RESPONDING TO CHANGE IN THE WORKPLACE:

INNOVATIONS IN LABOR-MANAGEMENT-GOVERNMENT COOPERATION

Labor-Management Cooperation At

Miller Dwan Medical Center

####### 

# United States of America

June 25 -- 26, 2001 Mexico City, Mexico

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**I. BACKGROUND:**

1.  Founding of Miller Dwan Medical Center

    The location for this initiative is Duluth, Minnesota, a shipping
    port positioned at the southern end of Lake Superior, one hundred
    fifty miles from the Minneapolis/St. Paul metro area and about 130
    miles from the Canadian border. There are currently three hospitals
    serving the residents of Duluth, northeastern Minnesota, northern
    Wisconsin, upper Michigan and Canada. One of the three hospitals,
    Miller-Dwan Medical Center ("MDMC" or "Miller-Dwan"), has a distinct
    history and structure.

    The journey began in 1917, when philanthropist, A. M. Miller, upon
    his death, donated \$600,000 to the city of Duluth in memory of his
    son, Athol Miller. This bequest specified that the money be used for
    "the establishment of a free and public hospital and dispensary, in
    a cheerful and convenient location of the city." The hospital was to
    be for secular use[^1]" to benefit the sick and helpless poor,
    without distinction of sex, color, creed or nationality."

    The Trust Fund failed to identify how daily operations were to be
    funded. Consequently, the city was reluctant to begin construction
    until funding for the daily operations was established so this
    project would not become a burden for the taxpayers of Duluth. This
    process took some time. The funds sat idle and accumulated for
    twelve years until in 1931 a court agreed that the future Miller
    Hospital could accept patients who were able to pay for their health
    care without violating the rules of the Trust. In 1934, the new
    fifty-bed hospital opened for business.

    Only 6 years later, the only public hospital in Duluth, which
    provided health care to the indigent, had to close due to
    deteriorating conditions. Consequently, the need for health care
    service to the indigent increased and Miller Memorial Hospital
    expanded from fifty to eighty-five beds. Throughout the early
    1950's, Miller Memorial Hospital operated as the primary treatment
    center for citizens in Northeastern Minnesota who would otherwise
    have been without medical care.

    Challenges to Resources of MDMC by New Developments in the Health
    Care Industry

    By the late 1950's, a medical center that provided free health care,
    such as Miller Memorial Hospital, was becoming unnecessary. The
    expanding system of social welfare in Minnesota was rendering the
    original focal point and mission of Miller Memorial Hospital
    obsolete since more people began to qualify for assistance by the
    state and this left fewer individuals without medical coverage. As a
    result, fewer individuals were able to meet the qualifications of
    the Trust, which was designed to assist indigent persons. Therefore,
    a major change was needed in order for Miller Memorial Hospital to
    continue its existence. At this time, the City of Duluth obtained a
    court decision that preserved the original intention for the use of
    the hospital but also allowed funds to be used to expand the
    facility so Miller Memorial Hospital could become a "general"
    hospital. This decision also allowed for the growth of services and
    the number of hospital beds. In addition, money from the Miller
    Trust, money from revenue bonds, Federal Hill-Burton[^2] funds and a
    major donation of 2.4 million dollars from benefactor, Mary C. Dwan,
    all contributed to the expansion of the new general hospital, which
    was renamed Miller-Dwan Medical Center.

    Throughout the 1970's, many hospitals, including Miller-Dwan, faced
    decreasing revenues and increasing competition from other
    facilities. In the wake of this challenge, the Board of Directors
    realized that it was time for a second major change. Miller-Dwan
    Medical Center thus started planning new programs such as a burn
    unit, a dialysis treatment facility, physical rehabilitation
    services, and mental health and chemical dependency programs. The
    shifting of resources to these new programs helped Miller-Dwan to
    avoid duplication of services that existed at the other two
    hospitals in Duluth. In this way the Medical Center not only assured
    its survival, but also significantly decreased the need for
    consumers to travel long distances to obtain specialized medical
    care.

