Planned Parenthood: Bargaining after Dobbs
Editor’s Note
Keighlyn Alber
I am a medical care assistant at Planned Parenthood Keystone in Wilkes-Barre, Pennsylvania and sometimes travel to Allentown. I’m a member of OPEIU, Local 32. I am responsible for patient intake and education about birth control. I do phlebotomy [venipuncture to draw blood] and ultrasound. We are an island up here, the only Planned Parenthood in all of northeastern Pennsylvania. The rest of our affiliate is basically southeastern Pennsylvania, excluding the Philadelphia area. I just had my six-year work anniversary. There are a handful of people at the organization who have been there a long time, but turnover is high. I am one of the long-time employees. I have dual degrees. Initially I was going for chemistry and then for an MA in Women’s and Gender Studies. During my schooling, Trump was elected. I felt I needed to do something more on the ground. I moved back to my hometown, Wilkes-Barre, where Planned Parenthood had an opening for a medical care assistant at a nearby office.
I was slightly overqualified for the job, but I have always cared about the mission of Planned Parenthood. Gender-affirming care is something that we now offer, and I am passionate about it. The Planned Parenthood Federation of America is a national nonprofit. Planned Parenthood Action Network is a 501(c)(4) in which you are allowed to advocate politically, whereas the health centers are 501(c)(3)s and are broken up into different affiliates, based on the location. Planned Parenthood has different affiliates. Each of them has their individual management and their own system, even though we are all under the Planned Parenthood name. Different affiliates can offer different services, depending on state regulations and legal requirements, particularly regarding abortion access
My shifts are eight hours, depending on the day, the number of patients, and their needs. My day starts by helping to get the clinic set up: checking that refrigerators containing medications and specimens are at the right temperature; making sure temperatures are logged; checking controls on other equipment and making sure everything is clean and ready to go for the patients. I see patients all day. Our schedule is usually full. Because we are the only Planned Parenthood in our region, we see a lot of people from different places in Northeast Pennsylvania. Some patients drive one or two hours to get to our clinic. Most days I am talking to patients, getting their medical information, and educating them on different things, including birth control. I do lab work. I collect specimens, label them and make sure that they are ready to send off. On days when we are providing abortions, I do ultrasounds, as I was trained to do through the clinic. At Planned Parenthood Keystone, people can schedule appointments by calling or going to our website and scheduling an appointment.
Gender-affirming care is something that we now offer, and I am passionate about it.
Our call center is contracted out, so call center workers are not entirely a part of our Planned Parenthood staff. They are able to access our schedules to schedule patients. If patients call and have a question that the call center staff cannot answer, they will call one of the sites. Then they are transferred to a medical care assistant like myself, who is also responsible for being on the phones and answering questions. We are short-staffed. The clinic I work at has a manager, a licensed nurse practitioner who sees our patients, a medical assistant at the front desk who has been there for twenty years, and usually two or three staff who are called back-office medical care assistants. We are the ones who are responsible for patient intake and getting patients ready to see the nurse practitioner. I was getting paid $13 an hour when I started. Planned Parenthood bumped up the starting salary to $17.25 or $17.50 for staff who work at one single site. If you are traveling between different sites, you get $19.50-$22 an hour as an incentive to drive greater distances and work up to four sites. It is the same care assistant job, but they can just throw you wherever they want to put you to work that day.
If you are traveling between different sites, you get $19.50-$22 an hour as an incentive to drive greater distances and work up to four sites.
Right now, we have two floating holidays—just fourteen hours that we can use, giving enough notice during the year. We also have accrued PTO (paid time off) that you can pull from your bank, depending on the number of hours you work. Planned Parenthood’s paternal and maternal leave is still very limited. For example, a nurse practitioner in our center gave birth at the end of last year. She got breaks and time to pump, but no paid maternity leave. That all goes through the Family and Medical Leave Act (FMLA). She worked up until she gave birth so that she could get the twelve-week requirement for FMLA. If workers go over their hours, they get a little ding from management that says, hey, do not do that. They really try to avoid overtime. It is a hard situation because I know that the organization is financially struggling.
