During this time when many people are experiencing a significant increase in oppression, I feel obligated to raise a critical concern about an upcoming layoff by Hennepin County Medical Center. HCMC is in the process of cutting its workforce by as many as 275 positions — notifications will be made in late February.
As a public safety-net hospital, HCMC is responsible to ensure that people of color, immigrants, Native folks, Muslims, LGBTQIA people and disabled folks are advocated for. The administration is currently analyzing which employees to lay off. I am concerned that the analysis does not include an assessment of how people of color will be affected. It is important to note that HCMC’s patients are 63 percent people of color, served by a staff that is 72 percent white and a board of directors that is 81 percent white. It would be irresponsible to ignore these facts when analyzing which employees to lay off at HCMC.
The need for cost-effectiveness regularly leads to cutting jobs that can be outsourced and those that do not generate revenue. Jobs like community health workers, interpreters and environmental service workers would fall into these categories and are positions held disproportionately by people of color and ones necessary for clients of color.
My concern was validated after learning that in 2003-04 Hennepin County had multiple staff reductions in which people of color accounted for 17 percent of county employees but 28 percent of those laid off. I asked HCMC’s vice president of public relations about data from previous years’ layoffs (2003, 2009) to determine whether people of color were overrepresented. The reply? The information was in a storage unit, and a time frame of when I would receive it was unavailable. Essentially, we don’t know how previous layoffs have affected employees of color.
When the Minnesota Visiting Nurse Agency, my previous employer, merged with HCMC last year, they cut our interpreting department staff. The decision was made to instead use videoconferencing via iPad or phone conferencing rather than an in-person interpreter, because it was cheaper. Working in an uncontrolled home environment has made it difficult to use this technology due to calls being dropped because of poor Wi-Fi connections.
One example of the iPad video interpreting software failing a patient occurred with an elderly, non-English-speaking client who had been released from HCMC due to debilitating pneumonia. This illness required equipment to feed and move the patient; it was my responsibility to assess what equipment would best help the family care for the patient and order the necessary supplies. In order to do this, an interpreter was necessary; however, while we were trying to relay information to the family via the iPad, the call was dropped numerous times in a two-hour visit. I left without being able to relay critical information to the family about the risks posed to the patient and how to prevent further health complications. A few days later, I discovered that the patient had died from pneumonia. Effective education might have prevented this. I saw that by cutting interpreters the ability to provide consistent quality care to my non-English-speaking patients had also been cut. While I do not pretend to know anything about running a hospital, this incident demonstrated to me that my employer chose not to prioritize the care of non-English-speaking clients.
Throughout history, health care providers have been responsible for validating slavery through “science,” by perpetuating racism via legislation allowing for involuntary sterilization, segregation of care facilities, and purposefully making access to medical and nursing education difficult for people of color. And yet, effort has not been made to increase this access, which is proven by the disproportionately small number of people of color working at HCMC.
We call ourselves a “safety net,” so let’s ensure our actions match our words. We as a community need to demand that HCMC does better. Their analysis needs to include a transparent assessment to ensure that people of color are not disproportionately laid off. We need our county institutions to be as strong and equitable as possible to defend our communities from the oppressive practices of our federal government.
Tressa Casey, of Minneapolis, is an RN.