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When Lab Assistant Cher Gonzalez talks, her manager and facility leaders listen. That's just one of the many benefits, she says, of working in the Labor Management Partnership at Kaiser Permanente. Watch this short piece to see a union worker's perspective of the LMP.
For the first five years after the Permanente Foundation Health Plan opened to the public, there were no separate regions. Three hospitals—two in Northern California and one at the Fontana steel mill in Southern California—served the new members.
The Oakland hospital opened on Aug. 21, 1942, and the Richmond hospital opened nine days later. Once the plan went public, the International Longshoremen and Warehousemen’s Union and other unions were prominent among the early member groups. Oakland city employees, union typographers, street car drivers and carpenters also embraced the plan. In 1953, state-of-the-art hospitals opened in San Francisco and Walnut Creek, as well as Los Angeles. Today, three union locals in Northern California belong to the Coalition of Kaiser Permanente Unions: SEIU-UHW (28,800 members), OPEIU Local 29 (2,400 members) and IFPTE Local 20 (1,300 members).
Harry Bridges, the ILWU president, wanted a hospital in the San Pedro area in 1949, and it was his promise of a large and stable membership that convinced health plan leaders to expand. He proved as good as his word, and KP became the sole supplier of medical care to ILWU’s 6,000 West Coast members. The Southern California Permanente Group was established in 1950. In 1951, the 15,000 members of the Retail Clerks Union Local 770 in Los Angeles, at the time the largest local in the country, joined the plan. Today, there are 13 coalition locals in Southern California: SEIU-UHW (18,000 members); UNAC/UHCP (16,000); United Steelworkers Local 7600 (6,000); OPEIU Local 30 (4,000); UFCW locals 770 (a descendant of the clerks union), 324, 135, 1428, 1442 and 1167 (3,860 total); Teamsters Local 166 (500); KPNAA (350); and SEIU Local 121RN (200).
Health plan enrollment opened to the community in 1947 with the opening of an outpatient facility across the Columbia River from the closed Kaiser shipyards. It became a region in 1951 and has been at the forefront of several innovative practices. In 1964, it launched the Center for Health Research to advance evidence-based medicine. In 1974, it became the only KP region to provide prepaid dental services. In 1991, the Northwest started Kaiser-on-the-Job, a workers’ compensation program that has since spread to all regions. Coalition locals in the Northwest are: OFNHP/ONA (3,400), SEIU Local 49 (3,900), UFCW Local 555 (900) and ILWU Local 28 (65).
Hawaii opened in 1958—before the territory became a state—with strong support from the building and construction trades, which benefited strongly from Henry Kaiser’s hotel and housing projects. It was the last region to join the partnership, in 2009. The Hawaii Nurses Association, OPEIU Local 50 (800 members), belongs to the coalition.
The Ohio region was the first organizational expansion of the health plan outside the western United States. The Community Health Foundation in Cleveland—which had been established by the Meatcutters and Retail Store Employees Union and had a structure similar to KP’s—merged with Kaiser Permanente in 1969 to form the Kaiser Community Health Foundation. The region left KP in 2013.
Colorado also joined Kaiser Permanente in 1969, after requests from a group of labor, medical, university and government leaders. The United Mine Workers had regional headquarters in Denver, and Kaiser Permanente had longstanding relations with UMW through the Kabat Kaiser Institute in Vallejo, later known as the Kaiser Foundation Rehabilitation Center, where injured miners were treated. Today, SEIU Local 105 (3,500 members), UFCW Local 7 (1,800) and IUOE Local 1 (23) belong to the union coalition.
In 1980, KP acquired the failing Georgetown Community Health Plan and, through the use of existing community hospitals, began to operate profitably within two years. Kaiser Permanente believed locating in the Washington, D.C., area would provide high visibility regarding health care legislation. The effort was successful: In 1992, Jim Doherty, president of the Group Health Association of America, the professional organization for HMOs, remarked that the move “did more for the HMO movement than any single act since the HMO Act of 1973.” In 1984, the region opened its first pharmacy and changed its name to Kaiser Foundation Health Plan of the Mid-Atlantic States. In 1996, it acquired Humana Group Health Inc., one of the country’s oldest HMOs. OPEIU Local 2 (3,800 members) and UFCW locals 400 and 27 (1,600 total) belong to the coalition.
The Georgia region opened in 1985. Its first medical director was Harper Gaston, MD,
a Northern California physician and Georgia native who was proud to return home and serve the initial 265 members. In 1988, the region experienced dramatic growth when the state of Georgia came aboard as a major account and Kaiser Permanente acquired the financially ailing Maxicare Georgia HMO; within a year, the region celebrated its 100,000th member milestone. UFCW Local 1996 (1,800 members) is part of the Coalition of Kaiser Permanente Unions.
Visit Kaiser Permanente's 70th anniversary mini-site.
Format:
PDF
Size:
8.5” x 11”
Intended audience:
Frontline employees, managers and physicians
Best used:
Post on bulletin boards, in break rooms and other staff areas to share with your team members how a Genetics UBT reaches more patients with smoking cessation info.
