SDHSA MOVES QUICKLY TO PROTECT UCSD HOUSE STAFF!

March 31, 2020

SDHSA Moves Quickly to Protect UCSD House Staff During this Pandemic!

            SDHSA is taking action! SDHSA received a number of reports of incidents (regarding PPE etc.) which may have placed UCSD House Staff in danger from the COVID-19 Pandemic. SDHSA responded immediately developing new policies and proposals to protect the House Staff and their families. Among the measures that SDHSA has just taken was to file a Formal Grievance on March 30, 2020 with UCSD. The Grievance addresses various policies and procedures including:

  1.          SICK LEAVE POLICY & PRACTICE

            The SDHSA understands the House Staff have numerous requirements, including minimum clinical time, procedures, and case numbers, dictated by ACGME and other oversight organizations. Yet, these factors do NOT override the considerations of personal health and the safety of all involved. Recently, it has come to the attention of the SDHSA that some Departments may either explicitly or implicitly prohibit the taking of accrued Sick Time off or, affirmatively discourage House Staff from doing so.[1] Even if someone does take an accrued paid Sick Day off,  it appears that some Departments often demand that the Sick Days be “made up.” The situation appears to be aggravated by UCSD’s policies which have created a “culture” of either “guilt” or “just don’t even ask” so that House Staff feel that they must not take any sick time off.

SDHSA has demanded:

  1.          Affirm Sick Time Available. The University immediately issues a Statement to the heads of all Departments reminding them of their duties under the law and the MOU and to cease and desist from discouraging House Staff from using accrued Sick Time.
  2. Effect on Completion of Programs. Each Program should work directly with the appropriate oversight organizations to develop and make policies that include administrative leave / other options for sick or COVID-19 exposed residents which might prolong their residency and thereby also preventing House Staff from advancing to the next PGY year or starting jobs or fellowships on time.

2. PERSONAL PROTECTIVE EQUIPMENT (PPE)

SDHSA has demanded:

  1.          Guaranteed PPE. All House Staff shall be guaranteed free and timely access to adequate Personal Protective Equipment at all locations they are assigned to work. This should include at least one (1) new N95 or equivalent mask per house officer per day.
  2. Personal PPE. In the event of a shortage of PPE, allow individuals to supply their own PPE and offer free and timely “fit testing” for such PPE.
  3. IPads / Non-Contact Systems. Encourage nurses to minimize exposure and PPE use by employing systems to decrease entrance to rooms. This includes UCSD providing IPads for patient-provider communication located in a safe place for all COVID-10 r/o positive room. This includes an IPads in every room in ED.
  4. Create a PPE Ombudsman for Each Location.  UCSD to implement a monitored PPE Ombudsman immediately reachable by telephone number at each hospital / work location so that a Physician may immediately report and obtain a resolution of a PPE request / denial situation. House Staff should not feel compelled to enter what they consider a dangerous situation and/or lose their job to have the providing / issuance of requested PPE determined at a later date and time after they have already been exposed.
  5. Sterilization. If new PPE is NOT available, provide for sterilization / cleaning apparatuses for decontamination for mask and other PPE re-use.
  6. Scrub Machines.  All House Staff to have access to scrub machines.
  7. Lockers. UCSD to provide lockers to House Staff for storage of PPE to allow for re-use of PPE.

3.    COVID-19 TESTING

SDHSA has demanded:

  1.          Priority Testing. Free, priority, on demand access to COVID-19 Testing for House Staff.
  2. Self-Quarantine. The option to self-quarantine for House Staff Exposed to COVID-19.
  3. PCP Availability. Expedited or dedicated PCP availability for House Staff. UCSD should have one (or several) PCPs be made readily available specifically for House Staff who fall ill. A dedicated hotline for residents to call to arrange expedited care would also be a potentially helpful solution.
  4.     ENT

4. PAY FOR ALL REQUIRED EQUIPMENT

SDHSA has demanded: UCSD immediately implements a policy of providing and/or reimbursing House Staff for all required equipment and/or reasonably necessary equipment to perform their assigned duties. This is to include reimbursing any expenses incurred by House Staff in acquiring such safety and protective equipment because UCSD failure or inability to provide it to House Staff at the time they need it to perform their assigned employment.

5. COMMUNICATION AND TRANSPARENCY TO HOUSE STAFF DURING CRISIS

SDHSA has demanded:

  1.          PPE Transparency: The University needs to disclose the AMOUNT and TYPE of PPE which is available at each location. SDHSA demands that UCSD publish and/or communicate with all House Staff via email, publication on the University website or other form, the daily mask, glove, gown, hat count, supply chain status, burn rates and what is the UC doing to ensure adequate supply.
  2. VOLUNTARY ASSIGNMENT / HAZARD PAY: House Staff pulled from other rotations to serve on “overflow” teams should be strictly voluntary and should come with adequate additional compensation as a result. House Staff should NOT be forced to serve as the “emergency pool” of physicians that the hospital gets to call on in a time of crisis.

SDHSA has demanded:

  1.          Dangerous Assignments Voluntary.  If the UC cannot meet a standard allowing House Staff to determine if their assignment is reasonably safe for them (and their family), then their assignments must become voluntary.
  2. Hazard Pay. Hazard Pay should be available for those who voluntarily accept assignments which exposes them to COVID-19.
  3.          Fellow Moonlighting Pay. Fellows are allowed to have moonlighting positions under their contracts with UCSD.  If Fellows volunteer to work as attendings, they should be entitled to reimbursement at a moonlighting hourly rate. 
  • 6. BENEFITS      
  •          Free Lodging.  UCSD should pay 100% for lodging for House Staff who are Quarantined, Exposed and may not safely return to their home or Other relevant circumstances.
  • Lodging Approval. House Staff should not require daily approval (this is cumbersome and impossible as a resident). Approval should be good at least for a week or the term of their assignment to a dangerous situation.
  •      7.     ACGME REQUIREMENTS DURING COVID 19

            SDHSA has demanded: It should be incumbent upon UCSD to facilitate these adaptations by contacting the Board’s directly on behalf of all House Staff.

  •        8.    NO RETALIATION

            The options and personal choices given to House Staff during this crisis MUST be available without risk of retaliation, termination nor suffering any career repercussions or punishment.

Join: SDHSA continues to work tirelessly on behalf of the House Staff. But we need your support. SDHSA is sustained solely by Membership Dues. If you are NOT a member – please join now. https://www.sdhousestaff.org/. Stronger Together!


[1] See See Selected Questions & Answers from SDHSA’s House Staff Survey 2020 Re: Sick Days and Providing Protective Clothing.