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Money, union woes plague Catholic Healthcare West

Los Angeles

The score remains very close so far this year between Catholic Healthcare West and Service Employees International Union: eight elections in which the health care mega-system has been forced to accept unionization; seven in which it has successfully withstood it.

And, with contract negotiations still to come, predictions are for contention to continue, even after the votes have been counted. “We are having an extremely difficult time in the bargaining,” said SEIU executive vice president Eliseo Medina. “I see nothing but conflict ... for the rest of the year.”

As in any contest, a simple numerical report of outcome belies the drama and, in this case, ironic twists in a protracted battle that is as much about interpretation of Catholic social teaching as economics and power.

Catholic Healthcare West, sponsored by nine orders of Catholic nuns, is one of the nation’s largest health care networks, with 48 hospitals in California, Arizona, and Nevada. In just a decade, the system grew from 12 hospitals to its present size: “the largest not-for-profit health care system in the West,” according to its 1998 annual report, the latest available.

The report says the system spent $136 million, 4 percent of its expenses, on people who could not afford services “due to being uninsured or underinsured.” But the figures come in the context of significant financial strain.

Despite assets of $6.2 billion, Catholic Healthcare West’s bond rating dropped two notches in the wake of an operating loss of $310 million in fiscal 1999, according to reports last summer and fall. It was the nonprofit’s third straight year to lose.

Compounding the losses, leaders of the Catholic system came under attack from an aggressive secular union. Ironically, the union accused hospital leaders of failing to respect Catholic teaching, which supports workers’ right to engage in collective bargaining.

The controversies have drawn in state officials and church leaders, including Archbishop Roger Mahony of Los Angeles.

Undoubtedly, the cumulative financial losses figured into the system’s choice for a new president and chief executive officer to take over June 1 from Mercy Sr. Phyllis Hughes, interim president and CEO since September 1999. Lloyd Dean, his selection announced April 5, brings a resumé to the job that lists skills in financial turnaround and revenue growth.

Dean has been executive vice president and chief operating officer for Advocate Health Care, Oak Brook, Ill., which last year led Modern Healthcare’s list of 100 health care networks with outstanding performance in seven areas.

Asked what the new leadership’s approach to unionization will be, CHW vice president for corporate communications Lori Aldrete reaffirmed that the system has no overall policy toward unions except its fundamental support for workers’ freedom of choice.

“The organization right now feels very strongly that employees have the right to make their own informed choices,” Aldrete emphasized. The health care system is also convinced of its right to provide employees with what it views as accurate information about the union.

But Dominican Sr. Mary Priniski of Atlanta, a member of one of the religious orders that sponsors the health care system, worries about an uneven playing field. “I happen to think that when you’re in a power relationship,” said Priniski, “my telling them what I think has an element of coercion to it.” Prinisky is coordinator of the Commission on Justice for the Glenmary Home Missioners.

The health care system Dean will steer into the new millennium is not the only Catholic medical organization with allegations of union fighting. Catholic hospitals in Iowa, Missouri, Arkansas, Illinois, Ohio and New York figure among those with contentious labor disputes in the past year.

Sr. Barbara Pfarr, coordinator of the Religious Employees Project of the National Interfaith Committee for Worker Justice, fears that the general rule is for Catholic hospitals to lean hard on employees trying to organize. “High-powered pressure on the part of management for workers not to be involved in union activity,” Pfarr said, “is very prevalent in our Catholic health care institutions.”

At Catholic Healthcare West, it was against a background of rapid growth and, more recently, financial struggle that the union elections took place, involving nurses, technicians and service and maintenance employees at various sites.

For Catherine Sims, a registered nurse who works in postpartum care at St. John’s in Oxnard, north of Los Angeles, the union vote was “about giving quality care.”

Sims said, “Our patient loads have gotten heavier and heavier.” She expressed a common theme: The vote to unionize has been as much about making good on a professional promise to deliver compassionate care as about better wages and benefits.

Workers supporting unionization hope the union can address fundamental issues in a health care market squeezed by managed care and fierce pressures to lower costs.

The labor conflicts at Catholic Healthcare West led hospital, church and labor leaders to produce a working paper last summer on “A Fair and Just Workplace: Principles and Practices for Catholic Health Care.” The paper was the brainchild of Sr. Mary Roch Rocklage of Sisters of Mercy Health System.

Bringing together Catholic Healthcare West, the AFL-CIO, SEIU, and others, the Catholic Bishops’ Conference document pointed to “common ground” among its authors on “the need for a new way for labor and management to relate to one another.”

