January 26, 2015

Bargaining updates in Northern California

Kaiser Permanente has a long and productive relationship with organized labor. But we know actions speak louder than words, and that’s why we are proud to employ more union workers than any other health care organization in the country. In fact, nearly two-thirds of our workforce is made up of union-represented employees. Kaiser Permanente is one of the largest employers in all of California, with more than 60,000 employees in Northern California alone. We employ roughly 16,000 nurses throughout Northern California and more than 48,000 nurses throughout the country.

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We believe the bargaining table should be a place of mutual respect and we are prepared to listen carefully and respond respectfully to the union’s bargaining team, and as always, bargain in good faith to reach agreement. At Kaiser Permanente, we believe that bargaining should consider both the needs of our employees, and what will best help our organization meet the needs of our members and patients.

Bargaining updates are posted below:


Update from January 26, 2015:

Kaiser Permanente and California Nurses Association have a new three-year contract; nurses ratify agreement.

We are very pleased to announce that Kaiser Permanente nurses have voted to ratify the agreement, and we have a new, three-year contract with the California Nurses Association (CNA).

This agreement accomplishes the key objectives we laid out at the beginning of bargaining:

  1. To slow the growth of our long-term liabilities;
  2. To continue in our effort to restructure benefits and improve our affordability while also providing leading benefits to our nurses;
  3. To increase our operational flexibility in the workplace and;
  4. To continue to promote a professional practice environment for our nurses that contributes to our providing high quality patient care.
  5. Now, we will begin the process of training and educating our managers to understand and effectively implement the contract.

    The agreement demonstrates that Kaiser Permanente and our nurses have a shared commitment to quality, service and affordability for our members. Although we have had disagreements at times with CNA, as this agreement reflects, we have been able to work through those disagreements, and ultimately agree on common goals that are in the best interests of our members, employees and our entire organization.

    Gay Westfall, senior vice president, Human Resources, KFH/HP

    Connie Wilson, vice president, Human Resources, The Permanente Medical Group.


    Bargaining update from January 17, 2015:

    Kaiser Permanente and California Nurses Association (CNA) reach agreement; strike notice withdrawn.

    Please see below for a media statement released today by Kaiser Permanente, announcing the good news that Kaiser Permanente and CNA have reached a tentative contract agreement:

    Kaiser Permanente is pleased to announce that it reached a tentative agreement late Friday night with the California Nurses Association (CNA) for a new three-year contract. This agreement accomplishes the priorities Kaiser Permanente laid out at the beginning of bargaining: 1) slowing the growth of our long-term liabilities; 2) offering comprehensive benefits to our nurses that are consistent with our commitment to affordability; and 3) providing operational flexibility in the workplace.

    Kaiser Permanente is committed to providing the highest quality and most affordable care to the American people, while also being the best place to work. For the organization to deliver on this vision, everyone – management and labor, physicians and staff – must work together.

    Kaiser Permanente has an unparalleled track record for working together constructively with labor to solve problems and make progress to improve the care and service offered to members and patients.

    “We greatly respect and value our nurses,” said Gregory A. Adams, group president and regional president of Kaiser Foundation Hospitals and Health Plan, Inc., in Northern California. “This agreement is aligned with our commitment to improve our quality and affordability and to be a national model for the delivery of health care.”

    “The agreement demonstrates that Kaiser Permanente and our nurses have a shared commitment to affordability for our members,” Adams said. “Although we have had disagreements at times with CNA, as this agreement reflects, we have been able to work through those disagreements, and ultimately agree on common goals that are in the best interests of our members, employees and our entire organization.”

    CNA members will be voting to ratify the new contract over the next month.

    As a result of this tentative agreement, the January 21-22 strike notice for Kaiser Permanente medical centers in Northern California has been withdrawn.


    Bargaining update from January 8, 2015:

    Kaiser Permanente and California Nurses Association (CNA) Bargaining:

    The facts about Kaiser Permanente’s proposals — Part 2 (pdf)

    We understand that nurses will hear different information about the proposals Kaiser Permanente has made around retiree health benefits and pension, and we want them to have the facts. Here is Part 2 of questions and answers about Kaiser Permanente’s proposals. Click here for Part 1 »

    Permanente’s proposals around retiree medical benefits and pension are intended to help preserve the excellent benefits packages that our nurses deserve. At the same time they are intended to make sure that Kaiser Permanente remains strong well into the future. We want you to have the facts about our proposals.

    Why is Kaiser Permanente proposing a change in retiree health benefits?

    The problem that Kaiser Permanente and most other large employers are facing is that the cost to provide retiree health benefits continues to go up, at a pace that is faster than other expenses and faster than what we are earning. If we don’t make modifications to help slow down and reduce our future costs, it will threaten the future of Kaiser Permanente and our ability to provide these benefits to our employees and those who retire.

    How are other employers dealing with the rising costs of benefits?

    Most companies, even most hospitals and health plans, have stopped providing retirement health benefits altogether. Nationally, the number of large employers providing any retiree health coverage has dwindled down to about 25 percent. Their employees will have basic Medicare coverage when they retire but the employers are choosing not to provide any benefits that supplement Medicare.

    What is Kaiser Permanente proposing?

    Unlike many other employers, Kaiser Permanente is not planning to eliminate this benefit. We understand how important this benefit is to all of our employees, and we have proposed a solution that will enable nurses to keep an excellent retiree health benefit that few others have outside of Kaiser Permanente. Our retiree health proposal does not affect current retirees or nurses who retire before 2017. For those retiring in 2017 or later, under our proposal Kaiser Permanente will cover the full cost of the monthly retiree health premiums from 2017 to 2026. After 2026, Kaiser Permanente will continue to contribute a fixed amount each month for the premium and the retiree will begin making a cost share contribution for the rest of the premium.

