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Shared values clash in hospital-labor war
NCR Staff

National labor leaders waging an uphill battle to organize workers in a major Catholic health care system are calling on health care administrators and religious orders to live up to the church’s social teachings (see table below) -- teachings that, for more than a century, have come down strongly on the side of unions.

Union supporters say the hospital system, as part of a vigorous antiunion campaign in California, has likened a labor organization to greedy big business, hired notorious “union-busters” and endorsed or tolerated tactics that overstep the legal line. Despite the church’s social teaching, they say, surveillance, intimidation, interrogation, antiunion letters signed by nuns and chaplains -- even morning prayer in the chapel -- have served as strategies in an increasingly bitter fight.

Leaders of Catholic Healthcare West (see below for description), one of the largest health care systems in the country, deny any violation of law, ethics or church teaching in the campaign. Meanwhile, Catholic activists supporting workers, including some Los Angeles area priests, say the clash is all too familiar. For decades, Catholic hospitals around the country have consistently met organizing efforts with strong antiunion campaigns, activists say.

“Catholic leaders are all for unions when they’re for farm workers or poultry pickers but are vociferously opposed when unions come to their own institutions,” said Notre Dame Sr. Barbara [Pfarr], a Chicago-based nun seeking a more even playing field for workers. [Pfarr] is coordinator of the Religious Employers’ Project of the National Interfaith Committee for Worker Justice (see below for description).

Four system officials interviewed by NCR, including a nun whose order sponsors Catholic Healthcare West, said they endorse workers’ freedom to join a union. They insisted that allegations of employer-endorsed intimidation and other illegal activities are untrue.

Bernita McTernan, senior vice president for mission services and human resources, said, “I don’t think we’d say we prefer not to have a union, but that we have a just workplace and we would like to have our employees make a choice.” She added, “We believe in Catholic social teaching. We uphold it.”

Opposing Catholic Healthcare West, a system sponsored by nine religious orders, is Service Employees International Union (see below for description), a division of AFL-CIO. The service union is one of the most aggressive and successful unions in the country in terms of organizing efforts. Since the early 1980s, in a period when many unions have stagnanted or declined, the service union has doubled its membership, from 600,000 to 1.2 million workers.

Catholic Healthcare West, formed just 12 years ago, operates 37 hospitals, 35 of them in California, along with ancillary facilities, home care and physicians organizations. The system ranks seventh in size in the nation. Gross revenues totaled $3.1 billion last year.

[Pfarr] said the Interfaith Committee created her position “because of the notorious antiunion reputation” of religious orders that oversee health care. It’s not unusual, she said, for nuns to fight on the front lines of union battles involving farm workers or other oppressed groups even as their orders are fighting unions in their own institutions.

“This has been a black eye in the Catholic church for decades,” [Pfarr] said. “We have a long history of terrible tension between religious employers and organized labor. For all of our social teachings, we are terrible employers.”

Union leaders said they had filed a dozen charges against Catholic Healthcare West in the present campaign. In one case, the National Labor Relations Board has upheld the complaint, union leaders said, two have been dismissed on appeal, and the rest are pending.

“There have been some questions about why we should be so opposed” to union organizing, said Michael Erne, president and CEO of the system’s Sacramento region, “when in fact the church, many sisters and priests have been so supportive” of unions elsewhere. Many, he noted, have supported organizing campaigns for farm workers in California. “The difference here,” he said, “is that here our sponsors are the Sisters of Mercy. They own us. We work for them. They have a just workplace as one of their core values.”

In the present campaign, the union is targeting Catholic Healthcare West facilities in Sacramento and in Southern California.

Erne personally opposes a unionized work force because, he said, “it sets up an adversarial relationship” in the workplace and the union takes credit when the environment improves. “When you get into a union situation and you do the right thing, typically you never get credit for it,” he said. “The union always takes credit. So if you have management with the right intentions ... it’s disheartening to never get credit for it, especially where justice in the workplace is a core value.”

Erne said he sees “confusion” about Catholic teachings on workers’ rights. “It’s clear to me that the Catholic church supports the right to organize,” he said. “But clearly, from our view, that also respects their right to choose ... to make an informed decision after carefully weighing both sides.” He decried reports of intimidation. “If it is going on, it is unauthorized and it’s wrong,” he said.

Some workers and union leaders disagree that the workplace in the system’s facilities is “just.” In a union-sponsored survey of Catholic Healthcare West employees in Los Angeles and Sacramento, workers reported widespread dissatisfaction with working conditions and expressed concerns about quality of patient care in light of staffing cuts. A shift from fee-for-service to managed care in recent years has put hospitals in a cost squeeze and dramatically altered the work environment, nurses and other employees said.

