BCNU Update Magazine May 2016

MAY 2016 SPECIAL ISSUE

ONE CONTRACT FOR ALL NURSES

A STRONGER VOICE TO ADVANCE BLUE Rx FOR IMPROVED ACCESS TO DRUGS THE PROFESSION OF NURSING

UPDATE BRITISH COLUMBIA NURSES’ UNION

ON MAY 10

NURSES VOTE

WWW.BCNU.ORG

GET INFORMED! HIGHLIGHTS OF PROPOSED PROVINCIAL COLLECTIVE AGREEMENT INSIDE

May 2016_Special Issue_final.indd 1

4/25/2016 11:47:59 AM

BCNU MEMBER PORTAL

INFORMATION THAT MATTERS TO YOU BCNU is pleased to offer a dynamic member portal – a space to access information that’s as unique to you as the region you work in.

Calendar event registration • register online to attend events in your region, including meetings, training, workshops and conferences

Take advantage of members’ – only information • new bargaining language • forms • surveys • exclusive offers available only to BCNU members

Easily access your personal information • find out which region you work in • look up your BCNU leadership team, including your worksite steward • update your profile info online, quickly and easily • look up your BCNU membership ID number

If you experience problems signing in, please contact the membership department at memberservices@bcnu.org.

May 2016_Special Issue_final.indd 2

4/25/2016 11:48:20 AM

3

UPDATE MAGAZINE May 2016 Special Issue

UPDATE

•

•

CONTENTS vol 35 no2

may 2016

SPECIAL ISSUE

INSIDE

5 7 8 9

President’s Report

BCNU President Gayle Duteil says the proposed agreement was worth the wait.

Benefits

New contract expands drug coverage and avoids cost-sharing.

Workload and Staffing

New contract language builds on previous successes and provides new tools to achieve safe staffing.

Job Security

Key agreements were made to protect nurses from contracting out.

12 Professional Practice

Nurses will gain recognition at the higher levels of provincial policy making.

INFORMED VOTE BCNU South Fraser Valley region members vote at April 7 regional meeting and bargaining report-out. For the first time members are able to vote at polling stations ahead of the May 10 voting deadline.

14 Uniting the Nursing Family Proposed agreement will bring all nurses together under one contract.

16 Violence and Mental Health Key agreements were made to establish a culture of workplace safety.

17 Compensation

Wage increases and improved premiums will see more money in nurses’ pockets.

Improved Access NURSES’ BARGAINING

13

VOTING FOR SAFE PATIENT CARE

New Blue Rx drug plan almost doubles the drugs available to nurses.

Page 6

Over 90 percent of BCNU’s members are eligible to participate in the Nurses’ Bargaining Association ratification vote until May 10.

May 2016_Special Issue_final.indd 3

4/25/2016 11:48:50 AM

MOVING? NEW EMAIL?

BC Nurses’ Union

UPDATE MAGAZINE

MISSION STATEMENT The British Columbia Nurses’ Union protects and advances the health, social and economic well-being of our members, our profession and our communities.

BCNU UPDATE is published by the BC Nurses’ Union, an independent Canadian union governed by a council elected by our 43,000 members. Signed articles do not necessarily represent official BCNU policies.

EDITOR Lew MacDonald CONTRIBUTORS Juliet Chang, Sharon Costello, David Cubberley, Gayle Duteil, Gary Fane, Michelle Livaja, Dan Tatroff, Patricia Wejr PHOTOS Lew MacDonald

CONTACT US

STAY CONNECTED

When you move, please let BCNU know your new address so we can keep sending you the Update, election information and other vital union material. Give us your home email address and we’ll send you the latest BCNU bulletins and news releases. And if you’ve changed your name, please let us know.

BCNU Communications Department 4060 Regent Street Burnaby, BC, V5C 6P5 PHONE 604.433.2268 TOLL FREE 1.800.663.9991 FAX 604.433.7945 TOLL FREE FAX 1.888.284.2222 BCNU WEBSITE www.bcnu.org EMAIL EDITOR lmacdonald@bcnu.org MOVING? Please send change of address to membership@bcnu.org Publications Mail Agreement 40834030

Please contact the Membership Department by email at membership@bcnu.org or by phone at 604-433-2268 or 1-800-663-9991

May 2016_Special Issue_final.indd 4

Return undeliverable Canadian addresses to BCNU 4060 Regent Street Burnaby, BC, V5C 6P5

4/25/2016 11:48:51 AM

PRESIDENT’S REPORT

UPDATE MAGAZINE May 2016 Special Issue

GAYLE DUTEIL

WORTH THE WAIT

PHOTO: ALEXIS SULLIVAN WALTERS

O

N BEHALF OF YOUR BARGAINING COMMITTEE AND COUNCIL, I am pleased to present the details of our proposed agreement with health employers.

This round of bargaining was a long one, but your voice and your input at bargaining information workshops over the past two years were critical for ensuring we got our priorities right in order to achieve a balanced agreement that meets the needs of all nurses while ensuring the provision of safe patient care.

I am proud to announce that, for the first time, we have achieved a comprehensive, unified provincial contract that benefits all nurses – LPNs, RNs and RPNs – across all sectors, including the community.

This agreement will greatly advance the profession of nursing by giving nurses a stronger voice in the shaping of health care policy and delivery. Nurses will gain representation at the higher levels of provincial policy and decision making. We will see greater career development opportunities, optimized scopes of practice and increased funding for ongoing education.

A new expedited grievance and arbitration process will resolve disputes far more quickly, and build directly on the previous contract’s ground-breaking language aimed directly at addressing workload. We have also addressed job security by ensuring that no nurse will be laid off or lose benefits and seniority due to contracting out.

The agreement will see the establishment of a new provincial framework for violence prevention that supports the important work our union has been doing to prioritize nurses’ well-being and establish a culture of workplace safety.

And we have addressed the mistake that was the Pharmacare tie-in. Next year, all members will gain access to Blue Rx, an expanded formulary that greatly improves nurses’ access to prescription drugs. Almost twice as many drugs will be covered, and no member will lose existing coverage as a result of the change. Our contract also remains one of only

May 2016_Special Issue_final.indd 5

5

two in Canada where extended health care premiums are 100 percent employer-paid.

There is no denying that the bargaining environment was a difficult one. The provincial government’s “economic stability” mandate meant all public sector employers, including health authorities, were bound to negotiating five-year collective agreements within a fixed fiscal envelope.