    What about the claim that Kaiser Permanente will make money on Kaiser Permanente retirees’ premium contributions?

    That is incorrect. Although Kaiser Permanente is a health care provider, it still costs us money to pay for medical care for our employees and retirees. The care for most retirees is only partially covered by Medicare reimbursement, which is being reduced for health care providers by the federal government. Approximately 77 percent of today’s retiree health costs for nurses is covered by Medicare reimbursement. The rest of the costs must still be paid by Kaiser Permanente.

    As we said above, these benefit costs are continuing to grow, and at such a fast pace that we need to make changes to be prepared for the future. We are proposing that a portion of these costs eventually be shared by retirees. These contributions, like all of Kaiser Permanente’s revenues, will be invested back into providing care. As a nonprofit we must invest all of our earnings and margin back into the organization. This enables us to keep our rates down and deliver high-quality affordable care to more people. We use our margin to cover retiree health benefits and pensions of our employees, along with investing in technology and equipment to help transform care, updating equipment and buildings, and building facilities to serve members.

    See the PDF for a look at how Kaiser Permanente spends all of the money it receives »


    Bargaining update from January 6, 2015:

    Kaiser Permanente and California Nurses Association (CNA) Bargaining:

    The facts about Kaiser Permanente’s proposals — Part 1 (pdf)

    We understand that nurses will hear different information about the proposals Kaiser Permanente has made around retiree health benefits and pension, and we want them to have the facts. Here are some questions and answers about Kaiser Permanente’s proposals.

    Is Kaiser Permanente's retiree health proposal a big “takeaway?"

    Our proposal is similar to the current retiree health benefit for 78 percent of our 180,000 employees. We are asking our nurses who retire in 2017 and later, starting 10 years from now, to make a partial contribution to share the cost of their retiree health premium. Our proposal does not affect current retirees or nurses who retire before 2017. Under the proposal, Kaiser Permanente pays the entire retiree health monthly premium from 2017 to 2026. After that, Kaiser Permanente will continue to contribute a fixed amount toward the premium each month and the retiree will make a contribution for the rest of the premium. We are not proposing to eliminate benefits. We are proposing a reasonable and responsible change to help continue to provide excellent retiree benefits.

    How does the retiree health proposal work?

    Our proposal continues to provide nurses and their eligible dependents with a Kaiser Permanente-provided retiree health plan with benefits that are over and beyond basic Medicare and exceed most individual Senior Advantage plans. The benefits and out-of-pocket expenses, including office visits, ED visits, co-pays for inpatient care, etc., are to be the same as the plan offered to active nurses.

    Our proposal does not affect current retirees or nurses who retire before 2017. We are asking nurses who retire in 2017 and later to participate in the cost of retiree health premiums beginning in the year 2027. This means that, under our proposal, Kaiser Permanente continues to cover the full cost of the monthly premiums from 2017 to 2026 for nurses retiring on or after Jan. 1, 2017, and eligible dependents. After 2026, Kaiser Permanente will continue to contribute a fixed amount each month for the premium, for the life of the retiree and eligible dependents and the retiree will begin making a cost share contribution for the rest of the premium.

    What is Kaiser Permanente’s proposal around nurses’ pensions?

    We are not proposing any changes to pensions for current nurses or retirees. We face similar problems with escalating future pension costs as we do with retiree health benefits. Our pension proposal requests that we form a management and labor group (KP-CNA) over the next three years to study the issue of rising pension costs and make recommendations to address the cost for future hires only, not for current employees.

    Why is Kaiser Permanente proposing these changes when the organization is doing so well financially?

    This is not about improving our current financial performance. It is about keeping Kaiser Permanente strong in the future for all of us and for those who come after us. We’re proud that Kaiser Permanente provides richer benefits than most other companies and we are doing our best to keep it that way. From the money we earn today we must cover the cost of health benefits and pensions for current employees and those already retired. At the same time, from the same earnings, we must also set aside money to provide these benefits for those who will retire in the future.

    The problem that we and most other large employers are facing is that the cost to provide retiree benefits continues to go up, at a pace that is faster than other expenses and faster than what we are earning. Recently, our benefits costs were growing four times faster than any of our other expenses, which is not sustainable. This is a problem we have been addressing with employee groups since 2012, knowing that if we don’t make changes to help slow down and reduce our future costs, it will threaten the future of Kaiser Permanente and our ability to continue to provide these benefits. We’ve seen this happen in other industries, and we are passionate about preventing it from happening to the people of Kaiser Permanente. By making reasonable and responsible changes that involve everyone’s participation (78 percent of Kaiser Permanente employees already participate in a modified or capped retiree health plan) we can help protect retiree benefits.

    What about the claim that Kaiser Permanente is making big profits?

    Any money we have left over each year is our margin. As a nonprofit, we are required to invest our earnings and margin back into the organization. Having a healthy margin — which is the money left over after we pay for the costs of providing care — is the result of good planning and is not something to be criticized. It enables us to keep our rates down and deliver high quality affordable care to more people. We use our margin to cover retiree health benefits and pensions of our employees, along with investing in technology and equipment to help transform care, updating equipment and buildings, and building facilities to serve members.

    Print or download a PDF of the facts about Kaiser Permanente’s proposals — Part 1 »


    Bargaining update from December 17, 2014:

    Update from bargaining today

    Today, the California Nurses Association (CNA) revisited two of the union’s original operational proposals: Union Proposal 16, concerning nurses’ use of sick leave; and Union Proposal 3, concerning travelers. We have a signed tentative agreement for Union Proposal 3.


    Bargaining update from December 17, 2014:

    Update from bargaining today

    Today, the California Nurses Association (CNA) revisited two of the union’s original operational proposals: Union Proposal 16, concerning nurses’ use of sick leave; and Union Proposal 3, concerning travelers. We have a signed tentative agreement for Union Proposal 3.