    The late 1980's and 1990's brought additional changes to the medical
    care industry, including hospitals. These changes included rising
    health care costs, further reduction in reimbursements, a federally
    implemented fixed payment system, and preferred provider networks
    that shifted economic power to large buyers of medical services. In
    order to survive, hospitals had to dramatically increase efficiency
    and customer service without reducing quality. Although Miller-Dwan
    had increased its specialty services such as dialysis and the burn
    unit, these initiatives did not immunize Miller-Dwan from facing
    these same challenges.

    Unions Representing Workers at MDMC

Miller-Dwan Medical Center works with four separate and unique unions
that represent over 53 percent of their employees. The unions involved
are:

1.  **UNITED FOOD AND COMMERCIAL WORKERS (UFCW) LOCAL 1116** UFCW, LOCAL
    1116, located in Duluth, represents over 160 service employees at
    Miller-Dwan. This bargaining unit includes nursing assistants,
    orderlies, foods service employees, housekeeping employees and other
    assistants in providing patient care. UFCW, Local 1116 has over 4400
    members through out northern Minnesota, northwestern Wisconsin, and
    North Dakota. Besides the employees at Miller-Dawn Medical Center
    the Local's membership includes employees from retail groceries,
    manufacturing, home health care, clinics, nursing homes, paramedic
    providers and pharmacies.

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1.  **MINNESOTA LICENSED PRACTICAL NURSES ASSOCIATION (MLPNA)** The
    MLPNA represents over 100 licensed nurses at Miller-Dwan Medical
    Center. The MLPN Association originally was an organization designed
    to provided education and support for licensed nurses through out
    Minnesota. When licensed nurses started organizing, it was natural
    for their association to also become their exclusive representative.
    The MLPNA represents members through out the state. Their members
    work in many different health care settings including clinics,
    hospitals, home care and nursing homes.

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1.  **INTERNATIONAL UNION OF OPERATING ENGINEERS (IUOE) LOCAL 70** IUOE
    Local 70 represents ten skilled maintenance employees at
    Miller-Dwan. The unit includes those individuals who take care of
    the physical plant including the hospital's mechanical and
    electrical systems. IUOE Local 70 is a statewide local, with over
    5000 members, headquartered in St. Paul, MN. IUOE, Local 70's
    membership comes from a range of different job classifications and a
    wide variety of businesses such as hospitals, manufacturing plants,
    schools, county and cities, stores, and hotels.

    **MINNESOTA NURSING ASSOCIATION (MNA):** MNA represents over 160
    Registered Nurses at Miller-Dwan. They are a statewide organization
    located in St. Paul, Minnesota. Like the MLPNA they originally began
    as an education and support society for registered nurses. In
    addition, MNA has been very active in legislative and regulatory
    areas dealing with health care. Like the MLPNA, when registered
    nurses started to organize and bargain collectively the Minnesota
    Nurses Association expanded their services to include providing
    Union Representation.

    II\. History of Labor-Management relations at MDMC

    A. Early 1990's - Contentious relationships escalate

    The relationship between MDMC and its four unions has always been
    traditional and contentious. Their relationship more closely
    reflected the labor-management atmosphere for the region than the
    philosophy and mission statement for MDMC, which encourages respect,
    innovation and compassion. [^3]

    There were not a lot of grievances at MDMC once a collective
    bargaining agreement was in place, but the process of collective
    bargaining agreement negotiations was at the very least harmful to
    MDMC and its employees. The lack of grievances was in part due to
    the general philosophy of MDMC of respect and caring for patients
    and employees. Relationships between supervisors and employees on a
    day-to-day basis tended to reflect that philosophy, while the
    relationship between top management and union representatives did
    not. It was far more contentious. A second factor contributing to
    the low number of grievances is that individual employees did not
    bring forth complaints either because they did not know their rights
    under their collective bargaining agreement or they did not want to
    rock the boat.

