American Family Children's Hospital, part of the UW Health complex on Madison's west side. Nurses in the UW Health system have been seeking to restore union representation since 2019. (Photo by Erik Gunn/Wisconsin Examiner)

This report has been updated with reactions from UW Health and SEIU.

Five and a half years after nurses launched a campaign to restore union representation at UW Health, the state’s highest court ruled Friday that the Madison-based hospital system has no obligation to collectively bargain with employees.

Act 10, the 2011 state law that stripped most union rights from public employees, also removed legal guarantees of union representation for University of Wisconsin Hospital and Clinics Authority’s employees, Justice Brian Hagedorn wrote for a unanimous Court.

“When we examine the statutory language along with the statutory history, it is clear that Act 10 ended the collective bargaining requirements formerly placed on the Authority,” Hagedorn wrote.

The Court rejected the argument from Service Employees International Union (SEIU) that with the Act 10 changes, the hospital authority as a corporation fit the definition of “employer” under the Wisconsin Employment Peace Act.

The Peace Act defines an employee as anyone working for hire other than an independent contractor and an employer as a person — including partnerships, corporations and some other legal entities — that engages the services of an employee.

The hospital authority doesn’t automatically meet that definition, however, Hagedorn wrote.

Hospital, nurses union respond

The hospital system affirmed the Court’s ruling “that the Wisconsin Peace Act does not apply to UW Health” in a statement Friday, adding, “UW Health appreciates the court’s deliberate, diligent and final review.”

In a statement, SEIU and the UW Health nurses said they would continue to seek union recognition.

“While we are disappointed by the Wisconsin Supreme Court decision, which found that UW Health nurses are not covered under the Wisconsin Employment Peace Act, we are not deterred,” SEIU and the UW Health nurses seeking union recognition said in a statement.

“Our fight to restore collective bargaining rights doesn’t end in the courtroom,” the union statement added. “We will continue to explore all possible pathways to restoring our full collective bargaining rights, including seeking voluntary recognition and passing legislation, to ensure that all of us, no matter who we are or where we work, have a seat at the table and a voice in our workplace.”

A 2022 agreement between the hospital and the union to discuss issues of concern is continuing, according to the nurses’ union statement.

Over the last three years, “hundreds of nurses have become official union members and have been meeting with top administrators to address critical issues around retention, safe staffing, and quality patient care,” the statement said. “Earlier this year, UW nurses and management mutually agreed to extend this agreement through 2027. All the while, we continue to leverage our collective voice to elect pro-worker leaders at every level of government.”

UW Health has in the past made statements declaring that Act 10 prevented the hospital system from engaging with the union.

“Based upon legal advice received from both internal and external counsel, UW Health is concerned about the lawfulness of engaging in collective bargaining, which is not authorized under any statute,” the hospital system’s press secretary, Emily Greendonner, told the Wisconsin Examiner in an email message Friday.

“While today’s decision provided final clarity that we are not required to collectively bargain, the question of whether we are legally allowed to do so has not been decided by the courts,” Greendonner said.

Ruling relates Act 10, hospital system history

The hospital system was spun off from the University of Wisconsin in 1996 into a new “public body corporate and politic,” the UW Hospital and Clinics Authority. The hospital system’s employees were state employees represented by unions and with collective bargaining rights under Wisconsin’s state employment relations law.

The hospital authority “is not defined as a corporation,” Hagadorn wrote, “it is a ‘public body corporate and politic.’” He cited the Peace Act’s definition of “employer” that states the term does not include “the state or any political subdivision thereof.”

The 1996 law creating the new hospital authority removed its employees from the state employment relations law and added language specifying that the hospital authority was an employer under the Peace Act.

Act 10 changed that, Hagedorn wrote — repealing the hospital authority’s collective bargaining duty that was in the 1996 law as well as all other references to collective bargaining.

“In sum, Act 10 purged references to the Peace Act from the Authority Statute,” Hagedorn wrote.

“When it created the Authority, the legislature added the Authority as an employer under the Peace Act and imposed numerous other collective bargaining provisions. In Act 10, the legislature eliminated the Authority as a covered employer along with other collective bargaining requirements. We therefore hold that the Authority is no longer covered by the Peace Act and is not required to collectively bargain under the Peace Act.”

Friday’s ruling was the final stop for a case that started in September 2022. In an agreement brokered to avert a planned three-day strike by nurses demanding union recognition at UW Health, the hospital system and SEIU agreed to a joint petition to the Wisconsin Employment Relations Commission (WERC).

