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    KPCC: Kaiser Permanente fined $4 million over long waits for mental health care

    By Stephanie O’Neill, KPCC:

    The California Department of Managed Health Care has fined Kaiser Permanente $4 million for failure to provide timely mental health care to patients.

    A 2012 survey by state health officials found 40 percent of Kaiser’s wait times exceeded 14 days – too long, officials said, for someone who needs help now.

    The penalty was levied under a first-in-the-nation law on timely access that allows enforcement actions to take effect before anyone has been harmed, according to Health Access California, which sponsored the 2002 legislation.

    Kaiser Permanente, the state’s largest health care provider, said in a statement that it has been “fully engaged for more than a year” to improve its timeliness in providing initial, non-urgent appointments and has already corrected nearly all of the problems cited in the 2012 survey.


    Associated Press: Kaiser Permanente fined $4 million by Calif agency


    State officials fined Kaiser Permanente $4 million, saying the health care giant failed to provide adequate mental health services, a newspaper reported.

    The fine issued on Tuesday by the California Department of Managed Health Care is the second-largest in the history of the agency, the Sacramento Bee said.

    Investigators said Kaiser failed to see mental health patients fast enough and that the company’s description of its mental health services was so complicated and misleading it “could dissuade an enrollee from pursuing medically necessary care.”

    “The amount of the proposed penalty is unwarranted and excessive, and is unnecessary to ensure our corrective actions,” said John Nelson, vice president for Kaiser Permanente. “We will review this with the DMHC.”

    The department issued a report three months ago listing numerous deficiencies that noted a “Frequently Asked Questions” sheet for Kaiser in Northern California said the company did not offer long-term individual psychotherapy.

    The department also pointed out a website for Kaiser’s Northern California Department of Psychiatry that said the company did not “begin treatment with individuals whose problems are of such long-standing nature that short-term treatment would probably not be helpful.” It went on to say the psychiatry department would refer such people elsewhere, although the treatment would not be covered by Kaiser.

    Officials with the managed health care agency said advising patients that long-term psychotherapy is unavailable violates a state law that says mental illness must be treated on par with physical illnesses.

    Kaiser, which has 7 million members in California, was fined after it failed to move fast enough to correct deficiencies pointed out last year, DMHC Director Brent Barnhart said.

    Nelson said Kaiser has hired new providers to reduce the waiting time for appointments and is recruiting more.

    In 2008, Anthem Blue Cross was accused of wrongly rescinding health care coverage and hit with a $10 million fine.


    Sacramento Bee: Kaiser mental health care lacking, state says; HMO hit with $4 million fine

    By Cynthia Craft, Sac Bee:

    Imposing the second-largest fine in its history, the California Department of Managed Health Care on Tuesday slapped Kaiser health plans with a $4 million penalty for failing to provide mental health treatment in a timely manner.

    The department also issued a cease and desist order to Kaiser, forbidding the health plan from continuing practices in violation of state law, which ensures equal care for mental and physical health.

    An investigation that started in 2012 found that Kaiser’s written description of its mental health services was so complicated and misleading that it “could dissuade an enrollee from pursuing medically necessary care.”

    Kaiser Permanente officials responded Tuesday by saying improvements are under way, and they plan to challenge the fine as too stiff.

    Only one other fine in the history of the department exceeded Kaiser’s.

    That was in 2008 when Anthem Blue Cross was hit with a $10 million penalty for wrongfully rescinding consumers’ health insurance coverage.

    “The amount of the proposed penalty is unwarranted and excessive, and is unnecessary to ensure our corrective actions,” said John Nelson, vice president for Kaiser Permanente. “We will review this with the DMHC.”

    Three months ago, the department released a detailed report saying Kaiser needed to see mental health patients more quickly and improve its public disclosures or face penalties.

    It provided Kaiser with a laundry list of deficiencies to correct, including these examples:

    • A FAQ sheet for Kaiser in Northern California says: “We offer brief, problem solution-focused individual counseling. Research shows many people improve in a single visit. … We do not offer long-term individual psychotherapy at Kaiser.”

    • Kaiser’s website for its Northern California Department of Psychiatry says: “In general, we do not begin treatment with individuals whose problems are of such a long-standing nature that short-term treatment would probably not be helpful. We will refer such individuals (elsewhere), although this treatment will not be a Kaiser-covered benefit and will not be paid for by Kaiser.”

    • Kaiser has failed to ensure that appointments for mental health care are offered in a timely manner, making patients wait too long between visits.

    Managed Health Care officials said advising patients that long-term psychotherapy is unavailable violates the state’s mental health parity law. The law says that mental illness must be treated on par with physical illnesses.

    The investigation follows complaints in 2011 by the union representing Kaiser’s mental health clinicians that Kaiser’s mental health practices were deficient.

    Last March, the department issued a report that contained serious findings but offered Kaiser the opportunity to correct them prior to being fined.

    However, DMHC Director Brent Barnhart said Kaiser did not move fast enough to fix its problems.

    “The department’s actions are a result of both the seriousness of (Kaiser’s) deficiencies and the failure of Kaiser to promptly correct them,” Barnhart said.

    For its part, Kaiser said it has been working diligently to improve its mental health care.

    The health care giant pointed out that state regulators did not find fault with members’ ability to receive urgent or emergency mental health services.

    In addition, Nelson said, Kaiser has hired new providers to reduce the waiting time for appointments, and is recruiting more.

    Nelson also pointed to data indicating that the majority of requests for initial therapist appointments are booked within 10 business days.