Format:
PDF
Size:
8.5” x 11”
Intended audience:
Frontline employees, managers and physicians
Best used:
Post this card highlighting a UBT that cut annual storage, transportation and destruction fees on bulletin boards and in break rooms. Share to encourage discussion on efficiency.
Format: Printed posters and pocket-sized cards on glossy card stock
Size: Three 8.5” x 11” posters and three 4" x 6" cards
Intended audience: Frontline staff, managers and physicians
Best used: On bulletin boards in break rooms and other staff areas, and at UBT meetings for team discussion and brainstorming
Description: This packet contain useful materials for UBTs, such as:
Minimum order: 1
The bustling front office of Northern California’s regional Claims Administration department moves a lot of paper.
Based in Oakland, they’re responsible for sorting and scanning paper claims into digital format, storing the paper forms in boxes for the required 30 days, and then destroying them.
The team members call themselves “The Frontliners.”
But the cardboard storage boxes that hold all of that paper could only be used once. The department’s unit-based team wanted to make the job less wasteful.
So, a couple of team members suggested switching to reusable plastic bins and the idea immediately energized the UBT.
They jumped in with a plan to research and test different models of plastic storage containers. They chose an industrial-strength model sold by a KP-approved vendor, which brought the price down. The plastic bins, which have lids that securely snap shut, also eliminated the cost of packing tape and labels that had been used on the cardboard boxes.
The department rolled out the bins in September 2013 and in a year they figured a savings of $1,100.
Given the distributor was a KP vendor, the team was able to cut their purchase price by 30 cents. And since the team won’t need to replace the bins every year, their savings were expected to reach $3,500, which includes hiring an outside firm to come onsite to destroy old paper claims instead of transporting them elsewhere.
Management and union representatives agree the team effort made it a success.
“My motto is, teamwork is dream work,” says union rep and support lead Arnetta Williams. “We’re a really close team. It’s a partnership. Without this, you can’t accomplish anything.”
The new approach required thinking through changes in staff schedules and workflow, as well as ensuring that the changed procedures complied with all relevant regulations.
And the Frontliners’ UBT initiative was selected as a finalist in Kaiser Permanente’s 2014 MSSA (Marketing, Sales, Service and Administration) Innovates Program, a competition to encourage new ideas and efficiency.
Judy Cummings, a statewide manager with Claims Operations and Encounters, likened her role to that of a coach instead of a boss.
“The team is doing the work. They’re the ones out there who know what to do and how to do it,” she says. “I try to support them in being successful.”
Format: Printed posters and pocket-sized cards on glossy card stock
Size: Three 8.5” x 11” posters and three 4" x 6" cards
Intended audience: Frontline staff, managers and physicians
Best used: On bulletin boards in break rooms and other staff areas, and at UBT meetings for team discussion and brainstorming
Description: The January/February 2015 packet contains these useful materials for UBTs:
Minimum order: 1
When I was asked to represent The Permanente Medical Group at 2012 bargaining, I leapt at the opportunity. My own experience with partnership at Fresno Medical Center showed me what great things could be accomplished with collective problem solving.
I sat on the subgroup that looked at how to improve partnership to enhance performance and Kaiser Permanente’s operational agility. I was amazed at seeing so many people with different backgrounds sharing their thoughts and shaping the outcomes. From the highest levels of Kaiser Permanente and union leadership to the front line, everybody was around the table, and they were all equal in this venue. Everyone was heard and engaged.
I personally learned a lot from the different perspectives voiced by all of the individuals representing their fields. I strongly believe that collective wisdom is better than individual wisdom, and that with collective wisdom you can achieve anything in life. Interest-based bargaining, which assembles voices from all levels and reaches of Kaiser Permanente, is a great example of collective wisdom.
Another thing that struck me—how much folks craved the physician perspective. When I spoke, all 25 to 30 people in that subgroup really listened. And there were issues where a physician perspective was critical. That was a strong message I brought back to physicians. In most unit-based teams at Fresno, there is physician involvement. The intention is to bring those perspectives together to enhance the care for our members and patients. But does that mean if I walk into a UBT meeting I’ll see a doctor? Maybe yes, maybe no.
I’ve worked at Kaiser Permanente for 34 years, and I saw the pre-partnership years. They were contentious ones. We’ve had relative peace with coalition unions since partnership. That’s not to say that working in partnership is perfect in every way. It can’t be done without trusting each other. And how do you develop trust? Through transparency. The whole bargaining process was about transparency; essentially, everybody could share everything. That doesn’t mean people didn’t disagree.
The interest-based, collective approach takes into account everyone’s perspectives to reach a better outcome, which is ultimately a common goal—superior care for our members and patients.
Format:
PDF
Size:
8.5” x 11”
Intended audience:
Frontline employees, managers and physicians
Best used:
Inspire your team to discover new ways to deliver quality care to patients by reviewing this Northern California team's successful efforts to get more new moms breastfeeding their babies.
