Employees of two Wisconsin mental health clinics, both part of a national mental health nonprofit based in Oconomowoc, will vote next week on whether to join a union after what has become a highly contested campaign.

Almost two months after a four-day National Labor Relations Board hearing, the NLRB’s Minneapolis-based regional director this week ordered the elections at the clinics, operated by Rogers Behavioral Health in West Allis and Madison.

In the April 14 order, Regional Director Jennifer A. Hadsall rejected Rogers’ position that the election should include all 13 Wisconsin Rogers locations. Hadsall instead directed elections at the West Allis and Madison clinics, where a majority of employees had signed up with the National Union of Healthcare Workers, according to the union.

Union supporters at the Wisconsin clinics have said they decided to seek union representation in response to increased caseloads, changes in how employee productivity was measured and a reduction in individual time that therapists and other providers could spend with patients.

“All of the changes were about increasing the number of patients that were coming into the building,” Stephani Lohman, a nurse practitioner, told the Wisconsin Examiner earlier this year. “It did not seem to have a cohesive plan and no plan would be communicated.”

The NUHW is based in California. After employees at a Rogers clinic in Walnut Creek, California, organized in 2023 and elected the union to represent them in 2023, they negotiated their first contract in 2024.

Employees at two other California clinics and at a clinic in Philadelphia also joined the union, which those three clinics voluntarily recognized.

Union supporters at the West Allis and Madison clinics each sought voluntary recognition of the union after organizing over the past year.

In Wisconsin, however, Rogers declined voluntary recognition, and the employees then filed petitions with the NLRB for union elections.

Lohman worked at the West Allis clinic, known as Lincoln Center, and was among those active in organizing the union. She said she and two other employees were fired after submitting the petition to be recognized. The union has filed unfair labor practice charges claiming that the three firings were in retaliation for union organizing, which is against the law.

In response to an inquiry in March about the firings, Maureen Remmel, Rogers’ executive director for marketing and communications, told the Wisconsin Examiner via email, “We do not comment on confidential personnel matters and have acted in compliance with applicable law.”

Hadsall held a hearing that took place Feb. 23 through Feb. 27 at the NLRB’s office in Milwaukee, where Rogers’ lawyers argued for a bargaining unit of 1,383 employees encompassing all Rogers locations in Wisconsin — three hospitals in the Milwaukee area and 10 outpatient clinics around the state.

Rogers had “a heavy burden” to overcome the presumption that a single facility is an appropriate bargaining unit, Hadsall wrote in her order this week, and she found that management had  failed to do so.

The evidence in how Rogers is organized and supervises its employees was insufficient to overcome a general presumption in U.S. labor law — that a union bargaining unit representing a single health care facility in a larger network or organization is considered appropriate.

Evidence in the case showed that neither of the two clinics had “lost their separate identity such that a single-facility union would be inappropriate,” Hadsall wrote.

Union elections for about 68 employees at the West Allis Lincoln Center clinic and about 35 at the Madison clinic are scheduled for Wednesday, April 22.

For employees at both clinics who have been seeking union representation, the decision was welcome news.

“I’m thrilled and beyond thrilled,” said Erin Quinlan, a behavioral health specialist at the Madison clinic. “It really just vindicated how firm our stance is and how confident we feel about organizing a union and doing so for the Madison clinic.”

Lohman said she and other West Allis employees who have been seeking union representation were pleased as well.

“I’ve just been feeling really overjoyed,” Lohman said Thursday. She and the other fired employees will be able to vote in the West Allis union election, she said.

Rogers Behavioral Health has announced the organization will appeal the order to the full NLRB in Washington, but that will not forestall next week’s voting.

“We are disappointed with the NLRB regional office’s decision to allow separate bargaining units given that Rogers Behavioral Health operates as one unified system across Wisconsin,”  Rogers said in a statement, which Remmel delivered via email. The statement asserted that patients “can move seamlessly between different levels of care, supported by providers who collaborate across locations.”

In her order, however, Hadsall found that there was not sufficient evidence of “functional integration” across the system to overcome the presumption that a single facility is appropriate for a bargaining unit.

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Staff members at two Wisconsin mental health clinics are seeking union representation after what some employees describe as policy changes that have increased client caseloads and reduced one-on-one care for clients.

The clinics — one in Madison and one in West Allis — are owned by Wisconsin-based Rogers Behavioral Health. The Oconomowoc-based nonprofit organization operates a network of mental health hospitals, residential treatment clinics and outpatient clinics in 10 states.

Starting Monday, officials with the National Labor Relations Board will hold a hearing in Milwaukee to set union election dates for 63 employees in West Allis and 35 in Madison.

The hearing is expected to take up to three days, according to documents filed with the NLRB by a lawyer representing Rogers. The case will entail “extensive testimonial and documentary evidence” about which employees at each location should be included in the vote, the attorney stated in a motion to schedule the hearing and reserve the dates.

