SEE 10/4/23 3:30 PM UPDATE: While bargaining ended without a contract settlement 5 tentative agreements reached

“Operations continue as normal”

Kaiser Permanente Statement on National Bargaining with the Coalition of Kaiser Permanente Unions

Kaiser Permanente and leaders and members of the Coalition of Kaiser Permanente Unions were bargaining through the weekend to reach an agreement.

We continue to make progress on key issues such as a redesigned performance sharing plan with updated payout opportunities. Last week we reached tentative agreements in four key areas:, travel for continuing education, the use of temporary workers such as traveling nurses, tracking of staffing vacancies, and dispute resolution.

It is important to know that while the current national agreement expired at midnight PDT on September 30, operations continue as normal, and we will continue to honor all current contract provisions. Contract expirations do not mean a strike will happen. We remain optimistic that we will reach an agreement and avoid an unnecessary strike, which the Coalition unions have called for starting on Wednesday morning, Oct 4.

Wages

We lead total compensation in every market where we operate, and our proposals in bargaining would ensure we keep that position. In some places, a Kaiser Permanente employee leaving for a similar job at another organization would face a 20-plus percent pay cut, and lower benefits.

Included in our current offer are guaranteed across-the-board wage increases and a proposed $21 minimum wage in Washington, Oregon, Colorado, the Mid-Atlantic States (Virginia, Maryland, and the District of Columbia), and Hawaii starting in 2024; and a $23 minimum wage starting in 2024 in California.

Hiring and Staffing

Despite the acute shortage of health care workers nationally, we have been able to hire more than 50,000 frontline employees in the last two years: 29,000 people in 2022, and another 22,000 so far this year. Included in this year’s new hires are more than 9,800 people hired into jobs represented by the Coalition. Kaiser Permanente and the Coalition agreed in April to a goal of hiring 10,000 new people for Coalition-represented jobs by the end of 2023. We expect to reach the 10,000 new hire goal by the end of October, if not sooner, and we won’t stop there. We are committed to addressing every area of staffing that is still challenging. Additionally, our attrition rate of 7% is roughly a third of the industry average and continues to fall. These achievements underscore the value of a Kaiser Permanente job and reinforce our position as a leading health care employer.

Potential Strike Starting Wednesday

In the case that a strike does begin on Oct. 4, we have contingency plans in place to ensure members continue to receive safe, high-quality care for the duration of the strike. Our hospitals and emergency departments will remain open. Kaiser Permanente members can get updates on appointments, pharmacy guidance and where to get care on kp.org.

We’ll continue to bargain in good faith until we reach a fair and equitable agreement to ensure Kaiser Permanente continues to attract and retain the best people in health care — and remains a best place to work and get care. And that includes meeting our responsibility to continue to balance taking care of our employees and being more affordable to our members.

October 4, 2023 3:30pm UPDATE:

After 6 months of bargaining with the Coalition of Kaiser Permanente Unions, including a marathon effort that went through last night and into today, our bargaining sessions unfortunately ended without a settlement, and the Coalition strikes began.

While we have not reached a contract settlement, we have been able to reach a number of tentative agreements in bargaining, and our offers to date address the unions’ priorities, including:

• Across-the-board wage increases in all markets over the next four years.
• Updating the Performance Sharing Plan to include a minimum payout opportunity and potential for up to a $3,750 payout.
• Offering minimum wages of $23/hour in California and $21/hour in markets outside of California.
• Continuing and enhancing our existing excellent health benefits and retirement income plans.
• Renewing our strong tuition assistance and training programs, and increasing funding of the education trusts.

We remain committed to reaching a new agreement that continues to provide our employees with market-leading wages, excellent benefits, generous retirement income plans, and valuable professional development opportunities.

Together, we have faced the toughest challenges over the past three years. Kaiser Permanente, our industry, and our employees are now operating in a new cultural, labor, and post-pandemic environment that we are all working hard to understand. We are committed to finding workable solutions for this new environment that meet our responsibility to balance taking care of our employees and being affordable to our members.

We will coordinate with Coalition leaders to reconvene bargaining as soon as possible. We will work hard to reach an agreement so that together, we can all return to delivering on the mission of Kaiser Permanente for the benefit of our members, patients, employees, physicians, customers, and communities.

Meeting our shared staffing goal

On the same day that the Coalition strikes began, we’re pleased to confirm that we’ve met our goal of hiring 10,000 new Coalition-represented employees by year-end – and it is only October 4th. We’re not done yet. We are committed to addressing every area of staffing that is still challenging.

As a reminder: In April we agreed with the Coalition to a joint goal of hiring 10,000 people by the end of this year into jobs the Coalition cares about. We agreed this would be a great success if we could hire that many people into Coalition roles by the end of this year. We hit the goal three months early.

In total over the past two years, Kaiser Permanente has hired more than 50,000 people to join our teams.

