Union doctors and dentists who work at hospitals and other health care facilities operated by Los Angeles County will receive cost-of-living increases and bonuses under a new deal with the county that follows more than two years of negotiations and strike threats.
The tentative agreement with two bargaining units represented by the Alliance of American Physicians and Dentists is expected to be voted on by the Los Angeles County Board of Supervisors this month.
Members of the American Federation of Physicians and Dentists have prepared to go on strike in December, complaining that inadequate benefits have hindered recruitment and retention and pushed up vacancy rates for key positions in county facilities, including for psychiatrists in jails.
Much of the controversy centers on the “Megaflex” benefit plan Los Angeles County provides to more than 14,000 employees, including management and administrative employees, most of whom are not unionized. The program gives workers an additional 14.5% to 19% above their base salary to purchase benefits and allows them to keep any unused portion as income, according to county officials.
UAPD urges its members to take advantage of these benefits. The Department of Health Services countered that they already have an “extensive benefit plan” — the same as that of more than 35,000 other county workers — and that providing them all with a more costly benefit plan would prevent the county from moving Incentives focus on the hardest-to-find workers.
The two sides also sparred over the cost of expanding Megaflex: UAPD officials at one point estimated the incremental cost at about $20 million per year based on current salaries, but county officials pegged the expected cost at more than $86 million per year, with costs increasing as the increase as wages increase.
A strike planned for December was put on hold after the county and the union agreed to seek advice from outside experts on the impact of the Megaflex expansion.
In late April, UAPD announced that its bargaining team had reached a tentative agreement with the county, which was approved by union members in late May.
Under the agreement, workers’ cost-of-living increases will match other county employees’ cost-of-living increases, with an additional 2.75 percent to 19.25 percent increase for certain positions, according to the county executive’s office. Starting salaries have also increased for some medical specialties, such as neurology.
Additionally, the county agreed to enhance benefits “no later than January 1, 2026,” according to the executive’s office. Additional benefits include 401(k) plans and short-term disability benefits for doctors, who have complained they don’t get enough paid time off to recover from childbirth.
The range of existing benefits puts female doctors planning a pregnancy at a “disadvantage compared with private hospitals in the area”, Dr Michelle Armacost, a specialist neurologist at one of the county’s facilities, told the union stated in the released statement. “We asked for fair benefits, and we were willing to fight for it. The county heard us, and we won.
In addition to these increases, county staff not included in Megaflex will receive an annual bonus of $14,000 on top of their base salary, according to the executive’s office. Union officials also said the agreement features “physician loyalty bonuses for residents who choose to stay in the county after hospitalization.”
“These new agreements set competitive salaries and attractive benefits, which we hope will allow us to fill critical vacancies at county hospitals and other facilities and retain the services already provided to county residents,” the executive’s office said. Excellent medical staff providing essential services.
County officials did not immediately provide an estimate of how much it would cost to enter into a new contract with unionized doctors.
Benefits have long been a point of contention among county physicians. More than two decades ago, doctors employed by Los Angeles County were stripped of Megaflex benefits just a few years after they voted to unionize.
At the time, county officials said such benefits were only available to nonunion employees. “Doctors knew exactly what they were getting into,” then-superintendent Don Knabe said in 2001.
Labor officials condemned it as a move to undermine the fledgling union, calculating that some senior doctors’ benefit plans were worth $19,000 or more at the time. State lawmakers then banned the county from excluding workers from welfare programs because they were unionized, making the law retroactive to before Los Angeles County’s relocation. UAPD also sued the county and ultimately received a settlement of more than $10 million.
The union later negotiated a new agreement with the county that would allow existing workers to use Megaflex but a different plan for new hires, the county executive’s office said. As of December, only a handful of UAPD members – less than 200 – had Megaflex benefits, according to the county.
Dr. Christina R. Ghaly, director of the Department of Health Services, said in a report to county supervisors last year that over the years, “we have continued to Steady wage increases in negotiations.
UAPD President Dr. Stuart Bussey denied claims they “bargained away Megaflex” at a public meeting last year. Busey told the crowd that in the past “hiring wasn’t as bad as it is now” and state laws limiting pension benefits for government employees weren’t in effect. “Times have changed.”
Bussey said in a recent statement to union members that UAPD members “reject settlement until we reach a collective bargaining agreement that prioritizes patient care with competitive pay and benefits.”
“Your determination and patience have paid off, and we look forward to working with the county to fill the vacant positions.”
