Two Unions Enter Recognition Pact with Health Care Company

On May 2 the Service Employees union and the United Nurses Association/Union of Health Care Professionals (an AFSCME affiliate) announced a neutrality agreement with Tenet, the nation’s second largest for-profit health care corporation. The agreement allows the unions uncontested access to workers in 40 California hospitals and two in Florida.

In a period when newly organized workers frequently find themselves unable to leverage a first contract, the pact guarantees that management will sign a four-year “model contract” immediately after recognition.

There is a twist.

At some of the affected hospitals, the California Nurses Association and its sister union the Caregivers and Healthcare Employees Union were involved in organizing drives. Registered nurses supporting CNA at seven Tenet hospitals had petitioned for NLRB elections the day before the agreement was announced.

CNA sees the deal as shutting them out at Tenet. As part of a legal challenge, the union has now filed for NLRB elections at 17 Tenet hospitals in the state.

CNA Communications Director Chuck Idelson says bluntly, “It’s an illegal attempt by Tenet to handpick the union of its choice.” Under the National Labor Relations Act, companies are banned from selecting bargaining agents for workers.

CNA contends that SEIU and AFSCME offered themselves up as a “less adversarial” alternative to what the union sees as its own more aggressive brand of unionism. Idelson criticizes SEIU for becoming an “ally of convenience for the hospital industry” by locking RNs into a long contract that CNA views as “concessionary” if measured against its own contracts.

SEIU and AFSCME point to their greater density overall in the health care industry and to the eight Tenet hospitals in southern California where RNs were already represented by one of the two unions. SEIU represents 755,000 health care workers nationally and AFSCME 360,000. “This is a huge breakthrough for everyone who works in these Tenet hospitals, and for their patients too" said Luisa Blue, RN, president of the SEIU Nurse Alliance of Southern California. "Tenet RNs will have the backing of the nation's largest health care unions when they join together to improve standards for registered nurses."


Tenet has called the agreement “a strategic alliance” that “forges a powerful new partnership.” The company’s tumbling stock prices and mounting legal and political woes have driven its management to seek out changes in its business plan.

Company spokesman Steve Campanini remarked to the San Diego Union Tribune: “A union alliance like this helps us move forward when we are dealing with regulatory issues. We call it a strategic business move.”

Tenet stock prices have dropped 68% since last October. Strikes and other difficulties with unions and workers have added to the company’s difficulties, which have included lawsuits, criminal convictions, and investigations around over-billing and other fraud charges.



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It is in this environment that Tenet has sought to “achieve labor peace.” The company is relying on its partnership with SEIU and AFSCME to provide it “with multi-year, stable and predictable labor costs.” A Tenet press release says that the agreement “fosters a spirit of collaboration by putting in place both national and local teams made up of management, employees, and union representatives.”

SEIU and AFSCME, along with other unions, entered a similar labor-management partnership with the big California HMO Kaiser Permanente in 1997. CNA, which was fighting for a contract at Kaiser at the time, opposed this partnership too.


The unions are debating the model contract’s strengths and weaknesses. SEIU and AFCSME point to immediate raises; CNA says that increases in their contracts are much higher, pointing to first-year 10% and 22% raises for RNs vs. Tenet’s 8%.

One provision allows Tenet to “subcontract all or any part of any operation performed by Employees.” Another, dealing with seniority rights, allows the company to retain its pre-union arrangement even during recalls or layoffs.

The contract provides many protections that come with a standard union contract, including a grievance procedure, a progressive discipline system, successorship protection, etc. Mandatory overtime, a major issue in the chronically understaffed nursing field, is banned except in emergencies as defined by government authorities--or the hospital administrator.

The contract stipulates that the unions will neither strike nor picket when the second contract is negotiated four years from now.


Dueling leaflets flew as tensions among the unions heated up around Tenet. CNA leaflets claimed that SEIU was seeking a hostile takeover of CNA with the collusion of the health care industry, while SEIU attacked CNA for launching three recent hospital strikes.

For five months CNA nurses have been in a bitter strike at a San Francisco hospital owned by Tenet, Doctor’s Medical Center. The SEIU Nurses Alliance has been circulating leaflets that say SEIU is strong enough not to have to strike and that attack CNA for using strikes as a tactic. Last year CNA won a strike in Long Beach that the union says achieved better pension for RNs.

Tenet’s Campanini, in statements to the press, commented on what would happen if the two unions went head to head in an election: “Either there’s a vote for CNA, which would likely result in a protracted strike as they haggle over the contract. Or there’s a vote for SEIU/UNAC, which would result in an immediate 8% raise.”


SEIU organizers moved quickly to win representation elections. Shortly after the agreement was signed, six hospitals held private, non-NLRB elections in which SEIU or no union were the only ballot choices.

The two unions dispute turnout figures. At Daniel Freeman Memorial Hospital in Inglewood, CNA says that nurses voted 88-43 for SEIU, in a roughly 400-strong bargaining unit. SEIU says the vote was 316-94 among “more than 500 registered nurses and health care technicians.”

CNA filed legal challenges to the SEIU/AFSCME elections with the NLRB. If successful, the NLRB will conduct its own elections at disputed workplaces (federally-supervised elections trump other roads to union recognition) in which CNA will also appear on the ballot.