The biggest health care strike in U.S. history


A coalition of unions representing workers at Kaiser Permanente facilities in eight states reached a tentative agreement with Kaiser executives Oct. 13, less than a week after an estimated 75,000 workers struck for three days, the largest U.S. health care strike on record.

The agreement addresses many of the wage and staffing issues the Coalition of Kaiser Permanente Unions said drove the strike, but at least one union in the coalition is planning another walkout in Washington Nov. 1 if local negotiations with Kaiser remain locked up.

The Coalition of Kaiser Permanente Unions is made up of 11 local unions that bargain together across from Kaiser over a national contract that covers more than 85,000 Kaiser employees in seven states: Oregon, Washington, California, Colorado, Hawaii, Maryland, Virginia, plus Washington D.C. Coalition members include Oregon-based SEIU Local 49 and Washington-based SEIU Local 1199NW and Office of Professional Employees International Union Local 8.

Nearly 75,000 members of coalition unions walked out Oct. 4-6 protesting bad faith bargaining by Kaiser. The walkout did not include members of coalition unions in Maryland, Hawaii, and Northwestern Washington. The local contract that covers SEIU Local 1199NW in Washington included a no-strike clause and does not expire until Oct. 31.

Kaiser Permanente is a health maintenance organization (HMO), meaning it combines insurance coverage with direct provision of health care services. In the first six months of 2023, it reported more than $3 billion in profit.

The tentative agreement — brokered with the help of Acting U.S. Secretary of Labor Julie Su — provides 21% raises over four years for all coalition-represented workers. It also sets a minimum wage for Kaiser workers that will rise by Year Three to $25 an hour in California and $23 an hour elsewhere.

The agreement helps address the staffing crisis with increased investment in job training and an accelerated hiring process. And it includes protections against outsourcing.

Striking for patient safety

SEIU Local 49 represents about 4,000 Kaiser workers in Oregon and Southwest Washington.

Juanita Kamhoot, a certified nursing assistant (CNA) at Kaiser Sunnyside Medical Center, serves on Local 49’s executive board. Picketing on the sidewalk outside the hospital on the first day of the strike, Kamhoot said every member she talked to said they supported the strike because the staffing crisis has made their jobs more difficult in the last three years. Kamhoot said Kaiser’s CNAs frequently have 30 patients at a time, even though a new safe staffing law in Oregon based on national nursing standards recommends no more than seven patients per CNA. (Hospitals have until June 2024 to be in compliance with that new ratio).

“Just do the math,” Kamhoot said. “An eight-hour shift every day with vitals (for every patient) just doesn’t happen. … It’s really hard to go to a patient and ask them to wait and wait and wait.”

Patients also report long wait times to schedule appointments or get checked in when they arrive for care. Local 49 member Keven Dardon serves on the local bargaining committee and works at the patient registration desk at Kaiser Sunnyside. His job is to check patients in for their appointments and surgeries. He says in early 2020, his team had 60 workers — enough to fully staff all five check-in windows at the front desk from 7 a.m. to 5 p.m. Now the team has just 37 workers, and as many as three windows stay closed for the day.

“Sometimes there will be more than 20 patients with wait times more than 20 minutes,” Dardon said.

In the tentative agreement, Kaiser committed to hiring more employees, especially at Kaiser Northwest facilities in Oregon and Southwest Washington.

“I think a lot of us are excited to have this tentative agreement. … What was brought to the table is something that will improve our quality of care and how we can manage patient needs,” Dardon said.

It was the strike that moved Kaiser to offer a new, better proposal after stalling for months, he said.

“It really showed Kaiser we were very serious about the staffing crisis, and we were very serious about recruiting and retaining employees,” he said.

SEIU Local 1199NW still negotiating

Members of coalition unions were set to begin contract ratification votes Oct. 18.  If ratified, the agreement would be retroactive to Oct. 1.

But SEIU Local 1199NW continues to bargain a local add-on to the national contract. Local 1199NW represents 3,000 Kaiser workers at 36 Kaiser facilities in Washington. On Oct. 13 — the same day the national tentative agreement was reached — Local 1199NW announced its members voted 99% in favor of a strike starting Nov. 1.

Local 1199NW President Jane Hopkins said across the board, workers at Kaiser Washington are paid significantly less than comparable jobs at other health care providers in the state. In addition to the national raise, they want a local boost that closes that gap. It’s key to attracting and retaining talented staff, Hopkins said. 

“If a Kaiser nurse went to Swedish (Health Services), they will make a minimum of 20% more, today,” she said. “So even though the raises we got through the coalition were amazing and historic …  it’s not enough to keep up and catch up for wages here in Washington state.”

Local 1199NW met with Kaiser Washington for bargaining Oct. 13, but there were no sessions scheduled when this issue went to press. Hopkins said the union will be ready to meet when Kaiser selects new dates.

A three-day walk-out ended in a four-year contract. | PHOTO BY CHERYL JUETTEN


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