Union Organizing in the Health Care Industry – New Unions and Alliances Among Rivals

Though our nation’s economy has recently lost millions of jobs, the health care industry has continued to add them. Not surprisingly, unions are eager to sign up health care workers. In the last 10 years, the rate of union wins in the health care industry has grown faster than the national average. Unions are uniting to lobby for labor-friendly legislation to promote increased union membership in the health care sector.

In addition to traditional organizing, health care union organizers are using more radical corporate campaigns that target hospital donors, shareholders, community groups, and even patients. The unions push these target groups to put pressure on hospital owners to allow unions to organize their employees. Many critics have argued that some of these agreements with employers have greatly limited workers’ power and emphasized the union’s cooperation with management.

The following article provides an overview of the major unions involved in the health care industry, as well as strategies to ensure your organization is prepared and remains successful.

Service Employees International Union
The Service Employees International Union (SEIU) began in 1921 primarily as a janitor’s union and branched out to include government, security, and health care workers. By 2000, it was the largest, fastest-growing union in the United States, with much of that growth stemming from a series of strategic mergers with smaller unions. In June 2005, the SEIU and six other unions left the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) to form the Change to Win coalition. Citing the need for a renewed effort to organize workers, Change to Win purports to be focused on achieving fair wages, health care benefits, and secure retirement for all employees. The coalition also encourages workers to unionize on an industry-wide basis, consolidating smaller unions within larger unions.

SEIU Healthcare
In 2007, the SEIU announced plans to launch a new health care union to serve approximately one million members, such as nurses and service workers at hospitals and nursing homes. SEIU Healthcare combined financial and personnel resources from the 38 local SEIU Healthcare unions. Of the SEIU’s 1.9 million members, 900,000 work in health care. In September 2008, the SEIU reported it would begin several high-profile projects to bring business leaders, health care providers, community organizations, and elected officials together to work on the nation’s health care system. SEIU leaders were part of a May meeting held by President Obama to discuss a health care overhaul. More recently, SEIU members attended town hall meetings to speak out in support of the proposed health care reform. In August, the SEIU was part of a group-largely funded by the pharmaceutical industry’s lobby-that launched $12 million in television advertisements to support Obama’s health care proposal. This group, the Americans for Stable Quality Care, could spend tens of millions more this fall.

SEIU and NUHW
The SEIU attempted to consolidate three local units representing home health care workers into one unit last December, taking authority away from the local units. The SEIU accused the local unit officials of financial misconduct, and in response, the leaders of the local units criticized the SEIU’s practice of centralizing power at its Washington headquarters and making corrupt deals with employers. In January, a 150,000-member SEIU local unit in Oakland was put under trusteeship by the SEIU, and the local officials of that unit were dismissed. The ousted officials formed a new union, the National Union of Healthcare Workers (NUHW).

The NUHW announced the first workers had cast votes in favor of representation by the new union in March. A majority of 350 union-represented workers at four nursing homes in northern California managed by North American Health Care wanted to end their labor relationship with SEIU and join the NUHW. The day after this announcement, the SEIU filed unfair labor practice charges against the four nursing homes, charging that administrators of the facilities had illegally withdrawn union recognition and colluded with a competing labor union. In that same month, a National Labor Relations Board regional director ruled against the NUHW, saying that the contract between the SEIU and the hospital chain prevented the effort by a new labor union to represent 14,000 Catholic Healthcare West workers. Despite the ruling, the founding convention to formally launch the NUHW took place in April 2009. According to the NUHW, approximately 91,000 California health care workers have signed petitions filed at the labor board, stating they would like be members of the new union.

The NUHW also claims that, in response to these decertification drives, the SEIU has resorted to harassment and intimidation and tactics similar to union prevention. The SEIU argues that the new group has unfairly restrained and coerced workers, as well as complained to the National Labor Relations Board. A decisive battle between the two unions will come in 2010, when the SEIU-UHW contract with Kaiser Permanente expires and the opportunity for decertification elections reopens. Kaiser, the largest health care provider in California, has 50,000 workers that could potentially become members of NUHW.

