The situation: The recent decision by Legacy Compensation to change Care Management positions from Exempt to Non-Exempt status will have far-reaching negative impacts on primary care providers, patients in the outpatient setting, and on the Social Workers and RN Case Managers in the ambulatory setting.

The issues:

Patient care and provider satisfaction will suffer. Flexibility in the ambulatory setting is critical to meeting the needs of our patients and providers, as we cannot miss opportunities to intervene when our patients are in the clinic for a limited time and struggle with multiple barriers to attending appointments. Our clinics are staffed with multiple providers who can see upwards of 15-20 patients each day and rely on the availability and flexibility of their Care Management team to respond quickly to assess and collaborate on a treatment plan prior to the patient leaving the clinic. Our work is ongoing, and we have no routine coverage for unexpected or planned absences. We are also required to respond to urgent needs at other clinics when called--this can happen at any time.

There is no benefit, only harm, to outpatient ambulatory care management staff. It is our assumption per discussions with our Care Management Interim Director that this decision was driven by a need to comply with compensation criteria for hospital care management staffing, as it relates to staffing, shift and weekend coverage.  Inpatient care managers are eligible for shift differentials, weekend differentials, holiday pay, etc.  As the ambulatory Care Management staff are unfortunately grouped under the same job code, ambulatory staff do NOT have the ability to benefit from differentials or holiday pay and now lack the autonomy and flexibility to respond to the demands of the clinics in which they work. This change will lower engagement and increase burnout for ambulatory care management staff.

This change provides no additional benefit to outpatient care management staff while making it more difficult to meet the needs of our patients and providers. 

The solution: Now is the time to act, to demand change in the compensation structure for ambulatory care management.  Having a distinct and separate job code is the industry standard and reflects other licensed, clinical professional roles within Legacy, i.e. Inpatient vs Outpatient pharmacists. We care deeply about our patients and providers. The flexibility that comes with exempt status is essential to our ability to meet their needs.

Your action needed: Please sign this petition to signal your support for a change to the ambulatory job codes, to clearly identify the differences between inpatient and outpatient SW and RNCM, and ultimately return us to exempt status.   In one week, we plan to submit this petition to Care Management leadership, and LMG leadership with as many signatures as possible. Help us advocate for the resources and structure we need to support our patients and providers!