    The Kaiser Permanente bargaining team is in the process of preparing a proposed tentative agreement regarding sick leave that is intended to address the union’s concerns.

    Tentative agreement signed regarding travelers

    Kaiser Permanente shares the union’s perspective that providing our nurses with enhanced career opportunities is a priority. We presented a tentative agreement to CNA that fulfilled the union’s request that positions supported by travelers, which we are unable to fill otherwise, be evaluated and posted as training positions available to Kaiser Permanente nurses. (This would not include temporary positions, for example, positions in which the traveler is filling in for a nurse on leave.) The union signed this tentative agreement.

    Progress in bargaining

    At the bargaining table, our team stressed that we are committed to giving proposals the thoughtful consideration and evaluation needed and that we take the time to prepare responses that meet our mutual needs. Sometimes, as occurred today, much of the work occurs behind the scenes. We want to reassure our nurses that time spent away from the actual bargaining table is productive and necessary to help us reach an agreement.

    Bargaining will continue tomorrow, Thursday, Dec. 18.


    Bargaining update from December 16, 2014:

    Significant progress in bargaining today

    Today, Kaiser Permanente and the California Nurses Association (CNA) reached five tentative agreements on the union’s operational proposals. In addition, Kaiser Permanente presented two economic proposals — one on wage increases and the other on medical benefits for current employees.

    The tentative agreements address shared operational priorities: training programs for nurses, a smoother return to work for nurses who have been on leaves of absence, release to respond to disasters through the RN Response Network, uninterrupted time for training, and an enhanced and more flexible education reimbursement program.

    If accepted, our proposals for wages and medical benefits for current employees would keep our nurses’ wages and medical benefits among the best in Northern California.

    Medical Benefits for Current (a.k.a. “Active”) Employees

    There will be no changes in medical benefits for current employees in 2015. The new design — which is highly competitive — would be effective starting Jan. 1, 2016. Highlights of the proposal:

    • No premium cost share: Kaiser Permanente will continue to pay 100 percent of the health plan premium for active employees.
    • No deductibles.
    • No added cost for dependent coverage.
    • Modest changes to some copays.
    • To see key elements of this proposal, and to see a revised document with the status of all operational proposals, refer to the following documents:

      • Across the Board Wage Increase Proposal
      • Medical Benefits Proposal
      • Updated Status of Operations Proposals
      • Across The Board (ATB) Wage Increases

        These proposed ATB increases are consistent with the market and our commitment to providing market competitive wages to our employees, while remaining affordable for our members.

        • 2 percent in 2015
        • 2 percent in 2016
        • 2.5 percent in 2017
        • We look forward to continuing to discuss these and other proposals with the union. Bargaining will continue tomorrow, Wednesday, Dec. 17.


          Bargaining update from December 4, 2014:

          Today in bargaining, we presented a revised tentative agreement for the California Nurses Association’s (CNA) to sign. As the union requested at our session on Dec. 2, we removed the reference to Kaiser Permanente’s travel policy from our tentative agreement regarding union proposal No. 37, RN Response Network (RNRN).

          We are waiting for the union’s response.

          What’s next?

          The Kaiser Permanente bargaining committee is working to refine our tentative agreement on the union’s proposal No. 21, Leaves of Absence. We want to ensure that nurses who have been on extended leaves of absence and who have been cleared to return to practice at Kaiser Permanente have an efficient way to do so, while also ensuring they have the clinical competence to meet our commitment to provide high-quality care.

          Scroll down for a link to see the proposals referred to in this update, along with all 39 proposals and Kaiser Permanente’s responses.

          The next bargaining session is scheduled for Tuesday, Dec. 9.


          Bargaining update from December 2, 2014:

          Today in bargaining, the California Nurses Association’s (CNA) withdrew two of its operational proposals, but offered no counterproposals, tentative agreements, or other movement on the remaining open proposals.

          Kaiser Permanente is working hard at the bargaining table to resolve the operational proposals that advance our mutual interest. We’ve offered our positions or counterproposals on all of the union’s proposals.

          We call upon CNA to approach negotiations with a spirit of compromise, rather than simply clarifying its existing positions.

          Want to see CNA’s operational proposals and Kaiser Permanente’s responses? To see a description of each of the operational proposals, our responses and what we are offering, click here.


          Bargaining update from November 10, 2014:

          Statement on Strike by Nurses Union


          Bargaining update from November 6, 2014:

          Today, at the 21st bargaining session, Kaiser Permanente came to the table ready to continue bargaining in good faith, despite the California Nurses Association’s (CNA) planned strike, to work together to reach agreement. We presented two additional tentative agreements for the union to sign. Also, Stephen M. Parodi, MD, infectious disease specialist, medical director, Regional Hospital Operations for Northern California, presented Kaiser Permanente’s Ebola response program to the union’s bargaining team.

          We have repeatedly invited CNA to work with us on our Ebola strategy and provide input – which the union has refused to do. Dr. Parodi’s presentation was intended to help CNA understand how Kaiser Permanente’s approach meets or exceeds national standards, and addresses the union’s concerns about keeping nurses safe from this disease. The presentation centered on our four-pronged approach to diagnosing and treating potential Ebola patients and protecting our employees, members and the public:

              • Early identification of any patients who may have been exposed to Ebola
              • Includes training Kaiser Permanente employees at every potential point of patient entry on how to screen members, posting signs that prompt members to report any recent travel to Ebola-stricken countries or any symptoms of possible Ebola, and educating all front-line employees on the way Ebola is transmitted and how we can all protect ourselves.