California Nurses Association/National Nurses Organizing Committee
The California Nurses Association (CNA) began as a state chapter of the American Nurses Association (ANA) in 1903. The ANA has a federated structure: Nurses do not typically join the organization directly, but instead join their respective state organization, which has membership in the ANA. After several years of believing the ANA was not providing them adequate financial support to increase collective bargaining activity in California, the CNA broke ties with the ANA in 1995 and formed its own union, becoming the first state organization to secede from the ANA. Since its break from the ANA, the CNA has acquired a reputation as one of the most aggressive labor unions in the country. In 2004, the CNA began establishing itself in other states under the name National Nurses Organizing Committee (NNOC). The CNA voted to seek affiliation in the AFL-CIO in 2007. CNA membership has doubled over the last seven years and represents 80,000 members from all 50 states.

UAN-NNOC
In February, CNA/NNOC, United American Nurses (UAN), and the Massachusetts Nurses Association (MNA) announced the formation of another new union: the United American Nurses-National Nurses Organizing Committee (UAN-NNOC). With a combined membership of more than 150,000 affiliates in 19 states, it is the largest nursing union in the history of the United States.

National Federation of Nurses
The National Federation of Nurses (NFN) was officially launched in April at an event in Portland, Oregon. The NFN represents more than 70,000 nurses in six state nurses’ associations, including New York, New Jersey, Ohio, Montana, Oregon, and Washington. Based on a federated model (much like the ANA), the NFN recognizes the independence of each member organization. Membership is open to state nurses’ associations and other labor organizations that represent RNs. The NFN is tied to the ANA, which outlines standards for nursing practices, but has historically opposed nurse unionism and includes managers in its leadership. Since nurse union leaders expect many of the 15 unions with nurse memberships to flood hospitals with authorization cards if the Employee Free Choice Act (EFCA) passes, they want to establish their own national union to ensure nurses are organized by nurses.

SEIU and CNA: From Violent Disputes to Cooperative Agreements
The SEIU signed a neutrality agreement in March 2008 with an Ohio Catholic hospital to organize 8,000 workers. The day before voting was scheduled to begin, members of the CNA distributed leaflets to discourage workers from joining the SEIU. After the workers received the leaflets attacking SEIU and its arrangement with management for an election, SEIU called off the vote. Then at an April 2008 conference in Detroit, SEIU staff and members protested at a banquet of CNA members, resulting in violence. The two unions have also launched raids and counter-raids across the country, and both have sent mailings to thousands of nurses (including nurses in other unions, as well as nurses whose unions are currently trying to organize) attacking each other.

After more than a year of fighting, the SEIU and CNA signed a cooperation agreement in March. They will work together to bring union representation to all non-union RNs and other health care employees, as well as improve patient care standards. The unions have also agreed to refrain from raiding each other’s members and will work together toward common goals, including lobbying for congressional passage of the EFCA. SEIU and CNA will coordinate campaigns at the largest health care systems and launch an intensive national organizing campaign. Catholic hospital chains will likely be among the first targets.

In June, the U.S. Conference of Catholic Bishops and the nation’s largest unions (including the SEIU and the AFL-CIO) signed an agreement describing how union organizing will be conducted at Catholic health care facilities. (The document is similar to the one Catholic Healthcare Partners and Community Mercy Health Partners created last year with the SEIU before the CNA protest canceled the vote.) This agreement is significant because Catholic health care providers represent the largest employers and providers of services in many communities. The agreement provides seven guidelines for management at Catholic health care facilities and unions, making it easier organize health care workers at these facilities.

What This Means for Your Organization
Many experts agree that expanded unionization, along with the passage of the EFCA, will negatively impact our health care system. Both health care providers and industry analysts fear that unionization could mean higher costs and more restrictive work rules, adding to the soaring cost of delivering health care. Hospital and health care facilities need to be aware of these issues and how they can educate their supervisors and workers about the threat of unionization.

