After 14 months of bitter accusations and countercharges, the California Nurses Association and Kaiser Permanente settled their differences and agreed to a new contract.
The tentative deal, reached March 25, gives the nurses a 12% pay raise over four years and, more significant, a role in monitoring quality within Kaiser's hospitals and clinics.
The CNA called the new contract "a historic achievement in establishing groundbreaking provisions for patient-care protections." The new contract extends to Dec. 31, 2002.
Kaiser spokesman Tom Debley said it was a "win-win for the nurses and Kaiser Permanente."
About 7,500 Kaiser nurses represented by the CNA have been working without a contract since Jan. 31, 1997. They staged five one- and two-day strikes against Kaiser, each of which cost the HMO an estimated $10 million to relocate patients, hire out-of-state nurses and pay community hospitals.
The nurses worked at about 50 Kaiser hospitals and clinics in Northern California.
In one of the most heated healthcare labor disputes in recent memory, the CNA had branded Kaiser its Public Enemy No. 1 and launched a high-volume public relations campaign in California to denounce what they called its declining standard of care. Yet at the same time, Kaiser gained more new enrollees than ever before. In fact, Kaiser scored high in an annual ranking of how much of their premium dollars California HMOs spend on medical care (See story, p. 32). The two sides seemed locked in a death grip.
But in the past week, two new labor agreements were reached that broke the logjam. The CNA negotiated a contract for 1,700 nurses at Mercy Healthcare in Sacramento. It was the Mercy nurses' first contract as an organized bargaining unit.
On March 17, Kaiser reached a new contract governing 15,000 employees who are members of Service Employees International Union Local 250, after easy bargaining. Local 250 workers will receive a 3% annual raise in the three-year contract.
Local 250 President Sal Rosselli sent a letter to Kaiser executives urging them to settle with the CNA on similar terms. Kaiser decided to view the Local 250 settlement as "a window of opportunity." When Kaiser signaled its willingness to talk again, the CNA canceled another walkout scheduled for March 25 and serious negotiations resumed with the aid of a federal mediator.
Lila Petersen, spokeswoman for Kaiser, said the details of the nurse quality liaison positions have yet to be worked out, but they will report the nurses' thoughts on patient care to Kaiser's in-house quality committees.
"Once their concerns are taken in the quality review process, they have to be resolved. This gives the nurses a strong voice on quality," Petersen said.
The CNA made several concessions. It agreed to move retired nurses into Kaiser's Medicare HMO. Also, newly hired nurses in Santa Rosa and Sacramento will start at a lower wage than new hires in the San Francisco Bay Area. Kaiser had asked for this concession to stay competitive in those markets.
Henceforth, nurses in Santa Rosa will start at $20.89 an hour. Bay Area nurses will start at $24.57.
Under the old contract the average wage for a full-time nurse at Kaiser was $29.30 an hour. That's an annual salary of about $62,000, before benefits, overtime and special differentials.
Those are some of the highest wages for nurses in the U.S. Kaiser long maintained it needed wage concessions from its nurses to remain competitive.
Petersen said simply that "the settlement does meet all of our conditions. It allows us to continue to provide affordable healthcare for our members, and pay the nurses a good wage so they will stay with us."
The developing shortage of skilled nurses in California and around the country might have played a role in the willingness to offer new contract terms, she said.