Group Health Cooperative of South Central Wisconsin's East Side Madison clinic. (Photo by Erik Gunn/Wisconsin Examiner)

Directors of a Madison health care system will consider Thursday whether to change course in the organization’s response to a union organizing campaign.

Supporters of the union campaign at Group Health Cooperative of South Central Wisconsin put five motions before the board of directors at an in-person meeting in October — including one to voluntarily recognize the union, SEIU Wisconsin.

A statement from the co-op management Wednesday did not address whether the board will directly act on any of the motions when it meets.

“The motions are advisory to the Board of Directors concerning its instructions to management about the unionization efforts of our direct care employees,” Group Health stated. “All the Motions will be considered by the Board at the November 20th meeting. The results of those discussions will be communicated to our membership in a future statement.”

Group Health’s response to the union drive, which became public about a year ago, has produced a rift between the co-op’s management and some of its members, who have criticized the organization’s response as a betrayal of its progressive heritage.

“To me it was horrifying to learn that we had people leaving because the conditions were not tolerable,” said Ruth Brill, a Group Health member since 1979 who has supported the union organizing campaign.

According to union supporters, the five motions offered at an Oct. 11 in-person mass meeting to discuss the union organizing campaign passed unanimously. About 170 Group Health members attended that meeting, and union allies said it was the largest turnout in memory for an in-person meeting of co-op members.

Three of the five motions call on the board, the co-op management, or both:

• To report to members how much money Group Health has spent in 2024 and 2025 to pay the law firm Husch Blackwell, which has represented the co-op in connection with the union campaign.
• To voluntarily recognize SEIU Wisconsin as the representative for the professions and departments that the union first sought to represent when workers petitioned the National Labor Relations Board for a union election on Dec. 12, 2024. That motion also demands that Group Health “observe strict neutrality regarding the unionization of any of its workers.”
• To compile a report “of all meeting minutes, emails, and other communications involving Board members, administrators, and/or supervisory employees regarding union activity, from January 2024 to the present.”

The third motion also demands a report on all legal or consulting fees that Group Health has spent related to the union drive, including itemized details.

The fourth motion demands that the board and administration “faithfully follow the democratically expressed will” of the co-op members, charging that the membership has “been denied an opportunity to duly and fully exercise its role” in leading the co-op.

The fifth motion calls for a meeting by mid-January “on the democratization of GHC governance.”

“GHC says members are the most important part of our cooperative and yet the board is not listening to what the members have very clearly stated what they would like to happen,” said Dr. Nisha Rajagopalan, a family practice physician and among the union campaign’s leaders.

“If we are a cooperative that is for our members and our patients, those people showed up in the room and they voted and said exactly what they wanted, and we would like to hear the board uphold that,” said Katie Cloud, a certified medical assistant who has also been active in the union campaign.

Paul Terranova, a Group Health member for 25 years, organized a presentation to the co-op board earlier this year to make the case for unionization in the context of a nonprofit co-op. He later helped organize a slate of candidates for the board in opposition to four incumbent board members. All four of the rival candidates were elected in June.

Terranova said that board members have not communicated directly with Group Health members about the union campaign. Board discussions about the matter have been conducted in closed sessions.

The board’s consideration of the motions is “a really pivotal moment for GHC,” Terranova said, “and how they handle this is going to say a lot about whether this is still a cooperative or if it’s become just a corporate board with cooperative window dressing.”

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South Central Federation of Labor President Kevin Gundlach addresses a rally in support of Group Health workers seeking union representation on Monday, Oct. 13. (Photo by Erik Gunn/Wisconsin Examiner)

A stalemate between Group Health Cooperative of South Central Wisconsin and employees who have been seeking union representation for the last 10 months shows little sign of breaking soon.

At a mass meeting Monday at the Alliant Center in Madison, members of Group Health, sometimes called GHC for short, passed a motion directing the co-op to voluntarily recognize the union as the employees originally petitioned in December — covering three departments and a series of health care professionals.

The motion set a deadline of Friday, Oct. 17. Marty Anderson, Group Health’s chief strategy and business development officer, said Thursday that action on all the motions would likely be deferred, probably until November.

“We communicated clearly ahead of the meeting that all motions are advisory in nature,” Anderson said. “Any deadlines that would be in any of the motions would also be advisory in nature.”

Monday’s mass meeting was the first of its kind for Group Health members to ask questions of the co-op administration and express their opinions about the union drive. About 172 people attended, according to a Group Health spokesperson. Group Health has more than 50,000 Class A and Founding members — the two groups that were considered eligible to attend, according to the co-op.

In the spring, a volunteer committee met with the board to argue in favor of recognizing the union. 

People attending the Monday meeting described the crowd as strongly supportive of the union, and the voice votes in favor of recognizing the union and other motions favored by union supporters were unanimous, according to Service Employees International Union (SEIU) Wisconsin. 

