What's in a CIR contract?
Negotiated contracts between the employer and the employees are called “collective bargaining agreements.” CIR contracts not only document the terms and conditions of employment for housestaff at each hospital, but, very significantly, make enforceable those hard won gains. Because of different local needs and priorities, these collective bargaining agreements vary somewhat from one hospital to another. CIR negotiating committees —made up of housestaff from different departments and PGY levels, working with a CIR staff member— bargain diligently to win the best contracts possible.
Among the elements we work to include are clauses covering:
- Salary increases for each PGY level
- Health and other insurance benefits
- Malpractice coverage
- Cap on the number and frequency of on-call periods
- Specific dates for renewal/non-renewal notice of individual contracts
- Vacation and other leave time
- Sick, maternity, and disability leaves
- Fair disciplinary procedures with due process
- Grievance procedures leading to outside, impartial arbitration
- The right to be represented by CIR at negotiations, grievance meetings and hearings
- Protections from excessive assignments of “out-of-title” (non-physician) work
- Prohibition against discrimination based on race, gender, national origin, place of medical education, sexual orientation and age
- Access to one’s own personnel records
- Health, safety and security issues
- Program security, ensuring housestaff the right to complete their residency program
- Orientation pay
- On-call meals
- Evidence based work hour scheduling
- On-call pool compensation
- Good conditions for on-call rooms and lounges
- Professional education allowance
- Patient care funds
Below are some samples of actual contract language in different CIR collective bargaining agreements.
“All incoming residents shall be paid for orientation and/or work performed prior to July 1st of their first year, or they shall receive equivalent paid time off no later than June 30th of the academic year.”
Boston Medical Center
Boston, MA
“The County will arrange that the food left over from the food prepared daily for house staff and other physicians be packed, stamped with preparation dates and stored at the end of the day so that the food is available for the night meal. The County will prepare sufficient food daily to ensure that healthy night meals are available for all house staff who are assigned to nighttime duty or in-hospital on-call duty.”
Los Angeles County Hospitals
Los Angeles, CA
“The parties recognize the growing body of evidence linking increased medical errors with extended housestaff shifts of greater than 16 hours. These extended shifts have also been found to correlate with an increased risk of serious car accidents among housestaff. In the interest of maximizing patient safety and housestaff well-being, the PHT and CIR agree to form an Evidence Based Scheduling Committee to identify shifts greater than 16 hours and to implement strategies to eliminate these extended shifts six months after ratification of the contract.”
Jackson Memorial Hospital
Miami, FL
“Services will be provided for the movement of patients and materials…seven days a week, 24 hours a day for both routine/stat calls. “Phlebotomy services, including blood culture draws, shall be available twenty-four (24) hours a day, seven (7) days a week. IV Therapy Services, to start and maintain routine IVs, will be provided to all general care inpatient areas 24 hours a day, seven days a week.
“Clerical services will be provided [on inpatient areas] 16 hours a day, seven days a week.”
Boston Medical Center
Boston, MA
“A house staff officer who performs on-call duty for an absent or disabled colleague in addition to his/her anticipated normal schedule shall be compensated according to the following: $550 weekday, $650 weekend and holiday.”
Westchester Medical Ctr.
Valhalla, New York
“The County shall provide safe, secure on-call rooms, bathrooms and shower facilities which are readily accessible to patient care areas. On-call rooms shall be designated as smoke-free areas and properly maintained with adequate temperature control. The number of on-call rooms shall be sufficient for all housestaff officers on duty at night.
“On-call rooms shall have functional locks and the room key shall be available to each housestaff officer. On-call rooms shall be properly maintained seven (7) days a week. Where possible, on-call rooms shall be equipped with large-sized lockers for the secure storage of each housestaff officer’s personal effects.”
Los Angeles County Hospitals
Los Angeles, CA
“Effective January 2007, Trust shall provide each HSO $1,250 per residency academic year to be used as reimbursement for professional/educational expenses.”
Jackson Memorial Hospital
Miami, FL
“A $1,900 non-taxable, reimbursable professional education stipend shall be paid annually to each House Officer…Any House Officer who has not turned in receipts for the total amount of the annual stipend by May 1st of that year shall receive a payment (taxable) equal to the difference between the total annual stipend and the total reimbursable expenses claimed and documented by said House Officer.”
Cambridge Hospital
Cambridge, MA
“The amount of the CIR Quality Patient Care Fund will be $2.2 million each year. Mutual agreement of the administrative ‘team’ of 5 and a resident ‘team’ of 5 shall be required to initiate the authority to expand.”
Los Angeles County Hospitals
Los Angeles, CA
“Effective each April 1st and October 1st, the Corporation shall transfer a sum equivalent to 0.15 percent of the Gross Annual Payroll of housestaff officers to the Patient Care Trust Fund.” [This fund, which receives approximately $165,000 twice a year, is controlled by the CIR Executive Committee members in New York City.]
Health and Hospitals Corporation
New York City
>> Learn more about Patient Care Funds