Meeting our members’ needs

The health and wellbeing of our members and patients is our top priority. Because we are such a large organization, with multiple ways that members can access care, the impact of the strike is different at various locations. 

We have robust plans in place to ensure members continue to receive safe, high-quality care during the strike.

All our hospitals and emergency departments remain open. Our facilities will continue to be staffed by our physicians, trained and experienced managers, and our great staff. Thousands of qualified and trained contract staff are joining our Kaiser Permanente teams this week as well, to help meet our members’ and patients’ needs. We thank those Coalition-represented employees who have chosen to come to work and care for our patients, members, and communities.

Members who need urgent or timely medical care should continue to seek it at our hospitals and medical facilities. A strike should not dissuade anyone from seeking necessary care.

We will contact members affected by any necessary changes in our services. We may need to reschedule non-emergency and elective services in some locations out of an abundance of caution. Our members can follow any important updates to our care delivery on kp.org.

By Renée Saldaña, SEIU, Press Secretary, SEUI – United Healthcare Workers West

OAKLAND, Calif. – Bay Area unions IFPTE Local 20 and OPEIU Local 29 have approved a sympathy strike in support of the unfair labor practices strike at Kaiser Permanente hospitals and medical offices in California being called for by SEIU-United Healthcare Workers West between October 4-6.

A “sympathy strike” occurs when one union supports another union that is directly involved in a labor dispute.

“Kaiser’s unfair labor practices against SEIU-UHW in our local bargaining have not been remedied,” said Erica Chinchilla, a respiratory therapist at Kaiser Antioch. “A sympathy strike is a powerful act of solidarity where workers strike to support or aid another group of workers. We appreciate our Coalition partners’ willingness to stand with us as we protest these unfair labor practices committed by Kaiser in local bargaining against SEIU-UHW and its members.”

SEIU-UHW members include frontline workers such as respiratory care practitioners, dietary, environmental services, and nursing staff. OPEIU Local 29 represents office, technical and professional employees at Kaiser Permanente. IFPTE Local 20 represents clinical lab scientists, home health therapists, optometrists, genetic counselors, and other technical and professional employees at Kaiser.

Laboratory scientists provide information medical doctors need to properly diagnose and treat patients, as well as ensure correct blood products are given to patients during surgery or an emergency. Kaiser has not informed IFPTE Local 20 of coverage plans of this important work.

Unions in Oregon, Southwest Washington, Colorado, Virginia, Maryland, and Washington, D.C., which are part of the Coalition of Kaiser Permanente Unions, are also planning unfair labor practices strikes at the same time.

SEIU-United Healthcare Workers West (SEIU-UHW) is a healthcare justice union of more than 100,000 healthcare workers, patients, and healthcare activists united to ensure affordable, accessible, high-quality care for all Californians, provided by valued and respected healthcare workers. Learn more at www.seiu-uhw.org.

75,000 U.S. healthcare workers of the Coalition of Kaiser Permanente Unions protest claims of unfair labor practices

By Isaac Reese, 617 Media Group

10/4/23 7:00 P.M. UPDATE: “Frontline healthcare workers are awaiting a meaningful response from Kaiser executives regarding some of our key priorities including safe staffing, outsourcing protections for incumbent healthcare workers, and fair wages to reduce turnover. Healthcare workers within the coalition remain ready to meet at any time. Currently, the strike continues, and there are no sessions scheduled at this hour,” said Caroline Lucas, spokesperson, Coalition of Kaiser Permanente Unions.

More than 75,000 Kaiser Permanente workers in multiple states are now on strike to protest unfair labor practices and Kaiser executives’ failure to bargain in good faith over unsafe staffing levels at hundreds of Kaiser hospitals and facilities across the United States. 

Over the course of just three hours, the strike at Kaiser facilities expanded from coast to coast, following months of bad faith bargaining activity by Kaiser executives and repeated appeals by frontline healthcare workers for Kaiser executives to make the kinds of investments in staffing that could help stem employee turnover and reduce growing patient wait times.  

The strike began in DC and VA at 6AM ET this morning, expanded to CO at 6AM MT, then culminated with tens of thousands of workers striking in CA, OR, and WA at 6AM PT.

In the vast majority of locations, barring an agreement, the strike is expected to last for three days. It is already the largest healthcare worker strike in U.S. history. 

Healthcare workers are taking the work action to protest Kaiser executives’ bad faith bargaining, which is getting in the way of finding solutions to solve the Kaiser short-staffing crisis by investing in its workforce.

In recent days, Kaiser executives maintaining aggressive threats of outsourcing became a sticking point in negotiations, especially at a time when the company is failing to retain key employees. 

