San Francisco Nurses Ratify a Contract With Safe Staffing Levels

96% of Registered Nurses in the City and County of San Francisco overwhelmingly ratified a new contract today after months of consistent actions highlighting the impacts of inadequate staffing levels and the need for sustainable wages.

The one-year contract (which begins July 1) marks a major victory for Registered Nurses throughout the City and County of San Francisco hospitals, clinics and community. It starts with a $0.75% one-time bonus, with a total 3.25% COLA and with a 7.5% Medical Emergency Response Team Differential.

The ratification comes on the heels of the expansion of the new Zuckerberg San Francisco General Hospital. For several months leading up to the opening, Registered Nurses throughout the city spoke up about the high diversion rates, the inadequate staffing and the need for sustainable wages so nurses can be available to live and work in the Bay Area. Actions were held at Laguna Honda Hospital, San Francisco General and a massive rally at City Hall.

“We are extremely excited that our nurses ratified this contract with the City and County of San Francisco. Through this contract our patients will have the access to the quality services they need that helps to build a healthy San Francisco. Together with Nurses throughout the City we achieved two goals: We gained more staff to support the needs of San Francisco and we received a fair contract,” said Aaron Cramer, San Francisco General Hospital Registered Nurse.

Other contract benefits include:

  • Dedicated break coverage for units with Title 22 ratios
  • Increased staffing for Med Surg, Laguna Honda, SFGH Emergency Department, PACU, Psychiatry and Maternal Child Health
  • Part-time employees may apply for full-time reassignment
  • Fast tracked processes for tuition reimbursement
  • $50,000 life insurance for covered employees

Download the tentative agreement for San Francisco RNs

Download the Memorandum of Understanding for San Francisco RNs

Download the MOU Extension Agreement (2016-2019)

Watch a recap campaign video:

Read some of the coverage here:


Mission Local


San Francisco Examiner

San Francisco Examiner

San Francisco Examiner

San Francisco News

Download the Assignment Despite Objection Form
Download the Assignment Despite Objection Form for Jail and Health Services RNs
Download the Patient Safety Reporting Form

Related Pages:
Member Resource Center
Registered Nurses Industry Council page
SEIU Local 1021 Calendar

Nurses Declare Psychiatric Healthcare State of Emergency for San Francisco


New Data from City Shows Overcrowded Psychiatric Health System, and Epidemic of Untreated Mental Health Problems

More than 400 registered nurses and other healthcare staff at San Francisco General Hospital rallied to warn the public that the City’s psychiatric healthcare system has entered into a state of emergency, citing new data showing sharp jumps in the amount of time that the psychiatric emergency services and the emergency departments are on diversion, closing the facility to most new patients.

The City’s other emergency rooms do not offer the same level of care, especially for psychiatric issues; the result is an epidemic of untreated and under-treated mental health problems in the community.

These problems could worsen in the new facility, which was paid for with public money, but will open with services on diversion, departments understaffed, and no solutions in sight to this crisis.

The nurses released new data showing a sharp increase in 2016 in condition red for psychiatric emergency services. Psychiatric Emergency Services are “condition red,” essentially closed to new patients 34% of the time in January of 2016, up from 16% of the time in February of 2015. PES have been on condition red for approximately 250 hours each week of 2016.

The new data also showed that the San Francisco General Hospital Emergency Room is on diversion a record 60% of the time in February of 2016. That figure is expected to rise again in March. This indicates a significant and worrisome weakening of the City’s emergency room abilities.

“We see this crisis in psychiatric healthcare. We work in it. We know the tragedy. What can we do? We have to call it what it is, a state of emergency. City Hall wants to cover this up, but let’s fix it instead. We can’t let these problems just transfer to the new building and continue to fester,” said Jeanette Conley, a Psychiatric Emergency Services Registered Nurse.

On May 19th, nurses and healthcare workers will bring their message directly to Mayor Lee at City Hall. Join them, along City and nonprofit workers, to stand up for the communities they serve. Download the flyer (PDF).