    The state, however, said Kaiser made patients wait at least 14 days after an appointment before they could call to schedule another one, meaning a patient could not receive a treatment plan that was pre-scheduled for several individual appointments over a two- to three-month period.

    Dr. Andris Skuja, a Kaiser psychologist, offered strong words in reaction to the news of the $4 million fine and cease-and-desist order.

    “This action confirms what every Kaiser clinician knows,” Skuja said. “Kaiser doesn’t take mental health care for its patients seriously.”

    Kaiser has 7 million members in California.

    For enrollees who have had problems accessing care, department spokesman Rodger Butler suggested they call the department’s help line at (888) 466-2219.


    Capital Public Radio: State Says Kaiser Too Slow With Mental Health Care


    California health regulators say Kaiser isn’t doing enough to provide timely access to mental health services for its patients. As a result, the state announced a $4 million fine against Kaiser today.

    Listen to the report.


    L.A. Times: California fines Kaiser $4 million over access to mental care

    California officials have fined healthcare giant Kaiser Permanente $4 million for problems related to patient access to mental health services.

    The fine announced Tuesday stems from deficiencies the California Department of Managed Health Care identified in March that were found during a routine medical survey. This marks the agency’s second-largest enforcement action after a $10 million fine against Anthem Blue Cross in 2008 related to improper policyholder cancellations.

    “The Department’s actions are a result of both the seriousness of the deficiencies and the failure of Kaiser to promptly correct them,” said Brent Barnhart, director of the Department of Managed Health Care.

    “The Department is taking this action to ensure that Kaiser promptly corrects these deficiencies and provides its patients with the mental healthcare promised to them by their health plan,” Barnhart added.

    State officials said Kaiser’s problems covered a variety of issues affecting patients. It found that Kaiser needed to better track and monitor the availability of providers.

    The health plan needs to ensure that appointments are offered in a timely manner and improvements to care are made when deficiencies are identified, according to the state investigation.

    Regulators also said that Kaiser’s educational materials and its “frequently asked questions” included inaccurate information that could dissuade a patient from seeking care.

    John Nelson, a spokesman for Kaiser, said each of the state’s findings “has already been corrected or is very far along toward resolution.”

    In light of that, the company said the “amount of the proposed penalty is unwarranted and excessive.”

    Agency officials said they would conduct a follow-up survey in October to ensure Kaiser has corrected the deficiencies and is complying with the law.


    Law360 - SEIU Can't Sink Rival's Suit With SLAPP Law: Appeals Court

    Law360, New York (June 03, 2013, 6:48 PM ET) — A lawsuit brought by the National Union of Healthcare Workers president against rival union SEIU shouldn’t have been dismissed under California’s anti-SLAPP statute because the alleged assaults and intimidation at the heart of the complaint weren’t constitutionally protected conduct, a California appeals court ruled Friday
    The appeals court reversed a lower court order that granted the motion from the defendants — a group that includes the SEIU and United Healthcare Workers West arm — to strike the complaint pursuant to California’s anti-SLAPP law. Friday’s ruling ruling also nixed a decision that called on NUHW president Sal Rosselli and six fellow plaintiffs to pick up the tab for $57,890 in SEIU legal fees and expenses.

    The term SLAPP stands for “strategic lawsuits against public participation,” and the anti-SLAPP statute says that a lawsuit arising from acts “in furtherance of the person’s right of petition or free speech” under the U.S. or California constitutions in connection with a public issue can be targeted in a special motion to strike, like the one the trial court granted in this case.

    The appeals court said Friday that the San Francisco Superior Court dropped the ball by finding that the lawsuit took aim at the defendants’ exercise of constitutional rights, and that any protected speech or activities in the complaint were “merely incidental to the unprotected, illegal acts upon which plaintiffs‘ causes of action are necessarily based.”

    “The gravamen of all three of plaintiffs‘ causes of action is illegal conduct — violence, assault, threats of physical harm, intimidation and coercion — that is constitutionally unprotected,” according to the ruling.

    The August dismissal order said that the NUHW and SEIU-UHW were “locked in a protracted and bitter” fight over who gets to represent more than 100,000 workers. Rosselli used to be the president of the SEIU-UHW, but in January 2009, the local was placed in trusteeship and the leaders were relieved of their management responsibilities. Rosselli and others then stepped down and launched the rival NUHW.

    Rosselli and the six other NUHW-affiliated plaintiffs launched a suit in state court in February 2011, accusing the SEIU of turning to dirty tactics including threats and assault as the two labor groups jousted for power.

    Their first amended complaint contained allegations of threats, including death threats, discriminatory slurs and epithets, and other intimidation.

    In one alleged incident, SEIU agents threw eggs and water bottles at the plaintiffs and other NUHW supporters, hitting several of them. Plaintiff Angela Glasper was allegedly “harassed daily” by SEIU agents and received multiple death threats.

    In 2010, Rosselli and labor activist Delores Huerta visited a Kaiser Permanente facility in Modesto, Calif., only to be pushed out of the facility by SEIU agents, who allegedly yelled at Huerta, “Go back to the fields where you belong,” according to the complaint.

    Neither the NUHW or the SEIU-UHW immediately responded to request for comment on the decision on Monday

    Siegel & Yee’s Dan Siegel, an attorney for the plaintiffs, said Monday that he was pleased with the ruling.

    “We were frustrated,” Siegel said, “because the Superior Court seemed to think that because some of the matters that we’re discussing on our complaint did involve free speech, that somehow made all of the acts we’re complaining about acts of free speech.”

    The plaintiffs are represented by Dan Siegel of Siegel & Yee, and Angela Alioto and Steven Robinson of the Law Offices of Joseph L. Alioto and Angela Alioto.

