TA 6/6 Definitions open per diem proposals with clarification on

Oregon Nurses Association (ONA)/Sacred Heart Medical Center (Medical Center) and Sacred Heart Home Care Services (Home Care) Negotiations FINAL TENTATIVE AGREEMENTS (TA) for both the Medical Center and Home Care Services August 2, 2016 SACRED HEART MEDICAL CENTER PROPOSALS UPDATE Article ONA Sacred Heart Medical Center Status 3 Employee Per diem nurses Reached a TA on all TA 6/6 Definitions open per diem proposals with clarification on 6.1.4 Suspension Pending Investigation 6.4 Exit Interviews 7.7 Grievance Procedure 8.4.8 Combined 8/12 hour positions 8.5 Meal and Rest Period (8.6 in Home Care contract) 8.5.1 Unit Plans 8.5.2 (NEW) Quarterly Review of Meal and Rest Period per diem status and work requirements. 4/20 Provision for making nurse whole if put on unpaid suspension pending investigation. NEW: Exit interviews--upon request a nurse shall be granted an exit interview upon transfer or termination/resignation. 4/20 Provides for paying nurses who represent members in disciplinary or investigative meeting if unable to do so during shift. 5/20 New: Positions consisting of combinations of 8- and 12-hour positions shall not occur without mutual agreement between the nurse, the Medical Center and the ONA. The parties agreed to new language including: Missed break or meal periods due to patient care requirements or accurate reporting of missed meal or rest periods shall not constitute a basis for disciplinary action. There will be no public or publicized criticism of individual RNs for missing meal and/or breaks for accurate reporting. Unit meal and rest period plans will be a component of the unit staffing plan. Plans will be modified by unit based councils (UBC). If no consensus is reached, the plan will be referred to the staffing committee as a designated hot spot. The parties agreed to review trends in nursing units to determine if meal and break plans are adequate to ensure nurses are receiving their uninterrupted meal and rest breaks. The data will also be used to 4/21 countered by modifying 6.1.4 shall be paid instead of shall be made whole 4/25 clarified that paid for lost time is the same as be made whole 4/20 Accepted and TA TA 4/20 TA 6/17 1

Data 8.6.4 Deviation from anticipated days off 8.6.5 Mandatory overtime 8.7 Assignment to Non Regularly Scheduled Shift 8.9.1, 8.9.2, 8.10, 8.10.1 develop action plans for units and identify best practices. Work will be done at labor management committee (LMC) meetings. Both parties agreed to modified language as part of staffing package proposals: The Medical Center shall seek volunteers first - before changing nurses schedules. (this replaces reasonable efforts will be made. ) Also, the staffing office will change their practice and attempt to fill holes with per diems before asking FTE d nurses to change their schedule. Included language from the Oregon Nurse Staffing Law that makes explicit that nurses cannot be required to work past regularly scheduled shift more than one hour in case of unanticipated vacancy. Added provisions to offer incentive pay to fill known vacancies. Created process for recording overtime as mandatory or voluntary. Created process for review of mandatory overtime protocol with ONA. Requires Medical Center to provide minimum of two weeks notice prior to assigning a nurse to a non-regularly scheduled shift. A maximum of four nurses working nonregularly scheduled shifts for one cycle. And, new language stating - A nurse assigned to a non-regularly scheduled shift shall be kept whole in terms of their regular FTE without being required to work additional scheduled hours on other shifts. New language adds details of required orientation to a unit. Language specific to float pool was added to clarify number of units required to orient to and paid time to attend in-services in float units. TA 6/30 TA 6/30 TA 6/30 9.2.4 Compensatio n for extra shifts (CES) Contracts) 9.4.3 Excess of standard shift No nurse with less than six months experience will be floated. Increased CES pay to $18 per hour Deleted: This provision shall not be triggered if a nurse commences work within two (2) hours of his or her regularly scheduled shift, provided that the nurse is 6/10 Medical Center accepted ONA language change. 2