    The fact is, with such adversarial negotiations among top management
    and union representatives, the only reason the relationship between
    management and labor had not resulted in a strike was due to
    language in a No Strike Clause of the collective bargaining
    agreement that required the parties to participate in binding
    arbitration. By the early 1990s, the pattern of adversarial
    bargaining started to amplify. As the revenues for medical services
    provided by MDMC remained the same each year, or were actually
    lowered, the hospital felt it was impossible to meet the
    expectations of workers for wage and benefit increases. Due to the
    escalating cost of providing health insurance coverage for
    employees, MDMC wanted employees to share the burden. The Employer
    believed employees would use their health insurance more judiciously
    if they were paying part of the premium. A goal set by the Hospital
    was to reduce their contribution of 100% of the Health Insurance
    premium to 85%.

    In 1993, the MLPNA and MDMC were unable to reach an understanding on
    a new collective bargaining agreement. For the first time in recent
    history, even the FMCS mediator assigned the case was unable to
    bring the parties to a voluntary agreement. The conflict between the
    union and management heightened as cutbacks and lower-than expected
    wage adjustments were proposed. With the assistance of the FMCS
    mediator, the unresolved issues of the parties were submitted to
    arbitration. Although the arbitrator resolved the collective
    bargaining agreement, morale and trust remained low, which made
    cooperation impossible.

    The 1995 negotiations between MDMC management and the UFCW, Local
    1116, escalated to new heights of adversarial bargaining. The chief
    spokespersons for both sides had no trust of each other. Union and
    management perceived that the other side was lying, or at the very
    least withholding relevant information. This mistrust had already
    increased during and following the negotiations in 1992 over the
    employer contribution towards health insurance premiums.[^4]
    Participants from both sides of the 1995 negotiations describe them
    as: "Long caucuses[^5] with minimal time spent across the table."
    During this time, joint sessions involved raised voices, personal
    attacks, books being slammed, information being withheld, constant
    attempts to antagonize or "get" the other side, and teams walking
    away from the table in anger and frustration.

    At this point, there was no real communication and the parties
    requested assistance from the FMCS mediator. Despite the best
    efforts of the FMCS mediator, the parties were unable to set aside
    their anger and mistrust. The adversarial bargaining over the years
    had so bruised the relationship that there seemed to no longer be
    enough for either party to get what their side needed. Each side
    felt as if they needed to keep the other side from getting what they
    wanted or "winning." They had lost sight of their interests and were
    completely focused on the adversarial nature of the relationship.
    The lack of trust between the parties spread from the negotiating
    committees to the supervisors and employees. Once again, an
    arbitrator was used to settle the collective bargaining agreement,
    some eighteen months later, but morale was at an all time low.
    Cooperation between employees and supervisors was rare, and this was
    at time when Miller-Dwan leadership wanted employee involvement in a
    continuous improvement program.

    B. Mid 1990's : how the relationship changed THrough interest-based
    bargaining

    The FMCS mediator recognized that all the parties were tired of
    fighting and would like the situation to improve. It was, also,
    apparent that hospitals in Minnesota were dealing with many of the
    same challenges facing U.S. companies such as rapidly-changing
    technologies, cost reductions (due to reduced revenues)[^6], a more
    diverse workforce, changes in government regulations (including
    forms and documentation need to receive reimbursement for patients
    covered by the Federal Medicare program) and heightened competitive
    pressures.

    Like many employers during this time who realized they were in an
    unique position to enhance efficiency, Miller-Dwan recognized
    that 1) employee attitude directly affects customer satisfaction, 2)
    employees observe waste and opportunities for efficiency that top
    management does not know exist, and 3) the employees who actually
    deliver medical services determine the quality of services provided.
    The CEO of Miller-Dwan understood that labor-management
    relationships had major economic implications because they affected
    the quality, productivity, earnings, jobs and employment security of
    their workers. There was a growing need for more cooperative, less
    antagonistic relations between management and workers in order to
    improve the success of the Miller-Dwan Medical Center.

