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Nurses want union at Portland psychiatric center where state found mismanagement, low staffing

PMG FILE PHOTO - The Unity Center for Behavioral Health in Northeast Portland.

Legacy Health is throwing up obstacles to an effort to unionize nurses at the troubled Legacy Health-run regional mental health crisis center in Northeast Portland.

On May 13, nurses working with the Oregon Nursing Association gave management a petition calling for a union bearing the signatures of most of the 195 nurses who work at the Unity Center for Behavioral Health.

Legacy, however, challenged the petition to the National Labor Relations Board, which concluded a three-day hearing on Thursday, May 23, in downtown Portland.

In the hearing, a lawyer for Legacy, Jackie Damm of Ogletree Eakins, contended that Unity Center is not a stand-alone facility, meaning the 170 nurses' signatures gathered so far are not enough to trigger an election and give the union full access to employees to make its case.

Lawyer Tom Doyle of Bennett Hartman, meanwhile, cited Unity documents calling the site a stand-alone facility while cross-examining Legacy executives. "So references to Unity being a hospital, those would be inaccurate in Legacy's own documents?" he asked at one point.

The clash over the Unity union drive is just the latest evidence of strife there. Nurses say management has not listened as they've tried to address problems since Unity opened. The center has since been repeatedly dinged by the state regulators for poor management, insufficient staffing and unsafe conditions for employees and patients — conditions that investigators last year concluded led to two patient deaths.

Sarah Mittleman, a psychiatric emergency nurse for Unity who attended the NLRB hearing May 23, said she isn't surprised by Legacy's lack of cooperation with the nurses' wishes.

"They don't seem to value our opinion as nurses," she said. "So why would that be any different when we organize?"

Legacy defends its decision to challenge the union petition and denies trying to block the union.

"Unity Center operates under Legacy Emanuel Medical Center's license and is considered a specialty unit of Emanuel Hospital," said a statement relayed by a Unity spokeswoman. "We are pro-employee and this election is about retaining our ability to collaborate directly with our staff. We support our employees' right to make a choice on this matter and we are committed to ensuring it is an informed choice."

Felisa Hagins, the political director of SEIU Local 49, the union representing behavioral health specialists at Unity, doesn't buy it.

"This is a typical anti-union tactic," Hagins said of Legacy's maneuver. "This is just them being obstinate. What they really should be doing is sitting down with ONA and us and figuring out a partnership of how we can improve care at the Unity Center ... These nurses should have the right to come together."

Though Legacy management operates the center, it has only a 40% stake in the center's financial operations, while three other hospital systems each have a 20% stake, according to testimony at the NLRB.

Troubled history

Unity Center opened in Northeast Portland in January 2017 as a 24-hour emergency room providing mental health crisis services for adults and adolescents, with about 450 employees.

It received funding from the state, Multnomah County, donors and the support of three other health systems — Adventist Health, Kaiser Permanente and Oregon Health & Science University — who are partners in Unity Center. For the participating health systems, it was an opportunity to shift the burden of homeless mentally ill people, often in crisis, out of their emergency rooms. So they transferred their psychiatric nurses to Unity, where they became Legacy employees.

While the center was billed as a major advance in mental health care, critics and investigators soon found that in some ways it was a step backward. In April 2018 a state OSHA investigation found about 300 assaults and at least 23 injuries to employees over the first seven months of the center's operation. Investigators found a culture in which management didn't know how often employees were assaulted, and staffers were too afraid of retaliation to say anything.

That was followed by an investigation by the Oregon Health Authority — based on an employee's complaint that the center was a "hell hole" — which confirmed hazardous conditions for patient safety.

Legacy says it has fully addressed the unsafe conditions found by state investigators. Nurses who work at Unity say they aren't so sure.

If Legacy succeeds in its arguments to the NLRB, the union drive would need to win the support of hundreds more nurses, including those at nearby Legacy Emanuel Medical Center, Randall Children's Hospital, the Legacy Oregon Burn center and other locations — a pool of 1,659 nurses in all.

Full Legacy statement:

We have just received a copy of the Oregon Nurses Association petition and are reviewing it. Legacy is 100% committed to open, respectful and productive relationships with our employees, regardless of whether they are represented by a union or not. By working together with our employees we can understand and respond to their concerns, and benefit from their participation, knowledge and ideas to provide outstanding patient care each and every day. Legacy chooses to be pro-employee and we focus our energy on creating the best workplace we can.

We continue to deliver on the plan of correction and remain focused on the environment of care, the safety of our staff and patients, and our procedures and practices.

All inpatient units are open and functioning. Unit 1E reopened on February 5, 2019 and is currently at 78% capacity.

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