In the petition, the union argued that the hospital should be considered an employer under the Peace Act, while UW Health argued that Act 10 eliminated collective bargaining at the hospital system. WERC sided with UW Health, and Dane County Circuit Judge Jacob Frost subsequently affirmed the employment commission’s conclusion.

2025-06-27_SCOWI-SEIU v WERC

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Striking nurses picket outside UnityPoint-Health Meriter hospital Wednesday. (Photo by Erik Gunn/Wisconsin Examiner)

Nurses at Meriter hospital in Madison and the hospital’s management team are returning to the bargaining table Thursday, the third day of a five-day strike over a new labor agreement covering nearly 1,000 union-represented nurses.

The nurses, represented by Service Employees International Union (SEIU) Wisconsin, went on strike Tuesday after their last negotiating session with UnityPoint Health-Meriter on May 19 ended without an agreement.

As nurses rallied and picketed in front of the hospital Wednesday, the issue of staffing requirements was at the forefront of arguments offered by both the nurses and the hospital’s management.

“Let me be very clear, it is not unreasonable to want safe staffing guaranteed in our contracts,” said Carly Dickmann, a Meriter obstetrics, labor and delivery nurse.

“It is not unreasonable to want to feel safe at work and to have a voice in the procedures that impact us and our patients,” Dickmann continued. “It is not unreasonable to want fair compensation for our labor. It’s long past time for management to take us seriously. It’s time that Meriter listen to nurses and come to the table ready to make real, tangible changes to improve the hospital we love so dearly.”

A management position paper distributed Wednesday by the hospital’s communications department asserted that the hospital and the union both “agree that staffing levels are a critical component to safe patient care.”

The paper stated that the hospital’s approach to staffing assignments needed “to remain flexible” so it could move personnel in response to “patient needs and census changes.” It said the hospital would review “the staffing matrix” in four units the union identified as having problems, and that nurses and support staff in the affected units would be included in the process.

At the union’s picket line rally on Tuesday, bargaining team member Amber Anderson said the management proposal fell short.

“Meriter management refuses to put staffing solutions in our contract,” Anderson said, calling the management proposal “a vague promise to review staffing with no timelines, no accountability and no enforceable standards. That is not enough.”

The union has also focused on security and on wages. Union proposals have sought  increases particularly for nurses with the longest tenure, as well as metal detectors in certain areas.

The management paper said average wages would go up by $4.67 an hour over the life of the agreement under the hospital’s proposal, and that Meriter had plans to install weapons screening equipment in its emergency department this summer.

At Wednesday’s picket line rally, striking nurses heard messages of support from Milwaukee Mayor Cavalier Johnson, Milwaukee County Executive David Crowley and U.S. Rep. Mark Pocan (D-Black Earth).

Pocan recalled his visit to Meriter for three clogged arteries seven and a half years ago.

“And I got time to spend in the ICU and other rooms here at Meritor, and I received excellent health care,” Pocan said. “Not because of the comfort of the bed or the colors of the wall, not because of the profitability of the hospital, but because of the staff and the nurses at Meriter.”

Johnson came to Madison because he sees issues in the strike as important “not just for nurses in Madison, but really for nurses all across the state of Wisconsin,” he said in an interview. “When you stand with labor, it’s not just a sometime thing, it’s an all the time thing.”

Strikers also got support from union activists organizing at other area health care employers.

“The people who own the health care industry are running a race to the bottom, where executives try to lower quality of care, increase ratios as much as they possibly can get away with,” said Colin Gillis, who has been active in the effort begun more than five years ago to win union representation for nurses at the University of Wisconsin Hospitals and Clinics in Madison.

“And when they do it here, at the hospital next door, they look at their nurses and they say, ‘Hey, they take six patients at night, so can you,” Gillis said. “Well, you and your nurses are here to say, ‘Heck, No!’”

Dr. Ira Segal, who has been among the employees at Group Health Cooperative in Madison organizing a union, said his coworkers see the Meriter nurses as allies.

“Together, we will persevere and we will shape a future where workers and patients come before profit, and where every voice is heard,” Segal said.

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Pat Raes, a Meriter hospital nurse and president of SEIU Wisconsin, addresses union nurses and their supporters at a rally April 8, 2025. On Tuesday the union announced it would strike starting May 27. (Photo by Erik Gunn/Wisconsin Examiner)

Nurses at Madison’s Meriter hospital plan to walk off the job for five days starting Tuesday, May 27, after negotiations on a new union contract ended Monday night without an agreement.

