For years, workers at Keck Medicine of USC watched as wages and benefits at other top Los Angeles health systems crept ahead of what they were receiving. The workers in the various health systems were dealing with the same external factors, like skyrocketing L.A.-area rents, staffing shortages and inflation. But USC’s employees were falling behind.
“When I first started at USC, for me personally, it was a good environment,” said Elaine Williams, a patient care technician (PCT) at Keck Hospital for four years. “There was still a shortage of nurses and PCTs and such, but we made it work. Since then, though, it’s gotten worse.”
UCLA Health, Kaiser Permanente and other large systems have responded to staff shortages and inflation the past few years by improving wages and benefits, in some cases dramatically. But Keck-USC is going the other way in current negotiations, union officials say, in part by including wage freezes as part of their proposals. University officials roundly dispute that characterization.
The university is also proposing measures that would limit union activity on campus and shift a significant portion of health care costs to employees. Further, USC wants the right to subcontract union workers’ jobs to an outside company if it sees fit, with no guarantee of job protection.
Weeks of negotiations have produced little movement. And as progress has at times stalled completely, the National Union of Healthcare Workers is once again staring down the barrel of a strike — the threat of which is virtually the only way it has secured previous agreements with USC. (Disclosure: The NUHW is a financial supporter of Capital & Main.)
“It’s something we are absolutely considering,” said Francisco Cendejas, the lead negotiator for NUHW on the USC contract. “This whole thing is shocking and unthinkable, frankly.”
The contracts for some 2,000 workers at Keck Hospital of USC and the USC Norris Cancer Hospital expired in April. Months later, the sides don’t even agree on the basics — especially on the subject of pay.
Cendejas said the university’s standing proposal amounts to a wage freeze for more than 60% of the union’s workers, who fill multiple job roles including respiratory therapists, X-ray technicians, certified nursing assistants, licensed vocational nurses and anesthesia techs.
At most unionized hospitals (including Keck in the past), workers get paid in relation to the amount of time they’ve held their job — “reward for length of service,” Cendejas said. In these labor talks, he said, USC is proposing that anyone whose service time would trigger wages beyond what the standard pay grid calls for would receive no raise, but rather a lump-sum payment.
“They’d get a bonus,” Cendejas said, “but then their actual ongoing wage would be frozen. That’s not going to happen.”
In response to detailed questions from Capital & Main, a USC spokesperson provided a statement that said in part, “We are disappointed that the union has mischaracterized our initial economic proposal, which provides an increased compensation package for all caregivers.” It did not address the wage issue in detail.
The statement also emphasized that bargaining is ongoing. “We are ready and available to continue these discussions so that the parties may get closer to a new contract,” the university said, adding that it is trying to reach “a mutually acceptable agreement that provides market-competitive wage increases and other improvements that support our employees.”
A fact sheet distributed by the NUHW notes that USC Keck and Norris wages for its union workers are running anywhere from 9% to 19% behind the average in five key job classifications at UCLA, Kaiser and Providence Cedars-Sinai Tarzana, three other large-scale health-care employers in the area.
As USC’s wages have lagged, Elaine Williams said, its hospitals have struggled to hire and retain staff. “Where I work has 14 rooms, and at times I’ve worked as the only patient care technician there,” she said. “That’s one PCT for 14 patients, which is not good quality care. Understaffing is a real issue — PCTs were quitting because of the workload.”
Williams normally works three 12-hour shifts per week, but she said she has been picking up extra days lately to cover her increasing rent — and the shifts are available. “Some of my colleagues have looked for second jobs to survive,” she said. “It shouldn’t be that way.”
Organized labor has experienced a resurgence in Los Angeles and across California over the past two years. High profile victories by Hollywood writers and actors, along with hotel workers, teachers and others, have highlighted labor’s power to make significant gains during difficult times, and university workers are choosing to join unions in historic numbers.
USC, one of the largest private employers in the city of Los Angeles, has not been immune from that dynamic. The campus has been the site of multiple job actions and organizing drives, including by grad students, shuttle drivers and housing workers.
In its dealings with the NUHW, the university has pushed back on the union. The chief negotiator for USC in these talks, union officials say, comes from Morgan Lewis & Bockius, the same law firm that has been used by Amazon to hinder union organizing. The firm also represented USC management in its effort to deny that its football players were employees.
Tucked among USC’s proposals to the NUHW are two specific restrictions on union activity. The first, Cendejas said, would ban workers from meeting with their union representatives in the break room. The second would prevent workers from speaking publicly about USC’s patient-care or staffing issues, “like a gag order,” Cendejas said. (USC’s statement in reply to Capital & Main’s questions did not address these proposals.)
USC has also proposed modifying the HMO health care plan that has been a major selling point for many workers. In the past, it was an employer-paid plan; the university’s current proposal calls for workers to begin absorbing the cost of premium increases and for Keck to be able to modify the plan going forward.
A strike vote is looming, and several union members told Capital & Main that such strike authorizations have been needed in every negotiation it has had with the USC health system, which spans roughly 20 years.
Keck Medicine is a financial giant for USC, accounting for 41% of the university’s total revenue in 2023, according to the university’s consolidated financial statements for the years 2022 and 2023. Reporting by Pro Publica indicates that Keck posted 2023 revenue of nearly $2 billion.
“Keck Medicine is USC’s biggest revenue maker, but at the very earliest negotiation, they put major takeaways on the table that they’ve stuck to all along,” Cendejas said. “Our members are very ready to take that problem head on.” A year removed from California’s hot labor summer, it seems, the temperature is still rising.
