IOWA CITY — At 5:02 a.m. July 27, the Surgical and Neurosciences Intensive Care Unit in the University of Iowa Hospitals and Clinics sent a group text message to the nursing staff seeking help:

“SNICU is in need of RNs today.”

The next day, at 4:36 a.m., another text went out, this time seeking both registered nurses and nursing assistants willing to work extra shifts — over and above the regular assignments.

The daily texts seeking help continued at 5:31 a.m. July 29, with a second one coming later just before noon. And again July 30 and July 31, both before 6 a.m.

But if a nurse answers one of the calls for help and agrees to work an extra shift, he or she likely won’t see any extra pay from that for many weeks — a change from the way the UIHC compensated its nurses before the Iowa Legislature in 2017 stripped away many of the collective bargaining rights of public sector workers.

Melinda Myers — one of the staff nurses who collectively account for nearly two-thirds of the Service Employees International Union membership of more than 3,800 UIHC staffers — no longer answers such pleas.

“I don’t work overtime anymore,” Myers, 46, of Palo, told The Gazette.

Having spent her entire 21-year nursing career at the UIHC, Myers cited several reasons for rebuffing the recent requests, including that supervisors are “floating” volunteers to other units and putting them into situations for which they aren’t trained.

“The other reason is they just don’t care if you do it,” she said. “Your co-workers will say thanks for coming in. But it’s like any other day to administration.”

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Though nurses at the UIHC are classified as exempt — meaning they are salaried and as such do not get “overtime” pay — the university in some respects treats them as if they are hourly employees. They must clock in and out. And they get time-and-a-half “extra time” for working more hours. But when they see that extra money now has changed.

Before the GOP-led legislative changes to Iowa’s Chapter 20 collective bargaining law, the SEIU nurses worked under a contract that called for being compensated in the next paycheck for the extra shifts — and being paid time and a half for extra shifts, even if they had taken paid time off.

But the law changed, and so did the deal.

Before the legislative changes, UIHC nurses were paid extra time “based on hours worked as well as some hours not actually worked, including time spent on vacation,” said UI spokesman Tom Moore. But the federal Fair Labor Standards Act stipulates only hours actually worked need count toward the 40-hour threshold — meaning vacation and sick leave can absorb extra hours until the number actually worked reaches 40.

“After the Chapter 20 changes were implemented, overtime and supplemental pay became non-mandatory subjects of bargaining, and the state chose to count hours worked for the purposes of calculating overtime,” he said.

The university — which replaced the lengthy SEIU contract with an employee manual amended to its liking — “followed suit for all employees, including bargaining employees,” Moore said.

In the latest round of a government-mandated survey of more than 4,000 hospitals nationwide — submitted in September 2018, well after the collective bargaining changes went into effect — the UIHC scored below statewide averages for patient satisfaction in all but one of 10 categories, and below the national averages in all but three.

One of the questions asked patients to say if nurses “explained things clearly, listened carefully to the patient, and treated the patient with courtesy and respect.”

The percentage of UIHC patents who said nurses “always” communicated well — 77 percent of respondents — was below both the state and national averages.

The survey also asked about the ability to get help from available hospital staff “quickly when they used the call button or needed help in getting to the bathroom or using a bedpan.”

The UIHC rated only two of five possible stars in that category. Ten percent of the UIHC respondents — twice the statewide and national average rates — said they “sometimes” or “never” got the help.

‘This practice must cease immediately’

SEIU attorney Jim Jacobson sent the university a letter in November spelling out concerns about the slower pace of compensating nurses for the “extra time.”

Quoting Iowa Code, Jacobson wrote, “An employer shall pay all wages due its employees … at least in monthly, semimonthly, or biweekly installments on regular paydays which are at consistent intervals from each other and which are designated in advance by the employer.”

Extra time counts as wages, Jacobson argued. And a regular payday, according to the law, “shall not be more than twelve days, excluding Sundays and legal holidays, after the end of the period in which the wages were earned.”

