Acerca de Know Your Contract Current Collective Bargaining Agreement The Housestaff Association Collective Bargaining Agreement is the contract between HSA and Cook County Health. It establishes many of the rights, benefits, protections, and working conditions that apply to interns, residents, and fellows in the bargaining unit. Below you can view or download the current full Collective Bargaining Agreement and the current contract extension agreement. Full Collective Bargaining Agreement Review the complete HSA Collective Bargaining Agreement, including provisions related to compensation, benefits, scheduling, leave, educational support, grievances, discipline, and more. Quick Contract Highlights The current agreement includes important protections and benefits for HSA-represented residents and fellows, including: Commonly Used Sections: Salary & Stipends — pp. 3, 6, 8–11 Hours & Scheduling — pp. 28–31 Educational Stipend — p. 42 Leave — pp. 31–36 Discipline & Remediation — pp. 43–45 Grievance Procedure — pp. 45–48 Disability Insurance — p. 40 Wage increases through the current extension period. A $2,500 lump-sum payment for eligible housestaff working in December 2025 A $240 per-paycheck meal stipend Health, dental, vision, and disability benefits Educational stipend and reimbursement protections Limits and protections related to work hours and scheduling Due process and representation in disciplinary or remediation-related matters A formal grievance process to enforce the contract Paid leave and holiday protections Not Sure What Applies to Your Situation? The contract can be lengthy, and not every workplace issue is straightforward. Reach out to HSA if you have questions about scheduling, compensation, leave, reimbursements, benefits, discipline, patient care, safety, or another workplace concern. Email HSA: admin@hsacc.org Grievance Support: grievances@hsacc.org Need Help With a Workplace Issue? If you believe the contract may have been violated, or you are unsure where to start, contact HSA before responding to management or signing documents related to a workplace concern. Contact HSA / Request Support

Forms & Requests Go to: FAQs Workplace Support For workplace issues involving pay, scheduling, leave, discipline, remediation, contract violations, or other concerns. For residents or fellows placed on a PIP, remediation plan, probation, non-renewal concern, or other training-related process. Education & Training For concerns related to curriculum, supervision, didactics, rotation structure, evaluations, educational time, or training quality. For patient care, workflow, staffing, or systems issues affecting residents, fellows, or patients.Safety, For safety concerns, workplace hazards, staffing issues, facilities concerns, or working conditions. Get Involved For residents and fellows who want to become dues-paying members. For members interested in joining the board, becoming a department representative, or serving on a committee. Request Grievance Support Confidential PIP Reporting Form Submit a Concern or Update to the GMEC Chairs Patient Care & Safety Safety, Health & Working Conditions Survey Join HSA / Membership Form Board / Representative Interest Form Union Member Benefits Benefits for HSA-Represented Housestaff These benefits are negotiated through the HSA contract and apply to eligible housestaff in the bargaining unit. Salary & Raises HSA negotiates salary schedules and wage increases through the collective bargaining agreement. Salary increases are based on PGY level and negotiated contract increases. Meal Stipend HSA has negotiated a meal stipend for housestaff. Under the current extension agreement, the meal stipend increased to $240 per pay period. Educational Stipend Housestaff receive an educational stipend that can be used for eligible educational expenses, including conference expenses, study materials, exams, smartphones, laptops, and other approved training-related costs. Health, Dental & Vision Insurance Eligible housestaff have access to health insurance, dental insurance, and vision insurance through Cook County Health. Details are available in the HSA contract and through Cook County benefits materials. Disability Insurance Eligible housestaff receive disability insurance coverage through the HSA Benefit Trust. HSA also provides information about optional additional disability coverage for members. Paid Leave & Holidays The HSA contract includes protections for paid time off, sick leave, bereavement leave, holidays, paid parental leave, and other forms of leave. The current agreement includes additional holiday protections, including Pulaski Day and Juneteenth. Representation & Contract Enforcement HSA represents housestaff in enforcing the contract and addressing workplace issues, including concerns related to pay, scheduling, leave, remediation, discipline, reimbursements, safety, and working conditions. Additional Benefits for Dues-Paying HSA Members Dues-paying HSA members help fund the work needed to bargain strong contracts, enforce the agreement, support members, and organize around workplace issues. Members may also access additional union benefits and resources through HSA, NUHHCE, AFSCME, and Union Plus, including: Optional additional disability insurance opportunities AFSCME Advantage benefits Union Plus discounts and resources Legal service discounts Home and renters insurance options Auto insurance and car rental discounts Moving discounts Additional member-only resources and support Need Help Accessing a Benefit? If you have questions about salary, stipends, reimbursements, disability insurance, leave, health insurance, or other benefits, contact HSA. UNION PLUS SIGN UP Benefits available only to HSA members: Additional disability insurance coverage Opportunity for HSA members to purchase additional Guaranteed Standard Issue (GSI) disability coverage with benefits that include: No medical underwriting Options of $2,500, $5,000, or $7,500/month or above (on year graduation) for non-cancellable/guaranteed renewable coverage 15% discount from gender-neutral rates Contact an insurance rep here . Disability insurance Premium is paid by the HSA, so no direct cost to house staff. The plan is through Northwestern Mutual. Maximum monthly benefit is $2,500. Benefits accrue on the 91st day of disability. Benefits are payable until your Social Security normal retirement age. Able to convert to personal plan after residency. Full plan available here . Employer assistance program Confidential counseling; identity theft and fraud resolution; will/durable power of attorney preparation; legal assistance; etc. Summary flyer available here , and website available here! Disability insurance terms, eligibility, rates, and coverage options may vary. Please review the full plan documents and speak with the insurance representative for details. Become an HSA member today! HSA dues are 1% of the PGY2 salary, but the benefits of union membership are invaluable. Over the last fifty years, our union has worked tirelessly to secure better salaries, improved working conditions, and enhanced benefits for the Housestaff at Cook County. As interns, residents, and fellows, we are on the front lines of patient care, and our work conditions directly affect the quality of care we provide. By coming together as a union, we strengthen our commitment to advocating for changes that ensure our patients receive the best possible treatment. When residents are empowered and supported, they can focus more on patient well-being rather than facing challenges alone. Sign up here!