There are outside factors that have impacted our affiliate’s income and functions (e.g., the removal and replacement of Title X funding by Trump and Biden administrations, respectively; or the impact of Covid-19 on patient volume and services), but there may also be some mismanagement of funds. In 2022, our affiliate received a $7.5 million donation from [philanthropist and novelist] Mackenzie Scott. (She donated a total of $275 million to multiple Planned Parenthood affiliates.) My affiliate has had years to address its financial hardships and, to my knowledge, has still not accounted for where the entirety of Scott’s huge donation went, only pieces of it. They continue to tell employees that there is a deficit and have not yet “opened the books,” despite union requests to do so.
We decided to unionize last spring and wrote a letter, asking for voluntary recognition. I was on the team that wrote it, and management elected to voluntarily recognize us. But voluntary recognition came only after some union-busting emails. Currently, our union only covers non-licensed staff who are not management. It does not cover a doctor or someone with a nurse practitioner license. Almost 80 percent of the medical care assistants were in support of a union. I am on the contract bargaining committee, and we recently had our very first bargaining session with management.
One issue we are bargaining about is layoffs and what that has meant in terms of our workload. In 2022, shortly after Planned Parenthood got the donation from Scott, they increased the wages of the lowest-paid employees to “market value.” A few months later, we had layoffs. We had another round of layoffs in 2024. It was mostly our lowest-paid employees. They also got rid of a lot of the nurse practitioners. I think that was really what got us moving. Non-licensed employees like me were doing a lot of their work.
. . . [W]e go way above and beyond what any medical care assistant does at any other office.
At any other medical office, a health care or a medical care assistant gets the patient, asks some questions, and then that is it. Whereas a medical care assistant at this Planned Parenthood affiliate is expected to do patient intake, talk to the patient about very personal things, know the ins and outs of all the different birth control methods, and be able to explain them to the patient—what they are, what they do, how to use them, side effects. We are expected to know all about STDs (sexually transmitted diseases) and where to test for them. We do phlebotomy, which medical assistants in most other medical offices don’t do because there is a specific phlebotomist. I do ultrasound. I am expected to be able to not just perform the ultrasound but also to inform the patient of what the ultrasound is, what I am looking at, how far they are in their pregnancy.
In addition to those medical procedures, we are expected to know how to check patients in and out. We are expected to know about insurance-claim payment scales, how to collect money and balance the books at the end of the day. Our position as union organizers is that we go way above and beyond what any medical care assistant does at any other office. We believe that we should be compensated for what we do.
Another issue was health insurance. A lot of people have been struggling with private health insurance plans and enormous bills. Planned Parenthood Keystone does cover reproductive and sexual health: We can get services through our facilities at no cost, but anything else is through insurance. I am basically paying out of pocket, because the deductibles and copays are very high. We are asking management to do better. They were like, “Nope”; this is our option. We are overworked and understaffed, with fewer staff expected to do more.
A lot of people in management positions are doing the jobs that medical assistance would typically do because we are so understaffed at most of our centers. I know other centers are struggling; they may not even have a provider to handle patient appointments. Recently many patients were calling our center saying, ‘Can I get birth control?’ I have run out. We couldn’t get appointments; there just was nothing. Our patients have seen their out-of-pocket expenses increase greatly on the sliding fee scale which we have for patients without insurance. A lot of patients who had been paying $50s for their Depo (Depo-Provera) shot every three months are now paying $80 to $100. We want to do right by our patients. We have to tell them costs went up or we don’t have appointments. The office staff are the ones getting yelled at over the phone about things completely out of our control, which is frustrating.
Planned Parenthood said they do not have enough cash on hand. Management voluntarily recognized our union, but I speculate it did that so they can blame the union for their cash-flow problem. Part of the reason it has taken us so long to start bargaining is because of layoffs. Management implemented a restructuring plan this past summer, and we had to bargain over that before we could do anything else. I feel quite fortunate at this point to be in Pennsylvania. There are some restrictions, but patient access is still decent.
Most of us have very strong feelings about what we do and believe passionately that patients should have access to care.
We see people from all over the country who cannot access care. It has been very tough on us. For most people who work at Planned Parenthood, it is not just a job. Most of us have very strong feelings about what we do and believe passionately that patients should have access to care. We are trying to build a healthy work environment. The happier we are at our jobs, the better we are going to be able to serve our patients and the communities around us.
