Nurses and and other workers in the Providence hospital system are protesting proposed changes to their benefits plan, which union negotiators say serve the financial interests of the nonprofit health care provider.

In response, Providence has defended the changes and said the nonprofit offers benefit packages that are some of “the most competitive in the state across all industries.”

Contract negotiations between unionized employees and Providence Health & Services representatives have spanned about nine months. Last week, the Washington State Nurses Association and UFCW 21 union negotiators had their first mediated sessions with Providence.

UFCW 21 represents 1,600 service and maintenance staff at Holy Family Hospital and Sacred Heart Medical Center, which include nursing assistants, financial counselors, housekeepers, dieticians and others. WSNA represents about 1,900 registered nurses at Sacred Heart.

“There was very, very, very minimal movement,” said Austen Louden, a food service ambassador at Sacred Heart on the UFCW 21 negotiating team.

While nurses are negotiating multiple components of their contract, both unions are resisting proposed changes to paid time-off policies.

Clint Wallace has been a nurse at Providence hospitals for 20 years, working for the past 15 at Sacred Heart in the intensive care unit. He is on the WSNA negotiating team and said that, in past years, Providence changed its benefits in line with how health care providers nationwide were changing. This time, however, he says it’s different.

Providence has posted a public, detailed statement online about the ongoing labor negotiations.

“We are seeking to modernize our benefits packages, which remain among the most competitive in the state across all industries,” the Providence statement reads in part. “Our goal through negotiations is to provide our caregivers with a comprehensive paid time-off plan that provides ample time off and cares for all caregivers, regardless of tenure.”

Providence has proposed to change its employees’ extended illness time benefit, eliminating a system that has been in place for years for employees who need to take extended sick leave to care of themselves or their family members, nurses and other health care workers said.

Patty Martin, a financial counselor and a member of the UFCW 21 negotiating team, has worked at Sacred Heart for 12 years. She has first-hand experience using the extended illness time benefit. She had to have emergency surgery on her gall bladder in 2012, which took her out of work for two weeks to recover.

“I’d been here five years, and I had only earned barely enough extended illness time,” she said. “Without that extended illness time, I wouldn’t have had enough PTO to keep me whole.”

These changes will impact long-time workers in the Providence system the most, negotiators agreed, because they have accrued hundreds to thousands of hours in extended illness time over the years. Providence notes that these changes address seniority.

“These changes help to support all caregivers regardless of seniority and better protect income gaps that may be experienced,” Providence’s online statement says.

Beyond eventually wiping out those accrued extended illness time hours, which can be used when an employee or their family member is sick, union negotiators say the new proposed short-term disability plan does not let an employee take care of a family member – only themselves.

“The bigger issue is that the short-term disability plan does not cover your spouse or your children,” said Stevie Lynne Krone, a supplemental nurse and negotiator at Sacred Heart. “A lot of people are single parents, so if their kid is sick and they have to take care of them, they would have to use PTO, if they had any.”

Providence has proposed a new plan that aligns with the state’s new paid medical leave plan, which is set to start in 2020. The state plan will pull from both employer and employee payroll tax.

“The state plan provides up to 12 weeks of partial income replacement for an illness or injury, or to care for a family member,” according to a statement provided by Providence spokesperson Beth Hegde. “Our caregivers can then use their PTO/sick time balances for 1-2 years (length of time still being negotiated) to supplement that state program, for 100 percent income replacement.”

So for the first one to two years, union members could access their extended illness time to make themselves whole financially (the state program only reimburses up to 65% of a person’s income, negotiators said), but once the program is gone, Providence is proposing to implement all-new plans.

The nursing contract negotiations include more than just compensation and paid time off, and nurses are asking for safe staffing in their negotiations. Staffing plans are set annually by a team of hospital leaders and nurses, but starting in January 2020, scheduling and staffing planners will also have to follow a new state law that mandates uninterrupted meal and rest breaks for certain health care employees in Washington.

The meal and rest-break law had been proposed and killed in the Legislature for about a decade but passed in the most recent session, largely due to the Democratic majority in the Senate. The Washington State Hospital Association opposed the legislation but negotiated the final version to include provisions that would help hospitals with its implementation.

“We are concerned with how hospitals will be compliant with this because it takes a one-size-fits-all approach,” Beth Zborowski, senior vice president of membership engagement and communications at the association, said. “We’re glad that the bill changed to allow for some of those patient care needs, but it does have some difficulties.”

The law will require hospitals to track employees’ breaks and whether or not they are taking them going forward, and the association is helping its members prepare to track those numbers. Some rural and smaller hospitals statewide have a couple years of lead time before they must comply with the new law. Ultimately, hospital association members felt like nurses were getting the breaks they needed, but the bill sponsors heard differently.

Spokane Democrat Rep. Marcus Riccelli, one of the bill’s sponsors, acknowledged that hospital administrators from Spokane weren’t happy about the measure because they felt like they were already complying with the rest and break requirements for their employees.

“My thing was there are bad actors out there that are not doing this, because I know firsthand that it’s not occurring, so what we want to do is not punishing (hospitals), if you’re already doing it,” he said.

The reality is that breaks and scheduling in the nursing world are commonly in flux. Wallace, who works in the intensive care unit at Sacred Heart, said he typically has care of two critically ill patients, but when he goes on break, he has to ask his buddy nurse to watch his patients, and vice versa.

“I feel for my buddy when I go on break, when they have to watch my patients, especially if my patients are actively being sick and need things being done,” Wallace said.

He said it is common for nurses to take their phones on break, so their colleagues can call them if they need help or have questions about patients.

Susan Stacey, a chief nursing officer at Sacred Heart, testified at the Legislature for WSHA about the rest and break law. She said the hospital already has a methodology in place when workers miss breaks.

“We do pay them overtime when they don’t get a break,” she said.

She said less than 5% of the time staff don’t get breaks, so the new law will impact the hospital in tracking the “why” behind those people not getting breaks.

Statewide, nationwide and locally, there is a nursing shortage, but on any given day, there could be an understaffing or overstaffing challenge.

“If I see that my patient needs something or are in-need, I’m not going on a break,” Wallace, the ICU nurse at Sacred Heart, said. “And if I see that I can slip out and take a 15-minute break, to lessen the load on my co-worker I will tell them to ‘call me if you need me.’ ”

WSNA has its next scheduled mediation on Aug. 28.

A multi-union rally of organizations that represent Providence workers around the state is scheduled for July 26 at Providence’s headquarters in Renton, Washington, and some local members from Spokane say they plan to attend the rally.

But Martin, the financial counselor who is on the UFCW 21’s bargaining unit, said she is not able to go to Renton. Three people on her team are out due to surgeries or sick family members and all of them using their extended illness time, Martin said.

“It was better to stay here and work,” she said.

An earlier version of this story misidentified the Washington State Hospital Association in an acronym.

Arielle Dreher's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.