In November 2023, all 27 resident doctors who work at West Suburban Medical Center, located on the border of the Austin neighborhood on the West Side of Chicago and the suburb of Oak Park, signed union authorization cards, held a union election and won with a unanimous victory. Joining the House Staff Association, which has been fighting for the wellbeing of patients and residents since 1974. "We are unionizing because all healthcare and hospital workers deserve fair treatment and fair compensation and because our patients deserve better services and resources.” - Dr. Clarissa O'Conor, Former organizer and Bargaining Team member. "We are unionizing because all healthcare and hospital workers deserve fair treatment and fair compensation and because our patients deserve better services and resources.” - Dr. Clarissa O'Conor, Former organizer and Bargaining Team member. "We are unionizing because all healthcare and hospital workers deserve fair treatment and fair compensation and because our patients deserve better services and resources.” - Dr. Clarissa O'Conor, Former organizer and Bargaining Team member. "We are unionizing because all healthcare and hospital workers deserve fair treatment and fair compensation and because our patients deserve better services and resources.” - Dr. Clarissa O'Conor, Former organizer and Bargaining Team member. Since unionizing in November, ongoing contract negotiations between the resident union and hospital CEO Manoj Prasad have stalled. Prasad continues to refuse to provide a budget for the residency program, or allocate graduate medical education (GME) funds to curriculum advancement. Over the last several contract bargaining sessions, Prasad and his legal team have stonewalled the residents and struck down all proposals to improve the residents’ working conditions, including providing safe drinking water and working telephones. The Family Medicine Residency at West Suburban was once regarded as a top program with a long history of providing robust, full-spectrum family medicine training. In the past, residents learned directly from doctors of family medicine, cardiology (including cardiac surgeons), intensive care, and other specialists. In the last few years, however, resident education has seen a steep decline due to multiple changes in hospital ownership. The hospital receives hundreds of thousands of federal dollars every year to support the residency program, however that money is not allocated to resident raises, resident training, or reasonable compensation for teaching faculty. West Suburban Leadership have strategically destroyed the structure of the residency program. Working conditions under Prasad and Fitzpatrick have been so volatile over the last several months that multiple faculty have resigned, leaving the program currently with only three core faculty, when at least eight are required to sustain a functioning program, per ACGME - the national residency accrediting body. Necessary requirements to graduate from a family medicine residency program- such as resident-led research projects, weekly protected instructional time, and faculty mentorship all which are set by the ACGME- have not and will not be completed with all but three faculty members left to lead these roles. Residents have to seek out external learning opportunities to fulfill both required and desired learning that residents (as well as faculty) deem necessary for their career goals. Residents must also fund their external learning opportunities, including malpractice if said opportunity is out-of-state, as current CME (Continuing Medical Education- funds provided to doctors by their employer to remain up-to-date on the most current medical information) is woefully insufficient. Some residents have even expressed a desire to seek open spots in other programs in pursuit of a better education. The hospital also suffers from dire patient safety issues. Many residents, nurses, attendings and other personnel can attest to multiple incidences where a specialist could not be reached or equipment malfunctioned (or simply was not available) in a life-or-death situation. There are patients who decompensate because they have not been seen by a doctor in 24 hours. There are cardiac arrest events without a working defibrillator. All of these traumatic patient experiences fall on the residents, who are required to assume responsibility of care in these situations, regardless of who the patient’s primary provider is. Residents have served as primary advocates for these patients, fighting daily to address and improve these conditions via the hospital’s patient safety event reporting system, but to no avail. Despite residents speaking about these concerns over and over, Prasad and Fitzpatrick claim there are no patient safety issues at West Suburban Medical Center. As residents continue to escalate these concerns - concerns that are shared by all hospital staff - to hospital leadership, Prasad has retaliated by barring residents and faculty from patient safety meetings, claiming he is working with a small group to address these issues instead. The residents of West Suburban Medical Center strive to provide excellent patient care in the face of disinvestment in the surrounding community, however there is only so much we can do with a system so broken. The goals of a for-profit healthcare system at West Suburban are in opposition to its needs as a safety-net hospital. Moreover, West Suburban’s descent into poor patient care and safety, as well as lack of adequate medical personnel reflects a disinvestment in the Black and Brown communities it serves. Follow @ residentsunitedatwestsuburban on Instagram!