James Wilging
I am a senior community organizer at Planned Parenthood and a member of the SEIU Healthcare Minnesota and Iowa. I work for Planned Parenthood Minnesota, North Dakota, and South Dakota Action Fund. During Covid-19, I worked as a homecare worker and was a member of the SEIU (Services Employees International Union) in Seattle, Washington. I knew I wanted to get out of home health care and into a steady office job when we all were adapting to the new Covid normal in 2021-2022.
I found a job in the call center at Planned Parenthood. I decided to give it a go. It was really challenging during the pandemic and, frankly, quite scary. It was a great opportunity for me to move into new things. I worked in the health services call center that handles scheduling for the organization. I scheduled for four to five states across our affiliates. I scheduled folks for reproductive services, including abortion care. I was there for two years, and I enjoyed that.
A typical day there is about 85 percent spent either on the phone or documenting calls to make sure patients are set up correctly for their appointments. People share a lot with you on the phone—they do not usually call Planned Parenthood to talk about the top forty on the radio. They usually have quite a bit going on in their lives when they reach out to us, right? Our health services staff are always looking for more support in the health centers, looking for staff-to-client ratios they are comfortable with in terms of working conditions. In the call center, we had among the highest turnover in the organization because of how hard the work is. People did not really always understand exactly what they were getting themselves into when they started that type of work, right? Long hours on the phone are not for everybody, and difficult conversations on top of that make for a tough working environment.
I feel very lucky that I have stories I carry with me from the call center to inform me in my organizing. I really flourished in the call center, but so many of my peers did not have that same experience. When we were hired, wages were not very competitive at $17 an hour. We were working hard. The call center has some of the lowest-paid employees in the organization, and we pushed for a higher wage so that we could retain the people who were great at the work. We did not feel that their time was being adequately compensated. That was a big push for me personally.
People share a lot with you on the phone—they do not usually call Planned Parenthood to talk about the top forty on the radio.
Getting in there to do bargaining was to try to create more fair and transparent wage scales so staff could anticipate their financial planning. Not just week to week, but hopefully for years to come. In 2022, Roe v. Wade was overturned due to the Dobbs decision by the Supreme Court. I have always been a very political person, and politics has always fascinated me. That decision lit a fire under me to get more involved with our political organizing programs here at Planned Parenthood.
There are opportunities for a career ladder at Planned Parenthood. I ended up transitioning out of my role in scheduling and now do community organizing. Working in the scheduling call center was certainly an enlightening experience for me. I saw how valuable that work is to the communities we serve. Planned Parenthood focuses on, and prioritizes, sexual and reproductive health. We are obviously a proud abortion provider in the region where we are safely and legally able to do so. We make sure that we are always following state and local legislation. We are proud to offer abortion care to our patients who need access to it in a way that abides by all state guidelines. For anything that falls into that purview, we are at least a good resource to point you toward someone who can be a long-term provider for you, even if we ourselves are not going to be a long-term provider.
It was challenging as we saw surrounding states such as the Dakotas, Iowa, and Nebraska begin to impose abortion restrictions that did not exist before Dobbs. Understanding day in and day out the ramifications of those decisions on the communities that we serve, that was tough. We have a few different organizations that work under a Planned Parenthood umbrella: the 501(c)(3) organization, Planned Parenthood North Central State provides health care services and education to our community. Our 501(c)(4) organization, Planned Parenthood Minnesota, North Dakota, South Dakota Action Fund, is a smaller organization within the organization that does political and legislative lobbying.
The [Dobbs] decision lit a fire under me to get more involved with our political organizing programs . . . .
Mostly my work now is separate from our health center work. The bulk of my work is done through the 501(c)(4) organizations—Planned Parenthood, Minnesota, North Dakota, South Dakota Action Fund—which handle our political and legislative initiatives. My work focuses on engaging our community of supporters in the political and legislative work that we do here at Planned Parenthood. I work really long hours now. As you can imagine, leading up to the 2024 presidential election, we have a lot of work to do, especially in Minnesota, with its really slim electoral margins. We tend to skew Democratic on the presidential side, but our local elections are very tight. In 2022, we elected a pro-choice Governor and pro-choice majorities in the state house and state senate. We were able to solidify this pro-choice trifecta over the past two years. Our main goal is doing the best we can to maintain it, heading into the next legislative session.
