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La Familia union reports improved working conditions amid statewide health care worker shortages

La Familia raised more than $200,000 through GoFundMe to keep its doors open. (Mo Charnot)

Following successful union negotiations last month, La Familia Medical Center reports ongoing improvements, according to physician and union member Sue Katz, as well as CEO Brandy Van Pelt-Ramirez.

Last year, staff balked over working conditions at the Santa Fe clinic, which serves approximately 15,000 mostly low-income and uninsured patients, alongside extreme financial struggles that initially hit after the COVID-19 pandemic.

Katz, a physician who has worked with La Familia for 33 years, tells SFR that while financial deficits at the clinic became clear after COVID-19, former CEO Julie Wright’s interactions with staff after she was hired in early 2023 eventually drove the staff to unionize. Katz described Wright as “disrespectful of staff, insulting and discriminatory.”

Wright tells SFR she has “no response” to these allegations, and adds that “there are two sides to every story.” During her time working at La Familia, she says, “I learned a lot, and that’s all I’m going to say.”

Katz cites constantly changing schedules and increased patient loads without discussion as some of the issues that led to unionization, along with inadequate nursing and security staff.

“We started unionizing to try to have more say in how La Familia was run and to try to keep the provider staff present because people were starting to leave or they were being fired,” Katz says.

Van Pelt-Ramirez, who became La Familia’s interim CEO after the employees unionized in September 2023 and dismissed Wright from her position, tells SFR the union has “defined the direction La Familia is going in.”

“It’s a good way to open up communication, and I think that’s one of the things that we struggled with, with the previous CEO,” Van Pelt-Ramirez, who became the official CEO in March, says. “We’ve been able to sit at the table and agree on what the providers need. We look at it from a business perspective of what the patients need, what La Familia needs, and I think it’s going to result in greater collaboration in the future.”

Van Pelt-Ramirez says the collective bargaining agreement “really put things on paper” in terms of salary structure and staff-to-patient ratios, using standards set by the Medical Group Management Association to determine how to safely have providers see their required number of patients. Additionally, they set up pay incentives for providers who choose to see extra patients.

Katz notes that the union’s primary goal “had nothing to do with gaining money,” and that instead of pay increases, providers asked to have a transparent salary structure for all staff and protections for employees from mistreatment and being fired.

“We’re doing what we should do, and we’re working with the administration and trying to meet their needs as well,” she says. “It feels like there’s more protection for us if there were to be a capricious administrator again…I think it was really empowering. It really gave me hope for La Familia.”

As a result, the clinic has made gains filling out its provider vacancies. According to Chief Development Officer Jasmin Milz, La Familia has recently hired four new doctors, a new nurse practitioner and a new psychiatrist—with three nurse practitioner positions the clinic’s only remaining vacancies. Katz also notes that two providers who joined La Familia as part of a post-graduate residency program and “did not want to join last year because of all the problems,” recently decided to join the clinic full time.

Outside of La Familia, provider shortages remain high: According to a July 2024 report from University of New Mexico’s School of Health & Sciences, by the end of 2022 the state had a shortage of 334 primary care physicians; 5,704 RNs or clinical nurse specialists; 1,796 EMTs; 119 and 114 psychiatrists and occupational therapists; 482 pharmacists and 88 dentists.

Similarly, Presbyterian Medical Services recently reported it has vacancies for 34 primary care providers; 23 medical assistants; 18 behavioral health positions; 12 customer access representative positions and six community support workers. The report states that PMS has an “insufficient supply of providers that is exceeded by ever-growing demand.”

During a July 3 presentation before the Legislative Health and Human Services Committee, union members working at the UNM’s Sandoval Regional Medical Center asked legislators to hold the hospital’s management accountable by “forcing them to meet us at the table and bargain for a good and fair contract that prioritizes patient safety and quality care.”

The providers described a litany of issues with their working conditions similar to what employees at La Familia alleged: inadequate staffing; high turnover; disrespect from management and low pay. Furthermore, the hospital has, since the union formed in 2021, “refused to meet at the bargaining table” with the staff, according to union members.

Physical therapist Regina McGinnis told the committee that the quality of patient care has been “a slow progression downhill for the past few years,” and registered nurse Gigi Regusis says providers are “doing the absolute best we can for our situation,” but “we have so many patients and not enough nurses.”

Van Pelt-Ramirez says she believes taking a collaborative approach with La Familia’s providers has aided in improving administration and provider relationships.

“My approach from the beginning has been, ‘tell me what I can do to help you, and let me tell you what we need as an organization to keep us alive,’ and being able to do that has been huge,” Van Pelt- Ramirez says. “[La Familia] lost a good percentage of providers in the six months the previous CEO was here, there was a lot of damage control that needed to be done.”

Now, Van Pelt-Ramirez says, the clinic is working toward gaining financial sustainability after surviving a funding crisis in November last year that led to the clinic asking for donations to keep the clinic afloat. As of press time, its GoFundMe page reports $200,950 raised of its $1 million goal.

Van Pelt-Ramirez adds that clinic leadership is investigating whether they can potentially secure state funding through the Legislature, as Milz describes state funding for the past several years as “flat.” Both also note that La Familia has been looking at maximizing reimbursements from insurance companies and looking for ways to help providers gain more time to see patients.

“The biggest group of people that came forward the most was our patients, because they’ve been here for years,” Van Pelt-Ramirez says. “Their parents, multiple generations have come here, so we have some patients who give $5 a month, or just as much as they can. Our patients really rallied around us.”

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