UNITED STATES DEPARTMENT OF LABOR

Employment and Training Administration

TA-W-98,192

VHS HURON VALLEY-SINAI HOSPITAL, INC.

D/B/A HURON VALLEY-SINAI HOSPITAL

ACCOUNTING DEPARTMENT

COMMERCE CHARTER TOWNSHIP, MICHIGAN

TA-W-98,192A

VHS DETROIT RECEIVING HOSPITAL, INC.

D/B/A DETROIT RECEIVING HOSPITAL

DETROIT, MICHIGAN

TA-W-98,192B

VHS HARPER-HUTZEL HOSPITAL, INC.

D/B/A HARPER-HUTZEL RECEIVING HOSPITAL

DETROIT, MICHIGAN

TA-W-98,192C

VHS REHABILITATION INSTITUTE OF MICHIGAN

D/B/A REHABILITATION INSTITUTE OF MICHIGAN

ACCOUNTING DEPARTMENT

DETROIT, MICHIGAN

TA-W-98,192D

VHS SINAI-GRACE HOSPITAL, INC.

D/B/A SINAI-GRACE HOSPITAL

DETROIT, MICHIGAN

Negative Determination Regarding Eligibility

To Apply For Worker Adjustment Assistance

And Alternative Trade Adjustment Assistance

TRADE ADJUSTMENT ASSISTANCE

In accordance with Section 223 of the Trade Act of 1974, as
amended ("the Act"), 19 U.S.C. § 2273, the Department of Labor
("the Department") 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:

(B) 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© of the Act, 19 U.S.C. § 2272(c), defines the
terms "Supplier" and "Downstream Producer."

The investigation was initiated in response to a Trade
Adjustment Assistance for Workers (TAA) and Alternative Trade
Adjustment Assistance (ATAA) petition dated February 7, 2022 and
filed on February 8, 2022 by a State Workforce Office, on behalf
of former workers of VHS Huron Valley-Sinai Hospital, Inc., d/b/a
Huron Valley-Sinai Hospital, Accounting Department, Commerce
Charter Township, Michigan (TA-W-98,192); VHS Detroit Receiving
Hospital, Inc., d/b/a Detroit Receiving Hospital, Detroit,
Michigan (TA-W-98,192A); VHS Harper-Hutzel Hospital, Inc., d/b/a
Harper-Hutzel Receiving Hospital, Detroit, Michigan (TA-W-
98,192B); VHS Rehabilitation Institute of Michigan, d/b/a
Rehabilitation Institute of Michigan, Accounting Department,
Detroit, Michigan (TA-W-98,192C); VHS Sinai-Grace Hospital, Inc.,
d/b/a Sinai-Grace Hospital, Detroit, Michigan (TA-W-98,192D). The
workers' firms are hospital subsidiaries of Detroit Medical Center
which is a subsidiary of Tenet Health Corporation.

In accordance with 20 CFR 618.110 group of workers is defined
as, ""¦including teleworkers and staffed workers."

The petition alleges that worker separations, or threats
thereof, were due to foreign trade. "The Detroit Medical Center
(DMC) is an alliance of hospitals and is owned by Tenet Healthcare.
On or around July 9, 2021, Tenet Healthcare allegedly outsourced
their Michigan based accounting staff with the DMC to the
Philippines. Included in this petition, as attachments, are
multiple locations within the DMC that are owned by Tenet Health.
The total number of adversely affected workers within the region
is believed to be 40-50 spread across all locations. More layoffs
may have occurred throughout the United States within Tenet
Healthcare's holdings for the same reason."

In order to be considered eligible to apply for adjustment
assistance under Section 223 of the Trade Act of 1974, the group
of workers seeking certification (or on whose behalf certification
is being sought) 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.

Per 20 CFR 618.110, Article means "a tangible good or an
intangible good sold or produced by a firm. The good must be the
subject of the sale or production, and not an object that is
produced incidentally to the sale or production. An article can be
measured in individual production units or commercial production
units, such as with commodities. Sale of an article is the means
by which revenue is generated, accumulated, or calculated."

During the investigation, the Department obtained information
that revealed that the petition workers' firm does not produce an
article within the meaning of Section 222(a) or Section 222(b) of
the Act; rather, the workers' firm is engaged in activities related
to the supply of healthcare services.

ALTERNATIVE TRADE ADJUSTMENT ASSISTANCE

In order for the Department to issue a certification of
eligibility to apply for Alternative Trade Adjustment Assistance
("ATAA"), the group of workers must be certified eligible to apply
for Trade Adjustment Assistance ("TAA"). Because the group of
workers are denied eligibility to apply for TAA, the group of
workers cannot be certified eligible for ATAA.

Conclusion

After careful review of the facts obtained in the
investigation, I determine that all workers of VHS Huron Valley-
Sinai Hospital, Inc., d/b/a Huron Valley-Sinai Hospital,
Accounting Department, Commerce Charter Township, Michigan (TA-W-
98,192); VHS Detroit Receiving Hospital, Inc., d/b/a Detroit
Receiving Hospital, Detroit, Michigan (TA-W-98,192A); VHS Harper-
Hutzel Hospital, Inc., d/b/a Harper-Hutzel Receiving Hospital,
Detroit, Michigan (TA-W-98,192B); VHS Rehabilitation Institute of
Michigan, d/b/a Rehabilitation Institute of Michigan, Accounting
Department, Detroit, Michigan (TA-W-98,192C); VHS Sinai-Grace
Hospital, Inc., d/b/a Sinai-Grace Hospital, Detroit, Michigan (TA-
W-98,192D) engaged in activities related to the supply of
healthcare 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 27th day of June, 2022



/s/ Hope D. Kinglock
_______________________
HOPE D. KINGLOCK

Certifying Officer, Office of

Trade Adjustment Assistance