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Nurses and Healthcare Professionals Alert Public of Chronic Understaffing and Title 22 Staffing Ratio Violations in SFDPH


Informational Picket Educates Public on Problem of Understaffing at San Francisco General Hospital and San Francisco Department of Public Health

Could Potentially Compromise Delivery of Care and Patient Safety as Health Research Demonstrates Nurse Understaffing Leads to Worse Patient Outcomes

Registered nurses, Nursing Assistants, Radiology Techs, and other healthcare workers gathered outside General Hospital on Thursday, February 25 to ring the alarm bell for the public about chronic understaffing and Title 22 violations occurring across SF Department of Public facilities.

Although San Francisco is on the verge of opening a new hospital building, the healthcare workers will report on the ongoing and unaddressed issue of understaffing.

For example, when nurses are on their legally-mandated breaks, they utilize a buddy system which puts them and the hospital out of compliance with Title 22 Staffing Ratio Laws. During break time, this buddy system could potentially place 1 nurse responsible for up to 10 patients, depending on the unit they work on.

Another example of short staffing occurs in the radiology department. San Francisco General is a Level 1 trauma center that relies heavily on the radiology department to perform imaging in a timely manner. Understaffing in this department could lead to a delay in care, and every minute counts for trauma patients.

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SF RN Bargaining Survey -2016


San Francisco Department of Public Health (SF DPH) is the heart of the city and cares for some of the most vulnerable residents. In the midst of a thriving economy, SF DPH remains understaffed and under resourced, which compromises patient and staff safety. We strive to provide the best possible care to our patients but need the resources to do so. We have an opportunity to do this when we begin contract negotiations in March. Our contract expires on June 30th of this year.

Our current salary, when compared to other area hospitals ,will not enable SF DPH to recruit experienced nurses as we prepare for the transition to the new hospital. We need fair wages and benefits that allow us to retain nurses committed to serving our diverse community. We need to ensure that front-line nurses have a voice in DPH policy decisions that affect our patients and us.

We need to hear from you to prioritize all of our issues at the bargaining table. Thank you for filling out the SEIU 1021 RN bargaining survey today.

Complete the survey

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Notice to SF Registered Nurses: Bargaining Team Election


It’s time to elect the Bargaining Team! The San Francisco Registered Nurses contract expires on June 30th this year, and we urge you to nominate yourself or someone in your chapter that will represent your values.

We are holding nominations and elections to the Bargaining Team from our three different SEIU 1021 RN Chapters of SFGH, Laguna Honda and RN Community.

RN Bargaining Team Members should

  • Be a member of SEIU 1021
  • Be open to learning new things
  • Represent all RNs, not just their specific work area
  • Be committed to sharing information with coworkers


  • Be organized
  • Inspire confidence in judgment and ability
  • Be a good communicator
  • Be willing to assess risks and outcomes
  • Be able to tolerate tense situations and conflict
  • Must be willing and able to put in the time. Most meetings
    are during the day
  • Bargaining Team members will be paid “lost time” by the
    City. “Lost time” means you don’t lose pay but you also don’t
    get overtime.
  • Attend meetings that sometimes go into the evening and
    are on weekends, possibly on their scheduled days off.

February 8 to February 19
Notice of Elections and Nominations
The notice will be posted on and union bulletin boards at your worksites. Any member may nominate themselves or another member in their Chapter. The Election Committee will verify the eligibility of all candidates.

February 20 to February 22
Eligible candidates announced
Eligible candidates’ names will be posted on The date, time, and location of voting will also be posted on union bulletin boards.

February 24 to March 2
Voting will take place in person at various worksites with contested seats. Dates, times, and voting locations will also be posted on union bulletin boards and on

March 2
Vote Count and Results Announced
Ballots will be counted at 5:00 pm on March 2nd. The results of the elected Bargaining Team members and alternates will be posted on

SEIU 1021 Chapters & RN Programs

Bargaining Team Member(s)
to be Elected


Med-Surgery 4
ED 1
Labor & Delivery, NICU 1
Psychiatry/BHC, PES 1
Critical Care 1
Adv. Practice, from DPH, HSA, SFFD 1
Clinics 1
Laguna Honda TOTAL: 2
RN Community TOTAL: 5
COPC (Clinics)/CBHS (Mental Health Clinics0 2
DPH Programs (MCAH, Call Centers, H@H, APS) 1

Download a copy of this flyer and the nomination form (PDF)

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Oakland Airport Hilton, September 26-27


For the latest updates, go to:

The convention will be a transformative event, where members will gain greater clarity, energy, motivation and direction to step more fully into their power, with grace, vision, courage and knowledge. This is an opportunity for chapter building, engaging and developing potential leaders, hence making it a priority for staff and elected officers.

