Thousands of UC San Francisco Workers Are Preparing to Strike

Shawn Singh said he feels angry that the San Francisco hospital emergency room where he works is so understaffed that patients often wait too long to get a bed.

The UC San Francisco nurse case manager said he often assesses adults facing heart problems, kidney failure, septic shock and other life-threatening conditions as they lie on gurneys or sit in crowded hallways, denied the dignity of a private space.

“They’re in their most vulnerable moments with people walking by them in a hallway — in a public hall receiving care while they wait for a bed upstairs — because there is just not enough staff to be able to plan discharges for patients and make rooms available,” Singh, a 34-year-old San Jose native, said.

In the five years Singh has worked at UCSF, he said hiring and retention problems have worsened, squeezing overworked employees and delaying patient care. The university has largely ignored pleas to improve working conditions, including during current labor contract negotiations that started in June, Singh added.

He’s ready to strike as a last resort.

“I’m there to fight for my patients,” he said. “The university is not bargaining with us in good faith. They’re not going to the table with the sense of urgency that we want them to have to be able to hire more staff, retain staff.”

More than 4,000 health care, research and technical workers at UCSF authorized their union to call a strike over what they say is the university’s failure to bargain in good faith about short staffing and other top concerns. The members’ vote, which concluded Wednesday, passed with 98% support, according to the University Professional and Technical Employees Local 9119, which represents more than 19,000 physician assistants, optometrists, clinical lab scientists and other UC employees statewide.

The threat of a walkout at UCSF comes as 37,000 UC service and patient care workers with a separate union, the American Federation of State, County and Municipal Employees Local 3299, are also preparing for a potential statewide walkout. That strike authorization vote passed with 99% support, AFSCME said Thursday.

Both unions filed unfair labor practice charges with the California Public Employment Relations Board this month, alleging that the university has refused to provide essential job vacancy and financial data needed to assess the extent of staffing crisis and develop solutions in ongoing contract negotiations.

The charges maintain that the state’s third-largest employer has also acted illegally by announcing it intends to significantly increase employee health care costs, as outlined in an email to staffers, without negotiating over the changes. Health care workers said the move will exacerbate recruitment and retention issues.

About 36% of UCSF employees said they felt burned out always or very often on the job, higher than the national health care average of 29%, according to a university staff survey last year. Patients spend an hour longer on average at the UCSF Medical Center emergency department where Singh works, compared to wait times at other large hospitals in the state and nationwide, according to Medicare.gov figures.

Heather Hansen, a spokesperson for UC’s Office of the President, said the strike authorization votes by UPTE and AFSCME were disheartening but not surprising.

“It seems that no matter what we presented at the table, UPTE’s move towards a strike was a foregone conclusion,” Hansen said in a statement. “We are disappointed and hope UPTE can reconsider its position and continue earnestly bargaining towards a mutually beneficial agreement.”

She added that the university’s teams will keep bargaining across the system on proposals that include salary raises for UPTE members of 5% in 2025, 3% in 2026 and 3% in 2027. UC has also offered to increase pay for AFSCME workers by 26% over a five-year contract, according to Hansen.

She said the university is working to produce information on vacancy rate and other data “on a rolling basis.” Hansen added that health insurance contribution rates for UPTE-represented employees are under negotiation, with UC offering credits to help offset these costs, though the union considers them insufficient.

“Bad faith has a clear and legal definition under the Higher Education Employer-Employee Relations Act, and we look forward to the Public Employment Relations Board reviewing and determining the merits of the charge,” Hansen said.

UC’s response to those charges is due Nov. 27, after the university requested and received an extension, according to Felix De La Torre, general counsel with the California Public Employment Relations Board. If an agency attorney finds enough evidence of an unfair practice by UC, the agency would issue a complaint and move the case to a settlement conference.

Nationwide, short staffing is a common concern for hospital employees due to burnout and turnover, as many employers are generally opposed to investing more in their workforce because of the costs, according to Rebecca Givan, an associate professor of labor studies at Rutgers University.

“If they can get away with lower staffing levels, they can increase their revenue,” Givans, who has followed the health care industry for 25 years, said. “And so they would prefer to do that.”

The health care industry is very competitive and employers — even those in public and nonprofit institutions — are focused on revenue and minimizing costs. Employers tend to make investments they believe will help them compete for patients, Givans said.

“They have to be in that sort of arms race to have flashier buildings and more amenities and better branding and advertising campaigns — and all of those things which aren’t really directly related to patient care,” Givans said. “But that’s the health care economy that we’re in.”

Liz Perlman, executive director at AFSCME Local 3299, said UC is prioritizing raises for top executives and chancellors and the construction of new hospitals in San Francisco, Oakland, Sacramento, and elsewhere while keeping facilities dangerously understaffed and paying too little to many frontline staffers.

“Ultimately, we want more care. We want to provide more services,” Perlman said. “But the problem is, if you build buildings but you don’t take care of the people who work inside them, frankly, the buildings are worthless.”