Others say working conditions are only part of the picture, noting that Catholic social teaching supports workers’ right to form unions, period, even if conditions are good. For example, Msgr. George Higgins, who served for more than 45 years as consultant to U.S. bishops on labor and economic issues, pointed out as recently as June that Pope John Paul II has described unions in two encyclicals as “indispensable.”

The pope has described labor unions as “places where workers can express themselves,” organizations that “serve the development of an authentic culture of work and help workers to share, in a fully human way, in the life of their place of employment,” Higgins said in a speech at the University of Notre Dame.

Caring environment

[Pfarr] went to California in mid-July to meet on behalf of workers with nuns whose orders sponsor Catholic Healthcare West. The result, she said, was deeply disappointing. Three nuns refused to see her, two appointments were canceled and a number of phone calls were not returned, she said. According to [Pfarr], the nuns she met with, five in all, and only three of them decision- makers, “repeatedly said to me that they have nothing in common with the union, don’t share any values, don’t have a common mission and that the union is only about gaining membership and making money. That kind of closed-mindedness is a real concern for me.”

McTernan, the system vice-president, said she thought [Pfarr] had been treated fairly. The meetings, she said, though “not as many as she wanted ... included some top-level people,” including McTernan herself, as well as “some sisters in the field.”

[Pfarr] said some of the nuns had the impression that she is “in the union’s pocket” -- a false impression, she said. The Interfaith Committee derives only about 13 percent of its support from unions, the rest from religious groups, foundations and individuals, she said.

“Our organization is pro-worker. We’re the first to say unions aren’t perfect,” [Pfarr] said. “But we need room for dialogue, for reconciling differences.”

Ironically, [Pfarr] said, some nuns who sponsor hospitals say they can’t intervene in the union battle because they are not involved in day-to-day operations. “I think it’s a false separation,” she said. “If one of the hospitals was performing abortions they wouldn’t say that.”

Dominican Sr. Julie Hyer, speaking for the religious orders that sponsor the hospitals -- said the sponsors do take ultimate responsibility -- and do not oppose unions. “One of the very fundamental things we believe is that an employee has the right to choose whether to be represented by a union. We support that 100 percent,” she said. Hyer is CEO of Dominican Hospital in Santa Cruz.

Further, she said, the campaigns in Sacramento and Southern California are regional matters. “That’s the strength of the system, to realize there are times and places for corporate policy and centralized activities and times and places for decentralization,” Hyer said. “It’s very appropriate that those local facilities would declare their way of dealing with the union.”

Who’s in charge?

Mary Kay Henry, a union leader who is working on several fronts to forge links with nuns who sponsor Catholic Healthcare West, said the question of who holds authority has become a major issue for organizers.

“I think there’s a war within the corporation over who has authority over what,” she said. “Half of it is genuine confusion and half of it is a way to keep us running around without getting answers.”

Union organizers, several of whom describe their work as an extension of long-standing social justice concerns, say they had hoped for better reception at Catholic Healthcare West, given its mission and core values. Union organizers say they share those values: respect for human dignity, stewardship, collaboration, excellence in health care delivery and justice for all -- for employees as well as people who lack access to health care and other basic needs. In fact, the union organizers say, they would urge the system to ensure that access for its own employees’ children by providing paid health insurance for dependents at all facilities.

Hyer said employee benefits are not uniform throughout the system’s facilities.

Erne, of the system’s Sacramento region, said the union’s expectation of openness and dialogue was unrealistic. “You have to put things in context here,” he said. “Employees have been bombarded with a lot of extremely negative information about Mercy Healthcare Sacramento. We took a stand. We decided we needed to respond to that.”

Union leaders, for their part, say the system’s campaign has portrayed the union in the worst possible light. They say they tried unsuccessfully for more than a year to run a positive campaign, hoping to elicit cooperation with the system’s officials and sponsors and to foster discussion of shared concerns.

Of five hospitals in Southern California, organizing is most intense at Robert F. Kennedy Medical Center in Hawthorne and St. Francis Medical Center in Lynwood.

Three unions, including the California Nurses Association, an organization of registered nurses, have conducted successful campaigns in at least 11 Catholic Healthcare West facilities in recent years. Nancy Cartwright, the system’s director of public affairs, said 28 percent of the system’s employees belong to unions. Workers at some facilities were organized before the system was created in 1986.