    The defendants are represented by Jeffrey Demain, Jonathan Weissglass and Anne Arkush of Altshuler Berzon LLP and Glenn Rothner of Rothner Segall & Greenstone.

    The case is Sal Rosselli, et al. v. SEIU, et al., case number CGC-11-508420, in the Superior Court of the State of California, County of San Francisco.

    —Editing by Jeremy Barker.

    Reuters: Battle at Kaiser Permanente is sign of vibrant unions in healthcare

    By Amanda Becker

    (Reuters) - The Service Employees International Union fended off an upstart rival last week in a union-on-union battle over California healthcare workers, a symptom not of labor’s decline but of its growth in the health sector.

    The SEIU-United Healthcare Workers West, in the largest private-sector election since Ford Motor Company was unionized in the 1940s, bested the National Union of Healthcare Workers-California Nurses Association after receiving 58 percent of nearly 33,000 votes cast by Kaiser Permanente workers.

    The replay of the SEIU’s 2010 election victory, which was thrown out by the National Labor Relations Board, was three years in the making, spawned dozens of unfair labor charges and cost both unions millions of dollars.

    Kent Wong, director of the labor center at the University of California Los Angeles, characterized the long-running dispute as “growing pains” for organized labor in an industry where it has achieved significant growth even as union membership has declined nationwide.

    “The success in organizing healthcare has resulted in some internal challenges,” Wong said in an interview. “It’s not unusual for unions to be competing for members, especially in an area where there has been a sharp rise in union density.”

    The healthcare industry has been a bright spot for unions and California in particular has been the focus of successful labor unionization efforts. Healthcare workers make up more than half of the SEIU’s 2.1 million members, with local- and state-government workers, public school employees, and private-sector maintenance, cleaning and security employees rounding out its roster. The NUHW, with roughly 10,000 members, earlier this year joined forces with the California Nurses Association, an AFL-CIO affiliate that represents 85,000 nurses and other healthcare workers.

    In 2012, there were 14.4 million workers who were members of a union in the United States and the membership rate was 11.3 percent, down from 14.8 million workers and a membership rate of 11.8 percent the year before, according to the Bureau of Labor Statistics.

    In California there was a membership rate of 17.2 percent in 2012. Some of the SEIU’s most successful recent organizing efforts have been in the healthcare industry and it now represents 110,000 nurses, 40,000 doctors, more than 50,000 home aides and 160,000 workers at nursing homes.

    “The old image is of a union worker being a steel worker or an auto worker but the typical person today is a teacher, nurse, firefighter or airline pilot. Nurses are one of the most unionized groups in society,” said Alex Colvin, who chairs the labor relations department at Cornell University. “This isn’t an area where unions are dying.”



    But the Kaiser Permanente election, to the SEIU and the NUHW, was about more than bolstering membership ranks. It was about what sort of union should be representing nurses and healthcare workers.

    The NUHW got its start in 2009 when its leader, Sal Rosselli, was ousted from the SEIU-UHW following a power struggle between leaders of United Healthcare Workers West and national SEIU officials.

    Rosselli and other former SEIU leaders formed NUHW. Its second-in-command, John Borsos, described SEIU as being a “top-down, corporate” union while the NUHW is “bottom up, more democratic.”

    “SEIU is too cozy with Kaiser and the industry,” Borsos said in an interview.

    The two unions’ disagreements over workers, Kaiser contracts and the future of the labor movement within the healthcare industry have been costly. The do-over Kaiser election cost the SEIU $4.5 million, according to its own estimates. The CNA loaned a comparable amount to the NUHW this year to in large part finance the election effort.

    “And at the end of the day, not a single new person is represented by a union,” SEIU spokesman Steve Trossman said. “Those are resources that could be used elsewhere.”

    Cornell’s Colvin pointed out that the country’s largest union, the AFL-CIO, was formed in 1955 by the joining of two competitors, the American Federation of Labor and the Congress of Industrial Organizations.

    “I think the leadership of unions gets concerned because they don’t like to see the infighting, but it can indicate an area were unions are vital and there are groups of workers that want to be represented,” he said.

    Borsos said NUHW is evaluating its next steps.


    Bloomberg BNA: In Rerun Election Mirroring First One, SEIU-UHW Retains Kaiser Representation

    By Joyce Cutler

    SAN FRANCISCO—California Kaiser Permanente workers voted to retain Service Employees International Union–United Healthcare Workers West in a rerun representation election for the largest health care bargaining unit in the West, consisting of 45,000 workers, according to a National Labor Relations Board tally of ballots released May 2.

    After two days of counting mail-in ballots, NLRB said 18,844 ballots (58.4 percent) were cast for SEIU-UHW, and 13,101 (40.6 percent) went to the National Union of Healthcare Workers-California Nurses Association. Another 334, or 1 percent, voted for no union, and 309 ballots were challenged. NLRB said 32,588 valid mail ballots of the 45,000 eligible voters were received by the Oakland regional office during three weeks of balloting.

    “At a time when unionization is down to 7 percent in the private sector, it’s time for people like the leaders of NUHW and CNA, who call themselves ‘progressives,’ to focus on organizing non-union workers instead of attacking people who already are in a union and have the best contract in the country,” SEIU-UHW President Dave Regan said in a statement May 2.

    NUHW President Sal Rosselli in a statement issued the same day said he was “stunned” by the results.

    “Speaking from decades of experience in elections like this, we have many questions that deserve answers,” he said.

    NUHW in a separate statement that day charged that SEIU prevailed through a “campaign of fear, intimidation, and collusion with management.”

