DEPARTMENT OF LABOR

Employment and Training Administration

TA-W-85,749

ST. THOMAS MEDICAL GROUP
WORKING ON-SITE AT NASHVILLE HEALTHCARE SOLUTIONS
NASHVILLE, TENNESSEE

Notice of Revised Determination
After Statutory Reconsideration

As required by the Trade Adjustment Assistance Reauthorization
Act of 2015 (TAARA 2015), which was enacted as Title IV of the
Trade Preferences Extension Act of 2015, Public Law No. 114-27,
section 405(a)(1)(A), the investigation into this petition was
reopened for a reconsideration investigation to apply the
requirements for worker group eligibility under chapter 2 of title
II of the Trade Act of 1974, as amended by the TAARA 2015, to the
facts of this petition (statutory reconsideration).
The initial investigation, initiated December 31, 2014,
resulted in a negative determination, issued on January 29, 2015,
that was based on the firm does not producing an article. The
determination was applicable to workers and former workers of St.
Thomas Medical Group, working on-site at Nashville Healthcare
Solutions, Nashville, Tennessee. The workers’ firm is engaged in
activities related to the supply of bill processing for medical
services.
Based on information reviewed during the reconsideration
investigation, the Department of Labor determines that the workers’
firm acquired services from a foreign country.
Section 222(a)(1) has been met because a significant number
or proportion of the workers in such workers’ firm have become
totally or partially separated, or are threatened to become totally
or partially separated.
Section 222(a)(2)(B) has been met because the workers’ firm
has acquired from a foreign country services like or directly
competitive with services supplied by the workers which contributed
importantly to worker group separations at St. Thomas Medical
Group, working on-site at Nashville Healthcare Solutions,
Nashville, Tennessee.
Conclusion
After careful review, I determine that workers of St. Thomas
Medical Group, working on-site at Nashville Healthcare Solutions,
Nashville, Tennessee, who are engaged in activities related to the
supply of bill processing for medical services, meet the worker
group certification criteria under Section 222(a) of the Act, 19
U.S.C. § 2272(a). In accordance with Section 223 of the Act, 19
U.S.C. § 2273, I make the following certification:



"All workers of St. Thomas Medical Group, working on-site at
Nashville Healthcare Solutions, Nashville, Tennessee who
became totally or partially separated from employment on or
after December 31, 2013, through two years from the date of
certification, and all workers in the group threatened with
total or partial separation from employment on the date of
certification through two years from the date of
certification, are eligible to apply for adjustment assistance
under Chapter 2 of Title II of the Trade Act of 1974, as
amended.”
Signed in Washington, D.C., this 6th day of October, 2015



/s/ Hope D. Kinglock____________
HOPE D. KINGLOCK
Certifying Officer, Office of
Trade Adjustment Assistance






DEPARTMENT OF LABOR
Employment and Training Administration
TA-W-85,749

ST. THOMAS MEDICAL GROUP
WORKING ON-SITE AT NASHVILLE HEALTHCARE SOLUTIONS
NASHVILLE, TENNESSEE

Negative Determination Regarding Eligibility
To Apply For Worker Adjustment Assistance
And Alternative Trade Adjustment Assistance

In accordance with Section 223 of the Trade Act of 1974, as
amended ("Act"), 19 U.S.C. § 2273, the Department of Labor herein
presents the results of an investigation regarding certification of
eligibility to apply for worker adjustment assistance.
Workers of a firm may be eligible for worker adjustment
assistance if they satisfy the criteria of subsection (a) and (b)
of Section 222 of the Act, 19 U.S.C. § 2272(a) and (b). For the
Department of Labor to issue a certification for workers under
Section 222(a) of the Act, 19 U.S.C. § 2272(a), the following three
criteria must be met:
(1) The first criterion (set forth in Section 222(a)(1) of the
Act, 19 U.S.C. § 2272(a)(1)) requires that a significant
number or proportion of the workers in such workers' firm, or
an appropriate subdivision of the firm, have become totally or
partially separated, or are threatened to become totally or
partially separated
(2) The second criterion (set forth in Section 222(a)(2) of the
Act, 19 U.S.C. § 2272(a)(2)) may be satisfied in one of two
ways:
(A) Increased Imports Path:
(i) sales or production, or both, at the workers' firm must
have decreased absolutely, AND
(ii) imports of articles like or directly competitive with
articles produced by such firm or subdivision have
increased; and
(iii) the increase described in clause (ii) contributed
importantly to such workers' separation or threat of
separation and to the decline in the sales or
production of such firm or subdivision.

