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8 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 1 8 NEWS BRIEFS CALIFORNIA W orking in health care, four of the most worrisome words to hear can be, "They're sell- ing the hospital." And without a union, a sale or merger can be devastating for workers and patients. Fortunately, when Dignity Health and Colorado-based Catholic Healthcare Initia- tives (CHI) announced in late 2017 that they planned to merge, California Nurses Association-represented nurses working in Dignity's California facilities were able to forcefully advocate for themselves, their patients, and the hospitals' surrounding communities. At a series of hearings throughout the state this summer, Dignity nurses argued to California Attorney General Xavier Becerra, who needed to approve the deal for facilities within Cali- fornia, that the new non-Catholic entity, Integrated Healthcare Operations, must maintain service, charity care, and access levels. In late November, when Becerra approved the merger, nurses saw many of their demands reflected in the conditions he placed on the deal. "As nurses, we are the voice of patient advocacy in our communi- ties, and we came together at every hearing on the merger to speak up for our patients, and for the working conditions that enable us to provide quality care," said Kathy Dennis, RN, of Mercy General Hospital in Sacramento and a board member of CNA/NNOC. "We are proud of the positive impact our collective power had on this merger." Key terms of the merger, highlighted by nurses, include: • Contract protections: Dignity will fully honor the terms and conditions of nurses' hard- won collective bargaining agreement in all facilities, to the benefit of patient care and nurse health and safety. Nurses must be empowered to speak up for patients and for safe working conditions, without fear of retaliation. • Continuation of hospitals and services: Dignity Health must maintain required services at the vast majority of Dignity facil- ities for a minimum of 10 years with the remainder guaranteed for at least five years. • Women's health care services: Dignity must maintain women's health services and reproductive services for at least five years. If Dignity seeks any changes after five years, it must go back to the attorney general. • Charity care: Dignity must maintain current levels of charity care, and remain in compliance with the requirement of the state of California. • Community benefits: All current community benefits must be maintained for each individual hospital and be adjusted annually for inflation. • Dignity pension plan: The pension plan covering all nurse members is guaranteed, helping to retain experienced nurses for the community. • Earthquake seismic retrofit: Dignity Health shall commit necessary investment to meet and maintain Office of Statewide Health Planning and Development seismic compliance until 2030. Additionally, Dignity must maintain all current city or county contracts and programs for five years or more, and a new mandate was added that Dignity, through the merger, expends $20 million over six years on a new homeless health initiative. "Nurses will never be silent when a merg- er between major entities has such a huge impact on our communities," said Carol Koelle, RN, of St. Bernardine Medical Center in San Bernardino. "We are proud that we spoke up to help protect the future of our hospitals and the communities we serve." —Staff report Nurses make impact on Dignity, Catholic Health Initiative merger