Workers at the West Allis and Madison locations want to join the National Union of Healthcare Workers. The California-based NUHW already represents Rogers employees at three locations in California as well as one in Pennsylvania.

Three employees at the West Allis clinic have been fired, according to the union, which has filed an unfair labor practice charge with the NLRB. The union is accusing Rogers of violating federal labor law by retaliating against the terminated health professionals for supporting the union.

The Wisconsin Examiner sent email messages to Rogers Friday morning, Feb. 20, seeking comment about the union drive, and at the invitation of the organization’s communications office sent five questions Friday afternoon. Rogers has not responded; this report will be updated with comments Rogers supplies.

Clinic employees cite increased caseloads

Employees involved in the union drive said in interviews that they and their colleagues enjoyed their jobs and caring for their patients. But recent changes, they said, have made their work more difficult and didn’t benefit patients.

“When I first started, people were pretty happy and satisfied with their roles,” said T’Anna Holst, a therapist who works at the West Allis clinic. “As time goes on, caseloads kept increasing for therapists.”

Other program changes reduced patients’ ability to have individual time with their clinicians, which “was really unfortunate for us, but also for the patients, who were expecting that when they come to our program,” Holst said.

“All of the changes were about increasing the number of patients that were coming into the building,” said Stephanie Lohman, a nurse practitioner. “It did not seem to have a cohesive plan and no plan would be communicated.”

Lohman said she is one of the three employees fired from the West Allis clinic, and that her termination came the Monday after she and nearly a dozen other coworkers had presented a petition seeking union recognition. When she directly asked the upper level executive who fired her, she said, she was explicitly told  she was being dismissed “without cause.”

“Our local leaders, including my direct boss, were not aware this was happening,” Lohman said, adding that she was not given time to prepare notes in order to transfer coverage for the patients in her care.

Patient advocacy

At the Madison clinic, Erin Quinlan is a behavioral specialist whose job includes assisting therapists and helping to conduct group therapy sessions.

“The people that I work with are incredible,” Quinlan said. “They care very, very deeply about the work that they do and having a positive impact on the lives of patients.”

After she was hired in July 2024, “Caseloads increased and individual time with patients was decreasing,” Quinlan said. “I just became concerned about how that was impacting our being able to support those patients.”

Coworkers shared those concerns, she said.

Employees said they were left with the impression that the changes that concerned them were coming from higher up in the organization’s hierarchy, not their local managers.

Lohman said that in measuring staff productivity, the organization moved to relying on “metrics like visits per day.” That replaced a system that took into account that some patients needed more time than others, she said.

Increased caseloads were presented as ways to increase the number of patients being served, Lohman said, but instead, employees were working “to their maximum capacity, ignoring actual patient or worker needs.”

At the clinic level, “Rogers is run by caring professionals,” she said. “Despite the corporate push to do metric care, patient-centered care continues to be done.”

All three employees said they and their coworkers believed forming a union and being able to bargain collectively would give them a stronger voice as advocates for their patients.

“I take being an advocate and speaking up as a very important part of my job,” Quinlan said. She added that she routinely sought to raise concerns with “anyone who would listen, including management.”

She said she got no response, however. “It was because I didn’t really see any return communication, that was when I made the decision to go to the union,” Quinlan said.

Both the Madison and West Allis groups initially petitioned for Rogers to voluntarily recognize the union, citing large majorities of supporters. The organization rejected those requests, and union supporters then sent petitions for elections to the NLRB.

Union represents other Rogers workers

The NUHW grew out of a California health care union that was founded in the 1930s and subsequently joined what would later become the Service Employees International Union. After an acrimonious split from SEIU in 2009, the National Union of Healthcare Workers formed as an independent union.

An unsigned memo from the organization urging employees to vote against the union was briefly posted at the Madison clinic in the days after members petitioned for union representation Jan. 23. The Wisconsin Examiner obtained a photograph of the memo, which employees said was later taken down.

The memo describes the union as having “no experience or connection in Wisconsin.” It does not state that Rogers employees in four other U.S. clinics are now represented by the union.

Employees at a Rogers mental health and addiction services clinic in Walnut Creek, California, voted for the union to represent them in 2023 and settled a first contract in 2024.

“It’s an excellent contract,” said NUHW’s communications director, Matt Artz, and included “substantial salary increases and caseload limits,” according to the union’s website.

After employees at Rogers clinics in Los Angeles and San Diego petitioned for union representation, the union was recognized voluntarily at those locations, which then negotiated contracts similar to the agreement at Walnut Creek, Artz said. In December 2025, a Rogers clinic in Philadelphia also voluntarily recognized the union after being petitioned by employees there. 

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