But under a new pay schedule, which was provided to The Gazette, nurses who amassed extra time between Jan. 28 and March 10, 2018, for one example, didn’t see that reflected until their May 1 paychecks. Extra time earned between June 3 and July 14 that year was not paid out until Sept. 1, according to the new schedule.

“I am unaware of any agreement that allows for this payment schedule,” Jacobson wrote to UI Vice President for Legal Affairs and General Counsel Carroll Reasoner. “I am writing to inform you that this practice must cease immediately. I would also request that you notify me in writing whether you plan to discontinue this unlawful practice, and if so, when.”

UI Human Resources responded two weeks later, refuting allegations of breaking the law. The UIHC pays union employees on or around the first of each month “for their salaried wages” earned the past month, Human Resources Associate Vice President Jana Wessels wrote.

Adjustments for SEIU employees — like extra time — “must be calculated after the end of the six-week period in which they are earned and then are paid in the next available paycheck.”

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UIHC spokesman Moore stressed, in response to questions from The Gazette, the hospital’s nurses are salaried staffers who earn guaranteed monthly wages.

“On top of this, although not required by their contract or law, we choose to pay extra compensation to those who take on extra hours,” he wrote in an email. “This is in recognition of their important work in caring for our patients, who need us around the clock. This compensation is paid after the fact. And, given their six-week work schedule, would sometimes be included in the next pay cycle.”

‘UIHC will save thousands’

Documents provided to The Gazette show the UIHC began using an extended payout schedule in July 2017 — after lawmakers stripped the Chapter 20 collective bargaining rights. An SEIU assessment of extra time earned by members of its bargaining unit — based on information it received from the university — shows the number of extra hours tallied and paid out plummeted in fiscal 2017 and 2018.

Where union members accumulated 161,445 extra hours in fiscal 2016 — costing the hospital $7.7 million — they tallied 79,235 hours in fiscal 2017, costing $3.8 million.

The following year, that number dropped again to 36,600 hours, costing $1.7 million.

Those decreases came even as overwhelmed units across the packed hospital — 811 beds often more than 90 percent full — requested nurse volunteers willing to take on extra shifts. And in trying to fill gaps, the UIHC turned to “traveling nurses,” those coming from outside the hospital and earning premium pay but not employee benefits.

The university in late June 2017 told The Gazette it was using the full-time equivalent of 216 traveling nurses — or 240 total — with many earning a starting hourly rate of $59. Working a standard 2,080 hours a year, that 216 could cost the hospital more than $26 million a year.

In comparison, the average total base compensation for a staff nurse, including benefits, is $89,865 — $43.20 an hour.

At that time, UIHC was reporting 2,648 staff nurses, with a full-time equivalent of 2,244.

As of last month, the hospital had 2,418 staff nurses — or the full-time equivalent of 2,018, according to UI officials.

Following efforts to dramatically reduce its reliance on traveling nurses, it slashed that contingent to 40, the full-time equivalent of 38.6.

Those staffing dips come even as the hospital grows and reaches record patient numbers.

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“There’s a lot of need, and we’re willing to work for it,” said April Haven, 36, of Cedar Rapids, who’s worked in a UIHC intensive care unit for nine years. “If I worked an overtime shift and they wrote the check tomorrow, I would do it.”

But Haven said she typically doesn’t take extra shifts because of the lag in compensation.

“We can’t wait that long,” she said. “We should be paid more frequently.”

As a single mother juggling schedules and budgets and employer demands, Haven said, the changes have been “very frustrating.”

“If I’m going to work overtime, I want the money now,” she said. “I don’t want the money a month and a half from now. I don’t feel you should have to watch the calendar for when it’s picked up. I feel you should have it paid in your next paycheck.”

Myers, the veteran UIHC nurse, said requests for extra help are coming so often and being ignored by so many that she foresees mandatory shifts — or extra time — on the horizon.

“It’s getting to the point where people are getting denied vacation days because there is not enough help,” she said.

