Howard Brown Health (HBH) is the largest LBGTQ health center in the Midwest. It has eleven clinic sites across the city of Chicago. In 2019 Howard Brown Health nurses negotiated their first contract after a victorious union drive. That contract expired on August 11, 2022. After months of fruitless negotiations for a new contract, the nurses issued their strike notice to management on September 16 with plans to walk-out on Monday October 3rd if the executive leadership at Howard Brown did not bring more meaningful changes to the bargaining table. On September 30th, the last day of bargaining before the strike, the union reached a tentative agreement with the organization, wherein the management met almost all of the nurses’ demands. The tentative agreement includes: an immediate 5.5% raise, progressive 2% raises every year of the contract, 3% cost-of-living adjustments, $1,500 retention bonus each year for three years, staffing ratios (1 full-time RN to every 2 primary care providers), a more lenient attendance policy, and additional health and safety provisions. Healthcare activist and former HBH employee, Mary Bowman, spoke to two of the union nurses on the bargaining team to learn more about what the nurses are fighting for, and how they won a better contract through social justice unionism and strategic use of strike action.
Describe the bargaining process.
Rob Garness: We came to the bargaining table ready. We had lost like half of our nursing staff over two and a half months this spring, through a combination of people quitting because of toxic management, leaving for better pay elsewhere, and unfair disciplinary practices. Some of us are working the job that we need three nurses to do, so we were bearing the load of being understaffed. But the organization is not really giving meaningful bonuses to anybody but executive leadership who themselves were given $20,000 bonuses during the pandemic.
Audra Thompson: Starting in June, we were meeting once a week with Howard Brown management and at first making really good progress. Some stuff took a while, mainly because they didn’t bring any power players. We had to constantly explain what our jobs are, explain that we are degreed professionals with specialties in our field. And negotiations really slowed down just immediately when they finally started talking wages, economics, almost grinding to a halt for several weeks, maybe a month. They didn’t respond to our initial economic proposal for about two months. Finally their response was rejection, just overall, no counter. It took us a long time to get to this place.
How did y’all decide to strike?
RG: When it seemed as though we just weren’t gonna make any movement, especially on economics, we all agreed as a bargaining unit that a strike was the way forward. The number one issue for all of us was our wages and appreciation pay. And management not budging on those at all really provoked the strike.
AT: We sent out polls asking if workers were willing to strike. All the polls came back almost unanimous in favor of striking. Almost everyone was ready to go, including all the new people we hired.
RG: We have worked very, very hard to take care of our community without being appreciated or compensated fairly. Management is using the profits at a nonprofit LGBT organization to fatten their own wallets, rather than give it back to the community and to queer folks who put their lives on the line during pretty scary times. They really don’t treat their workers as well as they can, and we’re gonna challenge them to do that.
What were the original demands?
AT: Staffing ratios were something we had to fight for because they didn’t understand how many nurses are needed to do their job. We also were asking for safety measures. Monkeypox hit right in the middle of our bargaining. We wanted all employees to be eligible for monkeypox vaccinations immediately, and management refused. Then a couple weeks later they put out a notice saying that some employees [including the union nurses] had been granted the ability to be immunized. That’s a common thing they do. They take something that the union puts forward and then say, “Look at what we did.” We also fought for the ability of nurses to decline to see patients who are on behavioral contracts for violence of any kind, patients who have threatened or repeatedly sexually harassed nurses. There was a lot of back and forth with management about that, but we eventually got additional safety measures added to the contract.
RG: We also were working to revamp the disciplinary process because that was part of how we lost so many nurses. Nurses were being retaliated against for advocating for patients. Two of our nurses were fired within the last contract because they advocated for a patient’s need. Higher-ups disagreed with what they were advocating for doing and then both were fired for insubordination without having had any other discipline prior. We want our discipline section to have strong protections for nurses so that we feel comfortable advocating for our patients, for our colleagues, and for ourselves.
Howard Brown Health has a social justice mission to provide care for LGBTQ individuals who are largely medically underserved. HBH also has a high percentage of queer and trans employees which is a point of pride for the organization. How has your treatment as employees and at the bargaining table compared to the organization’s mission?
AT: I have never been more affirmed than doing my work at Broadway Youth Center. Never in my life. Like to the point where I don’t know if I can go back to working right in a place that doesn’t respect me. Nothing has been as affirming as working with the people I work with. We’re queer, we’re Black and brown. I’m working in the heart of my community for the heart of my community, and there’s literally nothing that means more to me. But it is always telling when you’re sitting [at the bargaining table] across from the three cis white queers in your organization, the hierarchy, and being told, “You’re not worth this.” I think that Howard Brown can do better. I think that Howard Brown is responsible for doing better, for upholding its mission and putting its money where its mouth is.