    Rosselli told BNA May 3 that Kaiser withheld performance bonuses typically granted in spring, with SEIU used as a threat of future pension and benefit loss if workers went with NUHW.

    NUHW and CNA officials will hold “internal legal and political meetings” over the next week to consider the matter of filing objections, Rosselli told BNA.

    Repeat Results

    The rerun election had the same results and outcome as the 2010 representation election at Kaiser, NLRB said.

    In a 2010 mail ballot election, Kaiser employees throughout California voted to remain with the incumbent SEIU UHW, rejecting NUHW (195 DLR AA-1, 10/8/10).

    In July 2011, an NLRB administrative law judge, finding election interference by SEIU-UHW, recommended that a new election be conducted (138 DLR AA-1, 7/19/11). In August 2011, NLRB ordered that a new election be held (155 DLR AA-1, 8/11/11).

    SEIU spokesman Steve Trossman told BNA May 3 that there was “absolute election fatigue among folks.”

    “[B]ut what I think is really gratifying is that Kaiser workers hung in there and they voted their conscience and they voted because they understood what was at stake,” he said.

    “And what was at stake was the best contract, the best jobs in the hospital industry, or turning it over to an organization that has utterly failed at Kaiser for the last three and a half years,” Trossman said.

    NUHW won representation for 4,000 Kaiser workers in 2010, oustingSEIU-UHW (16 DLR A-18, 1/27/10218 DLR A-1, 11/12/10).

    “They still don’t have a contract. Those workers have lost 9 percent in raises that SEIU got that they would have had if they stayed with SEIU. [NUHW has] just been an utter failure,” Trossman said.

    NUHW maintains that Kaiser management granted “unequal facility access to SEIU-UHW staff and illegally abridged the speech rights of workers supporting NUHW-CNA.”

    NLRB, just days before the ballots were mailed April 5, issued a complaint alleging that a member of management at one Kaiser facility violated federal law by “interfering with, restraining, and coercing employees in the exercise of the rights’ guaranteed” workers under the law (Kaiser Found. Hosps., NLRB Reg’l Dir., No. 20-CA-096950,complaint issued 3/29/12; 75 DLR A-12, 4/18/13).

    ‘Tortured’ History

    Harley Shaiken, a professor specializing in labor issues at the University of California at Berkeley, called the campaign “a long, tortured road.”

    “But this looks like it’s the end of the line on it,” he told BNA May 3.

    “It was a very bitter, costly dispute but the vote was decisive. I think it’s an important victory for the SEIU … in many ways, it’s a flagship contract in health care,” he said.

    Trossman said NUHW-CNA spent $10 million on the election and SEIU$4 million to $5 million. NUHW says those numbers are reversed. CNA spent $5 million on the campaign, Rosselli said.

    “We had 200 staff. SEIU brought in 800 staff from all over the country in addition to their California staff. Despite that and despite the fear, 14,000 folks voted for us, despite this David-Goliath scenario,” Rosselli said.

    One issue, Shaiken said, is that with more than 93 percent of the private sector not organized, “having these kind of resources poured into decertifying a union within the labor movement, it’s hard to see what the positive outcome of it could be.”

    Shaiken called the election fight “the nuclear option.”

    “It is tried rarely and seldom if ever on this scale,” he said.

    Yet the battle is “rooted in history as well as in contemporary disagreements,” the professor said. “And you can see how we got here, but it’s unclear what the gain from it is. Whatever the gain or loss, I do think this is a defining moment.”

    Nelson Lichtenstein, UC Santa Barbara history professor and union watcher, told BNA May 2: “[The] original effort of SEIU to take over UHW-West, this will be SEIU’s Iraq, and I think the last four years has proven to be the case.”

    Battles With Health Care Providers

    The election is the largest since the 10,000-member NUHW affiliated with the 85,000-member CNA in January with a stated goal of restoring worker and patient safety standards. The groups found common enemies in SEIU, Kaiser, and Sutter Health (2 DLR A-11, 1/3/13).

    NUHW was formed by Rosselli and other former SEIU leaders one day after the national union placed the 150,000-member UHW local into trusteeship (16 DLR A-20, 1/28/0920 DLR A-12, 2/3/09).

    The U.S. Court of Appeals for the Ninth Circuit in March upheld a verdict finding that former officers of Service Employees International Union, United Healthcare Workers West, owe $1.5 million to UHW. The amount was based on successful claims that the officers breached fiduciary duties and violated UHW’s constitution by opposing SEIU’s jurisdictional plan for long-term health care workers in California and diverting UHW resources to form the rival NUHW (Service Employees v. Healthcare Workers, 195 LRRM 2341, 9th Cir., No. 10-16549, 3/26/13; 59 DLR A-2, 3/27/13).

    NUHW is appealing the dismissal of a lawsuit alleging that SEIU and some of its top leaders violated California civil rights laws by engaging in a “policy and practice of utilizing physical intimidation against those in the labor movement who they consider to be enemies” as a violation of the state’s Strategic Lawsuit to Prevent Public Participation law (Rosselli v. SEIU, Cal. Ct. App., No. A133896, case argued and submitted 4/3/13; 162 DLR A-10, 8/22/11). A decision is due this summer.

    Blunders and Olive Branches

    Lichtenstein said “the whole thing was a blunder on the part of theSEIU.”

    “It’s always been in SEIU’s court to extend their hand to NUHW and resolve this” as SEIU has done with other unions it battled, Lichtenstein said.