              • Effectively isolating patients identified as at risk for having Ebola
              • Includes work flows for quickly and safely isolating hospital, clinic and home health patients.

              • Immediate escalation to Kaiser Permanente Infectious Diseases Alert Teams
              • Kaiser Permanente has infectious disease experts and Infectious Diseases Alert Teams at every medical center. If our experts confirm the risk of Ebola is present, designated care teams will follow a series of steps to efficiently and safely transfer the patient to a higher level of isolation and care, either in the local Emergency Department or at one of our two designated Ebola treatment centers at Oakland Medical Center or South Sacramento Medical Center.

              • Protection of our care-giving teams
              • This includes personal protective equipment (PPE) and work flows that meet or exceed guidelines from the Centers for Disease Control and Prevention (CDC), Emory University, University of Nebraska and the State of California — coupled with intensive and ongoing training and drilling of all appropriate care team members.

                The union presented two items it characterized as counter proposals — but which, while reworded, contained no change from the union’s original proposals. We requested that the union make forward progress on any proposal. CNA agreed to sign a tentative agreement regarding GRASP® regional meetings (union proposal No. 28). We await the signed document.


                Bargaining update from October 28, 2014:

                Kaiser Permanente and the California Nurses Association’s (CNA) are scheduled to return to the bargaining table on Thursday, Oct. 30, the only date on which the union agreed to meet. We are ready to conclude bargaining around the open proposals that CNA brought to the table.

                Kaiser Permanente is bargaining in good faith

                CNA is now representing that we “have no intention of settling a contract” and that we are “not bargaining in good faith.” Nothing could be further from the truth. For example:

                              • We asked for another contract extension; the union did not respond.
                              • We offered to meet every day, including weekends; the union agreed to meet on only one day.
                              • Throughout our 19 sessions, we have been actively bargaining over 39 proposals that CNA brought to the bargaining table. CNA has stressed that agreement on these proposals is vital to the safety of our patients and our nurses. We want to resolve a majority of these issues before adding new issues to the table, and have been consistently trying to push forward in this process.

                                What about Kaiser Permanente’s wage and benefit proposals?

                                We are prepared, and wish to move immediately to our wage and benefit proposals, once we have resolved a majority of the proposals CNA brought to the table. CNA is spreading fear based on speculation about what our economic proposals might contain.

                                As we continue to say: We will keep Kaiser Permanente the best place for nurses to work. We look forward to bargaining in good faith with CNA to resolve those proposals now on the table.


                                Bargaining update from October 23, 2014:

                                Today, at the 19th bargaining session, Kaiser Permanente came to the table ready to bargain to resolution the open noneconomic proposals. We were disappointed in the California Nurses Association’s (CNA) unwillingness to negotiate productively. The union declined to sign any of the 10 tentative agreements we gave them yesterday with our signatures in place.

                                Today in bargaining

                                Discussions today revolved around several open proposals, including the following:

                                              • Kaiser Permanente’s Ebola readiness: Kaiser Permanente continues its readiness preparation, and once again invited CNA to participate in a regional work group of representatives and infectious disease experts to expeditiously discuss and resolve any real issues between the parties.
                                              • Tuition reimbursement: We offered to include certain approved educational apps and journal subscriptions as part of the tuition reimbursement benefit.
                                              • Break relief: We have verbally agreed to the union’s proposal to avoid having our nurses take breaks in the first or last hours of their shifts. Today we presented options for making this happen, and asked for CNA member participation in local meetings to help resolve this issue.
                                              • Uninterrupted training time: We shared with the union the work now underway to refine and enhance the system that alerts call center nurses to take training.
                                              • CNA failed to commit to bargain tomorrow, the last day of the contract extension. Kaiser Permanente continues to bargain in good faith to resolve the proposals now on the table.


                                                Bargaining update from October 22, 2014:

                                                Kaiser Permanente Gives California Nurses Association (CNA) 10 Tentative Agreements to Sign

                                                We urge the union to sign these agreements and resolve their open proposals.

                                                CNA Proposal

                                                Kaiser Permanente Offer/Agreement

                                                CNA Response

                                                Training Positions

                                                Kaiser Permanente agreed to 310 training positions over 3 years, in areas including OR, L&D, Home Health, ICU and more; and gave CNA a tentative agreement to sign.

                                                None yet

                                                Break Relief

                                                Kaiser Permanente agreed to stop having nurses take breaks in the first and last hour of their shifts, and gave CNA a tentative agreement to sign.

                                                None yet

                                                Uninterrupted Training Time

                                                Kaiser Permanente agreed to uninterrupted training time, and gave CNA a tentative agreement to sign.

                                                None yet

                                                Education Funding

                                                Kaiser Permanente agreed nurses may submit up to $500 for education-related travel expenses as part of the recently announced tuition reimbursement policy enhancement, and gave CNA a tentative agreement to sign.

                                                None yet

                                                Leaves of Absence

                                                Kaiser Permanente agreed to a work re-entry process for nurses who have been on long-term leaves of absence, and gave CNA a tentative agreement to sign.

                                                None yet

                                                Safe Patient Handling Regulations (CA)

                                                Kaiser Permanente agreed to place a reference to the new state regulations in the collective bargaining agreement, and gave CNA a tentative agreement to sign.

                                                None yet

                                                GRASP® Regional Meetings

                                                Kaiser Permanente agreed that GRASP® educators can attend Regional GRASP® meetings, agreed to provide one GRASP® educator per medical center, and gave CNA two tentative agreements to sign.

                                                None yet

                                                GRASP® Educators

                                                PPC Committee

                                                Kaiser Permanente agreed to add one chief nurse representative to the PPC, and gave CNA a tentative agreement to sign.

                                                None yet

                                                RN Response Network

                                                Kaiser Permanente agreed to this proposal and gave CNA a tentative agreement to sign.