And the so-called me-too clauses contained in other health sector unions’ contracts limited some of our options at the bargaining table. Those unions bargained fast and settled early, leaving nurses to essentially negotiate for all public sector health care workers as we aimed to achieve a superior contract for our members.

But creativity was the order of the day.

We didn’t settle early, and our negotiators skillfully managed to craft an agreement that accomplishes much considering the environment we were working in. And I’m pleased to note that – in order to prevent a repeat of the me-too clause – we have negotiated a “me first” clause that requires the next round of nurses’ negotiations to commence no later than June 1, 2018, ahead of other bargaining associations.

All things considered, the terms of this proposed contract have definitely been worth the wait. I am very proud of what our bargaining team was able to achieve. This tentative agreement took many hours and many long nights spent away from family to achieve. But it would not have been possible without their knowledge and expertise.

This contract will only be ratified if a majority of BCNU members cast ballots in favour. Your vote is your voice and, as always, your choice.

There is a lot of information to digest.

Attend one of our telephone town halls or read the contract highlights in this special issue of Update magazine to help you better understand the proposed terms of settlement. If you require more details please visit the BCNU member portal at www.

BCNU.org.

Eligible members can vote at any BCNU information session and union meeting.

You can also vote at worksite polling stations until May 10.

4/25/2016 11:48:52 AM

6

JOINT BENEFITS TRUST COST-SHARING PROPOSAL

NOT WORTH THE RISK NURSES’ BARGAINING ASSOCIATION MEMBERS stood firm against the benefits framework that was ratified by other health sector bargaining associations.

Health employers have been successful in negotiating a cost-sharing agreement model with many other unions that exposes their members to significant liability and uncertainly. These agreements, called joint benefits trusts (JBT), create a not-for-profit organization that assumes responsibility for all the assets, obligations and services associated with the provision of benefits, such as extended health, dental, group insurance and long-term disability (LTD). And as joint trustees, workers share the responsibility for financing the cost of future benefits.

Prior to the creation of a JBT, the responsibility for providing benefits rests primarily or solely with the employer. In the case of nurses, the NBA provincial collective agreement requires employers to pay for 100 percent of premium costs. Workers whose unions are not members of the NBA are required to pay a significant share of the annual costs of their health and welfare benefits.

A JBT is funded through a fixed percentage of payroll, and its members are responsible for paying for increases in drug costs and LTD payments.

Employers have been demanding JBTs to address rising benefits costs. Their biggest concern is the growing cost of LTD payments. Instead of accepting the employer’s cost-sharing framework, nurses argued that a timely and pro-active duty-to-accommodate (DTA) process would be the most effective way to address this issue.

Under the proposed agreement, the union has agreed to work with the employer to maximize the number of injured or disabled members who can be permanently accommodated. Employees will provide acceptable medical information to their employer that sets out any limitations or restrictions. If it is determined that the employee requires permanent accommodation, the employer will contact them within two weeks to discuss options, and within four weeks, the employer will offer transitional work or must begin paying at the previous rate of pay. update

May 2016_Special Issue_final.indd 6

BLUE Rx IMPROVES NURSES’ ACCESS TO PRESCRIPTION DRUGS Almost DOUBLE the drugs are available under Blue Rx than under the Pharmacare tie-in and NO MEMBERS LOSE COVERAGE as a result of the change from the current drug plan to Blue Rx

ALMOST FULL COVERAGE Only 200 drugs are excluded from coverage due to efficacy and cost, or because they are categorized as Supplemental drugs (e.g. non-prescription drugs, lifestyle drugs, vaccines)

KEY DRUGS COVERED

High usage drugs not currently covered, or that require Special Authority under Pharmacare tie-in, no longer require any preapproval under Blue Rx in order to be covered:

BLUE Rx 92% of the Blue Rx formulary is automatically covered

PHARMACARE TIE-IN 73% of the Pharmacare formulary is automatically covered

4/25/2016 11:48:59 AM

UPDATE MAGAZINE May 2016 Special Issue

7

INCREASED BENEFIT COVERAGE

GS

New contract improves access to drugs, avoids cost-sharing

W

HEN CHANGES to drug coverage were negotiated during the last round of bargaining, BCNU was assured that members’ prescriptions would still be covered after the switch to the provincial drug formulary and the introduction of the Pharmacare tie-in. However, after ratification it became all too clear that many nurses could not get their drugs covered.

Since the last collective agreement was signed, BCNU successfully grieved the application of the Pharmacare tie-in. An arbitrator’s consent award resulted in improvements to implementation problems at Pacific Blue Cross and restored coverage for many of the drugs existing members were receiving previously.

Cheques totalling over $1.2 million were also mailed to members who incurred outof- pocket costs relating to the Pharmacare tie-in.

Despite the fix, the Pharmacare tiein remains a major problem, and many members still cannot access the drugs they need. Our experience with the plan made protecting and expanding existing benefits one of the highest priorities for Nurses’ Bargaining Association negotiators. We are pleased to have reached an agreement that meets this goal. The proposed contract expands members’ drug coverage without requiring co-payments from wages or agreeing to cost-sharing in a Joint Benefits Trust (see sidebar: Not Worth the Risk).

Effective Jan.1, 2017, members will gain access to Blue Rx, an expanded formulary with almost double the number of drugs covered by the Pharmacare tie-in, and

May 2016_Special Issue_final.indd 7

which requires fewer prior approvals. No member will lose coverage as a result of the change, and all nurses and their dependants who have had drugs grandparented under the Pharmacare tie-in consent award will continue to be grandparented.

Of the approximately 1,200 drugs available under Blue Rx, some 1,100 are covered automatically without any additional steps required. Only 75 drugs require Special Authority from BC Pharmacare, and 31 drugs can be accessed after Pacific Blue Cross provides Prior Authorization, which is less stringent than the BC Pharmacare Special Authority process. Prescriptions may also be retroactively reimbursed when purchased within 90 days of approval.

Members may submit a doctor’s note to Pacific Blue Cross if a generic drug is not tolerated and, unlike Pharmacare, members are not required to try and fail at least two generics in order to receive approval for the brand.

Blue Rx is a dynamic formulary that allows new drugs to be added as needed, making it more responsive to members’ needs in the years ahead. In rare circumstances drugs may be removed from the formulary, for example, in the case of safety concerns.