    “The remarkable thing about NUHW, always in labor history established unions of whatever sort never back dissident factions. It’s just not done. But in this case it was done. Basically the political and union base of the Bay Area and California did back NUHW,” Lichtenstein said. “I do think that it will be wise on the part of the SEIU to extend an olive branch to the leadership and the activists of NUHW and end this thing, this internecine warfare.”

    NUHW after results were announced said together with 18,000 CNA-represented Kaiser registered nurses and 5,000 NUHW-represented Kaiser employees, “13,000 workers belong to a majority of Kaiser workers in California who stand united and ready to fight the downward spiral of cuts that SEIU-UHW and employers like Kaiser are forcing on healthcare workers everywhere.”

    “We’re happy to have it over,” Trossman said. “We think finally we’ve hit the end of the road. I’m hopeful they won’t do it again.”

    Rosselli said the focus now is on the contract campaign “to force Kaiser to get off of their concessions for their workers and force Kaiser to deal with patient care issues around staffing.”

    Kaiser representatives were not available for comment.


    NUHW-SEIU Face New Showdown at Kaiser

    Cal Winslow in Beyond Chron:

    In April, 43,000 Kaiser Permanente workers in California will vote, again, to decide which union will represent them, the Service Employees International Union (SEIU) or the National Union of Healthcare Workers (NUHW), the latter now allied with the California Nurses Association (CNA-NNU).

    The issues in this contest are many. What is at stake is important. Very important. Let me say this right off – it is likely that this event, this election, will be as important as any for labor, in the coming year, indeed in the foreseeable future. What is at stake is in part about numbers, big numbers here and who gets them, also the shrinking numbers in US labor, as grim reports routinely remind us. But it is not just about “density” (the number of union members in a population or industry) that vastly exaggerated concept; we’ll return to this.

    What is at stake here goes much farther than that. Rather, it is about what kind of unions we will have, what kind of unions workers will have, and it is the answer to this that will likely tell us what kind of future labor will have. 

    On Monday, February 11, the National Labor Relations Board (NLRB), cleared the way for this election, a rerun of the fall 2010 election, won convincingly by SEIU, the results of which they, the NLRB, in July 2011 threw out.

    The 2010 election involved the largest number of workers in a certification dispute since the early 1940s, that one at Ford in the heyday of the US trade union movement. This one will be, if anything larger, 45,000 it’s reported.

    The players are big, Kaiser Permanente, the biggest Health Maintenance Organization (HMO) in the country, 9 million members, 167,000 employees nationwide, 40 hospitals, 1.6 billion in net income (“profits”) in 2011 – and the bulk of all this here in California, where it’s Oakland based CEO, George Halverson “earns” $9 million in salary annually and benefits beyond belief.

    SEIU remains the nation’s second largest union, with nearly 2 million members, 600,000 of whom work in California. Its healthcare affiliate, United Healthcare Workers-West (UHW) represents for now 45,000 Kaiser service and tech workers; its leaders and staff inherited their positions, beneficiaries of the 2009 trusteeship imposed by the SEIU international. Dave Regan, its Cornell University grad president, receives $300,000 a year (plus benefits), this in an industry where tens of thousands (in California hospitals) work for less than $20,000 annually.

    Against them, the NUHW, founded by members expelled in 2009 from UHW, now 10,000 members strong, and the CNA, with 85,000, 17,000 of them working for Kaiser in northern California.

    Inequality, then.

    And if that isn’t enough, Kaiser and SEIU have combined against latter, working together here; they are a team, a labor-management partnership in the deepest sense of this concept. When Judge Lana Parke, the Washington, DC based administrative judge, threw out the first Kaiser election, she did so, because, she found, “that certain conduct of SEIU-UHW in the circumstances of unfair labor practices committed by Kaiser Foundation Hospitals and Southern California Kaiser Permanente Medical Group among three professional collective-bargaining units of Kaiser employees in Southern California interfered with the employee’s exercise of a free and reasoned choice among /Kaiser/employees…” 

    That is, she argued, SEIU used Kaiser’s “illegal” denial of raises to NUHW members in southern California, the case in point, to frighten and intimidate Kaiser’s workers into supporting SEIU and SEIU rode this to victory in the election. Moreover, she wrote, “the Board does not lightly set aside representational elections…” concluding that “a new election will be held in accordance with the terms of this notice of election. All eligible voters should understand that the National labor Relations Board Act, as amended, gives them the right to cast their ballots as they see fit and protects them in the exercise of this right, free from interference by any other parties.” 

    If only this could be true (and remember it took the NLRB more than a year to schedule the first election, almost as much time to set the second. The wheels of “justice” at NLRB turn slowly). Nevertheless the elections are scheduled now, ballots are to be sent out on April 5, voting is to be completed by April 29, with counting to begin May 1.

    What are the issues? Much of this will be fought out over current contracts and contracts to come – the CNA northern California nurses contract with Kaiser expires next year, 2014. NUHW contends that SEIU has given away concessions at every turn, not just at Kaiser but in hospitals throughout the state, and notably in negotiations with the giant chains, including Sutter Health, Dignity, and Daughters of Charity. CNA concurs.

    At Kaiser, these concessions already include: cutbacks in medical benefits, including an invasive “Wellness Program,” also in retirement benefits plus retiree medical benefits, also dental coverage. Protections from subcontracting have been given away as well as seniority rights and job security – Kaiser has eliminated 1000 jobs under SEIU’s current contract. 

