March 5, 2025 (Portland, Ore.) – Leaders from Oregon AFSCME, the Oregon Nurses Association (ONA), and Service Employees International Union (SEIU) Local 49 provided testimony for the Oregon Health Authority’s (OHA) OHSU-Legacy Community Review Board in support of the proposed acquisition of Legacy Health by OHSU. OHA is currently reviewing the proposed acquisition to understand how it might impact healthcare services in Oregon. The three unions represent the largest group of workers within Legacy and OHSU facilities, totaling more than 14,000 employees.

Labor leaders offered testimony about the benefits the acquisition would have on all healthcare workers, patient care, and access to healthcare for Oregonians. This includes an agreement between OHSU and union-represented workers. Meg Niemi, President of SEIU Local 49, wrote, “I cannot underscore enough how unprecedented the agreement between OHSU and labor is. We know of no other agreement of its kind in which the vast majority of the workforce was negotiated with in advance and offered a secure, equitable future. This is the kind of leadership we need to ensure Legacy’s dedicated and skilled caregivers feel respected and continue to provide the personalized care they are known for.”

In the agreement, OHSU has committed to greater job security for healthcare workers, which will lead to stability for patients, significant investments in culturally competent workforce development and training, and making the combined health system an exemplary employer in terms of fair compensation and job security. Research consistently shows that patient outcomes improve when workers have safer working conditions, higher wages, better benefits, and more job satisfaction.

Anne Tan Piazza, Executive Director of ONA, highlighted Legacy’s inability to make crucial capital investments. She noted that OHSU has pledged $1 billion to strengthen Legacy’s ability to deliver high-quality care by financing essential facility upgrades and hiring additional frontline staff. “Simply put, the investments that OHSU is prepared to make into the Legacy health system once the acquisition is approved is lifesaving for Oregonians. The Legacy Health Board estimates that the system will require between $300 and $750 million in additional investment over the next five years to meet community needs. But it appears that Legacy does not have the capital. Legacy’s reporting to the Oregon Health Authority has shown negative operating margins since 2021,” Piazza said.

Lamar Wise, the Political Director of Oregon AFSCME offered testimony on the benefits of public ownership: “By transitioning Legacy into OHSU’s public framework, we are bringing greater accountability and transparency into the healthcare system. OHSU is a public institution, which means decisions about patient care and hospital operations won’t be made behind closed doors or dictated by private corporate interests. The Governor appoints OHSU’s board, and their meetings, agendas, and financial reports are available to the public. This kind of transparency ensures that the voices of patients, workers, and the broader community will always have a seat at the table.”

About AFSCME, ONA, and SEIU
The Service Employees International Union (SEIU) Local 49 advocates for better lives for working people and their families across Oregon and SW Washington. The American Federation of State, County and Municipal Employees (AFSCME) is a leading public service union dedicated to representing public sector workers. The Oregon Nurses Association (ONA) represents nurses and healthcare professionals across Oregon, focusing on quality patient care and fair working conditions.

Prepared statements:

 
Testimony of Lamar Wise, Political Director for Oregon AFSCME
My name is Lamar Wise, and I serve as the Political Director for Oregon AFSCME, representing 39,000 of public service workers across the state. Today, I am here to express support for the merger between Oregon Health & Science University and Legacy Health. This transaction represents a critical step toward ensuring both the stability of healthcare jobs and the long-term well-being of the patients these institutions serve.

For far too long, healthcare workers at Legacy Health have faced uncertainty—whether through stagnant wages, inadequate job protections, or the threat of layoffs. This merger offers something that has been sorely lacking: real security. Through the labor agreement we negotiated with OHSU, unionized Legacy employees will see their wages adjusted to match the higher pay scales at OHSU, guaranteeing pay parity without any reductions in benefits for at least a year. In an industry where burnout is at an all-time high, this kind of economic stability is essential.

More than just wages, this agreement also protects jobs. No layoffs will occur for at least 12 months after the merger, and for those who may be impacted in the following year, there will be an enhanced severance package that includes six months of base pay, continued medical and dental coverage, and access to recall and training opportunities. Workers will also see a real commitment to their professional development, with an annual $10 million investment in education trusts. These funds will ensure that frontline caregivers have access to the training they need to grow their careers while strengthening Oregon’s healthcare workforce. Additionally, this agreement will advance workplace equity by addressing bias in hiring, promotions, and disciplinary actions, with unions having access to diversity metrics to help hold the system accountable.