                                                None yet

                                                Also in bargaining today, we continued discussions with CNA over Kaiser Permanente’s readiness to diagnose and treat Ebola.

                                                We are firmly committed to protecting our nurses with PPE that meets or exceeds CDC standards. We believe that Kaiser Permanente and CNA fundamentally agree on the standards to follow and the steps we need to take to protect our employees and patients. Kaiser Permanente proposed to meet with CNA in a small group of representatives and infectious disease experts to expeditiously discuss and resolve any real issues between the parties.


                                                Bargaining update from October 16, 2014:

                                                Today, Kaiser Permanente responded to CNA’s revised proposal related to Ebola preparedness. We understand our nurses’ — and all our employees’ — concerns that we stay safe should we be called upon to treat a patient diagnosed with this disease. We offered to meet as a small work group to discuss and resolve our mutual concerns regarding this vitally important issue. We await the union’s response.

                                                We are well prepared to safely screen and treat for Ebola

                                                Kaiser Permanente is committed to ensuring that any and all patients we admit for treatment of Ebola virus disease get the best care possible, using reliable clinical evidence and safety approaches.

                                                We have implemented extensive protocols, training and simulations to ensure our staff is prepared to screen all incoming patients, and our care teams are prepared to treat any patient who may be diagnosed with Ebola virus disease, with the safety of all our employees and members being of our utmost concern.

                                                Today in bargaining

                                                In today’s session, CNA refused to bargain over 36 proposals they themselves have put on the table, demanding that we first make a wage and benefit proposal. We explained once again that we believe negotiations will move more expeditiously if we focus first on the issues already on the table before moving to wages, benefits and other issues. And, as we have stated in the past, the union is also free to bring economic or any other proposals it would like, at any time.

                                                CNA has not yet committed to another bargaining session. We told CNA that we are anxious to continue bargaining and are available tomorrow, this weekend, and every day next week to meet.


                                                Bargaining update from October 14, 2014:

                                                Today was the 16th bargaining session between Kaiser Permanente and the California Nurses Association (CNA). We made progress on a number of the 37 remaining noneconomic proposals the union brought to the table. Despite this incremental progress, however, much work remains to be done on these proposals.

                                                The union has pushed for a date by which Kaiser Permanente will provide proposals on wages and benefits, and has accused Kaiser Permanente of delaying — which could not be further from the truth. We have bargained in good faith, responded to each union proposal, and continue to work diligently in an effort to gain more tentative agreements.

                                                Typically during contract bargaining at Kaiser Permanente and other organizations, the union and management have agreed to bargain noneconomic proposals to resolution before bargaining economic proposals. This approach allows proper attention to be paid to proposals having to do with our nurses’ working conditions — issues that are important to keeping Kaiser Permanente the best place for nurses to practice their profession and calling. With this in mind, we made the same agreement with the union when we started bargaining. We have repeatedly told the union that we would be able to present wage and benefit proposals on Oct. 16 — IF we were able to show significant progress on the proposals already on the table.

                                                Given the number of proposals that remain open, it is unlikely that we will be able to start discussion on economic proposals this coming Thursday. The union is, of course, free to make wage and benefit, or any other proposal it likes. We believe, however, that the most expeditious way to reach overall agreement on a collective bargaining agreement is to narrow the issues already on the table before taking on new issues.

                                                Today in bargaining

                                                 In today’s session, there was discussion about the following:

                                                              • Long term leaves of absence: Discussion from both parties concerns minimum qualifications required for nurses who have been on long-term leave to be able to bid on posted positions.
                                                              • GRASP®: Kaiser Permanente made a counterproposal regarding the number of GRASP® educators in the region, and guidelines for their work, geared toward advancing Kaiser Permanente nurses’ knowledge of the GRASP® patient acuity system.
                                                              • Resource nurses: CNA gave a presentation regarding the need to have additional nurses on standby, without patient care assignments, to provide assistance as needed.
                                                              • Educational expense reimbursement: The union provided a counterproposal that included examples of additional materials and mobile apps they propose be covered under Kaiser Permanente’s tuition reimbursement policy, as well as related travel expenses.
                                                              • RN Response Network: Kaiser Permanente presented a counterproposal that agreed to the union’s request for 25 nurses regionwide being granted unpaid leave in the event of disasters, to participate in the union’s emergency response program.
                                                              • Our next scheduled bargaining session is Thursday, Oct. 16.


                                                                Bargaining update from October 9, 2014:

                                                                Today was the 15th bargaining session between Kaiser Permanente and California Nurses Association (CNA).

                                                                To date, the union has presented Kaiser Permanente with 39 proposals, to which we have responded. We are waiting for CNA to consider the counterproposals we have made and further respond. Today the union ended the session at about 12:15 p.m., after discussing only a few items.

                                                                As we’ve said before, CNA has asked that we present our "economic" proposals, but the union is not bargaining actively over the many proposals it has already placed on the table. We have urged CNA to work through these proposals, some of which have clear economic impacts, with a greater sense of urgency. To keep things moving, we have repeatedly summarized for the union what is still outstanding. We have asked if additional information is needed in order for them to respond to our counterproposals. We have offered to meet additional days, but the union has said they are not available next Monday or Wednesday. And to be clear, the union is free to bring its own "economic" proposals to the table, as it already has done. The union’s suggestion that Kaiser Permanente is stalling, as we have heard, is simply untrue.

                                                                Today in bargaining

                                                                Today, there was discussion about the following:

                                                                              • GRASP Regional Education Committee — The union made a counterproposal around the number of inter-rater reliability audits conducted.
                                                                              • Nurse Practitioners — CNA gave a presentation on nurse practitioners. We explained the process used to determine Nurse Practitioner staffing needs.
                                                                              • Educational Expense Reimbursement — The union will be providing more specific examples of reference materials they propose be covered outside of the current policy.
                                                                              • Proposed language in the contract about appropriate use of sick leave.
                                                                              • Updating side letters and appendices.
                                                                              • The next bargaining session is scheduled for Tuesday, Oct. 14.