    The FMCS mediator, Commissioner Alan Langhor, met with
    representatives from MDMC and MLPNA to explore a new approach to
    collective bargaining called **Interest Based Bargaining
    (IBB)**.[^7] After an overview and a discussion of IBB, the parties
    agreed to give the new bargaining process a try. FMCS provided
    training on IBB and the skills necessary to be successful in this
    process. The skills that were taught included non-defensive
    communication, appreciating differences, brainstorming, consensus
    decision-making, listening, and managing conflict. Through
    non-threatening interactive exercises, the parties started to build
    a degree of understanding for the needs of the other party. FMCS
    provided facilitation for the bargaining process and the parties
    worked through the issues one at a time. During the negotiations
    both sides agreed that they would use the Interest Based Problem
    Solving model to assist them resolve issues during the term of the
    new collective bargaining agreement. Through the successful
    application of Interest Based Bargaining, the parties realized they
    had many common interests. They recognized a need to solve problems
    jointly in order help Miller-Dwan continue to be competitive and
    provide decent wages and benefits to its workers. The parties agreed
    to establish a Labor Management Committee (LMC) to meet monthly and
    resolve issues that arose.[^8]

    The success of using IBB in the negotiations with the MLPNA lead
    MDMC to approach the IUOE, Local 70 about using this model. The
    Business Representative for Local 70 typically held traditional
    (that is, adversarial) views about management \-- management is
    viewed as "the enemy" that cannot be trusted, and whatever helps
    management hurts the workers. The Business Representative strongly
    doubted that this approach would work. Nonetheless, he was willing
    to give it a try since the Local 70 members at Miller-Dwan had heard
    very positive comments from members of the MLPNA negotiating
    committee. The FMCS, once again, provided training and facilitated
    the IBB negotiation process, focusing on their common interests and
    treating issues as "problems" that need to be solved. As a result,
    the process was so successful that the parties established a Labor
    Management Committee (LMC). The LMC was incorporated into their
    collective bargaining agreement and was used to deal with both
    current on-going problems and any new issues that arose during the
    term of the collective bargaining agreement.[^9]

    Seeking to continue the pattern of success with the IBB model of
    negotiations, FMCS provided an overview of the process to yet
    another union at Miller-Dwan, the Minnestota Nurses Association
    (MNA). However, the MNA chose to stay with traditional bargaining,
    which emphasizes competing positions and demands, as opposed to
    common interests. The MNA Staff Representatives had unsuccessfully
    tried the IBB process with a different employer and consequently
    were not willing to make the commitments necessary for IBB to work.
    MDMC management was disappointed with MNA's decision, but still
    wanted to focus on interest and information sharing in their
    traditional collective bargaining agreement negotiations. To this
    end, they agreed to share information and talk about interests and
    options rather than just making demands of each other, a modified
    version of IBB. On this basis, the collective bargaining agreement
    negotiations were successful. MNA representatives and MDMC
    representatives have built upon this relationship by meeting to
    discuss and resolve issues that have surfaced since the completion
    of those negotiations.

    Finally it was time for the real test of Interest Based Bargaining.
    Was it possible to use such a process when the chief spokespersons
    for MDMC and the United Food & Commercial Workers (UFCW) local union
    had such a contentious history with each other that involved
    deep-seeded personality conflict? Although the spokespersons from
    MDMC and UFCW Local 1116 were skeptical, the parties were willing to
    give it a try. In this case, the desire for change and the need to
    improve relationships overcame the skepticism. This case
    demonstrated the benefits of IBB, because it allowed the two parties
    who were blindsided by previous history and personality conflict
    among party members to re-focus their interests back towards their
    respective goals and the needs of their members, a process that
    resulted in a successful, voluntary agreement.