The hospital management and Service Employees International Union (SEIU) Wisconsin, which represents about 950 nurses at the hospital, are divided over pay, security provisions and whether the hospital should commit to specific ratios of how many patients are under a nurse’s care.

If the strike goes forward, it is scheduled to last for five days, with union members returning on Sunday, June 1.

Update: In a statement Tuesday, Meriter said there was a bargaining session scheduled for Monday, May 26, the day before the strike is scheduled to start. An SEIU Wisconsin spokesperson said Wednesday that the union never agreed to that session, and that a bargaining date has been scheduled for Thursday, May 29.

In order to allow hospitals to secure temporary replacement staff or move patients, federal law requires hospital workers to give at least 10 days notice before striking, which SEIU Wisconsin gave May 9. The union also opted for a fixed duration for the walkout.

“We don’t take going on strike lightly, but we truly feel in order to make the changes that are necessary we’re willing to fight to make things safe for our patients,” said Pat Raes, a long-time Meriter nurse and also president of SEIU Wisconsin, in an interview May 14.

“We’ve called a five-day strike because our goal isn’t to walk away from the table — it’s to make UnityPoint Meriter finally hear the voices of nurses,” Raes said Tuesday. “This timeline reflects the urgency of our demands while giving the hospital every opportunity to return to negotiations in good faith.”

She said the five-day window was chosen to match the standard five-day contract used by health care staffing agencies, such as would be called to cover the striking nurses, “to send a strong, clear message without unnecessary disruption to patient care. We hope Meriter uses these five days to come back with real solutions.”

The hospital, UnityPoint Health-Meriter, is one of 17 regional hospitals in the large, Iowa-centered nonprofit health care chain, UnityPoint Health.   

“We’ve been in a union environment for decades and know that a strike could happen. We always work very, very hard to avoid that,” said Sherry Casali, market chief nursing officer for the hospital, in a statement released to the press Tuesday. “I think both parties would prefer not to have a strike.”

The hospital statement said Meriter’s management was disappointed there were not more talks prior to Monday. “Meriter leadership will remain available throughout this week to return to the table and we encourage SEIU to do the same,” the statement said.

In past years, the union and the hospital have worked with federal mediators during contract talks. This year federal mediation wasn’t available after President Donald Trump issued an executive order in March gutting the Federal Mediation and Conciliation Service (FMCS), nursesan independent federal agency.

Although that order was blocked by a federal judge May 6, the union and hospital turned instead to the Wisconsin Employment Relations Commission.

Defined patient-nurse ratios have been a longtime goal for union nurses. California and Massachusetts both have state laws setting certain minimum ratios, according to  NurseJournal.org. A limited number of other states require hospitals to publish their nurse-to-staff ratios.

“The more patients you take care of once you get above that ratio puts every patient that you’re taking care of at higher risk for complications and higher risk for mortality,” Raes said.

The statement the hospital issued Tuesday acknowledged that “both parties agree on the importance of safe and effective staffing,” but said that mandated ratios “limit flexibility” and could make it more difficult “to adjust to patient needs and staff availability in real time.”

The hospital statement said the facility relies on its charge nurses, who “are key to staffing and have clear avenues to discuss any patient care needs throughout each shift.”

There are limits to flexibility, however, according to the members of the nursing staff. Flexibility “sometimes works and sometimes doesn’t,” said Amanda Husk, a postpartum nurse. “We just know there’s always a base need for nurses to make sure patients are safe.”

Husk said ensuring that the ratio of nurses is always sufficient “also prevents burnout and turnover of nurses. That’s a big deal.”

Raes said nurses also wanted stronger security measures — including metal detectors — in light of violent incidents at hospitals across the country that have led to injuries or deaths of health care workers.

The hospital’s statement said its security staff regularly updates security measures and plans additional unspecified changes this summer.

On pay, Raes said that while nurses in their first 12 years have had significant raises, those at the upper end of the scale for pay and longevity don’t see their pay keeping up.

The shift to a 401(k) retirement plan from a standard pension has diminished the incentive for more experienced nurses to stick around, said Raes, while the original pension plan encouraged longevity on the job.

Meriter’s statement said the hospital’s most recent pay offer would keep its nurses “some of the best-paid nurses in Wisconsin” as well as in Madison. 

This report was updated Wednesday with new information about when upcoming bargaining is to take place. 

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