“Kaiser executives are refusing to listen to us and are bargaining in bad faith over the solutions we need to end the Kaiser short-staffing crisis,” said Jessica Cruz, a licensed vocational nurse at Kaiser Los Angeles Medical Center. “I see my patients’ frustrations when I have to rush them and hurry on to my next patient. That’s not the care I want to give. We’re burning ourselves out trying to do the jobs of two or three people, and our patients suffer when they can’t get the care they need due to Kaiser’s short-staffing.”

Strike lines are set up at Kaiser Permanente hospitals and medical office buildings across the country, including California, Colorado, Washington, Oregon, Virginia and Washington, D.C. 

Workers on strike include those employed as licensed vocational nurses, emergency department technicians, radiology technicians, ultrasound sonographers, teleservice representatives,  respiratory therapists, x-ray technicians, optometrists, certified nursing assistants, dietary services, behavioral health workers, surgical technicians, pharmacists and pharmacy technicians, transporters, home health aides, phlebotomists, medical assistants, dental assistants, call center representatives, and housekeepers, among hundreds of other positions.

BACKGROUND

The Coalition of Kaiser Permanente Unions represents 85,000 Kaiser healthcare workers in seven states and the District of Columbia. In April, the Coalition began its national bargaining process ahead of the September 30th contract expiration. On Sept. 22, Coalition unions representing 75,000 Kaiser healthcare workers gave Kaiser executives 10-day notices for an unfair labor practice strike beginning Oct. 4. The Coalition and Kaiser Permanente last negotiated a contract in 2019, before healthcare workers found themselves on the frontlines of the COVID pandemic that has worsened working conditions and exacerbated a healthcare staffing crisis.

At issue, healthcare workers say, are a series of unfair labor practices related to bargaining in bad faith, along with simmering staff concerns related to unsafe staffing levels that can lead to dangerously long wait times, mistaken diagnosis, and neglect. After years of the COVID pandemic and chronic understaffing, Kaiser healthcare workers are calling on management to provide safe staffing levels.

Workers say that Kaiser is committing unfair labor practices and also that understaffing is boosting Kaiser’s profits but hurting patients. In a recent survey of 33,000 employees, 2/3 of workers said they’d seen care delayed or denied due to short staffing. After three years of the COVID pandemic and chronic understaffing, healthcare workers at Kaiser Permanente are calling on management to provide safe staffing levels.

Kaiser has reported ​​$3 billion in profits in just the first six months of this year. Despite being a non-profit organization – which means it pays no income taxes on its earnings and extremely limited property taxes – Kaiser has reported more than $24 billion in profit over the last five years. Kaiser’s CEO was compensated more than $16 million in 2021, and forty-nine executives at Kaiser are compensated more than $1 million annually. Kaiser Permanente has investments of $113 billion in the US and abroad, including in fossil fuels, casinos, for-profit prisons, alcohol companies, military weapons and more.

The Coalition of Kaiser Permanente Unions unites more than 85,000 healthcare workers at Kaiser Permanente facilities in California, Colorado, Oregon, the District of Columbia, Hawaii, Maryland, Virginia, and Washington

Kaiser issued a statement last month responding to the then-threatened strike.

Allen D. Payton contributed to this report.

During the East Bay Leadership Council’s Installation Awards dinner on August 9, 2023 Kaiser Permanente Diablo was presented with the East Bay Leadership Medal. It is the highest honor to an organization recognizing outstanding service in support of the Council and the broader East Bay community. Kaiser Permanente currently is the third East Bay employer to receive this honor twice since the award was founded in 1987.

Kaiser Permanente Diablo includes locations in Antioch, Dublin, Livermore, Martinez, Pleasanton, San Ramon and Walnut Creek.

The Council offered the following about the honorees and the evening: “Kaiser Permanente is not only a world-class health system and one of the East Bay’s largest employers, but a force for generosity spanning from affordable housing construction to gun violence prevention. On top of it all, Kaiser has supported the East Bay Leadership Council’s mission through sponsorships and staff volunteerism that continues to expand our impact and reach as an organization. We are honored to present Kaiser with our top organizational award.”

By East Bay Leadership Council

The sold-out event featured inspiring words from the honorees — Chadi Chazbek, Bielle Moore and Kaiser Permanente — who have all been influential in fostering a thriving East Bay community.

In his opening remarks, EBLC’s President & CEO, Mark Orcutt, shared what is at the heart of the EBLC community, “You would not be here tonight if you were hopeless and disinterested in taking on the challenges we face as a region. You are here because you believe as I do that a group of well-informed and driven leaders can change the world.”

Past Chair Leo Scott passed the baton to Peggy White, who expressed why she is excited to take on the role of Chair of the Board, “The hallmark of my career has been putting my passion and energy into causes that I care deeply about. And I care deeply about the Council’s mission to make the region a better place to live and work.”

It was an inspiring and heartwarming evening, full of appreciation and recognition for the important work being done to make the East Bay a place where businesses and residents thrive.

