Memorandum of Understanding for Cardiac Surgery

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					                                       Memorandum of Understanding
                                           Nurse Practitioners

The existing NP MOU (originally agreed to on 9/24/2008), paragraph 745 was revised as follows effective

The University and the Association agree to the following:

Salary Setting
Each Nurse Practitioner will be assigned to one of three tiers upon implementation of this memorandum
for incumbents and upon hire for future hires. The tier designation is determined by the work, the
complexity of the assessment and management required by the patient population, the stability of those
patients and the level of technical skills that must be employed. If an incumbent’s base salary exceeds
the maximum of the range for the NP’s calculated points, that individual’s base salary will not be reduced.
Additional base increases may not be awarded until the individual’s salary is within range, of the
appropriate tier. Salary that would have been awarded in base will be provided in a lump sum gross
wage payment. Salary range will be adjusted each year to reflect any institutional increase provided for
Advanced Practice Professionals.

 Tier #1                              Tier #2                            Tier #3

 Outpatient,   primary    care,       Inpatient, sub-acute care          Predominately critical care of
 psych/counseling, H & Ps and         and/or               outpatient    patients requirements continuous
 management      of    common         management of complex              monitoring    and      interventions,
 problems,                            problems of relatively stable      unstable patients and          highly
                                      patients      and/or     using     technical interventions.      Special
                                      technical interventions            labor market differentials/incentives
                                                                         as applicable

Placement on the appropriate salary scale will be determined by:
    1. Tiers
        Tier #1 = $66,580-$86,560-$106,540 (Minimum starting salary = $66,580)
        Tier #2 = $73,240-$95,210-$117,180 (Minimum starting salary = $76,220)
        Tier #3 = $80,560-$104,730-$128,900 (Minimum starting salary = $87,551)

    2. The number of points, determined by
           NP Experience = 1 point per year
           Non-NP RN Experience = 0.75 point per year, 7 year maximum
           Related non-RN Clinical Experience, or additional RN Experience in excess of 7 years
           (effective February 1, 2010) = 0.50 per year, 5 year maximum.
           Total possible points for Non-NP RN Experience, related non-RN Clinical Experience and
           additional RN Experience remains 7.75 points.
           Intent Note: Any calculation found to be in error after the implementation of the NP MOU
           amendment may be brought forward to and corrected by Human Resources.

Target Audience: Nurse Practitioners | Author/Contact: Rus Lauren | Last reviewed: 6/2/10                        1
Tier #1

0-4 points = $66,580-$76,734
5-8 points = $74,161-$83,666
9-14 points = $80,861-$91,041
15-23 points = $87,989-$98,325
24+ points = $95,028-$106,433

  Tier #2
Minimum starting salary $ $76,220
0-4 points = $76,220-$85,260
5-8 points = $82,401-$92,720
9-14points = $89,611-$100,713
15-23points = $97,336-$108,707
24+ points = $105,061-$117,182

Tier #3 (includes Neonatal and Cardiac Surgery *)

0-4 points = $87,551-$96,131
5-8 points = $92,907-$101,779
9-14 points = $98,336 - $107,641
15-23 points = $104,031-$115,101
24+ points = $111,241-$128,895

* Cardiac Surgery/Heart Failure Special Labor Market
Minimum starting salary $87,882
0-4 points = $92,882 - $102,686
5-8 points = $98,346 - $110,595
9-14 points = $103,810-$121,857
15-23 points = $115,764-$130,088
24+ points = $123,584-$141,087

Target Audience: Nurse Practitioners | Author/Contact: Rus Lauren | Last reviewed: 6/2/10   2
Neonatal Nurse Practitioners
An employee in the Neonatal Nurse Practitioner role will be eligible for a quarterly bonus of $1000
retroactive to January 1, 2009. Bonuses shall be prorated for part-time employees. The quarterly bonus
periods shall begin on January 1, April 1, July 1, and October 1, as the case may be. Eligibility for a bonus
payment shall be forfeited if a full-time employee is absent for any reason, except for scheduled Paid Time
Off or holiday time off, in excess of one hundred twenty (120) hours in a given quarter. Part-time employees
shall have absences prorated when making this calculation.
Salary Progression
Once placed at the appropriate base salary upon hire (or implementation of this agreement), salary
progression will occur annually, based on an annual performance review, through merit increases
awarded at the discretion of the University, consistent with the department’s salary program and/or labor
market adjustments.

