SF city workers' unions rally in front of general hospital
San Francisco city workers' unions gather in a rally at San Francisco General on Friday to demand more staffing and less outsourcing. Photo by Junyao Yang on Feb. 16, 2024.

San Francisco spends too much money outsourcing city jobs, and too little hiring full-time staff who actually live in the city.

That’s according to a slew of unions who held a rally today outside Zuckerberg San Francisco General Hospital to call attention to what they called severe understaffing. They said San Francisco spends $5.2 billion a year hiring part-time workers, and asked the city to stop “wasteful contracting” and instead fill vacancies with permanent jobs. 

“We need to stop bringing people in on short-term contracts that take our money home and spend it in their communities,” said Heather Bollinger, a nurse at San Francisco General and president of the SEIU 1021 nurses’ chapter. “It’s time for the city of San Francisco to invest in the people who have proven that they will stay.”

Understaffing has taken a toll on crucial public service across city departments, particularly impacting the Department of Public Health and thereby the hospital, the unions said. San Franciscans can surely feel it: Patients wait more than six hours to receive care, and nurses work 12- to 16-hour shifts, the unions said, with no time for meal or rest breaks. 

More than a 100 nurses, physical therapists, librarians and other city workers, many wearing purple shirts reading “Fix our city,” gathered outside San Francisco General around noon. They chanted “Rise up, shut it down, San Francisco’s a union town!” and “When we fight, we win!”

The workers are represented by SEIU 1021, IFPTE Local 21 and other city unions. Collectively, the unions represent more than 25,000 workers — nurses, Muni operators, firefighters, social workers and others who are, or will be, in contract negotiations this year.

That will matter in November: The mayor’s race will give unions significant leverage in contract talks; union members and endorsements will be a key source of support for candidates. And that will all come in a year when the city will be forced to balance its budget to avoid a quarter-billion-dollar deficit.

A woman holding a microphone in front of a building.
Heather Bollinger, a nurse at Zuckerberg San Francisco General Hospital and president of the SEIU 1021 nurses’ chapter, addresses the crowd at the rally on Feb. 16, 2024. Photo by Junyao Yang.

But, for those rallying Friday, higher-level strategy was a distant concern. Working conditions were top of mind.

“We know that this hospital has reported its nurses have missed 16,000 breaks — 16,000,” said Bollinger. Nurses, she said, often do not have enough break time for a quick snack. “We’re just asking for a bite of food, people, and that’s in a 12-hour shift.”

At one point, Bollinger warned speakers using a concrete bench for a platform to do so carefully: “I don’t want anyone falling off. Trust me, you’ll be here for eight hours, sitting in our waiting room, waiting for an ice pack.”

Other departments, such as the San Francisco Public Library, “basically have to rob from Peter to pay Paul,” said Nicole Germain, the library’s Portola branch manager.

“We have to take away from one team to go help another team. Then the other team is scrambling,” Germain said, referring to short staffing. “And this happens every single day.” 

A group of people holding signs at a rally
City workers hold picket signs while chanting “Rise up, shut it down, San Francisco’s a union town!” Photo taken on Feb. 16, 2024 by Junyao Yang.

In 2023, San Francisco had a 13.7 percent vacancy rate for all permanent city jobs with some 4,793 vacancies, according to a civil grand jury report. As of October 2023, there were more than 600 vacancies in the Department of Public Health, the highest number of any department. 

The city’s long hiring timeline is to blame for the high number of vacant jobs, the report said. Instead of filling those vacancies, the city has resorted to hiring temporary workers, who largely come from outside of San Francisco. This was especially true during the pandemic. 

At the Department of Public Health, the number of temporary workers doubled between 2020 and 2023, rising from 250 to more than 500, according to the Civil Grand Jury report. 

And, in public services like health care, continuity matters, said Theresa Rutherford, president of SEIU 1021.

“You see the patient, you know their diagnosis, you know what’s necessary. They know your face, they come back,” said Rutherford. “We’re not able to do that if we’re short-staffed or if we are hiring temporary people who are here today, gone tomorrow.”

A group of people holding signs in front of a building.
More than 100 San Francisco city walkers show up at the rally on Friday, Feb. 16, 2024. Photo by Junyao Yang.

Long-term healthcare workers are usually more committed to their jobs than registry nurses, who are typically only on 13-week contracts, said Jenny McGrane. “Filling the vacant positions with registry staff is a short-term Band-Aid on a festering wound.”

The city, the unions said, acts as though it is easier to hire short-term workers than to fix the hiring process and fill vacancies with permanent hires. “But we would expect [the city] to recognize the value of changing a system that’s not working,” said Zach Vickers, a physical therapist and member of IFPTE Local 21.

The city rejected union demands to prevent wasteful spending on outsourcing during bargaining, the unions said. 

A strike, union leaders said, could be on the table. 

“Nobody wants to go on strike. It’s a last resort,” said Jennie Smith-Camejo, spokesperson for SEIU 1021. “If the city doesn’t want to listen, they don’t want to pay attention, then we have to make them listen.”

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Junyao Yang is a data reporter for Mission Local through the California Local News Fellowship. Junyao is passionate about creating visuals that tell stories in creative ways. She received her Master’s degree from UC Berkeley Graduate School of Journalism. Sometimes she tries too hard to get attention from cute dogs.

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6 Comments

  1. What percent of full-time staff versus contract workers live in the City? And what difference would it make if they didn’t? Wouldn’t contract workers save money? They would not get City retirement benefits.

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    1. Exactly that – the cost of benefits for city workers is prohibitive and it is cheaper to pay contractors an hourly rate for only the hours they work. You can also fire them on a dime if demand drops.

      Hardly a SF thing – outsourcing is a global trend. As well as healthcare costs, public sector workers are on expensive DB pensions, which have all but vanished in the private sector.

      Throw in the prevalence of unions in the public sector and it is a no-brainer to outsource.

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  2. Had a friend who was in the hiring process for a city job for over a year, they would reached out a few times over 12 months asking for them to complete the next step of the interview process. They didnt seem very serious about filling the position

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  3. Maybe outsourcing would make less sense if city workers were not on such expensive healthcare and pension benefits?

    And why does it matter where a city worker lives as long as he/she can get to work on time?

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