Thank you to our sponsors for making this uplifting event possible and thank you to our board and community members for your ongoing commitment to EBLC. We are excited for the year ahead!

More information about the East Bay Leadership Council Awards night can be viewed here:

https://eastbayleadershipcouncil.com/news/installation-awards-recap-photos-and-more

For more information about the EBLC visit East Bay Leadership Council.

Allen D. Payton and Antonia Ehlers of Kaiser Permanente contributed to this report.

The California 2023 Maternity Care Honor Roll recognizes hospitals that met or surpassed the statewide target to reduce births via cesarean section in first-time mothers with low-risk pregnancies

Sutter Delta Medical Center, Contra Costa Regional Medical Center also make list

By Antonia Ehlers, PR & Media Relations, Kaiser Permanente Northern California

Kaiser Permanente Antioch Medical Center is one of 107 hospitals named to the California 2023 Maternity Care Honor Roll for meeting the statewide target of cesarean sections for low-risk births leading to improved health outcomes for mothers and their newborns.

Childbirth is the number one reason for hospitalization in the U.S., according to the California Health Care Foundation.  Overuse of C-sections can lead to serious health complications for both mother and baby and unnecessary C-sections are also considered a health equity issue since rates are higher among people of color.

Kaiser Permanente Northern California is a leader in innovative approaches to maternal care and is working to improve equity in maternal health. Our hospitals are among the best in the country for meeting rigorous standards for maternity care, including low C-section rates, elective early deliveries, and for following important protocols to safely protect new mothers and their babies.

As part of our comprehensive prenatal care, our care teams work closely with our patients to deliver high-quality maternity care and reduce the risk of complications. If pregnant patients have a high-risk pregnancy or a chronic condition such as high blood pressure, we tailor their care to reduce risks. And mothers who choose to breastfeed get the support they need to be successful.

Last year, 43,177 babies were delivered at Kaiser Permanente Northern California hospitals.

“Kaiser Permanente is a leader in providing exceptional maternity care that provides new families with the support they need,” said Pam Galley, senior vice president and area manager of Kaiser Permanente’s Diablo service area. “We are committed to providing our members and patients with high-quality, equitable maternal health care.”

The 107 hospitals on the honor roll represent half of all 211 California hospitals that offer maternity services and participate in the California Maternal Quality Care Collaborative’s Maternal Data Center.

Reducing C-section rates starts with the culture of the hospital, involving changes to physician practice patterns, education of nurses, support staff and families, and implementation of new policies within the facility, according to Cal Hospital Compare, which publishes the maternity care honor roll.

“Our Kaiser Permanente clinicians are committed to providing the best outcomes for our families as they entrust us with their care,” said Sharon Mowat, MD, physician in chief at Kaiser Permanente’s Antioch Medical Center. “We strive every day to provide the support these new families need as they begin this life-changing journey.”

In 2015, the California Health and Human Services Agency began recognizing hospitals that meet the 23.9% statewide target of C-sections for low-risk births through its Maternity Honor Roll. Beginning this year, CHC changed the C-section rate threshold for honor roll hospitals from 23.9% to 23.6% to align with the Healthy People 2030 goals. This year’s award reflects calendar year 2022 hospital discharge and birth certificate data.

Sutter Delta Medical Center in Antioch and the Contra Costa Regional Medical Center in Martinez also made the 2023 Honor Roll list For more information on the California 2023 Maternity Care Honor Roll visit https://calhospitalcompare.org/programs/maternity-care-honor-roll/

Allen D. Payton contributed to this report.

By Antonia Ehlers, PR & Media Relations, Kaiser Permanente Northern California

Kaiser Permanente is the largest union-represented health care employer in the U.S. – with nearly 75 percent of our employees represented by unions. We are currently bargaining with the Coalition of Kaiser Permanente Unions, which represents about 88,000 employees in a variety of roles. The Coalition is part of our historic, 26-year-long Labor Management Partnership, the longest-lasting partnership of its kind in the country.

Kaiser Permanente is fully committed to reaching an agreement with the unions affiliated with the Coalition just as we have done in every national bargaining since 1999. Our priority is to reach an agreement that is mutually beneficial and ensures we can continue to offer our people market-competitive pay and outstanding benefits. We are confident that we will reach an agreement that achieves that goal, before the contract expires on September 30. And we are confident that our new agreement will strengthen our position as a best place to work and ensure the high-quality care our members expect from us remains affordable and easy to access.

Strike Authorization Vote

Strike authorizations are a common bargaining pressure tactic that give union leaders the ability to call for a strike in the future. Throughout our negotiations we have seen Coalition leaders attempt to rally their unions’ members to threaten a strike despite important progress made through negotiations.

This tactic does not reflect any breakdown in bargaining, nor does it indicate a strike is imminent or will happen at all. It is a disappointing action considering our progress at the bargaining table. It does not reflect our commitment to reaching an agreement that ensures we can continue to provide market-competitive pay and outstanding benefits.