The details of a “fair and just” work environment, according to the paper, include not only fair wages and adequate benefits, but “safe and decent working conditions, and the right to participate in decisions which affect one’s work.”

While expressing “great appreciation for many sections of the paper,” Aldrete also has concerns. Catholic Healthcare West thought the document unduly targeted Catholic health care, she said.

Aldrete stressed that Catholic health care “continues as a ministry, not a commercial enterprise. Any implication ... that the ministry has been supplanted by commercial considerations is both inaccurate and harmful.”

Nonetheless, outsiders think that Catholic Healthcare West -- and many other Catholic hospitals around the country -- are downright unfriendly to unions. A report filed by the Fair Election Oversight Commission, chaired by the former speaker of the state assembly, cried foul in a union election in Sacramento.

“Managers and supervisors systematically interfered in employees’ decisions about whether to form a union,” said the commission, convened by former California State Assembly speaker Antonio Villaraigosa.

The report found that hospital managers in Sacramento “misused power and authority” by pushing employees to reject the union in individual conversations and mandatory meetings, according to a March 17 statement by Villaraigosa’s office. Further charges were that management “restricted employees’ freedom of speech” and “provided false and distorted information.”

Accusations flew in Oxnard as well. “They really used intimidation,” said Sims of the way St. John’s management treated her in the unionization campaign.

Stephanie Lara-Jenkins, another St. John’s RN, said that when fellow nurses from a neighboring SEIU-represented hospital sent a letter and balloons to show solidarity, officials ordered housekeepers to take the balloons down. The letter of support was replaced, Lara-Jenkins said, by anti-union flyers.

The union has come in for its share of criticism, too.

In Los Angeles, director of spiritual health care services at St. Francis Medical Center, Br. Richard Hirbe, accused SEIU of a distorted campaign. “No union can make claim to building God’s kingdom as (its) mission, just as no union can make you a guarantee, only a shallow promise of a ‘better life,’ “ said Hirbe in a letter to hospital employees almost two years ago. “Promises are not reality. SEIU does not want you to know the whole truth.”

Interviewed the morning after the March 23 no-vote at St. Francis Hospital in Los Angeles, Hirbe described feelings at the hospital the night before as “very triumphal.” Explaining that SEIU tried to impugn the hospital’s faithfulness to its Catholic identity, Hirbe said the plan backfired. “It was a lie,” he said. The mission to the community makes employees “jump out of bed and run to get here in the morning,” he added.

Hirbe was viewed by some as overstepping his bounds as spiritual leader. A letter dated March 8 from two women religious, a hospital chaplain, and a representative of the Episcopal Social Justice Ministry accused him of inappropriately participating in an anti-union committee.

The letter was addressed to Hirbe and Sr. Martha Ann Kramarz, assistant director of chaplain services at St. Francis. In a March 15 response, Hirbe and Kramarz labeled the allegations false. They said they had “consistently upheld and supported the teachings of the church on organized labor.”

A vote by registered nurses’ in Ventura County grew out of a deadlock that not even Cardinal Roger Mahony of Los Angeles could break. Dave Bullock, president of SEIU local 399, explained that Mahony had brought hospital and union officials together in a “series of mediation sessions” in late fall. Sr. Carolita Hart, director of health affairs for the Los Angeles archdiocese, said Mahony hoped the two sides could work something out “without having all ... this mud-slinging thing that was going on at the time.”

The roar of controversy grew loud enough to again elicit the archbishop’s intervention before the March elections at two hospitals in Los Angeles. In a March 10, letter addressed to CEO Hughes and SEIU’s Medina, Mahony urged both to heed last summer’s “A Fair and Just Workplace.”

“Ultimately, workers must choose how they wish to be represented in the workplace,” said Mahony. “They must decide what means will affirm their dignity and preserve the mission of Catholic health care.”

With some 40 years’ experience in health care, Hart laments the wedges union battles have driven between employees who at one time saw themselves as family.

“Some of these people have been best friends for years and years and have worked side by side,” Hart said. “Now they don’t even speak to each other.”

Even where the elections resulted in union victories, hopes are guarded. “Nobody expects Nirvana with the union,” said Lara-Jenkins, one of the nurses at St. John’s. “Things will remain the same until we change them.”

Respiratory therapist Hillman refused to see a no decision in Sacramento as a defeat. “Everyone worked very hard,” she said. “They deserved to go into work with their heads held high.”

“I think it’s not over yet,” she said.

National Catholic Reporter, April 28, 2000