Roseann DeMoro, executive director of the registered nurses’ association, said Catholic hospitals “run the standard campaign. They hire the secular union busters, the notorious ones. Employees are not free to choose.”

Disturbing change

DeMoro’s union represents 30,000 nurses, more than a fourth in Catholic hospitals and about 15 percent in facilities operated by Catholic Healthcare West. The fact the union has organized eight Catholic Healthcare West facilities in the past few years “speaks volumes” she said. “Five to 10 years ago, people identified with the mission of Catholic hospitals. Now they feel it’s more a business run for the bottom line.”

Guadalupe Moore, a licensed vocational nurse, said she feels disoriented by recent changes. Moore said of her job at St. Francis Medical Center, “It’s not the personal thing it used to be. Health care is changing so much. Big business has taken over. They’re not going to listen to us unless we have a bargaining unit behind us.” Moore has worked at St. Francis for 28 years.

Matthew Euen, senior biomedical technician at St. Francis, said he had contacted the union because of what he described as a disturbing change in managers’ attitudes toward employees after the hospital linked up with Catholic Healthcare West about two years ago. “Employees took a real back seat,” he said. “A number of us had some complaints. They told us if we didn’t like it, we could go elsewhere.”

To Euen, the hospital’s antiunion campaign is nothing short of “brutal harassment.” He alleged that he and others had been told in one-to-one meetings with supervisors that they should not support the union. Euen said he feels that supervisors are constantly watching him, and managers have taken steps to limit his work-related activities in parts of the hospital where he used to go freely.

At the same time, some employees told NCR that working conditions and managerial demeanor had actually improved since the organizing efforts began -- a change several workers described as part of the antiunion strategy.

Previously, said Moore, when nurses would complain about staffing and other concerns, the response seemed to be, “If you don’t like it, there’s the door.” Employees felt they weren’t respected, she said.

“The last five years have been extremely difficult” for employees, said Erne, who assumed his Sacramento post less than a year ago. “My job is to put that behind us, to be as responsive as possible. When I came I expected my priorities would be more on being competitive, but the fact is the human issues, even before the union campaign, have become the highest priority.” He added, “This is a tremendous organization that has a reputation for having a caring environment, not just for patients but for employees as well.”

‘Nasty stuff’

Despite those assurances, Jono Shaffer, organizing coordinator for the service union’s western region, complained of “very low road, nasty stuff” during the campaign, an accusation that hospital leaders sharply denied.

“Low road? It’s just amazing to me they would say that” given some of the union’s own published materials, said Susan Whitten, vice president for strategy and marketing in Southern California. She cited, for example, a full-page ad that ran July 23 in the West Coast edition of The New York Times facing off prounion statements by Catholic leaders, including Pope John Paul II, against allegations of intimidating tactics by hospital authorities. Whitten said quotes and names were taken out of context. Sources said nuns around the country were infuriated.

“I think we’ve been incredibly accommodating” to union leaders, Whitten said. “Union organizers are on our campuses and cafeterias. They have access to our employees as much as they want, except on patient floors.” She added that administrators had fielded complaints from employees about organizers calling on people at home. “Many employees are tired of the whole thing. They would just like it to go away,” she said.

Both McTernan and Erne said that the system’s officials consider it imperative that administrators respond to employees’ concerns.

McTernan defended consultants hired by the hospital -- organizations such as Management Science Associates of Independence, Mo., one of the firms described by union leaders as a union buster. Erne said that was a mischaracterization. The Missouri firm, he said, deals broadly with human resources. McTernan said such consultants were needed to help hospitals deal with legal issues related to union organizing.

Officials at Management Science Associates did not respond to a telephone inquiry about the firm.

[Pfarr] feels that much of the controversy surrounding the campaign derives from employers’ failure to recognize power imbalances in dealing with employees. “I think the employer has a moral responsibility to be very careful what supervisors say and how they act, because they carry so much weight,” she said. A letter or even an offhand comment from a boss has “tremendous power” to intimidate. “A union’s power is only persuasive. An employer has the power to determine whether employees get a good shift or a bad one, what their benefits, even their livelihood, will be.”

Letters and memos have served as important tools in the hospitals’ campaign. At Robert F. Kennedy Medical Center, three members of Daughters of Charity, Sr. Elizabeth Parham, Sr. Therese Marie Pham and Sr. Michele Randall, urged employees in a letter dated April 17 to “please say no” to the union’s “meaningless rhetoric. ... To introduce a third-party into our family at RFK would be disruptive and may negatively impact our good working relationship,” the nuns wrote.