Under the new agreement, many existing extended health benefits will be maintained or increased. For example, allowance for hearing aids will rise to a maximum of $1,000 for each ear, every five years (from $600 every four years). Prometrium will remain covered, and contraceptive coverage will continue for RNs and RPNs. LPNs will receive this coverage immediately upon ratification. All massage and physiotherapy benefits will remain intact. update

4/25/2016 11:49:04 AM

8

MAJOR ADVANCES ON WORKLOAD AND STAFFING

Proposed new contract builds on the successes of the past year

B

CNU’S FIGHT FOR SAFE patient care begins in the workplace and continues to the bargaining table. From the provincial staffing grievance settlement reached last April to this year’s arbitrated staffing settlement that compels employers to follow through on their staffing commitments, we have been unwavering in our commitment to make a positive difference in our working lives and for our patients.

That commitment made all the difference in negotiations with the Ministry of Health and provincial health employers, and has resulted in a tentative agreement that builds on the historic workload and staffing language contained in the previous collective agreement.

The proposed five-year agreement acknowledges that, despite existing protocol MOUs covering staff replacement, regularization of hours, additional patient demand and vacation replacement, a significant “compliance gap” remains. A new joint process will now be established to sort out just how many nurses remain to be hired to meet the previous contract’s staffing commitments.

In addition, a letter of agreement acknowledges the need for a comprehensive health human resource management framework, and commits government to better achieve critical health service delivery objectives that include hiring more nurses.

NEW TOOLS FOR SAFE PATIENT CARE

The proposed contract will see each health authority establish a Nurse Relations Committee (NRC) composed of union representatives and employers who will meet

May 2016_Special Issue_final.indd 8

bi-weekly. These committee members will have decision-making authority to work collaboratively to address nurse staffing and general labour relations issues.

In addition, the agreement proposes the creation of a new Nurse Staffing Secretariat Steering Committee (NSC) that will work with health employers to set annual targets for compliance with the protocol MOUs and ensure they have “time specific strategies and budgets in place to meet compliance targets.” Reporting to the NSC,

a new Nurse Staffing Secretariat (NSS) will monitor compliance.

The NSC will also determine which local issues may be referred to a new provincial Staffing Oversight and Arbitration panel (SOA) for review and adjudication. The SOA will be comprised of a neutral chair and one representative from both the NBA and the Health Employers Association of BC. It will provide formal oversight of all disputes over provisions relating to baseline nurse staffing and long- and short-term

4/25/2016 11:49:06 AM

UPDATE MAGAZINE May 2016 Special Issue

absence coverage. It will also have the power to adjudicate these disputes, determine whether or not the employer is compliant and direct the employer to fix any non-compliance issues within a set time period.

EXPEDITED GRIEVANCE AND ARBITRATION PROCESS

Under the terms of the proposed agreement, health employers have agreed to an NBA proposal that will see an expedited dispute resolution process replace the current timeconsuming and expensive process of resolving grievances at individual arbitrations. A standing British Columbia Healthcare Office of Arbitration (BCHOA) will be created with the goal of shortening the time it takes to resolve disputes, provide continuity of contract interpretation and establish best practices for good labour relations.

Currently, nurses often find themselves waiting a year or more for a grievance to be resolved, sometimes at a high financial cost to the griever. A standing office of arbitration, staffed with two arbitrators for a three-year term, should dramatically reduce legal costs to the parties by removing the many delaying tactics that run up large bills with consulting lawyers.

The new process will also reduce the current grievance procedure from three steps leading to arbitration, down to two steps. This should speed up the resolution of disputes and reinforce the value of solving issues prior to arbitration.

ADDITIONAL PATIENT DEMAND

In addition to the establishment of a framework that supports existing workload language, an article that used to be found in the PRF language has moved to Appendix QQ – Additional Patient Demand. This strengthens the provision that allows a charge nurse to call in more nurses in an emergency, if no management is available.

NEW PROCESS TO EXPEDITE VACANCY POSTINGS

Over the past year, BCNU has been successful in holding employers to account for the

May 2016_Special Issue_final.indd 9

9

PROTECTING JOB SECURITY Proposed agreement contains safeguards against contracting out as a result of the increasing shift to community care

O

NE OF THE MOST significant gains in this tentative agreement involves the extension of job security guarantees to the community and long-term care sectors (including affiliates). This is a big win given health authorities’ intention to move care currently delivered in the hospital sector into the community and long-term care (LTC) sectors.

For acute care and community nursing, health employers have now agreed that “no nurse will be involuntarily laid off due to contracting out or due to shifting health care resources from acute care to communities or long-term care.”

Nurses working in the LTC sector will also be protected from layoffs that have become more common due to increased contracting out. Publicly owned and operated LTC employers will not lay off nurses as a result of any contracting out. And in the affiliated LTC sector (i.e., for-profit and notfor-profit employers funded through contracts with health authorities), no more than 100 positions a year may be contracted out, and no nurse will lose any salary, benefits, service or employment as a result.

Any nurse involuntarily laid off will be offered positions in another health care affiliate, in an owned-and-operated facility, in community health or in acute care.

Involuntarily laid-off nurses who require additional training to qualify

for an alternate position will be provided with opportunities by the health authority, supported by a new $5-million education fund.

In addition to the new limits on contracting out for affiliate employers, the Ministry of Health will also be requesting these employers cease the contracting out of any nursing services while it undertakes a comprehensive review of health authorities’ LTC funding. That includes a review of service standards, and “education and training gaps of nurses” required to support the ministry’s planning of community care services.

TACKLING THE USE OF AGENCY NURSES

While agency nurses are showing up in many areas of public health care, BCNU has never been able to get a clear picture from health authorities of how widespread the use actually is. Agencies charge as much as $80 an hour for these nurses. How much of this goes to the nurse and how much to agency profit is not clear.

This tentative agreement will require employers to provide quarterly reports on the use of agency nurses. Employers have also agreed that agency nurses and nursing contractors will not supervise or otherwise direct the work of BCNU members, and there will be discussion on the development of a not-for-profit organization to provide required nurse staffing. update

4/25/2016 11:49:07 AM

10

staffing commitments made in the last round of bargaining. During negotiations, employers cited “churn” as the number one issue affecting their staffing obligations.

Churn is the length of time it takes to get a nurse into a vacant position. It also refers to the knock-on vacancies that typically follow the initial movement.

Changes proposed to Article 17.01 will speed up the posting and filling of vacancies enabling health authorities to get nurses into positions more quickly. Positions will be posted twice a week, on Tuesdays and Thursdays, for a period of 72 hours.

