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

2. 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

3. 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

4. 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

5. 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

6. National Labor Code
Figure 11-2

7. 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

8. 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

9. 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

10. 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

11. 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

12. Appropriate Bargaining Units in Healthcare
Figure 11-4

13. 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

14. 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

15. 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

16. 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.

17. Negotiation Process
Figure 11-7

18. 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

19. 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

20. 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

21. 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

22. 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

23. Employee Grievance Process
Figure 11-9