Q: What are the qualifications to be a delegate?

A: To be eligible, a member would have to had paid dues for any 4 months in 2014 as well as either January or February, 2015.

Q: Can fee payers participate in the nomination and/or delegate election process?

A: Yes, once they sign a membership form, then they can nominate and vote.


 Q: How many delegates can each Chapter elect?

A: Every Chapter gets 2 delegates automatically. After 300 members, each chapter will have 2 additional delegates. For every additional 150 members, a chapter will have 2 additional delegates.


Q: What is the period of time for completing elections?

A: April 20-July 20, 2015


Q: What is an “uncontested ballot”? (Previously referred to as “white ballot”)

A: When there are more or an equal number of delegate slots as candidates, that is referred to as a uncontested ballot and the chapter does not need to hold a full election.


Q: How are alternate delegates selected?

A: In case a delegate can’t participate due to scheduling, illness, etc. Chapters should select alternates even if the delegate election for that Chapter is uncontested or the Chapter does not elect the full number of delegates which it is entitled to.

Here are the rules for selecting alternates: All Chapters are encouraged to select at least two (2) alternates. Alternates need to be ranked by votes received (e.g. the highest vote total becomes Alternate #1, second highest voted becomes Alternate #2, etc.)

In Chapters with “uncontested ballots” (where there are more or an equal number of delegate slots as there are candidates, thus making an election unnecessary), Chapters are still encouraged to select up to two (2) alternates and designate these as Alternate #1 & #2.

Convention Delegates, who become ineligible or unable to attend, shall notify the 1021 Convention Election Committee in writing no later than 8/20/15. An Alternate or Alternates will then be credentialed and seated. Delegates who notify the 1021 Convention Election Committee after 8/20/15 will not be replaced by an alternate.

Q: Which chapters may select honorary delegates? How will honorary delegates be selected?

A:Workers who have recently organized with Local 1021, but who have not ratified their first collective bargaining agreement may select honorary delegates.  The process for selecting honorary delegates will be as follows:  two (2) honorary delegates will be elected at upcoming membership meetings.


If you are a Delegate:

Q: How will delegates register for the convention?

A:  Once the delegate certification form is turned in, the delegate will be sent a welcome letter by e-mail and mail which gives them directions on how to register.  (That is why it is critical that their contact information is on certification form).


Q: Do we pay lost time for delegates attending the Convention?

A: Yes, follow the local’s lost time policy. Anyone working from 12:01am on Saturday through 11:59pm on Sunday will receive lost time.

For example: If a delegate works anytime on Saturday or Sunday they may request lost time. So for instance if a member has a shift that starts 11pm on Friday September 25th but goes to 7am Saturday the 26th they may request the time off for their Friday shift and they would receive lost time per the guidelines specified in the policy.


Q: What are the rules around Friday night hotel stays for delegates?

A: Delegateswho travel 75 miles or more (one way) are qualified for Friday night lodging. All Delegates are entitled to Saturday night lodging (there is no required miles to qualify).


Q: What are the rules around the hotel stay on Saturday evening?

A: All delegates are encouraged to stay at the hotel regardless of how close they live to the venue. The local will pay the cost for double occupancy. Depending on room availability, they may request a single room but would need to pay the additional costs.


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San Francisco Registered Nurses Contract

SF RNs get your contract here:
2014-2016 Staff Nurses Contract 


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San Francisco RNs Approve Tentative Agreement

2014 RN Bargaining Team

Here, get the flyer: RNs APPROVE TA 

We are pleased to announce that San Francisco Registered Nurses of SEIU 1021 have ratified a new two-year agreement by a 90% margin! The votes were tabulated on June 16, with a majority of RN members participating.

