366 Human Resources Management for Public and Nonprofi t Organizations
2007 – 2008. Five staff positions were cut from management as well (Fleming,
2007a, 2007b, 2008; Loft, 2007a, 2007b).
The impact of competition and organizational restructuring has
become an issue in nonprofit organizations. Contracts have called for
employers to notify employees of impending layoffs and offer voluntary
leaves of absences to employees before reducing their hours. In other
circumstances, unions have been called on to defend professional auton-
omy and improve working conditions. Collective bargaining has expanded
the scope of labor negotiations to include such issues as agency - level
policymaking, agency missions, standards of service, and professional
judgment. Other negotiated topics have been coverage for malpractice
and professional liability insurance, legal representation of workers, workload
issues, the provision of in - service training, fi nancial assistance for licens-
ing examinations, and remuneration for enhanced education. Professional
employees in both the public and nonprofi t sectors are joining unions due
to changes brought about with privatization and the shift toward managed
care not only in the health care fi eld, but also in the provision of social
welfare services. As more public services become privatized and former
public employees enter nonprofi t agencies, nonprofi t managers can expect
to see an increase in union activity.Privatization of Public Services
The movement toward the privatization of public services was acknowledged
by AFL - CIO president John Sweeney in 1995 when he spoke to the Califor-
nia Association of Public Hospitals. He projected that 1.7 million health
care workers could lose their jobs as a result of proposed cuts in Medicare
and Medicaid. He expressed concern that an increasing number of public
sector service workers, such as technicians, nurse aides, and nurses work-
ing in hospitals, nursing homes, home health agencies, ambulatory clinics,
blood banks, public health programs, and health maintenance organiza-
tions, could lose their jobs as more health care services become privatized.
In fact, in the health care organizations, unions are visible and vibrant.
Nurses in West Virginia, Kentucky, and California have gone on strike in
2008 in protest over working conditions, lack of professional input, and
wages.
Regardless of whether public health services become privatized, many
unions have already adopted an aggressive posture to organize public,
private, and nonprofi t health care facilities. As health care jobs continue