The Oregon FNHP and its role in a ground breaking national agreement 

When was the last time you saw the words—"utter lack of opposition from management"—associated with a campaign to organize a union?

You are not dreaming. This is reality for the Oregon Federation of Nurses and Health Professionals. It’s also reality for the 24 other union locals that represent the employees of health care giant Kaiser Permanente.

In a landmark labor-management partnership that was crafted in 1997, 64,000 union members and more than two dozen locals became part of a joint venture that has since led to a national agreement and to shared roles in decision-making affecting every aspect of patient care at Kaiser Permanente facilities. Under the terms of the partnership, the unions have agreed to get behind Kaiser Permanente as a high-quality, union-endorsed, low-cost health plan for working families. Kaiser also agrees to remain union, and in organizing drives sponsored by "Partnership Unions," the company pledges to stay neutral and recognize new units on presentation of proof that a majority of the workers want the union.

The whole agreement, crafted by hundreds of unionists and Kaiser managers and being implemented by hundreds more, came out of the realization that the two sides must work together in today’s competitive health care industry to make the business of health care succeed while ensuring that the best health care is delivered to patients—by the people directly responsible for that care. Some 7.6 million of Kaiser Permanente’s 8.1 million patients nationwide are affected by this first-ever national contract in the health care industry.

The nurses who organized 20 years ago and are members of the OFNHP are among the first to begin implementing and realizing the possibilities of the partnership.

"I don’t think morale has ever been better because we get to work on what we think is important—union work, projects to improve our working in the ICU, education," says Brenda Cusick, charge nurse on the intensive care unit at Kaiser Sunnyside Medical Center. "Through the partnership, we in the ICU have become almost a self-governing department. We have a charge nurse on each shift, and the day shift charge nurses work in an expanded role, replacing managers." The partnership contract enables them to deal with staffing, patient care, doctor and administrative support and to engage the entire staff on the unit in consensus decision-making, explains Cusick, who offers a concrete example:

"We recently reached consensus with the supervisors to develop a system for accepting patients on the unit based on known staffing. After exhausting all possibilities to increase staffing, i.e., agency nurses, double time, etc., we [decided] we will not accept additional patients unless we have the staff to serve them. We will not make people stay on mandatory overtime to create openings for new beds."

The process

The national agreement was drafted by the Common Issues Committee, of which OFNHP’s former president Kathy Schmidt was a member. Its total make-up was 15 union leaders and 12 management leaders. Seven Bargaining Task Groups (BTGs), made up of approximately 300 management and union representatives, provided recommendations on issues ranging from wages to workplace innovations.

As the national negotiations proceeded, local negotiations began. Each local union had its own independent negotiations over local issues. Once the local and national negotiations were completed, members of local unions voted, by union, on a single package including the tentative national agreement and the tentative local agreement. By September 2000, the Coalition of Kaiser Permanente Unions completed its common issues bargaining, and by October 13, the process was officially complete when the last of the 25 local partnership unions officially ratified the national agreement.

In addition to joint decision-making power, the agreement gives OFNHP nurses a minimum wage increase 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 wage raises tied to meeting performance targets in each of the last two years.

Two of the most recent groups to join the OFNHP—through card-check recognition and without management opposition—and to become a part of the ground breaking labor-management partnership are approximately 475 medical professionals and more than 100 lab professionals. Both are currently negotiating their own agreements with the overlay of the national agreement offering them structure, as well as opportunity to express creative ideas and engage in true shared decision-making at their workplaces.

Jeanne Empey, a nurse practitioner who is a member of the new professional unit negotiating team, says she’s excited about beginning contract negotiations.

"One of the biggest reasons I participated in organizing our union was to be able to create a structure to participate in decision-making," says Empey. "Through collective bargaining, we can influence decision-making to improve patient loads, continue to provide high-level quality care and reduce burnout.

"Through a good contract, we can also provide avenues for professional advancement," continues Empey. "By creating a career ladder or merit system we can acknowledge and compensate our achievements and create more leadership roles for health care professionals."

The possibilities that are there if health care workers choose to organize are tremendous, says OFNHP’s Kathy Schmidt. "We were able to break new ground because we came together with different unions and tried to figure out what we could do to improve the health care system and the working conditions of our members," she says. "What this is all about is the hopefulness and the power of the collective."