Keeping prevention on track

December 30, 1993

As other cities cope with a frightening spread of drug-resistant tuberculosis, Baltimoreans can take comfort in the fact that only about one case a year has been showing up here. Moreover, in the past two decades, the city has dropped from No. 1 in the country in per capita cases of treatable TB to 28th. For that success, we can thank the unglamorous but essential work of the city Health Department. Prevention pays off, as do the city's exemplary efforts to monitor TB patients and ensure that they take their medicine.

So when several dozen workers in the department's clinics aimed at TB, AIDS and other infectious diseases complain about a change in employment status, the city ought to listen. In this case, officials have listened, and there seems to be no reason the majority of complaints can't be resolved.

With the termination of a $5.5 million contract with Union Memorial Hospital, 77 health clinic workers are being folded into the city's employment system. About 30 of them will get pay raises. Others are seeing a pay cut, some of which are negligible given the better benefits package offered by the city. In some cases, however, the loss will be significant and workers have threatened to find other work. The change is also causing some gaps in insurance coverage and other benefits.

None of these problems is insurmountable. The city has guaranteed each employee who is dissatisfied with the new job classification a full review by the end of March. It also seems dTC likely the city can find a way to cover any worrisome gaps in benefits.

In the long run, the move erases an inequitable two-tier system in which workers doing equally arduous and risky work were making significantly different salaries. Just as important, the cancellation of the Union Memorial contract will eventually yield a couple of hundred thousand dollars in administrative savings that can be used to improve services in clinics that are often swamped with patients. No change like this is ever completely painless. But in this case the benefits are clear, and there seem to be reasonable remedies for the hardships entailed.

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