HSA Statement and Solidarity Actions for Friday, January 23 Dear HSA Members, As healthcare workers and union members, we share a core commitment: hospitals must be places of safety, dignity, and care for all people. When policies or enforcement actions create fear in our communities or interfere with access to care, they directly undermine our work as clinicians, learners, and advocates for public health. In recent weeks, federal Immigration and Customs Enforcement (ICE) activity has intensified across the Midwest, with significant impacts in Minneapolis–St. Paul and here in Chicago. Community members, workers, and healthcare professionals have raised serious concerns about the effects of these actions on immigrant communities, public trust, and safety. In Minnesota, medical staff at public hospitals have publicly expressed alarm about ICE presence in and around healthcare settings, warning that enforcement activity may deter patients from seeking care and disrupt the delivery of safe, effective medical services. These concerns resonate deeply with us at Cook County Health. Many of the patients we serve — and many of our coworkers — are part of immigrant communities that already face structural barriers to accessing care. Actions that increase fear or uncertainty around hospitals risk worsening health outcomes, delaying treatment, and eroding the trust that is essential to patient care and medical education. Healthcare settings should be places of healing and learning — not sites of intimidation or enforcement. In response to the escalation of ICE activity, labor unions and community coalitions in the Minneapolis–St. Paul area have called for a Day of Truth and Freedom on Friday, January 23. This action asks people to withhold labor and economic participation and to engage in protests or solidarity actions as a collective statement in support of immigrant communities and accountability in federal enforcement practices. While Minnesota is the focal point, solidarity actions and conversations are unfolding in cities across the country, including Chicago, reflecting a broader labor and immigrant justice movement. It is important to understand that this call for action is not a traditional, contract-ratified strike under collective-bargaining protocols. Rather, it is a community- and labor-led mobilization grounded in shared values: dignity, safety, and care for working-class and immigrant communities. As healthcare workers and union members, we hold dual responsibilities — the right to engage in protected collective activity and the obligation to safeguard patient care and continuity of services. For this reason, the most responsible ways for healthcare workers to engage are those that honor both our solidarity and our professional commitments. Participating off-duty or in non-work-related ways — such as community events, advocacy, education, or mutual aid — allows members to show support while ensuring that patient care and training responsibilities are not compromised. Actions that interfere with clinical duties or continuity of care may carry professional or contractual consequences, and members should remain mindful of workplace policies. For those who are unable to attend protests or public actions, there are still powerful ways to support communities affected by ICE enforcement. This includes participating in Know-Your-Rights education, supporting mutual aid and legal defense efforts, and contributing to rapid-response funds that provide food, housing assistance, healthcare access, and legal support to impacted families. Collective care takes many forms — and all of them matter. There are also concrete, everyday ways to demonstrate solidarity that are visible, values-aligned, and compatible with our roles as healthcare workers. Solidarity does not have to look the same for everyone. For members who want to participate in visible, values-aligned ways while remaining attentive to patient care and workplace responsibilities, here are a few meaningful options: ·       Wear HSA or union apparel on Friday as a visible sign of solidarity with immigrant communities and the broader labor movement. ·       Participate in the economic blackout where possible by avoiding purchases at the hospital café or nearby businesses across the street during the day. ·       Contribute to mutual aid by bringing: o   Canned or boxed, shelf-stable food, or o   Clean, gently used coats Donation boxes will be available in the main lobby downstairs. If you have questions about appropriate items or distribution, social workers on your floor or in the Emergency Department can help guide you, or you can check in with a Family Medicine resident on the 8th floor. For members who want to take an additional step beyond visible solidarity or mutual aid, contacting elected representatives can also be a quick and effective form of advocacy — and you do not need to be an expert to do it well. Many tools provide short scripts and automatically connect you to the correct offices: ·       5 Calls ( 5calls.org ) — helps you find your federal and state representatives and provides brief call scripts on current issues. ·       USA.gov – Find Your Elected Officials ( usa.gov/elected-officials ) — a direct way to identify your representatives