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Supporters of a proposal to raise the minimum wage for California health workers point to Inglewood, where last fall voters approved a wage hike that primarily applied to staff at dialysis clinics and at the city鈥檚 only hospital. But the implementation of that local measure has been bumpy, signaling potential problems for the larger effort.

went into effect Jan.1, raising the minimum wage for those workers to $25 an hour. Then in March, Centinela Hospital Medical Center, a 362-bed acute care facility owned by Prime Health Care, laid off 48 workers and reduced hours for others, earlier this month by the Service Employees International Union-United Healthcare Workers West. The local union led Inglewood鈥檚 measure and its parent organization, SEIU California, is sponsoring the statewide bill.

The union alleges hospital administrators made the cuts in retaliation to the newly implemented wage increase, even though prohibits health facilities from funding the pay increase by laying workers off or reducing their benefits.

Centinela officials maintain that the hospital is complying with Inglewood鈥檚 minimum wage ordinance. They say they laid off workers after a thorough assessment that determined the hospital was overstaffed in certain units. Centinela offered nearly half of the affected staff other positions within the hospital and many accepted, according to a hospital spokesperson.

鈥淭he recent reduction in force was entirely unrelated to the ordinance and affected 2% of the staff,鈥� Susan Lowe, Centinela鈥檚 spokesperson, said in an email. 鈥淚t was related to strategic changes in operational needs and improvement measures, and staff have been added in areas that positively impact patient care and address community needs.鈥�

While the lawsuit is pending, the union is advocating for a broader pay hike for California health workers via , by Los Angeles Democratic Sen. Maria Elena Durazo, a longtime labor leader. Durazo鈥檚 bill calls for a minimum hourly wage of $25 that would be adjusted annually for inflation. California鈥檚 minimum wage is currently $15.50, although it鈥檚 higher in some cities and counties.

If the proposal becomes law, the new minimum wage would go into effect in January 2024 and benefit an estimated 469,000 health workers. It would include people who make slightly more than $25, who would likely get a corresponding pay increase, by UC Berkeley鈥檚 Labor Center.

Qualifying workers would receive an average increase of $5.74 per hour, which would increase operating costs at health facilities by about 3%, the report said. Some lower paid workers in health facilities include nursing assistants, patient aides, medical technicians and janitorial workers.

The proposal faces a great deal of opposition from industry heavy hitters, including hospital executives, clinic leaders and the doctors鈥� lobby, which argue this isn鈥檛 something all providers can afford or easily implement, especially when they鈥檙e dealing with other stressors in their budgets. The California Chamber of Commerce lists

But union leaders say the time is now, especially as the industry grapples with workforce shortages that are burning out current staff. 鈥淭wenty-five dollars an hour breaks down to roughly $50,000 a year,鈥� said Renee Salda帽a, a spokesperson for SEIU-UHW. 鈥淚t鈥檚 not asking for the moon, this is just the baseline of a fair wage for the people who provide vital treatment.鈥�

Who would benefit

Eneryk Santana last month joined the tens of thousands of people who commute daily across the San Diego-Tijuana border for work or school. He鈥檚 a medical assistant at San Ysidro Health Center in Chula Vista and the high cost of living on the U.S. side, he said, forced him to look for housing in Mexico.

To avoid rush hour traffic at the border crossing, he tries to leave his place by 4 a.m. While the border cities are less than 20 miles apart, the process of crossing the border can take up to a few hours on busy days. The commute has been an adjustment, but he said his monthly rent in Tijuana is about $1,000 less than what he was paying in Chula Vista 鈥� a significant difference for someone making $22 an hour.

For Santana, a boost in pay would allow him to consider moving back to the U.S., he said. Ideally it could also mean more people attracted to this type of work. 鈥淏eing short-staffed, when someone calls off, we don鈥檛 have much staff who can cover,鈥� Santana said. 鈥淎nd it鈥檚 hard not only for workers, but also for the patients, who sometimes have long wait times.鈥�

Workers in clinics and hospitals account for about half of all workers who would see a boost in pay under Durazo鈥檚 bill, according to the analysis from UC Berkeley鈥檚 Labor Center. Because of their current low earnings, workers in home health services and nursing homes would see the biggest difference 鈥� approximately a 40% increase.

Three-fourths of the workforce who would receive a raise under the bill are women, and almost half are Latino, according to the report.

The fight against industry

Hospitals are leading the opposition to the wage hike, arguing that some facilities are in precarious financial situations. A handful of . Last week a Montebello hospital and a hospital in the San Joaquin Valley at the beginning of this year.

Having to boost minimum wage pay, hospital leaders say, would only add to that strain. A wage hike at this time 鈥渢akes a very serious problem and makes it impossible,鈥� Carmela Coyle, president of the California Hospital Association, recently said in a call with reporters.

Punctuating its point, the hospital association earlier this month that found that 1 in 5 hospitals are in an 鈥渦nsustainable financial position鈥� and at risk of closing. Hospitals are considered at-risk if their incomes aren鈥檛 covering costs, meaning they are losing money, and have increasing debt, said the report, which sampled 114 hospitals.

Union leaders have pushed back on hospitals鈥� arguments, noting that most hospitals are part of large health systems that can weather rough patches.

Health economists have described the current landscape of California hospitals as a mixed bag with independent and rural hospitals, especially, experiencing severe financial pressures.

During the peak of the pandemic, hospitals had increased expenses, but also received . That funding phased out in 2022. The state has not yet audited totals for this last fiscal year, but in 2021, altogether California hospitals , up from the , according to financial data from the Department of Health Care Access and Information.

A coalition of counties has also , noting the bill would apply to workers at county public health and mental health departments, as well as clinics and hospitals operated by counties.

Implementing such a bill would cost the counties hundreds of millions of dollars annually, said Kalyn Dean, a legislative advocate with the California State Association of Counties. To absorb that cost, she said, counties could be forced to reduce services and cut jobs in other government departments.

Meanwhile, clinic leaders say that while they support the idea of boosting pay for their workers, they are subject to strict reimbursement rules that do not allow them to take on the additional expense. The vast majority of community health centers鈥� patients , the health insurance program for low-income people. Medi-Cal pays these centers a fixed amount per patient visit. Modifying that amount to afford a wage increase would require both state and federal approval, said Dennis Cuevas-Romero, vice president of government affairs at the California Primary Care Association, which represents health centers.

鈥淯nlike other businesses, we can鈥檛 just say, 鈥極K, the state requires us to increase the minimum wage, let鈥檚 just increase the cost of our services.鈥� We are prohibited from doing so,鈥� he said.

Some provider groups are likely to seek an exemption from this bill, but community health centers say they would like to find a way to make this work because a 鈥渘ightmare鈥� scenario would be for their clinic employees to leave for better-paying jobs at a nearby hospital.

鈥淥ur health centers want to get there,鈥� Cuevas-Romero said. 鈥淚 think the questions are: Where鈥檚 the money coming from? And how do we implement it?鈥�

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