    How did this happen? Since the FMCS Mediators who did the Interest
    Based Bargaining training were well aware of the history of the
    relationship between MDMC and UFCW, the training was geared towards
    listening, understanding and team building. At the outset, ground
    rules were created based on Interest Based Bargaining, and they
    prepared a plan for how the parties would move to traditional
    bargaining if the IBB approach did not succeed. In addition, the
    Federal Mediator who facilitated the bargaining obtained an
    agreement from the parties to follow the process and not take short
    cuts. Not only did the parties arrive at an agreement based on
    consensus, but they dramatically improved their relationship. As
    they began to resolve issues through the IBB process, their trust
    increased and their relationship with each other greatly improved.
    They further agreed to form a Labor Management Committee in order to
    deal with several complex issues raised in negotiations and to
    address issues that arose during the length of the collective
    bargaining agreement.

    FMCS made additional training available to the parties to provide
    the best possible chances of success for each of the Labor
    Management Committees. Group problem-solving techniques and a
    process to implement and evaluate decisions were included in the
    additional training. The FMCS mediator provided initial facilitation
    of the LMCs until the parties were familiar with conducting
    effective and productive meetings. The parties then met on their
    own, with the understanding they could request further assistance
    from FMCS to help with difficult issues and/or provide additional
    training.

    C. Labor Management Committees: Goals and accomplishments

    The four Labor Management Committees each developed their own ground
    rules and mission statement.[^10] Since the mission statements were
    developed individually they are different, but they basically share
    the same philosophy. The goals of the LMCs are: prompt resolution of
    issues through the use of a interest based problem solving process,
    and to deal with each other openly and respectfully with the
    expectation that the relationship between labor and management will
    improve which ultimately benefits both employees and management.

    Under their agreement, either party may bring issues to the Labor
    Management Committee. The committee members must determine through
    consensus the order of pending issues and any additional issues
    received. The goal of the LMCs is to remain focused on "interests"
    and an IBB approach in order to prevent deterioration of their
    current relationship. The parties actively seek data to reduce
    assumptions and opinions.

    Some of the issues that this collaborative process has successfully
    dealt with include:

    1.  Job assignments for existing positions

        Joint education on collective bargaining agreement changes

        Clear understanding of the intent of the parties on new
        collective bargaining agreement language

        Trust built through problem solving, understanding, and sharing
        information

        Sale of specialized service (dialysis)

        Merger of units

        Issues dealing with Prescription Drugs

        Reaching consensus on how no pay days are to work

        Roles of supervisor's are changing from directing to coaching

        Accept differences and disagreements as positives

        Jointly developed a Safety Program and repercussions for failure
        to follow such program.

        Information sharing benefits both parties and helps build trust

        Solved problem of employees failing to give proper notice and
        leaving co-works short of help

        Flexibility to meet department needs in holiday scheduling and
        no pay days

        Education and training

        In house competencies

        Identify job skills needed

        Peer problem solving

        Education on Drug & Alcohol testing

        Overtime issues

        Merger discussions and plans

The current structure of the Labor Management Partnership is
specifically tailored to each of the four unions separately. Each Labor
Management Committee has there own ground rules and operating styles.
For example, the IUOE/MDMC LMC focuses more on general discussion and
the UFCW/MDMC LMC more closely follows the process of interest based
problem solving. The Committees meet monthly unless there are pressing
issues that require more frequent meetings. The length of time each LMC
meets varies. Some meet all day, while others meet for half a day.

The individual party determines who will be their representatives on the
Committee. Larger bargaining units have larger committees than smaller
units such as Local 70. Each Committee through consensus determines the
number of participants from labor and management, and while the number
of members from labor or management may not be equal they are
approximately the same.

Decisions are made by consensus and each has ground rules that determine
the number of members needed for a quorum. The LMC is the formal
mechanism, although other cooperative efforts are handled through the
parties without the involvement of the entire committee.