Communication with your employees is a critical first step. Many issues are involved in the possible unionization of a health care facility (economic factors, working conditions, quality of patient care, employee satisfaction, etc.). To prepare for possible union activity, identify issues that are relevant to your facility and address those needs publicly. Train leadership and include information about your union-free policy in the employee hiring and orientation procedures. Assess your wage and benefit structure, and be sure to promote what you offer.

You can use brochures, meetings, video, webinars, e-mail, Web sites, or eLearning tools to reach your employees. The most effective efforts include an employee feedback system that encourages two-way communication.

Starting With the Right Legal Business Type, Sole Proprietorship

When starting your business, one of the things you will need to figure out is the legal form you should register your business as, in order to ensure that you are operating with the correct business profile and level of financial protection to suit your precise needs.

Though not a lawyer, having worked in several countries, across 3 continents, I have picked up a few things that I suspect will prove helpful in your decision making process, and would suggest that you consider some of the following issues carefully.

To start with, in all the countries I have worked, it was clear that there were usually a combination of 3 or 4 legal business types used to legally conduct business. And for the most part the similarities were significant.

The most common of these business types is a Sole Proprietorship. And though these may known by different names, in different countries, they are essentially subject to the same rules, regulations, financial protection and taxation.

So, when considering this business type it is good to be aware of essentially three key features that typically govern this type of legal business form.

1. You are personally liable for the debts of the business

With this type of legal business type, you are the business. This means that the bank can take your house in lieu of a debt incurred to conduct business. If you get sued for something you did wrong in your business, you also stand to loose your personal assets, including your house and car as they are all on the line.

From an operational perspective it means that bank accounts will be in your personal name, as if you had no business. Notably in most countries it would be possible to register a trading name, which you could attach to your bank account in order to receive checks in the name of your business, however it is still you that are on the hook.

One thing to keep in mind though is that even though operating your business as this type of entity exposes you to personal liability, in most countries where this is a serious risk, you are able to insure against liability from suits. And when it comes to debt, the upside is that you can use your personal credit history to conduct business cheaper, which if managed well, should never really prove to be an issue. Just pay your bills and all will be fine.

2. Your business is taxed as if it is you.

Simply put the profits from your business are treated as personal income, and you would declare it as such. You are also able to deduct most of your personal expenses, that relate to your business, from your taxable income, which might mean that if you work from home, a part of your living expenses could potentially be deductible. Essentially the business is you, and for the most part the expenses you incur to earn a living are treated as tax deductible expenses.

3. You are unable to sell the business, you can only sell the assets.

Though for the most part this will not prove a significant issue, it is important to realize that since you are the business, you cannot sell the business. You are able to sell the assets of the business, which may include trading names, stock, customer databases etc. however you have to be aware that to transfer the debts and liabilities of the business, you have to specifically contract that into the sale. And even then it does not necessarily resolve all the issues that may potentially arise, even after the sale of the business.

Here are some of the benefits of this type of business:

1. It usually costs nothing or very little to set up or register.

2. Business operating costs are considerably lower than the other available legal business forms, e.g. your accountant and lawyer will likely cost you significantly less, because things are just simpler.

3. It is easy to setup, and you can start operating your business very quickly.

4. As mentioned above you can rely on your personal credit history for conducting business so this will, initially at least, make things a little easier.

5. It is easy to close down as you simply stop doing business. There is usually little or no cost to shutting down this type of business, except of course for liquidating the assets and paying off debts and liabilities.

In a nutshell, if you are looking to operate a small business with little risk of someone suing you, and you are fine with putting your house up as collateral for your business debt, then this might be the one for you.

And though personally I do not prefer this type of business, either way I would suggest that you do take the time to discuss this with your accountant and lawyer before making a decision.