But this merger is about more than just workers—it’s also about patients and the communities that rely on these hospitals. By transitioning Legacy into OHSU’s public framework, we are bringing greater accountability and transparency into the healthcare system. OHSU is a public institution, which means decisions about patient care and hospital operations won’t be made behind closed doors or dictated by private corporate interests. The Governor appoints OHSU’s board, and their meetings, agendas, and financial reports are available to the public. This kind of transparency ensures that the voices of patients, workers, and the broader community will always have a seat at the table.

At its core, this merger is about building a stronger, more equitable healthcare system—one that prioritizes workers, protects jobs, and ensures that Oregonians have access to high-quality care for generations to come. Public ownership brings stability where private interests have failed, and it guarantees that the healthcare needs of our communities take precedence over corporate bottom lines. I urge you to support this merger and help create a healthcare system that truly works for everyone.

Thank you for your time and consideration.

Testimony of Anne Tan Piazza, Executive Director of the Oregon Nurses Association
My name is Anne Tan Piazza and I am the Executive Director of the Oregon Nurses Association. We represent more than 23,000 frontline healthcare professionals across Oregon including more than 4,800 at OHSU and more than 3,800 at Legacy. I am here today to speak in support of the proposed acquisition of Legacy Health by OHSU. ONA members recognize the profound, positive impact this acquisition will have on our state’s healthcare system – both for patients and frontline caregivers.

This acquisition represents a crucial step in expanding access to high-quality care for all Oregonians and there is significant support for this acquisition within the medical and healthcare communities, including the more than 2,300 legacy nurses who just voted to join ONA in a historic union election.

Simply put, the investments that OHSU is prepared to make into the Legacy health system once the acquisition is approved is lifesaving for Oregonians. The Legacy Health Board estimates that the system will require between $300 and $750 million in additional investment over the next five years to meet community needs. But it appears that Legacy does not have the capital. Legacy’s reporting to the Oregon Health Authority has shown negative operating margins since 2021.

Meanwhile, OHSU has made a commitment of $1 billion that will shore up Legacy’s ability to deliver high-quality care by financing needed facility upgrades and hiring additional frontline staff.

If OHSU’s acquisition of Legacy is not approved, there is a good chance it will be sold to a private equity firm or private equity backed hospital operator, which would have disastrous outcomes for patients. The risks to patients in a private equity owned health system are substantial. A 2023 study led by researchers at Harvard Medical School found that patients “are more likely to fall, get new infections, or experience other forms of harm during their stay in a hospital after it is acquired by a private equity firm.

On behalf of the Oregon Nurses Association, I urge you to approve this acquisition, as it aligns with our long-term vision for a healthier, patient centered healthcare system in Oregon. Thank you for your time and consideration.

Testimony of Meg Niemi, President of SEIU Local 49
My name is Meg Niemi, and I am the President of SEIU Local 49. We are proud that Legacy caregivers from Emanuel and Good Sam Hospitals have been in our union since the 1950s, and have since been joined by workers at Randall Children’s, Unity Center for Behavioral Health, and Mt. Hood Medical Center.

The more than 1,300 Legacy members in our union include housekeepers, registration reps, and CNAs -- the people who check you in, help at your bedside, make your food, and keep your room clean. The majority of our members are women and people of color. Many have been priced out of the Albina neighborhood where they grew up, but they commute to take care of the people in their community who seek their familiar faces and care.

SEIU members have faced years of discrimination from Legacy. During the pandemic, Legacy cut the hours of the predominantly female and BIPOC housekeeping staff in North Portland. In 2021, our union members nearly had to strike for Legacy to finally agree to equal pay for workers in North Portland and workers on the West Side doing the same jobs -- a demand they’d been making since the 1950s. And over the past year, Legacy refused to even talk with union workers about this merger, despite many of them having worked at Legacy for decades. In contrast, OHSU met with SEIU members at Legacy and put binding commitments on paper, including pay equity across the two systems.

SEIU members support this merger and it’s time we listen to the people who provide the care. I cannot underscore enough how unprecedented the agreement between OHSU and labor is. We know of no other agreement of its kind -- in which the vast majority of the workforce was negotiated with in advance and offered a secure, equitable future. This is the kind of leadership we need to ensure Legacy’s dedicated and skilled caregivers feel respected and continue to provide the personalized care they are known for.

I urge you to approve the OHSU-Legacy transaction.