A campaign to organize low-wage workers at Los Angeles County nursing homes has begun to show results, with workers at eight homes voting to organize since November and four elections set for later this month.

The Service Employees International Union said that the membership of its county Local 399 which had consisted of 1,800 hospital and nursing home workers has added 700 more nursing home workers since its statewide campaign began six months ago, bringing the Local's membership to 2,500.

The union which already represents employees at 24 county nursing home, who have been slowly organized over the past 15 years is seeking to improve pay and working conditions, which it links directly to patient safety.

The campaign is especially targeting certified nursing assistants, or CNAs, who make up the bulk of nursing home workers and perform such chores as assisting residents with their feeding, dressing and hygiene.

"Nursing home employees work under terrible conditions," said Lisa Hubbard, an SEIU spokeswoman. "We believe that nursing home operators choose to pocket profits instead of improving staffing and working conditions."

A spokeswoman for a nursing home industry trade group said the union's accusations are wildly off base, contending that the core problem in the nursing home industry is a lack of money in the system.

"Greedy? Fourteen percent of the nursing homes in California are in bankruptcy right now," said Betsy Hite, director of public affairs for the California Association of Health Facilities. "The SEIU needs to recognize that this is a system in crisis."

Two-thirds of nursing home care in the state is paid for by Medi-Cal, with the state and federal government providing matching funding. The trade group estimates that California nursing homes receive only $110 per day per patient, 20 percent less than the national average.

Even so, the trade group contends that the average pay for a nursing home worker has risen to about $10 per hour, higher than the $7-per-hour union estimate.

Profit-skimming allegations

But while union officials agree that lack of government funding is an issue, they also contend that the state's flat-rate payment system allows unscrupulous owners and operators to skim profits that should go into wages and patient care thus making direct organizing a necessity to improve pay and conditions.

To bolster its argument, the union points to an audit conducted earlier this year by the state Department of Health Services that found that $1.6 million of $35 million appropriated by the state in the 1999-2000 fiscal year specifically for nursing home pay raises was not given to workers.

The nursing industry trade group has criticized the audit as being poorly done, contending that in fact $110 million was spent by nursing homes in an effort to be competitive in a tight labor market.

"It (the audit) was bogus," Hite said. "It's not to say that there were not facilities that did not pass through funding, but it is to say that for every facility that spent less than what they were supposed to, there were 10 that overspent."

Colin Wong, executive director of the state's Bureau of Medi-Cal Fraud and Elder Abuse, said he has no doubt that, whatever the cause, low wages for nursing home workers contributes to poor care.

"There is a direct connection between poor quality care in nursing and understaffing, and one of the underlying causes of understaffing is failure of nursing homes to pay adequate wages to attract workers," he said.

"Not too long ago the per-hour average pay for nursing home workers was less than $7 per hour. When fast-food chains are able to pay their workers a better wage than nursing homes can pay health care workers, there is a major problem."

Local organizer

Low pay prompted Juan Angeles to help organize his fellow workers at the Crescent Bay Convalescent Hospital in Santa Monica, where workers voted to join the union by 28-3 vote on Nov. 17.

Angeles, 40, said he is an "activity assistant," organizing various activities for the residents at the Santa Monica facility, where he has worked for the past three years.

Angeles said he makes $9.40 per hour, forcing him to live with his father and send his two children, ages 12 and 9, and wife back to Mexico. He also works a second job at another nursing home job on weekends that pays a little more, $11 an hour.

"We are standing up for a better situation in our lives," said Angeles. "At some point it has to start. I am not afraid."

Angeles said the workers' committee has already started negotiating with the nursing home's management, and is seeking a hourly wage of $12.50 for its CNAs. Administrators did not return phone calls for comment last week.

Hubbard said the union spent last summer and fall contacting workers at many of the county's 376 skilled nursing facilities, encouraging them to organize by holding elections under the National Labor Relations Act.

It also is requiring that a majority of workers sign cards seeking an election, rather than just the 30 percent required under federal law, because the approach has proven more effective at organizing.

As part of its campaign, the union is sponsoring legislation by Assembly Majority Leader Kevin Shelley, D-San Francisco, that would require the state's Department of Health Services to set minimum staffing ratios for nursing homes.

The bill would require CNA-to-patient staffing ratios of 1-to-5 in the day, 1-to-10 in the evening and 1-to-15 at night. It follows a succesful bill authored by Shelley last year requiring the department to conduct a study of nursing home staffing ratios.

Hite called the new bill "premature" given that the study is not even due out until this spring.

The SEIU, which represents 220,000 health care workers statewide, also is seeking staffing ratios for hospital nurses as part of a separate campaign on behalf of the 35,000 nurses it represents in California. The state is expected to issue them later this year.

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