                                                                                Bargaining update from October 8, 2014:

                                                                                Kaiser Permanente and California Nurses Association (CNA) engaged in productive discussion on multiple proposals on the table yesterday and today.

                                                                                What happened in today’s negotiations

                                                                                So far this week, we have given the union our responses or counterproposals on topics including:

                                                                                              • Training opportunities for our nurses
                                                                                              • Donations by nurses to the union’s RN Response Network
                                                                                              • GRASP® use, GRASP® Educators and GRASP® committee participation (GRASP® is an acronym for Grace Reynolds Application and Study of PETO [Poland, English, Thornton and Owens] )
                                                                                              • Professional Performance Committee membership clarification
                                                                                              • The inclusion of state regulations on safe patient handling in the text of the Collective Bargaining Agreement
                                                                                              • Appropriate engagement of traveler nurses
                                                                                              • Re-entry protocols for nurses who have been on extended leaves of absence
                                                                                              • We have received tentative agreements from the union on only two of the 39 operational proposals we have addressed. These proposals focus on key aspects of nurses’ working lives, and it is important that we resolve as many of them as possible before moving our attention to the economic proposals.

                                                                                                We await responses from CNA on those proposals that remain open for negotiation. The next bargaining session is scheduled for tomorrow, Thursday, Oct. 9.


                                                                                                Bargaining update from October 1, 2014:

                                                                                                Progress Made in Today’s Negotiations

                                                                                                Kaiser Permanente and California Nurses Association (CNA) signed two tentative agreements and engaged in productive discussion about proposals on the table today.

                                                                                                What happened in today’s negotiations

                                                                                                              1. Tentative agreements
                                                                                                                • Kaiser Permanente and CNA tentatively agreed that nurses will be able to access BRN-approved courses that provide continuing education or continuing medical education units during non-scheduled work time without pre-approval from managers. Educational leave for employees on any leave of absence would require management pre-approval. We also tentatively agreed to add one quality liaison.
                                                                                                                • Kaiser Permanente gave the union responses to seven operational proposals.
                                                                                                                  • Included was a response to the union’s concerns about Kaiser Permanente’s level of preparedness in the event we receive patients suspected of being infected with Ebola virus. We assured the union that Kaiser Permanente has comprehensive plans and procedures in place for such events and that we continue to develop a proactive approach.
                                                                                                                  • Kaiser Permanente’s bargaining team is eager to complete bargaining on operational proposals. This would pave the way to begin discussing economic proposals on Oct. 16. CNA’s bargaining committee requested that we cancel tomorrow’s bargaining session so that the union bargaining team can caucus.

                                                                                                                    The next bargaining session is scheduled for Tuesday, Oct. 7.


                                                                                                                    Bargaining update from September 30, 2014:

                                                                                                                    Today was the 11th meeting between Kaiser Permanente and the California Nurses Association (CNA). Kaiser Permanente and CNA mutually agreed to extend the current collective bargaining agreement to Friday, Oct. 24, in order to provide more time for negotiations.

                                                                                                                    What happened in today’s negotiations

                                                                                                                    Today, CNA’s bargaining team expressed a desire to begin negotiating economic proposals. We told them we would make economic proposals on Oct. 16, provided that sufficient progress has been made on the operational proposals that are currently on the table.

                                                                                                                    We are waiting for CNA to respond to 20 pending counterproposals that Kaiser Permanente made at the table Sept. 17 and 18 in response to CNA’s proposals on operational issues — including our counterproposals on specialty training for nurses, break and relief timing and nurses’ participation in reviewing new technology. CNA has not yet responded to our counterproposals, and instead brought seven items to bargaining today that added to their existing operational proposals. Kaiser Permanente’s bargaining team is considering these additions.

                                                                                                                    In response to CNA’s information requests, we have furnished extensive materials and will continue to do so, as appropriate.

                                                                                                                    The next bargaining session is scheduled for Wednesday, Oct. 1.


                                                                                                                    Bargaining update from September 18, 2014:

                                                                                                                    Today was the 10th meeting between Kaiser Permanente and the California Nurses Association (CNA). Negotiations continued to be respectful and productive, as Kaiser Permanente presented proposed solutions that we believe will resolve the challenges described in the union’s proposals, while supporting Kaiser Permanente’s ability to deliver on its mission of delivering high-quality, affordable health care services and to improve the health of our members and the communities we serve.

                                                                                                                    Report from today’s negotiations

                                                                                                                    As of today, we have responded to all 38 of CNA’s current proposals. We await 20 responses from the union.

                                                                                                                    Educational leave

                                                                                                                    Today, we presented a counterproposal regarding educational leave. We share a mutual interest in ensuring our nurses can swiftly access BRN-approved courses that provide continuing education or continuing medical education units during non-scheduled work time.

                                                                                                                    Optimal break/meal timing

                                                                                                                    We also presented two letters of intent, to answer seven union proposals. We share a mutual interest in avoiding scheduling nurses to take breaks in the first or last hour of their shifts — these are important times in which our nurses assess their patients and exchange information on patient care with nurses coming in to work the next shifts. Kaiser Permanente presented its plan to solve this issue without needing to hire additional nurses, but instead by facilitating movement of staff nurses to achieve and maintain balanced staffing levels in each medical center, unit and shift.

                                                                                                                    Training nurses in new specialties

                                                                                                                    We presented a letter that details our commitment to creating a nurse fellowship program that will allow us to post and fill training positions, to ensure that into the future we will have nurses where our patients need them and that our nurses have the opportunity to enhance their professional practice.