On March 31, 10 nuns signed a letter addressed to employees of St. Vincent Medical Center in Los Angeles warning that a union would “be very detrimental to the hospital, our patients and to each of you.” Union leaders said the campaign at St. Vincent had become so hostile they put it temporarily on hold.

The nuns’ letter echoed points made in a March 31 memo to employees from Peter P. Aprato, the hospital’s administrator. Aprato described labor unions as “dying relics from the 1930s.” The union’s sole purpose today, he said, “is to recruit new union members to help bail out organized labor’s dismal and failing financial and membership positions.”

Br. Edward Spink, manager of spiritual care at Robert F. Kennedy, turned the union’s claim for promoting justice on its head in his letter to employees. “It disgusts me that when we are vulnerable” because of “transitions in health care,” the union “marches in as the champion of employee rights,” he wrote. “They seek the vulnerable, disenfranchised and the poor. They seek moneys you do not have to spare. ... It’s a justice issue.” Employees complain that a chaplain has also expressed antiunion sentiments during prayer, asking God to help employees to do the right thing -- vote against the union.

[Pfarr] said some employees who earlier expressed interest in a union have fallen away, fearing reprisals from supervisors. The system’s language about “freedom of choice” is deceptive, she said, when employers spend “megabucks” on consultants who teach them how to keep the union out. Union organizers assert the system’s campaign has cost millions, siphoning dollars from patient care. Erne declined to estimate its cost in his region but said cost issues had been “blown all out of proportion.”

In late August, some 44 employees pressed for information about the cost -- one of five demands they set before Richard J. Kramer, chief executive officer of the system. Kramer was vacationing, so McTernan met with the group. The group also demanded that officials stop interfering in organizing efforts, respect the church’s historic support for unions and stop efforts to break the union in places where it already exists. Henry said a contract remains elusive at St. Joseph Hospital in Stockton, Calif., even though a majority of employees asked for union representation two years ago.

Fr. David O’Connell, pastor of St. Francis Cabrini Parish in South Los Angeles, cites considerable support for workers among Los Angeles priests. “It seems strange that Catholic Healthcare West and the union say they want the same thing, that workers be free to choose, yet workers say the atmosphere is not free,” he said. “There’s something fishy someplace. If they both want the same thing, why can’t they get together on it?”

Fr. Stan Bosch, pastor of Our Lady of Victory and Sacred Heart parishes, said some members of clergy plan to go into the hospitals and talk to workers during lunch and breaks. Priests plan to collect information and present it to archdiocesan bishops for review, he said.

Bosch was among about 10 priests and ministers who led a prayer vigil June 24 on the steps of St. Francis Medical Center. According to news reports, only 11 employees out of a work force of 1,400 were there. Workers who were present attributed the small turnout to fear.

Jobs on the line

The union’s goal is to get Catholic Healthcare West to agree to recognize bargaining units after a majority of workers sign cards inviting union representation. The method, which bypasses an often contentious election, relies on employer approval, since it is allowed, but not required, under U.S. law.

David Miller, senior research analyst for the union, said, “Some workers are saying they can’t sign cards because they would lose their jobs. It’s illegal to threaten workers with their jobs, yet workers say that’s what’s going on.”

Erne, previously an administrator in Denver with a division of Catholic Health Initiatives, another Catholic hospital network, disputes such accusations but acknowledged that administrators have their work cut out for them in dealing with dissatisfaction. “I take great pride in trying to create the right environment for employees,” he said. Erne said his region had been “hurting a little” when he arrived. “Changes in health care have been very hard on employees,” he said.

Labor leader Henry also has perceptions to fight -- most notably the notion that unions are little more than big businesses that aim to victimize workers. She finds that characterization appalling. “That’s like saying Catholic Charities is a big business, just sucking off the welfare system,” she said.

Even amid the fray, Henry, a product of 12 years of Catholic education and previous work in anti-hunger campaigns, holds out hope that common ground is possible.

“It’s really the social justice tradition of the church that made me gravitate to this kind of work in the first place,” she said. “Given the radical changes in the Catholic health care, I feel really urgent in reaching agreements with Catholic health care that make sense for workers.”

Miller, the union’s research analyst, who holds a divinity degree from the Pacific School of Religion in Berkeley and previously worked for the Interfaith Council on Corporate Responsibility, envisions a day when Catholic employers and unions will be able to put some of their differences to rest. “If we could get past some of those, there are a lot of things we could do together, both legislatively and in the work site, because of our common justice focus,” he said.

