New London — Lawrence + Memorial Hospital made what it called its "last, best and final offer" to the union representing about 800 nurses and technicians, delivering its terms electronically late Tuesday night to the union's negotiating team and in a letter sent to the workers Wednesday.

No meetings took place between the two sides on Wednesday, and none have been scheduled. However, spokesmen for both the union and the hospital said a session today or Friday is possible.

Many of the workers, who went on strike Nov. 27 and have kept up daily pickets outside the main hospital and the Pequot Health Center in Groton, turned out for meetings at the union hall Wednesday about assistance available from the United Way and about applying for unemployment compensation. The unemployment funds would cover work days lost since the lockout began Saturday night, when the nurses and technicians ended a four-day strike but the hospital did not let them return to their jobs. L+M officials said they could not go back to work until there is a new contract because of union threats of on-again, off-again strikes. Union officials deny such threats were made.

Since the strike, the hospital has been staffed by 150 to 250 replacement nurses and technicians.

The hospital posted the offer on its internal website and at www.lmhospital.org, its public site. In his letter, President and Chief Executive Officer Bruce Cummings urged nurses and technicians "to express your views of our proposal to your union and request that your voice be heard through a vote of union membership."

The offer, which the union dismissed as a "rehashing" of proposals it already has rejected, addresses the union's central sticking point of job security with a commitment that L+M "will not transfer any acute care services currently performed by the bargaining unit members to other L+M entities." Acute care services include the Emergency Department, operating rooms, medical-surgical services and labor and delivery services, among others. According to the Connecticut Hospital Association, treatment for severe injury, episode of illness, urgent medical condition or surgery is considered acute care.

Regarding non-acute care services, which includes many outpatient departments, the hospital's offer states that if those are transferred to hospital affiliates, unionized workers who are laid off as a result would be eligible for special assistance and support, components of which are described in the offer.

Hospital spokesman Michael O'Farrell said the language regarding transfers of non-acute services is included so that the hospital can remain "efficient, flexible and adaptable" to the rapidly changing health care environment.

"There are no mass transfers planned," he said. "We're not hiding behind a grand plan."

In an email message, Gary Cass, L+M's director of human resources/labor relations and lead negotiator, told Greg Kotecki, his counterpart at the union, that "both sides have gone as far as they can on this subject," referring to the transfer issue.

"Because there was no change on the union's part on work transfer or any of the remaining issues, the hospital is transmitting its last, best and final offer," he wrote.

O'Farrell said the 800 union members should decide what happens next. "We hope (union leaders) will take (the offer) to the members," he said.

Matt O'Connor, spokesman for AFT Connecticut, said the hospital's offer has not changed since before the lockout began.

"We have already rejected it, so it cannot be considered a last, best offer," he said.

The hospital's attorney has contacted Kotecki and federal mediator John Carpino to schedule a meeting for Dec. 10, O'Connor said.

"If they were truly offering a LBO (last best offer), they would not be offering to continue negotiations," he said in an email message.

In the union's latest counterproposal, which preceded the hospital's offer, L+M would pledge that if any services are transferred from the hospital, affected union members would be able to keep their jobs at the new locations. Guarantees that unionized staff would be able to "follow the work" are the heart of protections the union is seeking in the new contract. The counterproposal was presented during Tuesday's negotiation session.

In the counterproposal, pay and benefits of the transferred workers would be renegotiated, and they would remain part of the union. If transferred work is not available, the employee would have the same layoff support listed in L+M's offer.

O'Connor said the union is concerned that L+M's definition of "non-acute" versus "acute" care services is "so broad you could drive an ambulance through it," so it is seeking to remove those terms from the new contract.

The issue about transfer of services became a point of contention for the union over the last year, after L+M moved outpatient psychiatric services, the obstetrics-gynecology clinic and some cardiac care services out of the main hospital to affiliated physicians' offices in the community. An unfair labor practice charge regarding the transfers is pending.

O'Connor said that next year, the hospital plans to move the Joslin Diabetes Clinic and occupational health and infectious disease services out of the hospital. L+M officials said the only active transfer plans are for the Joslin Diabetes Center, which does not employ any unionized nurses or technicians.

j.benson@theday.com

L+M's 'last, best and final offer' includes:

• A commitment that the hospital will not transfer any acute care services currently performed by bargaining unit members to any other L+M entities.

• A commitment that if a union member is laid off due to the transfer of a non-acute service from the hospital to another L+M entity, the affected employee will be provided with the following options and support in addition to those already in the contract:

• Priority to be hired for vacant union positions

• “Bumping rights” for the jobs of less senior unionized employees

• Eligibility to be retrained for another job

• Placement on a recall list to fill vacancies for two years

• Six months' severance pay and benefits

• Retraining and priority placement options for an employees who lose more than eight hours a week of work because of service transfers.

Union bargaining units' latest offer:If the hospital transfers any work, operations, services or procedures historically performed by bargaining unit members to other L+M Corp. controlled entities, the following procedure will be followed:• Affected bargaining unit employees shall be offered any transferred work that he/she is qualified to perform.• The parties agree to bargain the affected employees' rate of pay and benefits.• Affected employees shall be covered by the collective bargaining agreement that covered said employee at the time of the transfer of work.• In the event that the transferred work is not available to the impacted employee, the same list of options and support listed by the hospital for laid-off employees would be provided.