Integral Care Union Drive Nears the Finish Line
Helping the helpers
After more than a year of organizing, the United Workers of Integral Care are on the verge of unionizing the workforce at the largest mental health care provider in Travis County.
Organizers had hoped Integral Care's board of trustees would sign off on the union at their March 31 meeting by approving the consultation policy proposed by UWIC, but the item was not placed on the agenda. Instead, Integral Care CEO David Evans led a discussion on the unionization effort, highlighting minor concerns he had about the policy, which would establish the union's structure. But Evans and board Chair Hal Katz (a partner at the high-powered Austin law firm Husch Blackwell), agreed that approval of the union was imminent.
Evans reiterated this point in an interview Tuesday, April 5. "I anticipate that our board will consider a consultation policy, maybe with some minor modifications, at their April meeting and move forward with approval," he said. "When you're involved in health and human services and hear folks inside your organization asking for better working conditions, more safety, and better pay and benefits, those are concerns we as leaders should be interested in."
That said, UWIC organizers have not viewed Evans' actions to date as receptive. Emails obtained by the Chronicle through an open records request show that initially Evans declined to meet at all with union organizers on the advice of legal counsel, premised on Texas law's prohibition of collective bargaining (or a right to strike) among local government employees, with exceptions for first-responder unions. (Federal law also requires that transit workers be allowed to unionize.) The UWIC organizers from the Communication Workers of America District 6 were well aware of that prohibition; the proposed consultation model is what's used by teacher unions with school districts, including Education Austin with Austin ISD.
Employees fear that Evans' proposal to form a new Employee Advisory Council is intended as an end run on the union. The EAC would be limited to 38 employees, pulled from a cross section of agency departments, and lack a regular meeting schedule, while the union, on the other hand, would be open to all nonexecutive personnel (about 950 people) and require IC executives to meet monthly with an Integral Care Consultation Committee elected by the membership.
Evans disagreed with this framing, though he acknowledged that he likely mishandled his introduction of the EAC. The internal group would complement the union, not compete with it, he said, and unify the work of employee groups that already exist. Under the consultation model, the ICCC would propose policy changes and seek consensus with leadership before submitting them to the board; if consensus isn't achieved, a vote among ICCC members and leadership would be recorded for the board's consideration within 30 days.
Organizers from CWA – which has leveraged its strength as one of Texas' few well-established industrial unions (it represents AT&T employees) to help many nonprofits and agencies around the state – estimate that since the drive launched publicly in December they have helped collect signed union cards from about 20% of the IC rank-and-file. The exact number is fuzzy because turnover at Integral Care is so high – which several current IC employees told us was a motivation to unionize.
Data obtained by the Chronicle (see chart) shows that separations among seven different front-line employee classifications increased by 51% in 2021, with the trend continuing in 2022. Employees say this is at least partly due to management's indifference. "The first few months of the pandemic were chaotic for everyone, so I don't fault the agency for that period," Jenn Kolb, who's been at IC for three years, told us. "But after a year, the situation was getting worse, not better. Upper management paid lip service to our concerns but didn't do much to help."
The UWIC organizers have already declared victory on one front: In December, the board increased the base hourly wage for all positions from $15 to $20. Evans' leadership team had proposed an eight-month compensation study, but after an outcry from employees, the board agreed to the wage increase as well as an accelerated study to be concluded by May. Integral Care estimates that about 30% of the workforce saw a pay increase, which has been a boon for employee morale – and an early indicator of the difference a union can make.
One peer support specialist, who asked we not use her name for fear of retaliation from management, told us the raise has transformed her life. "Now, I can afford a place to live where I don't have to share a bathroom with three guys. I see my friends and decompress, which allows me to better serve my clients," the specialist said. (Evans told us, "Leadership will not retaliate for any type of engagement or work with the union.")
Other IC staffers also emphasized the link between improved working conditions and better patient and client care. Kara Peeples works on Integral Care's Assertive Community Treatment team, which treats some of the most challenging mental health patients in Austin. Staffers specialize in housing, counseling, life skills, and other areas, allowing care teams to share the work and forestall burnout. But ACT has been without a counselor for more than a year, so Peeples and her colleagues either need to handle those client needs as best they can, or make referrals to IC clinics with months-long waiting lists. "These folks are oppressed and have been run through failed systems," Peeples told us. "Failing to retain employees makes it harder to prevent that from happening again."
Editor's note (April 7 3pm): This story has been updated since publication to correct the number of members of the proposed EAC and the CWA unit working on the organizing effort. We regret our errors.