9.4.4 Consecutive weekends (9.4.3 in Home Care contract) 9.6.1 Shift Differential, Evening 9.14 Preceptor Pay 9.16 Payroll practices 9.19 Care of Sexual Assault Victim 10 Paid Time Off (PTO) 11.1.3 Continuation of Benefits paid at the premium rate if he or she works in excess of the nurse s standard shift. The parties agreed to language stating that nurses who have agreed to work consecutive weekends without premium pay can withdraw that authorization with two cycles notice to their manager. 5/20 Propose increasing evening shift differential from $2.35 to $2.50 5/20 Propose increase in preceptor pay from $1.50 to $2 per hour. The parties agreed to new language stating that new hires will receive education regarding payroll readability during their new employee orientation. 5/20 New Language: A nurse who is trained or certified in the care of a sexual assault patient shall receive $150 in addition to their regular rate of pay for each exam they perform. The parties agreed to adding new language to the contract that incorporates the new Paid Sick Leave Law provisions but does not change the PTO cap or accruals. 5/12 Provides for the continuation of health insurance benefits for nurse who is absent from work due to a workplace injury. ONA rejected memorandum of understanding (MOU) maintains proposal of 5/12 6/10 Medical Center accepted ONA proposal 6/10 Medical Center accepted ONA proposal 6/10 Medical Center counter proposal: A nurse who is trained and/or certified in the care of a sexual assault patient shall receive $150 stipend per shift when they perform such an exam. Nurses that received SANE certification pay pursuant to 9.11 shall not be eligible for this stipend. 6/17 Medical Center proposed MOU which would require parties to meet and discuss these proposals after negotiations are concluded. 11.2 Family and Medical Leave ONA agreed to revised MOU New language: Agreed to have on-call nurses be eligible for Family Medical Leave (FMLA)/Oregon Family Leave (OFLA) based on hours compensated. 11.8 Light Duty 13.9 Assumption of Duties of The parties agreed to new language The Medical Center shall make a reasonable effort to accommodate light or modified duties for nurses on workers compensation. ONA accepted 4/25 Medical Center proposes deleting second from the last sentence of this article. This would allow a nurse that is 3

New Positon 14.2.4 Mandatory Low Census Maximum 14.2.5 Protocol for addressing excess low census 14.3.1, 14.3.2, 14.3.3, 14.3.6 Work Force Reorganizati on. Notice 15.7 Pharmacy Benefit for Retirees 15.7 Medical Premium Assistance (different from Only mandatory low census (MLC) hours will be counted in determining whether a nurse has exceeded the MLC hours. Nurses maximum MLC hours shall be calculated as follows for six consecutive cycles: add grid that defines MLC max to contract Added actions to consider to remedy excess low census: Allowing nurses to voluntarily reduce scheduled hours with continued benefits level and guaranteed return to scheduled hours for a specific number of cycles: Allowing nurses to voluntarily be removed from the schedule for a specific period of time with continued benefit level and guaranteed return to schedule hours without utilizing PTO. Parties agreed to improvements in work force reorganizations including language: the Medical Center shall present the reorganization plan at a unit staff meeting with an invitation to ONA and unresolved reorganization negotiations shall be suspended 30 days prior to the expected start date for renegotiation of this agreement and remain suspended until a new agreement is implemented. Also, agreed to a 30-day extension of the 60-day timeline by either party. The Medical Center and ONA shall agree to evaluate the effectiveness of the reorganization to identify additional changes that may need to be made and evaluate whether the goals originally identified were met. This will occur within 60 and 120 days after the implementation of the reorg. 6/17 Modified Medical Center proposal to eliminate pharmacy benefit for future retirees but to continue them for current retirees. 6/17 Accepted Medical Center proposal of 5/24. transferring to another unit to assume their new duties after the end of the four week cycle following the cycle in which acceptance occurs. 4/25 Proposing to eliminate this benefit. 6/17 Agreed to ONA proposal 5/24 New: Medical Center will continue to offer Premium Assistance Program through the duration of this Agreement. Through this benefit, eligible nurses may receive financial assistance to TA 5/24 TA 4/21 TA 5/24 4