III\. LessonS Learned

1.  Labor Management Cooperation allows employees input into the
    decisions that affect their lives at work. It encourages ownership
    and pride.

    Cooperation is not easy and takes a great deal of commitment. You
    don't always go forward. When you start to go backwards its
    important to acknowledge it quickly and find out what needs to
    change.

    Open communication reduces stress.

    In order to achieve cooperation, both parties need to be perceived
    as equals by having equal opportunity for input and accepting
    responsibility for the outcome.

    It may take longer to make decisions but when the decisions are made
    they are workable. When individuals make decisions the illusion of
    progress is more likely. That is, they often believe they have
    solved a problem only to find out it does not work or creates worse
    problems.

    Labor and Management have a lot more in common then they usually
    think. Partners do not need to like each other, but if they want the
    organization to continue long-term they need to be respectful,
    honest, and trustworthy -- that they do what they say they are going
    to do.

IV\. future objectives

The training provided in communications, understanding, and appreciating
differences has been for only those individuals participating either in
negotiations or on the Labor Management Committees. Plans are being made
for FMCS to train employees and front line supervisors in non-defensive
communication, listening skills, and appreciating differences. The goals
of the training are to assist MDMC in promoting a culture that values
differences, encourages constructive resolution of management conflicts,
and encourages employees and supervisors to work as a team.

V. REPLICATION OF PARTNERSHIP

Whether another economy can duplicate the partnerships at Miller Dwan
Medical Center depends on a variety of factors:

1.  Both parties have to want an improved relationship.

    The balance of power between Labor and management must be close. If
    one side has significantly more power then the other party, any
    cooperation will be only on the surface. This means workers have to
    have rights that are protected and enforced by the government. It is
    important however, that workers rights do not give them
    significantly more power than that of the Employer.

    Disagreement needs to be culturally acceptable. If culturally
    showing respect means not disagreeing, it will be hard to work
    through differences in order to reach the best solution. This does
    not mean there should not be rules or a process to deal with
    disagreement.

    The workers need to have sufficient education that allows them to
    participate in decision-making. This includes critical thinking and
    the ability to analyze data. While workers will naturally know what
    will make their job easier or more efficient, they also need to
    understand the big picture if they are to have real decision making
    input.

    Employees need to share in the gains of cooperation either directly
    or indirectly. They need to be recognized for their efforts and
    contributions, in addition to recognition if there are any financial
    gains.

**What is Interest Based Bargaining?**

IBB is an alternative to traditional bargaining. *An approach that uses
assumptions/beliefs, principles, steps, and techniques that are
distinctly different from traditional bargaining.* It is important that
all parties understand and agree to the process. Scheduling the
orientation session well before the actual negotiations are scheduled
allows time for all parties to explain the process to and gain support
from their constituents, and to make a decision as to whether they want
to participate in the training. It is also important that the mediator
believe the parties are ready to use IBB.

**Where Did IBB Come From?**

-   It developed from watching successful traditional negotiations and\
    identifying behaviors and attitudes that made the process more
    likely to\
    succeed and to improve the relationship between the parties.

-   The emphasis in traditional bargaining is on the relative power of
    the parties and their willingness to use it both in regard to
    specific issues as well as the overall settlement.

-   IBB uses a problem solving/consensus approach to negotiations that
    focuses on the interests of the parties.

-   IBB will not, and should not, be seen as a replacement to
    traditional bargaining that all parties must embrace. It is an
    alternative that offers distinct advantages in a proper setting*.*

## PAST Model {#past-model .unnumbered}

The interest-based approach used the PAST model as a guideline. PAST is
an acronym for Principles, Assumptions, Steps and Techniques. These are
the guiding forces behind IBB, even though the acronym itself is rather
inappropriate because in IBB, you focus on the present and the future,
not the past.