Growing dissatisfaction 

At a rally outside the Alliant Center before the meeting, South Central Labor Federation President Kevin Gundlach, a Group Health member, charged that the co-op “has lost its way” in its response to the union organizing drive.

“We want GHC to listen to the workers,” Gundlach said. “And these workers know, and it says on my shirt here” — he pointed to his chest — “it’s better in a union.”

Group Health has rejected charges that it’s trying to thwart the union drive, contending that it simply wants health care employees in all departments to take part in the union representation vote — not just those from departments and job classifications that were included in the original union petition.

Union supporters say that claim is disingenuous and a ploy to “dilute the vote,” in the words of several workers interviewed — racking up votes against the union from employees in departments that don’t have the same concerns.

Anderson denied the charge. “We don’t know” what the votes will be, he said.

According to workers involved in the union drive, the Group Health union campaign grew out of increasing dissatisfaction in specific co-op departments with working conditions and what they contend was a lack of input into the co-op’s practices.

“I feel like we can improve the patient care that we provide through unionization and through increased involvement in decision-making,” Dr. Nisha Rajagopalan, a family physician who has worked at Group Health for 22 years, said Thursday.

Pay practices, employee turnover and a voice at the table are all reasons employees have cited for supporting the union.

“GHC leadership stopped collaborating with us and despite our many patient care concerns and our many meeting requests,” said Julie Vander Werff, a physician assistant, the lead speaker at the Monday rally.

Who should be in the union?

Complicating the organizing campaign is the conflict over exactly who among Group Health’s workers should be included in the union.

Union supporters involved in the organizing drive originally proposed that the union represent a bargaining unit of about 220 people. They were doctors, physician assistants, nurse practitioners and nursing staff in three departments: primary care, urgent care and dermatology. Their petition also included physical therapists, occupational therapists and health educators.

The petition was filed Dec. 12, 2024. Group Health filed a brief asserting that the unit the employees sought “was an inappropriate unit,” said Anderson, the Group Health executive.

To resolve the differences, a National Labor Relations Board staffer held a meeting on Dec. 30 in Madison, where he moved between separate rooms, one housing Group Health executives and the co-op’s lawyer, the other housing SEIU Wisconsin staff and Group Health employees leading the union drive.

The NLRB staffer suggested to the union group that they narrow their petition to a single clinic, Group Health employees wrote in a letter to the Group Health board of directors Feb. 10, 2025. Hoping to get an agreement, they took the suggestion.

Group Health opposed the single-clinic unit, however. In subsequent hearings the co-op management’s lawyer argued the vote should include all direct care employees, including in departments that weren’t part of the union’s original petition.

After reviewing briefs from both sides, the NLRB regional director in Minneapolis who heard the case ruled that the single clinic unit that the union had proposed would not be an appropriate bargaining unit. The decision issued by Regional Director Jennifer Hadsall stated that the unit proposed by the employer, Group Health, was appropriate and set an election among all the co-op’s health care employees.

SEIU Wisconsin, however, moved to block the election. A raft of pending unfair labor practice charges against the employer could scare employees from voting for the union, SEIU charged. Hadsall agreed to block the vote until the charges are resolved.  

As a result, the vote is on hold. The NLRB investigation of the charges is on hold as well, because of the federal government shutdown.

Shared concerns, conflicting concerns

In her order, Hadsall also included a footnote that states she did not address the unit that the employees had originally asked for because it had not been formally litigated.

“We had always argued that we are a clinically integrated organization,” Anderson said. “Our staff floats between various parts of the organization and different clinics. And the bargaining unit was established [consisting of] all of our clinical sites and all of our direct care employees.”

But pro-union employees say there are concrete differences between employees who are in the groups that they had originally included in the union petition and the rest of the Group Health staff — including direct care providers.

“Initially our bargaining unit included employees who were in primary care and urgent care,” said Rajagopalan, the family doctor. “We practice similarly and we share the same concerns. There are other departments within GHC that don’t share the same concerns [and] practice very differently than we do. That’s why our initial bargaining unit is an appropriate unit.”

Pat Raes, president of SEIU Wisconsin and a nurse at UnityPoint-Meriter hospital in Madison, said that throughout her health care career she’s seen many workplaces where only some groups of workers are unionized.

“At the bedside or at the side of the patient, it doesn’t make a difference because the priority is patient care,” Raes said. “It’s not whether you’re unionized or not.”

Addressing the rally before Monday night’s meeting, Steve Rankin said it was “entirely normal” for workers in a single workplace to be represented by different unions or no union depending on their department or position.

“There is no reason that everyone at Group Health has to be in the same union,” said Rankin, who joined Group Health when it was founded in 1976 and has been active in marshalling Group Health patients to support the union effort. “We call on GHC to recognize the bargaining unit chosen by the workers themselves and to commit to bargaining in good faith toward the contract.”

While the board has yet to consider the motion that was passed at Monday night’s meeting, Anderson said Thursday that voluntary recognition was unlikely. 

“We want an NLRB sanctioned and overseen vote,” he said. “That’s always going to be our criteria.”

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