California Labor Leader's Influence to Expand Due to Obamacare

A month into the new year and it is obvious who the 2013 Person of the Year in California will be: Rose Ann DeMoro.

Never heard of her? Memorize the name.

She is more powerful than the head of the California prison guards’ union.

More powerful than the head of the California teachers’ union.

And arguably more powerful than any woman in California other than Ann Gust—Gov. Jerry Brown’s wife.

Who is she?

Rose Ann DeMoro is executive director of the California Nurses Association /National Nurses Organizing Committee, a national labor union devoted to expanding the power of all direct-care RNs.

Previously, she headed the California Nurses Association and won major victories over formidable opponents.

DeMoro is perhaps best known as the woman who defied Gov. Arnold Schwarzenegger’s attempt to undo California’s first in the nation nurse-to-patient ratios.

She also devised the “Queen Meg” theatrics that helped defeat Meg Whitman’s gubernatorial bid.

As a former Teamster and the daughter of Irish-Italian parents, DeMoro excels at using theatrics, strikes and demonstrations as potent weapons for both ridiculing and defeating her opponents.

An ardent feminist (her unfinished Ph.D. dissertation at UC Santa Barbara, Checking Out Sexism, was about supermarket cashiers), DeMoro invokes the reality that 90 percent of nurses are women and that her job includes creating “a culture of feminism” that helps RNs fight back.

She wants to organize hospital nurses nationwide to win federal mandates for nurse-to-patient ratios, just as she did in California. Sen. Barbara Boxer introduced just such a bill last year.

However, these are not the reasons DeMoro will be California’s 2013 Person of the Year.

An astrologer might conclude that “her stars are aligned.” Especially, in California, where the new Affordable Care Act is in fast-track mode. 

Specifically, whatever DeMoro wants, she will get.

The question is, “What does DeMoro want?” Just more union members? More RNs with two-year degrees? More RNs with four-year bachelor of science degrees? And/or more RNs fast-tracked into higher paying, higher quality jobs like Nurse Practitioner?

These should be big questions for DeMoro. With the shortage of M.D.s, the looming retirement of aging RNs, and the huge expansion of health care coverage for all Californians—alongside the attendant needs for nurses in community health care centers, hospitals and nursing care facilities—it would be easy for the nurses union to overlook the long view and just go for more of the same. More membership. More dues. More political clout.

But doing so might result in the same decline that the California prison guards’ union is facing. After winning the three-strikes initiative, which led to more prisoners, and the need for more prison guards (with increased union membership, and more dues, contributed to more political candidates), those guards are now waning in influence. 

Three-strikes no longer exists. Prison populations are declining, and court-mandated realignment means even fewer prisoners. Not a plan for a better future. 

The nurses could avoid the same trajectory if DeMoro fights for better education as well as better working conditions for her membership.

DeMoro’s time is now. Her place is California.

Gov. Brown has called for a special legislative session this month, to clarify the new federal health care law’s rules, regulations and mandates.

Estimates project as many as 8 million previously uninsured, or underinsured Californians, will soon be eligible to enroll and receive subsidized health care (PDF).

Adding these millions to the existing system will require thousands of new doctors, nurse specialists and RNs.

Should DeMoro choose to help her direct-care RNs, she should push the California legislature to pursue long-lasting changes for a better skilled, better educated and better prepared membership, including:

• Tuition remission for California dependents at state colleges and universities that are enrolled in two-year or four-year RN, or Nurse Practitioner programs. (Pennsylvania’s Temple University Hospital currently offers such a benefit).

• Priority enrollment at those same higher education campuses, often a practice for returning military veterans.

• State assumption of education costs for advanced degrees (four-year B.S. for nursing, nursing specialists and nurse practitioners) with a signed contract to work in state or community health care settings.

• Promotion of online offerings for four-year B.S. degrees in nursing. Huge numbers of two-year RNS and LVNs are single parents, or part of a two-parent working family. The last two years of an RN degree are mostly academic, not clinical, in nature, and hence, lend themselves to online coursework. This would allow nurses squeezed between children and work to find a time-saving, less costly path to a better, more respected education. As of now, the two-year RN is often left out of the state’s best hospitals, overlooked for promotions and not considered “professional” enough for the more sophisticated, desirable positions.

• Pilot projects to make educational advancement a right—not an ordeal—for all nurses.

If for-profit universities can offer these degrees online, why can’t California’s colleges and universities do the same? After all, if the government can subsidize big banks and agri-business, surely they can subsidize nurses.

Finally, educating, promoting and defending nurses in California not only guarantees a better health care outcome for patients, it also eliminates the need for importing medical professionals from those poorer countries now exporting their precious health care professionals to the U.S.

Look for Rose Ann DeMoro’s next move in 2013. She has the power and the planets are in position.