Oregon Health and Science University's Advanced Practice Providers, a title encompassing nurse practitioners, physician associates and midwives, are negotiating their first contract.

About 600 of the providers statewide are represented by the Oregon Nurses Association.

Chelsey Chapman, physician associate at OHSU Cascades East Family Medicine in Klamath Falls and a union member, said her team is frustrated with OHSU's slow progress after a year of bargaining. Chapman said the providers play a vital role in all health care settings, including hospitals, emergency rooms and teaching but the system does not value them enough.

"They just are having difficulties understanding why providers are burned out and why there needs to be changes," Chapman contended. "What we've been doing, the status quo, it's just not safe and it's not sustainable any longer."

OHSU said it does not have the money to meet the union's demands. Chapman countered, citing their plan to invest more than a billion dollars into a Legacy merger, which fell through earlier this month. She emphasized the union is focused on improving patient safety, quality of care, and provider retention.

Chapman explained defining workload is a big part of retention. She said the providers carry a heavy administrative burden long after they have left a patient, which is time they are not paid for.

"We call it 'pajama time,'" Chapman noted. "We're charting at home, we're answering MyChart messages from home, and it's really contributing to burnout amongst all areas of medicine. "

Chapman stressed Oregon cannot afford to lose more providers amid a health care staffing shortage. Data show the state needs 40% more primary care providers in the next decade to meet the need.

Chapman added Advanced Practice Providers can help, as they are trained and certified faster than physicians. The union is urging OHSU to finalize the contract.

"Working in rural Oregon, it really means the difference of us surviving the next 10 months versus being able to thrive and practice in primary care for the next 10 years," Chapman contended.

One report showed 70% of Oregon primary care providers reported stress and exhaustion in their practice at an all-time high, which is 10 points higher than the national level.

Coaches in the Renton School District, just south of Seattle, are organizing with the American Federation of Teachers to fight for what they say are "fair wages" in their first union contract.

Buddy Ryan, head boys track and field coach at Hazen High School, said Renton coaches get paid much less compared with neighboring school districts, which contributes to a 45% turnover rate in coaches from year to year.

"I'm not expecting to go buy a new car off a season of coaching, but I'm not expecting to make minimum wage to be responsible for all these kids," he said. "I think the reality is, a fair wage for a fair day's work is what everybody looks for."

Renton School District has proposed a 2.5% wage increase, far below what the coaches asked for. AFT has said the district has the funds to pay coaches fairly. The district did not respond to a request for comment.

Ryan said the low pay and high turnover rate costs the district more money in training and degrades the quality of the sports programs.

"And then what's the cost to the kids that get a different coach every year? Well, you know what ends up happening? These parents get tired of it and they take their kids to private schools, or they move and transfer them to other schools," he said.

Ryan noted that sports, along with other extracurriculars such as band, are what motivate many kids to keep their grades up in order to participate. He said the district should want to keep the programs strong.

"It's just like when you're a kid at dinner," he said, "and your parents say, 'You've got to eat your vegetables or you don't get dessert.' Well, that dessert is the after-school activities."

Nevada groups concerned about affordability, clean air and health care are speaking out against the "One Big Beautiful Bill Act" recently signed by President Donald Trump.

The new law extends tax cuts from 2017, funded partially by huge cuts to Medicaid and SNAP food benefits.

Dr. Joanne Leovy, steering committee chair for the Nevada Clinicians for Climate Action, noted it also ends the tax credit for electric vehicles on Sept. 30, which drives up the price of an EV by $7,500 while promoting the sales of gas-powered vehicles.

"This bill will dump an extra 2.1 billion tons of climate pollution into the atmosphere over the next decade," Leovy pointed out. "Increasing greenhouse gas emissions by about 7% over prior projections; the equivalent of adding more than 400,000 cars to the road."

The new law also cuts tax credits for rooftop solar and energy efficient home upgrades. Backers said the savings were necessary to fund other administration priorities, such as increased funding for immigration enforcement.

Yolanda Kemp, a member of the American Federation of State, County and Municipal Employees Local 4041, said she worries about job losses in the public sector.

"When states, cities, towns, and schools lose essential federal funding, they will be forced to make cuts to their budgets as well, putting all public services and jobs at risk of being cut," Kemp stressed. "And let me tell you, the 'Big, Beautiful Bill' that is supposed to help hardworking Americans is nothing more than another billionaire giveaway paid for by us."

The change to Medicaid and SNAP are not immediate but will be phased in mostly in 2027 and 2028.


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More than 1,100 caregivers at Portland's Providence St. Vincent Medical Center have voted to unionize, joining the Service Employees International Union Local 49.

Hospital staffers, including certified nursing assistants, cooks, lab assistants, pharmacy techs, environmental workers and patient representatives, will soon begin collective bargaining with management over a new work contract.

Finn McCool, senior food service attendant at Providence St. Vincent Medical Center in Portland, said changes to working conditions in the hospital were a major driver to organize.

"There's a lot that makes St. Vincent a great place to work, but we've also seen just tons of changes over the years around staffing and benefits," McCool explained. "My fellow caregivers really knew that jobs were only going to get harder."

The St. Vincent caregivers will join thousands of other unionized workers at Providence hospitals in Oregon, Washington state and other parts of the country. Providence officials released a statement, recognizing the union and saying they were prepared to work with it toward a new contract.

McCool noted the company made several changes to staffing and work policies without feedback from its employees, with changes to the employees' health care benefits causing a major upheaval.

"It's been a recent change to our health care plan with Aetna switching over, and that was probably a very large reason why a lot of us decided to vote yes," McCool pointed out. "We had our own internal health care system. We changed to a different thing. Co-pays changed. Things were definitely a lot harder with increased deductibles."

McCool stressed political uncertainty, particularly in the government's health care policies, was also a significant concern.

"We're seeing a lot of changes going on with the government with cuts, especially right now," McCool observed. "What threatens us is cuts to Medicare and Medicaid. Our CEO said, 'These cuts are threatening the hospital.'"