The continuing dispute over the unionization of workers at Yale-New Haven Hospital — accompanied by a series of well-publicized investigations into its financial practices — has placed the institution at the center of political debate in New Haven and Hartford.

City and state officials have made the hospital a key target of both legislation and heated rhetoric, responding to concerns about aggressive debt collection practices, alleged overcharging of Medicare and its relationship with the local community. But both the hospital and some of its chief critics said despite the end of a 16-month long contract dispute between Yale-New Haven and its 150 unionized dietary workers, the over-arching issue at the hospital remains an ongoing organizing drive by some of its workers.

The list of controversies that have emerged in recent months surrounding the hospital is long. Connecticut Attorney General Richard Blumenthal, the hospital workers’ union and members of a clinic at Yale Law School have all filed or supported lawsuits challenging Yale-New Haven’s billing practices. An audit released this summer by the U.S. Department of Health and Human Services alleged Yale-New Haven Hospital overcharged Medicare $800,000 for organ transplant services over four years. And state and federal investigators said last month they were exploring whether the hospital was overcharging government agencies for medical supplies bought from a company that had ties with several Yale-New Haven executives.

Yet Vin Petrini, a spokesman for the hospital, said many of these issues — and the political scrutiny surrounding each of them — link back to the dispute between the hospital and supporters of an attempted organizing drive by Service Employees International Union District 1199.

“They’ve employed some challenging tactics using opportunities to damage our reputation and put pressure on leadership to agree to alternative forms of organizing employees here,” Petrini said. “There’s been a focus on the hospital because of the organizing efforts of the SEIU, which have been unsuccessful over the past several years.”

New Haven Mayor John DeStefano Jr., who has criticized Yale-New Haven Hospital in the past on the issue of labor relations, said while each of the controversies was significant in its own right, it is the unionization debate that has placed the hospital in the political spotlight.

“The hospital has placed itself in a position of scrutiny by its response to the organizing drive,” DeStefano said. “I think these kinds of issues will continue to arise, and in some ways, they are surrogate issues for the organizing drive.”

Beyond the investigations and lawsuits, the Board of Aldermen is also considering a resolution which would call for the hospital to allow a Community Review Board to investigate its debt collection practices. Partly in response to controversy at Yale-New Haven, the Connecticut General Assembly also passed a new law last year governing funds designed to offer free care to low-income patients.

The increased focus has come to the hospital as local political debate surrounding Yale University has quieted since it signed a new contract with its two largest unions, locals 34 and 35. The University and the hospital are separate entities, although Yale-New Haven serves as the primary teaching hospital for the Yale School of Medicine and several Yale administrators — including President Richard Levin — serve on its board.

SEIU District 1199 spokesman Bill Meyerson also said his union has been active at the hospital for years, but was overshadowed by the controversies at the University. In addition, Meyerson said in contrast to the settlement reached at the University, the hospital’s dietary workers were not pleased with the contract they ultimately signed — helping to keep public focus on Yale-New Haven.

“I think that there hasn’t been a shift, but with the [contract] settlement at the University, what you hear about is the hospital, because that hasn’t been resolved,” Meyerson said.

The hospital contends, however, that the political focus on Yale-New Haven misses larger issues facing the health care industry. Petrini cited a national decline in union membership as a possible cause of the struggles at Yale-New Haven, while he also pointed out that other hospitals have faced “confusion” over the same Medicare rules the hospital has been accused of breaching.

But although Petrini said the union organizing effort has had little effect on the operations of the hospital, DeStefano and others said they do not believe that the issues surrounding the hospital will go away.

“The larger point of view I have is that this is all part of a conflict that is probably going to get more intense,” DeStefano said.

PAULA BRADY
JACOB LEIBENLUFT