[Pfarr], too, longs for reconciliation. During campaigns like the one in California, “mud is slung on both sides, and that isn’t good for anybody,” she said. “I’ve seen it all. Sometimes unions act unethically; sometimes hospitals act unethically. No matter who wins, the atmosphere is poisoned.”

Catholic Healthcare West
History: Founded in 1986 in a merger of 12 facilities operated by the Sisters of Mercy of Auburn and of Burlingame, Calif. Since then, facilities operated by seven other religious orders have been added, as have several non- Catholic hospitals.
Size: The system presently consists of 37 acute care facilities with nearly 8,000 beds and more than 1,400 skilled nursing beds in California, Arizona and Nevada. The system employs some 30,000 workers. Gross revenues for 1997 were $3.1 billion.
Participating religious orders: Sisters of Mercy, Auburn and Burlingame, Calif.; Dominican Sisters of Adrian, Mich.; Daughters of Charity, Province of the West; Sisters of Charity of the Incarnate Word, Houston; Dominican Sisters of San Rafael, Calif.; Dominican Sisters of St. Catherine of Siena of Kenosha, Wis.; Franciscan Sisters of the Sacred Heart of Frankfort, Ill.; Sisters of St. Francis of Penance and Christian Charity of Redwood City, Calif.

National Interfaith Committee for Worker Justice
History: Pro-worker organization founded in 1996 by Kim Bobo, formerly organizing director of Bread for the World, an anti-hunger group.
Purpose: To mobilize and educate the U.S. religious community on workplace issues. Develops educational resources, organizes local interfaith committees in major cities.
Size: 10 full-time staff; annual budget, $425,000. Funded by private foundations and individuals, and by religious and labor organizations in equal amounts, according to policy. Board consists of 45 religious leaders.
Activities: Ongoing projects include the Religious Employers’ Project, which aims to reduce tension between unions and religiously-owned health care organizations, and the Poultry Workers’ Justice Project, which aims to focus national attention on often-deplorable working conditions for some 200,000 poultry workers, many of them new immigrants. The Religious Employers’ Project is headed by Notre Dame Sr. Barbara [Pfarr].

Service Employees International Union
History: Founded in 1921 as Building Service Employees International Union, organizing janitors. Affiliate of AFL-CIO.
Membership and size: 1.2 million workers in service occupations and health care, up from 600,000 in 1986. More than 600,000 members presently work in health care. Third-largest and fastest-growing if U.S. unions.

Catholic social teaching: a sampler

Pope John Paul II
Centessimus Annus, 1992
... The freedom to join trade unions and the effective action of unions ... are meant to deliver work from the mere condition of a commodity and to guarantee its dignity. ... The right of association is a natural right of the human being. ... Trade unions ... serve the development of an authentic culture of work and help workers to share in a fully human way in the life of their place of employment.

“On Human Work,” 1981
... Catholic social teaching holds that unions are ... indeed a mouthpiece for the struggle for social justice, for the just rights of working people in accordance with their individual professions.

U.S. bishops
Pastoral letter: “Economic Justice for All,” 1986
The purpose of unions is not simply to defend the existing wages and prerogatives of the fraction of workers who belong to them, but also to enable workers to make positive and creative contributions to the firm, the community and the larger society in an organized and cooperative way.
Footnote to document: Even if most injustice and exploitation were removed, unions would still have a legitimate place. They are the normal voice of labor, necessary to organize social life for the common good.

Vatican II
“The Church in the Modern World,” 1965
Among the basic rights of the human person must be counted the right of freely founding labor unions. These unions should be truly able to represent the workers and to contribute to the proper arrangement of economic life. Another such right is that of taking part freely in the activity of these unions without fear of reprisal.

Pope Pius XI
Quadragesimo Anno, 1931
For as nature induces those who dwell in close proximity to unite into municipalities, so those who practice the same trade or profession, economic or otherwise constitute as it were fellowships or bodies. These groupings, autonomous in character, are considered if not essential to civil society at least a natural accompaniment thereof.

Pope Leo XIII
Rerum Novarum, 1891
[T]he beneficent achievements of the guilds of artisans among our ancestors have long been well known. ... It is gratifying that societies of this kind composed either of workers alone or of workers and employers together are being formed everywhere, and it is truly to be desired that they grow in number and in active vigor. ... they are highly opportune and are formed by their own right.

National Catholic Reporter, September 4, 1998 [corrected 09/11/1998]