Unhealthy Debate

There's a new and nasty labor-management war. Health care is the battlefield. San Francisco is the front line.

The Ambassador is home to a program created by workers for a health care group known as Visiting Nurses and Hospice of San Francisco, in conjunction with city welfare agencies. The program provides medical care for low-income AIDS patients and drug users in the Tenderloin.

And that link to the city makes the Ambassador a particularly good place for Visiting Nurses and Hospice (VNH) workers to call attention to their battle with California Pacific Medical Center, which owns VNH.

This plan of attack runs directly through the community, supported by the well-established network of political activism in San Francisco.

In November, the Service Employees International Union held a "community election" for the right to represent the workers. This process for forming a union local has not been widely used for several decades. Essentially, the union had sidestepped a union election process under the auspices of the National Labor Relations Board, because the appeals process associated with an NLRB election can drag on for years.

The November election was, indeed, a community event -- but one that California Pacific didn't find at all pleasant. It was presided over by the Rev. Cecil Williams, the politically influential pastor of Glide Memorial United Methodist Church, and Superior Court Judge John Dearman, a former law partner of Mayor Willie Brown. They presented the overwhelmingly pro-union results of the election to California Pacific.

But management has steadfastly refused to recognize the community election format and its outcome.

"We don't know that it's the workers who are behind this," says Sara Kelley, director of public affairs for California Pacific. "Our position is to abide by the NLRB process that is in place for this. We would absolutely honor an NLRB process."

In fact, California Pacific filed a complaint with the NLRB alleging that the union had engaged in coercion, intimidation, and various other nasty practices. When the board found no wrongdoing in those regards, the company appealed. The union then filed an unfair labor practices complaint against management. Both complaints are still pending, but Service Employees International isn't waiting for NLRB action to flex its political muscle. That political backing is based not just on support for workers, but also on consumer concerns.

"We believe that there's a direct, fundamental, and necessary relationship between the empowerment of workers in the health care industry and the quality of care that consumers receive," says Jeff Sheehy, a leader in the Harvey Milk Lesbian/Gay/Bisexual Democratic Club.

Delegations representing the gay, senior, and Asian communities visited the office of Dr. Martin Brotman, CEO of California Pacific Medical Center, and the law office of California Pacific board member Michael Roosevelt. The union leafleted Roosevelt's home in Orinda. Mayor Brown called Brotman.

During the last four months, more than 200 people from various organizations have rallied at the VNH offices on Geary Boulevard, at the entrance to the California Pacific Medical Center on Webster Street, and in front of the Financial District offices of Sutter/CHS Corp., the Sacramento-based health care conglomerate to which California Pacific is attached. On one occasion, 23 people were arrested.

"I've been at different actions where they [union sympathizers] have blocked patients from registering," says Kelley. "They've blocked patients from access in wheelchairs. I've specifically talked to physicians whose windows are over the organizing, and the bullhorns and the drums are preventing them from talking to their patients."

California Pacific still refuses to recognize the election.

At a lunchtime rally in front of the Visiting Nurses and Hospice offices last month, Eleni Hulenicki, a registered nurse who works for the agency, spoke out about the "human connection" she felt was being lost in the restructuring of health care. One of her patients also spoke out, saying he wished patients could join the strike.

Nurse and patient are connected by a lifeline. As managed health care shifts more of the sick away from hospitals, the home health care industry has grown by leaps and bounds.

Nurses, aides, social workers and therapists who work for home health agencies such as VNH care for the sick and dying in expensive homes, apartment buildings, and run-down hotel rooms all over San Francisco. They check on new mothers, frail seniors, drug users, AIDS patients. They feed and bathe people, administer medication, record vital signs, and sometimes call in other services to help. They hold hands. And sometimes, they are the last ones to say goodbye.

The day after the rally, Hulenicki was suspended from VNH. According to union representatives, the nurse had accepted an assignment from the agency in February to assess a patient's mental and emotional state.

What Hulenicki did was, quite simply, wrong. She is not legally qualified to make an assessment of a psychiatric patient.

VNH management told her she was being suspended because she did not follow policy on psychiatric patients. In other words, the agency was punishing her for not refusing the assignment given her by the agency itself. Hulenicki argues that she was unaware of the agency policy on psychiatric assignments.

Still, the timing of the entire incident is suspicious.
Management says the date of Hulenicki's reprimand for the psychiatric assignment -- one day after she criticized VNH at a union rally -- was merely a coincidence.

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