The employer will then make a selection decision within seven business days of the posting’s closing.

The successful applicants will be notified and, once confirmed, will have 48 hours to accept or decline the position. If the offer is declined or there is no response, the employer may then offer the position to the next eligible applicant.

And if a successful applicant is promoted or transferred within 90 days of starting the new position, the employer may award the resulting vacancy to the next eligible candidate without reposting.

Changes to Article 17.02 now allow employers to make temporary appointments

RURAL AND REMOTE RECRUITMENT Under the proposed contract, a new $2-million dedicated fund will address nurse recruitment and retention issues facing communities in rural and remote areas. Following a review of Northern, Interior, Island and Vancouver Coastal Health authorities, a joint commission will be authorized to approve grants from the fund to make jobs more attractive to nurses. Examples of possible grants include tuition relief, loan forgiveness and housing assistance.

May 2016_Special Issue_final.indd 10

Health employers have agreed to an NBA proposal that will see an expedited dispute resolution process replace the current timeconsuming and expensive process of resolving grievances at individual arbitrations. to positions where the incumbent has been granted a leave of absence greater than nine months (increased from six months).

In addition, temporary vacancies of up to 14 months will now require a commitment to work for the duration of the term (bona fide exemptions are allowed). Casuals may apply for regular vacancies during this term and, if successful, the employer will either hold the new position for the casual or release the nurse immediately.

Where no employee accepts a temporary position, the employer may appoint a newly graduated nurse.

The issue of churn and ongoing staffing challenges, such as those in geographic locations that have seasonal changes in ser-

vice delivery needs, will also be addressed through the creation of seasonal part-time positions. These will allow nurses to work a compressed annual FTE in a six-month period while receiving pay and benefits pro-rated over 12 months. Upon ratification, BCNU will work with the employers to ensure fairness in the application of this new contract language.

INTERNAL WORK SCHEDULE CHANGES

A new addition to Article 25 will require that, when a line first becomes vacant, it will be offered to all other regular employees in the unit, ward or program in order of seniority and within their existing job status (F/T to F/T and P/T to P/T within .08 of their FTE). There would be no requirement to post the vacancy or conduct an interview.

At no time can this process result in a change of classification, status or a difference of more than .08 FTE. The remaining job vacancy that results will be handled as in Article 17.01 (72hour posting, selection decision within seven business days, 48 hours to accept or decline). That way if, for example, a nurse in a full-time position is seeking a parttime position, they will be able to eventually access their desired position when it becomes available in this process.

RELIEVING IN HIGHERRATED POSITIONS

New language has been added to Article 18 so that, in the event that a regular employee relieves in a higher-rated job for four consecutive weeks or more,

4/25/2016 11:49:19 AM

UPDATE MAGAZINE May 2016 Special Issue

11

the employee will receive the rate of pay attracted by the position retroactively.

A STRONGER VOICE TO SHAPE HEALTH CARE POLICY AND DELIVERY

BETTER VACATION RELIEF

The proposed provincial contract includes a series of innovative committees, panels and secretariats created to strengthen the voice of nurses and deliver their concerns to key decision makers. They are explained in brief below:

Beginning April 1, 2017, community nurses will be replaced for at least three weeks (up from two weeks) of vacation each year, “except where service levels are reduced.” The employer agrees to make “all reasonable efforts” to replace vacation leaves using regular relief/float positions.

In acute and long-term care, employers commit to establishing regular vacation relief positions where there are 10 or more baseline FTEs in the same job and required competencies.

IMPROVED ON-CALL, CALL-BACK AND CALL-IN STANDARDS

One side effect caused by health authorities not hiring enough nurses to fill vacancies and meet spikes in acuity has been the over-reliance and even abuse of on-call provisions. Our proposed agreement with employers now includes new provisions that are fairer to nurses, improve their work-life balance and make the use of on-call much more costly to the employer.

This approach involves three prongs: first, raising the on-call premium from $3.75 to $5.75 per hour for the first 72 hours, and from $4.75 to $6.25 per hour thereafter in each calendar month. Second, regular full-time nurses are entitled to a minimum of two hours at the overtime rate when called back and aren’t used or work less than two hours; all hours beyond two are worked at overtime.

Third and very importantly, there will be a minimum of eight consecutive hours off after completing call-back and before beginning their next regularly-scheduled shift, with no loss of pay. update

May 2016_Special Issue_final.indd 11

ARBITRATION BCHOA BC Healthcare Office of Arbitration The new BCHOA will expedite the time it takes to resolve disputes, provide continuity of contract interpretation and establish best practices for good labour relations. It will adjudicate all grievances and disputes between health employers and nurses. Arbitrators – appointed by the BC Attorney General – will have full jurisdiction over all contract matters.

STAFFING NRC Nurse Relations Committee Each health authority will establish an NRC composed of union representatives and employers who will meet bi-weekly. These committee members will have decision-making authority to work collaboratively to address nurse staffing and general labour relations issues. Unresolved issues will be referred to the NSS (below).

NSS Nurse Staffing Secretariat Reporting to the NSC (below), the NSS will be responsible for establishing data and reporting requirements for compliance with the protocol MOUs and attempting to resolve staffing-related issues.

NSC Nurse Staffing Secretariat Steering Committee Co-chaired by representatives from BCNU and the Ministry of Health, the NSC will establish targets and strategies for ensuring that employers fully implement the nurse staffing provisions

initially agreed to in the 2012-2014 contract. The committee will monitor compliance and refer issues to the SOA (below) if required.

SOA Staffing Oversight and Arbitration Panel The new SOA consists of one neutral chair, one union rep and one employer rep. The panel will provide formal oversight and adjudication of all disputes arising from the implementation of collective agreement provisions related to the maintenance of nurse staffing levels, and will determine whether the employer is compliant with these provisions.

PROFESSIONAL PRACTICE PRC Professional Responsibility Committee The proposed PRC will be the new name for what is currently the PRF committee. Every employer will establish a PRC, composed of standing members (one appointed by the NBA, one by the employer) and ad hoc members (the nurse with the concern, a PRF rep or union steward, the immediate supervisor and the excluded manager or excluded designate).

NPS Nursing Policy Secretariat The NPS will be established to review the current regulatory environment with the goal of developing policies that will allow all nurses to work to their full scope of practice within high functioning teams that respect nurses’ professional autonomy.

