Union Triage

Andrea Prebys considers herself a dogged foot soldier in one of the most ambitious, wide-scale union organizing drives in recent Southern California history. So even as the summer-heated asphalt at the Shell station across the street from Monterey Park’s Garfield Medical Center burns through the bottom of her shoes, she waits patiently for her contact to show up. Several minutes late, stout, tattooed Jose Guillen finally arrives for the street corner meeting.

And he’s laden with bad news. “I’m not a charge anymore,” the former G.I. reports to his union organizer. After a year as the top guy in Garfield’s transportation department, he’s been demoted. “They took my position away,” he says glumly.

It’s a major setback for Guillen. After working at Garfield for seven years, he still makes only $10.88 an hour. His department, responsible for moving patients around in wheelchairs and on gurneys, had already been cut from three people to two. Sometimes he’s the only worker on duty. And now he’s lost what little authority, what little upward mobility, he had won.

Prebys is angered by the news. But, then again, she gets paid to get angry. She was deployed to Los Angeles from Oregon last June. Her assignment, along with that of up to 125 organizers of the Service Employees International Union (SEIU, is to recruit and unionize in one, coordinated, fell swoop, literally tens of thousands of hospital workers — from nurses to techs to orderlies — spread out among scores of hospitals statewide. She is backed up by a battery of labor lawyers, a team of Sacramento lobbyists and a sophisticated communications network.

At stake in this battle is much more than the wages or working conditions of the hospital staff. Some time ago the SEIU concluded it was no longer worth it to burn up bundles of union resources trying to organize one “hot shop” or hospital at a time. An increasingly conglomerated economy called for a new union strategy: trying to organize entire sectors of the economy in one big bite. If the SEIU can win its current hospital campaign, it could establish a new model for all of American labor.

But for the moment, Prebys knows she has to proceed worker-by-worker, so she concentrates all her attention on Guillen. For 20 minutes they plot their next move. Prebys reassures Guillen that his demotion is but one more “ridiculous” cost-cutting measure that can be turned back against management. “It’s this kind of thing,” she says, “that you guys are going to be able to use to get people active and really excited about the organizing, because these are the kind of things you can change by having a union.” Prebys asks Guillen to redouble his efforts to sign up new workers from the inside.

“Cool,” says Guillen, at least momentarily heartened by the thought of an organized fight back. “That’ll work,” he says as he trudges back to his post.

Five years ago, the SEIU shook up the sometimes sleepy world of American trade unionism when it began to successfully recruit and organize 120,000 California home health-care workers, winning them representation and higher wages. Now, in its massive hospital worker campaign, the SEIU is attempting to make another dramatic leap forward for California organized labor.

At ground zero in SEIU’s strategy is the giant Tenet Healthcare Corporation, a notoriously anti-union chain that operates 40 California hospitals, including Garfield, and employs 35,000 California workers, making it the second biggest hospital chain in the U.S. In its effort to unionize the Tenet chain, the SEIU — with a half-million members in California alone — is using an innovative and controversial approach that it first pioneered in 1997 when the union signed a sweeping agreement with the Kaiser chain. “This is an enormous effort by employees of the nation’s second largest hospital system to unite on behalf of patients and professionals to make improvements from the bedside up,” SEIU spokesperson Lisa Hubbard says of the current effort.

Much of organized labor is investing many of its hopes in SEIU’s push against Tenet. In the era of Bush, increasing privatization and sliding union representation, the notion that thousands of ordinary workers in one of the country’s fastest growing industries can be organized is tantalizing.

But not everyone is cheering. The much smaller California Nurses Association (which represents about 50,000 nurses statewide) calls SEIU’s strategy with Tenet a sellout and is pushing several legal challenges that have, in turn, blocked organizing efforts in more than 15 local hospitals. The feud between the two unions has turned ugly, each side claiming the other is doing the boss’s bidding. In the meantime, what is potentially Southern California labor’s most crucial campaign in a decade is in danger of slowing down because of the infighting.



Central to SEIU’s strategy — and to the controversy — is an agreement it signed last May with Tenet. The accord came after a yearslong union-run “corporate campaign” against Tenet that focused on declining working conditions and more and more patient-care decisions in the hands of corporate managers rather than health workers. After fierce resistance, Tenet reversed course and decided to cut its losses, making a deal with labor, rather than continue fighting on multiple fronts.

Tenet could hardly afford an all-out labor war. Last August, it had to pay $54 million to settle allegations that two of its Redding doctors performed unnecessary heart surgeries. The company is now being investigated by federal authorities for Medicare fraud and for paying illegal kickbacks to physicians. In the midst of all of this, Tenet CEO Jeffrey Barbakow — once the highest-paid executive of a publicly traded company — resigned, walking away with $111 million.