Association 15.7 proposal) 15.8 Employee Discount 15.9 Enhanced Chronic Condition Program 15.10 Insurance Expenses incurred at PeaceHealth Facilities 16.2 Continuing Education Program 16.3 Educational Days and Expenses 16.4 Tuition Reimbursem ent 16.6 Extended Training Programs 6/17 Accepted Medical Center proposal of 5/24. 6/17 Accepted Medical Center proposal of 5/24. 6/17 Accepted Medical Center proposal of 5/24. The parties agreed to clean up of this article to differentiate between voluntary trainings and in-services; mandatory trainings and inservices and meetings. We also agreed that nurses can either return to work after a training so that they will not suffer any loss in pay or take low census with or without PTO if the class is less time than the regularly scheduled shift. Nurses shall be paid for obtaining required certifications. Increased ONA Education Funds to $205,000 in 2016; $215,000 in 2017 and $220,000 in 2018 Increased provision of tuition reimbursement for Medical Center RNs from $55,00 to $120,00 and for Home Care from $5,000 to $15,000 Added Behavioral Health sponsored training programs. cover 100% of the cost of their Employer provided medical premiums. This would apply to households with income less than 250% of the federal poverty level. 5/24 New: The Medical Center will offer nurses and their dependents covered under employer medical plans to most favorable discount for services rendered at PeaceHealth facilities, providers and laboratories. 5/24 New: Nurses enrolled in the Enhanced Chronic Condition Program are eligible to receive free preventive medications..conditions covered under this program include: diabetes, COPD, asthma, congestive heart failure and coronary artery disease. 5/24 New: Nurses covered under PeaceHealth Insurance plans who have outstanding balances to PeaceHealth Facilities and/or providers will be offered a reasonable payment plan upon request. Nurses that comply with the payment plans will not be subject to further collections or garnishment. TA for Home Care 7/11 TA MC 7/19 TA 6/29 5

17.8 Staffing (17.6 in Home Care 18 Nursing Care Delivery 20.1 Sale or Transfer 20.7 Labor Management Committee 20.7.1 Labor Management Health Benefits Committee Parties agreed to language as part of staffing package proposals to modify staffing request and documentation (SRDF) process and distribution. Nurses are encouraged and expected to notify their manager, house supervisor/house coordinator or charge nurse/facilitator of staffing issues as close as possible in time proximity to the event(s) giving rise to the staffing concern and if practical prior to submitting an ONA Staffing Request and Documentation Form (SRDF). The Medical Center will assure that documentation of staffing deficiencies and requests are not discouraged. Retaliation or intimidation of an individual nurse who submits documentation of staffing deficiencies shall not be tolerated. Medical Center contract only: Manager responses to SRDFs shall be sent to the PNCC Chair AND Staffing Committee. The parties agreed to many changes in this article (see upcoming redline for all the language). Changes in language include: adding the staffing matrix to the staffing plans (a subcommittee will be developed to do this work); paid time for nurse representatives to attend UBCs on a quarterly basis to assist with staffing plan development; paid joint training of staffing committee members and UBCs on best practices for staffing plan development, implementation and evaluation, better processes for unit staffing plan approvals at the unit level. Also provides for ONA unit steward to be an ad hoc member of the UBCs. Proposed maintaining current language but adding merger to the title and body of article. LMC meetings to be held monthly not to exceed two hours unless extended by mutual agreement 5/12 New: Labor Management Health Benefits Committee joint committee with administration and other represented employee groups and system level convening twice a year 5/24 Proposes creation of a health benefits committee that would include nurses, administration and other represented employee groups. 6/17 Modified Medical Center proposal adding provision for benefits committee to meet with benefit reps from TA 6/30 6

20.10 New Article: Introductory Meeting for Managers 20.11 New Article: Contract Training 21.1 Duration Appendix A Wage Rates Appendix F /Appendix I Mandatory Training Appendix re: Prevention and Response to Violence in the Workplace New Appendix Voluntary Call New MOU Workers compensatio 4/20 Propose new requirement for new managers to meet with ONA and bargaining unit co-chairs with paid time for nurse. 4/20 Propose joint trainings on contract with nurses and administration following ratification with paid time for nurses 5/20 Propose a three year contract expiring June 30, 2019. 8/1 Agreed to March 15, 2019 as new contract expiration. The parties agreed to a 2.5% raise retroactive to July 1, 2016; a 3% raise July 1, 2017; a 3% raise on July 1, 2018. The parties also agreed to adjust steps 7-8 so that they are 1-year steps instead of 2-year steps. This becomes effective July 2017. Package with Article 16 agree to 4-month notice of mandatory trainings ONA agreed to 4-month notice requirement. Agreed to task force to address workplace violence and safety protocols. 4/25 Proposed adding Voluntary Call Pilot program as a permanent Appendix in contract. 5/20 added provision to let any unit that wants to participate can. Both parties agreed to make the current voluntary call program permanent for Med/Surg and OHVI units. Other units can participate by mutual agreement. Added a pilot program for University District voluntary call for Medical, Behavioral Health, Emergency Department and Rehabilitation with Regional Infusion Center able to participate at a later date with mutual agreement. The parties agreed to meet and negotiate continuation of insurance benefits for nurses injured or ill as a result of a workplace event. PeaceHealth twice a year. This will be a joint committee with SEIU. 4/25 Countered deleted paid time provision but otherwise accepted proposal with addition of deadline within 90 days of new manager hire date. 4/25 Countered with some language revisions and a deadline of within 90 days of ratification. 5/24 Counter proposal: four year contract expiring June 30, 2020 7/19 proposed 3 year contract expiring March 15, 2019 4/25 Medical Center proposing to reduce notice requirement for mandatory training from six months to three months. Changed Employee Information Center to Learning Management System TA 6/29 7