Every department . . . faces unique challenges. . . . [H]ealth services staff specifically face a lot of struggles: long hours . . . providing care to patients who need a lot of emotional support and at times a lot of education.
We voted to unionize with the SEIU (Service Employees International Union Healthcare) Minnesota and Iowa in 2022 and have one wall-to-wall union that covers all PPNCS (Planned Parenthood North Central States), staff excluding managerial employees, managers, and a small number of staff with access to certain confidential information. We negotiated our contract throughout 2022 and 2023 and finally got it in place in January 2024. It took quite some time: thirty-four bargaining sessions; but that is not unusual for a first contract. Every department here at Planned Parenthood faces unique challenges. Our health services staff specifically face a lot of struggles: long hours, those difficult shifts providing care to patients who need a lot of emotional support, and at times a lot of education.
Our new contract does lay out minimum pay grades for every job classification that we have in our organization. It leaves something to be desired, but we were able to raise our minimum starting wage from $17 to $19 an hour in the contract. My understanding is they might even be hiring slightly above that, but, in contract language, we were able to guarantee that. There is one call center that handles all calls for our five-state affiliate: Minnesota, Iowa, Minnesota, Nebraska, North and South Dakota. They have their own staff and are separate from the health centers. The health centers will all have individual staffing plans, based on their capacity and the amount of patients coming into their health centers.
In our contract, we do have guaranteed PTO. We have different banks for accumulating leave, which can be utilized in the event of an extended emergency that is separate from your PTO balance. We have quite competitive parental leave. It is about eight weeks at full pay with flexible usage during the first year of a new child joining the family. This applies to birthing parents, adoptive parents, parents via surrogacy, foster parents, and parents due to court-ordered placement. If you are an hourly paid employee, you are eligible for overtime after forty hours. We have over four hundred people in our unit. We span across four to five states.
Our priorities heading into bargaining were increased wages across the board for staff, specifically for our lowest-paid staff, who were making wages we felt were far below what they deserved for the work they were doing. Also, we wanted to create more affordable and accessible health insurance options, specifically affordable options that would cover families. I joined the bargaining team midway through the process. Originally, we had fourteen or fifteen members, who were elected. After nine months into the process, many of them chose to leave the organization. Six of us were chosen via an election to replace them.
A good bargaining process does not typically have either side walking away feeling super satisfied.
I was mostly involved in economic bargaining. Those conversations around wages and health insurance were challenging. When you go into something like this, you have high hopes for what you can achieve for your peers. Somebody working with them on the ground knows how impactful it would be to their quality of life, if we were able to get everything that we wanted out of a contract. I will say that it was challenging at times to find compromise that felt like we were bringing back to our folks what they truly deserved. A good bargaining process does not typically have either side walking away feeling super satisfied. I am not surprised that there were some things on the cutting room floor I think our people deserved. But it was our first union contract.
In the future, we hope to expand our pay scales to create clear and competitive wages that incentivize employee longevity and get more accessible healthcare options so our staff can afford coverage for themselves and their families. There is still improvement to be made but we did win a lot. Before, we did not have job protections. We did not have grievance and arbitration procedures. We did not have things like a Labor Management Committee to continue conversations between union staff and our management teams. All of those are massive wins. It was difficult, but it was possible because we were able to form something—a union—that truly gives our staff the ability to advocate for themselves and to be treated fairly in the workplace. It serves both our staff and our patients, because it allows us to have long-term employees who are truly experts at providing sexual and reproductive health care, education, and advocacy to the community.
I think the new contract will help us create the work environment we aim for over years to come. Planned Parenthood does work throughout communities in a variety of different ways, whether that is providing health care, education, or advocating for policies and legislation that enhances the lives of our community members. Find opportunities to give time to our causes so that you can support our workers and our patients. Talk to your family and friends about how sexual and reproductive health care is something that should not be cloaked in stigma or shamed. It is something we should be proud of providing—something that enhances the lives of our neighbors so that we are all able to live in a good community together.
Author Biography
Kressent Pottenger holds an MA labor studies from The Joseph S. Murphy Institute for Worker Education and Labor Studies at CUNY and was awarded the SEIU 925 Research Fellowship by Wayne State University in 2012. She is currently working on a research project about 925 and women organizing in the workplace.
