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ORGANIZING INDUSTRY-WIDE: HEALTH CARE WORKERS IN VERMONT
by Aaron Brenner

The Justice for Healthcare Workers Campaign (JHWC) is a coalition of Vermont health care workers, health care unions, and community activists that is leading a combined struggle for both health care workers’ rights and better health care for all. Central to the struggle is a strategic plan to organize all the health care workers in the state. “People make the connections, why it is right and in their interest to support health care workers’ organizing, because of the link between workers’ rights and better patient care,” says James Haslam, director of the Vermont Workers Center (VWC).

JHWC has pushed the Vermont legislature to pass bills that help both workers and patients, and it has held rallies, forums, workshops, and public education events around the need for universal access to health care. At these events, union health care workers demonstrate to the community how unions give workers more power to push for better staffing ratios, better training, expanded patient rights, and universal access.

So far, as a result of JHWC activity, thousands of health care workers have joined unions and several pieces of progressive health care legislation have passed in Vermont.

In the Troublemaker’s Handbook 2, we describe a successful JHWC effort to support a union drive by nurses at Fletcher Allen Hospital in Burlington (see “Vermont Nurses Reach In to Each Other and Out to the Community” in Chapter 15 on Organizing New Members). Here we discuss JHWC’s origins, structure, and strategic approach.

ROOTS IN ACTIVISM
JHWC is a project of the Vermont Workers’ Center, a chapter of Jobs with Justice. The Workers’ Center brings together hundreds of individuals and dozens of organizations (unions, churches, and community groups) to fight for workers’ rights. In addition to running a workers’ rights hotline, it organizes rallies, public hearings, forums, and direct action.
VWC leaders launched JHWC when they recognized two developments.

First, VWC leaders had enough experience from supporting previous health care organizing drives that they knew what worked. Through the late 1990s, they had worked on successful drives by the American Federation of Teachers’ (AFT) health care division at Copley Hospital (now a local of United Nurses and Allied Professionals (UNAP), an independent regional health care union) in the small town of Morrisville, by the United Electrical Workers (UE) at Berlin Health and Rehabilitation Center, by the Office and Professional Employees International Union (OPEIU) at Rutland Regional Medical Center, and by AFT Healthcare at Brattleboro Retreat Hospital (now a UNAP local).

And second, from those drives they had an extensive network of supporters among health care workers, activists fighting for better health care, clergy, community leaders, and politicians. These people could be mobilized to aid further health care organizing.

Jan Schaffer, Vermont/New Hampshire AFL-CIO director and a leader of the VWC, sums up the group’s thinking: “The steering committee of the Workers Center has tried to figure out what it can do that is pro-active, that strengthens organizing in different sectors. When we looked at health care, we saw growing union density and a movement around single-payer universal health care. We asked what role unions could play in that movement and how we could begin to change the discussions around health care so the concerns of workers and patients are taken into account. How do we build a structure that can promote both organizing and quality health care?”

JHWC was the answer to those questions.

INTER-UNION COOPERATION
Like VWC, JWHC is a coalition of individuals and organizations. Participating unions include AFT Healthcare, UNAP, UE, OPEIU, AFSCME Council 93 at several facilities, and the independent Vermont State Employees Association, representing public health care workers and nurses. All the unions are VWC members, so they have supported each other’s organizing efforts in the past, usually in the form of mobilizing members.
The formation of JHWC strengthened this inter-union cooperation, because it provided a means for the unions to discuss their organizing plans before they began. JHWC does not have the power to decide which unions organize which workers, but its leaders’ experience and the resources it can offer give unions reasons to listen when it makes suggestions. As a result, JHWC plays an integral role in the formation of unions’ organizing plans and can coordinate the timing of organizing to make sure each drive gets the resources it needs.

At regular monthly meetings, the steering committee discusses how JHWC can support current and future organizing efforts by the unions. “Much of the discussion is in terms of a union saying ‘if we launch an organizing drive,’ or ‘should we?’” says Haslam. The group considers various targets, which unions have the resources necessary, and what type of community support can be mobilized. Then it helps individual unions put together and execute an organizing drive.

This was how AFT Healthcare decided to launch the drive at Fletcher Allen Hospital, then the second-largest employer in Vermont and provider of more than half the state’s health care.

