BISMARCK, N.D. -- North Dakota has seen a vote that hasn't taken place in the state for quite some time: a union-approved contract in health care.

This week, nurses at St. Alexius Health Bismarck Medical Center ratified a labor agreement with the hospital's parent company. It comes after these workers became the only unionized nurses in the state. They're represented by the Minnesota Nurses Association, which works in multiple states.

Association member Angie Grosz, who works at the hospital, said it's the culmination of several years of standing in solidarity with her fellow nurses to create some history.

"It's the first hospital in North Dakota with a nurse's union," she said, "and now the first hospital working under a contract."

North Dakota is not viewed as a union-rich state, and nurses have said that's underscored by having an out-of-state labor group supporting them. MNA has said the deal was struck after more than 20 negotiating sessions that centered on staffing, workplace-violence protections, and a defined wage scale. It's believed to be the first such contract in the state in more than 40 years.

The Minnesota Nurses Association said it hopes these changes will help retain more registered nurses in Bismarck. Not only will this benefit staff members, Grosz said, but also the people they care for.

"This has really created a great opportunity to for nurses to have a stronger say in their workplace and in the care that they can provide to their patients," she said.

In a statement released after the deal was first reached, the hospital's parent company, Catholic Health Initiatives, said it was happy to finalize an agreement. It added that it appreciated working with the nurses to continue to provide top-quality care to the community.

According to the Bureau of Labor Statistics, North Dakota has the second-fewest number of unionized workers in the country, at just under 18,000.

The agreement announcement from MNA is online at mnnurses.org, and the company statement is at chistalexiushealth.org.


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Researchers have said rural communities face a host of unique challenges, and access to paid leave is one of them. Advocates hope the needs of rural families are part of the debate, as discussion ramps up for a statewide program in Minnesota.

Gov. Tim Walz has included a paid family- and medical-leave program in his proposed budget.

Leota Goodney, activist and retired accounting firm operator from Northfield, said creating pathways for such a benefit could be helpful to small businesses in rural areas. She said it is a struggle everywhere, but is more profound in Greater Minnesota, where smaller firms and the self-employed are considered key drivers of local economies.

"There are not large employers like there are in the urban areas, and many of the large employers in the urban areas already offer some kind of paid family leave," Goodney pointed out.

A report by the think tank New America said only 61 % of women in rural communities have paid time off of any kind to care for a new child or an ill loved one.

The Walz plan calls for nearly $670 million to get the program started, with a less than 1% payroll tax to maintain funding. The Minnesota Chamber of Commerce argued it would place too much financial stress on small businesses.

The organization estimates the plan would cost Minnesota businesses $1 billion, but Goodney countered having employers and their staff pitch in is a small sacrifice in establishing a benefit which can help recruit workers for rural areas.

"I definitely think that it makes living more attractive in rural areas," Goodney asserted. "This is a way to keep people from leaving rural areas to go somewhere else where they can actually make a living."

Nearly a dozen states have adopted paid-leave laws. Minnesota's plan would cover up to 12 weeks of medical leave and up to 12 weeks of family leave.

The state has a $17 billion surplus and Democrats feel optimistic about pushing proposals such as paid leave through because of their majorities. It remains unclear what will be in the final spending plans with several priorities announced in recent weeks.

The state's unemployment rate for women with children younger than age 6 has reached nearly 4%, and according to a new report, around 400,000 parents across North Carolina say they've had to miss work because of a lack of child-care options.

Founder and CEO of Creative Economic Development Consulting Crystal Morphis said nationwide, 16,000 child-care centers shut their doors during the pandemic - and persistent low wages make it difficult to attract workers as those centers reopen.

She said moms of young children especially are feeling the effects.

"In North Carolina, women have about a 10% lower labor-force participation rate than men anyway," said Morphis. "Since the pandemic, there's probably still about a million women sitting on the sidelines throughout the country."

According to federal data, more than 50,000 parents nationwide missed work in December 2022 because of child-care issues.

Data show more than 26,000 North Carolina kids dropped out of preschool and child-care programs during the pandemic.

Cassandra Brooks is the director of Little Believers Academy, a preschool in Clayton. She explained that society's most essential jobs depend on parents having affordable and reliable child care.

"Then those people can't go on to work in their industries," said Brooks. "They can't go on to work at the gas stations, the grocery stores, all of these things that we utilize daily. They can't because they don't have child-care assistance."

Alexandra Porter said she's one of the lucky ones. The single mother of two from Clayton has affordable child care.

Porter said knowing her preschooler is safe and learning during the day has made it easier to continue working at her state government job.

"Being able to come to work is a blessing," said Porter, "and it feels good knowing that I have somewhere to take my child every day so that I can come into work to make my money to take care of my children. "

According to the report, more than half of North Carolina families with young children live in areas designated as "child-care deserts."

New York's minimum wage would increase to more than $20 an hour by 2026 if a bill in Albany is successful.

Known as "Raise Up NY," it would raise the minimum wage over the next three years and index it each year after to match inflation. It would increase wages for almost three-million workers, or about a third of the state's workforce, by 2024.

Some opponents argued a higher minimum wage would discourage people from seeking better jobs.

Sen. Jessica Ramos, D-Jackson Heights, who is spearheading the legislation in the Senate, pointed out some people do not have a choice. She feels the perception of minimum-wage workers isn't entirely true.

"Everybody seems to think that it still is true that fast-food workers are kids working after school," Ramos observed. "But we know that a lot of these workers are actually the main breadwinners in their family. They are even older people who should be on the path to retirement."

The Economic Policy Institute said more than half the workers who would be affected by the legislation are parents.

Some companies are voicing concerns higher labor costs would hurt their bottom line. Ramos countered it is wrong for the state to build its post-pandemic economic recovery on the backs of low-wage workers while inflation is at an all-time high.

While New York state's minimum wage has been at or around $15 an hour since 2019, many feel it needs to catch up with current inflation. A report from the National Employment Law Project finds a stagnating wage could erase the benefits earlier increases created.

Ramos emphasized indexing the minimum wage over time could benefit businesses, too.

"By pegging it to inflation, you are allowing businesses, especially small businesses, to be able to plan ahead, to know what those annual increases might be," Ramos stressed. "That often actually results in better retention of workers."

She added the bill has strong bipartisan support. In a 2022 poll, 70% of likely voters said they believe workers need to earn at least $20 an hour "to live at a decent level." The bill is currently in committee.