Medical School Council Response To The Benefits Office

In the Medical School Council meeting of November 14, 2007 significant concerns regarding recent actions of the Office of Benefits were raised. Specifically, 1) benefit dollars have been decreased to $800 for all faculty and 2) the ability to earn an extra 100 benefit dollars was tied to a requisite survey that discloses personal health information. Charlene Hays, Vice-President of Human Resources, Heidi Conway, Senior Director for Benefits Services and HR Shared Services, Patricia Brown, Senior Director of Johns Hopkins Health Care and Dean Miller were in attendance and addressed the concerns presented by the MSC. The Council found the responses to be unsatisfactory, and consequently, voted to make a formal statement to the Office of Benefits on behalf of the School of Medicine faculty:

The council agrees with both Johns Hopkins Healthcare and the Office of Benefits that the promotion of improved employee health is a laudable goal. We recognize that healthcare costs are rising at an unprecedented rate and that improving employee health would potentially decrease the financial burden of providing healthcare. However, the means by which Johns Hopkins Healthcare and the Office of Benefits attempted to meet this goal are objectionable.

A) Flat Rate of Benefit Dollars ($800.00)

In initial salary negotiations, benefits are considered as part of the hiring package. Further, subsequent salary raises are based on the initial negotiated salary. Thus, a decrease in benefits is, essentially, a decrease in the salary package. While we understand the financial dilemma presented by the rising cost of healthcare, we must be cognizant of the fact that reducing benefit dollars across all faculty does not equalize the benefit payout among faculty (as was stated during the MSC meeting), but merely reduces the benefit dollars for all and, thusly, reduces the salary package for all.

B) Health Risk Assessment (HRA) for Money

Per earlier statements and an e-mail from Ms. Conway, there was an allocation of $900 to provide benefits for each employee. According to Ms Conway, the Office of Benefits “made the decision that we would use 100 of those dollars to motivate employees to think about their lifestyles, get an assessment of their health risks, and make a commitment to positive change.” While we strongly agree that encouraging healthy lifestyles is important and beneficial to all, we take issue with any action forcing faculty to complete a Health Risk Assessment in order to obtain benefit dollars that were designated for them. It is enough of a burden for faculty to absorb reduced benefit dollars; it is coercive and unethical to further demand faculty complete a personal HRA in order to recoup any benefit dollars allotted to them.

C) Privacy of HRA.

The HRA consent states:

If you consent to be bound by this End User Notice and Consent, information about you may be shared with licensees in two forms: (1) aggregate data (your data combined with those of other participants which does not personally identify you), and (2) personally identifiable data (data specific to and identifiable to you).

and

This notice contains our policy with respect to our security and privacy practices. This policy and notice may change at any time.

Although the Office of Benefits and Johns Hopkins Healthcare assured the MSC that private health information would only be reported in aggregate, this assurance is not clear in the consent to the HRA. The consent clearly states that personally identifiable information may be given out. There has been no clarification to the faculty of who may and who may not receive personally identifiable information nor specifically how this information may be used. Additionally, the main page linking to the HRA specifically states that the HRA is confidential; this implies that no identifiable information can be linked to the respondent. That statement and the consent are contradictory and require clarification. Further, it is particularly worrisome that the consent states that “this policy and notice may change at any time.” The faculty must be informed of what this means to them.

D)Communication and Transparency

In the past, the MSC has requested better communication from the Benefits Office. Despite their assurances that communication would improve, their failure to honor their assurances continues to be a source of concern. Although we were informed that there have been ongoing discussions for 3 years on the changes in benefits, the lack of communication to the faculty makes the decisions appear sudden and capricious. Because of inadequate communication, lack of transparency and non-inclusiveness in the process, members of the MSC have received multiple complaints from their constituents. Many of the faculty report feeling devalued and disrespected. The Office of Benefits must recognize that their decisions affect numerous lives and those lives represent the heart and soul of Johns Hopkins. Johns Hopkins is among the best medical institutions in the world, but it is wise to keep in mind that it is the faculty and staff who make Johns Hopkins what it is.

As a result of the above, the Medical School Council, on behalf of the School of Medicine faculty, is making the following requests:

1)The $100 allocated for the HRA should be automatically and immediately allotted to all faculty; i.e., the $100 should not be contingent upon completing the HRA. We ask that the Office of Benefits consider other means for helping faculty realize potential areas of health risks and ways to address these risks. The MSC will be happy to work with the Office of Benefits to conceive other methods of assisting the faculty in pursuing a healthy lifestyle.

2)The HRA, in and of itself, is not an objectionable method for assisting faculty in assessing their health risks (if not tied to benefit dollars); however, there must be much more clarification on how this information will be utilized. The faculty should be informed of any and all risks of providing such information. If the policy of non-disclosure may be revoked at any time, the faculty must be informed on what this means to them. Further, the faculty must not be told that their responses to the HRA are confidential if this is not absolutely true; i.e., if the information can be used to target certain individuals, this must be stated upfront along with specific information on how this will be done and what it means to the targeted faculty. Thus, we request a public explanation of privacy issues, risks and protections associated with the HRA as well as how data obtained from the HRA will be used, whether certain faculty will be targeted and how any targeted faculty will be impacted.

3)In keeping with the goals of communication and transparency, we request a public explanation detailing the breakdown of how the faculty’s 34% fringe benefits are being apportioned.

4)The faculty should not only be informed well in advance of any decisions that wholly and directly influence their salary package, including benefit dollars, but also have a Medical School Council representative participate in the discussion phase of these matters.