A strike by hundreds of health care workers at Maui Memorial Medical Center and other hospitals will proceed, according to the union representing them.

The United Nurses and Health Care Employees of Hawaii, representing more than 900 workers, said Friday it is gearing up for the strike, as scheduled, on Monday.

UNHCEH had provided 10 days’ notice to employer Maui Health of its intention to hold a three-day strike, starting Monday. After two bargaining sessions Thursday and Friday, UNHCEH Chair Matt Pelc said the two parties are still far apart.

“We’re far off in terms of what a fair agreement is,” he said. “Ideally, we don’t have a strike. Nobody wants a strike.”

But a strike is necessary to call attention to the serious issues at stake, he said.

The strike is scheduled for 7 a.m. Monday, starting with a walkout by the night shift at Maui Memorial, continues from 7 a.m. to 7 p.m. Tuesday and Wednesday and ends at 7 a.m. Thursday, when day shift returns to work.

Workers at Kula Hospital and Lanai Community Hospital also plan to picket on those days.

Maui Health has issued a statement saying all of its hospitals, emergency departments, clinics and offices will remain open.

Additionally, Maui Health says it has contingency plans and a temporary workforce in place to ensure the best care for its patients and that patients should not let union activities deter them from receiving medical care.

The union offered management a rapid-response team of registered nurses willing to respond to emergencies during the strike.

Negotiations are scheduled to resume through the weekend, but the union has already planned a picket sign-making party on Sunday.

According to Pelc, the primary issues the two parties disagree on are wages and safe-staffing ratios.

Without adequate wages that keep up with the high cost of living on Maui, health care workers will keep on leaving, which makes it difficult to retain staff and leads to more shortages.

Additionally, UNHCEH argues that wages for the same positions should be equal across the state and across the Kaiser Permanente system.

The union says a ward clerk at Maui Memorial, for instance, makes about 19.7% less on average than a ward clerk down the street at a Kaiser clinic. Receptionists and lab assistants make 20% less, and a clinical coordinator about 17% less.

These wage differences play out in turnover rates, according to the union — which are at a high of 16.2% for Maui Memorial ancillary staff compared with only 7.3% at Kaiser’s other hospitals and clinics.

“We only wanted to do a three-day strike to make sure management knows this is very serious,” said Pelc, who is also a CT tech at Maui Memorial. “As the only acute-care facility on the island, we worry about the community. These are our friends and our family who come to the hospital. There is nowhere else for them to go.”

But, he said, “If we don’t move these basic needs, the community will suffer for another however many years.”

The union says it is also fighting for safe staffing, and proposed the same gold standard of nurse-to-patient ratios Kaiser has already agreed to in its contract with registered nurses in California.

Safer-staffing ratios are being advocated by unions across Hawaii, including at Kapi‘olani Medical Center for Women &Children, and across the nation as staffing shortages persist. Advocates say overall outcomes are better for patients as well as for hospitals.

In an Instagram post, the union displayed a chart with these specific ratios from the Kaiser California contract in place since 2008: 1-to-1 for emergency room trauma, 1-to-2 for critical care and labor and delivery, and 1-to-3 for ER visits and pediatrics.

“We just want what the other Kaiser hospitals have,” said the post.

Maui Health has said it adheres to “safe, industry- standard, evidence-based staffing protocols that prioritize patient outcomes and safety, supported by ongoing monitoring and adjustments.”

Kaiser took over management of Maui Memorial, Kula Hospital and Lanai Community Hospital from the state in 2017, forming Maui Health as a wholly owned subsidiary of Kaiser Foundation Hospitals.

Maui Health said it is a nonprofit organization and separate employer from Kaiser Permanente entities.

“Maui Health is affiliated with Kaiser Permanente, but is a separate entity from Kaiser Permanente,” said the organization in a statement. “While we are able to leverage efficiencies through the affiliation, Maui Memorial Medical Center operates independently as a community-based hospital.”

Maui Health is responsible for managing day-to-day operations for all its hospitals and clinics, including negotiations with unions, and contracts Kaiser for back office support, it said.

While Maui Health is legally a separate entity, Pelc said workers’ paychecks come from Kaiser, and the lead negotiator is a Kaiser vice president. Also, Maui Health has implemented Kaiser policies.

“We use all the (Kaiser) policies when it’s convenient,” he said, “and then when it’s not, they pull out Maui Health.”

On top of the struggles from the COVID-19 pandemic, Maui health care workers have been hit hard by the tragedy of the Aug. 8, 2023, wildfires, said Pelc, which resulted in skyrocketing rent.

“I personally know five to six nurses who had to leave the island because their rent shot up,” he said.

Negotiations between the two parties began in July, while the contract for Maui Health workers expired Sept. 30.

The three-day strike is an unfair labor practices strike, the union said.

While Maui Health said the unfair practice allegations are “generic in nature and unclear” without saying who, how or what happened, Pelc responded with, “We believe it’s pretty clear.”

UNHCEH represents registered nurses, imaging techs, pharmacists, physical therapists, admitting clerks and receptionists, among others.

“We believe the best place to resolve our differences and reach an agreement is at the bargaining table,” said Maui Health in a statement, “and we remain committed to continuing to bargain in good faith to reach a mutually beneficial agreement to avoid a strike. Our bargaining team is prepared and eager to engage in productive discussions at upcoming scheduled bargaining sessions.”

Maui Health said while it acknowledges and respects the union’s right to voice its perspective on the progress of negotiations, it is grateful to both negotiating teams for their dedication to this important process.

“They have worked tirelessly, and we feel significant progress has been made over the last week,” said Maui Health in a written statement. “While negotiations can be complex, we are committed to ensuring that our decisions reflect the best interests of our employees and patients and the future of health care for our community. Again, we respect our employees’ right to share their views, encourage open communication throughout this process, and are committed to maintaining transparency as we continue these discussions at the bargaining table.”