Over and over, privatization schemes in New Jersey have failed consumers, workers, and taxpayers alike, often raising costs and diminishing services for the public. It is particularly concerning when the costs can be in the lives of our most vulnerable, elderly and residents with mental illnesses. The lease of Bergen Pines, NJ’s largest hospital, to a private company nineteen years ago was a particularly egregious example of a lopsided contract that gave millions in profits to a private company with little accountability to the taxpayer.
The contract between the Bergen County Improvement Authority (BCIA), and Solomon Health Group to operate Bergen Regional Medical Center (BRMC) is coming to a close in a year. Bergen County Executive Tedesco has established a task force to review the history and develop recommendations for the future of the hospital. We have a chance to do it right this time, and cannot repeat the mistakes of the past.
Health professionals and community advocates opposed the privatization back in 1997, raising numerous objections to the sweetheart contract. Some of our worst projections came true at a hospital critical to providing mental health, long-term care, and addiction services for all of New Jersey.
While the privatization plan left the Bergen County Improvement Authority (BCIA) with the operating license for the hospital, the private operator had the controls, with little accountability. Secret loans, a lack of financial transparency, insider-dealing, staff and service cuts, lawsuits, compromised patient care, and labor disputes all plagued the earlier days of the privatization contract.
The County and hospital managers have been embroiled in years-long lawsuits over investments to improve the aging buildings and infrastructure, over cuts in services, loans and financial transparency. No one has yet to really add up the real cost of the contract, in lawsuits or millions in affiliate fees and owner profits.
While Solomon paid for maintenance, the County paid for capital improvements: it seemed that everything became a capital improvement. While the BCIA was technically responsible for upholding patient safety laws and regulations, they often were not even informed of violations. When services were cut, the BCIA was essentially powerless to force a reinstatement of services. A bottom-line standard for nurse staffing levels was too often skirted by the hospital, with no consequences.
Over the years, County administrations have come and gone, but the failures of the original contract made accountability and oversight nearly impossible. Whoever the hospital partner is in the future, the contract has to maintain County authority and responsibility for access to quality care and essential mental health services, and ensure a safe and secure work environment for dedicated nurses, social workers and staff.
HPAE, with 500 nurses and health professionals at BRMC, has witnessed and challenged both Solomon Health Group and the County administration when privatization and cost-cutting threatened the health and safety or patients and workers. That’s why we’ve drafted a set of standards that we are asking the County Task Force, the County Executive, and our local elected officials to make sure is part of any agreement with outside companies or partners.
- Improved Oversight & Authority: The BCIA must retain the license to operate the hospital and the authority to ensure full compliance with patient safety, financial reporting, governance and labor laws and regulations.
- Protection of the Hospital’s Mission for Patients: Preference should be given to not-for-profit partnerships that focus on the mission of the hospital.
- Effective Enforcement: Strengthen remedies for contract violations, such as financial penalties and appointment of on-site monitor.
- Safe Staffing Requirement. Set safe standards for nurse and caregiver staffing for all hospital units.
- Service Protections and Enhancements. Determine services based on community need and protect and expand services, with BCIA approval for any change or reduction in health services.
- Workers’ Rights Protections. Recognize existing unions, collective bargaining agreements, and rights of the workforce.
- A Proven Track Record Review every applicant’s track record for patient/resident safety, employee safety, labor relations and financial transparency.
- Investment in A Safe Facility for Patients and Workers: Make needed capital improvements, with shared financial responsibility for maintenance and improvements.
- Accountability to Taxpayers & Financial Transparency. Require annual audited financial statements for BRMC and any affiliates with business or financial relationship, and provide financial information to the public through the NJ Open Public Records Act.
- Public disclosure of Self-dealing and a ban on conflicts of interest. Require disclosure and prior review and approval by the County of all transactions between a partner or manager and any of its related or affiliated entities.
For the first time in years, nurses, health professionals, and patient advocates have reason to be encouraged by the actions of our County Executive. Bergen County Executive Tedesco’s had made a commitment to protect our hospital and its patients, to enhance services and provide accountability. The future of Bergen Regional Medical Center and the fragile population we serve are depending on us to do it right this time.
Ann Twomey is President of Health Professionals and Allied Employees (HPAE)