Partnership in Flux

The Importance of Strong Relationships

By Katie Ekstrom

AFT Health Care, Spring 2022One of the more challenging things about a labor-management partnership is navigating and maintaining the relationships that are at its core. These relationships impact the way that both sides approach negotiations. Building strong partnership relationships takes time, communication, and trust; when those break down, the partnership falters. That is what happened during our most recent round of bargaining at Kaiser Permanente—and it is what nearly drove us to strike in November 2021.

The labor-management partnership at Kaiser dates back to 1997. Although any partnership has ups and downs, our work with Kaiser had been going well, and the organization’s commitment to unions and worker voice was strong. Then, after the former chief executive officer died unexpectedly in 2019, there were changes in key leadership roles. Most importantly, just as we were entering bargaining in 2020, Kaiser hired a new chief human resources officer who did not have a background in healthcare or with labor-management partnerships.

Because of these changes, we had little time to build relationships, and the partnership lacked the openness and dialogue of previous years. When the pandemic hit, we were shocked at how management was allocating resources. While we were advocating for critical additional staffing and PPE, Kaiser was spending millions of dollars on a bogus research study about employee compensation. The study concluded that all our job classifications were overpaid. We easily debunked that assertion through simple online research, but it fit management’s (also bogus) narrative that Kaiser was in dire financial straits.

At the bargaining table, Kaiser’s new leaders proposed an egregious two-tiered wage scale that would have created two classes of employees in our unions. It seemed designed to turn members against each other. Of course, we were not going to agree to any two-tier system, so negotiations were both incredibly painful and fruitless. For months, we continued to bring up the staffing crisis and the need to educate new frontline providers to replace staff who were taking positions in other hospitals, retiring, or abandoning healthcare altogether—in part because of the pandemic and in part because of Kaiser’s working conditions. Management claimed that they could not afford to continue increasing payroll. We countered that since they could not hire or retain enough people now, they would never successfully recruit others for less money. But they refused to understand. It was as if we were speaking two different languages.

By the fall of 2021, our only option left was to strike—and we were prepared. The Alliance of Health Care Unions, which includes 21 locals of 10 different national unions, represents over 50,000 Kaiser employees in eight regions. Our members were unified, largely because they saw Kaiser’s position as putting patients at risk. The locals’ votes authorizing the strike were overwhelming. For example, 96 percent of the AFT members (Kaiser employees in Oregon represented by Local 5017) voted to strike. Not surprisingly, soon after this demonstration of our solidarity, management gave up on the two-tier wage system and began bargaining in good faith. We only narrowly averted what would have been the largest private sector strike in the history of the country. In the end, we did not get everything we wanted, but we did win strong contracts—with wage increases, good healthcare and retirement benefits, funds for career development, commitments to reduce the use of traveling nurses, and more information for making staffing decisions. Our solidarity was the key.

Partnerships evolve over time; so far, our current evolution has not been for the better. After these contentious, protracted negotiations, many of our members are still angry—and rightfully so. But the former executive director of the alliance regularly asks a question that I think is important: “If you hate each other, do you still have a partnership?” For me, the answer is yes.

The partnership has allowed us to bargain for improvements in working conditions that I do not believe we would have won otherwise. We would not have gotten card check neutrality or the no-cancellation clause that gives our members income security. We would not have created our unit-based teams, which give members a say in the work they do and meaningful opportunities to enhance patient care. We would not have our amazing educational trust, which funds career development and is the most popular opportunity we offer our members outside of pay and benefits.

Looking to the future, we’re proud of the work that’s getting underway to promote equity, inclusion, and diversity. This will be a collaborative labor-management effort to provide social justice training and learning opportunities for all staff. We have a chance to create a culture shift toward greater equity in everything we do, and that’s exciting.

Working inside the confines of a partnership is not for everyone, but I’m cautiously hopeful about where we can go from here. I’m eager to see what can happen if we can build the positive, trusting relationships with management that we need to solve problems together every day for our patients. It won’t be easy. But we’ll see what the future holds.


Katie Ekstrom is the Northwest director of the Alliance of Health Care Unions (which represents over 50,000 Kaiser Permanente employees) and former vice president of the Oregon Federation of Nurses and Health Professionals, AFT Local 5017. Previously, she worked for Kaiser Permanente for nearly 10 years as a frontline care provider.

[Illustration by Pep Montserrat]

AFT Health Care, Spring 2022
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