(B) Shift in Production Path:
(i) there has been a shift in production by such workers'
firm or subdivision to a foreign country of articles like
or directly competitive with articles which are produced
by such firm or subdivision; and
(ii)(I) the country to which the workers' firm has
shifted production of the articles is a party to a free
trade agreement with the United States;
(II)the country to which the workers' firm has
shifted production of the articles is a beneficiary
country under the Andean Trade Preference Act, African
Growth and Opportunity Act, or the Caribbean Basin
Economic Recovery Act; or
(III)there has been or is likely to be an increase in
imports of articles that are like or directly
competitive with articles which are or were produced by
such firm or subdivision.

For the Department to issue a secondary worker certification
under Section 222(b) of the Act, 19 U.S.C. § 2272(b), to workers of
a Supplier or a Downstream Producer, the following criteria must be
met:
(1) a significant number or proportion of the workers in the
workers' firm or an appropriate subdivision of the firm
have become totally or partially separated, or are
threatened to become totally or partially separated;

(2) the workers' firm is a Supplier or Downstream Producer to
a firm that employed a group of workers who received a
certification of eligibility under Section 222(a) of the
Act, 19 U.S.C. § 2272(a), and such supply or production
is related to the article that was the basis for such
certification; and

(3) either
(A) the workers' firm is a supplier and the component parts
it supplied to the firm described in paragraph (2)
accounted for at least 20 percent of the production or
sales of the workers' firm; or
(B) a loss of business by the workers' firm with the firm
described in paragraph (2) contributed importantly to the
workers' separation or threat of separation.


Section 222(c) of the Act, 19 U.S.C. § 2272(c), defines the
terms "Supplier" and "Downstream Producer."
The investigation was initiated in response to a petition
filed on December 31, 2014 on behalf of workers of St. Thomas
Medical Group working on-site at Nashville Healthcare Solutions,
Nashville, Tennessee. The workers' firm is engaged in activities
related to the supply of processing of billing for medical
services.
The investigation revealed that St. Thomas Medical Group
working on-site at Nashville Healthcare Solutions, Nashville,
Tennessee, does not produce an article within the meaning of
Section 222(a) or Section 222(b) of the Act. In order to be
considered eligible to apply for adjustment assistance under
Section 223 of the Trade Act of 1974, the worker group seeking
certification must work for a "firm" or appropriate subdivision
that produces an article. The definition of a firm includes an
individual proprietorship, partnership, joint venture, association,
corporation (including a development corporation), business trust,
cooperative, trustee in bankruptcy, and receiver under decree of
any court.
During the investigation, the Department of Labor obtained
information that revealed that the workers' firm did not produce an
article; rather, the workers' firm supplied processing of billing
for medical services.
In order for the Department to issue a certification of
eligibility to apply for alternative trade adjustment assistance
(ATAA), the worker group must be certified eligible to apply for
trade adjustment assistance (TAA). Since the workers are denied
eligibility to apply for TAA, the workers cannot be certified
eligible for ATAA.
Conclusion
After careful review of the facts obtained in the
investigation, I determine that all workers of St. Thomas Medical
Group working on-site at Nashville Healthcare Solutions,
Nashville, Tennessee engaged in activities related to the supply
of processing of billing for medical services are denied
eligibility to apply for adjustment assistance under Section 223 of
the Trade Act of 1974, and are also denied eligibility to apply for
alternative trade adjustment assistance under Section 246 of the
Trade Act of 1974.
Signed in Washington, D.C., this 29th day of January, 2015.


/s/Michael W. Jaffe
______________________________
MICHAEL W. JAFFE
Certifying Officer, Office of
Trade Adjustment Assistance