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Strained relations between Yale-New Haven Hospital and the Service Employees International Union District 1199 have continued into November, nine months after the union local settled its 16-month labor contract dispute.

Tensions remain after the Connecticut Supreme Court recently refused to hear an appeal for the dismissal of a SEIU lawsuit against the hospital over excessive billing of indigent patients, and union leaders have voiced concern that YNHH will not negotiate with the community about the construction of its cancer center.

SEIU attorney Daniel Livingston said the putative class action lawsuit, which lists a number of local residents as plaintiffs, is indicative of general tension between the hospital and local residents.

“It is part of a broad struggle by many people in the community who are supposed to be served by the hospital or are working for the hospital,” Livingston said. “For the union, as with trade unions in general, there is a sense that the interests of other poor or working people are common.”

The lawsuit — the latest development in a lengthy conflict between the union and hospital — accuses the hospital of violating state law by billing uninsured patients for more than just the cost of care.

Though a superior court judge recently dismissed nine of the 15 original counts against the hospital because some patients were billed but never actually paid above cost, the union has repleaded one of the dismissed counts.

Livingston said that although they are not plaintiffs in the case, some YNHH employees who had also spent time as hospital patients were the first to bring the alleged overbilling and mistreatment of indigent patients to the union’s attention.

YNHH spokesman Vin Petrini said the lawsuit is unfounded and represents an attempt by the union to pressure hospital leaders into making unrelated concessions.

“The lawsuit is one motivated by a desire by the SEIU to organize hospital employees — rather than a case that speaks to the merits of the law,” Petrini said. “The hospital will continue to defend itself vigorously. It is quite unusual that a judge would throw out those nine counts, and I think it speaks to the weakness of the case.”

A different issue concerning the hospital, union and community members — that of the new cancer center, scheduled to open in 2008 — has also resulted in conflict between the groups.

Though representatives of a new SEIU-staffed group, Community Organized for Responsible Development, said they are glad the cancer center will be built, they want to ensure community concerns surrounding its erection, ranging from construction dust to insufficient job creation, will be heard.

District 1199 spokesman Bill Meyerson said a recent poll of more than 800 local residents by the Greenberg Quinlan Rosner research group showed the community’s support for the cancer center hinges on the hospital’s compliance with local interests.

“The most significant thing is that 79 percent of those polled support a community benefits agreement as a condition of Yale-New Haven Hospital’s building a cancer center,” Meyerson said. “What that means is that there needs to be an agreement between the hospital and community organizers that will include the promise of creating more affordable housing, better access to health care, ensuring environmental protection, space for youth recreation, local hiring and a fair process for workers to unionize.”

Meyerson said although the hospital has had some informal discussions with CORD about community concerns, the group will not be satisfied until YNHH agrees to participate in formal negotiations about the center’s construction.

Petrini said YNHH has already done much to reach out to the New Haven community.

“The hospital has met with CORD and has spent the last several months in the community talking about priorities,” Petrini said. “We’ve been a strong partner with the community all along.”

The Rev. Scott Marks, a CORD organizer and the New Haven director of the Connecticut Center for a New Economy, said he is hopeful the cancer center can benefit local residents and employees, as well as the hospital.

“I have reached out to the hospital to talk about ideas hundreds of residents in the Hill have brought up,” Marks said. “While it’s an amazing opportunity to gain a facility like the cancer center, we need to make sure residents have access to good, negotiable jobs and livable wages. The community is in tough times and is headed for tougher times, and it needs that.”

Marks and other CORD members said although hospital representatives missed a scheduled meeting with the organization earlier in the fall, communication between the two has progressed since.