Hospice East Bay Workers Hold One-Day Strike Amid Contract Dispute

Frustrated by delays in securing their first union contract nearly two years after organizing, workers at one of the Bay Area’s oldest hospice care organizations went on a one-day strike on Tuesday.

Before dawn, some of the nonprofit’s 80 represented employees began picketing outside the Pleasant Hill headquarters of the nearly 50-year-old Hospice East Bay, demanding progress toward enshrining what they describe as modest workplace standards. The push for a contract comes amid the organization’s looming affiliation with a larger hospice chain based in Florida.

“We’ve asked for pretty simple things,” said Jill Tobin, who’s helped dying patients through their final moments for more than four years as a Registered Nurse Case Manager at Hospice East Bay.

“For example, we proposed to keep our benefits the same as they are now. We just wanted them protected under a contract,” Tobin said. “[Hospice East Bay] said no, they want the right to make them worse. And so, that’s been really shocking and disappointing.”

Historically, patient care at the hospice has been “top notch,” Tobin said, but she’s noted a slow erosion since 2023, when nurses, bereavement counselors, pharmacists and others voted to join the National Union of Healthcare Workers. Since then, she said her caseload has jumped from 10 to 15 people, which she called painful for practitioners and patients both.

“You’re coming into their home, you’re taking off your shoes, right? Your whole kind of goal is to build rapport and be present with them first and foremost. Like that’s really the medicine of hospice work,” Tobin said.

The workers’ initial proposal included safe staffing ratios and a 5% wage increase every year for the next three years. But workers said they’ve been met with resistance, and have accused management of several unfair labor practices — including improperly freezing employees’ existing annual raises and laying off a cohort of represented musical therapists.

Claire Eustace, a spiritual care counselor, said she’s worried about clients losing access to her specialty’s services, as well.

“I’m afraid that we have this big nonprofit that is taking over … probably starting some time in August. I’m afraid that the priority on spiritual care is gonna go away,” Eustace said.

UC Berkeley Labor Center Deputy Executive Director Laurel Lucia said nonprofit providers like Hospice East Bay, which serves Alameda, Contra Costa and parts of Solano counties, have a special duty to the community in a field that is increasingly facing corporatization by for-profit owners.

Better conditions for workers, Lucia added, do affect patient experience.

“There is research from other health care sectors that’s shown that adequate wages are an important component of retaining health care workers,” Lucia said. “And kind of relatedly, there is research showing the importance of adequate and consistent staffing to patients having good quality of care.”

Hospice East Bay spokesperson Rico Marcelli said he couldn’t speak to the bargaining process, other than to say that management remains committed to being at the table with workers.

As for the decision to lay off the musical therapists, Marcelli said Hospice East Bay decided as part of its effort to contend with serious financial challenges — including a more than $4 million increase in operating losses in 2024 over the prior year.

“Nonprofit hospice care is under threat right now,” Marcelli said, “and part of that is lowered [Medicare] reimbursement rates.”

Medicare and Medicaid reimbursement for hospice, which provides 92% of Hospice East Bay’s hospice revenue, Marcelli said, has not kept pace with increases in labor and other patient care expenses. For the current fiscal year, reimbursement for hospice care in Contra Costa County was cut by 1.4%.

Marcelli said hospice services will not be affected by the one-day strike and that he’s hopeful the two parties will come to an agreement soon.

“I’m sure we’re going to be able to get over these differences because we have to. If we don’t come together, we’re not going to be able to fulfill our mission.”

KQED’s Nibras Suliman contributed to this report.