We urge our employees to reject any call for a strike and continue to focus on providing care and service to the patients who need them. We take any threat to disrupt care for our members seriously and have plans to ensure continued access to health care by our members, patients, and the communities we serve, should any union call for a strike. Our members, patients, and our communities need us to be there for them.

Allegations of Unfair Labor Practices

From the start, we have bargained in good faith to come to an agreement, working diligently in partnership to address the many complex issues at the table. This week, over the course of our sixth formal negotiation session since national bargaining began in April, we offered proposals on important issues including improvements to the performance sharing bonus plan (PSP) and an enterprise-wide guaranteed minimum wage for our Coalition-represented employees. In addition, committees met on staffing, operational savings, and local bargaining agreements.

As always, one of the key issues in this bargaining involves compensation and Kaiser Permanente has made clear we are standing by our proven commitment to provide market-competitive wages and excellent benefits. In fact, as a leading employer, our philosophy is to pay our employees above the local market, to attract and retain the best employees.

Bargaining is dynamic and involves give-and-take. Accusations from union leaders that Kaiser Permanente has not bargained in good faith are unfounded and counterproductive.

We take bargaining seriously and believe that our employees deserve market competitive wages and excellent benefits. We are hopeful union leaders will set aside the counterproductive tactics of this week, so we can focus on working together to deliver an agreement. We remain committed to bargaining with our Coalition unions in good faith and in the spirit of partnership. We will focus our energy on frank and productive discussions that lead to an agreement, and to doing our part to ensure there are no disruptions to the high-quality care we provide.

Staffing

We, like all health care organizations, have experienced staffing challenges driven by the pandemic and its lasting effects. For healthcare systems this has been made worse by the backlog in care and the increase in needs and acuity we’re seeing across the country.

While Kaiser Permanente has experienced the same pressures, through diligent work and an unwavering commitment to our people, we have weathered these staffing challenges better than most health care organizations. Kaiser Permanente’s average employee turnover rate of 8.5 percent, as of June 2023, is significantly lower than the rate of 21.4 percent across health care. Talented people who recognize the value of our current wage and benefit offerings want to work at Kaiser Permanente, which is why about 96 percent of candidates for Coalition-represented positions accept our employment offers—significantly above the industry average.

Kaiser Permanente and the Coalition have agreed to work together to accelerate hiring, and we set a joint goal in bargaining of hiring 10,000 new people for Coalition-represented jobs in 2023. Kaiser Permanente’s efforts to date have resulted in more than 6,500 positions filled, and we are aggressively recruiting to fill more.

Our staffing approach reflects our shared commitment to ensure every Kaiser Permanente patient receives extraordinary care, every time and in every place.

Wages and Benefits

We are leaders in employee wages and benefits, and we have reiterated our commitment in bargaining to continuing to provide market-competitive wages and outstanding benefits. In fact, our philosophy is to deliver compensation that provides wages above the local market (up to 10 percent above market) to attract and retain the best employees.

Kaiser Permanente also offers employees opportunities to learn new skills and grow their careers, and we’re committed to providing a safe and equitable work environment. In addition, we want to ensure that we help our employees build long-term economic security with low-cost health insurance, industry-leading retirement plans, and other benefit programs to support their health and well-being.

It’s also worth remembering that during the pandemic, we took extraordinary steps to support and protect our workforce, and to support their mental as well as physical health. We provided $800 million in employee assistance to ensure that front-line employees had access to alternate housing options, special child care grants, and additional paid leave for COVID-19 illness and exposure.

The unions’ current negotiating position is that wage increases should not be market-based. This prevents us from addressing wage disparities that exist in in many of Kaiser Permanente’s markets where, for some jobs, wages are significantly higher than our targeted wage level, and in other cases our employees’ wages are below other competitors in the market, impacting our ability to attract and retain the best people.

While being a best-in-class employer is a fundamental part of who we are, we cannot continue a national approach for determining wages and ignore local market conditions. We also have a responsibility to make health care more affordable for our patients, members, and customers, including government agencies. For many families and businesses, health care costs are increasingly unaffordable, and growing. Wages and benefits make up about half the cost of health care, across the country. We must work together with unions on the critical goal of ensuring that health care remains affordable.

We are committed to our philosophy of providing market-competitive pay and excellent benefits, and we’ve made that clear in bargaining. We are committed to addressing areas where staffing is challenging, and we are making great progress. And we are committed to doing all this while striving to help health care be more affordable.

85,000 Kaiser Permanente healthcare workers to hold strike authorization vote Monday over what they claim are unfair labor practices, say chronic under-staffing is driving a growing patient care crisis

By Renée Saldaña, Press Secretary, SEUI – United Healthcare Workers West

A strike may be looming at one of the nation’s largest employers.