4/25/2016 11:49:19 AM

12

STRENGTHENING NURSES’ VOICE

Improved professional responsibility process now available to all nurses, promises access to key decision makers and provides innovative twopronged approach for resolving PRFs

B

UILDING ON PREVIOUS GROUND-BREAKING CONTRACT language, BCNU has again negotiated a series of improvements to Article 59, the Professional Responsibility Clause.

The proposed language will improve accountability and cooperation, and help nurses take their concerns to key decision makers through the newlyformed Nursing Policy Secretariat (NPS) and Nurse Staffing Secretariat (NSS).

A new, two-pronged process will enable binding resolutions. PRFs that focus on staffing issues will now be referred to the Nurse Relations Committee (NRC) and, if necessary, the NSS, and on to arbitration if still not settled. Unresolved PRF issues not focused on staffing go to the Senior Review Committee (SRC) and, if required, to a health authority CEO and then the NPS. Two major gains are included in the proposed contract. Firstly, LPNs will now use the same Professional Responsibility Process (PRP) as RNs and RPNs. Secondly, nurses working in affiliates can now also take PRFs forward to the NPS if they remain unresolved after their employer’s board of directors has reviewed them.

To enhance common understanding of the process, both BCNU and the employer will agree to deliver PRP education – to members and management – based on an agreed-

May 2016_Special Issue_final.indd 12

upon curriculum and co-facilitated by both parties.

Standing members of the Professional Responsibility Committee (PRC) can now request and be provided access to documents and data needed to reach a satisfactory resolution.

Also, every effort will be made to schedule members’ attendance at the PRC on a scheduled shift. If that’s impossible, members will be compensated at straight time.

PRC members can now limit the number of attendees at a reasonable level – but the PRF authors will decide who will attend and speak for them. The PRC will also identify a time frame for reviewing the action items.

If progress isn’t being made, the SRC may refer the matter to the NPS. Either party must notify the appropriate health authority CEO of their intent to make a referral. Within 14 days of receiving notification, the CEO will acknowledge receipt and communicate any resolution to the parties.

If the SRC can’t make a unanimous recommendation, a written report outlining its findings will be issued to BCNU and the health authorities. Either party can then refer the matter to the NPS. Another important change concerns contract language that gives nurses the authority to call in additional staff when management isn’t available. The language has been moved, unaltered, from Article 59.08 to Appendix QQ – Additional Patient Demand. update

Conversation with manager

File PRF

PRC

OTHER ISSUES

TWO PRONGS An improved PRF process will allow PRFs that be referred to a Nursing Relations Committee (NRC) and, if ne Staffing Secretariat (NSS), and on to arbitration if still not sett

4/25/2016 11:49:21 AM

13

ADVANCING THE PROFESSIONAL PRACTICE OF NURSING New agreement builds on past contract wins to advance nurses’ professional influence within the public health care system

A

SERIES OF IMPORTANT new measures will help enhance the nursing profession, optimize all nurses’ scope of practice and keep nurses professionally engaged through career development.

AN EXPANDED SCOPE OF PRACTICE FOR ALL NURSES

Health authorities have often made it difficult for nurses to work to their full scope of practice. But our proposed contract includes historic language that will examine and expand the scope of practice of LPNs, RNs and RPNs. LPNs’ scope of practice will be harmonized across the health sector and each employer will ensure they are working consistently to full scope. A review will include using LPNs for immunizations, IV therapy, advanced wound care and working in community settings.

RPNs will work to their full scope of practice and have access to entry level

medical positions, and to positions on all wards, units or programs where mental health disorders are a significant concern.

That includes emergency units, community programs, pediatrics and long term care facilities.

RNs’ scope of practice will be expanded and standardized to include prescribing, suturing, ordering routine lab work and diagnostics and discharging. A review will include incorporating RN First Assist, RN First Call, Integrated Primary Care and RN Anesthetists.

POLICY LEADERSHIP

A Nursing Policy Secretariat (NPS) will be established in the Health Ministry that includes unprecedented BCNU involvement in the development of nursing/health services policies. The NPS will deal with a variety of issues, including the expansion of nursing practice to respond to patient/ population health needs, the standardization of a provincial approach for nurses to meet regulatory conditions, the resolution of inconsistencies in permitted scopes of practice and enabling expanded scopes.

EDUCATION AND CAREER DEVELOPMENT

OTHER ISSUES

NRC

NSS

SRC

CEO

ll allow PRFs that focus on staffing issues to e (NRC) and, if necessary, to the new Nurse tion if still not settled.

May 2016_Special Issue_final.indd 13

(Binding Arbitration)

NPS

The NBA will administer a $5-million training and education fund that includes funding to help RN/RPN diploma nurses achieve a nursing baccalaureate, to assist LPNs become RNs/RPNs and to increase the scope of practice for RNs, RPNs and LPNs. To deal with the growing shortages of specialty nurses, at least 850 FTEs of specialty education will be funded for 2016/17, and ongoing annual funding for required FTEs will be provided for the term of the agreement. update

Q&A

RATIFICATION VOTE

You can vote for our new provincial collective agreement until May 10 Am I eligible to vote?

The vast majority of BCNU’s over 42,000 members are covered by the Nurses’ Bargaining Association provincial collective agreement (PCA) and are eligible to participate in the ratification vote until May 10.

Eligible members include licensed practical nurses (for the first time), registered nurses and registered psychiatric nurses who deliver care in the public sector for one of the six health authorities or their affiliates. Also eligible to vote for the new PCA are BCNU members working in undergraduate/ employed student nurse positions and all nurses on maternity leave, LOA, WCB and LTD.

Who is not eligible to vote?

BCNU members cannot participate in the ratification vote if they are covered by other contracts, such as the public service agreement, and those working under a variety of independent contracts, including those that cover private long-term care facilities, Aboriginal communities and provincial prisons.

When can I vote?

BCNU has changed the voting process to make it easier than ever before to participate in a PCA ratification vote.

In the past, all voting was done on one day. Now members have numerous opportunities to cast their vote

4/25/2016 11:49:21 AM

14

Q&A CONTINUED

UNITING THE NURSING FAMILY

BC nurses now under one contract – across designations and sectors

F

ADVANCE POLL South Fraser Valley region community steward John Ginther and Langley Memorial Hospital full-time steward Carol Canuel are joined at the ballot box by BCNU President Gayle Duteil during April 7 regional meeting and bargaining report-out.

up to and including the May 10 deadline: at information sessions and union meetings conducted multiple times in every region until April 30, and at worksite polling stations from now until May 10.

