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Legacy Nurses Win Right To Unionize at Unity Center

June 12, 2019

Registered nurses at the troubled Unity Center for Behavioral Health in Northeast Portland have won their bid for a unionization vote.

The National Labor Relations Board’s Seattle regional director that the roughly 200 registered nurses at Unity are a distinct labor unit and entitled to form their own labor bargaining entity.

The ruling sets a June 19 vote for the nurses to decide whether they want to be represented by the Oregon Nurses Association.

The Portland-based nonprofit Legacy Health system, which manages and is the lead owner of Unity, had challenged the union drive, saying Unity is so intertwined with two major Legacy hospitals that it could not be considered a separate facility and the Unity nurses could not be considered a standalone work unit.

The board rejected those arguments.

Nurses at Unity deal predominantly with patients who have mental health problems, which is substantially different work than that done by nurses at Legacy Emanuel Medical Center – a general hospital providing primary care and surgery - and Randall Children’s Hospital, ruled Randall Hooks, the board’s Seattle regional director.

Legacy said it disagrees with the board's decision and will appeal. "We value our employees and the opportunity to speak directly with them on all matters related to the care of our patients,” Legacy said in a statement.

The move to appeal won’t postpone the vote unless the board agrees to a delay.

More than 80 percent of Unity’s registered nurses signed the petition calling for a union vote, said Sarah Mittleman, a registered nurse at Unity and an advocate for the unionization.

“I’m ecstatic, and so are most of my co-workers,” Mittleman said. She said she’s confident nurses on June 19 will vote to unionize. At that point, Legacy would need to begin negotiating a contract with the union. Mittleman said the union will give workers “a voice at the table” over many issues, including employee and patient safety.

If pro-union nurses prevail on June 19, Unity would become the first Legacy-run facility to bring in the Oregon Nurses Association.

The union represents nurses at many health care systems in the state, but not Legacy.

Labor unions, including the nurses association, have made big strides into Oregon’s health care systems in recent years, gaining thousands of new members amid the industry’s uncertainty, change and cost-cutting.

Opened in 2017 as a regional behavioral health care facility that consolidated mental health patients from four health care networks in the Portland area, Unity has repeatedly been cited by state regulators for poor management, insufficient staffing and unsafe conditions for employees and patients. The dangerous conditions lead to two patient deaths, investigators concluded last year.

At a three-day hearing in May, Legacy had sought to derail the union drive, arguing that the Unity nurses are part of a larger group of about 1,600 registered nurses at Unity, Legacy Emanuel and Randall.

Legacy said it considers Unity a “specialty unit” of Legacy Emanuel, which is about a mile away.

Unity is jointly owned by Legacy, a 40 percent stakeholder, and three other hospital systems – Adventist Health, Kaiser Permanente and Oregon Health & Science University – which each hold 20 percent.

With about 450 workers, Unity opened in 2017, the concept being to centralize care for behavioral health patients, who previously had been scattered among the four systems.

Many workers at Adventist, Kaiser and OHSU shifted over to work for Unity when it opened. Mittleman, a registered nurse for 17 years, said she had worked as a psychiatric nurse at OHSU for about three years, before shifting over to Unity when it opened.

Hooks, the board’s regional director, said the panel has long held that a unit of workers at a “single facility” is “presumptively appropriate,” for forming its own labor unit, “unless (the facility) has been so effectively merged or is so functionally integrated that it has lost its separate identity.” The burden is on the employer to rebut that presumption, Hooks wrote.

Unity has its own management and president, he wrote. “There is significant local autonomy over operations and labor relations,” he wrote.

Also, the registered nurses at Unity have specialized roles and training distinct from registered nurses at Emanuel and Randall, he wrote. Nurses at Unity rarely work at Emanuel and Randall, and vice versa, he wrote. Nurses at Unity have a “behavioral and mental health focus” and are “much more focused on talking with their patients,” he wrote. That’s very different from the nurses at Emanuel and Randall, who are heavily focused on assessing the physical condition of patients and monitoring medical equipment, he wrote.

Christian Wihtol can be reached at [email protected].