In 2014, RNs and our allies came together at rallies, hearings, and ‘Worker Wednesdays’ to call out misguided City Hall policies hurting safe staffing throughout DPH.

We also started a public conversation about City Hall policies that have made San Francisco the City in America with the fastest-rising rate of economic inequality.

This agreement would not have been possible without the solidarity actions of RN members, the dedication of the RN Bargaining Team, and the full support of our organization!


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Tentative Agreement Reached between SEIU 1021 RNs and the City of SF

Our RN Bargaining Team Recommend A ‘Yes’ Vote 

RN Summary Flyer: RN Tentative Agreement Summary 2014

All Tentative Agreements: 2014 RN and SF  Contract Bargaining Tentative Agreements

RN Voting times 1

RN Voting times 2

RN Voting times 3

RN Voting times 4

RN Voting times 5

On Friday, May 30, our RN bargaining team reached atentative agreement with city administrators. In this deal, we won improvements in staffing and won wage increases that keep up with the cost of living. Our bargaining team worked hard to reach this two-year deal and they are unanimously recommending a ‘YES’ vote.

This tentative agreement is subject to your approval/ ratification. We encourage all members to attend informational meetings and vote. Notices for informational meeting and voting locations will be posted at your work site and on

During contract negotiations, RNs and our allies came together at rallies, hearings, and ‘Worker Wednesdays’ to call out misguided City Hall policies hurting safe staffing throughout DPH. We also started a public conversation about City Hall policies that have made San Francisco the City in America with the fastest-rising rate of economic inequality.

Our fight against income inequality continues. We are pursuing a broad program that includes raising the minimum wage to $15 by 2017; protections for tenants and affordable housing; safe staffing for public health and 9-1-1; and an end to tax giveaways to tech CEOs.

Here are highlights of the settlement:

  • City pattern wages (3% in October 2014 and 3.25% in October 2015).
  • 2 year contract expiring June 30, 2016.
  • Health plan—Individuals: 100% of Kaiser rate for Kaiser & Blue Shield. Families & dependents: 95% for Kaiser & 90% for Blue Shield.
  • An additional 26.6 FTEs of RNs to improve staffing models at SF General Hospital, to be hired by November 2014, for the Emergency Room and break relief in med/surg and stepdown units.
  • Strengthen staffing enforcement and dispute resolution.
  • New right to arbitrate violations of Title 22.
  • The city to provide monthly reports to the union on their progress filling the backlog of vacancies.
  • Increase tuition benefits–$2500 per year for CEUs and $3000 for master’s and doctoral study. $500 towards travel and lodging for educational programs. Mayuse ed leave towards bilingual certification.
  • Improve practices around job posting, job bidding, equitable access to out-of-staffing assignments, and involuntary reassignment and layoff process.
  • Improve workplace violence language, including expanded safety training programs for non-hospital worksites.
  • New rights for PHNs to reduce their hours.
  • Ability to carry salary steps between status (P103 to 2320), and ability to leave DPH and come back at the same salary step.
  • Blood draws counting toward productivity for Health@Home.
  • P103s will not be cancelled if there are 2320s in the unit that want to use accrued vacation days instead.
  • Managers will schedule vacation days for nurses approaching the cap in vacation accrual.
  • Pension flip: The City contribution of 2.5% towards the pension cost will be converted into a 1.9% base wage increase for all employees, including P103s.



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Unsafe Staffing Conditions Exposed!

San Francisco General Hospital:
“Our staffing shortage is forcing nurses to do the work of other people like clerks, we don’t have a system to document how breaks are being covered.  We haven’t been able to provide break coverage on a consistent basis.”

unsafe staffing exposed at SFGH vfinal v2-page-001 unsafe staffing exposed at SFGH vfinal v2-page-002

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Bargaining Update #6: More take aways….

Please Fill Out Strike Commitment Cards!

Let the city know we are committed and united!



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