    And still Kaiser wants more – this is clear for all to see in the demands that Kaiser has placed on the table with NUHW’s 4000 Kaiser members, demands they have steadfastly and bravely rejected. It is interesting here to note that at the same time, now, Sutter Health has more than 100 concessionary demands on the bargaining table with its nurses. These and Kaiser’s demands are, of course, exactly what nurses there can expect next year. Across the industry things are, if anything worse. Among the most provocative ingredients in these negotiations is SEIU’s tactic of coupling concessions with “winning” “me too” clauses. These clauses involve management’s agreement to match for SEIU members any gains made in bargaining by other unions – in practice they work as an incentive for management to maintain a hard line.

    Deborah Burger, a CNA co-president and Kaiser RN at Santa Rosa, argues “look what SEIU has already agreed to, there have just been too many takeaways, what’s at stake for us is the precedent for everyone who works in the industry. It’s staggering. It makes our fight all that much harder. It already is at Sutter and everywhere else.

    “Our contract with Kaiser comes up in 2014. We knew it was going to be a fight, just look at the proposals Kaiser has put on the table for NUHW. If SEIU had held the line and fought, we’d be out there with them. But, no, so NUHW’s fight is our fight. It’s better for us to fight now, to help NUHW, to stop management now, to put a stop to these precedents.

    “So we’re out there every day, the nurses are walking the floors, every unit, every shift; we’re talking about the importance of this election. Kaiser has had it easy with SEIU; they’ve been let off the hook. It won’t be so easy this time.”

    In 2010, NUHW fought alone. They relied on the self-help of the members, a depleted staff, little money and volunteers. SEIU ran what Randy Shaw called “the classic union-busters strategy of relying on massive spending (between $20-40 million) to spread falsehoods about NUHW in robo-calls, email blasts, slick mailers and worksite visits …. /it was/the most expensive union election campaign in history.” He estimated that as many as 2600 full-time staff was sent to California for the election. NUHW leaders were “swift boated” (they stole your money), members were threatened (you won’t get your raise) and bullied (number one bully Regan is said to have told stewards, “If you’re not throwing chairs you’re not doing your job). The result was not a happy one by any means but still, in hindsight, winning 11,364 (against 18,290) votes for a militant, democratic worker led union was not so bad, not these days. Not against these odds.

    The battle then is on. Rumors are that hundreds of SEIU full-timers are already here. The lying has begun. The bullying has begun; really it never stopped. According Oakland labor lawyer Jonathan Siegel NUHW supporters are “bullied by SEIU, threatened by Kaiser, threatened with trespass and arrest, kept out of facilities. At the same time, it’s an open door for SEIU.” 

    Bullying? What exactly is meant by this? Here’s the case of Gloria Watkins. It’s all too typical. On July 20, 2012, NUHW representative Gloria Watkins was surrounded by over two dozen SEIU-UHW stewards in the hallway of Kaiser Permanente’s Vallejo Medical Center, and was then verbally and physically attacked by this angry mob. 

    The SEIU stewards, while on Kaiser’s paid time, encircled Ms. Watkins, clapping and chanting in a hostile manner, deliberately causing her to fear for her safety. After Ms. Watkins sat down on a bench, one of the stewards sat beside her and repeatedly struck her in the torso with her elbow for about five minutes straight, while continuing the volley of verbal harassment. Kaiser security officers and managers witnessed the incident and did nothing to stop it, the lawsuit alleges. The setting? Remember, a healthcare facility. Who needs this?

    Bad enough? For NUHW veterans it is just that much worse. They’ve watched their once proud union wrecked. UHW before trusteeship was a growing union, the fastest growing in California, it was progressive, democratic, militant; it stood by other unions in struggle. It was clean – it is said to have blown the whistle on Tyrone Freeman, the former head of SEIU’s southern California, 190,000 member, local 6434. Freeman was once a rising star in SEIU; he was handpicked for his position by Andy Stern, the former SEIU president. He’s now just been convicted on 14 counts of embezzling perhaps as much as $1 million from his one-time members, mostly $9 an hour, bottom-of-the-ladder healthcare workers. He awaits sentencing, facing as much as 180- years in prison (LA Times January 28, 2013). A note, this was all done on Eliseo Medina’s watch; Medina was then an SEIU vice president in southern California. He’s now the union’s secretary-treasurer!

    Mell Garcia is a medical assistant as Kaiser Hayward; she’s worked there 30 years. She was an elected steward and an elected executive board member of UHW under the pre-trusteeship regime. “These years /with SEIU/ have been depressing, frustrating, and sometimes hopeless. I used to be a steward. So people still come to me, they need help, and they have nowhere else to go now. They come to me but I can’t help them. So Kaiser has a free hand; they do whatever they want.

    “Yes, there’ve been changes, but all for the worse. Just take one example, the environmental staff /cleaners, housekeeping/. They’re having their work areas doubled, even tripled. SEIU says nothing. And there’s nothing we can do about it.

    “So what’s this about for me? I want my union back. I want a contract that is upheld, every day. I want to come to work and feel strong, to have some power, to be secure about my job, my future, that’s what a union is about for me.” This, of course, won’t show up in discussions of “density.”

    Alas, the odds still favor SEIU-Kaiser. But there are factors that in this round favor NUHW. First, of course, there is the alliance with the CNA and with it the National Nurses United (NNU), the largest nurses union in the country. This is inestimable. Kaiser workers united in one union, working together.

    The alliance, announced in Oakland on January 3, this year, was, Sal Rosselli, president of NUHW, told the press, “an affiliation whose time has come.” The chair of CNA’s Kaiser bargaining team, Zenei Cortez, RN (also a CNA co-president) explained, “Uniting together, CNA and NUHW are taking a huge step forward in achieving our joint goals.” 

