Essential workers at Maui Memorial Medical Center are planning to walk off the job Monday morning if a new collective bargaining agreement has not been reached by that time.
Unless a new labor agreement is reached beforehand, a number of essential workers at Maui Memorial Medical Center in Wailuku, Kula Hospital and Lanai Community Hospital are planning a three-day strike beginning at 7 a.m. Monday and ending when they return to work Nov. 7.
Maui Memorial Medical Center, Kula Hospital and Lanai Community Hospital all operate under the Maui Health banner and are managed by Kaiser Permanente, which also runs other Kaiser-branded health care facilities on Maui.
Kaiser Permanente took over managing Maui Health from the state in 2017, according to union representatives, who say that change in management came with Kaiser promising to elevate care standards but those promises have not been kept. Maui Health workers are covered by separate contracts, which union representatives say has led Maui Health workers to earn lower wages and receive fewer benefits than their counterparts, while also facing higher patient-to-staff ratios.
Workers say this has led to lower standards of care and increased burnout in the Maui Health system, among other issues.
In a statement issued by Maui Health on Wednesday, representatives from the hospital say ongoing negotiations are underway and they believe an agreement can be hammered out prior to Monday’s walkout.
“We remain committed to continuing to bargain in good faith to reach a mutually beneficial agreement to avoid a strike,” the statement reads. “Our bargaining team is prepared and ready to engage in productive discussions at the remaining scheduled sessions, including on Oct. 31, Nov. 1, 2 and 3.”
Officials from the hospital said the Maui Health and United Nurses and Health Care Employees of Hawaii union bargaining teams have met 19 times in 14 weeks, and together they have reached more than 20 tentative agreements.
Representatives from the hospital added that Maui Memorial Medical Center is operated by Maui Health, a nonprofit organization that’s governed by a board of directors, which includes members of the Maui community. Maui Health is affiliated with Kaiser Permanente, but is a separate entity.
“While we are able to leverage efficiencies through the affiliation, Maui Memorial Medical Center operates independently as a community-based hospital,” according to the statement. “Maui Health is responsible for managing day-to-day operations for all our hospitals and clinics, including negotiations with unions, and contracts Kaiser Permanente for ‘back office support’ in areas such as technology and EMR, and supply chain/purchasing. As such, decisions regarding employee negotiations are handled by Maui Health.”
Hospital representatives say their goal is “to reach an agreement with UNHCEH/UNAC that “provides market-competitive compensation and benefits for our employees while ensuring we can continue to provide our community access to the high-quality health care they need and deserve. We take these discussions very seriously and are deeply invested in ensuring a positive outcome for our employees and community.”
According to the union representatives, the two sides are still a long way apart and the biggest issues facing the workers planning to strike next week are high patient-to-staff ratios and low wages.
The union reportedly represents about 900 employees in the Maui Health System on Maui and Lanai including registered nurses, social workers, physical and occupational therapists, speech/language pathologists, MRI and mammography technicians, financial counselors, clerks, receptionists and more.
Melissa Pua is a nurse at Maui Memorial’s emergency room who said she’s willing to walk off the job Monday primarily because of her staffing concerns.
“The biggest concern, personally, is staffing-to-patient ratios — having more staffing available each shift and every shift,” she said. “Right now, we don’t have anything to protect our patient-to-staff ratios.”
Melissa Robinson, a registered nurse at Maui Memorial, also said she and her coworkers are “stretched pretty thin” and receiving less pay than their peers at Kaiser’s clinic just down the road.
“The nurses at the hospital are not making what the nurses at the clinic are currently making,” she said while adding that, “we’re just asking for the same ratios that every other Kaiser facility has.”
She said that while the nurse-to-patient ratio varies at different facilities, Maui Memorial is in dire straits.
“In the (emergency department), you have nurses that are in a pod that used to have three nurses to nine patients, and they’ve recently changed that to put two nurses in a pod, so now if one nurse has a critical patient come in that requires one-on-one care, the other nurse in that pod is now taking care of eight patients,” she said.
Robinson also said some of the employees at Maui Memorial have not received any increase in their pay for years.
“Every single day there are people walking off the job that have been here for so long,” she said. “They are so knowledgeable in their job, but they’re just not getting paid liveable wages.”
Pua, Robinson and other members of the United Nurses and Health Care Employees of Hawaii union also say that while the discussions regarding a new labor agreement have been ongoing since this summer, they have made little progress.
Matt Pelc, a CT technician and chair of the United Nurses and Healthcare Employees of Hawaii union, said the community has been hurting ever since COVID, and many staff members at Maui Memorial cannot afford to live on the island because of the high cost of living.
“We’re trying to make it so nurses and health care workers can afford to stay and care for our ohana,” Pelc said.
According to Pelc, the workers union is asking for concessions that Kaiser has steadfastly opposed for Maui Health but agreed to in its contracts covering registered nurses in California, where the RN-to-patient ratios match what Maui Health is asking for.
As a result, Pelc said, the turnover rate for registered nurses at Maui Memorial is more than three times higher than it is at Kaiser’s other clinics and hospitals in Hawaii — 13.86% compared to 4.2%. He also pointed to the number of open listings online as evidence Maui Memorial is chronically understaffed.
However, representatives from the hospital paint a different picture, saying that while nationwide there’s been a shortage of health care professionals since the pandemic, many areas at the hospital are “fully staffed” or close to “fully staffed.”
They noted that staffing and hiring are not one and the same and absences due to illness in staff can sometimes result in challenges.
“Maui Health’s nursing teams review the census and current patient and staffing mix, including patient acuity and volume, to allocate appropriate staffing resources tailored to meet the needs of each unit,” the statement reads. “This happens around the clock daily to help ensure the highest level of care for our patients, and patient and clinician safety.”
Another big piece of the union’s demands have to deal with wages, especially for the lowest-paid workers.
According to figures provided by the union, a ward clerk at Maui Memorial makes on average 19% less than the same classification down the street at a Kaiser clinic. Additionally, receptionists and lab assistants make nearly 20% less and a clinical coordinator earns 17% less.
Pelc also cited a June 2024 study by the Hawaiʻi State Rural Health Association, “Maui Together,” showing that 39% of medical professionals are contemplating moving to the Mainland while 40% are considering a reduction in hours and 35% are thinking about leaving medicine altogether.
Maui Health representatives said, if there is a strike at the Maui and Lanai hospitals, they will remain open and operating as usual, as they have prepared for the possible disruption by securing a temporary workforce of nurses and health care professionals who can help “as long as needed.”