On Monday August 28, Kaiser workers in California, including Antioch, will start to vote to authorize a strike over unfair labor practices. The voting ends September 12th.   The unions will strike dates soon after we get the results of the vote. The contract expires for a large bulk of the Kaiser workers in the coalition (58,000) on September 30th, so a strike could potentially start as early as October 1.

We are expecting a majority of the workers to vote in favor of a strike. We will keep you posted on any other developments.

On Thursday, August 24, healthcare workers employed by Kaiser Permanente announced details of a potential strike authorization vote at a hybrid in-person and virtual press conference.

Following the UPS labor settlement with the Teamsters, the labor negotiations covering 85,000 Kaiser healthcare workers – represented by the Coalition of Kaiser Permanente Unions – have now become the largest single-employer labor negotiations occurring in the United States. The Coalition unites healthcare workers at Kaiser Permanente facilities in California, Colorado, Oregon, the District of Columbia, Hawaii, Maryland, Virginia, and Washington.

At issue, healthcare workers say, are a series of unfair labor practices related to contract bargaining, along with simmering staff concerns related to unsafe staffing levels that can lead to dangerously long wait times, mistaken diagnosis, and neglect.

If Kaiser executives don’t take swift action to rectify the unfair labor practices that detailed at the press conference, workers say they’ll have no choice but to strike. Workers also say the company needs to immediately and substantively address the growing care crisis at its hospitals and clinics.

Barring a breakthrough in the ongoing negotiations including a resolution of the unfair labor practices in question, the healthcare workers announced the strike authorization vote date and plans.

“Kaiser cannot keep bargaining in bad faith and committing unfair labor practices. Kaiser is facing chronic under-staffing because workers can’t afford to live in LA on the low wages they pay us,” said Miriam de la Paz, a unit secretary at Kaiser Permanente in Downey, California. “If Kaiser’s millionaire executives won’t work with us on a plan to hire more people so we can give every patient the attention they deserve, we’re prepared to vote for an unfair labor practice strike.”

“We want Kaiser to stop committing unfair labor practices, and bargain in good faith. It’s heartbreaking to see our patients suffer from long wait times for the care they need, all because Kaiser won’t put patient and worker safety first,” said Paula Coleman, a clinical laboratory assistant at Kaiser Permanente in Englewood, Colorado. “We will have no choice but to vote to strike if Kaiser won’t let us give patients the quality care they deserve.”

“Our patients expect more from a healthcare system that reported $3 billion in profits in the first half of this year alone, and so do we,” said Nahid Bokaee, a Pharmacist in Sterling, Virginia. “Kaiser can afford to end this dangerous understaffing, but they choose not to. For the sake of our patients and our colleagues, we’re prepared to authorize a strike because Kaiser cannot keep bargaining in bad faith and committing unfair labor practices.”

BACKGROUND

The Kaiser healthcare workers are members of the Coalition of Kaiser Permanente Unions, which represents more than 85,000 healthcare workers in seven states and the District of Columbia. In April, the Coalition began its national bargaining process. The Coalition and Kaiser Permanente last negotiated a contract in 2019, before healthcare workers found themselves on the frontlines of the COVID pandemic that has worsened working conditions and exacerbated a healthcare staffing crisis.

Tensions have been rising as the workers’ contract expiration looms. Earlier this month tens of thousands of healthcare workers picketed Kaiser hospitals across the U.S. to protest the company’s growing care crisis.

Workers say that Kaiser is committing unfair labor practices and also that under-staffing is boosting Kaiser’s profits but hurting patients. In a recent survey of 33,000 employees, two-thirds of workers said they’d seen care delayed or denied due to short staffing. After three years of the COVID pandemic and chronic understaffing, healthcare workers at Kaiser Permanente are calling on management to provide safe staffing levels.

Even as some frontline healthcare heroes live in their cars and patients wait longer for care, Kaiser released new financials this month indicating they made ​​$3 billion in profit in just the first six months of this year. Despite being a non-profit organization – which means it pays no income taxes on its earnings and extremely limited property taxes – Kaiser has reported more than $24 billion in profit over the last five years. Kaiser’s CEO was compensated more than $16 million in 2021, and forty-nine executives at Kaiser are compensated more than $1 million annually. Kaiser Permanente has investments of $113 billion in the US and abroad, including in fossil fuels, casinos, for-profit prisons, alcohol companies, military weapons and more.

“Strabismus” could affect as many as 30,000 people in Contra Costa and is correctable

“I look at the picture and go ‘wow’! I just feel good.” – patient Kyle Emard

“It’s an out-patient surgery. You go home the same day.” – Dr. Daniel Greninger

By Allen D. Payton

After living with being both cross-eyed and deaf for most of his life, 49-year-old Kyle Emard can now see straight thanks to the talent and skills of Kaiser Permanente ophthalmologist, Dr. Daniel Greninger whose office is in Antioch. He corrected Emard’s vision impairment known as strabismus.