    Numbers count. So does money. The nurses, however, bring more, beginning with the respect with which they are held in the hospitals. One CNA banner reads, “Save a life, you’re a hero. Save 100, you’re a nurse!” Then, add to this, these nurses are fighters; they have a history of fighting. The CNA, born in a 1990’s rebellion, is one of the few examples of such a union in the US today – above all it is known for its stunning victories in the fight for staffing in California hospitals, magnificent victories, and victories for workers and patients alike, for us all. It’s a progressive union– it stands for single payer healthcare, for fair taxation (the Robin Hood tax), for killing the Keystone pipeline. (Am I saying CNA is perfect? Why would I? same goes for NUHW, but certainly that’s not the issue we face and we’re likely to wait a long time for something much better.) The CNA, it might be added, has entered this fray with its plate full already. In a knock- down fight with Sutter, nurses at eight Sutter facilities have struck since contract negotiations began; there were four one-day strikes held on Christmas Eve, these protesting major cuts to patient care and nurses’ standards. At this point, Sutter remains apparently undeterred, it’s entire array of concessionary demands on the bargaining table, including, according to Joann Jung, Director of the CNAs Sutter division, “severe cuts in healthcare benefits for nurses and their families.” At Alta Bates Summit, 2000 nurses continue to fight management’s demands, even as SEIU-UHW has already accepted deep cuts. “The ‘me too’ clause there,” reports Jung, “puts an enormous burden on the nurses. It’s altogether unfair.” Sutter, by the way, is another fabulously wealthy, “non-profit.” It has long been plagued by the this, criticisms compounded by the fact that Sutter has San Francisco’s lowest rate of providing charity care to low-income patients, hardly consistent, it seems, with its non-profit status and medical mission.

    There’s more. In the spirit of the nationwide attack on public workers and pampered, overpaid teachers in particular, in June this past summer, SEIU’s Dave Regan appeared in Sacramento with the Duane Dauner, President/CEO of the California Hospital Association, to support an attempt to roll back California’s hospital staffing ratios, including nurse to patient rations, these ratios the products of decades of struggle. Why? Regan suggested that money saved could be spent to uplift those less-well paid than, say, nurses! Sure! The California Hospital Association is the healthcare equivalent of the Chamber of Commerce. It represents the industry that profited $4.4 billion in 2010. Regan, ever generous, offered this in support –the rollback of the bill could save hospitals as much as $400 million in the first year alone. “Jaw dropping,” responded the healthcare blog, Stern Berger with Fries.”

    More to the point, in 2011, CNA nurses twice joined NUHW on Kaiser picket lines, each time, 20,000 strong, the largest hospital strikes in US history. So we have a lot going for us, a lot more than last time. The nurses for a start, but also a large and growing core of tough, experienced NUHW members. There is also the fact that past confusions about SEIU-UHW – just who and what it is – have, at least for many, been cleared up. The case can be made that SEIU is Kaiser’s union. And the concessions, the absence of representation, the retreat of the union on all fronts is there to see. 

    I hope I don’t exaggerate the importance of the outcome of this conflict. I don’t think I do so. At the same time, I hope, as I think we all do, that there will in fact be major events to come, say, another Madison, another Chicago teachers strike, the sooner the better. But that takes nothing away from this argument, nothing away from the significance of the April election.

    Any why not? Much has been made of the recent report of the Bureau of Labor Statistics, the report (“Union Members, 2012” January 23, 2013) that found that labor’s numerical decline continues apace; membership is now down to 11.3% over all, and just 6.6% in the private sector, the lowest, we are told since the turn of the past century, the 1900s that is.

    This is dreary to be sure. Yet there is perhaps a silver lining. California, the state with the highest number of union members, 2.4 million, appears to have gained union members, another 100,000 (though it’s not at all clear just where and how, but we’ll leave that for now). The point would seem to be, importantly, that unions can grow, though how is not yet so clear. There are certainly factors that bode well for us – no Scott Walker here, the state is dominated by democrats, overwhelmingly. Obama won by three million votes, for what that’s worth. A right-to-work campaign then seems unlikely. We have some pretty strong unions – the ILWU just shut down two of California’s three major ports, including the huge port at Los Angeles. The two big teachers unions seem full of potential. There are others.

    We have after all 2.4 million members, in the nation’s most highly diverse state. We have an increasingly large, restive and frustrated immigrant population. And we have the bitter, ongoing experience of the foreclosure crisis. There is as well the legacy of the great crash and the great recession that persists. Unemployment remains near 10% - while Silicon Valley enjoys yet another gold rush and San Francisco gleams. How can unions not grow in conditions such as these?

    I’ll suggest one reason. They don’t grow because of unions like SEIU – and sadly there are many of these. Some time back, we asked the question in these pages, “What is the SEIU?” There have been various answers (not specifically to us). Rose Ann DeMoro, executive director of CNA once called SEIU a “management surveillance team,” an organization that “will do anything to get dues.” HERE’s Mike Casey referred to SEIU as “the company union in our industry.” Somewhat more expressively, Vince Giblin of the Operating Engineers (and he should know) called SEIU’s illustrious then president Stern “the Darth Vader of the labor movement.” We’ve waited in vain until now for opinions to the contrary. It does appear, however, that there is much evidence to support the view that SEIU is something less than a union. Mell Garcia says simply, “It’s a bosses union. If the bosses could make a union they’d make SEIU.”

    At the same time, well-known labor scholars Nelson Lichtenstein and Bill Fletcher have called suggested that NUHW is a “model union.” Also, “the fight between NUHW and SEIU is not a question of an old-fashioned ‘raid’. /It is/instead a process which seeks to reestablish an ongoing, democratic and highly successful union whose health and outlook is essential to any revitalization of trade unionism, on both a state and national basis.”