In large part, it was the union’s immense political power, its close ties to powerful Democratic politicians in Sacramento, that brought the industry giant to the bargaining table. Just a few weeks before signing the May agreement, Tenet president and acting CEO Trevor Fetter turned to his investors and explained why making peace with the union was so important. “[M]ost of the negative publicity that the company faces in California and a certain degree of legislative activity is sponsored and fomented by the unions, and I must tell you that the unions are a formidable force in California,” he said in a conference call.

The compromise reached in the agreement was clear: Tenet agreed to employer neutrality, pledging recognition and good-faith bargaining if the SEIU could win informal private elections among the workers. Basic pay raises of up to 32 percent and improved working conditions were granted in the agreement. Additional perks could be won when final contracts were negotiated unit by unit.

The union, grasping the possibility of bringing in thousands of new members, also gave ground, abandoning, for now, the fight for company-paid pensions and surrendering the right to strike during the bargaining period. This was a compromise the SEIU was more than willing to entertain.

And Tenet knew that the union’s political power was a double-edged sword that could, potentially, also benefit the company. Tenet would be gaining a new, brawny political partner in its efforts to win more money from the state reimbursement system.

The SEIU ardently argues that the agreement with Tenet is of landmark value because only the muscle and political clout of a powerful union like the SEIU working in partnership with the employers can restore decent standards of patient care that — in recent ‰ years — have fallen by the wayside. “We think that union contracts are the only way to change health care and achieve access for everybody,” says Mary Kay Henry, director of the SEIU’s Southern California Hospital Campaign. The union proudly points to more than 2,500 workers at seven hospitals who have already voted to join SEIU under terms of the May agreement. And myriad other elections are still in the works as the union wages an uncertain battle against an often still adversarial Tenet.

As to the agreement, “it’s a choice we make gladly,” says a young SEIU organizer working on the Tenet campaign. “If we can make a deal that brings 25,000 workers a union contract, higher wages, better conditions, more power over staffing decisions and on top of that allows us to rein in a corporation like Tenet, what do we have to apologize for?”


A small group of SEIU organizers gathers at the union’s Inglewood office to jump-start the Labor Day weekend with a dizzying dose of fieldwork. The union is gearing up for elections among business, office and clerical workers at Tenet-owned Centinela Hospital Medical Center. This weekend they’ve planned several days of “house calls.” The idea: to catch workers at home, where organizers can talk to them freely about what the union is doing and collect cards of support, pledges to vote “yes” in eventual union elections.

The reality: more often than not, organizers don’t make it past the front door.

But 30-year-old organizer Lilly Vallee, a tall, green-eyed woman of Polish descent, has a modicum of luck. One worker is at home with his two young kids when she shows up at his door in Inglewood, across the street from Centinela. The TV set is blasting in the background. The man has been at the hospital for several years — since well before Tenet took over the facility in January 1997.

In his first years there, he was getting yearly wage increases as high as 10 percent. Then the raises were cut in half. Since Tenet took over, the annual increases have further dropped, to around 4 percent. Vallee tells him that he’s lucky in a certain way, that his raises are higher than in most Tenet hospitals. And then she plays one of her strongest cards. If he and his co-workers vote in the SEIU, they would, under terms of the agreement with Tenet, receive an immediate pay increase of 6 percent in the first year and 5 percent in each of the following three years.


“If I give 20 years to the facility, I want something back,” the man says, lamenting the lack of any company pension plan. “That’s a lot of time, a lot of work.”

“That’s right! That’s right!” Vallee says encouragingly, sensing an opening to talk union — though the SEIU/Tenet agreement offers no pension plan.

“It’s all about money and I understand that,” the worker says. “It’s just that . . . people have to get compensated for the time they’re putting in. We’re getting shoved around.”

But when Vallee asks him directly whether he supports bringing in the union, the man remains frustratingly uncommitted. “If we can work on the pension plan, then I’m interested in the union,” he says. In the meantime, he adds, he’ll still be looking into other options: private pension plans, 401(k)s and other individual solutions.

Vallee, meanwhile, hasn’t written him off. She’ll see to it that the union contacts him again and probably a third time before it goes ahead with elections in his department.

The face-to-face visiting is an unpredictable science. Later that day when Vallee visits another Centinela worker who is thought to be anti-union, she’s handed a pleasant surprise. Longer shifts and short staffing have turned the 47-year-old woman staunchly pro-union.

The house calls are part of an aggressive and tenacious organizing strategy that the SEIU has developed in the past couple decades. At a time when union membership was on the national decline — union density dropped from 16 percent to 13 percent in the period from 1997 to 2002 — a handful of unions including the SEIU, CNA and several others were responsible for reversing that trend in California. (For the same period, union density in the state grew from 16 percent to 18 percent.) From its celebrated Justice for Janitors campaign to the more recent California home care campaign (billed by The New York Times as the largest labor campaign since the 1930s), the SEIU has bucked the national labor trend by winning major victories.

