Alameda Health System workers announced a planned strike during a press conference on Sept. 25 outside the county administration building in downtown Oakland. Credit: Sara Kassabian

East Bay healthcare workers have put the Alameda Health System on notice that they’re ready to strike starting Oct. 7. The potential strike comes after fruitless negotiations between hospital workers and the public health system’s management over new contracts that determine pay, benefits, and workplace safety.

Leaders of the two unions, Service Employees International Union Local 1021 and the California Nurses Association, said the strike is long overdue.

“At the end of the day, our members are so tired,” said Mawata Kamara, a registered nurse at San Leandro Hospital, and a member of the CNA board of directors. “We came this far as a bargaining unit but understand that our members wanted to strike six months ago.”

Hospital workers say that understaffing, inadequate training, and documented shortages of personal protective equipment for healthcare workers to deal with the pandemic, are just some of reasons they’re ready to walk out. Union leaders also accuse AHS administrators of mismanaging the public health system and causing a budget crisis. 

The unions say the solution is to give the county full control over the hospitals once more. Currently, the hospitals are owned by the county but AHS, an independent government agency, manages them. 

SEIU 1021 members have been bargaining with AHS for nine months, while CNA has been in contract talks with the hospital system for two years.

AHS spokesperson Terry Lightfoot disagreed with the unions and said the hospitals have adequate supplies of protective equipment to treat COVID-19 patients, and he said AHS management has ensured that each hospital meets state mandated staffing requirements.

AHS operates three county-owned hospitals including Highland Hospital in Oakland, which is the region’s trauma center, and San Leandro Hospital and Alameda Hospital. AHS hospitals and clinics serve primarily low-income residents, including people who rely on Medi-Cal, and all three AHS hospitals have been caring for COVID-19 patients during the pandemic.

AHS workers appear unified in their willingness to strike. Union leaders said 98% of SEIU 1021 members across all three hospitals voted to walk out. CNA represents health workers at Alameda Hospital and San Leandro Hospital, and union leaders told The Oaklandside that 99% of their members at San Leandro Hospital, and 100% at Alameda Hospital voted to strike. 

One other recent development that workers say is leading to the potential strike were job cuts. AHS recently laid off community health outreach workers who help domestic violence and sexual abuse survivors undergoing medical treatment. Interpreters employed by the hospitals were also laid off. 

During a press conference last Friday outside the county’s administration building in downtown Oakland, Oakland District 4 City Councilmember Sheng Thao spoke out in support of the AHS workers. 

“As a survivor of domestic violence, to say that you’re cutting our community outreach workers, that’s insane,” said Thao. “This is life or death.”

Sheleka Carter is one of the laid off community health outreach workers at Highland Hospital who worked with sexual assault survivors. Carter said the layoffs feel like retaliation. A few months ago she reported Highland’s low supplies of protective equipment like face masks and gowns to AHS managers. After months of correspondence with AHS officials about these safety concerns, Carter’s job was eliminated. 

“It could only be deemed as a retaliatory action against the workers,” said Carter.

The unions also claim that the breakdown in negotiations was due to AHS negotiators not understanding the complexities of the healthcare system and the needs of nurses and other hospital staff, especially during the pandemic.

“It was tedious, it was excruciating trying to explain my experiences and some of the things I go through as a nurse to someone who thinks I’m exaggerating some of the safety concerns,” said Kamara.

In an effort to avoid the strike, the Alameda County Board of Supervisors suggested that the AHS Board of Trustees bring in a new, outside negotiator to broker discussions with SEIU 1021 members. Last week, AHS announced it is hiring an outside negotiator.

John Pearson, a registered nurse at Highland Hospital and chapter president of SEIU 1021, welcomed the new negotiator. “We’re glad, we don’t think anybody in AHS was capable of negotiating.”

Union leaders believe the ultimate solution to AHS’s labor woes is to have the county take over management of the hospitals once more. AHS’s Board of Trustees and management have opposed this idea, but last week the trustees said in a statement that they are open to exploring “alternative governance structures.”

“We feel that it is critical that AHS and the county Board of Supervisors meet and discuss how best to deliver healthcare to vulnerable populations in Alameda County, [but] what that may look like in a future situation is unclear at this point,” said AHS spokesperson Terry Lightfoot. “I think both parties are interested in having a conversation without any preconceived notions about what that might be.” 

Alameda County District 3 Supervisor Wilma Chan said in an interview that the Board of Supervisors wants to see more accountability from AHS administration and improvements to labor relations.  

“The fact that negotiations for CNA have been stuck for two years is problematic,” said Chan. 

Chan said that the Board of Supervisors has been looking at different county-led, public health system models across the state to identify which type of health system governance will maintain high levels of patient care while also making the system more accountable to the Board of Supervisors, the public, and labor unions.

If it happens, the October strike will coincide with the AHS Board of Trustees’ budget vote for the upcoming fiscal year. According to documents from a 2019-2020 Alameda County grand jury report, more than 80 percent of the health system’s operating budget is spent on staff salaries. The report estimates that, even before the projected losses from the COVID-19 pandemic, AHS faces a deficit of up to $453 million for 2019-2022.

Chan said that this problem is not unique to AHS and that public hospitals are underfunded in general.

Lightfoot said that the goal in developing next year’s budget is to limit the impact of possible cuts on staff and services.

Pearson, the nurse and union leader, said that the health system’s budget can’t be reduced any further and that AHS has been running on bare bones for too many years already.

“The way this ends up playing out is on the backs of patients and on us,” said Pearson. “People are fed up.”

Correction: the Alameda Health System is a public health authority created by the state Legislature and Alameda County, not a private nonprofit corporation.