    So why the silence in the labor movement. And why more of the same from labor’s academic and activist friends, a wider silence this time perhaps than last time. Why is this conflict largely ignored? The only reference to it in a recent Nation magazine roundtable on the state of labor was a lament that it was happening at all.

    The movement today, it seems to me, is desperate, desperate for something good to happen, especially something big. And among other things, it wants big numbers, big numbers as an answer to dwindling statistics. The SEIU promised above all density. And it’s still riding on that. But not much. So the call to organize persists. And rightly so. Walmart. Fast Food. The port truckers. Grand Stephen Lerner schemes. Smart organizers are needed. Miracle cures, power structure analysis. Revolutionary new tactics. Indeed we do need these. But into what kind of unions?

    There is also the long haul and this is at least in part what the California conflict is about. So we return to this question of what kind of unions we need. And what kind of members? This is not, again, just a question about numbers then. It’s about people. I sometimes think this conflict in California is a little like the rank-and-file rebellions of the 1970s, the fights to transform the unions, to change them into something better.” There was then one slogan that still resonates, “Organize the organized.” Ken Paff, the organizer for Teamster for a Democratic Union, (TDU) reminded me that “trucking is in the service sector, it’s non-exportable, and there are more trucks moving than ever before. So there’s still much to do in “core sectors of industry” but that needs “commitment from international – and money The Kaiser workers, organized, inevitably represent this potential. There are literally millions of unorganized healthcare workers today. I think we don’t pay enough attention to this. And in this case, the Kaiser fight is in many ways organizing, or reorganizing the organized, that is the Kaiser workers trapped in SEIU. It’s a fight within the unions – but it’s an important fight, there’s no escaping it. Is this so bad? The Nation correspondent writes that “the worst news this winter is not about numbers, or bad legislation, but rather that some of our most effective union organizers are going to be fighting over already-organized workers in two or more major inter-union battles.” I don’t think this is true. We needed the CIO in the 1930s; it precipitated giant steps for labor. A win for CNA-NUHW will be such a step, and today. Walmart workers, port truckers, the vast numbers of the unorganized can only be beneficiaries.

    CNA’s Deborah Burger responds, “I can see unions growing, but only if they are relevant, and just as long as they really belong to the workers. But what’s the point of a union if all it does is argue management’s case; what’s the point if it’s just someone else on the other side of the bargaining table?

    “They press have made a big deal of Tyrone Freeman’s conviction and that’s right. But there are other crimes, bigger crimes. What about SEIU’s crimes. It’s criminal, these concessions, it’s taking money from hardworking, low-wage people, putting it into the pockets of the George Halverson’s, and using it to subsidize this industry, in this case they’re financing Kaiser and it’s expansion, it’s now global ambitions. They’re putting our money into the pockets of others. How much will this cost a worker, how much over a lifetime? How much will it cost us all? A lot more than Freeman got.”

    And Sal Rosselli: “Can unions grow? We’re doing it every day. We’ve gained a thousand members in the past two years, and we’re on the defensive in this fight with SEUI, we’ve got them between us and the employers. The truth is that healthcare workers today need a union more than ever, hospital profits are unprecedented, yet they’re on the attack for more.

    “Workers want unions because they want power, power against the employer, power at work, power in society. They want that but most unions don’t offer it. We and CNA are still exceptions. But we can do it.”

    In an interesting article, Chris Maisano, writing in Jacobin, suggests this:

    “The external challenges confronting union today are massive, and their importance should not be minimized. But they shouldn’t be used as an excuse to avoid asking hard questions about labor’s inability (or perhaps unwillingness) to mobilize its most precious resource – its current members. If only 5% of US unionists /out of 14 million members today/were turned into trained, disciplined activists with a class orientation and a long term strategic vision, there would be about 750,000 of them. How different would this country look if we had that?”

    Very different indeed. It still depends, however, on what kind of union, but this is what the California election is all about.

    Cal Winslow is the author of Labor’s Civil War in California, PM Press, 2012 (second edition, revised and expanded), an editor of Rebel Rank and File: Labor Militancy and Revolt From Below during the Long Seventies (Verso, 2010), and an editor of West of Eden, Communes and Utopia in Northern California (PM Press, 2012). He is editor of the e-pamphlet, “Which Way to Wellness, A Workers Guide to Healthcare in the Workplace.” He is a Fellow at UC Berkeley, Director of the Mendocino Institute and associated with the Bay Area collective, Retort. He can be reached at


    LA Times: Ex-SEIU local exec convicted of stealing from low-income members

    Paul Pringle and Hailey Branson-Potts, Los Angeles Times

    A onetime rising star in national labor circles who headed California’s biggest union local was convicted Monday on federal charges that he stole tens of thousands of dollars from his low-income members.

    Tyrone Freeman, who represented about 190,000 homecare workers as a leader of the Service Employees International Union, was found guilty on 14 counts after a 10-day trial in Los Angeles.

    Jurors deliberated two and a half days before returning their verdict. The trial followed a nearly four-year investigation triggered by a series of Times reports on Freeman’s financial practices.

    “This was a case about abuse and betrayal,” U.S. Atty. André Birotte Jr. said in a statement after the verdict. “Freeman abused his position as leader of the SEIU, and he betrayed the hardworking people whose interests he was supposed to represent.”

    Freeman, 43, faces a maximum of more than 180 years in prison when he returns to court for sentencing in April. His attorneys declined to comment.

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