OR BCNU’S OVER 9,000 LPNS, THE PROPOSED AGREEMENT IS IN many ways both the beginning and the end. It is the beginning of a journey that, for the first time, sees the vast majority of BCNU LPNs united with RNs and RPNs not only in one union, but also in one provincial contract.

It is also the end of a path that began in 2006, when LPNs first looked for improved representation. That path saw LPNs vote to join BCNU in 2012, and then become members of the Nurses’ Bargaining Association in 2013. LPNs were elected to BCNU Council in 2012 and 2014, and have played a critical role on our provincial bargaining committee and representing LPNs covered by independent agreements.

Upon ratification, LPNs will no longer be bound by the old Facilities and

NEW LEVELS AND CATEGORIES Nursing jobs will now be categorized into six levels and four job groups: • Community Health Activities (CH) • Direct Patient/Client/Resident Care Activities (DC) • Educational Activities (ED) • Program and Service Activities (PS) CLASSIFICATIONS CH

DC

Level 1 (LPN)*

LPN1

LPN1

Level 2 (LPN)

LPN2

LPN2

Level 3 (RN/RPN)**

CH1

DC1

Level 4 (RN/RPN)

CH2A/CH2B

DC2A/DC2B

ED2

PS2

Level 5 (RN/RPN)

CH3

DC3

ED3

PS3

Level 6 (RN/RPN)

CH4A/CH4B

DC4

ED4

Where can I vote?

Eligible members can vote at any BCNU information session or union meeting.

You can also vote at polling stations until May 10 if they are set up at your worksite.

Check bcnu.org and click on News and Events, then the Events Calendar where you can select your region to get the most current voting information.

How do I get more information on upcoming meetings and where to vote?

For more information on where and when you can vote, please visit bcnu.org and click on News and Events, then the Events Calendar where you can select your region. Check back frequently for the latest information or contact your regional chair. update

May 2016_Special Issue_final.indd 14

ED

PS

LPN2 PS1

* To include LPN Orthopedic Technologists (previously FBA SA25). ** To include Licensed Graduate Nurses, who are defined by the College of Registered Nurses of British Columbia as “nurses granted LGN registration in BC prior to Oct. 1, 1990. An LGN registrant may perform or provide services as if he or she is a registered nurse registrant.”

Effective April 1, 2016, LPNs who receive the Operating Room (previously FBA SA29) wage rate will be grandparented. In future, a qualification differential will be equally applied to all nurses in accordance with Article 53.01.

4/25/2016 11:49:22 AM

UPDATE MAGAZINE May 2016 Special Issue

Community Bargaining Association contracts and, for the first time, will be covered by the NBA collective agreement.

LPNs will enjoy access to NBA extended health and dental benefits, vacation entitlements and most general provisions.

Employers have agreed that LPNs will be included in a consolidated certification list no later than September 1, 2016, and will meet with nurses within 30 days of ratification to reach this objective. It is also agreed that any currently employed LPN who has lost seniority since April 15, 2013, as a result of resigning from, or being terminated (without cause) from, a position will be credited the lost seniority hours.

The proposed agreement also merges language covering community nurses fully into the collective agreement with the removal of Section 2 from the contract. update

LPN MERGER AT A GLANCE LPNs who are now members of the Nurses’ Bargaining Association will see the following contract improvements upon ratification of the proposed contract:

APRIL 2016

Provision

NBA Language

 On-call premium

$5.75 for first 72 hours, $6.25 thereafter

 Vacation

20 days (starting) • $25 deductible • Unlimited massage & physio

 Benefits  Casual pay in lieu of benefits

12.6%

 Casual shift cancellation

Cannot be cancelled without bonafide reason

 Salary on promotion

Minimum $200

 Promotion anniversary date

Promotion does not change date

 Isolation allowance

48 locations

 Election leave

4 hours • 2.0x all stats • 2.5x superstat

 Stat & superstat

A PROMISE KEPT When BC’s LPNs were deciding which union should represent them in 2012, BCNU pledged that they would have a better future alongside their RN and RPN colleagues.

We pledged that LPNs would see improved contract and practice conditions and superior career development and licensing support. The proposed NBA provincial agreement has made good on these pledges, and now sees LPNs with a stronger contract.

May 2016_Special Issue_final.indd 15

15

 Severance

1 week for every 2 years

 WCB leave top-up

10%

 Safe Workplace Training

3 weeks

APRIL 2017

Provision

NBA Language

 Night shift premium

$3.50/hour

 Weekend shift premium

$2.30/hour

 Supershift premium

$1.00/hour

SEPTEMBER 2017

Provision All LPNs receive a $1.00 per hour increase (for all increments)

4/25/2016 11:49:23 AM

16

ESTABLISHING A CULTURE OF SAFETY Employer commits to making the delivery of care safer and healthier for nurses and patients

O

UR NEW TENTATIVE agreement makes health care delivery safer for nurses and their patients, and commits health authorities to create “a culture of safety and violence reduction in every worksite.”

Violence Prevention Framework Our bargaining team successfully negotiated the creation of a new violence prevention framework – by September 2016 – that clearly recognizes the vulnerability of direct care providers in today’s health care workplace.

The proposed violence prevention language includes $4 million to retrofit six additional high-risk sites with enhanced violence prevention training, procedures and security.

The employer also agrees to evaluate and continue building on the progress made at four high-risk sites already targeted for action (Hillside Centre in Kamloops, Abbotsford Hospital, Victoria’s Seven Oaks, and Coquitlam’s Forensic Psychiatric Hospital).

Employers will also undertake a gap analysis and review of critical incident support practices and resources across health authorities.

The new language also requires effective security/safety officer protocols at listed high-risk sites and training for hands-on action during Code Whites. It also calls for a review of plans and implementation status, with upgrades as needed, at 50 high/ medium-risk sites by September 2016.

Joint Occupational Health and Safety Committees To help establish a culture of safety and violence prevention in every worksite, the employer has agreed to improve the way

May 2016_Special Issue_final.indd 16

Joint Occupational Health and Safety ( JOHS) committees function. For example, the proposed contract calls for the mandatory release of members from regular duties to attend JOHS meetings and to perform related duties and functions.

JOHS committee members will be paid at the appropriate rate of pay if an investigation is scheduled outside their regular hours.