                                                                                                                    The next bargaining session is scheduled for Tuesday, Sept. 30.


                                                                                                                    Bargaining update from September 17, 2014:

                                                                                                                    Today was the ninth meeting between Kaiser Permanente and the California Nurses Association. Negotiations continued to be respectful and productive.

                                                                                                                    Report from today’s negotiations

                                                                                                                    To date, we have presented 11 counter proposals to CNA. Today, the union responded to one regarding education leave approval. Kaiser Permanente is reviewing the union’s counter proposal.

                                                                                                                    Kaiser Permanente gave a counter proposal regarding CNA’s RN Response Network (RNRN), a charitable organization that organizes and supports disaster relief. The union is reviewing our counter proposal. We share a mutual interest in supporting nurses who wish to help care for those affected by disasters. If agreed upon, Kaiser Permanente will:

                                                                                                                                  • Add RNRN as an option for charitable donations listed in the collective bargaining agreement.
                                                                                                                                  • Grant up to 30 days unpaid leave for up to 15 nurses region-wide during each event requiring emergency response.
                                                                                                                                  • Allow nurses to use accrued vacation time when responding to disasters where relief efforts are not sponsored by Kaiser Permanente.
                                                                                                                                  • Kaiser Permanente and CNA share a commitment to protect nurses from workplace injuries. We described this today in a presentation response to the union’s proposals for lift teams. We presented detailed information about our Patient Mobilization Safety Program and reinforced our invitation for nurses to participate in Regional Workplace Safety Steering Committee meetings.

                                                                                                                                    Additional bargaining dates

                                                                                                                                    The union gave eight dates on which it will be available for bargaining from Sept. 30 to Oct. 16. The union agreed to consider another contract extension as the Sept. 30 expiration date nears.


                                                                                                                                    Bargaining update from September 10, 2014:

                                                                                                                                    Sept. 10 was the seventh meeting between Kaiser Permanente and the California Nurses Association (CNA). The process of negotiations continued at a steady rate, reflecting the extensive work being done in a short amount of time to prepare responses to the union's proposals. We want to acknowledge the time and efforts of the bargaining team and the many Kaiser Permanente professionals supporting bargaining, in addition to their regular duties.

                                                                                                                                    Report from bargaining

                                                                                                                                    Today, CNA gave verbal responses and requested clarification about counter-proposals Kaiser Permanente gave the union last week, in which Kaiser Permanente:

                                                                                                                                                  • Announced an increase in our tuition reimbursement policy.
                                                                                                                                                  • Proposed to extend reimbursement for continuing education units.
                                                                                                                                                  • Proposed an increase in quality committee nurse practitioner representatives.
                                                                                                                                                  • Proposed uninterrupted time for completion of legally required compliance training.
                                                                                                                                                  • Kaiser Permanente then presented responses to five previous union proposals, some of which involved multiple elements, including:

                                                                                                                                                                  • A Kaiser Permanente counter-proposal with enhanced nurse residency training programs for needed specialties based upon business needs.
                                                                                                                                                                  • Our mutual interest in supporting nurses who want to volunteer to provide disaster relief, including facilitating leave requests for a mutually agreed upon number of nurses, and Kaiser Permanente's existing policy to consider paying travel expenses on a case-by-case basis.
                                                                                                                                                                  • Reiterating that we value our nurses' professional judgment along with the judgment of our managers — and that the contract already provides for this judgment to prevail concerning the complexity of a home health patient's condition — by allowing extra time for consultation as well as a process to ensure safe staffing predictions in home health care.
                                                                                                                                                                  • Follow-up to last week's bargaining

                                                                                                                                                                    After last week's bargaining, CNA published an alert that incorrectly described Kaiser Permanente's proposal for a voluntary program for call center nurses to work remotely. The union incorrectly characterized our proposal as an attempt to "outsource" work. Our proposal is intended to respond to what we have heard from nurses about their desire to work from home, as well as for Kaiser Permanente to operate as efficiently and effectively as possible.

                                                                                                                                                                    Also following last week's session, CNA prompted an article in a labor-friendly local publication with untrue allegations about staffing and equipment at the Oakland Medical Center, reflecting CNA’s recent statements resisting the use of technology in health care. The allegations made in the article are unfounded. We use appropriate technology as an adjunct for our care teams because it benefits our patients and leads to better, more reliable and consistent patient outcomes.


                                                                                                                                                                    Bargaining update from September 4, 2014:

                                                                                                                                                                    To date, Kaiser Permanente has met six times with the California Nurses Association, receiving 38 proposals from the union as of last week. On Sept. 4, in respectful and productive negotiations, we presented nine written responses — eight counter proposals and one letter of understanding. In addition, we engaged in positive discussion about union proposals we have not yet responded to in writing. Over the next several days, Kaiser Permanente’s bargaining team will send additional counterproposals for the union’s consideration. The next bargaining sessions are scheduled for Wednesday, Sept. 10, and Thursday, Sept. 11.


                                                                                                                                                                    Bargaining update from August 28, 2014:

                                                                                                                                                                    Today, Kaiser Permanente met with the California Nurses Association (CNA) to continue negotiations. To date, the union has presented 38 proposals. Our bargaining team has responded to 15 of these, and is working diligently on responses for those that remain. We are identifying areas of mutual interest and look forward to discussing these with CNA.

                                                                                                                                                                    In today’s negotiations, CNA gave two stirring presentations — one on violence against care team members in the workplace, and another on the union’s RN Relief Network (RNRN), which provides nurses in rapid response to natural disasters in the United States and abroad. We told the union that we agree in principle with the need to support our nurses in these vital efforts, and that we will develop a response to CNA’s RNRN proposal that builds on Kaiser Permanente’s existing policies. In addition, we let the union know that we have mutual interest in finding agreement about the union’s proposal related to workplace violence, to support our nurses’ well-being.