“After I was born my eyes would look straight ahead. But when I was five, my eyes started to go inward,” Emard shared through a sign language interpreter. “My mom asked me if I wanted surgery. I said, ‘no, no’.”

And he never did have the corrective surgery, until last year.

“I never had any bullying,” Emard said. “I was playing football, wrestling and traveling all over the country. My grandfather had a travel agency. It didn’t bother me. People would ask me what was wrong with my eye. They thought I was blind in one eye. During conversations people would look past me, not sure which eye to look at. I’d think, ‘they’re not looking at me’. I’d say, ‘I’m looking at you’.”

“I graduated from high school. I got ready for college. Then I bought a house,” he continued. “My mom asked me, again if I wanted surgery, and I told her ‘no’.”

“Strabismus describes eye misalignment problems,” Greninger explained. “In Kyle’s case this is most likely attributed to accommodative esotropia. That’s a condition where a person’s eyes turn in excessively due to them trying to focus. Kyle is far sighted.”

“This is very common for eye misalignment problems,” the doctor added. “People have a hard time looking at those with strabismus.”

“Sometimes it would be a serious discussion and people would say, ‘look at me’, And I was,” Emard shared. “It was annoying.”

“For some people it’s more than annoying,” Greninger interjected. “For people with strabismus it’s a quality-of-life impact issue.”

“What is particularly unique for me from the doctor’s side of it is Kyle also has hearing impairment. He has to communicate visually,” he continued. “Sometimes people with strabismus and hearing impairment have double vision. Sometimes depth perception is affected.”

Emard began wearing his first pair of glasses when he was five years old. But his vision progressively worsened, through the years.

“Kyle mainly looked out of one eye,” the doctor shared. “But surgery was done on both eyes. More on the right eye than the left.”

“For people with hearing impairment it’s called Usher Syndrome in which people have both hearing and vision impairment,” Greninger continued. “People assumed Kyle had that. Usher syndrome is a completely different genetic condition in which patients often have very significant hearing and vision deficits and are often functionally blind.  In Kyle’s case, I think people knew he was deaf, and then saw his eye drifting and assumedthat he also couldn’t see due to Usher syndrome, which would be incorrect.”

“People assumed I was blind in one eye,” Emard shared.

Asked if it was difficult to read a book, watch TV or go to the movies, he said, “No.”

“His sight was fine. He could see 20/20 but he was only looking out of one eye,” the doctor replied. “If you have strabismus as a child, often the brain learns to ignore one eye to avoid seeing double.  In adults, acquired strabismus can often result in double vision. Kyle’s problem, accommodative esotropia, typically develops between 2-6 years of age, and is related to hyperopia, or far-sightedness.”

Emard said he continued to wear glasses, then mainly contacts in high school. He went snow skiing, snowboarding and dirt biking.

“I wouldn’t go up high places, just small hills,” he shared. “I played roller blade hockey, defensive end in football. That was all before.”

A graduate of Leigh High School in San Jose, Emard attended Gallaudet University in Washington, DC.

“It’s one of the best known colleges for the deaf. All the instruction is in ASL (American Sign Language),” Greninger added.

“It’s a muscle issue. There are six muscles that are attached to the eye that move it in different directions. Up and down, left and right, and torsion that twists the eye,” he explained. “In strabismus, sometimes it’s a disease of the eye muscles. More commonly it’s the brain not telling the eye to do something. Our brains are usually hardwired to know how much to turn to focus.”

The Surgery

Asked when he decided to have the surgery Emard responded, “After my mom passed away three years ago. My family had money. Everything I was doing was done for the deaf organization. I felt it was the right time.”

The surgery took place last September.

“I met Kyle in 2022 after I had received a referral from one of my colleagues, a consult request. We set up a video chat with an interpreter,” Greninger shared. “We do video consults, first. For this condition it’s important for me to know the history of the condition.”

“We had that first video visit. We used some remote tools which allowed Kyle to take photos and videos at home,” the doctor continued. “We were able to use the components of technology that we didn’t have five years ago. I then had him come in for a complete eye exam to make sure his eyes were healthy.”

Asked if the technology is better, Grenginer said, “It’s safer, now. It’s about an hour-and-a-half surgery.”

“I can’t go into the brain and turn a screw a quarter inch to change how the brain controls the eye,” he explained. “So, we put in an eyelid speculum, we make a small incision over the eye and we find where the eye muscle is. It’s red and very small. We put in a small suture, like a stitch where the muscles connect to the white of the eye. Then I detach the muscle with surgical scissors and move it to a new position. If we move it back that creates some slack and decreases the force on the eye for turning.”

“I wear special surgical loops to help me see. But it’s all done with hands no lasers,” the doctor stated. “The amount we move the muscles is determined by the measurements we take in the office. Deciding which muscles to move and in which pattern based on the person’s problem are the intellectual work of my specialty.”