Once a drive begins, the union does most of the worker organizing, while JHWC coordinates community support. At times, JHWC members will help with internal organizing by giving advice and doing organizing training, but most of the group’s attention is on getting community members--including other unions--to pressure the employer.

“One of our first big successes was getting folks at UNAP locals to send strong support for the nurses at Fletcher Allen to organize with AFT,” says Haslam. Two UNAP locals in Vermont had once been affiliated with AFT Healthcare, and significant hostility had existed between the two unions. “Management would have used it against AFT, but UNAP prevented it. Their members and officials wrote lots of letters to Fletcher Allen management to demonstrate their support for the nurses. It helped that we have a great relationship with them from past work together.”

JHWC is building on the Fletcher Allen victory. “When another hospital starts organizing it will be easy to mobilize, since lots of people are ready to go and are familiar with the issues,” says Haslam. “The coalition is developing the organizing plan, contributing resources, and trying to get a union to do the organizing, which it will then support with staff, volunteers, money, and community mobilization.” Following just this outline, AFT Healthcare organized the licensed practical nurses at Fletcher Allen and is in the midst of organizing the service workers there.

None of the unions organizing health care workers in Vermont are traditional health care unions, which may explain why there have been few jurisdictional disputes. “JHWC doesn’t have a policy on how to split up the workers, but so far it has not come up,” says Haslam. “The unions involved don’t represent the same type of workers; some are at nursing homes, others at rehab centers or hospitals. Much of the organizing being done is internal, where a union has already organized one unit and is going after another, so there is no competition there.” The fact that there are still dozens of unorganized hospitals, nursing homes, and other health facilities in Vermont should help prevent conflicts for quite some time.

Haslam also points out that the unions have vastly different resources. AFT Healthcare, with 70,000 nurses and professionals, has more resources than UNAP, a small regional union with 11 locals and 4,000 members. “After Fletcher Allen, AFT has been very aggressive with its organizing plans. AFSCME is looking at nonprofit mental health facilities and nursing homes. The smaller unions do not have the same level of resources, but they help with planning, mobilize community support, and contribute money and people to the public effort in support of universal access to health care.”

JHWC has talked about building one health care workers’ union, but that “is a bigger picture than we can figure out now,” Haslam says. “We have talked about getting nurses’ contracts to expire at the same time. They can be in four different unions, but if their contracts expired at the same time it would vastly increase their leverage.”

JHWC is also putting together plans for specific industry segments, such as nursing homes, where the issues are very different from those faced by hospital nurses. “We are realizing that in Vermont, because we lack resources, we have to be pro-active about getting resources here and developing organizing plans, so we don’t spread ourselves too thin,” says Haslam.

BIG PICTURE ATTRACTS COMMUNITY SUPPORT
JHWC’s initial goals went beyond union organizing; the group wanted legislation that would improve the quality and accessibility of health care in Vermont. These goals are still in place and, as it turns out, they are related. “JHWC frames workers’ unionizing efforts in the larger context of the struggle for better health care,” says Haslam.

This approach helps JHWC win community support, particularly from clergy, says Hal Leyshon, formerly a VWC leader and president of the AFL-CIO Central Labor Council in Burlington. “We look for clergy to speak out in support of unionization. We explain to them that it is a question of elemental justice. Health care workers need to earn a livable wage. It is not right that the workers provide health care but cannot afford it themselves. They are members of the community, who take care of our loved ones. We remind the clergy that the quality of health care is suffering because of the workers’ poor wages and working conditions. Unionization is necessary to increase the quality of health care, because it will allow nurses to negotiate better patient/staff ratios and eliminate the health threats caused by tired nurses working forced overtime.

“At first, the clergy try to mediate between workers and employers,” says Leyshon. “They want to avoid adversarial situations. But we explain that union-busting employers and their lawyers undermine the workforce and the community, not unions. Then the clergy want to avoid a strike. So we explain to them that the best way to prevent a strike is with strong community support that demonstrates that if there were a strike, the workers would win because a majority of them would walk out and the community would stand behind them.”