                                                                                                                                                                    In bargaining this week, Kaiser Permanente and CNA mutually agreed to extend the current collective bargaining agreement to Sept. 30, 2014, in order to provide additional time for negotiations. This means that all of the terms of the current collective bargaining agreement, including the no-strike provision, will remain in effect through Sept. 30.

                                                                                                                                                                    By mutual agreement, negotiations will continue on Thursday, Sept. 4.


                                                                                                                                                                    Bargaining update from August 20, 2014:

                                                                                                                                                                    In the first day of bargaining last week, Kaiser Permanente management’s bargaining team presented an overview of the changing health care environment and what we need to do today in quality, service and affordability, so we can be sure that the organization will be here in the future to provide high quality, affordable health care for generations to come. The Kaiser Permanente team also was proud to use the opportunity to acknowledge how our nurses are influencing and transforming health care, for the good of our patients and the nursing profession. And we stated our unwavering commitment to keeping Kaiser Permanente the pre-eminent place for nurses to work in health care.

                                                                                                                                                                    In our presentation we shared with the union bargaining team, and the assembled nurses, the principles that will guide us through bargaining.

                                                                                                                                                                    We will:

                                                                                                                                                                    Ensure that Kaiser Permanente continues to be the best place for nurses to work

                                                                                                                                                                    This includes continuing to provide competitive wages and benefits, a safe workplace, the right resources and technology, and providing for a secure retirement.

                                                                                                                                                                    Do the right thing for our patients

                                                                                                                                                                    Our members and patients are at the center of everything we do. As health care transforms, we have a responsibility to change as well, for the benefit of our patients, our members and our communities.

                                                                                                                                                                    Make health care more affordable for our members and others in the community

                                                                                                                                                                    We believe that the cost of health care in this nation has reached a level that is unsustainable and out of reach for most people, and we are committed to lead the effort to change this.

                                                                                                                                                                    Lead the way in quality, value and affordability

                                                                                                                                                                    Every one of us in health care has a choice – either seize the opportunity to be an architect of change, or choose to wait and see what others do and hope for the best. We choose to lead.

                                                                                                                                                                    Kaiser Permanente and the California Nurses Association (CNA) met again on August 20 for contract negotiations, during which the union shared 11 proposals. Dialogue was productive and respectful. Negotiations will continue on August 21, and are scheduled to take place on Tuesday, Wednesday and Thursday of next week, as well.


                                                                                                                                                                    Bargaining update from August 7, 2014:

                                                                                                                                                                    Statement by Gay Westfall, senior vice president, Human Resources, Kaiser Foundation Hospitals and Health Plan, Northern California

                                                                                                                                                                    Oakland, Calif., August 7, 2014 – Negotiations for a new collective bargaining agreement between Kaiser Permanente and the California Nurses Association (CNA) were scheduled to start on July 31. The current bargaining agreement is set to expire on Aug. 31.

                                                                                                                                                                    Initiating negotiations has been problematic due to issues we are trying to resolve, including agreement on a neutral site for bargaining as well as basic ground rules for how the proceedings will be conducted.

                                                                                                                                                                    For bargaining to be productive, it is important that it take place in a neutral location and with ground rules that foster reasonable discussion. We asked a federal mediator to assist us in coming to agreement on some simple yet important principles before negotiations begin, for example, that each party be given the opportunity to present and explain proposals without interruption, and be assured that the parties will conduct themselves professionally and not be disruptive during the bargaining proceedings.

                                                                                                                                                                    We were in discussions with the union through late last night and early this morning, but were unable to resolve the outstanding issues. As a result, we notified CNA that we would not be bargaining today.

                                                                                                                                                                    Meanwhile, today, there were approximately 200 union members rallying at our downtown Oakland offices to divert attention from negotiations. We are concerned about this disruptive behavior at the outset of what are important negotiations for our nurses and the organization.

                                                                                                                                                                    We care deeply for our nurses and for what they do every day for our patients. We take seriously our commitment to keeping Kaiser Permanente the preeminent place for our nurses to practice their profession and calling.

                                                                                                                                                                    Kaiser Permanente is ready to come to the bargaining table, confident that we can reach a mutually beneficial agreement and look forward to a meaningful dialogue and an atmosphere of mutual respect.


                                                                                                                                                                    Bargaining update from July 31, 2014:

                                                                                                                                                                    Statement by Gay Westfall, senior vice president, Human Resources, Kaiser Foundation Hospitals and Health Plan, Northern California:

                                                                                                                                                                    Oakland, Calif., July 31, 2014 – Today was supposed to mark the opening of negotiations for a new collective bargaining agreement between Kaiser Permanente and the California Nurses Association. The current agreement is set to expire on Aug. 31, 2014.

                                                                                                                                                                    Both parties agreed to meet on July 31. For the benefit of both, we believe it is best that bargaining take place in a neutral location. We have been in discussions for a number of weeks on this topic and proposed multiple sites. In an effort to facilitate an agreement, we secured a neutral location, and invited the union to meet us there. We said we would be there ready to bargain and we were. The nurses’ union refused to meet us there, or at any other neutral site, to bargain. Instead, the union continued to insist that today’s session had to be at its own headquarters. We are disappointed that the union used this approach at the outset of what are important negotiations for our nurses and the organization.

                                                                                                                                                                    Kaiser Permanente is ready to come to the bargaining table, confident that we can reach a mutually beneficial agreement, and look forward to a meaningful dialogue and an atmosphere of mutual respect. We care deeply for our nurses and for what they do every day for our patients.