Jane Hopkins, a registered nurse and president of SEIU Healthcare 1199NW, which represents nurses and other healthcare workers at six Providence-affiliated hospitals, said the union used to have a more contentious relationship with management. After employees went on strike in January 2020 during contract negotiations, the two groups agreed to work together, with an eye toward equity and racial justice, she said. She described the relationship as transparent, with union members meeting with hospital leaders monthly to discuss labor issues.
To manage 52 hospitals across seven states, Till said Providence practices subsidiarity, meaning it operates as an organization of separate employers. He recommends having an on-the-ground human resources team at hospitals and divisions to stay on top of evolving state and county labor-related policies while keeping upper management informed. Union contracts are negotiated at the local level, with leaders at each hospital responsible for communicating any changes.
“Our total rewards [including benefits and compensation] and a lot of how people perform the work can be negotiated based on what those folks need. … What might be important to a population in rural Montana is probably different than the population in Anchorage, Alaska,” Till said.
Keegan Fisher, chief human resources officer for Providence Swedish’s north division, oversees facilities in the Puget Sound and Alaska markets. Within his division, there are 29 collective bargaining agreements across more than a dozen hospitals.
“Each of those collective bargaining agreements has nuances that make them specific to their local hospital,” he said.
Fisher helps align hospital policies and union contracts with Providence’s metrics for success, including improving employee retention and staff engagement.
“As the divisional HR leader, I ensure that we’re moving in the same direction, but also that each unique location is able to respond to the challenges or crises they are seeing,” Fisher said. Using a digital scorecard, his division tracks labor issues and outcomes human resources teams need to address. The platform allows them to stay in the loop about topics with which labor unions want leaders to engage.
A changing economic landscape could be a reason to adjust policies at the local level. Providence Swedish, which became affiliated with Providence in 2012, reopened its contracts with more than 7,000 Seattle-area workers represented by SEIU Healthcare 1199NW a year before they expired, after it became clear employees weren’t being paid market-competitive rates.
“We knew it was not going to be attainable for [the hospitals] to have safe staffing without doing something drastic,” Hopkins said. “It wasn’t a surprise when [management] said we’re behind the market and we need to be where we used to be, which is in front of the market.”
After negotiating for about six weeks, the hospital and union reached an agreement in September, increasing salaries over two years 21.5% or $6.50 per hour, whichever is higher.
Till said local autonomy was also helpful at the beginning of the pandemic. Leaving the decision up to individual facilities of whether to enforce a COVID-19 vaccine mandate accommodated staff in different states. The system’s affiliates negotiated the details of implementing requirements for unionized employees, including giving them time off to get their shots.
But making facility-by-facility decisions sometimes thwarts efficiency when the company does want to set up system-wide policies. Although Till said local autonomy can inspire creative solutions, Providence had to wait until the federal government established a nationwide vaccine mandate for healthcare workers in order to eventually enact rules throughout the organization.
The Providence system also opened union contracts at each of its facilities when it announced in September 2021 a $1,000 COVID-19 bonus for staff.
“We had to go contract-by-contract and talk to all of our labor partners to make sure that they were OK with their unionized caregivers also getting a bonus,” Till said. He added that some unions didn’t accept the bonus because they couldn’t reach an agreement.
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