In response to The Gazette’s requests for total extra time paid to staff nurses for the 2018 and 2019 budget years, the university said the data is not readily available and would cost The Gazette $1,875 to get.

SEIU President Cathy Glasson said delaying extra time payments, allowing vacation and leave time to absorb some of the extra hours and extending the period of time within which that can happen has saved the hospital a lot.

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“By making it harder to qualify for overtime pay, UIHC will save thousands, if not millions of dollars on the backs of the dedicated nurses and professionals who provide care and support 24/7 to patients and their families,” she said in an email.

‘It’s not the right thing to do’

When contacted for this article, Iowa Workforce Development spokeswoman Molly Elder said the state doesn’t have an overtime law, and the matter is one for the federal government.

A representative with the U.S. Department of Labor told The Gazette it hasn’t looked into the UIHC-nursing dispute or heard from the union on the matter.

“If employees or the union believe they are not being paid in accordance with the law, they should contact the wage and hour division district office in Des Moines,” said Rhonda Burke, deputy director for public affairs at the Department of Labor’s Midwest region.

SEIU attorney Jacobson told The Gazette that even if the university isn’t violating the law — which, he notes, is not his position — it’s acting amorally with the pay.

“Even if we give them the benefit of the doubt and say that it is legal, it’s not the right thing to do — to withhold people’s payments for that long,” Jacobson said. “What’s the incentive to work overtime if I’m not going to see it for 2.5 months?”

Other nurses in state facilities sue

Nurses at the UIHC aren’t the only ones fighting changes in how they’re compensated for extra time since the legislative changes.

Registered nurses staffing state facilities — like prisons through the Department of Corrections or mental health facilities through the Department of Human Services — don’t get overtime pay any more.

In a lawsuit filed in June in Polk County, registered nurses — previously considered hourly employees, capable of earning overtime — contend the state in July 2017 “improperly classified” them as exempt from overtime laws. That reclassification, which according to the suit came after Iowa limited public union rights, separated RNs from licensed practical nurses and certified nursing assistants, who remain eligible for overtime.

About 600 registered nurses at nearly 20 state facilities have been affected by the change.

“We work in a dangerous environment,” said Christine Kleiber, a 57-year-old nurse at Coralville’s Iowa Medical and Classification Center, where she has worked since 2007. “We have multiple assaults weekly — not necessarily always staff, but offender on offender, that we get involved in.”

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For the decade before the compensation change, Kleiber was a licensed practical nurse. She used overtime money to help advance her education and become an RN — a classification she earned the day before the state’s change, removing her overtime eligibility.

Kleiber said she has considered leaving but is near retirement. Others are in different spots.

“They’ve moved on to places where they get compensated,” she said.

A Department of Corrections spokesman declined to comment, citing the litigation.

Kleiber said the change came down as a verbal edict, although attorney Bruce Stoltze Jr. — representing the nurses — said he has the pay stubs to prove it.

That’s because extra shift requests come daily — although now they’re often mandated, as few nurses see the financial incentive to volunteer.

“People used to volunteer a lot more to cover empty spaces,” Kleiber said. “Now the mandate list is used every day because there’s not enough volunteers. So you go to work pretty much every day planning on being forced. You go prepared with extra food and extra water. You prepare your family for you not to be home that evening.”

These changes at the UIHC and other state public facilities are happening even as Iowa scrambles to fill nurse vacancies — listing associate nursing degrees and practical nursing programs at community colleges as eligible for a new “Future Ready Iowa Last-Dollar Scholarship” aimed at encouraging students to get degrees and certificates needed to fill “high-demand” jobs.

SEIU President Glasson — who ran for governor last year as a Democrat — said the state’s treatment of its nurses will counteract the goals of those scholarship efforts.

“What the Iowa Board of Regents and UIHC administration have done by changing how they pay overtime to nurses and professionals shows their true anti-union and anti-worker colors,” Glasson said.

Comments: (319) 339-3158; vanessa.miller@thegazette.com