“I don’t want to over-compensate or under do it,” he continued. “It’s done in millimeter precision. We’re measuring the half-millimeter. Each millimeter moves the eye three degrees.”

“I knew I was nervous out of fear of losing my eye,” Emard shared.

“Each time I saw you I was more comfortable,” he said to the doctor.

“I don’t remember the surgery. When I woke up, I thought, ‘I’m ready’. But I looked and was shocked,” Emard exclaimed.

“It’s general anesthesia surgery so you’re asleep the whole time,” Greninger said. “We were able to get a sign language interpreter to be there in Walnut Creek the whole day, which I think is very important to give people the same level of care. I was really happy the leadership and nursing staff were able to provide that.”

“We had to move three muscles on Kyle’s eyes. One muscle on his left eye and two muscles on his right eye,” the doctor explained. “First, we relaxed the muscle on the left eye. Then on the right eye we tightened the outside muscle and relaxed the inside muscle.”

“I remember the right eye was much more red than the left,” Emard explained. “After surgery I did have double vision for a little while but then it went away. I had full vision. I could see all the way around. It was strange.”

“After the surgery I felt the same,” he added.

He used eye drops for a few a days, “but the redness lasted a few weeks,” Emard shared.

Asked how long the recovery time is Greninger said, “About six to eight weeks. I usually tell patients in two months’ time people won’t be able to tell they had the surgery. Kyle came back to see me about six months later to see if everything was fine, about March of this year.”

“Sometimes I forgot. ‘Did I have surgery?” Emard stated. “I posted and let everyone know on Facebook and showed the before and after photos and got almost a thousand likes. After my surgery I cried a lot because my mom wasn’t around to see it. But she’s happy, now.”

Emard lives in Livermore, works in Fremont as a middle school counselor and has one child, a 15-year-old son.

Asked what his son thought Emard said, “He said ‘wow!’ He was shocked. He just kept looking around my eye, opening my eye. He was used to looking at me inward.”

“On the day of my surgery my son was at school, and he was all worried. He said my dad’s fine and the teacher said, ‘good’. The week after he had a football game and my friend drove me. I sat alone by the goal post. I told people I didn’t want to talk yet I’m still healing. But I had to be there.”

Asked if it has impacted his job Emard said, “It’s about the same” then spoke of the difference between the school pictures from last year compared to this year.

Asked if he feels different about himself, he said, “Oh, yes. I look at the picture and go ‘wow’! I just feel good.”

“After surgery my friends were gathering and said they missed my lazy eye,” Emard said with a laugh. “I’m happy every day.”

Asked if people who have the surgery get counseling after, Dr. Greninger said, “The psycho-social impact of strabismus has been well studied.  Characters in movies with strabismus often are portrayed with other disabilities, and people may wrongly assume that all people with eye misalignment have other intellectual handicaps.  Studies have shown that childhood strabismus can negatively impact a teacher’s perception of a student’s motivation or focus.  In addition, strabismus in adulthood can sometimes be a barrier to success in the workplace or finding a romantic partner.”

“Even the term lazy eye – we don’t use that term,” he continued. “Some people despite having strabismus they use the term lazy eye. It has a certain connotation to it. We think if it as a negative There’s a misunderstanding of people with strabismus.”

30,000 County Residents Have Correctable Vision Impairment

With offices at Kaiser Permanente Antioch Medical Center on Deer Valley Road, Dr. Greninger grew up in San Ramon, graduated from Cal High and earned his undergrad at Dartmouth College. He did his residency at UCSF Medical Center in Ophthalmology followed by a Fellowship in Pediatric Ophthalmology and Adult Strabismus at Oregon Health Science University in Portland.

“I started at the Antioch Medical Center in 2013. It’s been about 10 years of offering the surgery in Contra Costa County,” the doctor shared. “About half of my practice is adult strabismus and about half are children. We do about 100 to 150 surgeries like this each year.”

“We estimate we have about 15,000 with eye misalignment problems in our service area,” Greninger stated. “Sometimes people can have a medical problem like a stroke, thyroid eye disease, a neurological condition or facial trauma from an accident or assault. They can cause eye alignment problems. Probably half my adult patients had it as children and it either came back or it was never dealt with.”

He also estimates there are as many as 30,000 people in Contra Costa County suffering from strabismus which is correctable.

“Many people have this and don’t know something can be done or has been on the back burner for a long time,” Greninger stated. “Sharing stories like Kyle’s is good to let people know something can be done. I have patients come to me and say, ‘I wish I had come to you earlier’.”

“I try to put myself in the patient’s shoes to see how they’re thinking. It’s a leap of faith for a patient. It takes a lot of bravery to trust a doctor with your eyesight,” he said.

“It’s an out-patient surgery. You go home the same day. Most of the eye surgeries are done in Walnut Creek,” Greninger added.