The Travel Health and Safety Mistake That Could Cost Your Company Thousands

Workplace health and safety has become commonplace for most companies globally. However, the same basic standards and compliance are conspicuously absent for those whose workplace includes travel. If you want to know more about this mistake that could cost your business thousands if not rectified, then read on. In this article we will look at workplace health and safety, travel hazard identification, travel health and safety in conjunction with the potential business losses. By the end of this article you will have the four basic steps to evaluate your risk and the correction steps to save your business from significant loss.

Workplace Health and Safety

All developed countries have very mature workplace, site or project health and safety regulations, many with stiff penalties for noncompliance. While the overarching legislation provides compliance and standards guidelines, companies are able to apply their own evaluation and measurement of foreseeable threats, following a standardized methodology. This enables companies to benchmark their final results and permits replicatable processes.

Due to this common approach and process maturity, many companies have ventured even further by creating self imposed higher standards such as “no harm”, “zero loss”, “100% safe” and other similar internal campaigns to reduce or eliminate any-and-all injury in the workplace, site or project.

Workplace health and safety is not just practiced in the country of origin but also applied to all their various projects and worksites around the world as a global health and safety standard.

Construction companies have taken this philosophy to the nth degree by displaying at the point of entry to their project, all incidents, days lost, days since last safety event and so on.

Why is none of this applied to travel health and safety?

Travel Hazard Identification

Following on from the workplace health and safety model, activity and location risk registers are typically made before commencement of works and maintained throughout the life of the work activity. When was the last time you saw a travel health and safety risk register or hazard identification register that used a standardized methodology?

If you already have a workplace risk register, documenting the foreseeable threats, naked threat levels, treatment solutions, control measures and residual risk level following all modifier actions, why don’t you have the same documentation for travel health and safety?

If you don’t apply the same process, maintain the same documentation and conduct the same degree of education and communication to reduce the risk, for travel health and safety then you don’t a travel safety program at all. This mistake will not only cost you from a productivity and efficiency perspective but expose you to legal recourse should it be proven you have failed to mitigate the travel health and safety threats of your extended workplace and travel activity.

Travel Health and Safety

Travel health and safety is not an unachievable task. All the steps have been exhibited above. The only reason it has not already been applied to any company travel management program is due to ignorance, laziness, lack of education, lack of resources, over confidence and avoidance. None of which are defensible for companies that suffer loss of life, reduction in people capital, decreased productivity and financial loss.

Due to the amount or time consumed in business travel, travel may actually constitute a majority component of your overall “workplace”. This is particularly acute for companies with high people capital business models, that sees a lot of consultants, academics, professionals or contractors traveling to the client’s physical business site/s from their respective city/country of residence.

Business Loss

You can’t improve what you can’t measure. Travel health and safety should be measured for loss to the business ranging from productivity to direct financial losses. The problem is that because the cumulative losses are rarely identified in a single cost centre or business unit and more likely spread across multiple functions and business units, businesses fail to identify or acknowledge these overall travel health and safety losses.

Tangible losses are one issue whereas the intangible losses are another matter entirely. Reputation, legal, market share, new business, training and development are all plausible losses from foreseeable risk.

Failure to implement a travel health and safety strategy will in time be discovered as a grave mistake and cost the company/business unit thousands of dollars (or more) in losses.

Conclusion

There is no requirement to do anything new, simply extend the current workplace health and safety methodologies to encompass “all likely places of work” which would include travel.

The four basic steps to correct this mistake are: 1. Identify the hazards; 2. Assess the risk; 3. Apply control measures; and 4. Manage the residual risk.

You should now be able to identify the significant void between workplace health and safety and that of travel health and safety, in particular hazard identification, regulatory compliance and the potential business losses.

Review your real status now. Identify the areas for improvement immediately, implement positive changes and enjoy the benefits that contribute to your business travel productivity, efficiency and safety. The information contained in this article will save you thousands in potential losses should you not consider travel a foreseeable risk to your business travellers or not consider travel an extension of your overall workplace.

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