Kaiser HMO Workers Strike for Safe Staffing

After a three week strike, health care workers in Denver have won an important part of their demand for adequate staffing. The 1,200 workers at Kaiser Permanente won the right to go directly to federal court to enforce language calling for safe staffing levels. "Ask any health care worker across the country," said Ernest Duran, Jr., president of United Food and Commercial Workers Local 7. "Safe staffing is a universal issue. Denver is the only Kaiser location in the country where workers have enforcement on staffing." Meanwhile, top Kaiser brass has agreed with the Coalition of Kaiser Unions to negotiate a first-ever national contract for Kaiser workers. Kaiser is one of the nation's largest health maintenance organizations; it claims about eight million members nationally and about 358,000 in central Colorado. Kaiser and most of the unions representing its workers launched a national "partnership" in 1997 that was arranged largely by the AFL-CIO. Through the partnership, union members were to get a voice in Kaiser's decision-making, and thereby improve quality of care. In return, the unions would promote Kaiser to the public as a "provider of choice."


The unions involved in the partnership--including SEIU, UFCW, AFSCME, and others-- formed the Coalition of Kaiser Unions, with offices in Washington. But the partnership has not always worked out as planned; workers in Denver wanted more than a voice.

The Colorado strike, by registered nurses, physician assistants, nurse practitioners, optometrists, and other members of UFCW Local 7, did not shut down the HMO's 16 area medical offices and one emergency care center. Physicians, temporary replacements, some line crossers, and other staff maintained a reduced schedule while postponing many appointments.

Clerical workers, technicians, and licensed practical nurses--members of SEIU Local 105--were bound by a no-strike contract clause and kept working. They showed solidarity by wearing buttons, joining picket lines, and attending rallies. When Kaiser management bought lunches for non-strikers, SEIU members would bring the plates of food to strikers on the line, said SEIU Local 105 President Mitch Ackerman.

Adequate staffing, enough to ensure quality patient care, was the top strike issue, said the UFCW's Duran. UFCW members were asking for binding arbitration on staffing issues, but had to compromise. The two sides settled on a six-person labor-management committee to examine staffing questions. If the committee cannot agree, issues can be brought to an arbitrator who can force Kaiser to make "penalty payments" for inadequate staffing levels.



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The union's new right to take staffing issues directly to federal court would bypass grievance and arbitration machinery. "If that happens we'll have the right to any applicable [corporate] document on staffing or patient care," said Duran, who previously worked as the local's attorney. "Moreover, we can place Kaiser officials under oath and question them in a deposition about patient care/staffing issues."

"I think the committee may reach a consensus on the easy issues. We'll probably have to go to court on the harder ones," Duran added. "If we do, the court can order Kaiser to pay damages, increase staffing, or take other measures to ensure quality and ethical patient care."

Local 7 also won a guarantee that no jobs will be lost to subcontracting; the company will still be allowed to subcontract work on a temporary basis. On wages, the union had demanded a 15 percent pay increase over three years, and settled for 12.8 percent. The contract was approved by over 90 percent of voters.


Early in the strike, a company official told the press that staffing should not be addressed in Local 7's contract since Kaiser and its unions had formed a national partnership to deal with such issues. Duran said there had been partnership meetings in Denver, but no agreement on staffing--at least not from the management side. "The partnership will never address that issue. It has to be solved through collective bargaining," he said.

SEIU's Ackerman agreed that "staffing is absolutely the top priority for every health care worker." Kaiser's partnership unions will use national bargaining, he said, to get an agreement on staffing that is "more than lip service.... We'll look at staffing language from all over the country and take the best pieces."

A national survey has gone to Kaiser workers whose unions are in the partnership. Bargaining is set to begin in May, with the aim of a tentative settlement by early September, according to Ackerman. Then Kaiser workers can decide, on a city-by-city basis, to sign on to the national contract or stick to their own agreements, he said. "It's an exciting opportunity to do in health care what steel and auto have done for years."