n and temporary modified work for on the job injury/illness New MOU Emergency Department (ED) Holding CareConnect Training Side Letter The parties also agree to meet and discuss best practices and enhancements to provide modified duty assignments and support nurses with work-related injuries. This shall commence no later than first quarter of 2017. Orientation to ED holding. Agreed to MOU that specifies adequate orientation for nurses and facilitators in ED holding. Every effort shall be made to ensure that nurses do not suffer a loss of pay as a result of attending trainings required for CareConnect implementation. The parties shall appoint a nurse to participate as a liaison for the project. And, staffing shall comply with unit staffing plans during the implementation of CareConnect. SACRED HEART HOME CARE SERVICES PROPOSALS UPDATE Article 8.9 Orientation and Skills Maintenance 9.6 Hourly Differential 13.7 Regional Assignments 16.2 Continuing Education Program 16.3 Education Hours and Expenses ONA Strengthen language for required orientation. Provides for nurse s judgment to be respected regarding their skills and experience in taking a patient care assignment. Parties agreed that all nurses who work or are scheduled to work on call a minimum of three consecutive hours after 1500 shall be paid a differential of $2.50 per hour. This provision does not apply to nurses who choose to flex their regular schedule Sacred Heart Home Care Services (Home Care) Agreed to assign preceptor to all new nurses. beyond 1700 hours. 5/18 ONA accepted 5/18 Proposed adding email to Available regularly scheduled regional patient care assignments shall be noticed to bargaining unit nurses by email and in-house voice mail. 5/18 Proposed adding The Agency shall reimburse a nurse for the cost of obtaining any certification required for their position. (Specified both Propose decrease in education hours from 750 to 500 and increase of dollars for cost of education from $11,500 to $24,000. Propose that pooled funds be available beginning February 1 each year instead of April 1. Status TA 6/22 TA 5/18 TA 7/11 17.4 Increased paid time for professional TA 5/18 8

Committee Meetings Appendix I Mandatory Training MOU Staffing Task Force Orientation Functional Technology Workplace Safety nursing care committee (PNCC) members to attend meetings and perform work on behalf of PNCC from 20 hours to 30 hours. ONA agreed to a 4-month notice for mandatory trainings this does not apply to the Medical Center which is still part of a package with Article 16 5/18 Propose re-establishing staffing task force with 60 days of ratification. Add language that directs staffing task force to develop a methodology for determining and accounting for weights of visits in its staffing recommendations. Propose monthly meetings to start then quarterly meetings after current staffing issues have been addressed. Agreed to creation of orientation task force. 5/18 Proposing an interest-based discussion and contract language develop with Home Care. 6/22 Counter with proposal to have LMC provide input instead of PNCC 5/18 Proposing an interest-based discussion and contract language develop with Home Care. 6/22 Accepted Home Care proposal with some modifications. 5/18 Home Care countered with minor language changes. Home Care willing to engage in interestbased discussion on this topic. 6/22 Proposed adding the acquisition of technology to Article 18.4 with PNCC input. Home Care accepted Home Care willing to engage in interestbased discussion on this topic. 6/22 Proposed appendix affirming commitment to providing for workplace safety and making safety a standing item for the LMC TA 7/13 TA 5/18 TA 6/22 TA 6/22 TA 6/22 9