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Behavioral health workers at Legacy Health’s Unity Center seek to unionize

The union drive at the psychiatric facility is the latest effort by the Oregon Nurses Association to organize medical workers
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Unity Center for Behavioral Health in Portland. | LEGACY HEALTH
July 13, 2023

Staff at Unity Center for Behavioral Health, the Portland psychiatric facility, have formally asked to be represented by the state’s largest nurses union. 

The Oregon Nurses Association announced in a press statement that 57 crisis intervention specialists, counselors, therapists and social workers employed at the Northeast Portland facility filed for union recognition with the National Labor Relations Board on Monday. The facility is funded by several health systems and operated by Legacy Health.

If the drive succeeds, the workers will join the union that has been leading efforts to organize medical workers across the state. The nurses union currently represents 15,000 nurses and other health care workers including nearly 700 nurses at Legacy’s other hospitals. 

The move comes even as Legacy Health is facing a “financial crisis,” a top executive recently told The Oregonian/OregonLive, with losses of $10 million a month forcing it to sell off its laboratory services unit.

While the number of employees involved is small, the filing is significant because Legacy has been the slowest health system in the state to unionize. For years, only nurses at Legacy’s Silverton hospital belonged to the nurses union. In 2019, nurses at Unity voted to approve the union after the health system fought the organizing campaign. Earlier this year nurses at Legacy Mt. Hood Medical Center followed suit

Separately, Legacy has accused the state of pressuring it to unionize while slapping the system with hefty fines for violating the state's meal break rules.

The association’s  statement described the challenges staff face in providing care at the 24-hour psychiatric hospital in a state that hasn’t “adequately funded mental and behavioral health care.” The union cited a 2022 study that put Oregon near the bottom in a ranking of states for their prevalence of mental illness and lower rates of access to care.

“We’re experiencing a brain drain. Tenured clinicians who’ve acquired the comprehensive system knowledge and skill set find better working conditions elsewhere rather than stay at Unity,” Raffi Serafino, a social worker at Unity Center, said in the statement. “Our efforts to partner with leadership and resolve this problem have been ignored for too long.” 

Staff are unionizing to advocate for patient-to-worker ratios, improved care and to hold Legacy leaders accountable, according to the union. 

Legacy Health  responded with a statement: “We respect our staff members’ rights to determine union representation through a secret ballot election to be held by the National Labor Relations Board, and we look forward to sharing additional information when we can.” 

Legacy can choose to recognize the union. Or the health system can call for a hearing by the National Labor Relations Board followed by a vote by eligible workers on whether to unionize. A simple majority vote by workers is needed to form a union. 

The Unity Center opened its doors in 2017 as collaboration between Legacy Adventist Health, Kaiser Permanente and Oregon Health & Science University. Operated by Legacy, the 80-bed facility is intended to provide a better option than emergency departments for people experiencing a mental or behavioral health crisis. 

However, the Unity Center ran into serious problems within a year of opening. An Oregon Health Authority investigation in 2018 found it lacking in oversight and that one patient committed suicide while in its care. 

Since then, the Unity Center has faced a lawsuit from a mental health therapist alleging retaliation for complaining about patient and staff safety. The facility also had to turn patients away, in addition to being fined for not reporting assaults and other issues. 


You can reach Jake Thomas at [email protected] or via Twitter @jakethomas2009.

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