Moral leverage helps win the support of clergy, but a different kind of leverage is decisive with politicians. “Several years ago we got tired of politicians who said they supported labor but did nothing,” says Leyshon. “So we insisted that politicians who asked for labor support sign a pledge saying that they would support organizing drives. The pledge is specific. It requires the politician to write letters to the community supporting the right to organize and saying that if they worked at the hospital, they would support a union.” The JHWC tries to convince politicians who have not signed the pledge by mobilizing large numbers of community members and workers to informational picket lines, community meetings, and legislative hearings.

Once they are on board, clergy and politicians might meet with management, send a letter, sponsor public hearings, attend rallies, or hold press conferences. In the drive to organize the Berlin Health and Rehabilitation Center, activists launched an Appeal to Fairness, which included community petitions supported by politicians and clergy. Then, to win a first contract, the campaign organized candlelight vigils, rallies, parades, and informational pickets. Community delegations delivered the Appeal to the Center’s corporate parent at its U.S. headquarters and at its shareholder meeting in Toronto. Not only did the workers win a good contract, the campaign’s publicity about workers’ rights and staffing ratios pushed the state of Vermont to implement the first-ever staffing rules for nursing homes.

UNIONIZATION + LEGISLATION = BETTER HEALTH CARE
JHWL does more than propagandize about the link between better health care and unionization. During the Fletcher Allen contract campaign, supporters of JHWC introduced bills on nurse/patient ratios, against mandatory overtime, and for whistleblower protection to the state legislature. With the aid of independent Congressman Bernie Sanders, JHWC then sent a survey to the state’s 8,000 nurses, asking them to vote for or against the bills. Of the 880 nurses who returned the cards in favor of the bills, 800 were union members, demonstrating to politicians, clergy, and health care workers alike the potential political mobilizing power of unions.

The mailing also supported the organizing effort at Fletcher Allen. Hundreds of nurses marched with the cards to the floor of the legislature. They arrived at the Capitol on a fire engine to demonstrate the “state of emergency” of the state’s medical system. The event captured media attention, boosted spirits, and reinforced the nurses’ demand for a contract that included staffing ratios.

The legislative effort during the Fletcher Allen organizing campaign demonstrates one of the principles behind JHWC’s approach. “We want to emphasize that legislative tactics are used in the service of organizing,” says Leyshon. “The legislative campaign empowered the nurses at Fletcher Allen, helped them win a contract, and prepared the way for future organizing at other health care facilities. The unions got 80 health care worker contacts at non-union workplaces from the mailing. Those nurses can help with organizing going forward.”

It helps that Vermont is a relatively progressive state with a progressive congressperson, Bernie Sanders. Several times during organizing drives, Sanders has held hearings to investigate the conditions of health care workers and the state of health care at particular facilities. JHWC has turned out hundreds of people to these hearings, which ended up exposing hospital managements to harsh criticism.

REPLICATING THE MODEL
JHWC will continue to insist on the participation of rank-and-file health care workers in all its activities. “One of the limitations of our work is that it can be a bit staff-heavy,” admits Haslam. “Political support for the nurses at Fletcher Allen was largely done by staff. The nurses were incredibly involved, especially in the early stages of building community support. The union had lots of work to do to build the organizing drive and build the internal committee. It asked us to coordinate the external support and the community outreach. I worked with a rank-and-file committee from the hospital doing outreach. We met to decide what we would do, who would do it, who would be our spokespeople. The political support sometimes came down to me. But we stress that members initiate and participate in everything we do. We are not rent-a-community-support.”

VWC leaders believe they can reproduce the JHWC model in other industries. “We are initiating an organizing coalition in the building and construction trades,” says Leyshon. “We are uniting unions that have not worked together before, introducing them to a strategic approach that will help build union density in the industry. Right now, only about five percent of the workers are unionized. We have contractors paying off the books, no workman’s compensation, no benefits, and no pensions. Lots of state funds go into construction, so there is considerable leverage if we can develop a public message.”

“We have to change the culture around how public money is used for building and how the public views construction so that the focus is on workers and jobs, not on the contractor,” says Schaffer. “The Workers Center is developing an overall strategy and putting together a statewide coalition of people who can implement it.”

[Aaron Brenner is a labor historian, researcher, writer, and editor in New York City. He has written about international labor solidarity, union reform movements, and rank-and-file rebellions by Teamsters, telephone workers, and postal workers, and is the editor of The Encyclopedia of Strikes in American History. He authored the chapter on Organizing New Members for A Troublemaker’s Handbook 2.]