Healthcare Human Resource Management Flynn Mathis Jackson Langan Labor Relations and Healthcare Organizations Chapter 11 PowerPoint Presentation by Tonya L. Elliott, PHR

After you have read this chapter, you should be able to: Learning Objectives After you have read this chapter, you should be able to: Explain the labor relations challenges facing the healthcare industry Describe the National Labor Relations Act, including the unique healthcare provisions Outline the stages of the unionization process Discuss the collective bargaining process Identify the contract negotiations process in the healthcare industry

Unions Union --- A formal association of workers that promotes its members’ interest through collective bargaining --- The official employee representative Unions in the United States Represent about 13.5% of the U.S. civilian workforce Union membership declining Unions targeting service sector Union activity in healthcare industry likely to increase

Why Employees Unionize Employees feel mistreated Employees concerned about staff-to-patient ratios Employees believe a union can negotiate financial & job security, and better working conditions JOB DISSATISFACTION Poor working conditions Lack of recognition Job stress Lack of career opportunities Not allowed to make independent decisions

Labor-Relations Philosophy Union-management relationship Adversarial Collaborative Both parties try to control process & relationship Information used selectively to gain advantages Decisions made by compromise Not favorable for long-term relationships Shared responsibility to address mutual concerns from both sides Openly share information Decisions made by consensus Favorable for long-term relationships

National Labor Code Figure 11-2

National Labor Relations Act (NLRA) Provides specific guidelines to govern the organizational—employee relationship The right to bargain collectively Defines unfair labor practices Also known as: Wagner Act Enforced by: National Labor Relations Board (NLRB) Federal Mediation and Conciliation Services (FMCS) -- Agency that mediates labor negotiations and conflicts

Taft-Hartley Act & Landrum-Griffin Act (rights of management) Passed in1947 Designed to equalize the efforts of the NLRA Defines and prohibits unfair labor practices by unions Landrum-Griffin Act (rights of union members & their unions) Passed in 1959 Designed to protect workers from the unions that represent them Curtails corrupt union practices

NLRA & the Healthcare Industry Special provisions specific to healthcare industry Purpose: To protect communities in case of strike 10-day strike notice - required of unions who intend to strike Negotiation Notification - requires parties to notify FMCS 90 days prior to contract expiration, of intent to begin negotiation Impasse - when the parties cannot resolve a dispute - requires notification to FMCS & mediator is assigned Board of inquiry - investigates, reports, & recommends solutions to resolve contract disputes

Unionization in Healthcare Manager’s role is to create positive work environment in order to avoid unionization Unionization is frequently… A vote AGAINST management vs. A vote FOR the union

The Union Campaign Process Step I: Organizing campaign Group of employees approach union or union approaches employees Informational meetings held by union for employees Union assesses likelihood of a successful campaign Step II: Authorization cards NLRB requires 30% of employee group to sign authorization cards to hold a union election If 30% or greater, then Representation Election

Appropriate Bargaining Units in Healthcare Figure 11-4

The Union Campaign Process (cont’d) Step III: Representation Election Election is supervised by NLRB, union, & management Determined by simple majority = 50% + 1 employee Step IV: Certification Union becomes exclusive bargaining representative Management or union can challenge results if they believe election was handled improperly or unfair labor practices occurred Simple majority reached Simple majority not reached No election for at least 12 months

Unfair Labor Practices Interfering with, restraining, or coercing employees in the exercise of their right to organize or bargain collectively Dominating or interfering with the formation or administration of any labor organization Encouraging/Discouraging membership in any labor organization by discriminating with regard to hiring, tenure, or conditions of employment Discharging or otherwise discriminating against an employee because he/she filed charges or gave testimony under Act Refusing to bargain in good faith Management Interfering with, restraining, or coercing employees in the exercise of their right to organize or bargain collectively Causing an employer to discriminate or discourage union membership Refusal to bargain in good faith Conducting secondary boycotts Organization or recognition picketing by a union where the employer has recognized another union as the official bargaining agent Unions

The Union Campaign Process (cont’d) Step IV: Certification (cont’d) Employees may decertify the union The employee group removes the union as their representative Signatures from 30% of employee union members to hold de-certification election Determined by simple majority = 50% + 1 employee Step V: Contract Negotiation (collective bargaining) Initial contract sets foundation for the union-management relationship

Collective Bargaining – Contract Components Management rights clauses - Right to manage, direct, and control its business Union security clauses - Right to bargain on behalf of represented employees - Dues check-off process – union dues deducted from paychecks Wages and benefits - Base and premium pay, shift differential, incentives - Health, dental, life, disability benefits, etc. Working conditions - Work schedules, workplace safety concerns, etc.

Negotiation Process Figure 11-7

Interest-Based Bargaining Negotiation process that emphasizes problem solving and consensus building Typical Steps: Select an issue Clarify the issue Discuss each party’s interests Generate options through brainstorming Evaluate options Selection options that meet mutual needs Document agreed solutions Requires collaborative relations

Key Strike Concerns For Management For the Union Communication to stakeholders on contingency plan Staffing concerns for continuing patient care Training managers to provide patient care How to treat staff members who cross the picket line Arranging for supplies and equipment deliveries across the picket line For Management Communicating to NLRB and management of intent to strike & employees of strike authorization Planning logistics of maintaining picket line Scheduling pickets Providing information hotline to update striking members Planning public relations to influence public opinion For the Union

Finalizing The Agreement Negotiations complete Draft of contract agreement prepared for review Constituents review & hold ratification vote Constituents reject Constituents accept Re-negotiate/strike/ratify Formal agreement signed

Contract Administration: Labor-Management Committees Comprised of: Management – appointed by organizational leaders Union – elected by their colleagues Bargaining agents Purpose: Identify common problems Interpret contract language Resolve issues

Contract Administration: Grievance Procedures A formal process used to resolve issues between managers and workers Arbitration Union and company present their cases to a mutually selected arbitrator, who makes binding decision Mediation Third party facilitates discussions and proposes solutions to the two parties; suggestions not binding

Employee Grievance Process Figure 11-9