## Principles {#principles .unnumbered}

These principles were developed by observing behaviors and tactics that
consistently generated positive outcomes for both parties. While they
originated in observations of traditional bargaining, what sets them
apart in the IBB process is that they are used
[consistently]{.underline} and [exclusively]{.underline}.

-   Focus on the issues, not on personalities or on the past

-   Focus on the interests underlying the issues, not on positions

-   Focus on mutual interests and helping to satisfy the other party\'s
    interests as well as your own

-   Judge options with objective criteria rather than power or leverage

-   Information sharing is critical for effective solutions

    **CRITICAL Assumptions/Beliefs**

-   Both parties have the right to exist

-   Both parties have legitimate interests

-   Negotiation, like other phases of the collective bargaining process,
    can enhance the relationship between labor and management

-   Solutions that satisfy mutual interests are more durable

-   Mutual gain is possible in negotiation; the process does not have to
    be win-lose

-   Parties should help each other achieve a positive result

-   Full disclosure of information is crucial

-   When you make decisions based on criteria, you do not need to rely
    on power

    **CRITICAL Assumptions/Beliefs Continued**

-   Policy makers must attend training and approve of process

-   The context in which negotiations occur must change. Parties must
    expand dialogue with constituency. You must know their interest;
    they must change their definition of success. IBB involves a meeting
    of interests rather than achieving specific pre-determined solutions

> **Steps of ibb**
>
> There is a specific cycle or process for interest-based bargaining.
> The
>
> importance of following the process is two-fold.
>
> First, it lays out a natural problem solving sequence.

Second, it assists all of the participants in staying on the IBB track
and not reverting to traditional bargaining.

1.  Select and focus the issue

-   An issue is a topic or subject of negotiations

2.  Discuss interests

-   An interest is one party's concern, need or desire about an issue

2.  Generate options

-   Options are solutions that can satisfy an interest

2.  Establish objective criteria

-   Criteria are characteristics or factors to compare and judge options

-   Examples: simplicity, fairness, affordability, flexibility, legal,
    acceptable

2.  Apply the criteria to the options

-   There are a variety of different tools to complete this step

2.  Develop the solutions

-   How can the options be used as real solutions?

2.  Reduce the solution to written language

## Techniques

> There are four main tools or techniques used in the interest-based
> process. Using these tools helps to identify a variety of options or
> possible solutions to a problem.

1.  Brainstorming

-   Used to develop options and criteria. Helps the parties to be
    creative by restricting evaluation and not assigning ownership of
    ideas.

2.  Consensus Decision Making

-   Arriving at agreements that all members of the bargaining teams can
    support. Used when moving from one step of the process to the next.

2.  Flip charting

-   Used to record all ideas of the group and display on the walls so
    that the group can have a common focus, reduce misunderstandings,
    and unify the group effort.

2.  Active Listening

-   Communication techniques to help be sure that you understand the
    message you receive and that others understand your message

### MISSION STATEMENTS

#### MILLER DWAN AND UFCW 1116 LABOR MANAGEMENT COMMITTEE

> The mission of the Labor Management Committee of the United Food and
> Commercial Workers Union and Miller-Dwan Medical Center is to promote
> team building and open and respectful communication to ensure prompt
> resolution of issues. The skills developed in the successful 1998
> contract negotiations will be utilized to meet the needs of both
> parties.

#### MILLER DWAN AND IUOE LOCAL 70 LABOR MANAGEMENT COMMITTEE

> The mission of the Labor Management Committee of the United Food and
> Commercial Workers Union and Miller-Dwan Medical Center is to promote
> team building and open and respectful communication to ensure prompt
> resolution of issues. The skills developed in the successful 1998
> contract negotiations will be utilized to meet the needs of both
> parties.

#### MILLER DWAN AND MLPNA LABOR MANAGEMENT COMMITTEE

> The Labor Management Committee is a forum for communication between
> management and the LPNs which is in our mutual interest.
>
> We are committed to working openly and honestly in an atmosphere of
> trust and respect.
>
> We believe our efforts will result in an enhanced work environment
> that will be evidenced by improved decision making, timely resolution
> of concerns and an improved relationship between labor and management.