and their contact information. ·       ACLU Action ( aclu.org/action ) — offers advocacy resources and action alerts related to immigrant rights and civil liberties. If helpful, here is a short guiding script: “As a constituent and healthcare worker, I am calling to urge my representative to oppose ICE operations in our cities, particularly in and around healthcare settings. I also urge support for policies that ensure access to care and patient safety for immigrant communities.” These actions may feel small on their own, but taken together, they demonstrate collective care, shared values, and solidarity with communities directly impacted by immigration enforcement — all while honoring our responsibilities as healthcare workers. HSA stands in solidarity with immigrant communities, healthcare workers, and labor organizations calling for systems rooted in care rather than punishment. We remain committed to advocating for hospitals that are safe spaces for healing and learning, to protecting our members, and to supporting the communities we serve. If you have questions or want to talk through how to engage thoughtfully, your HSA representatives are here to support you. In solidarity, Housestaff Association Leadership

Residents united in support of patient safety and optimal learning conditions: Dear Leadership,  We are writing to express our outrage and deep disappointment regarding the sudden and unilateral curricular changes to the Neuro ICU and MICU rotation, changes being implemented in less than one month without adequate notice. Today, we join together in collective action alongside our IM, FM, and EM colleagues because it is clear our voices are not being heard through traditional channels.  These changes were crafted behind closed doors, with little transparency and even less regard for the concerns raised by the Curriculum Committee, our peer-selected representatives who are simply advocating for the best interests of the residents. This is not collaboration. It is dismissal.  With the academic year just over 2 weeks away, there is still no clear or finalized schedule for either ICU rotation. Why are we forcing residents into a mandatory Neuro ICU rotation when there are already issues getting elective time in their specialty of choice, not to mention critical staffing needs in Firm C Blue that would benefit from these same residents? Why not focus efforts on strengthening the general neurology curriculum first, rather than patchworking an ill-conceived plan at our expense?  As for the MICU, in an era when programs nationwide are abandoning 24-hour call structures, this administration is inexplicably reinstating a 24+4 q4 call model. This regressive move worsens the schedule, removes essential supervision for interns on post-call days, and eliminates a valuable learning role for day float seniors—undermining both education and patient safety.  To date, leadership has not even had the courtesy to formally announce these sweeping changes to the IM residents outside of the Curriculum Committee or hold a single Town Hall to hear resident concerns. Since we’ve been denied the opportunity to speak, we are presenting you with the results of our resident survey, which overwhelmingly reflect how deeply unpopular and unsafe these changes are.  We are left with no choice but to take action. This collective action is not symbolic—it is necessary. Our learning, safety, and dignity demand better.  The IM Residents  Click here to review the polling data from the Internal Medicine Residents.

We’d love to hear your thoughts on our priorities! Your experiences and insights are incredibly valuable and will significantly guide us during negotiations. Cook County Hospital 1975 - Photo taken by the HSA Recently, we’ve identified several key issues that we plan to tackle: - A salary increase that reflects the current market value for our collective. - Ensuring that HR promptly informs the board when union representation is requested. - If residents are asked to take on leadership duties, such as creating schedules or organizing purchases for study materials and clothing, they should be compensated fairly, including an increase in pay for chiefs. - Updating the pay schedule to align with our start and transition dates of July 1. - Introducing new provisions regarding termination or leaves of absence. - Adding language for penalties related to violations of the contract. The bargaining process thrives on collaboration and requires compromise. While we may not be able to achieve all our goals right away, we can still make meaningful strides over time. It’s crucial for us to understand how these issues have impacted you and your program. Your feedback will help us hone in on what truly matters to all of us. Thank you for taking the time to share your perspective—we genuinely appreciate it! If you're serious about securing a strong contract, join the union today . Remember, only union members can vote on contract changes —By signing up now and working together, we have the power to advocate effectively for the changes we demand. For more information about the House Staff Association please visit our website: hsacc.org   or contact HSA @ admin@hsacc.org . To file a grievance, please email grievances@hsacc.org .