DEPARTMENT OF VETERANS AFFAIRS EASTERN KANSAS HEALTHCARE SYSTEM EISENHOWER VA MEDICAL CENTER LEAVENWORTH, KANSAS and LOCAL 1765, NATIONAL FEDERATION OF FEDERAL EMPLOYEES, FEDERAL DISTRICT 1, IAMAW, AFL-CIO
United States of America
BEFORE THE FEDERAL SERVICE IMPASSES PANEL
|In the Matter of
DEPARTMENT OF VETERANS AFFAIRS
LOCAL 1765, NATIONAL FEDERATION
Case No. 04 FSIP 110
DECISION AND ORDER
The Department of Veteran Affairs (VA), Eastern Kansas Healthcare System, Eisenhower VA Medical Center, Leavenworth, Kansas (Employer), filed a request for assistance with the Federal Service Impasses Panel (Panel) to consider a negotiation impasse under the Federal Service Labor-Management Relations Statute (Statute), 5 U.S.C. § 7119, between it and Local 1765, National Federation of Federal Employees, Federal District 1, IAMAW, AFL-CIO (NFFE or Union).
After investigation of the request for assistance, the Panel determined that the dispute, which arises from bargaining over changes to routine laboratory tests provided to Title 38 employees, should be resolved through written submissions, including rebuttal statements. The parties also were advised that, after considering the entire record, the Panel would take whatever action it deems appropriate to resolve the dispute, which could include the issuance of a binding decision. The parties' final offers and written submissions, including rebuttal statements, were received pursuant to this procedure, and the Panel has now considered the entire record.
The Employer provides hospital, nursing home, domiciliary, outpatient, and psychiatric care to veterans and their dependents. The Employer's two main service locations are in Leavenworth and Topeka, Kansas; it also operates several smaller clinics in Kansas and Missouri. The Union represents approximately 210 Title 5 and Title 38 professional employees, including registered nurses, physical therapists, doctors, pharmacists, and social workers. Some are in the General Schedule (GS), GS-3 through -11, while others occupy special Title 38 pay classifications. The parties' master collective bargaining agreement (MCBA) expired in May 2000, but its terms will continue in force until a successor agreement is implemented. The parties also are governed by the terms of a supplemental agreement that has expired, but will remain in effect until it is renegotiated.
ISSUE AT IMPASSE
The issue in dispute is whether the Employer, in exercising its discretion under VA regulations, should change the types and schedule of routine laboratory tests provided to Title 38 employees.
1. The Employer's Position
The Employer's proposal is:
a) On a voluntary basis, lab work will be provided every 2 years, unless voluntary clinical assessment establishes the need for one or more of these tests to be provided annually. (Emphasis in original.)
b) The lab work provided will be as follows: Hemoglobin/Hematocrit (HH); Fasting Glucose; Urinalysis; Fasting Lipid Panel; Thyroid Stimulating Hormone (TSH) for women over 40; and Prostate Specific Antigen (PSA) for men over 50.
Currently, in accordance with the VA Handbook, the Employer offers its employees the opportunity to (1) have a physical examination, which may lead to further laboratory tests, or (2) have only laboratory work performed.1/ In the first situation, an employee has a physical examination and, as a result, a battery of laboratory tests is ordered. This option is not affected by the Employer's proposal, as an employee will still be able to sign up for an examination annually and appropriate laboratory work would be performed as a part of that examination.
As to the second scenario, which is the subject of the current impasse, an employee can choose to skip the physical examination and just request laboratory tests. The proposal changes the kinds of tests offered and reduces their frequency from annually to once every 2 years. Screening tests presently being offered include: Complete Blood Count (CBC); Comprehensive Metabolic Profile (CMP); Fasting Lipid panel; TSH; and PSA for men over 50. The proposed modifications would permit the use of subtests rather than the complete test, i.e., the HH instead of the CBC, and the Fasting Glucose in place of the CMP. The other tests are unchanged except that the TSH would now be provided only to women over 40 rather than all women.
The VA Handbook does not dictate which laboratory tests should be offered to employees; this determination is delegated to the discretion of the local medical facility.2/ As a result, there are no standard screening tests.3/ After a review of laboratory utilization services in 2002, "it was determined that a change  was warranted based upon current clinical knowledge and standards." According to the recommendations in the United States Preventative Services Task Force (USPSTF) Guidelines,4/ the current battery of tests being provided to employees is beyond the "accepted standard of care of preventative medicine." Continuing this particular ser