RG: It’s a bit of a double-edged sword, being a queer person who works at Howard Brown. Because it’s almost as if we’re being held hostage. The people that wanna work at Howard Brown are passionate about taking care of the LGBTQ+ community, and as a result, management thinks that they can strongarm us, even when we have very meaningful concerns. We stay here because of our patients. They know that, and they exploit that.
What did Howard Brown stand to lose facing off against its own workers?
AT: Clout, which Howard Brown would hate to lose. But also trust, faith. They can’t bring in the kind of people they need to, people who earnestly want to work with LGBTQ populations and with the most marginalized communities in Chicago. It’s hard to bring dedicated folks in at the wages they’re willing to pay. They can’t afford to lose the kind of employee who wants to work in this environment, and they need to understand that.
RG: We don’t want to destroy Howard Brown. We want to make Howard Brown better. And that’s going to come from the workers uniting and demanding that management behave better, that they take better care of their patients, their community, and their workers. That’s really what it comes down to.
The HBH nurses’ union was organized prior to the wave of mass unionization at Amazon warehouses and Starbuck’s stores across the country. The upswing in union drives and so-called “Strike-tober” has injected new energy into the U.S. labor movement. 15,000 nurses just went on strike in Minnesota, the largest private sector nurses strike in U.S. history. How do you see the HBH nurses’ fight in the context of this political moment?
AT: Well, it’s so exciting, right? I was a barista for 10 years at Starbucks and every day I was just like, damn, I wish I knew anyone here who was willing to strike. No one had the energy or even the context. We needed something like COVID to remind us that we’re humans and we have physical, emotional, mental needs that must be met. And that we are not mindless automatons. We deserve respect and care. And unfortunately we live in a society, especially as Americans, where the only way to receive care is money. We’ve already had so many folks from across industries reach out to us saying, “We’re here for you.” There’s just so much solidarity and it’s such a good reminder that it still exists.
RG: I think that this speaks to a greater realization amongst American workers that we deserve to be treated with respect. If there’s any silver lining in the awful healthcare crises we’ve been going through the past few years, it’s that people started understanding that they deserve to be treated fairly, that they deserve to be paid fairly for their work, that their voices matter. And most importantly, it’s our work that is making the executives and managers their money. Therefore, we need to have more control over our work and our money. They would not be making what they’re making if it wasn’t for our labor. We deserve to be treated and paid fairly for the labor that they are enriching themselves with.
How did the absence of a fair contract impact Howard Brown’s patients?
AT: Patient care suffers without resources and that’s something we struggle with in community health constantly. Nurses are one of those resources. Nurses are burnt the fuck out. Nurses were burnt out before COVID. They’re absolutely wrecked now. All the [COVID] variants, monkeypox, it’s never-ending for us. And it’s never-ending for our patient population because in a lot of cases, we’re the only medical support that they have. If there’s not enough of us, if we’re so burnt out that we’re considering quitting, that’s just naturally gonna impact patient care. This is a nine-to-six job that is really exhausting, and emotionally intense. We don’t just give people antibiotics or collect samples; we are trauma stewards. And that has to be part of the consideration when you are thinking about how you are compensating your employee: that all aspects of their lives are impacted by their work. I love my job so much. And if they don’t meet some of these needs, then it gets harder and harder for people to remain at the organization.
The union for non-nurse workers at Howard Brown, Howard Brown Workers United, won their election by 97% earlier this year. What is the relationship between your unions?
RG: Their union will strengthen ours and vice versa. Having a wall-to-wall union is only gonna strengthen our contract and their own. Our unionization was a key component in the rest of Howard Brown feeling comfortable unionizing. They saw our successful campaign three years ago. In our first contract, we fought for sick bank accrual and extended parental leave for everyone, not just nurses, and then management took the credit. When we’re all in a union, management can’t take credit for it anymore. Instead it’s what the union did for us, for our patients. And I only hope that the very strong fight that we’re giving emboldens everybody else to fight for their own fair treatment. We’re all stronger together.
What would you say to other healthcare workers who want to organize their own workplace? What can other healthcare workers take from the fight the HBH nurses are waging?
AT: I hope they’re able to see that we didn’t do this alone. And we aren’t doing it alone now. There’s so many groups in Chicago who we can contact and rely on and trust and it’s a matter of reaching out and establishing community. I hope that people see that like there are open arms and certainly open ears and lots of people willing to support.
RG: Reach out to one of your local unions and talk through with them what you’re experiencing and what they can bring you as a union. It’s a fundamental first step. It can inform you so that you can then inform your colleagues. I can honestly say despite the ups and downs that have gone on since our first contract, I feel more secure in my job. I feel more able to speak up without retaliation. So honestly, if you’re looking for a sign, this is it. Just reach out to a union and see what they can do for you. It’s as simple as that.