SEIU, California hospitals create parternship that aims to be model
SEIU, hospitals strike unique deal to work together
The biggest healthcare union in California reached a pact with the state hospital association that calls for immediate steps to make nice and a pledge to work together to improve and reduce the costs of care, and could provide a template for partnerships in other states.
The three-page agreement between the California Hospital Association and Service Employees International Union-united Healthcare Workers West calls for the association to introduce the union brass to hospital executives. The SEIU, in exchange, dropped its support of two ballot initiatives aimed at hospitals. CHA spokeswoman Jan EmersonShea said the sides developed the concept last fall at the bargaining table: “Hospitals share many of the same values and goals that organized labor does,” she said.
Those goals of the agreement—called the Partnership for Healthy California—include improving the quality of healthcare, reducing costs and decreasing the rate of chronic disease in the state. There’s no timetable for when specifics will be decided, but even in the partnership’s infancy, SEIU-UHW President Dave Regan says he has an idea on how he defines success. “I think if we’re successful that over the next 10 years that Californians will become healthier and that the rate of chronic diseases will decline,” Regan said.
“This is unprecedented, it involved real risks on both sides,” he said. “I think there’s a genuine sense if we can make this work in California, you can make this work anywhere in America.”
A national SEIU spokesman declined to say whether the union is pursuing similar agreements in other states, though he pointed to the Partnership for Quality Care, a coalition that includes the SEIU and individual hospitals and systems in several states. “There are examples out there of things that are in motion in the public’s eye that show hospitals and our unions doing things together,” SEIU spokesman Carter Wright said.
The CHA can’t force any of its 500-plus hospitals to hold union elections. But the agreement could help the SEIU form relationships and expand its more than 150,000 membership base, said Judy Thorp, managing director of Chicago-based Huron Consulting Group. “SEIU just wanted to get a stronger foothold within the healthcare industry, and essentially this could be one way to do it,” she said.
A spokeswoman from the American Hospital Association said she couldn’t recall a similar agreement between a state hospital group and a union. Whether other states and unions will follow the model is unclear, as the SEIU and CHA have yet to share specific details on how they’ll make improvements.
The SEIU-UHW pulled back support for a ballot measure that would have required notfor-profit hospitals to deliver care worth at least 5% of their annual net revenue or lose property tax exemptions, and another that sought to prohibit all hospitals from charging more than 25% of the actual cost of care. The agreement could save the CHA as much as $58 million to $60 million, Emerson-shea said, because the association was prepared to spend that much on campaigns to battle the two measures.
About a third of state hospitals were exempted, including those operated by publicly funded hospital districts. Emerson-shea noted that many of the more unionized hospitals were also exempt. That includes California’s two largest providers, which weren’t mentioned by name on the initiatives: the former Catholic Healthcare West—san Francisco-based Dignity Health—and Oakland-based Kaiser Foundation Hospitals. The initiatives excluded systems “that are part of an integrated nonprofit health system or part of a safety net nonprofit health system as defined by the measure.” By the criteria of the ballot measure, Kaiser was the only system in the state that qualified as an integrated not-for-profit, and Dignity was the only safety net system.
John Borsos, secretary/treasurer of the National Union of Healthcare Workers, said he’s suspicious of the closer rapport between the SEIU and the CHA. The NUHW represents about 9,000 workers and was formed in 2009 with former SEIU-UHW leaders, including Borsos. He said the move represented the SEIU-UHW saving face: “I think it was just a PR stunt to begin with,” Borsos said. “There was no support in the Legislature; it had no chance of succeeding.” The NUHW is pushing a ballot measure that would limit retirement benefits for executives working in healthcare districts funded by taxpayers, only allowing those hospitals to offer them if they provide the same benefits to all employees. The initiative was motivated by the news last year that Salinas (Calif.) Valley Memorial Healthcare System paid former CEO Sam Downing a retirement and severance package worth $4.9 million.
Emerson-shea said the CHA opposes that bill, saying it could keep hospitals from recruiting top-notch executives.
The deal could help the SEIU gain members in California, where strife between the union and hospitals flared in a protest outside San Francisco General Hospital this spring.