## 

## GROUND RULES

#### MILLER DWAN AND UFCW 1116 LABOR MANAGEMENT COMMITTEE

1.  No alternates

    Meetings will be on paid time

    Quorum is a 100% of the members

    Experts will be invited as needed

    Communications will be joint and may include issues and interest as
    well as final resolution

    Communications will be review by entire committee before being
    distributed

    Information charting will be the minutes; The employer will have
    minutes typed

    Minutes will be distributed to all members before the next meeting

    Information charts will be available when minutes are reviewed

    What is said in the meeting stays here unless part of communication
    report

    One person talks at a time

    No personal attacks

    It is ok to have humor if not hurtful

    Use consensus for decisions

    Full participation\-\--everyone participate

    No ownership of ideas

    Breaks taken as needed

    Freedom to invent without evaluation

    Probing a link between interest and options (when developing options
    consider interest)

    Start and end on time

    No side Bars

    No Snacks at meetings

[^1]: The other two private hospitals in Duluth were started and
    operated by religious organizations.

[^2]: Hill Burton Funds were monies made available to hospitals by the
    Federal Government for construction, renovation and expansion of
    hospital facilities. In order for hospitals to receive these funds
    they needed to agree to care for patients even if they were unable
    to pay and did not qualify for either state or federal government
    assistance.

[^3]: Northeastern Minnesota historically has been an area of strong
    unions and highly grueling labor-management relationships, be it in
    the taconite mines, on the shipping docks, or in the general
    business environment.

[^4]: UFCW members were covered under the Union's Health and Welfare
    Plan, while all other Miller-Dwan employees were under the
    Miller-Dwan's Health Insurance Plan. MDMC did not want to move the
    UFCW employee's under the Hospital's plan because this group's
    experience with high usage of health insurance. If the UFCW members
    were to transfer to the Hospital's plan, the cost of MDMC's health
    insurance premiums would have dramatically increased. Since the
    Union Health and Welfare plan, like all such plans, require all
    employees under the collective bargaining agreement to belong to it,
    it was extremely important to the Union that the Hospital pay the
    full premium cost. At the same time, other Miller-Dwan employees
    under the hospital plan, and who could decline coverage if they did
    not need it, had to pay 15% of the premium cost themselves if the
    signed up for health insurance, while Miller-Dwan medical center
    paid the remaining 85%. When Miller-Dwan management failed to
    recognize the differences in a Union Health and Welfare Plan and
    their own, they insisted the employees covered under the Union's
    plan also pay 15% of the premium cost. In order to reach an
    agreement the Union inflated the premium cost so that the 85% paid
    by the Employer was equal to a 100% of the premium cost. During the
    term of the collective bargaining agreement, it became obvious to at
    least some of management negotiators they had been mislead. Since
    the chief negotiator for the Hospital, in the 1992 negotiations had
    left, it was unclear whether he had been a party to the deception.

[^5]: A caucus refers to a meeting held within a bargaining committee,
    by itself, away from the table. By its very nature, a caucus often
    means that the parties are not negotiating or work9ing together
    while it is taking place

[^6]: In the past, Hospitals were able to charge whatever it cost them
    to treat and care for a patient. There existed what was called
    "usual and customary cost" that a hospital needed to explain if they
    exceeded. Now payments were being made at a set dollar amount
    depending on the diagnosis. If it cost the hospital more to treat a
    patient then what was allowed to the hospital for that specific
    medical problem, the hospital had to absorb the loss.

[^7]: See Appendix 1 for explanation of IBB.

[^8]: See appendix B for ground rules and mission statement

[^9]: See appendix B for ground rules and mission statement

[^10]: See appendix B for a copy of the ground rules and mission
    statements.