work.

Q. Are experienced nurses leaving Michigan Medicine?

A. Over the past two years, Michigan Medicine has been experiencing an increase in “internal churn,” which is a term our recruitment team uses to describe internal transfers. Nurses are not leaving the organization, but they are transferring to new units. In fiscal year 2022 (through May) 791 nurses have transferred from one unit to another. We typically have approximately 500 transfers per year. Overall, we are very pleased that our nurse vacancy rate is 5% compared to the current national average vacancy rate of 17%.

This internal churn can lead to some units experiencing higher turnover than other units but does not mean that nurses are leaving the organization. In fact, our separation rate for fiscal year 2022 (through March) is 8.1%. The national average in 2021 was 22.5%.

Q. Why are so many of the newly hired nurses recent graduates?

A. June and July are typically a time of increased hiring for new nurses because many are graduating nursing school. Of nurses hired over the summer months, a higher percentage are new graduates simply because of the timing of year. Our recruitment team works hard year-round to recruit new and experienced nurses to Michigan Medicine, but summer is the best time of year to hire newly graduated nurses.

Q. What does it mean that Michigan Medicine maintains staffing ratios at the 75th percentile?

A. Michigan Medicine utilizes the National Database of Nursing Quality Indicators (NDNQI) when budgeting for and scheduling staffing on inpatient units. This database tracks a metric called “hours per patient day” or HPPD. HPPD is a measurement of the average number of hours needed to care for each patient on a given unit. Other areas (Ambulatory, ED, OR/PACU) do not utilize HPPD but apply similar principles when budgeting and scheduling staff.

When budgeting for staff and building the schedule, we staff for the number of hours needed, not the number of individual nurses.

We aim to staff between the 50th and 75th percentile, which does not mean that we have a “grade C” for our staffing, it means that we have staffing levels that are in the top 15-20% of hospitals across the country that participate in the NDNQI.