Union, Heal Thyself

In exchange for increased membership, the SEIU promised to use its clout with Sacramento Democrats to advance nursing home industry interests. This meant steamrolling the nursing home industry's traditional political enemies — including AARP and health advocates for disabled and elderly residents. Patients' advocates rankled healthcare executives by demanding that any increases in government subsidies be linked to specific requirements similar to a patients' bill of rights by increasing oversight and accountability, expanding and training staff, and taking better care of patients. They insisted that without these kinds of safeguards, the nursing home company owners and administrators would simply keep the money. It was this standoff the SEIU helped break.

Once the alliance deal was inked in 2004, the SEIU went to work sponsoring a bill — in defiance of patients' groups — that increased government subsidies by more than $1 billion. Notably, it did not include the accountability measures favored by AARP and others. "Without mandated staff-to-resident ratios and no increased staff training requirements, the bill does not foster increased quality of care," the bill's Assembly analysis summarized opponents' concerns at the time.

When I spoke with Thomason last week, he seemed committed to rewriting this history, painting a misleading picture of the SEIU lobbying agreement. He also mouthed nursing home industry criticisms of the new UCSF study, and attempted to downplay his own involvement in the 2004 bill. Before taking his current job as chief lobbyist for UHW-West, he was a health policy consultant for Assembly Majority Leader Dario Frommer, author of the 2004 bill. "There was a whole coalition that involved the nursing home industry and SEIU and senior advocates," Thomason said. "It had a lot of support right out of the gate."

Pat McGinnis, executive director of California Advocates for Nursing Home Reform, recalls it differently. "It's absolute bullshit to pretend they had wide consensus among seniors' groups," he said. "The people it was going to affect in the first place were adamantly opposed to the bill going forward without accountability and quality of care standards being included. For him to say that there was consensus, he simply knows that that is not accurate."

When I spoke with Vellardita, he backed Thomason's claim that the new UCSF study is premature: "Studies suggest the verdict is not in," he said.

The study's lead author begs to differ. "The industry is claiming it's too early to tell, but they got the money, and they spent the money," Harrington retorted. "It's quite a bit of money, and they made decisions about what to do with it."

It's now up to UHW-West to retake the moral high ground and lobby for some fundamental changes that guarantee better care. "Our position is that changes have to occur," Vellardita said after I spoke with Thomason.

Let's hope so.