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East Bay Health Care Workers Are Striking Against Austerity and for Public Control

Workers in Alameda County, California’s public health system say they have long struggled under austerity and mismanagement. They are currently on strike, demanding safe working and patient care conditions, and democratic accountability for a health system that should serve the needs of the public.

Health care worker in Alameda County. (Photo by Justin Sullivan / Getty Images)

On Wednesday, October 7, about three thousand nurses and other public health care workers in California’s Alameda County began a five-day strike. The strike affects eight public hospitals and clinics in the East Bay administered by the Alameda Health System (AHS).

The strike followed a breakdown in negotiations between AHS and Service Employees International Union Local 1021 after nine months of bargaining. The union’s members overwhelmingly support the strike: 98 percent of members at Highland, Alameda, and San Leandro Hospitals voted to walk out. The California Nurses Association, which also represents workers in AHS, reported that 99 percent of members at San Leandro Hospital and 100 percent at Alameda Hospital voted to strike.

Meagan Day reported on the horrifying austerity conditions in AHS earlier this year. Years of underfunding and negligence by management had left the system understaffed and underresourced before COVID-19. When the pandemic began, AHS workers said they suffered from extreme understaffing and shortages of personal protective equipment (PPE), hand sanitizer, and other necessary medical supplies.

Since then, workers have fought management to address working and patient care conditions that they say remain dangerous.

Striking Against Austerity and Retaliation

“Our demands are that management start providing some of the basic things that we’ve proposed, like clothing for homeless patients, so that they’re not leaving barefoot or in hospital socks without shoes; and providing air conditioning at Fairmont [another AHS hospital],” said John Pearson, an emergency room nurse at Highland Hospital.

Amanda Beeson, a physical therapist at Highland, described workers’ struggle to secure COVID-safe working conditions. “When the pandemic hit, we requested a proposal regarding COVID and hazard pay, and we never heard anything from management. Meanwhile, at our work sites, we’re fighting to get tested or fighting for contract tracing, because of exposures, and nothing’s really happened,” Beeson said. “We’ve had to file [California Occupational Safety and Health Administration] complaints to actually get our management to do something about the lack of COVID management.”

Workers also claim management retaliated against some employees who have demanded safe working conditions in the midst of the pandemic. Sheleka Carter, a community health outreach worker at Highland who formerly worked with the Sexual Assault Response and Recovery Team (SARRT), said that AHS laid off the SARRT workers because they had demanded work-from-home options.

“Our PPE started getting locked up at the beginning of the pandemic. Our coworkers expressed their concerns about coming in contact with a system that we know is very intimate, as a Sexual Assault Response and Recovery Team worker working in the ER,” Carter said.

“Usually, it’s about two providers, a law enforcement officer, and an advocate working with the patients. So in a pandemic, that’s a health concern, not only for the patient, but for ourselves and our families. We expressed that to management. They made excuses [and] still wouldn’t provide the PPE. As a result, one of our coworkers was exposed to a person under investigation [for COVID-19]. And he shares an office with me, he shares a close quarter office with our other coworkers. And he went out on quarantine, and so did all of the other sexual assault workers,” Carter said.

Afterward, SARRT workers demanded that they be able to work remotely using telehealth options, as many rape crisis centers were already doing. But management refused the demands — and later fired the workers. “We felt like we were blatantly retaliated against,” Carter said.

She hopes that the strike will send a message to AHS leadership that this behavior is unacceptable. “This strike has the ability to let the AHS leaders know that we are three thousand–plus members, with very similar fights, very similar concerns, very similar complaints. It’s not out of happenstance that all of your workers are having problems in a system. It’s not happenstance that seven campuses of workers have been coming out for two days now, in droves.”

Adrian Jackson, a respiratory therapist at Highland, said that the strike is about AHS patients as well as workers. “We know that we take care of the people in the county, and this contract is for the people in the county, it’s not just for us, this is to take care of everybody. It’s the people’s contract, at the end of the day.”

Jackson said, “The people that take care of people — why would you put them in a position where they can’t take care of themselves?”

For Public Control

Workers are also resisting management’s attempts to roll back previous contract victories. “We’re not ready to settle unless they can do that, because their takeaways don’t make any sense. And they’re things that people fought decades to get, that protect our patients, like nurse-to-patient ratios,” Pearson said. “We asked for a cost-of-living raise. We also asked for no layoffs for the term of the contract.”

But the strikers’ most politically significant demand is that Alameda County take AHS back under public control.

In 1998, AHS became formally independent of the county. It has since been governed by a board of trustees, appointed by the county board of supervisors. The health system’s independence from the county has led to major problems, Pearson explains: “The current arrangement is that the county does not directly fund AHS, except for a really tiny sales tax… What [the county does] now is loan money, because [AHS is] a separate entity from the county.”

This structure has meant that AHS has been in debt for almost its entire existence as an independent entity. As of 2018, it still owed over $64 million to Alameda County. This debt is part of the reason that AHS has so severely underfunded its hospitals and clinics.

In addition to allowing for better funding, taking the health care system back under public control would make it democratically accountable to the public.

“The people running [AHS] are not elected. And it’s been almost impossible for us or even the county to hold them accountable,” Pearson said. “We need the county to be directly in charge, because they’re accountable to voters.”

The strike already seems to be working. On Wednesday, October 8, the board of supervisors announced that they were dismissing the entire AHS Board of Trustees.

Carter is optimistic that this is the first step toward the county taking AHS back and toward the union winning its other demands. “That’s where it has to start. They need to settle our contract. They need to not do takeaways. They need to give people their jobs back, and make things right and make people whole again.”