There will also now be critical incident support for nurses following traumatic events (time off without loss of pay to attend). And, to help protect nurses in their worksites, affiliate employers are now required to provide violence prevention training.

grams and worksites. HEABC will provide $687,000 to the program over the next three years.

The popular workshops, currently operated

by BCNU, help nurses identify and recognize signs of compassion fatigue, burnout and post-traumatic stress disorder, while providing them with the skills needed for developing personal and professional resilience.

Enhanced Disability Management Program The Enhanced Disability Management Program (EDMP) is a pro-active, customized disability management program designed to help members suffering from an illness or injury. Currently, 25 percent of any EDMP cost savings (now $1.29 million per fiscal year) is allocated to NBA prevention initiatives. The proposed contract calls for the establishment of a new OH&S and Violence Prevention Committee that will discuss and make recommendations on the allocation of those funds to OH&S programs and violence prevention initiatives.

Mental Health The bargaining team successfully negotiated a series of progressive changes aimed at creating psychologically healthy worksites. Those changes include implementing specific and measurable healthy workplace objectives, addressing psychological risk factors, and increasing accountability through regular progress reports.

National Standards The health authorities will adopt the National Standards for Psychological Health and Safety, with implementation to start April 2017. The Mental Health Commission of Canada released the Standard in 2013.

This set of principles, guidelines and tools is currently being launched across the country.

Resiliency Workshops The employer acknowledges the success of BCNU’s resiliency workshops and agrees to work with the union to develop a single provincial program for employees working in high trauma units, departments, pro-

HIGH PRIORITY The proposed agreement builds on the progress made at the four high-risk sites already targeted for action, and will provide $4 million to retrofit six additional high-risk sites with enhanced violence prevention training, procedures and security.

4/25/2016 11:49:24 AM

UPDATE MAGAZINE May 2016 Special Issue

IMPROVED COMPENSATION

Wage increases achieved in tough fiscal climate

T

HE PROVINCIAL GOVERNMENT’S “ECONOMIC STABILITY” mandate sees public sector employers, including health authorities, negotiating five-year collective agreements within a fixed fiscal envelope.

The total compensation package for nurses grows based on a government wage mandate of 5.5 percent over five years, plus four possible economic stability dividends (ESDs) should economic growth exceed annual projections (2016 – 2019).

The proposed provincial contract contains the following improvements: Wage Increases April 1, 2015

1.0% (retroactive)

February 1, 2016

.45% Economic Stability Dividend* (retroactive)

April 1, 2016

.5% (retroactive)

February 1, 2017

1.0% + Economic Stability Dividend*

April 1, 2017

.5%

February 1, 2018

1.0% + Economic Stability Dividend*

April 1, 2018

.5%

February 1, 2019

1.0% + Economic Stability Dividend*

17

ECONOMIC STABILITY DIVIDEND EXPLAINED The 2014 Economic Stability Dividend (ESD) was approved by government for the current public sector bargaining mandate.

Under the ESD, the government will only provide for any additional pay increases when the annual growth in real gross domestic product (GDP) is greater than expected. Real GDP measures the value of economic activity which exceeds inflation.

If actual real GDP exceeds the forecasted GDP, a conditional percentage wage increase, amounting to 50 percent of the difference, is applied to the hourly wage rate at the first pay period after February 1 of 2016, 2017, 2018, and 2019.

For example, in 2015 economic growth was 0.9 percent higher than projected. Half of this amount (0.45 percent) was then applied as a wage in increase in February of this year. Historical real GDP growth rates show that a general wage increase would have occurred in six of the years between 2000 and 2012 had the ESD formula been used. These increases would have varied from 0.04 percent to 1.44 percent. The cumulative total over the 12 years would have been 2.93 percent compounded.

*See sidebar: ECONOMIC STABILITY DIVIDEND EXPLAINED

Premiums Effective April 1, 2016, the weekend premium will rise from $2.00 per hour to $2.30 per hour, the on-call premium will rise from $3.75 to $5.75 per hour for the first 72 hours, and from $4.25 to $6.25 thereafter.

Casual Availability Bonus Casual employees will receive $2.00 per hour for all hours worked in the previous six months if they accept 85 percent of the shifts they are offered to work.

Closing the LPN Wage Gap In September 2017, all LPNs (Nurse Level 1 and Level 2) will receive a $1.00 per hour increase for all increments.

Registration Fee Coverage BCNU Council has decided that the $10-million in damages the union will receive from employers for failure to meet their previous staffing commitments will be used to offset some or all of the costs of annual college registration fees (excluding any costs for ARNBC) for RNs and RPNs in 2016/17. update

May 2016_Special Issue_final.indd 17

“ME-TOO”

“ME-FIRST”

The government wage pattern accepted by other public sector bargaining associations was locked in place by a so-called “me-too” clause that made it impossible for the Nurses’ Bargaining Association to negotiate a superior wage package that would not then require employers to provide the same improvement to members of other bargaining associations.

To prevent this from happening again, the NBA has negotiated a “me-first” clause that will see 2019 negotiations commence no later than June 1, 2018 – ahead of other bargaining associations.

4/25/2016 11:49:24 AM

18

Who Can Help?

BCNU IS HERE TO SERVE MEMBERS

BCNU CAN. Here’s how you can get in touch with the right person to help you.

CONTACT YOUR STEWARDS For all workplace concerns contact your steward. REGIONAL REPS If your steward can’t help, or for all regional matters, contact your regional rep. EXECUTIVE COMMITTEE For all provincial, national or union policy issues, contact your executive committee.

