The members of the Oregon Federation of Nurses and Health Professionals put their beliefs, desires and work lives on the line by voting to ratify the first-ever national union agreement in the health care industry with employer Kaiser Permanente.

In late September, following years of planning and the involvement of hundreds of Kaiser Permanente members and managers, OFNHP members voted--by 90 percent--to incorporate into their contracts a five-year national agreement in which unions and employees are integrated into planning and decision-making forums at all levels including budget, operations, strategic initiatives, quality processes and staffing. "Through this agreement, the members of our unions who work at Kaiser Permanente are guaranteed a greater voice in the decisions that affect the patient care and services we deliver," says OFNHP president Kathy Schmidt.

In addition to joint decision-making power, the agreement gives OFNHP nurses minimum wage increases of 7.5 percent in each of the first two years, 5 percent in 2002, 4 percent in 2003 and 4.5 percent in 2004, with additional raises tied to performance targets in each of the last two years. Dental hygienists and technicians will receive pay increases of 4 percent in each of the first three years and 3 percent and 3.5 percent in the last two years.

"The economics are excellent and should go toward making Kaiser Permanente one of the employers of choice," says Schmidt, who notes there are improvements in benefit and retirement monies as well.

The process, which Kaiser and its partner unions were calling "common issues bargaining," was huge and the goals were mighty: Coordinating collective bargaining among more than 60,000 employees with as many as 33 contracts in 25 locals of eight international unions at the largest health maintenance organization in the U. S. for the purpose of labor-management peace and an equal voice, quality care, job security, patient satisfaction and business prosperity.

The Common Issues Committee, of which Schmidt was a member, drafted the national agreement. That committee was made up of 15 union leaders and 12 management leaders. Seven Bargaining Task Groups (BTGs), with 20-30 management and union representatives on each, provided recommendations on issues ranging from wages to workplace innovations. Among the task group participants were OFNHP members Kathy Petrin (Quality and Service BTG), Meg McGowan-Tuttle (Wages BTG) and Marshall Wolner (Pension and Retirement BTG). Some 250 union members made up the Union Bargaining Council, which also had key input.

This unusual approach to bargaining was born three years ago when Kaiser Permanente and its unions agreed to a National Labor-Management Partnership Agreement in which both would work as equals. The deal included the AFL-CIO's agreement to promote Kaiser as health plan of choice for members and Kaiser's agreement to provide job security and to voluntarily recognize unions where employees registered their interest in joining.

It took a year of discussions among Kaiser Permanente representatives and the AFL-CIO Coalition of Kaiser Permanente Unions to come to the tentative agreement that was finally released in mid-September.

In the pact, joint staffing teams would create an annual plan for each department covered by the agreement that would include mutually acceptable numbers, mix and qualifications of staff in each unit. Disputes over staffing go through a resolution process that can lead to a neutral third party who ensures the resolution.

"The agreement to give frontline care-delivery union members joint decision-making rights with their managers over staffing and quality of care and quality of service is something that every health care professional who's ever formed a union [has] always dreamed of," says Schmidt.