On October 1, 2010, following the September implementation of the salary program (see attached Letter
of Intent), the Association, Nursing Administration and HR will jointly review the distribution of salary
increases to NPs to identify any salary increase of less than 2%, and review the rationale which led to the
decision. An NP receiving a salary increase of less than 2% may employ the dispute resolution

Additional Pay:

 A.      Additional Hours

         1.        Workload Review: NPs may be required to periodically work extra hours to meet the
                   needs for patient care without compensation. NPs may request a workload review
                   meeting with Nurse Manager/Clinical Director and Association Representative to review
                   concerns of excessive workload or persistent additional hours related to patient care.
                   The meeting will take place within seven (7) calendar days of request. Following a
                   review of data, the Employee, Nurse Manager/Clinical Director, and Association
                   Representative will review a number of possible actions, including but not limited to
                   temporary modification of task expectations, obtaining additional personnel, resources
                   and modification of work load.

                   The issue(s) presented and the outcomes of the meeting will be documented by the
                   Nurse Manager/Clinical Director and provided to the Director of Nursing, Association
                   Leadership and Human Resources within seven (7) calendar days of the meeting’s

         2.        Additional Compensation: If the excessive workload or persistent additional hours
                   continue after a workload review meeting is held, additional compensation, if approved
                   in advance by the Nurse Manager, Nursing Director and/or Department Administration,
                   may be provided when additional effort is expected for an extended period of time.
                   Reasons for additional compensation can include, but are not limited to:
                     a) Staffing Shortage
                     b) Work schedule does not permit flexibility
                     c) Work cannot be delayed to a different time period or transferred to other staff.
                  Approval for additional compensation will not be unreasonably withheld.

 B.      Additional Shifts: NPs who work additional shifts of at least four hours that cannot be provided
         an equal amount of time off within three (3) months will be compensated for that time at their
         regular rate of pay. At the time that the work is occurring and with mutual agreement, the three
         (3) month time frame for providing equal time off may be extended to six (6) months.

Target Audience: Nurse Practitioners | Author/Contact: Rus Lauren | Last reviewed: 6/2/10                     3
$6.13 per hour for all Tiers.

Shift Differential:
Effective February 1, 2010, $3.00 per hour for Evening and Night Shifts

Evening: Shift starting at or after noon but before 8:00 p.m.
Night: Shift starting at or after 8:00 p.m. but before 4:00 a.m.

Additionally, Departments may choose to individually fund additional pay to cover off-shifts, weekends
and holidays.
Professional Development:
Each Nurse Practitioner will receive a minimum of $1500 per year prorated by appointment fraction for
the purpose of professional development & continuing education (CE). The approval process related to
the use of professional development funds will be determined by each unit/department. Other
certifications, including but not limited to ATLS, PALS, NRP or ACLS, required by a section or department
will be funded separately by each department and will not be included in the annual allocation of
professional development funds for the individual nurse practitioner.
Use of professional development funds may include, but is not limited to: membership to professional
organizations, funding for specialty certifications, books, online continuing education programs, and
computer software designed to enhance professional growth and development.
Posting and Selection Process
The University will post open positions in the following manner:
The position “Nurse Practitioner” will be posted in those instances in which the work involved is uniquely
appropriate to be performed by a person who is qualified as a Nurse Practitioner.
A posting for an “Advanced Practice Professional” is one for which the body of work is reasonably
undertaken by a Nurse Practitioner or another non-physician professional credentialed to perform
delegated medical functions
When the University posts a position for a non-physician professional credentialed to perform delegated
medical functions, nurse practitioners may also be considered. Eligibility to apply will be indicated on the
Postings for all such positions will clearly describe the required and desired qualifications that will be the
selection criteria.
Hiring decisions will be made using most qualified selection criteria. If the Nurse Practitioner applicants
are equally qualified, then the selection will be made on the basis of seniority, highest to lowest.
Other Provisions
In areas in which NPs work and provide cross-coverage with other non-physician professionals
credentialed to perform delegated medical functions, scheduling of work and time off will be integrated to
the extent feasible; if a Reduction-In-Force occurs, the order of reduction will begin with the staff member
with the least University service (seniority), except that the University may retain employees, irrespective
of service, who possess the necessary skills, knowledge, and abilities to perform the available work which
are not possessed to the same degree by other employees in the same classification.

In the event an employee believes the placement on a tier and/or within a point range is not correct, the
University of Michigan Health System Human Resources Department will review the matter, provided the
request for review is made within the thirty (30) calendar day period following the date of execution of this
Parties will meet no later than January, 2010, to consider the terms of this MOU and the internal and
external labor market conditions as potential for change in these terms, and otherwise to consider the
interests of either party in connection with the employment of Nurse Practitioners.

Target Audience: Nurse Practitioners | Author/Contact: Rus Lauren | Last reviewed: 6/2/10                        4
Unless otherwise provided by this MOU, all other terms and conditions of the existing agreement will

Target Audience: Nurse Practitioners | Author/Contact: Rus Lauren | Last reviewed: 6/2/10              5

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