The Tenet campaign itself is the culmination of the SEIU’s broader struggle to take on California hospitals on a “wall-to-wall” basis — trying to organize the entire sector from $75,000-a-year RNs down to $8-an-hour orderlies. For much of the late ’90s, organizers wearing the trademark purple shirts representing “Your Favorite Union” (as the SEIU likes to call itself) could be seen in or around hospitals across the state. They waited in the facility parking lot or approached workers at home, trying to raise support. Since 1998, more than 28,000 hospital workers throughout California joined the SEIU.

The masterminds of the new thinking saw it as a direct response to the increasing concentration of hospital ownership and power in the hands of a few industry giants, with Tenet foremost among them. In the end, they say, this is about the survival — or the continued relevance — of the labor movement. “Well, we could have this fight hospital by hospital, where a corporation of 36 hospitals has the resources to fight their employees, or we could take it on as a system, right?” says Sal Rosselli, president of the SEIU’s Oakland-based Local 250. “The fight isn’t against one individual hospital.”


The fight is also, increasingly, with another union. The California Nurses Association — an independent union not affiliated with the AFL-CIO — is a traditional craft union made up almost exclusively of the best-paid health workers, the registered nurses, a constituency it has nurtured for a century. The SEIU, by contrast, is an industrial-style union that aims at organizing the entirety of a targeted employer’s work force.

These long-standing differences have now boiled over into near open warfare: shouting matches in front of hospital facilities, each side accusing the other of sleeping with the boss. The CNA is fuming over Tenet’s agreement with the SEIU — a deal it calls “bribery” — because it effectively shuts the smaller union out of much of the organizing process.

A section of the CNA Web site, indeed, is titled “SEIU Watch: Enemy of Registered Nurses.” On a recent evening in Culver City, two CNA organizers leafleted outside Tenet’s Brotman Medical Center where the SEIU has been concentrating much of its efforts — and winning elections. The pamphlets contained a cartoon of a sinister-looking man (a Tenet boss) moving an SEIU puppet across a platform marked “Staged Election.” The caption, to the right, reads, “What have you really gained through the Tenet/SEIU backroom deal?”


“The huge irony here is that their [SEIU’s] rap is that ‘We’re so strong, we’re national, we have 40 kazillion members,’ and so on. If they’re that big and strong, why such a mediocre agreement?” says Bill Gallagher, a CNA organizer. He argues that the May agreement between the SEIU and Tenet was reached over the heads of the workers and is an old-fashioned sellout. Gallagher points to the absence of a pension plan and the provision barring workers from striking for seven years.

Aside from challenging the May agreement between the SEIU and Tenet in court, the CNA and a recently created sister union — CHEU — have filed for elections with the National Labor Relations Board at 18 hospitals. The upshot is that because of the lengthy hearing process, some Tenet workers will now have to wait months — maybe even years — until they can vote on unionizing.

SEIU officials scoff at what they claim is the CNA’s hypocrisy. The smaller nurses’ union, they say, signed an agreement of its own a few years back with the Catholic Heathcare West chain. They claim that the CNA also sat in on the original talks with Tenet — only to pull out when the SEIU wouldn’t grant it sole jurisdiction over the nurses. But, in a measure of how controversial even the barest facts can be, the CNA claims it never took part in the talks.

Meanwhile, the intra-union war only escalates. The CNA has been sending out organizers of its own to Tenet facilities, in some cases asking workers to “Vote No” in union elections organized by the SEIU. The SEIU recently responded by leading a march of 75 workers on the CNA offices, demanding an end to what they called its obstructionist tactics.

And to some workers, predictably, the union infighting is a turnoff. A nurse on her way to work at Brotman where CNA was leafleting said, “To me, it’s just crazy stuff. Do they really care about the employees or is it just a competition between the two unions?”


Against the overwhelming power of the hospital giants, the unions’ disagreements may seem petty. But the SEIU’s attempt to organize an entire sector of the economy in one massive campaign is at the heart of the labor movement’s debate over its future and its survival.

And while some say this kind of large-scale industrywide organizing and willingness to forge agreements with the bosses is necessary to fight America’s progressive corporatization, others say the model may not apply so widely. Nelson Lichtenstein, labor historian at UC Santa Barbara, points to Detroit in 1937, where the famous sit-down strikes effectively shut down Chrysler and GM. As a result, he says, small-parts firms eager for stability and predictability were calling up the unions asking them to come in and organize their shops. “And you can call that making a deal,” Lichtenstein says, “but it was based on a kind of militancy that the union had demonstrated.” Maybe, he says, in places like hospitals where labor already has a certain momentum, unions like the SEIU can do the same sort of thing. But whether this applies beyond the quasi-public domain of health care, he’s unsure: “That makes it sound like you can do this anywhere, and you can’t,” he says. “In the real private sector — you know, some taco factory in South L.A. — you aren’t going to get an agreement with them.”

Yet, Lichtenstein concludes, with the “fantastically bitter management opposition to unions in every way, shape and form” found in today’s workplace, “almost anything you can do to get people together and organize is a good thing. And once people get organized, amazing things start happening beneath the radar screen.”

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