EXECUTIVE COMMITTEE PRESIDENT Gayle Duteil C 604-908-2268 gayleduteil@bcnu.org

EXECUTIVE COUNCILLOR Deb Ducharme C 250-804-9964 dducharme@bcnu.org

VICE PRESIDENT Christine Sorensen C 250-819-6293 christinesorensen@bcnu.org

EXECUTIVE COUNCILLOR Dan Murphy on leave

TREASURER Mabel Tung C 604-328-9346 mtung@bcnu.org

EXECUTIVE COUNCILLOR Adriane Gear C 778-679-1213 adrianegear@bcnu.org

REGIONAL REPS CENTRAL VANCOUVER Judy McGrath Co-chair C 604-970-4339 jmcgrath@bcnu.org

May 2016_Special Issue_final.indd 18

Marlene Goertzen Co-chair C 778-874-9330 marlenegoertzen@bcnu.org

COASTAL MOUNTAIN Kath-Ann Terrett Chair C 604-828-0155 kterrett@bcnu.org

SIMON FRASER Lynn Lagace Co-chair C 604-219-4162 lynnlagace@bcnu.org

EAST KOOTENAY Lori Pearson Chair C 250-919-4890 loripearson@bcnu.org

Cam Ward Acting co-chair C 604-240-1242 camward@bcnu.org

FRASER VALLEY Katherine Hamilton Chair C 604-793-6444 katherinehamilton@bcnu.org NORTH EAST Veronica (Roni) Lokken Chair C 250-960-8621 veronicalokken@bcnu.org NORTH WEST Sharon Sponton Chair C 250-877-2547 sharonsponton@bcnu.org OKANAGAN-SIMILKAMEEN Rhonda Croft Chair C 250-212-0530 rcroft@bcnu.org PACIFIC RIM Rachel Kimler Chair C 250-816-0865 rachelkimler@bcnu.org RIVA Lauren Vandergronden Chair C 604-785-8148 laurenvandergronden@bcnu.org SHAUGHNESSY HEIGHTS Claudette Jut Chair C 604-786-8422 claudettejut@bcnu.org

SOUTH FRASER VALLEY Jonathan Karmazinuk Co-chair C 604-312-0826 jonathankarmazinuk@bcnu.org Michelle Sordal Co-chair C 604-880-9105 michellesordal@bcnu.org SOUTH ISLANDS Margo Wilton Co-chair C 250-818-4862 mwilton@bcnu.org Lynnda Smith Co-chair C 250-360-7475 lynndasmith@bcnu.org THOMPSON NORTH OKANAGAN Tracy Quewezance Chair C 250-320-8064 tquewezance@bcnu.org VANCOUVER METRO Meghan Friesen Chair C 604-250-0751 meghanfriesen@bcnu.org WEST KOOTENAY Lorne Burkart Chair C 250-354-5311 lorneburkart@bcnu.org

4/25/2016 11:49:24 AM

UPDATE MAGAZINE May 2016 Special Issue

19

OTHER CONTRACT CHANGES Our tentative agreement includes several other important changes that are highlighted below. For more information on these and all the other language provisions in the new Provincial Collective Agreement, please visit the Member Portal at www.bcnu.org.

EXPANDED LEAVES Compassionate leaves of absence with pay in the event of a death will be extended to include step-children, step-parents, step-brothers, step-sisters and legal guardians. Paternity leaves are expanded from 7.5 hours to 37.5 hours, and adoptive leaves are established at 37.5 hours. Special leaves are modified to include up to 7.5 hours annually for nurses to assist an immediate family member address a serious or potentially life-threatening illness. Special leave hours can also now be banked, with time accrued at one site portable to another.

MAINTENANCE OF STRAIGHTTIME PAID HOURS (MOA re: Appendix MM) – From 2016 to 2019, HEABC will provide the NBA with the total number of straight-time paid hours nurses in the public system work each year.

During those years, the total number of nurses’ straight-time paid hours will be no less than the total number of straight-time paid hours worked in 2016. And, each year, HEABC will also supply the number of FTEs, broken down by FT, PT and casual, as well as the number of overtime hours worked by nurses.

period after April 1, 2016, new employees (LPN /RN/RPN) will no longer be eligible to receive the Qualification Differential payments set out in Articles 53.04 (University Preparation) and 53.05 (Baccalaureate Degree).

MODERNIZED COLLECTIVE AGREEMENT Within three months of the ratification of the proposed collective agreement, HEABC and the NBA will establish a joint working group to review the collective agreement, and identify opportunities to improve its structure and clarity, including potentially re-writing certain provisions of the agreement – on a without-prejudice basis – in plain language.

STEWARDS (Article 6.04 C) – Accompanying a member, at her request, to respectful workplace meetings has been added to the current list of steward duties and responsibilities.

RECORDS REMOVED (Article 16.03 B) – Members may request that a letter of expectation be removed from their file and destroyed 36 months after the letter’s date (provided the behavior or conduct that resulted in the letter of expectation being issued has not reoccurred within the intervening period).

JOB DESCRIPTIONS (Appendix HH) – The current agreement calls for each health authority and Providence Health Care to reduce the number of job descriptions to 60 by March 31, 2014.

(Some health authorities had over 1,000 job descriptions.) BCNU was concerned that designing job descriptions had become a “cottage industry” that helped some employers ensure they could hire the candidate of their choice. Several employers did cut the total number, but others claimed that 60 was too low and wanted the current language removed. Both sides now agree that within six months of ratifying the tentative agreement they will – with assistance from the Nurse Staffing Secretariat – negotiate a viable settlement.

MEET YOUR PROVINCIAL BARGAINING COMMITTEE

REGULAR PART-TIME EMPLOYEES (Article 11.03 C) – When it doesn’t result in overtime, and after exhausting the casual call-in list, the employer will now offer shifts to part-time employees based on seniority.

TEMPORARY POSITIONS (Article 17.03 B) – Employers may create regular temporary project positions (i.e., pilot projects or term specific assignments) from the current 12 months to up to 36 months.

These positions are not renewable after the project’s end date – unless both sides agree to renew or extend the time limits.

BACCALAUREATE DEGREE (Article 53.05) – Effective from the first pay

May 2016_Special Issue_final.indd 19

TEAM EFFORT From left: Margo Wilton, Carolin Bleich (BCNU staff), Michelle Grant, BCNU Director of Communication Systems and Policy Advisor Patricia Wejr, Carly Poissant (BCNU staff), Rhonda Croft, Rachel Kimler, BCNU President Gayle Duteil, Donna Bouzan (BCNU staff), Mary Jean Power, JJ. van Doorn, Jonathan Karmazinuk, Marlene Goertzen, Tracy Mailey-Baur, BCNU Executive Director of Negotiations and Strategic Development Gary Fane, BCNU Director of Legal Services and General Counsel Umar Sheikh, and Linnea Kubik (BCNU staff).

4/25/2016 11:49:30 AM

Proposed Provincial Collective Agreement

RATIFICATION VOTE Your BCNU Council and Bargaining Committee recommend you vote yes There are many opportunities to cast your vote up to and including May 10 For voting times & locations • check your BCNU bulletin board • talk to your stewards or regional chair • visit www.BCNU.ORG

PM 40834030

May 2016_Special Issue_final.indd 20

4/25/2016 11:49:31 AM